The value of ultrasonic examination of the lumbar spine in infants with specific reference to cutaneous markers of occult spinal dysraphism.
OBJECTIVE
To present part of the rationale behind the recent update to the M12 guideline in The Royal College of Radiologists' publication "Making the best use of a department of clinical radiology", 4th edition 1998, which stated that ultrasound was useful in screening for dysraphism in infants with cutaneous markers such as sacral dimple or hairy patch.


METHODS
Over a 10-year period a total of 223 infant lumbar spines were scanned, for various clinical indications. Forty of these patients had already had abnormalities detected antenatally by foetal ultrasonography. One hundred and eight-three patients had abnormalities detected on postnatal clinical examination; most of these had various cutaneous markers, some had other congenital abnormalities.


RESULTS
There were a total of 29 patients with dysraphism; 24 were detected antenatally and five postnatally. Of the five, two had two or more cutaneous markers and three had anorectal anomalies. All 86 of the patients with simple sacral dimples, pits or sinuses were normal.


CONCLUSIONS
As an isolated abnormality, simple dimples or pits are not useful markers of spinal dysraphism. The authors suggest a new imaging protocol, resulting in improved diagnostic efficiency.
Robinson
A J
AJ
Department of Diagnostic Radiology, St Mary's Hospital, Manchester, UK.
Russell
S
S
Rimmer
S
S
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D012871:Skin Diseases / Q000000981:diagnostic imaging*; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging*; D014463:Ultrasonography