Common Minor Problems /

Sacral dimple

01 In Brief

Sacral dimples are common - maybe 1:20 babies will have some sort of isolated skin dimple in the gluteal fold. Do they all need imaging?

02 What Do I Need To Know?


From see reference below

Cutaneous markers of OSD (occult spinal dysraphism otherwise known as spina bifida occulta) are more likely to be associated with OSD if they are above the gluteal cleft (truly sacral in location) because they are more likely to be contiguous with the dura. Those that are within the gluteal fold are much less likely to be contiguous with the dura and are much more likely to be a normal variant.

`Some indications that a skin dimple may be simple or low risk include:

  •  Position – within the gluteal fold or coccygeal position
  •   Single dimple
  •  < 5 mm diameter
  •  Base of dimple is visible
  •  Dimple is oriented straight down (i.e. caudal) not cephalically (i.e. toward the head)
  •  No other dermal abnormalities or masses
  •  Distance < 2.5 cm from anus
  •  Normal neurological examination

Evaluation for potential OSD usually includes spinal ultrasound in infants and magnetic resonance imaging of the lumbar spine for older children. In 2005, the Royal College of Radiologists revised protocol for imaging says “[i]solated sacral dimples and pits may be safely ignored (< 5 mm [in diameter], < 25 mm from anus). Ultrasound of the neonatal lumbar spine is the initial investigation of choice if there are other stigmata of spinal dysraphism, associated congenital abnormalities or a discharging sinus".


03 What Others Say

  • Mayo Clinic

Sacral Dimple

  • Auckland districh health Board

Sacral Dimples 

04 Clinicians Tools and Resources

  • Pediatric

Does this sacral dimple need to be evaluated?

The information published here has been reviewed by Flourish Paediatrics and represents the available published literature at the time of review.
The information is not intended to take the place of medical advice.
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Last updated: 07/05/2014