ILLUMINATIONS
Spinal sinuses, dimples, pits and patches: what lies beneath?
Correspondence to:
For correspondence:
Dr Helen Williams
Radiology Department, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK; helen.williams@bch.nhs.uk
Keywords: cutaneous lesions; magnetic resonance imaging; occult spinal dysraphism; ultrasound
| The first 150 words of the full text of this article appear below. |
Skin lesions such as lipomas and hairy patches found over the spine are well recognised as markers of rare, concealed underlying spinal abnormalities—otherwise known as occult spinal dysraphism (OSD) (table 1
). Detection of OSD in infants is difficult because an abnormal neurological examination is often not apparent until the child becomes ambulatory, or even later. The associated spinal abnormalities include intraspinal lipomas, cord tethering and split cord malformation or diastematomyelia. Skin and neural tissues have common ectodermal origins, therefore anomalies of both may occur simultaneously. The discovery of a midline skin lesion in an otherwise well, asymptomatic neonate or child often prompts a search for OSD using imaging. However, it is sometimes not clear which lesions warrant imaging—particularly in the case of skin dimples, and so-called birth marks or cutaneous vascular lesions that are all common in infants. The purpose of this article is to clarify the indications for
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