Decision to use ultrasound vs MRI as first-line imaging is somewhat institution dependent G. Urinary and bowel dysfunction are nearly universal. z. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Attempted resection of a bicornuate uterus "septum". Sacral dimples. 5 cm from anus • Less than 5 mm diameter • Localized in gluteal cleftThe initial examination within the first 24 hours of birth is critical in determining newborn patients' general well-being and identifying any red flags that may warrant further evaluation. 4. 6 Therefore, we could consider these patients low risk for having OSD. Findings present in 11% of healthy newborns are unlikely to be useful markers for a rare condition like OSD (estimated incidence 0. Bust get. 419 - other international versions of ICD-10 M67. F. Morbidity and. Flashcards. The vertical line starts from sacrum to the perineum. 1,2 This is of importance because on rare occasions, sacral dimples. He seems completely healthy otherwise. A duplicated gluteal cleft associated with occult spinal dysraphism. Almost always, if the dimple is within the gluteal crease, there is no underlying spinal abnormality and no investigation is necessary. 821A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. there is a duplicated gluteal cleft; there is more than one dimple; the dimple lies outside the sacrococcygeal region; there are any neurological abnormalities noted; The above may be associated with an underlying neurological problem, for example spinal dysraphism. Figure 4. They are not harmful to one’s health and do not necessitate. 1 The underlying cause of pilonidal disease is. 8 became effective on. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus regarding guidelines for accurate classification of these wounds. 2 may differ. com. 5 cm above the anus) and solitary. Sacral dimples are very common—they’re present in 2-4% of newborns overall! Almost all neurosurgical referrals for suspected OSD in children <1yo are for evaluation of a dimple. When these were followed up with repeat ultrasound at 2 1/2 months the vast majority of these (83. 8% had deviated or duplicated gluteal creases, 15. Asymmetric forked gluteal cleft is a condition in which the two sides of the buttocks form a V-shape, rather than a U-shape. APR with en bloc resection of the posterior wall of the vagina. Q82. Single, deviated gluteal crease with dimple. Motor/sensory grossly normal. 3) should raise concern for OSD, whether or not a dimple is present. Business, Economics, and Finance. According to his pediatrician it was only done out of an abundance of caution and typically there are two or more markers for spina bifida. Laterality will need to be indicated another way. 5 became effective on October 1, 2023. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. Ultrasound is valuable for imaging of infants and young children and for. 5 should be used on the newborn record - not on the maternal record. MeSH Code: D010864. A neonate Caucasian girl, a product of an uncomplicated pregnancy, was found to have asymmetric gluteal crease. The health care provider is busy examining the newborn, but the mother is obviously aware that something is not right. 5 weeks old and is still yellow. [1]. Combinations of deviated or duplicated gluteal crease + dimple, deviated or duplicated crease + hair, and dimple + hair were common groupings. 8 became effective on October 1, 2023. 155 Other ear, nose, mouth and throat diagnoses with cc. not so much: Pilonidal "dimples" are properly called "pits", are always in the midline in the gluteal cleft, and are where infection of the pilonidal cyst starts, as dislodged hairs can work themselves into these. Asymmetric gluteal cleft. 1 became effective on October 1, 2023. GameStop Moderna Pfizer Johnson & Johnson AstraZeneca Walgreens Best Buy Novavax SpaceX Tesla. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis (inflammation of the skin). The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. 8 became effective on October 1, 2023. The examination is performed with high-frequency. IP is usually found in the groins, vulva, axillae, submammary folds, gluteal cleft, navel, intergluteal crease, penis, lips, and web spaces. 730 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The superior tip of the intergluteal cleft. 9 Bilateral Complete cleft lip 749. A duplicated gluteal cleft associated with occult spinal dysraphism. Fig. He had an ultrasound at a week old and it was negative. Similar. 2 deletion syndrome include heart defects, poor immune system function, a cleft palate, complications related to low levels of calcium in the blood, and delayed development with behavioral and emotional problems. 4,16,18,19 A simple sacral dimple is located in the midline, within the gluteal cleft, has a diameter less than 5 mm, and is less than 2. 7% had lumbosacral and/or coccygeal hairiness. Cute vs. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. 89 specifies anus/rectum, M53. Non-duplicate identified articles were independently reviewed by two authors (J. 1 - other international versions of ICD-10 P92. Almost always, if the dimple is within the gluteal crease, there is no underlying spinal abnormality and no investigation is necessary. Unilateral Incomplete cleft lip 749. Is composed mainly of collagen fibres, it is strong enough to support the sacrum. kdmahnke13. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). The patient’s. During colonoscopy, evidence of. my full-term newborn boy has an asymmetric 'y' shaped crease at the top of his intergluteal cleft. 1). She has had RSV, Brinchiolitis, surgery to detether her Tethered Spinal cord. Sign up. Sacral dimples are relatively common, occurring in 2-4% of newborn infants. , four cases of asymmetrical gluteal fold, two cases of dermal sinus, one case of hairy tuft, one. Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft Kaitlin N. It is estimated that 2% to 4% of all newborns will have a sacral dimple. Our content is doctor approved and evidence based, and our community is moderated, lively, and welcoming. Read More. 7 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 5cm · >5mm diameter · Not midline in location · Base not visible (Schenk, 2006) Return to Referral and Diagnosis Return to Surgery and Follow-up Simple Sacral Intragluteal Dimple Dimple within a symmetric gluteal crease AND less than 5 m i nd a etrWITH h sc u abno m l it es A soc ia t. Q82. View all the articles associated with any code, right from the code page! Thank you for choosing Find-A. Some aren't visible, while others can look like a small pit or dimple in the skin. 8%) showed a combination of 2 markers (single dimples in common, deviated or duplicated gluteal furrows in 22, cutaneous masses in. Dec 1, 2018 at 7:24 PM. They may be associated with a tuft of hair. Now I’m freaking myself out because everything you see on google says tethered spinal cord. 2, 3 It is most commonly encountered in young men in their 20s and 30s, although women can also be affected. Gluteal Region – Earth's Lab. 02). There are many approaches to examining a newborn, many of which are acceptable. Access records and results, view and pay bills, request prescription renewals, and request appointments. 32 No. The most common MSS lesions were “simple dimple” (125 infants), defined as a soft tissue depression ≤25 mm above the anus (regardless of size or depth), and deviated gluteal fold (DGF; 53 infants), defined as any abnormal gluteal fold (including bifid or split gluteal cleft) without an underlying mass. 6% had dimples, and 24. The cystic mass extended into a dilation of the central canal due to. 4). g. The purpose of this study is to describe the range and frequency of cutaneous lumbosacral and coccygeal findings encountered during the newborn examination in a population of apparently healthy. basically, the top of his bum crack makes a y shape…Had our first well check today and scheduled an ultrasound. Duplications with other complex rearrangements. 0 - other international versions of ICD-10 Q36. A total of 211 (84. The crease is nearly always present and usually not perfectly symmetrical. C. Feb 4, 2023 at 3:55 PM. SPINE: Normal curvature with no defects or dimples. The gluteal cleft and the gluteal fold both occur normally in humans. The 2024 edition of ICD-10-CM Q82. The official AHA publication for ICD-10-CM and ICD-10-PCS coding guidelines and advice. Had our first well check today and scheduled an ultrasound. I made the mistake of googling, and it says it could be a sign of spina bifida or tethered spine. Cleft lips and cleft palates happen when tissues of the upper lip and roof of the mouth don't join together properly during fetal development. split; divided; a crack or crevice; an indentation between two parts, as of the chin Not to be confused with: clef –. a Ventral view showing two heads, with anencephaly in the left twin, a shared thorax with a single umbilical cord, and two normal upper and lower extremities. hemangioma, telangiectasia The 2024 edition of ICD-10-CM P01. A sacral dimple can be a sign of a serious spinal problem in a newborn if the dimple is large or appears. Cleft foot is a rare congenital (meaning your baby was born with it) anomaly in which the foot didn’t develop properly during fetal development. kdmahnke13. The 2024 edition of ICD-10-CM Q36. tenderness. P83 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. SGD patients developed with ulcer were all am-bulatory unlike the pressure sore. A total of 34 (24%) patients had an abnormal spinal US; 15 (44%. The condition, which has an annual. E. It is also known as the “butt crack” and “intergluteal cleft. A duplicated gluteal cleft associated with occult spinal dysraphism. D ISCUSSION. 1 Global variations in incidence have been reported, ranging from 0. mbort True Blue. She is almost 2 and it has caused her no problems thus far. Congenital dermal sinus form due to a focal failure of dysjunction between the cutaneous ectoderm and. 2, 3 It is most commonly encountered in young men in their 20s and 30s, although women can also be affected. In newborns, the diagnosis is very ambiguous due to physiologic instability originating from the inborn laxity. 5 - other international versions of ICD-10 P01. Apr 24, 2016 at 7:40 PM. Change diapers promptly after voiding or soiling. The 2024 edition of ICD-10-CM Q37. A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris. The 2024 edition of ICD-10-CM Q92. Had our first well check today and a scheduled ultrasound. (e. Figure 1. Have any other moms on here. · No relation to gluteal cleft · Distance from anus >2. Skin. 18 Although it has long been recognized that midline uncomplicated dimples located within the gluteal crease (so-called coccygeal pits) are unlikely to be associated with a tethering lesion, Gomi. Babies with congenital hip dislocation can also have asymmetrical gluteal folds. If a sacral dimple is paired with other symptoms such as bruising, tufts of hair or skin tags, it could be a sign of a spinal condition. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 4%) presented with isolated markers (200 with solitary dimples, 6 with deviated or duplicated gluteal furrows, four with cutaneous masses, and one with hypertrichosis). Although fistulas above the gluteal cleft may be associated with spinal dysraphism, coccygeal pits are benign and do not need imaging. 8%. There is no skin. All racial/ethnic groups had double to quadruple the risk of lumbosacral hair when compared with. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Spina Bifida Occulta (Occult Spinal Dysraphism) Spina bifida occulta is a common anomaly consisting of a midline defect of the vertebral bodies without protrusion of the spinal cord or meninges. 딤플보다 엉덩이 틈새 (gluteal cleft) 기형 은 경증 OSD와 연관성이 있어 꼭 추가적인 검사 를 해야해요. basically, the top of his bum crack makes a y shape when. The patient has an unusual sacral crease and sacral dimple. nervous system sacral dimples Pediatrics in Review Vol. Fourteen (21%) of the 67 patients had an abnormal spinal ultrasound; 5 of. Specialty: General Surgery. The current prospective study from Tel Aviv assessed 254 infants less than 6 months of age who were referred for neurosurgical consultation; 154 had these isolated, low-risk skin. It is a common skin condition affecting opposing cutaneous or muco-cutaneous surfaces. Similar. 4. These cysts are usually caused by a skin infection and they often. Of 1096 infants included in the study, 24. Methods. This is the American ICD-10-CM version of Q37. 730 became effective on October 1, 2023. rubrum and presents as an asymmetrical erythematous patch with a scaly, annular border in the groin. This is mostly a problem with HSG preoperative evaluation. This is the American ICD-10-CM version of Q82. The estimated overall incidence of pilonidal disease is 26:100,000. 438 Clarendon Street, South Melbourne, VIC 3205. This can cause problems starting around age 2-3 (potty training age) is when parents start to see some signs. Moisturiser every night. 9 may differ. It is decorated from the upper side with rhinestones and colorful studs. The gluteal cleft refers to the separation of the buttocks. Diagnosis and Referral Pathway for DDH This DDH Diagnosis Pathway is appropriate for metropolitan regions and also for remote regions that lack access to reliable hip ultrasonography. The management for this syndrome is individualized and may include surgical intervention to fuse or excise the duplicated organs. The internet is a wonderful resourceWe would like to show you a description here but the site won’t allow us. Since that time, the operation has evolved and improved to the procedure practiced by The Sternberg. . Q82. What an incredible first year. Sacral epidermal anomalies include dimples, tracts, lipomas, hemangiomas, and tufts of hair and may be associated with a neural tube defect, such as spina bifida. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. 5 cm above the anus) and solitary. in the sacrococcygeal area as shown in Figure 1. 5 - other international versions of ICD-10 Q82. Off-midline closure procedures such as the Karydakis flap and the Bascom cleft lift , which remove the pilonidal disease, flatten the gluteal cleft, and bring the incision off the midline. The gluteal cleft is an anatomical characteristic found in both males and females. Asymmetry. The buttocks are retracted laterally with adhesive tape to expose the gluteal cleft. Congenital branchial cleft anomaly. 6 - Congenital sacral dimple. 2 deletion. basically, the top of his bum crack makes a y. 2 may differ. Skin stigmata were classified into seven types, dimple, deformed gluteal cleft, hair, subcutaneous mass, appendage, discoloration, and protruding bone, and included 1056 isolated and 199 complex ones. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. from anal verge, multiple dimples, Skin lesions and Associations (duplicate gluteal cleft, asymmetrical intergluteal crease, skin tag, tail like appendages, hairy tuft, pigmentation,Had our first well check today and scheduled an ultrasound. Created for people with ongoing healthcare needs but benefits everyone. The lesions appeared to spare the central crease and were tender. k. Usually occur in combination of other masses, e. Congenital dermal sinuses represent cutaneous depressions or tracts that are lined by stratified squamous epithelium. Clinical pearl: Gluteal cleft anomalies (e. Most patients are asymptomatic and lack neurologic signs, and the condition is usually of no consequence. And ulcers in SGD were observed in locations that force both gluteal regions to evert. Spina Bifida Occulta (Occult Spinal Dysraphism) Spina bifida occulta is a common anomaly consisting of a midline defect of the vertebral bodies without protrusion of the spinal cord or meninges. ings in newborn infants. 7 may differ. e. Design: Before-and-after trial. Some consider the term spina bifida occulta. (1)(2) These defects, which result from abnormal fusion of the neural tube during embryonic development, are placed into two broad categories: open and closed. There are several names for this area: natal cleft, gluteal crease, gluteal crevice. [6] Physical exam findings include midline pits in the superior gluteal cleft and may be associated with cephalad or lateral tracking sinuses. ” It affects an estimated 26 per 100,000 persons, 1 occurring primarily in young adults with a 3:1 male predilection. 9 - other international versions of ICD-10 Q35. 5 may differ. In 2 cases, there were differences in respondents' choice to image or consult a subspecialist depending on their percent clinical full time equivalent spent taking care of neonates <1 month of age: (1) coccygeal hair (P = . Pilonidal cysts and sinuses are a spectrum of pilonidal disease conditions that occur between the buttocks (gluteal crease or cleft) near the tailbone in the lower back. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 1 Atypical Sacral Dimple: Not in midline, not in sacrococcygeal region, >5 mm deep, >2. This can cause problems starting around age 2-3 (potty training age) is when parents start to see some signs. A thorough physical examination of a newborn should be done within 24 hours of birth. Learn. gluteal crease anatomy. 13 Q36. With thousands of award-winning articles and community groups, you can track your pregnancy. I’m emailing her doctor, but wondering if anyone else has noticed the same or experienced something like this??There was a notable lack of consensus on the appropriate management of certain gluteal cleft deviations and cutaneous vascular marks. About 1:1000 babies: It depends on the ethnic group, the family and pregnancy history, etc. kdmahnke13. long trunk, Y-shaped gluteal cleft, anteriorly displaced anus, clinodactyly, deep furrow and increased space between first and second toes, central and peripheral hypotonia, complete agenesis. 중복 엉덩이 틈새 (duplicated gluteal cleft)로 OSD와 연관되어 있어요. 6% had dimples, and 24. Tinea. 8% of the subjects. Pediatricians have been comfortable with assessing as insignificant the common low-lying midline dimple or deviated gluteal folds found at the nursery or first well-infant examination. basically, the top of his bum crack makes a y shape…ICD-10-CM Diagnosis Code M76. , aperta (open) if the. Prevention. Germolene. 5 - other international versions of ICD-10 Q92. Article. has demonstrated the high failure rate of the excisional procedures . Pediatricians have been comfortable with assessing as insignificant the common low-lying midline dimple or deviated gluteal folds found at the nursery or first well-infant examination. Physical examination findings that prompted a spinal ultrasound included isolated deep sacral dimple (34%); deep sacral dimple in association with other. I never thought to bring it up to the doctor until recently when my mom said it’s not normal. I’ve noticed my baby has a Y shaped cleft on her bottom. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 9% were worse. 2-7. To assess the clinical and economic consequences of different diagnostic strategies in newborns with suspected occult spinal dysraphism. May 2020; Hospital Pediatrics 10(6)D ISCUSSION. This is the American ICD-10-CM version of Q82. The 2024 edition of ICD-10-CM Q82. The right gluteal crease is lower than the left. shfkekhre. The other synonyms of gluteal cleft are anal. Pilonidal cysts can range from abscesses — painful collections of pus — to sinuses, and lead to persistent bloody drainage. Leopold, MD ; Edward S. The Dr said its not attached & not to worry. long trunk, Y-shaped gluteal cleft, anteriorly displaced anus, clinodactyly, deep furrow and increased space between first and second toes, central and peripheral hypotonia, complete agenesis. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). Duplicated Gluteal cleft. Newborns who became symptomatic were further evaluated and/or treated with antibiotics. Some asian groups have as high as 1 in 250 births with cleft, caucasians about. The right gluteal crease is lower than the left. non-midline lesion, forked gluteal cleft, coccygeal pit. states "Butt" that is less specific than "Gluteus Maximus". Ahn, MD ; Molly J. Cleft lift procedure overview. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. There was a notable lack of consensus on the appropriate management of certain gluteal cleft deviations and cutaneous vascular marks. 02) and (2) deviated gluteal crease (P = . An inconspicious examination does not need a further imaging, but suspicious results of sonography need an MR imaging dependent of clinical conditions. Results. Pediatr Rev. Ultrapotent or mid-potent corticosteroid creams alleviated the symptoms only slightly when used twice a day for 2–3 weeks. 1 Global variations in incidence have been reported, ranging from 0. Perianal tinea is uncommon. ICD-10-CM Q18. In association with other OSD associated congenital abnormalities like CEARMSGuideline for investigation of lumbosacral skin lesions in newborn infants WAHT-PAE-016 Page 1 of 6 Version 3. [Wu, 2020] Have been associated with Closed Neural Tube Defects. A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris. The two major types of spinal dysraphism are based on the appearance, i. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. Although the literature suggests clinical consensus regarding some lumbosacral findings (simple dimples or slate gray macules), expert recommendations vary regarding the management of other findings (duplicated gluteal clefts or coccygeal or sacral hair). swelling in the area. In newborns, the diagnosis is very ambiguous due to physiologic instability originating from the inborn laxity. This was the first year ICD-10-CM was implemented into the HIPAA code set. Of course google isn’t my friend and everything I’m reading mentions a tethered spinal cord. Our study found that cutaneous lumbosacral findings are more common in well newborns than previously reported. Body habitus may contribute to additional intertriginous sites, such as inframammary skin and. This is the American ICD-10-CM version of Q84. This shear stress mechanism of bruising has been reported as vertical linear bruises along an apparent strain line where the buttocks arch into the gluteal cleft. Gluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. This condition is. Approximate Synonyms. Collapse all. Results: Majority (80%) of infants had normal spinal US -Of the 20% of infants with abnormal spinal US that underwent spinal MRI only 5% had an abnormal spinal MRI -Neurosurgical consultation was documented for 13 infants with either abnormal US or MRI, of which only 2 required neurosurgical management for a tethered A dimple above the gluteal crease (the crease in the buttocks) Long hair (longer than 1 inch) growing on the back over the spine. This is the American ICD-10-CM version of Q82. 1. Open neural tube defects are lesions in which brain, spinal cord, or. In this case, which was the first one on whom we attempted the technique, we had designed the inferior flap as a medially based flap. They don't usually cause problems or need treatment unless they get infected. Q82. A cross-sectional assessment of cutaneous lumbosacral and coccygeal physical examination findings in a. For some babies, both the front and back parts of the palate are open. basically, the top of his bum crack makes a y shape…Had our first well check today and scheduled an ultrasound. I noticed that my LO’s buttcrack slightly curves at the top. ), and the gluteal cleft is normal. 5 cm. 27 This study also evaluated 207 neonates with. 99/year. P. Code. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. 1 - other international versions of ICD-10 P54. View article titled, Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft. A. Subcutaneous lipomas. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Epigastric mass; Epigastric swelling, mass. Our content is doctor approved and evidence based, and our community is moderated, lively, and welcoming. Sacral Dimple. This is the American ICD-10-CM version of P13. Study sets, textbooks, questions. Minimize friction—dry the skin by patting, not rubbing, keeping in mind that friction is one of the causes. 5cms from anal verge o Vascular lesion e. Code. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). The gluteal region comprises of superficial and deep muscle groups. - "A Cross-Sectional Assessment of Cutaneous Lumbosacral. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. From icd10data. The current prospective study from Tel Aviv assessed 254 infants less than 6 months of age who were referred for neurosurgical consultation; 154 had these isolated, low-risk skin. Overview. This is the American ICD-10-CM version of Q35. If too much fat it can be repaired by liposuction and fat transfer to the gluteal dimple. They have no associated abnormalities (hairs, skin markings, etc. It is a visible border separating ass into two parts. Stumbling or changes in gait or walking. Fully searchable through Find-A-Code's Comprehensive Search. Perianal candidal intertrigo presents as soreness and irritation with bright red erythema and satellite lesions extending into the natal cleft. The patient was born at 40 weeks and 1 day of gestation to a 21-year-old gravida 2 now para 2 mother by vaginal delivery. With thousands of award-winning articles and. Anusol suppositories. Figure 4. On the other hand, "sacral dimples" are higher on the lower back, usually on both sides (not in the middle). The cause of congenital earlobe deformities is unknown. The differentiation between the potentially dangerous dimples associated with dermal sinus, which can lead to meningitis and the harmless coccygeal dimple in the cranial gluteal cleft is presented.