Researchers in Israel prospectively examined the role of ultrasound (US) in 254 infants younger than 6. 5 cm from the anus) 2. The Dr said its not attached & not to worry. Code. As a result, no further investigation is needed for these simple dimples. Figure 4. Sacral dimples occur in the sacral area as small depressions or pits in the skin, most with a visible floor. Venus dimples are two dimples that appear on the lower back, just above the gluteal cleft. They did an ultrasound of his booty & spine when he was like a week old. Tailbone pain often feels dull and achy in the area between the gluteal cleft and above the anus but can also become sharp in certain situations (e. Among this group, 20% (46 of 235) had OSD. @BekaRoo, you would think so but I guess they see so many babies each day that they probably see a lot of sacral dimples and don’t think to mention it unless it’s very obviously a concern. Current data shows that a screening ultrasound is appropriate. A sacral dimple. Introduction. An approach to ultrasound investigation of sacral dimples is presented in . 5 cm from anus · Less than 5 mm diameter · Localized in gluteal cleft Further workup needed No intervention needed Referral for MRI Further workup needed Age < 8 weeks? (more info) Yes Age < 8o weeks No Referring provider Age ≥ 8 weeks to order. Sex hormones act on sudoriferous glands and affect hair growth; other factors like sitting for. Single dimple. Sacral dimples. Sacral dimples which have a clearly visualised base with a width of < 0. 01 coding with all applicable Excludes 1 and Excludes 2 notes from the section level conveniently shown with each code. 4 ). Basic Facts HAIR: The term “Pilonidal” technically means “nest of. Q82. Apr 24, 2016 at 7:40 PM. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. However, if referral is required please refer as soon as possible. Respondents differed on the type of imaging that they would perform, with 31% to 38% recommending. These tests may include: Ultrasound. The sacral prominence occurs where the last lumbar vertebra joins the sacrum. Cases in which the ultrasound findings are either equivocal or confirm spinal dysraphism may require an MRI of the spine and referral to the spinal rehabilitation clinic. Open the PDF for in another window. nervous system sacral dimples Pediatrics in. But these lesions are limited to the gluteal cleft whereas a dermal sinus tract originates above the cleft and can interconnect with the spinal canal and dura mater. Topics: congenital abnormality , cysts , magnetic resonance imaging , salmon patch , skin manifestations . A step-by-step drawing of the surgical process. The doc looked at their butt cracks and my daughter's has a crooked crease right at the top. . Nate has a wonky "Y" shaped butt crack and his second/third toes are slightly syndactyl (sp?). The intergluteal cleft (a. A few dimples were located in the upper portion of a deviated or Y-shaped crease and were therefore slightly off-midline even though located within the gluteal crease. The 129 (42%) out of 307 of these infants were further evaluated with ultrasound imaging of the spine. a. In this condition, the patient do not have a sacral dimple on both or either side. JS O, Bhalla VK, Needham L, Sharma S, Pipkin WL, Hatley RM, Howell CG (2014) Müllerian-type, cutaneous ciliated cyst in the gluteal cleft mimicking a pilonidal cyst. 06 [convert to ICD-9-CM] Epigastric swelling, mass or lump. However, imaging. Other perianal infectionsGluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. 2 mm (SD 19) above the coccyx (p = 0. Code. Yup my second has a sacral dimple. It is generally accepted that further evaluations via radiologic imaging and early neurosurgical referrals are required when atypical dimples exist. " by Holly A. , aperta (open) if the. Monday she will see a neuro sergion for a physical exam. However, high, or large sacral dimples, or combined with other abnormalities should be imaged, starting with spinal US3. 5 cm above the anus) and solitary. Sacral pits with cutaneous markers (lipoma, hypertrichosis, hemangioma)In fact, the authors feel that simple dimples and deviated gluteal clefts do not require any imaging whatsoever [13]. There was no difference in the rate of OSD based on dimple location. midline without visible drainage. This means that the butt crack will appear off-center. Those without OSD had a mean dimple position of 12. His chromsome deletion also has tethered cord listed as a possible diagnosis. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. Asymmetric or malformed Gluteal 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. Nevertheless, in some practices, imaging is routinely obtained on neonates with simple sacral dimples and/or deviated gluteal clefts with the indication of “rule out tethered cord. 9. Epub 2013 Aug 1. Care was taken to place the first limb in the gluteal cleft and along the gluteal fold, mirrored by the opposing flap (Figs. Not Included Here. nervous system sacral dimples Pediatrics in. Pilonidal cysts can range from abscesses — painful collections of pus — to sinuses, and lead to persistent bloody drainage. 4. Fossae lumbales laterales (dimples of Venus), which are considered to be hereditary, manifest themselves as symmetrical indentations on the lower back, above the gluteal cleft. Pregnancy was complicated by maternal obesity, mild intermittent asthma, hyperthyroidism, allergic rhinitis, anemia, and sickle cell trait. Simple sacral dimples have the following features 1: <5 mm in diameter. Anonymous. 77 days. Learn about the causes and what these dimples mean. Sacral dimples should be. 3). 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). Q82. Then, the surgical wound is closed by rotating other tissue to cover the area. It is a congenital condition, meaning it is there when the baby is born. 4% of the 5166 patients had abnormal spine ultrasounds, compared with the 4. Excludes2: congenital sacral dimple parasacral dimple . g. The following features of dimples are associated with OSD. A pilonidal cyst (also called pilonidal cyst disease, intergluteal pilonidal disease or pilonidal sinus) is a skin condition that happens in the crease of the buttocks — anywhere from the tailbone to the anus. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. 5 cm from the anal verge, dimples larger than 5 mm in diameter, multiple dimples, or dimples associated with other cutaneous stigmata including hypertrichosis,In contrast, for patients with a low-sacral dimple, flat hemangioma, and symmetric (Y-shaped) splaying of the intergluteal cleft, opinion on the need for imaging varied considerably (between 57%. The MyChart Patient Portal is an online tool that provides medical information about care provided at Johns Hopkins All Children’s and connects you to your health care team. Back dimples — indentations on your lower back — are a fairly common cosmetic feature. Loss of bladder or bowel control that gets worse. Spine ultrasonography (USG) is an effective and safe screening tool for patients with a sacral dimple. A sacral dimple is a small depression in the skin, located just above the buttocks. Nine papers addressing routine spine ultrasounds for children with sacral dimples showed that 3. 3% of infants) and thought by some to be associated with risks of congenital dermal sinuses. 14) The dimples of Venus, a sign for the identification of the posterior superior iliac spine (PSIS) below the fascia. 6% in general population and upto 45% of evaluation for SD • Size ,location in relation to anus, depth of the pit, concurrent presentation with other. Q82. Jun 18, 2023 at 1:42 PM. 21 A skin dimple is present on the flat portion of the sacrum well above the upper end of the gluteal cleft. Topics: Neural tube defects are among the most common forms of birth defect, affecting 1 in every 1,000 pregnancies. 5 cm of the anus without any associated abnormal masses or skin lesions. She had no rashes. Simple sacral dimples require no further investigation whereas complex ones do. In most cases, pilonidal dimples are benign and may just be accompanied by increased hair growth in the area. More than one hole may develop, and often these are linked by tunnels under the skin. The patient has an unusual sacral crease and sacral dimple. and occult spinal dysraphism are suspected when a cutaneous marker overlies the spine of a newborn and occur within the gluteal cleft without any skin markers. Typical dimples are found at the skin on the lower back near the buttocks crease. Q82. Duplicated gluteal crease. In this design, the advancement is done in a V-Y fashion and the medial portion of the flaps are elevated and advanced to cover the sacral defect. Most sacral dimples are harmless and don’t need treatment. These mimics could be Benign sacral dimple or pilonidal sinus. It goes laterally up to a virtual line converging the anterior superior iliac spine to the anterior edge of higher trochanter and Medially goes up to mid-dorsal line and natal cleft. Caution: Not every dimple, opening or abscess in the sacral regions is pilonidal disease. If the base could not be seen, this would be called a coccygeal pit. zoemcr. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). Dimples that are deep, large (> 0. Has anyone had any expierence with this ? Thanks x. 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. 273 results found. This topic will review the clinical manifestations, diagnosis, and management of closed spinal dysraphism. A V-shaped crease (sacral triangle), which arises from the. It is a visible border separating ass into two parts. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. a 1. Most sacral dimples are harmless. Diagnosis. doi: 10. 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. 2. A crooked crease between the buttocks. ICD-10-CM Diagnosis Code R19. 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. k. About 3 to 8 percent of the population has a sacral dimple. We have been told our 6 week old son has a forked gluteal (naval) cleft or I y-shaped crease at the top of his button - Answered by a verified Pediatrician. The goal of this procedure is to completely eliminate the gluteal cleft in the diseased area. The typical V-shaped lobster-claw deformity of the feet in the same infant. In contrast, for patients with a low-sacral dimple, flat hemangioma, and symmetric (Y-shaped) splaying of the intergluteal cleft, opinion on the need for imaging varied considerably (between 57%. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 6 [convert to ICD-9-CM] Congenital sacral dimple. In contrast, sacral dimples that are deep and large (greater than 0. This study included 230 infants under 6-months-old (130 males and 100 females; mean age 52. Simple sacral dimples are present in 3–5% of newborns are not associated with increased risk of neural tube defects or dermal sinus tracts []. 6 is exempt from POA reporting ( Present On Admission). 8, 13 Associated skin anomalies such as hair tufts or vascular lesions may also be found. 신생아 보조개 (Sacral Dimple) 은. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. Simple solitaire sacral dimples in asymptomatic neonates consisting of a single midline dimple that measures less than 5 mm in. Figure 1 shows the number of patients within each of these groups who did and. An approach to ultrasound investigation of sacral dimples is presented in . Sometimes a Pilonidal contains hair and sometimes not. 예전에는 잘 알려지지 않았지만. g. Sacral dimples are more likely to be associated with OSD if they are above the gluteal cleft. Lagertha1. Sacral dimple newborn – a prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. The only significant finding in that area would be a sacral dimple that is deep and that might need investigating for a condition known as spina bifida occulta. A sacral dimple is an indentation in the lower back, present at birth, but sometimes not noticed until the infant’s 6 week check. Dimples can also occur higher up above the gluteal cleft. <2. A fingertip placed on the dimple can be “rolled around” the tip of the coccyx. My oldest has a “duplicated gluteal cleft” which is also a marker for spina bifida. Both are considered mild birth defects. 5 cm from anus. We would like to show you a description here but the site won’t allow us. Includes. 5 cm of the anus and no association of other cutaneous stigmata. POA Exempt. 6 - other international versions of ICD-10 Q82. There is a necessity for detailed embryological knowledge for a better understanding of. Perianal candidal intertrigo presents as soreness and irritation with bright red erythema and satellite lesions extending into the natal cleft. However, if the sacral dimple is deep and large, greater than 0. Base of dimple is visible. In patients with a sacral dimple, the location of the dim - J neurosurg Pediatr). In very mild cases, such as isolated. Sacral Dimple. Sacral dimples are benign lesions, overall, especially as a solitary finding with no associated skin stigmata, and as such do not require further imaging. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in 28 (5%), other isolated cutaneous stigmata (subcutaneous lipoma, vestigial tail, hairy. While multiple studies (described below) have shown that ultrasound can be useful when a sacral dimple is identified, these studies do not differentiate between a. Figure 4. ICD-10-CM L05. [Wilson, 2016] Should be. PMID:In contrast, for patients with a low-sacral dimple, flat hemangioma, and symmetric (Y-shaped) splaying of the intergluteal cleft, opinion on the need for imaging varied considerably (between 57%. Answer: Gluteal cleft. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in. 3. 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. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. The hip line become curved in this. [Zywicke, 2011] Neural Tube Defects: [Zywicke, 2011] Open vs Closed When an infant is born with skin lesions or abnormalities of the lower back or gluteal cleft, the possibility of an association with spinal malformations, such as tethered cord syndrome, often prompts pediatricians to recommend spinal imaging. 5 cm from the anus. The patient has an unusual sacral crease and sacral dimple. The sacral dimple is congenital, meaning that it is present when an infant is born. Longitudinal grayscale. A sacral dimple is defined as a midline dimple less than 5 mm in diameter and no further than 2. Deep sacral dimple with associated finding(s) 5 (3) Associated hypertrichosis 19 (13) Multiple sacral dimples 18 (12) Duplicated gluteal cleft 8 (5) Skin tag 6 (4) Large sacral dimple (>5 mm) 3 (2) Hemangioma 2 (1) Location >2. [Wu, 2020] Have been associated with Closed Neural Tube Defects. a patch of hair by the dimple. Hypertrichosis. S. A sacral dimple can be a sign of a serious spinal problem in a newborn if the dimple is large or appears near a. A coccygeal pit was. Bilateral gluteal tendinitis; Gluteal tendinitis of left hip; Left gluteal tendinitis; Tendinitis of bilateral gluteal tendons. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. A butterfly- shaped rash across your nose and cheekView article titled, Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft. 5 cm from the anus without associated visible drainage or hairy tuft. Most sacral dimples do not cause any health issues. An odor from draining pus. Original poster's comments (2) 0. 8% to 7. 8. The thing is I also did notice during diaper changes there was a dimple there. Deep dimples were noted in 1. Whe the skin lateral to the dimple is stretched, skin can be seen covering the entire dimpled area. A deviated or duplicated gluteal cleft should raise concern for OSD, whether or not a dimple is present. Expand. buttocks The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, so named because it forms the visible border between the external rounded protrusions of the. This is the American ICD-10-CM version of Q82. 2). [Billable] [POA Exempt] There's more to see -- the rest of this topic is available only to subscribers. 4). With thousands of award-winning articles and community groups, you can track your pregnancy. tenderness. for Your PatientOur content is doctor approved evidence based, and our community is moderated, lively, and welcoming. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in. , hemangiomas. Asymmetric or malformed Gluteal cleft. It is present by birth in babies. Code. Babies with congenital hip dislocation can also have asymmetrical gluteal folds. Almost always, if the dimple is within the gluteal crease, there is no underlying spinal abnormality and no investigation is necessary. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. An approach to ultrasound investigation of sacral dimples is presented in . Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. Evaluation and Management of Sacral Dimples (Pilonidal Dimple) Y. I never thought to bring it up to the doctor until recently when my mom said it’s not normal. Q82. May 6, 2021 at 5:44 AM. Simple Dimple (<5mm deep and located within 2. More than 86% of spinal dysraphisms are associated with overlying cutaneous stigmata []. EPIQ 5G eL18 -4. Jun 18, 2023 at 1:42 PM. 1 a and b). gluteal cleft / natal cleft / cluneal cleft / butt crack) is the posterior deep midline groove in the gluteal region. Simple sacral dimples require no further investigation whereas complex ones do. 8 - other international versions of ICD-10 Q82. ICD-10-CM Diagnosis Code L05. Her skin was warm, dry, and pink, with a 3. Lastly, in the presence of isolated sacral dimple, hypertrichosis, small hemangioma, and pigmentary nevus, which are linked to a very low risk of OSD, we propose only a clinical evaluation. The gluteal cleft shield is directly applied on the skin and fixes itself above the waistband. 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. Five hundred twenty-two patients with a mean age of 6. In a transverse plane, the bony landmarks of the two cornua are identified at the proximal end of the gluteal cleft (Fig. 5. The upper angle is determined by the crossing of the bilateral. The area seemed tender to the touch and was without spontaneous drainage. A simple sacral dimple is: · No more than 2. Caudal regression syndrome results from an insult in early pregnancy (<4 th week of gestation). Rozzelle. nervous system sacral dimples Pediatrics in. It is shaped like an upside-down triangle and sits at the bottom of the spinal column, connecting it to the pelvis. Symptoms of Tethered Spinal Cord. At 6 months all her lanugo fell off except this little patch of hair on her low back and it looks like a little grey spot above the gluteal deviation. She took some pictures and sent them to a neurosurgeon who said we. This area is the groove between the buttocks that extends from just below the sacrum to the perineum, above the anus and is formed by the borders of the large buttock muscles called the gluteus maximus. A lump of the lower back. 2 mm (SD 19) above the coccyx (p = 0. 7) LUMBO SACRAL DIMPLES AND COCCYGEAL DIMPLES (PIT) • aka Sacral dimples; It’s a Whorl of skin that tracts to the coccyx • Most common minor malformations ; 4. I have read a post on here where a mama's baby did have a y shaped crack, sacral dimple and a tethered cord and the baby will have surgery at 6 months. 5 cm above the level of the anus with a relatively large ostium and an atypical appearance. If you have to split the glutei to see the dimple, then this is low-lying and less suspicious for dysraphism. basically, the top of his bum crack makes a y shape when squished. 5 cm, are positioned below the gluteal folds and have no other cutaneous features (dark hair, colour change) are innocent and do not require any further investigation. She said this could mean she has a tethered spinal cord. There was no difference in the rate of OSD based on dimple location. News & World ReportA sacral dimple is a small, usually shallow indentation in the small of the back, just above or within the crease of the buttocks. Dimple is less prominent. One of our neurosurgery RNs will gladly review and advise at no charge to help you determine next steps for your patient. 2013 Oct;98(10):784-6. There are no differences reported among ethnic groups. I've never heard of such a thing before he was born. 21 The dimple has an underlying tract of epithelial and fibrous tissue that pierces the underlying fascia and posterior vertebral elements, pierces the dura, and tracks. No other skin changes are seen. 6 - other international versions of ICD-10 Q82. 5 cm above the anus or proximate to the coccyx, and deviated gluteal folds (DGF) including all types of folds (bifid and split symmetrical without underlying. My youngest has a sacral dimple but it is. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). Three had associated asymmetric or Y-shaped gluteal clefts. CONTRAINDICATIONS: No absolute contraindications. However, if the sacral dimple is deep and large, greater than 0. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. Inflamed, swollen skin. Incidence of FTF in patients with sacrococcygeal dimples. Neural tube defects are among the most common forms of birth defect, affecting 1 in every 1,000 pregnancies. relevance of sacrococcygeal pits or dimples, which are very common (4. 8% reported by another study for children without sacral dimples. Coccydynia is a common condition that is known to be difficult to evaluate and treat. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. Motor function is generally more affected than sensory function and is correlated with the level of spinal aplasia. A simple sacral dimple, defined as a midline dimple, within the gluteal cleft and without associated cutaneous abnormalities, is a common finding and considered to be a. Specialty: General Surgery. Ranked among the best in the nation by U. A comprehensive review of 200 patients with spinal dysraphism found that 102 had a cutaneous sign. Stence, Todd C. The bottom of the dimple may not be visible, and sometimes the dimple is accompanied by changes in skin. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. 21 Lipoma Hairy Patch (1) Hairy Patch (2). rubrum and presents as an asymmetrical erythematous patch with a scaly, annular border in the groin. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. Most people associate the word sinus with the nose, but sinuses can occur anywhere in the body. 13422, 105:8, (890-894), Online publication date: 1-Aug-2016. One appendage was actually a “double” appendage, consisting of two tail-like appendages fused together at their bases. ICD 9 Code: 685. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. To date, the association with KS and closed NTD or tethered cord. 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. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in. Figure 2. figure 1. 5 cm from the anus. See full list on mayoclinic. Showing 1-25: ICD-10-CM Diagnosis Code Q82. GLUTEAL CLEFTS Although the Nelson Textbook7 states that imaging requirement is considered “uncertain” for gluteal fold deviations, several experts have said that an asym- metrical or bifurcated gluteal cleft may be a fairly good harbinger of occult spinal dysraphism. It separates the two glutes (and the buttocks) from each other and extends downwards from the third or the fourth sacral spine, deepening as it goes inferiorly. , lipomas, dimples, dermal sinuses, tails, hemangiomas, hypertrichosis) are cutaneous markers of spinal dysraphism. 14. A sacral dimple is found in the gluteal cleft, and you will need to separate the glutes to find it. Had our first well check today and a scheduled ultrasound. 6 - Congenital sacral dimple. In general, simple cutaneous lumbosacral markings , such as a simple sacral dimple or Y-shaped gluteal cleft, are unlikely to be associated with an underlying OSD. track my baby. GE LOGIC E9 ML6-15. Asymmetric Y-shaped gluteal cleft that is moderately associated with spinal dysraphism except if present with other lesions. Subcutaneous lipomas. These guidelines have therefore been prepared with a view to ensuringMy son who is 6 months old is scheduled for a MRI in June to check for a tethered cord. The patient’s mother had adequate prenatal care and a normal. 90. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. But if it's infected, the skin around the cyst may be swollen and painful. [Billable] [POA Exempt] There's more to see -- the rest of this topic is available only to subscribers. A simple sacral dimple was defined as a dimple located in the midline, within the gluteal cleft, and within 2. There is no dimple or hair just the y shaped cleft. The sacrum is an irregularly-shaped bone, shaped roughly like an inverted triangle, with its base superior and apex inferior. 5 cm of the anus. e.