G378(P) Sacral dimples and spinal ultrasounds: are we still imaging simple dimples?

Abstract

Aim This review aimed to assess the number of spinal ultrasounds performed on babies under two months of age in our regional neonatal centre, to assess the indications for performing these investigations and to investigate the frequency of abnormal results on the ultrasound. We noted anecdotally that we were performing many spinal ultrasounds, with resultant visits to clinics for the results and parental anxiety, and wished to investigate the number of spinal ultrasounds performed as recent evidence suggests that simple sacral dimples are not an indication for spinal ultrasound. Methods This was a retrospective review of cases of spinal ultrasound performed on infants aged less than six months in our centre. The radiology imaging management system was interrogated to provide these cases. Anonymised data was recorded, including infants age at time of scanning, indication provided on the request form and the result of the ultrasound scan. Results 32 spinal ultrasounds were performed in the previous 12 month period. The ages of the infants ranged from 3 days to 6 months. The most common indication for requesting the ultrasound scan was a sacral dimple with 65.6% (n=21) performed for this reason, with 6.3% (n=2) performed for a hair tuft in the sacral region. A spinal haemangioma was the reason for performing 12.5% (n=4) scans. Just over 81% (n=26) of scans were entirely normal. Three (9.4%) scans were abnormal, with all three having cord tethering: none of these infants had only a sacral dimple or a tuft of hair. All three babies were referred for neurosurgical review and as of yet no baby has had intervention. Conclusions Simple sacral dimples are still the most common reason for requesting spinal ultrasounds in our regional paediatric and neonatal centre and all ultrasounds performed for this reason were normal. We plan to create a local guideline to prevent unnecessary imaging of babies with simple sacral dimples.