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The research shows that ultrasound is a reliable means of screening for tethered cord syndrome in infants with dorsal midline skin stigmata.

However, such screening is not needed for infants with simple dimple and deviated gluteal fold findings -- who represented the majority of subjects in the current study -- as these lesions are not indicative of underlying pathology, according to Dr. Liat Ben-Sira and co-researchers from Tel Aviv Sourasky Medical Center, Israel.

The findings, reported in the December issue of The Journal of Pediatrics, stem from a study of 254 infants under 6 months of age with suspicious dorsal midline skin stigmata. Of these infants, 125 had simple dimple and 53 had deviated gluteal fold. All infants had ultrasound studies and clinical evaluations, and 50 babies were also assessed with MRI, considered the gold standard for screening.

The ultrasound findings strongly correlated with the MRI findings. On final evaluation, ultrasound was associated with a sensitivity of 96%, specificity of 96%, and positive predictive value of 96% in detecting clinically significant spinal cord findings.

Of 157 ultrasounds performed in infants with simple dimple and deviated gluteal fold, 96% provided high-quality images of the spinal components (96%), and none showed any clinically significant disease findings.

The present study suggests that no further work-up is necessary for low-risk skin stigmata, including simple dimple and deviated gluteal fold, the authors state. By contrast, high-risk stigmata, such as nonsimple dimple, hypertrichosis, tags, or any mass, warrant MRI evaluation. Further research, however, is needed to determine the roles of ultrasound and MRI in patients whose lesions lie between these two extremes, they note.

Source: Reuters Health

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