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Visual Diagnosis: Midline Thoracic Dimple in a 10-month-old Girl

Neha Gupta, Leyden Standish-Parkin and Sergey Prokhorov
Pediatrics in Review December 2019, 40 (12) e42-e45; DOI: https://doi.org/10.1542/pir.2018-0103
Neha Gupta
*Department of Pediatrics, Lincoln Medical Center, New York, NY
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Leyden Standish-Parkin
*Department of Pediatrics, Lincoln Medical Center, New York, NY
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Sergey Prokhorov
*Department of Pediatrics, Lincoln Medical Center, New York, NY
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  1. Neha Gupta, MD*
  2. Leyden Standish-Parkin, MD*
  3. Sergey Prokhorov, MD*
  1. *Department of Pediatrics, Lincoln Medical Center, New York, NY
  • AUTHOR DISCLOSURE

    Drs Gupta, Standish-Parkin, and Prokhorov have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

PRESENTATION

A 10-month-old girl presents to the clinic with a dimple at the level of the midthoracic spine that has been present since birth. The parents do not have any other concerns. Developmental milestones are appropriate for age. The mother reports that there is no discharge from the dimple, motor anomalies, or changes in bowel or bladder pattern.

The patient was born at 33 weeks’ gestation by cesarean delivery owing to fetal bradycardia. She had respiratory distress at birth and was treated with nasal continuous positive airway pressure for 1 day. The mother had a history of gestational diabetes, poorly controlled with insulin.

On physical examination, her temperature is 98.8°F (37.1°C), heart rate is 134 beats/min, and respiratory rate is 32 breaths/min. She has a dimple over the T5 spinous process; it is a very small opening without erythema or discharge (Figs 1 and 2). Mental status is appropriate for age, and no facial asymmetry or weakness is noted. She has normal sensory response to touch, normal motor examination findings with normal bulk and tone in arms and legs, and no nystagmus. She is able to crawl and has normal reflexes with absent clonus.

Figure 1.

A dimple in the midline of the back of a 10-month-old girl at the …

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Pediatrics in Review: 40 (12)
Pediatrics in Review
Vol. 40, Issue 12
1 Dec 2019
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Visual Diagnosis: Midline Thoracic Dimple in a 10-month-old Girl
Neha Gupta, Leyden Standish-Parkin, Sergey Prokhorov
Pediatrics in Review Dec 2019, 40 (12) e42-e45; DOI: 10.1542/pir.2018-0103

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Visual Diagnosis: Midline Thoracic Dimple in a 10-month-old Girl
Neha Gupta, Leyden Standish-Parkin, Sergey Prokhorov
Pediatrics in Review Dec 2019, 40 (12) e42-e45; DOI: 10.1542/pir.2018-0103
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