Sacral dimples are common and may occur as an isolated finding or as part of multiple syndromes. The suspicion of underlying spinal dysraphism is increased by:
- large size (>5mm)
- increased distance from the anus (>2.5cm)
- association with cutaneous stigmata (hair, cutis aplasia, haemangioma).
Reference: Nelson Textbook of Paediatrics, 18th Ed, 2007: Saunders.