Sacral dimples, abnormal ultrasound lumbar spine, evaluate for Chiari malformation, tethered cord protocol and syrinx, spina bifida.Two small red blanching vascular lesions above gluteal cleft. Brain: The cerebellar tonsils are not low-lying and there is intact cerebrospinal fluid flow across the foramen magnum. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Spine: The skin or subcutaneous lesions are not discernible. There is no evidence of a sinus tract. The conus medullaris lies at the L1 vertebral body level and the spinal cord displays normal signal and morphology. There is no evidence of a fibrofatty filum terminale. There is mild convex left thoracic scoliosis. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. The urinary bladder appears distended.
1. No evidence of acute Chiari malformation.2. The skin or subcutaneous lesions superior to the gluteal cleft are not discernible, likely due to the inherent resolution limitations of the modality. 3. The conus medullaris lies at the L1 vertebral body level, without evidence of a fibrofatty filum terminale. 4. Mild convex left thoracic scoliosis. 