Clinico-radiologic Findings in Group II Caudal Regression Syndrome
A 10-year-old girl presented with progressive lower extremity weakness, difficulty in walking, and urinary incontinence. She had urinary incontinence since infancy and had undergone surgery for neurogenic bladder 5 years earlier. She now had progressively increasing urinary incontinence,, increased weakness of the lower limbs, and bowel incontinence. Her legs showed wasting of both proximal and distal muscles. Scoliotic deformity was seen along with impairment in walking. No cutaneous stigmata were noted in the back. Blood investigation findings were normal. She underwent technetium dimercaptosuccinic acid scans, which revealed bilateral atrophic kidneys with impaired renal function and parenchymal scarring.\nMagnetic resonance imaging (MRI) examination of the lumbosacral spine revealed scoliotic deformity, bilateral sacral agenesis (S2 level), low lying spinal cord (L5 level), and syringohydromelia of the caudal spinal cord. Associated findings include anterior epidural lipoma, anterior lipomyelocystocele, an irregular trabeculated urinary bladder, bilateral hydronephrosis, and bilateral hydroureter [Figures -]. Based on the clinical and radiologic findings, a diagnosis of CRS Group 2 was made.