A dimple above the gluteal crease (the crease in the buttocks) Long hair (longer than 1 inch) growing on the back over the spine. This is the American ICD-10-CM version of Q35. Perianal tinea is uncommon. The presence of a capillary hemangioma, either flat or raised (strawberry), in the midline over the spine raises the suggestion of an underlying dysraphic defect, 4 , 64 in particular when it is associated with other cutaneous. 11 - other international versions of ICD-10 M26. 6 - other international versions of ICD-10 Q82. 411A became effective on October 1, 2023. May 6, 2021 at 5:44 AM. Fig. 1 – 6 These clinics allow for coordination of care and complex decision making amongst providers caring for patients with open spina bifida. These lesions include a subcutaneous mass, dermal vascular malformation, hypertrichosis (hair patch), a midline dimple or sinus tract, a skin tag, or an asymmetric gluteal cleft (Fig. Asymmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table, The clinic nurse reviews the. Genital- abnormalities, sexual abuse,. Replace diaper Hips Barlow - adduct hip bringing toward midline. This. ANSWER: SACRAL DIMPLE. Typically, pilonidal cysts occur after puberty. Abrasion, left great toe, initial encounter. All infants: • Assess the patency of the anus by using one hand to hold the legs and the other to gently spread apart the gluteal cleft. Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. 8Gluteal crease, gluteal cleft, buttock cleft, natal cleft: this is the crease between the right and left buttocks. 110 749. Patients with cutaneous stigmata such as a dimple, pigmented stain, skin appendage, or asymmetric gluteal cleft should be investigated radiographically with. 782. 57: Penile torsion: Gluteal asymmetry: CM ends at L2-3: CM ends at L2-3: No clinical TCS; PT: Male/0. Spinal dysraphism Dr. 121 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. docx from NUR 102 at Owens Community College. 110 749. Pilonidal cysts can range from abscesses — painful collections of pus — to sinuses, and lead to persistent bloody drainage. 8. [ 22] Neural tube defects (NTD) occur because of a defect in the neurulation process. To check the problem behind asymmetry ultrasound and x-ray test are performed. Gluteal cleft deviation, although seemingly specific, contains a spectrum of definition ranging from minimal physiologic asymmetry to significant deviation with associated asymmetric glutes . The cystic mass extended into a dilation of the central canal due to. 9 may differ. 155 Other ear, nose, mouth and throat diagnoses with cc. Ultrasound (US) is the primary modality for pediatric spine assessment due to its widespread availability, non-requirement of sedation, and absence of ionizing radiation. swelling in the area. Longitudinal grayscale ultrasound image shows a thickened, echogenic filum terminale (black arrow). 5–0. 9 became effective on October 1, 2023. Introduction. However, if the sacral dimple is deep and large, greater than 0. Multiple factors contribute, including genetics. tenderness. Pilonidal disease, although relatively common, often is not appropriately recognized and treated. Physical therapy exercises can help, although some people need other interventions. al disease. 4). for cutaneous lesions or an asymmetric gluteal cleft, which could suggest spinal dys-raphism, a variant of spina bifida. The 2024 edition of ICD-10-CM P08. On palpation this is noted to be over the right iliac posterior superior iliac spine. There is also limited abduction of the. The asymmetric gluteal cleft is a harmless condition with no serious cause. skin tags. A, A 15-year-old girl who presented with day and night wetting. Based on your photo, it looks like it could be improved with surgery. The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, so named because it forms the visible border between the external rounded protrusions of the gluteus maximus muscles. The patient has an unusual sacral crease and sacral dimple. 1960;93:508-14. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This is the American ICD-10-CM version of S30. View Week 1- Newborn Assessment YouTube Video by Nina Gold- typed. Senile gluteal dermatosis (SGD) is a common but seldom recognized condition. Several cutaneous abnormalities point toward possible spinal dysraphisms. Laterality will need to be indicated another way. The. Is the doctor ordering the hip xray to determine if the baby has dislocation of hips? Usually the gluteal fold is a sign of this. S90. The modified Bascom technique was applied, which involved an asymmetric ellipse-like, gluteal fat–preserving excision of the affected skin, the pilonidal sinus, and lateral tracts, a thick skin and fat tongue of tissue mobilization, and finally, complete lateralization of wound closure and flattening of midgluteal groove. 0 Bilateral Incomplete cleft lip 749. Block, MD, FAAP, is Professor of Clinical Pediatrics, University of Louisville, and University of Kentucky, Lexington, KY; President, Kentucky Pediatric and. o Cleft lip – Refer to ear,. A review of 5 cases described a characteristic clinical presentation of a butterfly-shaped bilateral gluteal cleft lesion on most patients. 1 An occult spinal dysraphism (OSD) is covered by normal or near-normal skin, usually delaying diagnosis of OSDs compared with the more obvious open spinal defects. Elimination Disorders May 3, 2012 Napatia Tronshaw, MD Child and Adolescent Fellow University of Illinois at Chicago Institute of Juvenile ResearchIntertrigo in babies requires special care because the affected skin area is so delicate. This was the first year ICD-10-CM was implemented into the HIPAA code set. Common conditions on the differential diagnosis for plaque psoriasis include atopic dermatitis, nummular dermatitis, lichen. 41 - other international versions of ICD-10 Z89. Y shaped gluteal waiting for scan. 13 Q36. 4). 2024 ICD-10-CM Range M00-M99. Study with Quizlet and memorize flashcards containing terms like Weigert Meyer Law?, 1. Hip ClickNeural Tube Defect (NTD) Definition. A lump of the lower back. Oblique, paramedian, gluteal, or anterior approaches can occasionally be advantageous [1, 8, 9]. Because of low specificity, asymmetric thigh/gluteal folds should be interpreted with caution if findings on examination are otherwise normal. I can not find anything in the ICD-9 book that even comes close. Thigh folds that are asymmetrical rarely indicate hip dysplasia unless they are associated with uneven gluteal creases. ) (gestational age 40 weeks, birth weight 3460 g, length 54 cm) The female patient was transferred for spinal sonography at the age of 5 days due to an asymmetrical gluteal crease. Uroflow curve patterns. Spinal dysraphism should be suspected in infants with a lower midline back lesion such as a subcutaneous mass, dermal vascular malformation, hypertrichosis, a midline dimple or sinus tract, a skin tag, or an asymmetric gluteal cleft. 156 Other ear, nose, mouth and throat diagnoses without cc/mcc. See also[edit] Gluteal asymmetry: CM ends at L2-3: Not performed: None: Male/11. Neural tube defects are among the most common forms of birth defect, affecting 1 in every 1,000 pregnancies. This is the American ICD-10-CM version of L05. Lumbar spine XR was obtained in the office, which revealed incidental occult spina bifida at the L5 level (Figure 1). L05. caudal) not cephalically (i. 91 may differ. P. Since the anterior and posterior neuropores close last, they are the most vulnerable to defects. Small area of atrophic skin and cuta-neous appendage. A sacral dimple can be a sign of a serious spinal problem in a newborn if the dimple is large or appears near a tuft. A neonate Caucasian girl, a product of an uncomplicated pregnancy, was found to have asymmetric gluteal crease. A neonate Caucasian girl, a product of an uncomplicated pregnancy, was found to have asymmetric gluteal crease. 4 may differ. These anomalies occur in 4% of newborns 1 with fewer than half prompting medical concern. Remove the tibia and fibula. The two principal techniques are those elaborated in 1973 by the Greek surgeon George Karydakis and in 1987 by the American John Bascom. For example, low-set ears can be a sign of Turner syndrome or trisomy 18 or 21. This is the American ICD-10-CM version of Q65. Supplementing this, MRI offers an in-depth exploration of these conditions, aiding in preoperative. Postoperative wound-healing infections were described in 8. asymmetrical skinfolds at the neck b. Origin. Babies with congenital hip dislocation can also have asymmetrical gluteal folds. F. Symptoms are usually minimal, but mild to severe itching may occur. Menu. Physical therapy including core strengthening and aggressive hamstring stretching significantly improved the patient’s symptoms and functional mobility. Asymmetric Y-shaped gluteal cleft that is moderately associated with spinal dysraphism except if present with other lesions. 9 Bilateral Complete cleft lip 749. The 2024 edition of ICD-10-CM Q82. However, the vertebral defects may occur in association with other more severe anomalies of the spinal cord and sacral structures, such as split spinal cord malformation or various cavitary defects of the spinal cord. High-quality integration of care. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2-7. 1 The latter name, although. Asymmetric forked gluteal cleft is a condition in which the two sides of the buttocks form a V-shape, rather than a U-shape. The 2024 edition of ICD-10-CM Q83. Other names. The superior tip of the intergluteal. 0 Central cleft lip 749. Results: The most common LsCMs were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). Asymmetric gluteal cleft; High arched foot or feet; Hammer toes or claw toes; Discrepancy in leg muscle size, and strength (typically at the ankle) Gait abnormality, especially in older children; Absent perineal sensation; Diminished rectal tone; Majority of children evaluated in the neonatal period have perfectly normal neurologic examination. 819A became effective on October 1, 2023. Asymmetrical buttock creases can suggest hip dysplasia in infants but, like a hip click, an ultrasound or x-ray study will need to be done to determine whether the hips are normal or not. The goal of this procedure is to completely eliminate the gluteal cleft in the diseased area. Enuresis Enuresis Is the medical name for not being able to control your pee ,Sometimes enuresis is also calledDimple within a symmetric gluteal crease AND less than · Coccygeal position 5mm in diameter WITH no other associated cutaneous · Dimple base orientation to caudal coccygeal cartilage in abnormalities ultrasound · No associated mass Associated Cutaneous Abnormalities · Localized in cranial gluteal cleft Midline capillary hemangioma. A cutaneous lower midline back lesion such as a subcutaneous mass, dermal vascular malformation, hypertrichosis, a midline dimple or sinus tract, a skin tag or an asymmetric gluteal cleft can be detected in 90% of affected individuals . Hard to tell from pic though. asymmetric or atrophic labia majora Absent labia minora Vaginal duplication or atresia Uterine cavity duplication Undescended testis(es)Gluteal cleft synonyms, Gluteal cleft pronunciation, Gluteal cleft translation, English dictionary definition of Gluteal cleft. tethered cord. In our study, the infants with other physical findings but without ASM were more frequently diagnosed as DDH (28. INTRODUCTION. The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). the right of the gluteal cleft. The back must be examined for cutaneous lesions or an asymmetric gluteal cleft, which can indicate the presence of an occult spinal dysraphism. 1 author. Voiding diary • 1 week or more Physical exam • Gait – evidence of a subtle neurologic deficit • Flanks and abdomen – masses? enlarged bladder? • Lower back - cutaneous lesions? asymmetric gluteal cleft? Urinalysis • Specific gravity and urinary glucose level • Infection or blood in the urine? Thiedke CC. 120 Q36. Most sacral dimples are harmless and don't need treatment. C. closed spina bifida lesion: asymmetric gluteal fold or dimple, hemangioma, hairy patch, or other cutaneous markings; bulging fontanelle; rapid head growth; abnormal urinary voiding; leakage of meconium or stool; midline congenital anomalies: cleft lip or palate, cardiac murmur; arching of neckPerianal candidal intertrigo presents as soreness and irritation with bright red erythema and satellite lesions extending into the natal cleft. 8) GLUTEAL CLEFT DEVIATION • Minimal physiologic asymmetry to significant deviation with associated asymmetric glutes • Among the patients undergoing screening for OSD , upto 8% had asymmetric gluteal cleft deviation and 7% presented with Y shaped gluteal cleft • Unclear about the significance of an isolated deviated. Gluteal asymmetry: CM ends at L2-3: Not performed: None: Male/11. coccygeal pit, simple sacral. 2011 Mar;32 (3):109-13. a birthmark in the area. About 50% of patients with nail psoriasis complain of pain, stiffness or swelling of the interphalangeal joint in the absence of a diagnosis of arthropathy, which could suggest the early stage of PsA [ 7 ]. 4. 8. Asymmetry. degrees asymmetric compared with the unaffected side), leg length discrepancy, or asymmetric thigh/gluteal folds. A clearly visible unruptured thoracic meningocele, thoracolumbar myelomeningocele, and. stain, skin appendage, or asymmetric gluteal cleft should be investigated radiographically with ultrasound or MRI for underlying spinal cord abnormalities such as spinal dysra-phism and spinal cord tethering,1 even in cases without neurologic symptoms. The distinctive anatomic and radiologic features are discussed. ”. Histology showed a benign intradermal naevus. 9 is the only thing I can come up with and I am afraid that is to broad for insurance to pay. The gluteal sulcus is formed by the posterior horizontal skin crease of the hip joint and. Of the 47 patients, 16 (34%) were toilet trained at initial evaluation and 15 (32%) were toilet trained during follow-up. Applicable To. High-risk lesions are described as hypertrichosis, infantile hematoma, limited dorsal myeloschisis, dermal sinus track, subcutaneous lipoma, caudal appendage, midline pedunculated swelling, and sacral. Youssef, Seth W. An asymmetric gluteal cleft. Hydrocolpos 7. Palmar adduction ("cortical" thumb) in a normal infant. Hemihypertrophy and Beckwith-Wiedemann syndrome are associated with an increased risk of Wilms tumor. METHODS: Among the 72 male military service patients (median age,. Spinal sonography is the imaging modality of choice in the neonatal period for the diagnosis of spinalAn 18-month-old child had a surgical repair of a cleft palate and is now allowed to eat a regular diet. Abb. This is the American ICD-10-CM version of N63. 810A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. View Enuresis-WPS Office. The following code (s) above M31. We would like to show you a description here but the site won’t allow us. Introduction Spinal dysraphism is a group of diverse conditions that have variable imaging patterns. Fat stranding can be seen throughout the body. a. 49. Answer: Sacaral dimple. 8 cases per 1000 live births. occulta • Other findings concerning for a spinal cord abnormality are o conspicuous patch of hair. There are several names for this area: natal cleft, gluteal crease, gluteal crevice. It is the deep furrow or groove that lies. . An inconspicious examination does not need a further imaging, but suspicious results of sonography need an MR imaging dependent of clinical conditions. He presented with a verrucous wart-like midline mass on the superior gluteal cleft that had grown since his last resection. Applicable To. Neural tube defects are congenital anomalies of neural development with a spectrum of clinical manifestations; they can affect the cranium or spine. 7 ). Asymmetrical gluteal folds. The 2024 edition of ICD-10-CM N63. L30. This can cause problems starting around age 2-3 (potty training age) is when parents start to see some signs. Based on your photo, it looks like it could be improved with surgery. It is also called butt crack or ass crack. Epigastric mass; Epigastric swelling, mass. A recent meta-analysis of 6,143 studies by Stauffer et al. 810A became effective on October 1, 2023. Unspecified open wound of right buttock, initial encounter. Pediatrics. Psoriasis frequently affects the scalp, extensor surfaces of the elbows and knees, umbilicus, and the gluteal cleft. Normal neurological examination. In very mild cases, such as isolated. Oct 16, 2008 #3 Here, this link may help you. 2020 Nov; 47 (11):1050-1053 Epub 2020 Sept 10 View PubMed The modified Bascom technique was applied, which involved an asymmetric ellipse-like, gluteal fat-preserving excision of the affected skin, the pilonidal sinus, and lateral tracts, a thick skin and fat tongue of tissue mobilization, and finally, complete lateralization of wound closure and flattening of midgluteal groove. The infra-gluteal fold is the preferred donor site because the dermis is thick, and the fat tissue is more compact compared with the inguinal region. Definition. This is caused by an abnormal development of the muscles in the buttocks, often due to muscular dystrophy or other conditions. What causes asymmetric gluteal cleft? The asymmetric gluteal cleft may also associated with a condition named hip dysplasia. Base of dimple is visible. Q82. 100 749. Acral localized acquired cutis laxa as presenting sign of underlying systemic amyloidosis. < 5 mm diameter. View article titled, Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft Open the PDF for in another window Topics: congenital. 1 – 6 These clinics allow for coordination of care and complex decision making amongst providers caring for patients with open spina bifida. Pathology showed squamous cell carcinoma with tumor-free margins, and further imaging showed no evidence of. OBJECTIVE. Asymmetric or malformed Gluteal cleft. M26. FIG. Distance < 2. A fissure on gluteal cleft is a linear breakage of about 1 to 2 inch. Abb. 0 is for breech delivery and extraction of newborn. A 71-year-old woman with no relevant medical history presented with recurrent painful erosions on the gingivae and gluteal cleft of 1 year’s duration. Pilonidal disease refers to a subcutaneous infection occurring in the upper half of the gluteal cleft. Start studying Exam 4. N63. 6 became effective on October 1, 2023. The cephalad apex of that island comes to a gentle point 1 to 2 cm above the natal cleft (to avoid a divot when closed) in the midline or 1 to 2 cm off to the side of the excision. The authors believe that asymmetric gluteal folds are an important finding suggesting hip dysplasia in infants and further studies such as ultrasound or simple. The medullary conus. 02 [convert to ICD-9-CM] Gluteal tendinitis, left hip. 4. DX? dmaec True Blue. CONCLUSION. Common triggers include trauma, infection, and certain medications. Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft. A step-by-step drawing of the surgical process. Note asymmetric distribution of this scaly plaque that extended from tinea cruris in this. A dimple above the gluteal crease (the crease in the buttocks) Long hair (longer than 1 inch) growing on the back over the spine. Demet Demircioğlu . 5 cm above the anus or proximate to the coccyx, and deviated gluteal folds (DGF) including all types of folds (bifid and split symmetrical without underlying. A sacral dimple is a small dent or depression in your child’s lower back near the crease of their buttocks. g. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis (inflammation of the skin). Spine ultrasound at 1 day of age showed a cystic mass overlying the conofilar junction at the L3 level measuring 12 × 5 × 5 mm (Fig. The nurse teaches the mother of a toddler who has had cleft palate repair that her child is at risk for developing which problem in the future? a speech defect poor self. Liposuction and/or surgical. Spina bifida is a type of neural tube defect (NTD) characterized by a defect in the spinal column due to inadequate closure of bones of the vertebral column. You Selected: asymmetric gluteal folds Correct response: asymmetric gluteal folds. COMPARISON OF KARYDAKIS TECHNIQUE WITH LIMBERG FLAP PROCEDURE FOR SACROCOCCYGEAL PILONIDAL SINUS DISEASE IN TERMS OF HOSPITAL STAY AND WORK LOSSof the spinal cord, the anterior and posterior nerve roots and the cauda equina. Laterality will need to be indicated another way. 411A may differ. The dermofat graft is harvested with a fusiform shape from the infra-gluteal fold or inguinal region. Creation of an infra gluteal fold is done in the same fashion as the medial thigh tuck first described by Ted Lockwood, M. A sacral dimple. [Billable] [POA Exempt] There's more to see -- the rest of this topic is available only to subscribers. I can’t help but worry!!! 0. The right gluteal crease is lower than the left. 01 - other international versions of ICD-10 M76. Deviated gluteal creases varied in appearance from S-shaped to mostly straight with a superior angulation. The only significant finding in that area would be a sacral dimple that is deep and that might need investigating for a condition known as spina bifida occulta. 0 Central cleft lip 749. Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft. The gluteal crease was asymmetrical due to a subcutaneous mass. received a first dose of the Hep. Small area of atrophic skin and cuta-neous appendage. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Q30. Each referred participant was risk stratified based on specific physical exam findings. Urinalysis is performed to assess. 8 is a billable ICD code used to specify a diagnosis of other specified congenital malformations of skin. A complete work-up should include. the region of the cauda equina with extension to the spinal. 8 is considered exempt from POA reporting. Typical dimples are found at the skin on the lower back near the buttocks crease. Manifestations of occult spinal dysraphism Cutaneous stigmata Orthopedic deformities Urologic problems Asymmetric gluteal cleft Foot or leg deformities Neurogenic bladder Capillary. 411A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Of the 47 patients, 16 (34%) were toilet trained at initial evaluation and 15 (32%) were toilet trained during follow-up. It has been estimated that atrophy of the paraspinal muscles occurs in 20%-60% of people suffering with chronic lower back pain. It is cost. 1. The superior gluteal nerve is found in the lower pelvis and arises from the dorsal divisions of the L4, L5, and S1 nerve roots of the sacral plexus. ” Early IADDeep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Spinal sonography showed a subcutaneous echogenic mass in. convex lumbar curve d. 412A may differ. Neurologically, she was alert but could not move all the key muscle groups of her lower extremities. Methods: Lower body lift excision patterns were classified based on their relationship to the gluteal cleft. 810A became effective on October 1, 2023. Spinal sonography showed a subcutaneous echogenic mass which extended into the spinal canal in continuity with the Fig. D. Asymmetric gluteal cleft. Colloquially the intergluteal cleft is known as bum crack(UK) or butt crack(US). and falls within the superior portion or just above the gluteal cleft, and/or is associated with other cutaneous markers for neural tube defects, the infant is more likely to have an. Lower back- cutaneous signs of occult spinal dysraphism, asymmetrical gluteal cleft, lipoma, presacral dimple, hair patch, Neuro- gait, lower extremity strength, fine motor coordination. However, the variants of psoriasis and atypical cases may present more diagnostic difficulty. Dear Genius39459, it is hard to tell for sure without an examination. Code Tree. 2. Fat stranding is an important finding that alerts the radiologist to an abnormality. 115 Other randomized data including both de novo and recurrent. 13 Q36. The condition, which has an annual. 8 became effective on October 1, 2023. Gluteal asymmetry: CM ends at L2-3: N/A: No clinical TCS: Male/8. This is the American ICD-10-CM version of M76. Depending on the type of incontinence, the management strategies can include behavioral, pharmacologic, and/or surgical approaches. Pediatrician said she wasn’t worried at all since she has good leg movement and stuff, but she’ll keep an eye on it. View article titled, Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft Open the PDF for in another window Topics: congenital abnormality , cysts , magnetic resonance imaging , salmon patch , skin manifestations FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. At 2 week app pediatrician said baby has a y shaped butt crack which could be a indicator of spina bifida or tethered cord. They are the second most common congenital disability after congenital heart defects [ 1 ]. Synonyms: able to sit with support, unable to sit. abnormal caudal fixation of the spinal cord. This is the American ICD-10-CM version of S90. a patch of hair by the dimple. A crooked crease between the buttocks. These lesions often signify an underlying bony and/or spinal cord malformation. About us; DMCA / Copyright Policy; Privacy Policy; Terms of ServiceThe gluteal cleft was asymmetrical. mbort True Blue. Motor function is generally more affected than sensory function and is correlated with the level of spinal aplasia. These lesions include a subcutaneous mass, dermal vascular malformation, hypertrichosis, a midline dimple or sinus tract, a skin tag or an asymmetric gluteal cleft. Q82. Thanks, Angela Thomas, CPC. Congenital sacral dimple. The gluteal cleft is an anatomical characteristic found in both males and females. Patients with myelomeningocele are categorized based on the spinal segment affected. Q30. swelling in the area. There was an asymmetrical gluteal cleft and two obvious dimples above the gluteal cleft (Fig. 1. A pilonidal cyst is a cyst-like structure that develops in the upper portion of the crease between the buttocks. The purpose of this study was to illustrate the spectrum of solitary gluteal lesions in children. 011 Tracheostomy for face, mouth and neck. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks).