Minimal Spinal Dysraphism vs. Meningocele
Left picture: This newborn has a minimal spinal dysraphism with a lipoma which is recognizable from the outside. Right picture: In this case a meningocele is present. For the differentiation of the two lesions which look similar, the presence or absence of neurological signs are useful, e.g. an asymmetry in the structure of the muscles of the extremities, in adddition to the somewhat different local findings. Left picture: The former signs are recognizable on the buttocks. Right picture: Here, neurological deficits are missing. Although in lipoma of the back, isolated forms also occur without a relation to the spine and the spinal channel, a minimal spinal dysraphism must be first excluded by means of radiological imaging (MRI) prior to excision of such a lipoma.
Left picture: A roundish mass is visible over the sacrum; the surface of the skin displays a skin retraction. The shape and the size of the buttocks are asymmetrical. Right picture: The roundish mass over the sacrum is spherical and tight and cystic on palpation. Left picture: This mass is solid and smooth.