Brief Answer:
There is no harm in waiting.
Detailed Answer:
Dear XXXX,
Thanks very much for your direct query to me. I have gone through the question carefully. It appears that the first recommendation by her
pediatrician was right on, i.e. any mole or abnormality at the base of the spine needs further evaluation to rule out cord involvement.
While an
ultrasound examination of an organ such as the
spinal cord or the brain can be extremely informative in small infants, it is also true that an investigation such as a
Magnetic Resonance Imaging (MRI) is much more informative as it delineates with more detail the morphology and anatomical detail of these organs. It can differentiate between grey and
white matter abnormalities of the brain, for example, which an ultrasound cannot.
I must also point out that, essentially, while a computed
tomography scan (CT scan) exposes the patient to
radiation, an MRI is free from this side-effect as it does not radiate any waves, rather, it picks up the magnetic vibrations of your cells and transforms this into anatomical images. Hence, if your fear is connected to this particular concern, you may rest easy. Your daughter will not suffer any harmful effects even if the MRI is carried out.
This being said, I am happy to learn from you that your little one is doing well at present. If she has no movement problems in her legs, and she seems otherwise normal, you may be correct in waiting this out for a longer time - say another 2-3 months before taking a call. Remember also that spinal cord problems are often associated with brain abnormalities in such situations. This can be anything from a slight fluid collection inside her brain to large-scale fluid collections that can impinge on her growth and development. Hence, you should continue her follow-ups with the pediatrician and continue to monitor her development and head size over the next 3 months. If nothing abnormal ensues, then perhaps you are out of the woods and an MRI may not be needed.
This is as far as your first question is concerned. Coming now to the second question that you have posed at the end, I am not sure what it might be. Remember, this site allows you to upload pictures or reports, so, please take a picture with a good camera and send it to me and I will answer this to the best of my ability on the rebound.
Thank you so much, once again. I will await your reactions and your child's toe image for answer to the second query from you.
Until then,
Dr. Taher