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What does a tiny blood blister underneath the big toe indicate?

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Practicing since : 1982
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Hi, I have a 7week old baby girl. She was born with a small stork bite birthmark above her buttocks on the sacrum area. Her pedrtrician wanted to do an MRI at 5 weeks of age to rule out a tethered spine.I pushed for an ultrasound of the spine at 3 weeks of age and the radiologist found the spine to be normal. Should I still worry? She acts normal, lots of movement in her leg, regular bowels. She also has a tiny blood blister underneath her big toe. What might that be?
Posted Sat, 15 Feb 2014 in Child Health
Answered by Dr. Taher Kagalwala 5 hours later
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
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Follow-up: What does a tiny blood blister underneath the big toe indicate? 7 hours later
Thank you so much for your through explanation. Here is a pic of her foot. To me it looks like a blood blister.
Answered by Dr. Taher Kagalwala 39 hours later
Brief Answer: This is similar to a stork bite. Detailed Answer: This is a newborn mole, not a blood blister. You may safely leave it alone ... it might fade off over the next 6-12 months. There is no risk of bleeding unless the skin gets cut with an injury. Hope this helps. With best wishes, Dr. Taher. Do recommend me to your friends and colleagues.
Above answer was peer-reviewed by
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