Fig. 3

Four-month-old male infant presented with ARM, lower back cystic swelling, and lower limb anomalies. A Plain AP radiograph of pelvis showing pronounced structural skeletal caudal defect in the form of hypoplastic left iliac and ischial bones, absent femur on left side with only femoral head and neck visualized on right side. B Axial T2WI showing dilated central canal (thin black arrow) within a dilated subarachnoid space herniating outside confines of spinal canal (thick black arrow) through defect in posterior element of S1 vertebra. Note also ectopic location of left testis in left aspect of anterior pelvic wall (white arrow) which corresponds to diffusion restriction seen in C. D Catheterization of single opening in upper perineum discharging urine revealed contrast opacification of distal bowel rectal loop with non-visualized urinary bladder in keeping with rectourethral fistula. E Panoramic sagittal USG image showing tethered cord with herniating dilated central canal (thin white arrow) within a meningocele (thick white arrow) through defect in upper sacral vertebra giving cyst within cyst appearance. Type of spinal dysraphism: Terminal myelocystocele