Currarino Triad

HomeRadioGraphicsVol. 45, No. 9 PreviousNext Cases from the Cooky JarFree AccessCurrarino TriadKamyar Ghabili1 , Mohamed Badawy2, Rui Dai3, Irene Dixe de Oliveira Santo4, Yashant Aswani5Kamyar Ghabili1 , Mohamed Badawy2, Rui Dai3, Irene Dixe de Oliveira Santo4, Yashant Aswani5Author Affiliations1Department of Radiology, Penn State Health Milton S. Hershey Medical Center, 500 University Dr, Hershey, PA 170332Department of Radiology, Emory University School of Medicine, Atlanta, Ga3Department of Radiology, Massachusetts General Hospital, Boston, Mass4Department of Neuroradiology, New York Presbyterian–Weill Cornell Medical Center, New York, NY5Department of Radiology, University of Iowa Health Care, Iowa City, IowaAddress correspondence to: K.G. (email: [email protected], [email protected]).Kamyar Ghabili1 Mohamed Badawy2Rui Dai3Irene Dixe de Oliveira Santo4Yashant Aswani5Published Online:Aug 21 2025https://doi.org/10.1148/rg.250124MoreSectionsPDF ToolsAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookXLinked In Currarino triad, first described by Kennedy but later clarified as a unique complex of congenital caudal anomalies by Currarino, is also known as the ASP triad and comprises anorectal malformation, sacral osseous defect, and presacral mass (1) (Fig 1). Among these, the presacral mass is a critical component that differentiates Currarino triad from caudal regression syndrome. Anterior sacral meningocele is the most common presacral mass, but teratoma, enteric cyst, dermoid or epidermoid cysts, lipoma, hamartoma, rectal duplication cyst, or any combination of these may be present (1,2).Figure 1. Illustration shows the classic Currarino triad of anorectal malformation, sacrococcygeal defect, and presacral mass.Figure 1.Download as PowerPoint Anorectal malformations range from relatively simple anorectal stenosis to more complex presentations, such as imperforate anus or fistulas (rectoperineal, rectovaginal, retrovestibular, or rectourethral fistulas) (2). The sacral osseous defect, present in all cases, typically manifests as a hemisacrum with a preserved S1 vertebra (scimitar sacrum), although malsegmentation may also occur (3). Sacrococcygeal defects can be identified at radiography, CT, or MRI. Both CT and MRI can demonstrate the presacral mass, such as a meningocele showing communication with the spinal canal (Fig 2), while a teratoma displays fat components (4). Additionally, MRI is essential for surgical planning (5).Figure 2. Currarino triad in a 35-year-old woman with a history of imperforate anus who presented with pelvic fullness. (A) Longitudinal pelvic US image demonstrates a well-defined anechoic lesion (*) showing communication with the spinal canal (arrow). (B) Anteroposterior pelvic radiograph shows a sacrococcygeal osseous defect, appearing as a hemisacrum with a scimitar-shaped configuration (arrows). Of note, the S1 vertebral body is well preserved. (C, D) Axial (C) and sagittal (D) T2-weighted MR images of the pelvis show a well-defined, hyperintense, presacral cystic mass (*) communicating with the spinal canal (arrows), consistent with an anterior sacral meningocele.Figure 2.Download as PowerPoint Management comprises anorectal reconstruction and resection of the presacral mass to prevent complications, including rupture and malignant transformation (6).Disclosures of conflicts of interest: The authors, editor, and reviewers have disclosed no relevant relationships.References1. Kocaoglu M, Frush DP. Pediatric presacral masses. RadioGraphics 2006;26(3):833–857. Google Scholar2. Magudia K, Menias CO, Bhalla S, Katabathina VS, Craig JW, Hammer MM. Unusual imaging findings associated with germ cell tumors. RadioGraphics 2019;39(4):1019–1035. Google Scholar3. Gill KG. Congenital musculoskeletal anomalies: key radiographic findings. Pediatr Radiol 2022;52(4):777–785. Medline Google Scholar4. Lee JK, Towbin AJ. Currarino syndrome and the effect of a large anterior sacral meningocele on distal colostogram in an anorectal malformation. J Radiol Case Rep 2016;10(6):16–21. Medline Google Scholar5. Caro-Domínguez P, Bass J, Hurteau-Miller J. Currarino syndrome in a fetus, infant, child, and adolescent: spectrum of clinical presentations and imaging findings. Can Assoc Radiol J 2017;68(1):90–95. Medline Google Scholar6. AbouZeid AA, Mohammad SA, Abolfotoh M, Radwan AB, Ismail MME, Hassan TA. The Currarino triad: what pediatric surgeons need to know. J Pediatr Surg 2017;52(8):1260–1268. Medline Google ScholarArticle HistoryReceived: May 12 2025Accepted: May 19 2025Published online: Aug 21 2025 FiguresReferencesRelatedDetails Vol. 45, No. 9 Metrics Altmetric Score PDF download