The value of radiography, ultrasound and magnetic resonance imaging (M
RI) in detecting skeletal and intraspinal pathology was assessed in in
fants with anorectal malformations, and the need for spinal MRI examin
ation in this group of patients was evaluated. Twenty-one infants were
examined with radiography, ultrasound and MRI of the lower spine, The
detection of skeletal and intraspinal abnormalities was compared for
the three imaging modalities. Fifteen patients were normal in all thre
e examinations. Radiography showed bony skeletal abnormalities in six
children, although sometimes very subtle. By ultrasound both bony and
cartilaginous malformations were detected in all six patients and by M
RI in five patients. Five of the six children with skeletal abnormalit
ies had intraspinal pathology, detected in all cases by ultrasound and
MRI. However, the abnormalities were more clearly demonstrated by MRI
than by ultrasound. Spinal radiographs must be examined carefully for
abnormalities, because they can indicate the presence or absence of i
ntraspinal pathology. Normal radiographic and sonographic appearance o
f spinal anatomy in children with anorectal malformation makes MRI sup
erfluous, but if radiographs or ultrasound are abnormal, MRI should be
used to accurately depict possible intraspinal pathology.