What is the anatomical location of the gluteal cuff?

Anatomical Location of the Gluteal Cleft

The gluteal cleft is the vertical groove or furrow that runs between the two buttocks, extending from the sacrum superiorly down to the perineum inferiorly. 1

Precise Anatomical Boundaries

The gluteal cleft has specific anatomical landmarks that define its location:

• Superior boundary: The cleft begins at the level of the sacrum, just below the lower back 1
• Inferior boundary: It extends downward to the anterior perineum 1
• Lateral boundaries: The cleft is formed by the medial surfaces of the two gluteal (buttock) masses on either side 1

Clinical Significance of the "Tops of the Gluteal Cleft"

An important clinical landmark involves drawing an imaginary line between the tops of the two "forks" of the gluteal cleft (where the cleft bifurcates superiorly):

• Any dimple or skin finding at or below this line is typically normal and located within the gluteal cleft proper 1
• Any dimple or skin finding above this line is abnormal and located on the flat portion of the sacrum, cranial to the gluteal cleft 1

This distinction is critical because innocent coccygeal dimples lie within a centimeter of the coccyx within the gluteal cleft itself, whereas pathologic dermal sinus tracts are located cranial to (above) the gluteal cleft on the flat sacral surface 1

Relationship to Surrounding Structures

The gluteal cleft is distinct from adjacent anatomical regions:

• It lies inferior to the lower back/buttocks region, which extends from the inferior margin of the rib cage down to the inferior gluteal fold 1
• The inferior gluteal fold (the crease beneath each buttock) is a separate structure from the gluteal cleft itself 1