1 Department of Pediatrics, Children's Hospital 226 East Chestnut St., Louisville, Kentucky 40202
I must agree with Dr. Shaw that the term pilonidal sinus, like so many medical terms in common use, is an unwanted legacy of former days. I used it only because its meaning is generally understood, and I cannot believe that a term such as presacral sinus, which Dr. Shaw uses to describe a lesion lying posterior to the sacrum, is any less inaccurate or misleading.
As for the evidence presented in the case report, I was at great pains to point out that there could be proof of the diagnosis without biopsy; but I contest his implied assumption that such a diagnosis cannot be made on clinical and anatomical grounds alone.