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Generate impression based on findings.
71 years, Male. Reason: ngt placement History: failed swallow evaluation Dobbhoff tube tip projects over the gastric fundus. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view..Median sternotomy wires are noted.
Dobbhoff tube tip projects over the gastric fundus.
Generate impression based on findings.
Female 63 years old Reason: assess for trombosis History: transaminitis, hyperbilirubinemia, h/o hep C LIMITED ABDOMENLIVER: The liver has a nodular contour with widened fissures. Liver measures 12 cm in length. The parenchyma is severely coarse and echogenic. No suspicious hepatic lesions. BILIARY TRACT: The gallbladd...
1.Cirrhotic liver with patent vasculature.
Generate impression based on findings.
Ms. Hernandez is a 43 year old female with a personal history of recent right cyst aspiration in February 2014. No current breast related complaints. Three standard views of both breasts with one left spot compression view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is hetero...
Simple cysts in the left breast. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in one year to confirm stability of these findings. Results and recommendation were discussed with the patient.BIRADS: 2 - B...
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Female 49 years old; Reason: s/p ORIF right femur supracondylar fx, evaluate for healing Two views of the right femur demonstrate a plate and screw device affixing the distal femoral fracture in near anatomic alignment. A small amount of periosteal reaction adjacent to the fracture is indicative of some interval healin...
Orthopedic fixation of a healing distal femoral fracture.
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Known fracture, prior to cast removal. Evaluation of osseous detail is limited by overlying cast material. Three views of the right wrist demonstrate mild deformity of the distal radius. The fracture line appears less distinct, indicative of some interval healing. There is associated positive ulnar variance. The mildly...
Distal radial and ulnar fractures, as above.
Generate impression based on findings.
58-year-old male with left knee pain. Four views of the right knee show mild medial joint space narrowing and mild osteophyte formation. No joint effusion. No evidence of a fracture or dislocation.Four views of the left knee show mild medial joint space narrowing and mild osteophyte formation. No joint effusion. No evi...
Mild osteoarthritic changes of the knees without fracture or dislocation.
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35 years, Female. Reason: assess for obstruction History: h/o ventral hernia and abscess, now constipated Surgical clips and hardware are seen in the mid abdomen. Relative paucity of bowel gas.
Nonspecific bowel gas pattern.
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7 year old female with posterior neck pain status post motor vehicle accident.VIEWS: AP and Lateral (Two views) of the C1-T1 There is no evidence of prevertebral soft tissue thickening, fracture or malalignment. Vertebral disk space is within normal limits. There is no evidence of tracheal deviation. There is straighte...
Normal examination. There are no findings to explain the patient's symptoms.
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71 years, Male. Reason: Dobbhoff placement History: myasthenia Median sternotomy wires are again noted. Dobbhoff tube tip with guidewire projects over the gastric body. The tip of the tube may be kinked. Left greater than right lung base opacities and left pleural effusion.Nonobstructive bowel gas pattern. Note that th...
Dobbhoff tube tip projects over the gastric body and may be kinked.
Generate impression based on findings.
Swelling and tenderness of the left foot.VIEWS: Left foot AP, lateral and oblique on 2/9/15 (3 views) Improvement in osseous changes related to rickets. Soft tissue swelling with no fracture or malalignment.
Soft tissue swelling with no fracture or malalignment.
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17-year-old male with bumps of the right foot in a history of osteosarcoma of the right calcaneus. Left foot: Again seen are postoperative changes of calcaneal osteosarcoma resection and bone graft affixed with two screws. Surgical clips are again seen in the soft tissues. No evidence of recurrence or residual tumor. N...
Postsurgical changes from calcaneal osteosarcoma resection and reconstruction without interval change. Normal left foot.
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Right base of thumb pain Moderate osteoarthritis affects the first carpometacarpal joint. Mild osteoarthritis affects the IP joints.
Osteoarthritis, as above.
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Female 26 years old; Reason: left thumb metacarpal giant cell tumor, s/p excision and autograft ICBG reconstruction, evaluate for recurrence Three views of the left hand demonstrate bone graft material occupying most of the first metacarpal. Focal lucency at the lateral aspect of the bone graft, along with new angulati...
Post operative changes of the first metacarpal and slightly angulated fracture, as above.
Generate impression based on findings.
Or abdominal pain on the right lower abdominal quadrant.VIEW: Abdomen AP (one view) 2/9/15 1442 hrs. Right lower abdominal quadrant and pelvic surgical clips are noted. No specific abdominal gas pattern. No evidence of free air, ascites or obstruction.
No evidence of free air.
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Reason: 72 y.o.Male with HPT History: HPT There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield units through nodules (0seconds, 25 seconds, 55 seconds, 85 seconds...
1.No parathyroid adenoma is clearly appreciated. The thyroid beds are obscured by metal artifact. As a result a parathyroid adenoma in the thyroid bed may be obscured by metal artifact.2.Localization on PTH was via the innominate vein junction3.Status post thyroid surgery4.Multilevel degenerative changes are present in...
Generate impression based on findings.
There is mild nasal septal deviation to the left with a prominent left sided nasal septal bony spur impinging on the left middle nasal turbinate. There is a minimally displaced left nasal bone fracture, and minimal nondisplaced right nasal bone deformity with mild inward bowing. There is no overlying soft tissue swell...
1.Minimally displaced left and nondisplaced right nasal bone fractures.2.Mild leftward nasal septal deviation with prominent left nasal bony spur impinging on the left middle nasal turbinate.
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Reason: s/p crani History: ha The patient is status post recent left parietal craniotomy for removal of an extra-axial mass. There are air bubbles present at the prior tumor bed site. There is some subdural air are present at the craniotomy site. Surgical clips are present along the scalp tissues.The visualized portion...
1.Status post left-sided parietal craniotomy for removal of an extra-axial mass previously adjacent to the left paracentral lobule. There are postoperative changes present. No intraparenchymal hemorrhage is appreciated.
Generate impression based on findings.
Female 55 years old; Chronic arthralgias of hands, +CCP. RIGHT HAND: Minimal osteoarthritis affects the DIP joints. We see no erosions or specific radiographic features of rheumatoid arthritis.LEFT HAND: Minimal osteoarthritis affects the DIP joints. We see no erosions or specific radiographic features of rheumatoid ar...
Minimal osteoarthritic changes and other findings as described above. No specific radiographic features of rheumatoid arthritis.
Generate impression based on findings.
A right frontal approach ventriculostomy catheter is present with its tip in the right frontal horn. There is no CT evidence of postprocedural complication. Ventriculomegaly is present involving the lateral, third, and fourth ventricles. There appears to be mass effect within the dilated fourth ventricle displacing ce...
1.A right frontal approach ventriculostomy catheter is present with its tip in the right frontal horn without CT evidence of postprocedural complication. 2.Ventriculomegaly is present involving the lateral, third, and fourth ventricles. There appears to be mass effect within the dilated fourth ventricle displacing cere...
Generate impression based on findings.
69 year old female with a questionable history of osteomyelitis, ulcer and discolored second toe of the left foot. Again seen are a sideplate and screw device affixing a previous distal fibular fracture which is in anatomic alignment. The fracture line is indistinct.Diffuse soft tissue swelling and osteopenia is noted ...
Post fixation of a distal fibular fracture without complications.
Generate impression based on findings.
Reason: 72 y.o. F with HPT History: HPT There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield units through nodules (0seconds, 25 seconds, 55 seconds, 85 seconds):...
1.No parathyroid adenoma is clearly appreciated. The thyroid beds are obscured by metal artifact. As a result a parathyroid adenoma in the thyroid bed may be obscured by metal artifact.2.Localization on PTH was via the innominate vein junction3.Status post thyroid surgery4.Multilevel degenerative changes are present in...
Generate impression based on findings.
Female, 46 years old, with left and right-sided weakness. Assess for stroke. Grey-white differentiation is preserved. No evidence of parenchymal edema or mass effect is detected. Patchy periventricular and basal ganglia hypoattenuation is again seen similar to prior, a nonspecific finding. No evidence of intracranial h...
1. Patchy peri-ventricular and basal ganglia hypoattenuation is seen, similar to the prior examination. This is a nonspecific finding which may reflect age indeterminate microvascular ischemic disease, among other etiologies. Correlation with history and risk factors is suggested.2. Otherwise, no evidence of any acute ...
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Fall. Fracture? There is a complete subcapital fracture of the femoral neck with slight valgus angulation. Hip joint alignment is normal.
Femoral neck fracture as above.
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There are post-surgical findings related to a left parietal mass biopsy. There is interval increase in size of the large intraparenchymal hemorrhage in the left frontoparietal region that measures up to 55 mm, previously 40 mm, with a small amount of associated subarachnoid hemorrhage. There are new scattered smaller ...
1. Post-surgical findings related to left parietal lobe mass biopsy with interval increase in size of extensive intraparenchymal hemorrhage, with new adjacent small foci of hemorrhage and a small amount of subarachnoid hemorrhage in the left frontoparietal region with rightward midline shift measuring 8 mm.2. Unchanged...
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History of treated urachal cancer, now with diffuse metastases. There are numerous areas of increased uptake involving the bilateral ribs, spine, pelvis, bilateral humeri, and proximal femurs. The most prominent lesions involve the left posterior 8th rib, left mid-humerus, and distal right humerus. Degenerative related...
1. Numerous osseous lesions involving the axial and appendicular skeleton compatible with metastatic disease. 2. Prominent left mid-humerus lesion; if the patient complains of focal pain in this region, dedicated radiographs may be considered.
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Reason: Pt with LUL NSCLC s/p radiation, surveillance scan (f/u R nodule). History: Pt with LUL NSCLC s/p radiation, surveillance scan (f/u R nodule). CHEST:LUNGS AND PLEURA: Previously referenced pleural-based left upper lobe mass now measures 2.8 x 2.2 cm (image 53, series 5), previously 3.3 x 2.7 cm. Previously refe...
1.Decrease in size of referenced left upper lobe mass, however increase in size and number of lower lobe nodules compatible with metastatic disease.2.New lytic osseous lesions compatible with metastases.3.New nonspecific hypodense liver lesion is suspicious for metastatic disease.
Generate impression based on findings.
Reason: LLL nodule, s/p non diagnostic CT guided bx. plan for bronch. please do super D protocol History: cough, lung mass LUNGS AND PLEURA: Diffuse pleural calcifications and circumferential left pleural nodular thickening appears similar to the prior exam. A prominent mass along the left major fissure measures up to ...
Planning exam for bronchoscopic biopsy. Circumferential left pleural nodular thickening, a large left lung mass, and mediastinal lymphadenopathy are again seen, similar to the comparison CT exam. Primary lung cancer is suspected, although the appearance and possible intra-fissural location make mesothelioma an addition...
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Female 31 years old; Reason: 31 yo with RLQ tenderness, nausea, emesis, assess for acute appendicitis History: RLQ tenderness, concern for appendicitis ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No signif...
Uncomplicated acute appendicitis.
Generate impression based on findings.
Patient with metastatic breast cancer. Please evaluate for disease status. Increased radiotracer uptake is seen along the midthoracic spine, appearing similar to the prior examination. Faint punctate focus of increased activity overlying the L5 vertebra is unchanged. Increased radiotracer uptake corresponding to the ri...
Unchanged foci of increased radiotracer uptake without new suspicious lesion.
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5-year-old female with crush injury of the left hand, slammed in door. Evaluate for fracture.VIEWS: AP view of Left hand, AP and lateral views of the left fourth finger There is no soft tissue thickening. There is no evidence of fracture. Alignment is normal.
Normal examination.
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There is interval placement of a deep brain stimulator with tip in the region of the left basal ganglia with a small amount of pneumocephalus. There is no evidence of acute intracranial hemorrhage on this limited examination. The ventricles and sulci are normal in size and there is no evidence of midline shift. The pa...
Interval placement of deep brain stimulator with electrode tip in the left basal ganglia, without evidence of acute intracranial hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Urgent change in planned procedure. Laparoscopic median arcuate ligament release. Mesenteric bypass. Retained foreign object policy.VIEW: Abdomen AP (one view) 02/09/15, 1515 and 1517 Feeding tube tip is in stomach. Surgical clips are seen in left upper quadrant. Triangular air collection right upper quadrant is most l...
No unexpected foreign body.These findings were discussed by telephone with Dr. Skelly, the attending surgeon, on 02/09/15 at 1540.
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Female 16 years old Reason: injured Sun, eval for fx History: pain and swellingVIEWS: Left ankle and knee AP, lateral and oblique. 2/9/15 (6 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling.
Normal examination.
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57-year-old with history of cysts. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Interval decrease in bilateral breast masses compatible with involuting ...
Involuting cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Female 15 years old Reason: r/o fracture History: patella medially shifted <1min 2/6/15VIEWS: Left knee AP and bilateral oblique. 2/9//15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling.
Normal examination.
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54 year old female patient with metastatic breast cancer. Evaluate for progression of disease. Again seen is increased uptake of the right anterior chest which may represent post-therapeutic changes. There is redemonstration of increased uptake in the calvarium, thoracolumbar spine, ribs, proximal left humerus, and pro...
No significant change in number or distribution of areas of increased uptake.
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History of metastatic renal cancer on therapy. CHEST:LUNGS AND PLEURA: There is a new right lower lobe solid pulmonary nodule (series 4, image 80) measuring 0.9 x 0.9 cm and compatible with new metastasis. Scattered nonspecific micronodules are unchanged compared to prior study. Small left pleural effusion seen on the ...
1.Interval progression of disease including new right lower lobe pulmonary metastasis, new L2 vertebral body lytic lesion, new soft tissue metastatic lesion in left gluteal region, and increase in size of pelvic lymph nodes. Additional reference lesions similar to prior.2.Interval orthopedic fixation of left proximal f...
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81 years old female. Reason: history of metastatic colorectal cancer. This study was performed for restaging.RADIOPHARMACEUTICAL: 10.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates a new mass in the right lower lobe. There is a large hiatal hernia. There is...
1.New right lower lobe mass and right middle lobe nodule with increased metabolic activity, consistent with pulmonary metastases or lung cancer. 2.A new small right retrocrural hypermetabolic lymph node, suspicious for metastasis.3.A new focus of increased activity in the right lung upper lobe without definite CT corre...
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3-year-old male with history of chronic granulomatous disease. Pre-transplant evaluation. CHEST:LUNGS AND PLEURA: The numerous bilateral cavitary lesions seen on prior CT have resolved. Scattered bilateral streaky opacities, some of which demonstrate tree in bud configuration. No pleural effusion or pneumothorax.MEDIAS...
1.Prominent left axillary, left external iliac, and inguinal lymph nodes. Please see measurements above.2.Scattered bilateral streaky opacities in the lungs, some of which demonstrate tree in bud configuration. Findings may represent aspirated secretions or atypical infection. Previously seen cavitary lesions have reso...
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Male 68 years old Reason: assess for small bowel pathology History: sepsis, ARDS ABDOMEN:LUNG BASES: Small bilateral pleural effusions with bibasilar consolidation/atelectasis.LIVER, BILIARY TRACT: Diffusely hypoattenuating liver parenchyma consistent with fatty infiltration. SPLEEN: No significant abnormality notedPAN...
1.Findings consistent with small bowel obstruction with a transition point involving the ileum in the right lower quadrant. Findings may be chronic/intermittent in nature given similar prior imaging findings. 2.Bibasilar consolidation which could represent pneumonia/atelectasis with associated small pleural effusions.
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Female 49 years old Reason: Pt with stenotic IC valve, and Crohn's disease. Evaluate for small bowel disease. History: RLQ abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Postsurgical changes related to prior liver resection and cholecystectomy.SPLEEN: No significant abnormality...
1. Narrowing, mural thickening and mucosal hyperenhancement of the terminal ileum with mild inflammatory changes in the surrounding mesentery. The findings are suggestive of acute on chronic inflammation.2. No abscess or bowel obstruction.
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There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
No acute intracranial hemorrhage or skull fracture.
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50 year-old male with left knee pain. Four views left knee show no evidence of acute fracture or dislocation. No joint space narrowing or appreciable osteophyte formation.
Normal examination of the left knee.
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55 years, Male. Reason: Dobbhoff re-placement History: as above Dobbhoff tube tip projects over the gastric antrum. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view.Lung bases are clear.
Dobbhoff tube tip projects over the gastric antrum.
Generate impression based on findings.
Fall. Fracture? Mild osteoarthritis affects the knee. I see no fracture, malalignment, or joint effusion.
Mild osteoarthritis without fracture evident.
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55 years, Male. Reason: eval Dobbhoff placement History: s/p Dobbhoff Dobbhoff tube tip projects over the gastric body. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view.Lung bases are clear.
Dobbhoff tube tip projects over the gastric body.
Generate impression based on findings.
There is minimal bilateral maxillary sinus mucosal thickening. Otherwise, the paranasal sinuses are clear without evidence of air-fluid levels. The nasal cavity is clear. There is no significant nasal septal deviation. The bilateral mastoid air cells are clear. The lamina papyracea are intact bilaterally. The floor of...
Minimal maxillary sinus mucosal thickening without evidence of air-fluid levels.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Asymptomatic female presents for routine screening mammography. Heart transplant workup. Two standard digital views of both breasts including repeat right MLO and left CC views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pat...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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22-year-old male with arthritis and left knee pain. Evaluate osteotomy status. Four views of the left knee show postsurgical changes from a prior bilateral ACL reconstruction with osseous tunneling. Severe joint space narrowing is noted about the medial aspect of the knee with osteophytes which has progressed from the ...
Severe medial compartment osteoarthritis of the left knee which has progressed from the previous exam.
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Left proximal tibia lesion, evaluate for interval change There is a thin elongated ovoid focus of sclerosis within the anterolateral aspect of the proximal tibial diaphysis measuring just over 1.5 cm in longitudinal dimension and no more than 3 mm in transverse dimension. It may be based along the endosteum, but this i...
Elongated sclerotic focus in the proximal tibia perhaps representing a benign bone island.
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Male 33 years old; Right elbow limited ROM. Pain. Severe osteoarthritis affects the right elbow, as seen on the prior radiographs, with joint space narrowing, large osteophytes, and subchondral cysts. Multiple loose bodies are present within the joint space. A large loose body in the olecranon fossa measures approximat...
Severe osteoarthritis of the right elbow with multiple loose bodies within the joint.
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Evaluate pin fixation Three views of the right hand reveal no change in position of the pins in the fourth and fifth digits. The fractures and osteotomies have not healed at this time.
No change in position in PIN fixation
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There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unr...
No evidence of acute intracranial hemorrhage, mass, or cerebral edema.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
Generate impression based on findings.
Patient slipped on ice and fell striking head. Evaluate for subdural hematoma. There is no evidence of intracranial hemorrhage or mass effect. There is mild parenchymal volume loss. The basal cisterns are patent. There is no midline shift or herniation. There are calcifications of the cavernous portion of the internal ...
1. No evidence of intracranial hemorrhage or depressed calvarial fracture.2. punctate calcification in the left orbital apex may be vascular in nature or represent dural calfication, although a small optic nerve sheath meningioma cannot be excluded. An orbit MRI may be useful for further evaluation, if clinically warra...
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Left lower extremity numbness, weakness. Assess alignment, fracture. Again seen are posterior stabilization rods with screws entering the L2 through L5 vertebrae. I see no hardware complications. Amorphous bone graft material is again seen along the right lateral aspect of the lumbar spine. Multilevel degenerative disk...
Degenerative disk disease and postoperative changes appear similar to those seen on the prior study. I see no fracture.
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Male 53 years old; Reason: 53 yo male with hypoechoic pancreatic focus on ultrasound, please evaluate with CT History: 53 yo male with hypoechoic pancreatic focus on ultrasound, please evaluate with CT ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse hepatic steatosis. No focal liver l...
1.No focal pancreatic mass.2.Diffuse hepatic steatosis.
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Pain over entire right hip and entire right knee. 2 views of the right hip demonstrate mild osteoarthritis. We see no fracture.4 views of the right knee demonstrate hardware components of a total knee arthroplasty device situated in near anatomic alignment and without radiographic evidence of hardware complication. Ant...
Right hip osteoarthritis and right total knee arthroplasty, without fracture.
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Foot pain or treadmill. Evaluate for stress fracture Three views of the left foot are unremarkable. No evidence of stress fracture. No radiographic abnormalities..
Negative left foot examination
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Possible stress fracture. Two views of the right tibia and fibula demonstrate chronic appearing periosteal reaction along the anteromedial tibia which may indicate a healing stress fracture, though this is equivocal and appears similar to that seen on the prior study. We see no discrete fracture line.
Findings which may represent a healing tibial stress fracture, appearing similar to prior.
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10-year-old male status post renal transplant for posterior urethral valves. BLADDER Wall Thickness: Borderline bladder wall thickening to 4 mm, stable. Contents: Distended and normal. Distal Ureter -- SFU Grade** Transplant: 0 Ureteral Jets Transplant: Not observed KIDNEYS: Transplant kidney is noted in the right ...
1.Grade 1-2 hydronephrosis in transplant kidney, not significantly changed.2.Stable mild bladder wall thickening.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the ...
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History of metastatic esophageal cancer. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: Right-sided chest port tip with tip in the distal SVC. No mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications. Mild eccentric thickenin...
1.Interval placement of gastroesophageal junction stent which has migrated into the gastric body.2.Reference gastrohepatic nodal mass which is inseparable from the pancreas unchanged in size. Progressive atrophy of the pancreatic tail.3.Reference periaortic lymph node decreased in size. 4.No new sites of metastatic dis...
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Pain. Minimal osteoarthritis affects the left glenohumeral joint, essentially within normal limits for the patient's age. We see no additional shoulder findings to account for the patient's pain, although degenerative arthritic changes are present in the cervical spine.
Minimal osteoarthritic changes of the glenohumeral joint. Degenerative changes in the cervical spine may be better evaluated with dedicated cervical spine imaging if clinically warranted.
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Female 51 years old; Reason: SLE pt with mild Jaccoud's arthropathy c/o pain R 5th MTP at site of bunion. History: pain R 5th MTP at site of bunion. Bilateral pes planus is noted. No evidence of acute fracture or dislocation. No evidence of osteoarthritis.
Bilateral pes planus deformity.
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Pain. Osteoarthritis versus avascular necrosis. RIGHT KNEE: The right knee appears normal for the patient's age. No frank osteoarthritic disease or osteonecrosis is seen.LEFT KNEE: There is moderate medial joint compartment narrowing with small tricompartmental osteophytes indicating moderate osteoarthritis, which has ...
Osteoarthritis and other findings, as above.
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Female 44 days old Reason: 6 wk F s/p aortic arch reconstruction, vsd patch closure, extubated today. Evaluate for atelectasis. History: Status Post-Op Cardiac SurgeryVIEW: Chest AP (one view) 2/9/15 at 1631 hrs. Right IJ venous access terminates at the right atrium, however has been slightly retracted. Mediastinum tip...
Interval retraction of right IJ venous access and removal of ET tube.Right upper lobe subsegmental atelectases development.
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Left hip replacement in 1999, now with hip pain. Again seen are hardware components of a left total hip arthroplasty device. There is slight eccentric positioning of the head of the femoral component within the acetabular component, suggestive of liner wear. Otherwise, there is no radiographic evidence of complication....
Left total hip arthroplasty device and other findings, as above. We see no fracture.
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Pain after fall on ice. Fracture? Four views of the right elbow are provided. There is a comminuted intra-articular fracture of the radial head with approximately 2 mm of depression of the articular surface. Elevation of the distal humeral fat pad likely reflects hemarthrosis.Two views of the right forearm reveal the a...
Radial head fracture as above.
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Point tenderness for 1.5 weeks over left third metatarsal. Evaluate for third metatarsal shaft fracture. A small focus of poorly defined density is noted on the oblique view along the medial aspect of the neck of the third metatarsal. This could represent periosteal reaction from underlying stress fracture in the corre...
Possible third metatarsal stress fracture. If further imaging evaluation is warranted, repeat radiographs may be obtained in 7 to 10 days. This was relayed to Dr. Mimoto at the time of dictation.
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Hip pain and weakness after fall. Knee weakness and pain after fall. Two views of the right knee are provided. I see no fracture, malalignment, or joint effusion. Mild osteoarthritis affects the knee.Two views of the right hip are provided. Evaluation of the hip is limited by factors related to portable technique. Give...
Mild osteoarthritis of the right knee. I see no fracture. If there is strong clinical concern for femoral neck fracture, then dedicated radiographs or cross-sectional imaging of the right hip performed in the radiology department may be considered.
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Left hip pain for two weeks There is mild deformity of the acetabulum, with a horizontal roof. I suspect that this is due to the patient's known diagnosis of achondroplasia, revealed by the medical record. Lack of sphericity of the femoral head with a slightly underdeveloped femoral neck is also likely due to achondrop...
Mild deformity of the hip likely due to achondroplasia as described above. I see no acute abnormalities. If further imaging evaluation is clinically warranted, MRI may be considered.
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Female 62 years old Reason: please evaluate prior to starting new tx, provide bi-dimensional measurements per RECIST v 1.1 History: metastatic colon cancer CHEST:LUNGS AND PLEURA: Bilateral numerous lung metastases. An index right upper lobe nodule measures 1.4 by 1 cm on image number 29, series number 8.MEDIASTINUM AN...
Metastatic numerous lung nodules. Borderline enlarged mediastinal and hilar lymph nodes. Predominantly upper abdominal retroperitoneal adenopathy and mesenteric adenopathy suspicious for metastatic disease.
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Female 80 years old Reason: Met breast cancer needs re-evalation and compare to prior scan 1/2/15. Per RECIST 1:1 with bi-dimensional measurements. History: Met breast cancer needs re-evalation and compare to prior scan 1/2/15. Per RECIST 1:1 with bi-dimensional measurements. CHEST:LUNGS AND PLEURA: Biapical scarring, ...
Extensive diffuse bone metastases throughout the skeleton. Right gluteal subcutaneous soft tissue mass suspicious for metastatic disease.Interval increase in the size of the left lobe hepatic lesion suspicious for metastatic disease.
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Female 42 years old Reason: portal venous thrombus on RUQ History: elevated lipase ABDOMEN:LUNG BASES: Diffuse dense groundglass opacities and air space opacities are unchanged from previous CT.LIVER, BILIARY TRACT: Moderate hepatomegaly. Liver measures 23 cm in vertical dimension. Mild periportal edema. Portal vein an...
Moderate hepatomegaly. Small splenic infarct. No evidence of portal vein thrombosis.Persistent nephrogram of the kidneys on the delayed phase is suggestive of impaired renal function. Correlation with renal function tests is recommended.Leiomyomatous uterus.Diffuse air space opacities and groundglass opacities in the l...
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or ar...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother, diagnosed at the age of 55. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pa...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microca...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in mother, diagnosed in her 60s. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small m...
No mammographic evidence of malignancy. Physical examination is of increased importance for patients with dense breasts. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or ar...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt, maternal niece, and maternal cousin. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density,...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distributio...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt (diagnosed at the age 55), and ovarian cancer in mother (diagnosed at the age of 45). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma ...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Scattered benign calcifications, including arterial calcifi...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in maternal aunt. Personal history of left cyst aspiration in 2013. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of s...
Bilateral breast cysts of varying sizes. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Asymmetry in the far posterior left breast is p...
Focal asymmetry in the far posterior left breast. Additional imaging, including spot compression views and possible ultrasound, recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt and maternal cousin. Personal history of colon cancer. Two standard digital views, additional left MLO view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The brea...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal grandmother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, un...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
Generate impression based on findings.
Clinical question: CVA. Signs and symptoms: CVA. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Very mild patchy foci of periventricular and subcortical low-attenuation white matter is a nonspecific finding ho...
1.No acute intracranial process.2.Findings suggestive of mild chronic nonhemorrhagic small vessel ischemic strokes as detailed.
Generate impression based on findings.
Female 10 years old Reason: MVA History: pain over acromiumVIEWS: Left clavicle AP and axial 2/9/15 (two views) There is no evidence of fracture, malalignment or soft tissue swelling.
Normal examination.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two sisters (diagnosed at the age of 46 and 50). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Mu...
Bilateral partially obscured masses. Additional evaluation, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
Generate impression based on findings.
Clinical question: CVA. Signs and symptoms: LUE numbness and weakness. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Findings suggestive of mild to moderate age indeterminate small vessel ischemic strokes are...
Mild to moderate age indeterminate small vessel ischemic strokes.
Generate impression based on findings.
Female 9 years old Reason: pneumonia History: fever, cough, chest painVIEWS: Chest PA/lateral (two views) 2/9/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Left lower lobe opacity, either atelectasis or pneumonia.. No effusions or pneumothorax.
Left lower lobe opacity as described.
Generate impression based on findings.
concussion No evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures ...
No evidence of acute ischemic or hemorrhagic lesion on this scan.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of archi...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Two standard digital views, additional right MLO view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. M...
Bilateral stable benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
Generate impression based on findings.
Clinical question: Evaluate size of hemorrhage. Signs and symptoms: Evaluate size of hemorrhage. Nonenhanced head CT:Acute hematoma in the left hemisphere measuring at 55 x 36 -mm in size without convincing evidence of any significant change in its size, density or extend. Surrounding vasogenic edema and associated mas...
1.Stable left hemispheric acute hematoma with a small extension into the left subdural space, surrounding vasogenic edema and overall mass effect and deviation of midline to the right of approximately 7.8 mm.2.No convincing evidence of any new finding since prior study.
Generate impression based on findings.
altered mental status No evidence of acute ischemic or hemorrhagic lesion on this scan.Mild diffuse brain atrophy is age appropriate.Patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel disease. The ventricles, sulci, and cisterns are symmetric and unremarkable. There is ...
No evidence of acute ischemic or hemorrhagic lesion on this scan.Non specific small vessel ischemic disease.
Generate impression based on findings.
Clinical question: Evaluate for cerebral edema, CVA. Signs and symptoms: First time seizure. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is mild prominence of cerebellar and vermian folia the patient stated ag...
No acute intracranial process.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Long-standing creamy nipple discharge from the left breast. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Scattered benign calcifica...
Focal asymmetry in the right breast. An attempt to obtain the patient's prior mammograms should be made for comparison purposes.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON
Generate impression based on findings.
altered mental status, headache No evidence of acute ischemic or hemorrhagic lesion on this scan.There is focal low attenuation within the right transverse sinus which most likely represent arachnoid granulation.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is...
No evidence of acute ischemic or hemorrhagic lesion on this scan.
Generate impression based on findings.
Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister, diagnosed at the age of 39. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular densit...
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.