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Generate impression based on findings. | Evaluate for osseous abnormalities. CT of the pelvis reveals cortical thickening in both pubic and ischiac bones. There's also cortical thickening involving the right iliac wing. These findings represent Paget's disease. There is narrowing of both hip joints consistent with moderate osteoarthritis. No acute abnormaliti... | Paget's disease involving the pelvis. No acute abnormalities |
Generate impression based on findings. | 0-day-old female, evaluate ETT positionVIEW: Chest AP (one view) 2/11/15 10:46 ETT tip above the thoracic inlet. Streaky bilateral pulmonary opacities and basilar atelectasis. Left sided cardiac apex, aortic arch and stomach. The cardiothymic silhouette is normal. The bowel gas pattern is normal for age. | 1. ETT tip above thoracic inlet.2. Streaky pulmonary opacities likely relate to RDS. |
Generate impression based on findings. | Female 64 years old Reason: evaluate for bilateral hip OA History: hip and groin pain. AP view of the pelvis shows severe osteoarthritis of both hips, appearing similar to that seen on prior hip radiographs in September 2014. Degenerative arthritic changes also affect the visualized lower lumbar spine. | Severe osteoarthritis. |
Generate impression based on findings. | Female 60 years old Reason: eval for si DJD History: hip pain running.VIEWS: Two views of the pelvis. We have two views of the pelvis. Mild osteoarthritis affects both hip joints, slightly more advanced on the left. The sacroiliac joints appear normal for patient's age. Degenerative arthritic changes affect the visuali... | Osteoarthritis of the hips and lower lumbar spine. The sacroiliac joints appear normal. |
Generate impression based on findings. | Status post fall on outstretched hand.VIEWS: Right AP, lateral and oblique 2/11/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 41 years, Female. Reason: Stent placement History: Abdominal pain A right-sided nephroureterostomy stent proximal tip projects over the upper pole of the right kidney with proximal tip projecting over the expected location of the bladder. Multiple surgical clips are also noted at the upper pole of the right kidney. Non... | Right-sided nephrouretereostomy stent in the expected location. |
Generate impression based on findings. | Female 64 years old Reason: Prosthetic assess History: post-op. Two views of the left hip show components of a hip hemiarthroplasty device situated in near anatomic alignment, without radiographic evidence of hardware complication.AP view of the pelvis shows mild osteoarthritis of the right hip. Also, mild degenerative... | Left hip hemiarthroplasty in near anatomic alignment. |
Generate impression based on findings. | 73-year-old male patient status post urethroplasty. Scout film demonstrated a suprapubic catheter in place.Cystografin was administered by gravity via the Foley catheter and maximal distention was achieved at 200 cc, at which point the examination was terminated secondary to patient involuntarily voiding.Again seen is ... | Enlarging contained left anterolateral leak and new right posterolateral sinus tract. |
Generate impression based on findings. | 45 year old woman with history of asymmetry in the right breast on prior mammogram. 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. No dominant mass, suspi... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female 39 years old Reason: eval for arthritis, pain/swelling in knee History: eval for arthritis, pain/swelling in knee. We have 4 views of the right knee and 4 views of the left knee. There is severe osteoarthritis of the left knee, particularly affecting the medial compartment where there is near bone on bone apposi... | Osteoarthritis of the bilateral knees, left greater than right. |
Generate impression based on findings. | Male 49 years old Reason: pain History: pain. Three views of the left knee show severe osteoarthritis predominantly affecting the medial compartment where there is near bone on bone apposition. There are also tricompartmental osteophytes and a mild varus deformity of the knee. There is a small joint effusion with a 1.5... | Severe osteoarthritis and other findings as described above. |
Generate impression based on findings. | Wrist pain. Fracture years ago Three views of the left wrist reveal multiple defects from previous orthopedic hardware. There is narrowing and sclerosis of the basilar joint consistent with osteoarthritis. No acute abnormalities. When compared to the previous exam there has been removal of the orthopedic hardware | Removal of previously seen orthopedic hardware. Basilar joint osteoarthritis |
Generate impression based on findings. | Medial condylar intra-articular fracture Four views of the left elbow show decreased soft tissue swelling when compared to the previous exam. No joint effusion. There is a small ossific fragment adjacent to the medial condyle that represents a small fracture. | Small medial condylar fracture unchanged |
Generate impression based on findings. | Ms. Brooks is a 71 year old female with a personal history of left breast DCIS status post mastectomy. Recent diagnostic mammogram demonstrated a new asymmetry in the superior right breast with sonographic correlate. This will be the target for today's biopsy. Right breast ultrasound re-identified the target lesion for... | Successful ultrasound-guided core biopsy of the right breast lesion with clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | SCLC restaging. CHEST:LUNGS AND PLEURA: Trace pleural fluid on the right. Disease bronchiolitis in the lower lobes with debris in the right lower lobe bronchus most consistent with aspiration related bronchiolitis.Right upper lobe bronchial wall thickening and linear scar like opacities about the same; one lesion in th... | Interval enlargement of right hilar mass which now narrows be the superior vena cava, consistent with SVC syndrome.. A small eccentric filling defect within the SVC may be due to adherent mural thrombus or localized intravascular extension of tumor. Diffuse bronchiolitis pattern most compatible with aspiration. Increas... |
Generate impression based on findings. | 23-year-old male with dysphagia, G tube. Evaluate for aspiration. History of Lennox Gastaut with developmental disability. EXAMINATION: Oropharyngeal motility study 2/11/2015 10:15:00 Beth Harrison, speech and language therapist, supervised the examination.2 minutes and 26 seconds of fluoroscopy was used.Decreased stre... | Aspiration with no cough reflex. Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | 7-year-old female with history of neuroblastoma, off therapy CHEST:LUNGS AND PLEURA: Minimal basilar atelectasis. No suspicious nodules or masses.MEDIASTINUM AND HILA: Note is made of common origin of the left carotid and right brachiocephalic artery. No mediastinal or hilar lymphadenopathy. There is prominence of the ... | No evidence of recurrent disease. |
Generate impression based on findings. | 14 years old Female. Reason: initial staging for lymphoma. History: anterior mediastinal mass. This study was performed for initial staging.RADIOPHARMACEUTICAL: 6.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 112 mg/dL. Today's CT portion grossly demonstrates a large mediastinal mass and pericardial effu... | 1.Hypermetabolic mediastinal mass and lymph nodes, consistent with the patient's diagnosis of lymphoma. The hypermetabolic mass involves anterior and middle mediastinum and encases the great vessels.2.Hypermetabolic pericardial and left pleural thickening, suspicious for tumor involvement.3.Nonspecific a mild FDG uptak... |
Generate impression based on findings. | 10 day old female with increased work of breathing. Evaluate for presence of atelectasis or pneumothorax.VIEW: Chest AP (one view) 2/11/2015 11:22:53 Feeding tube tip in the stomach. Umbilical venous catheter tip in the right atrium. Bilateral hazy opacities similar to prior study. No pleural effusion or pneumothorax. ... | Persistent diffuse bilateral hazy lung opacities. |
Generate impression based on findings. | AIH. Evaluate for HCC. LIVER: The liver measures 16.4 cm in length. Mildly echogenic compatible with fatty infiltration and nodular in contour suggesting cirrhosis. There are no focal lesions identified. There is no evidence of intrahepatic biliary ductal dilatation. The portal vein is patent with flow towards the live... | Cirrhotic appearing liver with no focal liver lesions. Mild splenomegaly suggesting portal hypertension. |
Generate impression based on findings. | Hypoxia, RV failure. Chronic thromboembolic pulmonary hypertension. The comparison chest radiograph performed on 2/10/2015 demonstrates a small left pleural effusion with overlying atelectasis/consolidation and a trace right pleural effusion. The ventilation images show decreased activity on single-breath and wash-in i... | Low probability for pulmonary embolus. |
Generate impression based on findings. | Assess for skull base tumor. History of pulsatile tinnitus and dizziness. Family history of colon cancer. CT: There is an expansile lucent lesion in the left lateral posterior skull base with internal hyperattenuating foci and what may represent periosteal reaction inferiorly. Overall, the lesions measures up to 35 mm.... | 1. Expansile lucent lesion in the left lateral posterior skull base that measures up to 35 mm with compression of the left sigmoid sinus and superior portion of the internal jugular vein. Differential considerations include fibrous dysplasia or desmoid tumor, versus malignant neoplasms, such as sarcomas, perhaps arisin... |
Generate impression based on findings. | 54 year old woman with history of T-cell lymphoma and prior left breast mass biopsy in 2014. Three standard views of the left breast 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. A ribbon bi... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months (to get her back on a bilateral annual schedule). Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Dia... |
Generate impression based on findings. | 76 years, Female. Reason: ng History: ng NG tube side-port is at the distal esophagus with tip at the gastroesophageal junction. Sternotomy wires noted.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | NG tube side-port is at the distal esophagus with tip at the gastroesophageal junction, recommend advancement. Findings paged to pager 7816 at 1200 on 2/11/15. |
Generate impression based on findings. | Back pain There is mild narrowing of the L5/S1 intervertebral disk space which may reflect mild degenerative disk disease. I see no frank scoliosis. Coronal balance is within normal limits. There is a mild negative sagittal balance of less than 2 cm. There is loss of the normal cervical lordosis. | Mild negative sagittal balance and findings suggestive of mild degenerative disk disease at L5-S1. |
Generate impression based on findings. | Hypoxemia rule out PE. Motion artifact.PULMONARY ARTERIES: Technically suboptimal infusion quality, but no pulmonary emboli to the lobar level. Segmental and subsegmental emboli may not be visible.LUNGS AND PLEURA: Significant interval worsening of diffuse tree in bud and ground glass alveolar distribution opacities. I... | 1. Suboptimal examination with no evidence of pulmonary embolus to the lobe are level. Segmental and subsegmental emboli may not be visualized by this study and cannot be entirely excluded.2. Significant progression of endobronchial/alveolar opacities which may reflect infectious or cellular debris. Intralobular septal... |
Generate impression based on findings. | Evaluate for HCC. Cirrhosis LIVER: The liver measures 17.5 cm in length. No evidence of intrahepatic biliary ductal dilatation or dominant lesion. It is nodular in contour compatible with cirrhosis. The portal vein is patent with flow toward the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: Common duct mea... | No substantial interval change compared to prior. Cirrhotic appearing liver with findings compatible with portal hypertension (splenomegaly). |
Generate impression based on findings. | Pain following crush injury. Rule out forefoot fracture. I see no fracture or dislocation. I see no specific findings to account for the patient's pain. | No fracture evident. |
Generate impression based on findings. | 77-year-old with history of left breast pain. The patient describes nonfocal pain. 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. No dominant mass, suspic... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Knee pain and shoulder pain Four views of the right knee are provided. Moderate osteoarthritis affects the knee, particularly the medial tibiofemoral compartment. There is also chondrocalcinosis of the menisci. I see no joint effusion.Four views of the left knee are provided. Moderate osteoarthritis affects the knee, p... | Osteoarthritis of the knees and shoulders with other findings as described above. |
Generate impression based on findings. | 66 years old female with a history of lung cancer s/p chemoradiation with RUL mass and LN. Reason: evaluate for residual disease. RADIOPHARMACEUTICAL: 12.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 101 mg/dL. Today's CT portion grossly demonstrates a stable cavitary nodule in the superior segment of th... | 1. Interval decreased metabolic activity in the right lung nodule and right hilar lymph nodes.2.New FDG avid lesion in the left posterior abdominal wall. Suggest clinical correlation.3.New normal-sized mildly and metabolically active lymph nodes in the left inguinal region. Suggest clinical correlation. |
Generate impression based on findings. | Reason: mesothelioma s/p resection on observation, eval EOD, compare to previous History: none CHEST:LUNGS AND PLEURA: Postoperative changes in the left hemithorax redemonstrated.Nodular pleural thickening along the left hemidiaphragm (image 64 series 3) is stable.Small amount of loculated pleural fluid at the left cos... | 1.Stable appearance to the pleural nodularity along the left hemidiaphragm and postsurgical changes left hemithorax. No definite evidence of recurrent disease.2.Multifocal areas of pleural thickening and pleural calcification in the right hemithorax unchanged.3.Patulous appearance of the esophagus compatible with achal... |
Generate impression based on findings. | Pleural mesothelioma. CHEST:LUNGS AND PLEURA: Multiple pulmonary, septal and pleural nodules compatible with metastases, some of which are slightly larger. The reference right lung nodule measures 9 mm, previously 7-mm (5/41). Moderate right pleural fluid collection is new.Loculated pleural fluid and nodular pleural th... | Interval progression of disease in the upper abdomen. Left pleural disease not significantly changed however bulky lymphadenopathy has increased in some areas of the mediastinum as detailed in the body of the report. Right pleural effusion and ascites, new from the prior study. |
Generate impression based on findings. | Left leg weakness. Evaluate for CVA. There is subtle hypoattenuation in the posterior limb of the right internal capsule, which is age-indeterminate. There is mild parenchymal volume loss. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consi... | 1. Subtle hypoattenuation in the posterior limb of the right internal capsule, which is age-indeterminate. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is no contraindications, MRI of the brain is recommended.2. No evidence of intracranial hemorrhage.I personally... |
Generate impression based on findings. | Male 47 years old; Reason: GIST s/p resection, eval EOD, compare to previous History: none CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions. The hep... | 1.Stable exam following partial gastrectomy without evident metastatic disease. |
Generate impression based on findings. | Female, 49 years old s/p c-section, bilateral salpingectomy, and ureteral stent placement. RFO Trigger: Multiple surgical teams. Suspected RFO Location: Pelvis. Suspected RFO: None. JP drain, bilateral nephroureterostomy tubes, and midline staples are noted. No additional unexpected radiopaque foreign bodies. Nonobstru... | No unexpected radiopaque foreign bodies. Findings were discussed with attending surgeon, Dr. Lengyel, over phone, at 1210 on 2/11/2015. |
Generate impression based on findings. | Status post fall on February 5. Ambulatory but with prepatellar swelling. Four views of the right knee are provided. There is swelling of the soft tissues anterior to the patella compatible with hematoma. There is a transverse/oblique fracture of the underlying patella with fracture fragments in near anatomic alignment... | Nondisplaced patellar fracture. This was relayed to Dr. Birnie in person at the time of dictation. |
Generate impression based on findings. | History of T3N2b p16+ left tonsillar cancer status post chemoradiation completed 4/6/12 with subsequent right lung oligometastasis s/p SBRT completed 05/24/2013, then with progressed disease in lung on PET 3/2014, s/p VATS wedge resection with findings of multiple parenchymal and pleural-based nodules. Started pembroli... | 1. Post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence or significant lymphadenopathy in the neck. 2. Fluid within the left maxillary sinus may indicated acute sinusitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 78 years old; Reason: Reassess lung metastases History: COugh ABDOMEN:LUNG BASES: The thorax will be reported separately.LIVER, BILIARY TRACT: No suspicious hepatic lesions. Hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No ... | 1.Osseous metastatic disease of the lumbar spine and pelvis. |
Generate impression based on findings. | 76-year-old abnormality seen on CT of the liver. Please evaluate. LIVER: The liver measures 14.3 cm in length. The recent abnormality identified on CT measures 1.6 cm in diameter. It is near anechoic with posterior acoustic enhancement, findings most characteristic of a simple cyst. The calcification seen on recent CT ... | The liver nodule has sonographic features most compatible with a cyst; calcification noted on CT was not identified. A more definitive evaluation could be performed pre-and post enhanced cross-sectional imaging although a benign etiology is thought to be most likely based on imaging features. |
Generate impression based on findings. | Pain after fall. Rule out fracture. There is mild swelling of the anterior soft tissues of the leg, but I see no underlying fracture. Mild osteoarthritis affects the knee. Mild osteoarthritis also affects the ankle. A well corticated ossicle along the anterior aspect of the ankle joint may reflect old trauma or potenti... | Soft tissue swelling and osteoarthritis without acute fracture evident. |
Generate impression based on findings. | No history of trauma. Pain along dorsal and ulnar aspect of wrist, possibly distal radioulnar joint. There is mild soft tissue swelling along the ulnar styloid. I see no fracture or malalignment, and the wrist otherwise appears normal. | Mild soft tissue swelling along the ulnar styloid is nonspecific. |
Generate impression based on findings. | Balance problems. Back pain. Evaluate for degenerative disk disease. History of ACDF. History of lumbar laminectomy. Three views of the cervical spine are provided. Severe degenerative disease affects C4/5, C5/6, and C6/7. There is a minimal retrolisthesis of C5 relative to C6. There are minimal anterolistheses of C2 a... | Severe degenerative disk disease and other findings as above. |
Generate impression based on findings. | Female, 27 years old, with nasal blockage. Assess for chronic sinusitis. The frontal sinuses and frontoethmoidal recesses are clear. The sphenoid sinuses and sphenoethmoidal recesses are clear. The ethmoid air cells, anterior and posterior, are clear. The maxillary sinuses are free of significant mucosal thickening/deb... | No evidence of acute or chronic sinusitis. |
Generate impression based on findings. | Right leg pain. Metastatic prostate cancer, femoral rod, new pain. Two views of the right femur and two views of the right hip are provided. Again seen is an intramedullary rod and screw/nail device affixing the femur in anatomic alignment. I see no hardware complications. A poorly defined sclerotic lesion in the intra... | Orthopedic fixation of the femur, and metastatic prostate cancer as described above. |
Generate impression based on findings. | The thoracic spine is in normal alignment with a normal thoracic kyphosis. There are minimal degenerative changes; the vertebral body and disk heights are otherwise well maintained. No worrisome focal marrow signal abnormality is appreciated. There is no significant disk bulge, herniation, spinal canal or foraminal st... | 1. No thoracic cord signal abnormality. 2. No spinal canal stenosis in the thoracic spine. |
Generate impression based on findings. | Female, 38 years old, with nasal blockage and headache. Assess for chronic sinusitis, deviated nasal septum. The frontal sinuses and frontoethmoidal recesses are clear. The sphenoid sinuses and sphenoethmoidal recesses are clear. The ethmoid air cells, anterior and posterior, are clear. A lobular region of mucosal thic... | 1. No evidence of significant active or chronic sinusitis.2. No significant nasal septal deviation or other findings which would account for the patient's symptoms. |
Generate impression based on findings. | EGFR mutation on afatinib. CHEST:LUNGS AND PLEURA: Unchanged mildly nodular visceral and parietal pleural thickening. Right lower lobe lesion measures 16 x 9 mm, unchanged (5/66). No pleural fluid or pneumothorax.MEDIASTINUM AND HILA: The reference right prevascular region lymph node measures 6-mm, previously 5-mm (3/2... | Stable right lower lobe lesion and nodular pleural thickening. No significant change in the reference mediastinal lymph nodes. A nonindex upper abdominal lymph node is not significantly changed but should continue to be monitored, nonspecific. |
Generate impression based on findings. | Clinical question: Rule out hemorrhage. Signs and symptoms: Head trauma with loss of consciousness Nonenhanced head CT:There is no detectable acute intracranial hemorrhage, midline shift or hydrocephalus.The gray -- white matter differentiation is preserved. The CSF cisterns remain patent bilateral cement pressures are... | 1.No acute intracranial hemorrhage, mass effect, midline shift or hydrocephalus.2.Gray -- white matter is preserved.3.There is paucity of cortical sulci which could be within normal limits for patient of stated age of 22. Correlate with neurological evaluation and consider repeat CT if clinical concern persist. |
Generate impression based on findings. | Pain Three views of the right knee are provided. There is severe osteoarthritis with bone-on-bone apposition of the medial tibiofemoral compartment and tricompartmental osteophytes. There is a mild varus deformity of the knee.Three views of the left knee are provided. Severe osteoarthritis affects the knee, with near b... | Severe osteoarthritis. |
Generate impression based on findings. | Female, 64 years old, with metastatic head and neck squamous cell carcinoma enrolled in clinical trial (IRB 130311). Assessment of the oral cavity is significantly limited by streak artifact from dental amalgam. The floor of mouth and tongue base are unremarkable. No evidence of recurrent tumor is seen elsewhere along ... | 1. No evidence of progressive disease in the neck.2. Stable predominantly sclerotic lesion involving the manubrium. |
Generate impression based on findings. | Back pain, possible DJD. Mild degenerative disk disease affects L2/3, L3/4, and L4/5. Small osteophytes project from the anterior aspects of the lumbar vertebrae. Mild facet joint osteoarthritis affects the lower lumbar spine. Vertebral body heights are preserved and alignment is within normal limits. | Mild degenerative disk disease as above. |
Generate impression based on findings. | Pain Two views of the right hip show severe osteoarthritis with bone on bone apposition superiorly.The AP view of the pelvis reveals the aforementioned severe osteoarthritis of the right hip. Relatively mild osteoarthritis affects the left hip. Sclerosis within the body of the left pubic bone is likely degenerative in ... | Osteoarthritis and other findings as above. |
Generate impression based on findings. | Postop ORIF Evaluation of fine detail is limited by overlying cast material. A plate and screw device affixes a fracture of the distal fibula in near-anatomic alignment. Two orthopedic screws also affix a fracture of the medial malleolus in near anatomic alignment. The "posterior malleolar" fracture seen on prior studi... | Orthopedic fixation of distal fibular and tibial fractures as above. |
Generate impression based on findings. | Metastatic esophageal cancer status post 12 cycles of FOLFOX. CHEST:LUNGS AND PLEURA: Mild emphysema and scattered granulomas, but no suspicious lesions. The background lung parenchymal is slightly high in density.MEDIASTINUM AND HILA: Small mediastinal and hilar lymph nodes are stable to slightly improved. The referen... | Small mediastinal lymph nodes are stable to slightly smaller in appearance. Minimal residual thickening of the distal GE junction appears improved and the gastric thickening appears similar. No significant change in hepatic lesions. |
Generate impression based on findings. | Rheumatoid arthritis. DJD. Pain and subluxation and limited motion. Three views of the left hand are provided. There is narrowing of the distal radioulnar joint with osteophyte formation. There is mild narrowing of the radioscaphoid articulation with small osteophytes. Moderate osteoarthritis affects the basilar joint.... | Severe arthritic changes as described above appear predominantly degenerative in etiology, although may be secondary to an underlying inflammatory arthritis such as rheumatoid arthritis. |
Generate impression based on findings. | Ankle pain. Rule-out fracture.VIEWS: Right ankle AP/lateral/oblique (3 views), left ankle AP/lateral/oblique (3 views) 02/11/15 The bones are normal in appearance. Alignment is anatomic. No fracture is seen. A joint effusion is not present. | Normal ankles. |
Generate impression based on findings. | 84 year old male. Mesothelioma restaging. Cough. CHEST:LUNGS AND PLEURA: Two separate areas of nodular pleural thickening consistent with tumor in the left hemithorax:1. Left posterior mediastinal pleural tumor encasing the descending thoracic aorta at the level of the left superior pulmonary vein, 8 o'clock position: ... | Two nodular areas of pleural thickening in the left hemithorax consistent with known mesothelioma. Invasion into the diaphragm by the left basilar tumor cannot be excluded. No additional evidence of disease in the abdomen.Severe coronary artery calcifications. |
Generate impression based on findings. | Right hip pain. Rule-out fracture.VIEWS: Pelvis AP/frog leg (two views) 02/11/15 The femoral heads are round and smooth. There well directed into normally formed acetabula. Alignment is anatomic. No fracture is seen. | Normal examination. |
Generate impression based on findings. | 16-year-old female with knee pain, evaluate for fractureVIEWS: Right knee, AP, lateral, sunrise, skiers (4 views), left knee AP, lateral, sunrise, skiers (4 views), lumbar spine, AP and lateral (two views.) 2/11/15 11:54 Knees: Alignment is anatomic. There is no fracture, joint effusion or other specific finding to acc... | Normal examination. |
Generate impression based on findings. | 0 day old male (per chart 32 week old newborn infant) with respiratory distress. Evaluate endotracheal tube placement.VIEW: Chest and Abdomen AP (two views) 2/11/2015 11:46 ET tube tip at the level of the thoracic inlet. Persistent diffuse bilateral hazy lung opacities with minimal improvement. No pleural effusion or p... | ET tube tip at the level of the thoracic inlet. Persistent diffuse bilateral hazy lung opacities with minimal improvement. |
Generate impression based on findings. | Clinical question: Status post LVAD. History of ischemic stroke. Evaluate stroke. Signs and symptoms: Right arm weakness. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is interval evolution of a left MC... | 1.No acute intracranial findings. 2.Interval evolution of previously seen acute stroke or chronic phase in the left posterior temporal -- parietal region. |
Generate impression based on findings. | 65 years, Male. Reason: Dobbhoff placement History: Dobbhoff placement Bilateral chest tubes are unchanged. Median sternotomy wires, fixation plates, and mediastinal clips are unchanged. Interval removal of Swan-Ganz catheter. Dobbhoff tube tip projects over the first portion of the duodenum.Nonobstructive bowel gas pa... | Dobbhoff tube tip projects over the first portion of the duodenum. |
Generate impression based on findings. | Patient with metastatic prostate cancer (right pelvic lesion); needs surveillance scans. CHEST:LUNGS AND PLEURA: Mild chronic lung disease including sub pleural reticulation with mild traction bronchiectasis, similar to prior. Stable pulmonary micronodules. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA... | 1.Stable exam without evidence of new metastatic disease from patient's known prostatic carcinoma.2.Please see bone scan from same day for additional details regarding osseous metastases. |
Generate impression based on findings. | 13-year-old female with ankle pain, evaluate for fractureVIEWS: Left ankle, AP, oblique, and lateral (3 views), right ankle, AP, oblique, and lateral (3 views.) 2/11/15 12:06 Left ankle: Alignment is anatomic. No fracture or soft tissue swelling. The tibiotalar joint appears normal.Right ankle: Alignment is anatomic. N... | Normal examination. |
Generate impression based on findings. | History of bladder cancer, assess for recurrence ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Segment 4b subcentimeter low-attenuation hepatic lesion stable and likely benign. Status post cholecystectomy.SPLEEN: Calcified splenic granulomas, similar to prior.PANCREAS: No significant abnorma... | 1.Status post cystectomy with continent neobladder. 2.No evidence of tumor recurrence or metastatic disease. |
Generate impression based on findings. | Clinical question: Evaluate for acute process, hypertensive in emergency room. Signs and symptoms: Four days of headache. Nonenhanced head CT:There is no detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic stroke.In the cerebral cortex, cortical sulci, ventricul... | Negative nonenhanced head CT. |
Generate impression based on findings. | Lung mass in a patient with smoking history.RADIOPHARMACEUTICAL: 11.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates a spiculated left upper lobe mass, similar in size to the prior CT, which abuts the major fissure. Two additional subcentimeter nodules are ... | 1.Markedly hypermetabolic left upper lobe mass is consistent with lung cancer. A smaller hypermetabolic left upper lobe nodule may represent a synchronous malignancy or metastatic disease. 2.Mildly hypermetabolic left hilar and pretracheal lymph nodes are suspicious for nodal metastases.3.Three left renal lesions with ... |
Generate impression based on findings. | 66 years, Male. Reason: dht placement History: dht placement Dobbhoff tube is coiled with tip projecting over the gastric cardia. Prosthetic mitral valve. Chest findings unchanged from prior exam.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the gastric cardia. |
Generate impression based on findings. | Reassess lung metastases. Previous history of adenocarcinoma. LUNGS AND PLEURA: Consolidation surrounding the left upper lobe bronchus and extending to the lung apex appears less bulky, 21 x 37 mm (axial image 40) when measured in a similar fashion (previously 45 x 27 mm). The hypoattenuating component laterally measur... | Overall improvement in reference measurements. T11 vertebral body expansile metastasis effaces the thecal sac, cord compression cannot be accurately excluded by this technique. |
Generate impression based on findings. | 34-year-old female patient with abdominal pain and early satiety. UPPER GI:Double contrast visualization of the esophagus showed normal appearing mucosa. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peri... | 1.Thickened rugal folds and prominence of the area gastricae in the stomach as well as soft nodularity of the duodenum are compatible with gastroduodenitis.2.No abnormalities identified in the jejunum or ileum. |
Generate impression based on findings. | History of right frontal oligodendroglioma (grade 3) diagnosed 6/13, status post XRT and chemo (on decadron) with craniotomy. Evaluate for fluid collection at craniotomy site. There are post-surgical findings related to a right frontal craniotomy. There is diffuse white matter hypoattenuation of the bilateral frontal l... | 1. Post-surgical findings related to a right frontal craniotomy with a nonspecific epidural collection beneath the craniotomy flap measuring 3 mm in width.2. White matter hypoattenuation of the bilateral frontal lobes may represent edema, tumor infiltration, and/or radiation effects.3. Evaluation for abscess and tumor ... |
Generate impression based on findings. | Female 25 years old Reason: r/o fx History: slammed in car door. There is a 2-mm density along the ulnar aspect of the tuft of the distal phalanx, likely representing a small, minimally displaced fracture fragment. There is swelling of the soft tissues of the finger tip. | Minimally displaced fracture of the ulnar aspect of the tuft of the distal phalanx. |
Generate impression based on findings. | Male 50 years old Reason: RLQ pain History: same ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Dysmorphic hepatic contour is again seen and unchanged from prior exam.SPLEEN: Stable splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS,... | 1.No acute abnormality is evident to explain patient's right lower quadrant pain.2.Stable examination with dysmorphic contour of the liver and findings compatible with portal hypertension. |
Generate impression based on findings. | History of Diabetes. Feels food and water stay stuck in her stomach. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 64.3 % of peak activity (normal >70 %)1... | Gastric emptying within normal limits. |
Generate impression based on findings. | 72-year-old female. NSCLC. Please restage. CHEST:LUNGS AND PLEURA: Circumferential right pleural thickening is stable to mildly decreased. The reference right upper lobe pleural thickening is 11 mm, previously 14 mm (series 3, image 48). Reference pleural thickening adjacent to the right brachiocephalic vein is unchang... | Interval decreased size of right lung masses. No new sites of disease identified. |
Generate impression based on findings. | Prostate cancer, now with rising PSA following prostatectomy. New exam. No abnormal osseous foci are identified to indicate metastatic disease.Small lesions are noted in the left posterolateral 11th and 12th ribs represent healing fractures and correlate with the CT chest from 5/7/2013. A nonspecific focus is also seen... | Degenerative osseous changes and post-traumatic activity in the ribs without discrete evidence of bone metastases. |
Generate impression based on findings. | 15-year-old female with right tibial periosteal reaction. Chronic periosteal reaction is noted along the posterior aspect of the proximal tibia. This finding is compatible with stress fracture and appears similar to prior outside radiographs and CT. No acute fracture or dislocation. | Chronic periosteal reaction compatible with stress fracture and not significantly changed. |
Generate impression based on findings. | Clinical question: No skull or abdomen. Bump on top of the head. Tender to touch. Signs and symptoms: Szabo. Nonenhanced head CT:Examination demonstrate no evidence of acute intracranial process.There is normal density and anatomical morphology of cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray... | 1.No acute intracranial process.2.Diffuse scalloping deformity of the inner table of the skull with resultant bony thinning of the calvarium however without evidence of destructive/erosive changes of the calvarium and without associated extracranial or intracranial findings. Similar bony changes in the bilateral immedi... |
Generate impression based on findings. | 70 year-old woman with history of left breast ILC status post mastectomy in 2010. Three standard views of the right breast 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. No dominant mass, sus... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Dysphonia, weight loss, and neck mass There is an infiltrative necrotic mass involving the supraglottic larynx and hypopharynx with extension to the vocal cord and the subglottic region on the left with moderate airway narrowing. The laryngeal cartilage framework appears to be grossly intact. There are enlarged cervica... | 1. An infiltrative and necrotic supraglottic laryngeal mass and hypopharynx with extension to the vocal cord and the subglottic region on the left likely represents squamous cell carcinoma with moderate airway narrowing. 2. Bilateral cervical lymphadenopathy likely represents lymph node metastases. 3. Focal high attenu... |
Generate impression based on findings. | Reason: h/o SGLarynx ca and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: A new rounded solid nodule at the right lung apex measures 11 x 11 mm (series 4, image 47), suspicious for solitary pulmonary metastasis or primary lung malignancy. No other new suspicious pulmonary nodules or m... | 1. A new solid 1cm nodule at the right lung apex is suspicious for solitary pulmonary metastasis or primary lung malignancy. 2. Enlarging right paratracheal lymph node concerning for metastatic lymphadenopathy. |
Generate impression based on findings. | Female 67 years old Reason: fall on outstretched hands History: severe pain, limited ROM. Three views of the right shoulder are provided. The bones appear demineralized. We see no acute fracture or dislocation. Mild osteoarthritis affects the acromioclavicular joint. There are enthesopathic changes along the greater tu... | Mild degenerative changes of the shoulder, right elbow, and wrist as described above without a fracture. Please note that the humerus and bones of the forearm are not included in their entirety on these studies, and if further imaging evaluation is clinically warranted, dedicated humerus and forearm radiographs may be ... |
Generate impression based on findings. | History of NHL; Day 100 status-post auto stem cell transplant.RADIOPHARMACEUTICAL: 12.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 111 mg/dL. Today's CT portion grossly demonstrates lymphadenopathy within the right supraclavicular, anterior mediastinal, subcarinal and right cardiophrenic regions. The le... | Interval significant recurrence of the lymphoma within multiple lymph node regions in the neck, chest and abdomen. |
Generate impression based on findings. | History of neuroblastoma, now off therapy.RADIOPHARMACEUTICAL: 3.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 113 mg/dL. Today's CT portion of the neck demonstrates multiple small level II, III, and IV cervical lymph nodes, right greater than left, which have slightly increased in number and size compar... | Interval increase in number and size of multiple cervical lymph nodes with mild to moderate FDG activity in both sides of the neck. Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 40 year-old male patient with history of a left ileal ureter. Evaluate for reflux. Scout film demonstrated no abnormal calcification.Cystografin was administered by gravity via the Foley catheter and maximal distention was achieved at 500 cc, at which point the examination was terminated secondary to significant retrog... | 1.Reflux of contrast into the left ileal ureter without evidence of hydronephrosis. 2.Patient unable to void distended bladder. |
Generate impression based on findings. | 84-year-old female status post left total hip arthroplasty. Two views of the left hip demonstrate a total arthroplasty device in anatomic alignment without evidence of hardware complication or loosening. Subcortical lucency along the medial aspect of the femoral component of the device has been stable since at least 20... | Bilateral total hip arthroplasty devices without evidence of complication or interval change. |
Generate impression based on findings. | 60 year old female with history of epigastric pain, assess for gastric hernia, diverticulum, or paraduodenal hernia Double contrast visualization of the hypopharynx showed no mucosal abnormality or diverticulum. Double contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces o... | Normal examination of the esophagus, stomach, and duodenum. |
Generate impression based on findings. | 55-year-old female status post orthopedic fixation of distal radioulnar joint. Metallic distal ulnar prosthesis status post distal ulnar resection. Orthopedic sideplate/screw device is noted in the distal radius with surrounding defects from previous sideplate and screw device which has been removed. The radiocarpal jo... | Orthopedic fixation of the distal radius and ulna with wrist fusion as described above. |
Generate impression based on findings. | Head and neck carcinoma CHEST:LUNGS AND PLEURA: Stable reference right middle lobe nodule best seen on image 64 series 5 measuring 1 x 0.6 cm.Previously mentioned subcentimeter ground glass opacity within the right lower lobe no longer appreciated.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No si... | Stable examination. |
Generate impression based on findings. | Male 62 years old Reason: 62 yo M with PMH of psoriatic arthritis and OA in b/l hands History: b/l hand pain. We have 3 views of the left hand which show severe arthritic changes of interphalangeal joints, with osteophytes and predominately central erosions. There is ankylosis of the proximal interphalangeal joint of t... | Severe arthritic changes predominantly affecting the interphalangeal joints of the hands as described above. The overall picture is that of erosive osteoarthritis. |
Generate impression based on findings. | 61-year-old female with history of right greater tuberosity fracture as well as ORIF of proximal tibia. Three views of the right shoulder demonstrate an indistinct and nondisplaced greater tuberosity fracture line compatible with interval healing. The bones are diffusely demineralized.Two views of the right lower extre... | Healing greater tuberosity and tibial plateau fractures as described above. |
Generate impression based on findings. | 41-year-old female with outside hospital CT in September suggesting ileus versus small partial obstruction and complaints of abdominal pain and bloating after eating. No prior surgical history. The scout film shows a nonobstructive bowel gas pattern. Fluoroscopic evaluation showed normal mucosa throughout the small bow... | Essentially normal examination of the small bowel and proximal colon. |
Generate impression based on findings. | 60 year-old female with distal fibular and posterior tibial plafond fractures. Spiral fracture of the distal fibula is again noted which extends to the tibiotalar joint. An additional nondisplaced fracture of the posterior malleolus is also again identified. Both of these fractures appear similar to the prior study. So... | No significant interval change in ankle fractures as described above. |
Generate impression based on findings. | Reason: Re-evaluate for growth right middle lobe nodule and assess any change in adenopathy. Patient has history of lung cancer. Prior bilateral upper lobe wedge resections. History: none LUNGS AND PLEURA: Status post right upper lobe resection, with stable linear and nodular scarring along the suture line. A previousl... | 1. Stable 9mm right middle lobe ground glass nodule most likely representing AAH (atypical adenomatous hyperplasia). Continued followup imaging is recommended.2. New scattered small right lower lobe nodules, likely related to inflammatory process, including aspiration. 3. Bilateral upper lobe wedge resections without e... |
Generate impression based on findings. | 47 years, Male. Reason: Dobbhoff History: Dobbhoff Support devices are unchanged. Dobbhoff tube with tip projecting over the proximal gastric body.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the proximal gastric body. |
Generate impression based on findings. | 47 years, Male. Reason: Dobhoff placement History: Dobbhoff placement Support devices are unchanged. Interval removal of NG tube and placement of Dobbhoff tube with tip projecting over the proximal gastric body.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the proximal gastric body. |
Generate impression based on findings. | History of metastatic breast cancer on treatment, compare to prior imaging and evaluate for response and extent of disease. Numerous metastatic lesions in the axial skeletal and skull are not significantly changed. No new osseous lesions. | Stable extensive osseous metastases. |
Generate impression based on findings. | 28 years, Female. Reason: Assess for obstipation or colonic distension History: Hx of Crohn's; abdominal pain and distension Air-filled colon with average stool burden in the sigmoid colon and rectum. Nonobstructive bowel gas pattern. No intramural gas or pneumoperitoneum identified. | Average stool burden in the sigmoid colon and rectum. |
Generate impression based on findings. | Female 77 years old Reason: malabsorption / r/o vascular disease History: malabsorption / diarrhea CT Angiography: Mild aneurysmal dilatation of the abdominal aorta measuring up to 2.5 cm (series 9, image 60). There is no evidence of aortic dissection or significant stenosis. The origins of the great vessels, celiac ax... | 1.Abnormal edematous bowel wall thickening of the proximal colon consistent with focal colitis. Favor infectious or inflammatory etiology over ischemic disease.2.Severe aortic atherosclerotic disease with mild aneurysmal dilatation of the abdominal aorta. No evidence of aortic dissection or ischemia.3.Nonspecific cysti... |
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