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Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with a repeat left MLO view 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. Scattered focal asymmetries are stable in both breasts. An asymmetry in the left inferior breast on the initial MLO view disperses on the repeat view. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral benign focal asymmetries. 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. Personal history of benign left breast biopsy. Family history of breast cancer in sister, diagnosed at the age of 41. Two standard digital views of both breasts with repeat bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Partially obscured mass in the left lateral breast with percutaneously placed biopsy clip is compatible with prior benign breast biopsy. Other bilateral benign morphology masses and stable focal asymmetries are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Benign morphology mass in the left breast. 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: NSC - Screening Mammogram. |
Generate impression based on findings. | Right lower quadrant abdominal pain and right lower quadrant abscess. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Two subcentimeter low attenuation lesions within the hepatic dome are too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodule measures 1.6 x 1.9 cm (series 3, image 32) and demonstrates an attenuation of -10 Hounsfield units compatible with adenoma, unchanged. KIDNEYS, URETERS: Atrophic right kidney. Subcentimeter hypoattenuating focus at the inferior pole of the right kidney is too small to characterize. Renal retention of IV contrast from prior exam consistent with poor renal function.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic disease of the abdominal aorta and its branches more fully characterized on recent CTA. Multiple subcentimeter retroperitoneal lymph nodes are nonspecific with left para-aortic lymph node measuring 0.8 x 0.8 cm (series 3, image 38).BOWEL, MESENTERY: Ascending colonic submucosal fat deposition most suggestive of chronic colitis. No additional bowel wall thickening. No evidence of bowel obstruction. There is a presumed extraluminal collection of fluid and gas adjacent to the ileocecal junction which now contains enteric contrast (series 3, image 64) measuring 2.2 x 2.2 cm, previously 4.0 x 3.1 cm. Colonic diverticulosis. BONES, SOFT TISSUES: Moderate degenerative changes affect the thoracolumbar spine. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Ascending colonic submucosal fat deposition most suggestive of chronic colitis. No additional bowel wall thickening. No evidence of bowel obstruction. There is a presumed extraluminal collection of fluid and gas adjacent to the ileocecal junction which now contains enteric contrast (series 3, image 64) measuring 2.2 x 2.2 cm, previously 4.0 x 3.1 cm. Colonic diverticulosis. BONES, SOFT TISSUES: Moderate degenerative changes affect the thoracolumbar spine. OTHER: No significant abnormality noted | 1.Presumed pericecal collection decreased in size now measuring 2.2 x 2.2 cm. 2.Colonic diverticulosis. Submucosal fat deposition in ascending colon consistent with chronic colitis. 3.Atrophic right kidney. Renal retention of IV contrast from prior exam consistent with poor renal function.4.Left adrenal adenoma.5.Severe atherosclerotic disease better evaluated on recent CTA. |
Generate impression based on findings. | 19 years, Male. Reason: Please check NGT placement after it was advanced further History: N/V, NGT placement NG tube tip is in the proximal gastric body. Slight interval decrease in caliber of small bowel measuring 3cm with relative paucity of distal bowel gas consistent with small bowel obstruction. Contrast fills the bladder. Lung bases are clear. | NG tube tip in the proximal gastric body. Findings consistent with small bowel obstruction as noted on prior CT. |
Generate impression based on findings. | 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. |
Generate impression based on findings. | Male 39 years old Reason: effusion/abnormality History: pain and swelling remote injury. Partially imaged intramedullary rod of the tibia is noted. There is chronic deformity of the proximal fibula with fusion to the tibia. There is a moderately sized suprapatellar joint effusion. There is no underlying fracture or dislocation. There are tiny tricompartmental osteophytes, however the joint spaces are preserved. | Moderately sized suprapatellar joint effusion without definite underlying fracture as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. 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. Focal asymmetry in the right central breast, posterior depth is present. Scattered coarse benign calcifications have progressed in a benign fashion, many of which represent hyalinized fibroadenomas. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast. | Focal asymmetry in the right breast. Additional imaging, 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. | 66-year-old female patient with recurrent hiatal hernia status post open repair and ventral hernia. Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. There is a round opacity projecting over the distal esophagus, compatible with patient's known hiatal hernia. There is slight distortion of the thorax.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed a tortuous esophagus and a hiatal hernia measuring 4.5 x 5.0 cm (series 18). There is a fixed ventral hernia of the distal body of the stomach that measures 4.1 x 4.4 cm with a 2.2-cm neck (series 22). The ventral hernia did not increase in size on Valsalva. During the exam, spontaneous gastroesophageal reflux was observed to the level of the thoracic inlet (series 10). Fluoroscopic evaluation of esophageal peristalsis demonstrated cessation of the primary wave at the thoracic inlet with proximal escape and tertiary waves in the distal esophagus.Of note, the stomach was hypotonic and there was delayed emptying into the duodenum.TOTAL FLUOROSCOPY TIME: 5:22 minutes | 1.Medium-sized hiatal and ventral hernias as described above.2.Minor esophageal motility abnormality.3.Spontaneous gastroesophageal reflux. |
Generate impression based on findings. | Male 47 years old Reason: patellar fracture History: patellar fracture The patella fracture line is less evident indicating ongoing healing. Alignment is near-anatomic. Joint effusion has resolved. Soft tissue swelling has improved. Mild osteoarthritis affects the right knee. | Healing right patellar fracture. |
Generate impression based on findings. | 12-year-old female with clitorimegaly, elevated total and free testosterone, evaluate for ovarian or adrenal androgen producing tumor. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal. No intra-or extrahepatic biliary ductal location. No perihepatic fluid.SPLEEN: The spleen is normal.PANCREAS: Pancreas is normal with no evidence of pancreatic ductal dilatation.ADRENAL GLANDS: Normal. No discrete lesions are identified.KIDNEYS, URETERS: Normal with no evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal in caliber with no evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Bilateral innumerable, T1 with dark, T2 bright and non enhancing adnexal cysts, the largest of which is located in the left adnexa measuring 1.7 cm x 1.5 cm (series 1301, 27). BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal in caliber with no evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Normal examination. |
Generate impression based on findings. | Male 49 years old Reason: 49yo M w/ lower back pain History: lower back pain There is mild anterior wedging of the T12 and L1 lumbar vertebral bodies. There is subtle lucent area involving the posterior superior aspect of the L1 vertebral body.The disk spaces are normal. There is mild facet hypertrophic changes involving the mid lumbar spine.Calcific arteriosclerotic disease affects the aorta. | Mild facet degenerative change.Subtle lucency near the superior endplate of L1 may represent a Schmorl's node. If patient has pain in the upper back consider cross-sectional imaging. |
Generate impression based on findings. | 2-year-old male with right ankle fracture, out of castVIEWS: Right ankle, AP, oblique, and lateral (3 views) 2/12/15 12:12 Interval removal of cast. There is an oblique fracture of the distal tibial diaphysis with adjacent callous formation and periosteal reaction indicating an attempt at healing. | Healing distal tibial fracture as described above |
Generate impression based on findings. | 81 years, Female. Reason: Dobbhoff placement History: Dobbhoff placement Median sternotomy wires, fixation plates, bilateral chest tubes, and Swan-Ganz catheter are unchanged since prior exam. Dobbhoff tube tip projects over the gastric body and appears kinked.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the gastric body and appears kinked. Follow-up study may be considered to ensure resolution. |
Generate impression based on findings. | 66-year-old female status post lap banding 2009, evaluate position and dilation. Single contrast visualization of the esophagus showed no morphologic abnormalities. Fluoroscopic evaluation of esophageal peristalsis demonstrated cessation of the primary peristaltic wave at the midesophagus with secondary waves noted. There is slight delay in transit from the esophagus through the laparoscopic band. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. There is mild dilation above the laparoscopic band believed to be a dilated lower esophagus. No rugal folds are noted to suggest that this portion is stomach. The stomach is normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed. The duodenal bulb and sweep were within normal limits. TOTAL FLUOROSCOPY TIME: 4:27 minutes | 1.Mild motor abnormality of the esophagus.2.Dilation above the level of the laparoscopic band is believed to be distal esophagus, unchanged from 2011. |
Generate impression based on findings. | 14-year-old male with right ankle injuryVIEWS: Right ankle, AP, oblique, and lateral (3 views) 2/12/15 Interval removal of cast. There is mild residual soft tissue swelling about the ankle without underlying fracture visualized. | Mild soft tissue swelling without fracture evident. |
Generate impression based on findings. | 82-year-old female patient with nausea and reported history of gastric stenosis. Evaluate for gastric/pyloric stenosis. Single contrast visualization of the esophagus showed no significant morphologic abnormalities of the mucosal surfaces or mural contours. Fluoroscopic evaluation of esophageal peristalsis demonstrated cessation of the primary wave immediately proximal to the thoracic inlet with subsequent proximal escape to the level of the cervical esophagus. Tertiary waves were observed in the lower thoracic esophagus. A nonobstructive anterior esophageal web was noted in the cervical esophagus (series 3).The stomach was normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed without evidence of pyloric stenosis. Again noted was a retroverted duodenal bulb (series 13). Gastric mucosal detail for shallow ulcers or polyps is limited in this single contrast study.TOTAL FLUOROSCOPY TIME: 2:26 minutes | 1.Stable retroverted duodenal bulb without pyloric channel abnormality identified.2.Minor esophageal motility abnormality.3.Nonobstructive anterior cervical esophageal web. |
Generate impression based on findings. | Small cell bladder cancer, metastasis to lymph node. Restaging on chemotherapy. CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema.No suspicious pulmonary nodules or masses.Calcified nodules consistent with healed granulomatous disease.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Calcified mediastinal lymph nodes consistent with healed granulomatous disease.Normal heart size without pericardial effusion.No visible coronary artery calcification.Left paratracheal enlarged cervical lymph node, refer to separately dictated soft tissue neck report for further details.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: 2.6 x 2 cm fluid attenuation lesion in the right hepatic lobe, previously 2.6 x 1.7 cm, mildly larger from 7/2013 when it measured 2.2 x 1.4 cm. Additional subcentimeter hypoattenuating foci in the liver too small to characterize, unchanged and likely cysts.SPLEEN: Calcified splenic granulomata.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable bilateral hydronephrosis and hydroureter with nephroureteral stents in place.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Bulky confluent retroperitoneal lymphadenopathy, encasing the right renal vasculature and proximal SMA, with interval mild decrease in size of some lymph nodes.Reference right periaortic lymph node mass is 5.5 x 6 cm, previously 5.9 x 5.9 cm (series 4, image 100). Reference left periaortic lymph node is 2.3 x 2.3 cm (series 4, image 117), previously 3 x 3.1 cm.Reference right periaortic lymph node is 2.6 x 2.5 cm, previously 2.9 x 2.8 cm (series 4, image 126).Calcified atherosclerotic calcification of the abdominal aorta with a 2.5 cm aortic aneurysm just proximal to the bifurcation, unchanged. BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology. Bulky mesenteric lymphadenopathy with reference mesenteric node incompletely imaged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Extensive abdominal lymphadenopathy, with mild decrease in size of some reference lymph nodes. No new sites of disease identified in the chest or abdomen. |
Generate impression based on findings. | 18-year-old male with scoliosisVIEWS: Thoracolumbar spine, supine in brace AP (one views) 2/12/15 13:00 There is 50 degrees dextroscoliosis of the thoracolumbar spine (previously 45 degrees). No segmentation anomalies are noted. The lungs are clear. Nonobstructive bowel gas pattern. G-tube again noted. | Thoracolumbar dextroscoliosis, slightly increased from the prior exam. |
Generate impression based on findings. | 70 year-old male with history of TxN2a (SCC of the skin) s/p chemoradiation cycle 7 of 7 FHX completed 11/9/12. There are posttreatment findings in the right upper neck with persistent stranding of the fat in the right suprahyoid region. There is no evidence of abnormal enhancement or measurable mass lesions. There is no cervical lymphadenopathy by CT size criteria. The salivary and thyroid glands are normal. The airway is patent. There are postsurgical changes of anterior spinal fusion at C3-4. A left shoulder prosthesis is partially imaged. There is hypoattenuation within the left temporal lobe which appears similar to prior and likely represents encephalomalacia. There is opacification in the right mastoid air cells. The lung apices are unremarkable. | 1. Post-treatment findings without convincing evidence of recurrent tumor or lymphadenopathy in the neck.2. Left temporal lobe encephalomalacia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 75 years, Male. Reason: 75 year-old male with abdominal pain, evaluate stool burden or other etiology History: as above Nonobstructive bowel gas pattern with slightly above average stool burden. Vascular calcifications are noted. | Nonobstructive bowel gas pattern with slightly above average stool burden. |
Generate impression based on findings. | Indeterminant colitis status-post total colectomy with end ileostomy and a history of H. Pylori leading to outflow obstruction and distention with gastroparesis. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 86.2 % of peak activity (normal >70 %)1 hour: 75.9 % of peak activity (normal 30-90 %) 2 hours: 40.1 % of peak activity (normal <60 %) 4 hours: 7.0 % of peak activity (normal <10 %) . This failure has improved significantly from previous of 34% retention. | Gastric emptying is significantly improved from the previous exam and is now within normal limits. |
Generate impression based on findings. | Male 36 years old; Reason: s/p L shoulder recurrent dislocation, assess for bony deficiency of glenoid. please perform coronal, sagittal recons, humeral subtraction 3D reconstructions A large Hill-Sachs deformity is present. An osseous Bankart lesion is present. The rotator cuff is grossly normal. No fluid is seen in the subdeltoid bursa.No significant abnormality is otherwise evident. | Hill-Sachs deformity and Bankart lesion compatible with prior humeral head dislocation. |
Generate impression based on findings. | Ms. Felix is a 27-year-old female with recently drained abscess in the axillary region. Per her primary physician, there is continued tenderness just inferior to the drained abscess, with concern for loculated fluid. Upon physical exam, there is gauze material packed within a small incision in the upper left axillary region. There is minimal erythema and tenderness just inferior to this area.A targeted left axillary ultrasound was performed for the patient’s area of concern. Multiple echogenic foci with shadowing is seen in the upper axillary region, compatible with packing material. Just inferior and lateral to this is minimal parenchymal edema. However, there is no discrete fluid collection or abscess formation identified. The packing material fell out near the conclusion of the exam, and no large abscess was seen in the area of packing material. | Parenchymal edema without evidence of discrete fluid collection or abscess formation. The packing material fell out near the conclusion of the exam, and the patient will follow up with her referring providers to see when the material should be replaced. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 96 years, Female. Reason: NGT placement History: NGT placement Enteric feeding tube tip projects over the distal gastric body and sidehole projects over the proximal gastric body. Nonobstructive bowel gas pattern. Cardiomegaly is again noted. Dysmorphic calcifications in the pelvis may represent uterine fibroids. | Enteric feeding tube tip projects over the distal gastric body. |
Generate impression based on findings. | Ms. Haywood is a 55 year old female with a personal history of palpable lump in the left upper outer breast since the age of 13 with imaging characteristics of a benign fibroadenoma. No current breast related complaint. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Benign morphology mass in the left upper outer breast is stable when compared to multiple prior exams and compatible with a benign fibroadenoma based on prior ultrasound exams. Additional focal asymmetry in the right medial breast is also stable. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Stable benign left breast mass. 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: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Pain. Preop left total hip arthroplasty. Severe osteoarthritis of the left hip with osteophyte formation and joint space narrowing with bone-on-bone apposition. Subchondral cysts and sclerosis are noted. No fracture is present.Degenerative changes affect the visualized lower lumbar spine and left sacroiliac joint. | Severe osteoarthritis of the left hip. |
Generate impression based on findings. | Memory loss. Encephalopathy. The distribution of radiotracer throughout the brain is within normal limits. No significant regional hyper or hypoperfusion is present. | Unremarkable perfusion brain scan.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 71-year-old female with history of bladder cancer and prior enlarged supraclavicular lymph node (biopsy proven metastatic bladder cancer). Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. The left level 4 lymph node has decreased in size, measuring 2.8 x 1.6 cm in the transverse dimension and 2.5 cm craniocaudally. The salivary glands are unremarkable. There are multiple unchanged hypoattenuating nodules within the thyroid gland. The airway is patent. There is evidence of prior left pterional craniotomy with multiple aneurysm clips. There is partially imaged area of hypoattenuation within the right frontal lobe which appear similar to the prior CT head. The orbits are unremarkable. There is moderate multilevel degenerative disease of the cervical spine most notably at C4-5, C5-6 and C6-7. There is a calcified granuloma within the left upper lobe. | 1. Overall decrease in size of left level 4 lymph node metastasis. 2. Unchanged multiple subcentimeter thyroid nodules.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 42 years old Reason: fall History: pain , swelling , decreased ROM. There is soft tissue swelling surrounding the ankle joint. There is an oblique fracture of the distal fibula with posterolateral displacement of the distal fracture fragment. There is widening of the lateral joint spaces. Well corticated ossicle adjacent to the medial malleolus is likely due to prior injury to the deltoid.Three views of the right foot again demonstrate the distal fibular fracture as described above. No additional fractures dislocation or noted. There is diffuse soft tissue swelling surrounding the foot. Osteoarthritis affects the midfoot. | Minimally displaced distal fibular fracture as described above. |
Generate impression based on findings. | Status post fracture.VIEWS: Left wrist AP lateral 2/12/15 (two views) Material obscures fine bone details. Healing distal fracture of the left radius with periosteal reaction is in anatomic alignment. | Healing fracture in anatomic alignment after casting. |
Generate impression based on findings. | Female 20 years old Reason: thyroid CA History: tyroid CA s/p surgery and RAI RIGHT LOBE: Status post thyroidectomy.LEFT LOBE: Status post thyroidectomy..LYMPH NODES: There are benign appearing bilateral level 2 lymph nodes in the neck. These are not significantly changed from previous study. However, there are bilateral submandibular enlarged lymph nodes with microcalcifications suspicious for metastatic disease. Right submandibular lymph node measures 3 .6 x 2.5 cm. Left submandibular node measures 2.2 x 1.9 cm.OTHER: No significant abnormality noted. | Bilateral submandibular adenopathy suspicious for metastatic disease. |
Generate impression based on findings. | Prostate cancer, rising PSA. No abnormal osseous foci are identified to indicate metastatic disease. Significantly atrophic and hypofunctioning left kidney. A focus of activity in the left seventh rib corresponds with a rib fracture seen on the same day abdomen/pelvis CT. Faint diffuse activity in the soft tissues of the heart is nonspecific but pericarditis, hypercalcemia or amyloid deposition may be considered. | 1.No evidence of bone metastases. 2.Significantly atrophic and hypofunctioning left kidney. |
Generate impression based on findings. | Male 5 months old Reason: evaluate lungs s/p tracheostomy and NG tube placementVIEW: Chest and abdomen AP (two views) 2/12/15 at 1337 hrs. ET tube has been removed and a tracheostomy tube with the tip below the thoracic inlet has been placed. NG tube tip is at the stomach. Right lower extremity venous access terminates in the right external iliac vein. Cardiac silhouette size is normal. Large lung volumes, multifocal streaky opacities on a background of chronic lung disease with pattern of PIE. No effusions or pneumothorax.Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Interval tracheostomy tube and new NG tube placement.Multifocal streaky opacities on a background of chronic lung disease.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Right knee pain after fall. Right ankle pain after fall. Three views of the right knee reveal mild medial joint space narrowing with small osteophytes . There is some narrowing of the patellofemoral joint, especially along the lateral facet.Three views of the right ankle reveal diffuse soft tissue swelling. No fractures are seen. | Moderate degenerative changes right knee. Right ankle swelling |
Generate impression based on findings. | Male 72 years old; Reason: pt w/ known AAA, possible OR tomorrow, eval for increase in size. History: eval for AAA size. No PO/IV contrast. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Asymmetric fatty infiltration of the liver predominately of the right hepatic lobe, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cortical cysts. No hydronephrosis or nephrolithiasis in either kidney.RETROPERITONEUM, LYMPH NODES: Infrarenal fusiform abdominal aortic aneurysm measures 6 x 6 cm on image 81/series 3 and is unchanged in size. The aneurysm does not extend into the iliac vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Nonspecific sclerosis in the right symphysis pubis.OTHER: No significant abnormality noted. | 1.6-cm infrarenal abdominal aortic aneurysm. |
Generate impression based on findings. | Male 47 years old Reason: left ankle pain History: ankle pain Left ankle: Bone mineralization is normal. Alignment is anatomic. The joint spaces are normal. Mild osteoarthritis affects the midfoot at the talonavicular joint.No acute fracture or dislocation is evident.Left foot: Postsurgical changes in the first metatarsal head with moderate osteoarthritis of the first MTP joint with joint space narrowing and osteophyte formation. There are degenerative changes of the sesamoid bones. No acute fracture or malalignment. | Degenerative and postsurgical changes as detailed above. |
Generate impression based on findings. | Abdominal pain and family history of cancer. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the thoracolumbar spine most prominent at L5-S1 where there is vacuum disk phenomenon.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes affect the thoracolumbar spine most prominent at L5-S1 where there is vacuum disk phenomenon.OTHER: No significant abnormality noted | 1.No specific evidence of malignancy or findings to account for the patient's pain. 2.Degenerative disk disease most prominent at L5-S1. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in paternal 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | 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. | 33 year old female status post right lumpectomy with radiation and chemotherapy in 2005 for IDC grade 3 and left lumpectomy with radiation and tamoxifen in 2009 for DCIS, presents today for routine follow up. History of bilateral breast reduction in 2002. No current breast complaints. Family history of breast carcinoma in her maternal aunt and ovarian carcinoma and her maternal grandmother. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Postsurgical findings in both breasts, including volume loss, architectural distortion and surgical clips, are stable. There is a biopsy clip in the lower inner left breast and more recently placed clip at anterior left breast. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 71 years old Reason: left hip pain History: left hip pain Two views of the left hip shows moderate to severe joint space narrowing at the left hip joint with osteophyte formation. No acute fracture or malalignment.Single AP view of the left hip shows the aforementioned left hip osteoarthritis. Mild osteoarthritis affects the right hip. | Severe left hip osteoarthritis. |
Generate impression based on findings. | Male 64 years old Reason: eval oa, hx of numerous ortho procedures History: same. There is joint space narrowing with near bone on bone apposition of the medial and lateral tibiofemoral compartment. There are tricompartmental osteophytes. Degenerative arthritic changes affect the patella.Frontal views of the right knee demonstrate joint space narrowing with near bone on bone apposition medially. Post surgical clips in the lateral aspect of the right femur are noted. | Osteoarthritic changes of the left knee as described above. |
Generate impression based on findings. | Female 48 years old Reason: Pt w/ CKD s/p renal Tx. History: see above RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: Peritransplant fluid relating to intra-abdominal ascites.KIDNEY: The transplant kidney measures 13.4 cm. Subcentimeter cortical cyst noted. Slightly increased echogenicity of the transplant kidney.COLLECTING SYSTEM/URETER: There is no hydronephrosis.URINARY BLADDER: The bladder is incompletely distended but appears unremarkable.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels There is a brisk systolic upstroke and normal diastolic flow.Peak systolic velocities are as follows.Right iliac artery: 1.0 m/secAnastomosis: 0.9 m/sRenal artery Proximal: 0.8 m/sec Mid: 0.8 m/sec Distal: 0.8 m/sec The intrarenal resistive indices are normal measuring 0.6 - 0.7The renal vein is color Doppler patentOTHER: No significant abnormality noted | Slightly echogenic but otherwise unremarkable appearance of the transplant kidney in the right iliac fossa. Abdominal ascites. |
Generate impression based on findings. | Female 59 years old Reason: OA, pain History: OA , pain Bone mineralization is normal. Alignment is anatomic. The joint spaces are normal for age. There is mild sharpening of the tibial spines and mild early osteophyte formation.No acute fracture or malalignment. No joint effusion. | Minimal left knee osteoarthritis. |
Generate impression based on findings. | Bilateral sensorineural hearing loss, which developed during a bout of severe systemic illness and kidney disease. Right: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact. Left: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and essentially clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact. Miscellaneous: There are bilateral lens implants. There is mild right sphenoid sinus mucosal thickening. | Unremarkable appearance of the bilateral temporal bones. |
Generate impression based on findings. | Female 52 years old Reason: bilateral hip pain History: bilateral hip pain Two views of right hip demonstrates slight abnormal offset of the right femoral head neck junction suggestive of a CAM Type deformity. No acute fracture or malalignment. Joint space is normal. There are small osteophytes near the fovea of the femoral head.Left hip: Two views of the left hip shows a band of sclerosis along the left femoral neck. There is slight abnormal offset of the left femoral head neck junction suggestive of a CAM type deformity. There are small osteophytes near the fovea of the left femur. Two screws traverse the proximal shaft of the left femur without hardware complication.AP pelvis shows the aforementioned osteoarthritic changes and osteoarthritis of the sacroiliac joints. | Postsurgical changes in the left femur and other findings as detailed above. |
Generate impression based on findings. | 51 years, Male. Reason: Dobbhoff tube readjusted History: Dobbhoff tube readjusted Multiple surgical clips, surgical drains, and an IVC filter is noted. Dobbhoff tube projects over the gastric pyloric area. Residual contrast within the small bowel and colon.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube projects over the gastric pyloric area. |
Generate impression based on findings. | 51 years, Male. Reason: Dobbhoff placement History: post LT Multiple surgical clips, surgical drains, and an IVC filter is noted. Dobbhoff tube projects over the proximal gastric body. Residual contrast within the small bowel and colon.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube projects over the proximal gastric body. |
Generate impression based on findings. | Male 52 years old; Reason: rule out testicular torsion History: left testicular pain RIGHT TESTIS: The right testis measures 2.9 x 2.1 x 4.5 cm. No focal lesion is identified. Trace right hydrocele.LEFT TESTIS: The left testis measures 2.2 x 1.5 x 3.5 cm. No focal lesion is identified.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: There is a 0.5 x 0.4 x 04 -cm left epididymal cyst.OTHER: Bilateral small varicoceles noted. | No evidence of testicular torsion. No focal lesion is identified. Small bilateral varicoceles noted. |
Generate impression based on findings. | T2N2b right BOT SCC, HPV p16+. Completed 2 cycles of IC with carbo/taxol, and 5/5 cycles of TFHx (completed 1/16/15), now here for follow up. There are post-treatment findings in the neck. There is no measurable residual mass in the tongue. There has been interval decrease in size of the right level 2 lymphadenopathy, in which the largest lymph node measures 10 x 13 mm, previously 13 x 16 mm. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is a right internal jugular venous catheter. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. There is a small retention cyst in the left maxillary sinus. The imaged portions of the lungs are clear. | No measurable residual mass in the tongue and interval decrease in size of the right level 2 lymphadenopathy. |
Generate impression based on findings. | History of laryngeal cancer and CRT.RADIOPHARMACEUTICAL: 12.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 114 mg/dL. Today's CT portion again demonstrates extensive posttreatment and surgical changes in the neck. Thyroid nodules are again seen. A tracheostomy tube is again visualized. A catheter or endovascular device is present in the right upper chest. Coronary artery calcifications are seen. Within the lungs there is mild apical predominant emphysema, minimal scattered scarring and an unchanged 4-mm groundglass nodule in the apex of the left lung. Diverticulosis is noted. Again seen are degenerative changes throughout the spine.Today's PET examination demonstrates expected activity surrounding the tracheostomy and gastrostomy tubes. There is a significantly hypermetabolic left thyroid nodule which has a SUV max of 7.3 and which may represent either a benign or malignant thyroid nodule. A punctate subcentimeter significantly FDG avid lesion for size is noted in the right supraclavicular superficial subcutaneous tissue in the region of prior tumor/fluid and has a SUV max of 4.4. This could represent a small area of persistent inflammation versus tumor. No other suspicious FDG avid lesions are visualized. | 1.Punctate hypermetabolic right supraclavicular focus indeterminate for single small metastatic focus versus inflammation.2.No active metastatic disease elsewhere.3.Hypermetabolic left thyroid nodule which may be benign or malignant primary thyroid nodule. |
Generate impression based on findings. | Female 53 years old Reason: fracture/effusion History: pain bilateral knee post fall this am. There is severe osteoarthritis of the left knee with near bone on bone apposition of the lateral tibiofemoral compartment, which is unchanged from the prior exam. There are prominent tricompartmental osteophytes. No definite fracture is identified. | Severe osteoarthritis of the left knee without definite fracture. |
Generate impression based on findings. | Fall on ice A radiopaque BB marker is noted over the left lower rib cage, indicating the patient's location of pain. No fracture is identified.No focal lung opacities are present. | No rib fracture evident. |
Generate impression based on findings. | Female 77 years old Reason: CLL History: Comparison to prior scans CHEST: The exam is suboptimal secondary to motion artifact.LUNGS AND PLEURA: Calcific granulomata.Bibasilar atelectasis/scarring.MEDIASTINUM AND HILA: Moderate atherosclerotic calcifications of the aortic arch and descending aorta. Mild coronary artery calcifications.CHEST WALL: Right chest wall port with tip in the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Hypodense lesion in the inferior tip of the right lobe, unchanged, likely representing a liver cyst.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Solid mass in the mid left kidney extending toward the hilum measuring 2.5 x 1.9 cm (series 3, image 89), previously 2.5 x 2 cm. RETROPERITONEUM, LYMPH NODES: Redemonstrated is a cluster of ill-defined lymph nodes throughout the left periaortic area, which is unchanged. Reference nodes in the left periaortic area (series 3, image 110) measures 1.9 x 1.3 cm, previously 1.9 x 1.2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate degenerative changes of the lumbar spine with chronic endplate depressions at the L1 and L5 vertebral bodies.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered diverticulosis without evidence of diverticulitis.Soft tissue mesenteric mass which encases vessels and is stable in size measuring 4.0 x 1.2 cm (series 3, image 116), previously 4.0 x 1.3 cm.BONES, SOFT TISSUES: Multiple scattered soft tissue granulomas.OTHER: No significant abnormality noted. | 1.Stable size of mesenteric mass and retroperitoneal lymph nodes.2.Left kidney mass is stable in size, however, the lesion is suspicious for malignancy and renal cell carcinoma cannot be excluded. |
Generate impression based on findings. | Reason: ho tongue ca, s/p CRT, compare to previous. measurements pls History: none CHEST:LUNGS AND PLEURA: Scattered benign-appearing micronodules. No suspicious pulmonary nodules or masses. Mild basilar scarring or subsegmental atelectasis. No focal airspace consolidation.No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary artery calcification. No mediastinal or hilar lymphadenopathy.Small hiatal hernia.CHEST WALL: Right chest port, tip in the right atrium.Degenerative disease of the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable left renal cyst, unchanged.PANCREAS: Mild pancreatic atrophy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lumbar spine.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Ms. Randell is a 50 year old female with a personal history of benign left breast biopsy in 01/2014 for a fibroadenoma. She then had an MR guided biopsy along with terminal duct excision in 07/2014 for a papilloma. No current breast related complaints. Three standard views of both breasts, additional left MLO view, additional right CC view 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. Ribbon clip is present in the left lateral breast, at site of biopsy proven fibroadenoma. A rod-shaped clip is present in the left central breast, at site of biopsy proven papilloma. Scattered benign calcifications are present bilaterally. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. A pacemaker overlies the left axillary region. | 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. |
Generate impression based on findings. | Male 5 years old Reason: evaluate healing of fracture History: left wrist fractureVIEWS: Left wrist AP and lateral 2/12/15 (two views) Cast material obscures fine bone details. Healing distal radial fracture with periosteal reaction and callus formation is in near-anatomic alignment. | Healing fracture, in near anatomic alignment. |
Generate impression based on findings. | Male 64 years old Reason: unconjugated hyperbilirubinemia, please evaluate hepatic and biliary ducts as well as liver architecture to r/o obvious pathology History: unconjugated hyperbilirubinemia, please evaluate hepatic and biliary ducts as well as liver architecture to r/o obvious pathology Very limited study due to patient body habitus and bowel gas overlying the abdominal organs.LIVER: The liver measures 16.1 cm. Diffusely echogenic hepatic parenchyma suggestive of fatty infiltration. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No intrahepatic duct dilatation. The common duct poorly visualized.PANCREAS: Pancreas is not visualized due to bowel gas.KIDNEYS: The right kidney measures 11.6 cm. The left kidney measures 13.2 cm. There is no hydronephrosis.OTHER: The spleen measures 13.9 cm. | Limited study. Diffuse fatty infiltration of the liver. No biliary dilatation. |
Generate impression based on findings. | Recent stroke with vertebral artery occlusion. New headache and imbalance. NONCONTRAST CT HEADThere is a focal low attenuation on bialteral cerebellar hemispheres indicating age indeterminate but likely chronic ischemic infarctions, no change since prior exam.Underlying brain shows mild non specific small vessel ischemic lesions, again no change since prior exam.No evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKBilateral vertebral artery from the level of ostium appear to be completely occluded.The right vertebral artery is reconstituted at the level of C3 and that of the left side is reconstituted at the level of C1.The basilar artery appears to be small and bilateral Pcom arteries are patent.There is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. .There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through bilateral ICAs, MCAs and ACAs. Bilateral Pcom arteries are patent and Acom artery is also patent.No evidence of aneurysm, intracranial significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. | 1. Multiple low attenuations on bilateral cerebellar hemisphere indicate age indeterminate likely chronic ischemic lesions.2. No evident acute ischemic or hemorrhagic lesion on this scan.3. Bilateral vertebral arteries appear to be completely occluded from their origin and reconstituted distally (right:C3 and left:C1 level). |
Generate impression based on findings. | There is no acute intracranial hemorrhage, mass effect, or midline shift. There is patchy hypoattenuation of the cerebral hemispheres and insulae consistent with age indeterminate small vessel ischemic disease. The calvarium is unremarkable without fracture. The imaged portions of the orbits sinuses, and mastoid air cells are unremarkable. High attenuation dorsal to the dens on the most inferior images with punctate focus of calcification is favored to be related to CPPD but incompletely imaged. | 1. No acute intracranial hemorrhage or edema. 2. Patchy white matter hypoattenuation is consistent with age indeterminate small vessel ischemic disease. Note that CT is insensitive for the detection of acute ischemia. If further imaging is clinically warranted, MRI is recommended. |
Generate impression based on findings. | Seven month old male with history of rickets and elevated alkaline phosphatase. Evaluate for fracture.VIEW: Right and Left Femur AP, Right and Left Tibia/Fibula AP, Right and Left Humerus AP, Right and Left Forearm AP (8 views) 2/12/2015 13:48 Bilateral humeri and forearms are normal in appearance. No evidence of fracture or dislocation.Bowing of the bilateral femurs, left great than right. There is a metaphyseal fracture of the right proximal tibia. | 1. Metaphyseal fracture of the proximal tibia.2. Bowing of the bilateral femurs, left greater than right, may be physiologic or changes related to rickets. |
Generate impression based on findings. | Ms. Hairston is a 23-year-old female presenting with unilateral left clear/milky nipple discharge for the past few months. Patient says that the discharge is only elicited when she squeezes on her breast. Upon physical exam, no discharge is able to be expressed.A targeted left breast ultrasound was performed for the patient’s area of concern. No ectatic ducts or intraductal masses were identified. No suspicious cystic or solid mass is seen. | No ectatic ducts or intraductal masses identified. Patient should return to her primary care physician for further clinical management as warranted.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 64-year-old with history of left breast DCIS status post lumpectomy and radiation therapy. Three standard views of both breasts and lumpectomy magnification views 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, suspicious microcalcifications or areas of architectural distortion in either breast. Stable postoperative distortion and density with multiple surgical clips in the left upper outer breast. Scattered bilateral benign calcifications are noted. Stable right central breast focal asymmetry, unchanged and most similar to the 2012 comparison study. Benign appearing lymph nodes are projected over both axillae. | 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. |
Generate impression based on findings. | Pain No significant degenerative changes are noted. No malalignment is noted. | No evidence of osteoarthritis. |
Generate impression based on findings. | Male 27 years old; Reason: B testicular pain History: B testicular pain RIGHT TESTIS: The right testis measures 4.2 x 2.6 x 1.7 cm. No focal lesion is identified.LEFT TESTIS: The left testis measures 4.1 x 2.6 x 1.8 cm. No focal lesion is identified.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: Subcentimeter left epididymal head cyst.OTHER: Bilateral varicoceles. | No evidence of testicular torsion. Bilateral varicoceles. |
Generate impression based on findings. | Female 82 years old Reason: s/p L2-5 PSF, L2-4 XLIF, evaluate alignment History: see above There is levoconvex scoliosis of the lumbar spine. There are postsurgical changes with pedicle screw fixation from L2 to L5 with lumbar interbody fusion of L2 to L4.. The lumbar vertebral bodies are normal in height. Alignment is near-anatomic.No hardware complication is evident. Severe degenerative changes affect the L5-S1 disk. Postsurgical changes in the hips, suboptimally evaluated. Severe osteoarthritis affects the sacroiliac joints. | Scoliosis and postsurgical changes as detailed above. |
Generate impression based on findings. | 6-week-old female with pain and swelling, evaluate for fractureVIEWS: Left thumb, AP and lateral (two views) 2/12/15 14:31 Alignment is anatomic. There is no sclerosis or periosteal reaction about the interphalangeal joint. | No evidence of fracture or malalignment. |
Generate impression based on findings. | Female 84 years old Reason: assess prosthesis History: S/P TSA Components of a reverse total right shoulder arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. The bones are demineralized. No acute fracture is evident.Brace, catheter and drain have been removed. | Reverse total right shoulder arthroplasty as detailed above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in sister, diagnosed at the age of 42. 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 areas of architectural distortion are present. Stable left outer breast asymmetry. Scattered benign calcifications are present in the left breast. | 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. | Female 59 years old Reason: assess healing History: S/P ORIF right arm both bone fx, non-union The right ulnar fracture has been affixed by two plate and screw devices; the alignment is near-anatomic. The ulnar fracture site is obscured by the plate.The transverse radius fracture has been affixed by a side plate and screws. The fracture lines are indistinct in the radius indicating healing. | Healing radius and ulnar fractures. |
Generate impression based on findings. | History of metastatic small bowel neuroendocrine tumor please assess and provide index lesion measurements for RECIST. CHEST:LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules are present some of which are poorly visualized on the prior outside exam and which can be followed on subsequent exams. Mild basilar atelectasis. No consolidation or pleural effusionsMEDIASTINUM AND HILA: Atherosclerotic calcifications of the aorta. Mild atherosclerotic calcifications of the coronary arteries. A moderate hiatal hernia is present.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Heterogenous segment 3 liver lesion presumably representing a metastasis (series 7, image 104) measures 6.1 x 5.2, measured 6.1 by 4.8 cm previously. Low attenuation segment 6 lesion (series 7, image 110) also presumably represents a metastatic lesion and has also slightly increased in size. Arterial phase images demonstrate an additional hyperenhancing lesion in segment two (series 6, image 26) which may represent an additional metastatic lesion. Multiple additional low attenuation hepatic cysts appear stable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is moderate hydroureteronephrosis on the right which has slightly increased. The right ureter is dilated until a transition point near the bladder. No obstructing stones are seen. There has been interval placement of a left nephroureteral stent with interval resolution of left-sided hydronephrosis. A left exophytic renal cyst is present.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic disease of the abdominal aorta and its branches. BOWEL, MESENTERY: There is a soft tissue mass in the pelvis adjacent to loops of small bowel (series 7, image 153) which contains eccentric calcifications and is presumably patient's known neuroendocrine tumor. The mass has not significantly changed in size from the prior exam. There is apparent tethering and ill-defined soft tissue between the sigmoid colon and loops of small bowel in the pelvis (series 7, image 169) which appears similar to prior. No evidence of bowel obstruction.BONES, SOFT TISSUES: Moderate-severe degenerative changes affect the visualized thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Mild bladder wall thickening. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a soft tissue mass in the pelvis adjacent to loops of small bowel (series 7, image 153) which contains eccentric calcifications and is presumably patient's known neuroendocrine tumor. The mass has not significantly changed in size from the prior exam. There is apparent tethering and ill-defined soft tissue between the sigmoid colon and loops of small bowel in the pelvis (series 7, image 169) which appears similar to prior. No evidence of bowel obstruction.BONES, SOFT TISSUES: Moderate-severe degenerative changes affect the visualized thoracolumbar spine.OTHER: No significant abnormality noted | 1.Calcified soft tissue mass in the pelvis presumably representing patient's known neuroendocrine tumor, similar to prior.2.Multiple liver metastases which are stable to slightly increased in size.3.Moderate right hydronephrosis and hydroureter slightly increased from prior and likely related to inflammatory changes in the pelvis. 4.Interval placement of left nephroureteral stent and resolution of left sided hydronephrosis. 5.Ill-defined soft tissue/inflammation between the sigmoid colon and small bowel likely related to the neuroendocrine tumor.6.Moderate hiatal hernia. 7.Mild bladder wall thickening, recommend clinical correlation for cystitis. |
Generate impression based on findings. | Female 80 years old Reason: s/p stroke with residual R sided weakness, with radicular type pain assoc. paresthesias History: same Lumbar vertebral bodies are normal in height. There is straightening of the lumbar curvature.This disk heights are narrowed at L2-L3 and L5-S1 and to a lesser degree at L4-L5 with endplate sclerosis.There are facet hypertrophic changes involving the lower lumbar spine.There are sclerotic changes at the left L5 pars interarticulars suggestive of a healing fracture. | Degenerative changes and other findings as detailed above. |
Generate impression based on findings. | Female 67 years old; Reason: mucinous appendiceal cancer s/p 6 months of chemotherapy. evaluate current status of disease. being considered for debulking and hipec History: appendiceal cancer CHEST:LUNGS AND PLEURA: No new lung lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Right chest wall port terminates at the cavoatrial junction. There is stenosis of the right brachiocephalic vein at the thoracic inlet.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. Scattered hepatic hypodensities are unchanged. No dominant liver lesion. The hepatic and portal veins are patent. Extensive carcinomatosis noted surrounding the liver surface with mild scalloping of its borders.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive peritoneal and omental disease. Reference omental thickening in the lower abdomen measures 2.5 cm seen previously, 2.9 cm (image 123/series 3). If not likely significantly changed allowing for differences in technique and mobility of the omentum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Peritoneal disease surrounding the uterus adnexa and urinary bladder.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable to probably slightly decrease in the diffuse peritoneal/omental carcinomatosis. |
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. Scattered coarse benign calcifications are present in both breasts, many of which have progressed in a benign type fashion, and likely represent fibroadenomatous calcifications. Stable asymmetry in the left inner breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral benign breast calcifications. 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign lymph nodes present in the low axillary region bilaterally. | 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. | History of breast cancer with a T4 lesion seen on MRI. No abnormal osseous foci are identified to indicate metastatic disease. Minimal degenerative changes of the cervical spine. Nonspecific minimal soft tissue uptake in the soft tissues of the left anterior chest wall are unchanged. The T4 lesion noted on recent MRI demonstrates no increased activity on this exam and is therefore more likely a benign osseous lesion such as a hemangioma. | No evidence of bone metastases. Specifically, lack of activity in the T4 region may suggest a benign osseous lesion such as a hemangioma. |
Generate impression based on findings. | repeat head CT to evaluate stroke, right upper extremity weakness No evidence of acute ischemic or hemorrhagic lesion.Previously noted chronic ischemic infarctions on the right high parietal lobe and left temporoparietal lobe are seen without evidence of interval change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.Chronic ischemic infarctions on the right high parietal and left temporoparietal lobe as described above.If clinically indicated, brain MRI can be considered for further imaging evaluation. |
Generate impression based on findings. | Lateral ankle pain. No fracture. Three views of the right ankle reveal lateral soft tissue swelling. No fractures are visualized. | Lateral soft tissue swelling. No visualized fractures |
Generate impression based on findings. | 12-year-old female with right thumb pain with flexion and opposition, edema after injury. Evaluate for fracture of thumb or hand.VIEWS: Right hand PA, oblique and lateral (3 views) 2/12/2015 There is an epiphyseal fracture of the proximal phalanx of the thumb. Alignment of the remaining digits is normal with no evidence of fracture or dislocation. | Epiphyseal fracture of the proximal phalanx of the thumb. Findings were discussed with Dr. Ashley Barrile on 2/12/2015 at 4:10 PM. |
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 areas of architectural distortion are present. Scattered benign calcifications, including arterial calcifications, are present. | 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. | Female 44 years old Reason: 44 y/o F hx of obesity here with chronic left knee pain, concern for OA History: knee pain. There is no acute fracture or dislocation. No joint effusion. There is a bipartite patella with the fragment located superolaterally to the patella, measuring 13 x 25 mm. There is irregularity of the synchondrosis of this fragment. Tiny osteophytes are seen at the medial tibiofemoral compartment, otherwise no significant degenerative changes are noted.Frontal views of the right knee are unremarkable. | 1.Mild osteoarthritis of the left knee.2.Bipartite patella of the left knee, as described above. |
Generate impression based on findings. | Reason: r/o fracture or abnormality. s/p fall, c/o back pain History: back pain Thoracic spine: There is mild irregularity and linear area of sclerosis involving the superior endplate of the T5 vertebral body suspected to represent a mild compression fracture. Vertebral body heights and intervertebral disk spaces are otherwise preserved. Alignment is within normal limits. There are tiny anterior osteophytes without significant central canal or neuroforaminal stenosis. A small lytic lesion along the superior endplate of T4 vertebral body likely represents a small hemangioma. A hypoattenuating focus in the upper pole of the right kidney is incompletely characterized. Otherwise, the paraspinal soft tissues appear unremarkable. Mildly dysplastic appearance of the left L1 transverse process and hypoplastic rib is seen at the right L1 level. Lumbar spine: There is minimal retrolisthesis of L5 on S1, otherwise alignment is within normal limits. Vertebral body heights are within normal limits. There are multilevel disk bulges, most conspicuous at L5-S1 resulting in mild effacement of the thecal sac, but no evidence of significant spinal canal stenosis compression or neuroforaminal compromise. The paraspinal soft tissues appear unremarkable. There is a 7 mm ground glass nodular opacity in the right lung apex. | 1. Mild irregularity and sclerosis involving the upper T5 vertebral body suspected to represent a mild compression fracture. 2. Mild degenerative changes as described above. 3. A hypoattenuating focus in the upper pole of the right kidney is incompletely characterized, possibly a cyst. 4. 7 mm right subpleural apical nodular opacity favored to be related to scarring. |
Generate impression based on findings. | 40 year-old male, left ankle injuryVIEWS: Left ankle, AP, oblique, and lateral (3 views) 2/12/1514:55 Interval removal of splint. No evidence of fracture is identified. Alignment is anatomic. There is minimal soft tissue swelling about the ankle. | Removal of splint without evidence of fracture or malalignment. |
Generate impression based on findings. | Female 74 years old Reason: 74F alcoholic liver cirrhosis with ?chronic cholecystitis w RUQ pain History: RUQ abdominal pain LIVER: The liver measures 11.5 cm in length. Coarsely echogenic parenchyma consistent with history of chronic liver disease. There is a 2.6 x 2.2 cm hyperechoic lesion within the posterior right hepatic lobe which is consistent with a segment 7 hemangioma described on multiple prior studies. The segment 5 lesion described on prior cross-sectional imaging studies is not well seen on today's ultrasound. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Large gallstone within the gallbladder, limiting the evaluation of the gallbladder wall. There is no significant gallbladder wall thickening or pericholecystic fluid. Patent is sonographic Murphy's sign negative. There is no biliary duct dilatation.PANCREAS: Unremarkable where visualized.KIDNEYS: The right kidney measures 10.7 cm. The left kidney measures 10.2 cm. There is no hydronephrosis.OTHER: Trace bilateral pleural effusions. The spleen measures 13.5 cm. | 1. Cholelithiasis without evidence of acute cholecystitis. 2. Coarsely echogenic hepatic parenchyma consistent with history of chronic liver disease. Echogenic lesion within segment 7, presumably corresponds to hemangioma identified on prior studies. Segment 5 lesion described in prior cross-sectional imaging studies is not well seen on today's ultrasound. |
Generate impression based on findings. | Female 44 years old Reason: pre-op History: pain There is a chronic deformity of the right femoral head with an associated coxa vara. Moderate osteoarthritis affects the right hip joint with osteophyte formation and joint space narrowing.Single view of the pelvis shows aforementioned right hip abnormality and mild to moderate osteoarthritis of the left hip joint. Catheter-type device projects over the left abdomen. | Chronic changes in the right femoral head with associated coxa vara. |
Generate impression based on findings. | Ms. Kelly is a 27-year-old female presenting with a palpable lump in the superior left breast. Prior FNA of this area revealed fibrocystic changes. However, this lesion continues to remain suspicious on recent MRI. She presents today for ultrasound guided core biopsy of this area. Left breast ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic area measuring 2.8 x 1.0 x 3.4 cm at the 12 o’clock position with increased vascularity, 3 cm from the nipple. The lesion was somewhat subtle.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The left breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a lateromedial approach, four 12-gauge core needle (Celero) specimens were obtained of the lesion. Targeting was judged excellent. All specimens sank to the bottom of the prefilled container of 10% formalin. Specimen quality was judged excellent.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Bard wing clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital left CC and ML views revealed the percutaneously placed clip to be in the expected location in the peripheral aspect of the lesion. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Sheth. Dr. Abe was present during the procedure at all times. | Successful ultrasound-guided core biopsy of the left breast lesion with clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 67-year-old female with history of altered mental status. There is no evidence of acute intracranial hemorrhage. There are small scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but compatible with mild chronic small vessel ischemic changes. The gray-white differentiation is preserved. The basal cisterns are intact. The ventricles and sulci are symmetric. The calvarium and soft tissues of the scalp are within normal limits. There are partially imaged endotracheal and nasogastric tubes. | No evidence of acute intracranial hemorrhage, mass effect, or edema. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern, MRI of the brain is recommended. |
Generate impression based on findings. | Preoperative planning. Removal of prior prosthesis. There is extensive deformity about the elbow with marked fragmentation, compatible with the given history of a failed total elbow arthroplasty. Cement is present in the medullary space of the humerus and proximal ulna. No metallic hardware is present. The proximal ulnar medullary space is expanded, likely secondary to prior hardware loosening. The proximal radius has been resected. | Extensive deformity about the elbow compatible with a prior failed total elbow arthroplasty. |
Generate impression based on findings. | Great toe proximal phalanx fracture The fracture line at the great toe proximal phalanx is indistinct, with possible subtle periosteal reaction, indicating healing. The alignment is anatomic. | Healing great toe proximal phalangeal fracture. |
Generate impression based on findings. | NECK: There are unchanged postoperative findings related to thyroidectomy. There is unchanged 14 x 9 mm right tracheoesophageal groove mass with heterogeneous enhancement. There are no new lesions or significant cervical lymphadenopathy. The major salivary glands are unremarkable. The major cervical vessels are patent. There is an aberrant right subclavian artery. The osseous structures are unchanged and healed displaced left clavicular head fracture. The airways are patent. Please refer to accompanying dedicated CT chest for the details.HEAD: There is no evidence of intracranial hemorrhage, mass, or abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and left mastoid air cells are clear. There is an underdeveloped right mastoid with partial opacification. There is an unchanged small left occipital osteoma along the outer table. There are bilateral temporomandibular joint degenerative changes. The skull and extracranial soft tissues are otherwise unremarkable. | 1.Unchanged tumor within the right tracheoesophageal groove.2.No evidence of intracranial metastases.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Bilateral hip pain Marked osteoarthritis affects the hip joints bilaterally. No malalignment is present. | Marked osteoarthritis of the hips. |
Generate impression based on findings. | 37-year-old female patient with abdominal pain, and nausea and vomiting with food. Evaluate for gastric and esophageal dysmotility. Scout radiograph demonstrated a nonobstructive bowel gas pattern with a small amount of residual enteric contrast in the descending colon. Single contrast visualization of the esophagus showed a small hiatal hernia. During the exam, trace provoked gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary wave.The stomach was normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed. The gastric mucosal surface was normal.The duodenal bulb and sweep were within normal limits. TOTAL FLUOROSCOPY TIME: 3:36 minutes | 1.Normal esophageal motility.2.Small hiatal hernia. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral sebaceous cysts. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular density. Benign intramammary lymph node with fatty hilum is identified in the right lateral breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | 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. | Female 67 years old Reason: assess for fracture History: L.sided face and jaw swelling after a fall. There is no acute fracture. The frontal, maxillary, and mastoid sinuses are well pneumatized. Dental caries are noted. | There is no acute fracture. |
Generate impression based on findings. | Male 55 years old Reason: eval LLE radiculopathy History: same. Left-sided pedicle screws are seen affixing the L5/S1 joint. There is grade 2 anterolisthesis of L5 on S1. There are severe facet degenerative changes on the right side of the L5/S1 joint. The vertebral body heights and intravertebral disk spaces are preserved. There is no acute fracture or malalignment. | Grade 2 L5 on S1 anterolisthesis with right-sided facet degenerative changes. |
Generate impression based on findings. | Bilateral hip pain AP view of the pelvis reveals no acute abnormalities. there may be some minimal osteophyte formation at the head and neck junction of the right hip. The left hip is unremarkable.. | Questionable minimal degenerative changes of the right hip |
Generate impression based on findings. | Chronic lymphocytic lymphoma treated with R-CHOP and BR now on ibrutinib who presents for follow up. There is no definite cervical lymphadenopathy. The Waldeyer ring structures are not enlarged. The airway appears patent. The thyroid gland and major salivary glands are unchanged, including herniation of the left submandibular gland through a Boutonierre defect. The major cervical flow voids are intact. The imaged intracranial structures are grossly unremarkable. The imaged paranasal sinuses and mastoid air cells are clear. There is unchanged multilevel degenerative spondylosis. There is staphylomatous deformity of the globes, with implants present. The imaged portions of the lung are clear. | No significant lymphadenopathy in the neck to suggest recurrent lymphoma. |
Generate impression based on findings. | Male, 52 years old.Status post aborted left nephrectomy with multiple surgical teams involved. Again seen is a percutaneous right nephrostomy tube. A surgical drain projects over the left hemiabdomen. There is pneumoperitoneum. Skin staples project over the left flank and surgical staples project over the pelvis. No unexpected radiopaque foreign objects. Nonobstructive bowel gas pattern.Bilateral femoral pinning noted. | No unexpected radiopaque foreign objects.Findings discussed with Dr. Norm Smith via telephone at 3:33 PM on 2/12/2015 by Dr. S. McCann. |
Generate impression based on findings. | 49 year old female with history of recurrent left breast abscess presents for ultrasound study of a palpable abnormality in the left periareolar region. Focused ultrasound was performed for the marked area of the left periareolar region. There is a post-surgical scar at medial retroareolar region. No fluid collection is detected. No solid lesions or suspicious findings are not detected. | No fluid collection or suspicious abnormality in the left periareolar region.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Female 49 years old Reason: numbness to B thumbs some transient numbness to other fingers in both hands. Vertebral body heights are maintained. There is no acute fracture or subluxation. There is no evidence of bony neuroforaminal narrowing. There is straightening of the cervical spine and, degenerative changes including small anterior vertebral body osteophytes. | Degenerative arthritic changes of the cervical spine without evidence of bony neuroforaminal narrowing. |
Generate impression based on findings. | Back pain, T11 bone lesion and pulmonary nodules. Evaluate for bony lesions suggestive of metastatic disease. No abnormal osseous foci are identified to indicate metastatic disease. Specifically, no abnormal activity is noted in the T11 vertebral region to indicate an osteoblastic lesion. | No evidence of bone metastases. |
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