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Generate impression based on findings. | Reason: Stroke activations History: Above, slurred speech The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present. A small hypodense focus is present in the basal ganglia. These are unchanged since the... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 4.Old lacunar infar... |
Generate impression based on findings. | Male 72 years old; Reason: lumbar pain Moderate dextroscoliosis of the lumbar spine. Moderate facet hypertrophy. Grade 1 anterolisthesis of L4 on L5 with mild narrowing of the disk space. No fracture is present. | Degenerative changes, as above. |
Generate impression based on findings. | Exam is limited due to lack of contrast. Again noted is diffuse destruction and replacement of the L1-2 disk space with T2 hyperintense signal, although slightly decreased in confluence and thickness, along with destruction of the adjacent endplates and significant collapse of the L1 greater than L2 vertebral body. Ov... | 1. Expected evolution of diskitis osteomyelitis at L1-L2 level with slight decreased associated marrow edema and decreased confluence of fluid signal within the disk space. Stable extent of collapse of the L1 greater than L2 vertebral bodies. Slight decreased ventral epidural component of inflammatory changes, with per... |
Generate impression based on findings. | Male 14 months old Reason: abnormal lung exam (crackles), evaluating for heart size, edema, and airway bronchiectasis History: repeated respiratory exacerbationsVIEWS: Chest AP/lateral (two views) 2/17/15 at 1404 hrs. Cardiac silhouette size is normal. Peribronchial thickening, and subsegmental atelectasis of the poste... | Bronchiolitis with superimposed subsegmental atelectasis of the posterior segment of the right upper lobe. |
Generate impression based on findings. | Ms. Smith is a 58 year old female with a personal history of left breast mastectomy in 2005 with IDC followed by chemotherapy and radiation. Family history of breast cancer in sister, diagnosed at the age of 49. She has no current breast related complaints. Three standard views of the right breast were performed digita... | 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. | 29 year-old female with colon cancer status post hepatic resection and primary resection of tumor. Evaluate for recurrence. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest catheter tip of catheter near the cavoatrial junction. No ot... | 1. Multiple small diffuse hepatic nonspecific lesions but certainly worrisome for metastatic disease in patient with prior right hepatectomy. 2 status post subtotal colectomy with normal-appearing postoperative changes in the intestinal tract. |
Generate impression based on findings. | Male 63 years old Reason: Evaluate s/p Lt TKA History: Evaluate s/p Lt TKA. Components of a total knee arthroplasty device are situated in near anatomic alignment without radiographic evidence of complication. Skin staples, a drain, and foci of gas in the soft tissues reflect recent surgery. | Total knee arthroplasty. |
Generate impression based on findings. | 42 years, Female. Reason: Dobbhoff placement History: Dobbhoff placement Left basilar opacity. Dobbhoff tip projects over the gastric body. Left chest tube and right central venous catheter are noted. Nonspecific bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tip projects over the gastric body. |
Generate impression based on findings. | Female 38 years old; Reason: h/o T cell Rich B Cell Lymphoma with associated HLH s/p 6 cycles of R CHOEP in need of end of treatment staging. Please compare to prior. History: T cell Rich B Cell Lymphoma and HLH s/p 6 cycles of R CHOEP CHEST:LUNGS AND PLEURA: No focal pulmonary lesion. The pleural spaces are clear.MEDI... | 1.Decrease in the size of the reference lymph nodes. Please see PET portion of the exam for metabolic activity. |
Generate impression based on findings. | 69 year old female with constipation and nausea, evaluate for small bowel obstruction. ABDOMEN:LUNG BASES: Mild basilar atelectasis. Multiple pneumatoceles.LIVER, BILIARY TRACT: Scattered subcentimeter low-attenuation hepatic lesions too small to characterize but likely benign.SPLEEN: No significant abnormality notedPA... | 1.No evidence of bowel obstruction or other specific findings to account for patient's pain.2.Mild ectasia of the infrarenal abdominal aorta measuring up to 2.2 x 2.1 cm. |
Generate impression based on findings. | Left temporal lobe lesion. Portable CT surgery scan. Examination is obtained for operative planning and intraoperative navigation. Surgical frame in place.Streak artifact limits evaluation. Left temporal lesion extending into the left insula and left thalamus much better assessed on prior MRI. No significant intracrani... | Examination for operative planning and intraoperative navigation. Left temporal lesion extending into the left insula and left thalamus much better assessed on prior MRI. |
Generate impression based on findings. | Osteosarcoma. Evaluate for progression of lung nodules. LUNGS AND PLEURA: Post-surgical changes of left wedge resections.Multiple upper lung zone predominant small groundglass nodules, not significantly changed from 2012. Solid micronodules are not significantly changed from immediate prior exam.Left apical reference s... | Stable small solid and groundglass nodules. No new sites of disease identified. |
Generate impression based on findings. | 3-year-old female with foot painVIEWS: Left foot, AP and lateral (two views) 2/17/15 14:28 Alignment is anatomic. The osseous structures appear normal for the patient's age. | Normal examination. |
Generate impression based on findings. | Clinical question: intra operative head ct. Signs and Symptoms: same. Nonenhanced head CT:This is a surgical/treatment planning exam and not a diagnostic test.Examination is performed while a stereotactic device is secured to the calvarium without detectable complication.There is revisualization of a cavum septum pellu... | Treatment/surgical planning nonenhanced head CT as detailed. |
Generate impression based on findings. | Female 39 years old Reason: r/o renal stone History: LLQ pain, hematuria, no signs of infection on UA ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant... | Calcification in the left lower quadrant without findings suggestive of a recently passed stone favored to be a phlebolith. Trace free fluid in the pelvic cul-de-sac may be physiologic. |
Generate impression based on findings. | Reason: L pleural effusion ?loculations ?underlying mass. pancreatitis, eval for complications History: see above CHEST:LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema.No suspicious pulmonary nodules or masses. Small loculated pleural effusions, left greater than right.Scattered bibasilar ground glass... | 1. Large peripancreatic and peri-splenic loculated low density fluid collections likely related to known acute pancreatitis. These collections cause significant mass effect on the spleen, pancreas, and stomach.2. Debris within the left lower lobe bronchus and patchy areas of bibasilar consolidation and scarring, likely... |
Generate impression based on findings. | 2-year-old female with coughVIEWS: Chest AP/lateral (two views) 2/17/15 14:27 The cardiothymic silhouette is normal. The cardiac apex, aortic arch and stomach are left-sided. Bronchial wall thickening and large lung volumes with right middle lobe subsegmental atelectasis. No consolidation or pleural effusions. | Bronchiolitis without evidence of pneumonia. |
Generate impression based on findings. | Respiratory distress on BIPAP secondary to obstructive lung mass. Examination prior to chemotherapy. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits fo... | 1. No evidence of intracranial hemorrhage or mass effect. If there is significant suspicion for metastatic disease suggest MRI brain with contrast.2. Scattered areas of hypoattenuation in the periventricular and subcortical white matter are nonspecific but favored to represent chronic small vessel ischemic changes. |
Generate impression based on findings. | Female 38 years old; Reason: assess for metastatic cervical cancer History: none ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality note... | 1.No CT evidence of metastatic disease in the abdomen or pelvis.2.Soft tissue adjacent to the left external iliac artery likely represents the patient's left ovary. |
Generate impression based on findings. | 78-year-old male with urothelial cancer, evaluate for recurrence. CHEST:LUNGS AND PLEURA: No significant abnormality seen.MEDIASTINUM AND HILA: No adenopathy. Diffuse coronary artery calcifications. Heart size is normal without pericardial effusions. Mitral valve anulus calcification. CHEST WALL: No significant abnorma... | 1. Status post cystoprostatectomy without evidence of recurrent or metastatic disease and numeral and right lower quadrant ileal conduit urinary diversion with a left nephroureteral stent in stable position into the ileal conduit. 3. Presumed lymphocele in left pelvis stable and unchanged. 4. Moderately severe degenera... |
Generate impression based on findings. | 70 year old with history of DCIS status post left lumpectomy. Two standard and two implant displaced 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, sus... | 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 67 years old; Reason: History of prostate cancer now with biochemical failure. Please evaluate for distant disease/lymphadenopathy. History: biochemical recurrence of prostate cancer CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. Pleural spaces are clear.MEDIASTINUM AND HILA: No significant abnormality n... | 1.No lymphadenopathy.2.No suspicious sclerotic or lytic lesions. Please see same day nuclear medicine examination to better evaluate the osseous structures. |
Generate impression based on findings. | Female 83 years old Reason: rule out broken ribs History: fell a few months ago and has consistent pleuritic chest pain. Radiopaque markers were placed along the right rib cage. We see no fracture or other specific findings to account for the patient's chest pain. There are wires and plates affixing the sternum. Wires ... | No rib fracture or other specific findings to account for patient's chest pain. Other findings as described above. |
Generate impression based on findings. | Clinical question: Evaluate for intracranial hemorrhage? Signs and symptoms: Poor mental status following cardiac arrest. Portable nonenhanced head CT:Examination is severely limited due to portable technique. Images through posterior fossa are nearly nondiagnostic. Within this limitation however the fourth ventricle i... | Extensive cerebral edema with resultant complete effacement of gray -- white matter differentiation, effacement of the cortical sulci and regions of hypoxic change in bilateral basal ganglia, bilateral occipital lobes. |
Generate impression based on findings. | 11 year old female, postop evaluationVIEWS: Lower extremity scanogram, left tibia and fibula, AP and lateral (two views) 2/17/15 14:42 The right femur measures 47 cm in length and the left measures 44 cm. The right tibia measures 38 cm in length and the left measures 43 cm. The right total leg length is 85 cm and the l... | External fixation of left tibial osteotomy as described above without evidence of hardware complication. |
Generate impression based on findings. | 43 year old woman with history of abnormal mammogram and ultrasound of the right breast. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a poorly-defined hypoechoic mass measuring over 3 x 2.3 cm with numerous internal calcifications at the 11 o’clock position with increased va... | 1. Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.2. Successful ultrasound guided core biopsy of an abnormal right axillary lymph node. Pathology is pending at this time.3. A benign appearing lesion at 7:30 position in the right breast on outsid... |
Generate impression based on findings. | 1 year old female with history of cloaca and constipation. Evaluate degree of stool burden. VIEW: Abdomen AP (one view) 2/17/2015 15:06 Nonspecific bowel gas pattern with no definite evidence of obstruction. Average stool burden. Again seen are vertebral body deformities and malformations including fusion defect of the... | Nonspecific bowel gas pattern with no definite evidence of obstruction. Average stool burden. |
Generate impression based on findings. | 41 years old male with a history of melanoma, s/p wide local excision of melanoma and sentinel lymph node biopsy which was positive. Please evaluate for extent of disease and metastasis. RADIOPHARMACEUTICAL: 10.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 101 mg/dL. Today's CT portion grossly demonstrat... | 1.Small mild hypermetabolic lymph nodes in the neck and the bilateral axillary regions, which are nonspecific.2.Focus of increased activity in the hepatic flexure of the colon without definite CT correlation, which can be due to diverticulitis, adenoma or carcinoma. Suggest further evaluation of coloscopy.3.Nonspecific... |
Generate impression based on findings. | Two year old female with history of fractureVIEWS: Left forearm AP and lateral (two views) 2/17/15 15:13 A cast is again seen which obscures fine bone detail. Healing fractures of distal radius and ulna with persistent dorsal angulation of the distal radial fracture fragment. | Healing distal forearm fractures with persistent dorsal angulation of the distal radial fracture fragment. |
Generate impression based on findings. | Reason: thoracic aneurysm History: same LUNGS AND PLEURA: Subpleural interstitial opacity in the right upper lobe suggestive of fibrosis, unchanged.Triangular 5-mm solid nodule in the right middle lobe adjacent to major fissure, new since the previous scan and suggestive of an intrapulmonary lymph node (series 5/62).ME... | Slight increase in axial diameter of thoracic aortic aneurysm. |
Generate impression based on findings. | Female 72 years old Reason: dropped skillet on foot yesterday History: dropped skillet on foot yesterday. The bones are demineralized, suggesting osteopenia/osteoporosis. We see no fracture. Mild to moderate osteoarthritis affects the first metatarsophalangeal joint. A small ossicle in the soft tissues medial to the fi... | Demineralized bones without fracture. |
Generate impression based on findings. | 66-year-old male with history of metastatic gastric cancer now with abdominal pain, evaluate for bowel obstruction and evaluate stent. ABDOMEN:LUNG BASES: Mild basilar atelectasis.LIVER, BILIARY TRACT: Mild intrahepatic biliary ductal dilatation appearing similar to prior. The common bile duct is again dilated duct unt... | 1.No evidence of small bowel obstruction. 2.Gastroduodenal stent similar to prior. 3.Reference metastatic lesions overall similar to prior. 4.Persistent dilatation of the biliary tree due to partial obstruction near the level of the duodenum. |
Generate impression based on findings. | History of paraganglioma. Evaluate for recurrence. RADIOPHARMACEUTICAL: 11.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates postsurgical changes in the right neck. The right submandibular gland is surgically absent. A right carotid artery stent is present. T... | No evidence of FDG avid tumor. |
Generate impression based on findings. | Reason: SOB History: above PULMONARY ARTERIES: No evidence of pulmonary embolism. Anastomosis at the main pulmonary artery from prior cardiac transplant. LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.Mild septal prominence, suggesting pulmonary edema. Moderate pleural effusions, right greater than left, w... | 1.No evidence of pulmonary embolism.2.Pulmonary edema and pleural effusions with associated compressive atelectasis. Findings compatible with CHF.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 39 years old Reason: pain after fall History: pain, swelling. We see no fracture, malalignment, or joint effusion. No findings to account for patient's pain. | No findings to account for the patient's pain. If there is clinical concern for internal derangement, MRI can be considered. |
Generate impression based on findings. | 12-year-old female with fractureVIEWS: Right ankle AP, oblique, lateral (3 views) 2/17/2015 15:22 Interval removal of cast. Distal fibular physis remains widened with subtle bridging along the lateral aspect. Alignment is anatomic. No soft tissue swelling or joint effusion. | Healing fracture of the distal fibular fracture in anatomic alignment with subtle bridging of the lateral aspect of the fibular physis. |
Generate impression based on findings. | 55-year-old male metastatic lung cancer, liver metastases, status post chemotherapy ABDOMEN:LUNG BASES: See chest CT report for complete examination result and multiple left rib and metastatic lesions are again seen, appearing than previous and with probable additional foci. Nuclear medicine bone scintigraphy is a more... | 1. Increasing size of liver metastatic lesion and adjacent satellite lesion. 2. Increasing size and number of lytic skeletal metastatic lesions as described above. Nuclear medicine is a more sensitive indicator of extent and activity of skeletal metastatic disease. |
Generate impression based on findings. | Clinical question: Evaluate sinuses. Signs and symptoms: Frequent sinusitis without resolution after treatment medically. Ongoing facial pain. Medtronic fusion sinus CT:Frontal sinuses are well pneumatized and unremarkable.Ethmoid sinuses are well pneumatized and unremarkable.Sphenoid sinus is well pneumatized and unre... | 1.No evidence of sinusitis.2.Mild rightward nasal septum deviation, small rightward projecting bony septal spur resulting in mild deformity of the right inferior turbinate mucosa.3.Unremarkable orbits and well pneumatized mastoid air cells and middle ear cavities. |
Generate impression based on findings. | Female; 60 years old. Reason: 60 yo CF with history of mycosis fungoides with left renal exophytic hypoattenuating lesion on CT, further evaluate RIGHT KIDNEY: Right kidney measures 11.5 cm in length. The renal cortex is normal in echogenicity. There is a nonobstructing 6 x 4 x 4 mm renal stone in the inferior pole. Th... | 1.Nonobstructing right renal stone.2.1.3 cm minimally complex left renal cyst. |
Generate impression based on findings. | Female 64 years old Reason: hx of bladder cancer, evaluate for metastatic disease with delayed imaging History: see above ABDOMEN:LUNG BASES: Scattered nonspecific micronodules, unchanged.LIVER, BILIARY TRACT: No evidence of liver metastasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality n... | 1.Dramatic interval increase in multiple pelvic soft tissue nodules consistent with peritoneal tumor deposits. There is now invasion of the pelvic small bowel with circumferential involvement of bowel loops. No small bowel obstruction or intraperitoneal free air.2.Interval increase of multiple retroperitoneal lymph nod... |
Generate impression based on findings. | 16-year-old male with a fractureVIEWS: Right ankle AP, oblique, lateral (3 views) to 17/2015 15:30 Interval removal of cast material. A plate and screw device are again seen in the distal fibula with the distal fibular fracture in near-anatomic alignment. No evidence of hardware complication. Periosteal reaction along ... | 1. Distal fibular and tibial fractures in near anatomic alignment. 2. Area of lucency along the medial aspect of the tibial metaphysis and medial malleolus may represent healing and/or osteonecrosis. |
Generate impression based on findings. | There is again suggestion of slight prominence of the cerebral sulci especially involving the frontal and parietal lobes, as well as supratentorial ventricular prominence. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial f... | No acute intracranial abnormality. Stable nonspecific prominence of cortical sulci and supratentorial ventricular system. If there remains concern for an acute ischemic event, MRI brain is recommended. |
Generate impression based on findings. | Male 62 years old Reason: 62 y/o with neck pain eval acute changes History: neck pain. There are small intercalary osteophytes along the anterior aspect of the spine, but the intervertebral disk spaces are preserved, as are the vertebral body heights. There is perhaps mild multilevel facet joint osteoarthritis, but the... | Mild degenerative arthritic changes without fracture or other acute abnormality. |
Generate impression based on findings. | 4 year old female with fractureVIEWS: Left humerus AP, lateral (two views) 2/17/15 15:40 Healing proximal humeral fracture with improvement in posterior medial angulation of the distal fracture fragment. Bony remodeling and periosteal reaction is again seen reflecting interval healing. | Healing proximal humeral fracture in near anatomic alignment. |
Generate impression based on findings. | Male 45 years old Reason: ap lateral view History: 1 year post cervical laminoplasty. Patient is status post multilevel laminoplasty. The alignment is within normal limits. There is mild degenerative disk disease at C3/4 and C4/5. The vertebral body heights are preserved. | Postoperative changes of prior laminoplasty and mild degenerative disk disease as described above. |
Generate impression based on findings. | 5-year-old male with foot pain, history of neuroblastomaVIEWS: Left ankle, AP and lateral (two views) left foot, AP, lateral, and oblique (3 views). Ankle: There is moderate soft tissue prominence about the ankle and possible small effusion without underlying osseous abnormality. Alignment is anatomic.Foot: Alignment i... | Soft tissue prominence about the ankle and possible small effusion without osseous abnormality. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are essentially completely opacified except for a small focus of air in the right frontoethmoidal recess.Anterior ethmoids: The anterior ethmoid air cells are near completely opacified, worsened since the prior exam CT.Maxillary sinuses: There is improved a... | 1. Worsened pan sinus opacification. High-density material within the central maxillary sinuses likely represents inspissated secretions although superimposed fungal infection cannot be excluded.2. Polypoid opacification of nasal cavity again suggested, which may relate to sinonasal polyposis.3. Improved visualization ... |
Generate impression based on findings. | Pain. Fall. LEFT KNEE: No fracture or malalignment. Moderate degenerative changes are present, with osteophyte formation. Calcific density within the knee joint likely represents CPPD.RIGHT SHOULDER: There is a comminuted fracture through the distal third of the clavicle with minimal inferior angulation of the distal f... | Distal clavicular fracture, as above. |
Generate impression based on findings. | 50 year-old female status post video capsule ingestionVIEW: Abdomen AP (one view) 2/17/15 15:37 No radiopaque foreign body or capsule is visualized. The bowel gas pattern is nonobstructive. | No radiopaque foreign body or video capsule visualized. |
Generate impression based on findings. | History of metastatic bone lesions. Evaluate for mets. There are multiple areas of increased radiotracer uptake noted in the right parietal skull, posterior right 7th rib, and thoracic and lumbar spine including the T12 and L4 vertebral bodies. Increased uptake within the cervical and upper thoracic spine likely correl... | Multiple areas of increased uptake compatible with osseous metastatic disease. |
Generate impression based on findings. | 24 years, Male, Reason: Bright red blood drainage from urethra and drain bag concern for fistula History: Bright red blood drainage from urethra and drain bag concern for fistula. ABDOMEN:LUNG BASES: Small left pleural effusion with associated compressive atelectasis is unchanged. Central venous catheter tip terminates... | 1.Pseudoaneurysm in the right kidney along the course of nephroureterostomy tube with blood within the right renal pelvis, ureter and bladder.2.Left pelvic organized collection is decreased in size.3.Chronic ileus.4.Low lying endotracheal tube.Findings discussed with ICU resident at the time of this dictation. |
Generate impression based on findings. | Status post fracture.VIEWS: Right forearm AP lateral 2/17/15 (two views) Healing fractures of the right radius and ulna with minimal dorsal angulation are unchanged in alignment. | Healing fractures, unchanged in alignment. |
Generate impression based on findings. | Hyperparathyroidism localization. There is physiologic distribution of the radiopharmaceutical. An abnormal focus of increased radiotracer uptake is identified inferior to the lower pole of the right thyroid lobe. This focus washes out on delayed images. The right thyroid lobe appears to measure 4.8 cm and the left lob... | Abnormal focus of increased uptake inferior to the lower pole of the right thyroid lobe is highly suspicious for a parathyroid adenoma. |
Generate impression based on findings. | Rule out FAI, CAM Due to technologist error, the knees and pelvis were not scanned, and therefore some of the measurements below cannot be calculated. We will attempt to have the patient return for a complete study, at which time an addendum will be locked.MEASUREMENTS: CAM location : Three o'clock anteriorAlpha angle ... | Borderline CAM deformity and other measurements as described above. Please note that this is an incomplete examination and the patient will be asked to return for additional scanning of the pelvis and knees at no charge. |
Generate impression based on findings. | Reason: hx resected squamous cell ca of bladder History: evaluate for metastases LUNGS AND PLEURA: Scattered micronodules, unchanged from previous, most likely post infectious.No suspicious nodules.MEDIASTINUM AND HILA: Mildly enlarged inhomogeneous left lobe of the thyroid gland, unchanged.No significant lymphadenopat... | Stable micronodules and no specific evidence of metastatic disease in the thorax. |
Generate impression based on findings. | Male 6 days old Reason: is PCVC in correct placement? History: PCVC placement, respiratory distress syndrome.VIEW: Chest AP (one view) 2/17/15 at 1612 hrs. ET tube tip is below the thoracic inlet. NG tube terminates at the stomach. Umbilical lines unchanged. Abdominal drain is again present. Cardiac silhouette size is ... | Not centrally positioning of new PCVC.Interval improvement in right upper lobe atelectasis and development of right middle lobe opacity on a background of diffuse lung haziness. |
Generate impression based on findings. | Worsening reflux symptoms, on EGD large amounts of retained food and liquid despite 8 hrs of fasting. Evaluate for gastroparesis. Visually there was significant delayed gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as fol... | Significantly delayed gastric emptying. |
Generate impression based on findings. | Male 3 years old Reason: Cochlear implant placement History: Post-op cochlear implantVIEWS: Skull AP and lateral 2/17/15 (two views) Interval left cochlear implant placement. The implant does the complete curl of the cochlea. No evidence of kinking or disconnections. | Status post left cochlear implant as described. |
Generate impression based on findings. | Evaluate RML density. CHEST:LUNGS AND PLEURA: Post-surgical findings of right lower lobe wedge resection.Right middle lobe subpleural nodule with adjacent atelectasis is 17 x 12 mm, previously 7 x 6 mm (series 6, image 69).Stable bilateral scattered pulmonary nodules, likely post-inflammatory.MEDIASTINUM AND HILA: Norm... | Enlarging right middle lobe nodule with adjacent atelectasis, which may represent a granuloma although a primary lung malignancy is also possible. Short interval follow-up is recommended, alternatively PET-CT may be considered for further evaluation. |
Generate impression based on findings. | Reason: 80 y/o M with PMH of CHF, COPD, thoracic aorta dilation on CXR, please eval for AAA or other lung pathology History: as above CHEST:LUNGS AND PLEURA: Scattered benign-appearing pulmonary micronodules, some calcified. No suspicious pulmonary nodules or masses.Apical pleural scarring. Very small bilateral pleural... | 1. The thoracic and abdominal aorta are normal in caliber, stable from prior exam dated 10/2005. 2. Small pleural effusions, without other acute cardiopulmonary abnormality. |
Generate impression based on findings. | Reason: mets lung cancer, liver mets. sp chemo, pls c/w previous study and evaluate dx status. History: lung ca LUNGS AND PLEURA: Reference left upper lobe paramediastinal nodule measures 19 x 12 mm (series 9, image 35), unchanged.Left paramediastinal radiation fibrosis, unchanged.Left basilar low density pleural thick... | 1.Stable appearance of a left paramediastinal nodule/mass and adjacent post radiation changes.2.Multiple osseous metastatic lesions have increased in size from the prior exam.3.No new pulmonary nodules or masses.4.Subjective increase in left pleural metastatic disease with areas of extension to the chest wall as detail... |
Generate impression based on findings. | Right breast cancer. Surgery 2/18/2015 at 1 pm by Dr Jaskowiak. Right wire loc lumpectomy, SNBx, CALND, removal of left port in CDOR.RADIOPHARMACEUTICAL: The right breast was prepared in a sterile manner. A total of 1.069 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. Foci of increased ... | Sentinel node identified in the right axillary and right internal mammary stations. |
Generate impression based on findings. | Gait difficulty, cogwheeling rigidity. Evaluate for Parkinson's disease. Normal symmetric activity is seen in the basal ganglia. | Normal examination. No evidence of nigrostriatal dopaminergic dysfunction. |
Generate impression based on findings. | The liver is normal echogenicity measuring up to 5.1 cm in length. No intra-or extrahepatic biliary ductal dilatation. The gallbladder is contracted with no evidence of sludge or cholelithiasis. The gallbladder wall measures up to 1 mm in thickness, within normal limits. There is no pericholecystic fluid. The common b... | Normal examination with no evidence of biliary atresia. Contracted gallbladder with no evidence of sludge or cholelithiasis. |
Generate impression based on findings. | 12 year old female with epigastric and right lower quadrant pain. Evaluate for appendicitis. Visualized structure in the right lower quadrant measures up to 5-6 mm in diameter may represent an appendix, however it is unclear whether this is truly the appendix and therefore study is inconclusive to rule out appendicitis... | The appendix is not definitively visualized and study is inconclusive for ruling out appendicitis. There is small amount of free fluid in the lower abdomen. Scattered mildly prominent lymph nodes in the periumbilical region.Findings were discussed with ED physician Dr. Christine Babcock by phone on 2/13/2015 at 10:20 A... |
Generate impression based on findings. | 7 years old Male. Reason: Post therapy- evaluate uptake. History: Relapsed neuroblastoma s/p MIBG therapy. Extensive bone marrow uptake is in the skeleton including whole spine, skull, facial bones, sternum, ribs, pelvis, bilateral femurs, bilateral humeri and elbows as well as well as bilateral tibias. There is a focu... | Extensive MIBG avid bony metastasis.Focal soft tissue uptake in the right upper abdomen, which can be due to tumor or normal GI activtiy.Diffuse lung opacities in both lungs on CT, which can be due to edema or inflammatory change. |
Generate impression based on findings. | Fall/injury. I see no fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | Evaluate status-post left total knee arthroplasty Components of a left total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of complication. Skin staples, a drain, and foci of gas density in the anterior soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty. |
Generate impression based on findings. | 50 year-old female with left arm radiculopathy. Please evaluate for cervical spine DJD. Moderate degenerative disk disease affects C4/5, C5/6, and C6/7. There is mild narrowing of the C4/5 and C5/6 neural foramina on the left. Alignment is within normal limits and vertebral body heights are preserved. | Degenerative disk disease as above. |
Generate impression based on findings. | One year follow-up. Spinal stenosis in cervical region. The cervical spine is visualized down to C6/7; the cervicothoracic junction is not well seen due to overlying anatomy. Again seen are postoperative changes of multilevel laminoplasty. There is perhaps mild degenerative disk disease at C3/4 and C4/5. I see no spond... | Postoperative changes of prior laminoplasty and mild degenerative disk disease as above. |
Generate impression based on findings. | Possible fracture of right second toe. The PIP joint of the second toe is held in flexion, limiting evaluation of the phalanges. I see no fracture line. Please note that I cannot exclude the possibility of a subluxation or dislocation at the PIP joint. The PIP joints of the third and fourth toes are likewise flexed, li... | Limited evaluation of the right second toe shows no fracture line. Please note that I cannot exclude the possibility of a subluxation or dislocation at the PIP joint. If further imaging evaluation is clinically warranted, dedicated toe radiographs may be considered. |
Generate impression based on findings. | 59-year-old female with history of osteoarthritis. Signs and symptoms concerning for ligament tear or meniscal tear. Evaluate for joint disease. Four views of the left knee are provided. Severe osteoarthritis affects the knee, particularly the patellofemoral and lateral compartments. There is perhaps a slight valgus de... | Severe osteoarthritis as above. Please note that I cannot comment on the integrity of the menisci or ligaments of the basis of conventional radiography. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Left foot pain. History of trauma. Evaluate for fracture. I see no fracture or malalignment. The is mild soft tissue swelling adjacent to the fifth MTP joint. There is an accessory navicular bone, a normal variant. | No fracture evident. Other findings as above. |
Generate impression based on findings. | Chronic lower back pain. Evaluate for disk disease. The bones are demineralized, suggesting osteopenia/osteoporosis. There is approximately 25% loss of height of L1 indicating a compression fracture of indeterminate age, but not present on the CT scan from 2012. Remaining lumbar vertebral body heights are preserved. Se... | L1 compression fracture of indeterminate age and degenerative disk disease as above. |
Generate impression based on findings. | Pain. Gait difficulties. I see no fracture. There is mild osteoarthritis of the hip with chondrocalcinosis of the acetabular labrum. Numerous punctate metallic densities in the overlying gluteal musculature likely reflect prior heavy metal injections. Arterial calcifications are also noted within the soft tissues. | Mild degenerative arthritic changes without fracture evident. |
Generate impression based on findings. | History of breast cancer on Aromasin. Fell on ice. Pain in the left knee. Rule-out DJD. Four views of the left knee are provided. The knee appears normal for age, without frank degenerative joint disease. I see no fracture or other findings to account for the patient's pain.The right knee likewise appears normal for ag... | Normal-appearing knee without findings to account for the patient's pain. |
Generate impression based on findings. | Clinical question: ICH,? Herniation. Signs and symptoms: ICH. Unenhanced head CT:Examination is limited due to portable technique and motion artifact.Acute hematoma in the left thalamus measuring at 39 x 31 mm which is a slightly smaller than prior exam measurements.Surrounding vasogenic edema without appreciable chang... | 1.No evidence of new hemorrhage.2.Slightly smaller left hemispheric hematoma since prior exam as measured.3.Slight decreased size of shunted right lateral ventricle since prior exam.4.Overall mass effect from the hemorrhage and associated mass-effect demonstrate no gross interval change. |
Generate impression based on findings. | Clinical question: Assess for ICP, intimal or any change since prior exam. AMS, ammonia L470 and liver dysfunction. Signs and symptoms: As above. Nonenhanced head CT:There is no detectable intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. Tiny focus of low-attenuation in the right occipital l... | No acute intracranial process. No appreciable interval change since prior exam. |
Generate impression based on findings. | Clinical question: Intracranial hemorrhage. Signs and symptoms: SOB, acute change in respiratory status. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Evaluate for acute intracranial process. Signs and symptoms: Left-sided headache. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular sys... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Head trauma. Signs and symptoms: Head trauma evaluate for hemorrhage. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are periventricular and subcortical patchy foci of low attenuation ... | 1.No acute intracranial process.2.Age indeterminate small vessel ischemic strokes of moderate degree. |
Generate impression based on findings. | Clinical question: ICH. Signs and symptoms: AMS, syncope, found down and the Snow. Nonenhanced head CT:There is no detectable acute intracranial process CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is no detectable post traumatic calvarial or soft tissues of the scalp fin... | 1.No acute process.2.Large right MCA and a smaller left superior cerebellar artery territory chronic ischemic strokes without change since prior exam |
Generate impression based on findings. | Right knee washout, spacer in place. Again seen is a cement spacer device. Alignment is near-anatomic. Drains in anterior soft tissue reflect recent surgery. | Cement spacer and surgical drains as above. |
Generate impression based on findings. | Erythema, swelling, tenderness. Infection? There is diffuse soft tissue swelling, particularly along the volar and radial aspects of the wrist and distal forearm. I see no osteolysis to confirm osteomyelitis. Mild degenerative arthritic changes affect the wrist. Deformity of the distal diaphysis of the ulna is incomple... | Soft tissue swelling, old posttraumatic changes and osteoarthritis as above. |
Generate impression based on findings. | Clinical question: Rule out bleed or CVA. Signs and symptoms: Altered mental status. Nonenhanced head CT:Examination demonstrate a small focal region of cortical low attenuation of the left posterior frontal with subtle associated mass effect evident by effacement of adjacent cortical sulci (axial images 21 through 23)... | 1.No evidence of an acute or new findings since prior exam.2.Revisualization of a stable small left frontal subacute nonhemorrhagic ischemic stroke.3.Findings suggestive of mild age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Index finger trauma one week ago, swelling. Evaluate fracture. Maximal pain at DIP. There is diffuse soft tissue swelling. I see no malalignment or fracture. Specifically, the DIP joint is unremarkable. | Soft tissue swelling without fracture or malalignment. |
Generate impression based on findings. | left PCA territorial stroke NONCONTRAST CT HEADThere are evolving acute or subacute ischemic infarction on the left PCA territory involving left fusiform gyrus, parahippocampal gyrus mid-portion and left occipital lobe. These findings do not show any significant interval change since prior exam. There is another subtle... | 1. Evolving subacute ischemic infarction on the left PCA territory, no change since prior exam.2. Subtle low attenuation on the left frontal lobe white matter indicates possible age indeterminate ischemic lesion, no change since prior exam.3. Intracranial atherosclerosis with fetal left PCA with non visualization of th... |
Generate impression based on findings. | Acute worsening in mental status since 2/16 with rigidity, myoclonus, responsive only to pain. Evaluate for any acute abnormality. There is no evidence of intracranial hemorrhage or mass effect. There is parenchymal volume loss. The ventricles and basal cisterns are otherwise unchanged in size and configuration. There ... | No evidence of intracranial hemorrhage or mass effect. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | 87 years, Female, Reason: eval- hx of EVAR s/p Type 2 endoleak embolization History: eval repair. CHEST:LUNGS AND PLEURA: 1.4-cm (16/22) left upper lobe nodule. There is an additional high-density nodule in the left lower lobe which is slightly increased in size a 1.4 cm (16/56), previously 0.9 cm. Additional scattered... | 1.No evidence of endoleak status post coiling.2.Pelvic mass which may represent recurrent tumor or collapsed bowel loops. Recommend further evaluation with oral and IV contrast.3.Multiple pulmonary nodules are suspicious for metastatic disease. Follow up CT is recommended.Contrast extravasation description:Supervising ... |
Generate impression based on findings. | Hip pain. Rule out avascular necrosis. Patchy sclerosis in the femoral head is compatible with the suspected diagnosis of avascular necrosis. I see no subchondral fracture or articular surface collapse. Linear sclerosis in the medullary space of the proximal femoral diaphysis may represent additional osteonecrosis. | Findings compatible with osteonecrosis as described above. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 35-year-old male with history of Crohn's disease with revision of ileocolectomy on 1/24/2015 now with abdominal pain, evaluate for abscess or leak. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Small low attenuation lesion within hepatic segment 6 is not significantly changed compared to the... | 1.Postsurgical changes of ileocecectomy.2.Approximately 5 x 8 cm fat-containing lesion in right abdomen with adjacent inflammatory changes most consistent with omental infarct.3.Small pocket of fluid adjacent to the right upper quadrant ileocolonic anastomosis measuring 1.5 x 2.9 cm.4.No bowel obstruction or intraperit... |
Generate impression based on findings. | 67 years, Male. Reason: Confirm Dobbhoff placement History: Dobbhoff Bihilar lymphadenopathy, better evaluated on recent chest radiograph.Residual enteric contrast within the stomach. Dobbhoff catheter projected over the distal gastric body/antrum. Bowel gas pattern unremarkable. The pelvis is not imaged. | Dobbhoff catheter with tip projected over the distal gastric body. |
Generate impression based on findings. | Bilateral hip pain. Rule out hip fracture. Two views of the right hip are provided. Mild osteoarthritis affects the hip. There is slight prominence of the anterior aspect of the femoral head/neck junction suggesting a cam deformity. I see no fracture.Two views of the left hip are provided. Mild osteoarthritis affects t... | Osteoarthritis of both hips. I see no fracture. |
Generate impression based on findings. | 69-year-old male with leukocytosis and abdominal distention, evaluate for infectious or inflammatory process. Exam somewhat limited by motion.ABDOMEN:LUNG BASES: Please see chest CT done on same day for full details regarding the chest. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnorm... | 1.No specific evidence of infection in the abdomen or pelvis.2.Colonic diverticulosis without specific evidence of diverticulitis. No bowel obstruction. 3.Mild ectasia of the infrarenal aorta measuring up to 3.3 X 3.0 cm. 4.Please see dedicated chest CT for details regarding the chest. |
Generate impression based on findings. | 58 year-old female status post gastric perforation repair now with tachycardia and pain. ABDOMEN:LUNG BASES: Mild basilar atelectasis. Partially visualized coronary artery calcifications. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality n... | 1.Post-surgical changes about the stomach.2.Small collection of fluid and gas near the gastrohepatic ligament adjacent to the gastric antrum measuring 2.9 x 2.3 cm which may be related to gastric perforation. 3.Numerous foci of gas within the left anterior abdominal wall pannus which are nonspecific, correlate for clin... |
Generate impression based on findings. | 59 years, Male. Reason: Dobbhoff History: Dobbhoff Note that the lower portion of the pelvis is excluded from the field-of-view. Dobbhoff tube looped over the stomach with tip projecting over the gastric body. Nasogastric tube tip projects over the distal gastric body. Nonobstructive bowel gas pattern. | Dobbhoff tube looped over the stomach with tip projecting over the gastric body. Nasogastric tube tip projects over the distal gastric body. |
Generate impression based on findings. | 35 years, Female. Reason: 35yoF with known h/o GIB from pancreatitic cancer/XRT, now with acute abdominal pain/distention r/o obstruction/perf History: acute abdominal pain/distention GDA embolization coils in the mid upper abdomen. The tip previously projected over the right lower quadrant on prior study is no longer ... | Mildly prominent central small bowel loops, likely reflecting ileus. |
Generate impression based on findings. | Knee pain, swelling. Patellar fracture, other fracture? Four views of the right knee are provided. Chronic enthesopathic changes are noted along the anterior aspect of the patella. There is a nondisplaced fracture through an enthesophyte projecting from the anteroinferior aspect of the patella. There is swelling of the... | Nondisplaced fracture of right patellar enthesophyte and other findings as described above. |
Generate impression based on findings. | 54-year-old male with history of stem cell transplant patient with diffuse progressive ascending weakness, evaluate for infection. 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: CH... | 1.No specific evidence of infection. 2.Improvement in previously described diffuse infiltrative process in the retroperitoneum/pelvis. |
Generate impression based on findings. | 7-year-old male stepped on glass. Evaluate for foreign body.VIEWS: Left foot AP, oblique, lateral (3 views) 2/17/2015 Faint opacity in the subcutaneous tissues of the heel consistent with a foreign body. No soft tissue swelling or joint effusion is seen. No evidence of fracture or dislocation. | Foreign body in the soft tissues of the heel. |
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