instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | Thumb injury I see no fracture or dislocation. I see no specific findings to account for the patient's thumb pain. | No fracture or other specific findings to account for the patient's thumb pain are evident. |
Generate impression based on findings. | 87 year old female with altered mental status. There is no evidence of intracranial hemorrhage. There are patchy regions of low-attenuation within the supratentorial white matter and the left thalamus/basal ganglia compatible with age indeterminant small vessel ischemic disease. 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 is unremarkable. There is partially imaged swelling and low attenuation within the right posterior neck musculature. There are bilateral lens implants. | 1.No evidence of intracranial hemorrhage.2.Age indeterminant small vessel ischemic disease within the supratentorial white matter and left thalamus/basal ganglia. If there is clinical concern for acute ischemia, an MRI brain is suggested.3.Partially imaged edema and mass-like swelling in the right posterior neck neck musculature of uncertain etiology. Further evaluation is suggested. |
Generate impression based on findings. | 70 year old female with atrial fibrillation and trauma. There is no evidence of intracranial hemorrhage. There is mild global volume loss, atherosclerotic calcification of the distal internal carotid and vertebral arteries, and patchy foci of low attenuation within the supratentorial white matter which are compatible with small vessel ischemic disease. 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. | 1.No evidence of intracranial hemorrhage.2.Age indeterminate moderate small vessel ischemic disease. If there is clinical concern for acute ischemia, MRI brain is suggested. |
Generate impression based on findings. | No acute intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. No CT evidence of acute large territorial ischemia. Mild to moderate prominence of the ventricles and sulci, likely age related cerebral volume loss. Periventricular and subcortical white matter hypoattenuation likely small as ischemic disease of indeterminate age. There is no evidence of midline shift. Near complete opacification of the left maxillary sinus; otherwise, visualized portions of the paranasal sinuses and mastoid air cells are clear. | 1.No acute intracranial hemorrhage as clinically questioned.2.No CT evidence of acute territorial ischemia. If there is high clinical suspicion for acute infarction, further evaluation with MRI is recommended. |
Generate impression based on findings. | CT brain: No acute intracranial hemorrhage. No CT evidence of acute large territorial ischemia. Mild prominence of the ventricles and sulci, likely age related volume loss. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections or subdural hematomas. The mastoid air cells are clear. CT neck: Endotracheal and enteric tubes are noted with near complete opacification of the nasal cavity, moderate opacification of the ethmoid sinuses, and fullness within the oropharynx and the nasopharynx, which is likely secondary to secretions. Within the limitation of noncontrast examination, no definite collections to suggest abscess.The parotid glands, submandibular glands and thyroid lobes are symmetric bilaterally. No thyroid masses are identified bilaterally. There is no pathological lymph node enlargement or lymphadenopathy identified. | 1.Status post intubation with opacification of the nasal cavity as well as fullness of the oropharynx and nasopharynx which is likely secondary to secretions. No evidence of an abscess.2.No acute intracranial abnormality. |
Generate impression based on findings. | There is left submandibular duct dilatation suggesting ductal obstruction (series 10, images 10 through 20) without an obvious stone. There are associated inflammatory changes with mucosal swelling along the submandibular duct as well as the left hypopharynx. Left submandibular gland is hyperemic when compared to the right. No rim enhancing fluid collections to suggest an abscess. The parotid glands are normal in size and symmetric bilaterally without masses. Heterogeneous appearance of the left thyroid gland with associated calcifications is unchanged compared to prior examination. There are no nasopharyngeal, oropharyngeal or laryngeal masses identified and there is no airway compromise. The lung apices are clear. There is no clinically significant adenopathy. Cervical spondylosis noted. | Findings consistent with left submandibular sialadenitis with an obstructed submandibular duct as detailed above. No obvious stone is identified. |
Generate impression based on findings. | Cerebral infarction. Please identify potential source such as carotid stenosis or intracranial stenosis. Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. The right vertebral artery is occluded proximally and reconstituted via collaterals.There is no significant stenosis along the course of the left vertebral artery. The left vertebral artery has aortic arch origin. There is 40% narrowing at its origin.There are degenerative changes in the c-spine worse at C6-7 where there are end-plate osteophytes.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. There is 50% stenosis along the distal cavernous segment of the left ICA with an additional tandem 50% stenosis along the clinoidal segment.There is extracranial origin of the left PICA.There is high grade stenosis of the distal RVA at the V-B junction.The anterior communicating artery is medium size. The posterior communicating arteries are tiny. The right A1 is asymmetrically larger than the left.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense focus at the right basal ganglia measuring 25x10 mm axial dimensions. There is no associated hyperdensity.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Right basal ganglia subacute cerebral infarction without hemorrhagic conversion.2.RVA occlusion at its origin with some distal reconstitution via collaterals. There is high grade stenosis of the distal RVA at the V-B junction.3.Tandem 50% stenoses along the intracranial left ICA. |
Generate impression based on findings. | 2 year old female with fever and torticollis. There is tonsillar enlargement and bilateral cervical lymphadenopathy. Within the left parapharyngeal soft tissues there are two foci of peripheral enhancement and central low attenuation measuring up to 8 mm and 10 mm respectively. In addition, within level V on the right there is a 10-mm lymph node with central low attenuation. There is also a retropharyngeal effusion. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | Two left peritonsillar abscesses and bilateral cervical lymphadenopathy including a right level V node with a central abscess. Recommend repeat imaging if these fail to resolve clinically. |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Negative unenhanced brain CT. |
Generate impression based on findings. | Head CT:Redemonstrated are a few hypodense foci within the white matter, most prevalent adjacent to the right caudate body, without significant associated mass effect, and unchanged in appearance. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Max/facial/sinus CT:Opacification is noted within a few anterior bilateral ethmoid air cells which encroaches on the left ostiomeatal unit. Otherwise the remaining paranasal sinuses are clear as are the bilateral mastoid air cells and middle ear cavities and there are no air-fluid levels. The right maxillary sinus ostia is patent as are the bilateral frontoethmoidal and sphenoethmoidal recesses. The lamina papyracea are intact bilaterally. The floor of the anterior cranial fossa and cribriform plate region are unremarkable. The nasal septum is S-shaped. Note is made of a left-sided concha bullosa. Bilateral orbits and the posterior nasopharynx appear unremarkable. | 1.Small vessel ischemic disease of indeterminate ages.2.Opacification is noted within a few anterior bilateral ethmoid air cells which encroaches on the left ostiomeatal unit. |
Generate impression based on findings. | Female 20 years old; Reason: assess for peritonitis or intraabdominal infection History: recently treated for peritonitis - no ascites on US; pmhx of sle, esrd on hd (previously pd), recently d/c on 1/17 after being admitted for primarily peritonitis secondary to peritoneal dialysis catheter ABDOMEN:LUNGS BASES: Small left basilar linear atelectasis/scarring.LIVER, BILIARY TRACT: Focal fatty infiltration in region of ligament of teres. Mildly prominent gallbladder, no secondary signs of acute cholecystitis otherwise. SPLEEN: No significant abnormality noted.PANCREAS: Suggestion of pancreas divisum, a normal variant. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Numerous bilateral renal cysts, majority of which are too small to characterize. Largest cystic lesions in both kidneys measure greater than 10 Hounsfield units and may be mildly complex renal cysts but are indeterminant.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple loops of matted small bowel primarily ileum seen in pelvis. Additional collapsed right lower quadrant distal ileum seen, images 102 through 108 series 3. Just above matted areas in pelvis is relatively featureless and mildly thickwalled small bowel, image 109 series 3. Proximally, jejunum mildly dilated to 3.1 cm. Constellation of findings may reflect adhesive disease from prior inflammation particularly given patient's history and correlation with patient's clinical history recommended to exclude inflammatory bowel disease. Fluid seen distally in colon and ingested contrast only seen to mid small bowel level, may be due in part to timing of intravenous contrast bolus but underlying element of partial obstruction not entirely excluded. Dominant rim enhancing fluid collection seen in deep pelvis measuring 3.6 x 2.9 x 1.8 cm in craniocaudal dimension, image 124 series 3, concerning for an interloop abscess. Trace more free flowing pelvic ascites also present. A normal appendix is not well seen and possible that appendix involved in inflammation, correlation with patient's surgical history for prior appendectomy also recommended. Due to degree of matted and collapsed small bowel especially in pelvis, difficult to exclude additional smaller fluid collections, for example, coronal image 49 series 80228 and axial image 112 series 3, areas containing gaseous foci in addition to air could conceivably be narrowed loops of bowel but again nonspecific. Submucosal fat deposition involving portions of the cecum and ascending colon, reflecting chronic inflammation. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral spondylolysis. Ventral abdominal subcutaneous induration. | 1. Matted/adhesed ileal loops seen particularly in pelvis with dominant rim enhancing fluid collection suspicious for interloop abscess also visualized, please refer to discussion above for additional findings. 2. Numerous bilateral renal cystic foci, likely reflecting acquired cystic renal disease.3. Contrast extravasation during course of study, as described under Technique section. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: CVA? History: R pronator drift, slurred speech, b/l LE weakness The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 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.Findings were discussed with Dr Goldenberg at the time of this dictation. |
Generate impression based on findings. | Reason: ischemia History: R pronator drift, slurred speech, confusion, LE weakness Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.There is extracranial origin of the left PICA.The anterior communicating artery and the posterior communicating arteries are identified and are medium size.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease.3.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.4.Findings were reported to Dr Goldenberg at the time of this dictation. |
Generate impression based on findings. | Reason: posterior circulation evaluation History: AMS. Acute mental status change in last couple hours. 12-day old pontine infarct. steno-occlusive disease. Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. The left common carotid artery originates from the innominate artery.The left vertebral artery is small. There are atherosclerotic calcifications present at the origin of the right to vertebral artery associated with high grade stenosisAtherosclerotic calcifications are present at the carotid bifurcations left more than right with mild narrowing of the LICA origin.There are multi-level degenerative changes in the cervical spine.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The right A1 segment is hypoplastic. The right posterior communicating artery is small. The left posterior communicating artery is barely perceptibleThere is extracranial origin of the left posterior inferior cerebellar artery. The left vertebral artery is hypoplastic distally.There is approximately 60% stenosis at the left posterior cerebral artery P2 segment.There is 50% stenosis at the left M1 segment just proximal to the bifurcation..There is mild narrowing at the proximal left middle cerebral artery superior division there is mild focal dilation of the proximal portion of the inferior division of the right middle cerebral arteryCT head:A hypodense focus is present in the left pons which was also present on the prior exam.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.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.Subacute infarction involving the left pons. There is no evidence for hemorrhagic conversion.2.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. There is associated ventriculomegaly which is suspected to be related to atrophy, though normal pressure hydrocephalus in the appropriate clinical setting is a consideration.3.There are atherosclerotic calcifications present at the origin of the right to vertebral artery associated with high grade stenosis. Please note that the distal left vertebral artery is hypoplastic and the right PCOMA is small whereas the left PCOMA is imperceptible.4.There is a 60% stenosis at the proximal left P2 segment of the posterior cerebral artery.5.There is 50% stenosis at the left M1 segment just proximal to the bifurcation.6.Findings were reported to Dr Goldenberg at the time of this dictation. |
Generate impression based on findings. | Reason: aneurysm? History: hx of father death of aneurysm p/w new headache Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.There is extracranial origin of the right PICA.The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. Incidental note is made of empty sella.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for aneurysm.2.No evidence for cerebral vascular occlusive disease3.No evidence for acute intracranial hemorrhage. |
Generate impression based on findings. | Reason: evaluate for fracture History: s/p assault CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is soft tissue swelling along the right frontal scalp tissues without evidence for coup or countra-coup injury.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.CT maxillofacial bones:There are no fractures identified involving the maxillofacial bones.The skull base foramina are intact. There is left periorbital soft tissue swelling present.The orbits are intact with no abnormal mass lesions in either orbit. The visualized eyeballs are intact lacrimal glands are unremarkable. Extraocular muscles are intact. The suprasellar cistern is unremarkable.Visualized portions of the mastoid air cells and middle ears are clear. The visualized portions of the paranasal sinuses are clear. CT cervical spine:Patient motion obscures visualization at C5.The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina. | 1.Taking into account that C5 is mildly obscured due to patient motion which gives the artifactual appearance of fracture, there is no evidence for cervical spine fracture2.No evidence for acute intracranial hemorrhage mass effect or edema.3.No evidence for maxillofacial bone fracture. There is left periorbital and frontal scalp soft tissue swelling present. |
Generate impression based on findings. | Reason: evaluate for CVA History: slurred speech after syncopal episode The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of small hypodense foci in the left cerebellar hemisphere, right occipital lobe and right parietal lobe.A small hypodensity is present in the left pons.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact, however, the right eyeball is elongated in the AP dimension and has a thin scleral wall. | 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.Findings redemonstrate old small foci of infarction in the left cerebellar hemisphere, right occipital lobe and right parietal lobe.4.A small hypodensity in the left pons may represent lacunar infarct of indeterminant age.5.Right eye staphyloma is stable. |
Generate impression based on findings. | Reason: r/o intracranial abnormality History: fall-head trauma with loc The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild to moderate degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.The left eyeball lens is thin.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Periventricular and subcortical white matter changes of a mild to moderate degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Reason: r/o intracranial abnormality History: fall-head trauma with loc The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a left periventricular hypodensity present associated with adjacent volume loss.Atherosclerotic calcifications are present along the distal internal carotid arteries. There are calcifications present at the the globus pallidi bilaterally.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Air bubbles in the cavernous sinuses all likely related to venous air possibly from IV placement. | 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 mild degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Reason: r/o acute process History: vertigo, hx of multiple prior strokes The CSF spaces are appropriate for the patient's stated age with no midline shift. Hypodensities in the cerebellar hemispheres posteriorly are associated with volume loss.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries. | 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.Cerebellar lesions are likely related to old foci of encephalomalacia due to small infarctions. |
Generate impression based on findings. | Reason: eval for ICH History: HA The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense focus in the right cerebellar hemisphere representing subacute infarct based on correlation to recent MRI.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.subacute infarct in the right cerebellar hemisphere.3.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Reason: r/o acute process History: headache, blurred vision The CSF spaces are appropriate for the patient's stated age with no midline shift. Small hypodense foci are present in the left pons and the left basal ganglia.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. Periventricular and subcortical white matter hypodensities of a moderate degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate mildly hyperdense opacification of the right sphenoid sinus associated with wall thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Small lesions in the left pons and the left basal ganglia likely represent age indeterminant lacunar infarcts.3.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 4.Findings suggest chronic sinus obstruction at the right sphenoid sinus. Etiology is uncertain.5.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Reason: Stroke? History: new headaches + vision changes in ESRD/h/o CVA patient There is a new hypodense focus presen with loss of gray white distinction and sulcal effacement involving the medial left occipital lobe.There is redemonstration of foci of encephalomalacia centered in the right middle frontal gyrus, right inferior parietal lobule and posterior temporal lobe, right cerebellar hemisphere and medial occipital lobes.There is redemonstration of a hypodense focus in the left thalamus .Atherosclerotic calcifications are present along the distal internal carotid arteries.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Findings are compatible with a subacute infarction along the left occipital lobe centered in the left cuneus but extending to the precuneus, cingulate gyrus and near the calcarine fissure.2.Old lacunar infarct in the left thalamus.3.Multiple foci of encephalomalacia are redemonstrated intracranially (as detailed above) which are likely related to prior foci of infarction. |
Generate impression based on findings. | Abdominal painVIEW: Abdomen AP Multiple coils projected over the right iliac bone. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | HypotensionVIEW: Chest AP 2/21/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Umbilical catheters again noted. There is an abdominal surgical drain at the left upper quadrant. Cardiothymic silhouette normal. Left PICC unchanged. Diffuse atelectasis bilaterally minimally increased in the interval. No pleural effusion or pneumothorax. | Bilateral atelectasis increased in the interval. |
Generate impression based on findings. | Abdominal distentionVIEW: Abdomen AP The metallic bullet previously noted left of midline at the L4 level has been removed in the interval. There are metallic fragments projected over the right of midline at L4 level unchanged. Midline skin staples are noted from prior laparotomy. NG tube tip in the stomach. Multiple dilated small bowel loops which may represent ileus. Retained contrast within the large bowel. | Multiple dilated small bowel loops which may represent ileus. |
Generate impression based on findings. | ConstipationVIEW: Abdomen AP 2/21/15 NG tube tip at the GE junction. Mild amount of fecal burden improved from prior study. No evidence of obstruction. No pneumatosis or pneumoperitoneum. | Mild amount of fecal burden improved from prior study. |
Generate impression based on findings. | Line placementVIEW: Chest AP 2/21/15 Left upper extremity PICC with tip in the SVC. The umbilical venous catheter tip in the IVC. Cardiothymic silhouette normal. Minimal atelectasis left lower lobe. No pleural effusion or pneumothorax. | Left upper extremity PICC with tip in the SVC. |
Generate impression based on findings. | Feeding tube placementVIEW: Abdomen AP 2/21/15 Feeding tube tip in the body of the stomach. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Feeding tube tip in the body of the stomach. |
Generate impression based on findings. | Tube placementVIEW: Chest AP 2/22/15 ET tube tip at the level of the carina. NG tube with side hole in the distal esophagus. The umbilical arterial catheter is partially visualized. Cardiothymic silhouette normal. Bilateral lucencies likely representing PIE in a background of patchy atelectasis bilaterally. No pleural effusion or pneumothorax. | Bilateral lucencies likely representing PIE. |
Generate impression based on findings. | NG placementVIEW: Abdomen AP 2/22/15 Multiple midline skin staples from prior laparotomy. NG tube tip in the stomach. Minimal retained barium in the large bowel. Multiple dilated small bowel loops likely representing ileus. Metallic fragment to the right of midline at L4 level unchanged. Fractures involving L4 and right iliac crest again noted. Patchy opacities in the right lower lobe. | NG tube tip in the stomach. |
Generate impression based on findings. | Hypoxia feverVIEW: Chest AP 2/21/15 Cardiothymic silhouette normal. Peribronchial wall thickening with subsegmental atelectasis in the right middle lobe and left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Evaluate for foreign bodyVIEWS: Left hand AP left middle finger oblique and lateral No acute fracture or dislocation. No evidence of radiopaque foreign body. | No evidence of radiopaque foreign body. |
Generate impression based on findings. | Chest retractionVIEWS: Chest AP and lateral Endotracheal tube and feeding tube have been removed in the interval. Cardiothymic silhouette normal. Minimal patchy atelectasis in the right upper lobe. The previously noted atelectasis in the left lower lobe has improved. No pleural effusion or pneumothorax. | Minimal patchy atelectasis in the right upper lobe. |
Generate impression based on findings. | Increased work of breathingVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the left lower lobe. No evidence of radiopaque foreign body. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Hypoxia feverVIEW: Chest AP 2/21/15 The patient is rotated to the right. Cardiothymic silhouette normal. The apparent opacity at the right upper lobe could be a combination of thymus and atelectasis. No pleural effusion or pneumothorax. | The apparent opacity at the right upper lobe could be a combination of thymus and atelectasis and repeat radiograph could be obtained if clinically indicated. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | ET placementVIEW: Chest AP 2/22/15 ET tube tip at the level of the thoracic inlet. Right central line with tip in the SVC. Left PICC and NG tube have been removed in the interval. The stomach is distended. Cardiothymic silhouette at the upper limits of normal. Minimal patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. | ET tube tip at the level of the thoracic inlet. |
Generate impression based on findings. | FractureVIEWS: Left wrist AP, oblique and lateral Fractures involving the distal radius and ulna again noted and not significantly changed. There is mild medial displacement of the distal ulnar fragment. There is mild lateral displacement of the distal radial fragment. The overlying cast obscures fine bony detail. | Fractures of the distal forearm not significantly changed. |
Generate impression based on findings. | FractureVIEWS: Left forearm AP and lateral The fractures involving the distal radius and ulna again noted with mild dorsal angulation not significantly changed. The overlying cast obscures fine bony detail. | Fractures of the distal radial and ulnar not significantly changed. |
Generate impression based on findings. | CoughVIEW: Chest AP 2/21/15 Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Respiratory failureVIEW: Chest AP 2/22/15 ET tube tip at the level of the thoracic inlet. NG tube tip in the stomach. Cardiothymic silhouette normal. Right upper lobe atelectasis not significantly changed. No pleural effusion or pneumothorax. | Right upper lobe atelectasis not significantly changed. |
Generate impression based on findings. | mild edema in pt w/ arthrogryposisVIEWS: Left elbow AP and oblique The examination is limited due to contractures. There is soft tissue swelling about the elbow joint. There is mild cortical irregularity at the distal humerus at the lateral aspect. Evaluation for joint effusion is limited as there is no lateral radiograph of the elbow joint. The proximal radius and ulna are normal. | Mild cortical irregularity at the distal humerus at the lateral aspect may represent a buckle fracture or artifactual secondary to projection and lateral radiograph may be helpful for further confirmation. |
Generate impression based on findings. | 82 years old, Female, Reason: eval for esophageal leak History: s/p esophageal perforation LUNGS AND PLEURA: Bilateral small pleural effusions left greater than right. Compressive atelectasis is present bilaterally associated with pleural effusions. Upper lobe centrilobular emphysema is present. Small nodular densities are present in the left upper lobe (series 4, image 32), measuring up to 6 mm likely inflammatory or infectious in etiology, however interval follow up is recommended to ensure stability or resolution.MEDIASTINUM AND HILA: Pneumomediastinum is present. No extravasation or sinus tract is seen throughout the course of the esophagus. Contrast was administered through an enteric tube prior to scan with an additional bolus immediately prior to scanning. NG tube terminates in the distal esophagus. Contrast fills the distal esophagus into the stomach without evidence of esophageal perforation. There is reflux of contrast retrograde up the esophagus definite evidence of esophageal perforation. There is soft tissue density in the region of the esophagus which likely represents esophageal debris, however this could potentially also represent edema or hematoma. Small outpouching of contrast in the esophagus at the level of the carina and is favored to be within the lumen (series 3, image 41). The heart is within normal limits. There is a small pericardial effusion. No significant mediastinal lymphadenopathy by CT size criteria.CHEST WALL: Mild degenerative changes are present within the thoracolumbar spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. There is a small focus of air anterior to the spleen, seen on the inferior most slices, representing pneumoperitoneum. | 1.There is an anterior outpouching of the esophagus without definite evidence of current esophageal leak.2.Pneumomediastinum and pneumoperitoneum of unclear etiology. If further evaluation is clinically warranted dedicated abdominal CT is recommended.3.Bilateral pleural effusions with associated compressive atelectasis.4.6-mm pulmonary nodule in the left upper lobe is likely infectious or inflammatory in etiology, however interval follow-up is recommended to ensure stability or resolution. |
Generate impression based on findings. | 50 years old, Male, Reason: Patient has had 2 days of chest pain with increased D-dimer History: Chest pain, unremitting PULMONARY ARTERIES: Pulmonary opacification is adequate for lobar level. No pulmonary embolism is identified. The main pulmonary artery is dilated measuring up to 3.5 cm, which can be seen in the setting of pulmonary hypertension. The ascending aorta is within normal limits measuring 3.1 cm.LUNGS AND PLEURA: Left upper and lower lobe consolidation and atelectasis may represent a focus of infection in the correct clinical setting. There is mild right basilar atelectasis. Patchy nodular densities are present bilaterally, most notably in the right apex, and may be infectious or inflammatory in etiology.MEDIASTINUM AND HILA: Mild cardiomegaly is present. There is no evidence of pericardial effusion.CHEST WALL: Mild degenerative changes of the thoracolumbar spine. Extensive collaterals are present within the chest wall.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism to the lobar level.2.Dilated pulmonary artery which may be seen in setting of pulmonary hypertension.3.Atelectasis and consolidation the left lower lobe may represent a focus of infection in the correct clinical setting. Patchy nodular densities present bilaterally may be also infectious or inflammatory in etiology.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Evaluate for appendicitis abdominal pain ABDOMEN:LUNG BASES: No focal lung opacity or pleural effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable duplicated collecting systems bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is normal. There is a small amount of free fluid in the deep pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Normal examination of the appendix. |
Generate impression based on findings. | BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are unchanged scattered patchy foci of T2 hyperintensity within the supratentorial white matter that are most compatible with chronic small vessel ischemic disease. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable. There is a chronic appearing deformity of the left medial orbital wall.MRA NECK: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent, with the left originating from the aortic arch. There is no evidence of flow-limiting stenosis or occlusion. | 1.No evidence of significant steno-occlusive lesion within the neck.2.Unchanged mild chronic small vessel ischemic disease. Otherwise unremarkable MRI brain. |
Generate impression based on findings. | 54 years old, Female, Reason: eval tumor burden, sternal and pericardial involvement History: severe non-exertional sternal CP CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema. No pleural effusion or pneumothorax. Post surgical changes are present in the left lower lobe in the area of the previously noted nodular density. There is mild scarring and atelectasis adjacent to this postsurgical changes without definite evidence of local recurrent mass. A nodular density in the anterior right upper lobe (series 4, image 50), is not significantly changed in size compared to the prior exam measuring 4 mm. no focal consolidation. Mild bibasilar dependent atelectasis. No new suspicious nodules or masses are present. Previously noted nodular density in the right costophrenic angle is no longer identified on this exam.MEDIASTINUM AND HILA: Right chest port is present with tip in the cranial aspect of the right atrium. Heart size within normal limits. No significant mediastinal lymphadenopathy by CT size criteria. Stable small mediastinal lymph nodes are present. Coronary artery calcifications are present. The great vessels are within normal limits. Tumor is inseparable from the pericardial surface. The mass is inseparable from the pericardial surface is lower in density than on the prior exam possibly represent central necrosis. The tumor however measures 4.3 x 3.9 cm (series 3, image 68), previously measuring 3.5 x 4.0 cm. lymph node adjacent to the suprahepatic IVC is slightly larger in size measuring 1.2 x 1.0 cm (series 3, image 65), previously measuring 0.8 cm.CHEST WALL: No significant abnormality noted.ABDOMEN: There is no significant retrocrural lymphadenopathy by CT size criteria. LIVER, BILIARY TRACT: Hypodensity adjacent to the falciform ligament is unchanged in size, and may represent transient hepatic attenuation differences. No new hepatic mass lesion. The gallbladder is distended.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypoattenuating lesions within the kidneys are too small to accurately characterize, however are felt to most likely represent cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta without evidence of aneurysmal dilatation.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Interval resection of left pulmonary mass without evidence of definite local recurrence.2.Tumor inseparable from the pericardium is increased in size and appears more necrotic centrally.3.Stable lymphadenopathy.4.Stable right on pulmonary nodule. Follow up is recommended to ensure stability. |
Generate impression based on findings. | Line placementVIEW: Chest AP and abdomen AP 2/22/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Right upper extremity PICC coiled within a branch of the axillary vein. Cardiothymic silhouette at the upper limits of normal. Postsurgical changes from diaphragmatic hernia at the right lower lobe. Minimal atelectasis right lower lobe. The stomach is distended. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Malpositioned right upper extremity PICC. |
Generate impression based on findings. | There is an unchanged 3 x 10 mm lytic lesion within the left mandibular ramus adjacent to but distinct from the mandibular foramen. The foramen ovale are symmetric. The patient is status post right uncinectomy. There is marked mucosal thickening throughout the paranasal sinuses with mucosal opacification of the left maxillary sinus ostium and infundibulum as well as the left sphenoethmoidal recess. The nasal cavity is clear. There is mild leftward nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid groove and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There is a periapical lucency involving ADA tooth number 28. There is a chronic right zygomatic arch deformity. | 1.3 x 10 mm lytic lesion within the left mandibular ramus adjacent to but distinct from the mandibular foramen is unchanged since 2009 and non-specific but may be secondary to multiple myeloma. 2.Marked paranasal sinus mucosal thickening. 3.Apical periodontitis of ADA tooth number 28. |
Generate impression based on findings. | Mucosal thickening is present within bilateral maxillary sinuses (left greater right) which obstructs the left ostiomeatal unit. The right ostiomeatal unit is clear. The remaining paranasal sinuses are clear as are the bilateral mastoid air cells and middle ear cavities and there are no air-fluid levels. The bilateral maxillary frontoethmoidal and sphenoethmoidal recesses are patent. Note is made of bilateral Haller cells. The lamina papyracea are intact bilaterally. The floor of the anterior cranial fossa and cribriform plate region are unremarkable. The nasal septum is S-shaped. Bilateral orbits and the posterior nasopharynx appear unremarkable. Note is made of periodontal disease. | 1.Mucosal thickening is present within bilateral maxillary sinuses (left greater right) which obstructs the left ostiomeatal unit. The right ostiomeatal unit is clear. The remaining paranasal sinuses are clear as are the bilateral mastoid air cells and middle ear cavities and there are no air-fluid levels. 2.The nasal septum is S-shaped. 3.Note is made of periodontal disease. |
Generate impression based on findings. | 34 years old, Female, Reason: PE? History: hx of multiple dvt/PE on xarelto but vomiting and not taking with L calf pain, tachypneic, tachy PULMONARY ARTERIES: Pulmonary artery opacification is adequate to the subsegmental level. Chronic webs from prior pulmonary emboli are present within the lower lobe subsegmental arteries, unchanged. No new pulmonary embolus is identified.LUNGS AND PLEURA: Mild left lower lobe atelectasis. No suspicious pulmonary nodules or masses. No focal consolidation to suggest infection.MEDIASTINUM AND HILA: Heart size within normal limits without evidence of pericardial effusion. Coronary artery calcifications present. Prominent Soft tissue density in the prevascular space is larger than on the prior exam and may represent mottled lymph nodes versus thymus tissue.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Marked hepatic steatosis. Pneumobilia is present. | 1.No evidence of pulmonary embolism.2.Marked hepatic steatosis.3.Prominent soft tissue in the prevascular space is larger compared to the prior exam and may represent lymph nodes versus thymus tissue.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 25 years old, Female, Reason: PE History: SOB, chest pain PULMONARY ARTERIES: Pulmonary opacification is adequate to the subsegmental level. There is no evidence of pulmonary embolism. The main pulmonary artery and descending aorta are within normal limits for size.LUNGS AND PLEURA: No suspicious pulmonary nodules or masses are present. There is no focal consolidation to suggest infection.MEDIASTINUM AND HILA: There is no evidence of pericardial effusion. Heart size is within normal limits. There is no significant mediastinal lymphadenopathy by CT size criteria. Left vertebral artery arises from the aorta.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of pulmonary embolism. No specific findings to account for the patient's symptoms.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 37 years old, Female, Reason: eval for PE History: tachycardia, hypoxemia PULMONARY ARTERIES: After two bolus attempts, evaluation of the pulmonary arteries beyond the main pulmonary arteries is not diagnostic. There is no large central pulmonary embolus present.LUNGS AND PLEURA: No focal opacities are present. Atelectasis and small pleural effusions are seen in the lung bases. Scattered peripheral nodular and groundglass opacities within the left upper and right upper lobe (for example series 14 image 133, series 13 image 85) which are in nonspecific but could represent small foci of atelectasis and/or infection. There is evidence of vascular congestion.MEDIASTINUM AND HILA: The heart size within normal limits. There is no definite evidence of right heart strain. Is no evidence of pericardial effusion. There is no significant mediastinal lymphadenopathy by CT size criteria.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of central pulmonary embolism. 2.Several foci of groundglass opacity in upper lobes bilaterally may represent foci of infection versus atelectasis.3.Small bilateral pleural effusions with mild compressive atelectasis and evidence of vascular congestion possibly related to fluid overload. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Redemonstrated is a focus of vasogenic pattern edema in the left superior frontal gyrus with resultant very subtle regional mass-effect. Contrast administration demonstrates thin peripheral, ring enhancement measuring up to 15 mm. there are no other abnormal enhancing foci.The ventricles and sulci are normal in size. There is no midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Redemonstrated is a focus of vasogenic pattern edema in the left superior frontal gyrus with resultant very subtle regional mass-effect. Contrast administration demonstrates thin peripheral, ring enhancement measuring up to 15 mm. there are no other abnormal enhancing foci. The differential diagnosis would most likely include resolving hematoma, metastasis, abscess, primary brain tumor (glioblastoma multiforme), subacute infarct, contusion, or lymphoma. |
Generate impression based on findings. | 7 month old female with lethargy. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is fluid within the bilateral mastoid air cells and middle ear cavities. The skull and extracranial soft tissues are unremarkable. | 1.No evidence of intracranial hemorrhage.2.Non-specific fluid within the bilateral mastoid air cells and middle ear cavities. |
Generate impression based on findings. | 32 years old, Female, Reason: r/o PE History: SOB, palpitations, mild CP PULMONARY ARTERIES: Pulmonary artery opacification is adequate to the subsegmental level. There is no evidence of pulmonary embolism. The main pulmonary arteries within normal limits by 2.3 cm.LUNGS AND PLEURA: No focal consolidation to suggest infection. No suspicious pulmonary nodules or masses are present. No evidence of pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Heart size within normal limits without evidence of pericardial effusion. No significant mediastinal lymphadenopathy by CT size criteria.CHEST WALL: No significant abnormality noted. No significant axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Cholecystectomy clips are noted. | No evidence of pulmonary embolism. No specific findings to account for the patient's symptoms.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 2 year old male with neuroblastoma and abnormal movements. There is a 49 x 52 mm intraparenchymal hematoma within the right parietal lobe with extensive surrounding edema. There is also a mixed attenuation subdural hematoma along the right frontal convexity measuring up to 11 mm in thickness. These findings result in 18-mm leftward subfalcine herniation. There is obliteration of the right aspect of the suprasellar cistern compatible with uncal herniation. There is also mass effect upon the quadrigeminal cistern and minimal downward transtentorial herniation. There is dilatation of the right temporal horn compatible with trapped ventricle and dilatation of the left lateral ventricle compatible with developing obstructive hydrocephalus. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 5-cm right parietal intraparenchymal hematoma and 1 cm thick right subdural hematoma with resultant subfalcine, uncal, and minimal transtentorial herniation. There is developing obstructive hydrocephalus. These findings were communicated by the radiology resident on-call to be PICU physician in charge of the patient on 2/22/2015 at 7:36 a.m. |
Generate impression based on findings. | 53 years old, Female, Reason: eval PE History: CP, SOB, h/o breast ca and renal tx PULMONARY ARTERIES: Pulmonary opacification is adequate to the subsegmental level. No evidence of pulmonary embolism. The main pulmonary artery is prominent, which can be seen in the setting of pulmonary hypertension.LUNGS AND PLEURA: There is a focal opacity without evidence of air bronchograms in the left lower lobe measuring 3.4 x 3.0 cm (series 8, image 78). This may represent a metastatic mass, however focal consolidation and atelectasis is also considered. Focal opacity in the anterior right middle lobe measuring 2.0 x 1.4 cm (series 8 image 78). There is a somewhat spiculated nodule in the right middle lobe measuring 7 mm x 6 mm (series 8, image 69), suspicious for metastasis. Tree in bud opacities in right lower lobe may represent a focus of infection. Scattered nodular densities in the right upper lobe are also likely related to infection.MEDIASTINUM AND HILA: Coronary artery calcification as well as aortic valve calcification is present. No definite evidence of right heart strain. Small scattered mediastinal lymph nodes are present. No significant mediastinal lymphadenopathy by CT size criteria. Left thyroid nodule present.CHEST WALL: Evidence of renal osteodystrophy is present. Sternotomy hardware is present. No significant axillary lymphadenopathy by CT size criteria. Right mastectomy is present with collaterals in the chest wall.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Left adrenal gland is nodular in appearance and metastasis cannot be ruled out on this dedicated chest exam. | 1.No evidence of pulmonary embolism.2.Multiple suspicious nodules and masslike opacities, the largest of which is in the left lower lobe, are concerning for metastasis, however may represent large focal consolidation related to infection. Interval follow up imaging is recommended to evaluate for resolution and/or interval change.3.Multiple tree in bud opacities in the right lung likely representing focus of infection.4.Nodular appearance of the left adrenal gland, which is nonspecific and incompletely evaluated on this dedicated chest exam. Adrenal metastasis cannot be ruled out.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Increased oxygen requirementVIEWS: Chest AP and lateral 2/22/15 Cardiothymic silhouette normal. Marked scoliosis of the thoracic spine. G-tube in place. Minimal patchy atelectasis right lower lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis right lower lobe. |
Generate impression based on findings. | Female 59 years old; Reason: Hx of CHF, CAD here with suprapubic tenderness, diarrhea, nausea History: suprapubic pain and diarrhea ABDOMEN:LUNGS BASES: Incompletely imaged cardiomegaly. Small basilar atelectasis/scarring.LIVER, BILIARY TRACT: Hepatic hypoattenuating foci that are too small to characterize, e.g., in segment 3 on images 33 and 43 series 3. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Indeterminant 2.6 x 1.9 cm left renal lesion with associated field units of 16, image 52 series 3, similar attenuation on earlier noncontrast study, previously measured 1.1 x 0.8 cm . Additional smaller hypoattenuating renal lesions too small to characterize. Symmetric renal parenchymal enhancement.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis including diverticular disease involving sigmoid colon where there is also mild to moderate circumferential wall thickening, located in deep, image 123 series 3, minimal adjacent fat stranding present. No extraluminal gaseous foci seen, no discrete/rimmed fluid collection delineated. No definite secondary signs of acute appendicitis.PELVIS:UTERUS, ADNEXA: Appears to be status post hysterectomy, correlate with surgical history. Bilateral adnexal ovoid soft tissue prominence may reflect ovaries, axial image 123 series 3, as opposed to a mildly prominent appendix on the right side, no surrounding fat stranding seen, correlation with patient's surgical history recommended and pelvic sonography may be performed if clinically indicated.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes of spine. | 1. Findings suspicious for acute sigmoid diverticulitis.2. Indeterminant 2.6 x 1.9 cm left renal lesion, grown since 2005 exam, may be a mildly complex renal cyst but a minimally enhancing neoplasm not excluded on this nondedicated exam, further evaluation with contrast enhanced CT or MRI or sonography to exclude a solid lesion recommended.3. Bilateral adnexal ovoid soft tissue prominence may reflect ovaries, axial image 123 series 3, as opposed to a mildly prominent appendix on the right side, no surrounding fat stranding seen, correlation with patient's surgical history recommended and pelvic sonography may be performed if clinically indicated. |
Generate impression based on findings. | 44 years old, Male, Reason: eval reduction History: fx s/p FOOSH Comminuted fracture of the coronoid process is again seen on this exam. Multiple fracture fragments are seen. The largest fracture fragment is mildly distally displaced (series 8025, image 39). The fracture appears to involve the articular surface. The radial head is intact. The distal humerus is intact. There is moderate soft tissue edema present in the subcutaneous tissues. | Comminuted fracture of the coronoid process involving the articular surface with associated soft tissue swelling. |
Generate impression based on findings. | 58 year old male with alcohol abuse and loss of consciousness. There is no evidence of intracranial hemorrhage. There is mild atherosclerotic calcification of the distal internal carotid and vertebral arteries, and patchy foci of low attenuation within the supratentorial white matter that are compatible with small vessel ischemic disease. 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 evidence of intracranial hemorrhage. |
Generate impression based on findings. | 63 years old, Female, Reason: metastatic renal cell carcinoma, staging History: hematuria LUNGS AND PLEURA: Innumerable pulmonary nodules are present bilaterally, highly suspicious for metastasis. Reference left lower lobe pulmonary nodule measures 1.0 x 1.1 cm (series 6 and image 47). Reference right upper lobe pulmonary nodule measures 0.5 cm (series 6 and image 35). Small bilateral pleural effusions with mild compressive atelectasis.MEDIASTINUM AND HILA: The heart size is at the upper limits of normal. There is no evidence of pericardial effusion. Scattered mediastinal lymph nodes are identified not meeting size criteria for lymphadenopathy. Scattered atherosclerotic calcifications of the aortic arch and descending thoracic aorta. Hiatal hernia is present.CHEST WALL: No significant axillary lymphadenopathy by CT size criteria. No osseous lesions are identified.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Significant gastrohepatic lymphadenopathy is identified, however is difficult to measure on this noncontrast exam. Reference gastrohepatic lymph node measures 2.6 x 2.7 cm (series 4 image 97). A partially visualized exophytic mass is present on the left kidney, likely representing known renal cell carcinoma. There are numerous subtle hepatic hypodensities which are highly suspicious for metastasis, however are incompletely evaluated on this noncontrast chest exam. | 1.Innumerable pulmonary nodules are present bilaterally representing metastasis.2.Multiple partially visualized hepatic metastases.3.Partially visualized gastrohepatic lymphadenopathy.4.Partially visualized suspected exophytic mass of the left kidney with suspected hydronephrosis. If further evaluation is clinically warranted abdominal CT or ultrasound is recommended. |
Generate impression based on findings. | Female 50 years old; Reason: Evaluate for stone History: Abdominal pain ABDOMEN:LUNGS BASES: Interval improvement in previously seen trace pleural effusions, persistent small bibasilar atelectasis/scarring.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Areas of pancreatic atrophy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate nonobstructing right renal stone, image 48 series 3. Additional punctate right intrarenal hyperdense foci seen on prior CT imaging not well seen, may reflect interval passage of stones. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No secondary signs of acute appendicitis. PELVIS:Bilateral total hip arthroplasties with associated beam hardening artifact, making assessment of pelvic structures suboptimal.UTERUS, ADNEXA: Mildly heterogeneous hypoattenuation in region of endometrial complex, image 109 series 3, may be physiologic but correlation with patient's clinical history and further evaluation with pelvic sonography recommended. Subcentimeter right adnexal cystic focus, image 111 series 3.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance including components of hip arthroplasties. Relatively gracile appearing pelvic bones, areas of lucency in pelvis and increased resorption along sacroiliac joint without change. | 1. Punctate nonobstructing right renal stone. Additional punctate right intrarenal hyperdense foci seen on prior CT imaging not well seen, may reflect interval passage of stones.2. Mildly heterogeneous hypoattenuation in region of endometrial complex, may be physiologic but correlation with patient's clinical history and further evaluation with pelvic sonography recommended. 3. Interval improvement in previously seen trace pleural effusions, persistent small bibasilar atelectasis/scarring. |
Generate impression based on findings. | 77 years old, Male, Reason: Possible tracheobronchomalacia History: Wheezing and Dyspnea LUNGS AND PLEURA: The trachea and central bronchi are patent and normal in appearance. There is a single strand of likely represents mucus in the mid trachea (series 4, image 6 and 7). Trace left pleural effusion is present. Bibasilar septal thickening and mild groundglass opacity likely represents fluid overload. Focal consolidation in the right lower lobe may represent atelectasis and/or infection.MEDIASTINUM AND HILA: Severe coronary artery calcifications are present. Significant atherosclerotic calcification of the aortic arch and descending thoracic aorta. The heart size within normal limits. Scattered mediastinal lymph nodes are present not meeting size criteria for lymphadenopathy. Right thyroid nodule is present. Air and debris is present in the midesophagus.CHEST WALL: Mild degenerative changes of the thoracolumbar spine are present. Sternotomy hardware is present.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. High density material possibly representing sludge is present in the gallbladder. The gallbladder is difficult to evaluate on this noncontrast exam and is only partially visualized, however the gallbladder wall appears somewhat thickened and there may be pericholecystic fluid. This can be normal in the setting of congestive heart failure. No other significant abnormalities noted within the partially visualized upper abdomen. | 1. Mild pulmonary edema present bilaterally with small left pleural effusion.2. No evidence of tracheobronchomalacia as clinically questioned.3. Partially visualized thickened gallbladder wall can be normal in the setting of congestive heart failure and fluid overload, however is incompletely evaluated on this chest exam. If further evaluation is clinically warranted ultrasound is recommended. |
Generate impression based on findings. | 80 years old, Male, Reason: 80 male with AML, neutropenia, r/o baseline infiltrate History: AML LUNGS AND PLEURA: Evaluation of fine detail is limited by respiratory motion. Diffuse septal thickening and groundglass opacities are likely related to pulmonary edema. No large focal consolidation is present. No pleural effusion or pneumothorax is present.MEDIASTINUM AND HILA: Heart size at the upper limits of normal and there is small pericardial effusion. Scattered mediastinal lymph nodes are present. There is no significant mediastinal lymphadenopathy by CT size criteria. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hypodensity in the left hepatic lobe cannot be characterized on this noncontrast exam. | Diffuse septal thickening and groundglass opacities likely related to pulmonary edema. No focal consolidation to suggest infection as clinically questioned. |
Generate impression based on findings. | Male 33 years old; Reason: left flank pain ABDOMEN:LUNGS 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 noted.KIDNEYS, URETERS: Very minimal left-sided perinephric haziness with mildly edematous appearance of kidney compared to contralateral side. No hydronephrosis. No obstructing stone, no radiopaque stone seen in bladder. No radiopaque intrarenal nephrolithiasis seen. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Nonspecific sclerotic focus in visualized proximal left femur, image 135 series 3, may be a bone island. | 1. No evidence of obstructive urolithiasis. Very minimal left-sided perinephric haziness with mildly edematous appearance of kidney compared to contralateral side. Findings nonspecific and may be seen in setting of recently passed stone. Additionally, correlation with patient's clinical history and laboratory values recommended to exclude pyelonephritis. |
Generate impression based on findings. | Hypodense foci are present within the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar territorial cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Mucosal thickening is present within a few left ethmoid air cells. Otherwise the visualized portions of the remaining paranasal sinuses and mastoid air cells are clear. | Hypodense foci are present within the white matter without associated mass effect. This is nonspecific yet abnormal for patient age 49 years. The differential diagnosis would most likely include small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended. |
Generate impression based on findings. | Male 72 years old; Reason: Evaluate for nephrolithiasis, R flank pain ABDOMEN:LUNGS BASES: Status post sternotomy. Areas of linearity/scarring in portions of right middle lobe, lingula and right lower lobe. Punctate right lower lobe calcified granuloma.LIVER, BILIARY TRACT: Previously visualized hypoattenuating liver lesions not as well seen on this noncontrast study.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis. Minimal chronic perinephric stranding. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of acute diverticulitis, normal appendix.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of spine, most pronounced at L3/4 and L5/S1 levels, levoscoliosis of lumbar spine. | 1. No radioopaque nephrolithiasis. 2. Normal appendix. |
Generate impression based on findings. | 35 years old, Male, Reason: infiltrates, signs of PNA History: cough, immunosuppression, green sputum LUNGS AND PLEURA: There is a scarring and centrilobular emphysema located in the left upper lung. No evidence of infection or other acute abnormality.MEDIASTINUM AND HILA: Heart size within normal limits. There is no lymphadenopathy by CT size criteria. No evidence of pericardial effusion. No evidence of coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of infection or other acute abnormality. |
Generate impression based on findings. | Male 63 years old; Reason: pancreatitis vs other abdominal pathology History: n/v/d ABDOMEN:LUNGS BASES: Evaluation of lung fields suboptimal due to respiratory motion artifact. Small right greater than left consolidations.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Peripancreatic edema and mesenteric haziness seen, most pronounced around pancreatic head. Small fluid seen around proximal duodenum.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Enteric tube seen with tip near junction of gastric fundus and body. Collapsed stomach making assessment suboptimal. Mild diffuse mesenteric edema. Appendix prominent and thickwalled at midportion, measuring up to 11 mm, no pronounced adjacent inflammation seen. Additional stranding seen. Underdistention versus mild to moderate circumferential wall thickening at level of rectum, image 156 series 4, correlation with patient's clinical history and colonoscopy recommended. PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Foley catheter in collapsed urinary bladder, making assessment suboptimal. BONES, SOFT TISSUES: Spinal degenerative disease. | 1. Peripancreatic edema and mesenteric haziness seen, most pronounced around pancreatic head. Small fluid seen around proximal duodenum. Appearance suspicious for acute pancreatitis and correlation with patient's clinical history and laboratory values recommended. 2. Appendix prominent and thickwalled at midportion, measuring up to 11 mm, no pronounced adjacent inflammation seen, findings nonspecific. 3. Underdistention versus mild to moderate circumferential wall thickening at level of rectum, image 156 series 4, correlation with patient's clinical history and colonoscopy recommended. |
Generate impression based on findings. | Hypodensity is present within the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended. |
Generate impression based on findings. | Confluent hypodensity is present at several locations in the white matter, without associated mass effect. More discrete hypodense foci are present within bilateral basal ganglia and the right superior cerebellar hemisphere. There is diffuse volume loss without a specific lobar predominant atrophy pattern. There are no findings of ventricular obstruction or hydrocephalus. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Scattered sporadic foci of mucosal thickening can be found in the paranasal sinuses. The mastoid air cells are clear. Note is made of vascular calcifications. | 1.Advanced small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended.2.There is diffuse volume loss without a specific lobar predominant atrophy pattern. |
Generate impression based on findings. | Female 76 years old; Reason: Assess for diverticulitis or other acute abdominal process History: abdominal pain ABDOMEN:LUNGS BASES: Incompletely imaged heart borderline in size.LIVER, BILIARY TRACT: Multiple hypoattenuating hepatic lesions, largest of which measure simple fluid and are likely hepatic cysts, smaller lesions too small to characterize. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renocortical scarring, indeterminant subcentimeter right renal hypoattenuating lesion, image 54 series 3.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis with concomitant marked wall thickening seen at level of sigmoid colon, image 106 series 3. Lateral wall of sigmoid colon on images 104 to 105 series 3 particularly bulbous in appearance, uncertain whether secondary to adjacent phlegmon or due in part to an adjacent ovary but follow-up to resolution recommended to exclude underlying neoplasm.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Mildly distended bladder.BONES, SOFT TISSUES: Scoliosis. | 1. Findings compatible with acute sigmoid diverticulitis. Portion of wall of sigmoid colon particularly bulbous in appearance, uncertain whether merely thickened wall or secondary to adjacent phlegmon or due in part to an adjacent ovary but follow-up to resolution recommended to exclude underlying neoplasm. |
Generate impression based on findings. | Male 64 years old; Reason: RCC and bone lesion on the right hip History: as above plus right hip pain CHEST:LUNGS AND PLEURA: Biapical pleural nodularity/scarring, similar to earlier exam. Visualized central airways patent. Moderate calcified coronary artery disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left nephrectomy.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease. Stable asymmetry of psoas musculature with left side more prominent than right, nonspecific, assessment for underlying lesion suboptimal on this noncontrast study, appearance grossly similar to earlier study.BOWEL, MESENTERY: Moderate to large stool.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Again seen extensive lytic osseous metastatic disease involving right iliac bone and acetabulum. Mild deformity and relative lucency of right femoral head and associated neoplastic involvement not entirely excluded. Multilevel degenerative changes of spine.OTHER: Mild presacral edema and increasing small pelvic ascites. | 1. Increasing small pelvic ascites, of uncertain clinical significance.2. Osseous metastatic disease without significant change, as above. |
Generate impression based on findings. | Constipation Small to moderate stool seen, appearance in ascending colon. Relative paucity of small bowel gas, air seen distally in colon. No definitive evidence of small bowel obstruction. Status post sternotomy. Broken sternal wires noted. Degenerative spinal disease. | Small to moderate stool. |
Generate impression based on findings. | Intrauterine device Moderate stool in colon. Nonobstructive bowel gas pattern. Intrauterine device seen, oriented horizontally. | Intrauterine device as above, please note that evaluation for satisfactory IUD position would be better achieved with dedicated sonography.Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 43 years old, Female, Reason: Motor vehicle collision. Ribs: No evidence of displaced rib fracture or pneumothorax. Note is made of cervical spinal hardware.Lumbar spine: No fracture or malalignment.Pelvis: IUD is present. Bilateral osteoarthritis of the hips. Enthesopathic changes along the iliac wings. No acute fracture or malalignment.Left hip: Osteoarthritis without evidence of fracture. | No acute fracture or malalignment. |
Generate impression based on findings. | Abdominal pain Nonobstructive bowel gas pattern. Linear radiodensity left upper quadrant, may be a surgical clip/correlate with patient's surgical history. | Nonobstructive bowel gas pattern.Please refer to subsequent CT exam from same day for additional findings. |
Generate impression based on findings. | History of esophageal stent, persistent nausea and vomiting, evaluate for obstruction Scout film demonstrates right-sided chest port with tip near cavoatrial junction. Low lung volumes and bibasilar airspace disease/atelectasis present, more focal airspace disease also seen in right upper lung field, similar in appearance to 2/17/15 chest radiography. Distal esophageal stent seen. Retained contrast seen in incompletely imaged upper abdominal bowel.Upon delivery of contrast, no definite abnormal contrast extravasation seen to suggest a leak. No obstruction, with contrast seen traversing esophageal stent and entering stomach distally. Findings compatible with dysmotility with reflux observed during course of study. TOTAL FLUOROSCOPY TIME: 2 minutes 34 seconds | 1. Limited esophagram demonstrates no obstruction. Dysmotility with reflux seen.2. Low lung volumes and bibasilar airspace disease/atelectasis present, more focal airspace disease also seen in right upper lung field, similar in appearance to 2/17/15 chest radiography. Correlation with patient's clinical history recommended to exclude aspiration or underlying multifocal infectious process, further imaging with dedicated CT chest may be considered to assess for this and/or neoplasm. |
Generate impression based on findings. | 39 years old, Female, Reason: amputation of right toe, gangrene History: gangrene Interval amputation of the great toe at the mid metatarsal. Lucency along the medial aspect of the proximal phalanx of the second toe may represent fracture and/or osteomyelitis. Subluxation at the second PIP joint. Vascular calcifications. Calcaneal spur present. | 1. Lucency along the medial aspect of the proximal phalanx of the second toe may represent fracture and/or bone destruction secondary to osteomyelitis.2. Subluxation of the second PIP joint. |
Generate impression based on findings. | 25 years old, Male, Reason: r/o fracture or large effusion History: right ankle pain with inability to bear weight No fracture or malalignment is identified. | No fracture or malalignment. |
Generate impression based on findings. | 59 years old, Male, Reason: concern for osteo History: toe/foot infection Fragmentation and cortical destruction along the lateral aspect of the mid proximal phalanx of the third toe. There is significant soft tissue swelling in the area. In the absence of trauma this is suspicious for osteomyelitis. | Fragmentation and cortical destruction of the mid proximal phalanx with significant soft tissue swelling, consistent with osteomyelitis in the absence of trauma. |
Generate impression based on findings. | 29 years old, Female, Reason: eval for fracture History: s/p mvc w neck pain Straightening of the cervical spine. Alignment is otherwise anatomic. No acute fracture. No prevertebral edema. Please note that if there is strong clinical concern CT is more sensitive for cervical spine fracture. | No evidence of fracture or malalignment. |
Generate impression based on findings. | 65 years old, Male, Reason: 65 male with AML, C2 lesion. Please perform flexion/extension views to assess C2 instability. History: Neck pain No evidence of instability as clinically questioned. Lytic lesion in the odontoid process is better seen on recent CT. Degenerative changes of the cervical spine are present. | No evidence of instability as clinically questioned. |
Generate impression based on findings. | 79 years old, Female, Reason: r/o fx History: pain after fall No evidence of fracture or malalignment. Mild osteoarthritis of the acromioclavicular joint. | No evidence of fracture or malalignment. |
Generate impression based on findings. | 44 years old, Male, Reason: Eval elbow Fx History: Pain, swelling, Fx Comminuted fracture coronoid process of the ulna is again seen. Radial head appears intact. There is subtle density along the lateral aspect of the distal humerus without evidence of donor site, likely representing chronic changes or old injury. Significant soft tissue swelling and joint effusion is present. | Comminuted fracture of the coronoid process of the ulna without definite evidence of other fracture. |
Generate impression based on findings. | 44 years old, Male, Reason: r/o fx or dislocation History: pain, limited ROM Elbow: Comminuted fracture of the coronoid process of the ulna. There is no definite fracture of the radial head or distal humerus. Subtle density on the lateral aspect of the distal humerus without evidence of donor site likely represents chronic changes or old injury.Wrist: Minimally displaced comminuted fracture of the distal radius extending to the articular surface. Ulnar styloid avulsion fracture is present. | 1.Comminuted fracture of the coronoid process of the ulna without definite evidence of other fracture. 2.Minimally displaced comminuted fracture of the distal radius extending to the articular surface.3.Ulnar styloid avulsion fracture |
Generate impression based on findings. | 74 years old, Male, Reason: r/o fx History: catching, discomfort Mild osteoarthritic changes of the right hip without evidence of fracture or dislocation. | Mild osteoarthritis of right hip without evidence of fracture or dislocation. |
Generate impression based on findings. | 50 years old, Female, Reason: fx History: pain Tricompartmental osteophytes are present indicating moderate osteoarthritis. No evidence of fracture or dislocation. Small knee joint effusion is present. | Moderate osteoarthritis and small joint effusion without evidence of fracture or dislocation. |
Generate impression based on findings. | 77 years old, Male, Reason: fracture? History: ttp over left chest anteriorly over nipple, second MCP pain Ribs: No evidence of displaced rib fracture. No evidence of complications of rib fracture such as pneumothorax. Wrist: No evidence of fracture or malalignment. No evidence of bone destruction to indicate osteomyelitis. | No evidence of fracture or malalignment in the ribs or in the wrist. |
Generate impression based on findings. | 28 years old, Female, Reason: post-reduction History: post knee dislocation Interval reduction of knee dislocation which is now in anatomic alignment. Posterior splint material obscures fine bone detail. No new fracture is identified. | Interval reduction of knee dislocation, now situated in anatomic alignment. |
Generate impression based on findings. | 28 years old, Female, Reason: eval fx History: pain s/p fall Left Knee: There is subluxation of the distal femur posteriorly from the tibia and fibula. No fracture is identified.Left femur: No evidence of fracture or malalignment of the femur or hip. | Knee dislocation with subluxation of the distal femur posteriorly from the tibia and fibula.Findings were discussed between on-call resident and ER physician at 0445 2/22/15. |
Generate impression based on findings. | 75 years old, Female, Reason: c/f fxr or dislocation History: R ankle deformity and swelling Ankle: There is an obliquely oriented fracture through the distal right fibula with lateral displacement of distal fracture fragment. The distal fragment appears to maintain alignment with the talus which is dislocated from the tibia. The tibia is anteriorly dislocated from the talus. Additionally there are fragments posterior to the distal tibia which may represent posterior malleolus fracture.Tibia-fibula: No proximal fracture of the tibia or fibula. See findings of ankle for description of fibula and tibia fracture. | 1.Subtalar dislocation with anterior displacement of the tibia.2.Oblique fracture of the distal fibula.3.Questionable posterior malleolus fracture. |
Generate impression based on findings. | 26 years old, Male, Reason: r/o fracture History: assault, severe diffuse tenderness Forearm: No fracture or malalignment.Hand and wrist: There is swelling along the dorsal aspect of the hand without evidence of acute fracture or dislocation. | Soft tissue swelling without evidence of fracture or malalignment within the forearm, hand, or wrist. |
Generate impression based on findings. | Worsening nausea, vomiting and diarrhea Air seen in both small and large bowel, distribution suggestive of ileus type pattern. Compared to prior study, mild interval increase in amount of air in colon. Air seen to level of descending colon with small amount seen distally in expected region of rectum.Please refer to concomitant chest radiography from same day for additional findings. | Ileus type bowel gas pattern, as above. |
Generate impression based on findings. | Enteric tube evaluation, nausea Side-port of enteric tube in distal esophagus and further advancing by approximately 10 cm recommended. Residual contrast seen in cecum and ascending colon/hepatic flexure. Some layering contrast material seen in left upper quadrant bowel as well. Scattered colonic diverticula. No definitive evidence of bowel obstruction. Incompletely imaged bibasilar atelectasis/airspace disease. Ballistic material and surgical clips seen in right abdomen. | Further advancing of enteric tube recommended. |
Generate impression based on findings. | Dobbhoff tube repositioning Dobbhoff tube seen with tip in expected region of third portion of duodenum. Incompletely imaged remainder of abdomen demonstrates no bowel obstruction. Unchanged left basilar air space opacity. | Enteric tube as above. |
Generate impression based on findings. | Colonic stent with contained perforation, assess for obstruction Left upper abdominal/descending colonic stent. Additional upper abdominal and left-sided postsurgical sequela seen. Colon mildly prominent but no significant luminal dilatation seen at this time, right-sided colon measures 6 to 7 cm. Moderate stool seen in colon, including fecal material and air seen distally in sigmoid colon and rectum. Right basilar airspace disease. Evaluation for free air suboptimal as only portal supine views submitted. | No definitive evidence of obstruction. If there is continued clinical concern, further evaluation with CT imaging recommended. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.