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Generate impression based on findings. | Reason: eval atypical mycobacterial PNA, uncontrolled AIDS History: none LUNGS AND PLEURA: The left apical subpleural nodular opacity is decreased in size, measuring 16 x 11 mm (series 4, image 15), previously 20 x 13 mm. A right lower lobe nodular opacity (series 4, image 59) and a right upper lobe nodular opacity (se... | 1. Scattered nodular opacities, most of which are decreased in size. At least one new right lower lobe nodular opacity and increasing scattered right lung groundglass. Findings suggest resolution in some areas and new infection in others. 2. Increasing areas of groundglass, with septal lines and increasing effusions su... |
Generate impression based on findings. | Female 49 years old Reason: r/o fracture, broken hardware History: pain. Three views of the left ankle show a sideplate and screws device affixing a distal fibular fracture in anatomic alignment. The previously seen fracture line now appears nearly indistinct with residual minimal deformity seen on lateral views. Two o... | Orthopedic fixation of healing/healed distal fibular and medial malleolar fractures in anatomic alignment without radiographic evidence of hardware complication. |
Generate impression based on findings. | Osteoarthritis versus avascular necrosis. Joint pain. History of IV drug use and hepatitis C. LEFT HIP: Limited two view examination of the left hip demonstrates mild osteoarthritis. No subchondral fracture, articular surface collapse, or specific features of osteonecrosis are evident. LEFT HAND: Scattered osteoarthrit... | Osteoarthritic changes, without specific features of osteonecrosis. |
Generate impression based on findings. | T3N0 laryngeal carcinoma, s/p CRT. Neck: There are post-treatment findings with mild diffuse edema in the pharyngeal mucosal space. There is no measurable residual supraglottic mass. There is upper mediastinal lymphadenopathy, including a right paratracheal lymph node that measures 16 mm in short axis. There is a trach... | 1. No measurable residual treated supraglottic tumor.2. Partially-imaged upper mediastinal lymphadenopathy. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Extensive pulmonary emphysema and persistent right consolidation with air-bronchograms that may represent pneumonia. P... |
Generate impression based on findings. | Seizure-like episode with desaturation to 20-30s requiring bagging, posturing, eye movement, bradycardia. There is hyperattenuating material along the posterior falx cerebri and cerebelli that measures up to 8 mm in width. There may also be trace subarachnoid hyperattenuation in the right parieto-occipital region versu... | Slight diastasis of an accessory intraoccipital suture with acute subdural hemorrhage the posterior falx cerebri and cerebelli that measures up to 8 mm in width, but no midline shift or herniation. Possible trace subarachnoid hemorrhage in the right parieto-occipital region versus artifact. Discussed with Dr. Weiss at ... |
Generate impression based on findings. | Breast cancer. Innumerable osteoblastic lesions are noted throughout the spine, pelvis, bilateral femurs, bilateral humeri, skull, sternum and bilateral ribs, which are indicative of widespread osseous metastases. There is an enlarged lesion of the left hip which could conceivably be orthopedic significance and could b... | 1.Numerous widespread osseous metastases. 2.Particular note is made of a large lesion in left hip, which could conceivably be of future orthopedic significance and could be further evaluated with a plain radiograph. |
Generate impression based on findings. | 13-year-old male status post tibia and fibula osteotomyVIEWS: Right tibia and fibula, AP and lateral (two views) 2/26/15 15:44 External fixation device affixes the tibia osteotomy without evidence of hardware publication. An osteotomy of the mid-diaphysis of the fibula is also noted. Skin staples and drain reflect rece... | External fixation of tibial osteotomy without evidence of hardware complication. |
Generate impression based on findings. | Status post total hip arthroplasty AP pelvis reveals a total arthroplasty in anatomic alignment. There is no evidence of significant fracture or dislocation.Additional portable view of the right hip again reveals a total hip arthroplasty in anatomic alignment. | THA in anatomic alignment |
Generate impression based on findings. | Female 75 years old Reason: pt slipped on ice this am, has been able to walk with assistance History: left knee pain--mostly on medial aspect. There is soft tissue swelling about the medial aspect of the knee. There is severe osteoarthritis of the right knee joint with marked joint space narrowing and tricompartmental ... | Severe osteoarthritis with age indeterminate discontinuity of an orthopedic tibial pin. |
Generate impression based on findings. | Female 36 years old Reason: r/o acute process History: bite to hand. Three views of the left hand demonstrate no acute fracture, dislocation, or bone abnormalities. | Normal appearing left hand without radiographic evidence of fracture or underlying bone abnormality. |
Generate impression based on findings. | There is linear T1 hypointense signal involving the S2 segment, compatible with a sacral insufficiency fracture. There are new areas of low T1 signal in the sacrum with enhancement, suspicious for infiltrative tumor. There are areas of non enhancement predominantly in the left hemisacrum. There is mild presacral soft ... | 1. Sacral insufficiency fracture at the S2 vertebral level.2. Confluent areas of low T1 signal and enhancement involving the sacrum bilaterally are suspicious for infiltrative tumor. Relative lack of soft tissue component and relatively mild uptake on prior PET from 10/2014 raise possibility of osteoradionecrosis. May ... |
Generate impression based on findings. | History of any left renal mass and IVC thrombus now with chest wall pain. No abnormal osseous foci are identified to indicate metastatic disease. | No evidence of bone metastases. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 104 cm/sec.Right internal carotid artery: 86 cm/sec.Left middle cerebral artery: 111 cm/sec.Left internal carotid artery: 77 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | Male 26 years old Reason: table saw injury to r leg, eval bony healing, 3 months ago History: same. A predominately nondisplaced fracture of the mid tibial diaphysis is seen near anatomic alignment. There is bony bridging of the fracture lines suggesting partial healing. | Partial healing of nondisplaced tibial fracture as described above. |
Generate impression based on findings. | Reason: hx of head and neck cancer, now with new esoph lesion on PET, restaging History: dysphagia CHEST:LUNGS AND PLEURA: Severe centrilobular and paraseptal emphysema.Right apical consolidation and fibrosis are increased from the prior exam.Scattered subsegmental scarring/atelectasis. Debris noted within the right lo... | 1. Mediastinal lymphadenopathy is not significantly changed from the prior exam.2. Right apical fibrosis with increasing consolidation, suggestive of superimposed infection. |
Generate impression based on findings. | Patient with a 1 cm LOQ breast cancer. Surgery is 2-27 at 7:30 am.RADIOPHARMACEUTICAL: The right breast was prepared in a sterile manner. A total of 1.0 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. Several foci of increased activity are noted in the right axilla, representing the sent... | Sentinel nodes identified in the right axilla. |
Generate impression based on findings. | 24 year old male with a history of pacemaker removed in 2014 and retained lead fragment in the right ventricle and subsequent development of thrombosis on the lead. Preop robotic tricuspid valve repair, thrombus removal, removal of pacemaker lead fragment CPT Code: 75574 Coronary arteries: LM: The left main coronary ar... | 1. There is a deep myocardial bridge initiating at the mid left anterior descending artery. Beyond this, the apical LAD remains intramyocardial and is poorly visualized. A dominant second diagonal is present and is visualized to the apex. There are no significant coronary stenoses.2. A 2-3mm, mid ventricular, muscular ... |
Generate impression based on findings. | Female 86 years old Reason: recurrent stage IIIB fallopian tube cancer, now with weight loss, increase fatigue and rising CA 125 History: weight loss, fatigue CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Reference right epicardial lymph node is stable size measuring 3.0 x 1.4 cm (serie... | Significant interval increase in mesenteric disease and slight interval increase in lymphadenopathy in multiple lymph node chains consistent with progression of disease. |
Generate impression based on findings. | Female 62 years old Reason: 62 yo female with history of severe necrotizing pancreatitis, c/b severe walled off necrosis with severe abdominal pain, sp ERCP with necrosectomy x 2, most recently 2/26, with residual necrotic debris in the cavity. IR was initially consulted for percutaneous drain, however this procedure w... | Limited exam secondary lack of intravenous and oral contrast with a limited field of view. Within these limitations, there has been marked decrease of the multiloculated peripancreatic fluid collection. |
Generate impression based on findings. | Status post fracture Four views of the left shoulder reveal a comminuted slightly impacted surgical neck fracture. There is slight pseudosubluxation of the humeral head. | Comminuted fracture of the surgical neck of the humerus |
Generate impression based on findings. | Pain status post motor vehicle accident RIGHT SHOULDER: Mild osteoarthritis affects the acromioclavicular joint. No fracture or malalignment is present.LEFT SHOULDER: Mild osteoarthritis affects the acromioclavicular joint. No fracture or malalignment is present. | Mild AC joint osteoarthritis, without fracture or malalignment. |
Generate impression based on findings. | Status post right total hip arthroplasty One view of the pelvis and one view of the right hip demonstrates a right total hip arthroplasty device situated in anatomic alignment, without radiographic evidence of hardware complication.Mild osteoarthritis affects the left hip, as seen on the single frontal view. | Postoperative changes of a right total hip arthroplasty. |
Generate impression based on findings. | Patient with multiple myeloma. Sternal pain. Concern for sternal fracture. A portion of the cortex of the distal sternum, approximately 5 cm from its caudal tip, appears discontinuous, which may represent a fracture given the clinical history. No discrete myelomatous lesions are seen, however, a pathological fracture c... | Possible fracture of the distal sternum. Pathological fracture cannot be excluded. If further evaluation is clinically warranted, CT is recommended.Findings discussed with APN Dimeglio at 4:00pm on 2/26/15 |
Generate impression based on findings. | Swelling and pain An oblique fracture traverses the distal fibula, without displacement or angulation of the distal fracture fragment. The tibiotalar articulation is anatomic. Extensive soft tissue swelling is noted over the lateral malleolus.Orthopedic screws are noted in the first metatarsal, likely from a prior hall... | Distal fibular fracture. |
Generate impression based on findings. | on heparin infusion, cerebrovascular accident Re demonstration of multifocal low attenuations on bilateral hemispheres.No evidence of significant interval changes.No evidence of hemorrhage.Again additional imaging investigations such as brain MRI with and without contrast enhancement are recommended.The ventricles, sul... | Multifocal bihemispheric low attenuation lesions as described above.No change since prior exam.Brain MRI with and without contrast is recommended for further evaluation. |
Generate impression based on findings. | HTN and Alzheimer's dementia now with left-sided weakness. There is no evidence of acute intracranial hemorrhage or mass. There is mild patchy cerebral white matter hypoattenuation. There is diffuse mild prominence of the ventricles and sulci, but more pronounced in the medial temporal lobes. There is no midline shift ... | 1. Mild patchy cerebral white matter hypoattenuation likely represent small vessel ischemic disease of indeterminate age, but no evidence of acute intracranial hemorrhage or mass, or cerebral edema. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. Cerebral volume loss that i... |
Generate impression based on findings. | Evaluate pain into right shoulder and right hip for metastatic disease. Abnormal increased activity is noted within the left eighth rib, consistent with a bone metastasis. This corresponds with a permeative lesion seen on CT which may also involve a pathologic fracture.A medium-sized focus of abnormal activity is seen ... | Osseous metastasis in the left lateral eighth rib and also likely the right acetabulum. |
Generate impression based on findings. | Back pain. There is a posterior stabilization device with screws entering the L5 and S1 vertebrae. I see no hardware complications. There is an intervertebral spacer device at L5/S1 containing bone graft with intervertebral bony bridging of L5 and S1. Mild to moderate degenerative disk disease affects L1/2. I see no fr... | Postoperative changes of lumbosacral fusion and degenerative disk disease as above without evidence of instability. |
Generate impression based on findings. | Osteoarthritis. Pain. The bones appear slightly demineralized, suggesting osteopenia. Mild osteoarthritis affects the acromioclavicular joint and glenohumeral joint, essentially within normal limits for age. There is a compression fracture of T9 that appears similar to that seen on a chest radiograph from September 5, ... | Mild osteoarthritis. |
Generate impression based on findings. | Patient with right ankle pain and swelling after injury 3 months ago. Evaluate for residual injury/fracture. I see no fracture or other specific findings to account for the patient's pain. | Normal-appearing ankle, without fracture or other specific findings to account for the patient's pain. |
Generate impression based on findings. | Status post fall, severe pain with standing, swelling and lower leg medially then lower down tender to palpation on medial malleolus. Fracture? Three views of the left ankle are provided. There is perhaps mild soft tissue swelling, but I see no fracture or malalignment. I otherwise see no specific findings to account f... | Mild soft tissue swelling without fracture evident. |
Generate impression based on findings. | Seizure-like episode with desaturation to 20-30s requiring bagging, posturing, eye movement, bradycardia. There is hyperattenuating material along the posterior falx cerebri and cerebelli that measures up to 8 mm in width. There may also be trace subarachnoid hyperattenuation in the right parieto-occipital region versu... | Slight diastasis of an accessory intraoccipital suture with acute subdural hemorrhage the posterior falx cerebri and cerebelli that measures up to 8 mm in width, but no midline shift or herniation. Possible trace subarachnoid hemorrhage in the right parieto-occipital region versus artifact. Discussed with Dr. Weiss at ... |
Generate impression based on findings. | acute SAH NONCONTRAST CT HEADThere are diffuse acute SAH with IVH as well as mild ventriculomegaly (Fischer grade 4 acute SAH).No parenchymal hemorrhage is seen.No evidence of acute ischemic lesion.The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThere is ... | 1. Diffuse acute SAH, IVH with ventriculomegaly2. Right distal ICA aneurysm (3mm x 2mm) with suspicious adjacent blister like aneurysm (2mm x 1mm).Comment: discussed with Neurosurgery team (Dr.Awad) and planning for EVD before the angiography and subsequent angiography with planning for endovascular treatment under gen... |
Generate impression based on findings. | Status post right revision total hip arthroplasty The AP view of the right hip shows components of a total hip arthroplasty device situated in near-anatomic alignment without radiographic evidence of complication. A drain and foci of gas density in the soft tissues reflect recent surgery.The AP view of the pelvis revea... | Total hip arthroplasty as above. |
Generate impression based on findings. | Status post right total knee arthroplasty Components of a right total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of complication. Skin staples, a drain, and foci of gas density in the anterior soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty as above. |
Generate impression based on findings. | Patient with ankle pain and swelling. Please evaluate for fracture. There is mild soft tissue swelling about the ankle. I see no fracture or malalignment. The mid diaphysis of the fibula is absent, presumably due to prior surgery. | Presumed postoperative changes of the right fibula. I see no fracture. |
Generate impression based on findings. | Right knee pain status post mechanical fall. Evaluate for fracture. Mild osteoarthritis affects the knee. There is a small joint effusion. I see no fracture or malalignment. Note is made of arterial calcifications in the soft tissues as well as a stent in the femoral artery that extends off of the field of view of this... | Osteoarthritis and small joint effusion without fracture evident. |
Generate impression based on findings. | congestive heart failure, intracerebral hemorrhage. There is no evidence of acute ischemic or hemorrhagic lesion on this scan.There are metallic artifacts on the right distal ICA area indicating previously coiled aneurysm.Underlying brain shows patchy low attenuations on bilateral white matter suggesting non specific s... | No evidence of acute ischemic or hemorrhagic lesion.Small vessel ischemic disease. |
Generate impression based on findings. | acute SAH NONCONTRAST CT HEADThere are diffuse acute SAH with IVH as well as mild ventriculomegaly (Fischer grade 4 acute SAH).No parenchymal hemorrhage is seen.No evidence of acute ischemic lesion.The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThere is ... | 1. Diffuse acute SAH, IVH with ventriculomegaly2. Right distal ICA aneurysm (3mm x 2mm) with suspicious adjacent blister like aneurysm (2mm x 1mm).Comment: discussed with Neurosurgery team (Dr.Awad) and planning for EVD before the angiography and subsequent angiography with planning for endovascular treatment under gen... |
Generate impression based on findings. | seizure No evidence of acute ischemic or hemorrhagic lesion.Non specific small vessel ischemic disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The ... | No evidence of acute ischemic or hemorrhagic lesion.Non specific small vessel disease. |
Generate impression based on findings. | Swollen tender left lower extremity. Rule-out osteomyelitis or necrotizing fasciitis There is diffuse soft tissue swelling with reticulation of the subcutaneous fat. I see no gas density within the soft tissues. I see no radiographic evidence of osteomyelitis. Moderate osteoarthritis affects the knee. | Diffuse soft tissue swelling without specific radiographic features of osteomyelitis or necrotizing fasciitis. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Swelling. Is there a fracture? There is soft tissue swelling, particularly along the lateral aspect of the ankle. I see no underlying fracture. There may be a tibiotalar joint effusion, but this is equivocal. Small spurs are noted along the posterior and plantar aspects of the calcaneus which may not be of any clinical... | Soft tissue swelling without fracture evident. |
Generate impression based on findings. | Isolated tenderness to palpation of patella, mild effusion, no instability of the knee. Patella fracture? I see no fracture or malalignment. There is mild anterior soft tissue swelling and perhaps a small joint effusion. | Mild soft tissue swelling without fracture evident. |
Generate impression based on findings. | Laceration of the fifth finger. Evaluate for fracture of fifth metacarpal. There is perhaps mild soft tissue swelling along the 5th metacarpal, but I see no underlying fracture or malalignment. | No fracture evident. |
Generate impression based on findings. | 41 years, Female, Reason: Evaluate for lymphadenopathy in chest or abdomen, masses or intra-abdominal or pelvic abscess History: Fever of unknown origin. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Mildly prominent precarinal node.CHEST WALL: No significant abnormality notedABDOMEN:LIV... | No significant lymphadenopathy. |
Generate impression based on findings. | Pain over ulnar side of hand for one month after punching wall.VIEWS: Right hand PA/lateral/oblique (3 views) 02/26/15 No healing fracture is identified. The bones are normal in appearance. The capitate and hamate are fused, normal variant anatomy. The soft tissues of the hypo-thenar eminence are slightly thickened. | No healing fracture. |
Generate impression based on findings. | 53 years, Male. Reason: is Dobbhoff in correct place to use for tube feeds tonight History: malnutrition Enteric feeding tube tip projects over the distal gastric body. Surgical clip noted over the left upper quadrant. Nonobstructive bowel gas pattern. Spinal catheter tip projects over the T9 vertebral body. The lower ... | Enteric feeding tube tip projects over the distal gastric body. |
Generate impression based on findings. | Shortness of breath, Question of pulmonary embolism PULMONARY ARTERIES: The quality of this examination is diagnostic for the evaluation of pulmonary embolism. No pulmonary embolus. Normal size of the main pulmonary artery.LUNGS AND PLEURA: Subsegmental atelectasis involving the inferior aspect of the right upper lobe.... | No evidence of pulmonary embolus. Minimal bronchial wall thickening with debris and several bronchioles which raise a question of reactive airway disease.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Jaw pain. Evaluate for jaw dislocation. The Panorex radiograph of the mandible shows no fracture. Temporomandibular joint alignment is within normal limits. I see no specific findings to account for the patient's pain. | No fracture, dislocation or other specific findings to account for the patient's pain are evident. |
Generate impression based on findings. | 66 year old male with new axillary lymphadenopathy, concern for PTLD in stem cell transplant patient. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: CHEST:LUNGS AND PLEURA: Basilar... | 1.New left upper lobe opacity with configuration highly suspicious for pulmonary infarct. Recommend evaluation for pulmonary embolism with CT chest PE protocol or VQ scan. 2.Increasing basilar consolidation consistent with infection.3.Axillary lymphadenopathy stable compared to 2/19/2015 exam but new from 2013. 4.New r... |
Generate impression based on findings. | 15 year old female ventilator dependentVIEW: Chest AP (one view) 2/26/2015 16:01 ET tube tip below thoracic inlet. Feeding tube tip likely in the gastric antrum. Right upper extremity PICC tip in the right atrium.Spinal fusion instrumentation extends from T2 to L1.Near complete opacification of the left hemithorax with... | Near complete opacification of the left hemithorax with ipsilateral mediastinal shift likely a combination of pneumonia and atelectasis. |
Generate impression based on findings. | Knee swelling, pain. Dislocation or fractures? There is a small joint effusion with a 1 cm round focus of calcification in the suprapatellar pouch that likely represents a loose body, but I see no acute fracture. Moderate to severe osteoarthritis affects the knee. There is chondrocalcinosis of the menisci. | Osteoarthritis without fracture or dislocation. |
Generate impression based on findings. | 4-year-old male, rule out acute chestVIEWS: Chest AP/lateral (two views) 2/26/15 16:44 The cardiothymic silhouette is upper limits of normal. Low lung volumes and retrocardiac atelectasis without evidence of pneumonia or acute chest. | Low lung volumes without evidence of pneumonia or acute chest. |
Generate impression based on findings. | 54 year old male with history of esophageal cancer, evaluate extent of malignancy. CHEST:LUNGS AND PLEURA: Dependent atelectasis without suspicious nodules or masses. No pleural effusionsMEDIASTINUM AND HILA: There is diffuse circumferential esophageal wall thickening and mild paraesophageal soft tissue thickening comp... | 1.Interval postsurgical changes of recent laparoscopic jejunostomy tube placement including moderate pneumoperitoneum.2.Esophageal and paraesophageal soft tissue thickening compatible with patient's stated history of esophageal cancer without discretely measurable lymphadenopathy. |
Generate impression based on findings. | Frequent vomiting. Rule out pyloric stenosis.EXAMINATION: Interpretation of outside exam 02/27/15upper GI 01/22/15 performed at Methodist Hospital, Merrillville, Indiana 01/22/15 The scout radiograph of the abdomen excludes most of the pelvis. The bowel gas pattern is slightly disorganized.Fluoroscopy of the esophagus ... | Malrotation cannot be excluded. Gastric distention. |
Generate impression based on findings. | 19 day old male status post PDA ligation with hypotension and tachycardiaVIEW: Chest AP (one view) 2/27/15 2:44 Centra venous catheter tip in the SVC. Enteric tube side port at the EG junction. ETT at the thoracic inlet. PDA ligation clip is again noted.Patchy bilateral air space opacities are improved from the prior e... | Patchy bilateral air space opacities are improved from the prior exam. |
Generate impression based on findings. | Reason: s/p EVD removal History: s/p EVD removal There are foci of encephalomalacia present involving the left inferior frontal gyrus and part of the left superior temporal gyrus extending into the left supramarginal gyrus. There is associated enlargement of the left lateral ventricle. Foci of encephalomalacia is also ... | Status post recent ventriculostomy tube removal. The lateral ventricles are enlarged but remain stable when compared to prior exam. |
Generate impression based on findings. | Reason: pulmonary infiltrate seen on CXR, volume overload or infectious process? History: edema, ascites, cough, SOB LUNGS AND PLEURA: Scattered patchy areas of groundglass opacity, with an upper lobe predominance.No significant septal thickening. No pleural effusions.No suspicious pulmonary nodules or masses.MEDIASTIN... | 1. Scattered patchy upper-lobe-predominant areas of groundglass most likely represents viral pneumonia. Atypical edema and pulmonary hemorrhage are considered less likely.2. Subcutaneous edema/fluid and skin thickening involving the left breast may be due to patient positioning or an occluded left chest wall vein, howe... |
Generate impression based on findings. | 6-month-old male with PICC placement, feeding intolerance. VIEWS: Chest and abdomen AP (two views) 2/26/2015 16:31 Interval placement of left upper extremity PICC with tip at the confluence of the brachiocephalic veins. Tracheostomy tube in place. NG-tube tip in the stomach within the giant omphalocele. Right lower ext... | 1. Left upper extremity PICC tip at the confluence of the brachiocephalic veins. 2. Dilated bowel loops are noted within the omphalocele. |
Generate impression based on findings. | Female 63 years old Reason: 63yo F with history of SLE presenting with hip pain and fevers, concern for abscess. History: hip pain, fever ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality... | 1.No findings to explain patient's hip pain. No evidence of abscess. 2.Stable, large right lateral abdominal wall hernia without evidence of bowel obstruction. |
Generate impression based on findings. | 60 year old female with abdominal pain and fever, rule out acute process. ABDOMEN:LUNG BASES: Mild basilar atelectasis/consolidation. Calcified granuloma in the left lung base and calcified hilar lymph nodes compatible with prior granulomatous disease. Cardiomegaly and enlarged right atrium.LIVER, BILIARY TRACT: Hepati... | 1.Bilateral mild basilar atelectasis/consolidation which could be related to aspiration and/or infection. 2.No acute abdominal findings to account for the patient's abdominal pain.3.Hepatic steatosis.4.Findings compatible with right heart failure including reflux of contrast into an enlarged IVC and tributaries.5.Chole... |
Generate impression based on findings. | 47 years, Male. Reason: abdominal pain, r/o obstruction History: abdominal pain Interval removal of Swan-Ganz catheter, enteric feeding tube, and surgical drains. LVAD, sternotomy hardware, and AICD unchanged. Nonobstructive bowel gas pattern with moderate stool burden in the colon. Bilateral air space opacities are be... | Nonobstructive bowel gas pattern with moderate stool burden. |
Generate impression based on findings. | 19 day old male, assess lung expansion after PDA ligationVIEW: Chest AP (one view) 2/26/15 18:19 ETT tip at the thoracic inlet. Right central venous catheter tip in the SVC. Enteric tube side port at the EG junction. New PDA ligation clip. Extensive bilateral airspace opacities with interval improved aeration in the le... | Interval PDA ligation with slight improvement in left pulmonary opacities. No pneumothorax. |
Generate impression based on findings. | 79 year old male with abdominal pain, evaluate for obstruction. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Minimal basilar atelectasisLIVER, BILIARY TRACT: ... | 1.Findings highly concerning for closed loop small bowel obstruction. No associated intraperitoneal free air. Small amount of pelvic free fluid is present.Findings communicated by on-call resident to ER physician Dr. Turner at 12:22 a.m. on 2/27/2015. |
Generate impression based on findings. | 56 years, Female, Reason: kidney stone History: left flank pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Subcentimeter right renal hypodensity is too small to characterize and unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No... | 1.No hydronephrosis or obstructing renal stones.2.Ovoid region of hypoattenuation in the left kidney with peripheral calcifications is more prominent than the prior exam. While this could represent a minimally complex cyst, calcifications in the setting of caliectasis and scarring is favored. |
Generate impression based on findings. | 15 year-old male with tenderness status post traumaVIEWS: Right clavicle, AP and axial (two views) 2/26/15 19:18, Right shoulder, internal and external rotation (two views), 2/26/1519:17 Alignment is anatomic. The humeral head articulates normally with the glenoid fossa. The clavicle is intact. | Normal examination. |
Generate impression based on findings. | 66 years, Male. Reason: Eval colon distention History: Dilated colon, distention Persistent, but improved gas filled loops of small and large bowel compatible with ileus type pattern. Right pleural effusion is again noted. Gastrostomy tube projects over the gastric body. Prosthetic mitral valve again noted. | Persistent, but improved gas filled loops of small and large bowel compatible with ileus type pattern. |
Generate impression based on findings. | 9-year-old female with medial malleolus pain, everting foot with ambulation.VIEWS: Right ankle AP/lateral/oblique (3 views), left ankle AP/lateral/oblique (3 views) 2/26/2015 Normal alignment. No soft tissue swelling or joint effusion. No fracture or dislocation. | Normal examinations. |
Generate impression based on findings. | Left foot pain/swelling. Evaluate for fracture. Three views of the left ankle are provided. There is mild soft tissue swelling and perhaps a small tibiotalar joint effusion. I see no fracture or malalignment.Three views of the left foot are provided. There is mild diffuse soft tissue swelling. I see no fracture. There ... | Soft tissue swelling and arthritic changes as described above, without fracture evident. |
Generate impression based on findings. | 66 years, Male. Reason: ileus, r/o obstruction History: bowel dilation Persistent mild gaseous distension of small and large bowel compatible with ileus type pattern. No pneumoperitoneum on upright imaging. Right pleural effusion is again noted. Gastrostomy tube projects over the gastric body. Prosthetic mitral valve a... | Mild gaseous distension of small and large bowel compatible with ileus type pattern. |
Generate impression based on findings. | 7-month-old female with respiratory distressVIEW: Chest AP (one view) 2/26/1519:40 The cardiothymic silhouette is normal. Right upper lobe perihilar atelectasis. No pleural effusions or pneumothorax. | Right upper lobe atelectasis without pleural effusions or pneumothorax. |
Generate impression based on findings. | Lung cancer staging with suspicious SCV lymph node. CHEST:LUNGS AND PLEURA: The dominant hypermetabolic left upper lobe mass measures slightly smaller when compared to recent previous CT from 1/28/15. For example, using similar measurement, this is 3.6 x 3.7 cm (6/35), as compared to 3.5 x 4.2 cm. It has slightly reduc... | The dominant hypermetabolic left upper lobe mass compatible with malignancy measures slightly smaller 3.6 x 3.7cm, as compared to 3.5 x 4.2 cm. The second spiculated solid component that surrounds the left upper lobe bronchus and proximal branches has become less nodular, measuring 11 mm transverse, as compared to 20 m... |
Generate impression based on findings. | Female, 76 years old.Surgery greater than 8 hours and multiple surgical teams. No unexpected radiopaque foreign objects. Enteric feeding tube tip projects over the distal gastric body. Surgical drain projects over the left upper quadrant. Surgical sutures are noted in the left upper quadrant. Nonobstructive bowel gas p... | No unexpected radiopaque foreign objects.Findings discussed with the attending surgeon, Dr. Lengyel, via telephone at 18:19 hours on 2/26/2015 by Dr. Alexander. |
Generate impression based on findings. | Pain status post fall. Rule out fracture. I see no fracture or malalignment. The wrist appears normal for age. | No fracture or other specific findings to account for the patient's pain are evident. |
Generate impression based on findings. | Shoulder pain The distal clavicle appears slightly elevated relative to the acromion process on the AP view, but this may simply reflect normal anatomy for this patient. The remainder of the shoulder is normal. | Slight elevation of the distal clavicle of uncertain clinical significance. The shoulder otherwise appears normal. |
Generate impression based on findings. | Female 80 years old Reason: 80yo F with L hand swelling, leukocytosis, and pain out of proportion to exam; concern for necrotizing fasciitis. History: swelling, pain, leukocytosis. There is replacement of the subcutaneous fat along the dorsum of the hand with soft tissue density compatible with edema. This edema extend... | Superficial soft tissue edema without specific radiographic features of necrotizing fasciitis. |
Generate impression based on findings. | 61 years, Male. Reason: patient with emesis, assess for ileus History: emesis Nonobstructive bowel gas pattern with air filled loops of small bowel in the midabdomen. Moderate to large stool burden in the colon. Air space opacities are better evaluated on chest radiograph performed 2/26/2015. | Nonobstructive bowel gas pattern with air filled loops of small bowel in the midabdomen. Moderate to large stool burden in the colon. |
Generate impression based on findings. | Female 37 years old Reason: eval for stone, eval appendix History: R flank pain, hematuria ABDOMEN: Limited exam secondary to lack of oral and intravenous contrast. Lack of intravenous contrast makes evaluation of solid organ and vascular pathology suboptimal. Lack of oral contrast makes evaluation of bowel pathology s... | 1.Limited exam with lack of intravenous contrast making evaluation of solid organ pathology suboptimal. Within these limitations, there is a large well-defined, hypoattenuating fluid collection centered in the right paracolic gutter which likely represents a benign cystic lesions such as a lymphangioma, lymphocele, dup... |
Generate impression based on findings. | 68 years, Male. Reason: abdominal distention, obstruction? History: abd distension, constipation Examination is limited by patient body habitus. Mildly distended gas filled colon with paucity of gas in the rectum may represent colonic ileus versus colonic obstruction. Cholecystectomy clips noted in the right quadrant. | Mildly distended gas filled colon may represent colonic ileus versus colonic obstruction. |
Generate impression based on findings. | Spine trauma. Kyphosis AP and lateral views of the spine were obtained, per spinal survey technique. Please note that this technique is not optimal for evaluation of spine trauma. There are deformities of the L1 and L4 vertebral bodies which likely represent old fractures as seen on prior imaging studies. Multiple thor... | Chronic appearing vertebral body fractures, kyphoscoliosis, and degenerative changes as described above. If there is clinical concern for acute spine trauma, CT should be considered. |
Generate impression based on findings. | Female 76 years old, surgery with greater than 8 hours. Multiple surgical teams. The upper abdomen is excluded from the field-of-view. No unexpected radiopaque foreign objects. Partially imaged surgical drain projects over the left upper quadrant. Suture material projects over the mid pelvis. Expected post surgical pne... | No unexpected radiopaque foreign objects.These findings were discussed by the radiology resident on call via telephone with Dr. Lengyel, the attending surgeon, on 2/26/2015 at 18:19 hours by Dr. Alexander. |
Generate impression based on findings. | Reason: left lung nodule, s/p bilateral lung transplant History: as noted above LUNGS AND PLEURA: Status post bilateral lung transplant.Moderate linear scarring throughout the lungs.Small pleural effusions bilaterally, with adjacent small areas of subpleural atelectasis at the bilateral bases.A calcified pleural plaque... | 1. No suspicious pulmonary nodules or masses. A calcified pleural plaque anterolaterally in the left hemithorax corresponds with the nodular density seen on recent chest radiograph.2. Moderate linear scarring, pleural thickening, very mild bronchiectasis and small pleural effusions bilaterally, improved from outside CT... |
Generate impression based on findings. | 3-year-old male with pain and swellingVIEWS: Right hand, PA, oblique, and lateral (3 views) 2/26/15 22:58 Minimally displaced fracture of the distal tuft of the ring finger with overlying soft tissue swelling. The remaining osseous structures are intact. | Minimally displaced fracture of the distal tuft of the ring finger. |
Generate impression based on findings. | Central line placementVIEW: Chest AP and abdomen AP NG tube tip in the stomach. The umbilical venous catheter tip in the SVC. Cardiothymic silhouette normal. No focal lung opacity. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | The umbilical venous catheter tip in the SVC. |
Generate impression based on findings. | 34-year-old female with history of swelling, evaluate for SVC syndrome. History of bilateral internal jugular vein thrombosis. There is marked attenuation of bilateral inferior internal jugular veins. Bilateral upper internal jugular veins are patient and non-dilated to suggest a significant obstruction. No obvious ede... | 1. Marked attenuation of inferior bilateral internal jugular veins which is compatible with patient's history of chronic bilateral internal jugular vein thrombosis. Upper internal jugular veins are patent without dilatation. Bilateral brachiocephalic veins and visualized SVC are also patent. 3. Enlarged main pulmonary ... |
Generate impression based on findings. | Cardiac surgeryVIEW: Chest AP 2/27/15 Right central line with tip in the right atrium. Cardiomegaly unchanged. Midline sternal wires again noted. Patchy atelectasis bilaterally increased from prior study. No pleural effusion or pneumothorax. | Bilateral patchy atelectasis increased from prior study. |
Generate impression based on findings. | 44 years, Male. Reason: picc line placement History: as above Support lines overlie the patient. Peripherally inserted central catheter tip is located above the upper aspect of the image and is not seen. Radiodensity projected over the right iliac crest and additional incompletely evaluated radiodensities project over ... | PICC tip is located above the upper aspect of the radiograph and is not seen. Chest/neck radiograph should be obtained for visualization |
Generate impression based on findings. | Ms. Brooks is a 71 year old female with biopsy proven malignancy within the right superior breast. She presents today for wire localization prior to surgery. On review of the prior studies, the target is irregular, hypoechoic mass measuring 1.7 x 0.9 x 1.4 cm, located in the right breast in the superior region located ... | Successful needle localization of the right breast malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Cardiac surgeryVIEW: Chest AP 2/26/15 Midline sternal wires again noted. Right central line with tip in the right atrium. Cardiomegaly unchanged. Bilateral diffuse patchy atelectasis not significantly changed. There is a small right apical pneumothorax. | Bilateral patchy atelectasis and small right apical pneumothorax unchanged. |
Generate impression based on findings. | 6-year-old male with cough and fever, evaluate for pneumoniaVIEWS: Chest AP/lateral (two views) 2/27/15 2:25 Mild bronchial wall thickening and large lung volumes without evidence of pneumonia. Mild basilar atelectasis. The cardiac apex, aortic arch and stomach are left-sided.The cardiothymic silhouette is normal. | Bronchiolitis or reactive airway disease without evidence of pneumonia. |
Generate impression based on findings. | 1-day-old male on cooling protocol, esophageal temperature probe placementVIEW: Chest AP, abdomen, AP (two views) 2/27/15 4:04 Esophageal temperature probe tip in the distal thoracic esophagus. UVC catheter tip in the right atrium.The cardiothymic silhouette is normal. The cardiac apex, aortic arch and stomach are left... | Esophageal temperature probe tip in the distal thoracic esophagus. |
Generate impression based on findings. | Respiratory distressVIEW: Chest AP 2/27/15 Left upper extremity PICC with tip in the right atrium. Cardiothymic silhouette normal. Patchy atelectasis in the right lower lobe and left lower lobe minimally improved. No pleural effusion or pneumothorax. | Bilateral patchy atelectasis improved from prior study. |
Generate impression based on findings. | Evaluate foreign bodyVIEW: Abdomen AP 2/27/15 Gastrostomy tube in place. Metallic hardware at the left iliac bone and left proximal femur. There is a radiopaque foreign body projected over the stomach. Moderate amount of fecal burden at the descending colon and rectosigmoid region. Disorganized nonobstructive bowel gas... | Radiopaque foreign body projected over the stomach. |
Generate impression based on findings. | 41 years, Female. Reason: 41 F with abdominal pain, no bowel movements History: abdominal pain Nonobstructive bowel gas pattern. Average stool burden. | Nonobstructive bowel gas pattern. Average stool burden. |
Generate impression based on findings. | NSCLC initial staging. Head: There is no evidence of intracranial mass or abnormal enhancement. There is a punctate area of hypoattenuation in the left thalamus. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. Th... | 1. Left lower neck lymphadenopathy is compatible with metastatic disease. 2. No evidence of intracranial metastases.3. Partially imaged right lung mass. Please refer to the separate chest CT report for additional details.4. An area of hypoattenuation in the left thalamus may represent a lacunar infarct of indeterminate... |
Generate impression based on findings. | 59 year old woman with history of left breast mass seen on screening mammogram. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. There is an oval, circumsc... | Benign-appearing mass, likely a fibroadenoma, in the left breast. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: ND - Diagnostic ... |
Generate impression based on findings. | Abdominal distention and rectal decompression tube.VIEW: Abdomen AP (one view) 02/27/15, 0809 and 0810 Feeding tube is coiled upon itself in the stomach. Tracheostomy and gastrostomy tubes are present. A rectal tube has been placed. Left thoracolumbar curve is present. Bilateral developmental hip dysplasia is noted.The... | Decrease in caliber of bowel after placement of rectal tube. |
Generate impression based on findings. | 9-year-old male with history of Wilms tumor status-post right nephrectomy. 36 months off therapy. CHEST:LUNGS AND PLEURA: Left upper lobe micronodule is unchanged. No new suspicious micronodules are seen. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Heart size is normal. No mediastinal or hilar lymphadenop... | No evidence of disease recurrence or metastases. |
Generate impression based on findings. | 54-year-old male with history of heart transplant and recurrent upper respiratory symptoms. Please evaluate for sinus pathology. There is minimal mucosal thickening of scattered anterior ethmoid air cells. The remaining paranasal sinuses are clear. No air fluid levels are present. There is a chronic deformity of the ri... | 1. No significant paranasal sinus disease. There is minimal scattered ethmoid mucosal thickening but sinuses are otherwise well aerated. 2. Chronic right medial orbital wall fracture. |
Generate impression based on findings. | 41 year old woman with history of multiple breast cysts. History of paternal grandmother and great aunt with breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in ... | Stable, bilateral, benign appearing masses seen to be cysts on the prior ultrasound. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign... |
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