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Generate impression based on findings. | 12-year-old male, evaluate for shunt malfunctionVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 3/3/15 3:27 Right VP shunt catheter projects to the left of the midline. The shunt tubing courses down the right neck, anterior chest wall and abdomen, and is coiled with its tip in the pelvis.The cardiothymic silhouette is normal. No focal pulmonary opacities or pleural effusion. The bowel gas pattern is nonobstructive. | No evidence of shunt malfunction. |
Generate impression based on findings. | Mild reversal of normal cervical lordosis may be secondary to positioning. There are no acute fractures or subluxations. The visualized intracranial and paraspinal contents are unremarkable.C2/3: No significant central spinal canal stenosis.C3/4: No significant central spinal canal stenosis.C4/5: No significant central spinal canal stenosis.C5/6: No significant central spinal canal stenosis.C6/7: No significant central spinal canal stenosis.C7/T1: No significant central spinal canal stenosis. | No acute fracture or traumatic subluxation. |
Generate impression based on findings. | Metastatic colon carcinoma CHEST:LUNGS AND PLEURA: No significant change in reference right lower lobe nodule best seen on image 72 series 4 measuring 0.5 cm in diameter. While the majority of the micronodules have remained stable, there has been interval appearance of a few new micronodules. A representative new micronodule in the right middle lobe best seen on image 54 series 4 measures 0.5 cm.MEDIASTINUM AND HILA: Interval increase in size of supraclavicular, mediastinal, hilar and left paravertebral metastatic adenopathy. The reference AP window lymph node best seen on image 42 measures 3.8 x 3.1 cm; this is in comparison to 3.3 x 2.5 cm on 1/5/2015.Slight interval increase in size of pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Interval increase in size of bilobar hepatic metastases. Reference caudate lesion mass best seen on image 99 measures 6.6 x 6.4 cm; this is in comparison to 3.4 x 4.3 cm on 1/5/2015. Reference segment 6 right lobe lesion best seen on image 108 measures 4.5 x 2.9 cm; this is in comparison to 4.3 x 2.4 cm on 1/5/2015.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Reference right adrenal nodule stable measuring 3 x 1.7 cm best seen on image 116.KIDNEYS, URETERS: Interval worsening of left hydronephrosis; moderate bilateral hydronephrosis now present.RETROPERITONEUM, LYMPH NODES: Slight interval increase in size of extensive retroperitoneal metastatic adenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate again noted.BLADDER: Bladder distention again noted.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval progression in metastatic tumor burden as described. Worsening left hydronephrosis; bilateral moderate hydronephrosis now present. |
Generate impression based on findings. | Female 96 years old Reason: eval fracture History: eval fracture. Six views of the lumbar spine show marked disk space narrowing with vacuum phenomenon at the L5/S1 and disk space narrowing at L4/L5 with mild anterolisthesis of L4 on L5. Tiny anterior vertebral body osteophytes are noted. There is no acute fracture or post traumatic subluxation. Vertebral body heights and intervertebral disk spaces are preserved. The alignment is normal.Two views of the right hip show no acute fracture or dislocation. Mild degenerative changes affect the right hip joint. Note is made of vascular calcifications and artifact compatible with heavy metal injections in the soft tissues of the right buttocks.Two views of the right femur show hardware components of a right total knee arthroplasty device situated in near anatomic alignment with no radiographic evidence of hardware complication. Note is made of vascular calcifications. | No acute fracture or dislocation. Right total knee arthroplasty as described above. |
Generate impression based on findings. | Female 67 years old; pain RIGHT SHOULDER: Mild osteoarthritis affects the right acromioclavicular joint. Mild enthesopathic changes are present at the greater tuberosity, appearing similar to the prior study. LEFT SHOULDER: Mild osteoarthritis affects the left acromioclavicular and glenohumeral joints. Mild enthesopathic changes are present at the greater tuberosity, appearing similar to the prior study. A small focus of ossification above the greater tuberosity likely resides within the rotator cuff. A small spur projecting from the medial humeral neck likely reflects prior injury to the inferior glenohumeral ligament, of questionable current clinical significance.Mild degenerative disk disease affects the visualized cervical spine. | Mild osteoarthritis and other findings as described above, appearing similar to prior. |
Generate impression based on findings. | 59 years, Male. Reason: Eval stool burden, obstruction History: Abdominal pain Above average stool burden mainly within the ascending colon, transverse colon, and rectum. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. Right femoral screw is incompletely imaged. | Above average stool burden. |
Generate impression based on findings. | Reason: cxr with features concerning for possible sarcoidosis - family history of same in mother - CT for further clarification History: mediastinal lymphadenopathy LUNGS AND PLEURA: Scattered, benign-appearing micronodules. No suspicious pulmonary nodules or masses.No focal airspace consolidation. No pleural effusion.Mild bronchial wall thickening.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary artery calcification.Moderate bilateral hilar and mediastinal lymphadenopathy. For reference, an AP window lymph node measures 12 mm (series 3, image 27). A right hilar lymph node measures 13 mm (series 3, image 47).CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Scattered subcentimeter hepatic hypodensities incompletely evaluated, likely benign cysts. Multiple renal hypodensities, likely benign cysts.Scattered mildly prominent upper abdominal lymph nodes. | Moderate bilateral hilar and mediastinal lymphadenopathy without acute pulmonary abnormality. These findings are nonspecific but compatible with sarcoidosis. |
Generate impression based on findings. | 25 years, Male. Reason: Patient with back pain and hx of kidney stones History: back pain Multiple 3-4 mm radiodense foci in the distribution of bilateral kidneys is consistent with renal stones as demonstrated on prior CT. A 3-mm radiodensity adjacent to the right transverse process of L5 may represent suture material or a ureteral stone. Midline surgical staples reflect recent surgery. Small amount of pneumoperitoneum is likely postsurgical. Average to above average stool burden. | A 3-mm radiodensity adjacent to the right transverse process of L5 may represent either suture material or a ureteral stone. CT is recommended if clinical suspicion persists. |
Generate impression based on findings. | Female 56 years old; Reason: left hip pain Mild osteoarthritis affects the left hip, with small osteophytes along the lateral femoral head. The lateral center edge angle measures 37 degrees, not accounting for slight pelvic obliquity/rotation. The anterior center edge angle measures 36 degrees to the sourcil. The femoral neck shaft angle measures 133 degrees. The alpha angle measured on the modified Dunn view measures 55 degrees, which is borderline. Subjectively, there appears to be mild acetabular overcoverage, which is likely exaggerated due to the pelvic obliquity/rotation.Mild osteoarthritis affects the right hip, as seen on the frontal view. Degenerative arthritic changes are present in the visualized lower lumbar spine. | Mild osteoarthritis with measurements as described above. |
Generate impression based on findings. | The patient submitted outside mammogram dated 8/6/09. Submitted outside study was compared to the current mammogram dated 2/13/15. An asymmetry in the inner left breast, on the CC view is stable.A cluster of coarse calcifications in the left lower inner aspect is new. | A new cluster of coarse calcifications in the left lower inner aspect. Spot magnification views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 42 years old Reason: r/o fx or dislocation History: pain after fall. Three views of left shoulder show no acute fracture or dislocation. Alignment of the glenohumeral and acromioclavicular joints is within normal limits. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 81 years old Reason: need inlet and outlet views; open book History: s/p fall. AP view of the pelvis, two views of the bilateral hips, and inlet and outlet views of the pelvis show a comminuted fracture of the left superior and inferior pubic rami. Overlying bowel gas obscures detail and limits the evaluation of the pelvis, particularly the sacral region and an associated sacral fracture cannot be excluded. There is mild degenerative arthritic changes of the bilateral hips, but the alignment of the bilateral acetabular joints are preserved. The bones appear demineralized. Calcification in the right hip, superior to the femoral neck likely reflects calcific bursitis. | Comminuted left superior and inferior pubic rami fractures. Due to overlying bowel gas, an associated sacral fracture cannot be entirely excluded and a CT is recommended to evaluate the sacrum and sacroiliac joints. |
Generate impression based on findings. | The patient submitted outside mammogram dated 8/6/09. Submitted outside study was compared to the current mammogram dated 2/13/15. An asymmetry in the inner left breast, on the CC view is stable.A cluster of coarse calcifications in the left lower inner aspect is new. | A new cluster of coarse calcifications in the left lower inner aspect. Spot magnification views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 62 years old; Reason: left maxillary sinusitis History: sinusitis, possible dental origin on the left Multiple teeth are absent. Multiple dental fillings and implants are noted. There is no protrusion of the dental roots into the maxillary sinuses. No dental caries are seen. | No specific findings suggestive of a dental origin of the patient's left maxillary sinusitis. If further imaging is clinically warranted, dental radiographs are recommended. |
Generate impression based on findings. | Female 58 years old; Reason: US concerning for 2.7x1.9x2.5cm pancreatic mass. EUS on 3/2/15 no mass seen Suboptimal study due to paucity of intraabdominal fat.ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Patent portal veins, splenic vein narrowed along its course but patent, patent SMV. Patent arterial vasculature, branch vessels of expected celiac trunk originate directly from abdominal aorta, a normal variant.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct mildly prominent measuring 2 mm but within limits of normal, no discrete pancreatic mass delineated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Distended mildly thickwalled stomach containing large amount of layering debris/ingested material. Moderate wall thickening at level of gastric antrum/pylorus, coronal image 32 series 80716. Fluid seen distally in proximal duodenum which is mildly dilated in region of proximal third portion. Correlation with patient's clinical history to exclude SMA syndrome also recommended. Colonic diverticulosis, particularly pronounced in sigmoid colon.PELVIS:UTERUS, ADNEXA: Small uterine calcifications, may reflect underlying leiomyomatous disease.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Decreased osseous mineralization and multilevel degenerative changes of spine, most pronounced at L4/L5 and grade 2 anterolisthesis of L4 on L5 present. | 1. Suboptimal study due to paucity of intraabdominal fat.2. Pancreatic duct mildly prominent but measures 2 mm at level of neck which is within limits of normal, no discrete pancreatic mass delineated.3. Distended mildly thickwalled stomach containing large amount of layering debris/ingested material. Moderate wall thickening at level of gastric antrum/pylorus, may reflect inflammation/infectious process but underlying neoplasm not excluded. Findings worrisome for gastric outlet obstruction and correlation with patient's clinical history/endoscopy recommended. 4. Fluid seen distally in proximal duodenum which is mildly dilated in region of proximal third portion, correlation with patient's clinical history to exclude SMA syndrome also suggested. 5. Colonic diverticulosis, particularly pronounced in sigmoid colon. No evidence of acute diverticulitis. |
Generate impression based on findings. | Female 19 years old Reason: please evaluate renal cyst History: complex renal cyst on abdominal U/S, recurrent N/V and abdominal pain ABDOMEN: Lack of oral contrast makes evaluation of bowel pathology suboptimal. Within these limitations, the following observations can be made:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Redemonstrated is a left renal lesion which measures 1.8 x 1.8 cm (series 10, image 39), previously 1.7 x 1.7 cm. Given the short time interval between examinations, the slight increase in prominence is likely secondary to differences in technique. There is approximately 14 Hounsfield unit difference before and following administration of contrast, which is equivocal for true enhancement. Enhancing septa seen within the cyst, best seen on coronal imaging (series 80717, image 25).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction or intraperitoneal free air. Normal appendix.BONES, SOFT TISSUES: No significant abnormality noted | Indeterminate left renal cyst with characteristics which could reflect a mildly complex cyst but given the equivocal Hounsfield units and thin enhancing septa demonstrated on postcontrast imaging, a mildly enhancing renal cell carcinoma such as papillary type cannot be excluded. Based on the findings, the cyst is classified as a Bosniak 2F. Correlation with patient's clinical history and any available remote imaging recommended. |
Generate impression based on findings. | Pain. Breast cancer. The bones are slightly demineralized, suggesting osteopenia. Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. | Mild osteoarthritis. |
Generate impression based on findings. | Female 35 years old Reason: r/o fxr History: fall onto R knee. Four views of the right knee show no acute fracture or dislocation. No large joint effusion. | Normal-appearing knee without acute fracture or dislocation. |
Generate impression based on findings. | Shortness of breath, ongoing crackles. Question of new diagnosis of ILD or due to heart failure. LUNGS AND PLEURA: There is diffuse bronchial wall thickening and bronchiectasis which is most predominate in the right middle lobe, lingula, and lung bases. There are multiple nodules, patchy areas of consolidation with air bronchograms, and tree-in-bud opacities. There is also septal thickening, most predominately in the apices. There is no pleural effusion or pneumothorax.MEDIASTINUM AND HILA: The heart size is upper limits of normal. There is no pericardial effusion. There are numerous enlarged mediastinal lymph nodes within the right paratracheal, pretracheal, AP window, prevascular, and subcarinal lymph node stations. The largest right paratracheal lymph node measures approximately 21 mm in the short axis (image 33, series 4). There is hilar lymphadenopathy with a right hilar lymph node measuring 16 mm in the short axis (image 41, series 4). There are enlarged paraesophageal lymph nodes.CHEST WALL: There are multiple heterogeneous nodules replacing almost the entire right thyroid lobe and a 2 cm partially calcified thyroid nodule in the left thyroid lobe. There is no axillary lymphadenopathy. There are mild coronary artery calcifications. UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. There is redemonstration of intra- and extrahepatic pneumobilia of uncertain etiology. There is a 2 cm solid appearing right renal lesion and a heterogeneous right upper pole lesion which were not FDG avid on prior PET and likely benign. A left adrenal nodule has slightly increased in size measuring 25 x 23 mm, previously 22 x 21 mm, though was not FDG avid on prior PET and likely benign. | Extensive right middle lobe, lingular, and lower lobe bronchiectasis with patchy areas of consolidation, pulmonary nodules, and tree-in-bud opacities. These findings most likely represent a chronic infectious process due to MAI or other atypical mycobacterium. Sarcoidosis is a secondary possibility given the severity of lymphadenopathy. |
Generate impression based on findings. | Pain RIGHT HIP: Mild to moderate osteoarthritis affects the right hip.LUMBAR SPINE: Severe degenerative disk disease affects the L5/S1 level. The remaining intervertebral disk spaces and vertebral body heights are maintained. Moderate facet joint osteoarthritis affects the lower lumbar spine. There is mild grade 1 anterolisthesis of L3 on L4. Mild degenerative disk disease affects the visualized lower thoracic spine.Atherosclerotic calcification is present in the distal abdominal aorta. | Degenerative arthritic changes, as described above. |
Generate impression based on findings. | Female 34 years old Reason: r/o fx History: peds vs auto. AP view of the pelvis shows no acute fracture or dislocation. A radiopaque density seen just to the right of the midline pelvis likely represents an artifact.Two views of the right tibia/fibula show no soft tissue swelling. There is no fracture or dislocation. | No acute fracture or dislocation seen in the pelvis or the right tibia/fibula. |
Generate impression based on findings. | 17 year-old male status post right upper extremity gunshot wound two months prior, now with contracture. Evaluate for fracture.VIEWS: Right elbow AP, oblique and lateral, Right humerus AP and lateral (5 views) 3/2/2015 Alignment is normal. No joint effusion or soft tissue swelling. No fracture or dislocation.Two adjacent radiopaque 2 mm linear structures are seen along the anteromedial soft tissues of the humerus likely vascular clips. | No fracture or dislocation. |
Generate impression based on findings. | Female 44 years old; Reason: NGT position History: same Enteric tube is coiled in the stomach with its tip in the proximal gastric body.Excreted intravenous contrast noted in the pelvic calyceal system of the kidneys. | 1.Enteric tube terminates in the proximal gastric body |
Generate impression based on findings. | Male 52 years old Reason: evaluate for shoulder dislocation and fracture History: limited ROM and shoulder pain s/p fall from standing on ice. Three views of the right shoulder show no acute fracture or dislocation. A chronic appearing deformity of the distal capital likely reflects prior trauma. There is ossification of the superior aspect of the coracoclavicular ligament. Small osteophyte formation is seen at the inferior glenohumeral joint. Alignment of the glenohumeral and acromioclavicular joints is within normal limits. | No acute fracture or dislocation of the right shoulder. |
Generate impression based on findings. | Male 29 years old Reason: r/o fxr, dislocation History: swelling of L thumb MCP joint and thenar eminence s/p axial load injury to thumb while playing basketball. Three views of the left hand show no acute fracture or dislocation. A chronic appearing nonspecific defect seen on one the lateral side of the first metacarpal head has a well-defined sclerotic border. There is no associated joint space narrowing. While this could reflect gouty arthritis, in most likely is a normal variant in a patient of this age. | No acute fracture or dislocation of the left hand. |
Generate impression based on findings. | 10-year-old male with history of distal fibular metaphyseal fracture and medial malleolus fracture.VIEWS: Left ankle AP, oblique and lateral (3 views) 3/3/2015 8:21 3 K wires in the distal tibia and two screws in the distal fibula are intact and unchanged. Fracture lines are not visible. Alignment is anatomic. Demineralization is again noted. | Healing ankle fractures. |
Generate impression based on findings. | There is minimal reversal of the normal cervical lordosis. There is no evidence of fracture or subluxation. The vertebral body and disc space heights are preserved. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. | No acute fracture or subluxation. |
Generate impression based on findings. | Male; 25 years old. Reason: HCC by liver biopsy. CT with volumes ( total, right and left lobes) and triple phase liver protocol. Need to evaluate vascular invasion and extent of involvement prior to consideration of surgical resection. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions or focal areas of consolidation.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: There is a large mass involving the entire right liver lobe that measures 17.7 x 19.8 x 27.1 cm, TR x AP x CC (series 9, image 35 and series 80272, image 53). The mass demonstrates mild heterogeneous arterial enhancement as well as washout on delayed phase imaging. The underlying liver is non-cirrhotic. Conventional hepatic arterial anatomy is present, distorted by the mass but without evidence of arterial obstruction or invasion. Specifically, the mass displaces the right hepatic artery posteriorly. The main and left portal veins are patent but the right portal vein is compressed by the mass. The main and left hepatic veins are patent; the right hepatic vein is splayed but probably patent. Liver Volumes: Left liver 1148 mL, Right liver 4645 mL, Total 5794 mL. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted. Leftward displacement of the right kidney due to mass effect. RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal or mesenteric adenopathy. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Large mass occupying the entire right liver lobe which demonstrates arterial enhancement and washout. While the size and imaging appearance favor HCC, adenoma cannot be entirely excluded. 2.Conventional hepatic vasculature which is distorted and/or attenuated by the mass as described above, without definite evidence of obstruction or tumor invasion. 3.Liver Volumes: Left liver 1148 mL, Right liver 4645 mL, Total 5794 mL. |
Generate impression based on findings. | Biopsy proven triple negative IDC. Presenting for placement of a radioactive seed for presurgical localization. On review of the prior studies, there is a clip in the right upper outer breast with no residual enhancing focus seen on MR.The procedure, risks including bleeding, mistargeting and infection, and benefits of radioactive seed placement were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed toconfirm patient identity and site of procedure. The right breast was placed in an alphanumeric grid using a lateral to medial approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates fromthe grid, an IsoAid preloaded breast localization needle was placed through the mass and adjacent to the clip. On orthogonal mammography, adequate positioning of the needle was confirmed after adjusting depth so the needle tip was at the center of the target. The I-125 seed was then deployed. Repeat two view orthogonal mammograms reveal the seed to be immediately adjacent to the clip. The skin entry site was closed with a Band-Aid. A bracelet was placed on the right wrist labeled with the patient's name, MRN, number of seeds placed, right breast and surgical date (3/5/15). Post seed placement instructions were given to the patient.Patient tolerated the procedure well and left the breast imaging center in stable condition. Drs. Patel and Schacht performed the procedure. Dr. Schacht was present during the procedure at all times. | Successful seed placement for the known right breast cancer.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Abdominal distention.VIEW: Abdomen AP (one view) 3/3/15 at 703 hours. NG tube terminates in the stomach. Right lower extremity central line tip is at the IVC. Normal abdominal gas pattern. No evidence of obstruction or free air. No pneumatosis intestinalis or portal venous gas. No ascites. | Normal examination. |
Generate impression based on findings. | Female 62 years old Reason: assess for Osteoarthritis History: bilateral knee pain. Four views of the left knee: Severe osteoarthritic changes affect the knee with tricompartmental osteophyte formation and joint space narrowing with near bone on bone apposition of the medial compartment. No large joint effusion is seen. No acute fracture or dislocation.Four views of the right knee: Severe osteoarthritic changes affect the knee with tricompartmental osteophyte formation and joint space narrowing with near bone on bone apposition of the medial compartment. No acute fracture-dislocation. No large effusion is seen. | Severe osteoarthritis as described above. |
Generate impression based on findings. | The thyroid gland appears normal with the right lobe measuring 1.4 x 1.4 x 4.3 cm and the left lobe measuring 1.3 x 0.8 x 3.2 cm. The isthmus is normal size, measuring 0.2 cm. Thyroid parenchyma is normal homogeneous echogenicity. Prominent left level 3 cervical lymph node measures 1.0 x 0.5 x 2.2 cm. Additional small cervical lymph nodes are noted bilaterally. No fluid collections. | Normal thyroid gland. Prominent cervical lymph nodes, largest on the left, which are likely reactive in etiology. No fluid collection. |
Generate impression based on findings. | 62 years, Male. Reason: ngt adjusted History: ngt NG tube tip projects over the gastric antrum. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | NG tube tip projects over the gastric antrum. |
Generate impression based on findings. | Squamous cell carcinoma of the left buccal mucosa status post excision and CRTDecember 2012 with right neck recurrence status post excision January 2014. Hiccups, acute 10 days. There are post-treatment findings related to left partial mandibulectomy, neck dissection, left buccal mucosal tumor resection and regional radiation therapy. The mandible and hardware appear to be intact. There is ill-defined thickening of the soft tissues along the left maxillary alveolar ridge, which is unchanged or slightly less prominent. The fat along the left masseter muscle remains ill-defined. The fat in the left mandibular foramen is not well visualized, but unchanged. There is no definite evidence of measurable mass lesions or significant lymphadenopathy, within the limits of streak artifact from the metal hardware. The left submandibular gland is surgically absent. The thyroid and remaining salivary glands appear unchanged. The right internal jugular vein is not apparent, which is unchanged. The other major cervical vessels are patent. There are multiple dental caries. The appearance of the teeth and alveolar ridge are unchanged. The nonspecific soft tissue adjacent to the left posterior maxillary teeth/alveolar process is slightly smaller compared to prior study. There is persistent scattered paranasal sinus opacification. The imaged portions of the orbits are grossly unremarkable. There is unchanged degenerative spondylosis of the cervical spine. There are multiple spiculated upper lung nodules. There is a partially visualized right sided Port-A-Cath. | 1. Post-treatment findings in the neck with no definite evidence of measurable locoregional tumor recurrence.2. Multiple dental caries. Slight interval decrease in size of soft tissue along the left posterior maxillary alveolar process. 3. Multiple upper lung nodules. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 18 year-old male, rule out osteomyelitis.VIEW: Right elbow AP and lateral Alignment is normal. Small posterior joint effusion is present. No bone destruction is seen. No fracture or dislocation. | No bone destruction. |
Generate impression based on findings. | 62 years, Male. Reason: replace NGT` History: replace NGT NG tube tip projects over the gastric body, unchanged. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | NG tube tip projects over the gastric body. |
Generate impression based on findings. | 40-day-old male with fall, loss of consciousnessEXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, right femur AP, left femur AP, right tibia fibula AP, left tibia fibula AP, right foot AP, left foot AP (24 views) 3/3/15 2:08 An oblique nondepressed left parietal skull fracture is again identified, as seen on recent CT.No cervical spine fracture. The cardiothymic silhouette is normal. No focal opacity, pleural effusion, or pneumothorax. No rib fracture.The bowel gas pattern is nonobstructive.Thoracic and lumbar spinal alignment is maintained without fracture. Bilateral upper extremities are intact without fracture or malalignment. Bilateral lower extremities demonstrate no fracture or malalignment. | Left parietal skull fracture with additional fracture identified. |
Generate impression based on findings. | 68 years, Male. Reason: NGT replacement History: NGT replacement NG tube tip is partially visualized projecting over upper esophagus. Surgical suture material is seen in the right hemiabdomen. Diffuse gaseous distention of small and large bowel. Note that the pelvis is excluded from the field-of-view. | NG tube tip projects over the upper esophagus. |
Generate impression based on findings. | 83 year old female status post lumpectomy and complete axillary dissection in 2006 for IDC and DCIS, presents today for routine follow up. Patient received radiation, chemotherapy, and Arimidex. No current breast complaints. No family history of 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker has been placed on the scar overlying the central outer right breast, with expected volume loss and underlying postsurgical changes. Scattered benign calcifications are present. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Sitz marker placement.VIEW: Abdomen AP (one view) 03/03/15, 0532 and 0531 22 Sitz markers are identified including 6 in the rectum.Gastrostomy tube and left thoracolumbar curve are seen. Bilateral developmental hip dysplasia is again noted. Retained contrast is identified in the rectum. Mildly to moderately dilated bowel loops are present. | 22 Sitz markers are identified including 6 in the rectum. |
Generate impression based on findings. | 72 year old woman with history of right lumpectomy for triple negative IDC in 2005. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Local architectural distortion, volume loss, and stable dystrophic calcification in the upper right breast is consistent with history of lumpectomy. Multiple, benign-morphology masses and calcifications in the left lower breast are noted. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Exam is limited by patient motion despite multiple repeated sequences. The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and extensive confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific but may represent moderate to severe chronic small vessel ischemic changes, advanced for the patient's age.In addition, there are stable areas of encephalomalacia with marginal hemosiderin deposition centered in the right basal ganglia and the left thalamus. There is associated mild ex vacuo dilatation of the left posterior third ventricle with mild bowing of the midline to the left. There is also mild left cerebral peduncle atrophy. Patchy T2/FLAIR hyperintensity is also noted within the pons. There are a few foci of scattered susceptibility along the inferior right cerebellum which are nonspecific but likely laterally to chronic hemosiderin deposition. There is no diffusion abnormality. No extra-axial fluid collection is identified.There is a dural-based somewhat pedunculated appearing oval calcification with corresponding susceptibility at the right paramedian frontal vertex, measuring 7 x 10 mm in greatest axial dimensions.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | 1. No acute infarct. Extensive white matter abnormalities likely representing moderate-severe chronic small vessel schema changes advanced for the patient stated age.2. Evidence of previous hemorrhages in the right basal ganglia and left thalamus which may hypertensive in origin, now with persistent areas of encephalomalacia.3. Small right frontal vertex dural based calcified lesion could represent a meningioma or other incidental dural calcification. |
Generate impression based on findings. | Evidence of osteomyelitis. One view of the left hip demonstrates superior and lateral subluxation of the femoral head relative to the acetabulum, as seen on the prior CT scans. Deformity of the femoral head and acetabulum is compatible with sequela of septic arthritis and osteomyelitis. Erosive deformity of the femoral head is slightly progressed compared to the prior CT on 12/6/14. | Subluxation and deformity of the left hip compatible with sequelae of septic arthritis and osteomyelitis. |
Generate impression based on findings. | 68 years, Male. Reason: NGT History: NGT Interval advancement of NG tube with side-port and tip projecting over the distal esophagus and proximal gastric body, respectively. Surgical suture material is seen in the right hemiabdomen. Diffuse gaseous distention of small and large bowel. Note that the pelvis is excluded from the field-of-view. | NG tube side-port and tip projects over the distal esophagus and proximal gastric body, respectively. |
Generate impression based on findings. | 68 years, Male. Reason: NGT adjusted History: NGT Slight interval advancement of NG tube with side-port and tip projecting over the gastroesophageal junction and gastric cardia, respectively. Surgical suture material is seen in the right hemiabdomen. Diffuse gaseous distention of small and large bowel. Note that the pelvis is excluded from the field-of-view. | NG tube side-port and tip projects over the gastroesophageal junction and gastric cardia, respectively. |
Generate impression based on findings. | Knee pain Four views of the right knee demonstrate severe osteoarthritis, particularly at the lateral tibiofemoral and patellofemoral compartments. A small joint effusion is present with a loose body in the suprapatellar pouch.Moderate osteoarthritis affects the left knee as seen on frontal views. An ossific density projecting over the lateral tibiofemoral compartment likely represents a large loose body. | Severe osteoarthritis. |
Generate impression based on findings. | Male 51 years old Reason: assess for acute intraabdominal process History: abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Nonspecific, subcentimeter hypodense lesion in the right lobe of the liver which is too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mildly prominent appendix which is air filled and without periappendiceal fat stranding making acute appendicitis unlikely. No bowel obstruction or intraperitoneal free air.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBOWEL, MESENTERY: Underdistention of the left colon which makes evaluation suboptimal. Within these limitations, the bowel is unremarkable.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine most prominent at L5/S1. | No findings to explain the patient's abdominal pain. |
Generate impression based on findings. | There is streak artifact from dental amalgam that limits evaluation. Again identified are postoperative findings from prior right-sided superficial parotidectomy with right neck subcutaneous edema and fat stranding as well as loss of fat planes. In the region of the right parotid gland, there are nodular foci of mild enhancement which were not as conspicuous on the prior exam (series 6, image 37) currently measuring approximately 1.8 x 1.0 cm; additionally a superficial focus measuring up to 1.3 cm (series 6, image 35); while these may be posttreatment related, tumor recurrence cannot be entirely excluded. Mild uptake is seen in this region on prior PET from 1/21/2015.There is no significant cervical lymphadenopathy based on size criteria. Scattered subcentimeter bilateral lymph nodes are unchanged. The submandibular glands are normal in size and symmetric bilaterally without masses. There are no thyroid masses. There are no nasopharyngeal, oropharyngeal or laryngeal masses identified and there is no airway compromise. Cervical spondylosis again noted. Moderate amount of fluid in the right mastoid air cells is not significantly changed.Left lower lobe nonspecific micronodule (series 3, image 242). | 1.Postoperative changes in the right neck with nodular foci of mild enhancement in the surgical bed which have increased in prominence since prior. These are somewhat suspicious for tumor recurrence, although treatment related change remains a possibility. There is mild uptake within this region on prior PET. Ultrasound or follow-up PET may be helpful.2.Left lower lobe micronodule. Please refer to prior CT chest report for further details. |
Generate impression based on findings. | 68 years, Male. Reason: NGT History: NGT Interval advancement of NG tube with tip projecting over the gastric antrum. Surgical suture material is seen in the right hemiabdomen. Diffuse gaseous distention of small and large bowel. Note that the pelvis is excluded from the field-of-view. | NG tube with tip projects over the gastric antrum. |
Generate impression based on findings. | Female 75 years old; Reason: lower back buttock pain There is mild to moderate dextrorotoscoliosis of the lumbar spine. The bones are demineralized, suggesting osteopenia. Severe multilevel degenerative disk disease affects the lumbar spine. The vertebral body heights are maintained. There is hypertrophy of the spinous processes with associated degenerative changes.An aortic stent is incompletely imaged. Surgical clips project over the right hip. | Severe degenerative disk disease and other findings as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. There are new loosely clustered calcifications in the upper outer left breast. No suspicious masses or areas of architectural distortion are present. | New loosely clustered calcifications in the upper outer left breast. Magnification views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 65 years old; Reason: left knee pain Moderate osteoarthritis affects the left knee, with narrowing of the medial tibiofemoral compartment and small osteophytes. A large joint effusion is present. There is a focal depression of the medial articular surface of the medial femoral condyle, which may be chronic, but could represent an underlying stress fracture or "SONK." Moderate osteoarthritis affects the right knee, as seen on the frontal views. | Osteoarthritis, joint effusion, and focal depression of the medial articular surface of the medial femoral condyle, which may be chronic, but could represent a stress fracture or "SONK." |
Generate impression based on findings. | 25-year-old female with history of stage IIa Hodgkin's lymphoma status post chemotherapy LUNGS AND PLEURA: No suspicious nodule or mass.MEDIASTINUM AND HILA: Small reference right paratracheal lymph node measures 5 mm (image 33 series 3), unchanged. No residual mediastinal or hilar lymphadenopathy. The heart size is normal.CHEST WALL: No axillary or supraclavicular lymphadenopathy. No osseous lesions.UPPER ABDOMEN: Visualized portions of the liver, spleen, pancreas, and kidneys appear normal. | No residual lymphadenopathy. |
Generate impression based on findings. | Reason: Breast CA, and possible primary lung CA in LLL. Followup scan History: none CHEST:LUNGS AND PLEURA: Moderate upper lobe predominant centrilobular and paraseptal emphysema.A solid nodule at the left lung base measures 12 x 11 mm (series 5, image 188). This nodule measured 9 mm on 10/2013 and measured 7mm on 08/2010. The nodule is slightly lobulated. No spiculation, calcification, or evidence of fat density within the nodule. A right upper lobe pleural-based nodule measures 4 mm (series 5, image 96), previously measuring 5 mm. No new suspicious nodules or masses.Mild basilar scarring. Moderate dependent atelectasis. No new focal air space abnormality. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. No visible coronary artery calcification. No mediastinal or hilar lymphadenopathy.CHEST WALL: Surgical changes in the right breast and axilla.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal subcentimeter hypodensities, incompletely evaluated, likely benign cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | A slowly growing left lower lobe pulmonary nodule remains moderately suspicious for indolent primary carcinoma. This nodule was not hypermetabolic on recent PET imaging, although sensitivity is decreased by motion artifact. Additional considerations include carcinoid tumor or less likely hamartoma. Metastasis is considered unlikely, given the history and rate of growth. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 33 years old; Reason: follow up. Fracture. Bone detail is obscured by the overlying cast..The distal radial fracture seen on the prior radiographs is not visualized on this study, however, the alignment is within normal limits. | Limited study due to overlying cast, however, the alignment of the distal radius is within normal limits |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 60 year old female status post left mastectomy for DCIS in 2012, presents today for routine follow up. No current breast complaints. No family history of breast cancer. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present and stable. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. Benign appearing lymph nodes are projected over the right axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 66 years old; Reason: 66yr old male with history of MM; pre-auto SCT evaluation SKULL: No significant abnormality noted. No discrete lytic lesions are seen.CERVICAL SPINE: Degenerative disk disease affects the lower cervical spine. No discrete lytic lesions are seen.THORACIC SPINE: Mild degenerative arthritic changes affect the thoracic spine. No discrete lytic lesions are seen.LUMBAR SPINE: There is a compression fracture of the L2 vertebral body, with approximately 50% height loss. Underlying lucency and sclerosis within the vertebral body presumably represents a myelomatous lesion. A lytic lesion in the left transverse process of L5 is compatible with a myelomatous lesion. Severe degenerative disk disease affects the L5/S1 level. Facet joint osteoarthritis affects the lower lumbar spine. RIBS: No significant abnormality noted. No discrete lytic lesions are seen.PELVIS: No significant abnormality noted. No discrete lytic lesions are seen.UPPER EXTREMITY: No discrete lytic lesions are seen. Mild osteoarthritis affects the acromioclavicular joints.LOWER EXTREMITY: No discrete lytic lesions are seen. A small lucency with sclerotic border in the left hip likely represents a benign synovial herniation pit. | Findings compatible with multiple myeloma in the lumbar spine, as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable benign intramammary lymph node in the upper outer quadrant of the right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Hiccups for 10 days. Question of worsening pulmonary or other disease to explain hiccups. LUNGS AND PLEURA: There are multiple pulmonary nodules with some enlarging in size. A non-reference left upper lobe pulmonary nodule contiguous with a scarlike opacity has increased in size to 13 mm (image 25, series 6), 9 mm on a CT study from 12/5/2014. A groundglass scarlike opacity in the right upper lobe is more defined and denser in appearance on this examination (image 25, series 6). A reference left upper lobe subpleural nodule measures 10 mm (image 25, series 6), unchanged. Additional pulmonary nodules are stable.There is debris within the trachea. A reference left pleural metastasis invading the chest wall measures 27 mm (image 79, series 4), previously 24 mm. Additionally, there is increased pleural thickening in adjacent areas of the left lung base with destruction of adjacent ribs. MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No mediastinal or hilar lymphadenopathy. No visible coronary artery calcifications.CHEST WALL: A right chest port catheter terminates in the superior atriocaval junction.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Partially imaged gastrostomy tube. | Enlarging pulmonary and pleural metastatic lesions compatible with progression of disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. A pacemaker generator obscures the left axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. A metallic ring is attached to the left nipple. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 58 years old Reason: follow up History: follow up. Two views of the right femur again show an intramedullary rod and screw device affixing a short oblique fracture of the mid femoral diaphysis in near-anatomic alignment, without radiographic evidence of hardware complication. The fracture line is slightly less distinct on the current study than on the prior study. Mild deformity of the distal femoral diaphysis likely represents an old healed fracture. Heterotopic ossification in the soft tissues appears similar to the prior study. There is moderate osteoarthritis of the hip and knee joints. | Orthopedic fixation of healing femoral fracture. |
Generate impression based on findings. | 68 year old woman with history of IDC s/p right lumpectomy in 2006. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Local architectural distortion, parenchymal thickening, and surgical clips are noted in the right upper breast. Asymmetries in the left breast are stable. No dominant mass, suspicious microcalcifications, or areas of architectural distortion are seen in either breast. Benign appearing lymph nodes are projected over the left axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is mostly fatty replaced. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: pt w/ history of NSCLC from OSH pls eval for mets History: adenocarcinoma LUNGS AND PLEURA: Large enhancing soft tissue mass at the right apex, with invasion of the right chest wall and local osseous destruction of the right third and fourth ribs. The mass measures up to 6.6 x 5.2 by 6.2 cm (series 5, image 26; coronal, image 62). Associated right apical scarring and large bullae.An additional medial right apical pleural or extrapleural metastasis measures 1.4 x 1.0 cm (series 5, image 14).Additional scattered small nodules bilaterally measuring up to 4mm (series 7, image 80).Minimal right pleural effusion.Moderate apical predominant centrilobular and paraseptal emphysema, with multiple larger bullae.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Moderate coronary artery calcification. A right paratracheal lymph node measures 23 mm (series 5, image 45). A right hilar lymph node measures 13 mm (series 5, image 54).CHEST WALL: An enhancing expansile soft tissue mass within the lateral left fourth rib measures 4.4 x 4.0 cm (series 5, image 50) compatible with metastasis.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Scattered hepatic hypodensities, likely simple cysts. Large left adrenal mass (series 5, image 103) consistent with metastatic disease. Nonspecific splenic hypodensities. See same day CT abdomen and pelvis for additional findings. | Large right apical mass compatible with known primary lung cancer, with local extension into the chest wall. Multiple foci of metastatic disease including mediastinal/hilar lymphadenopathy, a right lateral chest wall lesion and a large left adrenal mass. |
Generate impression based on findings. | Female 20 years old Reason: right hip pain History: right hip pain. The lateral center edge angle is 28 degrees. The anterior center edge angle is 29 degrees measured to the sourcil. There is a very slight right coxa profunda deformity. The femoral neck shaft angle is 127 degrees. There is slight prominence of the anterior lateral aspect of the femoral head neck junction seen on the Modified Dunn view with an alpha angle of 55 degrees, which is borderline. | Possible minimal Cam deformity as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | There is no evidence of fracture. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The paravertebral soft tissues are unremarkable.T12-L1: No significant disc bulge, spinal canal or foraminal stenosis. L1-L2: Disc bulge, thickening of the ligamentum flavum and bilateral facet arthropathy. No significant spinal canal or foraminal stenosis. L2-L3: Thickening of the ligamentum flavum and bilateral facet arthropathy. No significant spinal canal or foraminal stenosis. L3-L4: Disc bulge, thickening of the ligamentum flavum and bilateral facet arthropathy, contributing to mild bilateral foraminal stenosis. No significant spinal canal stenosis. L4-L5: Thickening of the ligamentum flavum and bilateral facet arthropathy, contributing to mild bilateral foraminal stenosis. No significant spinal canal stenosis. L5-S1: Evidence of right hemilaminectomy. Severe loss of disc height, endplate degenerative changes and vacuum disc phenomenon, mild osteophytic spurs, thickening of the ligamentum flavum and bilateral facet arthropathy, contributing to mild spinal canal stenosis and severe bilateral foraminal stenosis. | Mild degenerative changes of the lumbar spine, most prominent at L5-S1, with mild spinal canal stenosis and severe bilateral foraminal stenosis. Mild bilateral foraminal stenosis at L3-L4 and L4-L5. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Three standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 67 years old; Reason: Evaluate for abdominal pain, L chest pain, recent G-tube insertion History: L chest pain, upper abdominal pain, recent G-tube insertion Postsurgical changes in the abdomen and multiple suture staples. Multiple leads project over the right. There are clips in the right upper abdomen. A gastrostomy catheter is projects over the left lower abdomen. The bowel gas pattern is non-obstructive.Postsurgical changes in the lumbar spine.There is airspace disease in the left lower lobe. | 1.Etiology for the patient's abdominal pain is not evident on the current exam consider CT scan if the symptoms persist. |
Generate impression based on findings. | 58 year old female status post right lumpectomy in 2009 for IDC with DCIS, presents today for routine follow up. Patient received radiation, chemotherapy, and hormonal therapy. History of benign left breast biopsy. Family history of breast carcinoma in her mother at age 76 and sister at age 60. No current breast complaints. Three standard views of both breasts 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. A linear marker has been placed on a scar overlying the upper outer right breast with expected underlying postsurgical changes and clips. A stable focal asymmetry is present in the right upper inner breast. A biopsy clip is present in the upper central left breast. No dominant mass, suspicious microcalcifications or areas of nonsurgical architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female; 61 years old. Reason: Staging for T3N1b colon adenocarcinoma History: 61 F s/p sigmoid resection of cancer, path report T3N1b - 3/17 nodes positive. Patient motion limits diagnostic sensitivity. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Dependent atelectasis/scarring. No pleural effusions or focal areas of consolidation. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Mild coronary calcifications. No significant mediastinal or hilar adenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions or biliary ductal dilatation. Cholecystectomy clips. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Midpole right renal cyst. No perinephric stranding or hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes s/p sigmoid resection for known carcinoma. No obstruction or free air. BONES, SOFT TISSUES: Sclerotic subcentimeter bone island in left ilium is unchanged. No suspicious osseous lesions. OTHER: Small ventral abdominal wall defect without hernia, unchanged. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Several enlarged but normal morphology external iliac chain lymph nodes are noted.BOWEL, MESENTERY: Postsurgical changes s/p sigmoid resection for known carcinoma. No obstruction or free air. BONES, SOFT TISSUES: Sclerotic subcentimeter bone island in left ilium is unchanged. No suspicious osseous lesions. OTHER: Postsurgical scarring in the anterior pelvic wall. | Postsurgical changes without evidence of metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements.An intramammary lymph node is present at upper outer quadrant in the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 74 years old; Reason: evaluate metastatic colon cancer response to treatment History: occasional blood in stool, fatigue CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change, including micronodules (for example, 2 mm left lower lobe pleural-based nodular focus, image 75 series 3) and perifissural right middle lobe calcified granuloma. Small dependent bibasilar atelectasis. Emphysema/subpleural cystic disease.MEDIASTINUM AND HILA: Unchanged small axillary lymph nodes, including 11 mm right axillary lymph node, image 33 series 3. Mediastinal/hilar calcified nodes, likely reflecting sequela from prior granulomatous disease.CHEST WALL: Right chest port with tip near cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. Decreased size and conspicuity of bilobar metastatic lesions, representative foci as follows:Reference segment 8 lesion measures 2.1 x 1.7 cm, image 88 series 3, previously measured 2.9 x 2.2 cm. Reference segment 7 lesion measures approximately 1.4 x 1.2 cm, image 95 series 3, previously measured approximately 1.8 x 1.6 cm. Patent visualized portal veins. Poor visualization of left hepatic vein peripherally, similar to prior study, may reflect mass effect/occlusion from adjacent metastatic disease.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable multiple bilateral hypoattenuating renal lesions, majority of which are too small to characterize.RETROPERITONEUM, LYMPH NODES: Small upper abdominal lymph nodes. Aortobiiliac atherosclerotic disease seen similar in appearance to prior exam, including atherosclerotic abdominal aorta with mural thrombus in the infrarenal abdominal aorta and involving proximal right common iliac artery with moderate to marked luminal narrowing again seen.BOWEL, MESENTERY: Scattered colonic diverticula without evidence of acute diverticulitis. Much of colon underdistended, particularly left and transverse colon, making assessment for wall thickening suboptimal.PELVIS:PROSTATE, SEMINAL VESICLES: Heterogeneous enlarged prostate gland, stable in appearance.BLADDER: Underdistended bladder.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. Multilevel degenerative changes of spine. | 1. Decreased size and conspicuity of hepatic metastatic lesions.2. Again seen heterogeneous enlarged prostate gland with relative hypertrophy of the median lobe, likely reflecting component of underlying benign prostatic hypertrophy. Additionally, correlation with patient's clinical history and PSA values recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense. Scattered benign calcifications including coarse calcifications at posterior left breast are present in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 4-year-old male with history of headache. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of accurate nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is within normal for patient's stated age of 4 years.Calvarium is intact and soft tissues of the scalp are unremarkable.Unremarkable images through the orbits. Extensive patchy opacification of all visualized paranasal sinuses and consistent with sinusitis. There is also bilateral opacification of mastoid air cells and middle ear cavities consistent with otitis media. | 1.Unremarkable nonenhanced head CT.2.Extensive pansinusitis.3.Bilateral otitis media. |
Generate impression based on findings. | Reason: is there a mass in the right sinus? History: chronic sinus pain b/l The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated. The nasal septum is deviated towards the right side and has a bones spur associated with it narrowing the right nasal passage.The frontal sinuses are clear.Maxillary sinuses demonstrate on opacity in the right maxillary sinus measuring 27 mm located along the anterior aspect of the right maxillary sinus. There is no associated osseous erosion or hyperdensity associated with this. This is also demonstrated on MRI scan or has heterogeneous signal. The density is subtly heterogeneous. Since the prior exam this lesion has changed positions and is now located along the anterior aspect of the maxillary sinus. This suggests that it likely arises from the medial wall of the maxillary sinus.Ethmoid air cells are clear . Sphenoid sinuses are clear. Some roots of molars extend into the floor of the maxillary sinuses. There periapical lucencies present along the left maxillary molars.Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits. | 1.Pedunculated lesion along the right maxillary sinus has changed position but not size since the prior exam. It is not particularly characteristic of mucous retention cyst. This could represent a polypoid mass. Lack of interval change in size and lack of bony destruction suggest that this is less likely aggressive. Please correlate with clinical symptoms.2.Left maxillary molar periapical lucencies raise the question of periapical abscess. Please correlate with clinical evaluation of the patients left sided molars. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female 41 years old; Reason: Constipation History: Abd pain Catheter type device projects over the left upper abdomen. Bowel gas pattern is nonobstructive. There is centralization of the bowel loops possibly due to ascites or other peritoneal disease.Stool burden is average. | 1.Nonobstructive bowel gas pattern |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Loosely clustered calcifications at lower inner quadrant in the left breast have progressed. Biopsy clip is seen in the right medial posterior breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Developing calcifications at lower inner quadrant in the left breast. Magnification views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 75 years, Male. Reason: eval ileus History: abd pain NG tube tip projects over the gastric antrum. Postsurgical changes from fundoplications surgery are again noted. Gas distended stomach is noted. Diffuse gaseous distention of small and large bowel is noted. Residual enteric contrast is noted in the transverse and descending colon. | Findings compatible with ileus. |
Generate impression based on findings. | Male 59 years old; Reason: NG advancement History: NG advancement Mild gaseous distention of the colon persists.Obstruction at the level of the anus is not excluded.Enteric tube is coiled in the stomach with its tip in the gastric body. | 1.Enteric tube tip in mid gastric body. |
Generate impression based on findings. | Male 52 years old Reason: left THA History: left THA. Three views of the left hip show hardware components of a left total hip arthroplasty device situated in near anatomic alignment with no radiographic evidence of hardware complication. Since the prior study, the drain has been removed. Skin staples are noted laterally and there is reticulation of the underlying subcutaneous fat suggesting edema.Three views of the right hip show severe osteoarthritis of the hip. Ossicles along the anterolateral aspect of the joint seen on the frog leg view may represent loose bodies.AP view of the pelvis reveals the aforementioned right hip osteoarthritis and left total hip arthroplasty. Severe degenerative disk disease affects the lower lumbar spine. | Left total hip arthroplasty and right hip osteoarthritis as above. |
Generate impression based on findings. | 48-year-old male with history of left arm weakness. Evaluate for stroke. There is a moderate-sized wedge-shaped area of hypoattenuation within the right inferior parietal lobule compatible with acute to subacute ischemic infarction likely in the distribution of the posterior parietal branch of the right MCA. There is effacement of the adjacent sulci, however there is no midline shift. There is no evidence of acute intracranial hemorrhage. The basal cisterns are intact. The visualized paranasal sinuses, mastoid air cells, and orbits are unremarkable. The calvarium and soft tissues are within normal limits. | Moderate-sized wedge-shaped area of hypoattenuation within the right inferior parietal lobule compatible with acute to subacute ischemic infarction likely in the distribution of the posterior parietal branch of the right MCA. An MRI could be useful if clinically warranted. |
Generate impression based on findings. | Male 54 years old; Reason: Constipation History: Constipation Bowel gas pattern is nonobstructive.Large free air. Catheter type device projects over the mid pelvis. | 1.No the bowel gas pattern.2.Persistent pneumoperitoneumfindings discussed with ANYANWU, EMEKA COLLINS at the time of the dictation |
Generate impression based on findings. | Cough. Evaluation of pulmonary infiltrates seen on cardiac MRI. Past smoker (quit in 1993). LUNGS AND PLEURA: There is a cluster of calcified and non-calcified pulmonary micronodules in the inferior right upper lobe which is likely post-infectious in etiology; these do not require follow up imaging. No suspicious pulmonary nodules are identified. There is no other focal airspace opacity, pleural effusion, or pneumothorax.MEDIASTINUM AND HILA: There is extensive mitral annulus calcification and severe coronary artery calcifications. There is no pericardial effusion. Calcified mediastinal and hilar lymph nodes are compatible with prior granulomatous disease. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Punctate hepatic and splenic calcifications are compatible with prior granulomatous disease. | No acute findings in the chest or evidence of infection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A round circumscribed mass at 12 o'clock position in the right breast is unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male 74 years old; Reason: NGT placement History: above Postsurgical changes in the upper abdomen and multiple skin suture staples.The bowel gas pattern is not obstructive. Airspace disease is noted in the left lower lobe.Enteric tube terminates in the region of the gastric fundus. | 1.Enteric tube tip is in the region of the gastric fundus |
Generate impression based on findings. | Male 54 years old Reason: left knee pain History: knee pain. Four views of the left knee show narrowing of the medial tibiofemoral compartment and small osteophytes indicating mild osteoarthritis. There is slight lateral tilting and translation of the patella relative to the femoral trochlea. Lucencies within the femoral trochlea may represent small degenerative cysts, although could also conceivably represent microfracture defects if there is a history of such surgery. There is a moderate-sized joint effusion. | Osteoarthritis as above. |
Generate impression based on findings. | Female 16 years old Reason: s/p l knee acl reconstruction History: s/p l knee acl reconstruction. Two views of the left knee show findings consistent with an ACL reconstruction, including distal tibial and proximal femoral tunnels and fixation devices. A small amount of heterotopic mineralization overlies Hoffa's fat pad in the soft tissues, medial to the medial epicondyle, presumably reflecting prior injury/surgery. There is a small joint effusion.The right knee appears normal as seen on the frontal view. | Orthopedic left ACL repair as described above |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There is a small area of architectural distortion at posterior upper outer quadrant in the right breast. Percutaneously placed biopsy clip is noted in the left central breast, mid depthNo suspicious masses or microcalcifications are present. | A small area of architectural distortion at posterior upper outer quadrant in the right breast. Spot compression views and possible ultrasound study are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EA - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 72 years old Reason: s/p MVA. Evaluate for evidence of fracture vs. degenerative changes. History: neck pain/stiffness and some radicular pain left arm and left tibial pain. We have two views of the left tibia/fibula. There is swelling of the soft tissues of the lower leg and ankle, but we see no radiographic findings to suggest a stress fracture. Mild osteoarthritis affects the knee with mild subchondral sclerotic changes which may reflect chronic avascular necrosis. Surgical clips are seen in the posterior aspect of the lower thigh.We have 6 views of the cervical spine. There is severe degenerative disk disease at C3/C4, with moderate degenerative disk disease affecting C4/C5 and C5/C6 and mild degenerative disk disease at C2/C3. There is minimal (grade 1) anterolisthesis of C3, minimal retrolisthesis of C4, and minimal retrolisthesis of C5, but these appear stable between flexion, neutral, and extension views. There is mild multilevel facet joint osteoarthritis that appears slightly worse on the left, with mild narrowing of the C4/C5 neuroforamina bilaterally and mild narrowing of the C6/C7 neuroforamen on the left. Note is made of sternotomy wires and surgical clips in the mediastinum. There is a mild rightward curvature of the cervical spine, but this may be an artifact of patient positioning for the examination. | Degenerative disk disease and osteoarthritis as described above. We see no fracture. |
Generate impression based on findings. | Metastatic melanoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Stable reference subcarinal lymph node best seen on image 39 of series 3 measuring 1.9 x 0.8 cm.CHEST WALL: Stable reference left axillary lymph node best seen on image 13 of series 3 measuring 1.9 x 1.1 cm. Left anterior first rib sclerotic lesion unchanged. Sclerotic T4 vertebral body lesion unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Stable low-attenuation focusPANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus absentBLADDER: No significant abnormality noted.LYMPH NODES: Stable bilateral mildly enlarged obturator lymph nodes. Reference right obturator lymph node best seen on image 171 of series 3 measures 1.4 x 2.3 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination. |
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