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Generate impression based on findings. | Pain. Evaluate for fracture status post fall 4 weeks ago. Two views of the right knee reveal a right total knee arthroplasty device in anatomic alignment without evidence of hardware complication. There is heterotopic bone superior to the patella and along the posterior knee joint. No acute fracture is evident. There i... | Right total knee arthroplasty without evidence of hardware complication. |
Generate impression based on findings. | Female, 28 years old, with severe headache. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. No parenchymal edema, mass effect or loss of gray-white distinction is detected.Low lying cerebellar tonsils are demonstrated similar to the prior examination. Brain morphology is oth... | 1. No definite acute intracranial abnormality is detected.2. Redemonstration of low lying cerebellar tonsils similar to the prior exam. |
Generate impression based on findings. | 66 year old female with intraoperative imaging. Single view of the pelvis demonstrates intraoperative construction of a total right hip arthroplasty in anatomic alignment. There is iatrogenic gas present in the soft tissues. Severe degenerative disease is present in the left hip. | Hardware components of a total right hip arthroplasty in anatomic alignment. |
Generate impression based on findings. | Postop. Prosthetic assessment. Three views of the left knee with weight-bearing reveal a left total knee arthroplasty device in anatomic alignment without evidence of hardware complication. No acute fracture is evident. | Left total knee arthroplasty without evidence of hardware complication. |
Generate impression based on findings. | 62 year-old female with history of left knee pain. Four views of the left knee demonstrate severe osteoarthritis affecting the left knee, including significant joint space narrowing, particularly in the medial tibiofemoral compartment. There is no evidence of joint effusion. No acute fracture or evidence of malalignmen... | Severe osteoarthritis of the left knee. |
Generate impression based on findings. | Question of healed osteotomy. Two views of the left forearm reveal two side plate and screw devices affixing a mid ulnar osteotomy. The osteotomy line is indistinct suggestive of healing. There is deformity of the proximal radius likely from prior fracture.Three views of the left reveal absence of the scaphoid and trap... | Healing osteotomy of the mid-ulna. |
Generate impression based on findings. | 28 years, Female. Reason: eval LP shunt History: severe HA Lumboperitoneal shunt catheter again seen, entering the spinal canal at the L3-4 level with the distal tip extending superiorly out of the field-of-view and the proximal tip in the left lower quadrant. No evidence of kinking or fracture is identified within the... | Lumboperitoneal shunt catheter without evidence of kinking or fracture. |
Generate impression based on findings. | 66 showed female status post total right hip arthroplasty. Single view of the right hip demonstrates hardware components of a total hip arthroplasty in near-anatomic alignment; no evidence of fracture or dislocation. Surgical clips, surgical drain, and iatrogenic gas are present in the soft tissues.Single view of the p... | Hardware components related to recent total right hip arthroplasty in near-anatomic alignment. |
Generate impression based on findings. | 60 year-old female patient with history of mild transaminitis status post cholecystectomy with persistent abdominal pain. Recent ERCP with concern for retroperitoneal perforation. Exam is not sensitive for detecting lesions in the solid organs due to the lack of intravenous contrast. Given those limitations, the follow... | Foci of air in the intraperitoneal and retroperitoneal spaces are suggestive of perforation. There is no active enteric contrast leak or fluid collection. |
Generate impression based on findings. | Status post lumbar fusion with pelvic fixation. Three views of the pelvis reveal screws within the pedicles of L2, L4, L5, and S1 bilaterally along with the right ilium with posterior stabilization rods and interposed disk spacers. No acute fracture is evident.An IVC filter is noted. | Postoperative changes of posterior lumbosacral spinal fusion. |
Generate impression based on findings. | Foot pain. Preop evaluation Four views of the right foot are unremarkable. No radiographic abnormalities. | Negative right foot examination |
Generate impression based on findings. | Evaluate fracture Three views of the left foot reveal a nondisplaced fracture of the base of the fifth metatarsal that appears to be extra-articular. No change in the exam | Nondisplaced fracture base of fifth metatarsal |
Generate impression based on findings. | 57 years old Female. Reason: seizure localization. History: seizures. ii The noncontrast CT portion of the brain is not remarkable. There is a low attenuation lesion in the left frontal bone. The FDG PET imaging demonstrates a large area of decreased metabolic activity in the right temporal lobe. Decrease metabolic act... | Hypometabolism in the right temporal lobe, right posterior parietal lobe and right occipital lobe. |
Generate impression based on findings. | 51 female with morbid obesity, diabetes mellitus, hepatitis B. Limited exam due to patient positioning, could not evaluate in decubitus position.LIVER: Increased echogenicity of the liver measuring 19.6 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow.GALLBLADDER, BILIARY T... | Stable mild hepatomegaly and increased echotexture suggestive of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | Female; 62 years old. Reason: tachycardia, doe, decreased mobility. Assess for PE. The ventilation images show a uniform distribution of activity on single-breath and wash-in images. There is no abnormal Xe-133 retention during the wash-out phase. Perfusion images show a nonsegmental area of decreased perfusion in the ... | Low probability of pulmonary embolism. |
Generate impression based on findings. | 70 year-old female with rheumatoid arthritis and left upper lobe NSCLC status post recent completion of radiation therapy CHEST:LUNGS AND PLEURA: Severe upper lobe predominant central and paraseptal emphysema is again noted. There is honeycombing at the lung bases with fibrosis and traction bronchiectasis.Pleural based... | 1.Slight interval decrease in size of the left upper lobe mass highly compatible with patient's primary NSCLC.2.Unchanged right lower lobe subpleural nodule.3.Unchanged severe combined pulmonary fibrosis and emphysema. |
Generate impression based on findings. | Male, 17 months old. Reason: physical abuse with elevated liver enzymes, eval for internal injuries History: deformed arm, multiple bruises all over body ABDOMEN:LUNG BASES: No focal consolidation or pleural effusions.No evidence of traumatic injury involving the visualized ribs.LIVER, BILIARY TRACT: No focal lesions o... | No evidence of solid organ or hollow viscus injury. No other posttraumatic findings. |
Generate impression based on findings. | 55 years old Male. Reason: Myeloma relapse with known extramedullary disease; bone disease re-evaluation - Baseline prior to chemotherapy. History: Myeloma relapse with known extramedullary disease; bone disease re-evaluation. RADIOPHARMACEUTICAL: 15.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 159 mg/d... | 1.Several new mildly hypermetabolic lymph nodes in the neck, which can be due to tumor or inflammatory change.2.Interval increased and uniform bone marrow activity in the visualized axial and proximal appendicular skeleton can be due to bone marrow reconversion. However, this finding makes detection of the osseous lesi... |
Generate impression based on findings. | Salivary gland adenoid cystic cancer with mets to lung. Dyspnea. CHEST:LUNGS AND PLEURA: Bilateral pulmonary nodules and masses compatible with metastases. Largest lesion occurs in the right upper lobe measuring 2 x 1.7 cm (5/33).Large loculated right pleural effusion with nodular pleural enhancement compatible with vi... | Bilateral pulmonary and right pleural metastases. Nodal metastases to the mediastinum and hila as well as the right internal mammary chain. |
Generate impression based on findings. | 59 year old male with h/o metastatic lung adenocarcinoma with bone pain on R ribs, bilateral ASIS, r/o bony mets History: pain over R 11-12 ribs, bilateral pain over ASIS. Focal increased uptake in the left lateral skull base is likely secondary to mastoid inflammation given findings on recent MRI. No abnormal osseous ... | No evidence of bone metastases. |
Generate impression based on findings. | 34-year-old female patient status post robotic hysterectomy, BSO for serous borderline tumor of the ovary with vaginal cuff abscess requiring vaginal drain placement. Recheck size of vaginal cuff abscess. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN:... | Complex fluid collection with vaginal drain as described above. Surrounding soft tissues are mildly obscured by induration. |
Generate impression based on findings. | Shoulder dislocation Four views of the right humerus reveal deformity of the humeral head consistent with a Hill-Sachs deformity. Small fragments are seen displaced laterally. In addition there are bone fragments seen in the axillary pouch most likely from a Bankart lesion. | Changes in the humeral head glenoid consistent with anterior dislocation |
Generate impression based on findings. | Surveillance imaging. Evaluate stability of spine for c-collar clearance. Four views of the cervical spine redemonstrates an oblique fracture through the spinous process of C2. There is no widening of the atlantodental interval with flexion and extension imaging. Alignment is anatomic. | Redemonstration of a C2 spinous process fracture without definite evidence of atlantoaxial instability. |
Generate impression based on findings. | 63 or female status post fall on heparin. Single view of the pelvis demonstrates normal anatomic alignment of the hips without evidence of acute fracture. There is no significant soft tissue swelling. Radiopaque material in the bowel likely relates to recent contrast examination, and partially obscures the pelvis. | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | Female 65 years old; Reason: kidney stone History: stone ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 4 millimeter obstructi... | 1.4-mm obstructing stone in the left ureter with proximal moderate hydronephrosis and hydroureter. Findings discussed with Dr. Blake Alberts at 4:35pm on 3/11/2015. |
Generate impression based on findings. | Male; 14 months old. Reason: Intermediate risk neuroblastoma; received 8 cycles of chemotherapy; assess for response to therapy. Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder. There is no abnormal focus of activity to indicate current MIBG avid tumor. | No MIBG avid tumor. |
Generate impression based on findings. | 71 year-old female with right foot pain. Four views of the left foot demonstrate severe hallux valgus deformity, as well as hammertoe deformity of the second through fifth digits. No acute fracture is identified. There is no significant soft tissue swelling. | Severe hallux valgus deformity; no evidence of acute fracture. |
Generate impression based on findings. | 2 years old, Female, Reason: Multiple skin bruises, evaluate for occult injury EXAMINATION: 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... | No evidence of acute or healing fractures. Adenoid hypertrophy. |
Generate impression based on findings. | Measuring TT-TG. Assessment of trochea for dysplasia. Right knee pain. The TT-TG distance measures approximately 28 mm. The trochlear depth is approximately 2 mm. There is a wiberg type 1 patella. No acute fracture is evident. There is a small knee joint effusion. | Findings consistent with trochlear dysplasia. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Postoperative changes are again seen from right frontal parietal craniotomy and underlying tumor resection from the posterior right frontal lobe. There has been no significant change in size or configuration resection cavity and associated encephalomalacia. There is persistent scattered susceptibility in the area rese... | 1. Interval delineation of tiny nodular foci of enhancement in the anterior right temporal lobe with equivocal perfusion findings, as evaluation is limited given small size of the findings. This is concerning for tumor progression versus post-treatment change, although continued follow-up is recommended.2. Otherwise, s... |
Generate impression based on findings. | Female, 80 years old, with history of recurrent esophageal squamous cell carcinoma. Since the prior examination, soft tissue thickening involving the upper cervical esophagus and adjacent tracheoesophageal groove has increased, now measuring up to 20 mm in thickness on sagittal imaging (image 42 series 80381), previous... | 1.Progressive thickening of the upper cervical esophagus and adjacent soft tissues is noted which could represent tumor growth or a treatment related effect.2.Interval placement of an esophageal stent. Progressive ill-defined infiltration of the soft tissues surrounding the stent is of uncertain significance but may be... |
Generate impression based on findings. | Female; 69 years old. Reason: flank pain History: solitary pulmonary nodule, lung cancer, abdominal mass, PET for cancer staging. . RADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 122 mg/dL. Today's CT portion grossly demonstrates the previously identified cavitary right upper lobe ... | 1.Solid component of right upper lobe lung nodule is hypermetabolic on PET and suspicious for primary lung neoplasm. 2.Additional hypermetabolic soft tissue mass in the left pelvis is suspicious for associated metastatic disease. |
Generate impression based on findings. | Chest wall sarcoma CHEST:LUNGS AND PLEURA: Interval mildly enlarging yet small right pleural effusion. No discrete superimposed focal air space abnormality other than scattered dependent atelectasis. Specifically no suspicious nodules or masses. Mild centrilobular emphysemaMEDIASTINUM AND HILA: No lymphadenopathy.The c... | Interval decrease in the large right chest and axillary mass see detail and reference measurements provided. No evidence of intrapulmonary disease, however a small new right effusion is of uncertain significance |
Generate impression based on findings. | Thyroid cancer LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No lymphadenopathy.Cardiac and pericardium are within limitsNo residual thyroid is observed, presumably postsurgical or treatmentCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits... | No findings to support metastatic disease |
Generate impression based on findings. | Chest wall mass LUNGS AND PLEURA: A focal right apical spiculated large nodule two small masses observed anteriorly this focus measures 2.0 x 1.7 cm (image 12 series 5) and abuts the anterior wall with mild thickening. Questionable small satellite nodular densities are also observed inferiorly as wells and associated s... | Suspicious right upper lobe focal mass with associated satellite nodules, effusion and pleural/fissural nodularity concerning for a primary malignancy with focal spread. Follow-up evaluation comparing with prior outside imaging if available might be helpful or more likely a PET scan given the lesions size and potential... |
Generate impression based on findings. | 67 year old female with h/o NSCLC s/p SBRT. Noted to have new spine metastases. Re-staging PET/CT to evaluate current extent of metastatic disease burden.RADIOPHARMACEUTICAL: 12.112 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 93 mg/dL. Today's CT portion grossly demonstrates upper lobe predominant emphys... | 1.Significant interval decrease in size and metabolic activity of right upper lobe pulmonary lesion. 2.Mild nonspecific increased activity in the right chest wall and bilateral axillary regions as described above, but no definite evidence of metastatic disease. |
Generate impression based on findings. | Male, 65 years old, with history of TIA. Non-angiographic findings:Precontrast images of the head show no evidence of parenchymal edema, mass effect or loss of gray-white distinction. At most, there may be very minimal patchy subcortical white matter hypo-attenuation which is nonspecific. No intracranial hemorrhage or ... | No evidence of significant vascular stenosis or occlusion in the head or neck. |
Generate impression based on findings. | Male; 77 years old. Reason: rule out pulmonary embolism History: RV strain on echo. The comparison chest radiograph performed on 2/11/2015 demonstrates cardiomegaly, small right pleural effusion, and nonspecific focal right lung base opacity. The ventilation images show a uniform distribution of activity on single-brea... | Low probability of pulmonary embolism. |
Generate impression based on findings. | 37 year old female with history of Lisfranc injury status post orthopedic fixation. Orthopedic screws affix the medial cuneiform to the first metatarsal; the head of the second metatarsal to the medial cuneiform; the middle cuneiform to the second metatarsal; and the third metatarsal to the lateral cuneiform. There is ... | Orthopedic fixation as described above, without evidence of hardware complication or significant interval change. |
Generate impression based on findings. | Female; 31 years old. Reason: metastatic breast cancer - baseline prior to starting new treatment History: Recent PET shows metastatic disease in the sternum. Punctate focus of increased tracer uptake in the lateral right jaw likely reflects dental disease. No abnormal osseous foci are identified to indicate metastatic... | No evidence of bone metastases. |
Generate impression based on findings. | Movement disorder, including unsteady gait, falls, retropulsion. Evaluate for Parkinson's disease versus essential tremor. Normal symmetric activity is seen in the basal ganglia. | Normal examination. No evidence of nigrostriatal dopaminergic dysfunction. Given the history, these findings are suggestive of essential tremor. |
Generate impression based on findings. | 89 years old Male. Reason: Evaluate for PE History: dyspnea, active malignancy, leg swelling. The comparison chest radiograph performed on 03/11/2015 demonstrates no pulmonary opacities or pleural fluid. The ventilation images show a uniform distribution of activity on single-breath and wash-in images. There is minimal... | High probability for PE. |
Generate impression based on findings. | Clinical question: Rule out intracranial hemorrhage. Signs and symptoms: Seizure-like activity. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Mild periventricular and subcortical low attenuation of white matt... | 1.No acute intracranial process.2.Mild age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Clinical question: ESRD on HD with complicated hospital care, gradual mental status decline and lethargy, found on floor. Signs and symptoms: Evaluate for intracranial process. Unenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic isc... | 1.No acute intracranial process.2.Mild age indeterminate small vessel ischemic strokes is suspected. |
Generate impression based on findings. | Clinical question: Rule out acute process. signs and symptoms: Headache Nonenhanced head CT:No acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Small focus of encephalomalacia in the right frontal lobe in the distribution of the right MCA is highly suggestive of... | 1.No acute intracranial process.2.Right frontal lobe chronic ischemic stroke.3.Unremarkable exam otherwise. |
Generate impression based on findings. | Clinical question: ICB. Signs and symptoms: Severe headache 4 days with no relief, blurred vision. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF sp... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Evaluate for any ischemic changes, hemorrhage or mass. Signs and symptoms: Right temporal headache and blurry vision. Nonenhanced head CT:There is no evidence of an acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic stroke.Slight prominence of c... | 1.Unremarkable exam for age.2.Mild chronic sinus disease. |
Generate impression based on findings. | Clinical question : Hydrocephalus? Signs and symptoms: Incontinence and psychiatric symptoms. Nonenhanced head CT:Detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic strokes.Slight prominence of cortical sulci, cerebellar and vermian folia and ventricular system for pati... | 1.No acute intracranial process.2.Slight prominence of cortical sulci, cerebellar and vermian folia for age without significant change since prior exam. |
Generate impression based on findings. | Clinical question: Evaluate intracranial hemorrhage. Signs and symptoms: Leg weakness, dysphasia and cranial nerve palsy. Nonenhanced head CT:No evidence of an acute intracranial process. CT however it is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Diffuse periventricular and subcortical lo... | 1.No evidence of an acute intracranial process.2.Post operative changes of left anterior frontal and temporal craniotomy with subtle underlying encephalomalacia.3.Focus of low-attenuation in the white matter of left occipital lobe without mass effect or parenchymal volume loss is not a specific. Correlate with history ... |
Generate impression based on findings. | Clinical question: Aphasia. Signs and symptoms: Aphasia. Nonenhanced head CT:New since prior exam is a focus of acute hemorrhage in the operculum a left anterior frontal lobe measuring at 31 x 38-mm increments axial dimensions. There is no significant surrounding edema however mild regional mass-effect is noted. Slight... | 1.Acute hemorrhage in the operculum and left anterior frontal lobe measuring at 3.8 times 3-cm with subtle regional mass-effect.2.Tiny lytic/calcific lesion of right parietal bone with a small heavily calcified extraosseous/epidural component appears benign however follow-up with MRI is recommended for further assessme... |
Generate impression based on findings. | Clinical question: ICH. Signs and symptoms: ICH. Nonenhanced head CT:Examination demonstrates slight interval increased size of a left frontal operculum parenchymal hemorrhage. On sagittal image 11 the finding measures approximately 41 mm in AP and 31-mm in cc compared to prior study measurements of 37 x 25. The mass e... | 1.Interval increased size of left frontal operculum parenchymal hematoma measuring to 41 x 31 on sagittal images compared to prior study measurement of 37 x 25mm and stable exam otherwise.2.Lytic and calcific right parietal calvarial lesion likely representing a hemangioma and less likely meningioma similar to prior st... |
Generate impression based on findings. | known hemorrhagic metastasis, follow up, headaches Multifocal hemorrhagic metastatic lesions are again seen. However, the maximum diameter of each lesions on the left frontal, left parietal, right parietal and bilateral occipital lobes appear to be increased since prior exam.In addition, there is evidence of intraventr... | Interval aggravation of known hemorrhagic metastasis lesions with new development of intraventricular hemorrhage. |
Generate impression based on findings. | Male, 36 days old. Reason: ? occult fracture History: sibling with injuryEXAMINATION: 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, righ... | Bowing fracture of the left ulna. No additional acute or healing fractures identified. |
Generate impression based on findings. | 35-year-old male patient with decreased appetite and decreased output from ileostomy. Evaluate for small bowel obstruction. ABDOMEN:LUNG BASES: Trace basilar atelectasis.LIVER, BILIARY TRACT: Diffuse fatty infiltration. No intra-or extrahepatic biliary ductal dilatation. No cholelithiasis or CT evidence of cholecystiti... | No evidence of small bowel obstruction. Focal dilatation of a loop of small bowel in the left hemiabdomen may represent adhesive disease versus postsurgical changes. |
Generate impression based on findings. | 13-year-old female with sickle cell disease and desaturation and crackles on exam.VIEW: Chest AP (one view) 3/11/15 Cardiomegaly is present. Triangular opacity silhouettes the medial portion of the left hemidiaphragm which could represent atelectasis or pneumonia. Evidence of vascular engorgement. Bone changes from sic... | Triangular opacity silhouettes the medial left hemidiaphragm which could represent atelectasis or pneumonia.Findings discussed with Dr. Kim at 0850 on 3/12/15 |
Generate impression based on findings. | Female 85 years old Reason: r/o acute process History: syncope, elevated LFTs. ABDOMEN:LUNG BASES: Left lower lobe consolidation with associated bronchiectasis, unchanged. Other micronodules stable. LIVER, BILIARY TRACT: Diffuse intrahepatic biliary dilatation and dilatation of the common hepatic duct with obstruction ... | New pancreatic mass and possible involvement of the superior mesenteric vein and shows jejunal branch. No arterial encasement or abutment. Intrahepatic biliary dilatation.Stable left abdominal wall stomal hernia.New finding of diffuse wall thickening suggestive of some mucosal edema involving small bowel loops in the p... |
Generate impression based on findings. | Male 17 years old Reason: eval for fx History: knee pain sportsVIEWS: Bilateral knee AP, and PA weight bearing, lateral and sunrise 3/11/15 (5 views) Possible right knee joint effusion with no evidence of fracture or malalignment. | Question of right knee joint effusion. |
Generate impression based on findings. | 17 year-old female with abdominal pain, concern for obstruction.VIEW: Abdomen upright AP (one view) 3/11/15 The cardiac apex and stomach are left-sided. Nonobstructive bowel gas pattern. No pneumatosis, portal venous gas or free air. | Normal examination. |
Generate impression based on findings. | Male, 17 months old. Reason: history of child abuse ? fractures History: multiple bruises/swellingsEXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis ... | Multiple fractures of varying ages involving the proximal humeral metaphyses and possibly the distal right radial metaphysis. Findings suspicious for nonaccidental trauma.Findings were discussed by the on call resident with Dr Orozco-Kellermeier in the ER on 3/11/2015 at 1:00 AM. |
Generate impression based on findings. | 68 male patient with recent CABG outside hospital and CT with pancreatic mass. Evaluate for tumor/metastatic disease. CHEST:LUNGS AND PLEURA: Left apical scarring noted. Moderate centrilobular emphysema. Nonspecific scattered micronodules.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes. Severe coronary ar... | Findings compatible with primary pancreatic tumor with bilobar liver metastases and direct extension into the left adrenal gland. |
Generate impression based on findings. | known hemorrhagic metastatic lesions follow up. No significant interval change of bihemispheric hemorrhagic metastasis since prior exam.Intraventricular hemorrhage appears to be not changed since prior exam.There is no midline shift.The osseous structures are unremarkable. The mastoid air cells are clear. | No significant interval change since prior exam. |
Generate impression based on findings. | Male, 17 months old. Evaluate for fracture History: upper arm deformityVIEWS: Right elbow AP, lateral, oblique (3 views) 3/11/2015, 1701 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | No acute fracture or malalignment of the right elbow. See same day osseous survey and humeral radiographs for additional findings. |
Generate impression based on findings. | Male, 17 months old. Evaluate for fracture. History: arm deformityVIEWS: right humerus. AP, lateral (2 views) 3/11/2015, 1700 Metaphyseal lesions involving the proximal humeri, with periosteal reaction, fraying, and corner fractures identified. There is greater periosteal reaction on the left, which is seen on addition... | Right humerus proximal metaphyseal fracture. Combined with additional findings on osseous survey, this is suspicious for nonaccidental trauma, however the possibility of osteomyelitis cannot be totally excluded. See same day osseous survey for additional details. |
Generate impression based on findings. | Male, 8 years old. Suspected sepsis. Evaluate LungsVIEW: Chest AP (one view) 3/11/2015, 1717 Mediastinal clips are unchanged in position. Left PICC tip at the junction of the brachiocephalic veins.The cardiothymic silhouette is normal.Postoperative changes in the right chest are again seen. Loculated pneumothorax and d... | Unchanged appearance of the chest. |
Generate impression based on findings. | 64-year-old male with head and neck cancer status post chemoradiation CHEST:LUNGS AND PLEURA: Biapical scarring/fibrotic changes related to radiation are unchanged.Debris is noted in the right central line lobe low bronchi appearing similar to the prior exam.There is increased subpleural consolidation with increase in ... | 1.Increased subpleural consolidation and increased tree in bud opacities in the right middle and lower as well as the left lower lobe compatible with aspiration.2.Mild interval increase in size of right paratracheal and retrocrural lymph nodes as described above. These may be reactive in etiology but continued follow-u... |
Generate impression based on findings. | Clinical question: Rule out ICH, skull fracture. Signs and symptoms: Fall with head injury and vomiting. Unenhanced head CT:There is no detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- wh... | 1.No acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.2.Acute on chronic pansinusitis. |
Generate impression based on findings. | 21-year-old female with periumbilical pain and right lower quadrant pain ABDOMEN:LUNG BASES: No significant abnormality noted. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNE... | Findings suggestive of early acute appendicitis without evidence of perforation or abscess. |
Generate impression based on findings. | 69 years, Female. Reason: 69 y/o with pseudoobstruction, s/p NG tube placement History: abdominal distention There is a nasogastric tube with its tip projecting over the body of the stomach and the side-port at the level of GE junction. There is marked gaseous distention of multiple loops of large bowel as well as seve... | 1.Diffuse gaseous distention of multiple loops of large bowel and several loops of small bowel, most consistent with colonic (given apparent colonic predilection) or diffuse ileus, although distal colonic obstruction is possible.2.NG tube with tip in the body of the stomach and side-port at the level of GE junction, ad... |
Generate impression based on findings. | 36-year-old male patient with history of escalating periumbilical abdominal pain radiating to both lower quadrants. Evaluate for appendicitis and diverticulitis. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Small splenule noted.PANCREAS: No signific... | Small umbilical hernia containing fat with mild associated fat stranding is noted. Recommend correlation with physical examination and point tenderness. Otherwise, no findings to account for patient's symptoms. |
Generate impression based on findings. | 68-year-old female with history of spinal stenosis/ scoliosis status post L-15 XLIF complicated by bowel injury status post repair now with leukocytosis and SOB PULMONARY ARTERIES: Adequate pulmonary artery opacification without evidence of pulmonary embolism. The main pulmonary artery caliber is within normal limits.L... | 1.No evidence of pulmonary embolism. 2.Moderate bilateral pleural effusions.3.Patchy opacity in the posterior segment of the right lobe most suspicious for aspiration/infection. Resolving edema is a consideration.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not... |
Generate impression based on findings. | Male, 6 years old. Pain after a fall. Evaluate for fractureVIEWS: Left elbow AP, lateral, oblique (3 views) 3/11/2015, 1816 Elevation of the posterior and anterior fat pads, compatible with a joint effusion.No acute fracture or malalignment is identified. | Elbow joint effusion without acute fracture or dislocation identified. Occult fracture cannot be excluded. |
Generate impression based on findings. | 69 years, Female. Reason: Resolution of distension? There is a nasogastric tube with its tip projecting over the body of the stomach and the side-port at the level of GE junction. There is marked gaseous distention of multiple loops of large bowel as well as several loops of small bowel, slightly improved from the prio... | 1.Diffuse gaseous distention of multiple loops of large bowel and several loops of small bowel, slightly improved improved from the prior examination, most consistent with colonic ileus, although distal obstruction is possible.2.NG tube with tip in the body of the stomach and side-port at the level of GE junction, adva... |
Generate impression based on findings. | Increased work of breathing and desaturation. Klebsiella urinary tract infection. History of chronic lung disease.VIEW: Chest AP (one view) 03/11/15, 1823 Tracheostomy tube tip is below thoracic inlet. Feeding tube tip is distal to GE junction and not included on the image. Lower extremity PICC tip is in intrahepatic I... | Large lung volumes and streaky opacities. Enlarged cardiac silhouette most likely due to pulmonary hypertension. |
Generate impression based on findings. | 34-year-old female with history of neuroblastoma with new onset of cough.VIEWS: Chest AP/lateral (two views) 3/11/15 Left upper extremity PICC with tip at the cavoatrial junction. Right central line tip in the right atrium. Upper abdominal surgical clips are again seen.Cardiac silhouette is mildly enlarged. Mild peribr... | No pneumonia. |
Generate impression based on findings. | Male 5 years old Reason: position of ET tube History: respiratory failure, nephrotic syndrome.VIEW: Chest AP (one view) 3/11/15 at 1735 hrs. Central line tip is at the right atrium. ET tube terminates below thoracic inlet. Interval NG tube removal. Cardiac silhouette size is enlarged. Interval worsening in multifocal p... | Multifocal opacities as described. |
Generate impression based on findings. | 69 years, Female. Reason: assess for worsening ileus or obstruction History: 60 y.o. woman with history of pseudoobstruction and increased abdominal distension, pain, acidosis There is marked gaseous distention of multiple loops of large bowel as well as several loops of small bowel, most consistent with colonic ileus,... | Diffuse gaseous distention of multiple loops of large bowel and several loops of small bowel, increased from the prior exam, most consistent with colonic ileus, although distal obstruction is possible. |
Generate impression based on findings. | 58 year-old female with knee and pelvic pain on the left status post fall from standing today. Single view of the pelvis demonstrates normal anatomic alignment. Chronic parasymphyseal and medial acetabular fractures are unchanged. There is no evidence of acute fracture. Stable appearance of metallic device projecting o... | Moderate left knee joint effusion. No acute fracture or malalignment is evident. Severe left knee osteoarthritis. |
Generate impression based on findings. | RFO trigger: Surgery length greater than 8 hours RFO trigger: Multiple surgical teams Suspected RFO location: Abdomen Name of suspected RFO: Unknown Attending Surgeon name/pager: Dr. Choi Body Mass Index (BMI): 21.37 Surgical drains are present in the left and right upper quadrant. There is a nasogastric tube with its ... | Postsurgical changes but no unexpected radiopaque foreign object identified.These findings were discussed via telephone with Dr. Choi by the radiology resident on call at 19:00 on 3/11/2015. |
Generate impression based on findings. | Male, 6 years old. Fall, pain. Evaluate for fracture.VIEWS: Left humerus AP, lateral (2 views) 3/11/2015, 1814 No acute fracture or dislocation.Elbow joint effusion. | Elbow joint effusion without acute fracture or dislocation. See same day elbow radiograph for additional details. |
Generate impression based on findings. | RFO trigger: R/O RFO Suspected RFO location: Abdomen Name of suspected RFO: surgical needle Attending Surgeon name/pager: room 15- tel 69415 Body Mass Index (BMI): 24.96 Catheter tubing is seen looped in the right lower quadrant. A sponge projects over the very right lateral field on the first image, but was removed on... | No unexpected radiopaque foreign object identified.These findings were relayed to Dr. Umansky at 20:57/11/2015. |
Generate impression based on findings. | 49-year-old female with persistent nausea and vomiting after LOA ABDOMEN:LUNG BASES: Mild basilar atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoatten... | Interval resolution of bowel obstruction without specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 78-year-old male with history of metastatic small cell lung carcinoma with brain mets admitted for falls and altered mental status. New opacity on chest radiograph. LUNGS AND PLEURA: Small right pleural effusion has increased in size when compared to prior. There are dense airspace opacities with air bronchograms withi... | 1. Complete obstruction of the bronchus intermedius by tumor/debris with resultant right middle and lower lobe dense airspace opacities likely representing postobstructive atelectasis and pneumonia. Small to moderate right pleural effusion.2. Overall increase in tumor burden with measurements as above.3. Unchanged L1 v... |
Generate impression based on findings. | 74 years, Female. Reason: evaluate Dobbhoff History: s/p TEE Limited study as pelvis is not included. There is a Dobbhoff tube with its tip projecting over the distal duodenum. There is a paucity of bowel gas which is unchanged from the prior exam. Surgical staples partially visualized and other postsurgical sequela un... | Dobbhoff tube with its tip projected over the distal duodenum. |
Generate impression based on findings. | Clinical question: Evaluate for sinusitis. Signs and symptoms: Pancytopenia. Nonenhanced maxillofacial CT:Paranasal sinuses are well pneumatized. Examination demonstrate tiny foci of mucosal thickening along the medial aspect of left maxillary sinus and unremarkable exam otherwise. Patent bilateral ostiomeatal units of... | No sinusitis. |
Generate impression based on findings. | 20 years, Female. Reason: abdominal pain, vomiting, IBD There is a nonobstructive bowel gas pattern. Average stool burden. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 47 years, Female. Reason: abdominal pain, evaluate for ileus History: abdominal pain There is a nonobstructive bowel gas pattern. Streaky left basilar opacity suggestive of atelectasis. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | known hemorrhagic metastatic lesions follow up. No significant interval change of bihemispheric hemorrhagic metastasis since prior exam.Intraventricular hemorrhage appears to be not changed since prior exam.There is no midline shift.The osseous structures are unremarkable. The mastoid air cells are clear. | No significant interval change of multifocal hemorrhagic metastasis with IVH since prior exam. |
Generate impression based on findings. | Female, 13 years old. Pain and swelling. Inversion ankle injury to leftVIEWS: left ankle, AP, lateral, oblique (3 views) 3/11/2015, 1806 Small joint effusion. Mild soft tissue swelling over the lateral aspect of the ankle. No acute fracture or dislocation. | Small joint effusion with no acute fracture or dislocation. |
Generate impression based on findings. | Respiratory distress syndrome. 2-year-old former 24 week gestational age patient.VIEW: Chest AP (one view) 03/12/15, 0540 Endotracheal tube tip is below thoracic inlet. Gastrostomy tube is present. Left upper extremity PICC has its tip in superior vena cava. Surgical clips are noted at the level of the GE junction.Card... | Continued bilateral lung opacities. |
Generate impression based on findings. | Male, 16 years old. Status Post-Op Cardiac SurgeryVIEW: Chest AP (one view) 3/11/2015, 1843 Status post interval median sternotomy. Surgical clips in the mediastinum. ET tube below the level of the thoracic inlet and above the carina. Enteric tube with distal sideport above the level of the GE junction. New right chest... | Postoperative changes in the right hemithorax and mediastinum without acute complication. |
Generate impression based on findings. | 44-year-old female with buttock pain, rectal abscess ABDOMEN:LUNG BASES: Mild atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Calcifications likely representing granulomas.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Slight prom... | Large buttock abscess without osseous involvement as well as findings raising the question of associated anal fistula. MRI is recommended for further evaluation. |
Generate impression based on findings. | 16 year old female with abdominal pain, concern for fecal impaction.VIEW: Abdomen upright AP (one view) 3/12/15 Nonobstructive bowel gas pattern. No pneumatosis, portal venous gas, or free air. Moderate formed stool burden is present. | Normal examination. |
Generate impression based on findings. | 38 years, Male. Reason: Crohn's disease, evaluate for obstruction History: abdominal pain, bloating Nonobstructive bowel gas pattern with a greater than average amount of stool burden, most pronounced in the ascending colon. | Nonobstructive bowel gas pattern with a greater than average amount of stool burden, most pronounced in the ascending colon. |
Generate impression based on findings. | Male, 16 years old. post op cardiac; evaluate for internal changes. HypotensionVIEW: Chest AP (one view) 3/11/2015, 2105 Status post median sternotomy. Surgical clips in the mediastinum. Percutaneous atrial lines.ET tube below the level of the thoracic inlet. Enteric tube now with distal sideport below the level of the... | Unchanged cardiopulmonary appearance. |
Generate impression based on findings. | 9 months old male. Assess ETT placement, assess for infiltrate Former 21 week gestation with tracheostomyVIEW: Chest AP (one view) 3/12/15 Tracheostomy tube tip is below the thoracic inlet. Feeding tube tip is distal to the GE junction, however is not included on this image. Lower extremity PICC tip is in the intrahepa... | Chronic lung disease with increased bilateral streaky pulmonary opacities. |
Generate impression based on findings. | 34-year-old male with history of pain and swelling of the left hand after injury at work on 3/9/15. Three views of the left hand demonstrate a subacute transverse fracture through the mid diaphysis of the second metacarpal with mild ulnar deviation of the distal fracture fragment. There is moderate associated soft tiss... | Subacute transverse fracture of the second metacarpal mid-diaphysis with mild ulnar deviation of the distal fracture fragment. |
Generate impression based on findings. | Call back from screening mammogram for right breast distortion. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. A distortion in question at outer quadrant in the right breast disperses into normal glandular tissue with spot compression. Fo... | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 66-year-old female with a prior CT raising question of right pulmonary infarct, assess for pulmonary embolism PULMONARY ARTERIES: Pulmonary artery opacification without evidence of pulmonary embolism to the segmental arterial level. The main pulmonary artery measures 2.2 cm, within normal limits.LUNGS AND PLEURA: Nonsp... | 1.No evidence of pulmonary embolism.2.Slight interval decrease in size of right upper lobe peripheral opacity. This may represent a resolving infarct or may be infectious in etiology.3.Stable indeterminate 6 mm right subpleural nodule. Continued follow up is recommended.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not ... |
Generate impression based on findings. | 85-year-old male with history of G-tube placed in colon, eval for abscess ABDOMEN:LUNG BASES: Basilar atelectasis and consolidation. Small pleural effusions. Cardiomegaly.LIVER, BILIARY TRACT: Hypoattenuating hepatic lesions likely represent cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnorm... | 1. G-tube tip adjacent to and communicating with the transverse colon as seen on recent IR study. No evidence of abscess.2. Pleural effusions with basilar atelectasis and consolidation which may represent aspirate or infection.3. Diffuse abdominal and pelvic ascites. |
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