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Generate impression based on findings. | Chest tube removalVIEW: Chest AP Cardiothymic silhouette at the upper limits of normal. Mediastinal clips, epicardial pacer leads and right central line unchanged. The right chest tube has been removed in the interval. Minimal patchy atelectasis in the right upper lobe. No evidence of pneumothorax. | Right chest tube removal without evidence of pneumothorax. |
Generate impression based on findings. | 44-year-old female presents for 6 month follow-up of right breast mass status post benign biopsy in August 2014. History of bilateral reduction mammoplasty in 2002. No family history of breast cancer. Three standard views of the right breast, with additional CC and MLO views, were performed digitally and reviewed with ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, for which the patient is due in August 2015. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening M... |
Generate impression based on findings. | Postop. Prosthetic assessment. Three views of the left knee reveal a total knee arthroplasty device situated in anatomic alignment without evidence of hardware complication. There is maturation of minimal heterotopic bone along the lateral aspect of the lateral tibial plateau. No acute fracture is evident. Single AP im... | Left total knee arthroplasty without evidence of hardware complication. |
Generate impression based on findings. | Male 57 years old History: continued pain s/p cholecystectomy, evaluate for bile leak. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile du... | Normal hepatobiliary imaging. No evidence of bile leak. |
Generate impression based on findings. | Female 49 years old Reason: 49F s/p lap RYGB c/b obstruction s/p LOA with persistent N/V History: N/V Single contrast evaluation of the esophagus demonstrated normal mural contours without evidence of fixed narrowing. Contrast flowed promptly into the residual gastric pouch and into the proximal jejunum without delay. ... | Postsurgical changes related to Roux-en-Y gastric bypass, with dilatation of a proximal loop of jejunum, just proximal to a focal narrowing, likely related to adhesive disease, as detailed above. |
Generate impression based on findings. | Status post right lumpectomy for breast cancer in 2002, presents today for routine follow up. No current breast complaints. Three standard views of both breasts with a right exaggerated CC view and spot compression view of left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parench... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient.If the patient submits her old mammograms, we can compare them with the current study to establi... |
Generate impression based on findings. | Reason: restaging CT esophageal cancer s/p resection s/p recurrence s/p RT s/p stent s/p chemo History: none currently CHEST:LUNGS AND PLEURA: Interval increase in left pleural effusion now moderate in size. Small trace right pleural effusion. Bibasilar atelectasis is increased. Scattered nodular groundglass opacities ... | 1.Increased thickening of the cervical esophogeal wall at the superior aspect of the stent as described above suspicious for tumor. Elsewhere unchanged circumferential thickening of the esophageal wall. 2.Increase in number of multiple small nonobstructing renal stones bilaterally. 3.Scattered nodular groundglass opaci... |
Generate impression based on findings. | 63-year-old male patient with history of duodenal carcinoid and lymphadenopathy presents for surveillance. Exam is not sensitive for detecting lesions in the solid organs due to the lack of intravenous contrast. Given those limitations, the following observations are made:CHEST:LUNGS AND PLEURA: Left apex scarring note... | 1.Overall stable to slight interval decrease in reference lymph nodes in the thorax, abdomen, and pelvis. Reference measurements provided above.2.Grossly stable duodenal polypoid lesion given limitations of differential bowel distention between examinations. 3.Inflammatory changes and foci of air in the subcutaneous ti... |
Generate impression based on findings. | The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is mild disk narrowing at L5-S1. The vertebral body and disk heights are otherwise well-maintained. No worrisome focal marrow signal abnormality is appreciated. There are bilateral L5 pars interarticularis defects, as seen on prior radiograp... | 1. Chronic bilateral L5 spondylolysis with minimal L4-L5 and L5-S1 spondylotic changes. No significant stenosis at any level. No MR evidence of cauda equina syndrome.2. Possible partial visualization of the fundus of the uterus which may be retroflexed, with heterogeneous appearance suggesting possible fibroids. Pelvic... |
Generate impression based on findings. | 73 year old female who has a complaint of palpable, tender area in the right upper breast/chest wall. History of left mastectomy in 2007. Patient received radiation. No family history of breast cancer. The patient is predominantly Spanish-speaking. The patient's daughter was present to assist in interpretation. MAMMOGR... | No mammographic or sonographic evidence of malignancy. Patient should return to her physician for management of focal tenderness. 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... |
Generate impression based on findings. | Recurrent squamous cell carcinoma status post adenoidectomy/tonsillectomy and a left neck dissection. MRI of the skull base on 2/19/15 demonstrated interval increase size of signal abnormality in the left sided skull base. Inferiorly, it extended down to the left carotid bifurcation with increased infiltration into the... | 1. Post-treatment findings in the neck with evidence of recurrent infiltrative tumor in the left perivertebral space with apparent skull base invasion and left vertebral artery encasement, as well as within the left carotid space with encasement of the internal carotid artery.2. No discernible evidence intracranial tum... |
Generate impression based on findings. | PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The postcontrast appearance of the salivary glands is unremarkable. There is an irregular area of nonspecifi... | 1. Mild minimal bilateral level Ib cervical lymphadenopathy although without suspicious morphology. These are nonspecific and may be reactive in etiology.2. Nonspecific left central thyroid irregular enhancement. |
Generate impression based on findings. | 65-year-old female with right rib pain status post fall yesterday. Three views of the ribs do not demonstrate fracture or malalignment. Please refer to accompanying chest radiograph for detailed description of intrathoracic findings. Moderate to severe degenerative disease of the right shoulder; questionable fracture o... | No evidence of rib fracture. Questionable fracture of the humeral head, for which dedicated right shoulder radiographs are recommended. |
Generate impression based on findings. | 88 year old female with a history of left lumpectomy for breast cancer followed by radiation treatment. The patient does not recall the time of her treatment. 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 co... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 39 year-old female with right ankle pain. Three views of the right ankle demonstrate normal alignment without acute fracture. A normal variant os trigonum is present posterior to the talus. There is mild soft tissue swelling. | No acute fracture or malalignment. |
Generate impression based on findings. | Female 73 years old Reason: 73yo w/ h/o breast CA s/p chemo/XRT. progressive decreased PO intake, FTT. Assess for pathology History: decreased PO intake. Limited single contrast evaluation of the esophagus demonstrated no fixed narrowing to suggest stenosis, or intraluminal filling defects to suggest mass lesion. Motil... | Limited evaluation, no evidence of stricturing. |
Generate impression based on findings. | 63-year-old male with history of tonsillar and supraglottic squamous cell carcinoma. CHEST:LUNGS AND PLEURA: Streaky left upper lobe opacities are likely post infectious or related to aspiration. Scattered nonspecific pulmonary micronodules. Right basilar pleural thickening and upper lobe opacities are no longer visual... | 1. Streaky left upper lobe opacities are likely post infectious or related to aspiration given their morphology and chronology. Continued follow-up is recommended.2. Unchanged pneumobilia and biliary ductal dilation, presumably postoperative in etiology.3. No convincing evidence of metastatic disease. |
Generate impression based on findings. | Male; 65 years old. Reason: 65M w lymphoma, sepsis unknown source eval for abscess/source, History: ventilatory support, transaminitis, abd distension, known c. diff ABDOMEN:LUNG BASES: Mild to moderate bibasilar atelectasis/consolidation, for which underlying infection cannot be excluded. Small to moderate predominant... | 1. Bibasilar atelectasis/consolidation, for which underlying infection cannot be excluded.2. Small to moderate left pneumothorax.3. New marked attenuation of the celiac trunk and proximal splenic and hepatic arteries, which may be due to thrombus versus severe vasospasm.4. Diffuse splenic ischemia versus infarct.5. Fin... |
Generate impression based on findings. | Shoulder pain. Three views of the right shoulder reveal no acute fracture or dislocation. The acromiohumeral distance is decreased. There is mild osteophyte formation at the acromioclavicular joint. There is a downsloping acromion. | 1. Mild AC joint osteoarthritis.2. Decreased acromiohumeral distance is suggestive of a rotator cuff injury. |
Generate impression based on findings. | 79-year-old male with cirrhosis status post pericardial stripping for restrictive pericarditis. Evaluate portal, hepatic vein and TIPS flow. LIMITED EXAM DUE TO PATIENT BODY HABITUS AND OVERLYING CHEST TUBES AND BANDAGES. LIMITED ABDOMENLIVER: Cirrhotic liver morphology with atrophy of the right hepatic lobe measuring ... | 1. No evidence of TIPS stenosis, however flow is pulsatile. 2. Left portal vein flow is not well assessed due to limitations of the study as noted. 3. Unable to visualize the right hepatic vein however the left and middle hepatic veins are patent with appropriate directional flow. 4. Focal round hypoechoic region adjac... |
Generate impression based on findings. | Female 52 years old Reason: 52 y.o. w/h/o crohns colitis s/p total proctocolectomy in 2013 with non-healing perinal wound. CT did not show fisutula, but continues to have drainage from external opening. Please perform fistulogram to find true tract. History: discharge from perineal wound, ? fistula Following administra... | Sinus tract arising from the perineum without evidence of fistulization as detailed above. |
Generate impression based on findings. | Male 85 years old Reason: evaluate for mets, prostate cancer History: weight loss No abnormal osseous foci are identified to indicate metastatic disease. Full urinary bladder noted, patient was unable to void. | No evidence of bone metastases. |
Generate impression based on findings. | Reason: evaluate for intracranial stenosis MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries. No aneurysms are appreciated.There is opacification of the entire left internal art... | 1.There is a left internal carotid artery string sign present with left internal carotid artery stenosis. It is suspected that there are tandem stenosis, however, the more significant stenosis is not readily identified. The left middle cerebral artery territory is supplied from via the posterior communicating artery. T... |
Generate impression based on findings. | Male, 63 years old, history of HPV-negative T4N2b Lt oropharynx SCC and T1 concurrent laryngeal SCC. Presumed treatment related findings are seen in the neck including infiltration of the subcutaneous fat and fascial planes as well as hyperemia of the submandibular glands.The nasopharyngeal mucosa is edematous but with... | 1.Interval increased prominence of thickened enhancing tissue is seen within the left oropharyngeal mucosal space. A region of hypoenhancement internally, which may represent necrosis, has also become larger. The nature of this change is uncertain and, while it could to some degree represent a reaction to therapy, the ... |
Generate impression based on findings. | 49-year-old female patient with abdominal pain and vomiting. Evaluate for intra-abdominal infection. ABDOMEN:LUNG BASES: Again seen are scattered parenchymal cystic changes in the lung bases.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormal... | 1.No acute intra-abdominal abnormalities to account for patient's symptoms.2.Right iliac fossa renal transplant without acute abnormalities. |
Generate impression based on findings. | 60 year-old male with history of head and neck cancer. CHEST:LUNGS AND PLEURA: Fillings defects are present in the right middle and lower lobar pulmonary arteries compatible with acute pulmonary emboli. No evidence of right heart strain. Scattered pulmonary micronodules are present. No suspicious lesions identified. Mi... | 1. Right middle and lower lobar acute pulmonary emboli.2. No evidence of metastatic disease.3. Left atrial appendage thrombosis is no longer visualized.Findings discussed with Kimberly Salminen on 3/13/15 at 1700. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with moderate global volume loss much greater than expected for patient's stated age. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-a... | No acute intracranial abnormality. |
Generate impression based on findings. | Reason: head and neck cancer/ screening for protocol History: see above CHEST:LUNGS AND PLEURA: Mild volume loss in the left lower lobe with dependent atelectasis.No suspicious nodules.MEDIASTINUM AND HILA: Calcified lymph nodes compatible with previous infection.No visible coronary artery calcification. No pericardial... | No significant abnormalities. |
Generate impression based on findings. | Female, 49 years old, history of left retromolar trigone cancer; pT3N0 SCC of the soft palate s/p palatectomy and left maxillectomy by Dr. Portugal (2/20/2015) with positive margin of the mass, and left lymph node dissection which was negative; chemoradiation not started yet. Brain: No mass effect, focal edema or suspi... | 1.Nonspecific heterogeneous enhancing soft tissue at the surgical bed, with may be postoperative. Also enhancing tissue along left inferior meatus, which could be correlated with direct inspection. Continued follow-up is recommended.2.Multiple necrotic left level 1B lymph nodes, new from prior study.3.Expected interval... |
Generate impression based on findings. | 37-year-old male patient with recent travel abroad present to new left lower abdominal pain that radiates centrally. Abdominal pain is associated with eating. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Multiple punctate hypodensities in the liver parenchyma adjacent characterize and like... | No intra-abdominal abnormalities to account for patient's symptoms. |
Generate impression based on findings. | Reason: hx of lung nodule seen on CXR, please evaluate, hx of bladder cancer History: see above LUNGS AND PLEURA: Interval resection of a left upper lobe nodule with residual postsurgical scarring.Small residual left pleural effusion.No suspicious nodules.MEDIASTINUM AND HILA: Asymmetric thyroid enlargement.No signific... | Postsurgical findings the left hemithorax with small residual pleural effusion. No sign of recurrent tumor. |
Generate impression based on findings. | Status post MVC. Question of dynamic subluxation. Flexion and extension imaging of the cervical spine reveals no atlantoaxial instability. No acute fracture is evident. Vertebral body heights are maintained. | No acute fracture or instability is identified. |
Generate impression based on findings. | Male, 17 months old. Concern for non accidental trauma, eval for corner fracture VIEWS: Right wrist PA, lateral, oblique (3 views) 3/13/2015, 1602 Corner fracture of the distal radius, best seen on the lateral view involving the anterior and posterior aspects of the bone.No additional fractures or dislocations identifi... | Corner fracture of the distal radius as detailed above. |
Generate impression based on findings. | 15-year-old male with injury and point tenderness to midshaft of ulnaVIEWS: Left forearm; AP and lateral. Left elbow; AP, oblique, lateral (5 views) 3/13/15 Left Forearm: No fracture or malalignment. No significant soft tissue swelling.Left elbow: No fracture or malalignment. No significant soft tissue swelling or join... | No fracture or malalignment. |
Generate impression based on findings. | Male; 52 years old. Reason: Pt s/p kidney transplant now s/p transplant nephrectomy. Now with PTLD. Evaluate for any metastatic disease History: as above Motion artifact mildly limits examination. The lack of oral contrast limits sensitivity for bowel pathology.CHEST:LUNGS AND PLEURA: No significant abnormality notedME... | 1. Mediastinal, retrocrural, and right iliac lymphadenopathy, suspicious for PTLD.2. Postsurgical changes in right iliac fossa. |
Generate impression based on findings. | 30 year old female with right heart failure, liver failure LIMITED ABDOMENLIVER: Normal echogenicity of the liver measuring 20.7 cm in length. No focal hepatic lesions. BILIARY TRACT: Status post cholecystectomy. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal... | 1. Patent hepatic inflow and outflow vasculature with no evidence of thrombus. 2. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction.3. Hepatomegaly. |
Generate impression based on findings. | Patient status post fall Persistent mild and more moderate fifth and sixth thoracic vertebral compression fractures similar to 2013. Overall alignment and remaining vertebral body heights are otherwise preserved. Mild to moderate degenerative changes involving the lower levels also similar. | Unchanged T5 and T6 compression fractures |
Generate impression based on findings. | Left wrist: Pain with palpation and rotation. Pain in the ulnar aspect of the wrist. Evaluate for fracture. Sacrum/coccyx: Pain after collision with car, thrown about 3-5 feet. Evaluate for fracture. Left hip: Pain. Left hand: Pain at the base of the fifth metacarpal bone. Evaluate for fracture of the fifth digit. Thre... | No acute fracture is evident. |
Generate impression based on findings. | Female 43 years old Reason: evaluate for kidney stones History: flank pain, passing stones ABDOMEN: Exam is limited secondary to lack of intravenous and oral contrast. Lack of intravenous contrast makes evaluation of solid organ and vascular pathology suboptimal. Lack of oral contrast makes evaluation of pathology subo... | No substantial interval change. Bilateral renal calculi. Mild right pelvocaliectasis. Probable infrarenal chronic caval occlusion. |
Generate impression based on findings. | Hemoptysis, cough and COPD. History of latent TB per electronic record.. LUNGS AND PLEURA: Severe emphysema. Suture line from wedge biopsy at the right apex. Debris in the trachea and mainstem bronchi. Lateral intercostal herniation involving the periphery of the right upper lobe between the right ribs 5 and 6 laterall... | No findings to account for the patient's source of hemoptysis. Emphysema. Two new calcified micronodules in the right lung statistically most likely represent healed granulomas in the absence of known neoplasm. |
Generate impression based on findings. | Shoulder pain. Interval continued healing of the humeral neck fracture with gross anatomic preservation of alignment and interval increasing callus formation. The fracture line is less distinct. There is downward displacement of the humeral head. | Healing right humeral neck fracture. |
Generate impression based on findings. | Male, 60 years old, with nasopharyngeal carcinoma, base nasopharyngeal carcinoma. Baseline images prior to starting systemic therapy. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. A mucus retentio... | 1.Findings are seen related to presumed interval resection of a nasopharyngeal tumor. There is mucosal tissue loss at this location. The left residual nasopharynx is hypoattenuating with some marginal enhancement which could be entirely post-treatment in nature, but continued observation is recommended.2.The clivus sub... |
Generate impression based on findings. | Intraparenchymal hemorrhage. There is redemonstration of a large intraparenchymal hematoma in the left insula and frontal parietal operculum, without significant interval change when allowing for differences in slice selection and angulation. Again measures 3.8-cm transverse by 5.0-cm AP by 2.9 cm CC, unchanged from re... | No significant interval change in large left frontal parenchymal hematoma with localized mass effect and minimal midline shift. |
Generate impression based on findings. | Rib/shoulder pain status post fall. There is increased density extending from the medial humeral head to the groove of the biceps tendon along with discontinuity of the cortex along the lateral border and slight cortical offset.Additionally, there is a defect of the inner humeral head with a fragmented component; this ... | Subtle discontinuity and cortical offset of the humeral head with abnormal density is concerning for an acute fracture. Additional inner humeral head defect is also abnormal though may be more chronic in etiology, possibly due to AVN. Given findings, CT of the shoulder may be considered for further evaluation. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is minimal mucosal thickening in a right anterior ethmoid air cell. The remaining imaged paranasal sinuses and mastoid air cel... | Mild left parietal subgaleal scalp hematoma without skull fracture or intracranial hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | The sagittal reformatted images demonstrate mildly exaggerated lordosis. There is 2 mm retrolisthesis of C3 on C4, C4 on C5, and C5 on C6. The vertebral body heights are well-maintained. There is loss of disk height at C3-4 through C5-6 levels. There is a tiny osseous fragment anterior/inferior to the C6 vertebral bod... | Multilevel cervical spondylosis without significant spinal canal stenosis and variable neural foraminal stenoses as described above. |
Generate impression based on findings. | There is minimal right maxillary sinus mucosal thickening with periapical lucency surrounding a right maxillary molar tooth again seen. Multiple other dental caries and periapical lucencies of the mandibular and maxillary teeth are similar to prior study. Due to increased field of view, there is now visualization of c... | 1.Minimal right maxillary sinus mucosal thickening with adjacent stable right maxillary molar periapical lucency.2.Extensive dental disease again seen. Dental exam correlation is suggested, if not already obtained. Please note that due to increased field of view on the current exam, there is contiguity of periapical lu... |
Generate impression based on findings. | There is an unchanged right transfrontal ventricular shunt catheter terminating in the right frontal horn. The lateral and third ventricular caliber is mildly smaller. There is persistent asymmetry with smaller right lateral ventricle as compared to the left.There is no evidence of intracranial hemorrhage, mass, or ce... | Unchanged right transfrontal ventricular shunt catheter terminating in the right frontal horn with mildly smaller lateral and third ventricular caliber. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is mild maxillary and ethmoid sinus mucosal thickening, as well as minimal right mastoid opacification. The skull and extracra... | No acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is a stable 5-mm ovoid fatty attenuation likely representing a xanthogranuloma of the choroid plexus in the left occipital horn on series 5 image 16. The ventricles and basal cisterns are normal in size and unchanged. There is no midline s... | No acute intracranial hemorrhage or mass effect. No evidence of disproportionate ventricular dilatation. |
Generate impression based on findings. | History of brain surgery as child for tumor, now breast cancer, +headache. There is a subcentimeter focus of hyperattenuation in the anterior left pontomedullary junction. There is a cystic area that measures up to approximate 4 cm in the left parietal lobe that appears to communicate with the left lateral ventricle an... | 1. Nonspecific subcentimeter focus of hyperattenuation in the anterior left pontomedullary junction. Differential considerations include acute hemorrhage, cavernous malformation, or neoplasm, for example. A brain MRI without and with contrast would be useful for further characterization.2. A cystic area that measures u... |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is diffuse volume loss with unchanged prominent ventricular system and marked nonspecific periventricular and subcortical white matter hypoattenuation. There is a stable small right cerebellar hemispheric lacunar infarct. There is no midli... | No significant change in marked age-indeterminate small vessel ischemic changes without acute intracranial hemorrhage. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | There is no suspicious intracranial enhancement, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses are clear. There is minimal scattered bilateral mastoid air cell opacification. The skull and extracran... | No acute intracranial hemorrhage. CT is insensitive for detection of early nonhemorrhagic stroke and metastatic disease. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is minimal nonspecific periventricular white matter hypoattenuation, likely age indeterminate small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. T... | Minimal small vessel ischemic changes without acute intracranial hemorrhage or mass effect. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | Low back pain, history of psoriasis, evaluate signal in the joints. The margins of the sacroiliac joints are well-defined. There is sclerosis along the iliac margin of the right SI joint, which could conceivably represent the sequela of prior sacroiliitis or be degenerative in etiology. Alternatively, this may reflect ... | Sclerosis along the iliac margin of the right sacroiliac joint may reflect sequela of prior sacroiliitis or be degenerative in etiology or perhaps reflect Paget's disease. Currently, the SI joint margins are well defined. Degenerative disk disease affects the lower lumbar spine. |
Generate impression based on findings. | Finger trauma and cellulitis (left first finger). Fracture? Evaluation of fine detail is slightly limited by overlying bandage. There is diffuse soft tissue swelling. Irregularity of the soft tissues dorsal to the middle phalanx may represent ulceration. I see no fracture. There is a boutonniere deformity of the finger... | Soft tissue swelling, boutonniere deformity, and other findings as described above; I see no fracture. |
Generate impression based on findings. | Patient with trauma to left medial ankle. Check for fracture. There is diffuse soft tissue swelling, but I see no underlying acute fracture. Mild osteoarthritis affects the ankle joint. There is thickening and ossification of the distal Achilles' tendon indicating chronic tendinopathy that appears to have progressed sl... | Soft tissue swelling and degenerative changes as described above without fracture evident. |
Generate impression based on findings. | No history of trauma. Pain at fifth metatarsal with walking. Tender to palpation here. Rule out fracture of fifth metatarsal or other lateral tarsal metatarsal issue. I see no fracture or other specific findings to account for the patient's fifth metatarsal pain. There is mild deformity of the fourth metatarsal head wh... | No specific findings to account for the patient's fifth metatarsal pain. Other findings as above. |
Generate impression based on findings. | Pain in right knee, fall, evaluate for fracture. I see no fracture. Moderate to severe osteoarthritis affects the knee. An ossicle along the superolateral margin of the patella likely represents a normal variant bipartite patella or less likely a loose body in the joint. There is a small joint effusion. Arterial calcif... | Osteoarthritis and other findings as above without fracture evident. |
Generate impression based on findings. | Fell off last two stairs 36 hours ago. Generalized pain from his knee down to his foot. Evaluate for an acute process. Three views of the left ankle reveal an approximately 1 cm triangular density lateral to the body of the talus and anterior/inferior to the fibular tip which likely represents an avulsion fracture. We ... | Findings compatible with a lateral ankle avulsion fracture as described above. Further evaluation with CT may be considered if clinically warranted. |
Generate impression based on findings. | Status post fall on 3/12/2015. Evaluate for an acute process. Four views of the left knee show a small joint effusion and mild osteoarthritis of the knee, but we see no fracture. | Small joint effusion without fracture evident. |
Generate impression based on findings. | Pain and swelling to the middle finger. Patient states the swelling is due to her finger getting pulled. Three views of the left middle finger reveal soft tissue swelling about the base of the finger. No acute fracture is evident. | Soft tissue swelling but no acute fracture evident. |
Generate impression based on findings. | Pain. Question of humeral head fracture. There is flattening of the superior aspect of the humeral head and sclerosis of the medial aspect suspicious for avascular necrosis. We see no discrete fracture on this single view. There is mild osteophyte formation along the inferior glenoid. | Osteoarthritis and findings suspicious for AVN. We see no fracture on this single view. If further imaging is clinically warranted, CT or MRI may be considered. |
Generate impression based on findings. | Fell with injury to wrist. Pain and swelling. Three views of the left wrist show soft tissue swelling along the ulnar aspect of the wrist without acute fracture evident. Alignment is within normal limits. | Soft tissue swelling without acute fracture evident. |
Generate impression based on findings. | Generalize hip pain, started two days ago. Patient also fell, however hip pain started before. Evaluate for fracture. Two views of the right hip show no acute fracture. Mild osteoarthritis affects the hip. A sclerotic focus within the femoral neck presumably represents a benign bone island. | Mild osteoarthritis without fracture evident. |
Generate impression based on findings. | 14-year-old male with left shoulder pain, history of fall.VIEWS: Left clavicle: AP and axial; left shoulder: internal and external rotation. (Four views) 3/13/15 Step-off of the superior border of the lateral aspect of the clavicle likely represents an acute minimally displaced fracture. Apparent bridging across the fr... | Acute minimally displaced left lateral clavicle fracture.These findings were discussed between the on call resident and ER physician at 1826 on 3/13/15. |
Generate impression based on findings. | Coronal T2 weighted images are limited by patient motion. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-vo... | 1. Low-lying right cerebellar tonsil which is slightly pointed appearance, with moderate crowding of structures. Findings are suggestive of possible mild Chiari one malformation. Please correlate clinically. Otherwise, unremarkable noncontrast MRI brain.2. Motion limited MRI of the cervical spine with no evidence of co... |
Generate impression based on findings. | Leg pain. Patient with likely cellulitis, question of osteomyelitis. Two views of the right tibia and fibula show diffuse soft tissue swelling. There is chronic appearing periosteal reaction and endosteal scalloping involving the fibula of uncertain etiology and significance, but does not have the typical appearance of... | Soft tissue swelling without specific radiographic evidence of osteomyelitis. If clinically warranted, further evaluation with MRI may be considered. |
Generate impression based on findings. | Plantar foot puncture wound, deep with concern for osteomyelitis. Foul smell and drainage. Three views of the right foot show mild soft tissue swelling and irregularity along the base of the forefoot which may represent the site of the puncture wound. We see no specific radiographic features of osteomyelitis. Plantar c... | Soft tissue swelling without specific radiographic evidence of osteomyelitis. If clinically warranted, MRI may be considered for further evaluation. |
Generate impression based on findings. | 42 year-old female with history of shortness of breath, presyncope and elevated d-dimer. PULMONARY ARTERIES: Technically adequate study to the level of the segmental branches. No evidence of acute pulmonary embolus. Apparent filling defects in the left lower lobar arteries is likely the result of motion artifact from v... | 1. No evidence of acute pulmonary embolus.2. Cholelithiasis.Findings discussed with Dr. Padela at 1100 on 3/14/15.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 5-year-old male with coughing and high feversVIEWS: Chest AP/lateral (two views) 3/13/15 at 5:25 p.m. The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Mild bronchial wall thickening is compatible with reactive airway disease/bronchiolitis. No pneumonia. No pneumothorax o... | Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | Female; 52 years old. Reason: Evaluate for tuboovarian abscess, other intraabdominal pathology/malignancy History: bloating, lower abdominal pain, cervical motion tenderness, fevers ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild dilation of the common bile duct measuring up to 8 mm with ... | No acute abdominopelvic abnormality evident. |
Generate impression based on findings. | Fell yesterday with pain to right hip joint. Question of fracture. Two views of the right hip show an intertrochanteric fracture with the fracture fragments in near anatomic alignment. Severe osteoarthritis affects the hip. | Intertrochanteric fracture. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. Right occipital lobe encephalomalacia, compatible with prior infarct. Generalized cerebral volume loss. Hypoattenuation of the periventricular and subcortical white matter, right greater than left, compatible with chronic small vessel ischemic disease. No evidence of hydro... | 1.No evidence for acute intracranial abnormality. CTs not sensitive for detection of acute nonhemorrhagic ischemia.2.Right occipital lobe encephalomalacia, compatible with prior infarct.3.Periventricular and subcortical white matter chronic small vessel ischemic disease. |
Generate impression based on findings. | 4-year-old female with cough and fever.VIEW: Chest AP (one view) 3/13/15 Interval removal left upper extremity PICC. The cardiothymic silhouette is normal. Surgical clips are noted in the upper abdomen. Overall low lung volumes. Mild peribronchial wall thickening is suggestive of bronchiolitis/reactive airway disease p... | Mild bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | 5-year-old male with VP shunt, vomiting, and headache.VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 3/13/15 A right frontal ventriculostomy catheter is present with tip near the midline. The shunt exits via a burr hole and traverses the right occiput, ri... | No extracranial VP shunt complications. |
Generate impression based on findings. | 53-year-old male with history of AML and fever. LUNGS AND PLEURA: Moderate centrilobular predominant emphysema and bronchial wall thickening. Diffuse and symmetric ground glass opacities, interlobular septal thickening, and septal lines most notably in the lower lobes, new from prior. Small bilateral pleural effusions.... | 1. Diffuse symmetric ground glass opacities, interlobular septal thickening and septal lines most notably in the lower lobes with small bilateral pleural effusions superimposed on moderate emphysema suggestive of pulmonary edema. Opportunistic infection is considered less likely.2. Small pericardial effusion. |
Generate impression based on findings. | Evaluation is limited due to lack of contrast. There is a prominent tubular soft tissue structure which extends from the upper esophagus to the left of midline anteriorly, to the skin surface, with a few foci of adjacent subcutaneous emphysema consistent with recent surgery. This is presumably the "spit fistula". An e... | 1. Expected postoperative changes from spit fistula. No evidence of focal fluid collection or abscess, although evaluation is somewhat limited due to lack of contrast.2. Nonspecific moderate-severe fluid opacification of right mastoid air cells and partial opacification of sphenoid sinuses. Please correlate clinically. |
Generate impression based on findings. | 14-year-old male with history of gunshot wound.VIEWS: Left Tibia-fibula: AP and lateral; Left knee: AP and lateral; Left femur: AP and lateral (6 views) 3/13/15 Left Knee: An 11-mm bullet is present in the anterior soft tissues of the knee inferior to the patella. Subcutaneous gas and significant soft tissue swelling i... | Bullet is present in the anterior soft tissues of the knee, inferior to the patella. Fracture of the tibial tuberosity. |
Generate impression based on findings. | 53-year-old male with history of hypoxia. Only limited views of the chest without contrast were obtained secondary to IV malfunction and hence this study is nondiagnostic. No evidence of acute abnormality on the limited views of the chest. | Non-diagnostic exam. |
Generate impression based on findings. | Male; 50 years old. Reason: evaluate for obstruction History: abdominal pain ABDOMEN:LUNG BASES: Mild bibasilar dependent subsegmental atelectasis. Stable right upper lobe nodule measuring 4 mm (series 4/6). Stable right lower lobe pleural-based nodule measuring 5 mm (series 4/14). Small cluster of micronodules in the ... | Findings most suspicious for acute pancreatitis with acute peripancreatic fluid collections. Gastric antrum wall thickening is likely reactive. Another less likely consideration would be gastric antral wall perforation given reported recent endoscopy, but there is no contrast leak or free air. Correlation with patient'... |
Generate impression based on findings. | Chest pain, enteric tube placement Enteric tube seen extending below level of hemidiaphragms, tip located in gastric body. Incompletely imaged diffuse bowel gaseous distention, small and large bowel involved, findings may reflect ileus but distal colonic obstruction another differential constriction. Pelvis excluded fr... | Enteric tube and incompletely imaged stable bowel gas pattern as above. |
Generate impression based on findings. | Abdominal pain, nausea, emesis, status post Roux-en-Y gastric bypass and now with obstructive symptoms Suboptimal exam due to patient motion artifact. Moderate to large amount of enteric contrast seen. Nonobstructive bowel gas pattern. Right upper quadrant surgical clips, compatible with prior cholecystectomy. | Nonobstructive bowel gas pattern. Please refer to recent CT imaging from 1 day prior for additional findings. |
Generate impression based on findings. | 59-year-old female with history of LVAD. Evaluate for pulmonary hemorrhage. LUNGS AND PLEURA: Diffuse ground glass and reticular opacities with associated interlobular septal thickening present in the middle and upper lobes bilaterally with relative sparing of the bases. No significant pleural effusions.MEDIASTINUM AND... | Diffuse ground glass and reticular opacities with associated interlobular septal thickening present in the middle and upper lobes bilaterally with relative sparing of the bases. No significant pleural effusions. This pattern is not typical of cardiogenic edema given its distribution and lack pleural effusions. Pulmonar... |
Generate impression based on findings. | 14-year-old male status post trauma with hematoma and tenderness to palpation of the lumbar spine.VIEWS: Lumbar spine: AP, lateral, L5-S1 lateral; Pelvis: AP; Chest AP (5 views) 3/13/15 at 10:20 p.m. Chest: The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. No pleural effu... | No fracture or malalignment. No acute cardiopulmonary abnormality. |
Generate impression based on findings. | No evidence of acute intracranial bleed. Generalized cerebral volume loss. Periventricular and subcortical white matter hypoattenuation compatible with age indeterminant small vessel ischemic disease. No evidence of mass, mass-effect, or hydrocephalus. The imaged paranasal sinuses and mastoid air cells are clear. The ... | 1.No evidence for acute intracranial abnormality. 2.Periventricular and subcortical white matter age indeterminant small vessel ischemic disease. |
Generate impression based on findings. | There is redemonstration of focal T2 hyperintense signal within the cord at the T11-T12 level, consistent with probable syrinx. Additional ill-defined hyperintensity just cranial to this level at the T10 and T11 levels on sagittal STIR images is similar to that on the prior postoperative exam, without convincing corre... | No evidence of cord compression. Essentially stable postoperative changes with continued complete effacement of the CSF space in the thecal sac along the thoracic spine with perhaps slight improved visualization of ventral CSF space at the cervical thoracic junction. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. No evidence of mass, mass effect, or hydrocephalus. Mild patchy ethmoid air cell mucosal thickening. The imaged portions of the orbits are intact. The osseous structures are unremarkable. | No acute intracranial abnormality. |
Generate impression based on findings. | Right lower quadrant abdominal pain, assess for small bowel obstruction Mildly prominent bowel with air seen distally in portions of transverse and descending colon. No definitive evidence of bowel obstruction. Incompletely basilar atelectasis. | No definitive evidence of bowel obstruction. |
Generate impression based on findings. | 60-year-old female with history of altered mental status and weakness. Evaluate for malignancy. LUNGS AND PLEURA: Linear opacities in the right lower lobe likely represents scarring. Mild bibasilar subpleural atelectasis. No suspicious pulmonary nodules are identified.MEDIASTINUM AND HILA: A subcarinal mediastinal lymp... | 1. Partially imaged large eccentric occlusive filling defect within the right internal jugular vein compatible with thrombus of unknown chronicity.2. Mediastinal/hilar lymphadenopathy as above is nonspecific, but may be reactive or metastatic in etiology. Continued followup is recommended. |
Generate impression based on findings. | Worsening abdominal pain Coiled enteric tube seen with tip located in right mid abdomen, exact location difficult to ascertain based on this imaging exam alone but may be located in jejunum, proximal portion of tube appears to extend laterally towards the left, correlate with patient's clinical history, uncertain wheth... | Dilated proximal small bowel seen centrally in abdomen with paucity of gas seen distally, suspicious for developing small bowel obstruction and correlation with patient's clinical history and continued followup recommended.Enteric tube as described, see above. |
Generate impression based on findings. | Female; 42 years old. Reason: assess for intraabdominal process History: abdominal pain, recent surgery ABDOMEN:LUNG BASES: Contrast opacifies the distal esophagus, suggestive of gastroesophageal reflux.LIVER, BILIARY TRACT: Status post cholecystectomy. SPLEEN: No significant abnormality notedPANCREAS: No significant a... | 1. Decreased inflammatory changes at right upper quadrant colonic anastomosis. 2. Small incisional seroma, for which infection cannot be excluded. |
Generate impression based on findings. | Reason: Abscess? History: Swelling on right face, concern for abscess Small fluid collection measuring 0.8 x 0.6-cm adjacent to the right maxillary alveolar process with rim enhancement. There is periapical and periradicular lucency of the adjacent tooth number 5 with dental caries and right maxillary cortical loss ant... | 1.Small fluid collection adjacent to the right maxillary alveolar process with rim enhancement, consistent with abscess. There is periapical and periradicular lucency of the adjacent upper premolar 5 with dental caries and right maxillary cortical loss anteriorly. 2.Left upper premolar 14 has abrupt cut off of the crow... |
Generate impression based on findings. | Abdominal pain, placement of nasojejunal tube Nasojejunal tube seen with tip just proximal to or at level of ligament of Treitz. Large stool burden, no bowel obstruction. | Enteric tube as above. |
Generate impression based on findings. | Assess for Dobbhoff tube placement Nonvisualization of a Dobbhoff tube. Percutaneous gastrostomy seen to left of midline at level of patient's L1 compression deformity, small air suggested in underdistended stomach. Nonobstructive bowel gas pattern. Additional multilevel degenerative disease of spine seen, decreased os... | Percutaneous gastrostomy as above. |
Generate impression based on findings. | Beam hardening artifact at the level of the shoulders limits evaluation. The scout lateral view and the sagittal reformatted images demonstrate normal alignment of the cervical spine, with straightening of the normal cervical lordosis. The vertebral body and disk space heights are well-maintained.There is no acute fra... | 1. No acute fracture or subluxation.2. Probable developmental variant versus less likely sequela of chronic fracture involving right pedicle of C2. |
Generate impression based on findings. | Female; 44 years old. Reason: assess for stone, hydro History: flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable hepatic cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No ... | No hydroureteronephrosis or perinephric stranding. No obstructing calculi evident, though evaluation of the distal ureters is mildly limited by multiple pelvic bowel loops and phleboliths. |
Generate impression based on findings. | Dobbhoff tube placement Dobbhoff tube seen with tip directed towards gastric fundus. Moderate stool burden. No bowel obstruction. Extensive and severe vascular calcifications, postprocedural coil placement seen in lower abdomen. Mild to moderate cardiomegaly. | Enteric tube as above. |
Generate impression based on findings. | Male; 31 years old. Reason: nephrolithiasis vs. SBO? History: LLQ abdominal pain, radiates to L flank, h/o Crohn's and nephrolithiasis ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormalit... | 1. 6 mm obstructing left mid ureteral calculus causing mild upstream hydroureteronephrosis.2. Questionable presacral space fluid collection versus unopacified bowel loops. Recommend clinical correlation, and further assessment with CT with p.o. contrast can be performed if clinically indicated, discussed with ED at 9 a... |
Generate impression based on findings. | 74-year-old male with history of AML, ILD and new chest radiograph findings. LUNGS AND PLEURA: There is extensive interlobular septal thickening, bronchiectasis, and peripheral honeycombing as well as severe emphysema. There are new subpleural nodules in the lateral aspect of the left upper lobe measuring 1.6 x 1.3 cm,... | 1. Interval increase in diffuse bilateral patchy groundglass opacities and discrete subpleural nodules superimposed on severe emphysema and ILD with wedge shaped consolidation in the right middle lobe and consolidation along the posterior aspect of the right lower lobe. Given the chronology, these findings are favored ... |
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