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Generate impression based on findings. | Clinical question: 46-year-old female with lymphoma status post LP for ITT chemotherapy. Signs and symptoms:anisocoria. Nonenhanced head CT:Detectable intracranial edema, hemorrhage, mass-effect, midline shift or hydrocephalus.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and grade I righ... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Reason: evaluate for PE History: chest pain, shortness of breat PULMONARY ARTERIES: Evaluation for pulmonary embolism is limited secondary to low bolus volume; 40 cc of contrast extravasated into the right antecubital fossa. The patient was evaluated and returned to the emergency room in good condition. No pulmonary em... | No pulmonary embolism. Postsurgical findings reflect prior right upper lobectomy without suspicious pulmonary nodule.Circumferential thickening in the mid segment of a diffusely patulous esophagus. Further evaluation with endoscopy is recommended.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not ... |
Generate impression based on findings. | Clinical question: Status post fall. Signs and symptoms: Status post fall. Nonenhanced head CT:No detectable acute intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkabl... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Is there fracture? Signs and symptoms: MVA yesterday. Restrained driver, pain in neck and lower back. Nonenhanced cervical spine CT:Images through the skull base demonstrate mucosal thickening in the right chamber sphenoid sinus. Menisci fracture.Bilateral mastoid air cells and middle ear cavities re... | No evidence of fracture or malalignment. |
Generate impression based on findings. | Clinical question: Is there hemorrhage. Signs and symptoms: Syncopal episode. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Slight prominence of cortical sulci for age and unremarkable exam otherwise. Unremar... | 1.Nonenhanced head CT.2.No evidence of fracture or malalignment of the cervical spine. |
Generate impression based on findings. | Clinical question: Objective tinnitus, rule-out mass. Signs and symptoms: as above. Nonenhanced head CT:There is no detectable acute intracranial process.The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is within normal for patient stated age of 8 years.Bilate... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Concussion: 53-year-old female with history of severe aortic stenosis, anemia, renal transplant with current Rhizopus infection. Signs and symptoms: Dyspnea, anemia. Nonenhanced head CT: Examination demonstrate prominence of cerebral cortical sulci as well as the cerebellar -- vermian folia patient's stated age of 53. ... | 1.Nonenhanced head CT demonstrate no acute intracranial findings.2.Unremarkable nonenhanced maxillofacial CT. |
Generate impression based on findings. | 64 year old female, history of left nephrectomy now status post complex TEVAR with no urine output. Concern for ischemia. ULTRASOUND KIDNEYSRIGHT KIDNEY: Increased echogenicity of the right kidney measuring 8.8 cm in length. Cyst at the midpole measures 1.0 cm x 0.9 cm x 1.0 cm. No hydronephrosis or shadowing calculi a... | 1. Increased echogenicity of the right kidney suggestive of parenchymal dysfunction. Subcentimeter renal cyst. No hydronephrosis. 2. Patent renal vasculature with no evidence of stenosis. |
Generate impression based on findings. | Clinical question: Assess for intracranial hemorrhage in setting of seizure-like activity this AM. Signs and symptoms: Assess for intracranial hemorrhage in setting of seizure-like activity this AM. Nonenhanced head CT:There is no detectable acute intracranial hemorrhage, edema, mass-effect, midline shift or hydrocepha... | 1.No acute intracranial process. CT is insensitive for detection of acute nonhemorrhagic ischemic strokes.2.Grossly stable extensive findings suggestive of age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Male, 6 months old. Evaluate for occult fractures History: 6 m/o male with unexplained bruisingEXAMINATION: 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 ob... | Normal examination. |
Generate impression based on findings. | 14-year-old male with gunshot wound to left ankleVIEWS: Left ankle AP, oblique and lateral; left foot: Lateral, oblique, AP (3 views) 3/16/15 Skin markers are placed at the lateral malleolus and over the lateral aspect of the plantar surface of the foot representing entrance and exit wounds of bullet. Comminuted fractu... | Distal fibular fracture secondary to gunshot wound with very small residual bullet fragments along the bullet tract. |
Generate impression based on findings. | Reason: h/o TxN2a head and neck ca, s/p CRT, eval response, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Lingular mucoid impaction with atelectasis (5/24). Mixed solid and ground glass nodule medial left lower lobe (4/185) measuring 2.3 x 1.9 cm. This is suspicious for a primary adenocarc... | Predominantly solid nodule medial left lower lobe measuring 2.3 x 1.9 cm suspicious for a primary adenocarcinoma. Additional satellite nodules within the left lower lobe suspicious for small metastases. Nonspecific, multifocal ground glass bilaterally.Mucoid impaction within distal bronchioles of the lingula.No mediast... |
Generate impression based on findings. | Male, 10 years old. Evaluate for pneumonia. History: cough, feverVIEWS: Chest PA/lateral (two views) 3/16/2015, 1914 Cardiac silhouette size is normal.Redemonstration of a curvilinear opacity at the medial right lung base. Mediastinum is shifted to the right. Right lung is small. Multiple dilated vessels in the expecte... | Scimitar syndrome. No evidence of pneumonia. |
Generate impression based on findings. | 12-year-old female with shoulder pain status post traumaVIEWS: Left shoulder: Internal and external rotation (two views) 3/16/15 No fracture or malalignment. The humeral head is normally positioned with the glenoid. No significant soft tissue swelling is noted. | No fracture or malalignment. |
Generate impression based on findings. | Cellulitis and foot, tender shin. Question of free air. Two views of the left tibia/fibula reveal no foci of gas within the subcutaneous tissues. No acute fracture or malalignment is evident. Extensive vascular calcifications are noted.Three views of the left foot show increased loss of soft tissue at the tip of the gr... | Probable osteomyelitis of the great toe tuft. |
Generate impression based on findings. | 49 years, Female. Reason: dobbhoff placement History: dysphagia Limited study, pelvis excluded from field of view. There is a Dobbhoff tube with its tip projecting over the proximal body of the stomach. There are diffuse interstitial and airspace opacities compatible with edema and infection as seen on the prior chest ... | Dobbhoff tube with its tip projecting over the proximal body of the stomach. |
Generate impression based on findings. | 35-year-old male. Extensive ulcers on sacrum. Evaluate for osteomyelitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, U... | Large sacral decubitus ulcer extending nearly to the bone with subcutaneous emphysema tracking along the right lower sacrum. Sclerosis and irregularity of the sacrum, likely reflects chronic osteomyelitis. Asymmetric increased sclerosis of the left superior pubic ramus is nonspecific, may be post-operative or reflect c... |
Generate impression based on findings. | Male, 6 years old. Asthma attack, wheezing, resp distressVIEW: Chest AP (one view) 3/16/2015, 1956 The cardiothymic silhouette is normal.Mild peribronchial thickening. Streaky right lower lobe opacities, compatible with subsegmental atelectasis. No pleural effusions or pneumothorax. | Reactive airway disease/bronchiolitis pattern, with no evidence of pneumonia. |
Generate impression based on findings. | Crohn's disease and long-term Remicade infusions. Persistent abdominal pain. Is terminal ileum narrowed?EXAMINATION: MR enterography without and with IV contrast 03/16/15 ABDOMEN:LIVER, BILIARY TRACT: Normal in appearance. No biliary ductal dilation is present. The gallbladder is normal in appearance.SPLEEN: Normal in ... | Normal examination. |
Generate impression based on findings. | Male, 4 years old. Evaluate for fracture. Foot pain. Dropped concrete slab on foot.VIEWS: Right foot AP, lateral, oblique (3 views) 3/16/2015, 1957 Minimally displaced transverse fractures through the first and second metatarsal diaphyses.Mild soft tissue swelling of the forefoot.No additional fracture or dislocation i... | Minimally displaced transverse fractures through the first and second metatarsal diaphyses. |
Generate impression based on findings. | Hit something with right hand today. Pain and swelling to right hand. Three views of the right hand show a middiaphyseal transverse fracture of the fourth metacarpal with slight radial and volar angulation of the distal fracture fragment. No additional fracture is identified. There is soft tissue swelling about the dor... | Transverse fracture of the fourth metacarpal. |
Generate impression based on findings. | 51-year-old female with possible diagnosis of lymphangiomyomatosis LUNGS AND PLEURA: Rapid accumulation of bilateral moderate sized pleural effusions with adjacent compressive atelectasis. Mild intralobular septal thickening. Numerous thin-walled cysts, variable in size, measuring up to 2.2 cm in diameter. Patchy perip... | 1.Amorphous mixed fat and soft tissue density lesion expanding the left renal space compatible with ruptured angiomyolipoma. Additional high density fluid with surrounding mesenteric fat stranding is noted throughout the abdomen compatible with more acute hemorrhage that that seen on prior exam.2.Patchy peripheral grou... |
Generate impression based on findings. | Male 42 years old; Reason: rule out stone History: Abd pain, hematuria Streak artifact from spinal fixation device as well as motion artifact limits evaluation. The absence of intravenous and oral contrast also limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations ... | Very limited study due to motion artifact, streak artifact and absence of intravenous and enteric contrast. Within these limitations there is no evidence of stone within the transplant kidney. Right inguinal hernia containing non obstructed bowel loops and trace fluid. No specific cause for patient's abdominal pain or ... |
Generate impression based on findings. | 10-year-old male with fever and productive cough, history of asthma.VIEWS: Chest PA/lateral (two views) 3/16/15 The cardiothymic silhouette is normal. No focal lung opacities. No pleural effusion or pneumothorax. Mild bronchial wall thickening and hyperinflation of the lungs is consistent with bronchiolitis/reactive ai... | Mild bronchiolitis/reactive airway disease. |
Generate impression based on findings. | There is trace hyperdensity within left greater than right occipital sulci, consistent with acute subarachnoid hemorrhage. No evidence of mass effect or hydrocephalus. Gray-white matter differentiation is preserved. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are intact. The osseous... | Occipital subarachnoid hemorrhage, left greater than right, without mass effect or hydrocephalus.Findings discussed with Dr. Kiraly by Dr. Stephanie Jo by telephone on 3/17/2015 at 9:55AM. |
Generate impression based on findings. | Pain swelling status post hit 2 to 3 weeks ago. Question of fracture or foreign body. Three views of the right hand reveal no acute fracture or malalignment. Tiny ossified fragments adjacent to the first metacarpophalangeal joint are likely chronic in etiology. No radiopaque foreign body is identified. Mild osteoarthri... | No acute fracture or radiopaque foreign body is evident. |
Generate impression based on findings. | 15 year-old female with syncope and shortness of breathVIEWS: Chest AP/lateral; cervical spine: AP and lateral (4 views) 3/17/15 Cervical spine: The vertebral heights and disk spaces are maintained. No fracture or subluxation of the cervical spine. No prevertebral soft tissue swelling. Straightening of the cervical lor... | No fracture or subluxation of cervical spine. No acute cardiopulmonary abnormality. |
Generate impression based on findings. | 46 year old female status post right mastectomy in 2008 for mucinous IDC with extensive DCIS, presents today for routine follow up. Patient received chemotherapy and hormonal therapy. History of benign left breast biopsy. No current breast complaints. No family history of breast cancer. Two standard and implant displac... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Multiple medical problems with right hand swelling/pain. Three views of the right hand reveal no acute fracture or malalignment. The bones are diffusely demineralized. | No acute fracture is evident. |
Generate impression based on findings. | Clinical question: 44-year-old female with history of ALL; pre-allo SCT evaluation. Signs and symptoms: As above. Unenhanced maxillofacial CT:There are small foci of soft tissue thickening in bilateral inferior aspects of maxillary sinuses consistent the minimal chronic sinus disease and tiny retention cysts. There is ... | 1.No detectable acute sinusitis.2.Minimal mucosal thickening in the dependent bilateral maxillary sinuses with slight interval worsening since prior study.3.Unremarkable paranasal sinuses otherwise.4.Nasal septum deviation to the left as detailed.5.Incidental note is made of a prominent periapical lucency of the right ... |
Generate impression based on findings. | Female, 17 years old. Swelling. Evaluate for fracture.VIEWS: Right hand, PA, lateral, oblique (3 views) 3/16/2015, 2008 Curvilinear lucency at the base of the second metacarpal raises the question of a nondisplaced fracture.Mild local soft tissue swelling. No significant joint effusion.No additional fractures or disloc... | Questionable nondisplaced fracture at the base of the second metacarpal. Correlation with point tenderness is recommended. Follow-up radiographs in 7 to 10 days may be helpful if clinically indicated. No additional fracture or dislocation. |
Generate impression based on findings. | The spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. The distal spinal cord and conus are within normal limits with the conus terminating at the mid L1 level.There is no s... | Minimal scattered dorsally projecting synovial cysts of the lower thoracic and lumbar spine, most prominent at the L5-S1 level on the right with associated facet degeneration. Otherwise, unremarkable noncontrast MRI of the entire spine. |
Generate impression based on findings. | Pain status post fall, left anterior chest wall bruise. Question of fracture. Metallic BBs denote the site of the patient's pain. No acute rib fracture is identified. | No acute rib fracture is identified. |
Generate impression based on findings. | Male 21 days old Reason: Is central line in correct placement? History: 34 weeker requiring central accessVIEW: Chest and abdomen AP (two views) 3/16/15 at 1809 hrs ET tube tip is below the thoracic inlet. Proximal side-port of NG tube is above GE junction. Left upper extremity venous access terminates at the axillary ... | Misplaced NG tube, removal of urinary bladder catheter time PCVC placement.Persistent right-sided hydropneumothorax.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | 16-month-old female with fever and coughVIEW: Chest AP (one view) 3/17/15 Aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Mild bronchial wall thickening is consistent with bronchiolitis/reactive airway disease. Streaky opacity in the right middle lobe may represent atelecta... | Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | Female, 17 years old. Pain, evaluate for fracture.VIEWS: Right shoulder, AP (internal, external) (two views) 3/16/2015, 2006 The osseous structures and joint spaces are normal.The humeral head is normally positioned with respect to the glenoid fossa.No significant joint effusion or soft tissue swelling. | No acute fracture or dislocation. |
Generate impression based on findings. | Male, 5 years old. Reason: Rule out alveolar ridge fracture. Frontal upper gum tenderness s/p fallVIEWS: Mandible, Panorex (one views) 3/16/2015, 2019 The visualized osseous structures and the temporomandibular joints are normal. | No acute fracture or dislocation. |
Generate impression based on findings. | Male 34 years old; Reason: hx renal tx on prograf, ESRD on HD History: RUQ/RLQ abd pain, vomiting, hematuria ABDOMEN:LUNG BASES: Mosaic attenuation pattern within the lung bases which may relate to phase of respiration. Severe pericardial and cardiac valve calcification. Punctate calcification in the left lung consiste... | 1.Abnormal appearance to the transplant kidney on this limited noncontrast exam. This would be better evaluated with dedicated transplant kidney ultrasound as indicated.2.Severe pericardial and cardiac valve calcification. |
Generate impression based on findings. | 70 year old female status post left lumpectomy in 2001 for IDC, presents today for routine follow up. Patient received radiation therapy. No current breast complaints. No family history of breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast pa... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Shoulder pain with popping and instability. Evaluate for bony pathology. There is slight inferior translation of the humeral head with respect to the glenoid on the Grashey view, but the clinical significance of this is uncertain. I see no fracture or frank dislocation. The acromioclavicular joint appears normal. | Slight inferior translation of the humeral head relative to glenoid seen on the Grashey view is of uncertain significance. I see no fracture or frank dislocation. If further imaging evaluation is clinically warranted, MR arthrography may be considered. |
Generate impression based on findings. | Male 11 years old Reason: position of IJ History: s/p nephrectomy and kidney auto transplantVIEW: Chest AP (one view) 3/16/15 at 1904 hrs. Right IJ central line terminates at the RA/SVC junction. Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. No focal lung opacitie... | Normal examination. |
Generate impression based on findings. | 76-year-old female. Known aortic aneurysm repair. Drop in hemoglobin, tachycardia. Bleeding?. ABDOMEN:LUNG BASES: Bibasilar dependent atelectasis. Calcified granulomas in the lung bases.LIVER, BILIARY TRACT: 9 mm arterially enhancing lesion (series 10, image 48), too small to characterize, may be a flash-filling hemang... | Stable type B dissection of the aorta without evidence of rupture. |
Generate impression based on findings. | 51 year-old female with dysphagia, evaluate for extrinsic compression of the esophagus The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are patent and unremarkable. The epiglottis, vallecula, piriform sinuses, and vocal cords appear normal. Small left tonsillar calcification. The parotid and... | 1. No evidence of extrinsic compression of the esophagus or other specific findings to account for the patient's dysphagia.2. Nonspecific small thyroid nodules for which further evaluation with ultrasound may be considered if clinically warranted. |
Generate impression based on findings. | 51 years, Female. Reason: abdominal distension, assess for ileus, obstruction History: abdominal distension, assess for ileus, obstruction Nonobstructive bowel gas pattern with a paucity of bowel gas and gas in the right hemicolon and stomach. There is a nasogastric tube with its tip projecting over the fundus of the s... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Wrist pain and swelling The bones are slightly demineralized. There is volar rotatory subluxation of the scaphoid. Mild degenerative arthritic changes affect the wrist. I see no fracture. | Volar rotatory subluxation of the scaphoid and mild degenerative arthritic changes. |
Generate impression based on findings. | Female 43 years old evaluate for unexpected radiopaque foreign object. Towel clips project over the right upper and left lower quadrants as well as over the left hip, and were confirmed by O.R. housestaff. No unexpected radiopaque foreign object is identified. Nonobstructive bowel gas pattern. | No unexpected radiopaque foreign object.These findings were discussed by telephone with Dr. Marie-Teresa C. Colbert, the surgeon, on 03/16/2015 at 19:00. |
Generate impression based on findings. | Pain in the right knee. Rule-out DJD. Four views of the right knee are provided. Severe osteoarthritis affects the knee, particularly the lateral compartment where there is near bone on bone apposition. The degree of osteoarthritis has perhaps progressed slightly when compared with the prior study. A bony excrescence p... | Osteoarthritis and other findings as above. |
Generate impression based on findings. | Female 4 days old Reason: eval lung fields History: term, perinatal depression, seizures. Abdominal distention.VIEW: Chest and abdomen AP (two views) 3/17/15 at 335 hours. Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. No focal lung opacities. No effusions or pneum... | Normal examination. |
Generate impression based on findings. | Male, 81 years old, newly diagnosed high risk prostate cancer with increased activity in the left maxillary/ethmoid sinus region and left calvarium on bone scan. A prominent vascular channel is evident traversing the left parietal bone, which may at least in part correlate with the focus of increased uptake seen within... | 1.Focus of increased radiotracer uptake within the left calvarium on bone scan may correlate to a vascular channel which seems to traverse this region. No definite or typical appearing calvarial metastatic lesions are seen.2.The field of view this examination is not adequate to assess the area of increased radiotracer ... |
Generate impression based on findings. | 64 years, Female. Reason: OG adjusted History: OG Pelvis is not included in the field of view and motion artifacts limits evaluation. There is an enteric tube with its tip projecting over the distal body of the stomach. Please refer to concomitant chest radiograph for further thoracic findings. | Enteric tube with its tip projecting over the distal body of the stomach. |
Generate impression based on findings. | Male 10 months old Reason: eval lung fields History: former 21 weeks with BPDVIEW: Chest AP (one view) 3/17/15 158 hours. NG and tracheostomy tubes again noted. Persistent soft tissue edema.Cardiac silhouette size is enlarged. Bibasilar opacities, likely atelectasis unchanged. Note is made that there is incomplete visu... | Within the limitations described above, persistent bibasilar atelectasis. |
Generate impression based on findings. | Female 40 years old; Reason: METASTATIC COLON CANCER ON CHEMOTHERAPY EVALUATE FOR INTERVAL CHANGE History: COLON CANCER CHEST:LUNGS AND PLEURA: 1.4 x 1.3 cm spiculated mass previously measured 2.2 x 2.0 cm in the right lower lobe (3:45). Previously seen 4 cm mass in the right upper lobe has significantly decreased in s... | 1. Significant interval decrease in size of pulmonary masses as above. 2. Redemonstrated right colonic mass, with apparent decrease in circumferential thickening. Associated decrease in size of local regional lymphadenopathy.3. Enlarged bulky uterus and cervix, likely secondary to fibroids, with likely related increase... |
Generate impression based on findings. | Male 48 years old; Reason: hepatobiliary pathology History: p/w chest pain, elevated WBC and Alk Phos; currently with cholecystostomy tube for acute cholecystitis ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Interval insertion of a cholecystotomy tube which appears coiled within the fundus... | 1.Decompression of the gallbladder secondary to cholecystotomy tube insertion. Persistent pericholecystic inflammatory changes without loculated fluid collection or abscess. |
Generate impression based on findings. | 66-year-old female. Pain, distention. Evaluate for an anastomotic leak. ABDOMEN:LUNG BASES: Small bilateral pleural effusions with adjacent atelectasis.LIVER, BILIARY TRACT: Left hepatic lobe lesion measures 2.3 x 2.8 cm, unchanged (series 3, image 44), previously biopsied to be a hemangioma.SPLEEN: No significant abno... | 1. Nonspecific presacral fluid collection may be post-operative although an anastomotic leak cannot be excluded. If high clinical suspicion for leak, correlation with a fluoroscopic study would be helpful.2. Findings suggestive of a small bowel obstruction.3. Small bilateral pleural effusions. |
Generate impression based on findings. | Reason: eval for sinusitis in pt with neutropenia History: neutropenic fever, L ear fullness; AML on the ABT-199/decitabine trial There is mucosal thickening of the left maxillary sinus and one of the left Haller cells, stable from prior study. Right Haller cell is clear. Ostiomeatial units are patent. Frontal, ethmoid... | 1.Bilateral TMJ degenerative changes, with lateral subluxation of the left TMJ. 2.Stable mucosal thickening of the left maxillary sinus and one of the left Haller cells. |
Generate impression based on findings. | Male 12 days old Reason: Is there increased infiltrates History: worsening vent settings /Pulm hemorrhageVIEW: Chest and abdomen AP (two views) 3/17/15 at 314 hours. Right mainstem bronchus intubation. Central line terminates at the SVC. UAC tip is at T10. Misplaced NG tube unchanged. Increasing soft tissue edema.Compl... | Misplaced NG and ET tubes.Complete atelectasis of the left lung and diffuse lung haziness with pattern of PIE of the right lung.Persistent complete paucity of abdomen chest. |
Generate impression based on findings. | 59 years, Male. Reason: pre op for peg History: constipation Nonobstructive bowel gas pattern. Moderate stool burden in right and transverse colon. High-density contrast material noted within the rectum from recent swallow study. Pelvic calcifications which appear to be within the vas deferens based on morphology. | Nonobstructive bowel gas pattern. Moderate stool burden in right and transverse colon. |
Generate impression based on findings. | 45-year-old female with numbness/tingling along ulnar aspect of arm/hand. Right shoulder pain. Rule-out C-spine DJD, pinched nerve. Evaluation of the cervicothoracic junction is slightly limited overlying anatomy. There are anterior vertebral body osteophytes at C4/5, but the intervertebral disk spaces are preserved. V... | Small anterior vertebral body osteophytes at C4/5 with no specific findings to account for the patient's symptoms. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 79 years, Male. Reason: 79 yo M with h/o CHF, now with elevated LFT's, AMS, s/p Dobbhoff placement History: AMS Pelvis excluded from field of view. Dobbhoff tip in antropyloric region. Nonobstructive bowel gas pattern. Vascular calcifications. Unchanged mediastinal surgical clips. Cardiomegaly and left basilar opacity,... | Dobbhoff tip in antropyloric region. |
Generate impression based on findings. | 64 years, Female. Reason: ETT and OG placement History: just was intubated Pelvis is not included in the field of view. There is an enteric tube with its tip projecting over the distal body of the stomach. Partially imaged pacemaker lead is unchanged in position. Please refer to concomitant chest x-ray for further thor... | Enteric tube with its tip projecting over the distal body of the stomach. |
Generate impression based on findings. | 12-year-old male with history of fractureVIEWS: Left elbow AP, lateral (two views) 3/17/15 Overlying cast material obscures fine bone detail. Healing fracture fragments are in unchanged position. The fractured medial epicondyle remains displaced medially. A fracture fragment adjacent to the lateral aspect of the humera... | Healing fracture fragments in unchanged position. |
Generate impression based on findings. | Pain. Has fracture remains nondisplaced? There is callus formation along the proximal diaphysis of the second metatarsal surrounding what appears to be a nondisplaced transverse fracture, the margins of which are indistinct. There is spur formation along the dorsolateral aspect of the first cuneiform, and there appears... | Healing fracture of the second metatarsal and other findings as above. |
Generate impression based on findings. | Exam is somewhat limited to to lack of contrast and suboptimal larger field of view.The left cervical plexus and brachial plexus are visualized. Slight asymmetric irregular and possible incompletely linear course of the mid left C5 and C6 nerve roots is questioned with slightly thickened and ill-defined appearance of ... | Questioned subtle abnormalities involving mid left C5 and C6 nerve roots which may suggest mild inflammatory changes/neuritis. No compressive mass or fluid collection. Follow-up imaging may be obtained as clinically indicated. |
Generate impression based on findings. | Female 34 years old; Reason: Metastatic breast cancer with acute jaundice and hyperbilirubinemia. Evaluate for progression of hepatic disease/hepatic obstruction. History: jaundice, hyperbilirubinemia CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules.The largest in the right lower node measures 6 mm. This is not... | 1.Extensive hepatic metastatic disease appearing similar/minimally increased compared to prior study.2.New right middle lobe lung nodule warrants close attention on follow-up imaging.3.Diffuse osseous metastatic disease is unchanged.4.New perihepatic fluid and increased pelvic free fluid. |
Generate impression based on findings. | Reason: 64 yo M with HCV/Etoh cirrhosis c/b newly diagnosed HCC, eval for mets History: newly diagnosed hepatocellular carcinoma. LUNGS AND PLEURA: No suspicious nodules. Patchy areas of mild groundglass opacities in the upper lobes. Bronchial wall thickening. Trace left pleural effusion. Minimal scarring/atelectasis a... | 1.No evidence of metastases.2.Minimal left pleural effusion.3.Nonspecific mild upper lobe ground glass opacities may represent early mild smoking-related interstitial lung disease, drug reaction, or hypersensitivity pneumonitis. The appearance is not typical of infection. |
Generate impression based on findings. | Male 44 days old Reason: Is there evidence of atelectasis History: tachypneaVIEWS: Chest AP/lateral (two views) 3/17/15 at 330 hours NG tube terminates at the stomach. Cardiac silhouette size is enlarged but stable. No change in right lung base atelectasis/mass. Bowel loops appears to be getting into the chest cavity a... | No change in right lung base atelectasis/mass.Anterior bowel loops at the level of the chest, location of the diaphragm above or below within cannot be ascertained. |
Generate impression based on findings. | Chronic bilateral lower extremity pain from knees to ankles. No history of trauma. Evaluate for bony pathology. Four views of the right knee and two views of the right tibia/fibula are provided. The knee appears normal, with no specific findings to account for the patient's pain. The tibia and fibula likewise appear no... | No specific findings to account for the patient's pain. Other findings as described above. |
Generate impression based on findings. | 43 years, Male. Reason: eval for post-op ileus History: abd pain, bloating Nonobstructive bowel gas pattern. Right upper quadrant surgical clips. Foley catheter in bladder. Multiple chest tubes and mediastinal drains and left lower lobe opacity, please see same day chest radiograph report for further details. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Stable postsurgical changes of right neck dissection, flap reconstruction, and radiation. There is stable loss of fat plane in the right masticator and buccal spaces. There is also persistent effacement of fat in the right mandibular foramen. Stable lucent lesion within the left mandibular angle. Unchanged erosive cha... | 1.No evidence of locoregional recurrence.2.Focal area of enhancement overlying the right mandible, stable from December 2013. Favor post treatment changes of parotid gland; attention on subsequent imaging.3.Progression of chronic sinus disease.4.Moderate-severe central canal stenosis at C5/6 level. Correlate with sympt... |
Generate impression based on findings. | Female, 56 years old, history oral tongue cancer, follow-up exam. Redemonstrated is evidence of bilateral neck dissection and partial midline mandibulectomy with bone graft reconstruction. The bone graft seems well incorporated on the left and at least partially incorporated on the right. The residual native right mand... | 1.Redemonstration of postoperative changes in the neck with no definite findings to suggest recurrent disease.2.The residual native right hemimandible shows a more prominent permeative appearance than on the prior examination. Findings could reflect an inflammatory process or the long-term effects of radiation.3.No pat... |
Generate impression based on findings. | Ankle pain, inferior/posterior to the lateral malleolus. Question of fracture. Three views of the left ankle reveal no acute fracture or malalignment. No ankle joint effusion is seen. Vascular calcifications are noted. | No acute fracture is evident. |
Generate impression based on findings. | Pain, AMS. Fracture after fall? Three views of the left shoulder are provided. The bones appear demineralized, but I see no fracture. Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. Note is made of carotid calcifications.Three views of the ribs are provided. The bones appear demineralized. Mi... | Degenerative arthritic changes and other findings as above. I see no acute fracture. |
Generate impression based on findings. | Male, 5 days old. Previous 32 weeks gestational age patient. Evaluate UVC positionVIEW: Chest and abdomen AP (two views) 3/16/20 15, 1922 Umbilical venous catheter tip at the level of a hepatic vein.Nasogastric tube with distal side port below the level of the GE junction.Cardiothymic silhouette is normal.Hazy bilatera... | Umbilical venous catheter tip is at the hepatic vein level. |
Generate impression based on findings. | Female, 87 years old.Complex EVAR/TEVAR. Surgical skin staples project over the right hip. No unexpected radiopaque foreign bodies are identified. | No unexpected radiopaque foreign body is identified within the pelvis.These findings were relayed to Dr. Steppacher, the attending surgeon, via telephone at 2315 hrs on 3/16/2015 by the resident on call. |
Generate impression based on findings. | Male; 62 years old. Reason: G tube in place? History: OSH with G tube in place Nonobstructive bowel gas pattern. Left nephroureteral stent in place. G-tube balloon within the gastric body. | G-tube balloon within the gastric body. |
Generate impression based on findings. | Reason: Restaging T3 oral cavity cancer History: none CHEST:LUNGS AND PLEURA: No pleural effusion or pneumothorax. Reference 7-mm nodule adjacent to the left major fissure (series 4, image 203) is unchanged in size. Scattered punctate calcified micronodules. No suspicious nodules or masses.MEDIASTINUM AND HILA: No sign... | 1.Unchanged 7-mm index nodule in the left lower lobe.2.Scattered subcentimeter lytic lesions throughout the skeletal system are nonspecific and not significantly changed since the prior exam. |
Generate impression based on findings. | 71-year-old female. Buttock hematoma. Tense area with erythema on right buttock. History of breast cancer. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No signif... | 1. 6.3 x 4.2 cm right medial buttock hematoma.2. Cervical mass consistent with known primary squamous cell carcinoma, decreased in size. Interval resolution of retroperitoneal and pelvic lymphadenopathy.3. Interval placement of left nephroureteral stent with resolution of hydronephrosis. |
Generate impression based on findings. | History of diabetes, wound to right second toe. History of amputation of the great toe on the right. Purulent drainage, swelling. Three views of the right foot reveal interval amputation of the first digit at the metatarsophalangeal joint. There is cortical destruction along the head of the first metatarsal laterally w... | Findings compatible with osteomyelitis of the first metatarsal head and second digit middle and distal phalanx. |
Generate impression based on findings. | Male 12 years old Reason: Interval change History: ETT, intubated, respiratory distress.VIEW: Chest AP (one view) 3/17/15 at 522 hours. Right upper extremity venous access terminates likely at the long thoracic vein. Cholecystectomy clips again noted. ET tube terminates below thoracic inlet. Thoracolumbar dextrorotosco... | No change in left lung opacities. |
Generate impression based on findings. | 22 years, Female. Reason: Evaluate for obstruction History: New NBNB vomiting without diarrhea Nonobstructive bowel gas pattern. No free air on upright view. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 14 years old Reason: post-op, status post fracture.VIEWS: Right knee AP and lateral 3/17/15 (two views) Trans-metaphyseal screws of the distal right femur are again noted. Interval increasing in periosteal reaction and callus formation on the medial aspect of the distal metaphyses and over the tip of the most su... | Healing fracture, in anatomic alignment with no evidence of hardware complications. |
Generate impression based on findings. | Status post fractureVIEWS: Right tibia-fibula AP and lateral 3/17/15 (two views) Healing distal fracture of the right tibia is in anatomic alignment. Fracture line is still visualized on lateral view. | Healing fracture , in anatomic alignment. |
Generate impression based on findings. | Drop in hemoglobin. Large thigh mass. Evaluate hematoma CT examination was performed of the pelvis with coronal and sagittal reconstructions. The visualized osseous structures are unremarkable. A large medial thigh mass is partially visualized.CT examination of the right thigh reveals a large medial mass that measures ... | Large right medial thigh mass consistent with a hematoma |
Generate impression based on findings. | Follow-up Again seen is an oblique fracture of the distal fibula with fracture fragments in near-anatomic alignment, and there is soft tissue swelling along the lateral aspect of ankle. This appears similar to the prior study accounting for slight positional differences. Chronic enthesopathic changes at the Achilles in... | Distal fibular fracture appearing similar to the prior study. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Circular skin marker was placed over the left u... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Patient hit wall with hand. Swelling, deformity. Question of fracture. Three views of the right hand and two views of the right wrist show oblique, comminuted fractures through the base of the fourth and fifth metacarpals. The fracture fragments are in near-anatomic alignment. There is soft tissue swelling about the do... | Comminuted fractures of the base of the fourth and fifth metacarpals. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reductions. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and dis... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Neck pain, previous fusion. Back pain. Two views of the cervical spine are provided. The patient has undergone multilevel laminectomy. The patient has also undergone anterior fusion at C6/7. The C6 screw is fractured. There is intervertebral device spacer device at C6/7. Amorphous density within the intervertebral disk... | Postoperative changes and severe degenerative disk disease as described above. |
Generate impression based on findings. | Female; 45 years old. Reason: Recent sx History: L flank pain ABDOMEN:LUNG BASES: Amplatzer device in the interatrial septum.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, UR... | Interval postoperative changes of left nephrectomy. Left retroperitoneal at least partially loculated nonspecific fluid collection may be due to an evolving hematoma or early abscess in the appropriate clinical context. Small amount of hemorrhage in the pelvis, likely postoperative in etiology. Remnant distal left uret... |
Generate impression based on findings. | Reason: rule out posterior circulation deficit History: dizziness Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no si... | 1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease.3.No evidence for acute internal hemorrhage mass effect or edema4.Posterior fossa arachnoid cyst vs. mega cisterna magna vs. less likely Dandy-Walker spectrum lesion, almost certainly congenital and incidental. It is unchanged from the prior... |
Generate impression based on findings. | Reason: evaluate for bleed expansion or hydrocephalus History: worsening mental status, unable to follow commands There is a 12-mm hematoma present in the right midbrain associated with intraventricular blood involving the third ventricle and to a lesser degree lateral ventricles. The temporal horns of the lateral vent... | 1.Right midbrain hematoma associated with intraventricular blood.2.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 3.Hypodensity in the right basal ganglia likely represents lacunar infarct - age indeterminant. |
Generate impression based on findings. | Reason: ICH - r/o vascular cause History: as above Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries.There is a 6x5 mm aneurysm along the lateral division of the right superior cerebellar artery appro... | 1.There are two right superior cerebellar artery aneurysms present associate with a suspected quadrigeminal plate cistern arteriovenous malformation. The aneurysm that is adjacent to the midbrain hematoma may be partially thrombosed and is thus suspected to have been the one that ruptured. Alternatively the hematoma ma... |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Severe centrilobular and paraseptal emphysema. Apical fibrosis and pleural thickening likely related to radiation changes. Scattered nonspecific calcified and noncalcified micronodules. No suspicious nodules or masses.Interv... | 1.No evidence of metastatic disease. 2.Interval aeration of previously seen fluid filled left apical bulla suspicious for persistent/active infection.3.Unchanged gallbladder distention, cystic duct stones, and mild intrahepatic biliary ductal dilatation. |
Generate impression based on findings. | 50 year-old female. Upper abdominal pain, elevated amylase and lipase. Ovarian cancer status post 9 cycles of MEK-162. Compare to 1/14/15 scan. CHEST:LUNGS AND PLEURA: Scattered stable micronodules, likely postinflammatory.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardi... | 1. New peritoneal deposit on the gastric antrum and additional suspicious peritoneal lesions adjacent to the pancreatic tail and studding the left anterior renal fascia. This may account for elevated pancreatic enzymes in given history - although an underlying component of pancreatitis cannot be entirely excluded, but ... |
Generate impression based on findings. | Anterior left knee pain after fall. Four views of the left knee reveal soft tissue swelling anterior to the patella. No acute fracture or malalignment is evident. No joint effusion is identified. | Soft tissue swelling without acute fracture evident. |
Generate impression based on findings. | Fall on left patella. Question of fracture. Five views of the left knee reveal no acute fracture or malalignment. There is mild osteophyte formation in the medial and patellofemoral compartments. Enthesopathic changes are noted at the quadriceps insertion. A small joint effusion is seen. | No acute fracture is evident. |
Generate impression based on findings. | Refractory acute leukemia. Complaining of dental pain. Question of source of neutropenic fever. Panorex radiographic mandible reveals poor dentition with loss of multiple teeth. There is no gross bone destruction to suggest osteomyelitis. No significant interval change. | Poor dentition appearing similar to the prior study. |
Generate impression based on findings. | Pain. Hammertoes. The bones appear slightly demineralized. There is a moderate hallux valgus deformity and moderate osteoarthritic changes at the first metatarsophalangeal joint. There appears to be a hammertoe deformity of second toe. Relatively mild osteoarthritic changes affect the midfoot and ankle. | Hallux valgus deformity and other findings as above. |
Generate impression based on findings. | 7-year-old female with history of wheezing.VIEW: Chest AP (one view) 3/16/15 Cardiothymic silhouette is normal. Right middle lobe opacity and streaky left lower lobe opacity may represent infection or atelectasis. No pleural effusion or pneumothorax. | Right middle lobe and streaky left lower lobe opacity may represent atelectasis or infection. |
Generate impression based on findings. | Increasing back pain, history of subacute compression fracture of L1 and status post kyphoplasty. Evaluate for changes. Five views of the lumbar spine show postsurgical changes of a kyphoplasty at L1. The remaining vertebral body heights are preserved. There is mild degenerative disk disease at L5/S1 with mild anterior... | Postsurgical changes at L1 without significant interval change. |
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