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Generate impression based on findings. | Question of left wrist fracture and left Mallet finger of small finger. Three views of the left wrist show a transverse fracture through the ulnar styloid. There is soft tissue swelling about the ulnar aspect of the wrist.Three views of the left fifth finger show a tiny osseous fragment along the proximal and dorsal as... | 1. Ulnar styloid fracture.2. Avulsion fracture of the base of the fifth digit distal phalanx. |
Generate impression based on findings. | Female 58 years old Reason: evaluate for abscess, fluid collection to assess for drainage History: History of renal cell carcinoma, and pelvic abscess ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Small amount of pneumobilia is unchanged. Peripancreatic ascites, similar to prior exam. Portal... | 1.No pelvic fluid collection, unchanged in size.2.Air fluid collection in the left nephrectomy bed, not significantly changed in size. New foci of air extending into left abdominal wall, superior to the left iliac wing, which again raises suspicion for fistulas connection. 3.Persistent ascites. |
Generate impression based on findings. | 61 year old with left breast pain. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. No suspicious... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female, 11 years old. Reason: painful wrist VIEWS: Right wrist, PA, lateral, oblique (3 views) 3/19/2015, 1436 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Hypertension, backache, headache. Five views of the lumbar spine show no acute fracture. The disk spaces and vertebral body heights are maintained. Alignment is anatomic. | No acute fracture is evident. |
Generate impression based on findings. | Pain, boutonnieres deformity on the right third and fifth. Evaluate RA or gouty arthropathy. Three views of the left hand show no acute fracture or malalignment. No erosive changes are seen. A small ossicle adjacent to the third digit PIP joint is most likely related to old trauma.Three views of the right hand show no ... | Probable erosion of the right fifth metacarpal head. |
Generate impression based on findings. | Male 65 years old Reason: history of smoking, age 65 History: screen for AAA The proximal abdominal aorta measures 2.4 x 2.3 x 1.8 cm.The mid abdominal aorta measures 1.7 x 2.1 x 1.9 cm.The distal abdominal aorta measures 1.7 x 2.0 x 1.8 cm.The right iliac artery measures 0.9 x 1.1 x 1.0 cm.The left iliac artery measur... | No evidence of abdominal aortic aneurysm. |
Generate impression based on findings. | Male; 46 years old. Reason: hx of gross hematuria, evaluate with delayed imaging History: see above ABDOMEN:Lack of oral contrast limits sensitivity for bowel pathology.LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No ... | Atrophic kidneys with poor renal enhancement and excretion, compatible with medical renal disease. No evidence of renal cell carcinoma. Limited evaluation of the ureters and bladder on delayed phase images due to poor contrast excretion. These findings do not obviate the need for cystoscopy as clinically indicated. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is minimal mucosal thickening in the left maxillary sinus. The right maxillary sinus is clear. The ostiomeatal units are clear. There is a large right and small l... | Very minimal sinus inflammatory changes. No CT evidence of acute or chronic sinusitis. |
Generate impression based on findings. | Metastatic RCC, right scalp tenderness and mass. There is no evidence of intracranial mass or abnormal enhancement. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells... | No evidence of intracranial metastases or discernible scalp lesions. |
Generate impression based on findings. | Pain and swelling status post injury 4 years ago. Three views of the right ankle show no acute fracture or malalignment. No ankle joint effusion is identified. | No acute fracture is evident. |
Generate impression based on findings. | 52 year old who is called back from screening mammogram for right breast asymmetry. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. Focal asymmetry at upper outer quadrant of right breast disperses into normal glandular tissue with spot co... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Status post fall onto left knee on 3/2/2015. Three views of the left knee show marked medial joint space narrowing and small tricompartmental osteophyte formation. There is possibly a small joint effusion. No acute fracture is evident. | Osteoarthritis. |
Generate impression based on findings. | 32-year-old female with bilateral breast pain, greater on the left. Family history of breast cancer diagnosed in two paternal aunts. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Circular skin... | Left 12 o'clock intraductal lesion and ductal dilatation, for which ultrasound guided biopsy is recommended. The patient also is scheduled for bilateral breast MRI the following day. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Pain. Question of fracture. Three views of the left ankle show no acute fracture or dislocation.Three views of the left foot show no acute fracture or malalignment. | No acute fracture is evident. |
Generate impression based on findings. | Clinical question: Patient is status post subarachnoid hemorrhage at OSH two weeks ago, now presents with worsening headaches. Signs and symptoms:Headache, nausea. Nonenhanced head CT:There is no detectable acute intracranial process. No evidence of subarachnoid hemorrhage. CT however is insensitive for early detection... | Negative nonenhanced head CT. |
Generate impression based on findings. | Male; 71 years old. Reason: High calcium and PTH. No abnormal focus of activity consistent with an enlarged parathyroid gland is seen. There is a small focus of increased activity in the anterior thyroid isthmus, but this would be an atypical location for parathyroid tissue and most likely represents a small thyroid no... | No scintigraphic evidence for parathyroid adenoma. |
Generate impression based on findings. | Staging biopsy proven left lower lobe lung cancer. CT shows multiple lung nodules.RADIOPHARMACEUTICAL: 10.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 110 mg/dL. Today's CT portion grossly demonstrates an approximately 2.5 cm nodule in the medial left lower lobe, not significantly changed from recent di... | 1.Four hypermetabolic nodules in the left lower lobe. The most dominant and metabolically active is seen medially and consistent with the patient's known lung cancer. The additional left lower lobe nodules seen laterally, superiorly, and inferiorly are more mildly FDG avid and could represent additional tumor foci vers... |
Generate impression based on findings. | Male; 65 years old. Reason: r/o aortic injury History: hypotension, abd pain CHEST:LUNGS AND PLEURA: Minimal bibasilar dependent subsegmental atelectasis. Mild subsegmental atelectasis versus scarring is also seen in the right upper lobe. Mild posterior left pleural thickening, though a trace left hemorrhagic effusion ... | Postsurgical changes from thoracic aortic arch graft repair with age-indeterminant pseudoaneurysm at the left posterolateral aspect of the graft. Mild left pleural thickening, but a trace hemorrhagic left pleural effusion cannot be excluded. As a result, acute pseudoaneurysm with recent rupture into the left pleural sp... |
Generate impression based on findings. | 58-year-old male status post C4-7 fusion. Two views of the cervical spine are provided. Postsurgical evidence of posterior fusion and laminectomy including pedicle screws and rod device affixing C4-7, without evidence of hardware complication. Surgical drain and iatrogenic gas reflects postoperative state. | Postsurgical changes of posterior fusion as detailed above. |
Generate impression based on findings. | Knee pain. Four views of the right knee show severe joint space narrowing of the lateral compartment and moderate narrowing of the medial compartment. Osteophyte formation is noted at the lateral and patellofemoral compartments. No acute fracture is evident. There is a large joint effusion. | Severe osteoarthritis. |
Generate impression based on findings. | Reason: Confirm DHT Placement History: AMS Dobhoff tube tip projects over the descending duodenum. Oral contrast noted within the large bowel. Bibasilar atelectasis. Persistent focal retrocardiac opacity. Overlying pacemaker and EKG leads. | DHT placement as above. |
Generate impression based on findings. | Left knee pain. Four views of the left knee show marked medial and lateral compartment joint space narrowing. No acute fracture is evident. No joint effusion is identified. | Marked osteoarthritis. |
Generate impression based on findings. | 58 year old female with h/o HCC please screen for mets. No abnormal osseous foci are identified to indicate metastatic disease. Inferior displacement of the left kidney due to splenomegaly is again noted. Slight abnormally superior position of the right kidney may be secondary to a cirrhotic liver and appears unchanged... | No evidence of bone metastases. |
Generate impression based on findings. | Female 64 years old Reason: breast cancer History: re-stage evaluate disease; compare to previous CT CHEST:LUNGS AND PLEURA: Right lower lobe pulmonary nodule measuring 2.7 x 2.0 cm, new from prior exam, suspicious for lung metastasis versus primary lung neoplasm.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadeno... | 1.Single pulmonary nodule, favor primary lung neoplasm over metastatic breast cancer.2.Destructive osseous lesion in the sternum, highly suspicious for metastatic disease.Findings discussed with Joanna Gibbs name via phone at 4 p.m. on 3/19/15. |
Generate impression based on findings. | Female; 66 years old. Reason: primary hyperparathyroidism, would like to evaluate for abnormal glands. No abnormal focus of activity consistent with an enlarged parathyroid gland is seen. However, there is an approximately 1 to 1.5 cm focus of increased activity corresponding to soft tissue within the left lateral brea... | 1.No scintigraphic evidence for parathyroid adenoma.2.Small focus of abnormal activity in the left lateral breast, which raises the possibility of primary breast cancer. Correlation with mammography, breast ultrasound, and/or MRI can be considered for further evaluation. The above findings were discussed with Dr. Joly ... |
Generate impression based on findings. | Hodgkin's lymphoma, restaging. There is continued decrease in size of right level IIa lymph node, previously measuring 23 x 26 mm, now 16 x 15 mm in the AP and transverse dimensions. There are additional small scattered neck lymph nodes throughout the neck which are similar to prior and not abnormal by CT criteria. The... | Continued decrease in size of the right level 2 lymphadenopathy consistent with treatment response. No new cervical lymphadenopathy. |
Generate impression based on findings. | Postoperative changes are again seen within the neck relating to previous total thyroidectomy and right neck dissection. Additional postoperative changes are now seen including a partially visualized median sternotomy, with nonspecific increased soft tissue density within the right paratracheal fat. In the area of the... | 1. Interval further postoperative changes from mediastinal lymph node resection and left neck dissection. Increased soft tissue density in the right paratracheal mediastinum in area of previous referenced lymph node with somewhat of an oval contour persisting as detailed above. This area of soft tissue measures greater... |
Generate impression based on findings. | Reason: sarcoma of breast, s/p mastectomy. Evaluate for recurrence or metastases History: none. LUNGS AND PLEURA: Multiple bilateral scattered micronodules, not significantly changed in size or number. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Mild c... | No evidence of metastatic disease without significant interval change. |
Generate impression based on findings. | ALTE. History: fever, congestion, cough. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. ... | No evidence of acute intracranial hemorrhage, mass, or cerebral edema. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | 52 year old female with left breast cancer; Left SNBx 3/20/15 at 7am; inject afternoon before. RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.905 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the left axilla... | Sentinel node identified in the left axilla. |
Generate impression based on findings. | Female 65 years old Reason: Adenocarcinoma of the lung please Please provide bi-dimensional measurements per RECIST 1.1 criteria and compare to prior outside exams. History: Lung cancer ABDOMEN:LUNG BASES: Large right pneumothorax is partially visualized. Please refer to CT chest performed on the same day.LIVER, BILIAR... | 1.No evidence of metastatic disease in the abdomen or pelvis.2.Large right pneumothorax.3.Cystic pancreatic lesion, likely represents sidebranch IPMN, stable dating back to 11/2014.Findings discussed with Dr. Villaflor via phone at 3:38 p.m. on 3/19/15. |
Generate impression based on findings. | Male, 14 days old. Reason: ex-preemie 2wks old with NEC and RDS History: desats, increased FiO2VIEW: Chest and abdomen AP (two views) 3/19/2015, 1507 ET tube tip below the thoracic inlet and above the carina. Enteric tube with distal side port below the GE junction. Left arm PICC, tip in the SVC. Left lower quadrant dr... | Persistent complications of surfactant deficiency. No bowel gas identified. Diffuse soft tissue edema. |
Generate impression based on findings. | 69 year-old female with left knee pain. Four views of the left knee demonstrate a small joint effusion, which has improved since the prior exam. There is severe tricompartmental osteoarthritis, with near bone-on-bone apposition, particularly in the patellofemoral compartment. No acute fracture is visible.The contralate... | 1.No acute fracture is identified. Interval improvement of the left joint effusion.2.Cortical irregularity along the medial tibial cortex of the right knee is noted. Further dedicated right knee radiographs are suggested, if clinically warranted.3.Severe left knee osteoarthritis. |
Generate impression based on findings. | Reason: Adenocarcinoma of the lung please Please provide bi-dimensional measurements per RECIST 1.1 criteria and compare to prior outside exams. History: Lung cacner. LUNGS AND PLEURA: Interval development of a severe right-sided pneumothorax. No significant mediastinal shift. A right upper lobe mass measures 4.3 x 3.1... | 1.Right upper lobe mass measurements are decreased from previous exam; however, due to large pneumothorax, measurements may not be entirely reliable.2.New severe right pneumothorax without significant mediastinal shift.3.New T7 compression deformity, age indeterminate.Findings relayed via telephone by Dr. Jahangir to D... |
Generate impression based on findings. | 67 year-old female with right knee pain. Four views of the right knee demonstrate mild sharpening of the tibial spines and tiny osteophytes, compatible with mild osteoarthritis. There is a trace joint effusion. There is no acute fracture or malalignment. | Mild osteoarthritis, which has mildly progressed from remote exam in 2008. |
Generate impression based on findings. | 54-year-old female with left breast pain. Three standard views of both breasts and additional ML and CC spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and dis... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 49 years old Reason: Back Spasm on Palp Right L-Spine, Pain on Back Flexion. History: Back Spasm on Palp Right L-Spine, Pain on Back Flexion. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal hepatic lesion. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCR... | Unremarkable study. If there is continued concern, MR of the spine should be obtained for further evaluation. |
Generate impression based on findings. | Male, 11 years old. Pain, inability to ambulate.VIEWS: Right foot, AP, lateral, oblique (3 views) 3/19/2015, 1520 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male 72 years old; Reason: Hodgkin lymphoma History: reevaluation CHEST:LUNGS AND PLEURA: Stable pulmonary micronodules, for example, indeterminant right-sided 3 mm lung nodule, image 59 series 5. Bilateral calcified granuloma.MEDIASTINUM AND HILA: Trace pericardial fluid.CHEST WALL: No significant abnormality noted.AB... | 1. Unchanged indeterminate left adrenal nodule.2. Stable pulmonary micronodules.3. Unchanged mildly prominent femoral lymph nodes.4. Bulbous contour of the spleen laterally, appears to correspond to hemangioma questioned on earlier MRI study, unchanged. 5. Stable T12 compression deformity.6. Please refer to concomitant... |
Generate impression based on findings. | Fall with grossly deformed right elbow. Evaluate for fracture or dislocation. Two views of the right elbow show marked deformity of the elbow from prior trauma. There is a chronic fracture of the proximal ulna with destruction of the proximal one third of the ulnar diaphysis with interposed bullet fragments. The radial... | Post-traumatic changes of the right elbow with radial head dislocation and chronic ulnar fracture. No acute fracture is evident. |
Generate impression based on findings. | 46-year-old female with biopsy proven benign mass (myofibroblastoma) presents for follow-up exam. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A prove... | Proven benign mass in the right breast, which is enlarging.No mammographic evidence for malignancy in the left breast.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 16 year old female with foot pain and swellingVIEWS: Left foot: AP, oblique, lateral; left ankle: AP, oblique, and lateral (6 views) 3/18/15 Foot: No fracture or malalignment. No significant soft tissue swelling is noted.Ankle: No fracture or malalignment. The ankle mortise joint is normal in appearance. No joint effus... | Normal examination. |
Generate impression based on findings. | 77-year-old female with signs of pulmonary fibrosis and interstitial lung disease, question of hilar mass. Deviated trachea on chest radiograph and SIADH LUNGS AND PLEURA: Increased intralobular septal thickening most pronounced in the lung apices. Mild diffuse groundglass opacities. Part solid and groundglass nodule a... | 1.Part solid and groundglass nodule in the left upper lobe is suspicious for malignancy. PET recommended for follow-up, or tissue diagnosis if possible.2.Increased intralobular septal thickening with small pleural effusions suggestive of mild edema. |
Generate impression based on findings. | 17 year-old female with history of VDRO, evaluate hipVIEWS: Pelvis AP (one views) 3/18/15 Interval removal of blade and screw device affixing the metadiaphysis of the left femur. Left femoral head is well directed into the dysplastic acetabulum. Right coxa valga is again seen. Right femoral head is well directed into t... | Healed left femoral varus derotational osteotomy with interval removal of plate and screw device. |
Generate impression based on findings. | Male, 19 years old. Reason: Evaluate for sacroiliitis History: lower back painVIEWS: Sacroiliac joints AP, bilateral oblique (3 views) 3/19/2015, 1537 The osseous structures and joint spaces are normal.No sclerosis or other joint space abnormality at the sacroiliac joints. | No evidence of sacroiliitis. |
Generate impression based on findings. | Male, 19 years old. Reason: evaluate cause of knee pain History: knee pain with bendingVIEWS: Left knee, AP, lateral, oblique (3 views) 3/19/2015, 1532 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 52 year-old status post right mastectomy 2008 for breast cancer followed by radiation and chemotherapy presents for routine follow-up. No current breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered f... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male, 47 years old.Reason: s/p right TLC placement, r/o pneumothorax History: as above Severe cardiomegaly. Support devices appear grossly unchanged. No new pulmonary opacities. Retrocardiac atelectasis and probable pleural effusion. | Limited examination. No significant interval change. |
Generate impression based on findings. | Shoulder pain. Evaluate for dislocation. Three views of the left shoulder show marked deformity of the glenoid and humeral head; this raises the question of a neuropathic joint. No acute fracture is evident. The bones are diffusely demineralized. No dislocation is identified. | Marked deformity of the right shoulder raises the question of a neuropathic joint; MRI of the cervical spine may be helpful to evaluate for a syrinx or other abnormality if clinically warranted. |
Generate impression based on findings. | Male 71 years old Reason: 71 yo M with hx of gout vs Ca hydroxyapatite crystal disease. evaluate for erosions, soft tissue calcification History: L ankle, 1st MTP pain Left foot: Bone mineralization is normal. Alignment is near-anatomic. There are extra-articular erosive changes at the base of the fourth and fifth meta... | Combination of osteoarthritis and probable gout with improvement in the erosive change. |
Generate impression based on findings. | Occipital/neck pain and history of metastatic renal cell carcinoma. Head: There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are cle... | 1. No evidence of intracranial hemorrhage or mass, although assessment for metastatic disease is limited without intravenous contrast.2. A diffusely enlarged and heterogeneous thyroid gland with minimal narrowing of the trachea is compatible with multinodular goiter. 3. Multilevel degenerative cervical spondylosis. |
Generate impression based on findings. | Evaluation for heart transplant. Question of signs of infection or malignancy, loose or cracked teeth. Panorex radiograph of the mandible shows no osseous destruction or fracture. Multiple dental fillings are noted. No periapical lucency is seen. | No acute fracture is evident. |
Generate impression based on findings. | 51-year-old female with history of left upper lobectomy (2010) for follow-up LUNGS AND PLEURA: Central airways are patent. Moderate centrilobular emphysema. No pneumothorax or pleural effusion. Postsurgical changes are noted in the left hilum. Focal consolidation in the superior segment of the left lower lobe with air ... | Focal consolidation in the superior segment of the left lower lobe with air bronchograms adjacent to the prior surgical site likely reflects atelectasis, unchanged. |
Generate impression based on findings. | Reason: neutropenic fever History: neutropenic fever. LUNGS AND PLEURA: Few areas of tree in but opacities in the right middle lobe, right upper lobe, and left lower lobe may represent sequela of aspiration. Scattered calcified granulomata. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Right PICC tip... | Scattered tree in bud opacities may represent bronchiolitis, either from aspiration or infectious, though not characteristic of fungal infection. |
Generate impression based on findings. | Male 71 years old Reason: 71 yo M with hx of gout vs Ca hydroxyapatite crystal disease. evaluate for erosions, soft tissue calcification History: L ankle, 1st MTP pain Left foot: Bone mineralization is normal. Alignment is near-anatomic. There are extra-articular erosive changes at the base of the fourth and fifth meta... | Combination of osteoarthritis and probable gout with improvement in the erosive change. |
Generate impression based on findings. | Male 71 years old Reason: 71 yo M with hx of gout vs Ca hydroxyapatite crystal disease. evaluate for erosions, soft tissue calcification History: L shoulder pain Bone mineralization is normal. Alignment is anatomic. Mild osteoarthritis affects the left shoulder joint with tiny osteophytes. There are enthesopathic chang... | Mild left shoulder osteoarthritis. |
Generate impression based on findings. | Pain Six views of the cervical spine show no acute fracture. There is reversal of normal cervical lordosis. Vertebral body and disk space heights are preserved. No prevertebral soft tissue swelling. | Mild reversal of the normal cervical lordosis may be secondary to spasm or positioning. |
Generate impression based on findings. | Male 61 years old Reason: S/p Left TKA History: S/p Left TKA Components of a total left knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication.The medial infarctions in the left distal femur are unchanged.Soft tissue gas and joint drain are present. | Total left knee arthroplasty as detailed above. |
Generate impression based on findings. | Spontaneous otorrhea and cerebrospinal fluid leak at the middle cranial fossawith encephalocele status post recent repair. There are interval postoperative findings related to right mastoidectomy and skull base repair with reconstruction of the right tegmen and a small amount of pneumocephalus, as well as trace extra-a... | Interval postoperative findings related to right mastoidectomy and skull base repair with bilateral nonspecific tympanomastoid opacification, but no evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | Female; 58 years old. Reason: eval for progression History: metastatic RCC, on sunitinib CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules consistent with metastases, which overall have mildly decreased in size, including the right hilar metastasis which was previously obstructing the right upper lobe bronch... | 1.Interval decreased size of pulmonary metastases.2.Interval decreased size of retroperitoneal lymphadenopathy.3.Interval increased size of posterior T6 lytic rib lesion.4.New mild right pleural effusion and abdominopelvic ascites. |
Generate impression based on findings. | Reason: 37yoF asthma exac with hypoxemia, rule out PE and infection History: as above PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism.LUNGS AND PLEURA: Minimal basilar atelectasis/scarring. No focal consolidation. The pulmonary artery measures 3.6 cm, enlarged and suggestive ... | 1.No evidence of pulmonary embolism.2.Bronchial thickening suggestive of reactive airway disease.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 13-year-old male with injury to left arm, concern for fractureVIEWS: Left wrist: PA, oblique, lateral; left elbow: Oblique, lateral, AP; left forearm: AP, lateral (8 views) 3/19/15 No fracture or malalignment of the wrist, elbow, or forearm. Mild soft tissue swelling is present within the wrist and forearm. No elbow jo... | Mild soft tissue swelling without evidence of fracture. |
Generate impression based on findings. | 47-year-old female with highly suspicious left breast mass and enlarged left axillary lymph node present for ultrasound guided biopsy of both areas. Left ultrasound re-identified the target lesions for biopsy. The first lesion to be targeted is an enlarged left axillary lymph node measuring 2.1 cm in a sub-pectoral loc... | Successful ultrasound-guided core biopsy of the left axillary and breast masses and clip placements. Pathology is pending at this time.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Metastatic endometrial cancer with right shoulder pain. Question of lytic lesion/dislocation. Three views of the right shoulder show marked destruction of the right acromion process of the scapula, which appears new from a chest radiograph from 1/2015. No acute fracture or shoulder dislocation is evident. A right chest... | Marked destruction of the acromion process compatible with a lytic metastasis given provided history of malignancy. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are right digital mammographic images (2/18/15), ultrasound images of right breast (2/18/15), images from ultrasound guided biopsy of right breast and post procedural right mammographic images (2/27/15) performed at Rush University Medical Center. For c... | 1. Biopsy proven invasive carcinoma in the right breast.2. Images of left breast are not submitted.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Male 61 years old Reason: History of lymphoma, please restage History: back pain CHEST:LUNGS AND PLEURA: Scattered ground glass and solid pulmonary micronodules appear similar to prior exam. Reference right pulmonary nodule measures 4 mm (image 56 years 5) unchanged. Scarring in the anteromedial lungs is again noted, l... | 1.No significant change in size and number of pulmonary nodules.2.Stable to slight decrease in size of hepatic metastases.3.Slight interval decrease in size of right axillary mass.4.New L1 vertebral body compression fracture. |
Generate impression based on findings. | Female, 17 years old. Reason: R/o Fracture. 17 year old female w/ bruise on hand History: Point tenderness over rt distal 4/5 metacarpalsVIEWS: Right hand, AP, lateral, oblique (3 views) 3/19/2015, 1616 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 42 year old female with enlarged right clavicle. Two views of the right clavicle are unremarkable. There is no evidence of fracture or malalignment. No significant soft tissue swelling. Bone mineralization is within normal limits. | No evidence of fracture or malalignment. |
Generate impression based on findings. | Restaging cervical cancer following chemoradiation.RADIOPHARMACEUTICAL: 11.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 116 mg/dL. Today's CT portion grossly demonstrates right chest Port-A-Cath with tip in the right atrium. Numerous calcified mediastinal lymph nodes are present. Punctate calcification ... | 1.Complete interval resolution of previous hypermetabolic tumor activity with no suspicious FDG avid lesion currently.2.Stable mild to moderately hypermetabolic gallbladder wall activity may reflect chronic cholecystitis or adenomyomatosis and could be further evaluated with gallbladder ultrasound as clinically warrant... |
Generate impression based on findings. | Female; 62 years old. Reason: evaluate for acute intraabdominal process History: abdominal pain, onset of vomiting ABDOMEN:LUNG BASES: Small left lower lobe calcified granuloma and calcified mediastinal and bilateral hilar lymph nodes, likely from prior granulomatous process.LIVER, BILIARY TRACT: No significant abnorma... | 1. No acute abdominopelvic abnormality.2. Large left renal angiomyolipoma, for which urologic consultation is recommended for potential treatment.3. Fibroid uterus. |
Generate impression based on findings. | 6-month-old male with pulmonary hypertension, trach dependent with feverVIEW: Chest and Abdomen AP (two view) 3/19/15 The tracheostomy tube is in the above level of the thoracic inlet. Feeding to tip and proximal sidehole in the gastric body. Peripheral catheter in the right femoral vein. Bilateral diffuse coarse lung ... | Malpositioned tracheostomy tube. Bilateral diffuse coarse lung opacities represent chronic lung disease unchanged. |
Generate impression based on findings. | Male; 69 years old. Reason: Evaluate for bone mets History: HCC No abnormal osseous foci are identified to indicate metastatic disease. Faint increased linear activity along the periosteum of the left distal tibia may represent shin splints or a site of remote fracture. | No evidence of bone metastases. |
Generate impression based on findings. | Male; 55 years old. Reason: 55 y/o h/o AML, fatty liver (per US), s/p 3 cycles of chemo and lap appendectomy still w/ vague b/l UQ pain. Please eval for any type of obstruction, malignancy, ileus, abnormality History: vague b/l UQ abd pain, pain worse in evening, no pain with palpation. s/p lap appendectomy; h/o FLD pe... | No definite findings to account for the patient's symptoms. The splenomegaly may be symptomatic, and clinical correlation for such is recommended. |
Generate impression based on findings. | 62 year old female with breast cancer; surgery on 3/20/2015 (bilateral SNBx and bilateral mastectomy; please inject both left and right sides. RADIOPHARMACEUTICAL: The left and right breasts were prepared in a sterile manner. A total of 1.01 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections... | Sentinel nodes identified in the bilateral axillae. |
Generate impression based on findings. | Male; 84 years old. Reason: evaluate for pulmonary embolism History: acute onset SOB. The comparison chest radiograph performed on 3/19/2015 demonstrates globular cardiomegaly and a probable small right pleural effusion but no focal pulmonary opacities. The ventilation portion demonstrates diffusely decreased activity ... | Low probability for pulmonary embolism. |
Generate impression based on findings. | Reason: eval for PE History: CP, tachycardia PULMONARY ARTERIES: The quality of this examination is limited secondary to the timing of the contrast bolus. No pulmonary embolus is noted to the lobar level. The segmental and subsegmental branches are poorly opacified. If there is high clinical suspicion for pulmonary emb... | Limited evaluation for pulmonary embolism due to timing of contrast bolus. No central pulmonary embolus to the lobar level is detected.Soft tissue induration and lymphadenopathy within the left axilla, partially included in the field of view. Further evaluation with dedicated left upper extremity and axillary imaging m... |
Generate impression based on findings. | Female; 24 years old. Reason: Evaluate for source of abd pain (appy, renal stones, intraabdominal mass) - Attn to T/L spine as well for compression fx History: abdominal pain, metastatic breast cancer, new back pain ABDOMEN:LUNG BASES: Stable chronic fracture deformity of the left ninth rib.LIVER, BILIARY TRACT: No sig... | 1. Greater than average stool burden, suggestive of constipation.2. Stable widespread bony metastatic disease. |
Generate impression based on findings. | Reason: r/o pulmonary embolus History: dyspnea, tachycardia, possible malignancy (renal cell) PULMONARY ARTERIES: The quality of this examination is good for the evaluation of pulmonary embolism. No pulmonary embolus is present.LUNGS AND PLEURA: Within the posterior basal segment of the left lower lobe (9/218), there i... | No pulmonary embolism.Predominantly solid nodule measuring 1.5 x 1.8 cm posterior basal segment left lower lobe. Minimal surrounding ground glass and reticulation. Associated bronchial wall thickening. While this may represent a focus of inflammation related to aspiration, a primary adenocarcinoma cannot be excluded. T... |
Generate impression based on findings. | Reason: tachy, SOB, anxious, O2 requirement, h/o DVT 1/2015 -- r/o PE History: tachy, SOB, anxious, O2 requirement, h/o DVT 1/2015 off Lovenox POD#0 -- r/o PE, previously reported history of tumor in right hepatic lobe, outside surgical pathology report of moderately differentiated rectal adenocarcinoma 2/20/15 PULMONA... | No pulmonary embolism.Postoperative changes from recent partial hepatectomy. Heterogeneous hepatic parenchyma with two foci of subcapsular gas and low density for which continued imaging with abdominal CT is recommended. Postoperative pneumoperitoneum. Minimal stranding of mesenteric fat likely postoperative fluid with... |
Generate impression based on findings. | Reason: Evaluate for intracranial hemorrhage History: RUE weakness and HA The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricul... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Patient with two episodes of hemoptysis and oral pharyngeal bleeding. Right carotid pseuodaneurysm noted on CT angiographyFLUOROSCOPY TIME: 29.7 minutes; Frontal Air Karma: 415.27 mGyLateral Air Karma: 238.5 mGyOPERATORS: Greg Christoforidis Right common carotid artery: There is a pseudo aneurysm at the origin of the d... | 1.Pseudoaneurysm at the distal right common carotid artery.2.Deployment of 8mmx10cm covered VIABAHN ENDOPROSTHESIS (MR Conditional up to 3T) from RICA to RCCA across the pseudoaneurysm with successful obstruction of the pseudoaneurysm and cessation of antegrade right ECA flow. There was reverse reconstitution of the RE... |
Generate impression based on findings. | CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. Neck CTA: The patient is status post bilateral carotid stent placement and proximal embolic coil occlusion of the left superior thyroidal artery and embolic coil occlusion of the left inferior thyroidal artery. Since the prior exam a... | 1.New pseudoaneurysm is present along the right common carotid artery immediately superior to the stent.2.There are filling defects within the right common carotid stent. It is possible that this represent endothelial reaction or mural thrombus.3.No evidence for cervicocerebral occlusive disease.4.Findings were discuss... |
Generate impression based on findings. | Reason: r/o mass History: headache with scalp tenderness The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the... | No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Reason: r/o acute intracranial hemorrhage History: HA, dizziness, mild vertigo, 9hrs s/p head injury with LOC The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified withi... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Paranasal sinus opacities are present. Sinusitis cannot be excluded. Please correlate with clinical symptoms. |
Generate impression based on findings. | Reason: assess mass History: mass, sob LUNGS AND PLEURA: Left upper lobe mass measures 5.2 x 6.1 cm (4/22). This is new since the prior CT. Associated foci of central necrosis with internal bronchograms. This does invade the left superior mediastinum, invading fat. There is a fat plane demonstrated between the left lat... | Left upper lobe suprahilar mass 5.2 x 6.1 cm. associated central necrosis, invasion into the superior left mediastinum and surrounding ground glass within the left upper lobe. This is compatible with malignancy. Associated bilateral hilar and aortopulmonary lymphadenopathy. |
Generate impression based on findings. | Female 57 years old; Reason: 57yo h/o renal txp 2011 with worsening renal fxn, morbidly obese with anasarca. now on IV diuresis. Txp team requesting CT wo eval for massive ascites or abdominal hernia History: volume overload Portions of the superficial abdominal wall are excluded from the field-of-view. The absence of ... | 1.No intra-abdominal ascites or abdominal wall hernia as clinically questioned.2.Small bilateral pleural effusions, left greater than right.3.Pericholecystic inflammatory changes. No gallstones are identified however CT is less sensitive than ultrasound in the detection of same. Consider right upper quadrant ultrasound... |
Generate impression based on findings. | Altered mental status.VIEWS: Chest and abdomen AP (two views) 03/19/15, 1700 Endotracheal tube tip is below thoracic inlet. Feeding tube tip is in distal gastric body. Lower extremity PICC tip is at junction of IVC and right atrium. A urinary bladder catheter is present.Left lower lobe remains atelectatic. The rest of ... | Reexpansion of the left upper lobe after repositioning of endotracheal tube. Small amount of bowel gas. |
Generate impression based on findings. | 78 year old with history of right lumpectomy in 1992 for breast cancer. Benign left breast surgery. 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 composed of scattered fibroglandular elements, unchanged in p... | 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. | Female; 39 years old. Reason: change in size of pancreatic pseudocyst or communication with pleural space? s/p cystgastrostomy w persistent pain, po intolerance and SIRS History: as above CHEST:LUNGS AND PLEURA: Moderate left pleural effusion, similar to prior. Moderate adjacent left lower lobe atelectasis/consolidatio... | 1. Mild interval decrease in peripancreatic fluid collections.2. New mild gas density within the left iliac fossa transplant kidney collecting system is most likely due to Foley catheter being in place. Recommend correlation with urinalysis for possibility of infection. |
Generate impression based on findings. | 82 years, Female. Reason: advanced stage uterine cancer with SBO, please check NG tube placement History: nausea/vomiting There is a nasogastric tube with its tip projecting over the body of the stomach. There is a nonobstructive bowel gas pattern. Bibasilar opacities suggest atelectasis. Surgical clips project over th... | Nasogastric tube with its tip projecting over the body of the stomach. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 9-year-old female experiencing altered mental status, with history of anoxic brain injury. Redemonstrated is marked enlargement of the lateral and third ventricles with mild enlargement of the fourth ventricle. Although there has been increase in size of the greatest transverse extent of lateral ventricles, the calvari... | Redemonstrated is marked enlargement of the lateral and third ventricles with mild enlargement of the fourth ventricle. Although there has been increase in size of the greatest transverse extent of lateral ventricles, the calvarium has also increased with greater age and skull growth. Thus, ventricle enlargement may be... |
Generate impression based on findings. | RFO trigger: BMI over 40 Suspected RFO location: na Name of suspected RFO: na Attending Surgeon name/pager: Tenney Body Mass Index (BMI): 42.14 NG tube tip terminates in the distal esophagus. Surgical drain with tip terminating in the right hemipelvis. Surgical clips are present within the pelvis. No unexpected radiopa... | No unexpected radiopaque foreign object identified.These findings were discussed by telephone with Dr. Tenney, the attending surgeon, on 3/20/2015 at 18:49.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are screening mammogram (2/9/15), diagnostic left mammogram and ultrasound (2/23/15), and images from stereotactic left breast biopsy and post procedural mammogram (3/3/15) performed at St. James Hospital in Olympia Fields, IL. No studies are available ... | Left breast focal asymmetry status post stereotactic biopsy revealing invasive ductal carcinoma. Continued surgical management is advised. BIRADS:6 - Known cancer. RECOMMENDATION:T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Low Apgar scores. Perinatal acidosis.VIEWS: Chest and abdomen AP (two views) 03/19/15, 2007 Endotracheal tube tip is at thoracic inlet. Feeding tube tip is at GE junction. Esophageal temperature probe tip is in lower esophagus. Umbilical venous line has its tip in right atrium. Umbilical arterial line is coiled upon it... | No focal lung opacity. Almost gasless abdomen. |
Generate impression based on findings. | 59 years, Male. Reason: Eval for obstruction History: Constipation Dilated loops of small bowel with gas present in the colon, suggestive of ileus. Sclerotic bone metastases better evaluated on the prior CT examination. Surgical clips project over the pelvis. There are bilateral pleural effusions with associated atelec... | Mild ileus-type gas pattern.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male, 12 years old. Evaluate for fracture History: wrist trauma, swelling, bony tendernessVIEWS: Right wrist PA, lateral, oblique (3 views) 3/19/2015, 1732 The posterior aspect of the radial physis is minimally widened. No other osseous abnormalities noted.Soft tissue swelling about the wrist. The pronator quadratus is... | Small joint effusion. Slightly widened posterior radial physis. If point tenderness is over the posterior distal radius, this may represent a Salter Harris 1 fracture. |
Generate impression based on findings. | Scrotal pain RIGHT TESTIS: No significant abnormalities noted. The right testis is located in the inguinal canal. Mild hydrocele is identified. The testis is 1.56 X 1.99 X 1.56 cms in 3 dimensions. LEFT TESTIS: No significant abnormalities noted. The testis is located in the scrotum. Hydrocele is noted as well. The tes... | Extensive bilateral , punctate calcifications of the epididymis, diagnostic considerations are either chronic calcifications due to recurring epididymitis or meconium epididymitis. |
Generate impression based on findings. | Pole multiple female with tracheoesophageal fistula post repairVIEW: Chest AP (one view) 3/19/15 at 2230 Gastrostomy tube is present in expected position. Cardiac silhouette is normal. Lucency along the upper right mediastinum represents air-filled dilated esophagus. No focal pulmonary opacities. No pleural effusion or... | Dilated air-filled esophagus along the upper right mediastinum. No pleural effusion or pneumothorax. |
Generate impression based on findings. | 60 year-old male status post esophageal stent (3/18/15), now with severe upper esophageal pain CHEST:LUNGS AND PLEURA: New moderate bilateral pleural effusions with adjacent atelectasis.MEDIASTINUM AND HILA: Right chest port tip is in the SVC. No extraluminal air is evident. Concentric esophageal thickening within the ... | New moderate pleural effusions with adjacent atelectasis. New small pericardial effusion. No pneumomediastinum or pericardium. Small pneumoperitoneum likely due to recent gastrostomy tube insertion. Findings were discussed with Dr. Waxman by Dr. Montner on 3/19/15. |
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