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Generate impression based on findings. | Female, 6 years old. Evaluate left femur s/p fracture and placed in traction VIEW: Left femur Lateral (1 view) 3/19/2015, 1826 Oblique fracture through the proximal femoral diaphysis with posterior angulation and approximately one shaft width anterior displacement of the distal fragment, and overriding.Significant surrounding soft tissue swelling. | Anteriorly displaced, posteriorly angulated oblique proximal femoral diaphyseal fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | RFO trigger: Multiple surgical teams Suspected RFO location: abdomen Name of suspected RFO: none Attending Surgeon name/pager: Dr. J. Matthews Body Mass Index (BMI): 28.9 Surgical clips project throughout the abdomen. There is a nasogastric tube with its tip projecting over the proximal body of the stomach. Endotracheal tube tip 3.0 cm above the carina. No unexpected radiopaque foreign body identified. | No unexpected radiopaque foreign body identified.These findings were discussed by telephone with Dr. Eton, the attending surgeon, on 3/20/2015 at 21:31.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 70 sutural female with intracranial hemorrhage, status post EVD removal There has been interval removal of the patient's left frontal approach ventriculostomy catheter with no postprocedural hematoma. Ventricular sizes are unchanged. There is unchanged subarachnoid and intraventricular hemorrhage. Resolving right frontal hematoma is stable. Subtle residual edema at this site still present and the minimal effacement of adjacent cortical sulci, unchanged in extent. Visualization of metallic density at the level of right cavernous sinus consistent with coiled aneurysm. | There has been interval removal of the patient's left frontal approach ventriculostomy catheter with no postprocedural hematoma. Ventricular sizes are unchanged. |
Generate impression based on findings. | 75 years, Male. Reason: eval for free air and/or obstruction History: new abd pain and firm abd on exam in pt w choledocholithiasis s/p ERCP today and clinical cholangitis Mild gaseous distention of small bowel. There is gas through the colon and in the rectum.Air space opacity in the left lung base. | IleusI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female, 6 years old. Reason: R/O Fracture History: Pediatric TraumaVIEW: Pelvis AP (one view) 3/19/2015, 1756 A displaced fracture of the proximal femoral diaphysis is incompletely imaged on this exam.Left thigh soft tissue swelling.No other fracture or malalignment identified. | Displaced left femur fracture, incompletely imaged. |
Generate impression based on findings. | Female 22 years old; Reason: incarcerated bowel? bowel ischemia? mass? liver or renal pathology/ History: lactic acidosis, abd pain CHEST:LUNGS AND PLEURA: Mild bibasal dependent atelectasis.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. No significant coronary artery calcification.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. No intra-or extrahepatic biliary duct dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large amount of debris in the stomach. Above-average stool burden. No evidence of obstruction or ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large amount of debris in the stomach. Above-average stool burden. No evidence of obstruction or ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Cholelithiasis.2.No specific cause for patient's symptoms is identified. |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The mastoid air cells are clear. | Negative unenhanced brain CT. |
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 heterogeneously dense, which may obscure small masses. A few scattered benign calcifications in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female, 6 years old. Pediatric trauma. Evaluate for fracture.VIEWS: Cervical spine AP, lateral (two views) 3/19/2015, 1759 The osseous structures and joint spaces are normal.The atlantodental interval measures 4 mm.The adenoids are mildly enlarged. No prevertebral soft tissue swelling. | No acute fracture or malalignment. |
Generate impression based on findings. | Male; 67 years old. Reason: R/o bleed- downtrending CBC History: Downtrending CBC Lack of intravenous contrast limits evaluation for solid organ pathology.LUNGS AND PLEURA: Interval removal of endotracheal tube. Moderate right pleural effusion, increased since prior. Stable small left pleural effusion. Increased patchy atelectasis/consolidation in the right lower lobe, for which underlying infection cannot be excluded. Stable small, irregular right middle lobe opacity (series 5/52).MEDIASTINUM AND HILA: Mild cardiomegaly. Trace pleural effusion. Stable pacemaker/ICD leads.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Dense residual oral contrast opacifies the right colon. Enteric tube tip in stomach. Rectal tube in place.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of perihepatic ascites, similar to prior.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Air within the decompressed bladder, likely due to Foley catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Left pelvic hematoma extending into the left inguinal canal is slightly increased in size measuring up to 7.5 x 6.9 cm (series 3/22), previously 7 x 5.9 cm. Scattered tiny locules of air within the hematoma are new since prior study, and this may be due to recent instrumentation, though superimposed infection cannot be excluded. The extension of the hematoma into the left inguinal canal is only partially visualized but similar to prior exam.Smaller nonspecific collection on the right side adjacent to the right external iliac vessels is grossly stable measuring 3 x 2.7 cm (series 3/27), previously measuring 3 x 2.7 cm.OTHER: Small amount of ascites in the pelvis. | 1. Increased right pleural effusion and right basilar nonspecific atelectasis/consolidation, for which underlying infection cannot be excluded. Stable irregular right middle lobe focal opacity, which may be due to infection but again follow-up CT in 3 months is recommended.2. Large left pelvic hematoma has slightly increased in size. New foci of gas within the hematoma may be due to recent instrumentation, though superimposed infection cannot be excluded.3. Stable smaller nonspecific right inguinal collection. |
Generate impression based on findings. | Small cell lung cancer CHEST:LUNGS AND PLEURA: The left apical mass with associated destruction of the left second rib is markedly decreased in size, now approximately 0.9 x 0.5 cm (series 5, image 21), previously 5.5 x 2.8 cm. Additional patchy opacities with centrilobular nodules in the right lower lobe are increased, representing obstructed debris and bronchiolitis. Small low density foci within these opacities likely represent air bronchograms, though cavitation is also a possibility. No associated air-fluid levels. Scattered pulmonary micronodules noted. Upper lobe predominant centrilobular emphysema is again noted. MEDIASTINUM AND HILA: The right perihilar soft tissue mass measures 3.1 x 3.1 cm (series 7, image 55), previously 5.7 x 5.1 cm. The subcarinal lymphadenopathy is markedly decreased. Normal-sized heart without pericardial effusion. Aortic valve calcifications are present. No coronary artery calcifications are evident.CHEST WALL: Right chest port tip in the SVC. No axillary lymphadenopathy by CT size criteria.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted. No hepatic lesions noted. No biliary ductal dilation.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple hypoattenuating renal lesions, which are too small to characterize, possibly representing cysts. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Moderate degenerative changes of the thoracolumbar spine. | 1. Markedly decreased size of the right perihilar mass, left apical chest wall mass, and mediastinal lymphadenopathy, compatible with treatment response. 2. Increased post-obstructive debris and bronchiolitis in the right lower lobe, compatible with infection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in a maternal cousin. Two standard digital views of both breasts for a total of 6 images were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Interval placement of a right dialysis catheter partially obscures portions of the right upper inner breast and axilla. Right upper intramammary lymph nodes are stable. Scattered benign calcifications in both breasts are also stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 14-year-old male with ankle painVIEWS: Right ankle AP, oblique, lateral (3 views) 3/20/15 No fracture or malalignment. Ankle mortise joint is maintained. Mild to moderate tissue swelling. | No fracture. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No extra-axial fluid collections. Gray-white matter differentiation is preserved. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are intact. The osseous structures are unremarkable. | No evidence for acute intracranial abnormality. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia. If there is high clinical suspicion, consider MRI. |
Generate impression based on findings. | 38 year-old female with palpable left breast mass. No family history of breast cancer. Family history of ovarian carcinoma in her paternal grandmother. MAMMOGRAM: Three standard views of both breasts, and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. A triangular marker has been placed in the area of palpable abnormality within the central outer left breast. No discrete underlying mammographic abnormality is appreciated. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the right axilla.ULTRASOUND: On physical examination, there is a 0.5 cm oval, soft, mobile mass at the 12:00 position of the left breast, areolar border.A targeted left ultrasound was performed for the palpable area of concern. There is no solid or cystic mass identified. A normal appearing fat lobule is noted immediately subjacent to the palpable area of concern, and likely accounts for the palpable lesion. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, to begin at age 40. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | No evidence of acute hemorrhage, mass-effect, midline shift, or CT evidence of large territorial ischemia. There is generalized cerebral volume loss appropriate for patient's age. There is mild ex vacuo dilation of the ventricular system in the setting of cerebral atrophy. There is mild periventricular hypoattenuation which is nonspecific but most likely represents age indeterminate small vessel ischemic disease. Small left maxillary retention cyst. Paranasal sinuses and mastoid air cells are otherwise clear. | No evidence of intracranial hemorrhage, mass effect, or CT evidence of recent large vascular distribution infarct. |
Generate impression based on findings. | Umbilical arterial line placement. Perinatal acidosis. Induced hypothermia.VIEWS: Chest and abdomen AP (two views) 03/19/15, 2108 Endotracheal tube tip is at thoracic inlet. Feeding tube tip is at the GE junction. Esophageal temperature probe tip is in mid esophagus. Umbilical venous line has its tip at junction of inferior vena cava and right atrium. Umbilical arterial line tip is at L3.Cardiothymic silhouette is normal in size. No focal lung opacity is present. The only gas in the bowel is in the stomach. | No focal lung opacity. Almost no bowel gas. |
Generate impression based on findings. | 26-year-old female with right knee pain after fall. Four views of the right knee demonstrate normal anatomic alignment. There is no evidence of fracture. A small joint effusion is present. | Small joint effusion without evidence of acute fracture or malalignment. |
Generate impression based on findings. | 52 year-old female experiencing headache No intracranial hemorrhage, intracranial mass, mass-effect, midline shift, or herniation is identified. Redemonstrated is global parenchymal volume loss, not significantly changed. Multiple areas of hypoattenuation are again seen in the periventricular and subcortical white matter, which are also not significantly. Gray-white differentiation is maintained. No extra-axial collections. No hydrocephalus. Empty sella is noted which is nonspecific but can be seen with pseudotumor although is more likely idiopathic at age 52 years. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1.No evidence of acute intracranial hemorrhage or mass effect. 2.Unchanged empty sella which is a normal variant but can be seen with pseudotumor although is more likely idiopathic at age 52 years.3.Chronic white matter disease. |
Generate impression based on findings. | Obstructive jaundice? Pancreatic adenocarcinoma. Portal vein thrombosis. CHEST:LUNGS AND PLEURA: Small nodule along the fissure (image 28; series 80242) may be an intrapulmonary lymph node.MEDIASTINUM AND HILA: Cardiomegaly. Moderate coronary artery calcifications. No significant adenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Moderate intrahepatic biliary ductal dilatation secondary to a presumed metastasis at the hepatic hilum. Perihepatic ascites is also noted. The portal vein is significantly compressed at the hilum and there may be a small amount portal vein thrombus. A few ill-defined hypodense lesions may represent early metastases and can be followed.SPLEEN: Metastasis versus evolving splenic infarct at the inferior aspect of the spleen.PANCREAS: Pancreatic tail mass invading the spleen measures 3.4 x 4.6 cm (image 98; series 3).ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonspecific low density lesion in the left kidney. RETROPERITONEUM, LYMPH NODES: Infrarenal abdominal aortic aneurysm measuring 4.3cm in diameter.BOWEL, MESENTERY: Peritoneal carcinomatosis. Four reference purposes, a implant in the right lower quadrant measures 2.5 x 2.2 cm (image 171; series 3)BONES, SOFT TISSUES: Degenerate changes throughout the spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate measures 4.4 x 5.2 cm (image 196; series 3).BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: 2.5-cm left common iliac artery aneurysm. | Pancreatic tail carcinoma with splenic invasion. There is a hepatic hilar metastasis which is causing partially occlusive portal vein thrombosis and biliary obstruction. 4.3-cm abdominal aortic aneurysm. Abdominal ascites. Carcinomatosis. Possible left adrenal metastasis. |
Generate impression based on findings. | Female, 6 years old. Reason: 1 view - AP left femur s/p fracture and placed in traction VIEW: Left femur AP (one view) 3/19/2015, 2157 Redemonstration of an oblique fracture through the proximal femoral diaphysis, with medial angulation and lateral displacement of the distal fragment by approximately one shaft width, and slightly decreased overriding compared to prior.Significant surrounding soft tissue swelling. | Oblique proximal diaphyseal left femur fracture with lateral displacement and slightly decreased overriding compared to prior. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 54 year old male with HIV, weight loss and history of prostate carcinoma. CHEST:LUNGS AND PLEURA: Scattered, relatively thin-walled cysts identified. Nonspecific micronodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Prominent subpectoral node on the right.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small right renal cyst.RETROPERITONEUM, LYMPH NODES: Enlarged gastrohepatic ligament node measuring 1.3 x 1.8 cm on image 112/225.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate calcificationBLADDER: Single, small focus of nondependent gas in the bladder. Correlate with recent instrumentation.LYMPH NODES: Mild right inguinal adenopathy with a node in the right groin measuring 1.3 x 1.7 cm on image 203/225. Prominent but morphologically normal left obturator lymph node.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Mild isolated adenopathy as noted above. |
Generate impression based on findings. | 30 year-old male with pain to the second digit status post reduction of joint dislocation. Two views of the right hand demonstrate interval reduction of the previously described dislocation of the middle phalanx of the right second digit. Alignment is now anatomic. There is no evidence of fracture. There is mild soft tissue swelling of the second digit. | Interval reduction of the second digit without evidence of underlying fracture. |
Generate impression based on findings. | 30-year-old male with pain to be second digit after injury in basketball. Three views of the right second digit demonstrate dorsal and slightly ulnar dislocation of the middle phalanx of the second digit with respect to the proximal phalanx. There is associated soft tissue swelling. No fracture is evident. | Dislocation of the middle phalanx of the second digit as above. |
Generate impression based on findings. | Female 44 years old; Reason: evaluate for pelvic abscess History: pelvic pain and fever after vaginal hysterectomy 2/2/15 ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions in the right hepatic lobe are too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 1.6-cm hypoattenuating lesion in right kidney probably represents a renal cyst. There is no hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Above-average stool burden.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace pelvic free fluid without loculation. | 1.Status post hysterectomy. No evidence of pelvic abscess as clinically queried. No specific cause for the patient's pelvic pain and fever is identified. |
Generate impression based on findings. | 71 year old female with history of the BRCA positive breast cancer status post oophorectomy now with weight loss, abdominal pain and loss of appetite. CHEST:LUNGS AND PLEURA: Bilateral calcified punctate nodules in the right upper and left lower lobe consistent with granulomas. No suspicious pulmonary nodules or masses. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Normal sized heart with no pericardial effusion. No significant coronary artery calcification. No mediastinal or hilar adenopathy.CHEST WALL: Bilateral breast implants. No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Small hypoechoic lesions in the liver (series 3, images 88 and 100) which are indeterminate and can be followed. Gallbladder is unremarkable. No intra-or extrahepatic delayed ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Irregular hypodense lesion in the distal body/proximal tail measuring 2.2 cm x 1.4 cm (series 3, image 112) associated with proximal pancreatic ductal dilatation. No surrounding soft tissue stranding or free fluid. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral pelvicaliectasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal in caliber with no evidence of obstruction. The appendix is well visualized and is unremarkable.BONES, SOFT TISSUES: Mild degenerative changes throughout the spine. No suspicious lesions are identified.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post bilateral oophorectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal in caliber with no evidence of obstruction. BONES, SOFT TISSUES: Mild degenerative changes throughout the spine. No suspicious lesions are identified.OTHER: No significant abnormality noted. | 1. Hypodense lesion in the distal body/tail of the pancreas associated with proximal pancreatic ductal dilatation; consider a primary cystic neoplasm of the pancreas or IPMN. Consider MRI or endoscopic ultrasound for further evaluation.2. Two indeterminate subcentimeter hypodense lesions in the liver can be followed. |
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 markers were placed over both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | An intraparenchymal hemorrhage is present centered within the right thalamus, extending into the adjacent ventricular system with expansion of the right lateral ventricle and to a somewhat lesser degree the left lateral ventricle. Hemorrhage extends through the third ventricle and into the fourth ventricle. The midline and basilar cisterns are maintained.Encephalomalacia is present wihtin bilateral anterior frontal lobes involving periorbital gyri and rectus gyri. This pattern is most suggestive of prior head trauma.The visualized portions of the paranasal sinuses and mastoid air cells are clear. | An intraparenchymal hemorrhage is present centered within the right thalamus, extending into the adjacent ventricular system. |
Generate impression based on findings. | 39-year-old female with history of left knee pain; denies trauma. Four views of the left knee demonstrate normal anatomic alignment. There is no evidence of fracture, malalignment, or significant joint effusion. Mild osteoarthritis affects the medial tibiofemoral compartment. | No evidence of fracture or malalignment. |
Generate impression based on findings. | Female, 12 years old. Reason: eval fx History: swelling, pain ulnar aspect s/p fallVIEWS: Right wrist, PA, lateral, oblique (3 views) 3/19/2015, 1946 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling.Normal variant spurlike projection of the posterior radial epiphysis. | Normal examination. |
Generate impression based on findings. | Reason: cancer staging, evaluate for mets History: metastatic nsclc 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 paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT without contrast is less sensitive than contrast enhanced MRI or contrast enhanced CT for the evaluation of metastases. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Patient reports intermittent left breast pain for approximately 2 weeks and inflammation of the inferior left breast/rib. Two standard digital views of both breasts and additional left MLO view 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. Right posterior intramammary lymph node is unchanged. Several small circumscribed masses in the left lateral breast are also unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 86-year-old female with concern for foreign body. Two views of the neck demonstrate calcified cricoid cartilage. However, no evidence of bony foreign body is identified. There is moderate degenerative disease of the cervical spine, including disk space narrowing at C3-4, C4-5, and C5-6. The bones appear diffusely demineralized. Osteoarthritis affects the facet joints in the cervical spine. Partially imaged pacemaker device and dental hardware. | Degenerative disease as above. No evidence of bony foreign body. |
Generate impression based on findings. | Female, 12 years old. Swelling, pain ulnar aspect, s/p fallVIEWS: Right hand, PA, lateral, oblique (3 views) 3/19/2015, 1943 The osseous structures and joint spaces are normal.No significant soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 65-year-old male history of trauma to the right third MCP joint. No evidence of acute fracture or malalignment. The middle and distal phalanges on the fourth digit are fused. There is evidence of prior surgery to the first metacarpal head. Osteoarthritis affects the basilar joint. | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | There has been interval placement of a left frontal approach ventricular catheter with its tip near the midline in the left lateral ventricle. There are no postprocedural complications. There has been slight increase in size of bilateral temporal horns.Redemonstrated is an intraparenchymal hemorrhage centered within the right thalamus, extending into the adjacent ventricular system, stable in appearance. Ventricular hemorrhages are stable. The midline is maintained. Slight increase in medialization of the uncus bilaterally causes slight effacement of the basilar cisterns.Encephalomalacia is present wihtin bilateral anterior frontal lobes involving periorbital gyri and rectus gyri. This pattern is most suggestive of prior head trauma.Other than a small focus of lobular soft tissue thickening in the left maxillary sinus, the visualized portions of the paranasal sinuses and mastoid air cells are clear. | 1.There has been interval placement of a left frontal approach ventricular catheter with its tip near the midline in the left lateral ventricle. There are no postprocedural complications. 2.There has been slight increase in size of bilateral temporal horns.3.Redemonstrated is an intraparenchymal hemorrhage centered within the right thalamus, extending into the adjacent ventricular system, stable in appearance. Ventricular hemorrhages are stable.4.Slight increase in medialization of the uncus bilaterally causes slight effacement of the basilar cisterns. |
Generate impression based on findings. | Male 19 years old; Reason: kidney stone History: stone The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Bibasal patchy opacities, left greater than right suggest aspiration/infection. Gynecomastia is incompletely imaged.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is moderate/severe left hydronephrosis and hydroureter to the VUJ without perinephric stranding. There is mild left renal cortical thinning. Innumerable calcifications are identified layering dependently within the upper, mid and lower pole calyces and within the left ureter. Additional non obstructing calcifications are identified within the upper and midpole of the right kidney. There is no right hydronephrosis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastrostomy tube in situ. Above average stool burden throughout the colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: The bladder is markedly distended with layering dependent densities, presumably representing a combination of debris and stones. The appearance suggestive of a neuropathic bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastrostomy tube in situ. Above average stool burden throughout the colon.BONES, SOFT TISSUES: Abnormality of the left hip joint. The left acetabulum is dysplastic and the left femoral head is displaced superiorly from the acetabulum. The right femoral head is well seated in the acetabulum. There is severe thoracolumbar scoliosis.OTHER: No significant abnormality noted. | 1. Moderate/severe left hydronephrosis and hydroureter with multiple layering calculi identified within the bilateral collecting systems and dependently within the bladder. This was not present on MRI lumbar spine 2009 and therefore an acute obstructive process should be excluded although there are some features to suggest a chronic component. 2. Bibasal patchy opacities, left greater than right suggest aspiration/infection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left breast benign biopsy in 2011. Family history of breast cancer diagnosed in maternal second cousin at age 41. Two standard digital views of both breasts were performed 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 distribution. Circular skin markers were placed over both breasts. Biopsy clip in the left lower inner breast, is unchanged in position. A few scattered benign calcifications bilaterally are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 59-year-old with anal neoplasm post chemo and radiation therapy. Evaluate for response to disease. CHEST:LUNGS AND PLEURA: Scattered, peripheral micronodules without change.MEDIASTINUM AND HILA: No significant abnormality noted. Resolved pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Small, dependent gallstone without obvious complication. No hepatic mass.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonobstructing calculi lower pole right kidney and upper pole left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Post hysterectomy.BLADDER: Incomplete distention.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable benign, sclerotic focus right femoral head.OTHER: Improved postradiation change in pelvic fat. | No evidence for metastatic disease or local mass.Bilateral nephrolithiasis.Cholelithiasis. |
Generate impression based on findings. | 58-year-old male with pneumonia and recent Impella, evaluate for abscess, pleural effusion, or retroperitoneal bleed CHEST:LUNGS AND PLEURA: Moderate right and small left pleural effusion with associated compressive atelectasis. Mild interstitial septal thickening. No suspicious nodules or massesMEDIASTINUM AND HILA: Impella device is noted with tip in the left ventricle. Small focus of gas within the right internal jugular vein likely iatrogenic. Scattered mildly prominent mediastinal and hilar lymph nodes. The heart size is normal. No pericardial effusion. Coronary artery stent is noted.CHEST WALL: Mild degenerative disease affects the thoracic and lumbar spine. No suspicious osseous lesions. No axillary, cardiophrenic, or retrocrural lymphadenopathy.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Enteric tube terminates in the stomach. High density material layering in the dependent portion of the ascending colon could potentially represent blood products although this is very nonspecific and clinical correlation for bloody stools would be needed. Partially visualized is a loop of bowel in between the right abdominal wall muscles, likely an internal abdominal wall hernia, nonobstructive in appearance.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of retroperitoneal bleed in the upper abdomen as clinical questioned. 2.Mild pulmonary edema pattern with moderate right and small left pleural effusion with adjacent compressive atelectasis. |
Generate impression based on findings. | Female; 65 years old. Reason: 65 yo female w/ pmh/o afib, TIA, hyperlipidemia w/ persistent abdominal pain in lower quadrants History: persistent abdominal pain ABDOMEN:LUNG BASES: 7-mm right lower lobe pulmonary nodule (series 4/8). Additional micronodule is seen in the right lower lobe (series 4/11).LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small left lower pole renal cyst. Additional smaller hypoattenuating lesion in the left superior pole is too small to characterize but likely an additional cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix visualized.BONES, SOFT TISSUES: Moderate multilevel degenerative arthritic changes of the lumbar spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy. No adnexal masses.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal appendix visualized.BONES, SOFT TISSUES: Moderate multilevel degenerative arthritic changes of the lumbar spine.OTHER: No significant abnormality noted | 1. Incidental 7-mm right lower lobe pulmonary nodule. If the patient is low risk per Fleischner Society criteria, recommend CT chest with contrast in 3 months. If the patient is high risk, recommend CT chest with contrast now.2. Moderate multilevel degenerative arthritic changes of the lumbar spine.Findings discussed with Dr. Karkowsky at 8:40 a.m. on 3/20/15. |
Generate impression based on findings. | Encephalomalacia is present involving the right cerebellar hemisphere as well as right occipitoparietal cortex consistent with remote infarction. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are essentially clear. Incidental note is made of an old right medial orbital wall fracture. | Encephalomalacia is present involving the right cerebellar hemisphere as well as right occipitoparietal cortex consistent with remote infarction. If there is clinical concern for acute ischemia, MRI would be recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right benign biopsy for cluster of calcifications. Family history of breast cancer diagnosed in mother. 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. Biopsy clip in the right upper outer quadrant is unchanged in position. Associated postbiopsy architectural distortion is unchanged. Adjacent cluster of calcifications is better visualized due to resolution of previous postbiopsy hematoma.No suspicious masses, new microcalcifications or new areas of architectural distortion are present. | Right upper outer quadrant postbiopsy change and residual calcifications. 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. | Male, 17 years old. Right lateral foot pain/swelling s/p basketball. Evaluate for fracture.VIEWS: Right foot AP, lateral, oblique (3 views) 3/19/2015, 1955 The osseous structures and joint spaces are normal.No significant soft tissue swelling. | Normal examination. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No extra-axial fluid collections. Hypoattenuation of the subcortical and periventricular white matter compatible with age indeterminant small vessel ischemic disease. There are foci of hypoattenuation in the left coronal radiata which appear more discrete than on 3/17/2015 study, raising possibility of evolving recent infarcts versus technique related differences. The imaged paranasal sinuses and mastoid air cells are clear. Degenerative changes at the temporomandibular joints. | 1.No evidence intracranial hemorrhage, mass effect, or hydrocephalus.2.Hypoattenuation of the subcortical and periventricular white matter is nonspecific but compatible with age indeterminant small vessel ischemic disease. There are foci of hypoattenuation in the left frontal corona radiata which appear more discrete than on 3/17/2015 study, which may be due to differences in technique versus evolving infarcts. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia and MRI can be considered for further evaluation.3.Right cerebellar enhancing lesion presumably representing metastasis is better seen on prior MRI and not appreciated on current study. |
Generate impression based on findings. | Hypoxia. Question of autoimmune disease. LUNGS AND PLEURA: No significant abnormality noted. No evidence of infection or edema. No evidence of fibrosis, honey-combing, ground-glass nodules, or mosaic-attenuation. Non-specific calcified and non-calcified pulmonary micronodules. Please note that prone and expiration images were not obtained; if there remains clinical concern for air-trapping, the patient may return for these sequences at no additional charge and an addendum to this report can be made. MEDIASTINUM AND HILA: Normal sized heart without pericardial effusion. Minimal coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: Multiple healed rib fractures bilaterally. Near-complete collapse of the T7 vertebral body, with mild associated degenerative changes. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Female, 12 years old. Left upper quadrant painVIEW: Abdomen AP upright (one view) 3/19/2015, 2120 Lumboperitoneal shunt is again seen, exiting the spinal canal at the level of L4, now with tip in the left midabdomen.Nonobstructive bowel gas pattern.Moderate stool burden. | Moderate stool burden, unchanged. |
Generate impression based on findings. | There has been interval left-sided craniotomy for resection of a cerebral cavernous malformation. Expected postoperative changes include pneumocephalus, extra-axial fluid admixed with blood products, subcutaneous swelling, calvarial fixation devices, and overlying skin staples. A small amount of parenchymal hypodensity is evident at the resection site. There are no postprocedural hematomas.The ventricles and sulci are normal in size. There is no mass effect or midline shift. There is no evidence for acute cerebral or cerebellar cortical infarction. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | There has been interval left-sided craniotomy for resection of a cerebral cavernous malformation with expected postoperative changes. |
Generate impression based on findings. | 60 year old with history of right lumpectomy for IDC grade 3 in 2012. Patient received chemotherapy and radiation therapy. No current breast complaints. Three standard views of both breasts and two spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Post surgical scar with surgical clips is re-demonstrated at upper outer quadrant in the right breast. Benign fibroadenomatous calcifications are again seen at right retroareolar region, and there are stable benign calcifications at posterior lower inner quadrant in the right breast. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | 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. | Asymptomatic female presents for routine screening mammography. Patient reports a right medial sebaceous cyst. Family history of breast cancer diagnosed in maternal niece in her 40's. Two standard digital views of both breasts, additional left CC view, 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 distribution. Bilateral benign calcifications have slightly increased in a benign fashion.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 5-month-old female intubated with respiratory distressVIEW: Chest AP (one view) 3/20/15 Endotracheal tube is between the thoracic inlet and the carina. The NG tube tip is below the caudal margin of the image and is postpyloric. Left femoral catheter tip is at the junction of the IVC and right atrium.The cardiothymic silhouette is normal. Improved left lower lobe atelectasis. Increased right upper lobe opacity. No focal pulmonary opacities. No pleural effusion or pneumothorax. | Improved left lower lobe atelectasis. Increased right upper lobe opacity may represent atelectasis or pneumonia. NG tube tip is postpyloric. |
Generate impression based on findings. | Sarcoidosis. Worsening DOE. LUNGS AND PLEURA: Scattered pulmonary micronodules. Minimal basilar peripheral reticular opacities are noted. No fibrosis, honeycombing, or septal thickening is present. No specific evidence of pneumonia or edema. No pleural effusions.MEDIASTINUM AND HILA: Mild to moderate mediastinal and hilar lymphadenopathy. For reference, a subcarinal lymph node measures 2.1 cm in short axis (series 3, image 42). Normal sized heart without pericardial effusion. Minimal coronary artery calcifications.CHEST WALL: No axillary lymphadenopathy. Moderate degenerative changes of the thoracic spine. A 4 cm right paraspinal lipoma is noted. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. Status post cholecystectomy. | Mild pulmonary findings compatible with sarcoidosis. Otherwise, no significant or specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of basal cell skin cancer of the upper chest diagnosed at age 58. Family history of breast cancer diagnosed in paternal aunt. 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 distribution. Circular skin markers were placed over both breasts. Subcentimeter circumscribed lobular mass in the right lower outer quadrant is unchanged. Benign calcifications in both breasts, including mild arterial calcifications, have slightly progressed in a benign fashion compared to prior.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Redemonstrated are postoperative changes which include decreasing pneumocephalus as well as stable extra-axial fluid admixed with blood products, subcutaneous swelling, calvarial fixation devices, and overlying skin staples. A small amount of parenchymal hypodensity is evident at the resection site, unchanged. There are no hematomas.The ventricles and sulci are normal in size. There is no mass effect or midline shift. There is no evidence for acute cerebral or cerebellar cortical infarction. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Redemonstrated are postoperative changes which include decreasing pneumocephalus as well as stable extra-axial fluid admixed with blood products, subcutaneous swelling, calvarial fixation devices, and overlying skin staples. |
Generate impression based on findings. | 34-year-old male with cough, evaluate infiltrate LUNGS AND PLEURA: No pleural effusion or pneumothorax. Apical predominant bronchiectasis and numerous irregular thin-walled cysts. Patchy apical predominant reticulonodular opacities.MEDIASTINUM AND HILA: Significant mediastinal and hilar lymphadenopathy. For reference, there is an anterior subcarinal lymph node measuring 12 mm (series 4, image 34). The heart size is normal. No pericardial effusion.CHEST WALL: The osseous structures are within normal limits. No suspicious osseous lesions. Prominent axillary lymph nodes. No significant cardiophrenic or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Splenomegaly. Prominent para-aortic lymph nodes measuring up to 13 mm (series 4, image 110). | Bilateral apical predominant patchy reticulonodular opacities with bronchiectasis and numerous irregular thin-walled cysts. Differential considerations may represent sarcoidosis, chronic hypersensitivity pneumonitis, Langerhans cell histiocytosis, or inhalational exposures (pneumoconiosis). |
Generate impression based on findings. | Abdominal distentionVIEW: Abdomen AP (one view) 3/19/15 at 1820 hrs. NG tube terminates in the stomach. Surgical clips are again noted. Multiple dilated, slightly featureless bowel loops mainly located in the left upper abdomen quadrant are again noted testicular swelling for obstruction or ileus. No free air or pneumatosis intestinalis. | Findings concerning for bowel obstruction or ileus as described. |
Generate impression based on findings. | Hematuria and abdominal pain. Rule out renal stones. Following observations are made given the limitations of an unenhanced study.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, URETERS: No hydronephrosis. No renal calculi. Study is insensitive for detecting small renal masses.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Appendix is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Intrauterine device.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No findings to explain abdominal pain and hematuria. No renal calculi. Study is insensitive for the detection of a small renal mass; if this is a consideration, I would advise an enhanced study for further evaluation. |
Generate impression based on findings. | 22-year-old male with history of gunshot wound to the neck. Please note motion limits details of exam. Two views of the cervical spine demonstrates normal anatomic alignment. No acute fracture is evident. A bullet is present in the superficial soft tissues of the right neck. There is massive prevertebral soft tissue swelling, which may represent hematoma secondary to vascular injury, measuring up to 7.3 cm anterior to the lower cervical spine. Multiple foci of gas are present in the soft tissues as well. An ET tube terminates approximately 6 cm above the carina. A radiopaque BB projects to the region of the right apex, and is partially visualized on the lateral, felt to represent a superficial marker. | Bullet fragment in the lateral right neck. No evidence of acute fracture or malalignment of the cervical spine. Massive prevertebral soft tissue swelling as above. |
Generate impression based on findings. | History of rheumatoid arthritis. Evaluate for progression. Three views of the left hand and three views of the left wrist wrist show resection of the carpal bones and distal ulna with a total wrist arthroplasty device. Three screws insert into the second, third, and fourth metacarpals. Lucency around the screws and radial prosthesis suggests loosening, similar to the prior study. The bones are diffusely demineralized. Narrowing and erosions at the MCP joints is similar to the prior study. Narrowing and sclerosis at the DIP joints is compatible with osteoarthritis.Three views of the right hand and three views of the right wrist again show a combination of osteoarthritic and rheumatoid arthritic changes with significant narrowing and sclerosis of the carpal bones, the MCP joints, and the interphalangeal joints. Erosive changes at the MCP joints appears similar to the prior study. There mild increased narrowing of the DIP joints with mildly increased erosive changes of the middle finger DIP joint. No acute fracture is evident. The bones are diffusely demineralized.Three views of the right shoulder again show deformity of the femoral head, osteophyte formation at the glenohumeral joint, and subchondral sclerosis; this appears increased from the prior study. There is interval increased erosion of the surgical neck of the humerus compared to the 2010 study involving up to one third of the humeral width. The bones are diffusely demineralized.Three views of the left shoulder show deformity of the humeral head, osteophyte formation at the glenohumeral joint, and subchondral sclerosis. No acute fracture is evident. There is mild erosion of the medial aspect of the surgical neck of the humerus. | 1. Osteoarthritic and rheumatoid arthritic changes of the hands and wrists, which appear grossly similar to the prior study except for increased erosion of the left middle finger DIP joint suggestive of a secondary process such as erosive osteoarthritis. 2. Increased erosion of the right proximal humerus with increased secondary osteoarthritis of the glenohumeral joint; although this is not of immediate concern for fracture, this should be taken in consideration in the future depending on the patient's activity level.3. Mild erosion of the left proximal humerus with secondary osteoarthritis of the glenohumeral joint. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reductions. Family history of breast cancer diagnosed in maternal aunt at age 76. 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. Bilateral small asymmetries are unchanged. Bilateral benign calcifications are also unchanged.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: please comment on edema and mass effect History: ams The CSF spaces are appropriate for the patient's stated age with no midline shift. There is hypodensity present involving white matter in the right frontal lobe, right external capsule and right anterior temporal lobe. This was also present on the prior days exam and does not appear to have changed appreciably. I has progressed since 3/5/15.A burr hole is present in the right frontal bone.The visualized portions of the paranasal sinuses demonstrate some mucosal thickening in the sphenoid sinus. The patient status post intubation. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. | 1.Compared to prior exam from 3 days ago, the white matter based lesion involving the right frontal lobe, right temporal lobe and the right external and internal capsules has remained stable though it is progressed since 3/5/15. Etiology is uncertain and the findings are not specific for a particular entity. Given its rapid progression and the lack of neoplasm on biopsy, an inflammatory condition including infection may be possible. This would include PML given its dominant white matter involvement. |
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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 50 year-old female with history of right ankle pain. Three views of the right ankle demonstrate normal anatomic alignment. There is no evidence of acute fracture. There is mild soft tissue selling along the lateral aspect of the ankle. | There is no acute fracture or malalignment. |
Generate impression based on findings. | 44-year-old male with pain and swelling to the left shoulder; concern for abscess. Inflammation and edema distort the fat planes in the left axilla. A low-density fluid collection within the subscapularis muscle, anteromedial to the glenoid and directly inferior to the coracoid process measures approximately 3.5 x 1.7 cm, without definite enhancing rim (series 80448, image 48). There is no adjacent cortical destruction to suggest bony involvement. The remaining musculature in the shoulder appears uninvolved. There is no significant associated lymphadenopathy.Mild degenerative disease affects the right shoulder, including small osteophyte formation, joint space narrowing and mild subchondral sclerosis.Limited views of the left lung apex demonstrate dependent atelectasis. | Low-density fluid collection within the subscapularis is concerning for evolving infection/immature abscess formation. Associated inflammation and edema in the left axilla. No adjacent bony involvement is evident. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right benign breast biopsy. Family history of breast cancer diagnosed in maternal grandmother at age 92 and ovarian cancer diagnosed in mother at age 73. 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. X-shaped biopsy clip in the left upper outer quadrant is unchanged in position. Left benign calcifications have progressed in a benign fashion. Right intramammary lymph node is also stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Left shoulder painVIEWS: The shoulder AP in internal and external rotation , Grashey and Y view 3/20/15 (4 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Cerebral aneurysm. There is no appreciable interval change in the left ophthalmic segment carotid artery aneurysm that measures up to 6 mm. The aneurysm features a wide neck and the left ophthalmic artery arises from the aneurysm. The bilateral internal carotid arteries are also mildly ectatic diffusely as is the origin of the left posterior cerebral artery, which is unchanged. There is no evidence of significant steno-occlusive lesions. There appears to be cerebellar volume loss. | 1. No appreciable change in the left ophthalmic segment carotid artery aneurysm that measures up to 6 mm.2. Apparent cerebellar volume loss. |
Generate impression based on findings. | 85 year old female status post left mastectomy in 2004 for DCIS, presents today for routine follow up. History of benign right breast biopsy. No current breast complaints. Family history of breast carcinoma in her sister. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications, some of which are vascular, are present. A biopsy clip is noted within the central slightly outer right breast. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 57 years old; Reason: cancer staging, known metastatic NSCLC. LUNGS AND PLEURA: The necrotic-appearing right apical lung mass is again seen. This mass invades the right upper lobe bronchus, causing right upper lobe atelectasis. The mass also invades the right pulmonary artery and right superior pulmonary vein. This mass is difficult to accurately measure for comparison due to interval development of surrounding right upper lobe atelectasis, though likely measures at least 6 x 6 x 6 cm. Post-radiation changes are noted in the superior segment of the right lower lobe. The innumerable pulmonary nodules bilaterally are increased in size and number. New nodularity in the mainstem airways bilaterally reflects additional metastatic disease. Small bilateral pleural effusions are present, slightly increased.MEDIASTINUM AND HILA: Normal sized heart. Small pericardial effusion, likely metastatic. Right hilar soft tissue likely represents a combination of lymphadenopathy and contiguous pulmonary masses, with narrowing of the right lung central airways. CHEST WALL: New rib fractures are noted bilaterally, suspicious for pathological fractures. UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Prominent upper abdominal lymph nodes are noted, though unchanged. Otherwise, no significant abnormality noted. Please refer to the separate CT report for further evaluation of the abdomen and pelvis. | 1. Large invasive right upper lobe mass with increased evidence of metastatic disease, as above.2. Tumor invasion of the right upper lobe bronchus with right upper lobe atelectasis. 3. Please refer to the separate CT report for evaluation of the abdomen and pelvis. |
Generate impression based on findings. | Female; 24 years old. Reason: r/o appy History: rlq and periumbilical pain with n/v 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, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix visualized in the right lower quadrant (series 3/images 94-99).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Small amount of endometrial fluid, likely physiologic. Small hypoattenuating right adnexal lesion, likely a physiologic cyst (series 3/108).BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: 1.7 x 1 cm partially visualized Bartholin's gland cyst (series 3/144).OTHER: Mild pelvic ascites measuring near water density, likely physiologic versus due to a ruptured ovarian cyst. | 1. No acute appendicitis.2. Probable physiologic cyst in the right ovary. 3. Mild pelvic ascites, likely physiologic versus due to a ruptured ovarian cyst. Pelvic ultrasound can be obtained for further characterization as clinically indicated. |
Generate impression based on findings. | There is a solitary punctate focus of T2 hyperintensity in the left frontal subcortical white matter without associated mass effect, restricted diffusion, susceptibility abnormality, or enhancement. A solitary punctate focus such as this is likely of no clinical significance. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. | Essentially negative contrast-enhanced brain MRI. Specifically, there are no MRI findings to explain the patient's symptoms. |
Generate impression based on findings. | Evaluate for intra-abdominal infection or inflammation. Abdominal pain and bloody stools. Concern for colitis. 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, URETERS: Punctate, nonobstructive left renal calculus.RETROPERITONEUM, LYMPH NODES: Subcentimeter lymph nodes in the right lower quadrant.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT evidence of colitis as clinically queried. A few small right lower quadrant mesenteric lymph nodes are noted. Punctate, nonobstructive left renal calculus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of cervical cancer diagnosed in maternal grandmother and aunt. 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. Stable left asymmetries. Stable scattered benign calcifications bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 37 year old female who has a complaint of right retroareolar pain. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla.ULTRASOUND: On physical examination, no palpable abnormality is appreciated.Targeted left ultrasound was performed for the patient's area of concern. At the 2 o'clock position of the right breast, in the area of pain, there is no solid or cystic mass identified. | No mammographic or sonographic evidence of malignancy. The patient should return to her primary physican for management of her right breast pain. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, to begin at age 40. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast biopsy. Family history of breast cancer diagnosed in maternal aunt and paternal aunt at age 35. 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 markers were placed over both breasts. Stable right posterior lateral asymmetry. Stable scattered benign calcifications bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Malignant neoplasm of the lung. Staging. ABDOMEN:LUNG BASES: Widespread metastases at the lung bases; most the nodules are approximately 5 to 10 mm in diameter. A reference nodule at the left lung base (image 11; series 10) measures 1.4 x 1.4 cm. Bilateral pleural effusions. Healing rib fractures bilaterally; correlate with chest CT. Small pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst.RETROPERITONEUM, LYMPH NODES: Gastrohepatic lymph node measures 2.2 x 1.5 cm (image 36; series 9). Subcentimeter retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Pelvic adenopathy. For reference purposes a left common iliac lymph node measures 1.4 x 1.3 cm (image 100; series 9)BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Innumerable pulmonary metastases. Healing rib fractures. Lymph nodes in the abdomen and pelvis with reference measurements given above. |
Generate impression based on findings. | Pain. Evaluate knee. Two portable views of the left knee show no acute fracture. There is moderate to severe medial compartment joint space narrowing. Osteophyte formation is noted in the medial and patellofemoral compartments. There is perhaps a small joint effusion. | Near severe osteoarthritis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. 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 distribution. Scattered bilateral benign calcifications have progressed in a benign fashion.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female; 51 years old. Reason: eval for pathology History: abd pain ABDOMEN:LUNG BASES: Stable scattered micronodules in the partially visualized lung bases. Minimal bibasilar dependent atelectatic changes.LIVER, BILIARY TRACT: No focal hepatic lesions. New biliary tree dilation due to biliary limb obstruction (see below). Biliary sludge and/or cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple stones previously seen in the left renal pelvis and calyces are no longer visualized, presumably due to interval removal. Small nonobstructing left lower pole stone. Stable left renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of Roux-en-Y gastric bypass. Marked dilation of biliary limb with transition point at jejunojejunal anastomosis in the midabdomen (series 3/77), compatible with high-grade mechanical small bowel obstruction. No pneumatosis, portal venous gas, or free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | High-grade small bowel obstruction of biliary limb with transition point at jejunojejunal anastomosis in the midabdomen. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in maternal grandmother. 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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Circular skin markers are placed over the right breast. Scattered benign calcifications have slightly progressed in a benign fashion.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 28-year-old male with left hip pain. Single view of the pelvis there is normal anatomic alignment without evidence of acute fracture. The lower lumbar spine and sacroiliac joints are unremarkable. Minimal osteoarthritis affects both hips.Single view the left hip demonstrates normal anatomic alignment without acute fracture. Minimal osteoarthritis affects the left hip. No significant bony abnormality is noted. | Minimal osteoarthritis of the hips. |
Generate impression based on findings. | Buccal mucosa cancer status post radiation, chemotherapy, and resection in 2009 now in remission, and seropositive, erosive RA. There are post-treatment findings in the neck. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and remaining salivary glands are unremarkable. There is extensive plaque at the carotid bifurcations. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. There is partial opacification of the mastoid air cells. There is pulmonary emphysema. | post-treatment findings in the neck without evidence of measurable mass lesions or significant cervical lymphadenopathy. |
Generate impression based on findings. | 6-month-old former 29 week gestational age patient with pulmonary hypertension.VIEW: Chest AP (one view) 03/19/15, 1908 Tracheostomy tube tip is at thoracic inlet. Feeding tube tip is distal to GE junction and not included on the image.Lung volumes are large with the hemidiaphragms of the 12th stir tubes. Coarse bilateral opacities are noted. Focal opacities are present in left lung. Cardiac silhouette size is probably enlarged. | Focal left lung opacities on background of chronic disease. These opacities may be pneumonia or atelectasis. |
Generate impression based on findings. | 4-year-old female with tachypnea and respiratory distressVIEW: Chest AP (one view) 3/20/15 at 0551 The cardiothymic silhouette is normal. Fluffy air space opacity in the left upper lung may represent a pneumonia or atelectasis. No pleural effusion or pneumothorax. | Air space opacity in the left upper lung is favored to represent a pneumonia over atelectasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history ovarian cancer diagnosed in maternal grandmother at age 70. 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 distribution. Left outer breast asymmetry is stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 59 year-old female with left radial neck fracture. Three views of the left elbow demonstrate the previously described slightly impacted, but essentially nondisplaced fracture of the radial neck. The fracture line is no longer well-visualized, indicative of interval healing. There remains mild cortical irregularity along the lateral aspect of the radial head. There is been interval resolution of the anterior and posterior fat pad elevation. | Radial neck fracture as above. |
Generate impression based on findings. | Male 18 years old Reason: Evaluation of lung pathology History: increasing ESR, CRP; CXR with concern of right effusion. LUNGS AND PLEURA: Multifocal opacities of the right upper lobe and both lung bases are again noted. Rim enhancement around the right pleural effusion is concerning for empyema. Small underlying pleural effusion is noted on the left lung base as well.MEDIASTINUM AND HILA: No significant abnormality noted. ET tube terminates below thoracic inlet.CHEST WALL: Skeletal deformities unchanged. Right-sided soft tissue scanning from previous chest tube placement noted.UPPER ABDOMEN: Normal partial view of the solid organs and hollow viscus of the upper abdomen. | Persistent multifocal opacities with no evidence of pulmonary abscess.Right-sided early empyema formation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. 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 distribution. Stable intramammary lymph nodes in both upper outer breasts. Scattered benign calcifications in both breasts are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 51 year-old male with history of pain and stiffness of the first MTP joint. Three views of the left foot demonstrate moderate osteoarthritis of the first metatarsophalangeal joint, including joint space narrowing and significant osteophytosis. There is fusion of the middle and distal phalanges of the fourth and fifth toes, which may be congenital, posttraumatic or postsurgical in nature. Mild osteophytosis of the midfoot is indicative of osteoarthritis. Mild stress reaction versus old injury is noted of the fourth proximal phalanx. There is no significant soft tissue swelling or acute fracture identified. | Moderate osteoarthritis of the first metatarsophalangeal joint. |
Generate impression based on findings. | Verbal report of elevated cANCA, question of vasculitis, reported history of chest pain Coronary arteries: Normal origins are noted.LM: The left main coronary artery arises normally from the left sinus of Valsalva and trifurcates into the left anterior descending, ramus intermedius and left circumflex coronary arteries. There are no significant stenoses present in the left main coronary artery.LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the one small diagonal and several septal branches. There are no significant stenoses in the left anterior descending artery. The one diagonal branch is too diminutive to evaluate on a postprocessing workstation; however, appears free of stenosis on axial images.Ramus: Large in caliber and free of stenosis.LCx: The left circumflex coronary artery is non-dominant. It courses normally in the left atrioventricular groove. It gives rise to two obtuse marginal branches. The first obtuse marginal branch is small and is unremarkable. The second obtuse marginal branch is large and free of stenosis. There are no significant stenoses in the left circumflex coronary artery.RCA: The right coronary artery is large and arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There are no significant stenoses in the right coronary artery. Approximately 3 cm of the posterior descending artery are visualized. No stenosis of the PDA is identified.CHEST:LUNGS AND PLEURA: Visualization of the lung parenchyma is limited by the field of view and length of scan which excludes a substantial amount of the lungs. Pulmonary micronodular in the peripheral superior segment of the right lower lobe (7/18). No pleural effusion.MEDIASTINUM AND HILA: Limited imaging in the z-axis direction was performed, which initiates at the level of the carina and extends to the dome of the diaphragm. The overall heart size is normal. No pericardial effusion is present. The appendage is free of thrombus. The right superior and middle lobe pulmonary veins share a common ostium. A right inferior pulmonary vein is unremarkable. There are two left pulmonary veins entering into the left atrium.No mediastinal or hilar lymphadenopathy.No evidence of aortic dissection of the visualized thoracic aorta.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Limited evaluation of the superior abdomen reveals no abnormalities. | There are no significant coronary artery stenoses present. |
Generate impression based on findings. | 15-year-old female with right knee pain after basketball injury. Four views of the right knee demonstrate no evidence of acute fracture, malalignment, or significant joint effusion. Note is made of bilateral congenital bipartite patellae, a normal variant. | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | Male; 83 years old. Reason: evaluate for abdominal process History: nausea, vomiting ABDOMEN:LUNG BASES: No suspicious pulmonary nodules or masses.LIVER, BILIARY TRACT: No suspicious hepatic lesions. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat-containing paraumbilical hernia.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Stable prosthetic hypertrophy with metallic fiducial markers within the prostate bed.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Left iliac sclerotic focus is unchanged and compatible with metastatic disease (series 3/88).OTHER: Stable penile prosthesis without evidence of complication. | 1.No findings to account for the patient's symptoms.2.Stable left iliac sclerotic focus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, additional right CC view, 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 distribution. Circular skin markers were placed over both axillae. Benign calcifications in both breasts are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Status post EVD placement. Evaluate for progression of intracranial hemorrhage and weakness. Redemonstrated is a left frontal approach ventricular catheter with tip near the midline in the left lateral ventricle. There is slight interval decrease in the size of the lateral and third ventricles. Again seen is an intraparenchymal hemorrhage centered within the right thalamus with extension into the adjacent ventricular system, stable in appearance. There is redistribution of the intraventricular hemorrhages. There is no midline shift. There is unchanged medialization of the uncus bilaterally, which slightly effaces the basilar cisterns. Encephalomalacia is again seen in bilateral anterior frontal lobes involving periorbital gyri and rectus gyri, most suggestive of prior head trauma. There are small mucous retention cysts in the left maxillary sinus. The remaining imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unchanged. Partially imaged is an endotracheal tube with secretions in the nasopharynx. | 1. Left frontal approach ventricular catheter is unchanged in position with slight interval decrease in the size of the ventricular system.2. Stable right thalamic intraparenchymal hemorrhage extending into the adjacent ventricular system with redistribution of intraventricular hemorrhages.3. Unchanged medialization of the uncus bilaterally causes slight effacement of the basilar cisterns. |
Generate impression based on findings. | Male 15 years old Reason: eval L hip for signs infection History: NF1, GSW, paraplegia, increased CRP PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Cortical destruction, bone erosion and fragmentation of the left acetabular roof, femoral head, femoral neck and major trochanter. Joint effusion. Increased thickening of the internal obturator muscle, and left iliopsoas muscle, with overall increasing in the left thigh diameter.OTHER: None. | Findings concerning for left hip osteomyelitis with joint effusion and thickening of the left iliopsoas and internal obturator muscles. |
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. Asymmetry in the left central breast posterior depth on the CC view.No suspicious masses, microcalcifications or areas of architectural distortion are present. | Asymmetry in the left central breast posterior depth, for which comparison with prior outside exam is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Right middle fossa craniotiomy and mastoidectomy for CSF leak. There are recent postoperative findings related to right mastoidectomy and skull base repair with reconstruction of the right tegmen with interval increase in swelling of the scalp overlying the craniotomy site. There is a small amount of residual pneumocephalus, as well as trace extra-axial fluid deep to the craniotomy. There is non-specific opacification of the remaining right mastoid air cells and middle ear. There is also left otomastoid opacification. The grey-white matter differentiation appears to be intact. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. There is mild scattered paranasal sinus opacification. | Postoperative findings related to right mastoidectomy and skull base repair with increased right scalp swelling and persistent bilateral nonspecific tympanomastoid opacification. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reductions in 1986. Family history of breast cancer diagnosed a maternal grandmother in her 50s. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Stable asymmetry in the left central breast. Scattered bilateral benign calcifications, including oil cysts, are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female 61 years old; Reason: metastatic breast caner - evaluate response to treatment with bidimensional measurements per recist 1.1 History: known lung mets CHEST:LUNGS AND PLEURA: The reference right lower lobe pulmonary nodule measures 3 x 3 mm (image 73; series 5), unchanged and possibly representing scarring. Slow-growing reference left lower lobe pulmonary nodule adjacent to the left major fissure measures 0.9 x 0.9 cm, slightly larger (image 49; series 5). Post radiation changes in the anterior aspect of the left upper lobe.MEDIASTINUM AND HILA: Reference mediastinal lymph node measures 0.7 x 0.6 cm (image 32; series 3), unchanged.CHEST WALL: Postsurgical changes in the left breast and left chest wall.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensities in the liver unchanged. The hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Status post right TRAM flap reconstruction of the left breast.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted. Subcentimeter pelvic lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slow-growing left pulmonary nodule with measurements given above. |
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