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Generate impression based on findings. | 79-year-old female with suspicious right upper lobe nodule CHEST:LUNGS AND PLEURA: Interval increase in size of right apical nodule measures 12 mm, previously 9 mm (series 5, image 44).The index right upper lobe pulmonary lesion cannot be accurately measured on the current study due to resolution of the walled cyst and... | 1.Interval increase in size of right apical nodule.2.Assessment of right upper lobe lesion is complicated by postradiation reduction and atelectasis. Interval improvement of the walled cystic component.3.Right lower lobe mass-like opacity appears decreased in size and may represent evolving fibrosis.4.Interval increase... |
Generate impression based on findings. | 50 year-old female with hip and knee pain. Moderate stool and gas obscure the fine details of the pelvis. However, mild osteoarthritis affects the hips and sacroiliac joints.Mild osteoarthritis affects the right knee. There is no evidence of significant joint effusion or acute fracture. Alignment is preserved. | Mild osteoarthritis of the sacroiliac joints, the hips, and the right knee. |
Generate impression based on findings. | Low back pain. Three views of the lumbar spine show no acute fracture. There is a very mild leftward curvature of the lumbar spine. Vertebral body heights and disk spaces are maintained. | No acute fracture is evident. |
Generate impression based on findings. | Left knee pain. Four views of the left knee show moderate to severe joint space narrowing of the medial compartment and moderate narrowing of the lateral femoral compartment. Medial compartment osteophytes are noted. No acute fracture is evident.A side plate and screw devices affixes the proximal right tibia on the fro... | Moderate to severe osteoarthritis of the left knee. |
Generate impression based on findings. | Pain. Three views of the right shoulder show no acute fracture or dislocation. There is near severe osteoarthritis of the right glenohumeral joint with near bone on bone apposition.Three views of the left shoulder show no acute fracture or malalignment. The glenohumeral and acromioclavicular joints appear normal. | Near severe right shoulder osteoarthritis. |
Generate impression based on findings. | 66 -year-old male with left shoulder pain. Three views of the left shoulder demonstrate mild osteoarthritis, including mild joint space narrowing and subchondral sclerosis. Alignment is anatomic, there is no evidence of fracture. Osteoarthritis also affects the acromioclavicular joint. | Mild osteoarthritis of the left shoulder. |
Generate impression based on findings. | 73-year-old female with neck pain. Four views of the cervical spine demonstrate slight demineralization, suggestive of osteopenia. There is severe disk space narrowing of the cervical spine and anterior vertebral body osteophyte formation, sparing C2-3 and C7-T1 levels. Bulky osteophytes cause moderate bilateral neural... | Degenerative disease of the cervical spine and left shoulder as above. |
Generate impression based on findings. | Male 17 years old Reason: foot fracture? History: pain swelling tender to L 4th metatarsalVIEWS: Left foot AP lateral and oblique 3/20/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 70 years old; Reason: mediastinal parathyroid adenoma History: s/p thyroidectomy LUNGS AND PLEURA: No specific evidence of infection or edema. No focal airspace opacities or pleural effusions. A ground glass micronodule in the left upper lobe is nonspecific (series 5, image 54).MEDIASTINUM AND HILA: An 8 x 7 mm ... | Unchanged 8 mm mediastinal nodule anterior to the pulmonary trunk. |
Generate impression based on findings. | Male 93 years old Reason: history of rising PSA with prostate cancer History: prostate cancer with rising PSA No abnormal osseous foci are identified to indicate metastatic disease. Increased uptake consistent with degenerative disease is again noted in both shoulders, knees, right L4-5, and right clavicular head, unch... | No evidence of bone metastases. |
Generate impression based on findings. | Female 44 years old Reason: metastatic breast cancer, needs surveillance imaging History: vaginal discharge Again seen are multiple osseous metastatic lesions, including in the lumbar spine, upper thoracic spine, skull and the ribs. There is suggestion of new lesion at L4-5, the right inferior sacroiliac, left proximal... | Findings suspicious for slight interval progression of osseous metastatic disease. |
Generate impression based on findings. | Anemia. Evaluate for retroperitoneal bleed. ABDOMEN:LUNG BASES: Bilateral pleural effusions (right greater than left) with overlying compressive atelectasis. Please refer to yesterday's chest CT for more details; these are not changed.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormal... | No evidence of retroperitoneal hematoma as clinically queried. Aortic balloon pump. Bilateral pleural effusions, unchanged. Nonobstructive abdominal wall hernia. |
Generate impression based on findings. | Restaging head and neck uvula cancer status post chemoradiation therapy.RADIOPHARMACEUTICAL: 11.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 103 mg/dL. Today's CT portion grossly demonstrates posttherapy changes in the neck. Right chest Port-A-Cath with tip in the SVC. Gastrostomy tube is noted.Today's ... | 1.Significant interval decrease in left parapharyngeal lesion indicating a significant metabolic response to therapy. Small residual moderate activity at this site and the stable moderate activity in a more inferior subcentimeter left jugular lymph node may reflect some residual tumor metabolism versus inflammation. At... |
Generate impression based on findings. | There has been evolution of the previously seen subdural hematoma over the right cerebral convexity. This collection has decreased in attenuation and now measures 9 mm in maximal thickness, previously 10 mm. There is no new intracranial hemorrhage. Scattered areas of white matter hypoattenuation suggests small vessel ... | Continued evolution of the right subdural hematoma without new intracranial hemorrhage. |
Generate impression based on findings. | 58 year old male with altered mental status on anti-coagulation. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is opacification and atelectasis of the left maxillary sinus. The imaged paranasal sinu... | No evidence of intracranial hemorrhage. |
Generate impression based on findings. | Healing fractures are again seen in the posterior left 10th and 11th ribs.The previously visualized healing fractures along the posterior left ninth and right ninth and 10th ribs are not visualized on this exam.Healing fracture of the clavicle high more callus formationCasting material obscures fine osseous detail and... | Healing fractures of the left 10th and 11th posterior ribs and left clavicle as detailed above. A left distal humerus fracture has significant new callus formation, compatible with acute presentation on 3/4/2015. Periosteal reaction along the left tibia is similar to the prior exam. |
Generate impression based on findings. | There is interval significant thickening and enhancement of the right frontal scalp, likely related to prior frontal scalp wound noted on medical records. Stable thickening of the right parietal scalp, which also appears enhancing on this contrast CT. No associated osseous changes noted.There are unchanged postoperati... | 1.Interval new thickening and enhancement of the right frontal scalp, likely at least in part related to prior wound and interval postprocedural changes. Correlation with physical exam is recommended as superimposed soft tissue infection would have a similar appearance. No focal fluid collection or abscess identified.2... |
Generate impression based on findings. | Female; 40 years old. Reason: assess for metastatic disease CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Right chest wall Port-A-Cath tip in the superior cavoatrial junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable punctate nonspecific hypoatten... | Mild retroperitoneal and pelvic lymphadenopathy has slightly decreased in size since prior study. Please see report from PET examination performed concomitantly. |
Generate impression based on findings. | 13-year-old female with tenderness to palpationVIEWS: Left tibia-fibula AP, lateral (two views) 3/20/15 No fracture or malalignment. No significant soft tissue swelling. | No fracture or malalignment. |
Generate impression based on findings. | Rheumatoid arthritis. Evaluate for disease progression. Three views of the left hand again show chronic erosive changes of the fifth metacarpophalangeal joint. Scattered arthritic changes affecting the interphalangeal joints appear similar to the prior study except for mild increased osteoarthritis of the middle finger... | No evidence of progression of rheumatoid arthritis. |
Generate impression based on findings. | Rheumatoid arthritis. Evaluate for erosive disease. Three views of the left hand reveal juxtaarticular osteopenia. A small erosion is noted at at the ulnar aspect of the lunate bone and the triquetrum. No fracture is evident.Three views of the right hand show juxtaarticular osteopenia. Small erosions are noted along th... | Bilateral carpal erosions compatible with rheumatoid arthritis. |
Generate impression based on findings. | 55 year old female status post right mastectomy in 2004 for breast carcinoma, presents today for routine follow up. Patient received hormonal therapy. No current breast complaints. No family history of breast cancer. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female, 5 months old. Reason: concern for VOD in stem cell transplant patient History: edema, tachycardia DOPPLER: Spectral and color Doppler of the inflow and outflow vessels of the liver and spleen was performedPORTAL VENOUS: Patent hepatopetal portal flow measures 0.3 m/sec.HEPATIC ARTERIES: Normal hepatic arterial ... | Normal examination. |
Generate impression based on findings. | Reason: mandibular or maxillary fracture History: fall onto face Head: No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No extra-axial fluid collections. Generalized cerebral volume loss. The imaged orbits are intact. Max/Facial: Multiple mandibular and ma... | 1.No fracture is identified.2.Multiple mandibular and maxillary dental periapical lucencies compatible with dental disease.3.No acute intracranial hemorrhage. |
Generate impression based on findings. | 16-year-old male with history of constipationVIEW: Abdomen AP (one view) 3/20/15 The abdomen radiograph is underexposed. Gastrostomy tube is present. Severe lumbar levoscoliosis. Nonobstructive bowel gas pattern with a small to moderate stool burden. No pneumatosis, free air, or portal venous gas. The right femoral hea... | Small to moderate stool burden. |
Generate impression based on findings. | 48-year-old female with history of left shoulder pain, decreased range of motion, sarcoidosis. Three views of the left shoulder demonstrate minimal osteoarthritis affecting the glenohumeral and acromial clavicular joints. Partially visualized sternotomy wires are unremarkable. There is no acute fracture or malalignment... | 1.Minimal osteoarthritis of the shoulders.2.Juxta-articular osteopenia of the carpal and metacarpal joints in the hands, without other discrete evidence of inflammatory arthritis. |
Generate impression based on findings. | 4-month-old female, evaluate pulmonary anatomy, history of chylothorax LUNGS AND PLEURA: Diffuse bilateral coarse pulmonary opacities with more confluent consolidation in the right and left upper lobes. No significant pneumothorax. Trace left pleural effusion. Left chest tube with tip near the apex. Endotracheal tube t... | 1.Diffuse bilateral coarse pulmonary opacities. 2.Trace left pleural effusion. 3.Linear calcification in the region of the left brachiocephalic likely represents a calcified thrombus. 4.Several left lateral rib fractures likely secondary to chest tubes. |
Generate impression based on findings. | Male 66 years old Reason: follow up for prostate cancer History: prostate cancer Again seen is widespread osseous metastatic disease in a so-called SuperScan distribution. While interval change of this disease is difficult to assess given its widespread nature, there are no new definite lesions identified, with multipl... | Widespread osseous metastatic disease with likely improvement over previous exam with no definite new lesion. |
Generate impression based on findings. | Reason: CVA History: CVA. Left hemiparesis and visual field defect. Right hemispheric syndrome. The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hyperdense MCA and ICA sign present.There is loss of the gray-white distinction along the middle cerebral artery distribution of t... | 1.Findings are suggestive of early evidence for right middle cerebral artery territory acute ischemic stroke due to right carotid terminus occlusion. 2.No evidence for acute intracranial hemorrhage or mass effect.3.On a couple hypodense foci in the basal ganglia bilaterally are suspected to be vascular related. They co... |
Generate impression based on findings. | Pain. History of JIA. Three views of the left hand show juxtaarticular osteopenia. There are erosions at the base of the ulnar styloid and lunate. Narrowing of the distal articulations is noted, most predominately affecting the MCP joints, without clear erosions. The carpal articulations are narrowed. Swan-neck deformi... | Inflammatory arthritic changes as described above. |
Generate impression based on findings. | Male, 47 days old. Increased work of breathing. Evaluate for aspiration.EXAMINATION: Oropharyngeal motility study 3/20/2015, 1330 Beth Harrison, speech and language therapist, supervised the examination.1 minute 53 seconds of fluoroscopy was used.Decreased expression of fluid with slow flow presentation, with 2 - 3 suc... | Penetration without aspiration as detailed above.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | Reason: Pleural mesothelioma please compare to prior exam provide bi-dimensional measurements per RECIST 1.1 criteria History: Pleural mesothelioma CHEST:LUNGS AND PLEURA: Pleural thickening/nodularity and loculated pleural effusion within the left hemithorax compatible with the stated history of mesothelioma.Level the... | 1.Nodularity and loculated pleural effusions in the left hemithorax as described compatible with the history of mesothelioma. Findings are not significantly changed since the outside hospital exam on 2/6/15.2.No evidence of metastatic disease in the upper abdomen. |
Generate impression based on findings. | 44-year-old female with history of orthopedic fixation of left ankle fracture. Three views of the left ankle again demonstrate a plate and screw device affixing a fracture of the distal fibular diaphysis, in near-anatomic alignment. There is no radiographic evidence of hardware complication. A K-wire and screw also aff... | Orthopedic fixation of distal fibular and tibial fractures as above. |
Generate impression based on findings. | 62 year-old female status post removal of left elbow hardware. Four views of the left elbow again demonstrate evidence of previous orthopedic fixation of the olecranon, not significantly changed when compared to prior exam. There is been interval resolution of soft tissue gas, which was likely postoperative. There is m... | Stable exam without evidence of acute fracture. Chronic deformities as above. |
Generate impression based on findings. | Images are limited secondary to portable technique, with areas of beam hardening and other artifact. There is a focal area of low density in the high right cerebellum, with more extensive abnormal low density in the right inferior cerebellum which appears predominantly to be a true finding although there may be a mild... | 1. Scattered areas of abnormal low density, the largest in the right inferior cerebellum, suggestive of embolic acute infarcts. Continued follow-up is recommended for impending cerebellar tonsillar herniation. No acute intracranial hemorrhage.2. Extensive paranasal sinus with air-fluid levels and mastoid opacification.... |
Generate impression based on findings. | 46 your old male status post left total hip arthroplasty. Single view of the left hip demonstrates hardware components of a total hip arthroplasty in near-anatomic alignment; no evidence of fracture or dislocation. Surgical drain and iatrogenic gas are present in the soft tissues. Frontal view of the pelvis demonstrate... | Total left hip arthroplasty as above. |
Generate impression based on findings. | Female 40 years old Reason: assess for metastatic cervical cancer RADIOPHARMACEUTICAL: 13.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion of the neck demonstrates no gross pathology.Today's PET examination demonstrates subcarinal hypermetabolic lymph nodes which have slightly d... | Moderate improvement in metabolic activity but some significant persistent metabolically active metastases involving multiple retroperitoneal and subcarinal lymph nodes.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 63-year-old female status post left total hip arthroplasty. Single view of the left hip demonstrates hardware components of a total hip arthroplasty in near-anatomic alignment; no evidence of fracture or dislocation. Surgical drain, and iatrogenic gas are present in the soft tissues. Frontal view of the pelvis demonstr... | Total hip arthroplasty as above. |
Generate impression based on findings. | Male, 8 years old. PMH of fevers x1 week and persistent abdominal pain. Would like to evaluate for alternate etiology ABDOMEN:LUNG BASES: New small bilateral pleural effusions, with mild associated compressive atelectasis bilaterally.LIVER, BILIARY TRACT: Normal hepatic enhancement, without focal lesion. No biliary duc... | Mild improvement in right-sided pyelonephritis. Left pyelonephritis is more apparent compared to the prior exam. New bilateral pleural effusions and increased free peritoneal fluid. |
Generate impression based on findings. | Male 24 years old; Reason: G-tube placement History: evaluate for G-tube placement Gaseous distention of small bowel and colon most suggestive of an ileus.Enteric contrast outlines the rugal folds of the stomach indicating the placement of the gastrostomy catheter.Postsurgical changes in the thoracolumbar spine, trache... | 1.Administered contrast outlines the rugal folds of the stomach confirming intragastric tube placement. |
Generate impression based on findings. | There is trace grade 1 retrolisthesis of L3 on L4 and L4 on L5. The scout lateral view and the sagittal reformatted images demonstrate the lumbar spine to otherwise be in normal alignment, with a normal lumbar lordosis. There is mild anterior wedging of the L1 vertebral body. The vertebral body heights are otherwise w... | 1. Progression of diffuse osseous lytic metastatic disease involving the visualized lumbosacral spine. Anterior wedge deformity of L1, consistent with pathologic compression fracture. Dorsal epidural spread of tumor at this level with moderate narrowing of the central spinal canal. Possible minimal extension of tumor i... |
Generate impression based on findings. | Adenocarcinoma metastatic to the brain of unknown primary.RADIOPHARMACEUTICAL: 16.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Today's CT portion grossly demonstrates left craniotomy defect with intraparenchymal hot areas of high and low density with intracranial air, similar to recent head CT... | 1.Small hypermetabolic sigmoid colon focus is present and while usually benign, colonic neoplasm is a consideration given the history. If there has not been a recent colonoscopy, this would be useful for further evaluation.2.Otherwise no suspicious FDG avid lesion. |
Generate impression based on findings. | Gastroesophageal cancer. Chemotherapy last given two weeks ago. Restaging exam.RADIOPHARMACEUTICAL: 14.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 86 mg/dL. Today's CT portion grossly demonstrates a large right and medium left pleural effusion. Large esophageal stent is noted. Ascites is present. There... | 1.Distal esophageal hypermetabolic lesion, compatible the patient's history of gastroesophageal cancer.2.Several small hypermetabolic paraesophageal and gastrohepatic region lymph nodes, suspicious for regional lymph node metastases.3.Numerous subtle hypermetabolic osseous foci, highly suspicious for multifocal bone me... |
Generate impression based on findings. | Neuroblastoma status-post MIBG therapy. Multiple areas of abnormal radiotracer uptake are again seen within the left supraclavicular region, the posterior right mediastinum, the distal left paraspinal region, and in a large portion of left retroperitoneum/ left upper abdomen. These areas appear somewhat decreased in si... | Multifocal disease in the left supraclavicular, chest, and abdomen while similar in distribution to previous has decreased somewhat in size and uptake although remain significantly MIBG avid. No osseous MIBG avid tumor. No new MIBG avid lesion. |
Generate impression based on findings. | Clinical question: Evaluate for intracranial hemorrhage. Signs and symptoms: Headache and head injury with loss of consciousness. Nonenhanced head CT:No detectable acute intracranial process. Unremarkable calvarium and soft tissues of the scalp. Unremarkable cerebral cortex, cortical sulci, ventricular system and the C... | No acute intracranial findings. |
Generate impression based on findings. | Clinical question: Evaluate for bleed. Signs and symptoms: AMS and possible fall. Unenhanced head CT:No detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces as well as gray --... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: 45-year-old male with metastatic cancer. Now with right facial droop. Rule out CVA or hemorrhage. Signs and symptoms: As above. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are tiny foci of l... | 1.No acute intracranial hemorrhage, mass effect, midline shift or hydrocephalus.2.Tiny foci of low-attenuation in bilateral inferior cerebellum and left caudate head of unknown etiology. Follow-up with an MRI is recommended to exclude possibility of ischemic strokes. |
Generate impression based on findings. | Clinical question: Evaluate for fracture or intracranial hemorrhage. Signs and symptoms: Head trauma, intoxicated and unclear history. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is been sensitive for early detection of acute nonhemorrhagic ischemic strokes.There is no detectable a... | No acute intracranial process. |
Generate impression based on findings. | Clinical question: Concern for encephalopathy versus intracranial hemorrhage. Signs and symptoms: Concern for abuse. Nonenhanced head CT:There is no evidence of an acute intracranial process. The cerebral cortex, cortical shoulders right, ventricular system, CSF spaces and gray -- white matter differentiation is within... | 1.Unremarkable nonenhanced head CT.2.Patchy opacification of bilateral mastoid air cells and right middle ear cavity concerning for otitis. Patchy opacification of paranasal sinuses. |
Generate impression based on findings. | Clinical question: Evaluate for intracranial changes, elevated pressure, hemorrhage, infection progression, herniation. Signs and symptoms: Left-sided weakness weakness and brain tumor. Nonenhanced head CT:Unremarkable images through posterior fossa and with normal size of fourth ventricle being midline.Examination dem... | 1.Significant interval increase in vasogenic edema in the right frontal lobe on this nonenhanced exam and likely secondary to metastatic disease Rituxan up with an MRI exam is recommended.2.Mass effect and deviation of midline to the left of approximately 13.5 mm.3.No evidence of hemorrhage or hydrocephalus. |
Generate impression based on findings. | Clinical question: AMS, thrombocytopenia. Signs and symptoms: AMS. Nonenhanced head CT:There is no detectable intracranial hemorrhage or mass effect.There are enlarged supratentorial ventricular system. There is a right posterior temporal approach ventricular catheter entering the right occipital horn, extending superi... | 1.No acute intracranial process.2.Enlarged supratentorial ventricular system with a ventricular catheter as detailed. No prior exams for comparison.3.Age indeterminate small vessel ischemic strokes of mild-to-moderate degree. |
Generate impression based on findings. | Clinical question: Rule out stroke. Signs and symptoms: 15 minutes of slurred speech, has been drinking. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is a focus of well demarcated low attenuation in the right b... | 1.No acute intracranial process.2.Chronic right basal ganglia lacunar infarct with ex vacuo dilatation right frontal horn. |
Generate impression based on findings. | Female, 4 years old. Reason: open fx History: ttpVIEWS: Right hand, PA, lateral, oblique (3 views) 3/20/2015, 1712 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male, 7 years old. Reason: please eval for obstruction or malrotation History: bilious emesisVIEW: Abdomen AP (one view) 3/20/2015, 1730 Nonobstructive bowel gas pattern.Small to moderate colonic stool burden. | No evidence of obstruction. |
Generate impression based on findings. | Female 94 years old Reason: Patient with chronic cough, SOB, expiratory wheezing + inspiratory upper airway sounds, CXR with LLL consolidation, possible mucous plugging . Please evaluate, rule out endobronchial lesion. LUNGS AND PLEURA: Small left lower lobe consolidation may represent focal atelectasis or pneumonia. M... | 1.Left lower lobe consolidation may represent focal atelectasis or pneumonia. No definite endobronchial lesion is identified as clinically queried.2.Ascending thoracic aortic aneurysm with findings suspicious for a type A dissection as described. This is better evaluated with a dedicated contrast enhanced gated exam. |
Generate impression based on findings. | Male, 8 years old. Reason: interval changes History: s/p esophageal dilationVIEW: Chest AP (one view) 3/20/2015, 1850 Mediastinal clips are again seen. New lower extremity central venous catheter tip at the IVC/RA junction.Persistent rightward mediastinal shift. Cardiac silhouette size cannot be evaluated.Postoperative... | Decreasing right lung aeration. |
Generate impression based on findings. | Female, 17 days old. Reason: r/o clavicle fracture. 2 week w/ protrusion of clavicle. History: protrusion of clavicleVIEW: Chest AP (one view) 3/20/2015, 1948 The aortic arch, cardiac apex, and stomach are left-sided.The cardiothymic silhouette is normal.No focal pulmonary opacities, pleural effusions, or pneumothorax.... | Healing left clavicular fracture. |
Generate impression based on findings. | Male, 7 years old. Reason: Rule out abd obstruction History: bilious emesis, abd pain, h/o pyloric stenosis s/p repairVIEWS: Abdomen AP, upright and supine (two views) 3/20/2015, 2005 Nonobstructive bowel gas pattern.No pneumatosis, portal venous gas, or free air. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female, 4 years old. Reason: rule out constipation History: abdominal painVIEW: Abdomen AP (one view) 3/20/2015, 2015 Nonobstructive bowel gas pattern.No significant stool burden. | No evidence of obstruction. |
Generate impression based on findings. | Chest pain and shortness of breath. Evaluate for pulmonary embolism. PULMONARY ARTERIES: No pulmonary embolus. Pulmonary arteries are normal in size.LUNGS AND PLEURA: Paramediastinal fibrosis, postradiation changes, and right upper lobe atelectasis are similar to prior exam. Small loculated right pleural effusion is al... | 1.No pulmonary embolism other findings to account for the patient's acute symptoms.2.Stable postradiation changes in the right upper lung.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male, 16 years old. Reason: rule out fracture History: tooth displacement, mandibular injuryVIEWS: Mandible Panorex (one view) 3/20/15, 2048 No acute fracture. The temporomandibular joints are normal.The maxillary sinuses are clear.Orthopedic hardware is noted comment can be better evaluated on physical exam. | No acute fracture. |
Generate impression based on findings. | Female 98 years old Reason: Evaluate for pulmonary embolus History: pleuritic CP, elevated D-Dimer 18 PULMONARY ARTERIES: Multiple, acute, large bilateral pulmonary emboli in the bilateral main pulmonary arteries and extending into the right middle, right lower, and left lower pulmonary arteries. Enlarged main pulmonar... | 1. Multiple acute bilateral pulmonary emboli with evidence of right heart strain as described.2. Right lower lobe opacity with features compatible with a developing pulmonary infarct.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Main.RV Strain: Positive. |
Generate impression based on findings. | Female 6 days old Reason: abdomen is loopy after a few days of starter feeds, evaluate for signs of NEC History: abdominal distensionVIEW: Chest and abdomen AP (two views) 3/21/15 at 711 hours. Interval removal of umbilical line and resolution of portal venous gas. NG tube terminates in the stomach. Cardiac silhouette ... | Interval removal of umbilical line and resolution of portal venous gas.Generalized, nonspecific bowel distention. |
Generate impression based on findings. | Female, 5 months old. Reason: ate, PNA, PE History: desatsVIEW: Chest AP (one view) 3/20/15, 2130 Enteric tube with distal side port below the GE junction.Large remedy CVC tip at the IVC/RA junction.The cardiothymic silhouette is normal.Increasing lung haziness, and scattered opacities, prominently in the left upper lo... | Scattered lung opacities, most prominent in the left upper lobe. |
Generate impression based on findings. | . Venous lower leg wound. Question of osteomyelitis. Three views of the right tibia/fibula show non-specific chronic periosteal reaction along the tibial and fibular diaphyses, similar to the prior study in 2013. No acute fracture is evident. There is edema in the soft tissues.Three views of the left tibia/fibula show ... | Chronic periosteal reaction along the bilateral tibial and fibular diaphyses is non-specific; this may can be seen with multiple entities and osteomyelitis cannot be excluded. |
Generate impression based on findings. | Female, 5 months old. Reason: tube placement History: new intubationVIEW: Chest AP (one view) 3/21/15, 0720 ET tube tip is in the right bronchus intermedius. Lower extremity CVC tip is in the IVC. Enteric tube terminates in the stomach.Interval opacification of the left hemithorax, with volume loss, compatible complete... | Right bronchus intermedius intubation, with associated right upper lobe and complete left lung atelectasis.Findings discussed with Dr. Lauren Rust via telephone at 8:00 a.m. on 3/21/15. |
Generate impression based on findings. | Female 30 days old Reason: change s/p distraction of mandible History: Obstructive sleep apnea.VIEWS: Skull AP and lateral 3/20/15 (two views) NG tube is present. Bilateral mandibular distractors are noted. Normal configuration of the skull. | Postsurgical changes as described. |
Generate impression based on findings. | 60-year-old male. Obstruction. ABDOMEN:LUNG BASES: Bibasilar atelectasis. Small left pleural effusion, new from prior.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted. No splenic artery aneurysm. Splenic vein is patent.PANCREAS: Extensive peripancreatic fat stranding and fl... | 1. Increased peripancreatic fat stranding/fluid around the body and tail consistent with acute pancreatitis. Slight increase in mild heterogeneity of the distal tail may represent small intrapancreatic collections or focal small area of necrosis (<10%).2. New small left pleural effusion.3. No small bowel obstruction as... |
Generate impression based on findings. | Male 66 years old Reason: 66M with h/o metastatic RCC to liver now with 2 weeks of RUQ pain, nausea /vomitting and low grade fevers and new doe/sob, eval for PE and tumor progression vs intra-abd infection History: abd pain, n/v CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged.MEDIASTINUM AND HILA: No signi... | Significant interval increase in the size and number of liver metastases. Subcutaneous nodule in the right lower quadrant has also increased in size.Soft tissue density in the right nephrectomy bed likely representing recurrent disease. Evaluation of this soft tissue density extending into the retroperitoneum is limite... |
Generate impression based on findings. | Female 2 days old Reason: evaluate bowel gas, evaluate for obstruction History: abdominal distentionVIEW: Abdomen AP (one view) 3/21/15 at 441 hours NG tube terminates in the stomach. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Female 2 days old Reason: evaluate ABD gas pattern, bowel dilation History: no lines - increasing respiratory distress; increasing O2 requirementVIEW: Chest and abdomen AP (two views) 3/20/15 at 1805 hrs. NG tube terminates in the stomach. Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is norm... | Minimal diffuse lung haziness consistent with TTN versus RDS.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 38 days old Reason: Please assess bowel gas pattern History: Abdominal distention, mechanical ventVIEW: Chest and abdomen AP (two views) 3/21/15 at 749 hours. ET tube terminates below thoracic inlet. NG tube tip is at the stomach. Right upper extremity PCVC terminates at the right atrium. Mediastinal tube unchange... | Persistent diffuse lung haziness with pattern of PIE.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male, 16 years old. Reason: eval R iliac vein patency History: swelling, pain VASCULAR:Arterial phase of contrast makes evaluation of the iliac veins suboptimal.Left common iliac venous stent at the level of overlying common iliac artery. Possible low density filling defect within the right common femoral and external ... | Possible thrombus within the right common femoral and external iliac veins, although evaluation of the venous system is poor due to suboptimal contrast timing. Recommend repeat Doppler exam for further evaluation. |
Generate impression based on findings. | Male 38 days old Reason: Eval lung fields History: s/p PDA repairVIEW: Chest and abdomen AP (two views) 3/20/15 at 1759 hrs. ET tube terminates below thoracic inlet. Central line tip is in the right atrium. NG tube terminates in the stomach. Mediastinal tip unchanged. Cardiac silhouette size is top normal. Persistent ,... | Persistent lung changes are prolonged surfactant deficiency.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Female 12 years old Reason: view valve setting on shunt History: s/p valve adjustment in settingVIEWS: Abdomen AP and lateral 3/20/15 (two views) Hakim valve setting is 25 mm of water. There no evidence of LP shunt kinking or discontinuity. Moderate stool burden with no evidence of obstruction or free air. | Hakim valve set at 25 mm of water. |
Generate impression based on findings. | Fall, shoulder pain, decreased range of motion. Question of fracture or dislocation. Three views of the right shoulder and two views of the right humerus show a impacted, transverse, and comminuted fracture through the surgical neck of the proximal humerus. No evidence of dislocation. | Comminuted fracture of the surgical neck of the humerus. |
Generate impression based on findings. | Clinical question: Evaluate for cause of cognitive impairment. Signs and symptoms: paranoia and cognitive impairment. Nonenhanced head CT:No detectable acute intracranial process. CT is insensitive for early detection of fracture nonhemorrhagic ischemic strokes.Very mild periventricular low-attenuation a white matter l... | 1.No acute intracranial process.2.Findings suggestive of mild age indeterminate small vessel ischemic strokes |
Generate impression based on findings. | Male 8 years old Reason: 8 yo M with abd pain, CT scan with free peritoneal fluid and incr pleural effusions, please eval VIEWS: Chest AP/lateral (two views) 3/20/15 2120 hrs Cardiac silhouette size is normal. No focal opacities, effusions or pneumothorax. | Effusion previously described on CT are not visualized. Note is made that chest CT the much more sensitive for the diagnosis of small pleural effusions. |
Generate impression based on findings. | 37-year-old female. Left flank pain. Hematuria. History of kidney stones. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted. Cholecystectomy clips.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abn... | 1. Punctate nonobstructive left renal stone. No ureteral stones or hydronephrosis. 2. A cystic structure in the left adnexa is 4.1 x 4.7 cm, may represent a physiologic cyst though follow-up US in 3 months suggested to confirm resolution. |
Generate impression based on findings. | Female 60 years old Reason: eval for intraabdominal or fascial infection History: purulent drainage around g tube ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Again noted metallic stent in the common bile duct and pneumobilia. Biliary prominence is unchanged.SPLEEN: No significant abnormali... | Fat stranding on the gastrostomy tube without evidence of drainable collection.Interval improvement in the left pyelonephritis findings. |
Generate impression based on findings. | Fall, deformity, pain. Evaluate for fracture or dislocation. Three views of the right shoulder show no acute fracture or dislocation. Mild osteoarthritis affects the glenohumeral joint. Moderate osteoarthritis affects the acromioclavicular joint. Deformity of the distal clavicle is likely related to old trauma. There i... | No acute fracture is evident. |
Generate impression based on findings. | Clinical question: ICH in the left putaminal. Signs and symptoms: Hemorrhage, rule out enlargement. Nonenhanced head CT:Small focus of acute hemorrhage in the left putamina measures at 8.5 x 5.5-mm in transaxial dimensions and without appreciable surrounding vasogenic edema. No prior exams for comparison.Findings sugge... | 1.8.5 x 5.6 millimeter hematoma of the left putamina. No prior exam for comparison.2.Minimal age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Pain and ecchymoses status post fall one week ago. Most severe at second through fourth metatarsal joints. Question of fracture. Three views of the ankle show diffuse soft tissue swelling. No acute fracture or malalignment is evident. No ankle joint effusion is identified. A small ossific density superior to the anteri... | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | 55-year-old female with intraventricular hemorrhage There is extensive right periventricular hypoattenuation compatible with encephalomalacia along the entire MCA territory with significant ex vacuo dilatation of the right ventricle. Large left parietal lobe intraparenchymal hemorrhage with dissection into the left ven... | 1.Large left parietal lobe intraparenchymal hemorrhage with extensive intraventricular component with surrounding edema as described above.2.Encephalomalacia along the right MCA territory with ex vacuo dilatation of the right ventricle.3.Right trans-frontal ventriculostomy catheter tip is in the right ventricle near th... |
Generate impression based on findings. | Female, 8 months old. Reason: rule out fracture History: concern for abuseEXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, rig... | No acute or healing fracture identified. |
Generate impression based on findings. | Clinical question: Facial abscess? Retro-orbital cellulitis? Signs and symptoms: Right upper face and lip swelling history of severe acne, adjacent steroids. Enhanced maxillofacial CT:Examination demonstrate normal density of retro-orbital fat and without abnormal enhancement. Normal appearing bilateral extra ocular mu... | 1.Unremarkable images through the orbits. 2.No evidence of facial or retro-orbital abscess formation.3.Mild chronic sinus disease as detailed.4.Mild subcutaneous fat stranding of bilateral facial soft tissues slightly more on the left however without detectable abnormal enhancement. |
Generate impression based on findings. | Female 14 days old Reason: Eval lung fields History: On CPAPVIEW: Chest and abdomen AP (two views) 3/21/15 at 346 hours. NG tube terminates in the stomach. Left upper extremity PICC tip is at the confluence of the right subclavian and innominate vein.Cardiac silhouette size is normal. Persistent bilateral diffuse lung ... | No change in diffuse lung haziness.Improvement in bowel distention. |
Generate impression based on findings. | Swelling, pain. Question of fracture. Three views of the right ankle show no acute fracture or malalignment. Soft tissue swelling is noted about the ankle, lateral greater than medial. Three views of the right foot show no acute fracture or malalignment. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | 49-year-old female. Liver transplant, abdominal pain. Evaluate for obstruction. Additional history from clinical service: packing material was placed around liver. EPIC history liver transplant 3/10 and 3/11 for subcapsular liver hematoma. Lack of intravenous contrast limits evaluation for solid organ pathology.ABDOMEN... | 1. Diffuse bowel dilatation is suggestive of an ileus. Large amount of abdominopelvic ascites.2. Mild nonspecific heterogeneity of the right hepatic lobe. Large amount of perihepatic packing material with possible small amount of residual hematoma at its periphery.3. A pocket of air in the central nondependent upper ab... |
Generate impression based on findings. | Male, 4 years old. Reason: rule out fracture History: concern for abuseEXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, right ... | Suggestion of a left elbow joint effusion. Occult fracture is not excluded. Recommend repeat dedicated elbow images in two weeks or correlation with point of maximum tenderness. No other traumatic fracture identified.Findings discussed via telephone with Dr Kahn in the ED at 9:10 AM on 3/21/2015 |
Generate impression based on findings. | Female 3 days old Reason: is the ett in proper position are the lungs clear History: rds, preterm reintubationVIEW: Chest and abdomen AP (two views) 3/21/15 at 437 hours. Right bronchus intermedius intubation. UVC terminates at the right atrium. UAC tip is at T6. NG tube tip is at the stomach.Cardiac silhouette is none... | ET tube displaced with consequent atelectasis of the right upper lobe the whole left lung.Normal abdomen gas pattern.Findings were communicated to and acknowledged by Dr. BOREN, MARY on 3/21/15 at 849 hours. |
Generate impression based on findings. | Swelling, inability to ambulate. Question of sprain or fracture. Three views of the right ankle show soft tissue swelling most notably about the lateral malleolus. No acute fracture or malalignment is evident. No ankle joint effusion is identified. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | Knee laceration from broken glass. Evaluate for foreign body/glass. Four views of the right knee show no acute fracture or malalignment. A small round opacity along the posterior aspect of the knee is likely artifact. No radiopaque foreign body is identified. No knee joint effusion is seen. | No radiopaque foreign body is identified. |
Generate impression based on findings. | Male 2 days old Reason: evaluate umbilical line placement History: Desaturation and blood per NG tube.VIEWS: Chest and abdomen AP, abdomen cross table lateral (3 views) 3/21/15 at 451 hours. ET tube tip is below the thoracic inlet. Esophageal temperature probe terminates at the lower third of the esophagus. Proximal si... | Misplaced NG tube and UAC.Small lung volumes with no focal opacities.No change in complete paucity of abdominal gas. |
Generate impression based on findings. | Male 26 years old Reason: 26yo w/CF, admitted for MSSA PNA c/b parapneumonic effusion, appears exudative. Now with L chest tube w/o significant change in XR. Considering intrapleural TPA,, need CT for further eval History: left chest tube LUNGS AND PLEURA: Diffuse bronchiectasis, mucous plugging, bronchial wall thicken... | 1.Large left hydropneumothorax with findings suggestive of multiple loculations as described.2.Sequela of cystic fibrosis with multiple peripheral opacities suggestive of superimposed infection.3.Cirrhotic morphology liver with evidence of portal hypertension. Numerous enlarged lymph nodes versus varices are only parti... |
Generate impression based on findings. | Hypertension and foot pain. Three views of the left foot show no acute fracture. There are degenerative changes at the calcaneocuboid articulation with osteophyte formation and sclerosis. There appears to be pes planus deformity but this is a nonweightbearing study. | Degenerative changes as above. |
Generate impression based on findings. | 55-year-old female with IVH 1. Normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal, with the right vertebral artery slightly hypoplastic relative to the left.2. Right ICA is occluded shortly after the ECA/ICA bifurc... | 1.No significant change in left parietal hematoma as described above.2.Slight interval decrease in degree of intraventricular hemorrhage and dilation with increased rightward midline shift.3.Right trans-frontal ventriculostomy catheter tip is in the right ventricle near the foramen of Monroe.4.Complete occlusion of the... |
Generate impression based on findings. | Clinical question: Evaluate status-post CSF drainage. Signs and symptoms: Headache. Unenhanced head CT:There is no evidence of any acute or new finding since prior exam.Stable mildly enlarged left lateral ventricle since prior study.Extensive encephalomalacia of right hemisphere identical to prior study. No change in t... | 1.No convincing evidence of any acute or new finding since prior study.2.Mildly prominent left lateral ventricle remains similar to prior study.3.No change in the position of a left sided ventricular catheter.4.Epidural thickening and with small amount of air under the right craniotomy flap similar to prior exam. |
Generate impression based on findings. | Hemoptysis. Evaluate for source of bleeding or infection ANGIOGRAPHY: The thoracic aorta is normal in size. Conventional aortic arch anatomy. No aneurysm or evidence of dissection. No significant atherosclerotic calcification. Origins of the celiac, superior mesenteric, and bilateral renal arteries are widely patent. N... | 1.Negative CT angiogram of the chest for active hemorrhage, however conventional angiography is more sensitive and can be considered as clinically significant hemoptysis. Otherwise, small volume hemoptysis may be secondary to either the mycetomas or bronchiectasis.2.Stable left upper lobe cavitary lesion with findings ... |
Generate impression based on findings. | Clinical question: History of CVA/evaluate for new lesions. Signs and symptoms: Frequent falls. Nonenhanced head CT:There are no prior exams for comparison as is requested by the clinical service as. Small wedge shaped low density defect along the inferior aspect of right cerebellum is consistent with a chronic right p... | 1.No acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.Moderate age indeterminate small vessel ischemic strokes.3.No prior exams for comparison. |
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