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Generate impression based on findings. | PHARYNX/LARYNX: The soft palate is coapted along the posterior wall of the oropharynx which limits evaluation. The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: Other than li... | 1. No definite evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. Please note that the pharynx is not as well aerated as on the prior exam, which somewhat limits evaluation.2. Interval decreased size of right upper lobe metastasis. |
Generate impression based on findings. | Male, 8 years old. Reason: rule out obstruction History: abdominal painVIEWS: Abdomen supine and upright (two views) 3/27/15, 1354 Nonobstructive bowel gas pattern.Large stool burden.No free intraperitoneal air. | Large stool burden. |
Generate impression based on findings. | Metastatic thyroid cancer. CHEST: Sensitivity for detection of of lymphadenopathy and solid organ pathology is limited by poor contrast opacification.LUNGS AND PLEURA: Bilateral apical scarring and mild emphysema. Left pleural thickening and a small left pleural fluid collection. In the left cardiophrenic angle, the pl... | 1. Left pleural thickening and fluid suspicious for metastatic disease but without significant change from the prior examination.2. Subpleural nodules which may reflect metastatic intrapulmonary lymph nodes on the left have decreased in size.3. Slight improvement in left internal mammary chain lymph node enlargement.4.... |
Generate impression based on findings. | 77-year-old male with history of metastatic esophageal cancer. Evaluate for progression of metastatic disease. CHEST:LUNGS AND PLEURA: New trace bilateral effusions. Basilar subsegmental atelectasis/scarring. No focal consolidation. Scattered pulmonary nodules are stable in number and stable to slightly more prominent ... | 1.Proximal migration of esophageal stent.2.Stable supraclavicular, mediastinal, and gastrohepatic lymphadenopathy.3.Worsening omental carcinomatosis.4.New moderate volume ascites with loculated fluid collection in the pelvis. |
Generate impression based on findings. | 59-year-old female with history of head and neck cancer. CHEST:LUNGS AND PLEURA: No suspicious lesions nodules or masses. Cluster of subpleural cysts in the right upper lobe is unchanged.MEDIASTINUM AND HILA: Right chest port with tip in the right atrium.Heart size normal with no pericardial effusion. No mediastinal or... | 1. No evidence of metastatic disease in the chest. Enhancing cervical lymph nodes are better evaluated on same day soft tissue neck CT.2. Cirrhosis and increased perihepatic ascites.3. Markedly dilated common bile duct, thought to be benign on prior MRCP. |
Generate impression based on findings. | 72-year-old male with left hip pain, right shoulder pain. Two views of the left hip and an AP view of the pelvis demonstrate hardware components of a left total hip arthroplasty with 3 cerclage wires in near anatomic alignment without evidence of hardware complication. Hardware components of a right total hip arthropla... | Postoperative and degenerative changes as described above. |
Generate impression based on findings. | 55-year-old female presents for 6 month follow-up of left breast most likely benign calcifications. Three standard views of the left breast and a few spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distri... | Benign calcifications in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic... |
Generate impression based on findings. | Postoperative changes relating to previous left occipital craniotomy for debulking of a mass are again seen. There is slight interval decrease the susceptibility in the resection bed. There is slight interval increase ill-defined intrinsic T1 hyperintensity along the left temporal occipital junction.. Associated vasog... | 1. Overall decreased in size of left occipital mass with significant decreased degree of associated enhancement and thickness of rind of enhancement.2. Significant interval decrease in degree of associated T2/FLAIR hyperintensity resolution of previous localized mass effect on the left lateral ventricle posteriorly.3. ... |
Generate impression based on findings. | 72-year-old male patient status post G-tube placement on 3/25/2015 now with fevers and abdominal pain. CHEST:LUNGS AND PLEURA: Biapical scarring is again noted and is likely due to radiation changes. Small bilateral pleural effusions with overlying atelectasis. There is debris versus soft tissue thickening of the bronc... | 1.Soft tissue density in the right lung base is of uncertain etiology and may represent post obstructive changes from aspiration given the questionable debris in the right bronchus intermedius. Cannot exclude metastatic disease.2.New small bilateral pleural effusions. 3.Nonspecific scattered prominent and mildly enlarg... |
Generate impression based on findings. | Female, 14 years old. Reason: 14 y/o F with acute renal failure, enlarged kidneys on OSH CT. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogeni... | Large kidneys for age bilaterally, without hydronephrosis.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thin... |
Generate impression based on findings. | Female, 60 years old, Reason: r/o inflammatory/opportunistic infection History: h/a immunosuppressed The procedure, indications, benefits, risks/complications and alternatives were described to the patient and informed consent was obtained. The patient was placed in the prone position and the inferior back was prepped ... | Successful fluoroscopy guided lumbar puncture. |
Generate impression based on findings. | There is no acute intracranial hemorrhage. There are prominent hypoattenuating foci in the bilateral, left greater than right, frontal corona radiata, right claustrum and right pons, which are age-indeterminate. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and sub... | 1. No acute intracranial hemorrhage. 2. Age-indeterminate small vessel ischemic changes including lacunar infarcts, in the left greater than right frontal corona radiata, right claustrum and right pons. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | 86 year-old female with fall. Three views of the right hand demonstrates no fracture. Moderate-severe degenerative changes affect the interphalangeal joint of the thumb. Mild degenerative changes affect the basilar joint and interphalangeal joints. | Degenerative arthritic changes as described above without fracture. |
Generate impression based on findings. | Female, 57 years old, with lightheadedness, losing balance. Assess for major vessel patency. Non angiographic findings:The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or ... | No significant vascular abnormalities are detected in the neck or head. |
Generate impression based on findings. | 27-year-old female with pleuritic chest pain, evaluate for pulmonary embolism PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: No pleural effusion or pneumothorax. The central airways are patent.Minimal b... | 1.No evidence of pulmonary embolism.2.No specific findings to account for the patient's pain.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 85-year-old male with history of gastric cancer. Significant weight loss, early satiety, evaluate for recurrent disease. CHEST:LUNGS AND PLEURA: Subpleural reticulation and honeycombing with traction bronchiectasis in a postero-basilar predominant pattern, compatible with UIP. Findings are mildly progressed from the pr... | 1.No specific evidence of disease recurrence.2.Stable T11 metastasis.3.Mild progression of pulmonary fibrosis in UIP pattern. |
Generate impression based on findings. | 62 year old female with left wrist pain, right shoulder pain. Three views of the left wrist show no fracture or malalignment.Three views of the right shoulder show no fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | Images are limited by patient motion. The cervical spine is in normal alignment, with straightening of the normal cervical lordosis. The vertebral body and disk heights are well-maintained, although there is diffuse disk desiccation. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of no... | 1. Significantly motion limited exams.2. Only mild spondylotic changes along cervical spine, most prominent at C6-C7 although there is only mild central spinal canal stenosis and bilateral foraminal narrowing.3. Focal lumbar spondylotic changes at L5-S1 with moderate-severe left and moderate right foraminal narrowing. |
Generate impression based on findings. | 62 years, Male. Reason: s/p DHT placement History: as above There is a nonobstructive bowel gas pattern. There is a Dobbhoff tube with its tip projecting over the distal body of the stomach. IVC filter position unchanged. Multilevel vertebroplasty is again evident. Surgical drainage catheter in the right upper quadrant... | Dobbhoff tube with its tip projecting over the distal body of the stomach. |
Generate impression based on findings. | 66 year old female with history of multiple cysts in the right lateral breast. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Multiple small circumscribed... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 86-year-old female status post reduction of anterior shoulder dislocation. Three views of the left shoulder demonstrate interval reduction of anterior shoulder dislocation. Degenerative arthritis affects the glenohumeral and acromioclavicular joints, without evidence of underlying fracture. | Glenohumeral joint in normal anatomic alignment without acute fracture. |
Generate impression based on findings. | Male, 47 years old, history of diskitis osteomyelitis, status post mitral valve replacement, with back pain. On review of the full thoracic spine, vertebral level numbering will be altered relative to the prior MRI, as indicated below. This yields 12 vertebral bodies bearing true ribs, 5 lumbar type vertebral bodies, a... | 1.When comparison is made to the prior CT examination from January 2015, progressive destruction of the L4-5 disk and endplates is seen. There is substantial progressive loss of bone from the L5 vertebral body.2.Lucent lesions along the T12-L1 endplates, with significant loss of bone at L1, is stable to at most minimal... |
Generate impression based on findings. | Reason: s/p reverse total shoulder. Four views of the right shoulder demonstrate components of a reverse total shoulder arthroplasty device, in near anatomic alignment, without radiographic evidence of hardware complication. Interval increase in the density of the existing heterotopic ossification in the adjacent soft ... | Postoperative changes and healing proximal humeral fracture as above. |
Generate impression based on findings. | Female, 4 days old. Reason: where is PICC tip History: PICC insertedVIEW: Chest AP (one view) 3/27/15, 1532 Right arm PICC, tip in the axillary. ET tube tip below the thoracic inlet and above the carina. Enteric tube with distal side port above the level of the GE junction. UAC tip at T7-8. UVC tip at the level of the ... | Right arm PICC, tip in the axillary vein. Persistent findings related to surfactant deficiency. |
Generate impression based on findings. | 41-year-old female with abnormal MRI, evaluate for instability. Four views of the lumbar spine demonstrate moderate disk space narrowing of L5-S1, however, incomplete segmentation of L5-S1, cannot be entirely excluded. There is mild disk space narrowing of L4-5. Facet joint osteoarthritis affects the lower lumbar spine... | Degenerative arthritic changes, as described above, which appear similar to recent MRI. |
Generate impression based on findings. | Female, 7 months old. Reason: eval for PTX History: hypoxiaVIEW: Chest AP (one view) 3/27/15, 1540 ET tube with tip below the thoracic inlet and above the carina. Enteric tube with distal side port at the level of the GE junction. Lower extremity PICC, tip in the IVC.The cardiothymic silhouette is normal in size. Pneum... | Left pneumothorax, with pneumomediastinum and subcutaneous emphysema. |
Generate impression based on findings. | 16-year-old male with right knee pain. Four views of the right knee again demonstrate an intra-articular, well-corticated fixed ossification posterior to the patella, unchanged when compared to prior. There is no evidence of acute fracture or malalignment. No significant joint effusion is present. | Probable synovial osteochondroma, unchanged when compared to prior exam. |
Generate impression based on findings. | History of squamous cell lung cancer right upper lobe status post wedge resection. Now with right lower lobe mass. Restaging exam. Also history of renal cell cancer.RADIOPHARMACEUTICAL: 13.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 89 mg/dL. Today's CT portion grossly demonstrates extensive emphysema ... | 1.Right anterior lung opacity clinically questioned is not FDG avid and most likely benign. Small faintly hypermetabolic ill-defined right apical opacity may also be benign inflammation although low-grade recurrent tumor is conceivable, and continued CT follow up should be considered to assure stability/resolution.2.Hy... |
Generate impression based on findings. | 79-year-old female with history of esophageal, breast, and thyroid cancer all in remission he with progressive rib pain. Evaluate for fracture or lytic lesion. There are no discrete, displaced fractures or focal pathologic rib lesions identified to suggest metastatic disease, within the limitations of radiographic tech... | No evidence of rib fracture or metastasis. If there is continued high clinical suspicion, consider cross sectional imaging or nuclear medicine bone scan for further evaluation. Postoperative and degenerative changes as described above. |
Generate impression based on findings. | 47-year-old female history of metastatic papillary thyroid cancer. CHEST:LUNGS AND PLEURA: Scattered bilateral pulmonary micronodules, nonspecific. Stable nodularity of the pleura and fissures which suggests early pleural/perilymphatic metastasis.MEDIASTINUM AND HILA: The heart size is normal without significant perica... | Overall stable appearance of extensive metastatic disease with measurements as above. Mild gaseous and fluid dilatation of the colon , which is incompletely imaged on this study. Consider dedicated pelvis CT if there is clinical concern for distal obstruction. |
Generate impression based on findings. | Eval shunt settings per neurosurgery Study is limited secondary to single lateral view. Ventriculostomy catheter device overlies the skull, with the tip projecting over the clivus in this oblique projection. The valve is projecting with the notch towards the efferent tubing. No prior is available for comparison. Radiol... | Shunt device as above. |
Generate impression based on findings. | Female, 14 years old. Pes planus, juvenile bunion.VIEWS: Left foot standing AP, lateral, oblique. Right foot standing AP, lateral, oblique. (Six views) 3/25/2015, 0752 Minimal hallux valgus deformity bilaterally, right greater than left.Otherwise, the osseous structures and joint spaces are normal. Alignment is normal.... | Mild bilateral hallux valgus. |
Generate impression based on findings. | LEFT TEMPORAL BONE: There is a hyperattenuating well-defined lobulated nodular skin lesion that measures up to 5 mm along the lateral aspect of the anteroinferior wall of the left external auditory canal. The rest of the external auditory canal otherwise appears to be intact. The middle ear and mastoid air cells are w... | A nodular skin excrescence that measures up to 5 mm along the anterior wall of the lateral left external auditory canal without evidence of deep extension or osseous erosion may represent a lobular capillary hemangioma. |
Generate impression based on findings. | Altered mental status There is continued evolution of large intraparenchymal hematoma in the left frontal lobe associated with surrounding vasogenic pattern of edema. There is associated adjacent sulcal effacement and mild compression of the left lateral ventricle which is slightly improved in the interval. There is tr... | Continued evolution of large left posterior frontal lobe intraparenchymal hematoma with surrounding vasogenic edema, local mass effect and minimal rightward midline shift. No new hemorrhage or new mass-effect. |
Generate impression based on findings. | Reason: asymptomatic superior cerebellar artery aneurysm, h/o SAH with burr holes, carotid stenosis History: SAH, frequent falls A 2 to 3-mm aneurysm arising from the origin of the left superior cerebellar artery has not significantly changed in size or shape.The intracranial vertebral arteries and the basilar arteries... | 1. Occlusion of the right ICA at its origin from the bifurcation. There is minimal flow related signal more distally, at the level of the carotid canal, up to the anterior genu. The intensity of this flow related signal has decreased from the prior examination which may reflect progressive narrowing or technical differ... |
Generate impression based on findings. | 12-year-old male with knee pain after landing from jumping.VIEWS: Left knee AP, oblique, lateral; and pelvis AP, frog leg (5 views) 3/27/15 Left knee: No fracture or malalignment. The extensor mechanism appears intact. There is no joint effusion.Pelvis: The femoral heads are seated in well formed acetabula. No fracture... | Normal examinations. |
Generate impression based on findings. | Male; 48 years old. Reason: Two bony lesions in the L anterior 3rd rib seen on CT with associated pain, please evaluate further- lytic vs blastic, possible etiologies. Mildly increased activity in the mid and lower thoracic spine is compatible with degenerative changes as confirmed on recent CT. No osteoblastic foci in... | No evidence of sclerotic or lytic bone lesions to indicate metastatic disease the left third rib or elsewhere in the skeleton. Also, no bone scan explanation for the patient's symptoms. |
Generate impression based on findings. | 65-year-old male patient with hematuria x 2 years and MM. Evaluate for renal stones. Exam is not sensitive for detecting lesions in the solid organs due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY T... | 1.No renal calculi. Note that the examination is not sensitive for the detection of renal lesions.2.Osseous abnormalities compatible with multiple myeloma. |
Generate impression based on findings. | Male; 65 years old. Reason: metastatic prostate cancer to the bones evaluate for disease progression. Multiple new subtle foci of increased tracer activity are identified in the bilateral ribs, right scapula, and right superior acetabulum. Previously identified sites of increased activity in the T11, L4, and L5 vertebr... | Progression of osseous metastatic disease, with multiple new and larger lesions. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. No signific... | No acute intracranial abnormality. |
Generate impression based on findings. | Female; 64 years old. Reason: primary hyperparathyroidism, please evaluate for adenoma History: chronic kidney disease. Small persistent focus of increased activity is seen in the left superior/anterior mediastinum, approximately 2-3 cm inferior to the left thyroid lobe. | Findings compatible with a slightly ectopic left parathyroid adenoma, located 2-3 cm inferior to the left thyroid lobe in the anterior/superior mediastinum. |
Generate impression based on findings. | Metastatic papillary thyroid cancer, follow up Neck: There are postoperative findings related to total thyroidectomy and neck dissection. There is no interval change in the ill-defined nonspecific soft tissue within the surgical bed. There is an unchanged subcentimeter neck lymph nodes. Please refer to the separate che... | 1. Post-treatment findings in the neck without evidence of measurable tumor recurrence within the thyroidectomy bed and no significant change in subcentimeter neck lymph nodes. 2. No evidence of progression of intracranial metastatic disease. There are subtle tiny dural-based areas of enhancement which are similar to p... |
Generate impression based on findings. | Recurrent right lower quadrant plain with dark blood in the stool. Normal ileocolonoscopy. Michael diverticulum. Angiographic images are unremarkable. Sequential imaging through 30 minutes demonstrates transient focus of increased activity in the right lower quadrant. However, this does not appear at the same time is n... | No evidence of ectopic gastric mucosa to suggest Meckel's diverticulum. |
Generate impression based on findings. | Female; 36 years old. Reason: Primary HPT. There is physiologic distribution of the radiopharmaceutical. Early planar images demonstrate two foci of abnormally increased activity in the right superior and left inferior thyroid poles, both of which washout on delayed images. | Sestamibi avid foci in the right superior and left inferior thyroid poles. Given history of hyperparathyroidism, one or both of these may represent parathyroid adenomas. Alternatively, given the ultrasound findings, nodules of thyroid origin (benign or malignant) may also be considered. |
Generate impression based on findings. | 38-year-old male patient with presumed achalasia and 60-pound weight loss. CT to evaluate for malignancy. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Incidental note of focal fat infiltration along the falciform ligament.SPLEEN: Splenules noted.PANCREAS: No significant abnormality noted.A... | 1.Patulous esophagus with air fluid level compatible with achalasia.2.No significant intra-abdominal abnormalities. |
Generate impression based on findings. | There are stable post-treatment changes in the neck, including those from right neck dissection. PHARYNX/LARYNX: There is only minimal residual ill-defined enhancement along the right base of tongue, now measuring 16-mm transverse. There is no significant residual extension of enhancement into the adjacent posterior r... | 1. Redemonstration of posttreatment change is within the neck, with further decrease size of ill-defined enhancement at the right base of tongue with no significant residual oral tongue extension.2. Mildly enlarged bilateral left level 4 and bilateral level 3 lymph nodes, increased in size since prior exam. These do no... |
Generate impression based on findings. | Male; 60 years old. Reason: History of prostate cancer. New foci of increased tracer activity are identified in the left lateral sixth rib and left posteromedial ninth rib near the costovertebral junction, compatible with new osseous metastases. There may also be a new focus of increased activity near the right T9 vert... | Mild progression of osseous metastatic disease, with several new and larger osseous lesions as described above. |
Generate impression based on findings. | 13-year-old female with trauma two weeks agoVIEWS: Right shoulder: Internal and external rotation; left shoulder: Internal and external rotation (4 views) 3/27/15 at 1630 Right shoulder: No fracture or malalignment. The humeral head is seated at the glenoid fossa. No significant soft tissue swelling.Left shoulder: No f... | Normal examinations. |
Generate impression based on findings. | 54-year-old female patient with chest pain. Evaluate for aortic dissection. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Large nodular left lobe of the thyroid is partially imaged. There is also rightward deviation of the trachea. No mediastinal or hilar lymphadenopathy. Cardiac size w... | 1.No evidence of aortic dissection.2.Incompletely imaged bulky left thyroid lobe. Rightward tracheal deviation is presumably secondary to this thyroid nodularity. Dedicated neck imaging can be obtained as clinically indicated.3.Irregularity of the right pedicle of the T2 vertebral body could represent a lesion, but dif... |
Generate impression based on findings. | Female; 37 years old. Reason: Metastatic breast cancer to spine, evaluate for other osseous disease History: Back pain. Exam is mildly limited by body habitus. There are multiple foci of abnormal osseous uptake in the thoracic and lumbar spine, left posteromedial seventh rib, right intertrochanteric hip, and left poste... | 1.Multifocal osseous metastases, the largest of which involves the left posterior calvarium. Further evaluation with dedicated imaging of this area can be considered if clinically indicated.2.Given the location of the right intertrochanteric hip metastasis and patient body habitus, there is increased concern for future... |
Generate impression based on findings. | Male; 85 years old. Reason: Significant weight loss; fatigue; early fullness and hx of gastric cancer; please evaluate for recurrent disease. Foci of increased activity in a linear configuration involving the right anterior fifth and sixth ribs are compatible with healing fractures and confirmed on recent CT. Increased... | 1.No convincing osseous metastatic disease.2.Healing right anterior fifth and sixth rib fractures.3.Multifocal degenerative changes and other nonspecific but also likely benign areas of increased tracer uptake as described above. |
Generate impression based on findings. | Male, 17 months old. Hip pain, limp.VIEWS: Left knee AP, lateral. Left tibia/fibula AP, lateral. (Four views) 3/27/15, 1716 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 63-year-old male patient with history of cirrhosis and pleural effusion. Evaluate effusion and evaluate liver for lesions. CHEST:LUNGS AND PLEURA: Mild emphysema. Scattered atelectasis and scarring in the right lung. Scattered subtle ground glass opacities in the right upper lobe are nonspecific and may represent infec... | 1.Cirrhotic liver morphology without suspicious appearing lesions. No significant interval change in intra-abdominal ascites.2.Mild interval decrease in retroperitoneal and left iliacus muscle hematomas.3.Scattered subtle ground glass opacities in the right upper lobe are nonspecific and may represent infectious/inflam... |
Generate impression based on findings. | Male, 3 months old. Reason: r/o fracture History: pain s/p fallVIEWS: Left forearm AP, lateral (two views) 3/28/15, 0054 An oblique fracture through the humeral diaphysis is partially imaged.No forearm fracture identified. Alignment is anatomic. | No forearm fracture identified. Oblique fracture of the humerus. |
Generate impression based on findings. | Female, 16 years old. History of liver transplant. Vomiting, sharp epigastric pain radiating to the back, similar to symptoms of prior pancreatitis. ABDOMEN:LUNG BASES: No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: Postsurgical changes of a liver transplant, with hepatomegaly and mild intrahepatic bi... | Normal appearance of the pancreas. Partial small-bowel obstruction is an additional consideration. Status post liver transplant, with hepatosplenomegaly and mild intrahepatic biliary ductal dilatation. |
Generate impression based on findings. | Reason: evaluate for kidney stone History: flank pain Evaluation of the solid organs limited by lack of intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL... | 7-mm obstructing stone in the mid/proximal left ureter with up stream moderate hydronephrosis as described above. Other nonobstructing stones within the kidneys.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male, 17 months old. Hip pain, limp.VIEWS: Pelvis AP, frog leg (two views) 3/27/15, 1714 The osseous structures and joint spaces are normal.The femoral head ossification centers are well directed into normal acetabula.Small to moderate feces within the rectum. | Normal examination. |
Generate impression based on findings. | Female, 4 years old. Laceration, subungual hematoma. Evaluate for fracture of the 4th and 5th digits VIEWS: Left hand PA, lateral, oblique (3 views) 3/27/15, 1845 The osseous structures and joint spaces are normal.Soft tissue swelling around the ring finger distal phalanx.No radiopaque foreign body identified. | Soft tissue swelling without fracture or malalignment. |
Generate impression based on findings. | Male, 4 months old. History of BPD with 10 days of cough/congestion, now with fever and increased SOB. Evaluate for pneumonia.VIEW: Chest AP (one view) 3/27/15, 2107 The cardiothymic silhouette is normal.Mild peribronchial thickening and increased lung volumes.Streaky bibasilar opacities, compatible with atelectasis. N... | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | Male, 3 months old. Tachypnea.VIEWS: Chest AP/lateral (two views) 3/28/15, 0050 The aortic arch, cardiac apex, and stomach are left-sided.The cardiothymic silhouette is normal.No focal pulmonary opacities, pleural effusions, or pneumothorax.Oblique fracture through the left humeral diaphysis. | Normal appearance of the chest. Oblique fracture left humeral diaphysis. |
Generate impression based on findings. | Male, 3 months old. Pain status post trauma. Evaluate for fracture.VIEWS: Left humerus AP, lateral (two views) 3/28/15, 0047 Minimally displaced oblique fracture through the left humeral diaphysis.Alignment is anatomic.Moderate soft tissue swelling of the left upper arm. | Minimally displaced oblique fracture through the left humeral diaphysis. |
Generate impression based on findings. | 60 year-old female with chest pain, shortness of breath, with history of lung adenocarcinoma PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. The main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: No pneumothorax or pleural effusion.Moderate apical predom... | 1.No evidence of pulmonary embolism.2.Large right lower lobe mass compatible with nonprimary. Probable pleural involvement of the mass may be the cause of the patient's pain.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicableRV Strain: Not applicable. |
Generate impression based on findings. | 40 year-old female patient with generalized abdominal pain, severe nausea/vomiting. Evaluate for bowel torsion or ischemia. ABDOMEN:LUNG BASES: Dependent atelectasis.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions are too small to characterize and likely represent cysts.SPLEEN: No significant abnormality no... | 1.Scattered colonic wall thickening is likely due to muscular hypertrophy from diverticulosis, however, mild colitis cannot be excluded.2.Free fluid in the pelvis may be physiologic if the patient is premenopausal or may be related to possible mild colitis.3.Progressively atrophic kidneys since 2010 with multiple hypoa... |
Generate impression based on findings. | CT HEAD WO: No intracranial hemorrhage or abnormal extra-axial fluid collections. The cerebral and cerebellar hemispheres and brainstem have normal morphology and attenuation. The ventricles have normal volume and morphology. The osseous structures are intact. The paranasal sinuses and mastoid air cells are clear.CTA ... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. No intracranial aneurysms |
Generate impression based on findings. | Female, 23 years old. Chest pain. Evaluate for pneumonia.VIEWS: Chest AP/lateral (two views) 3/28/15, 0052 Vagal nerve stimulator device lies within the left lower chest wall, with lead coursing upward to the left neck, unchanged in position from the prior exam. Cholecystectomy clips.The cardiothymic silhouette is norm... | No pneumonia. |
Generate impression based on findings. | Reason: eval for rib fx History: right CP after MVA Particular attention paid to the patient placed markers, no evidence of displaced rib fracture. There is normal anatomic alignment of the thoracic spine. For pulmonary findings, please refer to concurrent chest radiographs. | No displaced rib fracture. |
Generate impression based on findings. | The previously noted thalamic and basal ganglia abnormalities were better visualized on recent MRI. Cavitation of the expanded bilateral medullary olives again seen. The cerebral and cerebellar hemispheres and the brain stem are otherwise unremarkable in morphology and attenuation. Ventricular size is within normal li... | No intracranial hemorrhage or mass-effect. The previously noted thalamic and basal ganglia signal abnormalities and cavitation of the medullary olives are better visualized on recent MRI. |
Generate impression based on findings. | Reason: fracture History: swelling and pain The bones appear somewhat demineralized. Moderate tricompartmental osteoarthritis affects the right knee, including joint space narrowing (most significant of the patellofemoral compartment) and osteophytosis. Ossicles posteriorly in the knee joint may represent loose bodies.... | Small joint effusion and osteoarthritis without evidence of acute fracture. |
Generate impression based on findings. | Male, 4 years old. Rubinstein-Taybi syndrome. Abdominal pain.VIEW: Abdomen AP (one view) 3/28/15, 0143 Gastrostomy tube in place.Nonobstructive bowel gas pattern. Small to moderate stool burden.Multilobulated calcifications are seen in the region of the renal collecting systems bilaterally as well as in the low pelvis.... | Staghorn calculi within the renal collecting systems and a calculus in the low pelvis, which may be an obstructing bladder outlet/urethral stone, with marked distention of the urinary bladder.Findings discussed via telephone with Dr Paik in the ED on 3/28/2015 at 10:15 AM. |
Generate impression based on findings. | Reason: r/o fx History: pain There is mild soft tissue swelling. Sideplate and screws affix healed fractures of the fourth and fifth metacarpals, in near-anatomic alignment. Deformities along the proximal phalanx of the fifth finger and distal phalanx of the fourth finger suggest old healed fractures. Posttraumatic ost... | Chronic posttraumatic deformities without evidence of acute fracture. |
Generate impression based on findings. | 18 year-old female patient with nausea, vomiting, abdominal pain. Evaluate for bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Spleen is upper limits of normal.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant... | No acute intra-abdominal pathology seen to account for patient's symptoms. |
Generate impression based on findings. | Subarachnoid hemorrhage within the right post central and intraparietal sulci as well as within the left intraparietal sulcus is not significantly unchanged. The cerebral and cerebellar hemispheres and the brain stem are otherwise normal in morphology and attenuation. Ventricular size is within normal limits. No CT ev... | Small subarachnoid hemorrhage in the bilateral parietal lobes without significant interval change. |
Generate impression based on findings. | Reason: r/o fx History: foot pain No evidence of acute fracture or malalignment. Mild osteoarthritis affects the first metatarsophalangeal joint. Deformity of the proximal interphalangeal joint may relate to chronic trauma versus degenerative changes. Mild osteoarthritis affects the tibiotalar joint. | Mild degenerative changes as above, without evidence of acute fracture. |
Generate impression based on findings. | 36-day-old female, 2.5 weeks postpartum with new shortness of breath, chest pain, tachycardia Exam is limited due to respiratory motion, particularly at the lung bases.PULMONARY ARTERIES: Large extensive, near completely occlusive pulmonary emboli bilaterally in the right upper, middle, and lower lobe arteries as well ... | 1.Limited exam due to respiratory motion.2.Extensive bilateral pulmonary emboli with evidence of right heart strain. Considering the extent of occlusion of multiple vessels and the appearance of the thrombus, this raises the question of a chronic component. 3.Ill-defined airspace opacities primarily in the in the lingu... |
Generate impression based on findings. | Small focus of subarachnoid hemorrhage within the left intraparietal sulcus increased compared with the prior exam. Subarachnoid hemorrhage within the right post central and intraparietal sulci is not significantly changed. The cerebral and cerebellar hemispheres and the brain stem are otherwise normal in morphology a... | Subarachnoid hemorrhage as described above, increased in the left intraparietal sulcus. |
Generate impression based on findings. | Reason: r/o fx History: neck pain No evidence of acute fracture or malalignment. Disk spaces and vertebral body heights are preserved. The odontoid process retains a normal relationship with the arches of C1. | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | Examination is slightly motion degraded. Note that the superior peripheral vasculature was not evaluated on this exam.There are scattered atherosclerotic calcifications involving the cavernous and supraclinoid carotid arteries bilaterally. No evidence of significant stenosis or aneurysm involving the circle of Willis.... | No evidence of intracranial aneurysm or occlusion. Note that the superior, peripheral vasculature was not evaluated on this exam.. |
Generate impression based on findings. | Intoxication and altered mental status. Evaluate for injury. CT head: There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The partially imaged cerebellar tonsils are low-lying and extend ap... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Low-lying cerebellar tonsils are partially imaged and extend approximately 5 mm below the level of the foramen magnum. 3. Mild right periorbital contusion. No evidence of acute maxillofacial fracture. No retrobulbar hematoma. 4. Subtle irregularity invol... |
Generate impression based on findings. | Reason: 24F in MVA, restrained passenger now with R knee pain, unable to bear weight after accident, has point tenderness on medial knee and ischial tuberosity. No evidence of acute fracture or malalignment. There is no significant joint effusion or degenerative changes affecting the right knee. | No acute fracture or malalignment. |
Generate impression based on findings. | Reason: r/o fx History: knee pain Knee: No evidence of acute fracture or malalignment. There is no significant joint effusion. A low riding appearance of the patella (patella baja), raises the question of a possible extensor injury. Please correlate with partial extensor complex injury.C-spine: No evidence of acute fra... | Low riding patella may suggest extensor complex injury. Please correlate with injury mechanism and location of pain. No acute fracture is identified. |
Generate impression based on findings. | CT HEAD WO: No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are minimal a... | 1. No acute intracranial hemorrhage or mass effect. If there is continued suspicion for intracranial pathology consider MRI for further evaluation.2. No intracranial aneurysms or evidence of flow-limiting stenosis. |
Generate impression based on findings. | Reason: evaluate for foreign body History: large forearm laceration A large irregular soft tissue defect is present about the forearm, compatible with stated complex laceration. A tiny punctate density is noted along the posterior medial aspect of the proximal forearm, seen in multiple projections, which may represent ... | 1.Large forearm laceration. 2.Tiny ossific density in the posterior medial aspect of the proximal forearm may represent retained foreign body. 3.No evidence of underlying fracture. |
Generate impression based on findings. | No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hy... | No evidence of intracranial hemorrhage or mass effect. Scalp and calvarium are intact. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion. |
Generate impression based on findings. | 59-year-old female with hemoptysis LUNGS AND PLEURA: Right moderate pleural effusion with adjacent atelectasis/scarring. Mild traction bronchiectasis in the right lung base.Slight decrease in tree in bud opacities in the right lung base compatible with bronchiolitis.Nodularity along the left major fissure may represent... | 1.New right upper lobe groundglass opacity. Provided the history, this may represent hemorrhage or aspirated blood.2.Slight decrease in tree in bud opacities in the right lung base.3.Moderate right pleural effusion with atelectasis and scarring is not significantly changed.4.Bronchus intermedius stent with unchanged st... |
Generate impression based on findings. | 97-year-old female with shortness of breath and tachycardia PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Central airways are patent. No pneumothorax.Slight interval increase in moderate bilateral pleu... | 1.No pulmonary embolus is identified.2.Moderate bilateral pleural effusions suggestive of CHF.3.Severely dilated debris filled esophagus with tapering at the GE junction suspicious for achalasia. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV St... |
Generate impression based on findings. | Reason: r/o fx History: shoulder pain There is no evidence of glenohumeral dislocation or acromioclavicular separation. The anterior/inferior aspect of the gland is poorly visualized, and a minimally displaced Bankart fracture is not excluded.Osteophytes at the acromioclavicular joint suggest mild degenerative arthriti... | No definitive fracture is identified. However, the anterior/inferior aspect of the gland is poorly visualized, and a minimally displaced Bankart fracture is not excluded. If there is concern for a glenoid injury, may consider follow-up imaging.Discussed with ED provider, Dr. Keegan Checkett, on 3/28/15, at 10:15 am. |
Generate impression based on findings. | No intracranial hemorrhage or mass effect. Scattered periventricular and subcortical white matter hypodensities, likely represent mild age indeterminate small vessel ischemic disease. There is mild global parenchymal volume loss. Ventricular size is within normal limits. No abnormal extra axial fluid collections.The c... | 1. No evidence of intracranial hemorrhage or mass effect. 2. Scattered periventricular and subcortical white matter hypodensities likely represent mild age-indeterminate small vessel ischemic disease. If there is significant suspicion for acute ischemia, consider MRI for further evaluation. |
Generate impression based on findings. | Postoperative changes of right parietal burr hole with adjacent right parietal encephalomalacia and small focus of dystrophic appearing calcification (related to prior ventriculostomy catheter) appearing similar to the prior exam. The cerebral and cerebellar hemispheres and the brain stem are otherwise normal in morph... | No evidence of acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Reason: eval fusion History: back pain Significant overlying stool and bowel gas limits fine bone detail. There has been interval placement of posterior stabilization rods and interpedicular screws within L4 and S1, in near anatomic alignment. There is redemonstration of the L5 and S1 vertebral body compression fractur... | Orthopedic fixation and compression fractures as above. |
Generate impression based on findings. | Female, 6 months old. Desaturation.VIEW: Chest AP (one view) 3/28/15, 0544 Interval tracheostomy tube placement, with tip below the thoracic inlet and above the carina. Gastrostomy tube in place.The cardiothymic silhouette is normal.Linear right upper lobe opacities, compatible with atelectasis, decreased from the prio... | Tracheostomy tube placement. Decreased atelectasis. |
Generate impression based on findings. | Male 51 years old; Reason: r/o enlarged gallbladder History: abd pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis with phyringian cap. Moderate gallbladder distention. No biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Atrophic with diffuse calcificati... | No significant change from prior study, particularly in regards to the gallbladder. Redemonstrated cholelithiasis and changes of chronic pancreatitis. |
Generate impression based on findings. | Reason: eval for OA History: knee pain, decreased mobility Right knee: There is severe osteoarthritis, including bone-on-bone apposition in the medial tibiofemoral compartment, as well as subchondral sclerosis and tricompartmental osteophytosis. There is suggestion of mild varus deformity on these nonweightbearing view... | Severe bilateral osteoarthritis and suggestion of varus alignment of the knees. |
Generate impression based on findings. | 60 year-old female patient with abdominal pain. Evaluate for bleeding or obstruction. Exam is not sensitive for detecting lesions in the bowel and solid organs due to the lack of intravenous contrast. Note that patient motion also mildly limits evaluation. Given those limitations, the following observations are made:AB... | Findings suspicious for at least a partial small bowel obstruction given collapsed and thickened distal small bowel. Transition point may be somewhere in the pelvis, however, evaluation is limited due to the lack of intravenous contrast and the lack of contrast in the distal small bowel. Follow up imaging is recommende... |
Generate impression based on findings. | Reason: eval sagittal balance, History: back pain and right leg pain Multilevel disk space narrowing and anterior vertebral body osteophyte formation affects the spine. There is mild rotatory curvature of the thoracolumbar spine. The coronal balance is within normal limits. There is a positive sagittal balance of appro... | Mild multilevel degenerative arthritic changes and positive sagittal balance as above. |
Generate impression based on findings. | Reason: eval right ankle fracture History: ankle fracture; s/p ORIF Overlying cast/splint material limits fine bone detail. The bones appear demineralized. Sideplate and multiple screws affix medial and lateral malleolar fractures, in near anatomic alignment. There is no radiographic evidence of hardware complication. ... | Orthopedic fixation of distal tibial and fibular fractures as above. |
Generate impression based on findings. | Female 34 years old; Reason: r/o ischemia History: epigastric abd pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Nonspecific tiny hypodensity in the right hepatic lobe (3:22) is too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted... | 1.Trace right perinephric fluid is nonspecific, and may be related to known end-stage renal disease or early pyelonephritis. Correlation with urinalysis suggested. Otherwise no acute abdominal or pelvic pathology. |
Generate impression based on findings. | Reason: Eval pelvic fracture History: History of pelvic fracture Overlying bowel gas obscures fine bone details of the lower lumbar spine and upper pelvis. There is complete diastasis of the pubic symphysis, measuring up to 8 cm. The symphyseal edges appear grossly intact, without clear evidence of destruction.Surgical... | Diastasis of the pubic symphysis as above. |
Generate impression based on findings. | History of tonsillar squamous cell carcinoma, status status post chemoradiation. Also history of lung and prostate cancers, with weakness. Evaluate for metastases or ischemia. Evaluation for intracranial metastases is limited by lack of intravenous contrast. There is no evidence of intracranial hemorrhage or mass effec... | 1. Evaluation for intracranial metastases is limited by lack of intravenous contrast. No evidence of intracranial hemorrhage or mass effect.2. Mild chronic small vessel ischemic changes. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern, ... |
Generate impression based on findings. | 54-year-old female patient with flank pain. Evaluate for retained stone. ABDOMEN:LUNG BASES: Basilar atelectasis. Median sternotomy hardware noted.LIVER, BILIARY TRACT: Cholelithiasis. Prominent left hepatic lobe, suggestive of underlying chronic liver disease.SPLEEN: No significant abnormality notedPANCREAS: No signif... | 1.Nonobstructive right renal calculi are not significantly changed compared to prior examination.2.Right adnexal cyst may be physiologic if the patient is premenopausal. Recommend dedicated imaging as clinically indicated. |
Generate impression based on findings. | Reason: eval for rib fx History: rib pain/ rt side No evidence of acute rib fracture or malalignment. Multilevel disk space narrowing and anterior vertebral body osteophyte formation affects the thoracic spine. Mild osteoarthritis of the bilateral shoulders. | No evidence of acute displaced rib fracture. For pulmonary findings please see accompanying chest radiograph. |
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