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Generate impression based on findings. | 6-day-old male with history of emesis and distentionVIEW: Abdomen AP (one view) 4/2/15 at 1622 Nasogastric tube with tip in proximal side hole in the gastric body.Mildly distended bowel loops in a non-obstructive pattern. No pneumatosis, free air, or portal venous gas. | Mildly distended bowel loops in a nonobstructive pattern. |
Generate impression based on findings. | 61-year-old male with metastatic prostate cancer, constipation, nausea, vomiting. Evaluate for obstruction, concern for left inguinal hernia. ABDOMEN:LUNG BASES: Elevation right hemidiaphragm unchanged. Left basilar atelectasis. No other changes or abnormalities seen.LIVER, BILIARY TRACT: Scattered left lobe subcentime... | 1. Diffuse skeletal metastatic lesions again seen -- nuclear medicine scintigraphy is a more sensitive indicator of activity of disease. The distribution and appearance of the skeletal lesions appears similar, however slight increase in soft tissue component of the left inferior pubic ramus masses seen. 2. No evidence ... |
Generate impression based on findings. | Female; 85 years old. Reason: h/o met thyroid ca, compare to previous, measurements pls History: none LUNGS AND PLEURA: Scattered pulmonary micronodules are stable. Reference right middle lobe micronodule measures 3 mm (series 4/42), previously 3 mm. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: S... | Interval increase in size of left ninth rib lesion with large soft tissue component. Otherwise, no significant interval change. |
Generate impression based on findings. | Reason: r/o fx History: pain and bruising over right 4th and 5th metacarpals and fingers Three views of the right hand demonstrate the aforementioned oblique comminuted fracture of the fifth proximal phalanx, with intra-articular extension at the PIP aspect and mild dorsal and ulnar angulation of the distal fracture fr... | Redemonstration of comminuted fracture of the fifth proximal phalanx as above. No additional fracture is identified. |
Generate impression based on findings. | Exam is significantly limited due to extensive streak artifact from indwelling spinal instrumentation as well as limited by patient body habitus. There are bilateral pedicle screws from L1 through S1, with additional bilateral iliac wing screws. On coronal reformatted images, there is question of discontinuity of the ... | 1. Significantly limited exam as noted above. Suggestion of possible crossbar discontinuity along the left aspect at the L5 vertebral level. Otherwise, no other concern for instrumentation complication. No acute fracture.2. Suggestion of minimal grade 1 anterolisthesis of L3 on L4. Rightward convexity of the mid lumbar... |
Generate impression based on findings. | Female 43 years old Reason: Please include standing views. Assess severity of joint degenerative changes History: right knee pain Bone mineralization is normal. Alignment is anatomic. There is mild extensor compartment joint space loss and tiny osteophytes. Probable trace joint effusion. No acute fracture or malalignme... | Mild developing osteoarthritis. |
Generate impression based on findings. | Reason: extent of dental damage s/p syncope and fall on face; dental pain from broken teeth History: dental pain from broken teeth Single AP view of the mandible demonstrates multiple broken upper teeth (7, 8, and 9). Patient is partially edentulous. No mandibular fracture is identified. Multiple dental caries. No disl... | Multiple broken upper teeth as above. No evidence of mandibular fracture. |
Generate impression based on findings. | There is a stable area of encephalomalacia in the lateral right posterior frontal lobe consistent with a chronic infarct. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no new areas of abnormal attenuation. There is no extraax... | No acute intracranial abnormality. Stable small right posterior frontal chronic infarct. |
Generate impression based on findings. | Reason: assess scoliotic curve History: see above Two views of the cervical spine demonstrate moderate disk space narrowing at C5-6 and C6-7 with anterior and posterior vertebral body osteophytosis. Two views of the thoracic spine demonstrate rotary S-shaped scoliosis, with a levoconvex scoliosis of 24 degrees, centere... | T12 vertebral body compression fracture, which is likely chronic, and scoliosis, as above. |
Generate impression based on findings. | Mucoepidermoid cancer of the buccal and parotid area. 1) left infratemporal fossa mass in coronal plane and in axial plane, 2) nodule deep to left zygomatic arch. Neck: There are post-treatment findings related to left maxillectomy and palatectomy, partial resection of the left mastoid air cells, and left parotidectomy... | 1. Left maxillofacial region post-treatment findings without significant change in the size of the recurrent tumor deposits involving the left masticator space since February.2. The left foramen ovale and pterygopalatine fossa are widened likely reflecting perineural tumor involvement, with slight intracranial extensio... |
Generate impression based on findings. | Female 51 years old Reason: left ankle fx History: left ankle fx Two views of the left ankle shows a minimally displaced fibular fracture at the level of the tibiotalar joint. Soft tissue swelling has slightly decreased. There is some callus formation. | Healing fibular fracture. |
Generate impression based on findings. | Female 57 years old Reason: eval for CMC arthritis History: above Right: Bone mineralization is normal. Alignment is near-anatomic. There is moderate joint space loss at the carpometacarpal joint with small osteophytes. There is mild to moderate joint space loss at the interphalangeal joints and at the carpal metacarpa... | Bilateral carpometacarpal joint osteoarthritis. |
Generate impression based on findings. | The intra-axial nodule in the right superior frontal gyrus at the vertex straight mildly heterogeneous enhancement, and with surrounding vasogenic edema extending into the body of the corpus callosum. This mass measures 1.6 x 1.7 cm in greatest axial dimensions, by 1.7 cm CC. The large mass centered in the left fronta... | Enhancement associated with the right superior frontal gyrus intra-axial mass most consistent with metastasis, as well as diffuse enhancement of the left frontal bone metastasis. Smaller left squamosal temporal enhancing lesion, also likely metastasis. No other intracranial foci of enhancement noted to suggest addition... |
Generate impression based on findings. | Female 56 years old Reason: cyst humeral head History: pain Mild osteoarthritis affects the right shoulder mild joint space narrowing and small developing osteophytes. Mild osteoarthritis affects the right AC joint. There are new punctate calcifications adjacent to the humeral head with cystic changes at the supraspina... | Cystic change at the supraspinatus footprint with enthesopathic changes. Differential considerations include degenerative enthesopathic changes versus inflammatory enthesopathic changes |
Generate impression based on findings. | Newly diagnosed esophageal cancer. Neck: There is an irregular cervical esophageal mass that measures up to approximately 45 mm. Although the tumor extends to the party wall, there is no gross evidence of tracheal invasion otherwise. Although not significantly enlarged by size criteria, paratracheal and bilateral level... | 1. The cervical esophogeal mass measures up to approximately 45 mm. Although the tumor extends to the party wall, there is no gross evidence of tracheal invasion otherwise. 2. Although not significantly enlarged by size criteria, the paratracheal and level 2 lymph nodes demonstrate hypermetabolism on PET and may repres... |
Generate impression based on findings. | Pain, clicking, crunching. Evaluate left shoulder. Evaluation of the shoulder is slightly limited due to inability to optimally position the patient for the examination. Given this limitation, I see no specific findings to account for the patient's symptoms. I see no fracture, and alignment is within normal limits. Sur... | No specific findings to account for the patient's symptoms. Other findings as above. |
Generate impression based on findings. | Right foot pain, right ankle pain, right wrist pain. Three views of the right wrist are provided. There is a slight negative ulnar variance, but I otherwise see no specific findings to account for the patient's pain.Three views of the right ankle are provided. There is mild soft tissue swelling and small ankle joint os... | Mild ankle osteoarthritis and a small foreign body in the great toe as described above. Mild negative ulnar variance. |
Generate impression based on findings. | 92 year-old female patient with abdominal pain, altered mental status and hypotension. Evaluate for acute process. Exam is not sensitive for detecting lesions in the bowel and solid organs due to the lack of oral and intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: ... | No acute intraabdominal pathology to account for patient's symptoms. |
Generate impression based on findings. | Reason: post reduction History: above Two views of the right ankle demonstrate the previously seen ankle dislocation reduced to near-anatomic alignment. Overlying cast material limits fine bone detail. There is approximately 5 mm of dorsal displacement of the distal fibular fracture fragment. | Reduction of ankle fracture/dislocation as above. |
Generate impression based on findings. | Evaluate total knee arthroplasty Components of a right total knee arthroplasty are situated in near-anatomic alignment without radiographic evidence of hardware complication. A drain and foci of gas in the anterior soft tissues reflect recent surgery. There are extensive arterial calcifications. | Total knee arthroplasty as above. |
Generate impression based on findings. | Status post femoral reconstruction with total knee arthroplasty. The distal femur has been resected and reconstructed with a total knee endoprosthesis device. I see no complications. Surgical staples, a drain, and foci of gas density in the soft tissues reflect recent surgery. | Distal femoral reconstruction as described above. |
Generate impression based on findings. | Status post reduction of distal radius fracture Evaluation of fine detail is limited by overlying cast material. There is a comminuted intra-articular fracture of the distal radius with approximately 3 mm of dorsal displacement of the distal fracture fragments relative to the radial diaphysis. | Distal radius fracture as above. |
Generate impression based on findings. | Rule out fracture versus arthritis. Knee pain. There are tiny patellar osteophytes and a small joint effusion, but I see no fracture or malalignment. | Tiny patellar osteophytes and small joint effusion; no fracture evident. |
Generate impression based on findings. | Reason: eval for PE History: chest pain PULMONARY ARTERIES: The quality of this examination is adequate for the evaluation of pulmonary embolism. There is no pulmonary embolus.LUNGS AND PLEURA: This examination excludes the posterior costophrenic angles. No suspicious pulmonary nodules or pleural effusion.MEDIASTINUM A... | No pulmonary embolus. Prominent thymic tissue with suggestion of nodule in the anterior mediastinum. Follow up in 6 months to exclude interval growth recommended.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Status post fracture reduction.VIEWS: Right wrist AP and lateral 4/2/15 1747 hrs (two views) Cast material obscures fine bone detail. Distal right radial fracture is in anatomic alignment. | Status-post alignment and casting of distal radial fracture. |
Generate impression based on findings. | Female 12 months old Reason: eval for pna History: fever, increased WOBVIEWS: Chest AP/lateral (two views) 4/2/15 The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size and shape. Peribronchial thickening, large lung volumes and right middle lobe airspace opacity, either atelectas... | Bronchiolitis pattern with superimposed opacity of the right middle lobe as described. |
Generate impression based on findings. | Male 8 years old Reason: sob History: sobVIEW: Chest AP (one view) 4/2/15 at 2031 hrs. Multiple postsurgical skeletal deformities, surgical clips, residual contrast material at the pleural space and central line again noted. Cardiac silhouette size is normal. Interval worsening in right lung base opacity. Stable locula... | Interval worsening in right lung base opacity. |
Generate impression based on findings. | Status post reduction Evaluation of fine detail is limited by overlying splint. Again seen is a comminuted but predominantly oblique fracture of the proximal phalanx of the fifth finger, with mild (1 to 2 mm) radial displacement of the distal fracture fragment relative to the proximal fracture fragment. | Finger fracture as above. |
Generate impression based on findings. | Male 4 years old Reason: assess fracture s/p casting History: L ulnar fractureVIEWS: Left elbow AP, lateral and oblique 4/2/15 at 2250 hrs. (3 views) Cast material obscures fine bone detail. Transverse fracture of the proximal left ulna is in near-anatomic alignment. | Casting of near-anatomic alignment fracture of the left ulna. |
Generate impression based on findings. | 12-year-old male with history of swellingVIEWS: right tibia-fibula AP, lateral (two views) 4/2/15 at 2130 Soft tissue swelling over the lateral malleolus without evidence of fracture. The joint effusion is present at the ankle. A small well corticated ossicles inferior to the fibula, likely from prior injury. No malali... | Soft tissue swelling and joint effusion without evidence of fracture or malalignment. |
Generate impression based on findings. | Male 4 years old Reason: injury History: swellingVIEWS: Left forearm AP and lateral left elbow AP, lateral and oblique 4/2/15 (5 views) There is a transverse fracture of the proximal diaphysis of the left ulna with minimal ulnar angulation. | Left ulnar fracture as described. |
Generate impression based on findings. | Reason: fx? History: fall Three views of the left shoulder and two views of the left humerus demonstrate normal anatomic alignment without evidence of acute fracture or dislocation. Mild osteoarthritis affects the acromioclavicular joint. The humerus is unremarkable.Single AP view of the pelvis demonstrates mild osteoa... | Osteoarthritis without evidence of acute fracture or malalignment. |
Generate impression based on findings. | 33 day old male with respiratory distressVIEWS: Chest AP/lateral (two views) 4/2/15 at 2112 The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. No focal pulmonary opacities. No pleural effusion or pneumothorax. Increased lung volumes and flattening of the diaphragms is cons... | Bronchiolitis/reactive airway disease. |
Generate impression based on findings. | Reason: eval for pE History: Tachy, hypoxic PULMONARY ARTERIES: The quality of this examination is adequate for the evaluation of pulmonary embolism. No pulmonary embolus is present.LUNGS AND PLEURA: No suspicious pulmonary nodule or pleural effusion.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusi... | No pulmonary embolism.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 68 year old with history of right lumpectomy for breast cancer presents for routine follow-up. 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. No dominant ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | [ Reason: evaluate for necrotizing infection History: evaluation of necrotizing infection. ] Right: There is extensive ulceration with loss of the subcutaneous fat along the posteromedial aspect of the upper right thigh, extending into the perineum. There are also more discrete ulcers along the anteromedial aspect of t... | Extensive superficial ulceration/wounds as described above. We see no gas or fluid within or between the musculature to suggest a deep infection. Please note, however, we cannot exclude the possibility of a superficial necrotizing infection based on these findings. |
Generate impression based on findings. | Reason: eval fx History: dislocation s/p fall Two views of the right ankle demonstrate lateral dislocation of the talus with respect to the long axis of the tibia. There is an associated oblique fracture of the distal fibula that is displaced laterally along with the talus. Additional linear densities adjacent to the t... | Ankle fracture-dislocation as above. |
Generate impression based on findings. | Male 3 months old Reason: Interval change History: Respiratory distress, IntubatedVIEW: Chest AP (one view) 4/3/15 at 0 39 hours ET tube terminates below thoracic inlet. NG tube tip is in the stomach. Cardiac silhouette size is top normal. Interval improvement in left upper lobe and lingular aeration with persistent at... | Interval improvement in left lung aeration as described. |
Generate impression based on findings. | Reason: fx? History: MVC, midline tenderness Three views of the thoracic spine demonstrate normal anatomic alignment without evidence of acute fracture. Vertebral body heights and disk spaces are preserved.Five views of the lumbar spine demonstrate normal anatomic alignment without evidence of acute fracture. Vertebral... | No acute fracture or other findings to account for the patient's pain. |
Generate impression based on findings. | Female; 54 years old. Reason: 54 y.o with h/o Crohn's with diarrhea and weight loss. please eval severity of Crohn's and if any other etiology of symptoms History: diarrhea and weight loss ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant ab... | Findings most compatible with active inflammatory bowel disease affecting the neoterminal ileum and rectum, mildly increased since prior study but with overall similar distribution. |
Generate impression based on findings. | Male 3 months old Reason: eval for left lung reexpansion History: left lung atelectasisVIEW: Chest AP (one view) 4/2/15 at 1822 hrs. ET tube terminates below the thoracic inlet. NG tube tip is in the stomach. Cardiac silhouette size is top normal. Slight improvement in left upper aeration with persistent mediastinal sh... | Improvement in left upper lobe atelectasis. |
Generate impression based on findings. | Reason: r/o stress fx History: h/o osteomalacia c/o limping and malalignment Single AP view of the pelvis demonstrates slightly demineralized bones. We see no fracture or malalignment. Mild osteoarthritis affects the hips.Two views of the right lower leg demonstrate normal anatomic alignment, without evidence of acute ... | Mild osteoarthritis, but no fracture or other findings to account for patient's pain. |
Generate impression based on findings. | 58 year old male with history of AML presents with hemoptysis. LUNGS AND PLEURA: Moderate loculated right pleural effusion, increased in size and loculation, particularly superiorly. No significant interval change in right lower lobe consolidation. Bilateral scattered faint ground glass opacities, new and increased fro... | 1.Interval increase in size and organization of loculated right pleural effusion. Continued imaging is recommended; of particular note, if there is clinical concern for empyema, contrast enhanced exam would be recommended for future imaging.2.Persistent right lower lobe consolidation and increased scattered bilateral f... |
Generate impression based on findings. | Male 54 days old Reason: Eval lung fields History: Concern for infiltrateVIEW: Chest and abdomen AP (two views) 4/2/15 at 1813 hrs. ET tube terminates below thoracic inlet. Mediastinal clip and NG tube unchanged.Cardiac silhouette size is top normal. Persistent multifocal patchy opacities of the right upper, right midd... | Persistent multifocal opacities as described.Disorganized, slightly distended and nonspecific abdominal gas pattern. |
Generate impression based on findings. | 3-year-old female with elbow pain after fallVIEWS: Left elbow AP, oblique, lateral (3 views) 4/2/13 at 2244 Joint effusion is present with elevation of the posterior fat pad. Subtle cortical step off of the medial and lateral humeral metaphysis represents a fracture. | Supracondylar fracture. |
Generate impression based on findings. | Reason: fracture History: pain Two views of the right tibia/fibula demonstrate mild soft tissue swelling along the medial aspect of the lower leg, without underlying fracture.Two views of the left tibia/fibula demonstrate mild soft tissue swelling along the lateral aspect of the lower leg, without underlying acute frac... | Mild soft tissue swelling without evidence of acute fracture. |
Generate impression based on findings. | Reason: r.o. right anterolateral rib fx History: right rib pain s/p direct trauma Markers were placed along the right thorax and upper abdomen at the site of patient's pain. Minimally displaced fractures are present along the lateral aspect of the right eighth and ninth ribs. There is evidence of an old healed fracture... | Minimally displaced rib fractures as above. |
Generate impression based on findings. | 26-year-old male with non-infectious gastroenteritis and colitis with nausea and vomiting. Evaluate for perforation. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS:... | Mild wall thickening involving colon without evidence for perforation. Normal appendix. |
Generate impression based on findings. | 81-year-old male. Lung cancer status post RUL resection, presenting with abdominal pain, with known right ureteral stent. Evaluate for malignant disease, and abdominal process. Large parastomal hernia. Lack of intravenous contrast limits evaluation for solid organ and bowel pathology.ABDOMEN:LUNG BASES: Prominent right... | 1. New moderate hydroureteronephrosis with transition point in the distal ureter at site of surgical clips. Right nephroureteral stent with pigtail ends at the UPJ and bladder.2. No definite evidence for metastatic disease on this limited noncontrast exam. |
Generate impression based on findings. | Reason: r/o PE History: hypoxia to low 80s, SOB, PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism. No pulmonary embolus is identified.LUNGS AND PLEURA: There is severe upper lobe predominant centrilobular and paraseptal emphysema. Severe basilar predominant interstitial fibrosis, honey... | 1.No evidence of pulmonary embolism.2.Multiple right lung pulmonary nodules, some of which are new from the previous exam, with new mediastinal and bilateral hilar lymphadenopathy. While these likely reflect inflammatory changes, follow up imaging should be obtained after treatment of acute illness/6 weeks to ensure re... |
Generate impression based on findings. | Reason: yes History: pain/laceration Three views of the right hand demonstrate dorsal dislocation of the third middle phalanx relative to the proximal phalanx. Soft tissue swelling and gas density immediately proximal to the dislocated middle phalanx presumably represents patient's laceration. There is no evidence of a... | Proximal interphalangeal dislocation of the third digit as above |
Generate impression based on findings. | Reason: r/o fx History: assault Three views of the lumbar spine demonstrate perhaps minimal retrolisthesis of L5 relative to S1. Otherwise, the lumbar spine appears normal for age. No fracture is evident. | No acute fracture is evident. |
Generate impression based on findings. | There is no evidence of acute intracranial hemorrhage. There are stable lacunar infarcts involving the right anterior internal and external capsules along with mild patchy subcortical white matter hypoattenuation. The ventricles and sulci are normal in size and configuration. There are no masses, mass effect, edema, o... | 1.No acute intracranial hemorrhage.2.Stable lacunar infarcts involving the right anterior internal and external capsules 3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. They are stable from the prior examination. They are mainly... |
Generate impression based on findings. | 13-year-old male with leg pain and difficulty bearing weightVIEWS: Left tibia-fibula AP, lateral; pelvis AP, frog leg (4 views) 4/3/15 at 0003 Tibia-fibula: No acute fracture or malalignment. No significant soft tissue swelling.Pelvis: No acute fracture or malalignment. No evidence of SCFE. Femoral heads are seated at ... | No fracture or malalignment. No specific findings to account for patient's pain |
Generate impression based on findings. | Female 7 months old Reason: Obstruction History: Abdominal DistentionVIEW: Abdomen and chest AP (two views) 4/3/15 at 245 hours. Right mainstem bronchus intubation. NG tubes terminates at the stomach. Urinary bladder catheter, both left-sided chest drains and central line again noted.Cardiac silhouette size is normal. ... | Right mainstem bronchus intubation.Left lower lobe atelectasis.Improvement in the mediastinum in left-sided pneumothorax.Improvement in bowel distention as described. |
Generate impression based on findings. | 19 year-old female with positional headache. There are postoperative changes of parietal craniectomy with mesh cranioplasty. The brain parenchyma protrudes slightly into the calvarial defect. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The v... | Postoperative changes of parietal craniectomy with mesh cranioplasty, but no evidence of acute intracranial hemorrhage or mass.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 62 year-old female with history of hemoptysis. Evaluate for left ventricular aneurysm. LUNGS AND PLEURA: Subtle ground glass opacities at the posterior aspect of the left lower lobe, likely related to aspiration. Moderate sized cyst in the left upper lobe likely the sequela of prior infection. No suspicious nodules or ... | 1. No evidence of left ventricular aneurysm as clinically queried.2. Subtle ground glass opacities in the left lower lobe are nonspecific but likely related to aspiration, possibly aspirated blood. |
Generate impression based on findings. | Female; 55 years old. Reason: shock, evaluate source of ischemia; evaluate upper abdomen and pelvis History: r/o ischemic colitis CT ANGIOGRAM:Normal caliber of the abdominal aorta. Mild atherosclerotic calcifications of the distal abdominal aorta and bilateral common iliac arteries. The celiac artery, SMA, renal arter... | 1. No acute arterial occlusive disease is evident.2. Large pleural effusions and large amount of abdominopelvic ascites.3. Findings suggestive of elevated right heart pressures.4. Possible edema or infection involving the atelectatic right lower lobe. |
Generate impression based on findings. | 16 year-old female status-post ankle injury.VIEWS: Right ankle AP, oblique and lateral (3 views) 4/3/15 at 0139 Soft tissue swelling is present over the lateral malleolus. Increase space of the lateral ankle mortise joint is suspicious for ligamentous injury. No fracture is definitely identified. Osseous fragment of th... | Asymmetry of the ankle mortise joint with increased space laterally is suspicious for ligamentous injury. No definite evidence of fracture. If there is clinical concern for occult fracture follow up radiographs may be obtained. |
Generate impression based on findings. | 44-year-old male with acute pancreatitis and fever. Evaluate for increasing fluid collection post drainage and pancreatic necrosis. ABDOMEN:LUNG BASES: Bilateral pleural effusions, greater on the left with associated atelectasis, without significant change.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: N... | Moderate improvement in peripancreatic fluid collection and marked improvement in pelvic fluid collections after drain placement.Minimal enhancing pancreatic substance.Other findings are unchanged. |
Generate impression based on findings. | 76 year-old male patient with abdominal pain and distention. Exam is not sensitive for detecting lesions in the bowel and solid organs due to the lack of oral and intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: Basilar atelectasis and trace bilateral pleural effusi... | Cecal volvulus without significant bowel wall thickening, pneumatosis, pneumoperitoneum, or free fluid. |
Generate impression based on findings. | Male, 88 years old, stroke appear motor syndrome, right face arm and leg, dysarthria. Non-angiographic findings:Patchy periventricular and brainstem hypoattenuation is seen, a nonspecific finding. No definite evidence of any parenchymal edema, mass effect or loss of gray-white distinction is seen in this examination. T... | 1. Abrupt cessation of one of the M4 branches of the left MCA, in the vicinity of the known post central gyrus stroke.2. No additional high grade intracranial stenoses are seen.3. No significant vascular stenoses are detected in the neck. |
Generate impression based on findings. | Male 2 years old Reason: Interval change History: DesaturationsVIEW: Chest AP (one view) 4/3/15 at 643 hours. ET tube terminates below thoracic inlet. Central line and gastrostomy tube unchanged. Thoracolumbar levoscoliosis again noted.Cardiac silhouette size is normal. Small lung volumes and multifocal patchy opacitie... | Interval improvement in left upper lobe atelectasis. |
Generate impression based on findings. | 71-year-old male with facial pain, purulent sputum, and fevers There is mucosal thickening and air fluid levels in bilateral maxillary sinuses. There is also mild opacification of the anterior ethmoidal air cells. The other paranasal sinuses and recesses are clear. There is minimal leftward deviation of the nasal septu... | 1. Mucosal thickening and air-fluid levels in the maxillary sinuses suggesting acute sinusitis.2. Dental caries.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 12-year-old male with pain, swelling and nonweightbearingVIEWS: Tibia-fibula AP and lateral; ankle AP, oblique, lateral (3 views) 4/3/15 at 0233 Comminuted predominantly oblique fracture of the distal tibial diaphysis with lateral and posterior displacement of the distal tibial fracture fragment. Comminuted predominant... | Oblique fractures through the distal tibial and fibular diaphysis. |
Generate impression based on findings. | 69-year-old female with history of aortic insufficiency. Preoperative exam. LUNGS AND PLEURA: No suspicious nodules or masses. Calcified granulomas. No pleural effusions or evidence of infection.MEDIASTINUM AND HILA: The heart size is enlarged with a dilated left ventricle. The main pulmonary artery is dilated measurin... | 1. No acute pulmonary abnormalities.2. Cardiomegaly with dilated left ventricle is better evaluated on dedicated cardiac MRI from the same date.3. Enlarged main pulmonary artery suggesting pulmonary hypertension.5. Hepatomegaly and cholelithiasis. |
Generate impression based on findings. | 67-year-old male with syncope, history of alcohol abuse. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is diffuse prominence of the ventricles and sulci due to cerebral volume loss. There is no midline shift or herniation. The imaged par... | No evidence of acute intracranial hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 44 old female chest pain. Rule out PE. PULMONARY ARTERIES: Right lower lobe posterior subsegmental pulmonary embolus (series 7, images 189 through 197). No other pulmonary embolus is identified. No evidence of right heart strain. LUNGS AND PLEURA: Minimal atelectasis/scarring at the lung bases, right greater than left;... | 1.Right lower lobe subsegmental pulmonary embolism. Right basilar changes suggestive of mild atelectasis or scarring, though early infarction not excluded.2.Thymic hyperplasia of unclear etiology; no past medical history per EMR.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Single.Most Proximal: Subs... |
Generate impression based on findings. | Male, 64 years old. Limited field of view. No unexpected radiopaque foreign body. Note is made of midline staples and 3 surgical drains. The distal portion of the left sided drain appears to be kinked in the pelvis. A partially visualized enteric tube tip projects over the proximal body of the stomach with the side-por... | 1. No unexpected radiopaque foreign body.2. The distal portion of the left sided drain appears to be kinked in the pelvis.These findings were discussed by telephone with Dr. Dr. Hurst, the attending surgeon, on 4/2/2015 at 1955. |
Generate impression based on findings. | 5-year-old male fever and crackles on examVIEWS: Chest AP/lateral (two views) 4/3/15 and 0317 The cardiothymic silhouette is normal. Increased lung volumes with bronchial wall thickening is present consistent with a reactive airway disease/bronchiolitis pattern. Focal opacity in the left lower lobe and streaky opacity ... | Bronchiolitis/reactive airway disease pattern with a focal opacity in the left lower lobe that is favored to represent atelectasis, although may represent an infection. |
Generate impression based on findings. | 51 year-old male patient with abdominal pain and diarrhea. Evaluate for colitis or appendicitis. ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions in the right liver are incompletely characterized and likely represent cysts. No CT evidence of cholelithiasis or cholecyst... | 1.Unremarkable study.2.Interval resolution of inguinal lymphadenopathy. |
Generate impression based on findings. | Reason: evaluate ich History: evaluate ich, evd increased There is a redemonstration of a 41 x 21-mm axial dimension hematoma centered in the right deep cerebellar hemisphere which is unchanged when compared to the prior exam. There is associated mass effect and some subarachnoid blood products.There is mild enlargemen... | 1.Since the prior exam there is no significant change in the appearance of the patient's brain. There is redemonstration and no change of a right cerebellar hematoma associated with mass effect, extra-axial blood products and mild ventriculomegaly.2.Ventriculostomy tube is in stable position. |
Generate impression based on findings. | 36-year-old male. Hematuria. Evaluate for stones, anatomic abnormality. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URE... | No specific findings to explain the patient's hematuria. |
Generate impression based on findings. | 74 years, Male. Reason: s/p ngt placement History: post procedure The pelvis is excluded from the field of view. There is a nasogastric tube with its tip projecting over the gastroesophageal junction, the side port appears to be in the distal esophagus, advancement by approximately 5 cm is recommended. There is diffuse... | NG tube tip projects over the gastroesophageal junction with sideport in the distal esophagus. Advancement by approximately 5 cm is recommended. |
Generate impression based on findings. | 28-year-old male status post assault, rule out bleed. HEAD CT: There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There i... | 1. No evidence of acute intracranial hemorrhage or skull fracture2. No cervical spine fracture or malalignment.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Newborn female with line placementsVIEW: Chest and Abdomen AP (two views) 4/3/15 at 0243 UAC tip at T10. UVC tip in right portal vein.The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Diffuse lung haziness consistent with TTN or RDS. No focal pulmonary opacities. No pleur... | Bilateral diffuse lung haziness consistent with TTN or RDS. Organized, nonobstructive bowel gas pattern. |
Generate impression based on findings. | There is no evidence of acute intracranial hemorrhage. There are no masses, mass effect, edema, or midline shift. The ventricles and sulci are normal in size and configuration. The visualized paranasal sinuses and mastoid air cells are clear. | Normal CT of the head. If clinical concern persists, MR is more sensitive for findings of intracranial infection. |
Generate impression based on findings. | 22 year old male with episodic lower abdominal pain with microscopic hematuria. Evaluate for urolithiasis. Please note lack of IV and oral contrast limits evaluation of solid organ pathology, and also of the GI tract.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Liver morphology is unremarka... | Unremarkable examination. Specifically, no evidence of urolithiasis or hydronephrosis. |
Generate impression based on findings. | 63 year old female. Colon cancer. Please assess index lesion measurements for RECIST prior to start of therapy. CHEST:LUNGS AND PLEURA: Bilateral multiple pulmonary nodules consistent with metastases. 1.3 x 0.9 cm right lower lobe nodule (series 4, image 38) and 1.4 x 1.9 cm left upper lobe nodule (series 4, image 32).... | Metastatic disease in the lung, liver, and abdominal lymph nodes. |
Generate impression based on findings. | Female; 68 years old. Reason: SP repair of duodenal perforation History: continued bilious drainage ABDOMEN:LUNG BASES: Large pleural effusions with adjacent bibasilar atelectasis/consolidation, similar to prior study. Severe coronary artery calcifications. Cardiomegaly.LIVER, BILIARY TRACT: Status post cholecystectomy... | 1. Extraluminal air and contrast collection adjacent to the descending duodenum has slightly decreased in size with significantly decreased inferior extension. Surgical drain tip within the collection.2. Stable wall thickening of the sigmoid colon and rectum, again concerning for nonspecific colitis. |
Generate impression based on findings. | Reason: rule out stroke History: altered mental status; History of stem cell transplant. New garbled speech in setting of thrombocytopenia. HEAD:No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. Redemonstration of focal areas of prominent extra-axial space ... | 1.No acute intracranial abnormality. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia and MRI can be considered for further evaluation.2.Intracranial and cervical vasculature are within normal limits. No evidence of significant stenosis or aneurysms.3.Left thyroid inferior pole hypodense l... |
Generate impression based on findings. | Reason: Evaluate SDH History: SDH, increase in size There is redemonstration status-post right-sided craniotomy. There is redemonstration of the right-sided subdural hyperdense collection measuring approximately 9 mm in thickness on the current exam in similar dimensions on the prior exam.Atherosclerotic calcifications... | 1.Since the prior exam there is no significant interval change. The patient is status-post right-sided craniotomy. An extra-axial collection remains stable when compared to the prior exam.2.Punctate hypodense foci in the right caudate nucleus and left internal capsule are stable and likely represent prior lacunar infar... |
Generate impression based on findings. | Metastatic thyroid carcinoma on cediranib + lenalidomide, held since 6.7.13. Neck: Streak artifact related to dental amalgam and a left shoulder prosthesis obscures surrounding structures. There are postsurgical findings related to thyroidectomy. Within the limits of artifact. here is no measurable mass lesion in the n... | 1. No evidence of locoregional tumor recurrence or significant cervical lymphadenopathy, although the assessment is limited by streak artifact. Subsequent follow up via PET or ultrasound may be useful.2. No evidence of intracranial metastases. 3. Persistent prominence of the triventricular system may indicate normal pr... |
Generate impression based on findings. | 74-year-old female patient with abdominal pain and no bowel movement in 5 days. Evaluate for obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Gallbladder is enlarged, measuring up to 11 cm in length (series 3 image 37) with layering gallstones. There is irregularity and interruptio... | 1.Findings compatible with perforated cholecystitis with associated fluid collection.2.Lesion in the T10 vertebral body may be metabolic versus metastatic in etiology. Recommend correlation with patient's history/laboratory values and further characterization with MRI as clinically indicated.3.Large stool burden in the... |
Generate impression based on findings. | 40-year-old female with history of right benign excisional breast biopsy in 3/2014 for fibroadenoma. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pa... | 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. | 44-year-old male with renal transplant, graft dysfunction and graft pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, UR... | Findings suspicious for transplant renal vein thrombosis. I can exclude superimposed pyelonephritis.Progressive hydronephrosis and atrophic right kidney.Abdominal and pelvic fluid presumably dialysate.Right groin adenopathy.Dr. Christine Trotter text paged with results at 9:00 AM 4/3/15 as followsPlease call ext. 27857... |
Generate impression based on findings. | There is moderate, diffuse cerebellar volume loss. Small foci of hypoattenuation in the right pons are noted. There is no evidence of acute intracranial hemorrhage. There are no masses, mass effect, edema, or midline shift. The ventricles and sulci are normal in size and configuration. The imaged paranasal sinuses and... | 1.Diffuse cerebellar atrophy which is nonspecific but can be seen with EtOH use or anti-epileptic medications as well as other entities such as spinocerebellar atrophy and olivopontocerebellar atrophy. Please correlate with clinical exam findings.2.Likely prior right pontine lacunar infarcts.3.No acute intracranial hem... |
Generate impression based on findings. | 75-year-old male with history of new pleural effusion. LUNGS AND PLEURA: There is a new large left pleural effusion measuring more than simple fluid causing near complete atelectasis of the left lung with minimal aeration of the left upper lobe. The left hemidiaphragm is inverted. There is a large, multilobulated heter... | 1. Large tension hydrothorax with associated rightward mediastinal shift and inversion of the left hemidiaphragm.2. Large dominant left hemithorax hypervascular pleural-based mass with areas of necrosis measuring 9.3 x 5.7 cm with multiple smaller enhancing left sided pleural-based nodule. Differential diagnosis includ... |
Generate impression based on findings. | Reason: Evaluate ICH History: Evaluate ICH, EVD clamp/removal Patient is status post left sided craniectomy for hematoma evacuation. The hematoma centered in the left parietal lobe that extends into the left frontal lobe associated extra-axial and intraventricular blood. There is associated mass-effect with mild midlin... | 1.Stable postoperative appearance status post evacuation of a left parietal lobe centered hematoma. There is associated mass-effect with mild midline shift.2.Status post left internal carotid artery stent placement. |
Generate impression based on findings. | Palate mass. She noted it about a month ago. She believes she experienced some trauma with hot food to the area prior to noticing it. Neck: There is a hyperattenuating exophytic plaque like soft tissue lesion in the midline roof of the anterior oral cavity that measures 20 AP x 15 RL x 10 SI mm. There is no erosion of ... | A hard palate region soft tissue mass may represent a fibroinflammatory lesion, keloid, or lobulated capillary hemangioma (pyogenic granuloma), versus perhaps less likely a neoplasm. |
Generate impression based on findings. | Reason: MRSA bacteremia, Eval for osteomyelitis, vertebral pathology History: lower back and left leg pain. Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. There is no osseous erosion along the endplates and the no evidence of peri-vertebral infiltrati... | 1.No CT evidence for diskitis or osteomyelitis.2.There are mild degenerative changes present in the lumbar spine worse at L5-S1 where there is some mild encroachment of the nerve roots of the left lateral recess.3.There is a left-sided pleural effusion present. Please refer to recent chest CT for further comments. |
Generate impression based on findings. | 50 year old female with right complex ADH with multiple benign biopsies. On review of the prior studies, 1/28/2015 outside diagnostic mammogram. Target architectural distortion morphology and three biopsy clips are located in the right breast in the upper outer quadrant region located in mid-breast 11 o’clock. The proc... | Successful needle localization of the right breast distortion and 3 clips.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | There is moderate, diffuse parenchymal volume loss with prominent but symmetric ventricles and sulci. Patchy areas of white matter hypoattenuation suggest small vessel ischemic disease and appear similar to the examination from 2011. There is no acute intracranial hemorrhage. There are no masses, mass effect, edema, o... | 1.No acute intracranial hemorrhage.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. This is grossly similar to the examination from 2011. |
Generate impression based on findings. | 35 year old patient with epigastric and right upper pain, assess for mass. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No cholelithiasis or CT evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnor... | Unremarkable exam. |
Generate impression based on findings. | 70 year old female status post bilateral mastectomy presents to evaluate physician palpated mass in the right chest wall and area of pain marked by the breast surgeon Dr. Chhablani along the left chest wall. A targeted bilateral chest wall ultrasound was performed for the area of concern. Both these areas are marked wi... | Palpable abnormality over the right chest wall corresponds to a normal rib.Area of pain over the left chest wall corresponds to a loculated fluid collection with septations, most consistent with a seroma. Findings and recommendations were discussed with the patient and Dr. Chhablani in detail.BIRADS: 2 - Benign finding... |
Generate impression based on findings. | Question of signs of infection or malignancy, crack/chipped teeth. Panorex radiograph of the mandible shows several teeth are absent. Note is made of several dental fillings. There is a filling in the expected location of the first left maxillary molar but we see no underlying molar and this filling is possibly associa... | Absent teeth and multiple dental fillings without specific radiographic features of infection/malignancy. If further evaluation is warranted, dedicated dental radiographs may be obtained. |
Generate impression based on findings. | Pain. Fracture follow up. Three views of the left foot again show a transverse fracture through the base of the fifth metatarsal. The fracture remains visible though perhaps slightly less lucent which may represent early healing. The bones appear demineralized. Mild osteoarthritis affects the first metatarsophalangeal ... | Fifth metatarsal fracture as above. |
Generate impression based on findings. | Female, 64 years old, with right facial swelling and pain and right-sided numbness. Assess for periodontal infection, parotitis, or stroke. Patchy ventricular hypoattenuation is progressed from the prior examination. This is a nonspecific finding.No evidence of edema or mass effect is seen. No loss of gray-white distin... | 1.Mild progression of periventricular hypoattenuation likely extending age indeterminate small vessel ischemic disease.2.No definite acute intracranial abnormality or other specific findings to account for patient's symptoms.3.Please note that the parotid glands and the dental structures are not adequately visualized o... |
Generate impression based on findings. | Status post ORIF left humerus. Two views of the left humerus again show a plate and screw device affixing a transverse fracture of the mid-humeral diaphysis in near anatomic alignment. There is some maturation of callus particularly along the medial aspect of the humerus indicating some interval healing. | Orthopedic fixation of healing humeral fracture. |
Generate impression based on findings. | 66-year-old female with history of benign left breast biopsy in 2003. Family history of breast cancer diagnosed in sister at age 36, two maternal aunts, and maternal cousin in her 40s. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. Th... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
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