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Generate impression based on findings. | Feeding tube placement. Chronic granulomatous disease and bone marrow transplant.VIEW: Chest AP (one view) 04/04/15, 1307 Right central line tip is in right atrium. Left upper extremity PICC has its tip in superior vena cava. Feeding tube tip is just distal to GE junction and in fundus of stomach.Cardiothymic silhouett... | Feeding tube tip distal to GE junction. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild age-related sulcal prominence. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is an old left lamina papyracea fracture. The skull and extracranial soft tissues are unrem... | No acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | Left chest tube placement. Pneumothorax.VIEW: Chest AP (one view) 04/05/15, 0806 A left chest tube is present with its tip directed toward the apex.No pneumothorax is seen. Cardiothymic silhouette is normal. The aortic arch, cardiac apex, and stomach are left-sided. No focal lung opacity is present. Left costophrenic s... | No pneumothorax. |
Generate impression based on findings. | There is a right transfrontal ventricular shunt catheter again seen terminating in the right lateral ventricle. There is a small amount of parenchymal hemorrhage in the shunt catheter tract which appears slightly increased from the prior exam on series 5 image 24. There is decreased amount of contrast material/blood p... | 1.Decreasing contrast material/blood products in the ventricles with decreasing ventricular dilatation and decreasing hyperattenuation material in the subarachnoid space which likely reflect a combination of resolving blood products and/or contrast material. 2.Slightly increased parenchymal hemorrhage associated with t... |
Generate impression based on findings. | Cough.VIEWS: Chest AP/lateral (two views) 04/04/15 Moderate peribronchial thickening is present. Subsegmental atelectasis is seen in right middle lobe. No focal air space disease is present.Cardiothymic silhouette is normal. The aortic arch, cardiac apex, and stomach are left-sided. | Bronchiolitis/reactive airways disease pattern. |
Generate impression based on findings. | Female; 57 years old. Reason: rule out PE History: progressive hypoxia, cp, sob PULMONARY ARTERIES: No evidence of pulmonary embolism to the segmental level. No evidence of right heart strain.LUNGS AND PLEURA: No suspicious pulmonary nodule. Scattered ground glass opacities are seen in the lung bases. No pleural effusi... | 1.No evidence of pulmonary embolism.2.Scattered ground glass opacities in the lung bases are nonspecific however the differential includes infection, particularly atypical infection such as viral pneumonia, and edema.3.Right renal cysts are partially visualized, further evaluation with abdominal cross sectional imaging... |
Generate impression based on findings. | Increased work of breathing. Sickle cell anemia.VIEW: Chest AP (one view) 04/04/15, 2232 Endotracheal and enteric tubes have been removed. Left upper extremity PICC has its tip in superior vena cava.Segmental atelectasis is present in right upper and left lower lobes. Cardiothymic silhouette is normal in size. | Segmental atelectasis in right upper and left lower lobes. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular and subcortical white matter hypoattenuation representing age indeterminate microvascular ischemic changes. There is an old lacunar infarct in the right external capsule, and an old infarct versus dilated perivascul... | Mild age indeterminate microvascular ischemic changes and old lacunar infarcts with no acute intracranial hemorrhage or mass-effect. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | Surgery for tibia fracture.VIEWS: Right tibia-fibula AP/lateral (two views) 04/05/15 A cast obscures bone detail. Plate and screws device remains in place. Oblique fracture of mid and distal tibia is again seen. No angulation is present. The distal fracture fragment is displaced posteriorly by approximately 0.9 cm. Fra... | Postoperative changes with similar appearance to intraoperative exam. |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is minimal periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing chronic micro-vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is... | 1.Mild scattered atherosclerotic disease with no flow limiting stenosis in the neck or brain. No intracranial aneurysm.2.No acute intracranial hemorrhage or mass effect.3.Incompletely imaged aortic arch appears dilated to 4 cm in diameter, please correlate with dedicated chest imaging. |
Generate impression based on findings. | Fell off of bike. Wrist swelling.VIEWS: Left wrist PA/lateral/oblique (3 views) 04/04/15 Mild soft tissue swelling is present on the dorsum of the wrist. A joint effusion is not identified. No fracture is seen. | No fracture. |
Generate impression based on findings. | Fall off of bike. Elbow tenderness and swelling.VIEWS: Left elbow AP/lateral/oblique (3 views) 04/04/15 Proximal radius and ulna are fractured. The ulnar fracture is transversely oriented and the medial cortex is interrupted. The radial fracture is along the lateral aspect and is also transversely oriented. Minimal med... | Fractures of proximal radius and ulna. |
Generate impression based on findings. | Male 45 years old; Reason: bowel obstruction? History: abdominal pain, h/o colon CA ABDOMEN:LUNG BASES: Nonspecific ground glass opacities in the right lung base.LIVER, BILIARY TRACT: Liver has innumerable metastatic deposits. A reference segment 7 lesion measures 5.8 x 4.0 cm (image 32/series 3). Hepatic and portal ve... | 1.Findings of the sigmoid colonic mass with mesenteric extension causing a high-grade partial colonic obstruction.2.Extensive retroperitoneal nodal disease and metastatic disease to the liver. |
Generate impression based on findings. | Female; 69 years old. Reason: eval for pe History: hx polycythemia, chest pain, sob PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Small right pleural effusion with associated compressive atelectasis. Subsegmental right middle lobe atelectasis with minimal adjacent ground glass opacity which is... | 1.No evidence of acute pulmonary embolus.2.Small right pleural effusion with associated atelectasis.3.Diffuse bronchial wall thickening may be seen in reactive airway disease or bronchiolitis and can also be seen in the setting aspiration.4.Multiple enlarged mediastinal lymph nodes are nonspecific.5.Eccentric thickenin... |
Generate impression based on findings. | Liver failure and septic shock. Respiratory failure.VIEW: Chest AP (one view) 04/05/15, 0434 Endotracheal tube tip is below thoracic inlet. Feeding tube tip is distal to first portion of duodenum and not included on image. Right central line has its tip at junction of superior vena cava and right atrium. Left upper ext... | Worsening appearance of the chest with increase seen opacities and pleural effusion. |
Generate impression based on findings. | Male 85 years old; Reason: eval for torsion History: testicular pain RIGHT TESTIS: Right testes measures 4.5 x 2.0 x 3.6 cm; No suspicious testicular lesions.LEFT TESTIS: Left testicle measures 3.7 x 2.4 x 2.3 cm; no suspicious testicular lesions.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No ... | Findings of increased vascularity to the left testes and epididymis with a complex left hydrocele. Overall imaging findings are most suggestive of an epididymoorchitis with a reactive hydrocele.Recommend follow up following appropriate therapy to ensure resolution. |
Generate impression based on findings. | Drowning and intubated.VIEW: Chest AP (one view) 04/05/15, 0441 Endotracheal tube tip is at the carina. Feeding tube tip is in gastric body. Lower extremity PICC tip is at junction of intra-and suprahepatic IVC. Left chest tube remains in place.Cardiothymic silhouette is normal in size. No definite pneumothorax is seen... | No definite pneumothorax. Subsegmental atelectasis in left lower lobe. |
Generate impression based on findings. | Three day old full-term gestation with congenital syphilis and PICC placement.VIEW: Chest AP (one view) 04/04/15, 1439 Left upper extremity PICC tip is at junction of right atrium and inferior vena cava.Cardiothymic silhouette is normal in size. No focal lung opacity is present. | Normal examination. |
Generate impression based on findings. | Female 50 years old; Reason: R flank 8/10 TTP, R inner thigh/inguinal pain, LHC yesterday, c/f RP bleed vs nephrolithiasis History: as above ABDOMEN:LUNG BASES: Coronary artery stent is present within the coronary vasculature.LIVER, BILIARY TRACT: Liver is normal in morphology. It is diffusely hypodense compatible with... | 1.Mild infiltration of the fat in the right inguinal area and in the right iliopsoas muscle compatible with hematoma.2.Right hepatic lobe lesion. Further characterization is recommended. |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing indeterminate small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There... | 1.No acute intracranial hemorrhage, mass-effect or skull fracture.2.No significant cervical spinal stenosis.3.Two subcentimeter non specific thyroid nodules. |
Generate impression based on findings. | Proteus urinary tract infection. Possible renal stones. ABDOMEN:LUNG BASES: Lower lobe consolidation is present. Bilateral pleural effusion is seen right greater than left. Small pericardial effusion is present. A pericardial drain is noted. The heart size is enlarged. The blood pool is less dense than the ventricular ... | No calculi. Anemia. Pleural effusion, pericardial effusion, and ascites. Bowel thickening of wall of colon and rectum. |
Generate impression based on findings. | Low dose CT technique mildly limits image quality, especially for gray-white interface differentiation. Given this limitation, there is no evidence of intracranial hemorrhage, mass, or cerebral edema. There are triangular foci of bilateral basal ganglia hypoattenuation which are probably related to patient's underlyin... | 1.No evidence for cerebral edema. However if there is strong clinical suspicion, MRI is recommended for further evaluation as clinically indicated.2.Mild abnormal attenuation in the basal ganglia probably represents the patient's known Wilson's disease. |
Generate impression based on findings. | Male, 92 years old, status post head injury. Head:Subgaleal hematoma is seen along the left periorbital and frontal scalp. No calvarial fractures are detected.No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. Periventricular hypoattenuation is seen, a nonspecific finding w... | 1.No acute intracranial abnormality. Left-sided scalp hematoma without evidence of skull fracture.2.No acute fracture or dislocation of the cervical spine.3.Degenerative disk disease and posterior element hypertrophy throughout the cervical spine. A moderate to severe spinal canal stenosis is suspected at C3-4. |
Generate impression based on findings. | Female; 44 years old. Reason: eval for PE History: chest pain PULMONARY ARTERIES: No evidence of acute pulmonary embolism.LUNGS AND PLEURA: 5-mm pulmonary micronodule in the right lower lobe (series 9/49). No pleural effusion or focal consolidation.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart si... | 1.No acute pulmonary embolus.2.5-mm pulmonary micronodule. If there is a history of smoking, follow up in one year is recommended.3.No evidence of infection.4.Severe degenerative changes of the thoracic spine with narrowing of the spinal canal at multiple levels. Correlation with history and exam is recommended. If fur... |
Generate impression based on findings. | Male; 61 years old. Reason: PE History: Tachypnea PULMONARY ARTERIES: No evidence of acute pulmonary embolism. The main pulmonary artery measures up to 3.4 cm in diameter consistent with pulmonary hypertension.LUNGS AND PLEURA: Mild to moderate centrilobular emphysema. There is diffuse bronchial wall thickening which m... | 1.No acute pulmonary embolism.2.Mild to moderate centrilobular emphysema. Diffuse bronchial wall thickening which may be related to chronic bronchitis or reactive airway disease.3.Streaky opacities at the left lung base with areas of nodular thickening may represent scar however, follow up is recommended.4.Nodular opac... |
Generate impression based on findings. | Male 56 years old; Reason: 56 M with acute anemia, r/o retroperitoneal bleed History: acute anemia ABDOMEN:LUNG BASES: Diffuse airspace disease in the lingula and left lower lobe and subsegmental airspace disease in the right lower lobe representing either pulmonary hemorrhage or infection.LIVER, BILIARY TRACT: No sign... | 1.Left lower lobe predominant air space disease representing either pulmonary hemorrhage or pneumonia.2.No evidence of a retroperitoneal bleed or hemorrhage. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is moderate periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing indeterminate small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There i... | Moderate age indeterminate small vessel ischemic changes without acute intracranial hemorrhage or mass-effect. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is unchanged moderate periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing age indeterminate small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configur... | Moderate age indeterminate small vessel ischemic changes without acute infarct or mass effect. No significant interval change from yesterday's head CT. If there is persistent clinical suspicion for acute ischemia, further evaluation with MRI can be obtained. |
Generate impression based on findings. | There is no acute fracture, subluxation or prevertebral soft tissue swelling. The atlanto-occipital articulation is within normal limits. There is minimal straightening of the cervical spine. The facets are anatomically aligned. The vertebral body heights are preserved. The lung apices are clear. | No acute fracture or malalignment. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, abnormal enhancement, mass, or cerebral edema. There is mild patchy periventricular white matter hypoattenuation which is nonspecific, likely representing chronic microvascular ischemic changes. The ventricles and basal cisterns are mildly prominent compared to prior ex... | No acute intracranial hemorrhage or mass. Given the reported history of recently diagnosed lung cancer, contrast enhanced MRI should be considered for more sensitive evaluation of possible metastatic disease, as clinically indicated. |
Generate impression based on findings. | ECMO for diaphragmatic hernia.VIEW: Chest AP (one view) 04/05/15, 0454 Endotracheal tube tip is above the thoracic inlet. Feeding tube tip is at GE junction with side ports in esophagus. Umbilical venous line tip is in right atrium. Umbilical arterial line has its tip at T10. Right chest tube remains in place.Soft tiss... | Increasing soft tissue edema. Complete opacification of hemithoraces. |
Generate impression based on findings. | Five day old former 25 to 26 week gestational age patient with pneumothorax. Dusky abdomen.VIEWS: Chest and abdomen AP (two views) 04/05/15, 0458 Endotracheal tube tip is above the carina. Feeding tube tip is in gastric body and side port is at GE junction. Two right chest tubes remain in place. Umbilical venous line t... | Continued right tension pneumothorax. Almost gasless abdomen. |
Generate impression based on findings. | 40-day-old 32 week gestational age twin patient with diaphragmatic hernia. High pCO2.VIEW: Chest AP (one view) 04/05/15, 0449 Feeding tube tip is distal to proximal gastric body and not included on the image. Lower extremity PICC tip is at junction of intra-and extrahepatic IVC.Right pleural effusion persists. Some aer... | Continued right pleural effusion and small right lung after repair of right diaphragmatic hernia. Hazy opacity on left. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass-effect. |
Generate impression based on findings. | Male, 92 years old, history of periauricular and temporal squama cell carcinoma status post surgery and chemo radiation. Neck:Progressive skin thickening is seen in the left face just above the zygomatic arch (see image 9 of series 8). The skin at this location measures up to 7 mm in thickness, and previously measured ... | 1.Interval progression of skin thickening in the left face, just above the zygomatic arch. Clinical assessment of this region is highly recommended to exclude a new site disease.2.New focal skin and subcutaneous thickening at the midline vertex of the scalp. In the context of trauma, this could represent a small hemato... |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is moderate periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing age indeterminate small vessel ischemic changes. The ventricles and basal cisterns are mildly prominent, commensurate with a... | Moderate age indeterminate small vessel ischemic changes with no acute intracranial hemorrhage or mass-effect. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | Female 52 years old; Reason: RLQ pain, psoas sign c/f RP bleed s/p LHC 4/3 vs constipation History: as above ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. There is new branching gas within the liver predominantly left hepatic lobe and caudate which is new from... | 1.Findings of portal venous gas within the liver likely due to ischemia at the level of the hepatic flexure.2.No evidence of overt bowel perforation. |
Generate impression based on findings. | Distended abdomen and increased agitation.VIEW: Abdomen AP (one view) 04/05/15, 0648 Feeding tube tip is in gastric body. Right lower extremity PICC has its tip in the intrahepatic IVC.Femoral metaphyses are cupped and frayed. Periosteal reaction is noted along the proximal femurs. Soft tissue edema is noted.Lung volum... | Abnormal bowel gas pattern with disorganization. No evidence of perforation. |
Generate impression based on findings. | Female 75 years old; Reason: r/o intraabdominal abscess History: WBC to 16 ABDOMEN:LUNG BASES: Small bilateral pleural effusions. Mild basilar atelectasis.LIVER, BILIARY TRACT: The liver is normal in morphology. The gallbladder is contracted. Nonspecific hypodense lesion in segment 4 of the liver (image 24/series 4)SPL... | 1.Dilated loops of small bowel compatible with an ileus may be secondary to surgery or ongoing ischemia.2.Small foci of gas within the wall of the colon representing residual bowel wall pneumatosis.3.No drainable fluid collections in the abdomen or pelvis.4.Scattered mesenteric fluid.5.Splenic infarction. |
Generate impression based on findings. | Female 53 years old; Reason: Please eval for occult malignancy. Requested by rheumatology History: Has h/o multiple autoimmune phenomena, including unusual neuropathy, adrenal insufficiency. Wish to explore possibility of paraneoplastic syndrome ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT:... | 1.No bowel obstruction.2.No evidence of a neoplastic process in the abdomen or pelvis. |
Generate impression based on findings. | Female 71 years old; Reason: Central line (femoral) and OG placement History: Intracranial hemorrhage, coma Bowel gas pattern is not obstructive. A right femoral catheter projects over the right sacrum.A Foley catheter projects over the pelvis. No enteric tube visualized. | 1.Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 36 years old; Reason: Signs of infection History: Abdominal pain s/p appendectomy ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. Probable contracted gallbladder in the hepatic hilum. Hepatic and portal veins are patent. No ductal dilatation.SPLEEN: No si... | 1.Status post appendectomy with moderate amount of inflammation adjacent to the cecum. No drainable fluid collections.2.Cystic mass in the pelvis, further evaluation with pelvic sonography is suggested.3.Severe distention of the stomach most indicative of a gastric outlet obstruction.4.Probable contracted gallbladder a... |
Generate impression based on findings. | Male, 61 years old.Comments: Surgical Case Information | Procedure(s): Procedure(s): | KIDNEY TRANSPLANT | Operating Room: CDOR 15 CENTRAL | Surgeon(s) and Role: | * Yolanda Tai Becker, M.D. - Primary | * Omar G. Hussain, M.D. - Fellow | Bowel gas pattern is nonobstructive. A stent-type device projects over the right p... | No unexpected radiopaque foreign bodyThese findings were discussed by telephone with Dr. Beck, the attending surgeon, on 4/4/2015 at 11:35 p.m. by Dr.Baad. |
Generate impression based on findings. | Male, 64 years old.Comments: Surgical Case Information | Procedure(s): Procedure(s) with comments: | KIDNEY TRANSPLANT - xx | Operating Room: CDOR 17 CENTRAL | Surgeon(s) and Role: | * Piotr Witkowski, M.D. - Primary | * Julia Rose Berian, M.D. - Resident - Assisting | Postsurgical changes in the left hemipelvis with a... | No radiopaque foreign body.These findings were discussed by telephone with Dr. Witkowski, the attending surgeon, on 3:04am at 4/5/2015. |
Generate impression based on findings. | 8-week-old former 33 to 34 week gestational age patient with history of gastroschisis. Blood in stools.VIEW: Abdomen AP (one view) 04/05/15, 1019 Multiple dilated bowel loops are present in a disorganized pattern. Linear lucency is noted along the wall of multiple bowel loops in the left abdomen. Linear lucency is also... | Pneumatosis intestinalis. |
Generate impression based on findings. | Male 77 years old; Reason: cholecystitis History: tender RUQ ABDOMEN:LUNG BASES: Small left pleural effusion.LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious lesions. Hepatic and portal veins are patent. No biliary ductal dilatation. No gallbladder stones by CT.SPLEEN: No significant abnormality noted... | 1.Findings of a possible gastritis.2.Mild peripancreatic infiltration of the fat near the stomach, a mild tail pancreatitis is possible.3.Mild dilatation of the collecting systems of the kidneys due to obstruction at the level of the bladder.4.Findings suspicious for a prostate mass with invasion into the bladder. Furt... |
Generate impression based on findings. | Female 78 years old; Reason: osteomyelitis. History: deep sacral decubitus wound. PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Urinary bladder is decompressed by a Foley catheter.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Copious amount of fecal matter noted within the rectum .BONES, SOFT TISS... | 1.Findings of a coccygeal osteomyelitis with gas within the disk space and infiltration of the presacral fat.2.Rectal constipation. |
Generate impression based on findings. | Female; 67 years old. Reason: Abnormal CXR History: AMS; Abnormal CXR. Additional history obtained from electronically record indicates a prior history of breast cancer. LUNGS AND PLEURA: Multiple, round, bilateral pulmonary nodules of varying sizes. For reference, a right upper lobe nodule measures 1.4 cm (series 6/18... | 1.Multiple bilateral pulmonary nodules are highly suspicious for metastatic disease given the patient's history of breast cancer.2.3.1-cm soft tissue mass anterior to the left kidney is incompletely imaged but concerning for adrenal metastasis. This can be further evaluated with contrast enhanced abdominal CT.3.Soft ti... |
Generate impression based on findings. | Female, 71 years old, with intracerebral hemorrhage. Redemonstrated is a large left thalamic hematoma without significant interval change in size or morphology. The degree of surrounding parenchymal edema has progressed with more conspicuous edema affecting the left basal ganglia. Midline shift to the right of 11 or 12... | 1.No significant interval change in the size of a large left thalamic hematoma. Dissection into the lateral and third ventricles is also unchanged.2.Edema related to the thalamic hemorrhage has progressed becoming more conspicuous in the region of the left basal ganglia.3.Substantial mass effect related to the hemorrha... |
Generate impression based on findings. | Increased work of breathing. 10-month-old former 24 week gestational age patient with increased work of breathing.VIEW: Chest AP (one view) 04/05/15 Tracheostomy tube tip is below thoracic inlet. Feeding tube tip is distal to GE junction. Lower extremity PICC tip is in intrahepatic IVC.Soft tissue edema is seen. Change... | Changes from chronic lung disease. No new focal opacity. |
Generate impression based on findings. | Female, 79 years old.Comments: Surgical Case Information | Procedure(s): Procedure(s): | KIDNEY TRANSPLANT | Operating Room: CDOR 19 CENTRAL | Surgeon(s) and Role: | * Piotr Witkowski, M.D. - Primary | * Julia Rose Berian, M.D. - Resident - Assisting | Postsurgical changes in the right lower abdomen multiple suture cli... | Unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Witkowski, the attending surgeon, on 10:10 at 4/5/2015. |
Generate impression based on findings. | Female, 64 years old, history of severe, labile hypertension with persistent severe headache. Questionable slurred speech. Linear foci of hypoattenuation within the bilateral frontal lobes are unchanged. There is also very mild periventricular hypoattenuation, a nonspecific finding. Small chronic infarcts are suspected... | 1.No definite acute intracranial abnormality. Lucencies in the bilateral frontal lobes and cerebellum may reflect chronic ischemic injury.2.Periventricular hypoattenuation may reflect age indeterminate microvascular ischemic disease.3.If clinical concern for acute ischemia remains high, consider further imaging with MR... |
Generate impression based on findings. | Male 22 years old; Reason: s/p Dobbhoff placement History: same Small bowel gas pattern is nonobstructive. Enteric tube projects in the region of the gastric body. Sclerotic focus in the right superior pubic ramus. | 1.Enteric tube terminates in the region of the gastric body. |
Generate impression based on findings. | Female 69 years old; Reason: NG tube History: NG tube Bowel gas pattern is nonobstructive. Postsurgical clips are noted in the right upper abdomen. Enteric tube terminates at its tip in the region of the gastric body. There is patchy airspace disease in the left lower lobe | 1.Enteric tube terminates in the region of the gastric body. |
Generate impression based on findings. | Female; 63 years old. Reason: Eval cardiac structures and chest anatomy prior to redo MV Replacement History: Endocarditis of MV LUNGS AND PLEURA: Small bilateral pleural effusions with associated compressive atelectasis.7 mm right lower lobe lung nodule.MEDIASTINUM AND HILA: Prominent lymph nodes are seen throughout t... | 1.Small bilateral pleural effusions with compressive atelectasis.2.7-mm right lower lobe lung nodule, follow up CT in 3 months is recommended. Alternatively, comparison with outside cross-sectional imaging can be made to ensure stability.3.Dilated pancreatic duct and abnormal density in the area of the porta hepatis ar... |
Generate impression based on findings. | Female, 54 years old, with subdural hemorrhage. An aneurysm coil is redemonstrated in the right paraclinoid region. Streak artifact from the coiling obscures visualization of the right middle cranial fossa.Parenchymal hemorrhage is partially visualized in the right anterior temporal lobe. Thin subdural hemorrhage along... | 1.New ischemic lesions in the right frontal operculum, the right parietal and occipital lobes, and the right caudate nucleus.2.A thin subdural hemorrhage along the right cerebral hemisphere is perhaps slightly smaller.3.Parenchymal hemorrhage in the right anterior temporal lobe is partially visualized. No new intracran... |
Generate impression based on findings. | Female 21 years old; Reason: eval placement of NJ tube History: new leukocytosis Gas pattern is nonobstructive. Enteric tube terminates in the region of the proximal jejunum. | 1.Enteric tube terminates in the region of the proximal jejunum. |
Generate impression based on findings. | Male 76 years old; Reason: NG placement History: NG placement Enteric tube terminates at midline in the region of the distal gastric body. Its site hole is at the level of the gastric fundus.Above normal bowel gas pattern is nonobstructive. | 1.Enteric tube terminates in the region of the gastric body. |
Generate impression based on findings. | Female 32 years old; Reason: rule out obstruction o h/o Crohn's disease with ileostomy History: abdominal pain, n/v Scattered gas within nondistended bowel loops in the left hemiabdomen. The bowel gas pattern there is nonobstructive. The right hemi-abdomen is relatively gasless. Ostomy projects over the right sacroilia... | 1.Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 89 years old; Reason: NG History: NG Right chest tube points at the right lung apex.An enteric tube terminates in the region of the gastric body. Upper abdominal bowel gas pattern is nonobstructive. | 1.Enteric tube terminates in the region of the gastric body |
Generate impression based on findings. | Female 89 years old; Reason: NGT History: NGT Partially imaged is a right chest tube.Enteric tube is in the region of the gastric body.Bowel gas pattern is nonobstructive. | 1.Enteric tube region of the gastric body. |
Generate impression based on findings. | Male 44 years old; Reason: s/p Dobbhoff placement History: feeding tube Atelectasis and probable effusion in the left lung base.Enteric tube terminates in the region of the gastric body. Catheter device projects near midline via left abdominal approach.Upper abdominal gas pattern suggests an ileus. | 1.Enteric tube terminates in the region of the gastric body. |
Generate impression based on findings. | Male 44 years old; Reason: bowel perf? History: ams Via a left-sided approach a catheter terminates near midline in the upper abdomen. Additional catheter projects over the pelvis.Pelvis pattern is nonobstructive.There is gas adjacent to the cecum in the right lower abdomen which may be contained within small bowel how... | 1.Bowel perforation not excluded on supine view. |
Generate impression based on findings. | Male 48 years old; Reason: chest pain/abdominal pain s/p retroperitoneal surgery History: same Gaseous distention of the small bowel and colon suggests ileus.Multiple clips are projected in the left upper abdomen.Post surgical changes in the lumbar spine with pedicle screws and rods. IVC filter projects over the lower ... | 1.Findings suggestive of an ileus. |
Generate impression based on findings. | Female; 20 years old. Reason: possible 4th PIP avulsion fx History: ttp with crepitus and decreased rom at 4th PIP There is soft tissue swelling of the fourth finger with an underlying fracture along the medial aspect of the distal fourth proximal phalanx which extends to the joint space. No additional fractures identi... | Intra-articular fracture of the distal fourth proximal phalanx. |
Generate impression based on findings. | Female 65 years old; Reason: ileus ? History: post op with obstruction, NGT in place with little output Enteric tube terminates in the region of the gastric body. A catheter type device projects over the right ileum. The bowel gas pattern is nonobstructive. | 1.Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female; 60 years old. Reason: r/o fx History: pain after fall Moderate joint effusion. There is a comminuted fracture of the radial head with approximately 1 cm superior and 0.6-cm posterior displacement of the radial head fracture fragment. | Displaced, comminuted radial head fracture as described above. |
Generate impression based on findings. | Male 59 years old; Reason: eval J tube position History: nausea Percutaneous gastrostomy catheter projects over the gastric body. Its tip likely resides within the proximal jejunum.Postsurgical changes from a median sternotomy. | 1.Percutaneous gastrostomy catheter with its tip in the region of the proximal jejunum |
Generate impression based on findings. | Female 58 years old; Reason: 58 yo Stage IIIC Grade 1 primary peritoneal CA s/p pelvic RT p/w melena. ECG, enteroscopy and colonoscopy are negative. Unable to identify source of bleeding. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesi... | 1.No CT evidence of active hemorrhage. |
Generate impression based on findings. | Female; 57 years old. Reason: fx? necrosis? History: hip pain; no fall hx Mild osteoarthritis affects the hip. No evidence of acute fracture, dislocation or avascular necrosis. | Mild osteoarthritis. |
Generate impression based on findings. | Male; 18 years old. Reason: r/o fx/dislocation History: knee pain s/p basketball injury , worse at medial side, heard pop There is a small joint effusion. Cortical irregularity along the lateral femoral condyle seen best on the lateral views may represent a small depression fracture. Additional irregularity along the l... | Joint effusion, depression of lateral femoral condyle, and Segond fracture are suggestive of an ACL injury. These findings can be further evaluated with nonemergent MRI as clinical warranted. |
Generate impression based on findings. | Female 79 years old; Reason: s/p renal transplant; assess graft History: s/p transplant RENAL TRANSPLANT: Right iliac fossa renal allograft measures 11.9 cm. Its parenchyma is minimally echogenic. No perinephric fluid collections.LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No perinephric fluid collectionsCOLLECT... | 1.Patent renal vasculature.2.Slightly elevated intrarenal resistive indices. |
Generate impression based on findings. | Female; 36 years old. Reason: r/o infection, abnormality History: left sided neck pain, most severe along cervical node No acute fracture or malalignment. The prevertebral soft tissues are within normal limits. | Normal exam. |
Generate impression based on findings. | Male; 42 years old. Reason: need axillary view to r/o subluxation History: left shoulder pain No acute fracture, dislocation or subluxation. | No acute fracture or subluxation. |
Generate impression based on findings. | Male 32 years old; Reason: ? frontiers History: scrotal pain RIGHT TESTIS: Right testicle measures 3.9 x 2.3 x 3.5 cm. its parenchymal echotexture is normal. No focal intratesticular lesions. There is a small right hydrocele.LEFT TESTIS: The left testicle measures 4.0 x 2.9 x 3.1 cm . Its parenchymal echotexture is nor... | Trace right hydrocele. Otherwise unremarkable testicular sonogram. |
Generate impression based on findings. | Male; 42 years old. Reason: comparison for L shoulder per radiology request History: r/o L AC separation No acute bony fracture or dislocation. Hardware from median sternotomy overlies the mediastinum. Multiple screws from the superior mediastinal plate are fractured. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 49 years old Reason: eval liver History: ?cirrhosis, AKI LIVER: The liver has a nodular contour. Liver measures 15 cm in length. The parenchyma is moderately coarse and echogenic . No focal hepatic lesions.BILIARY TRACT: The gallbladder contains layering sludge. Wall measures 3mm in thickness. PANCREAS: The panc... | 1.Poor flow in the main portal vein highly suspicious for portal venous thrombosis.2.Consider cross-sectional exam for further elevation. |
Generate impression based on findings. | Male 61 years old; Reason: s/p kidney txp last night History: above RENAL TRANSPLANT: The transplant kidney measures 13.6 cm its parenchyma is mildly echogenic.LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: Trace perinephric fluid.COLLECTING SYSTEM/URETER: Mild collecting system prominence.URINARY BLADDER: Urinary ... | 1.Patent renal vasculature. |
Generate impression based on findings. | Female; 73 years old. Reason: eval for fxq History: fall, trauma The bones are diffusely demineralized.Left ankle: There is soft tissue swelling along the lateral aspect of ankle just distal to the fibular head are two small, linear densities which may represent avulsion fractures. Correlation with point tenderness is ... | Small linear densities in the soft tissues inferior to the fibula may represent avulsion fractures and correlation with point tenderness is recommended. Deformity of the distal fifth metatarsal and proximal fifth phalanx are likely chronic in etiology. |
Generate impression based on findings. | Female; 34 years old. Reason: r/o fx History: lateral ankle pain after fall There is soft tissue swelling about the ankle. No acute fracture or dislocation | Soft tissue swelling without acute fracture or dislocation. |
Generate impression based on findings. | Female; 88 years old. Reason: eval for hip fx History: hip pain Right hip: Hardware components a right hip hemiarthroplasty are situated in near anatomic alignment. Adjacent heterotopic ossification appears similar to the prior study.Left hip: Moderate osteoarthritis affects the left hip. No acute fracture or dislocati... | 1.Acute left inferior and superior pubic fractures. 2.Deformity of the right inferior pelvic ramus suggestive of a chronic fracture.3.Right hip hemiarthroplasty device without complication. |
Generate impression based on findings. | Female 62 years old Reason: evaluate liver for cirrhosis, mass or portal vein thrombus or hepatic vein thrombus History: history of cirrhosis and now encephalopathy LIVER: The liver has a mildly nodular contour. Liver measures 14.5 cm in length. The parenchyma is mildly echogenic. No suspicious hepatic lesions.BILIARY ... | 1.Liver has a mildly nodular contour.2.Patent portal vein. |
Generate impression based on findings. | Female; 64 years old. Reason: r/o osteo - s/p great toe amputation and fem/pop bypass History: Pain/redness The bones are diffusely demineralized. Status post great toe amputation through the mid proximal phalanx. Cortical irregularity, particularly along the medial aspect of the remaining proximal phalanx of the great... | Cortical irregularity particularly along the medial aspect of the remaining proximal phalanx of the great toe may be secondary to recent surgery however, if there is high suspicion for osteomyelitis, MRI may be considered. |
Generate impression based on findings. | Male; 19 years old. Reason: r/o frx History: pain Soft tissue swelling about the anterior aspect of the ankle without underlying fracture or dislocation. | Soft tissue swelling without acute fracture or dislocation. |
Generate impression based on findings. | Female 79 years old; Reason: evaluation prior to transplant History: eval prior to transplant ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology and is unremarkable for unenhanced technique. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCRE... | 1.Severe calcific arteriosclerotic disease of the abdominal aorta.2.Mild calcific arteriosclerotic disease of the iliac vessels. |
Generate impression based on findings. | Male; 26 years old. Reason: rule out dislocation vs fracture History: pain and deformity There is no joint effusion or dislocation. No definite fracture line is seen however, acute angulation in the radial neck raises a suspicion for a subtle, nondisplaced fracture. | No definite fracture line is seen however, acute angulation in the radial neck raises suspicion for a subtle, nondisplaced fracture. If clinical suspicion remains high, repeat radiographs may be obtained in 7 to 10 days. |
Generate impression based on findings. | Female; 19 years old. Reason: r/o fx History: pain T4-6 s/p MVC The cervicothoracic junction is obscured by overlying anatomy on the lateral view. Vertebral body heights and intervertebral disk spaces are maintained. Alignment is anatomic. | No acute fracture or malalignment. |
Generate impression based on findings. | Female 101 years old; Reason: mets of colon cancer to gastric History: vomiting ABDOMEN:LUNG BASES: Bilateral pulmonary nodules most suggestive of metastatic disease.LIVER, BILIARY TRACT: Bilobar hypodense hepatic lesions compatible with hepatic metastases. A reference hepatic dome lesion measures 4.7 x 4.6 cm (image 3... | 1.Findings of a cecal mass with metastatic disease to the liver.2.Cecal mass causes a near complete bowel obstruction which is severe given the ascites.3.Bilateral adrenal lesions.4.Gallstones, pericholecystic and mild adjacent fat stranding raises the suspicion for cholecystitis. Recommend ultrasound if there is a cli... |
Generate impression based on findings. | Male; 47 years old. Reason: r/o fx History: stab wound below the deltoid muscle There is a soft tissue defect corresponding to the patient's known stab wound with overlying bandages. There is no underlying osseous abnormality or radiopaque foreign body. | Soft tissue defect corresponding to the patient's known stab wound. No osseous abnormality or radiopaque foreign body. |
Generate impression based on findings. | Female; 92 years old. Reason: Eval for fx, dislocation; fall out of bed onto R elbow History: tenderness about elbow, abrasion The bones are diffusely demineralized.Right elbow: There is no joint effusion. Osteoarthritic changes affect the elbow. No acute fracture or dislocation.Right forearm: No acute fracture or disl... | No acute fracture or dislocation. |
Generate impression based on findings. | Female; 52 years old. Reason: wrist pain History: Fall There is soft tissue swelling about the radial aspect of the wrist without underlying acute fracture or dislocation. | Soft tissue swelling without acute fracture or dislocation. |
Generate impression based on findings. | Female 72 years old; Reason: recurrent ovarian cancer? History: Umbilically nodule CHEST:LUNGS AND PLEURA: Stable left lower lobe granulomata. There are scattered pulmonary micronodules. No dominant lung lesion. Pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. Extensive coronary calcifications are p... | 1.Calcified lesion near the umbilicus has grown. There are similar appearing lesions in the inguinal regions and in the right body wall. The overall findings are suggestive of partially treated disease with interval growth. |
Generate impression based on findings. | Male; 69 years old. Reason: s/p fusion History: s/p cervical fusion There is fusion of the C3 and C4 vertebral bodies appearing similar to the prior study. There has been interval anterior fixation of C4 and C5 with orthopedic hardware. There is prominence of the prevertebral soft tissues in this area which is likely p... | Status post C4-5 fusion. No acute fracture or evidence of hardware complication. |
Generate impression based on findings. | Female; 91 years old. Reason: 91F w hx of compression fracture and osteopenia w/ back pain History: back pain The bones are diffusely demineralized appearing similar to the prior study. Mild to moderate degenerative disk disease and facet joint osteoarthritis affects the lumbar spine. Again seen are compression fractur... | Unchanged T12, L2 and L3 compression fractures. No acute fracture or malalignment. |
Generate impression based on findings. | Female 58 years old; Reason: Metastatic Rectal Cancer History: Restaging CHEST:LUNGS AND PLEURA: Bilateral pulmonary lesions representing metastatic disease. The reference right pulmonary lesion measures 3.9 x 2.9 cm (image 65/series 5) previously, 3.6 x 2.5 cm.MEDIASTINUM AND HILA: Right chest wall port terminates at ... | 1.Slight increase in the size of the reference lesions in the chest. |
Generate impression based on findings. | Male; 67 years old. Reason: Eval for spine stability History: L2 compression fracture s/p kyphoplasty Thoracic spine: Postoperative changes of spinal fusion with T12 vertebral body cage as well as rod and screw device with orthopedic screws entering the left aspect of the T11 and L1 vertebral bodies. No radiographic ev... | Post operative changes as above. Deformities of the T6 and 7 vertebral bodies suspicious for mild compression fractures. |
Generate impression based on findings. | Male; 20 years old. Reason: chronicity of avascular necrosis History: hbss voc, back pain worsened by hip flexion Diffusely increased density of the bones compatible with the history of sickle cell disease.Left and right hips: No acute fracture or dislocation. Additional density in the femoral heads again may represent... | No acute fracture. Increased density in the femoral heads may represent overlap of bony structures or avascular necrosis without subchondral fracture or articular surface collapse. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Male 72 years old; Reason: 72 yo M with history of autoimmune pancreatitis s/p steroid therapy, now with jaundice found to have biliary stricture treated with biliary stent placement. Pt has persistent abdominal pain. CT with pancreas protocol for eval of pancreas History: history of autoimmune pancreatitis, abnormal L... | 1.Stable appearance of the pancreatic abnormalities with progressive atrophy of the gland. |
Generate impression based on findings. | Male; 56 years old. Reason: eval T7-L1 fusion w/ L costotransversectomy at T11 and debridement of T10-11 History: s/p T7-L1 fusion w/ L costotransversectomy at T11 and debridement of T10-11 for vertebral osteomyelitis Postoperative changes of T7 to L1 fusion and left costotransversectomy at T11. Posterior stabilization... | Postoperative changes as described above. No new acute fracture is identified. |
Generate impression based on findings. | Male; 76 years old. Reason: Evaluate for fracture History: unwitnessed fall Left hip: No acute fracture. Mild osteoarthritis affects the hip. Vascular calcifications project over the soft tissues.Right hip: No acute fracture. Moderate osteoarthritis affects the hip. Vascular calcifications project over the soft tissues... | No acute fracture is identified. |
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