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Generate impression based on findings. | Male 76 years old Reason: Please evaluate right second finger. Pain at PIP joint. History: Pain at PIP joint of right second finger. Moderate osteoarthritis affects the proximal interphalangeal joint of the index finger with additional osteoarthritic changes affecting the remaining interphalangeal joints. Mild osteoart... | Degenerative arthritic changes appearing similar to prior study. |
Generate impression based on findings. | Trauma. There is a hyperattenuating left cerebral convexity subdural hematoma that measures up to 3 mm in width. There also appears to be prominent soft tissue that may represent subdural hemorrhage along the right aspect of the endoclivus that measures up to 3 mm in thickness, but there is no mass effect upon the brai... | 1. Acute left cerebral convexity subdural hematoma that measures up to 3 mm in width and trace midline shift to the right. Subdural hemorrhage also measuring up to 3 mm in thickness along the right dorsal clivus is also suspected.2. No evidence of skull fracture. Discussed with the pediatric ED attending on serve at 11... |
Generate impression based on findings. | Male 43 years old Reason: r/o PE History: shortness of breath, O2 requriement, APLS The comparison chest radiograph performed on 4/10/15 demonstrates no focal pulmonary opacities or pleural fluid. The ventilation images show a focal area of decreased ventilation in the medial mid to lower left lung. uniform distributio... | Low probability VQ scan for pulmonary embolism. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (2/28/15, 3/12/15), ultrasound images of right breast (3/12/15), images from ultrasound guided biopsy of right breast and post-procedural right mammographic images (3/24/15) performed at Little Company of Mary. DIGITAL MA... | Biopsy proven invasive ductal carcinoma in the right breast. Breast MRI might be useful in staging purposes, in view of patient's dense breast tissue.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Female 28 years old Reason: eval LT Index finger History: pain Three screws affix an oblique fracture of the proximal phalanx in near anatomic alignment. The fracture line appears similar to prior study accounting for technical differences. No hardware complications. | Orthopedic fixation of proximal phalanx fracture as above. |
Generate impression based on findings. | 62 year old with history of right mastectomy in 2005 for invasive ductal carcinoma. Patient received radiation and chemotherapy. No new breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandu... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: RECTAL CARCINOID EVALUATE FOR DISEASE PROGRESSION History: RECTAL CARCINOID LUNGS AND PLEURA: Small ground glass nodules (7 mm in right upper lobe image 27/112 and 10 mm in right lower lobe image 59/112) are unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CORONARY ARTERY CALCIFICATION: None.CHE... | Small ground glass nodules in the right upper and lower lobe are unchanged in size and appearance. Though these are nonspecific, they are much more likely inflammatory than neoplastic. Continued follow up is recommended. |
Generate impression based on findings. | 77 years, Male. Reason: assess for obstruction, ileus History: abd pain, N/V Nonobstructive bowel gas pattern. Residual contrast remains opacifying the colon. No free intraperitoneal air is identified. No acute pulmonary process. Evidence of redundant sigmoid colon. Thoracolumbar scoliosis. | Nonobstructive bowel gas pattern. No free intra-peritoneal air. |
Generate impression based on findings. | Female 16 years old Reason: pain History: pain There may be slight flattening of the articular surface of the lateral femoral condyle which could possibly represent an impaction fracture sustained during an ACL tear in the correct clinical context. The left knee otherwise appears normal. The right knee appears normal a... | There may be slight flattening of the articular surface of the lateral femoral condyle which could possibly represent an impaction fracture sustained during an ACL tear in the correct clinical context. This can be further evaluated with MRI if clinically warranted. |
Generate impression based on findings. | 10 year old female patient with chronic cough, recurrent infections, fixed pulmonary obstruction on PFT, and common variable immunodeficiency. Question of bronchiectasis. LUNGS AND PLEURA: There is mild bilateral lower lobe bronchial wall thickening. Focal consolidation is noted in the right lower lobe. There is mosaic... | 1. Bilateral lower lobe bronchial wall thickening with focal right lower lobe consolidation. 2. Lower lobe mosaic attenuation may be seen in the setting of obstructive small airways disease, occlusive vascular disease, or parenchymal disease. |
Generate impression based on findings. | Male 28 years old Reason: injury evaluate for fracture History: pain Right thumb: No fracture.Right wrist: Mild soft tissue swelling along the radial side of the wrist. We see no fracture or malalignment.Left thumb: No fracture.Left elbow: No fracture, malalignment or joint effusion. | No fracture or malalignment. |
Generate impression based on findings. | Reason: eval for PE History: SOB, recent ACL surgery PULMONARY ARTERIES: No evidence of a pulmonary embolus. The pulmonary artery is normal caliber.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial ef... | No evidence of a pulmonary embolus. No significant pulmonary or pleural abnormalities identified.PULMONARY EMBOLISM: PE: Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 62 years old Reason: Eval for OA History: Pain Right shoulder: Moderate osteoarthritis of the acromioclavicular joint. Minimal osteoarthritis of the glenohumeral joint. Small density along the lateral aspect of the humeral head best seen on the Grashey view may represent a focus of calcific tendinosis at the inf... | Degenerative arthritic changes as described above with possible posttraumatic findings at the elbow. |
Generate impression based on findings. | 72 year-old with history of right breast cancer status post lumpectomy, radiation and currently on AI therapy. History of recent right breast stereotactic biopsy. Recent CT (outside) showed a density in the right breast. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 C... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. The next study is due in September 2015. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic M... |
Generate impression based on findings. | Female 44 years old. Reason: prosthetic assess. History: post-op Three views of the right hip demonstrate a right total hip arthroplasty in near anatomic alignment without evidence of hardware complication. Three views of the pelvis demonstrate the aforementioned right total hip arthroplasty and mild to moderate osteoa... | Right total hip arthroplasty as described above. |
Generate impression based on findings. | 82-year-old male. Ankle pain two weeks. TTP over anterior aspect of ankle. Demineralized bones. No fracture or dislocation. Extensive vascular calcifications. Mild osteoarthritis of the mid foot. Small plantar heel spur. | No fracture. Osteoarthritis. |
Generate impression based on findings. | Female 58 years old. Reason: pain History: pain Four weight-bearing views of the right knee are provided. There is bone on bone apposition of the medial tibiofemoral compartment on the skier's view with tricompartmental osteophytes indicating severe osteoarthritis. Ossicles overlying the posterior aspect of the knee ma... | Osteoarthritis. |
Generate impression based on findings. | 59-year-old male with history of nodular lymphoma. Evaluate for progression of disease and the lung lesions. CHEST:LUNGS AND PLEURA: Interval near complete resolution of the previously seen right upper lobe pneumonia, with only mild residual groundglass opacities in this area. Scattered adjacent ground glass nodules ar... | Interval decrease in size of reference and non-reference lymph nodes. Additionally, the right upper lobe consolidation has almost completely resolved over the interval, with only minimal postinflammatory findings as above. Follow the pulmonary findings to ensure resolution. |
Generate impression based on findings. | 37-year-old female with left-sided hemiparesis and known tumefactive lesions. Evaluate for new demyelinating disease. There has been significant interval improvement in size of two right hemispheric white matter lesions. One lesion is centered in the subcortical white matter of the right cingulate gyrus, measuring 32 x... | Interval decrease in size right hemispheric tumefactive white matter lesions, compatible with history of multiple sclerosis. No new lesions are identified. |
Generate impression based on findings. | Female 57 years old. Reason: eval RT wrist/out of brace History: pain Three views of the right wrist are provided. Again seen are two sideplate and screw devices affixing a comminuted intra-articular fracture of the distal radius. We see no evidence of hardware complication. The fracture lines remain visible and appear... | Orthopedic fixation of a distal radial fracture and other findings as described above. |
Generate impression based on findings. | Female, 36 years old, status post recent head trauma, with anisocoria of unknown timeframe. Head:The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The... | 1. Mildly displaced fractures of the nasal bones and the left anterior maxillary process.2. Soft tissue injury to the right face.3. No cervical spine fracture or dislocation.4. No acute intracranial abnormality. |
Generate impression based on findings. | Male 40 years old. Reason: eval fracture History: pain Three views of the left hand are provided. Again seen is an oblique fracture of the fourth metacarpal with fracture fragments in near anatomic alignment. The fracture line remains visible with a small amount of callus formation along the fracture indicating healing... | Healing fourth metacarpal fracture. |
Generate impression based on findings. | 64-year-old male pre-kidney transplant evaluation. After instillation of approximately 250 cc's of Cystografin, note is made of a normal-appearing bladder without evidence of mucosal lesions or filling defects. Bilateral nephroureteral stents in place. Incidental note is made of bilateral reflux into the ureters extend... | 1. Normal appearing bladder with bladder volume measurements provided above.2. Bilateral reflux likely related to the presence of nephroureteral stents.3. Mixed lytic/sclerotic changes of the incompletely imaged portions of the left superior and inferior pubic rami which are nonspecific but may represent changes relate... |
Generate impression based on findings. | 75 year old with history of left lumpectomy with adjuvant radiation therapy and chemotherapy in 2002. No new 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 elements, unchanged in patt... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 64-year-old male with history of pre-kidney transplant evaluation. Assess aorta and iliac for kidney transplant. Also, assess kidneys for inflammation. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significa... | 1. Normal vascular configuration with mild atherosclerotic calcifications as above.2. Bilateral perinephric stranding, likely chronic in etiology. |
Generate impression based on findings. | Restaging Hodgkin lymphoma status post chemotherapy, last 3/23/14.RADIOPHARMACEUTICAL: 12.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 91 mg/dL. Today's CT portions of the neck, chest, abdomen, and pelvis will be reported separately.Today's PET examination demonstrates complete resolution of previous hy... | 1.No FDG avid tumor currently identified in the neck, chest, abdomen, or pelvis.Diagnostic CTs of the neck, chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 23 year old with biopsy proven fibroadenoma in the left breast, presents for follow-up exam. Focused ultrasound is performed for left breast 3 o'clock position. Again detected is a circumscribed hypoechoic, oval mass measuring 26 x 16 x 26 mm (previous measurement: 26 x 19 x 26 mm), consistent with a biopsy proven fibr... | No significant change in the size of the biopsy proven fibroadenoma in the left breast BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Female, 73 years old, with altered mental status and known metastatic disease. Mild periventricular hypoattenuation is seen, a nonspecific finding which may reflect age indeterminate microvascular ischemic disease. A more focal small hypoattenuating lesion is evident in the anterior left insula, unchanged.No parenchyma... | 1. Mild age indeterminate microvascular ischemic disease.2. No acute intracranial abnormality.3. No CT evidence of intracranial metastases. |
Generate impression based on findings. | The left uterine artery was embolized using four 2 x 50 mm coils and stasis was achieved. The post-embolization angiogram confirmed these findings.The sheath was removed and manual compression held until hemostasis was achieved.The patient tolerated the procedure well without immediate complication. Routine post proce... | Successful left uterine artery angiogram showing active hemorrhage as detailed above. The left uterine artery was successfully embolized. No active extravasation of contrast was seen from the right uterine artery. PLAN: The patient is already admitted and will be followed by this (gyn-onc) service. |
Generate impression based on findings. | Male 59 years old; Reason: rule out renal recurrence or metastasis History: hx of renal cell carcinoma, sp partial nephrectomy ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.A... | 1.Grossly stable 1.1-cm lesion from the left upper kidney demonstrates minimal enhancement, and remains suspicious for a slow-growing neoplastic process. |
Generate impression based on findings. | 75 year old female with dementia and CVA who presents status post fall at home with left hip and leg pain. Rule out fracture. Pain with passive internal rotation at left hip. I see no fracture or malalignment. Mild osteoarthritis affects the hip. The bones appear slightly demineralized. | Mild osteoarthritis; no fracture evident. |
Generate impression based on findings. | Male 60 years old; Reason: Evaluate for ischemia History: Elevated elevated lactate CHEST:LUNGS AND PLEURA: Small pleural effusions and bibasilar atelectasis. Mild emphysema. Calcified and noncalcified pulmonary micronodules. Small left-sided pneumothorax, trace right-sided pneumothorax and small pneumomediastinum.MEDI... | 1. Thickened ascending colon, hepatic flexure and transverse colon, suspicious for acute colitis, worrisome for ischemic etiology given occlusive thrombus seen in SMA on earlier study (thrombus not as well delineated on this non-enhanced exam) and distribution. Other etiology such as infectious or inflammatory addition... |
Generate impression based on findings. | 59 year old with history of right lumpectomy with reexcision in 2008 for invasive lobular carcinoma. Patient received radiation, chemotherapy and hormonal therapy. History of benign left breast biopsies. No new breast complaints Three standard views of both breasts were performed digitally and reviewed with the aid of ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Pain. Evaluate right index finger. Again seen is a plate and screw device affixing a fracture of the middle phalanx in near anatomic alignment. Although portions of the fracture remain visible, there has been interval maturation of callus indicating some healing. There is mild soft tissue swelling of the finger. I see ... | Orthopedic fixation of healing middle phalangeal fracture. |
Generate impression based on findings. | Evaluate ankle pain. There is mild swelling of the lateral soft tissues of the ankle. I see no underlying fracture or malalignment. There is streaky calcification of the distal Achilles' tendon suggesting chronic tendinopathy. | Mild soft tissue swelling and chronic calcific tendinosis of the distal Achilles. |
Generate impression based on findings. | Restaging classical nodular sclerosing Hodgkin lymphoma status post chemotherapy, last 4/1/15.RADIOPHARMACEUTICAL: 14.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Today's CT portion grossly demonstrates a right chest Port-A-Cath with tip in the SVC. Multiple pelvic phleboliths are present bila... | Complete interval resolution of previous extensive hypermetabolic neck and chest tumor activity without convincing FDG avid tumor currently. Left abdominal and right inferior pelvic soft tissue foci considered more likely benign although attention to these regions to be made on follow-up exams. |
Generate impression based on findings. | There are foci of hypodensity throughout the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid c... | There are foci of hypodensity throughout the white matter without associated mass effect. Although these are nonspecific, they most likely represent small vessel disease of indeterminate ages. These can be further characterized by MRI if deemed clinically beneficial. |
Generate impression based on findings. | Fracture.VIEW: Right clavicle AP (one view) 04/13/15 There appears to be periosteal reaction along the superior aspect of the middle third of the clavicle. This has increased in the interval. On the prior exam this was felt to be a companion shadow of the clavicle. | Probable healing nondisplaced fracture of clavicle. |
Generate impression based on findings. | Female, 69 years old, history of clear cell odontogenic carcinoma. Redemonstrated is evidence of extensive prior surgery including bilateral mandibulectomy with bone and soft tissue grafting and neck dissection. The mandibular grafts are held in place with several plate and screw devices which appear similar to the pri... | 1. Evolving post surgical and treatment related findings in the neck.2. Stable nonspecific enhancing soft tissue at the root of the tongue.3. No definite evidence of progressive disease or pathologic adenopathy |
Generate impression based on findings. | 53 year old who is status post lumpectomy (05/14) for left triple negative breast cancer (less than 1cm) with no metastatic lymph node on sentinel lymph node biopsy, followed by radiation and chemotherapy, presents for mammographic follow up. Three standard views of both breasts and two spot magnification views of the ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient.If the patient submits her old mammograms, we can compare them with the current study to establi... |
Generate impression based on findings. | Reason: CVA History: CVA. Muscle weakness (generalized) The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the ... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Reason: mets lung cancer. s/p 8 cycles of Ganestipid maintenence therapy, with some slight proression in chest last CT scan. Pls c/w previous study and evaluate tx response. Pls provide bi-dimensional measurement to all lesions. History: mets lung cancer CHEST:LUNGS AND PLEURA: Reference right middle lobe nodule measur... | Grossly stable bilateral pulmonary nodules. |
Generate impression based on findings. | High-risk stage III colon cancer status post resection 2014 followed by chemotherapy, last January 2015. Restaging exam.RADIOPHARMACEUTICAL: 15.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 143 mg/dL. Today's CT portion grossly demonstrates a right chest Port-A-Cath with tip in the SVC. Moderate atherosc... | No FDG avid tumor. |
Generate impression based on findings. | Female 41 years old; Reason: evaluate response to treatment with bidimensional measurements per recist 1.1 compare to outside CT scan done on 2/19/15 History: target lesion in right hepatic lobe previously measured as 2.3 x 1.3 CHEST:LUNGS AND PLEURA: Not well seen on earlier exam is 4 mm left upper lobe lung nodule, i... | 1. Worsening hepatic metastatic disease, with new and enlarging lesions seen.2. New pulmonary micronodules present, concerning for new lung metastatic disease. 3. Mild interval enlargement of mediastinal and hilar lymphadenopathy, with more confluent adenopathy seen in paratracheal, subcarinal and bilateral hila. 4. Ne... |
Generate impression based on findings. | Pain along fifth metatarsal base of left foot. Evaluate for DJD versus stress fracture. I see no findings to suggest stress fracture. Small osteophytes at the Lisfranc joint, particularly the first and fourth tarsometatarsal joints, suggest mild osteoarthritis. There is slight widening of the space between the bases of... | Mild tarsometatarsal osteoarthritis and slight widening of the space between the bases of the first and second metatarsals may reflect prior Lisfranc ligament injury, but I see no findings to suggest stress fracture. |
Generate impression based on findings. | 24-year-old female with history of bilateral mastitis presents for follow-up mammogram. No current breast related complaints. History of benign left breast excisional biopsy. Family history of breast carcinoma in her maternal grandmother and maternal aunt. Three standard views of both breasts were performed digitally a... | No mammographic evidence of mastitis or malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually to begin at age 40. Prior to that, clinical follow up with the patient's primary care physician is recommended. Results and recommendation were discusse... |
Generate impression based on findings. | Swelling. Fracture? There is diffuse soft tissue swelling, particularly along the medial aspect of the ankle. I see no fracture. Arterial calcifications are noted within the soft tissues. There is a small plantar calcaneal spur which may not be of any clinical significance. | Soft tissue swelling and other findings as above without fracture evident. |
Generate impression based on findings. | Laceration/pain. Rule out fracture, foreign body. There is a defect in the soft tissues of the thumb distally, but I see no underlying foreign body or fracture. | Soft tissue defect without fracture or foreign body evident. |
Generate impression based on findings. | Hemorrhages are present within the right superior frontal gyrus, subdural spaces bilaterally primarily posteriorly at the convexity (measuring up to 5 mm bilaterally), within scattered sulci, and within basilar cisterns (predominately quadrigeminal and ambient cisterns).Scattered foci of hypodensity are present throug... | 1.Hemorrhages are present within the right superior frontal gyrus, subdural spaces bilaterally primarily posteriorly at the convexity (measuring up to 5 mm bilaterally), within scattered sulci, and within basilar cisterns (predominately quadrigeminal and ambient cisterns).2.Small vessel disease of indeterminate ages. |
Generate impression based on findings. | 57-year-old female with new right breast mass presents for ultrasound guided core needle biopsy. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 0.4 x 0.4 x 0.4 cm at the 10 o’clock position without increased vascularity, 4 cm from the nipple. The le... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Reason: pt on monthly Denosumab, Lupron, and Faslodex for breast cancer please eval disease status and compare to previous imaging History: breast cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CORONARY ARTERY CALCIFICATION: None.CHEST WALL: Previo... | Stable osseous metastases. New roughly 1 cm hypodense lesion in right lobe of liver, suspicious for metastatic disease. |
Generate impression based on findings. | Status post ORIF. Evaluate fracture healing. Again seen is a plate and screw device affixing a fracture of the distal radius in near anatomic alignment. I see no hardware complications. The fracture line is slightly less distinct on the current study than on the prior study, suggesting some interval healing. The mildly... | Orthopedic fixation of healing distal radius fracture and other findings as above. |
Generate impression based on findings. | There is redemonstration of extensive post-treatment findings in the neck, including total thyroidectomy, neck dissection, and slight interval decreased post radiation mucosal edema. There is a stable appearance of the ill-defined residual mass posterior to the cricoid and ill-defined nodularity in the left anterior n... | Continued stable appearance of residual mass posterior to the cricoid and left anterolateral neck focal nodularity along the treatment bed. Again, correlation with PET/CT would be helpful. |
Generate impression based on findings. | Shin pain for 3 weeks. Rule out fracture. Two views of the right tibia/fibula are provided. I see no acute fracture, nor do I see a stress fracture. A chronic appearing ossicle along the anterior tibial tuberosity may not be of any current clinical significance. A small ossicle distal to the fibular tip may reflect old... | Possible stress fracture of the posterior aspect of the proximal left tibial diaphysis. If further imaging evaluation is clinically warranted, repeat radiographs may be obtained in 7 to 14 days. Alternatively, MRI may be considered. |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Scattered sporadic foci of mucosal thickening are presen... | 1.No CT evident intracranial abnormality to explain the patient's altered mental status.2.Scattered sporadic foci of mucosal thickening are present without superimposed air-fluid levels. 3.Fluid is present within a few left mastoid air cells. |
Generate impression based on findings. | 63 year old female with metastatic breast cancer to lung, liver. On chemotherapy. Follow up scan. CHEST:LUNGS AND PLEURA: New right perifissural nodule measures 6 mm (series 5, image 99). An adjacent right fissural nodule which was previously seen now measures 9 mm (series 5, image 11) previously 7 mm. Other scattered ... | 1. Increasing size of pulmonary nodules. New right fissural nodule. 2. Increasing size of hepatic metastases. 3. Widespread osseous metastatic disease. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Scattered micronodules the largest measuring 4 mm (image 46/105) are unchanged.Minimal basilar subsegmental atelectasis may be secondary to aspirated secretions, stable.MEDIASTINUM AND HILA: S/P tracheostomyRight chest port ... | No evidence of metastatic disease.New bilateral nondisplaced rib fractures.L3 compression fracture. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Right upper lobe perifissural 5-mm nodule is unchanged and likely represents an intrapulmonary lymph node (series 4 image 45). Scattered benign punctate micronodules are unchanged. No new or suspicious nodules or masses. Bib... | No evidence of metastases. |
Generate impression based on findings. | 61-year-old woman VP shunt experiencing altered mental status. There is no evidence of acute intracranial hemorrhage.Redemonstrated is extensive encephalomalacia which is most pronounced in the right cerebral hemisphere. Encephalomalacia is also present in the high convexity of the left cerebral hemisphere and in the l... | 1.Encephalomalacia appears unchanged and in similar distribution. 2.A shunt catheter enters through the right frontal region, crosses the midline, and terminates near the left foramen of Monroe, unchanged in position. 3.The lateral, third, and fourth ventricles have increased in size. |
Generate impression based on findings. | 82 year-old female history of right nephroureterectomy 4/8. Now with low Foley output and high J-P drain output. ABDOMEN:LUNG BASES: There is a moderate right pleural effusion with associated compressive atelectasis.LIVER, BILIARY TRACT: There is a new peripheral hypodensity in the posterior aspect of the right hepatic... | 1. Postsurgical changes of right nephrectomy with urine leak from a small defect in the anterior aspect of the bladder resulting in retro and intraperitoneal fluid collections with scattered foci of air density.2. 10-mm hyperdensity located in the anterior aspect of the pelvis may represent a dropped surgical clip or p... |
Generate impression based on findings. | 42-year-old female with known biopsy proven fibroadenoma presents for annual examination. No current breast related complaints. No family history of breast cancer. 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 fibrog... | 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. | 25-year-old female with history of left flank pain and hematuria. Evaluate for nephrolithiasis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnor... | Left UVJ stone as above, without significant hydronephrosis or hydroureter. |
Generate impression based on findings. | Reason: pulmonary MAI, bronchiectasis, please assess for interval changes History: cough LUNGS AND PLEURA: Biapical pleural parenchymal scarring. Bilateral tree in bud opacities, slightly increased in the right lower lobe, and similar to prior elsewhere. Scattered bilateral bronchial wall thickening and mucus impaction... | Bronchial wall thickening, bronchiectasis and tree in bud opacities compatible with patient's history of MAI. In the right lower lobe there has been slight increase in the findings. Elsewhere, the appearance is the same. |
Generate impression based on findings. | There has been interval placement of a right frontal approach ventricular catheter with its tip terminating near the right foramen of Monro. Expected postprocedural changes include a small amount of hemorrhagic products at the insertion site, minimal pneumocephalus, calvarial burr hole, and overlying scalp changes. Th... | 1.There has been interval placement of a right frontal approach ventricular catheter with its tip terminating near the right foramen of Monro with expected postprocedural changes. 2.Mildly dilated supra-tentorial ventricles are unchanged. |
Generate impression based on findings. | Female 6 years old Reason: post-op resection History: post-op Three views of the left hand again show resection of the fifth ray through the base of the fifth metacarpal bone. Deformity and lucencies within multiple bones, consistent with known history of Kaposiform hemangioendothelioma and appearing similar to prior s... | Deformity and lucencies within multiple bones, consistent with known history of Kaposiform hemangioendothelioma and appearing similar to prior study. |
Generate impression based on findings. | New born with gastroschisis.VIEW: Chest AP (one view) 04/13/15, 1254 Endotracheal tube tip is at carina. Feeding tube tip is distal to GE junction and not included on image. Right upper lobe atelectasis is a new finding. No other focal opacity is present. Cardiothymic silhouette is normal. | Right upper lobe atelectasis most likely due to endotracheal tube tip at carina. |
Generate impression based on findings. | Female 79 years old Reason: 79y/o female with bilateral breast ca; surgery 4/13/15 left and right breast wire loc lumpectomy and bilateral axillary SNBx 1230pm DCAM; inject both Left and Right axilla please History: breast cancerRADIOPHARMACEUTICAL: The bilateral breasts were prepared in a sterile manner. A total of 0.... | Sentinel node identified in the bilateral axillae. |
Generate impression based on findings. | Reason: sp RYGB in Jan 2015 History: abdominal pain after eating Scout radiograph demonstrates residual contrast within the colon, related to recent CT abdomen, as well as suture material. There is a nonobstructive bowel gas pattern.Single contrast evaluation of the esophagus is unremarkable, without morphologic abnorm... | 1.Widely patent anastomosis, without evidence of obstruction.2.Prompt emptying of the gastric pouch into the efferent limb.3.Transient dilatation of the afferent limb could conceivably cause pain, although likely not in such a diffuse manner as the patient is experiencing.4.Postsurgical small bowel is otherwise unremar... |
Generate impression based on findings. | Female 43 years old Reason: pt on monthly Denosumab, Lupron, and Faslodex for breast cancer please eval disease status and compare to previous imaging History: breast cancer Stable radiotracer activity in the left temporomandibular joint and left frontal bone compatible with known metastases. Slight interval decrease i... | Stable to improved osseous metastatic disease with no new lesions. |
Generate impression based on findings. | Female 51 years old Reason: Metastatic breast cancer on therapy. Evaluate treatment response and extent of disease. History: Persistent left chest wall pain. New focus of radiotracer activity in the left posterior 11th rib correlating to a new fracture seen on today's CT scan. New radiotracer activity within the T12 ve... | 1.Interval progression of osseous metastatic disease with interval enlargement of most existing lesions and multiple new lesions within the calvarium.2.New radiotracer activity in the right posterior 11th rib and T12 vertebral body correlating with new fractures on CT. These may represent pathologic fractures.3.Note an... |
Generate impression based on findings. | Chest tube placement CDH repairVIEW: Chest AP ET tube tip immediately above the level of the carina. NG tube tip in the stomach. Bilateral chest tubes and umbilical lines again noted. Note that the sidehole of the right chest tube is within the subcutaneous tissue. Right upper lobe atelectasis new from prior study. Bil... | Right upper lobe atelectasis new from prior study. |
Generate impression based on findings. | Reason: eval LT elbow History: painVIEWS: Left elbow PA lateral (2 views) 4/13/15 14:06 Overlying cast obscures fine bone detail. Proximal radius and ulna in near anatomic alignment. Small amount of callous formation and periosteal reaction at the site of fracture. | Healing proximal radius and ulna fracture. |
Generate impression based on findings. | 55-year-old female with history of thyroid cancer. CHEST:LUNGS AND PLEURA: Debris within the left mainstem bronchus. New right middle lobe airspace opacity and consolidation. New bilateral lower lobe bronchiolar wall thickening, ground glass and tree-in-bud opacities compatible with bronchiolitis. Right apical post rad... | New dense right middle lobe opacity associated with bilateral lower lobe bronchiolitis is highly suggestive of pneumonia, likely related to aspiration. It should be followed to resolution to exclude an underlying mass |
Generate impression based on findings. | Male, 57 years old. Reason: eval for free fluid or mass History: suprapubic TTP while sedated LIVER: The liver measures 15.9 cm, with diffusely increased echogenicity, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No intrahepatic or extrahepatic biliary duc... | 1.Small to moderate pelvic free fluid. Possible right pleural effusion.2.Echogenic liver parenchyma may be related to hepatic steatosis/parenchymal dysfunction. |
Generate impression based on findings. | Female 20 years old Reason: 20F with new pathologic fracture of spine and adenocarcinoma on LN biopsy, evaluate for other bony lesions. History: pathologic fracture Focal increased radiotracer activity in the C7, T1, and T2 vertebral bodies compatible with the patient's known osseous metastatic disease and superimposed... | 1. Osseous metastatic disease and superimposed pathologic fractures at several levels at the cervicothoracic junction.2. Additional subtle lesion in the L4 vertebral body suspicious for an additional metastatic lesion. |
Generate impression based on findings. | There are again postoperative changes from prior sinonasal tumor resection. There is slight further decreased thickness of peripheral opacification in the maxillary sinuses. The right ethmoidectomy cavity appears essentially stable. The right frontoethmoidal recess remains opacified. The previously noted minimal linea... | Redemonstration of postoperative changes from prior sinonasal tumor resection, with further slight decreased peripheral maxillary sinus nonspecific opacification. No definite focal mass or cervical lymphadenopathy. |
Generate impression based on findings. | Scoliosis surgeryVIEW: Thoracolumbar spine PA (one view) 04/13/15, 1327 Ventriculoperitoneal shunt tubing and gastrostomy tube are present. A portion of the vagal nerve stimulator device is seen. The feeding tube tip is above the GE junction.A left thoracolumbar curve is again seen. A rod is in place extending from at ... | Postoperative changes. |
Generate impression based on findings. | Male 37 years old Reason: pain History: pain Moderate osteoarthritis of the knee with varus alignment. There is a horizontally oriented band of sclerosis in the medial tibial metaphysis, likely representing a stress fracture. Mild osteoarthritis affects the left knee as seen on the frontal view. | Osteoarthritis, varus deformity and findings of a medial tibial metaphyseal stress fracture. This was text paged to Dr. Birnie at 2:52 04/13/15. |
Generate impression based on findings. | Male, 75 years old. Reason: sepsis s/p PEG; elevated amylase interpretation, AKI LIVER: The liver measures 16.4 cm, with homogeneous echotexture, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation. The co... | 1. Echogenic renal cortex, suggestive of medical renal disease. 2. Benign-appearing right renal cysts are again seen, including a renal parapelvic cyst. |
Generate impression based on findings. | Scoliosis.VIEW: Spine PA (one view) 04/13/15, 1310 Gastrostomy tube and ventriculoperitoneal shunt tubing is seen. Feeding tube tip is above the GE junction.Hooks are present on the right side of the spine extending from the superior portion of the image which is at the T9 level through L5. A rod is threaded through th... | Placement of spinal fusion instrumentation. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Centrilobular emphysema. Scattered bilateral pulmonary micronodules some of which are calcified are stable and presumably benign.MEDIASTINUM AND HILA: No significant abnormality noted.CORONARY ARTERY CALCIFICATION: Moderate.... | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: pulmonary micronodule follow-up History: previous abnormal CT scan, history of smoking and COPD LUNGS AND PLEURA: Biapical pleural parenchymal scarring. Moderate to severe upper lobe predominant centrilobular emphysema, unchanged. Right middle lobe pleural and parenchymal scarring, unchanged. Scattered pulmonar... | Unchanged pulmonary micronodules compatible with postinflammatory etiology. No new or suspicious pulmonary nodules or masses. |
Generate impression based on findings. | Female 77 years old Reason: R Revision THA History: R Revision THA Right hip: AP view of the right hip and AP view of the pelvis at time stamp 13:14 and 13:19 show components of a right total hip arthroplasty device situated in near anatomic alignment. Skin staples, a drain, and gas density reflect recent surgery.Pelvi... | Total hip arthroplasty. |
Generate impression based on findings. | Female, 42 years old. Thyroid cancer s/p Surgery, I131. Follow up. RIGHT LOBE: Status post thyroidectomy. No focal lesion in the thyroid bed.LEFT LOBE: Status post thyroidectomy. No focal lesion in the thyroid bed.ISTHMUS: Status post thyroidectomy. No focal lesion in the thyroid bed.PARATHYROID GLANDS: No significant ... | No evidence of recurrent disease. |
Generate impression based on findings. | 52-year-old male with history of urothelial cancer of transplanted kidney s/p excision. CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions.MEDIASTINUM AND HILA: Heart size is normal with small pericardial effusion. Reference right paratracheal node measures 12 x 10 mm, previously 18 x 14 mm (26 of series 4). Refer... | 1. The surgical bed is markedly heterogeneous with areas of fluid and hyperattenuating soft tissue. This may simply represent resolving postsurgical changes or residual renal tissue from incomplete resection. A noncontrast CT of the pelvis may be obtained to determine whether there is abnormal enhancement within the su... |
Generate impression based on findings. | 75 years, Male. Reason: 75yo M w/ OG tube, confirm line placement History: as above The pelvis is excluded from the field-of-view. Orogastric tube tip in the distal esophagus, recommend advancing at least 10 cm. Nonobstructive bowel gas pattern. Please refer to recent chest radiograph for detailed thoracic findings. | Enteric tube in the distal esophagus, recommend advancing at least 10 cm. |
Generate impression based on findings. | Female, 68 years old. CKD stage 3, assess echogenicity, kidney size Suboptimal examination due to patient habitus.RIGHT KIDNEY: The right kidney measures 10.6 cm in length. Cortical echogenicity is difficult to assess. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 9.7 cm in length. Cortica... | Suboptimal examination limits evaluation of cortical echogenicity. No evidence of hydronephrosis. |
Generate impression based on findings. | Female 77 years old Reason: HIP ARTHROPLASTY REVISION (Right HIP) Single view of the pelvis obtained in the operating room at time stamp 11:02 shows the stem of the femoral component of a total hip arthroplasty device, the neck ofwhich overlies the lateral aspect of the acetabular cup. | Preliminary components of a total hip arthroplasty as described above. |
Generate impression based on findings. | 63 year old female with cough, SOB, fibrosis, evaluate ILD LUNGS AND PLEURA: Bilateral subpleural reticulations with associated mild patchy ground glass opacities. There are scattered areas of traction bronchiectasis and a few cystic areas. There is a mosaic attenuation pattern of alternating areas of increased and dec... | Intersitial fibrosis with traction bronchiectasis and areas of patchy ground glass opacity. There are equivocal areas of honeycombing. The imaging appearance has features of both NSIP and UIP. |
Generate impression based on findings. | Female 45 years old. Reason: R proximal tibia parosteal osteosarcoma, s/p resection/endoprosthetic reconstruction, evaluate for local recurrence/hardware complications. History: above Two views of the right knee and two views of the right tibia/fibula are provided. Again seen is a reconstruction of the proximal tibia w... | Proximal tibial reconstruction as described above. |
Generate impression based on findings. | Reason: HCC please assess and provide target lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Dense coronary artery and valvular calcificationsCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Status post right hepatec... | Essentially stable exam as above. |
Generate impression based on findings. | Soft tissue density material completely fills the external auditory canal, hypotympanum, mesotympanum, epitympanum, sinus tympani, round window niche, and the majority of mastoid air cells, without associated erosions.Fluid is also present within a few right mastoid air cells.The right external auditory canal and midd... | 1.Soft tissue density material completely fills the external auditory canal, hypotympanum, mesotympanum, epitympanum, and the majority of mastoid air cells without associated erosions.2.Fluid is also present within a few right mastoid air cells. |
Generate impression based on findings. | 5 year old female patient with urethral disruption. BLADDER Wall Thickness: Thickened Contents: Mildly distended and contains debris. A suprapubic catheter is present. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Observed. Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullar... | Findings most likely represent a rectal duplication cyst. Thickened bladder wall.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade... |
Generate impression based on findings. | Injury to the left kneeVIEWS: Left knee AP, oblique and lateral No acute fracture or dislocation. There is a small knee joint effusion. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 68 years old Reason: postop History: same Left hip: Components of a total hip arthroplasty device situated in near-anatomic alignment without radiographic evidence of hardware complication.Right hip: Right hip appears normal for age.Pelvis: The pelvis also shows orthopedic fixation of the lower lumbar spine to t... | Left total hip arthroplasty and other findings as described above. |
Generate impression based on findings. | TachypneaVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. The umbilical venous catheter tip at the cavoatrial junction. Cardiothymic silhouette cannot be evaluated. The large lucencies in the midline representing the pneumomediastinum not significantly changed. There is ... | Pneumomediastinum not significantly changed. Diffuse atelectasis increased from prior study. |
Generate impression based on findings. | 45-year-old male with palpable left subareolar mass. Three standard views of both breasts and left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. In the left retroareolar region there is a round dense mass like area measuring 1.8 ... | Masslike area in the left retroareolar region. The imaging appearance favors nodular gynecomastia over breast cancer. However breast cancer is not totally excluded. Therefore, surgical consultation is recommended, and a palpably guided tissue sampling could be considered.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATIO... |
Generate impression based on findings. | Male 83 years old. Reason: 10/10 R hip pain, dropping hgb History: As above A single portable view of the right hip demonstrates components of a total hip arthroplasty situated in near anatomic alignment without evidence of hardware complication. We see no fracture.There is mild deformity of the mid femoral diaphysis w... | 1.Total hip arthroplasty without fracture or specific finding to account for patient's dropping hemoglobin.2.Poorly defined lucency of the right acetabulum as well as an incompletely imaged deformity of the diaphysis of the right femur which are of questionable clinical significance, however, metastatic disease to bone... |
Generate impression based on findings. | 97-year-old female with history of melanoma. Evaluate for GI bleed. ABDOMEN:LUNG BASES: Bilateral moderate-sized pleural effusions with associated basilar atelectasis.LIVER, BILIARY TRACT: No suspicious hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No ... | 1. No evidence of active GI bleed.2. Moderate bilateral pleural effusions with associated compressive atelectasis, anasarca, cardiomegaly, and free pelvic fluid suggesting third spacing and volume overload.3. Severe atherosclerotic disease of the aorta and its branches with eccentric mural thrombus.4. Left adnexal hypo... |
Generate impression based on findings. | 63 year old female who was recalled from screening mammogram for left breast asymmetry. No family history of breast cancer. MAMMOGRAM: An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandu... | No mammographic or sonographic 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. |
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