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Generate impression based on findings. | Question of bowel perforation.VIEW: Abdomen crosstable lateral 4/30/15 at 1505 hrs. (one view) Vertebrae malformation, right lower extremity venous access and UVC again noted. Mild bowel distention with no evidence of free air or obstruction. No pneumatosis intestinalis or portal venous gas. | No evidence of bowel perforation. |
Generate impression based on findings. | 65-year-old female. Left hip pain. Marked osteoarthritis affects the left hip with joint space narrowing and osteophyte formation. There is suggestion of mild patchy sclerosis in the femoral head, and avascular necrosis cannot be excluded through. No evidence of subchondral collapse. | Marked osteoarthritis. |
Generate impression based on findings. | 68-year-old female. Hallux valgus. Post-surgical findings of a Lapidus procedure with screws affixing the first tarsometatarsal joint in anatomic alignment. First metatarsal head osteotomy is noted. Soft tissue swelling and foci of air in the adjacent tissues reflect recent surgery. Mild osteoarthritis affects the midf... | Post-surgical findings of a Lapidus procedure. |
Generate impression based on findings. | 58 year old female. Pain. Evaluate for fracture. Third metatarsal mid-diaphyseal fracture in anatomic alignment. Callus formation consistent with healing, similar to the prior study. | Third metatarsal healing fracture. |
Generate impression based on findings. | 44-year-old male. History of right shoulder repair with recurrent injury. A side plate and screws affix the proximal humerus in anatomic alignment. No radiographic evidence of hardware complication. No distinct fracture line is evident. Calcification above the greater trochanter, likely due to rotator cuff tendinopathy... | Orthopedic fixation of the right proximal humerus. |
Generate impression based on findings. | TraumaVIEWS: Left wrist AP, lateral and oblique. Left forearm AP and lateral and left elbow AP, lateral and oblique 4/30/15 (8 views) Salter-Harris two fracture of the distal radius weight dorsal angulation. Normal left elbow | Harris two fracture of the distal radius as described. |
Generate impression based on findings. | Female, 61 years old. Reason: IVC/hepatic vein clot? History: prior clots, supratherapeutic INR DOPPLER | 1.No flow is identified in the IVC inferior to the confluence of the hepatic veins, compatible with thrombosis. Flow is identified superior to the hepatic vein confluence. The hepatic veins are patent, the portal veins have normal direction of flow, and a hepatic arteries have normal waveforms.2.Heterogeneous appearanc... |
Generate impression based on findings. | Female 47 years old; Reason: generalized abdominal pain; history of spastic colon History: generalized abdominal pain; history of spastic colon ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Indeterminant hypodensity in the lateral left hepatic lobe measuring 2 cm is of slightly increased at... | 1. Findings suspicious for an internal hernia in the right lower quadrant with resultant partial small bowel obstruction, further described above. Discussed with Dr. Kupfer at 4:34pm on 4/30/2015. |
Generate impression based on findings. | 60 year-old female with history of large lytic skull lesion. Concern for metastatic disease favoring a breast primary. CHEST:LUNGS AND PLEURA: Mild apical scarring. No suspicious focal pulmonary nodule or mass. Mild atelectasis.MEDIASTINUM AND HILA: No mediastinal or hilar adenopathy. Normal cardiac size without perica... | No CT evidence of metastatic disease to the chest, abdomen or pelvis. |
Generate impression based on findings. | Male 13 days old Reason: where is the PICC History: line placedVIEW: Abdomen and chest AP (two views) 4/30/15 1516 hrs. NG tube terminates at the stomach. Right lower extremity PCVC tip is at the retrohepatic IVC.The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size and shape. Di... | Central line positioning as described.Bilateral diffuse lung haziness consistent with TTN versus RDS.Disorganized, likely age related and nonspecific abdominal gas pattern. |
Generate impression based on findings. | 6-year-old male patient with coughing for one week. Shortness of breath last night.VIEWS: Chest AP/lateral (two views) 4/30/2015 The aortic arch, cardiac apex, and stomach are on the left. There is right middle lobe, lingular, and left lower lobe streaky atelectasis. No pleural effusion or pneumothorax. Peribronchial t... | Bronchiolitis/reactive airways disease pattern with subsegmental atelectasis. |
Generate impression based on findings. | 62 year old female diagnosed with hepatocellular carcinoma presents for Therasphere mapping in conjunction with MAA. There is expected activity in the right hepatic lobe consistent with the known hepatocellular carcinoma. No abnormal extrahepatic activity is identified. Free pertechnetate within the kidneys bilaterally... | 1.No abnormal extrahepatic activity. 2.Lung shunt fraction measures 7.4%. |
Generate impression based on findings. | memory deficit and gait disturbances No evidence of acute ischemic or hemorrhagic lesion on this scan.Minimally increased ventricular system does not appear to be changed since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mas... | No evidence of acute ischemic or hemorrhagic lesion on this scan.No change of minimally dilated ventricular system since prior exam.If clinically indicated, brain MRI can be considered since CT is not sensitive for small acute ischemic stroke. |
Generate impression based on findings. | Male 13 years old Reason: right knee point tenderness patellar tendon insertion point . There is no fracture or malalignment. There is mild soft tissue swelling over the tibial tuberosity and there is perhaps some subtle thickening of the patellar tendon at its tibial attachment. There is a punctate calcification withi... | Nonspecific soft tissue swelling over the tibial tuberosity and other findings as described above. Consideration could be given to follow up radiograph or alternatively MRI may be considered if clinically warranted. |
Generate impression based on findings. | 56 year old female who was recalled from screening mammogram for questionable left breast distortion. 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 heterogeneously dense, which may obscure small masses, unchanged i... | 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 50 year-old female with right breast cancer needs lymphoscintigraphy on 5/14/2015 for surgery in 5/5/2015.RADIOPHARMACEUTICAL: The right breast was prepared in a sterile manner. A total of 1.1 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the r... | Sentinel node identified in the right axilla. |
Generate impression based on findings. | 19 year-old male patient with aplastic anemia complaining of rib pain.VIEWS: Chest PA/lateral (two views) 4/30/2015 The cardiac silhouette size is normal. No focal lung opacity, pleural effusion, or pneumothorax is identified. No displaced rib fracture is seen. | Normal examination. |
Generate impression based on findings. | Female 45 years old Reason: right hip pain History: right hip pain. Components of a left total hip arthroplasty situated in near-anatomic alignment however the distal aspect of the femoral stem is outside of the field of view of this study. Unremarkable radiographic appearance of the right hip. | Unremarkable radiographic appearance of the right hip. Please refer to recent MRI hip report 04/25/15 for additional findings including avascular necrosis. |
Generate impression based on findings. | 16-year-old male. TT-TG and assess trochlear dysplasia. Patellar instability. The tibial tubercle-trochlear groove distance is approximately 16 mm, which is borderline. Small knee joint effusion. The femoral trochlea is shallow indicating femoral trochlear dysplasia and there is moderate lateral translation of the pate... | Borderline TT-TG distance. Shallow femoral trochlea with moderate lateral translation of the patella. |
Generate impression based on findings. | 68-year-old male with fall, head trauma, upper cervical spine tenderness. Evaluate for hemorrhage, fracture or dislocation. Head:There is no evidence of intracranial hemorrhage, mass effect or cerebral edema. There is moderate to severe periventricular and subcortical white matter hypoattenuation suggestive of small ve... | 1.No evidence of intracranial hemorrhage or cerebral edema.2.Degenerative changes in the cervical spine, without evidence of acute fracture or subluxation.3.Interval lacunar infarct of the right putamen, age indeterminate.4.Mild progression in moderate to severe white matter hypoattenuation, suggestive of small vessel ... |
Generate impression based on findings. | 58-year-old female with a ventriculoperitoneal shunt and swollen abdomen. Evaluate for pseudocyst. Please note that lack of intravenous contrast limits evaluation for solid organ, bowel, and vascular pathology.ABDOMEN:LUNG BASES: Mild dependent atelectasis without a pleural effusion. No suspicious mass or nodule. Aorti... | 1. No evidence of a peritoneal shunt catheter pseudocyst or other specific findings to account for the patient's abdominal distension. 2. Patchy subchondral femoral head sclerosis compatible with avascular necrosis, without subchondral fracture or articular surface collapse. |
Generate impression based on findings. | Male 63 years old Reason: fracture History: fracture There has been interval removal of two K wires from the fifth digit. Again seen is a comminuted fracture of the proximal phalanx in gross anatomic alignment. The fracture line remains visible. The PIP joint is held in flexion and the DIP is held in extension. There i... | Interval removal of K wires from a comminuted fracture of the proximal phalanx. |
Generate impression based on findings. | Female 79 years old. Reason: rule out breast cancer mets, include sacral spine. History: back pain Thoracic spine: Age-indeterminate compression fracture of what appears to be T9 vertebral body. There is no definite lytic or sclerotic component, however, in the absence of additional imaging, we cannot exclude metastati... | Age-indeterminant compression fractures of T9 with a chronic, stable compression fracture of L3. No definite evidence of metastatic disease, however, it cannot be excluded on the basis of the current study. |
Generate impression based on findings. | Female, 20 years old. Reason: cholelithiasis History: abdominal pain with fatty foods LIVER: The liver measures 17.6 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. T... | No cholelithiasis, evidence of acute cholecystitis, or biliary ductal dilatation. No other acute abnormality to account for the patient's symptoms. |
Generate impression based on findings. | Male 16 years old Reason: r/o obstruction, constipation History: abdominal painVIEW: Abdomen AP (one view) 4/30/15 at 1527 hrs. Normal abdominal gas pattern. No evidence of obstruction or free air. No fecal accumulation noted. | Normal examination. |
Generate impression based on findings. | Female, 51 years old. Reason: please evaluate evidence of chronic liver disease or other cause of R flank pain (please also visualize kidneys) History: history of intermittent abnormal LFTs, R flank pain LIVER: The liver measures 14.9 cm, with homogeneous echotexture, and no focal lesion.The main portal vein is patent,... | Mild biliary ductal prominence status post cholecystectomy, an expected chronic finding. No renal stones, hydronephrosis, or other acute abnormality to account for the patient's symptoms. |
Generate impression based on findings. | 37-year-old female history of right lower back pain. Evaluate for kidney stones. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKID... | No evidence of nephrolithiasis as clinically queried. Unremarkable study. |
Generate impression based on findings. | Reason: 30 pack year smoking hx, BRCA2 carrier, hx of prostate cancer History: 30 pack year smoking hx, BRCA2 mutation carrier, hx of prostate cancer LUNGS AND PLEURA: Right upper lobe scar like subpleural opacity. Left lingular linear atelectasis/scarring. No suspicious pulmonary nodules or masses. No pleural effusion... | No suspicious pulmonary nodules/masses or significant abnormality. |
Generate impression based on findings. | Male, 25 years old. Reason: cholelithiasis or ductal dilatation History: RUQ pain, +Murphy's sign LIVER: The liver measures 12.4 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 d... | No cholelithiasis, evidence of acute cholecystitis, or biliary ductal dilatation. No other acute abnormality to account for the patient's symptoms. |
Generate impression based on findings. | Obstructive hydrocephalus. The exam was obtained for surgical stereotactic localization purposes, is extremely limited due to diffuse streak artifact. There is interval placement of a right frontal approach ventriculostomy catheter, with its tip in the in tear body of the left lateral ventricle. There is no discontinui... | No acute intracranial hemorrhage. Limited exam demonstrating expected postoperative changes from interval placement of right frontal approach ventriculostomy catheter with grossly stable ventricular size. |
Generate impression based on findings. | Status post OLT for HCC in June 2013 now with elevated AP. Evaluate for lesions. LUNGS AND PLEURA: Multiple right pulmonary nodules, which are new compared to visualized portions of the lung and prior CT abdomen and CTA coronary artery and suspicious for metastases. The largest in the right upper lobe measures 10 x 14 ... | 1.Multiple new right pulmonary nodules measuring up to 14 mm, highly suspicious for metastases. 2.See separately dictated CT abdomen performed on the same day. |
Generate impression based on findings. | Female 64 years old. Reason: r/o fracture. History: fall Patient positioning is mildly angulated given the portable technique, particularly on lateral views. The soft tissues appear normal without underlying fracture or malalignment evident. | No evidence of fracture. |
Generate impression based on findings. | Reason: abnl XR chest, RML nodule History: abnl xr chest LUNGS AND PLEURA: Right upper lobe lobulated nodule with internal cystic components measures 25 x 21 mm and correlates with the radiographic abnormality. This is highly suspicious for primary lung malignancy. Additional right apical 8 mm nodule with mildly spicul... | 1.Lobulated 25 mm right upper lobe solid nodule with internal cystic components highly suspicious for primary lung malignancy, which correlates with the radiographic abnormality.2.Additional right apical 8 mm mildly spiculated nodule may represent a metastasis or synchronous primary lung malignancy. 3.Upper limits norm... |
Generate impression based on findings. | Crohn's disease, evaluate for small bowel stricture/inflammation, diarrhea and right-sided pain ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Minimal intrahepatic biliary duct prominence, likely reflecting post cholecystectomy state.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormal... | 1. Terminal ileum within normal limits.2. Sites of active inflammation suggested in upper quadrant small bowel loops as described. 3. Multiple small right lower quadrant mesenteric lymph nodes, measuring up to 9 mm, likely reactive. |
Generate impression based on findings. | 69-year-old male with history of pancreatic cancer status post S/P RT and chemotherapy. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Heart size normal without pericardial effusion. Calcified mediastinal and hilar lymph nodes. Left chest port with tip in the SVC.CORONARY ARTERY... | Stable appearing ill-defined pancreatic head mass with encasement of the hepatic artery. No evidence of distant metastatic disease. |
Generate impression based on findings. | Female 69 years old. Reason: Back pain primarily on the right hand side, please capture view of the rib cage. History: tenderness over right lower rib cage. Lumbar spine: Vertebral body heights and alignment are preserved. Mild degenerative disk disease in the lower lumbar spine. No fracture evident. Mild osteoarthriti... | Degenerative arthritic changes of the lumbar spine without fracture evident. |
Generate impression based on findings. | Sagittal FLAIR images are not available. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are stable scattered punctate and ill-defined foci of T2/FLAIR hyperintensity within the periventricular and subcortical white matter bilaterally... | Allowing for differences in technique, no significant interval change in appearance of nonspecific scattered foci of white matter signal abnormality. |
Generate impression based on findings. | 56 year old male with history of treated head and neck cancer. EvaluateRADIOPHARMACEUTICAL: 13.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 90 mg/dL. Today's CT portion grossly demonstrates significant interval improvement of the pharyngeal mass and the previously identified cervical lymph nodes bilater... | 1.Markedly hypermetabolic left upper lobe and right upper lobe cavitary lesions as detailed above. Given the rapid interval development/evolution of these lesions, these may be infectious in etiology. However, given markedly hypermetabolic activity, tumor cannot be excluded.2.Moderately hypermetabolic mediastinal and h... |
Generate impression based on findings. | Reason: metastatic mesothelioma, constipation, epigastric pain, dysphagia. Evaluate for esophageal obstruction and bowel obstruction History: dysphagia, constipation LUNGS AND PLEURA: Left nodular pleural and fissural thickening compatible with patient's history of mesothelioma. Left pulmonary nodules. Please refer to ... | 1.Interval increase in diffuse interlobular septal thickening with centrilobular ground glass opacities and nodules compatible with edema. Slight interval increase in right pleural effusion.2.Stable left pleural nodularity, pulmonary nodules, loculated pleural effusion, and left basilar consolidation/atelectasis. See r... |
Generate impression based on findings. | 59 year old female status post left lumpectomy in 2003 for IDC, presents today for routine follow up. Patient received radiation therapy. History of benign right breast biopsy. No current breast complaints. Family history of breast carcinoma in her maternal cousin at age 45. Three standard views of both breasts were pe... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 92 year-old male with history of metastatic renal cell carcinoma. Evaluate for progression. CHEST:LUNGS AND PLEURA: Scattered micronodules, some of which are calcified. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Right chest port with tip in the SVC. Right cardiophrenic lymph node measures 12 x 7 mm... | Stable exam without significant interval change. |
Generate impression based on findings. | There appears to be transitional lumbosacral anatomy, with partial lumbarization of the S1 vertebra. For the purposes of this exam, the last fully formed disk is at L5-S1, only partially visualized. There is anomalous articulation of the right S1 transverse process sacrum with lack of a contralateral articulation on t... | 1. Transitional lumbosacral anatomy, although incomplete imaging through the upper sacral levels. If surgery is to be contemplated, correlation with imaging of the entire spine is recommended.2. Anomalous asymmetric articulation of the right S1 transverse process with the sacrum likely resulting in left greater than ri... |
Generate impression based on findings. | Worsening weakness There is no evidence of intracranial hemorrhage or mass. There is an unchanged subcentimeter focus of hypoattenuation in the right deep white cerebral matter. There is unchanged mild bilateral basal ganglia mineralization. The ventricles are normal in size and configuration. There is no midline shift... | 1. No evidence of intracranial hemorrhage or mass.2. Unchanged nonspecific subcentimeter focus of hypoattenuation in the right cerebral deep white matter, which may represent chronic ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Unchanged nonspecific mil... |
Generate impression based on findings. | 33-year-old male with a history of seminoma. Surveillance CT. CHEST:LUNGS AND PLEURA: Several micronodules are unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCORONARY ARTERY CALCIFICATION: None.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPL... | No evidence for recurrent disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 22 years old. Reason: evaluating for joint effusion/soft tissue swelling, boney degeneration, fx. History: Acute onset right ankle pain \T\ swelling, greatest at achilles, no trauma No significant soft tissue swelling or underlying osseous abnormality. Small joint effusion cannot be excluded. No fracture or malali... | No fracture evident. |
Generate impression based on findings. | Evaluate for intracranial bleed or mass post cardiac arrest. There is no evidence of acute intracranial hemorrhage or mass. There is redemonstration of left parieto-temporo-occipital encephalomalacia with unchanged ex vacuo dilatation of the left occipital horn, as well as several defects in the left cerebellar hemisph... | 1. Chronic infracts in multiple vascular territories, but no evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. Extensive intracranial atherosclerotic calcification.3. Paranasal sinus opacification is nonspecific and may be related to... |
Generate impression based on findings. | 2-day-old female patient with UVC and UAC. Evaluate for interval change in line placement.VIEW: Chest and Abdomen AP (two views) 4/30/2015 Endotracheal tube tip is at the thoracic inlet. Interval retraction of the UVC with tip still in the right atrium. The UAC tip is at the level of T8.The cardiothymic silhouette size... | UVC tip is in the right atrium. |
Generate impression based on findings. | 4-month-old male patient with stool from penis. Needs VCUG in the AM. Question of contrast passage.VIEW: Abdomen AP (one view) 4/30/2015 The abdomen is distended with multiple dilated bowel loops. Contrast is still noted within the stomach and the rectum. No evidence of free intraperitoneal air, pneumatosis, or portal ... | Contrast is still noted within the rectum. |
Generate impression based on findings. | 11 year old female patient status post reduction of left wrist fracture.VIEWS: Left wrist PA and lateral (2 views) 4/30/2015 at 1645 hrs Interval casting which obscures fine bone detail. Reduction of a left distal radius fracture in near anatomic alignment. | Left distal radius fracture in near anatomic alignment. |
Generate impression based on findings. | Reason: CVA History: CVA. Altered mental status The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. 2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | 32 years, Female. Reason: ? abdominal pain in Crohn's History: worsening pain Non-obstructive bowel gas pattern. No intramural or free air. Surgical clips right upper quadrant. Caval filter.Lung bases clear. Less than average stool burden. | No findings to explain pain. |
Generate impression based on findings. | 44 years, Female. Reason: Lost IUD threads; IUD not seen on pelvic ultrasound History: pelvic pain, heavy bleeding. Field of view to top of pubic symphysis. No IUD visible.Normal bowel gas pattern. Cholecystectomy clips and suggestion of central pneumobilia. Lap band angle of Phi 68 degrees. Band appropriately close to... | IUD not visualized. |
Generate impression based on findings. | 68 years, Female. Reason: follow up on ileus History: followup Mild mid-abdominal ileus, improved. No obstruction. Stent and surgical clips. | Improving ileus. |
Generate impression based on findings. | Stage IV invasive moderately differentiated esophageal squamous cell cancer (18-20 cm from the incisors) and colon adenocarcinoma s/p 12 cycles of FOLFOX at OSH presented to ED from HONC clinic concerning for sepsis, has been treated for bacteremia and is being admitted to the MICU for upper airway edema and monitoring... | 1. The cervical esophageal tumor compresses the trachea resulting in severe airway narrowing at the level of the thoracic inlet. 2. The esophageal tumor appears to be ulcerated and tumor perforation cannot be excluded. A fluoroscopic leak study may be useful for further evaluation if clinically warranted. 3. Extensive ... |
Generate impression based on findings. | History of assault: concern for nasal bone fracture. There is a minimally displaced fracture of the left nasal bone with mild overlying soft tissue swelling. No other fractures are identified. The orbits are unremarkable. There is diffuse sinonasal opacification. There is thickening and sclerosis of some of the paranas... | 1. Minimally displaced fracture of the left nasal bone with mild overlying soft tissue swelling.2. Sinonasal inflammatory disease with components of chronic sinusitis and polyposis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Head CT: There is redemonstration of parenchymal hemorrhage and associated edema involving the vermis and right cerebellum. There is persistent mass effect on the fourth ventricle. There is residual pneumoventricle. The third and lateral ventricles are unchanged in size, remaining mildly dilated. There is unchanged pa... | 1. Gradual evolution of a right cerebellar hematoma. 2. No discernible vascular malformation in the posterior fossa. 3. Bilateral ophthalmic segment internal carotid artery aneurysms, measuring up to 3 mm on the right and 5 mm on the left.4. No significant interval change in the appearance of the ventricular system. |
Generate impression based on findings. | T1N2bM0 right base of tongue cancer, status post resection on December 28, 2011 and chemoradiation completed on June 2, 2012. There are stable post-treatment findings. There is no evidence of mass lesions or significant cervical lymphadenopathy. For example, a right level 1B lymph node with preserved fatty hilum measur... | No evidence of locoregional tumor recurrence or significant lymphadenopathy in the neck. |
Generate impression based on findings. | History of sickle cell disease and preseptal cellulitis: acute progressing eye swelling, pain of jaw. Head: There is right preseptal fat stranding. There is no evidence of post-septal extension or fluid collection. The bilateral globes and ocular adnexa appear unremarkable. The cerebellar tonsils are low-lying and obli... | 1. Right preseptal cellulitis without evidence of post-septal extension or abscess formation.2. Findings compatible with Chiari I malformation.3. Diffuse expansion of the bone marrow spaces the maxillofacial skeleton and endplate depressions of the imaged upper thoracic vertebrae are likely related to sickle cell disea... |
Generate impression based on findings. | Reason: eval for PE, aortic dissection History: cp, sob PULMONARY ARTERIES: The technical quality of this examination is adequate for the evaluation of pulmonary embolism to the segmental level due to image noise from body habitus. No pulmonary embolus is present.LUNGS AND PLEURA: Scattered pulmonary micronodules, at l... | No pulmonary embolus to the segmental level is present.Superior anterior mediastinal rounded soft tissue density favors that of a thymoma, decreased in size over the last 5 years.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. ... |
Generate impression based on findings. | Right knee pain. Evaluate for osteoarthritis or other pathologies. Four views of the right knee are provided. Mild medial compartment narrowing and tiny osteophytes indicate minimal osteoarthritis, essentially within normal limits considering the patient's age. Similar minimal osteoarthritic changes affect the left kne... | Minimal osteoarthritis. |
Generate impression based on findings. | Left foot wound. Evaluate for osteomyelitis. There is diffuse soft tissue swelling. Again seen is ulceration of the soft tissues of the ball of the foot. I see no frank osteolysis to indicate osteomyelitis. Scalloping along the medial aspect of the head of the proximal phalanx of the first toe with underlying sclerotic... | Soft tissue ulceration but no specific radiographic features of acute osteomyelitis. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Hallux valgus (acquired); other hammertoe (acquired) Two orthopedic pins affix the first and second toes in near anatomic alignment, with the tips of the pins overlying the first and second metatarsal heads. Two orthopedic screws affix the first tarsometatarsal joint in near-anatomic alignment. The medial aspect of the... | Postoperative changes of hallux valgus and hammertoe corrections as described above. |
Generate impression based on findings. | Status post reverse total shoulder arthroplasty Components of a reverse total shoulder arthroplasty device are situated in near-anatomic alignment. A catheter overlying the medial aspect of the left shoulder presumably reflects interscalene block. The left lung is underinflated with basilar opacity that may represent a... | Postoperative changes of total shoulder arthroplasty as above. |
Generate impression based on findings. | Status post right reverse total shoulder arthroplasty Evaluation of fine detail is limited by overlying artifact. Components of a reverse total should arthroplasty device are situated in near-anatomic alignment. Drains/catheters and foci of gas density within the soft tissues reflect recent surgery. | Postoperative changes of total shoulder arthroplasty as above. |
Generate impression based on findings. | Left ankle pain and swelling. Left foot pain and swelling. Rule out fracture. Three views of the left ankle are provided. There is diffuse soft tissue swelling. I see no fracture. Arterial calcifications are noted in the soft tissues.Three views of the left foot are provided. There is diffuse soft tissue swelling parti... | Soft tissue swelling and arthritic changes as described above; I see no fracture. |
Generate impression based on findings. | Back pain status post fall There are 5 non-rib bearing lumbar vertebrae in addition to a transitional lumbosacral vertebra with hypertrophy of the left transverse process. I see no fracture or malalignment. Intervertebral disk spaces are within normal limits. There is perhaps mild facet joint osteoarthritis affecting t... | No fracture evident. Possible mild facet joint osteoarthritis. |
Generate impression based on findings. | left side partial seizure, follow up CT scan No evidence of acute ischemic or hemorrhagic lesion.Chronic temporo parietal encephalomalacia on the left side do not show any significant interval change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiati... | No evidence of acute ischemic or hemorrhagic lesion.No change of right temporo parietal encephalomalacia since prior exam. |
Generate impression based on findings. | Swelling and pain. Fracture? There is soft tissue swelling along the lateral aspect of the ankle. I see no underlying acute fracture. There may be a small tibiotalar joint effusion. A well corticated small ossicle distal to the medial malleolus may reflect old trauma but does not have the typical appearance of an acute... | Soft tissue swelling and possible ankle joint effusion without fracture evident. |
Generate impression based on findings. | head trauma No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremark... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | syncope and ataxia No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are u... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Pain, rebound during basketball. Evaluate for fracture. There is mild soft tissue swelling along the dorsum of the foot. I see no underlying fracture. An intramedullary rod and screw device within the tibia is incompletely imaged on this study. | Soft tissue swelling without acute fracture evident. |
Generate impression based on findings. | Reason: eval for pe History: hypoxia, tachypnea, tachycardia PULMONARY ARTERIES: The quality of this examination is technically adequate for evaluation of pulmonary embolism to the subsegmental level. No pulmonary embolus.LUNGS AND PLEURA: Subsegmental atelectasis involving the medial segment right middle lobe. Scatter... | No pulmonary embolism.Central bronchial wall thickening with areas of mucoid impaction and atelectasis in the right middle lobe.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Right ankle pain and swelling. Injury? There is soft tissue swelling along the lateral aspect of the ankle. There may also be a small tibiotalar joint effusion. I see no fracture, however. | Soft tissue swelling and possible small ankle joint effusion without fracture evident. |
Generate impression based on findings. | 37-year-old pregnant patient status post fall. Left knee pain. An intramedullary rod and screw device affixes a healed fracture of the distal tibial diaphysis in near anatomic alignment. I see no acute fracture. There is also a healed fracture of the distal fibular diaphysis. The knee appears normal. | Orthopedic fixation of healed tibial fracture; I see no specific findings to account for the patient's knee pain. |
Generate impression based on findings. | Reason: headache s/p fall History: headache s/p fall The CSF spaces are appropriate for the patient's stated age with no midline shift. There are subtle hypointense foci present in the subcortical white matter.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells a... | 1.There are subtle lesions in the subcortical white matter which are nonspecific. One possibility is that these are simply vascular related to, however they are nonspecific.2.No evidence for acute intracranial hemorrhage or mass.3.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | 64 years, Male. Reason: eval for constipation History: constipation and bloating for 4 days Nonobstructive bowel gas pattern. Greater than average stool burden. No evidence of pneumoperitoneum. The lung bases are clear. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Cellulitis. Osteomyelitis, subcutaneous gas? There is mild diffuse soft tissue swelling. I see no foci of gas within the soft tissues. I see no radiographic evidence of osteomyelitis. There is a prominent enthesophyte along the posterior aspect of the olecranon. | Soft tissue swelling without evidence of soft tissue gas or osteomyelitis. If there is strong clinical concern for osteomyelitis, MRI may be considered for further evaluation. |
Generate impression based on findings. | Leukemia and persistent fever. Infection or pulmonary edema?VIEW: Chest AP (one view) 04/30/15, 1710 Left central line tip is at junction of superior vena cava and right atrium. The spleen appears enlarged.Lung volumes are low. No focal lung opacity is identified. Cardiac silhouette size is normal. | No pneumonia or pulmonary edema. |
Generate impression based on findings. | Reason: r/o ICH History: s/p peds vs auto CT head: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 parana... | 1.No evidence for cervical spine fracture2.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her sister diagnosed in her 40s. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 22-year-old male. Right hip FAI. Mild osteoarthritis affects both hip joints with femoral head osteophyte formation.MEASUREMENTS: CAM location : 12 to 3 o'clock positionAlpha angle : 65 degrees at the 3 o'clock position Coronal center-edge angle : 34 degrees as measured to the lateral lip of the acetabular domeSagittal... | Osteoarthritis and CAM deformity with measurements as above. |
Generate impression based on findings. | Reason: r/o ICH History: s/p peds vs auto CT head: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 parana... | 1.No evidence for cervical spine fracture2.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Reason: eval for acute intracranial abnormality History: ground-level fall, head injury CT head: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 pa... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.There is a right orbital blow out fracture present with some prolapse of orbital fat into the maxillary sinus. |
Generate impression based on findings. | 16 year old female with pain, refusing to bear weight. Question of fracture.VIEWS: Left ankle AP, oblique, lateral (3 views), left foot AP, oblique, lateral (3 views) 4/30/2015 No acute fracture of the ankle is present. The ankle mortise is intact. No ankle joint effusion is identified.The bones of the left foot appear... | Normal examinations. |
Generate impression based on findings. | Male 68 years old. Reason: eval for fracture. History: fall, right proximal wrist pain. Two views of the left hip are provided. We see no fracture or dislocation. A single AP view of the pelvis is provided. We see no fracture in the pelvis. Arterial calcifications are noted in the upper thighs. Three views of the right... | Degenerative arthritic changes as described above. We see no fracture. |
Generate impression based on findings. | post subdural hematoma drain tube insertion. Right subdural drain tube has been inserted through the right parietal bone and the tip is located on the right frontal area.The maximum diameter of the right hemispheric SDH is now measured about 18.6mm on coronal scan and it was 28.8mm on prior exam.Mass effects of SDH aga... | Significant interval improvement of right hemispheric SDH volume and mass effects since prior exam.No evidence of new hemorrhagic or ischemic lesion. |
Generate impression based on findings. | 54-year-old female with no Pleurx drainage and evidence of pleural fluid on US, need to evaluate for loculation. LUNGS AND PLEURA: Innumerable bilateral pulmonary nodules have increased in number and size.Reference left upper lobe nodule measures 25 mm x 14 mm (series 6, image 13) previously 23 mm x 12 mm.Reference lef... | 1. Increase in size and number of innumerable bilateral pulmonary metastases with interval near complete collapse of the right lower lobe by known endobronchial lesion consistent with endobronchial tumor. 2. Small left pleural effusion which is loculated with left-sided Pleurx catheter terminating along the medial aspe... |
Generate impression based on findings. | Reported history of left jaw fracture with new tingling left face this morning. There is a minimally displaced fracture through the left angle of the mandible. This fracture traverses a portion of the mandibular canal and involves the alveolus of the left posterior mandibular molar with mild periapical lucency. Streak ... | Minimally displaced fracture of the left angle of the mandible as described above which traverses the mandibular canal, where there may be involvement of the left inferior alveolar nerve. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign calcifications noted bilaterally.No susp... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: Eval for progression of head/neck cancer History: cancer CHEST:LUNGS AND PLEURA: Biapical pleural-parenchymal scarring, unchanged. New bilateral small pleural effusions with overlying atelectasis and patchy consolidation, bronchial wall thickening and bronchiolectasis. Scattered pulmonary micronodules are uncha... | 1.New bilateral small pleural effusions with patchy consolidation, bronchial wall thickening and bronchiolectasis, possibly related to recurrent aspiration.2.No evidence of metastases. 3.Findings compatible with sickle cell disease and cirrhosis. Heterogeneous enhancement of the liver, although this examination inadequ... |
Generate impression based on findings. | Reason: assess NGT position History: NGT NG tube tip overlies the gastric fundus. The pelvis is excluded from the field-of-view. The lung bases are clear. Partially imaged dilated loops of small bowel are better evaluated on recent CT, compatible with small bowel obstruction. Postsurgical pneumoperitoneum and subcutane... | NG tube tip overlies the gastric fundus. Bowel gas pattern consistent with known small bowel obstruction. Pneumoperitoneum and subcutaneous emphysema, likely postsurgical. |
Generate impression based on findings. | 15-year-old male patient with ankle pain, refusing to bear weight.VIEWS: Right ankle AP, oblique, lateral (3 views) 4/30/2015 No acute fracture is evident. Alignment is anatomic. No ankle joint effusion is identified. Soft tissue swelling is noted about the ankle. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | Reason: evaluate for acute intracranial abnormality History: head injury, ground-level fall CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild degree are present.No abnormal mass lesions are appreciated intracra... | 1.No evidence for cervical spine fracture.2.No evidence for acute intracranial hemorrhage mass effect or edema.3.There are some mild degenerative changes present in the cervical spine.4.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular relat... |
Generate impression based on findings. | 3-year-old male patient who fell from roof.VIEWS: Cervical spine AP and lateral (two views), chest AP (one view), pelvis AP (one view) 4/30/2015 The cervical spine is visualized down to C6. However, on a subsequent thoracic spine radiograph, C7-T1 is adequately visualized. No acute fracture is evident. Reversal of the ... | 1. No acute fracture is evident. 2. Streaky left upper lobe opacity. |
Generate impression based on findings. | Unknown 3 days old Reason: evaluate for interval change in line placement VIEW: Chest AP and lateral (two views) 4/30/15 at 1655 hrs. UVC terminates at the right atrium. Cardiac silhouette size is normal. Right upper lobe atelectasis and residual right-sided pneumothorax unchanged. No effusion.Normal abdominal gas patt... | UVC position as described.Right upper lobe atelectasis and small right-sided pneumothorax.Normal limited pattern. |
Generate impression based on findings. | Altered mental status, history of FTD and cerebral palsy No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or herniation. Gray-white differentiation is maintained. No extra-axial collections. No hydrocephalus. Unchanged caliber of the ventricular system includin... | 1. No acute intracranial findings.2. Unchanged prominence of the lateral ventricles which is favored to be related to periventricular leukomalacia/remote parieto-occipital periventricular white matter injury. |
Generate impression based on findings. | 65 years, Female. Reason: Evaluate NGT History: s/p NGT adjustment Motion artifact limits examination. The pelvis is incompletely included in the field of view. Interval repositioning of the NG to with the tip terminating at the level of the proximal body of the stomach with the side port above the level of the GE junc... | Interval repositioning of the NG to with the tip terminating at the level of the proximal body of the stomach with the side port above the level of the GE junction, which needs to be advanced. |
Generate impression based on findings. | 65 years, Female. Reason: evaluate NGT History: NGT Pelvis is not completely included in the field-of-view. NG tube tip projects at the level of the antrum of the stomach. Nonobstructive bowel gas pattern. No evidence of pneumatosis intestinalis or portal venous gas. Surgical clips project over the right hemiabdomen an... | NG tube tip projects at the level of the antrum of the stomach. |
Generate impression based on findings. | 65-year-old female status post NG tube placement. Nonobstructive bowel gas pattern. No evidence of pneumatosis intestinalis or portal venous gas. NG tube tip projects at the level of the antrum of the stomach. Surgical clips project over the right hemiabdomen and pelvis. Round calcific densities project over the soft t... | NG tube tip projects at the level of the antrum of the stomach. |
Generate impression based on findings. | 3-year-old male patient status post fall from roof. ABDOMEN:LUNG BASES: No consolidation is noted in the lung bases.LIVER, BILIARY TRACT: No focal hepatic lesion or perihepatic fluid collection is identified.SPLEEN: The spleen is normal in appearance. No peri-splenic fluid collection.PANCREAS: The pancreas is normal in... | 1. No specific evidence of solid or hollow viscus organ injury.2. Incidental note of left distal radius and ulna fractures which can be further evaluated with dedicated radiographs. |
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