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Generate impression based on findings. | Reason: pt with substernal goiter and opacities in right lung hilum would like to evaluate the extent of thyroid disease and evaluate pulmonary hilar nodules History: dysphagia, tracheal deviation CHEST:LUNGS AND PLEURA: Calcified right middle lobe pulmonary nodules are unchanged. Bilateral lung base scarring. No suspi... | Thyroid goiter extending into the mediastinum without significant change from prior study.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 41-year-old male with history of seminoma status post bilateral orchiectomy and adjuvant radiation therapy in 2012. CHEST:LUNGS AND PLEURA: Few bilateral scattered micronodules, nonspecific. No suspicious pulmonary nodules identified. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Heart size is normal... | No evidence of metastatic disease. |
Generate impression based on findings. | 67-year-old male with fall, right hip pain. Rule out fracture/dislocation 2 views of the right hip were provided. Postoperative changes of right total hip arthroplasty with lucency involving the superior acetabulum with break of the lateral cortex of the ischium compatible with particle wear osteolysis. No acute fractu... | 1. Findings compatible with particle wear osteolysis and cup wear for which an orthopedic consultation is recommended. No acute fracture.2. Prepatellar soft tissue swelling and probable small joint effusion about the knee with degenerative arthritic changes. No acute fracture. |
Generate impression based on findings. | 85-year-old male patient with cognitive impairment. There is no evidence of intracranial hemorrhage. There is mild diffuse parenchymal volume loss. Calcifications noted in the bilateral vertebral arteries and the left cavernous internal carotid artery. There is no mass effect or herniation. Bilateral lens prostheses no... | 1.Mild diffuse parenchymal volume loss without acute intracranial hemorrhage or other acute abnormalities.2.Complete opacification of the right maxillary sinus with chronic wall sclerosis.3.Chronic appearing sphenoid sinus and mastoid air cell sclerosis. |
Generate impression based on findings. | Reason: interval assessment of R lung nodules History: none LUNGS AND PLEURA: Right apical scarlike nodular opacity (image 63 series 5) now measures 9 mm x 4 mm previously measuring 11 mm x 7 mm.Right lower lobe nodule (image 140 series 5) measures 7 mm x 6 mm previously measuring 8 mm x 5 mm.Scattered nonspecific micr... | 1.Right lower lobe nodule unchanged.2.Right upper lobe scarlike nodular opacity slightly decreased in size from the prior exam. |
Generate impression based on findings. | Male 67 years old; Reason: history of cholangiocarcinoma now status post radiation. Interval CT scan to evaluate disease status. History: cholangiocarcinoma CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change. Again seen left anterior lung scarring.MEDIASTINUM AND HILA: No significant abnormality ... | 1. Stable exam as described, including unchanged hepatic segment 4 lesion. |
Generate impression based on findings. | Male 76 years old Reason: evaluate R THA History: s/p R THA 6 weeks ago Right hip: Components of the total right hip arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. The joint drain has been removed. No acute fracture or malalignment.Pelvis radiograph r... | Postsurgical changes from a total right hip arthroplasty without radiographic evidence of hardware complication. |
Generate impression based on findings. | 54-year-old female needing preoperative evaluation for potential lung resection. The comparison chest radiograph performed on 5/7/2015 demonstrates no airspace consolidations or pleural fluid. The ventilation images show a uniform distribution of activity on single-breath and wash-in images. Mild abnormal Xe-133 retent... | 1. Nearly symmetric ventilation and perfusion images, with the left lung slightly decreased compared to the the right, as quantified above.2. Mild abnormal Xe-133 retention in the left lower lobe. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no acute intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/m... | No acute intracranial hemorrhage or mass effect. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and there are no contraindications, MRI of the brain is recommended. |
Generate impression based on findings. | 69-year-old male patient with high-grade prostate cancer. Staging exam. ABDOMEN:LUNG BASES: Minimal dependent bibasilar atelectasis.LIVER, BILIARY TRACT: Multiple hepatic lesions are identified. The largest hypoattenuating lesion is within the inferior right hepatic lobe and has discontinuous, peripheral enhancement me... | 1. Enlarged prostate compatible with history of malignancy.2. Multiple hepatic lesions; the largest lesion of which has imaging features suggestive of a hemangioma with incomplete characterization of the smaller lesions. Triphasic CT or MRI of the liver is recommended for further evaluation.3. Mildly enlarged inguinal ... |
Generate impression based on findings. | 85 year old male with mantle cell lymphoma. There is no evidence of significant lymphadenopathy in the neck. The Waldeyer ring structures are not significantly enlarged. The airways are patent. The thyroid and salivary glands are unchanged. There is unchanged atherosclerotic calcification involving both carotid bifurca... | 1.No evidence of recurrent lymphoma.2.Dental disease. |
Generate impression based on findings. | 52-year-old male with right ankle pain, history of gout and contralateral equal ankle pain 2 weeks ago, now resolved 3 weightbearing views of the right ankle were provided. There is bony spur formation along the anterior process of the talus. There is no bony erosion, acute fracture or malalignment. There is no soft ti... | No radiographic evidence of gout. |
Generate impression based on findings. | 15-year-old female with history of MVCVIEWS: Chest PA/lateral (two views), right knee PA/lateral/oblique (3 views), cervical spine PA/lateral/open-mouth/ (4 views) 5/7/2015 at 1353 The cardiomediastinal silhouette is within normal limits. The cardiac apex and stomach are on the left. No focal pulmonary opacities. No pn... | No acute abnormality to suggest traumatic injury. No significant abnormality otherwise. |
Generate impression based on findings. | Male 46 years old Reason: Eval s/p Left THA History: Eval s/p Left THA Components of a total left hip arthroplasty device is situated in near anatomic alignment without radiographic evidence of hardware complication. There is development of heterotopic bone near the proximal aspect of the femur.AP view of the pelvis sh... | Total left hip arthroplasty without radiographic evidence of hardware complication. |
Generate impression based on findings. | 70-year-old male with metastatic prostate cancer. Focus of increased activity in the superior left scapula, consistent with metastatic disease and not significantly changed.No new suspicious osseous foci identified. Redemonstration of asymmetrically decreased radiotracer uptake in an atrophic right kidney. Degenerative... | Left scapular metastasis without significant interval change. No new suspicious osseous lesion is identified. |
Generate impression based on findings. | Male 72 years old Reason: L hip/groin pain - cause? History: L groin pain 2 views of the left hip shows mixed sclerotic and lucent foci in the left greater trochanter and left ischium. Focus of heterotopic bone formation adjacent to the acetabulum. Moderate osteoarthritis affects the left hip. Fracture or malalignment.... | Sclerotic and lucent changes in the left hip and ischium. This may represent involvement from the patient's lymphoma, follow-up is suggested.Moderate left hip osteoarthritis. |
Generate impression based on findings. | 69-year-old male with high-grade prostate cancer. Staging examination. No abnormal osseous foci are identified to indicate metastatic disease. Mild increased uptake in the anterior lower cervical spine and lower lumbar spine, most compatible with degenerative arthritic changes. Faint asymmetrically increased activity i... | No evidence of bone metastases. |
Generate impression based on findings. | 84-year-old male with history of DJD now with persistent lower back pain despite conservative therapy 4 views of the lumbar spine were provided. There are 6 non rib-bearing lumbar vertebrae. Anterior osteophytes are noted throughout the lumbar vertebra most prominent at L6/S1 with end plate sclerosis and disc space nar... | Lower lumbar spine and sacroiliac joint osteoarthritis. |
Generate impression based on findings. | Reason: chronic right lower chest/upper back pain a year after PE History: right lower chest/RUQ pain when lying down CHEST:LUNGS AND PLEURA: Minimal scarring in the right lung base that was previously affected by the pulmonary embolus. No pleural effusions or pneumothorax. No suspicious nodules or masses. No focal con... | Minimal scarring of the right lung base at the area of prior involvement by pulmonary embolus. |
Generate impression based on findings. | 13 week old female with right duplicated collecting system. Decreased parenchymal activity of the superior quarter of the right kidney with normal activity seen in the remainder of the right kidney and the entire left kidney. This finding likely relates to cortical thinning of the right upper pole, particularly given t... | Decreased parenchymal activity of the right kidney upper pole as detailed above, but there is normal overall split function of the kidneys. |
Generate impression based on findings. | Solitary pulmonary nodule right lower lobe.RADIOPHARMACEUTICAL: 10.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 87 mg/dL. Today's CT portion grossly demonstrates severe bilateral pulmonary emphysema. Tree-in-bud opacities are seen in the lateral right lung base, new from recent diagnostic CT. The subcen... | 1.The recently identified subcentimeter medial right lower lobe pulmonary nodule on CT is not demonstrably FDG avid and may be benign. However, tumor cannot be entirely excluded and continued CT follow-up as per guidelines is recommended.2.Patchy hypermetabolic tree-in-bud opacities in the right lower lobe more lateral... |
Generate impression based on findings. | Reason: 67 year old F with LUL spiculated PET-avid nodule, please eval mediastinal LAD History: as above LUNGS AND PLEURA: Irregularly marginated nodule in the left upper lobe (image 94 series 5) unchanged in size and outside exam measuring 9.3 mm.Additional left upper lobe spiculated nodule (image 1:15 series 5 measur... | 1.Left upper lobe irregularly marginated nodule representing hypermetabolic nodule on recent PET scan. The configuration would favor this being inflammatory in etiology, however malignancy cannot be excluded.2.Additional scattered nodules and micronodules are unchanged compared with exam dated 2/5/2015 |
Generate impression based on findings. | Female 21 years old Reason: assess for signs of osteomyelitis History: sickle cell disease, pain in left leg, history of Salmonella osteomyelitis in left leg in 2005 requiring surgical intervention Left femur: There is patchy sclerosis of the left femoral head compatible with avascular necrosis. There is no subchondral... | Bone infarctions as detailed above. No specific radiographic evidence of osteomyelitis. Chronic changes in the proximal tibia. If early osteomyelitis is suggested in the tibia consider MRI. |
Generate impression based on findings. | 41-year-old female with low abdominal pain. Evaluate for hernia. ABDOMEN:LUNG BASES: Minimal scarring in the lung bases. No suspicious pulmonary nodules. No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion.SPLEEN: Spleen is unremarkable.PANCREAS: No foc... | Two hypoattenuating right adnexal lesions. Differential considerations include ovarian/paraovarian cystic masses versus abscess versus less likely hydrosalpinx, given the history of tubal ligation. Pelvic ultrasound is recommended for further evaluation. |
Generate impression based on findings. | 15-year-old male, evaluate location and healing of distal right femur fracture from gunshot.VIEWS: Right knee AP and lateral (2 views) 5/7/2015, 12:33 Cortical fracture of the anterior distal femoral diametaphysis is again seen approximately 10 cm proximal to the articular surface. Multiple tiny fracture fragments are ... | Fracture of the distal femur as described above. |
Generate impression based on findings. | 31-year-old female with history of breast cancer, now with pelvic pain. Evaluate for bony metastatic disease. No abnormal osseous foci are identified to indicate metastatic disease.Minimal benign hyperostosis frontalis is noted. Asymmetric breast soft tissue activity, compatible with known breast cancer and therapy cha... | No evidence of bone metastases. |
Generate impression based on findings. | Known left breast calcifications. 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 heterogeneously dense, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious area... | 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. | Reason: follow up GGO (4/11/12, 10/4/12, 4/29/13, 5/5/14) History: GGO LUNGS AND PLEURA: Multiple groundglass opacities in both lungs. No definite new lesions but slight increase in prominence of existing lesions. None with rapid progression. Right lower lobe solid nodule without significant change, now measuring 5 mm ... | Multiple bilateral groundglass opacities with slight increase in prominence, but none with rapid progression. Recommend continued annual follow up. |
Generate impression based on findings. | Male 67 years old Reason: pre-op History: pain Severe osteoarthritis affects the left knee with bone-on-bone apposition in the medial compartment. There is approximately 8 degrees of genu varus. | Left knee osteoarthritis and mechanical axis as detailed above. |
Generate impression based on findings. | Reason: Worsening shortness of breath History: Worsening shortness of breath LUNGS AND PLEURA: Continued improvement in left basilar opacities with moderate to severe centrilobular emphysema.Increasing right hemithorax consolidation with dilated bronchi and cavity formation.MEDIASTINUM AND HILA: No mediastinal or hilar... | Increasing right hemithorax consolidation and volume loss with persistent air-fluid levels in bronchi and cavities. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (11/20/14, 2/16/15), ultrasound images of the left breast (2/16/15), images from ultrasound guided biopsy of left breast with post procedural left mammographic images (3/6/15), images from ultrasound-guided wire localizat... | Biopsy proven malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 56 year old female status post left MCA aneurysm clipping. There are postoperative findings related to recent left pterional craniotomy for microsurgical clipping of a recurrent left middle cerebral artery aneurysm. Streak artifact from surgical clips in this region limits evaluation. There is extra-axial pneumocephalu... | Postoperative findings related to recent left pterional craniotomy with subjacent extra-axial air, fluid, and blood products. |
Generate impression based on findings. | Female 63 years old Reason: evaluate R TKA History: s/p R TKA 6 weeks ago Components of a total right knee arthroplasty device are situated in near-anatomic alignment. There is a small joint effusion.No acute fracture or malalignment. Mild soft tissue swelling persists. Status post removal of the joint drain and skin s... | Total right knee arthroplasty as detailed above. |
Generate impression based on findings. | 44-year-old female. Right breast mastectomy for breast cancer in 2004. No current 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 fibroglandular density, unchanged in pattern and distribution. A l... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient. Given patient's young age at cancer diagnosis, if additional imaging surveillance is desired, MR... |
Generate impression based on findings. | 68-year-old with history of left lumpectomy for DCIS in 2005. Personal history of ovarian carcinoma. Three standard views of both breasts 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 in pattern and distributio... | 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. | 80-year-old male with unusual tremor. Evaluate for Parkinson's disease versus essential tremor. Absence of bilateral putamen radiotracer activity and decreased bilateral caudate activity, compatible with Parkinson's disease given the patient's history. | Evidence of significant bilateral nigrostriatal dopaminergic deficiency. Findings compatible with Parkinson's disease. |
Generate impression based on findings. | Evaluate ankle fracture. 3 views of the left ankle reveal a spiral fracture of the distal fibula that extends down to the joint line. The fracture is indistinct consistent with healing. The bones are in anatomic alignment. | Healing distal fibula fracture |
Generate impression based on findings. | Image quality is somewhat degraded by motion artifact. There are post treatment findings related to suboccipital right craniotomy and right cerebellar tumor resection. There is interval increase in size of nodular enhancement in the resection cavity measuring 22 x 17 mm (AP x TR), previously up to 9 mm. There is a new... | 1. New postoperative findings related to resection of a right posterior neck mass with interval development of multiple new enhancing masses around the resection cavity with associated restricted diffusion, suspicious for tumor progression. Bilateral enlarged cervical lymph nodes, suspicious for metastatic nodal diseas... |
Generate impression based on findings. | Female 41 years old Reason: right knee pain s/p fall History: right knee pain Bone mineralization is near normal. Alignment is anatomic. No acute fracture or malalignment. Joint effusion has decreased.Jointline of the right knee is slightly elevated compared to the left. | Decrease in the joint effusion without definite fracture. |
Generate impression based on findings. | Postsurgical changes secondary to bilateral functional endoscopic sinus surgery are seen including medial antrostomies, uncinectomies, partial ethmoidectomies and partial middle turbinate resection. There is significant mucosal thickening with air-fluid level in the right maxillary sinus, moderately increased compared... | 1.Interval worsening of diffuse paranasal sinus opacification including bilateral maxillary sinuses, ethmoid air cells, sphenoid sinuses, and frontal sinuses. Hyperattenuating material within the right maxillary sinus may represent inspissated secretions and/or chronic fungal colonization.2.Increased opacification of t... |
Generate impression based on findings. | 21-year-old male with pain, (SER) 2-type, stable fracture of the ankle 3 weightbearing views of the left ankle are provided. Again seen is a healing nondisplaced distal fibular fracture as well as a small fracture fragment along the posterior distal tibia with minimal displacement. Calcification of the cortex of the di... | Healing distal fibular and posterior tibial fracture. |
Generate impression based on findings. | Female 17 months old Reason: NJ tube placement History: NJ tube placementVIEW: Abdomen AP (one view) 5/7/2015 at 1436 hours. NG tube terminates at the antral pyloric region. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction or free air. No ascites. | Feeding tube terminates at the antral pyloric region. |
Generate impression based on findings. | Female 57 years old Reason: pre-op History: pain Mechanical axis is 3 degrees of valgus.Osteoarthritis affects the right knee and tricompartmental osteophytes. Osteoarthritis affects the symphysis pubis. | Mechanical axis as detailed below. |
Generate impression based on findings. | Status post fibular fracture evaluate. 3 views of the right ankle reveal deformity of the distal fibula consistent with old healed fracture. No acute abnormalities. | Old healed fracture of the distal fibula in anatomic alignment |
Generate impression based on findings. | Osteoarthritis. Worsening knee pain 4 views of the right knee reveal a joint effusion. There is extreme narrowing of the lateral joint compartment with a bone-on-bone appearance. There are multiple small osteophytes. When compared to the previous film of 2013 there is little change. | Severe osteoarthritis with marked lateral joint space narrowing |
Generate impression based on findings. | 71-year-old female with pain, evaluate for infection 3 views of the great toe show mild degenerative changes at the MTP and IP joints. No acute fracture or malalignment is evident. No significant soft tissue swelling. No osseous erosion to suggest osteomyelitis. | Mild degenerative changes without evidence of infection. |
Generate impression based on findings. | Evaluate healing 2 views of the right radius and ulna reveal a middiaphyseal ulnar fracture. The fracture line is indistinct consistent with healing. The bones are in anatomic alignment. | Healing mid diaphyseal fracture of the ulna in anatomic alignment. |
Generate impression based on findings. | Female 10 years old Reason: evaluate healing of fracture History: left knee fracture/ status post pins removedVIEWS: Left knee AP, lateral on 5/7/2015 (2 views) Postsurgical changes of hardware removal are noted. Periosteal reaction along the lateral aspects of the distal metaphyses of the left femur are present. Early... | Periosteal reaction along the distal femur metaphysis and possible early fusion of the physes. |
Generate impression based on findings. | 46-year-old female with pain Right shoulder: 3 views of the right shoulder show no acute fracture. Alignment is anatomic.Right ankle: 3 weightbearing views of the right ankle show no acute fracture or malalignment. No significant soft tissue swelling. | No acute fracture or malalignment. |
Generate impression based on findings. | 63-year-old female with history of non-Hodgkin's lymphoma. CHEST:LUNGS AND PLEURA: There has been interval near resolution of bilateral patchy groundglass opacities. Multiple bilateral scattered nodules and micronodules, some calcified. Several nodules have resolved and several new nodules have appeared; for example a ... | 1.Evidence of disease progression includes increased adenopathy in the supraclavicular, axillary, retroperitoneal, hepatic hilar, mesenteric, and pelvic lymph nodes as well as new marked splenomegaly.2.Nearly resolved ground glass pulmonary opacities.3.Pulmonary nodules and micronodules redemonstrated, some new and som... |
Generate impression based on findings. | 86-year-old female patient with one week of significant left lower quadrant abdominal pain. Question of diverticular disease. ABDOMEN:LUNG BASES: Moderate coronary artery calcifications are noted. Non-specific left lower lobe pulmonary micronodule.LIVER, BILIARY TRACT: Fluid containing 1 cm hypodense right hepatic dome... | 1. No specific findings to account for the patient's symptoms.2. Cystic lesion of the proximal body of the pancreas may represent a sidebranch IPMN. |
Generate impression based on findings. | Male 67 years old Reason: right D-4 PIP pain/swelling History: see above Bone mineralization is normal. Alignment is near-anatomic. Osteoarthritis affects the interphalangeal joints evidenced by joint space narrowing. Osteoarthritis affects the first, second, third and fifth metacarpophalangeal joints.No acute fracture... | Osteoarthritis. |
Generate impression based on findings. | 65-year-old female with bilateral pain MTP, SI pain/scoliosis: iritis, evaluate for OA vs. SPA 3 weightbearing views of the left foot and 3 weightbearing views of the right foot were provided. Moderate osteoarthritis affect the bilateral first MTP joints and second right MTP joint. Osteoarthritis affects the mid feet a... | Osteoarthritic changes affect the feet, bilateral SI joints and lower lumbar spine. |
Generate impression based on findings. | 92-year-old female with right total hip arthroplasty Hardware components of a total right hip arthroplasty device are in near-anatomic alignment without evidence of hardware complication. Heterotopic bone formation is noted about the right hip similar to the prior exam. Degenerative changes affect the pubic symphysis a... | Right total hip arthroplasty device as described above. |
Generate impression based on findings. | 63-year-old female patient with history of non-Hodgkin's lymphoma presents with new cervical lymphadenopathy. There is interval increase in lymph nodes with prominent and enlarged lymph nodes in the neck, supraclavicular area, retropectoral and axillary regions bilaterally. For reference, a right level 2 lymph node mea... | New bilateral lymphadenopathy in the neck, supraclavicular area, retropectoral and axillary regions as well as increased prominence of lymphoid tissue in the nasopharynx. Reference measurements provided above. |
Generate impression based on findings. | Male 12 years old Reason: evaluate healing of fracture History: right femur avulsion fractureVIEWS: Right femur AP 5/7/2015 (1 views) Avulsion fracture of the lesser trochanter of the right femur is unchanged in alignment. | Avulsion fracture of the lesser trochanter |
Generate impression based on findings. | Female 72 years old Reason: right total hip History: right total hip There is an avulsion fracture of the lesser trochanter with mild healing. There is lucency in the proximal femur including the greater trochanter.There are lucent changes adjacent to the proximal aspect of the acetabular component with decentering of ... | Healing lesser trochanteric fractureDecentering of the femoral head suggestive of cup wear. |
Generate impression based on findings. | Lung cancer initial treatment strategy. Adenocarcinoma with massive pleural effusion. Whole body staging.RADIOPHARMACEUTICAL: 12.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 91 mg/dL. Today's CT portion grossly demonstrates a large left pleural effusion and near complete collapse of the left lung with o... | 1.Diffuse hypermetabolic activity studding the left pleural surfaces, highly suspicious for diffuse pleural seeding of tumor. A small more focal hypermetabolic lesion within the collapsed left lung could represent the primary tumor versus additional tumor seeding.2.Hypermetabolic lymph nodes in the left low neck and up... |
Generate impression based on findings. | 87-year-old male with pain along the medial longitudinal arch especially at the navicular Right foot: Severe osteoarthrosis affects the first MTP joint. Extensive atherosclerotic calcifications. Pes planus. Calcaneal plantar spur.Left foot: Severe osteoarthritis affects the first MTP joint. Extensive atherosclerotic ca... | Bilateral pes planus deformity. Severe degenerative disease as described above. |
Generate impression based on findings. | 65-year-old female Reason: history of anal cancer s/p chemoradiation with inguinal recurrence now s/p chemoradiation. History: anal cancer . CHEST:LUNGS AND PLEURA: Left lower lobe pulmonary micronodules are unchanged from the prior exam. No new suspicious lesions, focal airspace opacities, or pleural effusion. Bibasil... | 1.Asymmetric right rectal outpouching is inseparable from adjacent uterus with a visualized air-containing tract. Underlying uterine invasion/fistula formation cannot be excluded.2.Reference right inguinal lymphadenopathy is decreased in size compared to the prior exam. |
Generate impression based on findings. | 37-year-old female evaluate for bone mass, there is bony prominence over the area of the trapezium/trapezoid 3 views of the right hand were provided. Dorsal bony protrusion at the second or third metacarpal base most compatible with carpal boss. There is no acute fracture or malalignment. | Findings most compatible with carpal boss. |
Generate impression based on findings. | Reason: Assess Crohns History: Diarrhea Scout radiograph showed right upper quadrant clips and lower abdominal/pelvic sutures.Transit time to the colon was between 15 and 30 minutes. Fluoroscopic evaluation of the remaining small bowel showed no ulcers, sinus tracts, fistulae, or adhesions. No separation of bowel loops... | No active disease in the remaining small bowel. Chronic inflammatory changes of the transverse and descending colon. |
Generate impression based on findings. | 69-year-old female with hallux valgus, acquired. Closed dislocation of metatarsophalangeal joint 2 portable views of the right foot were provided. Interval removal of orthopedic hardware with placement of plate and screw device overlying the first metatarsophalangeal joint, interval resection of the second metatarsal h... | Postoperative changes with no evidence of hardware complication. |
Generate impression based on findings. | 57-year-old male patient with history of non-Hodgkin's lymphoma status post auto-SCT. Day 100 post transplant testing. CHEST:LUNGS AND PLEURA: Streaky bibasilar atelectasis/scarring. No suspicious pulmonary nodules are identified.MEDIASTINUM AND HILA: A mildly enlarged AP window lymph node measures approximately 1.5 x ... | Unchanged mildly enlarged mediastinal lymph node without other specific findings of disease recurrence. |
Generate impression based on findings. | 55-year-old female with right knee pain. 4 weightbearing views of the right knee demonstrates narrowing of the lateral tibiofemoral compartment, sharpening of the tibial spines and mild osteophytosis compatible with severe osteoarthritis. Moderate joint effusion. The extensor mechanism is intact. No acute fracture is e... | Severe osteoarthritis of the right knee as described above. |
Generate impression based on findings. | 55-year-old female with history of trauma to right middle finger distal phalanx 3 weeks ago now with difficulty extending the DIP The alignment is anatomic. Mild soft tissue swelling. No acute fracture or malalignment is evident. Osteophyte along the volar surface of the middle phalanx. | Soft tissue swelling without acute fracture or malalignment. |
Generate impression based on findings. | Male 15 years old Reason: evaluation of healing History: previous fx from last weekVIEWS: Right ankle AP, lateral and oblique 5/7/2015 (3 views) Cast material obscures fine bone details. There is no evidence of acute or healing fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | PHARYNX/LARYNX: There are prominent bilateral tonsilliths. The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The postcontrast appearance of the salivary glands is unremarkabl... | 1. Significant interval improvement in bilateral cervical lymphadenopathy with reference measurements as provided above.2. Stable appearance of smooth deformity of the left mid hyoid bone with associated soft tissue prominence which mildly encroaches upon the left paraglottic fat. This is of uncertain clinical signific... |
Generate impression based on findings. | 63-year-old female with bilateral knee pain 3 weightbearing views of the right knee and 3 weightbearing views of the left knee were provided. Mild genu valgus is noted bilaterally.Left knee: Interval progression of degenerative changes about the knee with extensive joint space narrowing with bone-on-bone apposition in ... | Severe degenerative changes affect the knees with interval progression from prior study. |
Generate impression based on findings. | 60-year-old male with history of CLL. CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary nodules and micronodules are slightly decreased in size and not significantly changed in number. No new suspicious pulmonary nodules. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Heart size is normal with no p... | Marked interval improvement in diffuse lymphadenopathy. |
Generate impression based on findings. | 16-year-old female with history of autoimmune hepatitis and cirrhosis, postop day 1 after TIPS placement Color and spectral Doppler were performed on inflow and outflow vessels.LIVER:The liver is hyperechoic and decreased in size, consistent with history of cirrhosis.GALLBLADDER, BILIARY TRACT: The gallbladder is fille... | 1.Patent TIPS, with velocities as above. 2.Small amount of free fluid, and findings consistent with history of hepatic cirrhosis. |
Generate impression based on findings. | Male 12 years old Reason: evaluate healing of fracture History: right wrist injuryVIEWS: Right wrist AP and lateral 5/7/2015 (2 views) Cast material obscures fine bone details. Buckle fracture of the distal radius is in anatomic alignment. | Buckle fracture of the radius in anatomic alignment after casting. |
Generate impression based on findings. | History of sinusitis with epidural abscess. Evaluate for infection or inflammation. Soft tissue neck CT study is requested.. Limited evaluation of the brain demonstrates a subdural collection measuring 1 cm in thickness along the right occipital lobe and tentorium which is increased since prior when it measured 6 mm, f... | 1. Limited visualization of the brain on this neck CT demonstrates slight increase in size of subdural collection along the right occipital lobe and tentorium compared to 5/5/2015; possibly related to redistribution versus increase in size of overall subdural collection. Follow-up head CT or MRI can be considered as cl... |
Generate impression based on findings. | 57-year-old female. History of left IDC/DCIS status post lumpectomy/SLNB in 2010. Three standard views of both breasts 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 in pattern and distribution. Architectural di... | 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. | Female 7 years old with Bilateral Breast Pain. Rule Out Mass vs. Cysts vs. Other. EXAMINATION: Sonograms of the soft tissues of the chest wall 5/7/2015 at 15:20 The patient indicated pain in the subareolar region of the right breast. Scanning in this area revealed a hypoechoic structure with linear branching surrounded... | Hypoechoic right subareolar structure likely represents an asymmetrically developed breast bud however, the differential also includes a fluid collection in the setting of infection. Clinical correlation is recommended. |
Generate impression based on findings. | 44-year-old male patient with right testicular cancer. Evaluate for retroperitoneal metastases. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No focal hepatic lesion.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormalit... | 1. Small bilateral obturator and inguinal station lymph nodes.2. No significant retroperitoneal lymphadenopathy. |
Generate impression based on findings. | 56-year-old female with positive rheumatoid factor and hand weakness Three weightbearing views of the left foot demonstrate no osseous erosions. Alignment is anatomic. Small joint effusion. Status post arthroplasty of the fifth digit.Three weightbearing views of the right foot show no osseous erosions. Small curvilinea... | Post-surgical changes without specific evidence of rheumatoid arthritis as described above. |
Generate impression based on findings. | 14-year-old male with left ankle pain, evaluate for fracture.EXAMINATION: Left ankle AP, lateral, and oblique views (3 views) 5/7/2015 at 14:48 Small joint effusion but no malalignment, or evidence of fracture. | Small joint effusion, no acute fracture or malalignment. |
Generate impression based on findings. | 51-year-old female with right breast cancer.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 right axilla, representing the sentinel node(s). This region wa... | Sentinel node identified in the right axilla.Findings text paged to Dr. Chhablani at the time 4:00 PM on 5/7/2015. |
Generate impression based on findings. | Female, 64 years old. Reason: abdominal pain, diarrhea since colonoscopy. R/O free air History: as above Nonobstructive bowel gas pattern. No evidence of free air seen on supine imaging.Surgical clips overlie the pelvis. Multiple vascular calcifications seen. | Nonobstructive bowel gas pattern. No evidence of free air. Note: Left lateral decubitus and upright imaging are more sensitive in the detection of free air. |
Generate impression based on findings. | Fall, limited range of motion, evaluate for fracture or dislocation No acute fracture or subluxation is seen within the cervical spine. There is exaggerated cervical lordosis. The cervical vertebral bodies are appropriate height. There is minimal retrolisthesis of C4 on C5 and minimal anterolisthesis of C7 on T1. Align... | 1. No acute fracture or subluxation is seen in the cervical spine.2. Subcutaneous nodule in the left posterior upper upper neck soft tissues at the C1 level, correlate with direct examination. |
Generate impression based on findings. | Reason: head and neck cancer, evaluate for tx, Please provide measurements History: as above CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules, some of which are stable and some of which have minimally increased since the previous scan.A reference right upper lobe nodule (series 6/43) measures 13 x 14 mm, sl... | 1.Multiple pulmonary nodules, suspicious for metastases, slightly increased in size. 2.Stable mediastinal lymphadenopathy. |
Generate impression based on findings. | Status post fracture.VIEWS: Right and left wrist AP and lateral 5/7/2015 (4 views) Interval removal of cast bilaterally. Healing fractures with periosteal reaction and callus formation of both distal radius and ulna with mild dorsal angulation are unchanged in alignment. | Healing fractures, unchanged in alignment after cast removal. |
Generate impression based on findings. | Female 13 years old Reason: history of ss, vortex port. Not flushing. Check placement. History: history of ss, vortex port. Not flushing. Check placement.VIEWS: Chest AP/lateral (two views) 5/7/2015 at 1553 hours. Central line terminates at the RA/SVC junction. Cardiac silhouette size is normal. No focal opacities, eff... | Normal examination. |
Generate impression based on findings. | 83-year-old female with heel pain x3 weeks Calcification of the distal Achilles tendon suggests tendinosis. No acute fracture is evident. Obliteration of fat pad of Kager may be secondary to accessory soleus muscle. No osseous abnormalities. | No acute fracture or malalignment. Suggestion of Achilles tendinosis. |
Generate impression based on findings. | Female, 53 years old. Reason: 53 y/o lady with chronic abdominal pain - SMA protocol History: 53 y/o lady with chronic abdominal pain - SMA protocol Scout radiograph showed a nonobstructive bowel gas pattern. Surgical clips in the midabdomen. TIPS in place. Right chest port, tip overlying the cavoatrial junction. Real-... | To-and-fro peristaltic flow within the duodenum, with limited contrast entering the fourth portion. These findings, in conjunction with recent CT findings, can be seen in SMA syndrome. |
Generate impression based on findings. | Female 58 years old; Reason: pt with met melanoma History: met melanoma on Pembro ABDOMEN:LUNGS BASES: Multifocal lung lesions again seen. No new sites of disease. Index lesion left lower lobe series 5 image 62, 1.2 x 1 cm. Previously 1.7 x 1.5 cm. This change is representative of several of the other lung lesions.LIVE... | 1.Decrease in size of index lesions however some subcutaneous lesions may have increased in size. No new sites of disease. |
Generate impression based on findings. | 14-year-old female with a history of aspiration now with desaturation and fevers. Evaluate for empyema, abscess or complicated pneumonia. LUNGS AND PLEURA: There is no pleural effusion or pneumothorax. The trachea and central bronchi are patent. The lungs are underinflated with streaky bibasilar opacities. A focal opac... | Left upper lobe pneumonia and bibasilar atelectasis. No evidence of pulmonary abscess, pleural effusion or empyema. |
Generate impression based on findings. | 53 year old with recurrent right breast cancer and chest wall mass. Ultrasound evaluation for chest wall mass is requested. Focused ultrasound of the chest wall detected a hypoechic mass measuring 40 x 14 mm, locating over the Sternum. Color Doppler detected increased blood flow within this mass. | Suspicious mass over the Sternum. Ultrasound guided biopsy can be performed, if clinically indicated. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | metastatic medullary carcinoma of the thyroid on Sunitinib for 5 years. MEN 2A syndrome. CHEST:LUNGS AND PLEURA: Stable calcified and noncalcified micronodules, likely postinfectious. No suspicious pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: Partially imaged nodule in the right tracheoesophageal gr... | No evidence of metastases in the chest or abdomen. Right tracheoesophageal groove mass; please refer to separately dictated CT neck report for further details. |
Generate impression based on findings. | Reason: Dx: lung cancer History: S/P 4 cycles evaluate CHEST:LUNGS AND PLEURA: Slightly increased right pleural effusion but decreased left pleural effusion, with a pleural drain in the left base.Right upper lobe irregular nodule (series 4/48) 31 x 14 mm, increased from 25 x 15 mm previously.Left lower lobe nodule adja... | 1.Slight interval increase in pulmonary nodules. 2.Interval insertion of a right pleural catheter with drainage of pleural effusion. |
Generate impression based on findings. | Male, 64 years old. Reason: Esophageal cancer post chemo/rt pre-op eval History: Esophageal cancer Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. Right chest port, tip at the cavoatrial junction.Double contrast evaluation of the esophagus and gastric ca... | 1. Circumferential narrowing at the gastroesophageal junction as described above correlates with the known esophageal mass. Additional suggestion of irregularity along the proximal portion of a small hiatal hernia may represent spread of tumor.2. An outpouching posteriorly in the upper esophagus may represent a diverti... |
Generate impression based on findings. | Female 31 years old Reason: 31 y/o woman with a recent diagnosis of node-positive breast cancer with new low back pain and pelvic pain. Evaluate for recurrent disease. History: Pelvic pain. CHEST:LUNGS AND PLEURA: Bilateral new lung metastases. An index right upper lobe lesion measures 1.7 x 1.1 cm on image #28, series... | New metastatic lung lesions, mediastinal adenopathy.New hypodense lesion in the head of the pancreas causing upstream pancreatic duct dilatation most likely represents a metastatic disease although, much less likely, a primary adenocarcinoma cannot be excluded. |
Generate impression based on findings. | 60-year-old male patient with altered mental status. Again seen are foci of hypoattenuation in the bilateral centrum semiovale, left greater than right, compatible with age-indeterminate small vessel ischemic disease. Age-indeterminate punctate lacunar infarcts are seen in the bilateral thalami, stable. Encephalomalaci... | 1.No acute intracranial hemorrhage, mass, or cerebral edema. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts and MRI should be considered if there is continued clinical suspicion.2.Moderate chronic small vessel ischemic disease,3.Left occipital encephalomalacia and chronic bilateral th... |
Generate impression based on findings. | A 54-year-old female with right frozen shoulder Three views of the right shoulder show mild degenerative changes to the glenohumeral joint and moderate degenerative changes to the acromial clavicular joint. No acute fracture or malalignment is evident. | No acute fracture or malalignment.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 80-year-old male patient with history of EVAR status post repair of type II endoleak, now status post EVAR 4/14/2015 for type I endoleak. 1 month surveillance. CHEST:LUNGS AND PLEURA: There are multiple calcified pleural plaques bilaterally.MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes are noted... | 1. Aorto-biliac stent graft with interval enlargement of the aneurysm sac and evidence of an endoleak within the inferior portion of the sac; this may represent a Type II endoleak.2. Patent right renal artery stent.3. Calcified pleural plaques. |
Generate impression based on findings. | 58-year-old female patient with altered mental status. Evaluate for acute interval change. There is no evidence of intracranial hemorrhage. Diffuse parenchymal volume loss is again noted, greater than expected for patient's stated age. Moderate periventricular white matter hypoattenuation appears similar compared to pr... | 1.No evidence of intracranial hemorrhage, mass, or cerebral edema. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2.There is redemonstration of moderate chronic small vessel ischemic disease. 3.Advanced global pare... |
Generate impression based on findings. | Reason: 31 y/o woman recently treated for node-positive breast cancer with acute vertigo. Evaluate for brain metastases. History: Vertigo Multiple, presumably-enhancing lesions are identified, concerning for metastatic disease. The largest lesion is a complex, partially cystic and partially solid, multilobulated mass i... | Multiple presumably-enhancing parenchymal lesions, the largest of which is a complex cystic/solid mass, which causes mass effect on the right lateral ventricle and slight leftward midline shift. Basal cisterns remain patent, without evidence of downward herniation. Findings are highly suspicious of metastatic disease. ... |
Generate impression based on findings. | Reason: 61F p/w nausea, vomiting, convulsive activity witnessed by EMS en route to ED, History: convulsive activity No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are ... | No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion. |
Generate impression based on findings. | Female, 62 years old. Reason: 62 y/o F with dysphagia to solids and liquids History: as above Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. A left renal stent in the infrarenal abdominal aortic stent are noted.Double contrast evaluation of the esophagu... | 1. No significant anatomic abnormality, dysmotility, or gastroesophageal reflux noted. 2. Small hiatal hernia. |
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