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Generate impression based on findings. | Slammed middle finger in car door. Near amputation.VIEWS: Left hand PA, left middle finger oblique/lateral (three views) 05/09/15 A soft tissue defect is noted along the lateral aspect of the middle finger distal phalanx. Soft tissue swelling is present as well. No bone abnormality or foreign body is identified. | Distal phalanx middle finger soft tissue injury. |
Generate impression based on findings. | 82 year old female with altered mental status. There are numerous supratentorial and infratentorial enhancing lesions (>20). Most lesions demonstrate mild surrounding edema. The largest of these is located within the left basal ganglia and measures up to 21 mm. There is no midline shift or herniation. The ventricles an... | 1.Numerous (>20) supratentorial and infratentorial presumed metastases without midline shift or herniation.2.Right parietal bone lesion also concerning for metastasis as it was not present on a prior CT. |
Generate impression based on findings. | Trauma. Rule out fracture.VIEW: Pelvis AP (one view) 05/09/15, 1922 The round, smooth femoral heads are well directed into normally formed acetabula. No fracture is present. The bones are normal in appearance. | Normal examination. |
Generate impression based on findings. | 42 year old female with left facial numbness. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unrema... | No evidence of acute intracranial hemorrhage. Please note that CT is insensitive in the detection of acute ischemia or trigeminal nerve lesions and if there is continued clinical concern, an MRI is suggested. |
Generate impression based on findings. | Female 54 years old; Reason: pt with acute elevation in bili and ast/alt with known liver mets. eval for pd and bil obstruction History: abd pain, jaundice ABDOMEN:LUNGS BASES: Incompletely imaged numerous pulmonary metastases and persistent left pleural effusion with underlying atelectatic/collapsed lung. Comparison t... | 1. Extensive hepatic metastases, some stable to mildly decreased in size and appearing less conglomerate, while others demonstrate mild interval increase in size. New from earlier study is severe left intrahepatic biliary duct dilatation. Increasing small ascites.2. New bilateral adrenal masses, suspicious for metastat... |
Generate impression based on findings. | 49 year old female with dizziness and seizure. There is no evidence of acute intracranial hemorrhage. There are unchanged areas of encephalomalacia within the right frontal lobe in the ACA distribution and within the left parietal lobe in the MCA or a watershed distribution with resultant ex vacuo dilatation of the lef... | 1.No evidence of acute intracranial hemorrhage.2.Unchanged areas of encephalomalacia within the right frontal lobe in the ACA distribution and within the left parietal lobe in the MCA or a watershed distribution. |
Generate impression based on findings. | Female, 36 years old, chronic nasal congestion and facial pain and pressure treated medically without resolution. Deviated nasal septum and question of nasal polyp in the left ostiomeatal unit. Mild bubbly secretions are seen within the left frontal sinus. The left frontoethmoidal recess is obscured by soft tissue thic... | 1.Mild paranasal sinus mucosal inflammation as detailed above.2.No definite evidence of any intranasal polypoid lesion is seen. |
Generate impression based on findings. | 73 year old female with left upper extremity weakness. There is no evidence of acute intracranial hemorrhage. There is global volume loss, atherosclerotic calcification of the distal internal carotid arteries, and confluent patchy areas of low attenuation throughout the supratentorial white matter most compatible with ... | 1.No evidence of acute intracranial hemorrhage.2.Moderate age-indeterminate small vessel ischemic disease and numerous supratentorial and infratentorial chronic appearing infarcts. Please note that CT is insensitive in the detection of acute ischemia and if there is further clinical concern, an MRI suggested. |
Generate impression based on findings. | Pain and limited range of motion. History: Pain and swelling. Diffuse soft tissue swelling most prominent along the dorsum of the hand without evidence of acute fracture or malalignment.Multiple enthesophytes affect the digits of the hand. Degenerative changes affect the first and second carpometacarpal joints. | Soft tissue swelling without acute fracture or malalignment evident.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 44 year old male with head and neck trauma. HEAD: There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is scattered paranasal sinus mucosal thickening as well as secretions within the left maxillary ... | 1.No evidence of acute intracranial hemorrhage or skull fracture.2.No evidence of cervical spine fracture.3.Paranasal sinus inflammation may represent sinusitis in the correct clinical setting. |
Generate impression based on findings. | Reason: Postreduction x-ray. History: Right ankle fracture. Overlying cast material obscures fine detail. There is been interval reduction of the distal fibular and medial malleolus fractures now in near-anatomic alignment. | Reduction of right ankle fractures.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: Left knee trauma. History: Pain. No large joint effusion. No acute fracture or malalignment is evident. | No acute fracture or malalignment evident.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 34 year old male with ETOH use and head trauma. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is minimal scarring within the soft tissues overlying the left zygoma. There is mucosal thickening... | 1.No evidence of acute intracranial hemorrhage or skull fracture.2.The imaged portion of an only partially included benign appearing expansile cystic lesion within the right maxilla appears grossly unchanged and is better evaluated on the prior maxillofacial CT. |
Generate impression based on findings. | Reason: Evaluate for ligamentous cervical spine injury. History: Tenderness to palpation of all cervical vertebrae. Limited evaluation of C7 and the cervicothoracic junction secondary to overlying anatomy. No acute fracture or malalignment is evident. Incompletely evaluated anterior fusion with bone graft material at C... | No acute fracture or malalignment is evident. No abnormal translation on flexion and extension views.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female, 65 years old, with pain and spinal stenosis. Assess for pedicle size. Severe erosive arthropathy affects the C4-5 disc space with loss of disc height, a mild anterolisthesis of C4 relative to C5, and a mild focal kyphotic angulation of the spine.The remaining cervical vertebral bodies demonstrate normal morphol... | 1.Severe degeneration of the C4-5 disc space with erosive endplate irregularity and erosive left facet arthropathy. There is a moderate generalized spinal canal stenosis and at least moderate left foraminal narrowing at this level.2.Left severe degenerative findings are seen at other levels as discussed above. |
Generate impression based on findings. | Cellulitis. Bone involvement?VIEWS: Right hand PA/lateral/oblique (three views) 05/09/15 Marked soft tissue swelling is seen along the dorsum. The bones are normal in appearance. | Marked soft tissue swelling with normal appearance of bones. |
Generate impression based on findings. | Respiratory failure and desaturations. Changing atelectasis?VIEW: Chest AP (one view) 05/10/15, 0534 Right upper extremity PICC tip is in right atrium. A gastrostomy tube is present. A left thoracolumbar curve is present.The right upper lobe is completely atelectatic. Streaky opacities are seen bilaterally. Cardiac sil... | Worsening right upper lobe atelectasis. Bilateral subsegmental atelectasis. |
Generate impression based on findings. | Reason: Patient thrown from truck yesterday and struck ground and patient struck in middle chest yesterday. History: Bilateral hip pain and pain to light palpation near sternum. The single AP view of the pelvis demonstrates no fracture or malalignment.Two views of the sternum demonstrate no fracture or malalignment. | No fracture or malalignment evident.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 27 year old female with head trauma. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | Reason: Severe pain over the left tibia. History: Severe pain. Soft tissue swelling about the ankle and perhaps the distal tibia. No acute fracture or malalignment is evident. Scattered nonspecific calcifications or phleboliths. | Soft tissue swelling without acute fracture or malalignment evident.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 54 years old; Reason: rule out stone History: llq suprapubic pain, left flank pain intermittently x 2 weeks ABDOMEN:LUNGS BASES: Relatively hypoattenuated appearance of intracardiac blood pool suggests underlying anemia.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality not... | 1. Lobulated fibroid uterus. Cystic tubular right adnexal structure visualized, may represent hydrosalpinx or ovarian cyst formation. Correlation with patient's clinical history recommended and further imaging with dedicated pelvic sonography should be considered. |
Generate impression based on findings. | Reason: Abnormality. History: Pain and swelling lateral knee. There may be a small joint effusion without acute fracture or malalignment. Small osteophytes indicate mild osteoarthritis on this nonweightbearing view. | Small joint effusion without acute fracture or malalignment. Mild osteoarthritis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 32 year old female with headache and history of subarachnoid hemorrhage. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is an unchanged 12 mm osteoma within the right ethmoid air cells with sur... | No evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | Gastrostomy tube insertion.VIEW: Abdomen AP (one view) 05/09/15 An unspecified amount of dilute barium was injected via the gastrostomy tube. The stomach is opacified. The first portion of the duodenum contains contrast. No free peritoneal air is seen. A moderate amount of feces is present in the colon. There are no di... | Gastrostomy tube within stomach. |
Generate impression based on findings. | Reason: Evaluate for fracture. History: Multiple recent falls, swelling. Four nonweightbearing views of the right knee demonstrate a small joint effusion. There is severe tricompartmental osteophyte formation and joint space narrowing indicating severe osteoarthritis. No acute fractures evident.Four nonweightbearing vi... | Severe osteoarthritis as above without evidence of fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female, 62 years old, history of T1 N2a squamous cell carcinoma of the left tonsil, HPV positive, status post CRT. No evidence of recurrent mucosal tumor is seen. No pathologic adenopathy is detected by size criteria.The salivary glands demonstrate a normal posttreatment appearance. The cervical vessels enhance normall... | No evidence of recurrent mucosal tumor or pathologic adenopathy in the neck. |
Generate impression based on findings. | There is a 1 mm displaced fracture of the posterior left mandibular body with a comminuted component along the lingual surface and a simple component along the buccal surface. The fracture courses anterior and posterior to ADA tooth #17 with resultant pericoronal lucency but no definite dental fracture. There is howev... | 1.Acute fracture of the posterior left mandibular body as described above.2.Multiple dental caries. |
Generate impression based on findings. | Female 44 years old; Reason: Acute onset RLQ pain w/ vomiting, diarrhea History: RLQ pain ABDOMEN:LUNGS BASES: Small dependent bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Splenule. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEY... | 1. Right adnexal 4.2 x 3.3 cm cystic lesion with adjacent tortuous/dilated tubular structure seen. Correlation with patient's clinical history/physical exam and laboratory values recommended to exclude physiologic cyst formation versus tuboovarian abscess and pyosalpinx/hydrosalpinx, further imaging with dedicated pelv... |
Generate impression based on findings. | 12-month-old male with history of chronic lung disease. Tachypnea and desaturations. VIEW: Chest AP (one view) 05/09/15, 2200 Tracheostomy tube tip is above carina. Feeding tube tip is distal to GE junction and not included on image. Lower extremity PICC has its tip in the intrahepatic IVC.Lung volumes are large with h... | Changes from chronic lung disease. No focal opacity. |
Generate impression based on findings. | Respiratory failure and endotracheal tube placement.VIEW: Chest AP (one view) 05/10/15, 0915 Endotracheal tube tip is below thoracic inlet. Right upper extremity PICC has its tip at junction of superior vena cava and right atrium. A gastrostomy tube is present. There is a left thoracolumbar curve.Right upper lobe atele... | Decreased right upper lobe atelectasis after intubation. |
Generate impression based on findings. | Reason: Patient choked last night, having slight difficulty breathing, Assess for soft tissue swelling affecting airway. History: Difficulty breathing. No significant soft tissue swelling. No unexpected radiopaque foreign object identified. There is presumed jewelry involving the nose and breasts.Prevertebral soft tiss... | No soft tissue swelling. There is presumed jewelry involving the nose and breasts. Correlate with exam.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Weaning ventilator. Intubated.VIEW: Chest AP (one view) 05/10/15, 0519 Endotracheal tube tip is above carina. Feeding tube coils upon itself with tip in gastric fundus. Ventriculoperitoneal shunt tubing is noted. Left upper extremity PICC tip cannot be traced further centrally than superior vena cava due to spinal fusi... | Improvement in appearance of chest with decreased left base opacity and less elevation of left hemidiaphragm. |
Generate impression based on findings. | Reason: Patient fell with ago and has continued pain and swelling-assess for fracture. History: Pain and swelling. Three views of the left shoulder demonstrate no acute fracture or dislocation. There are moderate degenerative arthritic changes of the acromioclavicular and mild degenerative changes of the glenohumeral j... | Degenerative arthritic changes without evidence of 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. | Female, 71 years old, history of follicular lymphoma status post 6 cycles of bendamustine rituxan completed in 2014 now with new symptoms in need of restaging. Image quality is degraded by motion artifact. Given this limitation, the following observations are made.A mild resurgence of lymphadenopathy is seen, though by... | Mild interval resurgence of lymphadenopathy. While the severity of disease is much less than that seen in 2012, and while most cervical lymph nodes have increased in size by only several millimeters, lymph nodes at level 4 on the left and in the upper mediastinum do show unequivocal and significant increases in size. |
Generate impression based on findings. | Trauma on Tuesday. Rule out fracture.VIEWS: Right tibia fibula AP/lateral (two views) 05/09/15, 2212, 2213, 2214, 2215 A splint obscures detail. An oblique fracture of the distal fibula is noted. The physis of the distal tibia appears widened. Alignment is anatomic. | Oblique fracture of distal fibula and Salter fracture of distal tibia. |
Generate impression based on findings. | Female 30 years old; Reason: pt with gastric bypass in 2005 presents with severe stabbing abd pain supraumbilical and in LUQ--assess for SBO vs other cause of abd pain History: stabbing abd pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Small periportal edema. Mildly heterogeneous live... | 1. Postsurgical changes related to prior gastric bypass. Small hiatal hernia. No bowel obstruction.2. Cholelithiasis. No secondary signs of acute cholecystitis. |
Generate impression based on findings. | There is a large lytic lesion infiltrating the C3 and C4 vertebral bodies and C3-C4 disc space with epidural extension to the right C3-C4 neural foramen and the ventral epidural space with effacement of the ventral thecal sac but without significant spinal canal stenosis. There is approximately 30% height loss of C3. ... | 1.Lytic lesions throughout the cervical spine most severe at C3-C4 where there is mild ventral epidural extension as well as extension into the right neural foramen but without evidence of spinal canal stenosis.2.Pathologic compression fracture of C3 with 30% height loss.3.Moderate cervical spine and right temporomandi... |
Generate impression based on findings. | Reason: Fracture. History: Lateral malleolus pain and swelling after injury. Mild soft tissue swelling about the ankle. Linear horizontal lucency at fibular tip seen on two views is likely a nondisplaced fracture. No large joint effusion. Plantar and posterior calcaneal spurs are noted. | Linear horizontal lucency at fibular tip seen on two views is likely a nondisplaced fracture.Findings communicated by telephone to the emergency department physician, Dr. Cheema, at 11:45 AM on 5/10/2015. |
Generate impression based on findings. | Reason: Fracture. History: Fifth metatarsal pain. No large joint effusion. No evidence of fracture or malalignment. Obliquely oriented lucency in the calcaneus best seen on the lateral view and likely represents a vascular channel though a fracture cannot be excluded. Dedicated calcaneal view could be obtained. Posteri... | Obliquely oriented lucency in the calcaneus best seen on the lateral view and likely represents a vascular channel though a fracture cannot be excluded. Dedicated calcaneal view could be obtained. 5th metatarsal appears normal. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with th... |
Generate impression based on findings. | Female 62 years old; Reason: r/o evidence of pancreatitis History: refractory hypotension Suboptimal exam secondary to absence of IV contrast and patient motion artifact.ABDOMEN:LUNGS BASES: Incompletely imaged central venous catheter with tip in right atrium. Mild to moderate cardiomegaly. Hypoattenuated appearance of... | 1. Suboptimal exam secondary to absence of IV contrast and patient motion artifact. 2. Moderate to large stool with desiccated appearance in rectum with surrounding wall thickening circumferentially, may be seen in setting of stercoral colitis. 3. Cholelithiasis. Gallbladder mildly distended, measuring 4.1 cm. No peric... |
Generate impression based on findings. | Reason: Pain. History: Pain. Moderate degenerative changes affect the tibiotalar joint and midfoot and appear similar to prior study from 2013. Again seen is a small radiodensity along the plantar aspect of the medial forefoot which likely represents a foreign body and is unchanged. There is a mild hallux valgus deform... | Moderate degenerative changes without evidence of 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. | Trauma. Fracture.VIEWS: Right ankle AP/lateral/oblique (three views) 05/09/15, 2330, 2331, 2332 A joint effusion is present. Mild soft tissue swelling is noted laterally. Oblique fracture of the distal fibular diaphysis is seen. Distal tibial physis is widened and a small metaphyseal fragment is noted posteriorly. | Nondisplaced fractures of distal fibula and tibia. |
Generate impression based on findings. | Reason: Left leg swelling, please evaluate for air. History: Left leg cellulitis. Reticulation of subcutaneous fat is consistent with edema. There are no gas density foci to suggest subcutaneous emphysema. No acute fracture or malalignment is evident. Moderate osteoporosis affects the left knee. | Subcutaneous edema without evidence of subcutaneous air. 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. | Reason: Evaluate right anterior chest for fracture. History: Right anterior rib pain. No evidence of displaced rib fracture. No pneumothorax is evident.Mild cardiomegaly with a right middle lobe opacity which may represent loculated fluid or consolidation. Nonspecific right sided pulmonary opacity for which CT is recom... | No evidence of displaced rib fracture. Nonspecific right sided pulmonary opacity for which CT is recommended. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: Evaluate for acute fracture, dislocation. History: Fall from 11 steps, right shoulder pain. No acute fracture or malalignment evident. | No evidence of 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. | Reason: Fall. History: Swelling. Ring on the fourth digit obscures visualization the mid proximal fourth phalanx. There may be mild soft tissue swelling along the dorsum adjacent to the metacarpal heads. Oblique lucency in the medial aspect of the base of the second metacarpal likely represents a small fracture fragmen... | Extensive degenerative changes with a lucency through the base of the second metacarpal which likely represents an acute fracture. Correlation with point tenderness is recommended.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Ankle fracture. A small joint effusion is present. Soft tissue swelling is identified laterally.A nondisplaced oblique fracture of distal fibular diaphysis is present. The distal tibial physis is widened. A small (0.5 x 0.3 x 0.7 cm) tibial metaphyseal fragment is noted posteriorly and is minimally displaced. The physi... | Nondisplaced oblique fracture of distal fibula. Nondisplaced Salter II fracture of distal tibia. |
Generate impression based on findings. | Reason: Evaluate for fracture, dislocation. History: Hand pain. There may be mild soft tissue swelling about the wrist without evidence of acute fracture or malalignment. | No acute fracture or malalignment evidentI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 48 years old; Reason: neutropenic fever, abdominal pain History: neutropenic fever, bacteremia, abdominal pain ABDOMEN:LUNGS BASES: Incompletely imaged central venous catheter with tip near cavoatrial junction and possible nodularity/scarring in the anteromedial left lung versus volume averaging artifact, image 1 ... | 1. Hepatosplenomegaly. Dilatation of the portosplenic confluence suggestive of underlying portal hypertension.2. Mild mesenteric/preaortic fat stranding, may reflect mild panniculitis. |
Generate impression based on findings. | Reason: Rule out fracture. History: Soft tissue swelling the left cheek, assault, unable to open mouth. Also stubbed toe status post assault. Panorex view of the mandible demonstrates minimally displaced oblique fracture of the left mandibular body. No additional fracture is evident. Three views of the second digit of ... | Minimally displaced fracture of the left mandibular body extending to molar. See follow up CT report for further details.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: Injury. History: Injury. Mild soft tissue swelling about the wrist. There is a cortical step-off along the radial aspect of the base of the fifth metacarpal which may represent a non-displaced fracture. | Cortical step-off along the radial aspect of the base of the fifth metacarpal consistent with a non-displaced fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | [Reason: Evaluate for fracture, subluxation of the right fifth metacarpal. History: Hand pain.] [Nondisplaced fracture of the base of the fifth metacarpal along the radial aspect which extends to the articular surface. The fracture fragment measures up to 1.4 cm on coronal views.] No additional fracture is evident. | [Nondisplaced fracture of the base of the fifth metacarpal as above.]I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: Evaluate for fracture, dislocation. History: Fall, foot pain, back pain, elbow abrasion Three views of the right foot demonstrate no fracture or malalignment.Three views of the right ankle demonstrate no fracture or malalignment.The single view of the lumbar spine demonstrates no fracture or malalignment.Two vi... | Depressed, comminuted fracture of the lateral tibial plateau as well as fractures of the anterior and posterior aspects of the tibial metadiaphysis. If further imaging is clinically warranted, CT may be considered for surgical planning.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree... |
Generate impression based on findings. | Male 40 years old; Reason: Pt with small cell CA and hx of pancreatitis with increased generalized abdominal pain: assess for new mets vs other process History: diffuse abd pain CHEST:LUNGS AND PLEURA: Severe apical predominant paraseptal emphysema. Unchanged left upper lobe perihilar lobulated mass, measuring 3 x 2.6 ... | 1. Again seen diffuse pancreatic parenchymal hypoattenuation with mild pancreatic tail ductal dilatation, suspicious for neoplastic involvement but acute on chronic pancreatitis another differential consideration. Mild peripancreatic fat stranding. Correlation with patient's clinical history and laboratory values recom... |
Generate impression based on findings. | Male 71 years old; Reason: Hx of pancreatic cancer w/ recent ERCP w/ stents placed, pls eval for SBO, ascites, stent stenosis, infection History: midepigastric pain and abdominal distention ABDOMEN:LUNGS BASES: New from prior CT study small right greater than left pleural effusions with underlying atelectasis. Scattere... | 1. New and enlarging hepatic hypoattenuating lesions. 2. Moderate intrahepatic biliary duct dilatation. Small central pneumobilia, but given degree of persistent biliary ductal dilatation, patency of biliary stent questioned and correlation with patient's clinical history recommended.3. Mild interval increase in size o... |
Generate impression based on findings. | Female 82 years old; Reason: eval for appendicitis, acute abd path History: RLQ pain, b/l CVA tenderness, fever, abd guarding ABDOMEN:LUNGS BASES: Left upper lobe 5 mm groundglass nodule, image 4 series 4. Calcified hilar lymph nodes, likely reflecting sequela of prior granulomatous disease.LIVER, BILIARY TRACT: No sig... | 1. Severe bilateral hydronephroureter with marked renal cortical thinning. On left side, ureteral and renal collecting system wall thickening, raising suspicious for superimposed infection or inflammation. Ureteral dilatation gradually tapers to the level of the expected ureterovesicular junctions/surgical clips. Corre... |
Generate impression based on findings. | Female 32 years old; Reason: r/o diverticulitis History: abd pain, h/o diverticulitis ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormalit... | 1. Acute diverticulitis involving splenic flexure/proximalmost descending colon with small focus of extraluminal gas (versus air in additional small diverticulum), coronal image 52, microperforation not entirely excluded. Bowel wall thickening and surrounding paracolic fat stranding present. |
Generate impression based on findings. | Female 41 years old; Reason: obstruction? History: pain, inability to tolerate PO, scant passage of flatus ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Status post cholecystectomy. SPLEEN: Multiple splenules.PANCREAS: 1.1 cm macroscopic fat-containing pancreatic tail focus, suggestive of ... | 1. Left greater than right adnexal cystic foci, measuring up to 3.7 x 2.4 cm on left side, most likely physiologic in etiology but may be further characterized with dedicated pelvic sonography if clinically desired. |
Generate impression based on findings. | Female 68 years old; Reason: s/p lap chole, g-tube, ERCP stone extraction now with drop in hemoglobin History: drop in hemoglobin ABDOMEN:LUNGS BASES: Moderate cardiomegaly. Bibasilar atelectasis and trace pleural effusions. Evaluation of pulmonary parenchyma suboptimal due to extensive respiratory motion artifact. Pun... | 1. Status post gastric bypass. Marked dilatation of the excluded stomach, which also contains percutaneous gastrostomy tube. Large amount of amorphous hyperdensity seen intraluminally with surrounding gaseous foci, appearance consistent with hemorrhagic material. Small adjacent and perihepatic simple appearing free flu... |
Generate impression based on findings. | Male 22 years old; Reason: Lower abdominal pain, increased bloating and flatus. Assess SB for any abnormal pathology/inflammation/wall thickening. History: Lower abdominal pain, increased bloating and flatus ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPL... | 1. Findings suspicious for inflammatory bowel disease. Mild mesenteric including perirectal adenopathy. Approximately 5 cm proximal to the terminal ileum is suggestion of nodular circumferential distal ileal wall thickening, involving loops located in lateral right lower quadrant. Small fecalized material in distalmost... |
Generate impression based on findings. | Male 64 years old; Reason: restaging cholangiocarcinoma History: restaging CHEST:LUNGS AND PLEURA: MEDIASTINUM AND HILA: Stable subcarinal lymph node, measuring 2.2 x 1.1 cm, image 46 series 4, previously measured 2.3 x 1.1 cm. Right hilar lymphadenopathy, including unchanged reference right hilar lymph node, measuring... | 1. Common bile duct stent. Small central pneumobilia. No significant intrahepatic biliary duct dilatation. Stable to mildly increased circumferential soft tissue thickening around common bile duct stent, measures approximately 2.2 cm across, previously measured 1.9 cm and presumably tumor. 2. Unchanged mediastinal and ... |
Generate impression based on findings. | Female 87 years old; Reason: surveillance CT for h/o colon cancer H ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No suspicious liver lesion. Layering cholelithiasis.SPLEEN: Calcified splenic artery aneurysm, measuring up to 1.1 cm, probably without significant change accounting for differ... | 1. Status post cecal/right colonic postsurgical resection with ileotransverse anastomosis, site of anastomosis unremarkable. 2. Essentially stable left adrenal lesion, stable diffuse nodular thickening of the right adrenal gland.3. Stable right renal lesions, including posteriorly located mid pole indeterminant hypoatt... |
Generate impression based on findings. | Male 62 years old; Reason: Hx of rectal cancer s/p chemo and surgery please assess for recurrent disease CHEST:LUNGS AND PLEURA: Anterior subpleural reticulations. Unchanged punctate left upper lobe calcified micronodules, images 31 and 40 series 5.MEDIASTINUM AND HILA: Severe calcified coronary artery disease.CHEST WA... | Status post low anterior resection for rectal malignancy. No evidence of metastatic disease. |
Generate impression based on findings. | Female 71 years old; Reason: Patient with h/o Foll. Lymphoma s/p 6 cycles of Bendamustine Rituxan completed in 2014 now with new symptoms in need of restaging. Please compare to prior. History: Follicular Lymphoma CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules. For example, stable 3 mm right middle lobe lung ... | 1. New moderate right sided hydronephroureter, to level of enlarged right iliac adenopathy. New and enlarging retroperitoneal and bilateral pelvic and inguinal lymphadenopathy.2. Thick walled distal esophagus containing contrast, may reflect esophagitis with underlying gastroesophageal reflux and correlation patient's ... |
Generate impression based on findings. | Female 82 years old; Reason: 82 year old with metastatic breast cancer. Restaging. Brain metastases seen on recent CT head imaging History: AMS CHEST:LUNGS AND PLEURA: Small right and trace left pleural effusions. Bibasilar atelectasis/scarring. Mild apical nodularity/scarring. Nonspecific punctate left lower lobe pulm... | 1. Suboptimal exam secondary to absence of IV and enteric contrast and patient motion artifact.2. Probable hepatic metastatic disease, new.3. Just beneath the mid sigmoid colon and intervening between the bladder and uterus is an air and fluid containing collection, measuring approximately 3 x 2.1 cm. Findings likely r... |
Generate impression based on findings. | Evaluate for RFO, postsurgical evaluation Female, 49 years old. Suboptimal study secondary to patient motion artifact. Enteric tube seen with side-port at gastroesophageal junction. Incompletely imaged nephroureteral stent overlying left iliac wing. Surgical clip placement. No unexpected radiopaque foreign body otherwi... | No unexpected radiopaque foreign body. |
Generate impression based on findings. | Interval advancement of enteric tube Enteric tube seen with sideport now located at junction of gastric fundus/body. Right upper quadrant surgical drain. Multiple skin staples. Presumed gaseous distention of stomach. Mildly dilated small bowel with relative paucity of bowel gas distally, most likely secondary to postop... | Enteric tube seen with sideport now located at junction of gastric fundus/body.Mildly dilated small bowel with relative paucity of bowel gas distally, most likely secondary to postoperative ileus due to patient's recently postsurgical state, however correlation with patient's clinical history and continued follow-up re... |
Generate impression based on findings. | Enteric tube placement Enteric tube seen just beyond gastroesophageal junction and further advancing suggested. Persistent bowel dilatation, similar to prior study, may reflect postoperative ileus but correlation with patient's clinical history and continued follow up recommended. Right upper quadrant drainage catheter... | Enteric tube seen just beyond gastroesophageal junction and further advancing suggested. Persistent bowel dilatation, similar to prior study, may reflect postoperative ileus but correlation with patient's clinical history and continued follow up recommended to exclude developing SBO. |
Generate impression based on findings. | Ileus versus SBO Right upper quadrant and pelvic drainage catheters. Multiple midline skin staples. Dilated small bowel, measuring up to 4.1 cm with relative paucity of bowel gas distally. Although findings may reflect postoperative ileus given patient's recent postsurgical state, developing small bowel obstruction a d... | Dilated small bowel, measuring up to 4.1 cm with relative paucity of bowel gas distally. Although findings may reflect postoperative ileus given patient's recent postsurgical state, developing small bowel obstruction a diagnostic consideration. Correlation with patient's clinical history and physical exam recommended.P... |
Generate impression based on findings. | Abdominal pain, generalized, evaluate for obstructive pattern or free air No free air on upright film. No definitive evidence of bowel obstruction. Relative paucity of small bowel gas. Air seen distally in right colon. Decreased osseous mineralization, multilevel spinal degenerative disease, scoliosis. Vascular and pan... | No definitive evidence of bowel obstruction.Relative paucity of small bowel gas. Air seen distally in right colon. |
Generate impression based on findings. | History of liver transplant status post ERCP with stent placement with abdominal pain Nonobstructive bowel gas pattern. Contrast seen in portions of colon along with moderate stool burden, latter primarily in the ascending colon. CBD stent placement with mild distal migration and more medial angulation seen when compar... | Common bile duct stent with mild distal migration/medial angulation as above. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Abdominal pain, nausea, vomiting, inability to tolerate by mouth, assess for obstructive pattern Right upper quadrant surgical clips compatible with prior cholecystectomy. Nonobstructive bowel gas pattern. No free air. | Unremarkable study.Please refer to concomitant CT imaging from same day for additional findings. |
Generate impression based on findings. | Status post upper GI, evaluate for barium prior to CT imaging Moderate amount of residual barium seen in large bowel, primarily in transverse and descending colon. In addition, ingested enteric contrast in preparation for CT imaging seen in stomach and portions of small bowel. Multiple right abdominal surgical clips an... | Enteric tube and distribution of contrast as above. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Nausea with vomiting Suboptimal study secondary to patient's body habitus. Enteric tube seen with side port in gastric body. Residual contrast seen in portions of colon. Again seen dilated small bowel, measuring up to 4.6 cm, primarily in left hemiabdomen, stable to mildly improved from prior abdominal radiography. Bow... | Again seen dilated small bowel, measuring up to 4.6 cm, primarily in left hemiabdomen, stable to mildly improved from prior abdominal radiography. Bowel gas pattern consistent with partial or incomplete small bowel obstruction.Incompletely imaged left basilar/retrocardiac consolidation. |
Generate impression based on findings. | Assess for ileus/obstruction Enteric tube seen coiled in gastric body. Layering pleural effusions. Left-sided drainage catheters. Centrally located mildly dilated small bowel loops, measuring up to 3.2 cm, with paucity of gas seen distally in small and large bowel, findings suspicious for developing small bowel obstruc... | Findings suspicious for small bowel obstruction. |
Generate impression based on findings. | Abdominal pain Suboptimal exam secondary to patient's body habitus, portions of right and mid abdomen excluded on submitted films. Enteric tube seen with tip in mid to distal gastric body. Left sided central venous catheter with tip near junction of innominate vein and SVC. Mild-to-moderate bowel dilatation seen diffus... | Suboptimal exam secondary to patient's body habitus, portions of right and mid abdomen excluded on submitted films. Mild-to-moderate bowel dilatation seen diffusely, appearance suggestive of ileus but correlation with patient's clinical history and continued follow-up recommended. |
Generate impression based on findings. | Evaluate Dobbhoff tube placement Suboptimal assessment due to multiple overlying leads and artifact. Dobbhoff tube seen in the gastric body. Paucity of bowel gas, with only small amount of bowel gas seen in partially imaged right abdomen. Midline skin staples. Please refer to concomitant chest radiography from same day... | Dobbhoff tube positioning and paucity of bowel gas as above. |
Generate impression based on findings. | 32 years, Male. Reason: gsw History: gsw No unexpected radiopaque foreign object is identified. Nonobstructive bowel gas pattern. The bones are unremarkable. | No unexpected radiopaque foreign object. |
Generate impression based on findings. | 66 years, Male. Reason: 66 y/o M with RUQ tenderness, recent DKA, eval for anatomic etiology History: as above Nonobstructive bowel gas pattern with average stool burden. No evidence of free intraperitoneal air. Lung bases are clear. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 61-year-old female status post trauma No acute fracture is evident. Slight inferior subluxation of the humeral head. Small osteophytes of the glenohumeral joint. Osteophytes at the acromioclavicular joint.Partially visualized central venous catheter in the left brachiocephalic vein and SVC. | Slight inferior subluxation of the humeral head. Degenerative changes without acute fracture. |
Generate impression based on findings. | 70 years, Female. Reason: no ostomy output X 2 days History: no ostomy output Nonobstructive bowel gas pattern without excessive stool burden. No evidence of free air. Degenerative changes of the visualized spine and sacroiliac joints. Again seen is a rounded calcific density in the pelvis likely representing a uterine... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 89-year-old female with fall and right knee abrasion Limited examination. One portable view of the right knee demonstrates severe narrowing of the lateral tibiofemoral compartment with bulky osteophytes and subchondral sclerosis compatible with severe osteoarthritis. Vascular calcifications are noted. No acute fracture... | Degenerative changes without acute fracture or malalignment. |
Generate impression based on findings. | Male, 48 years old. Reason: eval for bowel distension History: distension, pain Mildly dilated loops of small bowel, with air-fluid levels. Air is seen within the colon and rectum. No excessive stool burden.A proximal loop of small bowel has thickened folds.No free air seen on upright imaging.Surgical clips over the ab... | Mild ileus pattern. Thickened proximal small bowel folds of uncertain etiology. |
Generate impression based on findings. | Reason: 51 y/o M w/ h/o FL s/p SCT now with abd wound infection, worsening ascites and pain. please evaluation History: abd pain. ABDOMEN:LUNG BASES: Stable moderate left and increasing small right pleural effusion with overlying compressive atelectasis. Trace pericardial effusion, smaller to prior. Small retrocrural l... | 1.Interval decrease in size of rim-enhancing complex fluid collection with foci of gas with new pigtail catheter in place.2.New enlargement and thrombosis of the main portal vein.3.New cecal, proximal ascending colon, and terminal ileal nonspecific wall thickening, which may represent typhilitis in this clinical settin... |
Generate impression based on findings. | 40-year-old male with boxer's fracture status post reduction Overlying cast material obscures fine bone detail. Again seen is a fracture through the neck of the fifth metacarpal with mild volar angulation of the distal fracture fragment and mild impaction. There is also slight 2 mm radial displacement of the distal fra... | Interval reduction of fifth metacarpal boxer's fracture. |
Generate impression based on findings. | 59 years, Male. Reason: abdominal pain History: distension Nonobstructive bowel gas pattern without evidence of pneumoperitoneum. Interval removal of enteric tube. Small right pleural effusion and multiple pulmonary opacities in the visualized lung bases consistent with history of extensive metastatic disease. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 65 year old male with abdominal pain, elevated lactate. Evaluate for mesenteric ischemia. LUNG BASES: Small bilateral pleural effusions. Mild compressive atelectasis. Trace pericardial effusion.LIVER, BILIARY TRACT: Cirrhotic liver morphology. Prominent varices suggest long-standing portal hypertension. Few calcified h... | 1.Pneumatosis of the cecum and proximal ascending colon with associated pericolonic inflammatory changes suggestive of colitis. Differential includes ischemic etiology, and correlation with trending serum lactate is recommended.2.Questionable nonocclusive thrombus in proximal ileocolic branch of the SMA.3.Cirrhotic liv... |
Generate impression based on findings. | Male, 76 years old. Reason: Initial line placement History: Initial line placement DHT Exam is limited by significant motion artifact.Dobbhoff tube tip overlies the proximal gastric body.The lower pelvis is excluded from the field-of-view. Nonobstructive bowel gas pattern.Surgical changes of mitral valve repair. Cardia... | Dobbhoff tube tip overlies the proximal gastric body. |
Generate impression based on findings. | 40-year-old male with pain and swelling of the right hand after punching a wall 3 views of the right hand show a comminuted fracture through the neck of the fifth metacarpal with volar angulation of the distal fracture fragment and mild impaction. Overlying soft tissue swelling is present. Chronic-appearing deformity t... | Boxer's fracture of the fifth metacarpal. |
Generate impression based on findings. | 58 years, Female. Reason: eval for stool burden History: constipation Enteric tube with tip in the distribution just proximal to the ligament of Treitz. Nonobstructive bowel gas pattern with residual contrast again seen in the colon.Postsurgical staples in the right hemiabdomen. Surgical drain with tip overlying the ri... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male, 73 years old. Reason: cause of distension? History: Concern for c diff, and therefore toxic megacolon as cause of increased ab distension Nonobstructive bowel gas pattern.G-tube overlies the left upper quadrant.Left basilar pulmonary opacities are better seen on same-day chest radiograph.Scoliosis. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 20-year-old male with right wrist pain, known fifth metacarpal fracture 3 views of the wrist again show a subtle lucency through the base of the fifth metacarpal that is less distinct suggestive of interval healing. No acute fracture is evident. Alignment is anatomic. | Healing fracture to the base of the fifth metacarpal. No new fracture is evident. |
Generate impression based on findings. | Reason: intracranial lesion History: s/p fall There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. Atherosclerotic calcifications are present along the distal internal carotid arteries. The imaged paranasal sinuse... | No evidence for acute intracranial hemorrhage, edema or mass effect. Please note that CT is insensitive for the early detection of acute non-hemorrhagic cerebral infarction. |
Generate impression based on findings. | 52-year-old female with generalized back pain status post fall 4 views of the lumbar spine reveal no acute fracture or malalignment. Vacuum disc phenomenon is noted at L3/L4 and L4/L5 as well as mild disc space narrowing at L4/L5 and L5/S1 compatible with mild osteoarthritis. Otherwise alignment is anatomic with preser... | Mild osteoarthritis with no acute fracture or malalignment. |
Generate impression based on findings. | Female, 60 years old. Reason: eval constipation, bowel obstruction History: LLQ abd pain, constipation Vascular coils overlie the upper abdomen. LVAD and ICD leads in place.Mildly prominent loops of small and large bowel. Air seen within the rectum.Average stool burden. | No evidence of obstruction. Average stool burden. |
Generate impression based on findings. | 27-year-old female with gunshot wound to left leg Large soft tissue laceration along the lateral aspect of the thigh at the level of the distal femoral metaphysis likely represents bullet entry site. No acute fracture is evident. Alignment is anatomic. | Soft tissue laceration without evidence of fracture or malalignment. |
Generate impression based on findings. | Right-sided numbness, evaluate for ischemia No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collect... | No evidence of intracranial hemorrhage or mass effect. No CT evidence of large vascular distribution ischemia. |
Generate impression based on findings. | 14-year-old male with mediastinal mass, assess for pleural effusions.VIEW: Chest AP (one view) 5/10/2015 at 13:21 The heart size is normal. There is widening of the mediastinum compatible with upper anterior mediastinal mass as seen on the outside hospital CT. No focal lung opacity, pleural effusion, or pneumothorax is... | Upper anterior mediastinal mass, no pleural effusion. |
Generate impression based on findings. | 40 year old male with a history of thymic cancer. Evaluate for worsening peripheral metastatic disease. CHEST:LUNGS AND PLEURA: Unchanged pulmonary appearance including right side volume loss with an elevated right hemidiaphragm and adjacent compressive atelectasis in the lung base. Paramediastinal fibrotic changes wit... | Interval interval increase in size of the reference anterior mediastinal mass consistent with the patient's known history of thymic carcinoma, with reference measurements provided above. No significant interval change in mediastinal and cervical lymphadenopathy or osseous metastatic disease. |
Generate impression based on findings. | 59-year-old female status post left total hip arthroplasty Lateral view of the femur demonstrates a total hip arthroplasty device with a long femoral stem that is secured with cerclage wires and cement. Overlying staples and soft tissue drains are noted. No acute fracture or malalignment is evident. | Left total hip arthroplasty as described above. |
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