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Generate impression based on findings.
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Reason: Evaluate for evidence of interstitial lung disease versus evidence of lymphangitic cancer History: Persistent cough. Fixed right neck lymph nodes. History of SLE with lung restriction on PFTs LUNGS AND PLEURA: Calcified benign-appearing right lower lobe nodule. Other scattered micronodules measuring less than 4 mm. No suspicious nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy, except for calcified nodes from prior granulomatous disease.Lobulated area of fluid attenuation in the pericardial fat (series 3 image 64) may represent a pericardial cyst. No visible coronary arterial calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy. Hepatic and splenic granulomata.
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1. No evidence of interstitial lung disease or malignancy as clinically questioned.2. Lobulated fluid attenuation structure in the pericardial fat is most consistent with a pericardial cyst and is likely not of clinical significance.
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Generate impression based on findings.
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9-year-old male with increased pain with weight-bearingVIEWS: Left knee AP, oblique, lateral (3 views) 01/16/15 No acute fracture or malalignment is evident. No joint effusion.
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No acute fracture or malalignment is evident.
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Generate impression based on findings.
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7-month-old male status post NG placementVIEW: Chest/abdomen AP (2 view) 01/16/15 Right lower extremity central venous catheter is at the confluence of the iliac veins. ET tube tip is at the carina. Interval removal of NG tube. Placement of NJ tube tip in the third portion of the duodenum and side-port in the second portion of the duodenum.Nonobstructive bowel gas pattern. Interval improvement of left upper lobe collapse. Persistent patchy left upper lobe and left lower lobe opacities may represent atelectasis.
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NJ tube tip is in the third portion of the duodenum with side-port in the second portion of the duodenum.
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Generate impression based on findings.
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65-year-old male with history of shoulder pain. There is mild degenerative disease of the glenohumeral and acromioclavicular joints. There is no evidence of acute fracture or dislocation.
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Mild degenerative arthritic changes of the shoulder as above.
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Generate impression based on findings.
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32-year-old with history of bilateral diffuse breast tenderness for 3 months. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually beginning at the age of 40. Clinical correlation is recommended for the patient's diffuse breast pain. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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24-year-old male with chest pain and shortness of breath. Evaluate for pulmonary embolism. Motion artifact degrades image quality. PULMONARY ARTERIES: Diagnostic quality infusion. Although no pulmonary embolism is seen, the subsegmental vessels in the left lower lobe leading to be area of air space opacity are unopacified (vessels of this caliber are opacified elsewhere). There is an associated small mixed density anterior left lower lobe opacity most consistent with infarct. Pulmonary artery measures 29 mm.LUNGS AND PLEURA: Trace left pleural effusion. In the anterior left lower lobe, lateral costophrenic sulcus area abutting the major fissure, there is a wage-shaped opacity consisting of groundglass and consolidation (series 6, image 212), most consistent with an infarct.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. No signs of right heart strain.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Although no filling defect is identified, the subsegmental vessels in the left lower lobe are unopacified with associated left lower lobe opacity consistent with infarct. Trace left pleural effusion.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Not applicable.Most Proximal: Subsegmental.RV Strain: Negative.
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Generate impression based on findings.
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Head and neck cancer and CRT LUNGS AND PLEURA: Mild apical fibrosis. Stable to slightly improved appearance of left-sided irregular solid nodules. Reference lesion in the left upper lobe near the fissure decreased in size, measuring 18 x 10 mm, previously 20 x 10 mm name. The overall size and density of this lesion is subjectively decreased. No new nodules or pleural fluid.MEDIASTINUM AND HILA: Unchanged cardiomegaly. Thickening in the and enhancement of the distal esophageal segment just above the GE junction with adjacent prominent vessels, suspicious for distal esophageal varices, similar to previous.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Posterior gastric diverticulum (3/78). Mildly prominent gastrohepatic region lymph node (3/80) and enlarged gastrohepatic lymph nodes measuring up to 21-mm (3/88), not significantly changed. Hepatic morphology consistent with cirrhosis.
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Left pulmonary nodules stable to slightly improved. No new lesions. Cirrhosis with distal esophageal varices and unchanged chronic upper abdominal lymph node enlargement.
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Generate impression based on findings.
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73 year old female with history of multiple myeloma. The bones are demineralized.SKULL: No evidence of lytic lesions. Multiple dental fillings and hardware are present.CERVICAL SPINE: Moderate multilevel degenerative disease affects the cervical spine. No evidence of lytic lesions.THORACIC SPINE: Moderate multilevel degenerative disease affects the thoracic spine. No evidence of lytic lesions.LUMBAR SPINE: There is severe degenerative disk disease throughout the lumbar spine resulting in moderate dextroscoliosis. No evidence of lytic lesions.RIBS: Stable calcified granuloma in the left lower lobe. PELVIS: No evidence of lytic lesions. Moderate osteoarthritis affects the hips bilaterally. Mild osteoarthritis affects the SI joints.UPPER EXTREMITY: Hardware components of bilateral reverse total shoulder arthroplasties in anatomic alignment without radiographic evidence of hardware complication. No evidence of lytic lesions.LOWER EXTREMITY: Hardware components of bilateral total knee arthroplasties are situated in near anatomic alignment without radiographic evidence of hardware complication. There is heterotopic bone posterior to the both knees.
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Degenerative changes as above. There is no radiographic evidence of lytic bone lesions.
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Generate impression based on findings.
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Reason: evaluate RLL History: new opacity LUNGS AND PLEURA: Postoperative changes of right upper lobectomy. Stable scarring/atelectasis without interval change compared with prior studies and no specific finding to correlate with question findings on recent radiograph. Interval resolution of ground glass opacity in the right lower lobe seen on prior CT.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Mild coronary arterial calcifications.CHEST WALL: Postoperative changes of right thoracotomy and median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Biliary stent partially imaged with mild pneumobilia and vicarious contrast excretion through the gallbladder.
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Postoperative changes of right upper lobectomy without acute abnormality or significant interval change.
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Generate impression based on findings.
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76 year old female with abdominal pain, nausea, and vomiting. Evaluate for obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver again noted. Unchanged subcentimeter segment 8 hypoattenuating focus which is too small to characterize but statistically likely a cyst. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right upper pole hypoattenuating focus compatible with a cyst. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications affect the abdominal aorta and its branches.BOWEL, MESENTERY: No findings to suggest bowel obstruction. No evidence of colitis.BONES, SOFT TISSUES: Severe degenerative changes affect the lumbar spine with a severe compression deformity of L1 vertebral body, unchanged.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Sigmoid diverticulosis without evidence of diverticulitis or colitis. No findings to suggest small bowel obstruction.BONES, SOFT TISSUES: Severe degenerative changes affect the lumbar spine with a severe compression deformity of L1 vertebral body, unchanged.OTHER: No significant abnormality noted
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1.No evidence of small bowel obstruction. 2.No acute findings to account for patient's pain.3.Diffuse fatty liver.
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Generate impression based on findings.
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Male 52 years old; Reason: Assess for metastatic prostate cancer History: PSA 125; new left leg/hip pain There is a punctate focus of moderate activity in the right superior scapula which is nonspecific. There are several faint punctate foci in the right ribs, approximately the 5th and 9th, which are also nonspecific. No CT correlation was seen for the ribs; the scapular focus is not included in the abdominal CT field-of-view.Right sternoclavicular focus likely related to degenerative joint disease.There are no additional abnormal foci seen, specifically no abnormal focus is seen in the left hip or lower extremity.
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While there is no definite evidence of osseous metastatic disease, several punctate foci involving the right scapula and right ribs are visualized. These are considered more likely to be benign, however metastatic disease cannot be entirely excluded.
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Generate impression based on findings.
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Reason: evaluate for colovaginal fistula History: reported vaginal bleeding, liver purulence Scout radiograph showed a nonobstructive bowel gas pattern. Prompt contrast opacification of the rectosigmoid colon without evidence of a fistula, no abnormal contrast extravasation seen to suggest a leak. TOTAL FLUOROSCOPY TIME: 1:40 minutes
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No evidence of fistula or leak. If there is continued clinical concern, direct visualization/colonoscopy may be performed.
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Generate impression based on findings.
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Male 20 years old Reason: 20 y/o M with h/o Hodgkin's lymphoma, now w/ wt loss and LAD History: weight loss, dyspnea, LAD CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Right hilar lymph node measures 1.1 x 1.1 cm (image 42, series 4) enlarged by size criteria, but unchanged from the prior examination. The heart size is normal as is the caliber the great vessels. There is no evidence of pleural or pericardial effusion. The trachea and mainstem bronchi are patent. CHEST WALL: There is no evidence of axillary, subpectoral, cardiophrenic or retrocrural lymphadenopathy on the basis of size criteria.ABDOMEN:LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: There is no evidence of retroperitoneal lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: Subcentimeter slightly prominent pericecal lymph nodes are not pathologically large by size criteria and unchanged from the prior examination.BONES, SOFT TISSUES: Lucent appearance of the anterior aspect of the right acetabulum is artifactual, confirmed by prior biopsy.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: New enlarged left inguinal and left pelvic lymph nodes. Reference left inguinal node measures 1.4 x 2.1 cm (image two of 4, series 4). Reference left external iliac chain node measures 1.2 x 2.3 cm (image 18, series 4).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Lucent appearance of the anterior aspect of the right acetabulum is artifactual, confirmed by prior biopsy.OTHER: No significant abnormality noted
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New pelvic and inguinal lymphadenopathy worrisome for disease recurrence.
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Generate impression based on findings.
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58 years, Female. Reason: Check for stool burden History: abdominal pain, bloating Moderate to large stool burden. Nonobstructive bowel gas pattern. Calcified cholelithiasis noted.
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Moderate to large stool burden, nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Preop evaluation for lung nodule resection. History of mixed germ cell tumor metastatic to lung status post chemotherapy and orchiectomy. CHEST:LUNGS AND PLEURA: New nodule at the right lung apex (5/12).Right upper lobe nodule abutting the fissure (5/46), and a 12mm right upper lobe nodule tenting the cranial aspect of the major fissure (5/31) are not appreciably changed compared to most recent previous study but improved from an earlier study of 4/24/14.New sub-solid nodule right lower lobe (5/52).MEDIASTINUM AND HILA: Right hilar lymph node measures 14-mm, unchanged. No pericardial fluid. Normal heart size.CHEST WALL: Permeative appearance of the manubrium and sternum, present previously. Nonspecific focal lucency in the T6 vertebral body. Lucent lesion T12 vertebral body.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal dissection clips. Well-circumscribed bilateral retroperitoneal cystic lesions arising at the level of the left renal vein. The left periaortic lesion measures 4.9 x 5.3 cm in transaxial dimensions and 5.7-cm in craniocaudal length (3/122, coronal image 57). Aortocaval lesion measures 3.5 x 2 x 6 cm (3/122, coronal image 52). The right-sided lesion causes slight mass effect upon the IVC. Subcentimeter soft tissue nodules noted the inferior to the fluid-attenuation lesion between the aorta and the left psoas (3/131, 3/135), unchanged.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.The transverse duodenum is compressed by the retroperitoneal lesions and there is no evidence of bowel obstruction.BONES, SOFT TISSUES: Right L4 transverse process lucencies.OTHER: No significant abnormality noted.
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Pulmonary metastases increased in number. Permeative/lytic skeletal lesions nonspecific and may represent metastases.Bilateral well circumscribed unilocular fluid density collections in the retroperitoneum near dissection clips most likely represent lymphoceles and are slightly decreased in size; the possibility of cystic liquefaction is considered unlikely and these may be followed. Small left para-aortic lymph nodes are unchanged.
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Generate impression based on findings.
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Spine: There is normal kyphotic thoracic curvature. Again seen is a chronic compression fracture of T8 with approximately 50 % height loss which is unchanged dating back to 9/9/2009. No underlying lytic lesion or suspicious lesion. The remaining vertebrae of the thoracic spine demonstrate normal height. There is no spinal canal stenosis or neuroforaminal narrowing at any level of the thoracic spine. The visualized paraspinal contents are unremarkable. Severe apical predominant emphysema is noted. Enlarged main pulmonary artery up to 3.7 centimeters indicating pulmonary artery hypertension. Right hilar lymphadenopathy is visualized with reference measurement of 4.7 cm (series 4, image 47). Additional mildly enlarged mediastinal lymph nodes are noted. Post-surgical changes are noted about the stomach.
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1.Chronic T8 compression fracture unchanged from 9/9/2009 without underlying lytic component to suggest a pathologic fracture. 2.No other thoracic spine fractures or suspicious lesions.3.Apical predominant severe emphysema 4.Pulmonary artery hypertension.5.Nonspecific right hilar lymphadenopathy.
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Generate impression based on findings.
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53 years, Female. Reason: 53 y/o female with abdominal bloating and emesis for 3days, h/o of hypertriglyceridemia, evaluate for sbo Moderate to large stool burden. Gastric air fluid level noted in the upright film. Nonobstructive bowel gas pattern. No evidence of free air. Possible calcified cholelithiasis in the right upper quadrant.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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30 year old female with history of midfoot fracture concerning for Lisfranc injury. There is no evidence of acute fracture or dislocation. The Lisfranc joint is unremarkable. Alignment is anatomic. The soft tissues are within normal limits.
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No evidence of Lisfranc injury as clinically queried.
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Generate impression based on findings.
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65-year-old male with shock and lactic acidosis. Evaluate for mesenteric ischemia or infection. Evaluation for mesenteric ischemia is limited given lack of contrast enhancement.CHEST:LUNGS AND PLEURA: Moderate left and small right pleural effusion with overlying atelectasis/consolidation. Bilateral nonspecific groundglass opacities may be secondary to edema; although, infection cannot be completely excluded.MEDIASTINUM AND HILA: Nonspecific mildly prominent mediastinal lymph nodes. Severe cardiomegaly without pericardial effusion. Severe coronary artery atherosclerotic calcifications. Endotracheal tube with tip immediately above the carina.CHEST WALL: Mildly enlarged nonspecific bilateral axillary lymph nodes.ABDOMEN: Evaluation for mesenteric ischemia is limited given lack of contrast enhancement.LIVER, BILIARY TRACT: Multiple nonspecific hypoattenuating lesions scattered throughout the liver, some of which are compatible with simple cysts. Mild perihepatic ascites. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications affect the abdominal aorta and its branches, which may indicate stenosis of the vasculature.BOWEL, MESENTERY: Enteric tube with tip in the gastric fundus. Left colon and sigmoid are collapsed and possibly thickened. No portal venous gas or pneumatosis intestinalis. Mild pericecal ascites is nonspecific.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder is collapsed.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Left colon and sigmoid are collapsed and possibly thickened. No portal venous gas or pneumatosis intestinalis. Mild pericecal ascites is nonspecific. No evidence of small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Left colon and sigmoid are collapsed and possibly thickened. Given lack of contrast enhancement, evaluation for mesenteric ischemia is limited and the findings are nonspecific; however, given severe atherosclerotic disease of the aorta and visceral vessels, ischemia cannot be excluded. No pneumatosis intestinalis or portal venous gas.2.Cardiomegaly with bilateral pleural effusions suggestive of CHF.3.Bilateral groundglass opacities are likely edema in the setting of CHF. However, underlying infectious etiology is a diagnostic consideration.4.Bilateral basilar compressive atelectasis/consolidation.5.Mild perihepatic and pericecal ascites.Findings relayed to Stefanie Plummer, APN, over the phone at approximately 4:10 p.m.
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Generate impression based on findings.
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Male 66 years old; Reason: metastatic Prostate cancer, evaluation of disease during investigational treatment. please complete PCWG2 form History: metastatic Prostate cancer. Multiple foci of osseous metastatic disease are seen and appear similar to prior study, including the right mandible, bilateral ribs, thoracic spine, right femur intertrochanteric region and left mid humerus. Left mid humerus fracture appears stable. There there is evidence of post orthopedic surgery involving the bilateral femurs with stable postsurgical changes.There are no new suspicious osseous lesions.
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Stable multifocal osseous metastases.
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Generate impression based on findings.
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Labs and clinical history are suspicious for pheochromocytoma. Negative CT and MIBG. Recent lumbar surgery with infection on antibiotics.RADIOPHARMACEUTICAL: 14.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 100 mg/dL. Today's CT portion of the head, neck and chest grossly demonstrates scattered atherosclerotic including coronary arterial calcifications. There are trace bilateral pleural effusions. Please see diagnostic CT reports for details of the abdomen and pelvis.Today's PET examination demonstrates no suspicious FDG avid lesion to indicate pheochromocytoma or other neoplasm.Curvilinear activity extending from the subcutaneous tissues in the right posterior lumbar region are consistent with postoperative inflammation.
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1.No abnormal FDG avid lesion to indicate pheochromocytoma.Diagnostic CTs of the abdomen and pelvis also performed at today's visit will be reported separately.
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Generate impression based on findings.
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Movement disorder. Evaluate for Parkinson's disease versus essential tremor. There is markedly decreased activity involving the bilateral putamina. There is also some decreased activity involving the bilateral caudate nuclei.
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Findings consistent with significant bilateral nigrostriatal dopaminergic dysfunction. Given the history, these findings are suggestive of Parkinson's disease.
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Generate impression based on findings.
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The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. Marked calcification of the cerebellum and scattered subcortical calcifications which are unchanged compared to the exam dating back to 2006 and may represent an abnormality of calcium phosphorous balance or some other metabolic process.
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No evidence of acute intracranial hemorrhage or other acute intracranial abnormalities.Marked calcification of the cerebellum and scattered subcortical calcifications which are unchanged compared to the exam dating back to 2006 and may represent an abnormality of calcium phosphorous balance or some other metabolic process.
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Generate impression based on findings.
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Male 55 years old; Reason: prostate cancer Significantly increased activity in the right hip which when compared to CT correlated to a chronic, likely congenital, hip deformity with associated degenerative changes and right-left leg length discrepancy, with the right lower extremity shorter than the left. Increased activity in the left knee consistent with resulting degenerative disease. Increased activity in the bilateral elbows also likely related to arthropathy. Mild activity of the lower lumbar spine likely related to mild degenerative changes. No suspicious osseous lesion to indicate bone metastasis.
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No evidence of bone metastases.
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Generate impression based on findings.
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18 year-old female with right finger injuryVIEWS: Left fourth digit PA, oblique, lateral (3 views) 01/16/15 No acute fracture or malalignment.
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No acute fracture or malalignment.
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Generate impression based on findings.
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Sphenoid mass. There is a rather well-defined sclerotic focus in the planum sphenoidale that measures up to 10 mm, adjacent to the attachment of the sphenoid septum. There is partial opacification of the left maxillary sinus with what appears to be fluid. The other paranasal sinuses are clear. The nasal cavity is also clear. There is minimal nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable.
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1. A sclerotic focus in the planum sphenoidale that measures up to 10 mm likely represents an enostosis. 2. Findings suggestive of acute left maxillary sinusitis.
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Generate impression based on findings.
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0-day-old male for evaluation pneumoperitoneumVIEW: Abdomen AP (one view) 01/16/15 The UVC catheter has been retracted with tip in the right atrium. UAC catheter position unchanged. Interval resolution of previously visualized pneumoperitoneum. Interval improvement of right middle lobe opacity. Disorganized non-obstructive bowel gas pattern. No evidence of portal venous gas or pneumatosis intestinalis.
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Interval resolution of previously identified focus of intraperitoneal gas.
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Generate impression based on findings.
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Ms. Sandoval is a 35 year old female presenting for a short term follow-up of a right breast mass. She currently denies any right nipple discharge. 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. Focal asymmetry in the right outer breast is stable when compared to the prior exam. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. RIGHT BREAST ULTRASOUND
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Stable benign morphology mass in the right lateral breast. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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Reported passage of renal stone in October, assess for remaining calculus Large stool burden. No bowel obstruction. No radiodense focus seen to suggest intrarenal nephrolithiasis. Degenerative spine disease.
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No radiopaque calculus seen.Large stool burden, correlate clinically for constipation.
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Generate impression based on findings.
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Ms. Harris is a 43 year old female with a history of bilateral mastopexy in 01/2014. She returns for a short-term follow-up of findings seen on recent right breast ultrasound. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Post-surgical changes from prior mastopexy are again noted. There continues to be a partially lucent circumscribed lesion in the right upper outer breast. Previously identified area of distortion in the right upper inner breast is less prominent than on prior exam. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the right breast. RIGHT BREAST ULTRASOUND
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Probably benign oil cyst and fat necrosis in the right breast, compatible with provided history of recent mastopexy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).
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Generate impression based on findings.
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Female 8 months old with concern for aspiration.VIEW: Chest AP (one view) 1/16/2015 Tracheostomy with cannula in place. Gastrostomy tube position unchanged. PDA clip position unchanged. Streaky right basilar opacities suggests subsegmental atelectasis. The cardiothymic silhouette is normal.
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Streaky right basilar opacity suggestive of subsegmental atelectasis.
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Generate impression based on findings.
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75-year-old male with history of hernia repair in 2005. Reports pulling stitch out of one to like this with bloody drainage. ABDOMEN:LUNG BASES: Minimal left pleural effusion and associated atelectasis. Severe coronary artery calcifications.LIVER, BILIARY TRACT: Cholelithiasis without findings of cholecystitis.SPLEEN: Splenic artery calcifications.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypoattenuating left renal foci, nonspecific and incompletely evaluated on this exam but may represent benign cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis is again seen, without evidence of diverticulitis. Appendix within normal limits.BONES, SOFT TISSUES: Degenerative changes of the visualized spine, with loss of vertebral body height at the T12 level, similar to prior. No foreign bodies seen in the area of the umbilicus.OTHER: No significant abnormality notedPELVIS:Limited evaluation of the pelvis due to bilateral hip prosthetics.PROSTATE, SEMINAL VESICLES: Not clearly visualized on this exam due to artifact.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Small bilateral fat-containing inguinal hernias.OTHER: No significant abnormality noted
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No evidence of recurrent hernia. Diverticulosis, and other findings as above.
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Generate impression based on findings.
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60-year-old female with history of left shoulder pain. There is a downward sloping acromion. Moderate degenerative arthritic changes affect the glenohumeral and AC joints.
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Moderate degenerative disease as above.
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Generate impression based on findings.
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35-year-old female status post falling through stairs. There is no acute fracture or dislocation. Alignment is anatomic. Moderate degenerative disease affects the knee.
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Moderate osteoarthritis without acute fracture.
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Generate impression based on findings.
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52-year-old male with history of pain. Right foot: There is a marked hallux valgus deformity. There are hammertoe deformities of the second through fifth toes.Left foot: There is a marked hallux valgus deformity. Moderate degenerative disease affects the first MTP joint. There are hammertoe deformities of the second through fifth toes.Left ankle: There is a subtle irregular lucency through the lateral malleolus although no discrete fracture is identified. There is moderate soft tissue swelling about the ankle. Small tibiotalar joint effusion.Right ankle: There is no acute fracture or dislocation. Alignment is anatomic. The soft tissues are unremarkable.
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1. Left ankle swelling with subtle irregular lucency through the left lateral malleolus without evidence of discrete fracture. Follow up radiographs in 10 to 14 days are recommended.2. Degenerative changes and other findings as above.
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Generate impression based on findings.
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50-year-old male with history of hip pain. There is severe joint space narrowing especially superiorly with bone on bone apposition compatible with severe osteoarthritis. Moderate to severe osteoarthritis affects the right hip as seen on the frontal view. Moderate degenerative disc disease affects the visualized lower lumbar spine.
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Severe degenerative arthritic changes as above.
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Generate impression based on findings.
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84-year-old female with history swelling and pain. There is moderate soft tissue swelling about the ankle. There is no evidence of acute fracture or dislocation. There is a small tibiotalar joint effusion. There is nonspecific mild opacification of the Kager's fat pad however the Achilles' tendon appears intact.
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Soft tissue swelling and tibiotalar joint effusion without evidence of acute fracture.
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Generate impression based on findings.
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Esophageal cancer at the GE junction. Initial staging exam. New baseline for clinical trial.RADIOPHARMACEUTICAL: 14.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 81 mg/dL. Today's CT portion grossly demonstrates distal esophageal thickening. Enlarged left paratracheal and gastrohepatic lymph nodes are noted. Scattered atherosclerotic including coronary arterial calcifications are present.Today's PET examination demonstrates a medium sized markedly hypermetabolic distal esophageal lesion (SUV max = 15.8), compatible with the patient's diagnosis of esophageal cancer.A punctate adjacent distal paraesophageal hypermetabolic lymph node (SUV max = 5.6) indicates metastatic disease.Larger left paratracheal hypermetabolic lymph nodes (SUV max = 14.0) indicate additional metastatic disease.Enlarged markedly hypermetabolic gastrohepatic ligament lymph node (SUV max = 12.8) indicates additional metastatic disease.The appearance today is similar to the recent comparison FDG-PET. No new suspicious FDG avid lesion is identified.
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1.Markedly hypermetabolic distal esophageal mass, compatible with the patient's diagnosis of esophageal cancer.2.Several hypermetabolic nodal metastases in the left paratracheal, distal paraesophageal, and gastrohepatic regions.
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Generate impression based on findings.
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Pain, rheumatoid arthritis Left elbow: No radiographic abnormalityRight elbow: Small minimal degenerative changes with small osteophyte, however no superimposed additional acute abnormality, specifically no effusion. A small poorly visualized suspected benign-appearing cyst is observed in the coronoid of the olecranon
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Minimal degenerative changes without definitive radiographic findings of rheumatoid arthritis
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Generate impression based on findings.
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Female 21 months old Reason: requiring high ventilator settings History: requiring high vent settingsVIEW: Chest AP (one view) 1/16/15 at 1639 hrs ET tube tip is below the thoracic inlet. Central lines terminates at the RA/SVC junction. Feeding tube is coiled towards itself at the stomach antrum. Cardiac silhouette size is normal. Bibasilar opacities likely atelectasis or pneumonia.
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Interval worsening in lung aeration as described. Interval placement of feeding tube.
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Generate impression based on findings.
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Pain and swelling. Wrist: Mild diffuse swelling with diffuse marked demineralization limiting sensitivity. Mild radiocarpal degenerative changes without a discrete superimposed acute additional process however the scapholunate space is not well visualized. Consider follow-up imaging if there is concern for potential ligamentous injury and possible SLAC abnormality. Specifically no discrete abnormality to suggest a fracture given patient's history of falling one week agoKnee: Mild degenerative changes with narrowing, sclerosis and osteophytes more pronounced the medial compartments bilaterally. No discrete effusion or superimposed acute abnormality. Alignment preserved
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Mild scattered degenerative changes with incomplete poor visualization of the scapholunate articulation. Consider follow-up imaging if there is concern for focal abnormality however no evidence of a fracture observed within the limitations of this exam
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Generate impression based on findings.
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54 year old female history of pain. Right shoulder: Mild osteoarthritis affects the glenohumeral joint. There is amorphous density within the inferior aspect of the glenohumeral joint which is nonspecific.Left hip: Mild to moderate osteoarthritis affects the hip. The soft tissues are unremarkable.Right hip: Mild to moderate osteoarthritis affects the hip. The soft tissues are unremarkable.Cervical spine: There is moderate degenerative disc disease most pronounced at C5-6 with associated mild neuroforaminal narrowing at this level bilaterally. Vertebral body heights are maintained. The prevertebral soft tissues are within normal limits. There is loss of the normal cervical lordosis which may be secondary to positioning or muscle spasm.
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Degenerative changes as above.
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Generate impression based on findings.
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Right shoulder reverse arthroplasty with erosion, please compare with last side for glenoid eversion. Right shoulder: Associated artifact diminishes sensitivity related to the reverse total shoulder arthroplasty. Specifically no gross humeral component abnormality other than a focal cortical loss along the medial proximal diaphysis, possibly postsurgical. The glenoid component proximally however demonstrates small lucencies surrounding anchoring screws, specifically the more inferior and posterior fixation. The central post also demonstrates a diffuse lucency largely underlying the inferior aspect and similar to the plain film evaluation of 12/30/14. Overall angulation of the glenoid however appears similar when compared to prior plain films. No abnormal angulation appreciated3-D rendering is also provided for surgical planningLeft shoulder: Moderate degenerative changes of extensive chondrocalcinosis. Relative preservation of fat humeral head shape and position with mild degenerative disease. Alignment maintained. Surrounding soft tissues are unremarkable
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Left total reverse shoulder arthroplasty with questionable partial loosening of the glenoid component, described above. Mild degenerative changes of the left shoulder
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Generate impression based on findings.
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68-year-old male with history of bilateral leg pain. Pelvis: Surgical clips project over the pelvis. There is a penile implant. There are scattered arterial opacifications. No acute fracture. Enthesopathic changes are present at bilateral anterior superior iliac spines. Mild osteoarthritis affects the hips.Lumber spine: There is moderate multilevel degenerative disc disease most notably at L3-4. There is a subtle anterior wedging of L2, which is likely chronic. There is moderate facet hypertrophy throughout the lumbar spine. There is grade 1 anterolisthesis of L3 on L4. There are atherosclerotic calcifications of the visualized abdominal aorta and its branches.
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Degenerative changes as above without acute fracture or subluxation. If patient care warrants further imaging, an MRI of the lumbar spine may be obtained.
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Generate impression based on findings.
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21-year-old female with history of swelling. There is a plate and screw device situated in the distal tibial diaphysis without evidence of hardware complication. There is nonspecific swelling and soft tissue density immediately anterior to the orthopedic device. There are no acute fractures.
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Swelling and soft tissue density anterior to the orthopedic device is nonspecific but may represent a small hematoma or fluid collection.
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Generate impression based on findings.
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Female 54 years old Reason: Patient with SMA and celiac artery occlusion on MRI. Vague symptoms that may be suggestive of ischemia. Please eval for flow. Thanks History: Intermittent nausea, change of diet, unintentional v intentional weight loss. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Findings compatible with chronic liver disease. No focal liver lesions.SPLEEN: Mild splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Again noted occlusion of the celiac trunk at its origin. SMA is patent. There are several arterial collaterals in the peripancreatic region. Aneurysmal dilatation of the gastroduodenal artery is noted measuring up to 9 mm on image number 79, series number 8. Bilateral renal arteries are patent. However there is mild wall thickening involving the origin of the right renal arteries causing less than 50% stenosis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Chronic liver disease and splenomegaly. Chronic occlusion of the celiac trunk. Extensive peripancreatic arterial collaterals with aneurysmal dilatation of gastroduodenal artery.Mild wall thickening of the renal arteries and IMA. These findings cam be compatible with vasculitis such as fibromuscular dysplasia.Contrast extravasation as described above treated by Dr. Sanchez.
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Generate impression based on findings.
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Female 50 years old Reason: eval for stone History: pateint with recurrent UTI's, proteus, triple phosphate crystals on u/a ABDOMEN:LUNG BASES: Bilateral trace pleural effusions and dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrolithiasis. Punctate stones in the upper and lower pole of the right kidney. No evidence of hydronephrosis. No stones within the left kidney. No stones in the ureters or bladder.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:Artifacts from the bilateral hip prosthesis limits optimal evaluation of the pelvis.UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Right nephrolithiasis.
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Generate impression based on findings.
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Female 19 years old Reason: bilateral back pain with eleveted WBC evaluate cause History: back pain with nausea ABDOMEN:LUNG BASES: Trace pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Unremarkable study.
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Generate impression based on findings.
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Female 28 years old Reason: evaluation for possible IR drainage of TOA History: pelvic pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 6.7 x 3.6 cm left adnexal cystic lesion is seen on image number 107, series number 3. Characterization of this lesion with this noncontrast CT study is limited. Given the past history of tubo-ovarian abscess, an abscess cannot be excluded. Further evaluation with transvaginal ultrasound is recommended.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Left adnexal indeterminate cystic lesion. Given the past history of tubo-ovarian abscess, an abscess cannot be excluded..
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Generate impression based on findings.
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Female 59 years old Reason: concern for appendicitis, new epigastric pain with migration to RLQ History: above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Specifically, appendix is unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Unremarkable study.
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Generate impression based on findings.
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Female 59 years old Reason: rule out hydronephrosis--. NO CONTRAST History: elevated creatinine after surgery, low urine output This study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Bilateral small pleural effusions and dependent atelectasis. Moderate-sized title hernia and distended esophagus.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Small amount of free retroperitoneal air close to duodenum and retroperitoneal clips are present, likely postsurgical.BOWEL, MESENTERY: Small amount of free air and ascites in the peritoneum and mesentery. This is likely postsurgical, although, a perforation cannot be excluded.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Interval resection of patient's known uterine and left adnexal mass. Small amount of free air and fluid in the pelvis. Loculated left pelvic collection measuring 3.9 x 2.5 cm image number 134, series number 4, likely represents a small lymphocele.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Limited study due to lack of intravenous and oral contrast. No evidence of hydronephrosis. Postsurgical changes in the abdomen and pelvis. Distention of the stomach and esophagus.
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Generate impression based on findings.
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Female 29 years old Reason: severe left sided abdominal and chest pain, recent D\T\C for pregnancy termination and repeat D\T\C for retained POCs History: abdominal and chest pain CHEST:LUNGS AND PLEURA: Bilateral trace pleural effusions and dependent atelectasis.MEDIASTINUM AND HILA: Enlarged thyroid gland.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enlarged uterus with small amount of endometrial fluid compatible with postpartum status. Small left adnexal cyst.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No CT findings to explain patient's chest and abdominal pain.
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Generate impression based on findings.
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Female 46 years old Reason: appy History: periumbilical pain, nausea, fever ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Specifically appendix is unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted. Possible nabothian cyst in the left side of the cervix.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No CT findings to explain patient's abdominal pain.
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Generate impression based on findings.
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Male 55 years old Reason: s/p L. heminephrectomy recently. Now with abd pain. GFR 30 History: see above The study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Cardiomegaly. Left-sided trace pleural effusion. Mild right pleural thickening.LIVER, BILIARY TRACT: There is small amount of perihepatic ascites.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left partial nephrectomy. There is a ill-defined high density fluid inferior to the left kidney likely representing a hematoma. This measures 7 x 4 cm on image number 100, series number 3. In addition there is also a hematoma abutting the left psoas muscle medial to the left kidney on image number 67, series number 3 measuring 7.5 x 3 cm. Small amount of air in the left perinephric space is postsurgical.In the level of the left pelvis another hematoma measures 6.6 x 5.9 cm on image number 122, series number 3. Lack of intravenous contrast severely limits optimal evaluation of the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Limited study due to lack of intravenous contrast. Post surgical changes and extensive peri-nephric hematoma around the left kidney.Small amount of ascites.Lack of intravenous contrast limits optimal evaluation of the kidney and retroperitoneum for residual disease.
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Generate impression based on findings.
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Female 72 years old Reason: rule out hydronephrosis History: no urine output ABDOMEN:LUNG BASES: Bilateral large pleural effusions, slightly increased compared to previous study. Trace pericardial effusion. Bilateral dependent atelectasis.LIVER, BILIARY TRACT: Mild splenomegaly.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral diffuse thickened adrenal glands, unchanged.KIDNEYS, URETERS: Persistent moderate right-sided hydronephrosis with dilated right ureter. There is still residual intravenous contrast from previous CT throughout the right renal collecting system and right ureter. The left kidney is unremarkable. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Enlarged uterus with dilated endometrial cavity and a calcified fibroid.BLADDER: Bladder is collapsed with a Foley catheter. There is diffuse wall thickening of the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Generalized anasarca.OTHER: No significant abnormality noted
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Limited study due to lack of intravenous contrast. Bilateral large pleural effusions, moderate ascites and generalized anasarca and trace pericardial effusion.Moderate right-sided hydronephrosis and hydroureter persists.Enlarged uterus with dilated endometrial cavity compatible with patient's known history of gynecological malignancy.
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Generate impression based on findings.
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Male 57 years old Reason: perineal abscess History: perineal abscess ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left lower quadrant ostomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes in the pelvis. Interval placement of a percutaneous drainage catheter into the presacral fluid collection. Interval decrease in the size of the presacral fluid collection. Small amount of residual collection persists measuring 1.4 x 2.7cm. There is fat stranding around the coccyx. Osteomyelitis cannot be excluded. Subcutaneous abscess containing fecal material measuring 2.8 x 1.4 cm which fistulized to the skin. The wall of the pouch is diffusely thickened.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval decrease in the size of the presacral fluid collection. Small amount of collection persists. Inflammation surrounds the coccyx. Osteomyelitis cannot be excluded. There is a small subcutaneous abscess containing air and possible fecaloid material fistulizing into the skin.
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Generate impression based on findings.
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Male 62 years old Reason: hematemesis and weight loss, melena History: abd pain, vomiting ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Mild hepatomegaly.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small paraumbilical fat containing hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Fluid collection within the left gluteals muscle measuring 4.7 x 2.8 cm in image number 120, series number 3 adjacent to the left hip joint. This can be better characterized with an MRI of the left hip.OTHER: No significant abnormality noted
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Mild splenomegaly and diffuse fatty infiltration of the liver. Left gluteal collection adjacent to the left hip joint. MRI of the left hip may be helpful for further characterization of this collection, if clinically indicated.
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Generate impression based on findings.
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Female 75 years old Reason: Assess for bowel obstruction. History: Abd pain Again noted mild to moderately dilated bowel loops throughout the abdomen and pelvis which may be compatible with partial distal small bowel obstruction. Residual contrast from previous CT.no free air.
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Findings compatible with partial small bowel obstruction.
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Generate impression based on findings.
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Male 33 years old Reason: Crohns colitis with abd pain and diarrha, please eval for colonic dilation History: abd pain, diarrhea Nonobstructive bowel gas pattern. No free air.
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No free air.
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Generate impression based on findings.
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Female 44 years old Reason: 44 y/o hx of APL hx of perforation concern for perforation History: abdominal pain Nonobstructive bowel gas pattern. No free air.
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No free air.
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Generate impression based on findings.
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Female 53 years old Reason: NJT position History: above The tip of the and J-tube is in the proximal jejunum. Nonobstructive bowel gas 7. Cystogastrostomy tube is again noted with residual contrast in the left upper quadrant.
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No free air.
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Generate impression based on findings.
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Female 53 years old Reason: NJT position History: above The tip of the and J-tube is in the proximal jejunum. Nonobstructive bowel gas 7. Cystogastrostomy tube is again noted with residual contrast in the left upper quadrant.
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No free air.
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Generate impression based on findings.
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38 -year-old female with shortness of breath, tachycardia status post surgery to lower extremity. PULMONARY ARTERIES: Technically adequate examination. No evidence of pulmonary embolism. There is lack of contrast in the posterior segmental right upper lobe suggestive of a filling defect in the segmental right upper lobe pulmonary artery that may represent a pulmonary embolus of in (series 7, image 87).LUNGS AND PLEURA: No pleural effusion. Mild dependent bibasilar atelectasis. Patchy groundglass opacity in the lingula likely represents atelectasis.MEDIASTINUM AND HILA: Enlarged prevascular lymph node measuring 2.6 cm in short axis (series 7, image 58). No significant hilar lymphadenopathy. Heart size is normal. No pericardial effusion. No evidence of right RV strain.CHEST WALL: No significant axillary, retrocrural, or cardiophrenic adenopathy. The osseous structures are within normal limits.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia. Note is made of a small splenule. Enlarged gastrohepatic lymph node measuring 1.5 cm (series 7, image 226).
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1.Filling defect in the segmental right upper lobe pulmonary artery may represent pulmonary embolus of indeterminate chronicity. 2.Enlarged mediastinal lymph nodes as described above.Findings relayed to Dr. Chakour at 1024 on 01/17/15. PULMONARY EMBOLISM: PE: Indeterminate.Chronicity: Indeterminate.Multiplicity: Single.Most Proximal: Segmental.RV Strain: No
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Generate impression based on findings.
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Male 41 years old Reason: evaluate for perianal abscess, fistula - Crohns disease History: rectal pain, crohns disease PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal wall is thickened compatible with active inflammation of Crohn's disease. There are multiple small perirectal lymph nodes.There are two trans-sphincteric fistula arising from 9 o'clock and 6 o'clock of the rectum. These two fistula tracts communicate. There is a small collection immediately lateral to the right external sphincter measuring 2 x 0.7 cm. This collection then communicates to the subcutaneous tissues on the left gluteal region and fistulized this to the skin on the left side.The fistula arising from the 6 o'clock position communicates with this right sided collection but also extends to the posterior midline within the perirectal space where it blindly and is.As third, thin fistulous tract extends from one o'clock position anteriorly towards the scrotum. No evidence of collection anteriorly.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Three complex fistula as described above. The two trans-sphincteric posterior fistula tracts communicate with each other and a right-sided small collection. Active inflammation of the rectum.
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Generate impression based on findings.
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Female 34 years old Reason: 34 y.o. with longstanding h/o esopageal, small bowel, and large bowel crohns admitted with abd pain, diarrhea, and malnutrition. Please eval for active disease. History: abd pain, diarrhea, malnutrition ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild diffuse fatty infiltration of the liver.SPLEEN: Mild splenomegaly. Spleen measures 13 cm.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dilated esophagus. There is mild wall thickening of the distal esophagus. Small bowel loops are mildly dilated, likely representing ileus. No definite MR evidence of active Crohn inflammation. Colon is filled with fluid likely compatible with patient's known diarrhea.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a fistula in the left perirectal space associated with a small collection measuring 1 cm in diameter and fistula in to the skin in the midline. There is mild wall thickening of the rectum compatible with mild active disease.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Dilated esophagus with mild distal wall thickening. Dilated small bowel loops likely secondary to ileus.Left perirectal abscess and fistula as described above.
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Generate impression based on findings.
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Status post right total knee revision The previously seen total knee arthroplasty device has been removed and replaced with a cement spacer. Alignment is near-anatomic. Drains and foci of gas density within the anterior soft tissues reflect recent surgery.
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Postoperative changes of total knee spacer placement as described above.
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Generate impression based on findings.
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Diffuse joint pain. Evaluate for rheumatoid arthritis. Three views of the right hand are provided. There is chondrocalcinosis of the triangular fibrocartilage and articular cartilage of the wrist. There is soft tissue swelling and streaky calcification adjacent to the head of the first metacarpal, with small lucencies in the first metacarpal head could conceivably represent small erosions. There also appears to be chondrocalcinosis of the first metacarpal phalangeal joint. There is swelling of the soft tissues of the index and middle fingers with streaky calcifications that I suspect are arterial in etiology. Small lucencies in the head of the proximal phalanx of the index finger may represent small erosions, but this is equivocal. Mild osteoarthritis affects the distal interphalangeal joints.Three views of the left hand are provided. There is chondrocalcinosis of the triangular fibrocartilage and articular cartilage of the wrist. There is poorly defined mineralization of the soft tissues adjacent to the second metacarpophalangeal joint. There is swelling of the soft tissues about the PIP joint of the ring finger. There is mild narrowing of scattered interphalangeal joints. Small, shallow, superficial soft tissue prominences along the ulnar aspect of the middle finger and radial aspect of the ring finger are nonspecific but could represent small blisters.Three views of the right foot are provided. There is mild swelling of the soft tissues of the foot, particularly along its dorsal and medial aspects. There are arterial calcifications in the soft tissues. The bones appear slightly demineralized, but I see no discrete erosions. A lucency with sclerotic margins in the base of the distal phalanx of the great toe may represent a degenerative subchondral cyst.Three views of the left foot are provided. There is mild diffuse soft tissue swelling. There are arterial calcifications in the soft tissues. The bones appear slightly demineralized, but I see no discrete erosions.Four views of the right knee are provided. There is chondrocalcinosis of the menisci and articular cartilage. small osteophytes indicate mild osteoarthritis. I see no erosions. There may be a small joint effusion. Four views of the left knee are provided. There is chondrocalcinosis of the menisci and articular cartilage. Tiny osteophytes indicate mild osteoarthritis. There is chronic-appearing single-layer periosteal reaction along the anterior aspect of the distal femur that is nonspecific and not necessarily of any current clinical significance.
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Chondrocalcinosis and mild osteoarthritic changes as described above. Additionally, there are foci of soft tissue swelling within the hands, at least one of which appears to contain calcification, with equivocal underlying erosions. While the pattern is not typical of rheumatoid arthritis, the possibility of gout should be considered.
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Generate impression based on findings.
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Female 34 years old Reason: 34 y.o. with longstanding h/o esopageal, small bowel, and large bowel crohns admitted with abd pain, diarrhea, and malnutrition. Please eval for active disease. History: abd pain, diarrhea, malnutrition ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild diffuse fatty infiltration of the liver.SPLEEN: Mild splenomegaly. Spleen measures 13 cm.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dilated esophagus. There is mild wall thickening of the distal esophagus. Small bowel loops are mildly dilated, likely representing ileus. No definite MR evidence of active Crohn inflammation. Colon is filled with fluid likely compatible with patient's known diarrhea.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a fistula in the left perirectal space associated with a small collection measuring 1 cm in diameter and fistula in to the skin in the midline. The fistula also extends anteriorly on the left side towards the vulva. There is mild wall thickening of the rectum compatible with mild active disease.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Dilated esophagus with mild distal wall thickening. Dilated small bowel loops likely secondary to ileus.Left perirectal abscess and fistula as described above.
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Generate impression based on findings.
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43-year-old female with cough, sepsis, evaluate for pneumonia LUNGS AND PLEURA: Patient motion and poor inspiration limits sensitivity of the examination. There is a large irregular opacity in the left upper lung measuring 4.0 x 2.8 cm with additional smaller focal opacities in bilateral lungs (series 5, image 44). Small left pleural effusion with adjacent atelectasis is new. Right basilar atelectasis. Unchanged right middle and lower lobe scarring, hyperperfusion and patchy groundglass opacities consistent chronic thromboembolic disease. Bilateral calcified micronodules compatible with prior granulomatous disease is unchanged.MEDIASTINUM AND HILA: Moderate cardiomegaly and moderate pericardial effusion is increased since the prior exam. Enlarged prevascular lymph nodes measures 1.4 cm (series 2, image 24). Additional enlarged upper mediastinal lymph nodes. Prominence of the left hilar structures suggest lymphadenopathy in the absence of IV contrast. Right internal jugular catheter with tip at the superior cavoatrial junction.CHEST WALL: Left-sided ICD with lead in the right ventricular apex.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Enlarged suprahepatic IVC caliber.
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1.New multifocal airspace opacities, including a large opacity in left upper lobe, is suspicious for infectious etiology given the short time interval since the prior examination. Follow-up examination to document resolution is recommended.2.Cardiomegaly with moderate pericardial and left pleural effusion is increased.
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Generate impression based on findings.
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Vertigo and headache. There is apparent apparent linear hyperattenuation along the tentorial apex. There is no evidence of intracranial mass. The grey-white matter differentiation appears to be intact. The ventricles 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 scalp soft tissues are unremarkable.
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Apparent linear hyperattenuation along the tentorial apex may represent a prominent vascular structure or artifact versus acute extra-axial hemorrhage, or venous thrombosis. Follow up imaging, perhaps with MRI and MRV may be useful.Discussed with Dr. Yarlagadda at 10 AM on 1/17/15.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Male 77 years old Reason: re-imaging kidney lesion History: follow up imaging ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver, unchanged. Liver demonstrates nodular contours with hypertrophic left lobe suggestive of chronic liver disease. Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: Pancreas duct is diffusely dilated, not significantly changed from previous study.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Lateral renal cyst. There is a 2.2 x 1.9 cm cyst with coarse calcifications in the posterior mid left kidney. No definite enhancement is noted on CT within the lesion. However presence of thick calcifications limits of evaluation of this lesion for enhancement.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Fat-containing paraumbilical hernia.BONES, SOFT TISSUES: 2.3 x 1.1 cm hypodense lesion in the right lateral abdominal wall on image number 67, series number 11, likely represents hematoma.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Complex calcified cystic lesion involving the left kidney. Due to its calcifications, its enhancement cannot be optimally evaluated with CT. Follow-up MRI in 6 months may be helpful for further evaluation.Small right anterior wall hematoma.Diffuse fatty infiltration of the liver and possible chronic liver disease.
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Generate impression based on findings.
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There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles 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 scalp soft tissues are unremarkable.
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No evidence of acute intracranial hemorrhage or mass.
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Generate impression based on findings.
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Female 70 years old Reason: diverticulitis? History: prior diverticulitis, LLQ pain/tenderness. transplant. Cr 2.8, PO contrast only ABDOMEN:LUNG BASES: Trace left pleural effusion. Cardiomegaly. Trace pericardial effusion.LIVER, BILIARY TRACT: Hypodense lesions in the liver are unchanged but cannot be optimally characterized with this noncontrast CT.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys. Hypodense lesions in both kidneys which cannot theophylline characterize with this noncontrast CT but grossly unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Transplant kidney in the right iliac fossa. Hypodense lesion in the posterior aspect of the transplant kidney measures 1.7-cm image number 69, series number 4. There may be another hypodense lesion medial to this lesion measuring 1.6-cm in diameter image number 68, series number 4. An ultrasound of the transplant kidney may be helpful for further evaluation.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without CT evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Limited study due to lack of intravenous contrast.Indeterminate left renal lesion.Ultrasound of renal transplant may be helpful for further evaluation of the hypodense lesions within the transplanted kidney in the right iliac fossa.
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Generate impression based on findings.
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74-year-old male with history of ulcer and visible bone. Evaluate for osteomyelitis. There is replacement of the subcutaneous fat along the lateral aspect of the distal fibula with soft tissue density, with ulceration of the soft tissues superficial to the distal fibula. The ulceration does not appear to extend to the bone on this scan. There is minimal periosteal reaction along the distal fibula as seen on the prior radiograph, but there is no frank osteolysis to suggest acute osteomyelitis. The medullary space of the fibula appears normal as do the visualized distal tibia and remaining bones of the ankle. Mild degenerative arthritis affects the midfoot and tibiotalar joint. There are no discrete fluid collections. The visualized tendinous structures are unremarkable. There is soft tissue swelling about the dorsum of the foot. There is generalized fatty atrophy of the muscles of the ankles and foot.
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Soft tissue ulceration and equivocal minimal periosteal reaction of the distal fibula as described above, but we see no convincing evidence of acute osteomyelitis. If patient care warrants further imaging, a nuclear medicine study may be considered.
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Generate impression based on findings.
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Male 21 years old Reason: evaluate for intabdominal inflammatory process History: episode of abdominal pain with Nausea ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Trace amount of ascites of unknown etiology and significance.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No CT findings to explain patient's abdominal pain and nausea.
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Generate impression based on findings.
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Male 58 years old Reason: r/o aortic dissection History: vomiting chest pain abd pain CHEST:LUNGS AND PLEURA: Scattered micronodules, nonspecific.MEDIASTINUM AND HILA: No evidence of aortic aneurysm or dissection.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications. No evidence of aneurysm or dissection.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Diffuse atherosclerotic changes. No evidence of aortic aneurysm or dissection.
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Generate impression based on findings.
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52 year-old male with RVP + RSV and coronovirus LUNGS AND PLEURA: No pleural effusion. New pleural-based opacity in the right lower lobe at site of previous scarring measuring approximately 1 0.6 x 1.0 cm (series 5, image 121) was not present on the prior examination 10/7/2014. This likely represents atelectasis. Scattered micronodules measuring up to 4 mm seen bilaterally are unchanged. There is mild bronchiectasis of the right middle and right lower lobe. Focal tree in bud opacity in the right lower lobe (series 5, image 185) may represent bronchiolitis or prior infection.MEDIASTINUM AND HILA: Right chest port tip is at the superior cavoatrial junction. Heart size is normal. No pericardial effusion. No significant mediastinal lymphadenopathy. Prominent right hilar lymph node measures 1.2 cm (series 3, image 130).CHEST WALL: Degenerative changes to the thoracic spine are again noted. There is increased compression deformity of the T7 vertebral body and sclerosis of the inferior endplate of T9. Vacuum disk phenomenon is seen at the T6-T7 level and L1-L2 level.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of acute infection.
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Generate impression based on findings.
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74-year-old male with history of ankle pain. There is mild soft tissue swelling along the lateral aspect of the ankle. There is chronic-appearing single layer periosteal reaction along the distal fibula which is nonspecific but could conceivably represent prior osteomyelitis. We see no frank osteolysis to suggest acute osteomyelitis.
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Soft tissue swelling without definitive radiographic evidence of osteomyelitis.
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Generate impression based on findings.
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53 year-old female with history of knee swelling. The bones are demineralized. There is moderate osteoarthritis affecting the knee particularly at the patellofemoral joint. There are scattered arterial calcifications. There is mild swelling of the anterior soft tissues of the knee. There is no large joint effusion, fracture, or malalignment.
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1.Mild anterior soft tissue swelling and moderate osteoarthritis, however we see no acute abnormality.2.Demineralized bones may reflect osteoporosis/osteopenia, however a marrow replacing process cannot be excluded, e.g., if the patient has a known primary malignancy.
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Generate impression based on findings.
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Male 55 years old Reason: possible PCP pneumonia History: cough for 2 months, weight loss, failure to thrive with HIV CHEST:LUNGS AND PLEURA: Mild paraseptal emphysema. There is bronchial wall thickening and multiple centrilobular nodules in the right upper lobe and lower lobe associated with mild bronchiectasis and interstitial thickening. Similar changes are also noted in the left lower lobe. These findings are compatible with infection in a patient with HIV.MEDIASTINUM AND HILA: There is a 3-cm in diameter centrally necrotic mass in the prevascular space. This may represent a necrotic adenopathy secondary to an infection such as MAI, however, neoplasm cannot be entirely excluded.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Mild intra-and extrahepatic biliary dilatation, nonspecific. Etiology is unknown.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts. Subcentimeter right upper pole lesion, best seen on image number 99, series number 3 all uncertain etiology. It is too small to be accurately characterized.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Changes in bilateral lung parenchyma described above most compatible with infection in a patient with history of HIV.Prevascular centrally necrotic mass. Differential diagnosis includes necrotic adenopathy and less likely neoplasm.
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Generate impression based on findings.
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74-year-old female with history of left shoulder pain. We see no fracture or dislocation. Mineralization between the acromion and humeral head likely represents calcification of the rotator cuff. Mild osteoarthritis affects the acromioclavicular and glenohumeral joints. There is calcification along the dorsal aspect of the AC joint.
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Osteoarthritis and calcific tendinosis of the rotator cuff.
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Generate impression based on findings.
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59-year-old male status post falling on knee. We see no acute fracture. There is a small joint effusion. Moderate osteoarthritis affects the knee. There is chondrocalcinosis of the menisci. Again seen are wire fragments within the patella and distal quadriceps tendon presumably representing prior patellar fixation appearing similar to the prior study from 2012. There are scattered arterial calcifications.
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No acute fracture. Osteoarthritis, joint effusion, and other findings as above.
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Generate impression based on findings.
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21-year-old male with history of pain. Evaluate for SCFE. We see no acute fracture. In particular we see no evidence of slipped capital femoral epiphysis and the physis appears fused.
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No radiographic evidence of SCFE or other findings to account for the patient's pain.
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Generate impression based on findings.
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55 year old female with history of pain. Evaluate for scapular fracture. There is no fracture or malalignment evident. There are minimal degenerative arthritic changes affecting the shoulder.
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No fracture is evident.
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Generate impression based on findings.
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70-year-old male with non-squamous cell lung cancer with shortness of breath CHEST:LUNGS AND PLEURA: Left upper lobe ground glass nodule (series 4, image 45) measures 1.6 cm, previously 1.5 cm, and has been slowly increasing in size since 2008. Two nodules in the left lower lobe both measuring 6 mm (series 4, image 25) is similar to the prior exam. Calcified granuloma in the lingula. There is unchanged scarring, bronchiectasis, and pleural thickening with calcifications of the right hemithorax. No focal pulmonary opacities or pleural effusions.MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes not pathologically enlarged. Postoperative changes of esophagectomy and gastrectomy with primary anastomosis. The heart size is normal without pericardial effusion.CHEST WALL: Prominent left supraclavicular lymph node is unchanged. No significant axillary, retrocrural, or cardiophrenic lymphadenopathy. Healing left proximal humeral fracture. There is unchanged post surgical changes to the right fourth through sixth posterior ribs. Degenerative changes affect the thoracic and lumbar spine. No suspicious osseous lesions are identified.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No focal hepatic lesions. No intrahepatic or extrahepatic biliary ductal dilatation. The gallbladder is within normal limits. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate calcification in the left kidney may represent vascular calcification or a nonobstructing kidney stone. No perinephric inflammation or hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small nodule in the retroperitoneum adjacent to the right lobe of the liver (series 2, image 349) measures 6 mm, unchanged. Surgical clips noted. Atherosclerotic calcification of the aorta and branch vessels without aneurysmal dilatation.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.The bowel is within normal limits without evidence of obstruction. The appendix well-visualized and within normal limits.BONES, SOFT TISSUES: Degenerative changes affect the thoracic and lumbar spine. No suspicious osseous lesions are identified.OTHER: No significant abnormality noted.
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1.Left upper lobe ground glass opacity has been slowly increasing in size since 2008. Differential includes atypical adenomatous hyperplasia or indolent adenocarcinoma. No additional focal pulmonary opacities.2.Chronic changes to the right hemithorax are unchanged.
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Generate impression based on findings.
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19 year old female status post right internal jugular central venous placement.VIEW: Chest AP (one view) 1/17/2015, 18:44 Right central venous catheter with tip in the cavoatrial junction. The cardiothymic silhouette is normal. There is no focal air space opacity. No pneumothorax or pleural effusion is seen.
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Right central venous catheter with tip in the cavoatrial junction. No pneumothorax.
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Generate impression based on findings.
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There is no evidence of significant steno-occlusive lesions or intracranial aneurysm. The anterior and posterior circulations are intact. The anterior and posterior communicating arteries are patent. There is no evidence of large intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is a small retention cyst in the right sphenoid sinus. The skull and extracranial soft tissues are unremarkable.
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No evidence of significant steno-occlusive lesions.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Head trauma. There is a left parietal scalp laceration that has been repaired with skin staples. There is no evidence of intracranial hemorrhage. There is an arachnoid cyst overlying the anterior left frontal convexity that measures up to 12 mm in width with associated remodeling of the overlying calvarium. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is no evidence of displaced skull fractures.
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A left parietal scalp laceration has been repaired with skin staples, but no evidence of acute intracranial hemorrhage or skull fracture.
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Generate impression based on findings.
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Seven month old male with emesis.VIEW: Abdomen AP (one view) 1/16/2015, 18:14 The bowel gas pattern is disorganized and nonobstructive. No pneumoperitoneum, portal venous gas or pneumatosis intestinalis is seen. Moderate stool burden distributed throughout the colon. Partially imaged left lower lobe opacity.
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Disorganized nonobstructive bowel gas pattern.
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Generate impression based on findings.
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One day old male with fused fingers of the right hand.VIEWS: Right hand PA and lateral (two views) 1/16/2015 The third metacarpal is absent and the proximal third phalanx is deformed. The distal second and third phalanges are fused as are the fourth and fifth distal phalanges. The middle phalanges are not identified. No acute fracture or malalignment is evident.
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Osseous abnormalities of the hands as above.
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Generate impression based on findings.
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59-year-old male with left-sided numbness. Evaluate for etiology of transient neurologic symptoms. The images are partly degraded by patient motion.NONCONTRAST CT HEAD: There is no evidence of intracranial hemorrhage or mass. There are minimal punctate foci of cerebral white matter hypoattenuation, which are more conspicuous on the prior MRI. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is a small retention cyst in the right maxillary sinus. The skull and scalp soft tissues are unremarkable. CTA HEAD AND NECK: There is a punctate focus of calcification at the right vertebral artery origin. Otherwise, there is no evidence of significant steno-occlusive lesions, aneurysm, or vascular malformation. There is expected opacification of the venous structures.
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1.No evidence of acute intracranial hemorrhage or mass.2.No evidence of significant steno-occlusive lesions in the head and neck arteries.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Dizziness and vomiting. There is a pituitary mass that measures approximately 14 AP x 19 SI x 24 RL mm appears to impress upon the optic apparatus. There is no evidence of intracranial hemorrhage. There is unchanged mild patchy cerebral white matter hypoattenuation. The ventricles and sulci are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The orbits and scalp soft tissues are unremarkable. There is a right lens implant.
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1. A pituitary mass that appears to impress upon the optic apparatus likely represents a macroadenoma. A dedicated pituitary MRI may be useful for further evaluation if there are no contraindications for this modality.2. No evidence of intracranial hemorrhage. 3. Unchanged mild patchy cerebral white matter hypoattenuation likely represents small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.Discussed with Dr. Padella at 8:45 AM om 1/17/14.
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Generate impression based on findings.
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10-year-old male with hip pain, rule out septic joint.VIEWS: Right hip AP and frog leg lateral and pelvis AP and frog leg 1/16/2015 Persistent coxa Vara. The femoral head demonstrates smooth articular surface. There is moderate stool burden distributed throughout the imaged colon, predominantly affecting the rectum. No acute fracture or malalignment evident.
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Persistent deformity of the right hip without evidence of underlying fracture or malalignment.
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Generate impression based on findings.
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ET placementVIEW: Chest AP 1/17/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. There is a G-tube in place. Right chest tube and left central line in place. The side hole of the right chest tube is within the subcutaneous tissue. Cardiothymic silhouette normal. Minimal improvement in the aeration of the right lower lobe. The remainder of the right lung is opacified. Left perihilar atelectasis unchanged. Marked body wall edema.
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Minimal improvement in the aeration of the right lower lobe.
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Generate impression based on findings.
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There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular and subcortical white matter hypoattenuation, which is nonspecific. The ventricles are normal in size and configuration. There is no midline shift or herniation. There are periodontal lucencies in the right posterior maxillary alveolus. There is a left maxillary sinus mucus retention cyst. The imaged mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1.No evidence of acute intracranial hemorrhage.2.Nonspecific mild periventricular and subcortical white matter hypoattenuation, likely representing age indeterminate microvascular ischemic changes. CT is insensitive for detection of early nonhemorrhagic stroke.3.Periodontal lucencies in the right posterior maxillary alveolus, which may indicate dental disease that is beyond the field of view of the scan. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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ET placementVIEW: Chest AP 1/17/15 ET tube tip at the level of the thoracic inlet. NG tube tip in the stomach. Gastrostomy tube in place. Right chest tube and left central line in place. The sidehole of the right chest tube is within the subcutaneous tissue. There is now complete opacification likely atelectasis involving the entire right lung. Left perihilar atelectasis has increased in the interval. Cardiothymic silhouette cannot be evaluated.
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Complete opacification likely atelectasis involving the entire right lung.
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Generate impression based on findings.
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Bloody diarrheaVIEW: Abdomen AP 1/17/15 NG tube tip in the stomach. The stomach is mildly distended. Disorganized nonobstructive bowel gas pattern. The mildly dilated loop of bowel in the midline in the prior radiograph has resolved in the interval. No pneumatosis or pneumoperitoneum.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Abdominal distentionVIEW: Abdomen AP 1/17/15 There are surgical sutures projected over the left upper quadrant. Disorganized mildly dilated bowel loops without obstruction. No pneumatosis or pneumoperitoneum. Left lower lobe atelectasis new from prior study.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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7 year old female with pain and swelling after having finger caught in car door.VIEWS: Right second digit PA lateral and oblique (3 views) 1/16/2015 No acute fracture or malalignment is seen. No significant soft tissue swelling is evident.
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Normal examination.
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Generate impression based on findings.
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10-month-old female, evaluate Dobbhoff tube placement.VIEW: Abdomen AP (one view) 1/16/2015, 21:14 There is a Dobbhoff tube with its tip projecting over the body of the stomach. Disorganized nonobstructive bowel gas pattern. Moderate stool burden distributed throughout the colon. Multiple clips are seen over the proximal right thigh.
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Dobbhoff tube with tip in the body of the stomach.
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