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Generate impression based on findings. | Dental streak artifact again limits evaluation of the oral cavity. Within this limitation, there is no definite residual discrete enhancing tissue along the left base of tongue in area of previous mass. There is at most minimal asymmetric ill-defined enhancement along the cranial aspect of the previous mass, as seen o... | 1. Further decrease size of enhancing left base of tongue tumor with only minimal ill-defined enhancement remaining along the cranial aspect of the mass. Exam is again limited due to extensive streak artifact from dental amalgam.2. No cervical lymphadenopathy. |
Generate impression based on findings. | Study slightly limited due to patient motion. No evidence of acute intracranial hemorrhage. There is encephalomalacia in the left temporal and parietal lobes from prior MCA territory infarct, unchanged. Hypoattenuation within the pons is unchanged and likely related to chronic ischemia. Ventricles and sulci are promin... | 1.No acute intracranial hemorrhage or mass effect. Please note CT is insensitive for detection of acute nonhemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2.Left temporo-parietal encephalomalacia related to remote MCA territory infarct. |
Generate impression based on findings. | cT3N0 squamous cell carcinoma of the supraglottic larynx status post 7/7 cycles of FHx. There has been interval decrease in size of the supraglottic squamous cell carcinoma without evidence of measurable tumor. There is no evidence of significant cervical lymphadenopathy based on size criteria. Thin linear hyperattenua... | 1. Interval decrease in size of the supraglottic squamous cell carcinoma without evidence of measurable tumor.2. Probable inclusions cysts in the bilateral cheeks, in which the right-sided lesions now display signs of inflammation or infection. |
Generate impression based on findings. | 53 year-old woman with a history of right mastectomy in 2006 for inflammatory breast carcinoma. She is status post chemo- and radiation therapy. She has also an undergone left breast reduction surgery. No current breast complaints. Three standard views of the left breast were performed digitally and reviewed with the a... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. In view of history of breast cancer and dense breast, breast MRI may be useful for scree... |
Generate impression based on findings. | Female 74 years old Reason: RUQ, sepsis, source unknown History: RUQ, sepsis, source unknown Very limited study due to patient body habitus and skin dressings.LIVER: Liver measures 16.2 cm in length and demonstrates markedly heterogeneous and coarsened echotexture suggestive of chronic liver disease. The portal vein is... | 1. Very limited study. Heterogeneously coarse hepatic echotexture suggestive of chronic liver disease. 2. Abdominal ascites. 3. Right pleural effusion. |
Generate impression based on findings. | Male 65 years old Reason: evaluation of known renal nodule for status change, (left) History: Known nodule, no symptoms RIGHT KIDNEY: The right kidney measures 9.6 cm. The renal cortex is diffusely hyperechoic. Multiple anechoic lesions seen throughout the kidney are suggestive of simple cysts. LEFT KIDNEY: The left ki... | The renal cortex is hyperechoic bilaterally consistent with medical renal disease. Multiple anechoic lesions identified throughout both kidneys consistent with renal cysts. Continued follow-up is recommended in the absence of postcontrast imaging of these lesions as recommended on prior noncontrast CT. |
Generate impression based on findings. | Dysphagia. High-risk of esophageal / other cancer initial treatment strategy. Recent CT with nonspecific foci.RADIOPHARMACEUTICAL: 9.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 87 mg/dL. Today's CT portion grossly demonstrates small bilateral pleural effusions. There is a trace pericardial effusion. Mi... | No suspicious FDG avid lesion to indicate tumor activity currently in the neck, chest, abdomen, or pelvis. |
Generate impression based on findings. | Hypertension, tachycardia and elevated urine metanephrines. Rule out pheochromocytoma. ABDOMEN:LUNG BASES: Left pleural effusion indwelling chest tube. Small right pleural effusion with overlying compressive atelectasis. Moderate atelectasis at the left lung base. Esophageal stent appears patent and extends into the st... | No findings to explain clinical symptoms; no evidence of pheochromocytoma. Status post esophageal stenting with fluid in the posterior mediastinum which could be better evaluated on a dedicated chest CT. Left pleural effusion with indwelling chest tube. |
Generate impression based on findings. | Female 47 years old Reason: r/o path nodules History: asymptomatic now. Hx of TB in childhood. Incidental pul nodules (3) seen on esophagram;non smoker LUNGS AND PLEURA: Right upper lobe well circumscribed parenchymal nodule measuring 14 x 15 mm. There are scattered calcified micronodules likely intrapulmonary lymph no... | Right upper lobe well circumscribed nodule is likely benign and likely secondary to prior granulomatous infection.Inferior two nodules seen on esophagram are likely secondary to extrapleural artifact. |
Generate impression based on findings. | Reason: Follicular Lymphoma History: 67Yrs male with a history significant for melanoma (locally advanced), thyroid cancer, and recently-diagnosed follicular lymphomaRADIOPHARMACEUTICAL: 12.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 120 mg/dL. Today's CT portion grossly demonstrates postsurgical chang... | 1.Hypermetabolic confluent mesenteric lymph nodes have improved mildly, but still remain significantly metabolically active and compatible with current persistent tumor activity.2.New hypermetabolic small subcutaneous nodule in the anterior thyroid bed and stable hypermetabolic small prevascular lymph node could repres... |
Generate impression based on findings. | Parotid cancer with liver mets status post chemo. CHEST:LUNGS AND PLEURA: No significant change in appearance of the left lung with extensive chronic tissue necrosis and bronchiectasis. The intracavitary mycetoma in the left upper lobe has moved in position and is now dependent measuring 20 mm, previously 17 mm (5/46).... | 1. Progressive soft tissue thickening surrounding the G-tube tract suspicious for infection or inflammation, correlate for pain or signs of infection in this area.2. Although not significantly changed, some of the lymph nodes in the mediastinum, left internal mammary chain and porta hepatis appear minimally larger.3. H... |
Generate impression based on findings. | Eight-year-old male with abdominal distention/constipationVIEWS: Abdomen AP (one views) 01/30/15 Gastrostomy tube is in place. Small amount of stool is seen throughout the rectum and descending colon. Diffuse gas distended loops of small and large bowel are seen. No air fluid levels are seen. No pneumoperitoneum, pneum... | Nonspecific bowel gas pattern. No specific evidence for obstruction. |
Generate impression based on findings. | Images are slightly limited by patient motion. The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is mild narrowing with forming Schmorl's node at L1-L2, with interval distal degeneration. There is also mild narrowing of the L5-S1 disk although this is stable and may be developmental. The ve... | 1. Interval postoperative changes from tethered cord release with retracted ends of fatty filum, with stable level of conus termination at L1-L2. Appropriate ventral motion of the distal cord and conus as well as cauda equina nerve roots on prone imaging.2. Interval degeneration of L1-L2 disk with probable impending Sc... |
Generate impression based on findings. | Reason: pt with history of prostate Ca, now with new onset bone pain , elevated alk phos, r/o progressive disease/ bone mets History: bone pain, fatigue, increased alk phos Innumerable widespread confluent increased radiotracer uptake involving the axial and proximal appendicular skeleton as well as diffusely decreased... | Innumerable widespread confluent osseous metastases, new from previous. |
Generate impression based on findings. | Female 44 years old Reason: pt w/ RUQ pain, r/o biliary cause of pain History: RUQ pain LIVER: Liver measures 17.5 cm in length. No focal parenchymal abnormality. Portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: No evidence of gallstones, gallbladder wall thickening or perichol... | 0.4-cm echogenic focus adherent to the gallbladder wall which is suggestive of a gallbladder polyp. No specific cause for patient's right upper quadrant pain is identified. |
Generate impression based on findings. | Male 50 years old; Reason: concern for cteph History: rv failure The comparison chest radiograph performed on 1/29/2015 demonstrates cardiomegaly with no focal pulmonary opacities or pleural fluid. The ventilation images show a uniform distribution of activity on single-breath and wash-in images. There is abnormal Xe-1... | Very low probability for pulmonary embolism. |
Generate impression based on findings. | Non-small cell lung CA status post CRT. CHEST:LUNGS AND PLEURA: Small left pleural fluid collection, partially loculated in the upper thorax, not significantly changed in volume. Small volume of pleural fluid on the right is new.Progressive post therapeutic changes in the lungs bilaterally consistent with evolving radi... | Progressive post therapeutic changes in the lungs bilaterally. Nonspecific solid nodular focus within in the radiation field of the left upper lobe should be monitored on subsequent studies; if of clinical concern this area can be further characterized by PET scan. Increased in small volume of pericardial and pleural f... |
Generate impression based on findings. | 87 year-old female with confusion, rule out fracture A lucency along the medial aspect of the lateral tibial plateau indicates a nondisplaced tibial plateau fracture. Low lying patella and poor visualization of the extensor mechanism suggests injury to the extensor mechanism. Large joint effusion. Diffuse osteopenia is... | 1. Lucency along the lateral tibial plateau, consistent with a nondisplaced tibial plateau fracture, for which further evaluation with cross-sectional imaging should be considered if clinically warranted. 2. Low-lying patella and poor visualization of the quadriceps tendon suggestive of injury to the extensor mechanism... |
Generate impression based on findings. | 54-year-old male with history of left hip pain. Hardware components of a left hemi hip arthroplasty are situated in near-anatomic alignment without radiographic evidence of hardware complication. There is interval development of heterotopic bone within the adjacent soft tissues. Mild osteoarthritis affects the pubic sy... | Left hip arthroplasty as above. |
Generate impression based on findings. | 55-year-old male with history of foot ulcerations, erythema evaluate for gas There is mild soft tissue swelling about the foot without gas or discrete ulceration visualized. No erosions or bone destruction. Alignment is within normal limits. Small plantar calcaneal spur and unchanged cortical defect along the mid diaph... | Mild soft tissue swelling without gas or specific radiographic features of osteomyelitis. |
Generate impression based on findings. | Female 56 years old; Reason: 56F with h/o melanoma in 1989 now presenting with left axillary LN concerning for recurrent disease. History: disease staging CHEST:LUNGS AND PLEURA: Anteriorly located pleural based 7 mm right upper lobe lung nodule, image 42 series 4, with associated calcification suggested, may reflect p... | 1. Enlarged left axillary and subpectoral lymphadenopathy, suspicious for recurrent/metastatic disease.2. Additional indeterminant splenic and hepatic lesions as above. |
Generate impression based on findings. | 41-year-old female with history of ORIF of pelvis in 2000. A plate and screw device is identified coursing horizontally along the posterior aspect of the sacrum and SI joints. There is a second plate and screw device coursing obliquely along the left posterior aspect of the sacrum. A third plate and screw device affixe... | 1.Postsurgical changes of the pelvic fracture fixation as above.2.Enlarged uterus for which dedicated imaging may be obtained if clinically warranted. |
Generate impression based on findings. | Call back from screening mammogram for increasing calcifications in the right breast. An ML view and two spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. There are loosely clustered punctate calcifications with a few stable coarse calcifications in the righ... | Benign appearing calcifications in the right retroareolar region. Follow up in 6 months with right unilateral diagnostic mammogram is recommended. Results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Male 77 years old Reason: h/o transformed CLL, and biliary stenting History: RUQ pain, elevated Alk phos and ALT LIVER: The liver measures 17.0 cm in length. Hepatic echogenicity is mildly increased. No focal liver lesion is identified. Biliary stent in situ with satisfactory decompression of the biliary system. The ma... | Biliary stent in situ with satisfactory decompression of the biliary system. No specific cause for patient's right upper quadrant pain is identified. |
Generate impression based on findings. | 37 year old female with strong family history of breast cancer (sister diagnosed with breast cancer at age 38). 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 ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 28 years old Reason: eval for cholelithiasis History: intermittent RUQ pain LIVER: The liver measures 16.8 cm in length. Unremarkable appearance of the hepatic parenchyma. The main portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder ... | No evidence of cholelithiasis. No specific cause for patient's right upper quadrant pain is identified. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Scattered punctate micronodules and right middle lobe scarring, unchanged.There is no evidence of pulmonary or pleural metastases.Mild central lobular emphysema is upper lobe predominant.MEDIASTINUM AND HILA: Severe coronary... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 40 year-old female with history of right hip pain. Moderate osteoarthritis affects the hips, SI joints, and pubic symphysis. No evidence of acute abnormality. | Degenerative changes of the hips, SI joints and pubic symphysis as above. |
Generate impression based on findings. | 26 year-old female with left hip pain, assess for FAI MEASUREMENTS: CAM location : Minimal CAM deformity at the femoral head neck junction. Alpha angle : 61 degreesCoronal center-edge angle : 39 degreesSagittal center-edge angle : 69 degreesFemoral neck-shaft angle : 130 degreesAcetabular version (1 o’clock) : 3 degree... | Minimal CAM deformity with acetabular and femoral version measurements as described above. |
Generate impression based on findings. | History of right mastectomy in 2006 for invasive lobular carcinoma. Status post autologous right reconstruction. Family history of breast cancer in her mother and a paternal aunt. No current breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 55 year old who is called back from the screening study. An ML view and two spot magnification views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. There are diffuse punctate calcifications in both... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 53 years old Reason: rlo hydronephrosis History: Increasing Cr RIGHT KIDNEY: The right kidney measures 11.5 cm. Right upper pole cyst. There is no hydronephrosis.LEFT KIDNEY: The left kidney measures 11.6 cm. Subcentimeter left mid pole cyst. There is no hydronephrosis.URINARY BLADDER: The bladder is decompressed.... | No hydronephrosis. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Primary pulmonary hypertension, concern for amiodarone toxicity, low FEV1. LUNGS AND PLEURA: Scattered calcified and noncalcified micronodules nonspecific and too small to accurately characterize.No pleural fluid or pneumothorax. Mild dependent atelectasis resolves upon prone positioning of the patient.Mosaic attenuati... | 1. No conclusive radiographic evidence of pulmonary fibrosis or septal thickening to suggest Amiodarone pulmonary toxicity.2. Single area of ground glass opacity in the anterior left upper lobe could potentially represent focal acute interstitial pneumonitis related to pulmonary toxicity but is too subtle to accurately... |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major in... | 1. Continued stable post treatment changes relating to previous left parotid space rhabdomyosarcoma.2. Persistently enlarged right level 2a lymph node which is nonspecific and statistically most likely reactive in etiology.3. Unremarkable contrast enhanced MRI brain, except for minimally low lying cerebellar tonsils no... |
Generate impression based on findings. | Ankle painVIEWS: Right foot AP, lateral and oblique 1/30/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 9-year-old male with history of rhabdomyosarcoma, now greater than 12 months off therapy LUNGS AND PLEURA: Postoperative changes to the left upper lobe are again seen. Bibasilar, left greater than right, atelectasis. Scattered bilateral micronodules are stable compared to the prior examination. No new pulmonary nodules... | 1.Bibasilar opacities likely represent atelectasis. Follow-up to ensure resolution should be considered.2.No specific evidence of recurrent or metastatic disease in the thorax. Stable bilateral pulmonary micronodules and postoperative changes in the left upper lobe. |
Generate impression based on findings. | 52-year-old female with history of right shoulder pain. Four suture anchors are noted within the humeral head. There is widening of the acromioclavicular interval compatible with acromioplasty. There is no evidence of acute fracture. Alignment is anatomic. | Postsurgical changes as above without acute abnormality. |
Generate impression based on findings. | Male 56 years old Reason: previous kidney stone- left side History: chronic right flank pain RIGHT KIDNEY: The right kidney measures 11.4 cm. There is no hydronephrosis.LEFT KIDNEY: The left kidney measures 11.2 cm. There is no hydronephrosis. There is a 2.9-cm anechoic lesion at the mid pole of the left kidney suggest... | 0.6-cm left renal calculus as identified on recent CT. No right renal calculi. No hydronephrosis. |
Generate impression based on findings. | 19-year-old female with history of thumb injury. There is mild soft tissue swelling about the thumb and thenar eminence, but we see no fracture. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | 68-year-old female with an inflammatory arthritis, RA versus gout Right hand: Mild diffuse osteopenia. No erosions or other specific evidence of inflammatory arthritis. There is narrowing of the distal radial ulnar joint and scattered interphalangeal joints. A small ossicle adjacent to the ulnar styloid likely represen... | Diffuse osteopenia and arthritic changes as described above without specific radiographic features inflammatory arthritis. |
Generate impression based on findings. | 88-year-old female with pain, evaluate for fracture Limited exam demonstrating a trimalleolar fracture and tibiotalar joint dislocation. There is posterior dislocation of the distal fracture fragments. The talus is fractured as well but not well-visualized on this limited exam. Diffuse soft tissue swelling. | Limited exam demonstrating ankle fracture dislocation as described above. Further evaluation with CT is recommended if clinically warranted. |
Generate impression based on findings. | 69-year-old female with radiculopathy There is moderate degenerative disk disease at L5/S1, progressed from the prior exam. Lumbar alignment and vertebral body heights are maintained. Facet joint osteoarthritis affects the lower lumbar spine. Mild osteoarthritis affects the SI joints. | Degenerative arthritic changes as described above, progressed from the prior exam. |
Generate impression based on findings. | 39 year-old female with right knee pain Moderate medial joint space narrowing and small tibiofemoral osteophytes, progressed from the prior exam. A bipartite patella is again noted bilaterally, a normal anatomic variant. Moderate osteoarthritis also appears to affect the left knee as seen on the frontal views. | Moderate osteoarthritis, progressed from the prior exam. |
Generate impression based on findings. | COPD Sjogren's with mild bronchiectasis in 2006 now with clinical worsening and oxygen requirement. LUNGS AND PLEURA: No cysts, fluid or pneumothorax. Mild emphysema.Slight progression of airway thickening film with development of mild bronchiectasis in the anterior right upper lobe (4/42). Mild short segment bronchiec... | 1. Mild worsening of bronchiectasis, with development of mucoid plugging and peribronchovascular nodules suspicious for focal lymphoid hyperplasia versus LIP or lymphoma.2. Collapse of the airways consistent with severe tracheobronchomalacia.3. Severe coronary artery calcifications.4. No lymphadenopathy or cysts. |
Generate impression based on findings. | Female 38 years old Reason: r/o acute abnormalities History: shortness of breath, tachycardia, hx of ca, hx of PE The exam is limited secondary to lack of optimal opacification of the pulmonary artery.PULMONARY ARTERIES: No acute pulmonary embolism to the segmental level. Pulmonary artery is normal in caliber. No evide... | 1. Limited exam with no acute pulmonary embolism to the segmental level however the left pulmonary arteries are attenuated by presumed tumor.2. Pleural and lymphangitic tumor in the left hemithorax.3. Bilateral pleural effusions, right greater than left. 4. Lymphadenopathy and hepatic metastases.PULMONARY EMBOLISM: PE:... |
Generate impression based on findings. | Male 57 years old Reason: 57 yo M with etoh cirrhosis s/p OLT x 2 with recent CT demonstrating stenosis of the hepatic artery conduit, arterioportal fistula in the left hepatic lobe and stenosis of the suprahepatic IVC, at the anastomosis needing further evaluation History: s/p OLT x 2 with recent CT findings as above ... | The main hepatic artery at the porta hepatis, distal to the area of concerning stenosis on CT, demonstrates mild turbulence of the waveform with dampening of the upstroke. The peak systolic flow is measured at 0.6 m/sec and there is a reduced resistive index of 0.4 which can be seen in the setting of hepatic artery ste... |
Generate impression based on findings. | Female 57 years old; Reason: Patient with h/o T1N2b (per chart right tonsillar cancer) treated with surgery and radiation. Now with right tongue pain, groin pain, wt loss please evaluate. RADIOPHARMACEUTICAL: 14.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 103 mg/dL. Today's CT portion grossly demonstra... | 1.Multiple small but significantly hypermetabolic lymph nodes in the left neck are consistent with recurrent tumor activity. There is also asymmetric left pharyngeal activity which could reflect additional left neck tumor activity or benign uptake.2. No FDG avid tumor is identified in the right neck, chest, abdomen, or... |
Generate impression based on findings. | Reason: 61M with newly diagnosed metastatic neuroendocrine tumor of unknown primary, p/w abdominal pain, mets to liver and omentum History: 61M with newly diagnosed metastatic neuroendocrine tumor of unknown primary, p/w abdominal pain, mets to liver and omentumRADIOPHARMACEUTICAL: 9 mCi F-18 fluorodeoxyglucose (FDG).B... | 1.Extensive markedly hypermetabolic abdominopelvic carcinomatosis and hepatic metastases.2.No FDG avid tumor in the neck or chest. |
Generate impression based on findings. | Images are slightly limited by patient motion. The ventricles and sulci are within normal limits for age. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci as well as confluent areas of T2/FLAIR hyperintensity, consistent with mild chronic small vessel ischem... | 1. No acute infarct. Mild chronic small vessel ischemic changes.2. Unremarkable MRA of the head.3. Mild irregularity of the right carotid bulb with mild narrowing of the distal left common carotid artery due to eccentric plaque. Mild narrowing of the left vertebral artery origin. |
Generate impression based on findings. | 15-year-old female with stomach pain, flank pain, blood in urine BLADDER Wall Thickness: Findings consistent with bladder reconstruction. Contents: Multiple folds are again noted in the bladder wall consistent with neurogenic bladder. There is a moderate amount of debris within the bladder, increased since the prior ... | Neurogenic bladder containing bladder calculi and increased debris since the prior exam. Increased renal cortical echogenicity suggestive of medical renal disease. No hydronephrosis or renal stones.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of th... |
Generate impression based on findings. | 63-year-old male with history of pain. Left foot: Moderate osteoarthritis affects the first MTP joint. There is a plantar heel spur and a mild pes planus deformity. There are no radiographic findings of inflammatory arthritis.Right foot: Moderate osteoarthritis affects the first MTP joint. There is a plantar heel spur ... | 1.Degenerative changes at the feet as above.2.Chronic changes of rheumatoid arthritis without new erosions. |
Generate impression based on findings. | 58-year-old female with back and neck pain, history of DISH Right foot and ankle: The bones are diffusely demineralized. There is extensive intertarsal fusion involving the midfoot. Marked ossification extends along the Achilles tendon and plantar soft tissues likely related to the patient's history of DISH. Moderate d... | Flowing anterior vertebral body osteophytes consistent with DISH and marked fusion and bone formation involving the feet and ankles as well as additional findings as described above. |
Generate impression based on findings. | 20-year-old male with history of pain. There is no evidence of acute fracture or malalignment. The soft tissues are unremarkable. | No radiographic findings to account for the patient's pain. |
Generate impression based on findings. | Abdominal pain. Unspecified disease the pericardium. Moderate aortic regurgitation. Evaluate for aortic dissection. CHEST:LUNGS AND PLEURA: Minimal basilar atelectasis. No masses.MEDIASTINUM AND HILA: No evidence of aortic dissection as clinically queried. The ascending aorta measures 3.6 cm in diameter and the descend... | No evidence of aortic dissection. Cholelithiasis without evidence of cholecystitis. Ventral fat containing hernia as described unchanged in appearance since prior examination. Moderate pericardial effusion. |
Generate impression based on findings. | Three T1 weighted images are limited by motion artifact. The ventricles and sulci are prominent, as is a moderate global volume loss, greater than expected for the patient's stated age. The basal cisterns remain patent. There is no midline shift or mass effect. There are few nonspecific foci of T2/FLAIR hyperintensity... | A few foci of nonspecific T2/FLAIR hyperintensity within the bilateral cerebral white matter. Otherwise, unremarkable noncontrast MRI of brain. |
Generate impression based on findings. | Postoperative changes are again seen from previous left parietal craniotomy. There is a stable overall appearance of the additional metastatic lesion to the left high occipital calvarium which is T2/FLAIR hyperintense but with hypointense margins. It measures 1.0 x 1.9 cm, unchanged.The ventricles and sulci are promin... | 1. No acute abnormality. Stable mild chronic small vessel ischemic changes and right frontal encephalomalacia.2. No definite intracranial metastases identified although evaluation limited due to lack of contrast.3. Stable left occipital calvarial metastasis and postoperative changes from previous left parietal cranioto... |
Generate impression based on findings. | Abdominal pain. Unspecified disease the pericardium. Moderate aortic regurgitation. Evaluate for aortic dissection. CHEST:LUNGS AND PLEURA: Minimal basilar atelectasis. No masses.MEDIASTINUM AND HILA: No evidence of aortic dissection as clinically queried. The ascending aorta measures 3.6 cm in diameter and the descend... | No evidence of aortic dissection. Cholelithiasis without evidence of cholecystitis. Ventral fat containing hernia as described unchanged in appearance since prior examination. Moderate pericardial effusion. |
Generate impression based on findings. | There is an expected evolution of the previously identified bilateral supratentorial and infratentorial subdural blood products, with relative current dependent location of the hemorrhage. There is significant decreased amount of focal clot along the left paramedian frontal lobe, as well as decreased thickness of subd... | Interval expected evolution and redistribution of scattered bilateral supratentorial and infratentorial subdural blood products. No new acute intracranial hemorrhage. |
Generate impression based on findings. | 60 year-old male with left knee pain Moderate osteoarthritis affects the knee with joint space narrowing and tricompartmental osteophytes. Chondrocalcinosis is also noted. Similar findings affect the contralateral knee as seen on the frontal views. | Moderate osteoarthritis and chondrocalcinosis. |
Generate impression based on findings. | 35-year-old male, rule out foreign body A small metallic foreign body is noted within the distal aspect of the tuft. The underlying osseous structures appear unremarkable. | Metallic foreign body with unremarkable underlying osseous structures. |
Generate impression based on findings. | 83-year-old female status post left knee arthroplasty revision Hardware components of a total left knee arthroplasty revision are situated in gross anatomic alignment. The proximal aspect of the femoral component is not visualized on this exam. Diffuse soft tissue swelling and foci of gas are consistent with recent sur... | TKA revision as above. |
Generate impression based on findings. | Pain in left shoulder An impacted comminuted fracture through the left humeral head with associated minimal free fragment created by the tuberosity. Superimposed severe osteoarthritic changes largely involving the glenohumeral articulation. Large effusion. | Impacted comminuted fracture of the humeral head |
Generate impression based on findings. | Knee pain. Tibial plateau fracture. CT evaluation demonstrates the comminuted tibial fracture with a complex set of fracture planes extending through the tibial spines (both medial and lateral) and extending into the medial plateau. Minimal impaction is observed it fragments essentially remain in place and aligned.Mode... | Comminuted proximal tibial fracture with extension through the tibial spines and medial tibial plateau. See detail provided above |
Generate impression based on findings. | Ankle fracture. Check alignment Gross realignment of the complex comminuted trimalleolar fracture with only minimal displacement of fracture components. Gross symmetry of the mortise observed yet detail limited due to extensive overlying cast material | Gross realignment of the trimalleolar fracture |
Generate impression based on findings. | Female 56 years old; Reason: eval for obstruction, s/p gastric bypass here w/ nausea and vomiting History: n/v ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Two subcentimeter hypoattenuating liver lesions are too small characterize.SPLEEN: No significant abnormality noted.PANCREAS: No signi... | 1.Status post gastric bypass with high grade partial bowel obstruction at the jejunojejunal anastomosis. |
Generate impression based on findings. | Female 30 years old; Reason: R/o appendicitis, ovarian pathology History: 30 yo F p/w with RLQ pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significa... | 1.No evidence of appendicitis. 2.Hemorrhagic right ovarian cysts, likely physiologic. |
Generate impression based on findings. | Female 62 years old; Reason: eval stone History: R flank pain, hematuria The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Mild bibasal atelectasis.LIVER, BILIARY TRACT: Cholelithiasis. ... | 1.No renal stones. 2.Cholelithiasis without CT evidence of cholecystitis. |
Generate impression based on findings. | Status-post distal femoral replacement The distal femur has been resected and reconstructed with a long stem total knee endoprosthesis device. Alignment is near-anatomic. Skin staples, a drain, and foci of gas density in the soft tissues reflect recent surgery. | Distal femoral reconstruction as described above. |
Generate impression based on findings. | Male 37 years old; Reason: appendicitis History: RLQ pain and vomiting ABDOMEN:LUNG BASES: Minimal bibasal atelectasis. Marked abnormal thickening of the intraventricular septum, better evaluated on recent cardiac MRI.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion in the right hepatic lobe is too small char... | 1.New wedge-shaped areas of non-enhancement involving the upper and mid pole of the right kidney suggestive of infarction. Favor embolic origin given the multifocality.2.No evidence of appendicitis.3.Severe hypertrophy of the intraventricular septum better evaluated on recent MRI. |
Generate impression based on findings. | Heel wound. Rule out "osteo". There is a soft tissue defect along the posterior aspect of the heel presumably representing the known wound. Overall, the bones appear demineralized, suggesting osteopenia/osteoporosis, but I see no focal osteolysis to confirm osteomyelitis. Moderate to severe osteoarthritis affects the f... | 1.Heel wound without radiographic evidence of underlying osteomyelitis. If there is strong clinical concern for osteomyelitis, MRI may be considered.2.Findings suggestive of a healing (stress) fracture of the fifth metatarsal. |
Generate impression based on findings. | Status post right femoral component fracture Two views of the right hip show components of a total hip arthroplasty device with a fracture through the neck of the femoral component resulting in varus angulation. The acetabular component appears intact. Small foci of heterotopic ossification are noted adjacent to the gr... | Right total hip arthroplasty device with fractured femoral component as described above. |
Generate impression based on findings. | Female 69 years old; Reason: obstruction History: vomiting The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Mild left basal atelectasis.LIVER, BILIARY TRACT: No significant abnormality ... | 1. No evidence of bowel obstruction.2. Fat-containing lesions in the right kidney are suggestive of angiomyolipomas. 3. Indeterminate left renal lesion. Renal protocol CT/MRI would be helpful for further characterization. |
Generate impression based on findings. | Hand weakness. Evaluate for acromioclavicular separation or glenohumeral fracture. The bones appear slightly demineralized. I see no fracture or malalignment. Mild osteoarthritis affects the acromioclavicular joint. | Mild acromioclavicular joint osteoarthritis without fracture or malalignment. |
Generate impression based on findings. | Knee injury. Pain. I see no fracture or malalignment. Tiny osteophytes suggest minimal osteoarthritis, essentially within normal limits for age. I see no large joint effusion. | Minimal osteoarthritis, essentially within normal limits for age. I see no fracture or malalignment. |
Generate impression based on findings. | Motion artifact somewhat limits sensitivity. There are foci of restricted diffusion bilaterally in the centrum semiovale, the posterior body of the corpus callosum, the subinsular white matter on the left, and the deep white matter of the bilateral frontal lobes, compatible with small acute infarctions. There is scatt... | 1. Multiple small acute infarcts in the bifrontal white matter and the corpus callosum body.2. Moderate underlying chronic small vessel ischemic disease and evidence of chronic lacunar infarctions. |
Generate impression based on findings. | 77-year-old female with known OA, persistent fungemia and left knee pain, concern for septic joint Right knee: There is relatively poor visualization of the soft tissues due to technical factors. Given these limitations, we see no erosions or radiographic features of septic arthritis. Moderate osteoarthritis affects th... | Large left knee joint effusion which is nonspecific, but we cannot exclude septic arthritis. Severe osteoarthritis without erosions. |
Generate impression based on findings. | 41-year-old male with pain, rule out fracture Ankle: Mild soft tissue swelling is present along the lateral aspect of the ankle. There is a minimally displaced fracture of the lateral process of the talus. No additional fracture is evident.Foot: A small ossicle adjacent to the medial aspect of the second metatarsal hea... | Minimally displaced fracture of the lateral process of the talus. |
Generate impression based on findings. | 40 year-old female with calf hematoma There is reticulation of the subcutaneous fat consistent with edema that becomes confluent along the posterolateral aspect of the lower leg. We see no discrete fluid collection or hematoma. Mild edema extends between the gastrocnemius and soleus muscles, but we see no discrete intr... | Moderate soft tissue edema as described above without evidence of hematoma. |
Generate impression based on findings. | 68-year-old female status post fall on right hip Right hip: There is a complete fracture through the femoral neck with approximately 1 cm superolateral and slight anterior displacement of the distal fracture fragment relative to the femoral head.Left hip: We see no fracture or malalignment.Pelvis: The aforementioned ri... | Right femoral neck fracture. |
Generate impression based on findings. | 20 year-old female with point tenderness along third metacarpal, hit through door There is slight irregularity of the articular surface of the base of the proximal phalanx of the middle finger seen only on the oblique view, of uncertain clinical significance. While this may reflect old trauma, we cannot entirely exclud... | Mild irregularity of the articular surface of the base of the proximal phalanx of the middle finger of uncertain clinical significance. While this may represent old trauma, we cannot entirely exclude the possibility of a nondisplaced fracture of the articular surface. If further evaluation is clinically warranted, foll... |
Generate impression based on findings. | 43-year-old female with pain and swelling, twisted knee Tricompartmental osteophytes indicate mild to moderate osteoarthritis. A moderate joint effusion is present. No fracture is evident. | Osteoarthritis and moderate-sized joint effusion without fracture evident. If there is clinical concern for internal derangement, MRI is recommended. |
Generate impression based on findings. | Female 14 years old Reason: r/o fracture History: ran over by truck.VIEWS: Right tibia/fibula AP and lateral (two views) 1/30/2015, 1904 Mild soft tissue swelling of the anterior right mid tibial diaphysis noted. However, there is no underlying fracture or dislocation. There is subtle widening of the anterior proximal ... | Mild soft tissue swelling overlying the anterior mid tibial diaphysis without underlying fracture or dislocation. |
Generate impression based on findings. | 62-year-old female with history of NSCLC, vertebral body, tenderness, rule out fracture or bony pathology Evaluation of portions of the spine is limited due to extensive stool in the bowel. There is slight rightward curvature of the lumbar spine. Severe multilevel degenerative disk disease is present throughout the lum... | Severe multilevel degenerative disk disease. |
Generate impression based on findings. | Female 25 years old; Reason: 25F s/p lap chole on 1/27 now with leukocytosis and tachycardia; assess for biloma/hepatic abscess, etc History: tachycardia, leukocytosis The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observation... | 1. Postsurgical changes related to recent cholecystectomy. Moderate fluid with early loculation and inflammatory changes throughout the abdomen, somewhat more than would be expected. This appearance may be post inflammatory without infection however continued follow up is recommended. Biloma is felt less likely.2. Mild... |
Generate impression based on findings. | Female 50 years old Reason: Rule out PE History: Chest pain Exam is limited secondary to motion artifact, especially in the lung bases. PULMONARY ARTERIES: No evidence of acute pulmonary embolism to the segmental level. Pulmonary artery is normal in caliber without right heart strain.LUNGS AND PLEURA: No consolidation,... | Limited exam with no pulmonary embolism to the segmental level. No cardiopulmonary findings to account for the patient's chest pain.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 14 years old Reason: r/o fracture History: ran over by truckVIEWS: Right foot AP, oblique, and lateral (3 views) and right ankle AP, oblique, and lateral (3 views), 1/30/2015 A 2 x 5 mm density adjacent to the lateral aspect of the fibular epiphysis is compatible with an acute fracture. There are multiple areas ... | Distal fibular epiphyseal fracture with overlying soft tissue swelling. |
Generate impression based on findings. | Female 1 day old Reason: assess ETT and line placement History: 1 day old ex-36 weekerVIEW: Abdomen and chest AP (two views) 1/31/15 at 130 hours. ET tube tip is above the carina. Esophageal temperature probe and NG tube terminates at the stomach. UVC tip is at the SVC/08 atrium junction. Cardiac silhouette size is nor... | Interval placement of ET tube, central line and esophageal temperature probe and repositioning of NG tube.Diffuse lung haziness and lung vascular engorgement.Disorganized, slightly distended and nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 13 years old Reason: injured r ring finger playing water polo History: bruising notedVIEWS: Right hand PA, oblique, and lateral (3 views) 1/30/2014 Soft tissue swelling of the PIP joint of the fourth finger is noted. There is a small avulsion fracture and along the medial inferior corner of the fourth middle phala... | Small avulsion fracture of the fourth middle phalanx with overlying soft tissue swelling. |
Generate impression based on findings. | Male 40 days old Reason: Ex preemie, line displacement, follow-up History: Respiratory distressVIEW: Chest AP (one view) 1/30/15 at 1744 hrs. Tracheostomy tube terminates below thoracic inlet. Misplaced NG tube noted. Interval retraction of left upper extremity PICC, tip is at the proximal subclavian vein. Cardiac silh... | Misplaced central line and NG tube.Increasing in diffuse lung haziness, PDA is a consideration. |
Generate impression based on findings. | Female 45 years old Reason: renal stones, malignancy History: low back pain, chronic urinary incontinence, cachectic CHEST:LUNGS AND PLEURA: Bilateral pleural effusions, moderate on the right, small on the left, with compressive atelectasis. Additional small airspace opacities in the left lower lobe raising the possibi... | 1. No evidence of renal stones or malignancy.2. Bilateral pleural effusions with atelectasis. Small left lower lobe air space opacities raising the possibility of superimposed infection.3. Enhancing liver lesions are unchanged compared to prior study, favor benign etiology. |
Generate impression based on findings. | Female 15 years old Reason: Hematoma History: left arm weakness There is no evidence of hyperdense material extravasation or muscular hematoma. No evidence of joint effusion, fracture or malalignment | No CT findings to explain patient's symptoms. |
Generate impression based on findings. | Male 64 years old Reason: r/o PE History: tachycardia and left sided CP; d dimer 2.28 PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolism. The pulmonary artery caliber is normal without evidence of right heart strain. LUNGS AND PLEURA: No consolidation, pleural effusion, or pneumothora... | 1. No evidence of pulmonary embolism. 2. No acute pulmonary findings to account for patient's chest pain.3. Left common carotid artery is heavily calcified and stenotic appearing. Consider additional imaging to assess the extent of stenosis.4. Severe coronary artery calcifications, incompletely assessed on this non-gat... |
Generate impression based on findings. | The ventricles and sulci are within normal limits for age. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consistent with stable mild chronic small vessel ischem... | 1. Lack of contrast opacification of the posterior post-PICA right V4 segment except for a small segment of the very distal non-dominant right V4 segment which likely is related to retrograde flow. Findings are consistent with focal occlusion.2. Mild to moderate scattered intracranial arterial irregularities and narrow... |
Generate impression based on findings. | 74 year old female with recent fall, now presenting with confusion. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with mild age-related volu... | No evidence of intracranial hemorrhage. |
Generate impression based on findings. | Female 5 years old Reason: evaluate stool burden, acute intraabdominal process History: abdominal painVIEW: Abdomen AP (one view) 1/30/2014 There is a moderate amount of stool in the proximal ascending colon. No dilated loop of bowel, pneumoperitoneum, or pneumatosis intestinalis is seen. No evidence of bowel obstructi... | Moderate amount of stool in the proximal ascending colon. |
Generate impression based on findings. | Female 4 months old Reason: r/o pneumonia History: fever, tachypnea, hypoxiaVIEW: Chest AP (one view) 1/31/2014 0327 Interval increase in right upper lobe atelectasis with minimal rightward mediastinal shift, which may appear exaggerated due to patient rotation on the radiograph. Interval decrease in right middle and l... | Interval increase in right upper lobe atelectasis. Underlying infection cannot be ruled out. |
Generate impression based on findings. | Evaluation is limited secondary to lack of IV contrast. The right eye appears proptotic. There is mild enlargement and a slightly heterogeneous appearance of the right inferior rectus muscle, with somewhat ill-defined margins and surrounding fat stranding, which is suggestive of acute myositis/postseptal orbital cellu... | 1. Focal inflammation of the right inferior rectus is concerning for acute myositis/postseptal orbital cellulitis. The resultant mild mass effect is likely contributing to right proptosis. 2. Questionable additional inflammation in the right orbit lateral to the lacrimal gland.3. Chronic appearing bilateral maxillary s... |
Generate impression based on findings. | Female 35 days old Reason: Cardio-Pulmonary Assessment History: Status Post-Op Cardiac SurgeryVIEW: Chest AP (one view) 1/30/15 at 2122 hrs. ET tube tip is below thoracic inlet. Right IJ venous access terminates at the right atrium. Epicardial pacer leads, multiple mediastinal clips, bilateral chest tubes and pericardi... | Multiple postsurgical changes as described. |
Generate impression based on findings. | Female 1 day old Reason: assess ETT and line placement History: 1 day old ex-36 weekerVIEW: Abdomen and chest AP (two views) 1/31/15 at 132 hours ET tube tip is below the thoracic inlet. NG tube and esophageal temperature probe terminates at the stomach. UVC tip is at the hepatic vein. UAC terminates at T10.Cardiac sil... | Interval placement of umbilical lines, ET tube, NG tube and esophageal temperature probe.Right upper lobe atelectasis development.Disorganized, slightly distended and nonspecific abdominal gas pattern. |
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