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Generate impression based on findings.
14-month-old male with cough, fever, fast breathing, crackles at the left baseVIEWS: Chest AP/lateral (two views) 02/04/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Peribronchial cuffing suggestive of reactive airway disease/bronchiolitis pattern. Streaky retrocardiac opacity best seen on ...
Bronchiolitis/reactive disease pattern with retrocardiac atelectasis.
Generate impression based on findings.
23-year-old male with pain at fifth toe Alignment is anatomic. No fracture or other specific findings to account for the patient's pain. There is mild lateral soft tissue swelling.
No specific findings to account for the patient's symptoms.
Generate impression based on findings.
89 year-old female with left hip discomfort Hardware components of a right total hip arthroplasty device are situated in near-anatomic alignment without evidence of complication. A trochanteric femoral nail affixes the left hip. A nonunited lesser trochanteric fracture fragment is again noted. Severe degenerative disk ...
Post operative and chronic post traumatic changes as described above.
Generate impression based on findings.
Female 67 years old; Reason: eval for stone History: flank pain 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: No significant abnormality noted.LIVER, BILIARY TRACT: No significant ab...
1. No evidence of renal stone. If hematuria persists consider further evaluation with renal protocol CT abdomen (without the noncontrast study).2. Submucosal fat deposition along the ascending colon and terminal ileum suggestive of chronic inflammation with mild nonspecific mesenteric stranding about the right colon wh...
Generate impression based on findings.
54-year-old male status post fall Hip: No fracture or dislocation. The hip joint appears normal for the patient's age.Shoulder: No fracture or malalignment. A small ossicle inferior to the glenoid likely represents a loose body within the axillary recess.
No fracture or dislocation.
Generate impression based on findings.
48 year old female status post fracture reduction Cast material obscures underlying osseous detail. A comminuted distal tibia fracture is again noted in near anatomic alignment.
Casted distal tibia fracture as described above.
Generate impression based on findings.
86 year old female with pain Hips: Medial joint space narrowing consistent with mild osteoarthritis affects each hip. No fracture or dislocation.Knees: Limited nonweightbearing views demonstrate bilateral chondrocalcinosis and small osteophytes consistent with mild osteoarthritis affecting each knee.
Mild osteoarthritis and chondrocalcinosis without fracture or dislocation.
Generate impression based on findings.
24-year-old female with drainage from abdominal incision. Evaluate for abdominal abscess versus fistula. ABDOMEN:LUNG BASES: Large bilateral pleural effusions with overlying atelectasis.LIVER, BILIARY TRACT: Mass effect upon the left hepatic lobe from large fluid and gas containing collection as detailed below.SPLEEN: ...
1.Findings consistent with perforation of the small bowel in the right abdomen with contrast extravasation as detailed above.2.Possible fistulous communication of the upper abdominal contrast filled collection to the skin surface.3.Air and fluid filled collection at the upper abdomen resulting in posterior displacement...
Generate impression based on findings.
Female, 82 years old. No unexpected radiopaque foreign body. Drain and surgical staples are noted within the soft tissues. A rectal temperature probe is in place. IVC filter.
No unexpected radiopaque foreign body. These findings were discussed with Dr. Lee via telephone by the resident on call at 19:16 on 2/4/2015
Generate impression based on findings.
34-year-old female with history of left hip pain. Left hip: We see no acute fracture. Tiny ossicle adjacent to the superolateral aspect of the acetabulum likely represents an os acetabula, a normal variant. There are degenerative changes about the pubic symphysis.Left femur: We see no acute fracture. The knee joint is ...
No radiographic findings to account for the patient's pain. If patient care warrants further imaging, an MRI may be obtained.
Generate impression based on findings.
50 year-old female with history of intractable epilepsy, intraoperative imaging with bodytom after frame placement. Examination is performed with a stereotactic device secured in patient's calvarium without detectable complications. Examination is performed as a guidance for treatment/surgery and is not a diagnostic te...
1. Surgical planning nonenhanced stealth head CT as detailed.2. Postoperative findings related to right parietal craniotomies and depth electrode placement. The appropriate placement of depth electrodes should be determined by the clinical service. 3. No gross intracranial abnormality.
Generate impression based on findings.
82-year-old female with incorrect needle count Drain, gas and surgical staples in the soft tissues reflect recent surgery. No unexpected radiopaque foreign body.
No unexpected radiopaque foreign body. These findings were discussed with Dr. Lee via telephone by the resident on call at 19:16 on 2/4/2015
Generate impression based on findings.
Respiratory distress of the new born.VIEW: Chest and abdomen AP (two views) 2/5/15 at 530 hours. NG tube tip is at the stomach. UVC terminates at the right atrium. UAC coiled towards itself, tip is at L1 and dome at T10.Cardiac silhouette size is normal. No focal opacities, effusions or pneumothorax.Disorganized, less ...
Misplaced UAC.There is distended but still disorganized abdominal gas pattern.
Generate impression based on findings.
Eight year-old male with ankle pain, tenderness to palpation along the medial malleolusVIEWS: Left ankle AP/lateral/oblique (3 views) 02/04/15 Soft tissue swelling over the medial malleolus. No joint effusion. No specific evidence for fracture is evident. Alignment is anatomic.
Soft tissue swelling evidence of fracture or malalignment.
Generate impression based on findings.
Desaturations.VIEW: Chest and abdomen AP (two views) 2/5/15 at 637 hours. Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. No focal lung opacities. No effusions or pneumothorax.Disorganized, likely age-related and nonspecific abdominal gas pattern. No evidence of obs...
Disorganized, age related abdominal gas pattern.
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69-year-old female with history of foot pain. Redemonstrated is an oblique fracture through the mid diaphysis of the fifth metatarsal. There is slight medial angulation of the distal fracture fragment. There is mild soft tissue swelling about the lateral aspect of the foot. There is a moderate hallux valgus deformity.
Fifth metatarsal fracture appearing similar to prior.
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The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are well maintained. Bone marrow signal is heterogeneous with small foci of focal fat and hemangiomas. No destructive osseous lesions are seen. Artifact especially on the axial sequences limits evaluation. T...
1. Artifact slightly limits evaluation. There is evidence of T2 hyperintense lesions within the lower thoracic cord compatible with chronic demyelinating plaques. No new lesion is definitively appreciated. No pathologic enhancement to suggest active demyelination.2. Degenerative changes with mild spinal canal stenosis ...
Generate impression based on findings.
34-year-old female history of fifth digit swelling. Evaluate for osseous metastasis. Overlying cast material limits evaluation of the metacarpals and wrist. There is significant soft tissue swelling about the lateral aspect of the mid fifth finger. The underlying bone is unremarkable. We see no fracture or suspicious o...
Focal fifth finger swelling without fracture or radiographic evidence of osseous metastasis. If patient care warrants further imaging, an MRI may be obtained.
Generate impression based on findings.
13-year-old male status post reductionVIEWS: Right hand PA/oblique/lateral (3 views) 02/05/15 Cast material obscures fine bone detail. Again seen is a transverse fracture through the fifth metacarpal neck with persistent volar angulation of the distal fracture fragment.
Casting of Boxer's fracture of the fifth metacarpal with persistent volar angulation.
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65-year-old female history of right hip and low back pain. Evaluate for sacral insufficiency fracture. Redemonstrated is sclerosis and poor definition along the iliac margin of the right sacroiliac joint. There is also ill-defined sclerosis about the right sacrum. The left sacroiliac joint appears unremarkable. Moderat...
Sclerosis along the iliac, and to a lesser extent, the sacral aspect of the right sacroiliac joint is favored to be degenerative in etiology although this may represent a chronic insufficiency fracture.
Generate impression based on findings.
Female 4 months old Reason: follow up lung fields History: respiratory distressVIEW: Chest AP (one view) 2/5/15 at 814 hours Cardiac silhouette size is normal. Worsening in right upper and middle lobe atelectasis with mediastinal shift to the right. Persistent lung haziness.
Interval worsening in right upper and middle lobe atelectasis with mediastinal shift to the right.
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66-year-old male with history of abdominal pain and an eye on. Evaluate for pancreatitis. Please note lack of IV and oral contrast limits evaluation of solid organ pathology, and also of the GI tract.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatic steatosis is again noted. No biliary d...
1.No findings of pancreatitis on this limited exam.2.Hepatic steatosis.3.Subtle perirectal fat stranding, correlate with history/exam to exclude proctitis.4.Lumbarization of the S1 vertebral body.
Generate impression based on findings.
13-year-old male with swelling over the fourth and fifth digitVIEWS: Right hand PA/lateral/oblique (3 views) 02/04/15 Transverse fracture through the fifth metacarpal neck with volar angulation of the distal fracture fragment. Soft tissue swelling over the medial aspect of the hand. No additional fractures are identifi...
Boxer's fracture of the fifth metacarpal.
Generate impression based on findings.
11 year old female with abdominal pain and vomitingVIEWS: Abdomen AP (one views) 02/05/15 Moderate amount of stool throughout the colon. Nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. Valgus angulation of bilateral femoral necks. No acute fracture or malalignment ...
Nonobstructive bowel gas pattern.
Generate impression based on findings.
5-month-old female with cough and feverVIEWS: Chest AP/lateral (two views) 02/05/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Large lung volumes and mild to moderate peribronchial cuffing is suggestive of ...
Bronchiolitis/reactive airway disease pattern.
Generate impression based on findings.
Female, 52 years old, with right intraparenchymal hemorrhage, assess for interval change. There is redemonstration of the large parenchymal hematoma centered in the right thalamus, extending to the right triple peduncle, the size and density of which is not significantly changed since most recent exam. The surrounding ...
1.Minimal increase in the caliber of the left lateral ventricle. 2.Stable size of the large parenchymal hematoma centered in the right thalamus.3.Stable surrounding edema, associated mass effect, and quantity of intraventricular blood product.
Generate impression based on findings.
13-month-old male with fever and coughVIEWS: Chest AP/lateral (two views) 02/05/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is top normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Large lung volumes and moderate peribronchial cuffing suggestive of bronchio...
Bronchiolitis/reactive airway disease pattern.
Generate impression based on findings.
34-year-old male with history of seminoma status post chemotherapy. Evaluate response. CHEST:LUNGS AND PLEURA: No significant interval change in the right lower lobe nodule measuring 1.4 x 0.9 cm (series 5, image 50), previously measuring 1.4 x 0.8 cm (series 3, image 29); there are associated micronodules which are al...
1.Interval decrease in size of hilar, retroperitoneal, and pelvic lymphadenopathy.2.Stable right basilar nodule with associated micronodules.
Generate impression based on findings.
15-year-old male with pain over the lateral malleolusVIEWS: Left ankle AP/lateral/oblique (3 views) 02/04/15 No acute fracture or malalignment is evident. No soft tissue swelling. No joint effusion.
Normal examination.
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5-year-old male status post Broviac placementVIEW: Chest AP (one view) 02/04/15 Broviac line tip projects over the right atrium.Cardiothymic silhouette is unchanged. No pleural effusion or pneumothorax. No focal pulmonary opacities.
Broviac line tip projects over the right atrium
Generate impression based on findings.
46 year old male with longstanding history of dysphagia and eosinophilic esophagitis, now presents with worsening bloating and postprandial abdominal pain. Scout radiograph of the chest was unremarkable.Double contrast evaluation of the esophagus demonstrated mild ridging and persistent faint scalloping along the mid a...
1.Faint scalloping and ridging along the mid and distal esophagus, not significantly changed and compatible with the patient's known history of chronic eosinophilic esophagitis. 2.No new mucosal abnormality, obstructive lesion, or evidence of GE reflux.
Generate impression based on findings.
45 years, Female. Reason: constipation vs obstruction History: constipation Nonobstructive bowel gas pattern. Moderate to large amount of stool throughout the colon.Small right pleural effusion/thickening.
Nonobstructive bowel gas pattern. Mild to moderate constipation.
Generate impression based on findings.
4-month-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is below thoracic inlet and above the carina. NG tube terminates in the stomach.Cardiothymic silhouette is normal. Small left pleural effusion. Increased right upper lobe atelectasis with elevation of the minor fissure likely represents atelectasi...
Increased right upper lobe and and persistent left lower lobe atelectasis.
Generate impression based on findings.
68 years, Male. Reason: NG verification History: adjusted NG tube NG tube with tip in the proximal stomach and sidehole adjacent to the GE junction. Nonobstructive visualized bowel gas pattern. Note the lower abdomen and pelvis are out of the field-of-view.Left lower lung scarring/atelectasis.
NG tube with tip in the proximal stomach and sidehole adjacent to the GE junction. Recommend advancement.
Generate impression based on findings.
T1N0 right parotid adenoid cystic carcinoma, status post radiation therapy and surgery with right jaw pain. Evaluate for right jaw osteomyelitis. There are stable postoperative findings related to right parotidectomy and right face and neck radiation therapy. There is no evidence of measurable mass lesions. There are u...
1. Postoperative findings related to right parotidectomy without evidence of measurable mass lesions. 2. No definite significant lymphadenopathy to suggest metastatic disease. 3. Interval right mandibular ramus debridement, with a new defect in the retromolar trigone area, which may reflect excision and curettage, and ...
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Frequent headaches, short term memory problems, and visual disturbances. Evaluate for space occupying lesion. There is no evidence of intracranial mass or abnormal intracranial enhancement. There is no intracranial hemorrhage within limitations of post-contrast technique. The ventricles and basal cisterns are normal in...
No evidence of intracranial mass.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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61-year-old male with history of multiple myeloma. SKULL: Ovoid lucencies in the skull are favored to represent venous lakes versus myelomatous deposits. Overall, these appear similar to the prior study.CERVICAL SPINE: No discrete myelomatous lesions. There is moderate multilevel degenerative disc disease.THORACIC SPIN...
No discrete myelomatous lesions. Interval postsurgical changes in the lumbar spine.
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72 years, Female. Reason: Dobbhoff placement History: Dobbhoff placement Dobbhoff tube tip in the pyloric region. Remainder of the visualized structures are not significantly changed. See same day dedicated chest radiograph report for further details regarding chest.
Dobbhoff tube tip in the pyloric region.
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Female 24 years old Reason: PA malformations, PE History: behcet's disease PULMONARY ARTERIES: No acute pulmonary embolus. Pulmonary artery is normal in caliber without evidence of right heart strain. No evidence of pulmonary arterial malformations.LUNGS AND PLEURA: No focal consolidation to suggest infection. No suspi...
No evidence of pulmonary embolus. No acute cardiopulmonary abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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74-year-old with history of dense breasts, breast calcifications and bilateral breast reduction. Three standard views of both breasts and cleavage views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distr...
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: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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73-year-old male with history of metastatic prostate cancer. Bone pain. CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules are again seen, with reference lesions as follows:- Right upper lobe nodule (5/31) measures 0.9 x 1 .4 cm, unchanged from prior.- Left upper lobe nodule (5/25) measures 0.6 x 0.5 cm, unchanged.Addi...
1.Multiple pulmonary nodules without significant change in size.2.Interval increase in size of mediastinal lymph nodes.3.Multiple sclerotic bone lesions appear grossly stable, however refer to same day bone scan for more detailed evaluation.
Generate impression based on findings.
67-year-old male with history of prostate cancer with rising PSA. Evaluate for recurrence. CHEST:LUNGS AND PLEURA: There are scattered micronodules, which are nonspecific. Right upper lobe pleural-based thickening measures 1.6 x 1.7 cm and measures fat attenuation, likely lipoma. No pleural effusions or pneumothorax.ME...
1.No definite evidence of tumor recurrence.2.Nonspecific mildly enlarged right hilar lymphoid tissue and scattered pulmonary micronodules.
Generate impression based on findings.
Dobbhoff placement Dobbhoff tube coiled in the stomach with tip directed cranially in the fundus. Remainder of the surgical drains/staples and cardiopulmonary support devices are not significantly changed. See same day dedicated chest radiograph report for further details regarding chest.Bibasilar consolidation/atelect...
Dobbhoff tube coiled in the stomach with tip directed cranially in the fundus.
Generate impression based on findings.
There is mucosal thickening throughout the left maxillary sinus with frothy material which is nonspecific but could be an indicator of acute on chronic sinusitis. The nasal passages are near completely occluded as is the left osteomeatal complex. There is leftward nasal septal deviation which effaces the left nasal pa...
1.Left maxillary thickening and frothy material with occlusion of the nasal passages and left osteomeatal complex. This along with septated mucosal thickening of the sphenoid sinus indicates possible acute on chronic sinusitis.2.Leftward deviation of the septum which contributes to the effacement of the left nasal pass...
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43-year-old with personal history of breast cysts. 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. There are bilateral breast masses, at least sev...
Bilateral cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Diagnostic rather than screening mammogram is recommended given the high likelihood that ultrasound will be needed next year. Results and recomme...
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Female; 22 years old. Reason: please assess for possible progression of possible fungal pna History: aml pt here for consolidation chemo LUNGS AND PLEURA: Previously seen scattered, ill-defined semi-solid nodules have resolved, likely post infectious or inflammatory in etiology. No suspicious pulmonary nodules or masse...
1. Interval resolution of scattered semisolid nodules, likely post infectious or inflammatory in etiology.2. Further improvement in mediastinal lymphadenopathy.
Generate impression based on findings.
30 year-old female status post reduction Plaster material obscures underlying osseous detail. Distal radius fracture fragments are now in near-anatomic alignment. An ulnar styloid fracture is again noted.
Distal radius fracture reduction.
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30 year-old female after FOOSH There is a comminuted, impacted fracture of the distal radius with dorsal angulation of the distal fracture fragments. A minimally displaced ulnar styloid fracture is also noted.
Distal radius and ulnar styloid fractures as described above.
Generate impression based on findings.
Male 23 years old Reason: s/p ORIF History: s/p ORIF Postsurgical changes with plate and screw fixation of the distal radius and ulna fractures in near anatomic alignment. There is some bony bridging at the medial fracture line and callus formation with some sclerosis about the fracture at the ulnar fracture line. No h...
Healing distal radius and ulnar fractures as above.
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Reason: Restrictive lung physiology History: dyspnea LUNGS AND PLEURA: No significant abnormality noted. No evidence of interstitial lung disease. No air trapping identified on the expiratory imaging.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal evidence of a pericardial effusion....
No pulmonary or pleural abnormalities identified. No evidence of interstitial lung disease or air trapping.
Generate impression based on findings.
Sinusitis. There are postoperative findings related to endoscopic sinus surgery. There is moderate mucosal thickening in the bilateral maxillary sinuses, with a small amount of hyperattenuating secretions in the right maxillary sinus and diffuse sclerosis and thickening of the sinus walls. There is complete opacificati...
Postoperative findings related to endoscopic sinus surgery with persistent pansinus opacification suggestive of acute upon chronic sinusitis and suggestion of polyposis.
Generate impression based on findings.
5-year-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is above the thoracic inlet. Right internal jugular central venous catheter with tip at the superior cavoatrial junction. NG tube terminates in the stomach.Cardiothymic silhouette is normal. No pleural effusions or pneumothorax. Retrocardiac opacit...
Slight interval improvement of pulmonary edema pattern with persistent retrocardiac atelectasis.
Generate impression based on findings.
63-year-old male with shortness of breath and recent abnormal chest radiograph with new cavitary lesion. History of metastatic lung adenocarcinoma. LUNGS AND PLEURA: New thin walled cavitary lesion in the superior segment of the left lower lobe with mild surrounding consolidation measures up to approximately 4.5 x 4.4 ...
1. New cavitary lesion in the left lower lobe with appearance most suggestive of infectious etiology.2. Increased lingular tumor nodule.3. Stable left hilar mass and mediastinal lymphadenopathy.4. Increased gastrohepatic ligament lymphadenopathy and right adrenal metastasis.
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48-year-old female with history of distal tibia fracture There is a comminuted fracture of the distal tibia with mild lateral displacement of the distal fracture fragments. An oblique fracture of the proximal fibula is also noted. The knee and distal femur appear intact.
Distal tibia and proximal fibula fractures as described above.
Generate impression based on findings.
9-year-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is below thoracic inlet and above the carina. Left central venous catheter tip and right upper extremity PICC tips are in the superior vena cava.Persistent bilateral pleural effusions and retrocardiac atelectasis. Cardiac silhouette is top normal, ...
Unchanged pulmonary edema pattern.
Generate impression based on findings.
There is minimal mucosal thickening within the right sphenoid sinus. The paranasal sinuses are otherwise clear. The nasal cavity is also clear. There is mild leftward anterior nasal septal deviation. Mild irregularity involving the right nasal bone likely related to remote trauma. The lamina papyracea and ethmoid roof...
No significant paranasal sinus disease
Generate impression based on findings.
5-month-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip has been advanced and now is below thoracic inlet and above the carina. Gastrostomy tube is in place.Cardiothymic silhouette is normal. Large lung volumes. Blunting of the left costophrenic angle. Increasing right upper and persistent left lower l...
Increasing right upper and persistent left lower lobe opacities likely represent atelectasis with unchanged left pleural effusion.
Generate impression based on findings.
74-year-old female with infectious endocarditis, altered mental status; concern for septic emboli. 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, consis...
1. No evidence of intracranial hemorrhage or suggestion of septic emboli. Please note, non-enhanced CT is insensitive for detection of septic emboli and of acute non-hemorrhagic infarcts.2. There is evidence of left chronic otitis.
Generate impression based on findings.
Reason: s/p 3 yrs after LLL for T1aN0 Stage IA adenocarcinoma History: 6 mo f/u LUNGS AND PLEURA: Postsurgical volume loss in left lower lobe.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericard...
No evidence of recurrent or metastatic disease.
Generate impression based on findings.
15-year-old female intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is below the thoracic inlet and above the carina. Right internal jugular central venous catheter tip is obscured by the spinal instrumentation. Right upper extremity PICC tip is in the left atrium. Spinal rods and hooks are again seen, unchanged...
Increased right upper lobe opacity with mild improvement of left basilar opacity likely reflect atelectasis although infection cannot be excluded. Persistent bilateral pleural effusions. Slight interval improvement of the pulmonary edema pattern.
Generate impression based on findings.
72 years, Female. Reason: Dobhoff reposition History: Dobhoff reposition Dobbhoff coiled in the stomach with tip directed cranially at the fundus. Remainder of the visualized structures are unchanged. See same day dedicated chest radiograph report for further details regarding chest.
Dobbhoff coiled in the stomach with tip directed cranially at the fundus.
Generate impression based on findings.
Male; 66 years old. Reason: h/o SCT, now with persistent fevers and cough, please eval for signs of infection History: immunocompromised, URI sx, fever LUNGS AND PLEURA: Improved nodular opacities in the posterior right upper lobe. Increased mild streaky and nodular opacities in the right lower lobe with bronchial wall...
1. Increased opacities and bronchial wall thickening in the right lower lobe, most compatible with recurrent aspiration. Nodular opacities in the left lower lobe are in a pattern suggestive of aspiration bronchiolitis. 2. New axillary and retrocrural lymphadenopathy is nonspecific but likely reactive.3. New moderate no...
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Male 85 years old Reason: elevated alk phos, edema LIVER: The liver measures 16.0 cm in length and demonstrates mildly hyperechoic parenchyma. There is no focal liver lesion. The main portal vein is patent and demonstrates normal directional flow with peak velocity 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable app...
1. Mildly hyperechoic hepatic parenchyma suggestive of diffuse fatty infiltration. 2. Bilateral pleural effusions.
Generate impression based on findings.
Confirm NG tube placement. Interval placement of NG tube with tip in the body of the body of the stomach. Nonobstructive visualized bowel gas pattern. Note the lower abdomen and pelvis are outside the field of view.Left retrocardiac opacity.
NG tube tip in the body of the stomach.
Generate impression based on findings.
59 years, Male. Reason: pain abdomen History: pain abdomen Jejunal tube tip distal to the ligament of Treitz, unchanged. IVC filter and upper abdominal skin staples, unchanged. Ileus, not significantly changed. Bibasilar consolidation/atelectasis.
Ileus, not significantly changed.
Generate impression based on findings.
75-year-old male with rising PSA. Evaluate for disease. ABDOMEN:LUNG BASES: Moderate atherosclerotic calcifications.LIVER, BILIARY TRACT: Stable subcentimeter hypoattenuating liver lesion (series 3, image 27) and is too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality n...
No evidence of recurrent or metastatic disease.
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60 year-old male with multiple medical comorbidities representing a the days of left-sided numbness. Focal regions of hypodensity in the anterior limb of the right internal capsule and the left centrum semiovale may represent age-indeterminant infarctions. There are scattered areas of hypoattenuation in the periventric...
1. Focal regions of hypodensity in the anterior limb of the right internal capsule and the left centrum semiovale may represent age-indeterminant infarctions. However, CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. No evide...
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Eight-year old male with fever, cough, and left lower lobe cracklesVIEWS: Chest AP/lateral (two views) 02/05/15 Aortic arch, cardiac apex, and stomach are left sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Large lung volumes and minimal bronchial wall thick...
Bronchiolitis/reactive airway disease pattern.
Generate impression based on findings.
55 year old female presents for pre-kidney transplant evaluation. ABDOMEN:LUNG BASES: Right lower lung pulmonary micronodule (3/1) is partially seen, nonspecific. No pleural effusions or additional pulmonary abnormality. Extensive coronary artery and valvular calcifications affect the heart.LIVER, BILIARY TRACT: No sig...
1.Atherosclerosis and left common artery iliac ectasia as above. 2.Left adrenalectomy findings.3.Right upper lung pulmonary micronodules partially seen.4.Severe coronary artery calcifications.
Generate impression based on findings.
Male; 64 years old. Reason: assess for L pneumothorax History: subcutaneous emphysema LUNGS AND PLEURA: Chest true with its tip located posteriorly at the apex.Moderate left pneumothorax, mainly located anteriorly at the left base, slightly increased from previous O8 left pleural effusion has decreased.Multiple areas o...
1.Moderate left anterior pneumothorax, slightly increased compared to previous.2. Increased mediastinal and subcutaneous emphysema. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
Generate impression based on findings.
Right cochlear implant, but hearing and speech discrimination remaing extremely poor. Right: There are interval postoperative findings related to cochlear implantation. The device appears intact and the electrodes are positioned within the basal turn of the cochlea. However, there may be thinning or dehiscence of the c...
Interval postoperative findings related to right cochlear implantation, in which device appears intact. However, there may be thinning or dehiscence of the cochlear wall separating the electrodes from the labyrinthine segment of the facial nerve canal.
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Frontal sinus: The frontal sinuses now contain diffuse aerated secretions, with complete opacification of the frontoethmoidal recesses.Anterior ethmoids: There is moderate-severe opacification of anterior ethmoid air cells.Maxillary sinuses: There is moderate mucosal thickening in the left with moderate-severe thicken...
1. Significant worsening of paranasal sinus opacification, now at least moderate in degree with complete opacification of both ostiomeatal units. Air-fluid levels in the maxillary sinuses with numerous areas of aerated secretions suggestive of acute sinusitis.2. Bilateral mastoid air cell and middle ear fluid. Please c...
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78-year-old male with left-sided flank pain. Evaluate for kidney stone. Lack of IV and oral contrast material limits evaluation of solid organs and the bowel.ABDOMEN:LUNG BASES: Small right pleural effusion.LIVER, BILIARY TRACT: Cholelithiasis without evidence of gallbladder wall thickening or pericholecystic inflammat...
1.Mildly prominent proximal small bowel loops are nonspecific. Correlate clinically for obstructive symptoms.2.Small volume perihepatic and perisplenic ascites with diffuse mesenteric haziness suggestive of mild edema. 3.Small right pleural effusion. 4.No obstructing left nephrolithiasis as clinically questioned. 5.Pun...
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46 year old with known left fibroadenoma presents for annual mammogram. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Cir...
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.
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74-year-old male status post IM nail placement An intramedullary rod affixes the pathologic proximal femur fracture with two distal fixation screws. We see no evidence of hardware complication. There is minimal surrounding osseous bridging.
Orthopedic fixation of pathologic proximal femur fracture as described above.
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Female 63 years old Reason: evaluate for structural cause of mild hyperbilirubinemia History: mildly elevated total hyperbilirubin/unconjugated hyperbili LIVER: The liver measures 14.9 cm in length and demonstrates somewhat coarsened echotexture. There is no focal liver lesion. The main portal vein is patent and demons...
1. Mildly coarsened hepatic echotexture which is nonspecific but may be seen in setting of chronic liver disease. 2. No evidence of intra- or extra- hepatic biliary ductal dilatation.
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62-year-old female with pain Right hand: The osseous structures are within normal limits for the patient's age. No specific findings to account for the patient's symptoms.Left hand: There is irregularity of the ulnar styloid suggesting erosion. No additional erosions or other findings to explain the patient's symptoms.
Irregularity of the left ulnar styloid suggesting erosion, which can be seen in early rheumatoid arthritis.
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61-year-old female, rule out fracture Radiopaque markers were placed over the left lower chest wall site of patient's pain. No underlying fracture is noted. Marked colonic stool burden. The lungs are clear.
No visualized rib fracture.
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65-year-old female with lumbar back pain Posterior stabilization rods with screws entering the vertebral bodies of L2 and L3 without evidence of hardware complication. There is minimal anterolisthesis of L3 on L4 with flexion. There is partial fusion of the L2 and L3 intervertebral body disk space anteriorly. Severe de...
Orthopedic fixation of the lumbar spine with minimal subluxation as described above.
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2-year-old male with history of left Wilms, 12 months off therapy LIVER: Liver is normal in size and echotexture measuring 7.7 cm. Limited interrogation of the main portal vein demonstrates blood flow towards the liver measuring 0.3 m/sec.GALLBLADDER, BILIARY TRACT: No significant abnormality noted. The common bile duc...
Status post left nephrectomy without evidence of recurrent or metastatic disease.
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A patient submitted outside study for review. Submitted for review are right unilateral digital mammographic images (2/5/14), and ultrasound images (2/5/14) performed at The Queen's Medical Center. For comparison, digital mammographic images (7/22/13, 7/25/13) and ultrasound images (7/25/13) are available. Submitted st...
No mammographic or sonographic evidence of malignancy in the right breast for the study performed on February 2014. Annual mammogram is due for both breasts.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram.
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22 years, Female. Reason: h/o Crohn's disease with SBO worsening abdominal pain after NGT pull out History: abdominal pain Interval removal of NG tube. Several loops of dilated small bowel with air fluid levels compatible with small bowel obstruction. No pneumoperitoneum. Right lower quadrant sutures.
Findings compatible with persistent small bowel obstruction.
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Female 39 years old Reason: BL knee pain History: BL knee pain Right knee: Bone mineralization is normal. There is moderate medial compartment joint space loss and tricompartmental osteophytes. No joint effusion is evident. No acute fracture or malalignment.Left knee: Bone mineralization is normal. There is mild to mod...
Moderate right knee and mild to moderate left knee osteoarthritis.
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56 years, Male. Reason: Evaluate G tube History: Status post G tube placement. Contrast injected through the G tube opacifies the gastric folds and duodenal sweep, compatible with proper positioning. Nonobstructive bowel gas pattern. Average stool burden.
Proper positioning of G tube as described above.
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70 years, Male. Reason: eval position of broken Dobbhoff tip History: see above Dobbhoff tube with tip in the pyloric region. Fractured Dobbhoff tip is unchanged in position in the proximal stomach, slightly lateral to intact Dobbhoff tube. Nonobstructive visualized bowel gas pattern.
Fractured Dobbhoff tip is unchanged in position in the proximal stomach.
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80 year-old female with history of bunion. There is a severe hallux valgus deformity. Moderate osteoarthritis affects the first MTP joint and sesamoid bones. Mild osteoarthritis affects the midfoot.
Osteoarthritis and hallux valgus deformity as above.
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The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is mild disk height loss at L5-S1 with disk desiccation. The vertebral body and disk heights are otherwise well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is an area of intrinsic T1 and T2 hyperintensity i...
1. Focal right paracentral disk protrusion at L5-S1 with posterior displacement of the descending right S1 nerve root.2. Partially visualized likely cystic structure within the right pelvis possibly arising from the right ovary measuring at least 3.5 x 3.5 cm. Follow-up ultrasound may be obtained in 4-6 weeks.
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Female 57 years old Reason: history of PE, now with DOE History: DOE PULMONARY ARTERIES: No evidence of pulmonary embolus. Pulmonary artery is normal in caliber without evidence of right heart strain.LUNGS AND PLEURA: Left lower lobe granuloma compatible with previous renal disease.No suspicious pulmonary nodules or ma...
No evidence of pulmonary embolus.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative.
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BradycardiaVIEW: Chest AP 2/5/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left chest tube in place. Cardiothymic silhouette normal. Patchy atelectasis bilaterally in a background of chronic lung disease increased in the interval. No pleural effusion or pneumothorax.
Patchy atelectasis bilaterally increased in the interval.
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48-year-old female with history of total hip arthroplasty. Right hip: Hardware components of a right total hip arthroplasty device are situated in anatomic alignment without radiographic evidence of hardware complication. Surgical skin staples are noted laterally.Pelvis: Again seen are the aforementioned postoperative ...
Right total hip arthroplasty as above.
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InjuryVIEWS: Left elbow AP, oblique and lateral The overlying cast obscures fine bony detail. Within this limitation no definite periosteal reaction or acute fracture. No elbow joint effusion.
No definite periosteal reaction or acute fracture.
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34-year-old with history of left triple negative breast cancer. Routine follow-up. The patient admits to a 30-pound weight loss. Three standard views of both breasts, left laterally exaggerated CC view, spot magnification views of the lumpectomy site and spot compression of the right breast were performed digitally and...
No mammographic evidence of malignancy. Overall increase in background parenchymal pattern could relate to weight loss. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Additionally, given the patient's history of breast cancer at a young age, MRI on ...
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FractureVIEWS: Left humerus AP and lateral There is a healing acute fracture of the metaphysis of the left humerus. There is apex lateral angulation not significantly changed. There is periosteal reaction reflecting interval healing.
Healing humeral fracture as described above.
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Reason: RUL nodule History: surveillance, annual scan LUNGS AND PLEURA: Right upper lobe subpleural nodule with internal cavitation (image 54 series 5) is unchanged over 5 years. The solid component measures 10 mm x 6 mm previously measuring 11 mm x 6 mm.The internal cavitation has not changed.Scattered calcified granu...
Subpleural right upper lobe nodule without significant interval change over multiple exams dating back to 12/16/09. No new nodules identified.
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InjuryVIEWS: Left ankle AP, oblique and lateral No acute fracture or dislocation. The ankle mortise joint is normal.
No acute fracture or dislocation.
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The right uterine artery was embolized using 500-700 micron Embospheres until near stasis was achieved. The post-embolization angiogram confirmed these findings.LEFT UTERINE ARTERY EMBOLIZATION
1. Successful bilateral uterine artery embolization.2. Successful placement of a Denali IVC filter. The patient was entered into the IVC filter tracking database and should return to the interventional radiology department in 3 months for consultation regarding optional IVC filter removal.
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Confusion without new focal findings Right medullary infarct is better seen on prior MRI. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. There is mild global parenchymal volume loss commensurate with age with prominence of the extra-axial CSF spaces in the bilateral frontal r...
1. No evidence of intracranial hemorrhage or mass effect. 2. Right medullary infarct is better seen on prior MRI. Follow-up MR imaging can be considered for further assessment as clinically indicated.
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Ms. Williams is a 24 year old female presenting with unilateral right bloody nipple discharge. Recent ultrasound and MRI detected multiple intraductal masses, the largest of which was located in the right superior breast. This will be the target for today's biopsy. Right breast ultrasound re-identified the target lesio...
Successful ultrasound-guided core biopsy of the right intraductal lesion with clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
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60-year-old female with mycosis fungoides who presents for staging. Evaluate for adenopathy and visceral involvement. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are noted, some of which are calcified, likely secondary to prior granulomatous disease. No suspicious pulmonary masses. No pleural effusions or ...
1.Stable small retroperitoneal and mediastinal lymph nodes. 2.No evidence of new enlarged lymph nodes in the chest, abdomen, or pelvis. 3.Incompletely characterized left renal exophytic hypoattenuating lesion. Further evaluation with sonography is recommended. 4.Fatty infiltration of the liver. 5.Stable left thyroid no...
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Base of tongue edema on laryngoscopy and lymphadenopathy. There is apparent soft tissue thickening along the left posterior wall of the hypopharynx with a punctate calcification. Otherwise, the tongue base appears unremarkable. There is no evidence of significant cervical lymphadenopathy based on size criteria. The air...
Nonspecific apparent soft tissue thickening along the left posterior wall of the hypopharynx may be inflammatory in nature, represent redundant of normal tissues, or perhaps less likely neoplasm. Otherwise, the tongue base appears unremarkable.