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Generate impression based on findings. | Female 56 years old Reason: bilat knee pain r/o osteo History: bilat knee pain r/o osteo Right knee: Bone mineralization is normal. There is mild medial compartment joint space loss. No significant joint effusion. There are tricompartmental osteophytes. No acute fracture or malalignment.Left knee: There is mild medial ... | Bilateral knee osteoarthritis. Left knee effusion. No specific evidence of osteomyelitis. Consider joint aspiration. |
Generate impression based on findings. | Reason: 50 y/o f with restrictive lung disease on PFTs, eval for ILD. Also obstruction, eval for bronchiolitis, emphysema, etc. Also CAD history, eval for pulmonary edema. History: shortness of breath LUNGS AND PLEURA: Linear scarlike opacities left lung base, but no evidence of pulmonary fibrosis.Airways appear normal... | Left basilar scarring, but no evidence of interstitial lung disease or airways disease. |
Generate impression based on findings. | Male 63 years old; Reason: 63M with h/o multiple CVA's with cognitive issues, MI's, DM off metformin since admit 1/30/15 History: new lung nodules on CT (NOTE: Please discuss any issues with pt's wife due to his cognitive issues)RADIOPHARMACEUTICAL: 14.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/... | 1.Widespread hypermetabolic thoracic, abdominal and osseous metastatic disease.2.Heterogeneous cardiac uptake is suggestive of ischemic disease. Correlation with cardiac scintigraphy may be useful. |
Generate impression based on findings. | Seizure activity with history of migraines. NONCONTRAST CT HEADNo evidence of acute intracranial hemorrhage. No mass effect, midline shift or herniation. The ventricles, sulci, and cisterns are symmetric and unremarkable. No intra- or extra-axial fluid collection. The osseous structures are unremarkable. The paranasal ... | 1.No evidence of acute intracranial hemorrhage or mass effect.2.No evidence of significant steno-occlusive disease or aneurysms within the intracranial circulation. |
Generate impression based on findings. | 73-year-old male with history of metastatic prostate cancer, bony pain. Assess for progression. Multiple foci of abnormal radiotracer uptake in the scapulae, ribs, and vertebral bodies are increased in number and activity.Other increased radiotracer uptake in the cervical spine, shoulders, elbows, wrists, and knees lik... | Interval progression of bone metastases, as evidenced by increased number and activity of foci in the scapulae, ribs, and vertebral bodies. |
Generate impression based on findings. | 20 year old female patient submitted outside study for review. Submitted for review are ultrasound images of right breast (12/8/14) and limited right breast digital mammographic images (12/8/14) performed at South Shore Hospital. Per outside radiology report, the patient complained of right breast lump.ULTRASOUND IMAGE... | Questionable lesion in right breast at 11-12 o'clock position on the ultrasound. Repeat ultrasound study is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 34-year-old male with history of Hodgkin's lymphoma. Needs restaging after relapse. CHEST:LUNGS AND PLEURA: Interval increased small right pleural effusion and associated atelectasis. Previously seen right middle lobe nodule (4/80) measures 1.5 x 0.8 cm, increased from prior 4 mm.MEDIASTINUM AND HILA: Heart size within... | 1.Increased lymphadenopathy as above.2.Interval increase in pulmonary nodule size and small pleural effusion.3.New right posterolateral chest wall ninth rib expansile lytic lesion with associated soft tissue mass. |
Generate impression based on findings. | 41-year-old male with shoulder pain after fall Glenohumeral alignment is within normal limits. No fracture or other specific finding to account for the patient's symptoms. | No fracture or dislocation. |
Generate impression based on findings. | Male; 62 years old. Reason: NHL, SCCA head/neck History: NHL, SCCA head/neck LUNGS AND PLEURA: Interval development of multiple micronodules in the right middle lobe, the largest of which measures 4 mm (series 4/55).Right upper lobe sub-solid nodule measures 6 mm (series 4/46), unchanged.Previously described left upper... | Multiple new nonspecific micronodules in the right middle lobe. The distribution is atypical for metastases, and these could be inflammatory. Follow up in no longer than 3 months is recommended. Note that previously seen retroperitoneal lymphadenopathy is not included in this scan, and the next CT should include at lea... |
Generate impression based on findings. | 23-year-old male with pain and swelling after basketball injury There is an oblique fracture of the distal aspect of the proximal phalanx of the little finger extending to the articular surface without significant displacement. | Fifth finger fracture as described above. |
Generate impression based on findings. | 71 year-old female with rib pain along left side Radiopaque markers are placed along the left lower chest wall at the site of the patient's pain. The bones are demineralized limiting sensitivity, and there is moderate colonic stool and gas obscuring the lower ribs. No rib fracture is visualized. | No evidence of rib fracture. |
Generate impression based on findings. | Line placementVIEW: Chest AP and abdomen AP Nasogastric tube tip in the stomach. The umbilical venous catheter tip in the right atrium. The umbilical arterial catheter tip is looped within L2/4. Cardiothymic silhouette normal. No focal lung opacity. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel... | Malpositioned umbilical arterial catheter. |
Generate impression based on findings. | 53-year-old male with history of electrical burn and limited finger movement with volar wrist pain. The bones are slightly demineralized. Alignment is normal limits. There is no fracture or other specific findings to account for the patient's pain. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 2-year-old female with Langerhans histocytosis with pulmonary involvement LUNGS AND PLEURA: Significant interval improvement of bilateral pulmonary opacities. Small residual opacities are seen along the major fissure in the left lower lobe, right middle and lower lobe, and perihilar along the bronchovascular tree. The ... | Significant interval improvement of bilateral pulmonary nodules and cavities with mild residual disease described above. |
Generate impression based on findings. | History of osteomyelitisVIEWS: Right wrist AP and lateral Again noted periosteal reaction and sclerosis along the distal radius and ulna reflecting interval healing in a patient with known history of osteomyelitis of the wrist. There is minimal soft tissue swelling about the wrist joint. No acute fractures or dislocati... | Healing osteomyelitis involving the distal radius and ulna. |
Generate impression based on findings. | 73-year-old female with history of myeloma and back pain. Postsurgical changes of kyphoplasty at T9. There is a moderate thoracic kyphosis. There is no evidence of acute compression deformities. Moderate to severe degenerative disc disease affects the visualized cervical spine. Lytic lesions noted within bilateral clav... | T9 kyphoplasty without acute abnormality. Other findings as above. |
Generate impression based on findings. | There are unchanged postoperative findings related to left globe prosthesis and right lens prosthesis with atrophy of the left rectus muscles. There is unchanged right-sided proptosis without evidence of intraorbital mass or abnormal enhancement. There is no evidence of osseous lesion. The right optic nerve does not a... | Unchanged right sided proptosis without evidence of orbital mass. |
Generate impression based on findings. | Female 54 years old; Reason: Evaluate for cancer, being considered for lung transplant, ?R lung nodule seen on CT History: Possible lung noduleRADIOPHARMACEUTICAL: 13.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 126 mg/dL. Today's CT portion grossly demonstrates bilateral bronchiectasis with fibrosis an... | 1.No suspicious hypermetabolic pulmonary nodules identified to indicate lung cancer.2. However there are right inferior and left superior renal parenchymal lesions which are suspicious for renal cell carcinoma. Further evaluation with dedicated CT or MRI could be performed. |
Generate impression based on findings. | Knee painVIEWS: Pelvis AP and frog leg No acute fracture or dislocation. Both the femoral heads are seated within the acetabula. | Normal examination. |
Generate impression based on findings. | Redemonstrated are post-surgical changes from a right frontoparietal craniotomy and right hemispherectomy. Dystrophic appearing calcifications are again seen along the dura, which are unchanged. Unchanged small right sided extra-axial collection. Again seen is a ventriculostomy tube coursing through the left parietal ... | 1.Stable size of the ventricular system without evidence of hydrocephalus. .2.Stable post-surgical changes from a right hemispherectomy.3.Unchanged findings suggestive of periventricular leukomalacia along the left hemisphere. |
Generate impression based on findings. | Female 68 years old. Re-evaluate solitary pulmonary nodule. LUNGS AND PLEURA: Persistent right lower lobe septated, cystic thin-walled lesion with adjacent scarring is again seen. The lesion is contiguous with a right lower lobe bronchiole and appears similar in size without significant interval change, and is likely p... | Stable right lower lobe cystic lesion is most likely benign and post-infectious in etiology. Follow up with low-dose thoracic CT in 12 months can be obtained to confirm stability. |
Generate impression based on findings. | Frontal sinus: There is mild mucosal thickening of the right frontal sinus.Anterior ethmoids: Evidence of partial right sided ethmoidectomy. Moderate mucosal thickening of the left anterior ethmoid air cells. Mild circumferential mucosal thickening of the right ethmoidectomy cavity.Maxillary sinuses: Redemonstration o... | 1. Interval mixed change in paranasal sinus disease. Extensive mucosal thickening of the right maxillary, left posterior ethmoid, and left sphenoid sinus, with opacification of the left sphenoethmoidal recess. Otherwise, mild pan-sinus mucosal thickening.2. Status post functional endoscopic sinus surgery on the right. ... |
Generate impression based on findings. | Evaluate healing fractureVIEWS: Left hand AP, oblique and lateral Again noted irregularity involving the metaphysis of the fourth proximal phalanx not significantly changed from prior study. No definite periosteal reaction noted. | Probable Salter II fracture of the proximal fourth phalanx. |
Generate impression based on findings. | Female; 62 years old. Reason: evaluation preoperatively for meso History: evaluation preoperatively for meso CHEST:LUNGS AND PLEURA: Extensive, confluent nodular left pleural thickening, compatible with the known history of mesothelioma. For future reference, the following measurements are provided:At the level of the ... | 1. Extensive mesothelioma.2. Nodular opacities in both lungs are nonspecific and may be related to infection or inflammation. Metastatic disease or lung cancer primaries cannot be excluded. |
Generate impression based on findings. | 15-year-old female with tachypnea, PaO2 decreasing PULMONARY ARTERIES: Pulmonary artery opacification is adequate without evidence of pulmonary embolism. LUNGS AND PLEURA: Right upper lobe consolidation. Moderate right pleural effusion and minimal left pleural effusion is seen. Patchy bibasilar opacities likely represe... | 1.No evidence pulmonary embolism.2.Right upper lobe and bibasilar consolidation likely atelectasis.3.Moderate right pleural effusion and small left pleural effusion. |
Generate impression based on findings. | 87-year-old male with abnormal LFTs, weight loss, rib pain. Evaluate for malignancy.Per chart review, patient with history of bladder cancer CHEST:LUNGS AND PLEURA: Mild upper lobe predominant paraseptal and centrilobular emphysema. Mild bronchial wall thickening is again noted. No suspicious pulmonary nodules or masse... | 1.No focal hepatic lesions identified on this nondedicated examination. 2.Bilateral femoral head sclerosis suggestive of avascular necrosis. |
Generate impression based on findings. | 45-year-old female with history of patella fracture Again seen is a comminuted, intra-articular fracture of the patella with fracture fragments in near-anatomic alignment. A small joint effusion is again noted. | Nondisplaced patella fracture without significant interval change. |
Generate impression based on findings. | Ms. SimpsonWells is a 51 year old female with a personal history of right breast mastectomy in 09/2014 for recurrent IDC/DCIS treated with chemoradiation. Family history of breast cancer in paternal aunt. She has no current breast related complaints. Three standard views of the left breast were performed digitally and ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | The paranasal sinuses are clear. The nasal cavity is also clear. There is no significant nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid groove and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unre... | No evidence of sinusitis. |
Generate impression based on findings. | Female 58 years old; Reason: Pt w/ extensive state small cell lung CA; c/o severe pain in bilateral lower extremities. No suspicious osseous lesions are identified to indicate metastatic disease. | No evidence of bone metastases. No bone scan explanation for the patient's bilateral lower extremity pain. |
Generate impression based on findings. | 67 year old female with history of urothelial cancer. Evaluate for progression of disease. IRB # 13-0540. CHEST:LUNGS AND PLEURA: Reference left upper lobe nodule (7/31) has increased in size, measuring approximately 4.1 x 3 .3 cm, previously 2 x 2.8 cm. Additionally, other pulmonary nodules have increased in size, and... | Interval increased small right pleural effusion and pulmonary masses/nodules. Abdominal and pelvic findings are not significantly changed. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. There are no masses, mass effect or midline shift. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | No evidence of acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | 75-year-old female with a new pleural effusion and metastatic disease. Evaluate CHEST:LUNGS AND PLEURA: New large right pleural effusion with associated compressive atelectasis. Multiple subcentimeter micronodules along with the right minor fissure, likely intrapulmonary lymph nodes.MEDIASTINUM AND HILA: No mediastinal... | 1.Large right pleural effusion and multiple subcentimeter nodules along the right fissure which are likely intrapulmonary lymph nodes. Findings may be inflammatory in etiology.2.Nonspecific cluster of subcentimeter right cardiophrenic lymph nodes.3.Small pelvic ascites.4.Two subcentimeter hypoattenuating hepatic lesion... |
Generate impression based on findings. | Male 29 years old; Reason: patient with subacute onset of left testicular pain, with some fullness on exam History: left testicular pain RIGHT TESTIS: Echogenicity of the right testicle is normal in appearance. No significant abnormalities noted.LEFT TESTIS: Echogenicity the left testicle is normal in appearance. No si... | Small left varicocele. |
Generate impression based on findings. | Ms. Chande is a 59 year old female with a personal history of left breast lumpectomy in 10/2012 IDC with lobular features, followed by radiation and Arimidex therapy. No current breast related complaints. Three standard views of both breasts along with a laterally exaggerated left CC view were performed digitally and r... | Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnos... |
Generate impression based on findings. | Male 53 years old; Reason: evaluate for gastroparesis History: retained food on EGD and upper gi series Visually there was significantly delayed gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 92.4 % of ... | Significantly delayed gastric emptying. |
Generate impression based on findings. | Male 74 years old; Reason: 73yo M with history of R testicular mass with ultrasound performed at OSH and told it was benign, feels it is enlarging, repeat ultrasound to assess. History: scrotal mass RIGHT TESTIS: Multiple subcentimeter simple testicular cysts the largest of which measures 0.5 x 0.5 x 0.5 cm. Differenti... | 1. Very large right epididymal cyst.2. Multiple subcentimeter intratesticular cysts are present bilaterally as above. No suspicious testicular mass otherwise. |
Generate impression based on findings. | Female 59 years old; Reason: metastasis? History: C3 lesion No abnormal foci of osteoblastic activity either a C3 or elsewhere in the skeleton.No evidence of metastatic disease as clinically questioned. | Negative bone scan. Known C3 lesion is not actively osteoblastic and this may represent a benign lesion such as a hemangioma, although nonspecific. No evidence of osseous metastatic disease as clinically questioned otherwise. |
Generate impression based on findings. | Reason: NG placement History: NG placement NG tube with tip in the body of the stomach. Nonobstructive bowel gas pattern. Calcification in the right mid abdomen likely represents a small renal calculus.Bibasilar atelectasis. | NG tube with tip in the body of the stomach. |
Generate impression based on findings. | Reason: Dobbhoff History: Dobbhoff Interval removal of NG tube. Interval placement of Dobbhoff tube with tip in the proximal stomach. Nonobstructive visualized bowel gas pattern. Note the lower pelvis is outside the field of view. | Interval placement of Dobbhoff tube with tip in the proximal stomach. |
Generate impression based on findings. | Altered mental status, smelling noxious odors, hearing voices. Please evaluate for pathology. There is no evidence of intracranial hemorrhage, mass, or mass effect. No abnormal parenchymal or meningeal enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or hern... | No evidence of intracranial mass or abnormal enhancement. If there is continued suspicion for a structural lesion, consider MRI for further evaluation. |
Generate impression based on findings. | 83-year-old female with intermittent headaches after fall one month ago, history of bilateral dacrocystitis and nasolacrimal duct obstruction. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. Th... | 1. No evidence of intracranial hemorrhage or mass effect.2. Complete opacification and expansion of the left maxillary sinus consistent with mucocele with resultant occlusion of the left ostiomeatal complex.3. There is soft tissue density centered on the left medial canthus, which is more pronounced than on prior CT, a... |
Generate impression based on findings. | headache. No evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures a... | 1. No evidence of acute ischemic or hemorrhagic lesion.2. Multiple non specific radiolucencies on cervical spine, cervical spine MRI with and without contrast enhancement can be considered if clinically indicated.3. Disc degenerations with minimal lateral recess narrowings due to osteophytes on the right C45 and C56 di... |
Generate impression based on findings. | 9-year-old female with ulcerative colitis with increasing abdominal pain, poor weight gain, and worsening labworkEXAMINATION: MR enterography without and with IV contrast 02/05/15 ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality... | Limited study due to patient motion. Thickening and enhancement of the rectum, sigmoid colon, and descending colon up to the splenic flexure is consistent with patient's given history of ulcerative colitis. |
Generate impression based on findings. | Reason: ngt placement History: ng tube placement NG tube with tip at the GE junction. Nonobstructive visualized bowel gas pattern. Note the lower pelvis is outside the field of view. | NG tube tip at the GE junction. Recommend advancement. |
Generate impression based on findings. | For the purposes of numbering, there are 5 lumbar type vertebral bodies. Vertebral body heights are maintained. Alignment is maintained. There is no acute fracture. Multilevel degenerative changes are seen, as describe below:At L1-2 there is disk bulge without significant compromise to the spinal canal or neural foram... | 1. No destructive osseous lesions or compression fractures are seen in the lumbar spine. If there is high suspicion for metastatic disease, consider MRI for more sensitive evaluation. 2. Degenerative changes in the lumbar spine at multiple levels. There is moderate neural foramina stenosis at the left L3-L4 level which... |
Generate impression based on findings. | 52 year old female with history of multiple right breast cysts. History of ovarian cancer in a maternal aunt. No current 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 i... | 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. | 25 year old female with history of rectal prolapse and constipation. There was prompt opacification of the rectum and sigmoid colon. Trial straining demonstrated an anterior rectocele measuring 1.2 x 1.0 cm on the lateral view (series 25). The straining AP view demonstrated small bilateral lateral rectoceles (series 27... | 1.Anterior rectocele and small bilateral lateral rectoceles.2.Significant rectal prolapse extending well below the pubic symphysis on formal evacuation. |
Generate impression based on findings. | Anisocoria. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. There is mild plaque at the carotid bifurcations. There is multilevel degenerative spondylosis. The airways are patent. The imaged intracran... | No evidence of mass lesions in the neck. |
Generate impression based on findings. | Reason: Dobbhoff placement History: post Dobbhoff Interval removal of NG tube. Interval placement of Dobbhoff tube with tip in the pyloric region. Nonobstructive visualized bowel gas pattern. Surgical clips, IVC filter, midline skin staples, Primrose drain, and curvilinear wiring projecting over the pelvis, unchanged i... | Interval placement of Dobbhoff tube with tip in the pyloric region. |
Generate impression based on findings. | History of stroke, now anticoagulated No evidence of acute intracranial hemorrhage. There is encephalomalacia centered in the right inferior parietal lobule extending to the adjacent right temporal lobe and right occipital lobe. There is associated ex vacuo effect and widening of adjacent sulci. Redemonstrated are line... | 1.No definite evidence of acute intracranial hemorrhage or new mass effect.2.Large chronic right middle cerebral artery infarct. 3.Stable gyriform hyperdensities in the right greater than left frontal lobes, left occipital lobe, and right cerebellar hemisphere. These findings remain unchanged since 1/29/2015 and likely... |
Generate impression based on findings. | 80 year-old male with known type B dissection admitted for her blood pressure management in January 2015. The patient presents for one month follow-up CTA. CT ANGIOGRAM: Type B dissection originating distal to the left subclavian artery and extending approximately 5 cm above the diaphragm. The thoracic aorta measures u... | 1.Type B thoracic dissection as detailed above. No prior exam available for comparison, which was discussed with Ms. Braun, NP.2.Moderate to severe atherosclerotic calcifications affect the abdominal aorta and its branches, including origins of the celiac axis and SMA.3.Multiple scattered groundglass opacities througho... |
Generate impression based on findings. | 77 year-old female with upper and mid back pain after fall The bones are demineralized. There is a compression fracture of the T3 vertebral body which is new from the prior chest CT with mild associated kyphosis. The lower thoracic spine appears unremarkable for the patient's age. | T3 vertebral body compression fracture. |
Generate impression based on findings. | 3-year-old female with back pain, evaluate for scoliosisVIEWS: Lumber spine AP/lateral (two views) 02/05/15 Mild anterior wedging of L1. Mild leftward curvature of the lumbar spine. No segmentation anomalies. No acute fracture or malalignment. | Mild anterior wedging of L1 may be related to mild leftward curvature of the lumbar spine. No acute fracture is evident.Findings were discussed with Dr. Brayboy on 2/5/15 at 1648. |
Generate impression based on findings. | 66-year-old female status post nerve plaque, history of cancer The distal tips of bilateral nephroureterostomy catheters project over the pelvis. Surgical clips project over the lower abdomen and pelvis. The osseous structures are unremarkable for the patient's age. The sacrum is obscured by bowel gas. | Unremarkable osseous structures. |
Generate impression based on findings. | Reason: Dobbhoff History: Dobhoff Dobbhoff tube with tip in the proximal stomach. Nonobstructive bowel gas pattern. | Dobbhoff tube with tip in the proximal stomach. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern an... | Bilateral benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Evaluate umbilical lineVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. The umbilical venous catheter tip in the umbilical vein. The umbilical arterial catheter tip at T10. Cardiothymic silhouette normal. Minimal patchy atelectasis bilaterally without pleural effusion or pneumothorax... | The umbilical venous catheter tip in the umbilical vein. |
Generate impression based on findings. | 48 year-old female with history of adenocystic carcinoma the trachea with lung metastases.RADIOPHARMACEUTICAL: 11.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 108 mg/dL. Today's CT portion of the head, neck, and pelvis demonstrates no significant pathology. Please see diagnostic CT reports for details o... | 1.Treated pulmonary metastases have decreased in metabolic activity overall. New fairly mild activity associated with three treated nodules likely reflects post-radiation inflammation.2.Untreated pulmonary metastases have new or increased hypermetabolic activity.Diagnostic CTs of the chest, abdomen, and pelvis also per... |
Generate impression based on findings. | 71-year-old female with left hip pain There is marked joint space narrowing with subchondral cyst formation and osteophytes consistent with severe osteoarthritis affecting the hip. A small cleft within the posteromedial acetabulum corresponding to the edema seen on prior MRI may relate to old fracture deformity or oste... | Severe osteoarthritis as described above without evidence of acute fracture. |
Generate impression based on findings. | FractureVIEWS: Left elbow AP and lateral There are 4 K wires affixing a supracondylar fracture in near anatomic alignment without evidence of hardware complication. There is periosteal reaction indicative of healing. The overlying cast obscures fine bony detail. | Healing supracondylar fracture as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign right breast biopsy. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Bilateral partially ... | Bilateral partially obscured masses. An attempt to obtain patient's prior mammograms should be made for comparison purposes.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | 66 year old female s/p Ivor esophagectomy for esophageal cancer. Evaluate for leak. Single contrast evaluation of the esophagus demonstrated irregular contour of the distal esophagus secondary to postsurgical changes and edema following recent Ivor esophagectomy. There was transient delay in passage of contrast into th... | Postsurgical changes s/p Ivor esophagectomy without evidence of high grade obstruction or leak. |
Generate impression based on findings. | There is no definite evidence of proptosis. The bilateral globes are mildly elongated in the AP dimension, left greater than right. There is focal thinning suggested of the right globe just medial to the optic nerve insertion.The extraocular muscles and optic nerves are normal in size and density. No mass is seen in t... | 1. No definitive evidence of proptosis, enlargement of the extraocular muscles, or orbital mass.2. The bilateral globes are mildly elongated in the AP dimension, which may relate to myopia.3. There is also possible focal thinning of the right posterior globe, medial to the optic nerve insertion, suggestive of developin... |
Generate impression based on findings. | There is a inflammatory changes with soft tissue thickening along the right slightly greater than left upper eyelid. There is also diffuse enlargement and enhancement of the right lacrimal gland with a ill-defined margins suggesting inflammatory changes. There is mild localized mass effect upon the adjacent right late... | 1. Inflammatory changes of the right greater than left upper eyelids as well as diffuse enlargement, and enhancement of the right lacrimal gland as well as mild inflammatory changes suggested involving the left. No definite associated osseous erosions. Differential diagnosis includes Sjogren's, orbital pseudotumor, sar... |
Generate impression based on findings. | 50 year-old male with history of abdominal pain and bloody stool. Evaluate for infectious colitis. ABDOMEN:LUNG BASES: Fibrotic changes. Suture material seen along the right leaflet of the diaphragm. Correlate for prior surgery.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Status post splenectomy. There... | Findings consistent with active ulcerative colitis with subtotal colonic involvement and sparing of the cecum and proximal ascending colon. No evidence of perforation or abscess.Splenectomy with hypertrophy of accessory spleen.Left adrenal nodule.Other findings as above.I personally reviewed the Images and/or procedure... |
Generate impression based on findings. | PainVIEWS: Right hand AP, right middle finger oblique and lateral There is a Salter III fracture involving the base of the middle phalanx of the middle finger. There is soft tissue swelling at the PIP region. The remainder of the examination is normal. | Acute Salter III fracture base of the middle phalanx of the middle finger. |
Generate impression based on findings. | 57 year old male s/p LAR for rectal cancer. Please assess for leak prior to takedown. There is prompt opacification of the J-pouch, sigmoid, and descending colon with expected postsurgical changes including end-to-side anastomosis. Trial straining showed appropriate descent of the perineal floor, and voluntary anal sph... | Expected postsurgical changes s/p J-pouch creation without evidence of anastomotic leak. |
Generate impression based on findings. | Female; 57 years old. Reason: interim placement of pleurx catheter History: persistent SOB CHEST:LUNGS AND PLEURA: Interval placement of Pleurx catheter with tip at the lateral costophrenic angle. Significant interval decrease in left pleural effusion, but a small left pleural effusion persists with small amount of loc... | 1. Significant interval decrease in left pleural effusion status post Pleurx catheter placement with persistent small, partially loculated effusion.2. Subtle areas of left pleural thickening and nodularity, consistent with tumor involvement.3. Mild patchy atelectasis/consolidation in the left lower lobe, for which unde... |
Generate impression based on findings. | Female 87 years old Reason: chest pain, tachycardia, and hypoxia History: see above PULMONARY ARTERIES: No acute pulmonary embolus. The pulmonary artery is normal in caliber without evidence of right heart strain.LUNGS AND PLEURA: Low lung volumes.Mild septal thickening with symmetric, moderately large bilateral pleura... | 1.No acute pulmonary embolus.2.Moderately large, bilateral pleural effusions and septal thickening consistent with mild CHF.3.Multiple left sided, acute-appearing rib fractures. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicab... |
Generate impression based on findings. | Male 47 years old Reason: concern for pneumonia History: respiratory failure, s/p hypoxic arrest Motion artifact limits the evaluation of fine parenchymal detail, especially in the lung bases.LUNGS AND PLEURA: Low lung volumes with persistent mosaic attenuation of the lung parenchyma. There is chronic atelectasis and c... | Persistent right lower lobe atelectasis and consolidation likely secondary to chronic elevation of the right hemidiaphragm, unchanged from 7-31-14.No specific evidence of infection. |
Generate impression based on findings. | 79-year-old male with history of multiple myeloma, recent left femoral neck lesion. Rule out bone disease.RADIOPHARMACEUTICAL: 11.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 109 mg/dL. Today's CT portion grossly demonstrates extensive atherosclerotic disease, including severe coronary arterial calcific... | No suspicious FDG-avid lesion to suggest current tumor activity. |
Generate impression based on findings. | 56 years, Male. Reason: ileus vs sbo History: minimal stool output despite tf and aggressive bowel regimen, distended abd Enteric tube coiled with tip adjacent to the Ligament of Treitz. Overall relative paucity of bowel gas. Note the far lateral aspects of the abdomen and the pelvis are outside the field of view. Righ... | Overall relative paucity of bowel gas. No specific evidence of small bowel obstruction or ileus on this limited exam. |
Generate impression based on findings. | Male 34 years old; Reason: Relapsed Hodgkin lymphoma, in need of restaging, pt lost follow upRADIOPHARMACEUTICAL: 10.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 95 mg/dL. Today's CT portion of the neck demonstrates no significant pathology. Please see diagnostic CT reports for details of the chest, abd... | Extensive markedly hypermetabolic tumor involving lymph nodes from the neck through the pelvis, a right lung nodule, and right posterior rib / chest wall, markedly progressed from previous.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 51 years, Female. Reason: assess for obstipation History: 51 y.o. woman with a history of constipation alternating with diarrhea. ? overflow diarrhea Nonobstructive bowel gas pattern. Moderate amount of stool throughout the colon. | Moderate amount of stool throughout the colon. |
Generate impression based on findings. | 22 year-old female with history of pain. There is an oblique fracture through the distal diaphysis of the fifth metatarsal. Alignment is anatomic. There is mild soft tissue swelling about the lateral aspect of the foot. | Fifth metatarsal fracture as above. |
Generate impression based on findings. | Evaluate for aspirationVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. The stomach is distended. Minimal patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. | Minimal atelectasis left lower lobe. |
Generate impression based on findings. | Panserositis (pericardial effusion, bilateral pleural effusions, and ascites) of uncertain cause. There is no evidence of mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable, includin... | 1. No evidence of mass or significant lymphadenopathy.2. Partially imaged bilateral pleural effusions related to serositis. Please refer to the separate chest CT report for additional details.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: structural lung disease, other abnormality History: heart transplant workup LUNGS AND PLEURA: Calcified right upper lobe nodule compatible with previous granulomatous infection.Moderate right pleural effusion with underlying compressive atelectasis.Small subpleural scar-like opacity in the right middle lobe.MED... | Moderate right pleural effusion with underlying compressive atelectasis in the right lower lobe, compatible with CHF. No other significant pulmonary abnormalities. |
Generate impression based on findings. | Fall on outstretched handVIEWS: Right wrist AP, oblique and lateral There is sclerosis at the distal diaphysis of the radius likely reflecting a healing fracture at this site. The alignment is anatomic. The distal ulna is normal. | Presence of sclerosis at the distal radius likely reflecting a healing fracture at this site. |
Generate impression based on findings. | Right partial thyroid lobectomy and left thyroid nodule. There is heterogeneous left thyroid mass that measures up to 5 cm with scattered calcifications. There has been right thyroid lobectomy. There is no evidence of significant cervical lymphadenopathy based on size criteria. The salivary glands are unremarkable. The... | A heterogeneous left thyroid mass that measures up to 5 cm with scattered calcifications is nonspecific and neoplasm cannot excluded. |
Generate impression based on findings. | 37-year-old male status post left acetabular fracture after snowmobile accident There is a complex comminuted fracture of the left acetabulum involving the posterior column. An angulated fracture fragment is displaced slightly laterally. The proximal femur appears intact. The remainder of the pelvis is intact. | Complex left acetabular fracture. If further evaluation is clinically warranted, CT should be considered. |
Generate impression based on findings. | 59-year-old male with history of pain. Left knee: There are enthesopathic and posttraumatic changes at the inferior aspect of the patella. Additionally, there are tricompartmental osteophytes and joint space narrowing worse in the patellofemoral compartment compatible with moderate to severe osteoarthritis. The patella... | Degenerative and posttraumatic changes as above. |
Generate impression based on findings. | Reason: anisocoria, r/o malignancy History: none LUNGS AND PLEURA: 3-mm right lower lobe subpulmonic micro-nodule image 47 series 3, the lungs otherwise unremarkable.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Moderate focal coronary artery calcifications are present, the heart and pericardiu... | 1. No evidence of malignancy, sarcoid or similar abnormalities.2. Cholelithiasis.3. Very large hiatal hernia. |
Generate impression based on findings. | 58-year-old female with worsening left hip pain Mild to moderate osteoarthritis affects the left hip. Severe degenerative disk disease affects the lower lumbar spine with vacuum disk phenomena. There is grade 1 anterolisthesis of L4 on L5. Surgical clips project over the left ischium. | Degenerative arthritic changes as described above. |
Generate impression based on findings. | 53 year-old female with left foot pain Pes planus and hallux valgus deformities. Two screws transverse the first metatarsal. Postoperative changes of first metatarsal osteotomy. Mild osteoarthritis affects the first MTP joint and midfoot. | 1. Degenerative and postoperative changes as described above.2. Pes planus and hallux valgus deformities. |
Generate impression based on findings. | 29-year-old female with pain There is prominence of the femoral head-neck junction suggesting a CAM deformity. A small os acetabulare is noted. | Prominence of the femoral head-neck junction compatible with a CAM deformity. |
Generate impression based on findings. | 37-year-old male status post injury. There is a comminuted fracture of the tibial plateau without significant cortical step off along the articular surface. The comminuted fracture predominantly involves the lateral tibial plateau, but a transverse fracture line extends beneath the tibial spines with a vertical compone... | Comminuted tibial plateau and patella fractures as described above. |
Generate impression based on findings. | 11-year-old male with knee painVIEWS: Left knee AP/lateral, right knee AP/lateral, bone length radiograph (5 views) 02/05/15 No acute fracture or malalignment is evident. No joint effusion. No loose bodies. Undertubulation of the osseous structures. Metaphyseal flaring is present. Foreshortening of the femur with metap... | No acute fracture malalignment is evident. Other findings as above. |
Generate impression based on findings. | Female; 25 years old. Reason: evaluation of osteosarcoma preoperatively lung mets History: sob CHEST:LUNGS AND PLEURA: Multiple solid and partially ossified nodules and masses in both lungs, compatible with osteosarcoma metastases. For future reference, the largest lesion is in the right posterior costophrenic angle an... | 1. Osteosarcoma lung metastases with mild interval increased size in the largest lesion, which is in the right lower lobe. The other metastases are grossly stable in size. No new metastases.2. No evidence of metastasis in the abdomen. |
Generate impression based on findings. | 12-year-old male with bilateral left knee pain x 1 month along medial and lateral aspectsVIEWS: Right knee and left knee AP/lateral (4 views) 02/05/15 No acute fracture or malalignment is evident. Small left joint effusion is present. No loose bodies. The articular surfaces are smooth. Mild cortical irregularity along ... | 1.Small left joint effusion.2.Mild cortical irregularity along the medial aspect of the distal right femoral metaphysis. This may represent a normal variant and correlation with clinical examination is recommended. MRI may be considered if pain persists. |
Generate impression based on findings. | Reason: 58 yo female with history of AML; pre-allo SCT evaluation History: evaluate LUNGS AND PLEURA: Small calcified granuloma in the right lower lobe compatible with previous infection.No active disease and no pleural effusion.Elevation of the right hemidiaphragm, unchanged.MEDIASTINUM AND HILA: No lymphadenopathy.No... | No acute abnormalities. |
Generate impression based on findings. | Reason: possible follicular neoplasm of the thyroid History: r/o mets LUNGS AND PLEURA: No significant abnormality noted, specifically no evidence of metastases. MEDIASTINUM AND HILA: Left lobe thyroid heterogeneous enlargement, status post right sided thyroidectomy.Water attenuating "node" in the right paratracheal re... | 1. Enlargement of the left thyroid lobe, the right having been resected.2. No evidence of metastases.3. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | 22 year-old male with gunshot wound, evaluate for foreign body or fracture A moderate joint effusion is noted. There is a radial head and neck fracture with minimal displacement. A crescentic density adjacent to the medial epicondyle may represent a small avulsion fracture. No radiopaque foreign body. | Radial head and neck fracture and small avulsion fracture of the medial epicondyle. Joint effusion. No radiopaque foreign body. |
Generate impression based on findings. | HPV-positive T2N2B right tonsillar cancer, status post left tonsillectomy, right tonsil biopsy, and CRT on 9/26/14. There has been interval right neck dissection with fluid collections in the surgical bed. There has also been resection of the right internal jugular vein. There is no evidence of significant lymphadenopa... | 1. Interval right neck dissection with fluid collections that likely represent seromas.2. No measurable right tonsillar mass.3. Fluid within the left maxillary sinus is suggestive of acute sinusitis. |
Generate impression based on findings. | 18 year-old male jammed right index finger A faint density volar to the proximal aspect of the middle phalanx may represent a small capsular avulsion injury. There is overlying soft tissue swelling. | Questionable small volar capsular avulsion injury about the PIP joint as described above. |
Generate impression based on findings. | 56 year old female with history of pain. There is deformity and chronic flattening of the humeral head with bone-on-bone apposition. Additionally, there is sclerosis about the humerus. There is moderate osteoarthritis affecting the acromioclavicular joint.No acute fracture is evident. | Severe osteoarthritis and other findings as above. |
Generate impression based on findings. | 46-year-old female with reported history of ankylosing spondylitis. Right hip: Mild osteoarthritis affects the hip. There is no evidence of acute fracture or dislocation.Left hip: Mild osteoarthritis affects the hip. There is no evidence of acute fracture or dislocation.SI joints: There is mild left greater than right ... | Degenerative changes with no specific radiographic evidence of ankylosing spondylitis. If clinically warranted, an MRI of the SI joints may be obtained. |
Generate impression based on findings. | Male 51 years old; Reason: pT3b N1 prostate cancer now on ADT with PSA of 0.19. Evaluate for bone metastases. No abnormal osseous foci are identified to indicate metastatic disease.There are mild degenerative changes of the lower thoracic spine as compared to same day CT study. | No evidence of bone metastases. |
Generate impression based on findings. | 58-year-old male with history of low back pain. There is moderate degenerative disc disease especially at L4-5. There are small osteophytes projecting from the anterior aspect of L3, L4, and L5. Vertebral body heights are maintained. Surgical clips project over the lower abdomen. | Moderate degenerative arthritic changes as above. |
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