MRI OF THE CHEST WITHOUT CONTRAST:
HISTORY: Chest wall pain. Evaluate for inflammation and anterior pain.
Multiplanar images of the chest were obtained without contrast. The patient was claustrophobic.
The muscle bundles are symmetric from side to side. The bony structures appear unremarkable. No obvious destructive lesion is appreciated. The axillary region appears symmetric. There is no obvious mass, adenopathy, or abnormal fluid collection. Soft tissue appears symmetric.
Correlation with chest CT may be of value. Chest CT would have better resolution for lung parenchyma.
IMPRESSION: No abnormal increased signal on the T2 sequences to suggest an area of inflammation. There is no large fluid collection or mass. There is no obvious adenopathy. Correlation with a chest CT may be of value to better look at the lung parenchyma. The lungs are not as well visualized due to artifacts from the heart and lungs.
Thank you for your kind referral.
MRI OF THE LEFT FOOT:
HISTORY: Fell on foot, ankle.
Multiplanar images of the left foot were obtained. The tarsal bone appears intact. There is no large fluid collection. The muscle bundles are preserved. There is low signal on T1, high signal on T2 involving the medial aspect of the tarsal navicular bone as well as the accessory ossicle, the os tibiale externum adjacent to the tarsal navicular bone. This is suggestive of an area of bone bruise/contusion. It is difficult to discern a discrete fracture line.
Muscle bundles are preserved. There is no large fluid collection. The tendons appear unremarkable as well.
IMPRESSION: Evidence for bone bruise/contusion involving the tarsal navicular bone as well as accessory ossicle medial to the tarsal navicular bone, the os tibiale externum.
Thank you for your kind referral.
MRI OF THE BILATERAL HIPS AND PELVIS:
HISTORY: Right thigh and hip pain. No prior surgery.
There is no obvious fracture of either femoral head or proximal femur. The acetabula are intact. No significant joint effusion within either joint space is present to indicate bursitis or significant focal inflammation. Axial images and sagittal images of the pelvis do suggest a small hairline demarcation in the right iliac bone inferiorly. This could be an old injury or perhaps an unusual and asymmetric suture line. Alternatively, it could be a fracture line, which has healed. There is no significant edema around it or fluid in the surrounding musculature to indicate a definite acute fracture. No dislocation is present.
The SI joints are well maintained bilaterally. The alar wings show no evidence of fractures or lytic or blastic disease. We do see in the right hip a probable bone island with reference to the posterior and inferior right femoral head. It has an intrinsically low-intensity center on both T2 and T1; therefore, suggesting calcification or cortex bone. No lucent center is noted that would indicate a more serious concern such as an osteoid osteoma. One can confirm this by looking at a plain film and see if there is a bone island suggested in this region. Again, on the T2 weighted images, there is no evidence of edema around this region or contusion within the bony structures, and the cortex is intact.
IMPRESSION:
1. No evidence of acute fractures is seen on this exam. There is a possible very small bone island involving the posteroinferior right femoral head. No edema or cortical changes are noted around it. There is a possible old injury or a small asymmetric suture line noted at the right iliac bone. Again, no edema or dislocation to indicate acute fracture.
2. Both of the femoral joint spaces and the SI joint spaces are well maintained.
Thank you for your kind referral.
MRI OF THE LEFT ANKLE/ACHILLES TENDON:
HISTORY: Evaluate for Achilles tendon tear.
Multiplanar images of the left ankle/Achilles tendon obtained without contrast.
The Achilles tendon is abnormal in appearance with a wavy, lax appearance seen posterior to the distal tibia. The insertion on the calcaneus appears intact. However, there is abnormal increased signal in the Achilles tendon involving the posterosuperior aspect of the calcaneus with a markedly narrowed area posterior to the most distal aspect of the distal tibia with significant fluid surrounding the Achilles tendon. The tear would appear to be in the Achilles tendon posterior to most distal aspect of the distal tibia. On the axial images, the Achilles tendon does appear contiguous. It does have marked decreased transverse dimension within the area of concern where a more complete tear cannot be excluded. The lax appearance is suggestive of a complete tear. There is significant soft tissue edema about the ankle joints, slightly more medial than laterally along the ankle joints.
The bony structures and articulations appear maintained. There is no obvious fracture or dislocation. There is fluid posterior to the talus and the tibiotalar joint.
IMPRESSION:
1. The Achilles tendon is abnormal in appearance. There is a wavy, lax appearance of the Achilles tendon, which is seen in a complete tear. There is abnormal signal within the Achilles tendon near its insertion on the calcaneus. Also, the Achilles tendon posterior to most distal aspect of the distal tibia has abnormal signal in markedly narrowed transverse dimensions. This area is the most narrowed and may represent the area of complete tear. There is fluid adjacent to the Achilles tendon as well.
2. There is also soft tissue swelling about the ankle joints, both medially and laterally.
3. No obvious fracture or dislocation.
Thank you for your kind referral.
MRI OF THE LEFT AXILLA WITHOUT AND WITH CONTRAST:
HISTORY: Left axilla mass. Prior MRI noted periosteal reaction and cortical thickening proximal to mid left humerus with abnormality in the bone marrow.
Multiplanar images of the left axilla were obtained without and with contrast.
The proximal humerus appears intact. There does appear to be a couple of vessels in the proximal diaphysis of the humerus. The cortex appears relatively uniform and unremarkable in appearance. There is no destructive bony lesion. On the T1 weighted sequences, the marrow signal was fairly uniform. The cortices of the bone are also intact.
Muscle bundles are well preserved.
A vitamin E tablet was placed over the area of concern. There appears to only be adipose tissue in the area of the vitamin E tablet. No discrete cystic or solid lesion is readily identified in the area of the vitamin E tablet. No enlarged lymph nodes are identified. The vitamin E tablet appears to be along the anterolateral aspect of the left chest wall superiorly.
IMPRESSION:
1. The visualized portion of the left proximal humerus appears intact. The cortex is intact. The marrow signal appears preserved. No destructive lesion is identified.
2. In the area of concern, in the left axilla, where there is a palpable abnormality, there appears to be adipose tissue. There is no discrete cystic or solid lesion. No enlarged lymph nodes are readily identified.
Thank you for your kind referral.
MRI OF THE LIVER:
HISTORY: A (XX)-year-old female with cyst on liver. Family history of cystic disease.
Routine imaging of the liver is performed. Gadolinium was used.
There are numerous cysts of the liver. The largest is seen on the superior right liver and measures approximately 4.2 x 3.4 cm. Several are seen in the posterior right liver and very small ones, less than a few millimeters, are noted in the anterior subscapular region of the liver with regards to the right lobe.
When gadolinium was given, no abnormal enhancement was seen. We also see a probable 1 cm cyst in the body of the pancreas. There is a caudate cyst in the liver as well. No definite cystic disease is noted in the portion of the kidneys that are seen on this exam. One to two very small, 2 to 3 mm cysts are seen in the spleen.
IMPRESSION:
1. No abnormal enhancement was noted of any other structures believed to be cyst in the liver. There were numerous cysts, which are just 2 to 3 mm in size, largest is about 4 cm. Again, none of these enhance. They have clean, well-defined margins, and there was no evidence that would suggest they are not cysts.
2. There is a 1 cm cyst also noted in the mid to distal body region of the pancreas.
3. One to two 2 mm to 3 mm cysts are suggested in the body of the spleen.
Thank you for your kind referral.
