RADIATION AND ONCOLOGY TEST FILES

RADIO_T1

Radiology

RIGHT SHOULDER, THREE VIEWS

Three views were obtained, and these show a slightly comminuted fracture of the right scapula with the inferior and lateral margin of the scapula primarily involved.  No definite dislocation of the humerus within the glenoid is noted.  Fracture fragment off the lateral margin of the body of the scapula is displaced laterally approximately 8 mm.  Maximum dimension of this fragment measures 3 cm with maximum width measuring only 4 to 5 mm.  No additional or associated fractures or dislocations are present.

IMPRESSION:  Acute-appearing, slightly comminuted fracture of right scapula.

RADIO_T2

LEFT HIP

The tomograms demonstrate incomplete filling in of a major fracture zone involving the proximal left femur, as previously noted.

The major intramedullary fixation device is seen to project outside the superior and lateral cortical margins of the left femoral neck.

This is probably at least 1 cm in extent, but a precise measurement cannot be accurately obtained due to the superimposition of the metallic device on the femoral neck.

There is persistence of medial displacement of the major distal fracture fragment to the extent of some 1.3 cm.  Moderate varus deformity also persists.

Three additional partially threaded metallic pins are identified.  The most lateral one involves an avulsed greater trochanteric fracture fragment, while the other 2 are positioned at the level of the femoral neck and head.

IMPRESSION

1.  Comminuted proximal left femoral diaphyseal fracture with medial displacement of the major distal fracture fragment, with persistence of moderate with varus deformity.

2.  The major intramedullary fixation device projects outside of the margins of the superior and lateral aspects of the femoral neck.

3.  There is incomplete filling in of the fracture zone.

RADIO_T3

Radiology

CT SCAN OF LUMBAR SPINE SPINE

On the GE-9800 high-resolution CT scanner, multiple 3 mm thickness oblique scans were made through the disk interspaces at L3-L4, L4-L5, and L5-S1 levels.  Stacked 5 mm scans were then performed from the midbody of L3 to the upper portion of the S1 vertebral body.

L3-L4 LEVEL:  There is no evident disk bulging at this level.

The nerve roots are seen to exit freely.  There is no effacement of the dural sac, and the ligamentum flavum is normal in width.  Some hypertrophy of the facet joints is noted at this level.

L4-L5 LEVEL:  There is a minimal disk bulging in the left posterolateral aspect.

The nerve roots are seen to exit freely above this level.

There is no evident effacement of the dural sac.

The ligamentum flavum appears normal.  Some hypertrophy of the facets is noted at this level.

L5-S1 LEVEL:  Slight disk bulging is noted centrally and on the right posterolateral aspect, with moderate disk bulging noted on the left posterolateral aspect.

The nerve roots are seen to exit freely above this level of disk bulging.  There is slight apparent effacement of the dural sac at this level.

The ligamentum flavum appears normal in width.  Some hypertrophy of the facet joints is noted at this level.

Medial and lateral longitudinal reconstruction studies were performed and show no evident effacement of this dural sac at the upper L3-L4 and L4-L5 levels.  The L5-S1 level is not visualized.  The neural foramina all appear widely patent.

IMPRESSION

1.  The L3-L4 level appears within normal limits.

2.  Minimal disk bulging is noted at the L4-L5 level on the left with no evident impingement of the nerve roots.

3.  Moderate disk bulging is noted at the L5-S1 level, especially on the left posterolateral aspect.

4.  There is some apparent effacement of the dural sac.

5.  There is no evident impingement on the L5 nerve roots.