1 la An AP, lateral, and sunrise view of the left knee is obtained. A standing view of both knees is
obtained. A Rosenberg view is also obtained.

On the left, bony mineralization is normal. There is evidence of a lateral tibial plateau fracture.
Soft tissues demonstrate arterial calcification.

Chondrocalcinosis identified involving the lateral compartment of the knee. There is moderate
narrowing of the medial and lateral compartment of the left knee. The appearance and left knee
similar to May 1, 2011. fracture train 2 chicago Findings: At the fourth distal metatarsal there is a oblique fracture with slight lateral
displacement. There are no other acute fractures or dislocations. There is moderate
degenerative changes of the first tarsal- metatarsal joint with subchondral cysts and osteophyte
formation. The soft tissues are within normal limits. There is ossification of the interosseous
membrane due to prior trauma. fracture train 3 la An AP upright image that extends from the pelvis to the ankles is provided for interpretation.
There is a right knee arthroplasty. There is no apparent leg length discrepancy. no fracture train 4 chicago Impression:

Left knee 3 views, 12/1/2011:

Comparison is made to previous examination of 2/26/2011.

There is a knee prosthesis in place. There is no radiographic evidence of loosening of the
prosthesis. There are no fractures or dislocations. Allowing for technical differences, there has
been no change from 2/26/2011.
no fracture train 5 la Impression:

since 10/2/2007, views of the pelvis and right hip are unchanged except for minimal overgrowth of
the lateral aspect of the acetabular roof apophysis. No other evidence of degenerative changes
seen. No other interval change. no fracture train 6 chicago Lungs are clear focal consolidation. Tracheobronchial tree is patent. No lung masses or nodules
appreciated. There are no pleural pericardial effusions. Right lower base pleural thickening is
stable. There is no axillary, hilar, or mediastinal lymphadenopathy by CT size criteria. The
visualized thyroid is normal. no fracture train 7 la Study: Bilateral standing knees one view.

Findings: AP, standing view of both knees is compared to previous exam of 04/2011. There has been
no significant interval change in the appearance of the knees. Again there is an intramedullary
fracture in the tibia. Joint space narrowing is noted at the lateral compartment of the left knee. fracture train 8 chicago Opacification of the frontal sinus on the right side. Linear streaking of the occipital bone,
likely a non displaced fracture. fracture train 9 la Right humerus 2 views, 7/14/2012

There is a shoulder prosthesis in place. There is no radiographic evidence of loosening of the
prosthesis. Overall position and alignment is anatomic. A fracture of the distil humerus is noted.
The remainder of the humerus is unremarkable. fracture train 10 chicago Chest reveals linear opacity in right base which could be due to atelectasis since January 16, 2011.
There is no congestive heart failure, infiltrate. There are degenerative changes in thoracic
spine. There are vascular calcifications in the thoracic aorta. Accounting for differences in
technique there is no significant interval change.

Conclusion: No acute cardiopulmonary disease. no fracture train 11 la Findings: The heart is not enlarged. There is no congestive failure. The lungs are clear. There
is no adenopathy or pleural effusion. There are old healed fractures of the left second through
sixth ribs and an old fracture of the left clavicle. There are degenerative changes in the spine.

Conclusion: No active cardiopulmonary disease. No interval change. fracture train 12 chicago Impression:
Views of the hand and thumb accomplished on May 6, 2011.

The interphalangeal joint shows mild narrowing. Osseous structures are normally developed and
well-preserved. The MP joint of the thumb shows some eburnation and narrowing particularly of the
lateral aspect of the joint. The metacarpal articulation with the greater multangular has some mild
eburnation and some pseudocystic change is that joint is well.

Summary: osteoarthritic changes. The most prominent changes are of the proximal and distal
articulations of the first metacarpal
no fracture train 13 la Views of the coccyx and sacrum dated January 21, 2009.

normal osseous development and no fracture is seen. The SI joints are normal. Soft tissues are
normal

Summary: no fracture is seen. Note that injuries of the coccyx are not always visible on
radiographs and this study needs to be augmented by physical exam. no fracture train 14 chicago Impression:
PA and lateral chest accomplished on January 20, 2012.

The heart and mediastinal contours are normal. Hilar structures and pulmonary vessels are normal as
well. There no acute infiltrates or effusions. An old fracture of the left third rib is evident. fracture train 15 la Menisci: There is intrasubstance degeneration in the lateral meniscus without discrete tear. There
is complex degeneration of the posterior horn and body of the medial meniscus with extrusion.

Tendons: The quadriceps and patellar tendons are intact.

Ligaments: There is increased signal within it the ACL consistent with degeneration. The PCL, LCL
and MCL appear intact.

Bone/cartilage: There are tricompartmental degenerative changes. There are extensive degenerative
changes in the medial compartment with diffuse cartilage loss in the weight bearing region. There
is moderate thinning of the anterior aspect of the lateral femoral condyle cartilage with mild
heterogeneity. There is heterogeneity of the patellofemoral cartilage. Note is made of a distil
femur hairline fracture not previously noted. fracture train 16 chicago The study was compared to the prior dated 04/09/2011. The liver is heterogeneous with no focal
lesion. There is status post cholecystectomy. The common bile duct measures 3.4 mm.The portal
vein is patent and demonstrate hepatopetal flow. The kidneys are normal in size measuring 10.1 cm
on the right and 10.2 cm on the left side. No hydronephrosis is noted. A hypoechogenic lesion in
the superior pole of the right kidney is noted measuring 1.6 x 1.2 cm that may suggest a cyst.. The
infrarenal abdominal aorta measures 2.2 x 2.1 cm. Again bilateral aneurysm of common iliac arteries
is noted measuring 1.8 x 1.9 cm on the right and 1.6 x 1.9 cm in the left side. There is no fluid
in the Morrison's pouch. The spleen is normal in size and echotexture.

Conclusion:

Heterogeneous liver with no focal lesion. Stable aneurysm of common iliac arteries. no fracture train 17 la AP and lateral view of the left lower leg is obtained.

Bony mineralization is normal. There is no evidence of a fracture. Soft tissues are unremarkable.

Clips noted posteriorly in the soft tissues.

CONCLUSION:

1. No acute process no fracture train 18 chicago An AP of the left hand and 3 additional views of the fourth digit were done. There is a non
dislocated fracture. No other significant bone or joint abnormality. fracture train 19 la Diffuse osteopenia with evidence of L1-2 compression fracture. fracture train 20 chicago Impression:
Routine views of the left foot demonstrate normal development and no fracture or dislocation. No
foreign bodies seen. There is probable soft tissue swelling about the head of the metatarsals and
there is some minimal vascular calcification noted. no fracture train 21 la There is no evidence of axillary, hilar or mediastinal adenopathy. The great vessels are normal
throughout their course. There is extensive calcification of the coronary arteries as well as
some calcification of the aorta. The thyroid gland is normal.

The visualized unenhanced liver, spleen, pancreas, adrenal glands and kidneys are grossly normal.

There are no lytic or sclerotic lesions visualized. fracture test 22 chicago Findings: There is now evidence of a nondisplaced fracture involving the right superior pubic ramus
close to the symphysis. There is diffuse osteopenia with a stable old healed right
intertrochanteric fracture with internal stabilization as well as a left subcapital fracture
internally stabilized as well. There is an old left ischiopubic junction fracture deformity. Sacrum
and coccyx are mostly obscured by bowel content. There is heavy aorto iliac and branch
calcification.

Conclusion: Nondisplaced right superior pubic ramus fracture. fracture test 23 la There is no rib fracture, rib abnormality, pneumothorax, or pleural effusion. Other than for
clearing of the lungs, the chest examination has not changed from 2/29/2011. Cardiomediastinal
silhouette is stable. There are sternotomy wires. There is no evidence of congestive failure and
the lungs are now clear.

Conclusion:

No acute rib fracture, pneumothorax, or pleural effusion. No active cardiopulmonary disease. Other
than for the clearing of the lungs, no significant interval change from 2/9/2011. no fracture test 24 chicago Study: Left knee 3 views.

Findings: AP, lateral and sunrise views of the left knee are compared to previous exam of
05/07/2011. Accounting for difference in technique, has been no significant interval change in the
appearance of the left knee. Again there is tricompartmental degenerative arthropathy with joint
space narrowing which is worst at the lateral facet of the patellofemoral joint, and
tricompartmental osteophytes. There is no significant knee joint effusion.
no fracture test 25 la Findings: Multiple images of the right shoulder reveal a full thickness, near full width tear of
supraspinatus tendon with a few anterior fibers remaining. There is approximately 3 cm retraction
of the myotendinous junction. In addition, there is a small, articular surface tear of the
infraspinatus tendon at its insertion with laminar extension into the myotendinous junction.
There is mild fatty atrophy of the supraspinatus and moderate fatty atrophy of the infraspinatus
muscle. Overall there is diffuse muscular fatty atrophy throughout the shoulder musculature. There
is superior subluxation of the humeral head. There is increased longitudinal signal and thickening
of the interarticular portion of the biceps tendon consistent with a split tear. Thickening and
increased signal of the subscapularis tendon is consistent with tendinopathy. no fracture test 26 chicago Left fifth finger multiple views, 5/5/2015:

Comparison: 4/10/2015.

Findings: And AP of the left hand and for additional views of the fifth
finger are provided for interpretation.

There is a healing comminuted spiral fracture of the proximal phalanx of the
fifth digit. Other than for signs of healing, there has been no significant
interval change from the previous examination.
fracture test 27 la Comparison is made to the previous examination of 5/23/2011.

The heart is not enlarged. There is no evidence of congestive failure. The lungs are clear. There
is no adenopathy or pleural effusion.

Conclusion:

No active cardiopulmonary disease. No significant interval change.
no fracture test 28 chicago Left fifth digit multiple views, 6/16/2066:

An AP of the left hand and 3 additional views of the left fifth digit are
provided were done. There is a comminuted spiral fracture of the proximal
phalanx of the fifth digit with medial and dorsal angulation of the major
distal fracture fragment.
fracture test 29 la Clinical History
Man had cxr today f/u after fall 2-05 and per radiologist request left rib
views today to better view 9th rib left and adjacent ribs; still some pain
there. thanks

Impression
LEFT RIBS: 10/10/2012

Four views of the left ribs reveal fractures of the left ribs at the mid
axillary line of the left 5, 6, 7, 8 and 9th ribs. This was not shown on the
previous study. There is no definite hemothorax on the left side.
fracture test 30 chicago There is a non dislocated fracture in the second digit of the right hand.
No other significant bone or joint abnormality. fracture test 31 la Retroperitoneal ultrasound from 3/30/2011 is compared to the prior from 9/3/2011.

Findings: Right kidney measures 11.3 cm and left kidney measures 11.7 cm in length. No evidence
for hydronephrosis. Spleen measures 10.4 cm in the craniocaudal dimension. heterogenous liver
with no focal lesions. Liver measures 16 cm in the craniocaudal dimension. Hepatopetal flow in
the portal vein. CBD measures 4 mm and is within normal limits. Gallbladder and pancreas is
unremarkable. No evidence for aortic aneurysm. No free fluid.

Conclusion: 1. heterogenous liver with no focal lesions. no fracture test