Evaluation is limited by streak artifact related to bilateral total hip arthroplasty devices. Components of a left total hip arthroplasty device are situated in near-anatomic alignment. There are findings indicating chronic bone infarction of the proximal femoral diaphysis, but no findings to suggest loosening of the femoral component. There is cement adjacent to the superomedial aspect of the acetabular component, as seen on prior radiographs. Lucency between the bone and acetabular component or cement also appears similar to that seen on prior radiographs. However, there is marked thinning of the medial wall of the left acetabulum, as well as a defect spanning approximately 1.5 x 1.0 cm. Furthermore, there is a hemispherical soft tissue mass or collection within the pelvis along the medial acetabular wall, measuring 5 x 2.5 x 5 cm. Differential diagnosis includes acetabular fracture with adjacent hematoma, and also prosthesis loosening or particle disease with adjacent sterile fluid collection. The possibility of an abscess is also considered, for which evaluation is suboptimal given the aforementioned artifact and lack of intravenous contrast however, the adjacent pelvic fat planes appear preserved, which would be unusual for an inflammatory process. Thin lucency surrounds the posterior of the two left acetabular screws, which may reflect loosening. Small foci of heterotopic ossification are seen lateral to the left hip joint. Given the aforementioned limitations, we see no findings to suggest a large hip joint effusion. There are two collections within the subcutaneous fat of the lateral aspect of the proximal left thigh, subjacent to the greater trochanter. The larger is inferior and measures 4.5 x 3.5 cm in transverse dimensions and 5 cm in craniocaudal dimension. The smaller superior collection measures approximately 2 x 3 cm in transverse dimensions and 3.5 cm in craniocaudal dimension. Small foci of high density are seen within the periphery of these collections, and while abscess cannot be excluded, these may simply represent postoperative hematomas or seromas. Components of a right total hip arthroplasty device are situated in near-anatomic alignment. There is thin lucency at the bone-cement interface of the proximal femoral component, which could represent loosening, although the true clinical significance of this is uncertain and we see no findings to suggest loosening of the distal femoral stem. Cement along the medial aspect of the acetabular component is seen protruding slightly into the pelvis through a defect in the medial acetabular wall. We see no mass or findings to suggest a large joint effusion, given the aforementioned limitations. There are small foci of heterotopic ossification along the medial aspect of the proximal right femur. There are also findings to suggest chronic bone infarction of the visualized right femoral diaphysis. Sclerotic foci in the remaining pelvic bones and visualized lower lumbosacral spine are seen indicating chronic bone infarction, with loss of height of the visualized lower lumbar vertebral bodies.
anatomical entity_fin: {'hip': {}}location descriptor_fin: ['bilateral']procedure_fin: ['arthroplasty']clinical findings_fin: {'streak artifact': {'clinical finding': 'streak artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'streak', 'observation': 'artifact'}}anatomical entity_fin: {'hip': {}}location descriptor_fin: ['left']object_fin: ['arthroplasty device']clinical findings_fin: {'left total hip arthroplasty device': {'clinical finding': 'left total hip arthroplasty device', 'existence': 'pos_dx', 'descriptive_term': 'left total hip arthroplasty', 'observation': 'device'}, 'near-anatomic alignment': {'clinical finding': 'near-anatomic alignment', 'existence': 'pos_dx', 'descriptive_term': 'near-anatomic', 'observation': 'alignment'}}anatomical entity_fin: {'diaphysis': {}}location descriptor_fin: ['proximal']clinical findings_fin: {'chronic bone infarction': {'clinical finding': 'chronic bone infarction', 'existence': 'unc_dx', 'descriptive_term': 'chronic bone', 'observation': 'infarction', 'temporal_term': 'chronic'}}location descriptor_fin: ['adjacent']clinical findings_fin: {'is cement adjacent to the superomedial aspect of the acetabular component': {'clinical finding': 'is cement adjacent to the superomedial aspect of the acetabular component'}}clinical findings_fin: {'also appears similar to that': {'clinical finding': 'also appears similar to that'}}size_fin: [{'size': '1.5 x 1.0 cm', 'size_descriptor': 'thinning'}]anatomical entity_fin: {'wall': {'location descriptor': 'medial'}, 'acetabulum': {'location descriptor': 'left'}}location descriptor_fin: ['medial', 'left']clinical findings_fin: {'marked thinning': {'clinical finding': 'marked thinning', 'existence': 'pos_dx', 'descriptive_term': 'marked', 'observation': 'thinning'}, 'defect': {'clinical finding': 'defect', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'observation': 'defect'}}size_fin: [{'size': '5 x 2.5 x 5 cm', 'size_descriptor': 'mass'}]anatomical entity_fin: {'pelvis': {}, 'wall': {}}location descriptor_fin: ['medial']clinical findings_fin: {'hemispherical soft tissue mass': {'clinical finding': 'hemispherical soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'hemispherical soft tissue', 'observation': 'mass'}}imaging observation_fin: ['hematoma']location descriptor_fin: ['adjacent']object_fin: ['prosthesis']clinical findings_fin: {'acetabular fracture': {'clinical finding': 'acetabular fracture', 'cf_snomed': {'fracture': 72704001}, 'existence': 'pos_dx', 'descriptive_term': 'acetabular', 'observation': 'fracture'}, 'adjacent hematoma': {'clinical finding': 'adjacent hematoma', 'cf_snomed': {'hematoma': 385494008}, 'existence': 'pos_dx', 'descriptive_term': 'adjacent', 'observation': 'hematoma'}, 'particle disease': {'clinical finding': 'particle disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'unc_dx', 'descriptive_term': 'particle', 'observation': 'disease'}, 'adjacent sterile fluid collection': {'clinical finding': 'adjacent sterile fluid collection', 'existence': 'pos_dx', 'descriptive_term': 'adjacent sterile fluid', 'observation': 'collection'}}imaging observation_fin: ['fat']location descriptor_fin: ['adjacent']clinical findings_fin: {'abscess': {'clinical finding': 'abscess', 'cf_snomed': {'abscess': 128477000}, 'existence': 'unc_dx', 'observation': 'abscess'}, 'aforementioned artifact': {'clinical finding': 'aforementioned artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'unc_dx', 'descriptive_term': 'aforementioned', 'observation': 'artifact'}, 'intravenous contrast': {'clinical finding': 'intravenous contrast', 'existence': 'neg_dx', 'descriptive_term': 'intravenous', 'observation': 'contrast'}}location descriptor_fin: ['posterior', 'left']clinical findings_fin: {'thin lucency surrounds': {'clinical finding': 'thin lucency surrounds'}}anatomical entity_fin: {'hip joint': {'location descriptor': 'left'}}imaging observation_fin: ['foci']location descriptor_fin: ['lateral', 'left']clinical findings_fin: {'heterotopic ossification': {'clinical finding': 'heterotopic ossification', 'cf_snomed': {'heterotopic ossification': 128491006}, 'existence': 'pos_dx', 'descriptive_term': 'heterotopic', 'observation': 'ossification'}}anatomical entity_fin: {'hip joint': {}}clinical findings_fin: {'large hip joint effusion': {'clinical finding': 'large hip joint effusion', 'cf_snomed': {'hip joint effusion': 202379000}, 'existence': 'neg_dx', 'descriptive_term': 'large hip joint', 'observation': 'effusion', 'strength_term': 'large'}}anatomical entity_fin: {'subcutaneous fat': {}, 'thigh': {'location descriptor': 'proximal left'}}location descriptor_fin: ['lateral', 'proximal', 'left']clinical findings_fin: {'are two collections within the subcutaneous fat of the lateral aspect of the proximal left thigh': {'clinical finding': 'are two collections within the subcutaneous fat of the lateral aspect of the proximal left thigh'}}size_fin: [{'size': '4.5 x 3.5 cm'}, {'size': '5 cm'}]location descriptor_fin: ['inferior']clinical findings_fin: {'larger is inferior': {'clinical finding': 'larger is inferior'}}size_fin: [{'size': '2 x 3 cm'}, {'size': '3.5 cm'}]location descriptor_fin: ['superior']clinical findings_fin: {'smaller superior collection measures': {'clinical finding': 'smaller superior collection measures'}}imaging observation_fin: ['foci', 'hematomas']clinical findings_fin: {'high density': {'clinical finding': 'high density', 'existence': 'pos_dx', 'descriptive_term': 'high', 'observation': 'density'}, 'abscess': {'clinical finding': 'abscess', 'cf_snomed': {'abscess': 128477000}, 'existence': 'unc_dx', 'observation': 'abscess'}, 'postoperative hematomas': {'clinical finding': 'postoperative hematomas', 'cf_snomed': {'hematoma': 385494008}, 'existence': 'unc_dx', 'descriptive_term': 'postoperative', 'observation': 'hematoma'}, 'seromas': {'clinical finding': 'seromas', 'existence': 'unc_dx', 'observation': 'seromas'}}anatomical entity_fin: {'hip': {}}location descriptor_fin: ['right']object_fin: ['arthroplasty device']clinical findings_fin: {'right total hip arthroplasty device': {'clinical finding': 'right total hip arthroplasty device', 'existence': 'pos_dx', 'descriptive_term': 'right total hip arthroplasty', 'observation': 'device'}, 'near-anatomic alignment': {'clinical finding': 'near-anatomic alignment', 'existence': 'pos_dx', 'descriptive_term': 'near-anatomic', 'observation': 'alignment'}}imaging observation_fin: ['interface']location descriptor_fin: ['proximal', 'distal']clinical findings_fin: {'bone-cement interface': {'clinical finding': 'bone-cement interface', 'existence': 'pos_dx', 'descriptive_term': 'bone-cement', 'observation': 'interface'}}anatomical entity_fin: {'pelvis': {}, 'wall': {}}location descriptor_fin: ['medial']clinical findings_fin: {'defect': {'clinical finding': 'defect', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'observation': 'defect'}}clinical findings_fin: {'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}, 'large joint effusion': {'clinical finding': 'large joint effusion', 'cf_snomed': {'effusion': 41699000}, 'existence': 'neg_dx', 'descriptive_term': 'large joint', 'observation': 'effusion', 'strength_term': 'large'}}anatomical entity_fin: {'right femur': {'location descriptor': 'proximal'}}imaging observation_fin: ['foci']location descriptor_fin: ['medial', 'proximal']clinical findings_fin: {'heterotopic ossification': {'clinical finding': 'heterotopic ossification', 'cf_snomed': {'heterotopic ossification': 128491006}, 'existence': 'pos_dx', 'descriptive_term': 'heterotopic', 'observation': 'ossification'}}anatomical entity_fin: {'diaphysis': {}}location descriptor_fin: ['right']clinical findings_fin: {'chronic bone infarction': {'clinical finding': 'chronic bone infarction', 'existence': 'unc_dx', 'descriptive_term': 'chronic bone', 'observation': 'infarction', 'temporal_term': 'chronic'}}anatomical entity_fin: {'pelvic bones': {}, 'lumbosacral spine': {'location descriptor': 'lower'}, 'lumbar vertebral bodies': {'location descriptor': 'lower'}}imaging observation_fin: ['foci']location descriptor_fin: ['lower']clinical findings_fin: {'sclerotic foci': {'clinical finding': 'sclerotic foci', 'existence': 'pos_dx', 'descriptive_term': 'sclerotic', 'observation': 'foci'}, 'chronic bone infarction': {'clinical finding': 'chronic bone infarction', 'existence': 'unc_dx', 'descriptive_term': 'chronic bone', 'observation': 'infarction', 'temporal_term': 'chronic'}}
<s>[INST] Write the finding section for a radiology report based on the following information: anatomical entity_fin: {'hip': {}}location descriptor_fin: ['bilateral']procedure_fin: ['arthroplasty']clinical findings_fin: {'streak artifact': {'clinical finding': 'streak artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'streak', 'observation': 'artifact'}}anatomical entity_fin: {'hip': {}}location descriptor_fin: ['left']object_fin: ['arthroplasty device']clinical findings_fin: {'left total hip arthroplasty device': {'clinical finding': 'left total hip arthroplasty device', 'existence': 'pos_dx', 'descriptive_term': 'left total hip arthroplasty', 'observation': 'device'}, 'near-anatomic alignment': {'clinical finding': 'near-anatomic alignment', 'existence': 'pos_dx', 'descriptive_term': 'near-anatomic', 'observation': 'alignment'}}anatomical entity_fin: {'diaphysis': {}}location descriptor_fin: ['proximal']clinical findings_fin: {'chronic bone infarction': {'clinical finding': 'chronic bone infarction', 'existence': 'unc_dx', 'descriptive_term': 'chronic bone', 'observation': 'infarction', 'temporal_term': 'chronic'}}location descriptor_fin: ['adjacent']clinical findings_fin: {'is cement adjacent to the superomedial aspect of the acetabular component': {'clinical finding': 'is cement adjacent to the superomedial aspect of the acetabular component'}}clinical findings_fin: {'also appears similar to that': {'clinical finding': 'also appears similar to that'}}size_fin: [{'size': '1.5 x 1.0 cm', 'size_descriptor': 'thinning'}]anatomical entity_fin: {'wall': {'location descriptor': 'medial'}, 'acetabulum': {'location descriptor': 'left'}}location descriptor_fin: ['medial', 'left']clinical findings_fin: {'marked thinning': {'clinical finding': 'marked thinning', 'existence': 'pos_dx', 'descriptive_term': 'marked', 'observation': 'thinning'}, 'defect': {'clinical finding': 'defect', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'observation': 'defect'}}size_fin: [{'size': '5 x 2.5 x 5 cm', 'size_descriptor': 'mass'}]anatomical entity_fin: {'pelvis': {}, 'wall': {}}location descriptor_fin: ['medial']clinical findings_fin: {'hemispherical soft tissue mass': {'clinical finding': 'hemispherical soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'hemispherical soft tissue', 'observation': 'mass'}}imaging observation_fin: ['hematoma']location descriptor_fin: ['adjacent']object_fin: ['prosthesis']clinical findings_fin: {'acetabular fracture': {'clinical finding': 'acetabular fracture', 'cf_snomed': {'fracture': 72704001}, 'existence': 'pos_dx', 'descriptive_term': 'acetabular', 'observation': 'fracture'}, 'adjacent hematoma': {'clinical finding': 'adjacent hematoma', 'cf_snomed': {'hematoma': 385494008}, 'existence': 'pos_dx', 'descriptive_term': 'adjacent', 'observation': 'hematoma'}, 'particle disease': {'clinical finding': 'particle disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'unc_dx', 'descriptive_term': 'particle', 'observation': 'disease'}, 'adjacent sterile fluid collection': {'clinical finding': 'adjacent sterile fluid collection', 'existence': 'pos_dx', 'descriptive_term': 'adjacent sterile fluid', 'observation': 'collection'}}imaging observation_fin: ['fat']location descriptor_fin: ['adjacent']clinical findings_fin: {'abscess': {'clinical finding': 'abscess', 'cf_snomed': {'abscess': 128477000}, 'existence': 'unc_dx', 'observation': 'abscess'}, 'aforementioned artifact': {'clinical finding': 'aforementioned artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'unc_dx', 'descriptive_term': 'aforementioned', 'observation': 'artifact'}, 'intravenous contrast': {'clinical finding': 'intravenous contrast', 'existence': 'neg_dx', 'descriptive_term': 'intravenous', 'observation': 'contrast'}}location descriptor_fin: ['posterior', 'left']clinical findings_fin: {'thin lucency surrounds': {'clinical finding': 'thin lucency surrounds'}}anatomical entity_fin: {'hip joint': {'location descriptor': 'left'}}imaging observation_fin: ['foci']location descriptor_fin: ['lateral', 'left']clinical findings_fin: {'heterotopic ossification': {'clinical finding': 'heterotopic ossification', 'cf_snomed': {'heterotopic ossification': 128491006}, 'existence': 'pos_dx', 'descriptive_term': 'heterotopic', 'observation': 'ossification'}}anatomical entity_fin: {'hip joint': {}}clinical findings_fin: {'large hip joint effusion': {'clinical finding': 'large hip joint effusion', 'cf_snomed': {'hip joint effusion': 202379000}, 'existence': 'neg_dx', 'descriptive_term': 'large hip joint', 'observation': 'effusion', 'strength_term': 'large'}}anatomical entity_fin: {'subcutaneous fat': {}, 'thigh': {'location descriptor': 'proximal left'}}location descriptor_fin: ['lateral', 'proximal', 'left']clinical findings_fin: {'are two collections within the subcutaneous fat of the lateral aspect of the proximal left thigh': {'clinical finding': 'are two collections within the subcutaneous fat of the lateral aspect of the proximal left thigh'}}size_fin: [{'size': '4.5 x 3.5 cm'}, {'size': '5 cm'}]location descriptor_fin: ['inferior']clinical findings_fin: {'larger is inferior': {'clinical finding': 'larger is inferior'}}size_fin: [{'size': '2 x 3 cm'}, {'size': '3.5 cm'}]location descriptor_fin: ['superior']clinical findings_fin: {'smaller superior collection measures': {'clinical finding': 'smaller superior collection measures'}}imaging observation_fin: ['foci', 'hematomas']clinical findings_fin: {'high density': {'clinical finding': 'high density', 'existence': 'pos_dx', 'descriptive_term': 'high', 'observation': 'density'}, 'abscess': {'clinical finding': 'abscess', 'cf_snomed': {'abscess': 128477000}, 'existence': 'unc_dx', 'observation': 'abscess'}, 'postoperative hematomas': {'clinical finding': 'postoperative hematomas', 'cf_snomed': {'hematoma': 385494008}, 'existence': 'unc_dx', 'descriptive_term': 'postoperative', 'observation': 'hematoma'}, 'seromas': {'clinical finding': 'seromas', 'existence': 'unc_dx', 'observation': 'seromas'}}anatomical entity_fin: {'hip': {}}location descriptor_fin: ['right']object_fin: ['arthroplasty device']clinical findings_fin: {'right total hip arthroplasty device': {'clinical finding': 'right total hip arthroplasty device', 'existence': 'pos_dx', 'descriptive_term': 'right total hip arthroplasty', 'observation': 'device'}, 'near-anatomic alignment': {'clinical finding': 'near-anatomic alignment', 'existence': 'pos_dx', 'descriptive_term': 'near-anatomic', 'observation': 'alignment'}}imaging observation_fin: ['interface']location descriptor_fin: ['proximal', 'distal']clinical findings_fin: {'bone-cement interface': {'clinical finding': 'bone-cement interface', 'existence': 'pos_dx', 'descriptive_term': 'bone-cement', 'observation': 'interface'}}anatomical entity_fin: {'pelvis': {}, 'wall': {}}location descriptor_fin: ['medial']clinical findings_fin: {'defect': {'clinical finding': 'defect', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'observation': 'defect'}}clinical findings_fin: {'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}, 'large joint effusion': {'clinical finding': 'large joint effusion', 'cf_snomed': {'effusion': 41699000}, 'existence': 'neg_dx', 'descriptive_term': 'large joint', 'observation': 'effusion', 'strength_term': 'large'}}anatomical entity_fin: {'right femur': {'location descriptor': 'proximal'}}imaging observation_fin: ['foci']location descriptor_fin: ['medial', 'proximal']clinical findings_fin: {'heterotopic ossification': {'clinical finding': 'heterotopic ossification', 'cf_snomed': {'heterotopic ossification': 128491006}, 'existence': 'pos_dx', 'descriptive_term': 'heterotopic', 'observation': 'ossification'}}anatomical entity_fin: {'diaphysis': {}}location descriptor_fin: ['right']clinical findings_fin: {'chronic bone infarction': {'clinical finding': 'chronic bone infarction', 'existence': 'unc_dx', 'descriptive_term': 'chronic bone', 'observation': 'infarction', 'temporal_term': 'chronic'}}anatomical entity_fin: {'pelvic bones': {}, 'lumbosacral spine': {'location descriptor': 'lower'}, 'lumbar vertebral bodies': {'location descriptor': 'lower'}}imaging observation_fin: ['foci']location descriptor_fin: ['lower']clinical findings_fin: {'sclerotic foci': {'clinical finding': 'sclerotic foci', 'existence': 'pos_dx', 'descriptive_term': 'sclerotic', 'observation': 'foci'}, 'chronic bone infarction': {'clinical finding': 'chronic bone infarction', 'existence': 'unc_dx', 'descriptive_term': 'chronic bone', 'observation': 'infarction', 'temporal_term': 'chronic'}} [/INST] Evaluation is limited by streak artifact related to bilateral total hip arthroplasty devices. Components of a left total hip arthroplasty device are situated in near-anatomic alignment. There are findings indicating chronic bone infarction of the proximal femoral diaphysis, but no findings to suggest loosening of the femoral component. There is cement adjacent to the superomedial aspect of the acetabular component, as seen on prior radiographs. Lucency between the bone and acetabular component or cement also appears similar to that seen on prior radiographs. However, there is marked thinning of the medial wall of the left acetabulum, as well as a defect spanning approximately 1.5 x 1.0 cm. Furthermore, there is a hemispherical soft tissue mass or collection within the pelvis along the medial acetabular wall, measuring 5 x 2.5 x 5 cm. Differential diagnosis includes acetabular fracture with adjacent hematoma, and also prosthesis loosening or particle disease with adjacent sterile fluid collection. The possibility of an abscess is also considered, for which evaluation is suboptimal given the aforementioned artifact and lack of intravenous contrast however, the adjacent pelvic fat planes appear preserved, which would be unusual for an inflammatory process. Thin lucency surrounds the posterior of the two left acetabular screws, which may reflect loosening. Small foci of heterotopic ossification are seen lateral to the left hip joint. Given the aforementioned limitations, we see no findings to suggest a large hip joint effusion. There are two collections within the subcutaneous fat of the lateral aspect of the proximal left thigh, subjacent to the greater trochanter. The larger is inferior and measures 4.5 x 3.5 cm in transverse dimensions and 5 cm in craniocaudal dimension. The smaller superior collection measures approximately 2 x 3 cm in transverse dimensions and 3.5 cm in craniocaudal dimension. Small foci of high density are seen within the periphery of these collections, and while abscess cannot be excluded, these may simply represent postoperative hematomas or seromas. Components of a right total hip arthroplasty device are situated in near-anatomic alignment. There is thin lucency at the bone-cement interface of the proximal femoral component, which could represent loosening, although the true clinical significance of this is uncertain and we see no findings to suggest loosening of the distal femoral stem. Cement along the medial aspect of the acetabular component is seen protruding slightly into the pelvis through a defect in the medial acetabular wall. We see no mass or findings to suggest a large joint effusion, given the aforementioned limitations. There are small foci of heterotopic ossification along the medial aspect of the proximal right femur. There are also findings to suggest chronic bone infarction of the visualized right femoral diaphysis. Sclerotic foci in the remaining pelvic bones and visualized lower lumbosacral spine are seen indicating chronic bone infarction, with loss of height of the visualized lower lumbar vertebral bodies. </s>