The bones are diffusely demineralized, suggesting osteopenia which may be from disuse. Marked deformity of the distal tibia related to surgery and chronic infection is redemonstrated. There are findings of chronic osteomyelitis including chronic dense periosteal reaction is noted, mottled appearance of the underlying bone, and large central lucency or cavitation of the distal tibia. In addition, small skin ulceration at the medial aspect of the distal tibial metaphysis extends to the underlying bone with tract-like extension from cortex toward the centrally lucent intramedullary space. Several other similar tracts are noted with well-corticated margins, likely reflecting prior orthopedic screw tracts. Correlation with surgical history is recommended otherwise the possibility of sinus tracts from chronic infection may be considered.
clinical findings_fin: {'demineralized': {'clinical finding': 'demineralized', 'existence': 'pos_dx', 'observation': 'demineralized'}, 'osteopenia': {'clinical finding': 'osteopenia', 'cf_snomed': {'osteopenia': 312894000}, 'existence': 'unc_dx', 'observation': 'osteopenia'}, 'disuse': {'clinical finding': 'disuse', 'existence': 'unc_dx', 'observation': 'disuse'}}anatomical entity_fin: {'tibia': {'location descriptor': 'distal'}}location descriptor_fin: ['distal']clinical findings_fin: {'marked deformity': {'clinical finding': 'marked deformity', 'cf_snomed': {'deformity': 417893002}, 'existence': 'pos_dx', 'descriptive_term': 'marked', 'observation': 'deformity'}, 'chronic infection': {'clinical finding': 'chronic infection', 'existence': 'pos_dx', 'descriptive_term': 'chronic', 'observation': 'infection', 'temporal_term': 'chronic'}}anatomical entity_fin: {'tibia': {'location descriptor': 'distal'}}imaging observation_fin: ['central lucency']location descriptor_fin: ['distal']clinical findings_fin: {'chronic osteomyelitis': {'clinical finding': 'chronic osteomyelitis', 'cf_snomed': {'chronic osteomyelitis': 40970001}, 'existence': 'pos_dx', 'descriptive_term': 'chronic', 'observation': 'osteomyelitis', 'temporal_term': 'chronic'}, 'chronic dense periosteal reaction': {'clinical finding': 'chronic dense periosteal reaction', 'existence': 'pos_dx', 'descriptive_term': 'chronic dense periosteal', 'observation': 'reaction', 'temporal_term': 'chronic'}, 'cavitation': {'clinical finding': 'cavitation', 'existence': 'unc_dx', 'observation': 'cavitation'}}anatomical entity_fin: {'skin': {}, 'metaphysis': {}, 'cortex': {}, 'intramedullary space': {}}location descriptor_fin: ['medial', 'distal']clinical findings_fin: {'small skin ulceration': {'clinical finding': 'small skin ulceration', 'existence': 'pos_dx', 'descriptive_term': 'small skin', 'observation': 'ulceration', 'strength_term': 'small'}, 'centrally lucent intramedullary space': {'clinical finding': 'centrally lucent intramedullary space', 'existence': 'pos_dx', 'descriptive_term': 'centrally lucent intramedullary', 'observation': 'space'}}imaging observation_fin: ['margins']object_fin: ['orthopedic screw']clinical findings_fin: {'several other similar tracts': {'clinical finding': 'several other similar tracts', 'existence': 'pos_dx', 'descriptive_term': 'several other similar', 'observation': 'tract', 'quantity_term': 'several'}, 'well-corticated margins': {'clinical finding': 'well-corticated margins', 'existence': 'pos_dx', 'descriptive_term': 'well-corticated', 'observation': 'margin'}, 'prior orthopedic screw tracts': {'clinical finding': 'prior orthopedic screw tracts', 'existence': 'pos_dx', 'descriptive_term': 'prior orthopedic screw', 'observation': 'tract'}}clinical findings_fin: {'chronic infection': {'clinical finding': 'chronic infection', 'existence': 'unc_dx', 'descriptive_term': 'chronic', 'observation': 'infection', 'temporal_term': 'chronic'}}
<s>[INST] Write the finding section for a radiology report based on the following information: clinical findings_fin: {'demineralized': {'clinical finding': 'demineralized', 'existence': 'pos_dx', 'observation': 'demineralized'}, 'osteopenia': {'clinical finding': 'osteopenia', 'cf_snomed': {'osteopenia': 312894000}, 'existence': 'unc_dx', 'observation': 'osteopenia'}, 'disuse': {'clinical finding': 'disuse', 'existence': 'unc_dx', 'observation': 'disuse'}}anatomical entity_fin: {'tibia': {'location descriptor': 'distal'}}location descriptor_fin: ['distal']clinical findings_fin: {'marked deformity': {'clinical finding': 'marked deformity', 'cf_snomed': {'deformity': 417893002}, 'existence': 'pos_dx', 'descriptive_term': 'marked', 'observation': 'deformity'}, 'chronic infection': {'clinical finding': 'chronic infection', 'existence': 'pos_dx', 'descriptive_term': 'chronic', 'observation': 'infection', 'temporal_term': 'chronic'}}anatomical entity_fin: {'tibia': {'location descriptor': 'distal'}}imaging observation_fin: ['central lucency']location descriptor_fin: ['distal']clinical findings_fin: {'chronic osteomyelitis': {'clinical finding': 'chronic osteomyelitis', 'cf_snomed': {'chronic osteomyelitis': 40970001}, 'existence': 'pos_dx', 'descriptive_term': 'chronic', 'observation': 'osteomyelitis', 'temporal_term': 'chronic'}, 'chronic dense periosteal reaction': {'clinical finding': 'chronic dense periosteal reaction', 'existence': 'pos_dx', 'descriptive_term': 'chronic dense periosteal', 'observation': 'reaction', 'temporal_term': 'chronic'}, 'cavitation': {'clinical finding': 'cavitation', 'existence': 'unc_dx', 'observation': 'cavitation'}}anatomical entity_fin: {'skin': {}, 'metaphysis': {}, 'cortex': {}, 'intramedullary space': {}}location descriptor_fin: ['medial', 'distal']clinical findings_fin: {'small skin ulceration': {'clinical finding': 'small skin ulceration', 'existence': 'pos_dx', 'descriptive_term': 'small skin', 'observation': 'ulceration', 'strength_term': 'small'}, 'centrally lucent intramedullary space': {'clinical finding': 'centrally lucent intramedullary space', 'existence': 'pos_dx', 'descriptive_term': 'centrally lucent intramedullary', 'observation': 'space'}}imaging observation_fin: ['margins']object_fin: ['orthopedic screw']clinical findings_fin: {'several other similar tracts': {'clinical finding': 'several other similar tracts', 'existence': 'pos_dx', 'descriptive_term': 'several other similar', 'observation': 'tract', 'quantity_term': 'several'}, 'well-corticated margins': {'clinical finding': 'well-corticated margins', 'existence': 'pos_dx', 'descriptive_term': 'well-corticated', 'observation': 'margin'}, 'prior orthopedic screw tracts': {'clinical finding': 'prior orthopedic screw tracts', 'existence': 'pos_dx', 'descriptive_term': 'prior orthopedic screw', 'observation': 'tract'}}clinical findings_fin: {'chronic infection': {'clinical finding': 'chronic infection', 'existence': 'unc_dx', 'descriptive_term': 'chronic', 'observation': 'infection', 'temporal_term': 'chronic'}} [/INST] The bones are diffusely demineralized, suggesting osteopenia which may be from disuse. Marked deformity of the distal tibia related to surgery and chronic infection is redemonstrated. There are findings of chronic osteomyelitis including chronic dense periosteal reaction is noted, mottled appearance of the underlying bone, and large central lucency or cavitation of the distal tibia. In addition, small skin ulceration at the medial aspect of the distal tibial metaphysis extends to the underlying bone with tract-like extension from cortex toward the centrally lucent intramedullary space. Several other similar tracts are noted with well-corticated margins, likely reflecting prior orthopedic screw tracts. Correlation with surgical history is recommended otherwise the possibility of sinus tracts from chronic infection may be considered. </s>