.The frontal sinuses are underdeveloped. Patchy opacification and or or secretions are evident within the ethmoid air cells, sphenoid sinuses and maxillary sinuses. The sphenoethmoidal recesses are obscured. The maxillary outflow pathways are narrowed. Secretion or fluid is evident within the nasal cavity. The nasal septum is intact. The anterior skull base is symmetric and intact. Findings related to recent posterior instrumented fusion are seen. A plate and screw device has been fixed to the occiput to which stabilization rods are attached. These rods are internal fixed via bilateral lateral mass screws to the C3 and C4 levels. No instrument complications are suspected. Amorphous bone graft has been placed along the posterior elements down to C4. Right-sided hemilaminectomy of C1 is also evident. Erosions are evident at the atlantooccipital joints, right side more than left. Furthermore, the anterior arch of C1 and the odontoid process are partially eroded as well. Extensive ventral epidural thickening and fluid seen on the outside MRI is not as well appreciated on the present study though some degree of thickening likely does persist, and this material seems to contact the ventral surface of spinal cord. The CSF space along the lateral and dorsal aspects of the cord does seem to be preserved. The paraspinal soft tissues anterior and posterolateral to the C1 and C2 vertebral bodies are thickened and edematous. Spinal alignment is anatomic. The remaining vertebral bodies are intact and free of destructive lesions. No other significant spinal canal stenosis or neuroforaminal narrowing is detected. The posterior soft tissues of the operative bed contain small foci of air. A surgical drain is in place. No large fluid collections are suspected at this time. The pharyngeal mucosa is edematous perhaps secondary to the presence of NG and ET tubes. As above, the prevertebral soft tissues ventral to the C1 and C2 vertebral bodies are thickened and edematous. No discrete fluid collection can be identified, however. No pathologic adenopathy is detected in the neck. A few scattered mildly prominent lymph nodes may be reactive. The salivary glands are unremarkable. The thyroid appears slightly heterogeneous but this could be due to artifact. Lung apices are unremarkable. Aside from the osseous abnormalities of the cervical spine discussed above, the remaining bony elements are within normal limits.
clinical findings_fin: {'underdeveloped': {'clinical finding': 'underdeveloped', 'existence': 'pos_dx', 'observation': 'underdeveloped'}}anatomical entity_fin: {'cells': {}}clinical findings_fin: {'patchy opacification': {'clinical finding': 'patchy opacification', 'existence': 'unc_dx', 'descriptive_term': 'patchy', 'observation': 'opacification'}}anatomical entity_fin: {'sphenoethmoidal recesses': {}}clinical findings_fin: {'obscured': {'clinical finding': 'obscured', 'existence': 'pos_dx', 'observation': 'obscure'}}clinical findings_fin: {'narrowed': {'clinical finding': 'narrowed', 'existence': 'pos_dx', 'observation': 'narrow'}}anatomical entity_fin: {'fluid': {}, 'nasal cavity': {}}clinical findings_fin: {'secretion or fluid is evident within the nasal cavity': {'clinical finding': 'secretion or fluid is evident within the nasal cavity', 'cf_snomed': {'cavity': 2483006}}}clinical findings_fin: {'nasal septum': {'clinical finding': 'nasal septum', 'existence': 'pos_dx', 'descriptive_term': 'nasal', 'observation': 'septum'}, 'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'skull': {'location descriptor': 'anterior'}, 'base': {}}location descriptor_fin: ['anterior']clinical findings_fin: {'symmetric': {'clinical finding': 'symmetric', 'existence': 'pos_dx', 'observation': 'symmetric'}, 'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}location descriptor_fin: ['posterior']clinical findings_fin: {'recent posterior instrumented fusion': {'clinical finding': 'recent posterior instrumented fusion', 'existence': 'pos_dx', 'descriptive_term': 'recent posterior instrumented', 'observation': 'fusion'}}anatomical entity_fin: {'occiput': {}}clinical findings_fin: {'plate and screw device': {'clinical finding': 'plate and screw device', 'existence': 'pos_dx', 'descriptive_term': 'plate and screw', 'observation': 'device'}, 'stabilization rods': {'clinical finding': 'stabilization rods', 'existence': 'pos_dx', 'descriptive_term': 'stabilization', 'observation': 'rod'}}anatomical entity_fin: {'lateral mass': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral']clinical findings_fin: {'these rods': {'clinical finding': 'these rods', 'existence': 'pos_dx', 'descriptive_term': 'these', 'observation': 'rod'}, 'bilateral lateral mass screws': {'clinical finding': 'bilateral lateral mass screws', 'existence': 'pos_dx', 'descriptive_term': 'bilateral lateral mass', 'observation': 'screw'}}clinical findings_fin: {'instrument complications': {'clinical finding': 'instrument complications', 'existence': 'neg_dx', 'descriptive_term': 'instrument', 'observation': 'complication'}}anatomical entity_fin: {'bone graft': {}}location descriptor_fin: ['posterior']clinical findings_fin: {'amorphous bone graft': {'clinical finding': 'amorphous bone graft', 'existence': 'pos_dx', 'descriptive_term': 'amorphous bone', 'observation': 'graft'}}location descriptor_fin: ['right']clinical findings_fin: {'right-sided hemilaminectomy': {'clinical finding': 'right-sided hemilaminectomy', 'existence': 'pos_dx', 'descriptive_term': 'right-sided', 'observation': 'hemilaminectomy'}}anatomical entity_fin: {'joints': {}}location descriptor_fin: ['right', 'left']clinical findings_fin: {'erosions': {'clinical finding': 'erosions', 'existence': 'pos_dx', 'observation': 'erosion'}}anatomical entity_fin: {'odontoid': {}}location descriptor_fin: ['anterior']clinical findings_fin: {'eroded': {'clinical finding': 'eroded', 'existence': 'pos_dx', 'observation': 'erode'}}anatomical entity_fin: {'fluid': {}, 'surface of spinal cord': {}}clinical findings_fin: {'extensive ventral epidural thickening': {'clinical finding': 'extensive ventral epidural thickening', 'existence': 'pos_dx', 'descriptive_term': 'extensive ventral epidural', 'observation': 'thickening', 'strength_term': 'extensive'}, 'thickening': {'clinical finding': 'thickening', 'existence': 'unc_dx', 'observation': 'thickening'}}imaging observation_fin: ['cord']location descriptor_fin: ['lateral']clinical findings_fin: {'csf space along the lateral and dorsal aspects of the cord does seem to be preserved': {'clinical finding': 'csf space along the lateral and dorsal aspects of the cord does seem to be preserved', 'change_term': 'preserved'}}anatomical entity_fin: {'soft tissues': {}, 'vertebral bodies': {}}location descriptor_fin: ['anterior']clinical findings_fin: {'thickened': {'clinical finding': 'thickened', 'existence': 'pos_dx', 'observation': 'thickened'}, 'edematous': {'clinical finding': 'edematous', 'existence': 'pos_dx', 'observation': 'edematous'}}clinical findings_fin: {'spinal alignment is anatomic': {'clinical finding': 'spinal alignment is anatomic'}}anatomical entity_fin: {'vertebral bodies': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}, 'destructive lesions': {'clinical finding': 'destructive lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'destructive', 'observation': 'lesion'}}anatomical entity_fin: {'spinal canal': {}}clinical findings_fin: {'other significant spinal canal stenosis': {'clinical finding': 'other significant spinal canal stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'other significant spinal canal', 'observation': 'stenosis'}, 'neuroforaminal narrowing': {'clinical finding': 'neuroforaminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'neg_dx', 'descriptive_term': 'neuroforaminal', 'observation': 'narrowing'}}imaging observation_fin: ['foci']location descriptor_fin: ['posterior']clinical findings_fin: {'small foci': {'clinical finding': 'small foci', 'existence': 'pos_dx', 'descriptive_term': 'small', 'observation': 'foci', 'strength_term': 'small'}}object_fin: ['surgical drain']clinical findings_fin: {'surgical drain': {'clinical finding': 'surgical drain', 'existence': 'pos_dx', 'descriptive_term': 'surgical', 'observation': 'drain'}}anatomical entity_fin: {'fluid': {}}clinical findings_fin: {'large fluid collections are suspected at this time': {'clinical finding': 'large fluid collections are suspected at this time'}}anatomical entity_fin: {'mucosa': {}}clinical findings_fin: {'edematous': {'clinical finding': 'edematous', 'existence': 'pos_dx', 'observation': 'edematous'}, 'ng and et tubes': {'clinical finding': 'ng and et tubes', 'existence': 'unc_dx', 'descriptive_term': 'ng and et', 'observation': 'tube'}}anatomical entity_fin: {'soft tissues': {}, 'vertebral bodies': {}}clinical findings_fin: {'thickened': {'clinical finding': 'thickened', 'existence': 'pos_dx', 'observation': 'thickened'}, 'edematous': {'clinical finding': 'edematous', 'existence': 'pos_dx', 'observation': 'edematous'}}clinical findings_fin: {'discrete fluid collection': {'clinical finding': 'discrete fluid collection', 'existence': 'neg_dx', 'descriptive_term': 'discrete fluid', 'observation': 'collection'}}anatomical entity_fin: {'neck': {}}clinical findings_fin: {'pathologic adenopathy': {'clinical finding': 'pathologic adenopathy', 'existence': 'neg_dx', 'descriptive_term': 'pathologic', 'observation': 'adenopathy'}}clinical findings_fin: {'few scattered mildly prominent lymph nodes': {'clinical finding': 'few scattered mildly prominent lymph nodes', 'existence': 'unc_dx', 'descriptive_term': 'few scattered mildly prominent lymph', 'observation': 'node', 'strength_term': 'mildly - prominent', 'quantity_term': 'few'}}anatomical entity_fin: {'salivary glands': {}}clinical findings_fin: {'salivary glands are unremarkable': {'clinical finding': 'salivary glands are unremarkable'}}clinical findings_fin: {'heterogeneous': {'clinical finding': 'heterogeneous', 'existence': 'pos_dx', 'observation': 'heterogeneous'}, 'artifact': {'clinical finding': 'artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'unc_dx', 'observation': 'artifact'}}anatomical entity_fin: {'lung': {}, 'apices': {}}clinical findings_fin: {'lung apices are unremarkable': {'clinical finding': 'lung apices are unremarkable'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'osseous abnormalities': {'clinical finding': 'osseous abnormalities', 'existence': 'pos_dx', 'descriptive_term': 'osseous', 'observation': 'abnormality'}}
<s>[INST] Write the finding section for a radiology report based on the following information: clinical findings_fin: {'underdeveloped': {'clinical finding': 'underdeveloped', 'existence': 'pos_dx', 'observation': 'underdeveloped'}}anatomical entity_fin: {'cells': {}}clinical findings_fin: {'patchy opacification': {'clinical finding': 'patchy opacification', 'existence': 'unc_dx', 'descriptive_term': 'patchy', 'observation': 'opacification'}}anatomical entity_fin: {'sphenoethmoidal recesses': {}}clinical findings_fin: {'obscured': {'clinical finding': 'obscured', 'existence': 'pos_dx', 'observation': 'obscure'}}clinical findings_fin: {'narrowed': {'clinical finding': 'narrowed', 'existence': 'pos_dx', 'observation': 'narrow'}}anatomical entity_fin: {'fluid': {}, 'nasal cavity': {}}clinical findings_fin: {'secretion or fluid is evident within the nasal cavity': {'clinical finding': 'secretion or fluid is evident within the nasal cavity', 'cf_snomed': {'cavity': 2483006}}}clinical findings_fin: {'nasal septum': {'clinical finding': 'nasal septum', 'existence': 'pos_dx', 'descriptive_term': 'nasal', 'observation': 'septum'}, 'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'skull': {'location descriptor': 'anterior'}, 'base': {}}location descriptor_fin: ['anterior']clinical findings_fin: {'symmetric': {'clinical finding': 'symmetric', 'existence': 'pos_dx', 'observation': 'symmetric'}, 'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}location descriptor_fin: ['posterior']clinical findings_fin: {'recent posterior instrumented fusion': {'clinical finding': 'recent posterior instrumented fusion', 'existence': 'pos_dx', 'descriptive_term': 'recent posterior instrumented', 'observation': 'fusion'}}anatomical entity_fin: {'occiput': {}}clinical findings_fin: {'plate and screw device': {'clinical finding': 'plate and screw device', 'existence': 'pos_dx', 'descriptive_term': 'plate and screw', 'observation': 'device'}, 'stabilization rods': {'clinical finding': 'stabilization rods', 'existence': 'pos_dx', 'descriptive_term': 'stabilization', 'observation': 'rod'}}anatomical entity_fin: {'lateral mass': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral']clinical findings_fin: {'these rods': {'clinical finding': 'these rods', 'existence': 'pos_dx', 'descriptive_term': 'these', 'observation': 'rod'}, 'bilateral lateral mass screws': {'clinical finding': 'bilateral lateral mass screws', 'existence': 'pos_dx', 'descriptive_term': 'bilateral lateral mass', 'observation': 'screw'}}clinical findings_fin: {'instrument complications': {'clinical finding': 'instrument complications', 'existence': 'neg_dx', 'descriptive_term': 'instrument', 'observation': 'complication'}}anatomical entity_fin: {'bone graft': {}}location descriptor_fin: ['posterior']clinical findings_fin: {'amorphous bone graft': {'clinical finding': 'amorphous bone graft', 'existence': 'pos_dx', 'descriptive_term': 'amorphous bone', 'observation': 'graft'}}location descriptor_fin: ['right']clinical findings_fin: {'right-sided hemilaminectomy': {'clinical finding': 'right-sided hemilaminectomy', 'existence': 'pos_dx', 'descriptive_term': 'right-sided', 'observation': 'hemilaminectomy'}}anatomical entity_fin: {'joints': {}}location descriptor_fin: ['right', 'left']clinical findings_fin: {'erosions': {'clinical finding': 'erosions', 'existence': 'pos_dx', 'observation': 'erosion'}}anatomical entity_fin: {'odontoid': {}}location descriptor_fin: ['anterior']clinical findings_fin: {'eroded': {'clinical finding': 'eroded', 'existence': 'pos_dx', 'observation': 'erode'}}anatomical entity_fin: {'fluid': {}, 'surface of spinal cord': {}}clinical findings_fin: {'extensive ventral epidural thickening': {'clinical finding': 'extensive ventral epidural thickening', 'existence': 'pos_dx', 'descriptive_term': 'extensive ventral epidural', 'observation': 'thickening', 'strength_term': 'extensive'}, 'thickening': {'clinical finding': 'thickening', 'existence': 'unc_dx', 'observation': 'thickening'}}imaging observation_fin: ['cord']location descriptor_fin: ['lateral']clinical findings_fin: {'csf space along the lateral and dorsal aspects of the cord does seem to be preserved': {'clinical finding': 'csf space along the lateral and dorsal aspects of the cord does seem to be preserved', 'change_term': 'preserved'}}anatomical entity_fin: {'soft tissues': {}, 'vertebral bodies': {}}location descriptor_fin: ['anterior']clinical findings_fin: {'thickened': {'clinical finding': 'thickened', 'existence': 'pos_dx', 'observation': 'thickened'}, 'edematous': {'clinical finding': 'edematous', 'existence': 'pos_dx', 'observation': 'edematous'}}clinical findings_fin: {'spinal alignment is anatomic': {'clinical finding': 'spinal alignment is anatomic'}}anatomical entity_fin: {'vertebral bodies': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}, 'destructive lesions': {'clinical finding': 'destructive lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'destructive', 'observation': 'lesion'}}anatomical entity_fin: {'spinal canal': {}}clinical findings_fin: {'other significant spinal canal stenosis': {'clinical finding': 'other significant spinal canal stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'other significant spinal canal', 'observation': 'stenosis'}, 'neuroforaminal narrowing': {'clinical finding': 'neuroforaminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'neg_dx', 'descriptive_term': 'neuroforaminal', 'observation': 'narrowing'}}imaging observation_fin: ['foci']location descriptor_fin: ['posterior']clinical findings_fin: {'small foci': {'clinical finding': 'small foci', 'existence': 'pos_dx', 'descriptive_term': 'small', 'observation': 'foci', 'strength_term': 'small'}}object_fin: ['surgical drain']clinical findings_fin: {'surgical drain': {'clinical finding': 'surgical drain', 'existence': 'pos_dx', 'descriptive_term': 'surgical', 'observation': 'drain'}}anatomical entity_fin: {'fluid': {}}clinical findings_fin: {'large fluid collections are suspected at this time': {'clinical finding': 'large fluid collections are suspected at this time'}}anatomical entity_fin: {'mucosa': {}}clinical findings_fin: {'edematous': {'clinical finding': 'edematous', 'existence': 'pos_dx', 'observation': 'edematous'}, 'ng and et tubes': {'clinical finding': 'ng and et tubes', 'existence': 'unc_dx', 'descriptive_term': 'ng and et', 'observation': 'tube'}}anatomical entity_fin: {'soft tissues': {}, 'vertebral bodies': {}}clinical findings_fin: {'thickened': {'clinical finding': 'thickened', 'existence': 'pos_dx', 'observation': 'thickened'}, 'edematous': {'clinical finding': 'edematous', 'existence': 'pos_dx', 'observation': 'edematous'}}clinical findings_fin: {'discrete fluid collection': {'clinical finding': 'discrete fluid collection', 'existence': 'neg_dx', 'descriptive_term': 'discrete fluid', 'observation': 'collection'}}anatomical entity_fin: {'neck': {}}clinical findings_fin: {'pathologic adenopathy': {'clinical finding': 'pathologic adenopathy', 'existence': 'neg_dx', 'descriptive_term': 'pathologic', 'observation': 'adenopathy'}}clinical findings_fin: {'few scattered mildly prominent lymph nodes': {'clinical finding': 'few scattered mildly prominent lymph nodes', 'existence': 'unc_dx', 'descriptive_term': 'few scattered mildly prominent lymph', 'observation': 'node', 'strength_term': 'mildly - prominent', 'quantity_term': 'few'}}anatomical entity_fin: {'salivary glands': {}}clinical findings_fin: {'salivary glands are unremarkable': {'clinical finding': 'salivary glands are unremarkable'}}clinical findings_fin: {'heterogeneous': {'clinical finding': 'heterogeneous', 'existence': 'pos_dx', 'observation': 'heterogeneous'}, 'artifact': {'clinical finding': 'artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'unc_dx', 'observation': 'artifact'}}anatomical entity_fin: {'lung': {}, 'apices': {}}clinical findings_fin: {'lung apices are unremarkable': {'clinical finding': 'lung apices are unremarkable'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'osseous abnormalities': {'clinical finding': 'osseous abnormalities', 'existence': 'pos_dx', 'descriptive_term': 'osseous', 'observation': 'abnormality'}} [/INST] .The frontal sinuses are underdeveloped. Patchy opacification and or or secretions are evident within the ethmoid air cells, sphenoid sinuses and maxillary sinuses. The sphenoethmoidal recesses are obscured. The maxillary outflow pathways are narrowed. Secretion or fluid is evident within the nasal cavity. The nasal septum is intact. The anterior skull base is symmetric and intact. Findings related to recent posterior instrumented fusion are seen. A plate and screw device has been fixed to the occiput to which stabilization rods are attached. These rods are internal fixed via bilateral lateral mass screws to the C3 and C4 levels. No instrument complications are suspected. Amorphous bone graft has been placed along the posterior elements down to C4. Right-sided hemilaminectomy of C1 is also evident. Erosions are evident at the atlantooccipital joints, right side more than left. Furthermore, the anterior arch of C1 and the odontoid process are partially eroded as well. Extensive ventral epidural thickening and fluid seen on the outside MRI is not as well appreciated on the present study though some degree of thickening likely does persist, and this material seems to contact the ventral surface of spinal cord. The CSF space along the lateral and dorsal aspects of the cord does seem to be preserved. The paraspinal soft tissues anterior and posterolateral to the C1 and C2 vertebral bodies are thickened and edematous. Spinal alignment is anatomic. The remaining vertebral bodies are intact and free of destructive lesions. No other significant spinal canal stenosis or neuroforaminal narrowing is detected. The posterior soft tissues of the operative bed contain small foci of air. A surgical drain is in place. No large fluid collections are suspected at this time. The pharyngeal mucosa is edematous perhaps secondary to the presence of NG and ET tubes. As above, the prevertebral soft tissues ventral to the C1 and C2 vertebral bodies are thickened and edematous. No discrete fluid collection can be identified, however. No pathologic adenopathy is detected in the neck. A few scattered mildly prominent lymph nodes may be reactive. The salivary glands are unremarkable. The thyroid appears slightly heterogeneous but this could be due to artifact. Lung apices are unremarkable. Aside from the osseous abnormalities of the cervical spine discussed above, the remaining bony elements are within normal limits. </s>