RADIOLOGY REPORT

Patient name: {Doe, Jane}

Date of birth: 65 Y/O Examination date: 31 July 2020
Gender: Female Intern/Referring: Zac Williams
Dr:
ID Number: Practice CP2 - report
Study description: 1. MRI left shoulder arthrogram
2. MRI cervical spine
3. Chest X-ray

Indications for study: Sudden severe left shoulder and neck pain – cervical radiculopathy
(31/07/2020); history of ongoing treatment of spinal osteoarthrosis and
increasing levels of fatigue (6 months)

Study Findings:

1. Superior labral tear from anterior to posterior ‘1 Oclock – 2 Oclock’

2. C5 left nerve root encroachment, left C5 posterolateral disc protrusion
3. Mild cardiomegaly of the heart

Impression: 1. Left slap lesion

2. Left C5 posterolateral disc protrusion with nerve root encroachment

Recommendation: 1. Ct scan of shoulder to assess for further damage

Intern: Zac Williams

Signature:
Report Date: 31/07/2020
Reviewing Radiologist: {no reviewing radiologist} Date reviewed:

Signature:

Clinic supervisor:

Signature:

This report is used only for educational purposes with the CQ University Chiropractic Clinic System.