EFTA02726362.pdf

To: Leslie From: Kelly Daly 11-20-13 9:49am p. 1 of 1 Spine Associates Sean E. McCance, MD Peter Frelinghuysen, MD 1155 Park Avenue, NYC, NY 10128 Phone: (212) 3604500 Fax: (212)3604535 RADIOLOGY Name: EPSTEIN, JEFFERY Date 1111812013 Dx do instability 9 X-Ray US (standing) ❑ Scoliosis Series (36", standing) • AP- Lateral ❑ AP • Flex•Extension ❑ Lateral 9 Obliques x 2 ❑ Supine Bending • Lateral Ltanbosacral ❑ Active bend left ❑ Active bend right ❑ X•Rays (other) ❑ Swine hyper extension over a Bolster 9 kftay AP-Pelvis ❑ MRI ❑ CT ❑ X-Ray Cervical Spine ❑ Cervical ❑ Cervical ❑ Thoracic ❑ Thorack ❑ AP-Lateral ❑ Lumbar ❑ Lumbar 11 Flex-Extension n With Gadolinium n With Myelogram ❑ Obliques x 2 ❑ Closed ❑ Open mouth ❑ Open ❑ Other ❑ X-ray Thoracic spine ❑ Bone Scan O AP-Lateral ❑ Obliques x 2 ❑ 3 Phase Bone Scan ❑ Bone w/Spec CT SIGNATURE Kate Gumersell. RPA•C NYS 014654 DEA MG2336217 Sean E. titcCarxe, MD NYS 206265 DEA BM4915365 EFTA_R1_02214089 EFTA02726362