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there is moderately severe pulmonary edema predominantly in a perihilar distribution. superimposed pneumonia would be difficult to exclude, particularly at the lung bases. blunting of the left costophrenic angle suggests at least a small pleural effusion. no sizable pleural effusion on the right. no pneumothorax. heart size is enlarged. no acute osseous abnormalities identified.
<unk>-year-old female with shortness of breath
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left-sided pacemaker device is noted with leads terminating in the regions of the right atrium, right ventricle, and coronary sinus. moderate to severe cardiomegaly is present. the aorta is diffusely calcified. there is mild pulmonary edema with small to moderate size bilateral pleural effusions. associated bibasilar atelectasis is present. no pneumothorax or focal consolidation is otherwise present. clips are seen in the upper abdomen as well as surgical anchors within the right humeral head.
history: <unk>m with stroke
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there has been interval advancement of the ng tube; however, the side port still terminates at the ge junction, although the tip terminates in the mid gastric body. there is otherwise no significant interval change compared to exam from four and a half hours prior.
ng tube placement.
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pa and lateral views of the chest <unk> at <time> are submitted.
<unk> year old woman with pulmonary vein ablation for afib with rvr now with dyspnea. // eval for diaphragmatic paralysis eval for diaphragmatic paralysis
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ap portable upright view of the chest. mild cardiomegaly is noted. coarsened lung markings may reflect interstitial lung disease. no large effusion or pneumothorax is seen. no convincing signs of pneumonia. patient rotation limits assessment. allowing for this, the mediastinal contour is likely within normal limits. the bony structures are demineralized though appear intact.
<unk>f with cough, fever // pna?
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with syncope, vomiting // evaluate for acute process
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normal cardiomediastinal silhouette. linear opacities at the left apex may represent increasing radiation fibrosis. no pneumonia. no pulmonary edema. no pleural effusion. no pneumothorax.
history: <unk>f with chest pain // eval for acute process
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the lungs remain clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with hiv not taking medications, presents with fever/cough for <num> weeks // assess for infection
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there is a port-a-cath overlying the left chest with the tip in the mid svc. no change in the appearance of the right medial hemithorax in comparison to the radiograph dated <unk>. heart size is stable. the mediastinal and hilar contours are stable. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there is chronic elevation of the right hemi diaphragm. there are no acute osseous abnormalities. there are surgical clips seen in the right chest wall.
<unk> year old woman s/p mie // check interval change
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the lungs are normally expanded and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax.
history: <unk>f with syncope, sob // cardiomegaly?
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frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and fairly well-aerated lungs. linear atelectasis or scarring has not changed since at least <unk>. borderline cardiomegaly and mediastinal vascular engorgement are <unk>-<unk>. there is no pleural effusion. loss of height in multiple thoracic vertebral bodies is chronic, the result of renal osteodystrophy. .
cough.
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the heart size is mild to moderately enlarged. the aorta is tortuous. the mediastinal and hilar contours are unremarkable. lungs are slightly hyperinflated with flattening of the diaphragms suggestive of copd. atelectasis is noted in the lung bases without focal consolidation. no pleural effusion or pneumothorax is present. no acute osseous abnormality is identified.
history: <unk>f with shortness of breath and cough
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heart size is normal. mediastinal and hilar contours are within normal limits. lungs are clear. pulmonary vascularity is normal. no pleural effusion or pneumothorax is present. no acute osseous abnormalities are present. mild degenerative changes are noted within the imaged spine.
chest pain.
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single portable view of the chest. no prior. low lung volumes are seen. there is increased density projecting over the first right anterior costochondral cartilage. this could be potentially due to degenerative changes; however, given asymmetry, two-view chest x-ray suggested when patient is amenable. otherwise, lungs are grossly clear. cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are unremarkable. no free air is seen below the diaphragm.
<unk>-year-old male with cholecystitis. pre-operative chest x-ray.
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the lungs are well expanded. there is an elevated right hemidiaphragm consistent with recent right upper lobe lobectomy. the right perihilar consolidation has decreased from prior exam and likely represents resolving postoperative atelectasis. the lungs are otherwise clear. there is a small right pleural effusion. there is no left pleural effusion. the small right apical pneumothorax has decreased since prior exam. there is no left pneumothorax. moderate cardiomegaly is unchanged. a right-sided pacer is seen in the right anterior chest wall with an intact lead in appropriate position.
<unk> year old woman with pod<unk> s/p vats, rul lobectomy with desats // stability of apical pneumothorax
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right lower lobe fiducial markers in multiple areas of right-sided chain suture are unchanged. there is no evidence of pneumothorax status post biopsy. right-sided effusion and/or chronic pleural thickening is unchanged. the left lung is clear. there are no new cardiac or mediastinal contour abnormalities.
<unk>-year-old woman with lung nodule status post biopsy.
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since the prior study, there is a been interval improvement in bibasilar atelectasis and bilateral pleural effusions. mild cardiomegaly is unchanged. no focal consolidation concerning for pneumonia is identified. pulmonary edema has nearly resolved with only minimal interstitial edema remaining. left humeral head anchor screws are again noted.
history: <unk>m with etoh cirrhosis, increasing ams //
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cardiac silhouette size is borderline enlarged. the aorta is tortuous with atherosclerotic calcifications noted at the aortic knob. the mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. elevation of the right hemidiaphragm is chronic. subsegmental right basilar atelectasis is seen, but there is no focal consolidation. no large pleural effusion or pneumothorax is present. blunting of the right costophrenic angle is likely due to mild chronic pleural thickening. no pneumothorax is detected. no displaced fractures are seen.
history: <unk>m who fell, sustained head injuries, evaluate for rib fractures.
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low lung volumes. lung fields are clear. stable cardiomediastinal silhouette. no pneumothorax or pleural effusion. osseous structures are unremarkable.
history: <unk>f with shortness of breath // pulm edema
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frontal and lateral views of the chest were performed. the lungs are clear but hyperinflated. there is no pleural effusion, pneumothorax or focal airspace consolidation. the cardiac silhouette is top-normal in size but unchanged. the hilar structures are unremarkable and there is no evidence for pulmonary edema. the imaged upper abdomen is normal.
dyspnea on exertion, wheezing, leukocytosis and cough. evaluate for pneumonia pulmonary edema.
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the cardiomediastinal and hilar contours are normal. there is no pleural effusion or pneumothorax. lungs are well-expanded and clear without focal consolidation concerning for pneumonia. pulmonary vasculature is within normal limits. there is no abnormality in the visualized upper abdomen.
<unk>f with cough.
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there is a small to moderate right pleural effusion with associated basilar atelectasis and mild volume loss. the left lung base is clear. no significant pneumothorax is seen on this semi-erect view. there is mild prominence of the pulmonary vasculature. the cardiac silhouette is enlarged. mediastinal contours are within normal limits. there are lucencies beneath both hemidiaphragms greater on the left than right with lucency in the midline most concerning for free air in the abdomen.
<unk>-year-old woman with altered mental status.
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there continue to be small to moderate bilateral pleural effusions with bilateral lower lobe volume loss/infiltrate
<unk> year old man with bibasilar infiltrates // eval with better <num> view
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. median sternotomy wires extensive mediastinal clips are unchanged.
<unk> year old man with cough and wheeze. // assess for pulmonary edema, infiltrate
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cardiac silhouette size is normal. the mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. apart from minimal atelectasis in the left lung base, the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. no acute osseous abnormality is visualized.
history: <unk>m with exertional angina for <num> days, positive troponin at outside hospital
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ap view of the chest. no focal consolidation, pleural effusion, or pneumothorax. the cardiomediastinal and hilar contours are normal. unchanged apical pleural thickening.
microabscesses in the liver, peaking fevers. on therapy. evaluate for pneumonia.
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single frontal view of the chest. endotracheal tube, ng tube, single lead left chest wall defibrillator, and right picc are in stable position. lung volumes are low with slight asymmetric elevation of left hemidiaphragm. no focal consolidation, pleural effusion, or pneumothorax. heart size and mediastinal contours are normal.
subarachnoid hemorrhage. evaluate for progression of pneumonia.
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frontal and lateral views of the chest were obtained. new heterogeneous right infrahilar opacity is consistent with lower lobe pneumonia. some right pleural effusion may be present although the basal pleural interface reflects the normal contour. an apparent bulge in the mid portion of the right basal interface seen on the lateral view, is actually superimposition of the stomach and splenic flexure. widening of the mediastinum and obliteration of the right p;aratracheal stripe could be due to adenopathy or fat deposition. heart size is normal.
<unk>-year-old female with fever and cough.
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lung volumes are low but the lungs are clear. cardiac and medistinal contours are normal with mild atherosclerotic calcifications at the aortic arch. there is no pulmonary edema. no acute fractures are identified.
colangitis and bibasilar cracles.
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there is a left subclavian catheter, which terminates in the low svc. there is a dobhoff tube with the tip terminating in the region of the ge junction, unchanged compared to prior. the sternotomy wires appear intact and appropriately aligned. there are persistent bilateral pleural effusions, not significantly changed compared to prior. the extent of pulmonary edema is also unchanged. the cardio mediastinal silhouette is stable. there is no pneumothorax.
<unk> year old man with esrd on hd, malnutrition with dobhoff, r>l pleural effusions. // evaluate interval change in pleural effusions.
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chest, pa and lateral radiographs demonstrate unremarkable mediastinal and hilar contours. heart size is normal. faint rounded opacity is identified projecting over the left lateral border of the heart may represents nipple shadow. however, there appears to be a somewhat nodular density in the breast on the lateral views which appears deep to the nipple. no opacification concerning for pneumonia identified. no pleural effusion or pneumothorax evident. no osseous abnormality identified, though multilevel degenerative changes are present.
cough, please evaluate for pneumonia.
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the endotracheal tube is noted at the origin of the right mainstem bronchus, retraction by <num> cm is recommended. nasogastric tube appears coiled in the stomach. there is left lower lobe collapse. otherwise, the lungs are clear with no evidence of other consolidations or effusions. cardiomediastinal silhouette appears within normal limits. the aortic arch appears prominent.
evaluation of patient with altered mental status and brain hemorrhage.
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pa and lateral chest radiographs were obtained. the lungs are well expanded and clear. there is no focal consolidation, effusion, or pneumothorax. cardiac and mediastinal contours are normal. surgical clips projecting over the right chest are likely secondary to prior breast intervention.
cough and shortness of breath.
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frontal and lateral views of the chest were obtained. the heart is of top normal size with stable cardiomediastinal contours. the lungs are hyperinflated with flattened diaphragms. streaky left lung base opacity is similar to prior and compatible with atelectasis. a trace right pleural effusion is similar to prior. no pneumothorax. sternotomy wires, mediastinal clips, and two valvular prostheses are similar to prior.
<unk>-year-old female on coumadin with seizure. evaluate for pneumonia.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. there is a nodular opacity in the right upper lobe which is not well seen on the most recent chest radiograph in <unk> and has a retractile effect on the major fissure. no pleural effusion or pneumothorax is seen.
<unk> year old man with shortness of breath // please assess for pulmonary parenchymal process.
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ap portable upright view of the chest. ill-defined bilateral central perihilar opacities correspond to ground-glass opacities on the chest ct examination from <unk>, which may reflect atypical infection, inflammation, or blood. the overall appearance is minimally changed since the <unk> radiograph. there is no pneumothorax or pleural effusion. an endotracheal tube and orogastric tube are unchanged in position.
<unk> year old man s/p cardiac arrest now intubated // eval for interval change
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the lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. the cardiac and mediastinal contours are normal. no fracture identified.
<unk>-year-old status post motor vehicle crash with chest pain.
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pa and lateral views of the chest demonstrate stable mild cardiomegaly. the lungs are well inflated and clear. there is no evidence of pneumonia, pleural effusion, pulmonary edema, or pneumothorax. the cardiomediastinal silhouette is stable. mild calcifications in the aortic arch are again noted.
<unk>-year-old female with productive cough and subjective fever, with bilateral rhonchi. evaluation for pneumonia.
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there is a large opacity at the right lung base, which is likely due to elevation of the right hemidiaphragm from numerous bulky hepatic masses. aerated portion of the right lung apex is clear. there is a small pleural effusion on the left. left lung base opacity may represent adjacent atelectasis, although infection could be considered in the appropriate clinical setting. no pneumothorax bilaterally. no acute osseous abnormalities are identified. surgical clips are noted in the bilateral upper quadrants.
<unk>-year-old female with metastatic breast cancer, transferred for evaluation of worsening mental status.
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pa and lateral views of the chest provided. the lungs are hyperinflated. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with sob
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assessment is limited due to positioning. allowing for this limitation, there patchy pulmonary opacities in the left mid lung and the left base, overlying the region of the apex in this radiograph, with obscuration of the lateral hemidiaphragm. right basilar streaky opacities may represent chronic fibrosis and associated atelectasis. there is no pneumothorax. heart size cannot be properly assessed in this exam.
<unk>-year-old male with acute change in mental status.
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the right lower lung consolidation is overall unchanged or minimally improved from the most recent exam but new from the exam earlier yesterday, highly suggestive of aspiration/pneumonia. a retrocardiac opacity is new and may reflect aspiration in the appropriate clinical setting. pulmonary vascular congestion and mild edema is mild but increased. the heart size is mildly enlarged, overall unchanged. no pneumothorax or pleural effusion. mild emphysematous changes in the right upper lung.
<unk> year old man with schf, copd, aspiration pna and sepsis, pls evaluate for interval change // please evaluate for interval change
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the heart appears enlarged. there are bilateral increased interstitial opacities suggestive of mild to moderate pulmonary edema. bibasilar atelectatic changes are noted otherwise, the lungs are without focal opacity. no acute fractures are identified.
bilateral lower extremity edema, evaluation for pulmonary edema.
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frontal and lateral chest radiographs were obtained. there is persistent subcutaneous emphysema in the soft tissues surrounding the right hemithorax and now the left hemithorax and neck. a right chest tube has been removed. there is no appreciable pneumothorax. lungs are better aerated without evidence of consolidation. the heart size is normal. there is chronic dilation of the ascending aorta better seen on recent cta chest from <unk>. there is no pleural effusion or pulmonary edema.
patient status post chest tube removal, eval pneumothorax.
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there is slight blunting of the posterior costophrenic angles may be due to trace pleural effusions. no large pleural effusion is seen. there is no definite focal consolidation. no pneumothorax is seen. patient is status post median sternotomy and cabg. the cardiac silhouette is top-normal to mildly enlarged. no pulmonary edema.
<unk>m w/esrd, please eval for pulm edema // <unk>m w/esrd, please eval for pulm edema
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the cardiomediastinal and hilar contours are within normal limits. the aorta is mildly tortuous and calcified. the lungs are clear without focal consolidation, pleural effusion or pneumothorax.
<unk>m with fever and chills? // pna?
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cardiac silhouette remains enlarged. asymmetrical biapical pleural and parenchymal opacification is unchanged since recent study of <num> day earlier, and is more prominent on the right than the left, with associated upper lobe volume loss. nonspecific patchy bibasilar lung opacities are also unchanged.
<unk> year old man diabetes with cough, fever, sob // possible interval development of infiltrate c/w pneumonia? that would support diagnosis of bacterial pneumonia (since ed did portable and also patient got ivf since presentation) vs. different pattern that may suggest viral illness
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the cardiac, mediastinal, and hilar contours appear unchanged. the aortic arch is partly calcified. there is no pleural effusion or pneumothorax. the lungs appear clear. moderate anterior osteophytes are noted along the thoracic spine. mild pectus excavatum is present.
lightheadedness.
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there is slight increase in elevation of the left hemidiaphragm, consistent with atelectasis. a left pleural effusion is tiny if present. the cardiomediastinal and hilar contours are unchanged. the aorta is tortuous. a single lead pacemaker/ defibrillator device is present, with the lead ending in the region of the right ventricle. there is no pneumothorax, pleural effusion, or consolidation.
history: <unk>m with hemoptysis // ?pna
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a moderate volume of free intraperitoneal air below the diaphragm is attributable to recent surgery. the ng tube can be traced only as far as the lower esophagus and cannot be localized with respect to the postoperative esophagointestinal junction. heart size is within normal limits. mediastinal and hilar contours are unremarkable. there is no evidence for pulmonary edema, pulmonary consolidation, pleural effusion, or pneumothorax.
<unk>m s/p gastrectomy and esophagojejunostomy, splenectomy and ccy for strangulated hiatal hernia; now s/p ex lap, r colectomy for cecal volvulus, s/p ngt placement. evaluate for ngt placement
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frontal and lateral views of the chest demonstrate no focal consolidation, pleural effusion or pneumothorax. the hilar and mediastinal silhouettes are unremarkable. heart size is normal. there is no pulmonary edema.
dyspnea.
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the lungs are hyperinflated, and there is scarring noted at the bilateral lung apices and bases. streaky airspace opacities extending from the bilateral hila to the lung bases likely reflect atelectasis. there is no large pleural effusion or pneumothorax identified. no lobar consolidation. the heart is enlarged. the descending thoracic aorta is slightly ectatic. s-shaped scoliosis is centered within the mid thoracic spine.
history: <unk>f with chest pian sob nstemi // pna vs fluid
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patient is status post median sternotomy, transcatheter aortic valve replacement, and mitral valve replacement. cardiac, mediastinal and hilar contours are normal. lungs are hyperinflated without focal consolidation. pulmonary vasculature is not engorged. there is no pleural effusion or pneumothorax. no acute osseous abnormality is visualized.
history: <unk>f with severe respiratory distress
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the cardiac, mediastinal and hilar contours are unchanged, with the heart size within normal limits. there is diffuse calcification of the thoracic aorta. pulmonary vascularity is normal. lungs are hyperinflated but clear. no focal consolidation, pleural effusion or pneumothorax is seen. no acute osseous abnormalities are detected.
altered mental status worsening over the last few weeks.
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pa and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. the heart size is normal. the cardiac, hilar, and mediastinal contours are normal.
aids with cd<num> count of <num>. fever and cough concerning for infectious process.
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the heart size remains mildly enlarged. the mediastinal and hilar contours are stable, with calcification of the aortic knob again noted. left picc appears to have been removed. there is mild pulmonary vascular congestion. small amount of fluid is also noted tracking along the right major fissure. no left pleural effusion or pneumothorax is otherwise demonstrated. no acute osseous abnormalities seen.
productive cough for several days, confusion.
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pa and lateral chest radiographs demonstrate no focal consolidation. cardiomediastinal silhouette is within normal limits. several left-sided rib fractures are identified which include lateral fifth sixth and seventh ribs as well as the seventh rib posteriorly. there is no evidence of a pneumothorax. blunting of the left costophrenic angle may reflect atelectasis though a small pleural effusion cannot be excluded. increased density within the soft tissues is likely reflective of focal hematoma as in association with the rib fractures. the upper abdomen is unremarkable.
<unk>-year-old male with pain to the left posterior chest status post fall.
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a left pleural drain is seen projected over the left hemithorax, unchanged. there is large left pleural effusion, minimally decreased from the prior study. left lower lobe atelecatasis has improved. again, lucency below the right hemidiaphragm is consistent with recent abdominal surgery. opacity at the right base represents multiple lung nodules on right and right lymphadenopathy. known mediastinal lymphadenopathy better seen on recent ct. there is no evidence of pneumothorax.
metastatic renal cancer. assess for interval change.
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the lungs are well expanded and clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. the cardiomediastinal silhouette appears within normal limits. there is no displaced rib fracture identified.
history: <unk>f with chest pain
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there is no substantial change in appearance of patient's known diffuse bilaterally pulmonary metastases, which are better characterized on recent fdg pet-ct performed <unk>. there are no pleural effusions or pneumothorax. the heart border is indistinct due to overlying soft tissue lesions. no acute osseous abnormalities. again seen are multiple subcutaneous clips seen in the mid anterior chest wall.
<unk> year old woman with pleural effusion // eval
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interval removal of the feeding tube. the tip of the left picc line extends to the mid svc. minimal decrease in the extent of the bilateral parenchymal opacities. small bilateral pleural effusions are unchanged. no pneumothorax identified. unchanged s-shaped curvature of the thoracolumbar spine as well as a slight compression deformity of a mid thoracic vertebral body.
<unk> year old man with mm, tachypnea, c/f aspiration v. worsening infection, // evaluation for edema, aspiration
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the lungs are clear, without pleural effusion, or pneumothorax. the cardiac silhouette is normal in size, the mediastinal contours are normal. a distal right clavicular fracture is again noted, nondisplaced fractures of the left lateral seventh through possibly tenth ribs are present, but not optimally evaluated.
<unk>-year-old male with alcohol and cocaine use, status post fall, now with fever, question pneumonia.
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the lungs are well expanded. there is a dense retrocardiac opacity, with obscuration of the margin of the left hemidiaphragm and descending thoracic aorta, suggestive of left basilar consolidation. cardiac size is moderately enlarged, not significantly changed from prior exam. no large right pleural effusion or pneumothorax. dense calcifications of the aorta are reidentified. left deviation of the trachea and prominence of the upper mediastinum on the right is better assessed in prior ct and secondary to tortuosity of the vessels. right upper quadrant surgical clips.
shortness of breath.
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heart size is mildly enlarged. the aorta is tortuous. hilar contours are normal, and the pulmonary vasculature is normal. linear opacities within the lower lobes bilaterally likely reflect areas of subsegmental atelectasis. no focal consolidation, pleural effusion or pneumothorax is identified. there are multilevel moderate degenerative changes noted in the thoracic spine.
history: <unk>m with dysarthria and possible aphasia over <num> hours ago now resolved
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cardiac silhouette size is normal. the mediastinal and hilar contours are unremarkable. mild pulmonary edema is present. there is a small to moderate size left pleural effusion. patchy opacity within the left lung base is concerning for pneumonia in the correct clinical setting. no pneumothorax is present. there are no acute osseous abnormalities.
history: <unk>f with chest pain and productive cough // eval pneumonia
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the right picc terminates in the mid to lower svc. heterogeneous airspace opacities in the mid and lower left lung have improved. right lower lung is also better aerated. moderate bilateral pleural effusions right more than left, have slightly decreased. chronic right apical pleural thickening. cardiomediastinal silhouette is stable. prosthetic mitral valve and sternotomy wires are noted.
<unk> year old woman with hypoxia. now s/p diuresis // interval change in infiltrates after diuresis?
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portable semi-erect chest film <unk> at <time> is submitted.
<unk> year old woman with sbo s/p placement of ngt // pls eval location of tip of ngt pls eval location of tip of ngt
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. heterogeneous opacities are present in the left lower lobe with otherwise clear lungs. . no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
<unk> year old man with recent travel history to dr <unk>/w hemoptysis // please eval for consolidation or granulomatous lesion
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there is somewhat patchy, somewhat consolidative opacity in the medial right lower lobe. there is mild bibasilar atelectasis. there is no effusion or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>m with cp, sob, ?pna // ?cpd
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the heart is normal in size. the mediastinal and hilar contours appear within normal limits. a calcification projecting over the right lower lobe appears unchanged. the lung fields are otherwise clear. there are no pleural effusions or pneumothorax. mild degenerative changes are noted along the thoracic spine.
foreign body sensation in the right anterior chest.
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right-sided picc line with the tip in the low svc. previously seen left retrocardiac opacity has improved. the lungs are mildly hyperinflated with emphysema. no pulmonary edema. no pleural effusions or pneumothorax.
<unk> year old man i d, vac change for r hip. preop cxr // preop cxr surg: <unk> (vac change, i d)
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mild to moderate cardiomegaly is unchanged. the mediastinal and hilar contours are similar. pulmonary vasculature is not engorged. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is present. moderate degenerative changes are seen in the thoracic spine.
history: <unk>m with complaints of chest pain and shortness of breath
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frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. the lungs are clear. there is no pneumothorax, vascular congestion, or pleural effusion. ill-defined slight increase in density in the left base is felt to represent low lung volumes with overlapping vascular structures, less likely consolidation, to be clinically correlated.
<unk>-year-old male with chest pain. question acute process.
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heart size is top normal. mediastinal and hilar contours are unremarkable. lungs are clear. pulmonary vascularity is normal. no pleural effusion or pneumothorax is seen. old right-sided rib fractures are again noted.
chest pain.
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pa and lateral chest views were obtained with patient upright position. poor inspirational effort with high positioned diaphragm conceal portion of cardiac shadow which makes assessment of heart size difficult. on the lateral view in which the inspiration was better, suspicion for cardiomegaly cannot be confirmed. there is no configurational abnormality. the thoracic aorta is of ordinary <unk> but slightly elongated. no local contour abnormalities are seen. the pulmonary vasculature is not congested. there are no signs of pleural effusions in either lateral or posterior pleural sinuses. no evidence of acute or chronic pulmonary parenchymal infiltrates are present. no pneumothorax exists in the apical area on the frontal view. considering patient's history of bilateral lower extremity edema, it is noteworthy that the azygos vein is not distended. thus, there is no radiographic evidence of right-sided cardiac in-flow impairment. skeletal structures of the thorax are grossly unremarkable. our records do not include a previous chest examination available for comparison.
<unk>-year-old male patient with new bilateral lower extremity edema. evaluate for volume overload, cardiomegaly.
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frontal and lateral chest radiographs demonstrate a mild cardiomegaly. the lungs are well-aerated without focal consolidation, pleural effusion, or pneumothorax. minimal atelectasis is noted in the lingula. there is no appreciable pleural effusion or pneumothorax. the visualized upper abdomen is unremarkable.
evaluate for pneumonia in a patient with dyspnea and chest pain.
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low lung volumes are seen with secondary crowding of the bronchovascular markings. there is no definite superimposed consolidation or large effusion. there is elevation of the right hemidiaphragm as on prior. deformities of multiple posterior right ribs are compatible with previously seen right-sided rib fractures.
<unk>m with etoh abuse with hypoxia // eval pna
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pa and lateral views of the chest provided. interval placement of a left pacemaker with leads projecting over the right atrium and right ventricle. lungs are grossly clear. no pneumothorax. bilateral small pleural effusions. hilar and cardiomediastinal contours are normal.
<unk> year old man with new pacemaker implant // evaluate for pneumothorax and lead placement
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frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. lungs are clear. hyperdense rounded opacity in the apical portion of the left lung projecting over the left clavicle is of unclear etiology. no pleural effusion or pneumothorax identified.
palpitations and pre-syncope, evaluate for acute intrathoracic process.
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the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities identified.
<unk>m with sob and cp s/p stents,, // r/o chf
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endotracheal tube appears in place at the mid trachea. enteric tube traverses to the stomach. left-sided chest tube is noted with tip at the upper portion of the left lung. left apical pneumothorax is likely smaller and not clearly appreciated. lung aeration appears improved. bibasilar opacities consistent with atelectasis are again noted. cardiac and mediastinal silhouettes remain stable. post-surgical changes are partially visualized in the spine with vertical rods and horizontal screws.
status post l<num>-s<num> fusion, lateral l<num>-l<num> fusion, and intubation; for interval change.
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ap semi upright and lateral views of the chest provided. low lung volumes. lungs appear clear. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is stable. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with seizure disorder presenting with <num> seizures today.
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mild enlargement of the cardiac silhouette is present. the mediastinal and hilar contours are unremarkable. there is mild pulmonary vascular congestion. small bilateral pleural effusions are present along with bibasilar opacities, likely atelectasis. no pneumothorax is present. there are no acute osseous abnormalities.
history: <unk>m with dyspnea
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single frontal image of the chest again demonstrates large right upper lobe and right middle lobe masses, consistent with multiple previous chest studies and known history of metastatic melanoma to the lungs. there has been interval development of right upper lobe and right lower lobe hazy opacities, which could represent atelectasis or layering pleural effusion; however, in the appropriate clinical context, a developing pneumonia cannot be excluded. the left lung is again seen to be clear with no pleural effusion on the left. the cardiomediastinal silhouette appears to be unchanged, but visualization is limited due to adjacent right lung opacities.
<unk>-year-old female with known melanoma metastatic to the lung, now with new oxygen requirement and tachycardia.
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frontal and lateral radiographs of the chest demonstrate interval worsening pulmonary edema which is mild to moderate. small bilateral pleural effusions are new since the prior study. increase in opacity at the right base may be vascular engorgement or developing concurrent pneumonia. cardiomediastinal contour is enlarged since the prior study. no pneumothorax.
fevers with vomiting and gram-negative rod bacteremia. evaluate for pneumonia versus volume overload.
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the lungs are clear.the cardiac, hilar and mediastinal contours are normal.no pleural abnormality is seen.
<unk>m with <num> hr exertional-related angina transfer from <unk>. evaluate for pneumonia or acute cardiopulmonary process.
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lungs: the lungs are hyper inflated. linear atelectasis is seen in the right base. pleura: no pleural effusion is seen. heart: the heart is borderline. mediastinum and hila: there is no mediastinal mass. osseous structures: hypertrophic changes are seen in the dorsal spine. other findings: surgical clips are noted in the right upper quadrant
history: <unk>f with sob, cough // evaluate for chf
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the lungs are again noted to be hyperinflated with flattening of the diaphragms. persistent left lower lobe opacity with interval progression of right lower lobe opacity. again seen are calcifications along the left chest wall which are unchanged prior examination can consistent with calcified plaques. scarring within the left costophrenic angle is again noted. possible calcified plaques along the right lateral lung are similar to prior examination. no pneumothorax. heart size, mediastinal contour, and hila are unremarkable. the aorta is calcified consistent with atherosclerosis.
<unk> year old man with multifocal pna, ?tb, acute hypoxia on <num>l o<num>. assess for interval change or pulmonary edema.
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patient atelectasis/scarring is seen without definite focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are grossly stable. cardiac silhouette is mildly enlarged. prominence of the right hilum is stable. no pulmonary edema is seen.
history: <unk>f with shortness of breath and cough // consolidation
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chest, pa and lateral. there is minimal heterogeneous opacity in the right lower lobe, which is a chronic finding based on multiple prior studies. on the cta it was felt to represent a combination of air trapping and atelectasis. the lungs are otherwise clear. the heart is minimally enlarged, also unchanged. there is no pneumothorax or pleural effusion. pulmonary vascularity is normal.
<unk>-year-old woman with bilateral lower extremity edema. evaluate for pneumonia or fluid overload.
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monitoring and support devices are appropriately positioned. median sternotomy wires are intact. the parenchymal opacities in the right lung are slightly improved, as is the aeration of the right lung. parenchymal opacities and left lung are unchanged. no large pleural effusion. no pneumothorax.
<unk> year old man with stemi s/p arrest and ards. failed extubation yesterday // eval progression of pulm edema/opacities. please obtain in am rounds on <unk>
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cardiac silhouette size is normal. the mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. patchy opacity is noted within the left lung base, likely atelectasis. right lung is clear. no pleural effusion or pneumothorax is present. no acute osseous abnormality is detected.
<unk> year old man presenting with left sided ruptured back cyst also has reproducible right sided rib pain // ? rib fracture, acute process
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focal opacity seen in the left midlung laterally with fiducial markers compatible with known left upper lobe mass and is slightly more conspicuous on the current exam. the lung volumes are seen with secondary crowding of the bronchovascular markings. no new region of consolidation nor effusion. the cardiomediastinal silhouette is within normal limits. atherosclerotic calcifications seen at the aortic arch. chronic deformity of the right humeral head is noted.
<unk>f with cough // r/o acute process
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an endotracheal tube tip terminates approximately <num> cm from the carina, at the level of the thoracic inlet. an enteric tube tip courses below the left hemidiaphragm, and off the inferior borders of the film. remainder of the examination is unchanged. the cardiac and mediastinal contours are similar. persistent retrocardiac opacity likely reflective of atelectasis is present. deformity of the left ninth and tenth posterolateral ribs may again reflect acute or subacute rib fractures.
history: <unk>m with post intubation
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pa and lateral radiographs of the chest once again demonstrate a stable small right pneumothorax. a left-sided pneumothorax is not apparent. left greater than right small pleural effusions and basilar atelectasis are unchanged. mild cardiomegaly is unchanged.
evaluate right-sided pneumothorax.
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the lungs are clear with no evidence of consolidation, effusion, or pneumothorax. there is mild cardiomegaly. no focal consolidation, effusion, or pneumothorax is noted. leftward convexity of the mid thoracic spine is noted and may be positional. no acute fractures are identified.
evaluation of patient with abdominal pain.
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there is a large left pleural effusion, increased in size since the prior study. cardiac size cannot be adequately assessed in the presence of this effusion. the right lung is essentially clear. the upper mediastinal contours are unremarkable.
<unk>f with cough and malaise // eval for pneumonia
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the lungs are clear.the heart size is top-normal, however the, hilar and mediastinal contours are normal.no pleural abnormality is seen.
<unk> year old woman undergoing right femoral-to-popliteal bypass graft. preoperative radiograph.
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the lungs are clear although hyperexpansion is stable since <unk>, reflected by flattening of the diaphragms. cardiac silhouette is normal. there is no pleural effusion or pneumothorax. there is no pneumothorax. the blunting of the right costophrenic angle is stable.
chest pain.
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two views were obtained of the chest. the lungs are well expanded and clear. there is no pleural effusion or pneumothorax. the heart is normal in size with normal cardiomediastinal contours. no displaced rib fractures are identified.
fall with posterior rib pain.