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In comparison with study of <unk>, there are lower lung volumes with worsening pulmonary edema. Severe enlargement of the cardiac silhouette persists. Costophrenic angles are sharply seen. Fracture of sternotomy wires again seen.
postop renal failure and copd.
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The lungs are clear without infiltrate or effusion. The trachea <unk> mediastinal silhouettes are normal. There continues to be mild elevation right hemidiaphragm.
new are by symptoms of new oxygen requirement.
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There has been significant interval increase in right mid-to-lower lung opacity which may represent combination of worsening malignancy and underlying atelectasis/pleural fluid, although underlying infection may also be present. There are areas of lucency that project over the right lower lung opacity which may represent aerated lung, although cavitation is not excluded in the appropriate clinical setting. There is also left lower lobe opacity, to a lesser extent, which could also represent additional site of infection, malignancy, aspiration. No evidence of left pleural effusion is seen. There is no evidence of pneumothorax. The aorta is slightly tortuous. The cardiac silhouette is not enlarged.
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A single portable ap upright view of the chest was obtained. In comparison to the prior examination, there is increased moderate right pleural effusion with adjacent dense opacification, likely representing compressive atelectasis, consolidation not excluded. Small left pleural effusion and adjacent mild atelectasis, increased. Multiple scattered pulmonary nodules, largest in the left upper lung, are relatively unchanged. Surgical clips in the left lower chest are again noted. A small well-rounded density projecting over the right scapula was not present on the prior study and could be external to the patient. No pneumothorax. Cardiomediastinal contour is otherwise unremarkable.
<unk>-year-old woman with dyspnea, wheeze and history of breast cancer. evaluate for pneumonia or pleural effusion.
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Pa and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. A calcified granuloma is again noted in the right lower lung. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm.
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There is no mass, nodule, focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits.
weakness. evaluation for mass.
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Low lung volumes and portable technique severely limits assessment of the lung parenchyma. Known left anterior chest wall mass with rib destruction is seen to better detail on recent ct of <unk>. Nonspecific linear left basilar opacity probably represents atelectasis in this setting. Remainder of visualized lungs are grossly clear and have been more fully evaluated by a recent chest ct. Postoperative changes are noted in the left chest wall and abdomen.
<unk> year old woman with l frontal iph going to surg on <unk> for l crani and biopsy // r/o pna surg: <unk> (crani and biopsy)
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Moderate pulmonary edema and moderate left greater than right bilateral effusions have mildly improved. A left picc and right dual-lumen dialysis catheter are unchanged in position. The stomach is significantly distended despite an appropriately placed ng tube.
hep c cirrhosis with hepatorenal syndrome requiring dialysis. assess for pulmonary edema.
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The patient is status post median sternotomy and cabg, with wires and surgical clips that appear unchanged in comparison to the prior chest radiograph. Moderate cardiomegaly. Moderate interstitial edema. Bilateral pleural effusions, right larger than left, with fluid in the minor and major fissures. The linear opacity in the left upper lung represents scarring and appears unchanged in comparison to the prior chest radiograph. No pneumothorax is seen. There is diffuse heterogeneous increased density of the the bones.
<unk> year old man with copd, chf, with worsening pfts and shortness of breath // any infiltrate or chf
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Frontal and lateral chest radiographs demonstrate unchanged linear opacity in the left lower lung compatible with scar. The lungs are well expanded. There is no pleural effusion or pneumothorax. The cardiac silhouette remains mildly enlarged, the mediastinal contours are normal. A lap gastric band is noted which is changed in orientation as can be seen in prolapse. There are surgical clips in the right upper quadrant.
chest discomfort.
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Pa and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear of focal consolidation. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with cough and fever. question pneumonia.
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Pa and lateral views of the chest were provided. Midline sternotomy wires and mediastinal clips are again noted. There is a coronary stent also visualized. The heart size is grossly stable and likely within normal range. There is left basilar atelectasis. The right lung is clear. No pneumothorax is seen. The left sixth lateral rib fracture seen better on the concurrent left rib series is not clearly appreciated on this exam. No additional fractures are identified.
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No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. There may be minimal central pulmonary vascular engorgement but there is no overt pulmonary edema.
history: <unk>f with chest pain, recent positive stress test // eval ? edema, infiltrate
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In comparison with the study of <unk>, there has been complete clearing of the diffuse areas of opacification. At this time, there is no evidence of acute pneumonia, vascular congestion, or pleural effusion.
crohn's disease with leukocytosis, to assess for pneumonia.
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Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable
<unk> year old woman with intermittent dyspnea // intermittent dyspnea
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Pa and lateral chest radiographs. Basilar opacity overlies the lower spine on the lateral view. There is also some indistinctness in the right lung base on the frontal view. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal.
<unk> year old man with <num> weeks history of productive cough // rule out pneumonia or other acute process
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A right-sided port-a-cath is unchanged in position with the tip terminating in the proximal right atrium. Bilateral small pleural effusions, greater on the right than the left are unchanged from the prior study. No pneumothorax or new focal consolidation is seen. A diffuse opacity extending along the right paramediastinum adjacent to the neoesophagus is likely post-operative and unchanged. The pulmonary vasculature is not engorged. The cardiac and mediastinal silhouettes are stable.
<unk>-year-old male status post esophagectomy, here to re-assess for interval changes.
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Heart size is seen normal. Mediastinal and hilar contours are unchanged with tortuosity of the thoracic aorta again noted. Pulmonary vasculature is normal. Minimal streaky atelectasis is noted in the right lower lobe. No focal consolidation, pleural effusion or pneumothorax is identified. Moderate multilevel degenerative changes are noted in the thoracic spine. No displaced rib fractures are visualized.
<unk> year old woman with severe back pain
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The right ij terminates in the low svc. The et tube terminates <num> cm from the carina and should be withdrawn <num>-<num> cm cm. The ng tube is in the stomach in the region of the pylorus. Bibasilar opacities, right greater than left, are worse on the left since yesterday and represent pleural effusions and atelectasis. A heterogenous opacity in the right lower lung suggests pneumonia. The cardiomediastinal silhouette is normal. There is no pneumothorax. Also, there is no evidence of subdiaphragmatic air.
c. diff colitis with respiratory distress status post intubation. position of et tube, evidence of free air under the diaphragm.
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As compared to the previous radiograph, there is mild fluid overload and marked cardiomegaly at overall very low lung volumes. Areas of atelectasis are seen at the lung bases, but there is no evidence of pneumonia or pulmonary edema. Tracheostomy tube is in unchanged position.
chronic heart failure, exacerbation, leukocytosis, questionable pneumonia.
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Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen.
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In comparison with the study of <unk>, the right subclavian catheter tip has been pulled back to the mid-to-lower portion of the svc. The previously described large hiatal hernia has substantially reduced on this image.
central line pulled back.
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Nasogastric tube has been exchanged for a feeding tube, terminating in the proximal stomach. Exam otherwise appears similar to the prior study of one day earlier, except for apparent slight increase in pleural effusions, left greater than right.
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Left picc has changed in position, now terminating at the right tracheobronchial angle, with distal tip directed superiorly. It is uncertain whether this is extending superiorly into the right brachiocephalic vein or coursing posteriorly into the azygous vein at this level. In either case, repositioning is advised, as communicated by phone to dr. <unk> on <unk> at <time> a.m. At the time of discovery. Cardiomediastinal contours are stable. Within the lungs, widespread pulmonary nodules have apparently progressed since <unk>. Differential diagnosis includes a granulomatous infection from fungal or mycobacterial organisms versus widespread pulmonary metastases. Focal opacity in left retrocardiac region may be due to focal atelectasis and less likely an area of localized pneumonia.
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Portable semi-upright radiograph of the chest demonstrates low lung volumes and bibasilar atelectasis, which is new over the interval. Note is made of small bilateral pleural effusions. The heart is not enlarged. No pneumothorax. Left upper extremity picc ends in the right atrium, and should be pulled back <num> cm for positioning at the cavoatrial junction. Partially imaged pigtail drainage catheter in gj tube project over the left upper quadrant.
<unk> year old man with colon ca // line placement
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Ap single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study obtained <num> hours earlier during the same day. During the interval, the patient has been extubated. Previously described left internal jugular approach central venous line remains in unchanged position. No pneumothorax is seen. No og or ng tube can be identified below the level of the chest apex. General chest findings are unaltered in comparison with the previous study. Referring physician, <unk> <unk>, was paged at <time> p.m.no answer received until <time> pm.apparently the tube placement has failed.
<unk>-year-old male patient with replaced orogastric tube as previous tube was malfunctioning.
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Pa and lateral chest views were obtained with patient upright position. Comparison is made with the next preceding similar study of <unk>. The heart size remains within normal limits. No configurational abnormality is seen. Unremarkable presentation of thoracic aorta. The pulmonary vasculature is not congested. There is evidence of multiple surgical biopsy interventions performed in this patient with a metastatic testicular teratoma. One can identify multiple local pleural densities in the right hemithorax and evidence of surgical clips in the right mid portion and lower area consistent with previous wedge biopsies and removal of metastases. Similar changes exist also on the left side with local pleural thickenings and evidence of surgical clips in the left upper lobe area with linear pulmonary scar formations and local thickening in the apical area. There is no evidence of pulmonary congestion, local pneumothorax or massive pleural effusions in this patient with now acute left-sided shoulder pain. Our records include multiple chest examinations dating from <unk>. The next preceding available chest examination is dated <unk>. This finding of postoperative scar formations have actually regressed and on the present examination no acute findings are imminent. A further evaluation with chest ct is recommended after discussion with referring physician, <unk>. <unk>.
<unk>-year-old male patient with history of metastatic testicular carcinoma and teratoma, status post resection in lung who has intermittent left upper scapular pain near surgical site. locating for course of intermittent left upper scapular pain.
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Ap portable upright view of the chest. The heart is obscured by bibasilar opacities, likely reflecting a mixture of moderate pleural effusions with adjacent compressive atelectasis. Air bronchograms are demonstrated at the right base, concerning for underlying consolidation. There is no pneumothorax. The aorta is tortuous, demonstrating mild calcifications at the arch.
<unk> year old man with cirrhosis // eval pulm edema, effusions
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Ap and lateral views of the chest were obtained. Lungs are clear with no focal consolidation, effusion or pneumothorax. There is no evidence of chf. The heart is mildly enlarged, unchanged from prior exam. The bony structures are intact. There is atherosclerotic calcification of the aortic knob.
lethargy and cough, evaluate for infiltrate.
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The heart is mildly enlarged. The aorta is tortuous. The aortic arch is heavily calcified. There is a convex contour to the right upper mediastinum, fairly typical for mediastinal contour frequently seen with tortuosity of the great vessels, but are not specific. Other etiologies including lymphadenopathy or a large thyroid nodule could be considered. A band-like opacity in the lingula suggests minor atelectasis or scarring. There is also streaky posterior left basilar opacity which suggests minor atelectasis or scarring. There is more generally a mild interstitial abnormality suggesting slight vascular congestion, including peribronchial cuffing, although possibly airway inflammation could yield a similar appearance. There is no pleural effusion or pneumothorax. The bones appear demineralized. Mild degenerative changes are noted along the mid thoracic spine, which also demonstrates mild rightward convex curvature centered along the lower thoracic spine.
right upper quadrant pain.
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The heart size, mediastinal, and hilar contours are normal. The lungs are clear without pleural effusion, focal consolidation, or pneumothorax.
<unk>m with ? seizure, ? fall. evaluate for consolidation.
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The patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs appear clear.
dyspnea.
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Sternotomy wires are intact. Lung volume is low. There is no consolidation, pneumothorax, or pleural effusion. Cardiomediastinal and hilar silhouette are normal size. Large anterior osteophyte is noted in lower thoracic spine.trachea is deviated to the left at the thoracic inlet level.
<unk>m with worsening confusion over the past week. // <unk>m with worsening confusion over the past week.
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The right picc terminates in the upper svc. There is no pneumothorax, pleural effusion, pulmonary edema, or focal consolidation. The cardiomediastinal silhouette is normal.
<unk>f with recent perforated bowel on iv antibiotics, evaluate for picc location.
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An endotracheal tube terminates about <num> cm above the carina. An orogastric tube courses into the stomach, its tip below the imaged region of the epigastrium. The heart appears mildly enlarged. The lung volumes are low. Opacity at the left lung base suggests minor atelectasis, probably in the lingula. Pleural effusions are difficult to exclude but not explicitly shown. There is no pneumothorax.
endotracheal tube placement.
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Venous catheter tip mid svc. Decreased pulmonary vascularity. Mild interstitial prominence, improved. No pleural fluid. Normal heart size.
<unk> year old woman with aml admitted for mud transplant // please evaluate for pleural effusions
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Small left pleural effusion is seen, similar to prior to possibly slightly decreased. . Patchy left base opacity is again seen which may relate to pneumonia. The cardiac and mediastinal silhouettes are grossly stable. No pneumothorax is seen.
<unk> year old woman with copd and schf presenting with sob and cough // pulmonary edema vs pna
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Pa and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with dyspnea.
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Frontal view of the chest was obtained. Increased soft tissue thickness along the medial right upper mediastinum may be related to patient rotation. No focal consolidation, pleural effusion, or pneumothorax. The heart size is normal.
<unk>-year-old female with ankle fracture. preoperative film.
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Mild cardiomegaly is chronic. New interstitial abnormality in the left lower lobe could represent pneumonia, particularly viral or need assistance. Previous left pleural effusion or pleural thickening has resolved.
<unk>-year-old female with endocarditis. please evaluate on chest radiograph.
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There is a non-characteristic opacity in the left retrocardiac and left base area. The right basilar atelectasis and pleural effusion continue to improve. The remainder of the exam is stable including stable position of support and monitoring devices.
<unk>-year-old woman with new fever.
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The heart is normal in size. Moderate unfolding of the thoracic aorta appears similar. The mediastinal and hilar contours appear unchanged. There is similar flattening of the hemidiaphragms with an expanded anteroposterior dimension of the chest, consistent overall with hyperinflation. There is no evidence for pleural effusion or pneumothorax. The lungs appear clear. In the upper abdomen, nonspecific air-fluid levels are visualized, fully characterized.
cough. question pneumonia.
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Chest, pa and lateral. No acute fracture is identified. Persistent elevation of the right hemidiaphragm is chronic. Linear opacity in the left mid lung zone is unchanged. There is a small left pleural effusion. Mild pulmonary vascular congestion is noted. There is no pneumothorax. Mediastinal contours are normal. There are surgical clips in the right upper quadrant of the abdomen.
<unk>-year-old woman with mechanical fall. evaluate for traumatic injury.
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No previous images. The heart is normal in size and there is no vascular congestion or pleural effusion. Specifically, no evidence of acute focal pneumonia.
cough.
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Portable ap chest radiograph demonstrates a tiny right apical pneumothorax with surrounding subcutaneous emphysema, consistent with recent vats procedure. Diffuse interstitial opacities are grossly unchanged from <unk>. The right chest tube appears to be coiled back on itself. The cardiomediastinal silhouette is within normal limits.
recent vats with wedge resection.
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An endotracheal tube has been placed, which terminates approximately <num> cm above the carina. The cardiac, mediastinal and hilar contours appear unchanged, allowing for differences in technique. There is no pleural effusion or pneumothorax. The lungs appear clear.
found down.
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The patient is had median sternotomy and cabg. The cardiomediastinal silhouette is normal. If any, there are minimal bilateral pleural effusions with improved bibasilar atelectasis. Ett, left picc line, and ng tube are unchanged in position when compared to <unk> study. No focal consolidations or pneumothorax are seen.
<unk> year old man with pseudomonal pneumonia and persistent fevers // assess for progression of pneumonia
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The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Thoracic s-shaped scoliosis is again noted. Anterior cervical fixation hardware is partially visualized.
<unk>m with inc. neck spasticity; neck pain //
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There is platelike atelectasis in the right lower lung. Otherwise the lungs are clear without infiltrate or effusion.
<unk> year old woman with cough and fever // rule out infectious patholoy
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There is been near complete resolution of the previously noted large right pleural effusion status post thoracentesis. The left moderate pleural effusion is likely unchanged accounting for differences in lung volumes, with improved aeration now demonstrated. Patchy bibasilar compressive atelectasis persists. Cardiac and mediastinal contours are similar. No pneumothorax is detected. Right-sided port-a-cath tip terminates in the low svc. A biliary catheter is again noted within the right upper quadrant of the abdomen. Breast implants are re- demonstrated. Known diffuse osseous metastatic disease is better assessed on the previous ct.
history: <unk>f s/p thoracentesis right for malignant effusion // ? pneumothorax, compare to previous
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The lungs are hyperinflated. There is no focal parenchymal opacity. There is tenting of the left hemidiaphragm as well as leftward displacement of the mediastinum likely due to postradiation retraction. No pleural effusion or pneumothorax is present.
<unk>-year-old female s/p left mastectomy and radiation therapy, with recent placement of an expander, now with fever and cough. evaluate for pneumonia.
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Right-sided port-a-cath tip terminates in the low svc. The cardiac, mediastinal and hilar contours are normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. Previously demonstrated nodules on ct are not clearly identified on the radiograph. There are mild degenerative changes in the thoracic spine.
confusion.
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Left-sided port-a-cath tip terminates in the mid svc, unchanged. The heart size appears mildly enlarged but similar. The mediastinal contours are grossly unchanged. New right perihilar opacity is concerning for pneumonia. There is no pulmonary edema, pleural effusion or pneumothorax identified. No acute osseous abnormality is detected.
history: <unk>f with weakness, fever
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The lungs are clear. There is no consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with dyspnea x several weeks // please evaluate for effusion
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Again seen is a dual-lead pacemaker, moderate cardiomegaly, sternal wires, mediastinal clips, patchy areas of volume loss and bilateral small effusions, small pulmonary vascular redistribution. Compared to the study from five days prior, the effusions are slightly smaller and the aeration of the right lower lung is slightly larger, but the vascular plethora is more pronounced. The overall impression is that of persistent chf.
chest pain.
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Ap portable upright view of the chest. Multiple sternal wires, cardiac valve, right-sided picc, and left-sided pacemaker are unchanged in position since the <unk> study. The heart is mildly enlarged. There is no pneumothorax or pleural effusion. Bilateral linear opacities remains stable, likely reflecting atelectasis.
<unk> year old woman with acute mental status changes. // signs of aspiration, pna?
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There is no focal consolidation, pleural effusion or pneumothorax identified. Mild pulmonary vascular pulmonary edema. The size of the cardiac silhouette is enlarged but unchanged. Calcification of the aortic arch. Degenerative changes of the right glenohumeral joint.
<unk> year old man septic after prostate biopsy, increasing o<num> requirement // assess for acute pulmonary processes to explain hypoxemia
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In comparison with the study of <unk>, the monitoring and support devices remain in place. There is decreased opacification bilaterally, consistent with improving aspiration pneumonia. Some indistinctness of vessels could reflect some elevated pulmonary venous pressure. Specifically, there is no evidence of free intraperitoneal gas. However, this is not truly an upright image, so that small pneumoperitoneum could easily be missed. If this is a serious clinical concern, a true upright view could be obtained or ct performed.
to assess for free intraperitoneal gas.
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As compared to the previous radiograph, there is no relevant change. Normal chest radiograph without evidence of pneumonia or other parenchymal changes. Normal size of the cardiac silhouette. Normal appearance of the hilar and mediastinal structures.
evaluation for infection.
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Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable.
evaluate for pneumothorax in a patient with chest pain.
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The endotracheal tube is appropriately positioned, ending <num> cm above the level of the carina. A right subclavian central venous catheter ends in the low svc. An enteric catheter courses below the level of the diaphragm and out of the field of view inferiorly. There is central pulmonary vascular congestion without frank interstitial pulmonary edema. Subsegmental left retrocardiac atelectasis is not significantly changed. Mild elevation of the right hemidiaphragm is not significantly changed. Mild cardiomegaly is similar in appearance. The mediastinal contours are unchanged. There are no pleural effusions. No pneumothorax is seen.
left basal ganglia hemorrhage. intubated. assess for interval change.
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The cardiac silhouette size is mildly enlarged. The aorta is tortuous. Mediastinal and hilar contours are otherwise unremarkable. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. Mild degenerative changes are seen within the right acromioclavicular joint.
shortness of breath.
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A left chest wall port catheter tip terminates at the cavoatrial junction. There is no focal consolidation, pleural effusion or pneumothorax. Mild pulmonary vascular congestion has improved since the prior study. The imaged upper abdomen is unremarkable.
history: <unk>f with chronic trach, green tinged sputum // pls eval acute process, pna?
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There are bilateral interstitial opacities, greater on the right than the left, and suggestive of moderate to significant interstitial pulmonary edema. There is no evidence of a pneumothorax or a consolidation. There is a small left pleural effusion but no right effusion. Biapical pleural thickening is noted, greater on the right than the left. Post-cabg changes are visualized with intact median sternotomy wires. The cardiomediastinal silhouette is at the upper limits of normal. Atherosclerotic calcifications are visualized at the aortic arch. Bones are diffusely demineralized and limit evaluation for acute fractures. There is however no gross evidence of an acute fracture. Mild degenerative changes are visualized throughout the thoracic spine.
evaluation of patient with trauma, with right-sided chest pain.
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As compared to the previous radiograph, the left chest tube was pulled. There is a minimal millimetric left apical residual pneumothorax. Residual air in the left lateral soft tissues. The pre-existing right basal atelectasis is slightly smaller and denser than before. No newly appeared focal parenchymal opacities.
status post left upper lobe wedge resection, evaluation for interval change. pulling of chest tube.
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There is asymmetrical elevation of the right hemidiaphragm. Bibasilar opacities, more prominent on the right are consistent with aspiration/atelectasis in the setting of intubation. The heart is enlarged. No acute displaced rib fracture identified. Endotracheal tube ends <num> cm from the carina. Nasogastric tube courses into the stomach in of the field of view. No pneumothorax.
history: <unk>m with ich and femur fracture after fall // trauma film for pneumothorax
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There is persistent abnormal soft tissue density centered at the left hilum, potentially related to previously treated malignancy. Previously seen for infrahilar opacity on the left in <unk> has resolved. Biapical scarring is again noted. Elsewhere, the lungs are clear. Cardiac silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with ivdu, hx lung ca, hiv, with cough, rust / green sputum x <num>d, consititutional sxs // eval ? pna
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Pa and lateral views of the chest are provided. There is a poorly defined opacity in the right peripheral mid lung, seen best on the frontal projection, which is concerning for a very early pneumonia. This finding is new from prior exam. No pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette is stable. The bony structures are intact.
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Endotracheal tube terminates approximately <num> cm above the carina with the neck in a flexed position, and a nasogastric tube courses below the diaphragm, but the side port of this device is not confidently visualized. Lung volumes remain low, accentuating the cardiac silhouette and bronchovascular structures. Worsening opacities are present at both lung bases, involving the left lower lobe to a greater degree than the right. Though nonspecific, these findings may be due to aspiration pneumonia given clinical suspicion for this entity.
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Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. Right humeral cortically based lesion is unchanged since at least <unk>.
<unk> year old man with history of copd w/ worsening doe, sob, cough x <num> weeks, evaluate for pneumonia.
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Left picc is now malpositioned, directed superiorly within the right brachiocephalic vein, as communicated by phone to dr. <unk> at <num> a.m. On <unk> at the time of discovery. Stable cardiomegaly accompanied by worsening pulmonary edema and bilateral moderate-sized pleural effusions.
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Enteric tube remains in unchanged position. Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.
dyspnea and cirrhosis.
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The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear besides minimal atelectasis at the left lateral costophrenic angle angle. There is no pneumothorax. Hypertrophic changes noted in the spine. Limited assessment of the abdomen is unremarkable. A minimally displaced posterior left seventh rib fracture is noted.
<unk>m with fever, hypoxia, recent rib fx // r/o pna
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As compared to the previous radiograph, no relevant change is seen. Moderate bilateral pleural effusions. Areas of atelectasis at both lung bases. Borderline size of the cardiac silhouette with mild fluid overload. No pneumothorax.
motor vehicle accident, pneumonia.
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In comparison to the prior exam, the right lung masses have increased in size. For example, the central superior mass previously measured <num> cm. It now measures <num> cm. A large mass at the right base is also increased in size. It previously measured <num> cm and now measures <unk>.<num> cm. A third mass in the right mid lung zone appears stable. The left lung is essentially clear. There is no left pleural effusion. A right pleural effusion cannot be assessed for due to the large mass. There is no pneumothorax. The cardiomediastinal silhouette is unchanged and normal.
hypoxia. history of non-small cell lung cancer.
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Small left apical pneumothorax is unchanged. Otherwise, the lungs appear similar to prior same day chest radiograph. Left pacemaker is in unchanged position. The heart is difficult to assess due to surrounding opacities and compressive atelectasis.
<unk> year old man with lung cancer and severe pna // rule out worsening ptx
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Pa and lateral views of the chest. The lungs remain clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Mild mid thoracic dextroscoliosis is noted. No acute osseous abnormality detected.
<unk>-year-old female with chest pain for <num> days with persistent mild cough, nonproductive. radiation to the back.
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No focal consolidation, edema, effusion, or pneumothorax. The heart is normal in size. Mediastinal contours are within normal limits. No acute osseous abnormality.
<unk>-year-old man presenting with cough. evaluate for pneumonia.
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The patient is status post dual-chamber pacemaker placement with the leads terminating in the right atrium and right ventricle. No pneumothorax, mediastinal widening, or pleural effusions are seen. The patient had a tavr, and the cardiac silhouette is smaller. Previous pulmonary vascular congestion and mild edema have resolved since <unk>. The upper lungs are clear. Bibasilar pulmonary fibrosis is still present. The hila and pleura are normal.
<unk> year old man s/p dual chamber ppm implant // check for lead position and pnx. post pacemaker d/c chest xray- please place in <num>:<unk>:<num> am time slot.
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Pa and lateral views of the chest are obtained. The lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is mild kyphosis of the thoracic spine and possible fat deposition of the upper back, which may represent exogenous steroid use or <unk>'s disease.
<unk>-year-old female with left anterior chest pain.
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Pa and lateral chest views have been obtained with patient in upright position. Comparison is made with the next preceding portable chest examination of <unk>. Heart size appears unchanged on the frontal view, but the patient makes a much improved deeper inspirational effort, resulting in optimal separation of pulmonary vasculature, showing no evidence of cardiovascular congestion. The area of the tracheostomy cannula is unaltered and there is no conclusive evidence for any air in the surrounding superior mediastinal tissues. No pneumothorax is identified in the apical area on either side. On the lateral view, the posterior pleural sinuses are free from any fluid accumulation. As before, there is evidence of two sternal wires, the most superior located in the manubrium, lower one at the junction between the corpus and the xiphoid process. As this was a rather unusual presentation, old records were reviewed. A chest ct of <unk> demonstrated the presence of these circular wires, but showed also additional spiraling wires in the body of the sternum. The latter must have been removed. It is not clear what the purpose of this sternotomy was as the patient has no evidence of surgical clips or intracardiac prosthetic valves on the plain chest examination. Our radiologic reports do not clarify this question, but clinical available notes in the computer do not reach back to <unk>.
<unk>-year-old male patient status post tracheostomy placement. evaluate for postoperative air in chest.
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Frontal and lateral views of the chest demonstrate normal cardiac silhouette. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. Patient is status post cabg and median sternotomy wires appear intact. Mild multilevel thoracic spondylosis is noted.
<unk>-year-old male with diabetes and osteomyelitis, here for preoperative evaluation.
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As compared to the previous radiograph, the right chest tube has been re-positioned. The opacity at the right lung base, probably caused by a pleural effusion, has almost completely resolved. Unchanged persistent areas of mild basal atelectasis, combined to signs of mild fluid overload. The mediastinum remains relatively dense.
status post vats, chest tube placement, evaluation for effusion.
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The lungs are clear aside from a slowly resolving focal ovoid opacification in the right upper lobe which corresponds to a previous lung abscess, better delineated on ct chest dated <unk>. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is normal in size.
history: <unk>m with history of asthma, wheezing
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Single-lead pacer extends to the region of the apex of the right ventricle. No evidence of post-procedure pneumothorax. In comparison with the study of <unk>, there is again hyperexpansion of the lungs with flattening of the hemidiaphragms, consistent with chronic pulmonary disease. Small bilateral pleural effusions persist. Pulmonary vasculature is essentially within normal limits. No definite acute focal pneumonia.
pacemaker placement.
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Pa and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures appear intact. No free air below the right hemidiaphragm.
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Cardiac, mediastinal and hilar contours are normal. Linear opacity within the left upper lobe likely reflects an area of scarring. No focal consolidation, pleural effusion or pneumothorax is present. Pulmonary vasculature is normal. There are mild degenerative changes of the thoracic spine.
history: <unk>m with repeated falls, head strike
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Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. Right chest port tip in the proximal right atrium.
<unk> year old man with metastatic scc of head/neck and history of cns abscess admitted with ams. now with fever and hypotension // eval etiology of hypotension
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The cardiac silhouette size is normal. The aorta is mildly tortuous but unchanged. Mediastinal and hilar contours are otherwise within normal limits. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities seen.
chest pain.
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The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation.
<unk>f with cough, syncope, hypotension, evaluate for pneumonia.
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Compared to the prior radiograph of <unk> the lung volumes have improve. The left pleural effusion has decreased and is now small. Linear opacities in the left lung base represents platelike atelectasis. There is no new opacity or pneumothorax. The cardiac and mediastinal contours are normal. Nipple rings are noted.
<unk>-year-old man with fever. evaluate for pneumonia.
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Frontal and lateral views of the chest are obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. Rounded opacity projecting over the bilateral lung apices over the anterior bilateral first ribs are felt to be osseous in nature.
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Post cabg and tricuspid valve replacement changes. Dear lead pacemaker in situ. Endotracheal tube in situ with the tip <num> mm proximal to the carina. Swan-ganz catheter tip in the proximal pulmonary artery. Enteric tube in situ. Transverse cardiomegaly unchanged. Small left-sided pleural effusion, but this is similar compared to previous imaging. No new airspace consolidation.
<unk> year old man s/p cabg/tvring // eval for <unk> position
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Lung volumes are slightly low, accentuating the cardiac silhouette and resulting in crowding of bronchovascular structures. No definite focal consolidation is identified. There is no pleural effusion or pneumothorax.
history: <unk>f with sob // eval for consolidation
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Pa and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. Clips are noted in the right upper quadrant.
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As compared to the previous radiograph, the lung volumes have minimally decreased, likely as a result of the known widespread fibrotic lung parenchymal process. No newly appeared parenchymal opacities. No pleural effusions. No pulmonary edema. Moderate cardiomegaly with enlargement of the left ventricle and tortuosity of the thoracic aorta.
history of whipple surgery. abdominal pain.
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As compared to the previous radiograph, there is no relevant change. Sternal wires are in constant alignment, the clips and the pacemaker wires are in constant position. There is unchanged mild cardiomegaly and evidence of a small left pleural effusion, combined to a small left basal atelectasis. Mild fluid overload is still present.
chronic heart failure, evaluation for dyspnea.
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Frontal upright and lateral chest radiographs demonstrate well-expanded lungs. High position of ivc filter is again noted, but remains unchanged. Heart is normal in size and cardiomediastinal contour is unremarkable. There is no focal area of consolidation to suggest pneumonia. There is no pulmonary edema. There is no pleural effusion or pneumothorax. Degenerative changes are again seen throughout the thoracic spine.
dyspnea, cough, evaluate for pneumonia.
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A right internal jugular catheter terminates at the superior cavoatrial junction. Mild to moderate interstitial edema is minimally improved from the prior examination. There is no evidence of pneumothorax. No other significant change from the prior examination.
history: <unk>m with r ij // eval line
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Pa and lateral views of the chest. The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected.
<unk>-year-old female with mid chest pain.