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Pa and lateral chest radiographs were obtained. The lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax.
chest pain, evaluate for pneumonia.
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In comparison with study of <unk>, there is little change and no evidence of acute cardiopulmonary disease. Dual-channel pacer device with leads in good position in a patient with intact midline sternal wires. No evidence of vascular congestion, pleural effusion, or acute focal pneumonia.
intermittent dyspnea.
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Lungs remain hyperinflated. Increased interstitial markings bilaterally likely due to combination of chronic lung disease and mild interstitial edema. There are small bilateral pleural effusions with overlying atelectasis. Right base opacity may be due to combination of pleural effusion and atelectasis, but consolidation due to infection, aspiration, or pulmonary contusion not entirely excluded. No evidence of pneumothorax is seen. Biapical pleural thickening is again seen. The cardiac and mediastinal silhouettes are stable. Persistent loss of height of the mid to lower thoracic vertebral body. Fracture of a mid posterior right rib, possibly the posterior right sixth rib is of indeterminate age, but appears new since the prior study. Diffuse osteopenia.
<unk> year old man with pectus excavatum s/p fall and anterior rib strike // r/o acute pulmonary process
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There is near complete opacification of the left hemi thorax, compatible with large pleural effusion and collapse. The right lung is clear. Patient is status post median sternotomy and cabg, with intact median sternotomy wires. No pneumothorax.
history: <unk>f with new bipap requirement, osh cxr ?white out // ?pulm edema
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Tracheostomy and left-sided pacer defibrillator in the right ventricle are in adequate position. Right lower lung atelectasis accompanied by a small pleural effusion is stable. Mild cardiac congestion is also unchanged. Left lower lung atelectasis with small pleural effusion has increased. Mediastinal and cardiac contours enlargement is moderate and unchanged.
patient with chf, cad, afib, urosepsis, cardiopulmonary arrest, now intubated.
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Right-sided port-a-cath terminates at the cavoatrial junction without evidence of pneumothorax. There are bilateral pleural effusion with overlying atelectasis, increased compared to the prior study. Right base opacity may be due to combination of pleural effusion and atelectasis but consolidation is not excluded. The cardiac silhouette is moderately enlarged. Mediastinal contours are unremarkable. Lower esophageal is stent is re- demonstrated.
history: <unk>f with neutropenic fever, tachy, hypotension // eval for acute process
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The left lung base is more densely opacified when compared with the prior study of <unk>. Otherwise, there is little change in diffuse bilateral airspace opacities. Endotracheal tube, right-sided picc line, right chest wall pacer leads, and enteric tube are well positioned. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits.
<unk> year old woman with sob // comparison <unk> for worsening infiltrates
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Frontal and lateral views of the chest are compared to previous exam from <unk>. There are new small bilateral pleural effusions. Indistinct pulmonary vascular markings are seen. Right lung base opacity is seen medially, potentially due to atelectasis however component of infection is not excluded. Cardiac silhouette is enlarged but not likely changed from prior noting that the right heart border is not well seen. Coronary artery stent is identified. Single-lead pacing device seen with tip at the right ventricular apex. Hypertrophic changes seen in the spine as well as compression deformity of the lower thoracic vertebral body as on prior.
<unk>-year-old male with acute systolic chf exacerbation. question pulmonary edema.
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A right-sided pigtail catheter is in good position. There are several rib fractures identified on the right side. No pneumothorax is seen. Cardiomegaly is suggested. Elevated right hemidiaphragm is noted and there appears to be significant subdiaphragmatic air, presumptively bowel. Please see subsequent abdominal
<unk>m s/p fall from standing w/ b/l rib fractures (r <unk>, l <unk>), tiny r ptx, t<num> compr deformity // eval for right ptx exam @<unk>
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As compared to the prior chest radiograph from <unk>, there has been significant interval decrease in apparent number of pulmonary nodules, however, pulmonary nodules overall appear increased in size with more recent progression of metastatic disease seen on recent ct. Pulmonary nodules on current radiography were better assessed on ct. No definite new focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are ear similar to scout radiograph from chest ct from <unk> right-sided port-a-cath terminates at the proximal right atrium. .
history: <unk>f with cough, oncology patient // eval acute process, pna
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The tip of the right picc line projects over the distal svc. Surgical clips project over the thoracic inlet. There are increasing opacities at the left lung base which reflect atelectasis and/or pneumonia. A left pleural effusion is also suspected. The right lung appears hyperexpanded however no focal consolidation, pleural effusion or pneumothorax is identified. The size of the cardiac silhouette is enlarged but unchanged.
<unk> year old man with respiratory failure // eval for interval change
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Comparison with the study of <unk>, there are lower lung volumes which may account for the increasing prominence of a pulmonary vascularity. However, there may well be some elevation of pulmonary venous pressure. Mild bibasilar opacifications could reflect pleural effusion and atelectasis. However, in the appropriate clinical setting, supervening pneumonia could not be definitely excluded.
pacemaker with fever.
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable.
palpitations.
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Biapical emphysema and adjacent parenchymal scarring unchanged. Bronchial wall thickening is again demonstrated suggestive of chronic bronchitis. No pulmonary edema or acute consolidation. Heart size is normal. No pleural effusions or pneumothorax.
<unk> year old woman smoker, s/p stent assisted coiling, s/p ?laryngospasm after extubation followed by bronchospasm, now at baseline respiratory function after treatment with albuterol. // ?pulmonary edema
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The lungs are clear without focal consolidation, effusion, or overt pulmonary edema. The cardiomediastinal silhouette is stable, within normal limits for technique. No acute osseous abnormalities.
<unk>m with morbid obesity and sle presenting with chest tightness/sob. // cardiopulmonary abnormality?
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There is a focal opacity in the lingula. Otherwise, the remainder of the lungs are clear. Cardiac silhouette is normal. There is no evidence of an effusion or pneumothorax. No acute fractures identified.
fever and cough.
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The lung volumes are low. The superior segment of the right lower lobe is collapsed. The left lower lobe is completely opacified which may likely represent atelectatic collapse and less likely a consolidation. The mild pulmonary vascular congestion is unchanged. Moderate to severe cardiomegaly is stable. The mediastinal and hilar contours are stable. Small bilateral pleural effusions are unchanged. The right picc line terminates in the mid svc. <num> ng tubes terminate in the mid stomach. The et tube is approximately <num> cm from the carina.
<unk> year old man confirm ett and ngt position // confirm tube position
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A right internal jugular central venous catheter terminates in the lower superior vena cava. The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax. As before, the lower thoracic spine curves mild to moderately to the right side.
central line placement.
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Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. Atherosclerotic calcifications are seen in the aortic arch. Previously seen left basilar opacity and effusion have resolved. There is no confluent consolidation to suggest pneumonia. There is no pneumothorax, vascular congestion, or pleural effusion. A subcentimeter radiodensity overlying the right third interspace is unchanged since at least <unk>, likely representing a calcified granuloma. There is diffuse osseous demineralization.
<unk>-year-old female with altered mental status. question acute process.
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Et tube tip is <num> cm above the carinal. Right picc line tip is in the right atrium. Cardiomegaly and mediastinal contours are unchanged. Pulmonary edema has worsened, substantial, asymmetric left more than right and superimposed infectious process is a possibility.
<unk> year old man with ams, intubated // pna
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Lung volumes have slightly decreased. Central bronchovascular congestion with mild edema persists, overall unchanged. Stable linear scarring in the left mid chest and in the right lung base. No pleural effusion or focal consolidation. The heart is enlarged, overall unchanged. Mediastinal contours are unchanged. No pneumothorax.
<unk>-year-old man presenting with shortness of breath and ascites. evaluate for acute cardiopulmonary process.
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Multiple bilateral pulmonary nodules are again seen. There is scarring/ atelectasis at the lateral left lung base as well pleural thickening. There is persistent blunting of the left costophrenic angle. There is also slight blunting of the right costophrenic angle. Patchy left base retrocardiac opacity is seen, nonspecific, could relate to infection or metastatic disease. No pneumothorax is seen. Left-sided port-a-cath terminates in the right atrium.
<unk> year old man with colon cancer presenting with fever and exam suggestive of pna // pna?
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Lung volumes are low. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is unremarkable. Linear opacities in the lung bases are compatible with areas of atelectasis. No pleural effusion or pneumothorax is seen. Fiducial markers are seen within the right upper quadrant of the abdomen.
<unk> year old man with cirrhosis and hepatic encephalopathy
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The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with seizure // eval for pna
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A new electronic device resides in the subcutaneous soft tissues overlying the left mid chest. Allowing for differences in technique, the only other change is an apparent increase in the size of the heart, which now appears mildly enlarged. Streaky lingular opacity suggests minor scarring. Otherwise, the lungs appear clear. There is no pleural effusion or pneumothorax.
dyspnea.
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Mild bibasilar opacities are likely atelectasis. There is no pneumothorax or pleural effusion. Cardiomediastinal and hilar silhouettes are normal size.
history: <unk>f with epigastric abd pain // eval for acute process, free air
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There has been interval removal of the swan-ganz catheter with placement of a right ij cordis. . Otherwise, compared to the prior study there is no significant interval change.
<unk> year old woman with copd, pvod, on remodulin. // interval change
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Cardiac device is seen with single lead in appropriate position. Right ij swan-ganz catheter is in appropriate position and unchanged. Mild cardiomegaly is seen with minimal vascular congestion. No focal consolidation, pleural effusion or pneumothorax is seen.
<unk>-year-old woman with history of idiopathic cardiomyopathy and class iv heart failure, ejection fraction is <unk>%, currently listed for heart transplant at outside hospital. presents status post rhc swan placement.
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No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with seziure // pna?
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Pa and lateral views of the chest provided. 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>m with hypotension now resolved // ? pna
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In comparison with study of <unk>, there is no interval change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion.
tumor versus radiation necrosis, to assess for chest lesion.
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Pa and lateral views of the chest. The previously seen bilateral interstitial opacities are no longer visible. The lungs are grossly clear. There are no pleural effusions or pneumothorax. The cardiac, mediastinal, and hilar contours are normal.
bibasilar rales, cough, assess for infiltrate.
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The lungs are mildly hypoinflated with crowding of vasculature. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits.
<unk>f with hr <num>s, recent hip, ankle injury. assess for effusion or edema.
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Pa and lateral views of the chest provided. 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 ruq abd pain, shortness of breath // eval for acute process
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable.
wound dehiscence. preoperative radiographs.
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A right chest wall port-a-cath is in unchanged position ending in the lower svc. Is been interval removal of the right pleural drainage catheter. There is persistent blunting of the right costophrenic angle which may reflect small residual effusion. No focal consolidation, pneumothorax or left pleural effusion.
history: <unk>f with fever // pna?
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Single frontal ap upright portable view of the chest was obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No overt pulmonary edema is seen.
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Previously seen bilateral basilar opacities are markedly worse with an increase in the basal consolidation and bilateral pleural effusions. Mild vascular congestion is observed. An opacity in the left mid lung field is observed and correlates with a calcified pleural plaque in left hemithorax better visualized on prior ct; otherwise pleural surfaces are unremarkable. There is no pneumothorax. Aorta is mildly calcified. Heart size is within normal limits.
<unk>-year-old male with hypoxia.
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Comparison is also made to the ct scan from <unk>. Cardiac silhouette and mediastinum are within normal limits. There is no focal consolidation. There are small bilateral pleural effusions. No overt pulmonary edema is seen. There is increased sclerosis seen of the right sternoclavicular joint which is better assessed on the outside hospital ct scan. There is also some widening and irregularity of the right lateral clavicle suggestive of prior old trauma or surgery. A single metallic anchor is seen in the right humeral head. On the lateral view, there is calcification in the anterior longitudinal ligament consistent with dish.
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Low lung volumes are present. Heart size is accentuated as result, appearing mildly enlarged. Mediastinal and hilar contours are grossly unremarkable. Crowding of bronchovascular structures is present without overt pulmonary edema. Minimal patchy opacities within the lung bases likely reflect areas of atelectasis. No focal consolidation, large pleural effusion or pneumothorax is detected on this supine exam. There are no acute osseous abnormalities.
history: <unk>m with narcan status post suspected clonidine use // ? edema
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Left-sided aicd/ pacemaker device is noted with leads terminating in the regions of the right atrium and right ventricle. Epicardial leads are also seen terminating along the left heart border. Heart size remains mildly enlarged. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is identified. The lungs are hyperinflated with flattening of the diaphragms as before, suggestive of copd.
shortness of breath, cough
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Heart size remains normal. Widening of the upper mediastinum is stable and is accounted for by mediastinal fat as seen on chest ct from <unk>. Increasing indentation on the left upper trachea at the level of the clavicles may reflect new pathology in the left thyroid lobe, which appears hypertrophied on the prior chest ct. Left pleural effusion is small if present. There is no pneumothorax or right pleural effusion. There is no focal consolidation concerning for pneumonia. Pulmonary vessels appear slightly more engorged, but there is no overt edema.
systolic heart failure, history of pe, shortness of breath.
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Frontal and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding, although aeration and persistent bibasilar atelectasis are improved from <unk>. Right chest wall air has resolved. A right intravenous catheter ends in the lower svc with a port needle in place. There may be a small right pleural effusion. No pneumothorax.
<unk>-year-old woman status post right vats lung biopsy.
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Since <unk>, bilateral chest tubes have been removed. A tiny right apical pneumothorax is seen. No pneumothorax is seen on the left. The lung volumes remain low. Small bilateral pleural effusions, right greater than left, with some adjacent atelectasis are again seen. The heart size is unchanged.
<unk> year old man with b/l pleural effusions s/p chest tube placement and removal on <unk>. increased work of breathing since chest tube removal // eval for interval change in pleural effusions, presence of pneumothorax
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Compared to the prior exam, there has been minimal interval decrease in moderate right and small left pleural effusions with persistent bibasilar consolidation, most likely representing atelectasis. No pneumothorax is seen. Left pleural catheter appears similarly positioned. Right pleural catheter has been removed.
<unk>-year-old male with pleural effusion.
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Since chest radiograph <num> hours ago, no relevant change. Unchanged moderate cardiomegaly. Unchanged moderate pulmonary edema. The difference in appearance of the right hemithorax on previous radiograph is explained by patient's rotation on previous radiograph. Unchanged lower lung volumes. Support devices are unchanged in position from prior study. Small pleural effusions are unchanged in size.
<unk> year old woman with chf, endocarditis, trach // volume overload
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As compared to the previous radiograph, the lung volumes have substantially decreased. As a consequence, there is crowding of the vascular structures at the lung bases. However, there are bilateral additional parenchymal opacities that could reflect pneumonia in the appropriate clinical setting. The opacities are bilateral and symmetrical but do not fulfill the classical criteria for pulmonary edema. Moderate cardiomegaly. Presence of a minimal left pleural effusion cannot be excluded. At the time of dictation and observation, <time> a.m., on <unk>, the referring physician, <unk>. <unk>, covered by dr. <unk>, was paged for notification.
fever, unclear potential pneumonia.
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Stable cardiomegaly with permanent pacemaker in place. Low lung volumes accentuate the pulmonary vasculature. With this limitation in mind, there is no definite evidence of congestive heart failure. Patchy opacities are present at both lung bases and there is a suggestion of a small left pleural effusion.
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Single portable view of the chest is compared to previous exam from earlier the same day at <time> p.m. There is a new right ij central line with tip at the ra-svc junction. The lungs remain clear, there is no visualized pneumothorax. Cardiomediastinal silhouette is stable.
<unk>-year-old female with central line placement.
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There has been interval placement of a temporary pacing lead terminating in the region of the right ventricle via a right internal jugular approach. No pneumothorax. Lung volumes remain low. Moderate enlargement of the cardiac silhouette persists. The aorta is markedly tortuous and diffusely calcified. Pulmonary vasculature is not engorged. Linear retrocardiac opacity persists, likely atelectasis, without large pleural effusion or pneumothorax.
history: <unk>f with bradycardia , status post temp pacing wire
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The lungs remain hyperexpanded but without focal consolidation, pleural effusion, or pneumothorax. Two more nodular opacities in the right lower lung are stable since <unk> favoring a benign process. The cardiomediastinal silhouette is unchanged.
history: <unk>m with pmh cad/htn p/w back pain // eval for cardiopulmonary process
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Ap portable upright view of the chest. No radiopaque foreign body is seen in the chest. Overlying ekg leads are present. Lung volumes are somewhat low. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with borderline cardiomegaly. Imaged osseous structures are intact.
history: <unk>m with fb in esoph // fb?
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In this patient with known granulomatous polyangiitis, multiple areas of consolidation with peribronchovascular opacity is most confluent in the left mid and lower lung, slightly increased from prior exam. There is also subtle increased opacity in the right upper lobe. Findings are concerning for pneumonia. Otherwise, no significant change.
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Pa and lateral views of the chest demonstrate the lungs are well expanded with no evidence of focal consolidation, pneumothorax or pleural effusion. Cardiomediastinal silhouette is stable. No rib fractures are identified on this study. An <num>mm right upper lobe nodule is redemonstrated, unchanged since prior ct from <unk>.
<unk>-year-old man with mechanical fall on to right side with lateral rib pain. evaluation for right-sided rib fractures status post fall.
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Pa and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. No free air is seen below the diaphragm.
<unk>-year-old female with right flank pain.
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As compared to the previous radiograph, the position of the picc line is unchanged. The tip projects at the lower svc level. There is no evidence of complication, notably no pneumothorax. Otherwise, the radiograph is normal.
forearm sarcoma, evaluation of picc line position.
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The lungs remain hyperinflated with flattening of the diaphragms and relative lucency of the upper lobes, consistent with chronic obstructive pulmonary disease with pulmonary emphysema. There is persistent right base opacity similar as compared to the prior study, though slightly increased as compared to <unk>. Findings could be due to underlying pneumonia or aspiration. No large pleural effusion is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are grossly stable. Old bilateral rib fractures are again seen.
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The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Cervical spine hardware is noted.
<unk>-year-old woman with fever and back pain. evaluate for pneumonia.
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In comparison with the study of <unk>, there is probably little change in the degree of right apical pneumothorax. Continued opacification in the right upper zone is consistent with consolidation. Post-surgical changes are seen at the right base and along the lateral chest wall. The atelectatic changes at the left base have cleared.
decortication.
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Heart size is mildly enlarged. The aorta is tortuous with atherosclerotic calcifications noted at the arch. Pulmonary vasculature is not engorged. Focal opacity is seen within the right lower lobe concerning for pneumonia. There is likely a small right pleural effusion. Left lung demonstrates streaky atelectasis at the left lung base but no additional sites of focal consolidation. No pneumothorax or left-sided pleural effusion is demonstrated. There are no acute osseous abnormalities.
history: <unk>f with hypoxia and sob
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Cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are hypoexpanded but clear without focal consolidation concerning for pneumonia. Mild left basilar atelectasis is seen. The upper abdomen is unremarkable without evidence of pneumoperitoneum.
history: <unk>m with epigastric pain and ttp. hx necrotizing pancreatitis s/p roux-en-y // r/o free air, obstruction
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In comparison with the study of <unk>, the monitoring and support devices are in unchanged position. The left hemidiaphragm is not as sharply seen, consistent with volume loss in the left lower lobe combined with small effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered.
spontaneous cerebral bleed.
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A left picc terminates at the lower svc. The heart size is enlarged. There is no pneumothorax, pleural effusion, or focal consolidation. Moderate degenerate changes are again demonstrated throughout the thoracic spine, including multilevel bridging osteophytes. Extensive coronary vascular calcifications are incidentally noted.
picc placement.
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Supine portable ap view the chest provided. An endotracheal tube is seen with its tip located approximately <num> cm above the carina. An ng tube is seen coursing inferiorly with its tip at the ge junction. Midline sternotomy wires are noted. There is a left chest wall pacer device with leads in the region of the right atrium and right ventricle. There is bilateral hilar/perihilar opacity which is somewhat unusual in overall appearance and raises potential concern for adenopathy. There is a small left pleural effusion with left basal opacity likely atelectasis. The heart is mildly enlarged. Bony structures are intact.
<unk>m with intubation
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The heart size is within normal limits. The mediastinal and hilar contours are unremarkable. The lungs are hyperinflated and lucent with flattened hemidiaphragms, compatible with severe copd. However, no lobar consolidation is present and minimal bibasilar atelectasis is noted. Pulmonary nodules seen on prior ct are better evaluated on ct. No large pleural effusion or pneumothorax is present.
<unk>-year-old male with tachypnea.
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The heart is normal in size. The aorta is again mildly tortuous. There is no pleural effusion or pneumothorax. The chest is hyperinflated. The lungs appear clear. Small-to-moderate anterior osteophytes are present along several lower thoracic levels. There is a healed right posterolateral eighth rib.
near syncope.
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Left pleural effusion persists. No right pleural effusion is detected. Cardiomegaly persists. Cardiac hardware appears similarly positioned on this frontal view. No pneumothorax or focal consolidation is seen, however, evaluation of the left mid lung field is limited due to overlying hardware. No pulmonary edema is evident on this view.
<unk>-year-old female with lymphoma and congestive heart failure, now with shortness of breath.
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No previous images. There is enlargement of the cardiac silhouette in a patient with intact midline sternal wires and dialysis catheter extending to the region of the cavoatrial junction. Mild atelectatic changes are seen at the bases. There is some engorgement of ill-defined pulmonary vessels, consistent with some elevation in pulmonary venous pressure. No evidence of acute focal pneumonia.
low ejection fraction, to assess for pulmonary edema.
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Ap supine portable chest radiograph is obtained. The endotracheal tube extends into the right main stem bronchus. Retraction by at least <num> cm is advised. Port-a-cath resides in the right chest wall with catheter tip extending into right atrium. There are air bronchograms noted in the left perihilar region with consolidation. Otherwise, the lungs appear essentially clear. The mediastinal contour is difficult to assess and appears somewhat prominent. Imaged osseous structures are intact. Right upper quadrant clips are noted.
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The lungs are clear of focal consolidation, pleural effusion or pneumothorax. Lower lobe bronchiectasis is noted. The heart is normal in size. There are surgical clips projecting over the right breast. No displaced rib fractures are noted. Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referable focal findings should be clearly marked and imaged with either bone detail radiographs or chest ct scanning.
<unk>-year-old female with fall, no blood thinners, left hip fracture. please see the entire femur and for traumatic injuries.
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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 man with nephrotic syndrome and cough // pna?
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Endotracheal tube is seen terminating approximately <num> cm above level carinal. It should be withdrawn approximately <num> cm for more optimal positioning. Enteric tube is seen coursing below the diaphragm, inferior aspect not included on the image. The aorta is calcified and tortuous. Prominence of the main pulmonary artery is noted which may be due to underlying pulmonary hypertension. The cardiac silhouette is top-normal. Splaying of the carina is seen which can be seen with left atrial enlargement. There is suggestion of possible mitral anulus calcification. Perihilar opacities, right greater than left may be due to asymmetric pulmonary edema however, underlying aspiration or infection may be present. No large pleural effusion is seen. There is no pneumothorax.
history: <unk>f with ett og placement // eval for placement of ett, ogt
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Right lower lobe cavitary lesion is present. Right basilar opacity likely representing pleural effusion is noted. There is no pneumothorax. The left lung is clear. A hand overlies the lower chest. The cardiomediastinal silhouette is within normal limits.
<unk> year old woman with rll abscess s/p rll tbbx // ptx
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Compared to the prior study and allowing for differences in technique, the cardiomediastinal silhouette is probably unchanged. The posterior lower lobe opacity seen on the lateral view may be slightly denser and more confluent. Otherwise, allowing for technical differences, i doubt significant interval change in the bilateral opacities. No new superimposed opacity is identified. Doubt chf. The <num> mm rounded metallic density overlying the right upper/mid abdomen is compatible with a foreign body (question more shrapnel). On the lateral view from the prior study it lies posterior to the presumptive l<num> vertebral body.
<unk> year old man with pneumonia and likely ipf // please eval for complications of pna, interval change
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The heart is moderately enlarged, particularly at the left atrium, but stable. The hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. Nipple shadows should not be mistaken for pulmonary nodules. Deformity of the left lower ribs is likely secondary to prior surgery. Surgical clips project over the mid upper abdomen.
<unk>m s/p fall please evaluate for fx // <unk>m s/p fall please evaluate for fx <unk>m s/p fall please evaluate for fx
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Portable ap upright chest radiograph is obtained. Ekg lead and external pacer leads are noted as well as midline sternotomy wires and mediastinal clips. The lung volumes are low, but the lungs appear clear. No definite sign of pneumonia or chf. No pleural effusion or pneumothorax is seen. A retrocardiac density is compatible with known hiatal hernia. Imaged osseous structures appear intact.
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Et tube remains in good position. Vp shunt is partially assessed. There is worsening opacification in the left base with complete obscuration of left hemidiaphragm probably reflecting some atelectasis. In addition there is probably mild developing consolidation both right and left base. Some lucency projected over the lower left chest probably reflects some interposed bowel rather than a deep sulcus though attention to this area is suggested on follow-up.
<unk> year old man with ruptured aneurysm // eval for pulm infiltrates, ?ards?
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The heart size is normal. The mediastinal and hilar contours are unchanged, with moderate calcification of the aortic arch and descending aorta noted. There is no pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is seen. Scarring within the lung apices, right more so than left, is stable. Fractures of the right humeral neck and left-sided ribs are remote. Moderate dextroscoliosis of the thoracolumbar spine is re- demonstrated.
hypoglycemia.
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Frontal and lateral views of the chest were obtained. The cardiac silhouette is top normal. Mediastinal contours are unremarkable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Slight prominence of the hila most likely relates to pulmonary vascular engorgement. There are degenerative changes along the spine.
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Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation.
<unk>-year-old man with chest pain radiating to left arm
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Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. Clips are seen in the right upper quadrant likely denote prior cholecystectomy. No acute osseous abnormalities are seen.
chest pain.
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Aeration of the right lung has improved since the prior study. A moderate-to-large right pleural effusion has slightly increased. Right apical post-radiation scarring are stable. There is unchanged shift of the upper mediastinum towards the right. The left lung is clear with the exception of a small left pleural effusion. A right-sided picc line has been removed.
<unk>-year-old woman with non-small cell lung cancer and pleural effusion.
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When compared to prior, there has been no significant interval change. The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with chills, cough // eval for pna
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Ap and lateral views of the chest are compared to previous exam from <unk>. Again seen is elevation of the left hemidiaphragm with eventration posteriorly as previously seen. Streaky right basilar opacity suggestive of atelectasis versus scarring. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is unchanged. Extensive degenerative and potentially post-traumatic changes seen at the left humerus.
<unk>-year-old male with increased confusion.
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There is mild left apical pleural thickening. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Incidental note is made of nipple shadows. The cardiac silhouette is not enlarged. The mediastinal and hilar contours are unremarkable.
ms flare.
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The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The mediastinal contours are normal. The heart size is at the upper limits of normal, and unchanged since the prior exam. No fracture is identified.
chest pain and cough. evaluate for pneumonia.
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In comparison with study of earlier on this date, there has been placement of a dual-channel pacer device with leads extending to the right atrium and region of the apex of the right ventricle. No convincing evidence of pneumothorax. Continued substantial elevation of the left hemidiaphragmatic contour.
pacer device.
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Single portable supine view of the chest. The endotracheal tube is seen with tip approximately <num> cm from the carina. Enteric tube as only clearly seen to the ge junction and could potentially be terminating in this region and should be advanced. There multifocal regions of consolidation in the lungs predominantly at the bases. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. Old healed left lateral rib fracture is identified.
<unk>-year-old male found down, endotracheal tube placement outside hospital.
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Single frontal view of the chest was obtained. The patient is rotated somewhat to the left. There is no focal consolidation, pleural effusion, or evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen.
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The lungs are clear and the lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. Heart is normal size. The mediastinal and hilar structures are unremarkable.
right-sided chest pain, rule out pneumothorax.
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Lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation. Trace atelectasis is present in the left lung base. No displaced rib fractures are noted.
<unk>f with pain, s/p mvc // eval for fx
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The et tube is <num> cm above the carina. Og tube tip is in the proximal stomach with the proximal port just above the ge junction. This should be advanced slightly. The appearance of the lungs is similar to that of the prior day compatible with chf.
intubation, new og tube.
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Frontal and lateral views of the chest were obtained. Again bibasilar, right greater than left atelectasis/scarring is seen. There is no definite new focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No evidence of free air is seen beneath the diaphragms. There are no findings to suggest pneumomediastinum.
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Cardiac silhouette size is top normal. Mediastinal and hilar contours are normal. Lungs are hyperinflated with emphysematous changes again demonstrated. Lungs are otherwise clear without focal consolidation. No pleural effusion or pneumothorax is present. There is no pulmonary vascular engorgement. No acute osseous abnormality is visualized.
history: <unk>f with dizziness
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The heart size is stable and top normal. There are small bilateral pleural effusions, grossly stable compared to the prior study. There is no pneumothorax. Mild pulmonary edema remains. Additionally, left upper lung hazy opacity persists. Increased right basilar atelectasis is present.
anginal pain, shortness of breath, rule out pneumonia.
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Chain sutures are seen within the right hilum with evidence of asymmetric volume loss in the right lung compatible with prior right upper lobe resection. Diffuse interstitial opacities are compatible with chronic interstitial lung disease. Small amount of pleural fluid is seen on the right. The heart size is mild to moderately enlarged. The aorta remains moderately tortuous. There is no pulmonary edema. Calcified granuloma in the left mid lung field is unchanged. Hazy opacity in the right lung base may reflect atelectasis or progression of known chronic interstitial lung disease. There is no pulmonary edema, pneumothorax, or left-sided pleural effusion.
shortness of breath for <num> days with hypoxia.
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Ng tube tip is in the stomach. As seen on the kub taken earlier in the evening there multiple dilated loops of small bowel in the left upper quadrant there is no free air. The right hemidiaphragm is mildly elevated. There is volume loss at both bases. There are no focal infiltrates. The cardiac and mediastinal silhouettes are normal.
ng tube placement.
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Moderate cardiomegaly is unchanged since at least <unk>. Mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Trace fluid tracks along the major and minor fissure on the right side though there is no notable pleural effusion. Cephalization of vasculature is compatible with mild fluid overload. Pleural surfaces are otherwise clear without pneumothorax. Tenodesis screws are noted in the right humeral head from prior biceps tendon repair.
right upper quadrant tenderness to palpation with guarding.
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Lung volumes are low and there is volume loss in both lower lobes with a more focal area of opacity in the right lower lobe. It is unclear if this is due to atelectasis or if it is an early infiltrate. There is a small right effusion.
<unk> year old man with hcc s/p r hepatectomy and sob // assess for consolidation, effusion, atelectasis, or other etiology of sob
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Normal cardiomediastinal and hilar contours. Interstitial opacities at the costophrenic angles bilaterally, new since the remote prior study from <unk>. No pneumothorax or pleural effusion. Degenerative changes throughout the thoracic spine. There is no free intraperitoneal air.
<unk>-year-old man with epigastric and chest pain. evaluate for an acute cardiopulmonary process.