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Pa and lateral views of the chest. The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable.
<unk>-year-old female with chest pain. question pneumothorax.
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Ap and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are unchanged. Elevation of the right hemidiaphragm is again noted with post-surgical changes in the right chest from prior right upper lobectomy. Low lung volumes are again appreciated. Slight increase in interstitial markings may indicate an element of pulmonary vascular congestion. Right shoulder replacement is noted.
fall, acute mental status change with crackles on lung exam.
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The cardiac, mediastinal and hilar contours are unremarkable. There is a persistent left basilar opacity with volume loss which has long chronicity, but decreased since the most recent prior study. Corresponding mild elevation of the left hemidiaphragm is similar. There is no pleural effusion or pneumothorax.
cough, fever and chest pain.
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Comparison with the study of <unk>, there is continued substantial cardiomegaly with evidence of pulmonary edema. Retrocardiac opacification is consistent with volume loss in the lower lobe, though in the appropriate clinical settings, supervening pneumonia would have to be considered. The nasogastric tube has been removed.
altered mental status, to assess for pulmonary edema.
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No change in the position of the left pectoral pacemaker with leads in the right atrium and right ventricle. Median sternotomy wires are intact. Compared with the prior radiograph, mild interstitial pulmonary edema and the right pleural effusion have improved, with better lung aeration. Moderate enlargement of the heart is unchanged. No new focal consolidation or pneumothorax.
history: <unk>f with recent cardiac surgery for hocm, s/s chf. eval for acute process, attn. to chf.
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Frontal ap and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding. There is no focal consolidation, pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are unchanged. No acute osseous abnormality is identified. A small hiatal hernia is unchanged. Compression fractures in the thoracic spine are similar to <unk>.
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No evidence of free air. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax.
<unk>-year-old woman with colonoscopy, severe abdominal pain, ?free fluid on ultrasound, evaluate for free air
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The lungs are clear besides mild patchy left basilar opacity as on prior. The cardiomediastinal silhouette is stable. Atherosclerotic calcifications again noted at the aortic arch. No acute osseous abnormalities pain
<unk>m with h/o paroxysmal afib, cad, presenting with chest pain. patient with crackles on exam. // please eval for pneumonia
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Indwelling support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable allowing for patient rotation. Interval worsening of bilateral asymmetrical predominantly airspace opacities, which may reflect asymmetrical pulmonary edema, but superimposed process such as multifocal aspiration or developing infectious pneumonia is possible in the appropriate clinical setting. Dense left retrocardiac opacity is unchanged, likely representing a combination of atelectasis and pleural effusion.
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Indwelling support and monitoring devices are in standard position. Cardiomediastinal contours are within normal limits. Heterogeneous opacities in the left lower lobe have slightly progressed, and widespread poorly defined nodular opacities also appear slightly more conspicuous. The patient has a known underlying mac infection with bronchiectasis and centrilobular nodules on prior chest ct of <unk>. The worsening multifocal opacities as compared to that time could reflect the clinically suspected diagnosis of aspiration pneumonia superimposed upon chronic changes related to atypical mycobacterial infection. Chronic volume loss and bronchiectasis in right middle lobe and lingula appear grossly unchanged.
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Low lung volumes accentuate bronchovascular markings. Similar to the prior examination in <unk>, increased opacification involving the lateral right chest likely a combination of soft tissue and pleural thickening associated with chronic rib fractures. The lungs are clear. No pulmonary edema. No effusion or pneumothorax.
history: <unk>m with chf, dyspnea on exertion // pulmonary edema, infiltrate, effusion
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The lungs are clear despite low lung volumes particularly on the lateral view. There is no effusion, consolidation or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>m with t<num>dm and htn, p/w lightheadedness and diaphoresis // eval for pna or ptx
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Since the prior radiograph on <unk>, there has been no significant change. The right port-a-cath terminates in the cavoatrial junction. There are no focal consolidations, large pleural effusions or pneumothorax. Metallic clips noted in the mid-abdomen. Several metallic densities are demonstrated over the right humeral head, unchanged since prior examination.
<unk> year old woman with ams // e/o new focal opacity
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The heart is at the upper limits of normal size with a left ventricular configuration. There is mild unfolding of the thoracic aorta. The mediastinal and hilar contours appear unchanged. There are streaky posterior basilar opacities in the left lower lobe and probably in the lingula which are more suggestive of atelectasis than pneumonia, although an infectious process is difficult to completely exclude. Elsewhere, the lungs appear clear. There are no pleural effusions or pneumothorax. Mild degenerative changes are similar along the mid thoracic spine with slight minimal wedging of mid thoracic vertebral bodies that appears unchanged.
cough, fever and sore throat.
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Lungs are well expanded. Subtle reticular interstitial markings at the bases have significantly improved. No new focal opacity. No pleural abnormality. Heart size is normal. Cardiomediastinal and hilar silhouettes are unremarkable.
<unk> year old woman with scleroderma, ild presenting with cough and sob // r/o pna
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Lung volumes are low. Again seen are nodular opacities throughout the lungs, midly improved in the left lower lobe, otherwise unchanged compared to the prior chest radiograph and most recent chest ct. There is no new focal consolidation, pleural effusion or pneumothorax. A metallic fragment in the right lower lobe is stable. Cardiomediastinal silhouette is stable. The imaged upper abdomen is gasless.
<unk>-year-old man with pneumonia still spiking fevers.
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A left pectoral pacemaker remains in place. An accessed right pectoral mediport terminates in the upper right atrium. A moderate left pleural effusion has increased since <unk>. Retrocardiac opacification has also increased, most likely due to a combination of pleural effusion and atelectasis. The right lung remains clear. There is no pneumothorax. The heart and mediastinum are within normal limits. Extensive calcification of the thoracic aorta is again noted. Spinal degenerative changes are stable.
hx of nhl. s/p chemo. now with dyspnea and cough. please r/o pna, worsening pleural effusions, pulm edema etc. // hx of nhl. s/p chemo. now with dyspnea and cough. please r/o pna, worsening pleural effusions, pulm edema etc.
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Single semi-erect frontal view of the chest demonstrates patient to be moderately rotated to the left, distorting cardiomediastinal silhouette. This likely accounts for apparent mediastinal widening, which is accentuated by semisupine position and ap technique. Lung volumes are low, accentuating bronchovascular crowding. Allowing for such, there is mild perivascular congestion. Streaky bibasilar opacity could represent aspiration, evolving infection, or a component of atelectasis. There is no large effusion or pneumothorax. A tracheostomy is in place. Mild diffuse osseous demineralization is present. Moderate right greater than left glenohumeral osteoarthritis is present.
<unk>-year-old male with history of pneumonia.
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Lung volume is low. There is a large hiatal hernia. Bibasilar atelectasis noted with possible trace effusions. Cardiac silhouette is obscured by large hiatal hernia. There is no consolidation or pneumothorax. Compression deformities of the lower thoracic spine is noted.
<unk>/f with increased agitation
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Patient's condition required examination in sitting position using ap frontal and left lateral views. Comparison is made with the next preceding portable ap single view chest examination of <unk>. Heart size and mediastinal structures grossly unaltered. Same holds for the previously identified bilateral diaphragmatic linear calcifications compatible with the old asbestos exposure. Left-sided pleural thickenings both in apical area as well as lateral wall and left base remain unchanged and the presence of a small caliber pigtail ending catheter on the left base presumably draining the pleural space appears unchanged. No pneumothorax can be identified. No new pulmonary parenchymal abnormalities.
<unk>-year-old male patient with history of left-sided pleural effusion, assess for interval change.
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Heart size is mildly enlarged. Aortic knob is calcified. Mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Mild dependent atelectatic changes are seen in the lung bases. Trace pleural effusions are likely present bilaterally. No pneumothorax is present. There are no acute osseous abnormalities.
altered mental status and hypoxia.
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The lungs are well expanded and clear. The heart size is top-normal. The hilar and mediastinal contours are normal. There is no pleural abnormality. Wedge deformity of the mid thoracic vertebra is chronic.
<unk> year old woman with metastatic cervical cancer getting radiation, now with cough and fever for <unk> weeks. // assess for pna
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Frontal radiograph of the chest demonstrates interval placement of a right pleural tube and presence of very small right apical pneumothorax status post vats and wedge biopsy. There is a hematoma in the mid lung and an adjacent suture line is seen, presumably at the site of wedge biopsy. There is bibasilar atelectasis with no evidence of significant pleural effusion or pulmonary edema. The heart size is normal. Median sternotomy wires are unchanged in position compared to prior study.
<unk>-year-old female with ild, status post right vats and wedge biopsy. postoperative evaluation for pneumothorax or effusion.
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Again seen is free air under the right hemidiaphragm, slightly less than on the film from the prior day. Right picc line is unchanged. There is volume loss at both bases with a more focal retrocardiac opacity that could represent an early infiltrate.
<unk> year old man with hiv+hcv, s/p pea arrest and anoxic brain injury, with new hypotension and ronchorous breath sounds // assess for interval change, r/o pna
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Heart size is normal. Mediastinal and hilar contours are unremarkable and unchanged. Lungs are clear. Pulmonary vasculature is not engorged. No pleural effusion or pneumothorax is detected. Cervical spinal fusion hardware is incompletely assessed. Moderate to severe degenerative changes involving both glenohumeral joints are present. No subdiaphragmatic free air is present.
history: <unk>m with abdominal pain, neck pain and swelling
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The lungs are well inflated and clear. There is slight elevation of the left hemidiaphragm with air-filled loops of large bowel underneath the diaphragm. There is no pleural effusion or pneumothorax. Heart size and mediastinal contours are normal. Osseous structures are intact.
history: <unk>m with altered mental status, recent craniectomy for sah // evaluate for acute process
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Dialysis catheter remains in standard position, and cardiomediastinal contours are stable. Improving linearly oriented opacities in both lung bases suggestive of atelectasis. No new areas of consolidation to suggest the presence of pneumonia, but standard pa and lateral chest radiographs would provide more complete assessment of the lungs and may be considered for further assessment if symptoms persist.
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The cardiac silhouette is mildly enlarged. Mediastinal contours are grossly stable. No definite focal consolidation is seen. There is may be a trace pleural effusion although no large pleural effusion is seen. There is no pulmonary edema.
history: <unk>f with syncope // eval for pneumonia
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A right-sided picc terminates in the mid svc. The trachea is central. The cardiomediastinal contour is unchanged. There is persistent prominence of the bilateral upper lobe pulmonary vasculature with bilateral perihilar airspace opacities, the appearances are most consistent with pulmonary edema. No pleural effusion seen. No pneumothorax seen. Bilateral apical pleural scarring is symmetric. The visualized bony structures are unremarkable in appearance.
<unk> year old man with likely acute leukemia, copd and pna with shortness of breath // evaluate for volume overload vs. infection
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Status post prior median sternotomy. Interval removal of the endotracheal and gastric tubes. The tip of the right internal jugular central venous catheter projects over the cavoatrial junction. There are increasing bilateral layering pleural effusions with subjacent atelectasis. Moderate pulmonary edema is present as well. No pneumothorax identified. The size of the cardiomediastinal silhouette is enlarged but unchanged.
<unk> year old man with increased wob s/p extubation // please assess for acute pathology
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As compared to the previous radiograph, the pre-existing parenchymal opacities at both lung bases have markedly improved. The lung bases are better ventilated and areas of opacities, likely of atelectatic origin, persist only at the retrocardiac lung areas and left lung bases as well as at the medial aspects of the right lung. The monitoring and support devices are in unchanged position. The size of the cardiac silhouette is borderline and there is no evidence of pulmonary edema. The overall hypertransparency at the level of the right upper quadrant is consistent with free abdominal air (the referring note mentions perforated diverticulitis and status post multiple washouts). At the time of dictation and observation, <time> a.m., on <unk>, the referring physician, <unk>. <unk> was paged for notification.
perforated diverticulitis, status post multiple washouts, fever, evaluation for interval change.
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Frontal and lateral views of the chest are obtained. There are slightly low lung volumes. Mild basilar atelectasis is seen. There are mild basilar and right middle lobe atelectasis seen. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. There is suggestion of a possible hiatal hernia.
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In comparison with the study of <unk>, the right pigtail catheter remains in place. Again, there is pleural effusion on the right with loculation of fluid in the right major fissure. No definite pneumothorax is appreciated. Continued small left pleural effusion with atelectatic changes at the left base.
pneumothorax with pigtail catheter.
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The cardiomediastinal contour is normal. The lungs are clear. No pneumothorax seen. No rib fractures seen. There is degenerative disk disease noted in the mid thoracic spine. There are <num> lower thoracic vertebral bodies which demonstrate mild collapse, correlation with any clinical history of back pain recommended. A skin marker was placed over the site of the patient's discomfort corresponds to the posterior lateral ribs. Moderate degenerative change in the right acromioclavicular joint.
<unk> year old man with pleuritic right low dorsal chest pain. // cause of pain?
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Lungs: the lungs are well inflated. There is no consolidation. Pleura: no pleural effusion is seen. Heart: the heart is not enlarged. Mediastinum and hila: there is no mediastinal mass. Osseous structures: hypertrophic changes are seen in the dorsal spine. Other findings: none
history: <unk>f with dyspnea on exertion // r/o infiltrate vs chf
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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 silhouette is top normal. Mediastinal contours are unremarkable. No overt pulmonary edema is seen.
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The lungs are clear without focal consolidation, effusion, or edema. Mild left basilar atelectasis seen laterally. Cardiomediastinal silhouette is stable. No acute osseous abnormalities.
<unk>m with acute mental decline in <num> week since, fall, outside mri <num>d ago showing small temporal bleed felt unlikely to be cause of symtoms by outside provider // evaluate for interval change, acute process
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There has been interval placement of a nasogastric tube, which is seen coursing below the diaphragm and out of view on this image. An endotracheal tube is unchanged, in appropriate position. The inspiratory lung volumes are slightly decreased from the most recent prior study. There is increased retrocardiac opacification compatible with left lower lobe atelectasis. Interval blunting of the left costophrenic angle suggests interval development of a small left pleural effusion. There is persistent pulmonary vascular congestion. The cardiomediastinal silhouette is stable.
intracranial hemorrhage, currently intubated.
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Pa and lateral views of the chest were provided. There is subtle opacity in the medial right and left lung base which is similar to prior and may represent crowding of bronchovascular markings though the possibility of a subtle pneumonia is difficult to exclude in the correct clinical setting. No large effusion or pneumothorax. No signs of edema. Cardiomediastinal silhouette is normal. Bony structures are intact.
<unk>m with cough, dyspnea crackls on right-sided, rule out infiltrate.
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Ap and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. The heart size appears top normal but is not accurately measured on this ap projection.
seizure, rule out infiltrate.
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The patient is status post median sternotomy and transcatheter aortic core valve device placement which remains unchanged in appearance. Heart size remains moderately enlarged. Mediastinal contours on similar. There is moderate pulmonary vascular congestion which appears slightly worse in the interval. Trace bilateral pleural effusions are noted. Patchy atelectasis is noted in the lung bases. No pneumothorax is present. There are no acute osseous abnormalities.
history: <unk>m with dyspnea
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As compared to the previous radiograph, nasogastric tube has been minimally advanced. Tip now projects over the proximal parts of the stomach, the sidehole is still at the level of the gastroesophageal junction. No evidence of complications. Otherwise, unchanged chest radiograph.
nasogastric tube placement.
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Lung volumes remain low. Cardiomediastinal contours are within normal limits allowing for this factor. Right picc terminates in the mid superior vena cava. Right hemidiaphragm is persistently elevated with adjacent linear atelectasis. Small bilateral pleural effusions are present and haziness of upper abdomen is suggestive of ascites.
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Cardiomediastinal contours are normal. Lung volumes remain low, and patchy right basilar opacities are new, superimposed upon pre-existing areas of linear scar or atelectasis. Mild linear scarring at the left base is unchanged. There are no pleural effusions or acute skeletal findings.
<unk> year old woman with <num> week of cough, h/o pneumonia. rales at bases and rml lung field. // please r/o infiltrate
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Support and monitoring devices are in standard position. Interval decrease in width of cardiomediastinal contours accompanied by improving pulmonary edema. Persistent left retrocardiac opacity, which may reflect atelectasis and/or consolidation with adjacent small-to-moderate left pleural effusion. Partially layering right pleural effusion persists.
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The patient is rotated. The opacity in the right lung appears more widespread now with greater involvement of the perihilar region silhouetting of the right heart border and right hemidiaphragm. Apparent increased rightward shift of the mediastinum may in part be secondary to volume loss as well as patient position. Right pleural effusion is moderate, probably slightly increased. Left lower lung atelectasis is probably unchanged - the left costophrenic angle is cut off from the image. Left lung edema as increased and new from the prior exam. Left lower lung consolidation may also reflect focus of pneumonia. Mild to moderate cardiomegaly is unchanged. No pneumothorax. The ett is positioned is overall unchanged, approximately <num> cm from the carina. Right internal jugular venous catheter ends in the mid svc, unchanged. Enteric tube traverses the diaphragm and its tip unseen.
<unk> year old man with rlung infection. assess right lung opacity progression.
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Frontal and lateral views of the chest were performed. Blunting of the left costophrenic angle, most pronounced posteriorly, is again seen. There is no right pleural effusion. There is no pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are unchanged. A rounded density projecting over the right lower lung is unchanged from <unk>. Old right rib fractures are noted. Sternotomy wires, mediastinal clips and a valve prosthesis are unchanged.
chest pain, evaluate for an acute cardiopulmonary process.
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The right subclavian central line has been pushed down over <num> cm, tip ending in inferior svc. Heart size is unchanged. Lung are less inflated and there are no changes in the bibasilar opacities. There is no pleural effusion. Et tube is in standard position.
<unk> year old man with sah and pna
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Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax.
history: <unk>m with doe // pna?
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A portable erect frontal chest radiograph demonstrates a right chest port terminating at the cavoatrial junction and multiple sternal wires. The cardiomediastinal silhouette is top-normal in size. Opacity at the right lung base likely represents a combination of right pleural fluid and atelectasis. No definite focal consolidation is identified. There is no pneumothorax. Displaced fractures of right lateral ribs are incompletely characterized regarding chronicity, potentially acute.
evaluate for acute process in a patient status post fall, with right rib/flank pain.
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Compared with the prior film, a right ij swan-ganz catheter is now present, tip over proximal most right pulmonary artery. No pneumothorax is detected inspiratory volumes are somewhat low, but similar to the prior film. Allowing for this, there is moderate to moderately severe cardiomegaly, similar to the prior film. There is bibasilar atelectasis, slightly increased. No overt chf or gross effusion. No definite focal infiltrate.
<unk> year old man with cardiogenic shock and cardiac amyloid // any interval change?
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Chest pa and lateral radiographs demonstrate unremarkable mediastinal, hilar, and cardiac contours. Faint opacification with air bronchograms projecting over the right lower lobe with increased opacity also seen on the spine on the lateral view raises concern for early pneumonia. No pleural effusion or pneumothorax is evident.
cough, fever, right lower lobe crackles, <num> days postop axillary tissue dissection; please evaluate for pneumonia.
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Compared with the prior radiograph, the et tube and ng tube have been removed. The right internal jugular catheter remains in unchanged, satisfactory position. Lung volumes have improved with decrease in bilateral effusions. There are persistent bibasilar opacities. Mild cardiomegaly is unchanged with mild pulmonary vascular congestion.
pneumonia, assess volume status.
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Ap and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear of consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is stable. Severe degenerative change is seen at the shoulders bilaterally. Old right rib fracture is seen. There is no evidence of acute fracture.
<unk>-year-old female status post fall.
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There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. There is no subdiaphragmatic free air.
<unk>m with epigastric pain, anemia and concern for perforated ulcer, evaluate for free air or bowel perforation.
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The ng tube tip is in the stomach. Et tube, right ij and left ij lines are unchanged. The heart is severely enlarged. There is pulmonary vascular redistribution and bilateral alveolar infiltrates suggesting pulmonary edema, dense retrocardiac opacity consistent with volume loss/infiltrate/effusion.
ng tube placement.
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Frontal and lateral chest radiograph demonstrate clear lungs without focal consolidation. There is bilateral basilar atelectasis and no pleural effusion. No pneumothorax. Pulmonary vasculature is unremarkable. The cardiomediastinal and hilar contours unremarkable.
<unk>-year-old male with left facial droop. evaluate for intrathoracic process.
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The cardiac, mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax.
new onset of chest pain.
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There is no consolidation, pleural effusion, vascular congestion or pneumothorax. There is mild cardiomegaly and the aorta is tortuous, unchanged.
two-three-week history of cough and inspiratory crackles at the left base, treated with antibiotics.
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Again seen is the right chest tube, similar in position. The right hemidiaphragm remains elevated. Extensive subcutaneous emphysema along the right chest and abdomen is again noted. No obvious pneumothorax is detected. Patchy opacity along the mid and lower right chest wall and atelectasis at the right base again noted, grossly similar to the prior study. The possibility of a small amount of pleural fluid is suspected, also similar to the prior study. Minimal atelectasis in the left costophrenic region appears slightly more pronounced on the current study. Equivocal minimal blunting at the left costophrenic angle noted , without gross effusion. Doubt overt chf. Cardiomediastinal silhouette is partially obscured, but grossly unchanged.
<unk> year old woman s/p right upper lobectomy and right middle lobe wedge resection // interval change
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Left chest tube which terminates at the base with a possible small apical pneumothorax. Lungs clear. Small right pleural effusion new since <unk>. Pulmonary vasculature is normal. Heart size is normal. The mediastinal and hilar contours are normal.
<unk> year old woman s/p left lung biopsy // pacu cxr eval for ptx, chest tube placement
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Portable ap upright chest radiograph demonstrates a left picc with the tip in the superior svc. There is a small left pleural effusion, and no right pleural effusion is seen. The lungs are clear and the cardiac and mediastinal contours are normal. No pneumothorax.
cirrhosis and acute promyelocytic leukemia with decreased breath sound at the right base. evaluate for pleural effusion.
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Pa and lateral views of the chest. The lungs are clear of consolidation or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected.
<unk>-year-old female status post syncope.
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Pa and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is stable. Pacemaker leads are seen and are in appropriate position, unchanged from prior study. There are calcifications of the aortic knob. There is a right pleural-based calcified plaque.
a <unk>-year-old man with cough and fevers at home, has renal graft. question pneumonia.
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Enlargement of the cardiac silhouette is similar compared to prior. Increased interstitial markings are seen throughout the lungs without focal consolidation. There is no pleural effusion. Atherosclerotic calcifications again noted at the aortic arch. No acute osseous abnormalities.
<unk>f with cp // eval pneumo
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Frontal and lateral views of the chest were obtained. There is left mid-to- lower lung atelectasis. There is blunting of the left costophrenic angle which may be due to a small pleural effusion. There is also a large left hernia with air-fluid levels seen. The cardiac silhouette is top normal to mildly enlarged. The right lung is clear. There is no right pleural effusion. There is no pneumothorax.
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Two images are provided. On the first image, tube is coiled in the middle of the esophagus and needs re-positioning. The second image documents correct position of the now re-positioned tube. The patient continues to be intubated. A right subclavian catheter is in place. Low lung volumes. Mild-to-moderate right pleural effusion. Moderate pulmonary edema. Unchanged right lower lobe atelectasis.
new nasogastric tube placement.
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Ap upright and lateral views the chest were provided. There is a right upper extremity picc line. With its tip at the level of the right axilla. Midline sternotomy wires and mediastinal clips are unchanged. There is an aicd with leads extending into the region of the right ventricle. The heart remains mildly enlarged. There is no focal consolidation, effusion, or pneumothorax. No overt edema is present. Clips in the upper abdomen noted.
<unk>m with recent whipple p/w fungemia.
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A <num> mm nodule projecting over the right second anterior rib likely corresponds to a calcified granuloma. The lungs are hyperinflated but otherwise clear. There is no pneumothorax or pleural effusion. Mild to moderate cardiomegaly is unchanged. The descending thoracic aorta is tortuous. Moderate dextroscoliosis of the lower thoracic spine is unchanged.
<unk> year old man with cough, night sweats. assess for pulmonary disease
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There are low lung volumes. The cardiomediastinal silhouettes are stable and within normal limits. Aortic arch calcifications are again seen. The bilateral hila are unremarkable. Pulmonary vascular congestion has improved in comparison to <unk>. The lungs are clear. There is a small right pleural effusion with adjacent basilar atelectasis. There is no left effusion. There is no pneumothorax.
<unk>-year-old man with fever.
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Et tube is <num> cm above the carina. Right ij swan-ganz catheter appears to terminate in the right main pulmonary artery. Left hd catheter terminates in the upper right atrium. Left ventricular assist device in standard position. Feeding tube traverses past the diaphragm and beyond the inferior margins of this film likely in the stomach. Severe cardiomegaly stable. No pneumothorax. No definite large pleural effusions. Previously seen bilateral pulmonary opacities have slightly improved. Retrocardiac consolidation stable.
<unk> year old man with new ett // eval for position new ett
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In comparison with the study of <unk>, the right chest tube has been removed. There is a small apical pneumothorax on the right. There are low lung volumes with little overall change in the appearance of the heart and lungs.
chest tube removal.
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There has been interval placement of right picc, terminating in low svc. The lungs are well expanded and clear. There is no pleural abnormality. The mediastinal and hilar contours are unremarkable.
<unk>-year-old female with history of small bowel obstruction. picc placement
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No consolidation, pleural effusion or pulmonary edema is seen, and the cardiac and mediastinal contours are normal. There is right apical pleural thickening.
<unk>-year-old with history of asthma, <num> day history of cough, malaise. decreased breath sounds at the right upper lung fields. evaluate for abnormality.
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Compared to prior exam there has been improvement in left lower lobe collapse with greater aeration. Additionally, there has been improvement in the left pleural effusion which remains moderate in size. There has also been marked improvement of the right pleural effusion which is now minimal. Fluid is seen tracking along the left major fissure on the lateral view. Bibasilar atelectasis is unchanged. Cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax. Increased ap chest wall diameter is consistent with given history of copd.
copd with chronic left lower lobe pneumonia/collapse and bilateral effusions.
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Indwelling support and monitoring devices are unchanged in position except for slightly more proximal tip of the endotracheal tube, now terminating <num> cm above the carina. This could be advanced a few centimeters for standard positioning. Lung volumes are relatively low. Mild cardiomegaly is accompanied by pulmonary vascular congestion and worsening bibasilar lung opacities, left greater than right, most likely due to atelectasis. Aspiration is an additional consideration in the appropriate clinical setting. Small bilateral pleural effusions have also apparently increased since the prior study.
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Low lung volumes are stable with increased prominence of linear atelectasis the left lung base. The vascular pedicle has decreased in size and there is slightly decreased pulmonary vascular congestion although mild interstitial edema remains. No pleural effusion, pneumothorax, or focal consolidation.
<unk> year old woman with spina bifida, seizure disorder, recent uti, presenting with denuding skin and hypoxia // eval for hypoxia
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As compared to the previous radiograph, the monitoring and support devices are unchanged. Moderate cardiomegaly with mild fluid overload. There is elevation of the right hemidiaphragm and, likely, a small right pleural effusion that has newly appeared. No pneumothorax, no left pleural effusion.
questionable pneumonia, evaluation of interval changes.
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Endotracheal tube terminates <num> cm above the level of the carina. An enteric tube is seen coursing below the level of diaphragm, inferior aspect not well seen. Valve prosthesis, right-sided pigtail chest tube, external hardware, bilateral internal jugular central venous catheters are unchanged. Moderate cardiomegaly is seen accompanied by diffuse pulmonary edema, which appears slightly improved as compared to the prior study. Very small pleural effusions. Overall, the diaphragms are slightly better seen. There are small foci of opacity in the left mid lung and right upper lung, attention at followup.
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The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Left basilar linear opacities most likely represent atelectasis. No definite focal consolidation is identified. There is no pleural effusion or pneumothorax. Anterior left seventh rib fracture and suspected anterior left eighth rib fracture are unchanged.
<unk>m w/ cp x<num> hour now resolved.
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Partially imaged cervical hardware is noted.
history: <unk>f with cp // eval for ptx
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Lung volumes are low but clear. Mild cardiomegaly is unchanged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax.
ms and feeling unwell. evaluate for pneumonia.
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A left moderate-sized layering pleural effusion is seen with associated left lower lobe atelectasis. A small right pleural effusion is also present, and pulmonary vascular congestion persists. The et tube, right and left central line are unchanged in position.
<unk>-year-old woman with respiratory failure, septic shock, evaluate for interval change.
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Comparison is made to previous study from <unk>. There is an endotracheal tube whose distal tip is <num> cm above the carina at the level of clavicles. There is a right ij line with the distal lead tip in the proximal svc, stable. There is a feeding tube whose distal port is below ge junction. There are no pneumothoraces. There is prominence of the pulmonary interstitial markings without signs for overt pulmonary edema.
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Known displaced right posterior eleventh and twelfth rib fractures and a known right posterior nondisplaced rib fracture are not appreciated on this examination. The lung fields are clear. Cardiomegaly is mild.
history: <unk>f with pt s/p fall, palpable rib fracture, head strike, vomiting, unable to walk, esrd on dialysis planned dialysis today // evaluate for trauma,
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Pa and lateral views of chest. The heart size is mildly enlarged. The previous bibasilar consolidations have essentially resolved, although at the current time, platelike left lower lobe atelectasis is still present. There is no pleural effusion, pneumonia, pneumothorax identified. A compression deformity of a mid thoracic veterbral body is new since <unk>, but age indeterminate.
shortness of breath and hypoxia
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There is subtle increase in prominence of the hila since <unk> which may be due to pulmonary vascular engorgement. Subtle increase in suprahilar opacity, bilaterally, particularly on the left, may relate to vascular congestion, however, underlying infectious process is not excluded. No large pleural effusion is seen. There is no pneumothorax. The patient is status post median sternotomy and cabg with the cardiac silhouette stable to possibly slightly increased in size. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with afib // acute process?
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In comparison with chest radiograph from <unk>, pulmonary edema has mildly improved, though multifocal consolidations in the right lung have probably worsened and may reflect aspiration. There is no pleural effusion or pneumothorax. Significant left deviation of the trachea is unchanged and likely suggests thyroid enlargement or mass, though a thoracic aortic aneurysm cannot be definitively excluded based on this study alone.
<unk> year old man with babesios and sob // eval for interval change
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No previous images. There is no evidence of pneumothorax. There are low lung volumes which accentuate the transverse diameter of the heart and the superior mediastinum. Hazy opacification at the left base with obscuration of the hemidiaphragm is consistent with layering left pleural effusion and substantial volume loss in the left lower lobe. No substantial vascular congestion.
ivc filter placement with sudden right-sided chest pain, to assess for pneumothorax.
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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. There is no free air under the diaphragm.
<unk>-year-old man with foreign body sensation/discomfort since eating steak tip last night.
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Heart size is borderline enlarged. The mediastinal and hilar contours are unremarkable with mild calcification of the aortic knob noted. Apart from linear atelectasis or scarring in the left upper lobe, the lungs are clear without focal consolidation. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities.
seizure.
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Single right chest tube. Left lower lobe consolidation is mildly more prominent. Bilateral pleural effusions are stable allowing for difference in patient positioning. Stable right basilar opacity, likely atelectasis. Endotracheal tube has been removed. Surgical clips left chest wall. Catheter projected over right upper quadrant.
<unk> year old woman with metastatic breast cancer with malignant pericardial effusion s/p window, chest tube not draining and pt is tachycardic // any interval change in pleural effusion size?
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Again seen is a small right hydro pneumothorax, minimally increased from the prior study. A left retrocardiac opacity is minimally increased and again likely reflects a combination of pleural effusion and adjacent atelectasis or consolidation. Evidence of pneumothorax.
<unk> year old woman with persistent air leak // r/a ptx
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Comparison is made to the previous ct of the abdomen from <unk>. The tip of the endotracheal tube is within the trachea, <num> cm above the carina. It is slightly deviated to the left due to the enlarged aortic knob. There is a large amount of air seen projecting over the lower heart border. This is presumably related to pneumomediastinum from the surgery. The nasogastric tube tip is at the ge junction and this could be advanced several centimeters for more optimal placement. There are again seen bibasilar opacities abutting air-filled mediastinum. There is a faint right upper lobe opacification suggestive of asymmetric pulmonary edema or atelectasis. Subcutaneous gas within the lower neck soft tissues, right greater than left is present. These findings have been discussed with dr. <unk> by dr. <unk>.
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The heart size is moderate to severely enlarged. Rightward deviation of the trachea due to a large thyroid goiter is noted. Lung volumes are low. There is mild pulmonary vascular congestion. Small bilateral pleural effusions are noted, with a focal area fluid loculated in the left major fissure. Patchy opacities in the lung bases may reflect atelectasis, but infection cannot be excluded. There is no pneumothorax. No acute osseous abnormalities demonstrated.
history of abdominal distention and hypoxia.
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Portable upright chest radiograph. Moderate to large right and small left pleural effusions are unchanged from <num> day prior, increased from <unk>. Aside from accompanying atelectasis, the lungs are clear without pneumothorax. The heart and mediastinal contours as well as postsurgical changes are unchanged.
right-sided effusion and increasing shortness of breath.
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The heart continues to be enlarged, and there are bibasilar reticular markings compatible with stated clinical history of nsip. Pulmonary arteries are enlarged bilaterally, consistent with provided history of pulmonary hypertension. There is no focal consolidation, pulmonary edema or pleural effusions.
<unk> year old man with presumed nsip, systolic heart failure, with hypoxemia, group ii pulmonary hypertension. mildly worsening exertional hypoxemia, no fever or cough.
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Right-sided port-a-cath terminates at the cavoatrial junction. There is mild elevation of the right hemidiaphragm. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
<unk> year old man with c/o increased weakness // ? pna
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Compared to the prior exam, there is no significant interval change. The continues to be volume loss in both bases.
status post cabg, question atelectasis.
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There is little change in comparison to prior study. Mild bibasilar atelectatic changes are visualized but the lungs are without a focal consolidation. Evidence of prior surgical procedure is again noted with right posterior rib resection, left proximal clavicle resection, and multiple mediastinal clips associated with the patient's colonic interposition graft. Elevation of the left hemidiaphragm persists. The cardiomediastinal silhouette remains stable.
evaluation of patient with wheezing and shortness of breath.