Comparison made with previous CT chest abdomen pelvis from the 30th March 2018 and 10 August 2015. Previous right upper lobectomy for adenocarcinoma noted. Good opacification of the pulmonary arteries with no pulmonary emboli seen. Longstanding pulmonary trunk dilatation. The previously seen left upper lobe has increased in size is now encapsulated with a mass like consolidation and lingula lobe collapse. The bronchus leading into this is opacified with soft tissue material. Partial resolution of the previously present right middle lobe consolidation. There is an increase in size of the right middle lobe(previous 17mm now 21 mm) and lower lobe(previous 7mm now 11 mm) nodules. There is right perihilar adenopathy. However, there is no significant mediastinal adenopathy. Given the phase of contrast, imaged upper abdominal viscera are unremarkable. Mild degenerative OA in mid thoracic spine. No destructive bone lesion.

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atelectasis comparison consolidation normal paratracheal_hilar_enlargement parenchymal_lesion


HR was 95 bpm, was 85 bpm after 20 mg IV metoprolol. Satisfactory quality images were obtained. Unfortunately, he was unable to abduct his shoulders (pain), there is significant beam hardening artefact, particularly at the level of the diaphragm/distal RCA. 1. Patent LIMA to LAD. 2. Very good calibre patent SVG to OM. 3. Very good calibre SVG to RCA, the apparent filling defect in the very distal graft to the RCA is likely due to beam hardening artefact from the right elbow. Good opacification in the distal RCA distal to the anastomosis. RIMA is not harvested and is in its native position. Small pockets of anterior mediastinal air are expected post surgical findings (2 days post op). Mild atelectasis at both lung bases with tiny right basal pleural effusion. Tiny left apical pneumothorax with left apical atelectasis. All the chest drains and central lines have been removed. The lungs are clear with good lung expansion.

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atelectasis comparison normal other pleural_effusion pneumothorax


There is extensive mediastinal and hilar adenopathy noted. Bilateral supraclavicular nodes are within normal limits by size criteria. The nodes do not demonstrate necrosis or calcification. There is generalised bronchial wall thickening with interlobular septal thickening predominantly affecting the right lower lobe. There is associated nodularity present in the right lung. Subpleural reticulation predominantly in both the lower lobes especially on the anterior aspect. No pericardial or pleural effusion. Imaged upper abdominal viscera is unremarkable. Minimal degenerative change in the spine noted.

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Minor left upper zone nodularity/scarring. Remaining lungs are clear. Features have improved since previous. Hilar lymphadenopathy is once again noted, but again this has improved since previous.

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No filling defects are seen along the pulmonary arterial tree. Minimal amount of bilateral pleural effusion, more on the left side associated with small bibasal subsegmnetal atelectasis. Pericardial effusion is noted measuring 0.9cm in thickness (100-250ml in. volume). Left sided central venous line seen in situ. No enlarged mediastinal or hilar lymph nodes. Hepatomegaly. Otherwise limited scans through the upper abdomen are unremarkable.

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AP erect. Comparison is made with the previous chest xray from 31.5.14. There is patchy consolidation in the right lung base. Background chronic lung changes. No signs of overt heart failure. The right CP angle is slightly blunted which could be due to a small amount of pleural effusion or pleural thickening. The left CP angle is clear.

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CT Abdomen. No previous imaging for comparison, were scans performed at an external institution?. Recent surgery noted. Haematoma surrounding the aortic root. There is a persistant dissection extending from the descending thoracic aorta to the right internal and external iliac arteries. The dissection flap extends into the proximal coeliac artery and SMA, but the distal vessels are patent and opacified. The false lumen supplies the left renal and inferior mesenteric arteries, these opacify on the delayed phase. Left sided femoral line in situ, with tip in the distal IVC. Arch vessels are opacified. Endotracheal tube in situ. No central PE. No enlarged hilar or mediastinal lymph nodes. There are bilateral pleural effusions and lower lobe collapse. The right main pulmonary artery is ectatic at 3.1 cm. Calcification in the left main stem, but the coronary arteries appear patent. Right dominant circulation. Midline sternotomy wires noted. Small pericardial effusion. Nasogastric tube tip in the stomach. Multiple low attenuation cysts in the liver, the liver appears to have an irregular outline. Portal vein is patent, as are the hepatic veins and hepatic artery. Multiple cysts and non-obstructing calculi in the right kidney. There is a 2.4 cm calculus at the left renal pelvis, and a further 7 mm calculus in the lower pole of the left kidney. Neither is causing obstruction. The gallbladder, pancreas, spleen, and both adrenals are normal in appearance. Subcutaenous oedema noted. The unprepared small and large bowel appear normal. No obstruction, free fluid or enlarged abdominal or pelvic nodes. Degenerative changes in the spine, but no destructive bone lesion.

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The chest radiographs reported together with the recent dated 25 70. There is a moderate loculated right pleural effusion and a small residual apical pneumothorax. Multiple old right rib fractures again noted. Volume loss in the right hemithorax in keeping with previous lobectomy. The left lung has hyperinflated to compensate and appears clear. Heart size cannot be accurately assessed. No significant interval change since previous chest radiographs. Empty placeholder value or index.

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there is a mass lesion projected over the left hilum extending upwards and medially. The appearance suggestive of an underlying NHL until proven otherwise, the lung fields appear clear. Heart size normal, referral for at the oncologists opinion for further assessment.And management. Lateral soft tissue of the neck no significant abnormality seen. No pressure on their right passage seen. Fax report please to GP.

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AN ADDENDUM HAS BEEN ENTERED AT THE END OF THIS REPORT heart size appears enlarged, upper lobe blood vessel diversion noted. The lungs appear clear , this in keeping with raised made venous pressure. OA changes noted in the left shoulder joint. ADDENDUM START Reviewed with DR [REDACTED] clinical suspicion of TB ?? Miliary features There are multiple miliary masses consistent with TB taken in the context of a high clinical suspicion

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sternal wires seen in situ. Lung fields show mild congestive changes. CT ratio 14/27


Diffuse calcification mainly in the upper lungs in keeping with old TB but unfortunately in addition some soft tissue nodulation are seen, raising possibility of reactive tuberculosis, which is particularly suspected with the given history. Further follow-up is recommended The CP angles are clear blunted. Heart size and cardio mediastinal contour is normal. incidentally also, there is hiatus hernia with a fluid level.

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Compared to the previous chest x-ray of 19 September 2007, the lung metastases have increased in size, particularly on the left. Left hilar lymphadenopathy is also present.No evidence of major collapse or consolidation. carcinoma rectum. Lung metastasis.

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even allowing for the oblique projection, the heart is enlarged and there is some aortic unfolding. The is evidence of left ventricular failure. No major collapse or consolidation seen

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Rotated AP supine examination. Comparison made to the prior study of Sept 2012. Very large hiatus hernia noted behind the heart. Impression of pulmonary oedema preferentially affecting the right lung - the appearances may be due to patient positioning or severe mitral regurgitation. Prominent pulmonary vasculature in keeping with cardiac impairment. Pacemaker in situ with lead and body position unchanged since the prior study.

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The heart is not enlarged. There is marked flattening the left hemidiaphragm. There are emphysematous changes are on the left. There is also some scarring noted in the left lower lobe.The inferior aspect of the left hilum is also a little bit more rounded in shape. I suspect it is distorted due to an abnormality in the lung parenchyma. I suggest this patient have a CT of chest with contrast.

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Contacted by Dr [REDACTED] to request formal report. AP portable semi-erect radiograph. Rotated, underinflated. Comparison is made with previous chest x-ray 18/04/2017. No pneumothorax. No definite rib fractures, however given clinical history occult fractures are likely. No lobar collapse or consolidation. Some pulmonary congestion. ECG electrodes / Nasal oxygen tubing noted. Please note this is a sub-optimal investigation for assessment of rib fractures. If the patient is sufficiently well please consider departmental x-ray or CT.

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comparison consolidation normal object other recommendation technical_issue


Comparison has been made with the previous chest x-ray dated 25/01/2010. Deformity of the right lower ribs suggestive of previous trauma/surgery. There is pleural thickening in the right costophrenic region which also appears to be longstanding. The lungs appear emphysematous. No major collapse or consolidation in the left lung. Cardiothoracic ratio is 55%- in keeping with borderline cardiomegaly. A slight scoliosis of the upper thoracic spine, convex to the right.

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No lung lesion seen. The mediastinum appears widened. The right hemidiaphragm also appears elevated. CT scan of the thorax suggested to rule out any mediastinal abnormality/lesion.

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No pleural effusion. In the right upper lobe one/two tiny nodules and chronic scarring remained. Lung fields are otherwise clear. The size of the heart is normal.

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The heart is clearly enlarged. Mitral valve replacement noted. Previous median sternotomy noted. There is generalised pulmonary plethora with upper lobe blood diversion seen. There is also some increased ground glass shadowing in both lower zones, these changes are in keeping with cardiac failure.

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No previous x-ray available for comparison. There is suggestion of slight increased opacity in the right lower zone? Long standing inactive lesion. Normal heart size. There is a small hiatus hernia. A follow up x-ray in 3-4 weeks time suggested.

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comparison consolidation hernia normal recommendation


There is evidence of bronchiectasis in the right lung and probably also left base. Compared with the previous x-ray, there is suggestion of some loss of right lung volume probably due to lung fibrosis.There is suggestion of slight increased opacity in the right mid zone which could be due to acute infection. No other significant change seen.

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pretty clear. Right tonsillar Ca from 2012. ? Pneumonia. ? Left upper chest emphysema. Bilateral extensive surgical emphysema seen in the soft tissue of the chest wall and neck. No definite pneumothorax is identified on this images. Multiple calcified longstanding lesions seen in both lungs.

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Normal sized heart. Both lung fields show multiple metastatic deposits of varying size. Some blunting of the right costophrenic angle. Deviation of the trachea towards the left side with soft tissue density on the right which could be from the thyroid enlargement. There are cysts of the right 1st rib could be due to bony metastasis. Some elevation of the right hemidiaphragm.

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Mild pulmonary venous congestion. Fluid in the horizontal fissure but no pleural effusion. Old fracture of the right clavicular head and right 2nd rib. The is an opacity projected over right blade of the scapula. Is there a history of prostate cancer? Bone scan is advised if there is concern. Ward team notified.

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The right hemithorax is almost completely opaque presumably due to large pleural effusion and a? collapse/ consolidation of the right lung. Left lung is clear. Hiatus hernia is seen.

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atelectasis consolidation hernia normal pleural_effusion


There has been no appreciable change seen in the nonspecific linear opacity/thickening of the original fissure in the right lung. The hila and mediastinum appear normal. No pleural effusion seen. If the patient is no longer symptomatic, then no further x-ray chest is required.

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comparison consolidation normal other pleural_abnormality


There is a degenerative scoliosis. No rib fractures, pleural effusions or pneumothoraces identified. No major focal collapse or consolidation. XR Lumbar Spine and S.I. Joints : Degenerative scoliosis and osteopaenia noted. No acute fracture seen. Calcification noted in the abdominal aorta with no aneurysmal dilatation.

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Reference made to most recent chest x-ray of 30/3/17. The heart is enlarged (CTR 16:24). There is evidence of splaying of the carina, which could be in keeping with an enlarged left atrium. Additionally, there is perihilar opacification, suggestive of an acute cardiac failure. Bilateral pulmonary congestion and upper lobe venous diversion. Super-added infection is difficult to exclude, please correlate with inflammatory markers. No pneumothorax. No pleural effusions.

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cardiomegaly comparison consolidation normal possible_diagnosis recommendation upper_lobe_blood_diversion


Reference made to CT PA on 23/09/2016. Dual chamber pacemaker is noted. There is upper lobe diversion and possible left pleural effusion, suggestive of heart failure. There is moderate to severe cardiomegaly. There is opacification in the right mid and lower zone with gas within, in keeping with a large hiatus hernia which was seen on the previous CTPA. There is ateletasis in the right mid zone. No major collapse or consolidation.

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atelectasis cardiomegaly comparison hernia normal object pleural_effusion possible_diagnosis upper_lobe_blood_diversion


There is a radiolucent abnormality with sclerotic margin seen in the mediastinum at the level of the carina. I am not quite sure whether this is a large oesophageal diverticulum or a fatty lump. The mediastinum however is not widened. The lung fields are clear. Normal heart size. A CT scan of the thorax is suggested for further evaluation. Reports faxed to GP

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A nonhomogeneous opacity is seen in the left mid and lower zone presumably due to pleural effusion and? Collapse consolidation of the lung. Right costophrenic angle is also blunted presumably due to pleural reaction.

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The previous right middle lobectomy is noted with abrupt cut off of the right middle lobe pulmonary artery- likely due to previous surgery.Previous sternotomy noted. A trace pericardial effusion is present. There is narrowing of the right lower lobe pulmonary artery (see series two image 206). This is suspicious of a chronic pulmonary embolus. No acute pulmonary emboli have been identified. There is a small to moderate right pleural effusion with possible loculation. Impression Previous right middle lobectomy noted with areas of atelectasis/patchy consolidation in the right lung. A small to moderate loculated pleural effusion is noted on the right. Significant narrowing of the right lower lobe subsegmental pulmonary artery with marked thickening of the walls (series two image 213). This is suspicious of a chronic pulmonary embolus. No acute pulmonary emboli have been identified.

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cardiomegaly normal object pleural_effusion


AP semi erect examination with poor inspiration. Comparison made to the prior study of July 2014. Prominent right mediastinal border is longstanding and secondary to an ectatic ascending aorta. Perihilar congestion and prominent pulmonary vascular markings imply a degree of cardiac impairment. No convincing consolidation. Old untreated fractures of both proximal humeri and healed left rib fractures also noted. These were present on CT in 2014.

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The lungs are congested. There is some atelectasis at the lung bases. The heart is enlarged. Features are of heart failure. Unfolding of the calcified aortic arch is noted. Marked arthropathy of both shoulders. The visible ribs appear intact.

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Heart is probably enlarged. There is an element of pulmonary congestion associated with bilateral pleural reactions. No major collapse or consolidation seen.

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Hyper expanded left lung in keeping with emphysematous change. Much of the consolidation in the lower aspect of the right lung has cleared. There is however now a thick band of linear scarring/atelectasis seen just above the right costophrenic angle. Normal shaped cardiac contour.

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atelectasis comparison consolidation emphysema hyperexpanded_lungs normal


There is moderate to marked scoliosis associated with marked degenerative change and narrowing of disc spaces seen from L1-S1. No definite osteoporotic collapse were wedging seen. Multiple gallstones are noted. No lung lesion seen. Normal heart size.

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XR Pelvis Comparison is made to XR Pelvis 24/02/14 Clothing artefacts are projected over the left side of the radiograph. Mild degenerative change is noted in both hip joints. No acute bony injury seen. XR Lumbar spine and sacroiliac joint There is marked loss of vertebral disc space height at L4/5 and L5/S1, which is unchanged from the previous pelvic x-ray performed on 24/02/14. Normal vertebral body alignment is maintained. No acute bony injury seen. Vascular calcification of the aorta is noted. XR Chest AP supine view. Comparison is made to XR Chest 05/01/17. Unchanged bilateral reticular shadowing is noted in keeping with emphysema. No definite major collapse or consolidation. There is a tiny right sided pleural effusion. A left healing posterior 8th rib fracture is noted. No pneumothorax seen.

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There is collapse of the baseof the of the left lung. Elsewhere the lungs are grossly normal. New line no free air seen below the diaphragm. 20913115 10/11/2014 XR Abdomen The entire abdomen is not covered on this examination. In the visualised abdomen there is no evidence of any free air. The single small metallic clip is noted overlying the left transverse process at L1 which is of uncertain significance. Large bowel ais loaded with faeces with no specific features to suggest bowel obstruction. Please correlate clinically.

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consolidation normal object recommendation volume_loss


Almost complete opacification of right lung. The left lung is normal. ET tube in this just above the carina.


Cardio-thoracic ratio 21/35. Heart is enlarged. There is some pulmonary venous congestion. Lung fields are clear. The appearances are consistent with cardiac failure. Cardiac or opinion advised.

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There is collapse of the left upper lobe, with a large hila mass. There is thickening and inflammatory change seen along the basal bronchi of the left lower lobe. The lungs are otherwise clear. There is evidence of hyperexpansion of the right lung. No bony destructive changes seen. A fast track appointment has been made of this patient.

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AN ADDENDUM HAS BEEN ENTERED AT THE END OF THIS REPORT Cardiothoracic ratio 18.5/38. Normal size heart. Mitral lung lesion seen. There is hyperinflation of the lung fields. Little peribronchial thickening seen in the lower zones could be that the bronchitis. No change since April 2012. ADDENDUM START

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Cardiothoracic ratio 20/02/33. Heart is enlarged. Possible underlying pericardial effusion needs to be excluded. There is some pulmonary venous congestion.


Supine view. Right upper lobe fibrosis is longstanding. No active focal lung lesion. There is unfolding of the aortic arch. Old, healed fracture of the left humeral neck is noted.

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Supine view. There is mild pulmonary venous congestion. No major consolidation or collapse. There is left sided pleural reaction/small effusion. Even allowing for the projection, the heart appears enlarged. The visible ribs appear intact.

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There is cardiomegally. There is apparent elevation of the right hemidiaphragm, which could either be due to collapse and/or consolidation of the right lower lobe or pleural effusion or both,. There is thickening of the transverse fissure, which is slightly elevated towers and mediastinum suggestive of an element of collapse. The left lung remains clear.

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atelectasis cardiomegaly comparison normal


Heart is slightly enlarged. There is suggestion of mild pulmonary congestion. Small right sided pleural effusion is seen. Slight increased opacity is seen in the right paracardiac region - infection. No free air seen under the diaphragm.

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Ap, erect film. Patient is rotated. There is widespread interstitial shadowing with volume loss in both lungs consistent with fibrotic change. Severe degenerative changes seen in the left shoulder joint. The changes are so severe that concurrent consolidation cannot be excluded particularly in the left base. Previous CT scan is show evidence of asbestosis exposure with pleural plaques and widespread fibrotic change.

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There is a small pneumothorax on the left side (left lower zone). There may be partial collapse of left lower lobe. Fibrotic lesion seen in the left upper zone as before.

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Patient has dextrocardia. There is fusion of two posterior 5th and 6th ribs on the left. These are unchanged. No features to suggest heart failure / collapse or consolidation. There does appear to be a break in the cortex of the left clavicle but clinical correlation is advised and some dedicated left clavicular views may be appropriate.

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There is globular enlargement of the heart in association with a left sided pleural effusion. XR Lumbar Spine and S.I. Joints : There is moderate to severe degenerative change in the lumbar spine in association with a scoliosis which is convex to the right. Large, calcified abdominal aortic aneurysm noted anteriorly. No fracture is demonstrated. However, if there is clinical suspicion of one, CT of the area may help clarify. Poor lateral view. The alignment of the thoracic spine is maintained. No fracture is demonstrated.

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cardiothoracic ratio 14.7/28. Heart is not enlarged. There is some pulmonary venous congetion. Little blunting of both costophrenic angles and thickening of the right horizontal fissure consistent with cardiac failure under treatment. No consolidation seen.

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Normal sized Heart. Lung fields and show a 1.6 cm round density to the left of 11 dorsal vertebra posterior to the heart. There are no previous chest x-rays to compare. However the previous barium swallow dated August 2010 did not reveal this density There is old and healed fracture left eighth rib. But is probably nonspecific. However further assessment with CT scan of the chest and liver are advised.

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comparison is made with previous chest x-ray dated 09/02/2012. AP erect study. The lungs are clear with no focal consolidation, collapse or pneumothorax. Cardio-mediastinal contours within normal limits. No free gas under diaphragm. Degenerative changes seen within both gleno-humeral joints. Old right posterior 5th rib fracture noted. 20388391 20/01/2014 XR Abdomen comparison with previous pelvic x-ray dated 10/04/2012. Left DHS in situ, longstanding right neck of femur fracture seen but no acute changes. The right femur has migrated superiorly. Nonspecific bowel gas pattern. No evidence of obstruction or pneumo-peritoneum. 1.5cm calcified rounded opacity within pelvis remains unchanged. Degenerative changes of lumbar spine, most prominent at lumbo-sacral junction.

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The heart is enlarged CTR 15/22. The patient has had mitral and aortic valve replacements in the past. No adenopathy There is some upper lobe diversion but no frank pulmonary oedema Suggestion of a hiatus hernia behind the heart.

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cardiomegaly hernia normal object upper_lobe_blood_diversion


The right apical chest drain which was seen insitu and film of 5/12/07, is no longer seen. There is a moderate size Hydro pneumothorax on the right, it has not changed in size since the last radiograph. The small pleural reaction is noted on the left, this has been present on all previous films and may represent scarring.

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Cardiac thoracic ratio 19/27. Heart is markedly enlarged. There is upper lobe venous condition. There is a permanent pacemaker with pacing wires in situ. There are long-standing bilateral pleural plaques with calcification. Increased lung markings seen in the left base with peribronchial thickening consistent with previously noted bronchiectasis. Rest of the lung fields are otherwise clear.

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discussed previous chest xr with radiologist who consider there to be a right sided pleural effusion but need a PA film to comment fully patient remains short of breath The heart is enlarged CTR 13.3 /27. There is widening of the carina. there is a degree of pulmonary plethora. There are bibasal changes noted due in part to small effusions. There is a small focal area of consolidation seen in the left mid zone. While there is a degree of cardiac overload, there is now evidence fo inflammatory change in the left mid-zone.

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atelectasis cardiomegaly emphysema hernia object pleural_effusion

Cardiothoracic ratio 12/21. The heart is slightly enlarged. There is a large hiatus hernia. No active lung lesion seen. There is dorsal kyphosis with vertebroplasties of the mid dorsal vertebrae and the lower dorsal vertebra. No obvious signs of neoplasm. No obvious or signs of COPD. Review of the previous her CT PA in 2010 shows a mild bronchiectatic changes in the left base. If the symptoms persist or if there is further clinical concern a spiral HRCT can be done for further assessment.

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cardiomegaly comparison hernia normal object recommendation


CXR PA View There is no previous chest x-ray to compare. Linear band is noted in the left mid zone with an area of benign appearing calcification adjacent to it. This is long-standing change and most likely represent a small area of pleural calcification and a chronic fibrotic band within the lungs. The lungs are hyperexpanded but otherwise clear. No cardiomegaly seen.

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heart is enlarged. There is some pulmonary venous congestion. No signs of pulmonary oedema. The lung fields are otherwise clear.


There is spondylotic change associated with narrowing of disc spaces from C4 to C7. Heart is enlarged. There is mild pulmonary congestion associated with bilateral pleural reaction. No major collapse or consolidation seen. NAD.

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Hyperexpanded lungs, suggesting emphysema. Upper lobar pulmonary veins are prominent. Minimal pleural thickening. Cardiac size appears minimally enlarged. Old healed rib fractures right posterior mid chest.

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XR Tibia/Fibula (Lower Leg) Lt : No evidence of recent skeletal trauma. Vascular calcification. There is extensive calcification in the soft tissue of chest wall and the upper arms, may be myositis ossificans. No major collapse/consolidation. There may be however some inflammatory changes in the right lower lobe.

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PA erect CXR, compared with previous xrays dating back to 6/3/2013. Tiny residual surgical emphysema overlying the left hemithorax. There is residual loculated left basal pneumothorax and a tiny pneumomediastinum, with adjacent emphysematous bullae. Bilateral large volume lungs with scarring in the left upper and midzones. Pleural thickening noted in the right costophrenic angle. Superseded by CT.

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Heart is slightly enlarged. There may be mild pulmonary congestion. No collapse or consolidation seen. A homogeneous opacity seen in the right base probably due to pleural thickening.

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Previous sternotomy. The heart is moderately enlarged. There is mild pulmonary venous congestion, and possible early pulmonary oedema. Small areas of linear collapse in the left lower zone.

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The heart is enlarged. The lungs of plethoric. I think some bilateral airspace shadowing. The most likely explanation is cardiac failure. /

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Heart size normal. Bilateral upper lobe fibrosis and volume loss, and apical calcification. There are other changes in keeping with COPD. No active lung lesion; no change since 2/9/10.

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AP erect slightly rotated CXR, compared with previous x-ray dated 03/11/2011. Severe COPD changes with hyperinflated lungs and pronounced bronchovascular markings. Right mid and lower zone bronchial wall thickening noted with ring shadows suggestive of bronchiectasis. There is partial destruction of the right T7 pedicle - an underlying aggressive pathology should be considered. This exam been superseded by CT and MRI.

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Bilateral pleural effusions are noted more worse on the left. There is basal passive collapse left side. Vague opacity seen in the right lower zone appearances suspicious. Heart is mildly enlarged. Left side mastectomy noted. The appearances could be either infection or even could be secondary to metastasis.

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atelectasis cardiomegaly consolidation object pleural_effusion possible_diagnosis


AP erect radiograph, allowing for the projection the heart appears enlarged. There is upper lobe pulmonary venous blood diversion. There is suboptimal inspiration. Allowing for this there is air space shadowing within the left lower zone, which could represent a focus of consolidation. There is also a right paratracheal and apical opacification which could represent vascular ectasia or a possible soft tissue mass.

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AP erect view. There is mild pulmonary venous congestion with upper lobe blood diversion. Otherwise the lungs and pleural spaces are clear. There is unfolding of the aortic arch. Right shoulder hemiarthroplasty is in situ.

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No major collapse or consolidation seen. The left costophrenic angle is blunted which could be due to pleural reaction. The heart is not enlarged. However there is suggestion of mild pulmonary congestion. Prominent pulmonary vessels seen on the right side as before.

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AP erect view. Dual chamber pacemaker with intact leads is in situ. Sternotomy wires are noted. There is pulmonary venous congestion and cardiomegaly. No consolidation. Features are consistent with cardiac impairment.

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The heart remains enlarged with congestive changes in the lungs. No focal lesion. Follow-up advised. CHEST

cardiomegaly interstitial_shadowing normal other recommendation


(AP) The right pleural drain has been removed. There is a small persisting right pleural fluid collection and collapse/consolidation in the mid and lower zone, essentially unchanged from 6/5/12. The left lung remains clear.

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comparison consolidation normal other pleural_effusion


Supine view. Surgical clips are noted in the right axilla consistent with previous breast surgery and axillary node clearance. The heart is probably enlarged and the lungs appear congested. No active focal lung lesion. No change since previous CXRs dating back to 21/08/06.

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cardiomegaly comparison interstitial_shadowing normal object


Comparison is made the previous dated 11/03/2015. The lungs are clear. Despite projection the heart appears enlarged. Vascular calcification noted. Otherwise cardiomediastinal contour is normal. Degenerative change in the spine with scoliosis of the mid to lower thoracic region convex to the left.

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aortic_calcification cardiomegaly comparison normal scoliosis


As compared to 01/11/11 there is some improvement in the bilateral perihilar infiltrations. The outline of the left hemidiaphragm is not clear and there is slight blunting of the left costophrenic angle and this is new since previous examination. This could be due to underlying pleural thickening. There is depressed sternum.

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Normal sized heart. As compared to 08/08/15 there is significant reduction in the left mid zone consolidation. There is however still some residual consolidation.Little fibrotic changes seen in the right apex. Rest of the lung fields are clear. No new lesions The time interval between the scan is short. Further follow up chest x-ray can be done in about 6 weeks time.

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apical_fibrosis comparison consolidation normal other recommendation


COPD with inflammatory changes in the left lingular with pleural reaction. There may be an element of LVF. CHEST


There is evidence of cardiomegaly with a predominant left ventricular configuration despite the film was taken in an AP position. Prominent broncho-vascular pulmonary markings are identified suggesting COPD. Hazy shadow is identified in the left lower zone. Chest infection cannot be excluded and a follow up chest x-ray following antibiotic therapy is advisable. ETT and CVP line are identified in situ.

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cardiomegaly consolidation emphysema hyperexpanded_lungs object possible_diagnosis recommendation


No previous x-ray available for comparison. Abnormal opacity seen in the right upper zone. There is suggestion of multiple small cavities in the opacity. This is most likely T.B. lesions. However I'm not quite sure whether the lesion is active or inactive. There is also an opacity seen in the right cardiophrenic region which could be due to consolidation. There is also evidence of chronic lung changes bilaterally. Well established COPD is seen. CHEST

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AP erect rotated radiograph. Moderate left sided pleural effusion similar to previous chest x-ray dated 19/07/13. A small region of right lower zone airspace shadowing is unchanged since previous imaging. Dilated gas filled and neo-oesophagus in the left mediastinum, I note this patient has had a gastrectomy. EVAR graft noted in the epigastrium. Patient deceased at time of reporting.

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comparison consolidation hernia object other pleural_effusion technical_issue


Pigtail drain noted in the right pleural cavity. The right lung is otherwise clear, apart from some scarring the apex. There is inflammatory change seen in the left lower lobe.

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Comparison is made to the previous film performed on 12/02/14. There is evidence of previous thoracotomy, right sided volume loss and a right pleural effusion. There is a small amount of gas seen within the right pleural collection. No focal lesion on the left side.

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Heart is slightly enlarged. There is a degree of pulmonary congestion. Both costophrenic angles are blunted presumably due to pleural reaction. No major collapse or consolidation seen.

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There is generalised degenerative change. No osteoporotic collapse seen. There is a small linear atelectasis in the left base. Rest of the lung fields appear clear. Heart is enlarged. There is no CCF. No collapse or consolidation seen.

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No previous x-ray chest available for comparison. There is a homogeneous opacity in the right apex associated with some reduction in the right lung volume. There is also blunting of the right costophrenic angle - ? pleural effusion, ? pleural reaction, ? pleural thickening. The nature of the opacity in the right apex is not clear. CT scan of the chest is suggested to rule out neoplasm. The left lung is clear. CHEST

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Hyperexpanded lungs. There is a region of further linear atelectasis/scarring in the right base. The lungs are otherwise clear. No significant abnormality identified on the lateral radiograph of the sternum. There is an apparent soft tissue mass and the lower mediastinum, I suspect this represents hiatus hernia. However in view the history of sternal pain, I suggest this patient has a CT of the chest and upper abdomen.

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atelectasis hernia hyperexpanded_lungs normal recommendation


an obstructing right hilar mass in causing right lower and middle lobe collapse.a moderate right pleural effusion is present. further solid nodules suggestive of metastasis are seen in both hemi Thoraces. no significant change since the previous chest film. no free air abdominal pain. vomiting with constipation non-specific bowel gas pattern present.no evidence of perforation or obstruction

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AN ADDENDUM HAS BEEN ENTERED AT THE END OF THIS REPORT Normal sized heart. Left upper lobe shows a 3.1 cm mass close to the aortic knuckle. The left hemidiaphragm is slightly higher than normal. Few tiny calcified opacity seen in the right apex. There is fracture of left fourth rib towards the axilla. The rest of the lung fields are otherwise clear.

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There is minor thoracic scoliosis and severe degenerative change of the thoracic spine, with multiple bridging osteophytes. There is heavy calcification of the aortic arch. Heart is not enlarged (CTR 13/28). Lungs and pleural spaces are clear.

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Single chamber pacemaker with intact lead. There is pulmonary venous congestion. No consolidation or collapse. The pleural spaces are clear. The heart is mildly enlarged.

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cardiomegaly interstitial_shadowing normal object


AP semi-erect view. There is mild pulmonary venous congestion. No consolidation or collapse. Normal mediastinum. Small hiatus hernia is noted.


Semi-erect AP view. Comparison is made with the CXR from 31t October 2012. Poor inspiratory effort. Despite being an AP view, the heart is enlarged. Chronically enlarged pulmonary arteries. No focal collapse/consolidation. No active focal lung lesion. No pneumothorax. No pleural effusion. No destructive bony lesion.

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No previous imaging for comparison. The heart is not enlarged. There is some subtle left sided pleural thickening with parenchymal bands and parenchymal distortion on the left. Right lung is clear.

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Reported by [REDACTED] [REDACTED] by Dr [REDACTED] for the colorectal MDM 24/3/2010 A subsequent examination of 23/3/2010 shows a normal left lung hilum, and opacities projected over both upper zones are due to some sclerosis in the anterior ends of the first ribs. End of review The Left hilum is enlarged, there is opacity in the left upper zone suggestive of either infection or pulmonary metatastic lesion. Heart size normal. The nipple shadow noted in the lower zones bilaterally

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Comparison is made with the previous CXR dated 23/03/2018 At the site of previously demonstrated right upper lobe consolidation, there is now evidence of scarring and parenchymal distortion. Some lucency in this area could represent a pneumatocoele/residual cavity but could also represent an area of air trapping. Another area of scarring the left upper zone laterally corresponds with the previous left upper lobe cavitating consolidation. There are also signs of underlying emphysema. Heart size normal. Pleural spaces are clear.

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Slightly rotated AP semi-erect view. There is pulmonary venous congestion with mild cardiomegaly. There is perihilar peribronchial cuffing. There is thickening of the horizontal fissure, possibly due to a trace of right pleural fluid. Features are suggestive of mild heart failure. Distended bowel loops noted under splinted hemidiaphragms. No pneumoperitoneum.

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PA view. Suture marks in the left upper lobe consistent with previous resection. Associated upper lobe mild linear scarring and tenting of the left hemidiaphragm. There is some volume loss of the left hemithorax. The lungs and pleural spaces are otherwise clear. No pneumothorax. Normal heart size.

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Rotated AP erect view. Dual chamber pacemaker with intact leads is in situ. The heart is enlarged. There is pulmonary venous congestion. There is perihilar patchy air space opacity, left more than right. Features are suggestive of cardiac failure with pulmonary oedema. There may be superimposed infection.

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PA view. Comparison is made to previous examinations dated 12/07 and 14/04/2015. Persistent loculated moderate left pleural effusion. Small right pleural effusion also unchanged. There is pulmonary venous congestion with moderate cardiomegaly. Tracheal stent in situ. No change.

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cardiomegaly comparison consolidation object pleural_effusion


Portable rotated AP semi-erect view. There is pulmonary venous congestion with moderate cardiomegaly. There is patchy air space opacity in the left lower zone suggestive of infection on a background of cardiac impairment. Generalised osteopaenia. Moderate degenerative changes of the thoracolumbar spine.

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AP erect view. Sternotomy wires and mediastinal surgical clips are noted. The heart is slightly enlarged. There is mild pulmonary venous congestion. No consolidation or collapse.

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PA erect. Cardiac pacemaker with intact leads is in situ. The heart is slightly enlarged. There is emphysema. There is reticulation in the lung peripheries suggestive of fibrosis. No consolidation or collapse. There is mild pulmonary venous congestion with interstitial oedema. There is bilateral chronic apical pleural thickening, left more than right. No change since previous examination dated 04/08/2015.

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Slightly rotated AP erect view. There is thoracic scoliosis convex to the right. There is pulmonary venous congestion. No consolidation or collapse. The heart appears slightly enlarged. Tortuous descending thoracic aorta.

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Slightly rotated PA view. There is pulmonary venous congestion. No consolidation or collapse. Chronic pleural thickening at the left costophrenic angle noted. The heart is slightly enlarged. No change since previous examination dated 22/11/2015.

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AP supine view. There is pulmonary venous congestion with cardiomegaly. Unfolded and calcified thoracic aorta. Features are in keeping with heart failure. Anterior dislocation of the right shoulder noted. The shoulder was not dislocated on previous chest radiograph dated 19/12/2014. Report e-mailed.

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AP erect view. There is pulmonary venous congestion with upper lobe blood diversion. No consolidation or collapse. The heart is moderately enlarged. There are features of mitral valve disease.

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Portable rotated AP semi-erect. Shallow inspiration. There is bilateral chronic apical pleural thickening. There is pulmonary venous congestion with moderate cardiomegaly. No consolidation or collapse. Features of heart failure are unchanged since previous examination dated 12/12/2015.

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Portable slightly rotated AP semi-erect view. The left costophrenic angle is clipped. Inspiration is shallow. There is pulmonary venous congestion with cardiomegaly. No consolidation or collapse.

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PA view. Shallow inspiration. There is central pulmonary venous congestion. The lungs and pleural spaces are otherwise clear. Normal heart size. Unfolded and calcified thoracic aorta.

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Slightly rotated AP erect view. Shallow inspiration. There is pulmonary venous congestion with cardiomegaly. Unfolded thoracic aorta. Prominent right pericardial fat pad. No consolidation or collapse. No evidence of malignancy.

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PA view. Comparison was made to previous examination dated 31/12/2015. Previously moderate size right pneumothorax has enlarged. There is now almost complete collapse of the right lung. There is mild mediastinal shift to the left. Size reduction of the pneumothorax following aspiration procedure is noted on subsequent chest radiograph. There is a background of emphysema. The heart is enlarged.

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cardiomegaly comparison consolidation emphysema mediastinum_displaced pneumothorax volume_loss


There is reticular shadowing eminating from the superior aspect of the left hilum which is likely to represent fibrosis. There are at least five well-defined nodules also located in the left upper zone which may represent granuloma. Of the lung parenchyma appears inhomogeneous in the left upper zone. I suspect there is a cavity located between of the third and fourth posterior ribs on the left. There is also some fibrotic change in the right apex with a few small nodules. There is evidence of compensatory hyperexpansion of the rest of right lung. Active TB cannot be excluded.

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Comparison is made with the previous chest imaging dated 09/11/2015. Rotated AP erect chest radiograph. Suboptimal inspiration. The left hemidiaphragm is obscured. The mid the recent CT scan, there is a hiatus hernia. This is obscuring view of the left lower zone. Therefore, left consolidation cannot be excluded here. Calcification of the arch of aorta and bronchial tree. Dual chamber pacemaker in situ. The heart size cannot be commented on. No new bony abnormality is evident. Advanced degenerative change in both shoulders.

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Portable slightly rotated AP semi-erect view. The tip of a left internal jugular line is in the SVC. There is no pneumothorax. There is pulmonary venous congestion with cardiomegaly. Unfolded and ectatic thoracic aorta.

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Rotated AP semi-erect view. Large volume emphysematous lungs. There is a right-sided moderate size pneumothorax, up to 5.7 cm deep at the apex. Insertion of intercostal drain noted on subsequent examination several hours later. There is surgical emphysema in the right lateral chest wall. Heavily calcified thoracic aorta.

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Portable AP erect view. Shallow inspiration. There is pulmonary venous congestion with mild cardiomegaly. No change since previous examination dated 10/02/2016.

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cardiomegaly comparison consolidation technical_issue


PA view. Sternotomy wires are noted. The heart is enlarged. Calcified aortic arch. There is pulmonary venous congestion with prominent upper lobe blood diversion and interstitial oedema. No consolidation or collapse. Features of heart failure are unchanged since previous examination dated 07/12/2015.

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PA view. Comparison was made to previous examination dated 13/09/2015. There is persistent pulmonary venous congestion with upper lobe blood diversion. No consolidation or collapse. There is thickening of the horizontal fissure on the right. The heart is slightly enlarged. Unfolded and calcified thoracic aorta. Features are suggestive of mild heart failure.

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PA erect view. There is mild pulmonary venous congestion with cardiomegaly. Bilateral small pleural effusions. Features are suggestive of mild heart failure. Air space opacity in the left lower zone may indicate infection or pulmonary oedema. Longstanding widening of the superior mediastinum due to lymphadenopathy as confirmed on previous CT study dated 10/04/2015.

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Slightly rotated AP supine view. Shallow inspiration. There is pulmonary venous congestion with cardiomegaly. No consolidation or collapse. Unfolded and ectatic thoracic aorta.

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AP supine view. There is pulmonary venous congestion with cardiomegaly. No consolidation or collapse. Marked thoracic scoliosis convex to the right with associated chest wall deformity.

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AP semi-erect film. There is pulmonary venous congestion and suggestion of a small pleural effusion on the right side. The heart size cannot be accurately assessed.

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No previous imaging available for comparison. Lung volumes are increased in keeping with history of asthma. No collapse or consolidation. No pleural effusion. There is a hemispherical mass in the right paravertebral region which does not have the typical appearance of a pericardial fat pad. No hiatus hernia.

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Midline sternotomy wire sutures are seen. There is mild cardiomegaly, hilar vascular engorgement, upper lobe venous distension suggestive of mild LVF. The right CP angle is shallow presumably due to small pleural effusion.

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AP erect view. Sternotomy wires are noted. The heart is enlarged. Unfolded, ectatic and calcified thoracic aorta. Marked pulmonary venous congestion. There is air space opacity in the right lower zone suggestive of acute infection. Granulomata in the left upper lobe are in keeping with old TB.

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AP erect view. Dual chamber pacemaker with intact leads is in situ. The heart is slightly enlarged. There is air space opacity in the right mid zone within the anterior segment of the right upper lobe. There is pulmonary venous congestion. Features are suggestive of infection on a background of heart failure. No change since previous examination dated 13/04/2016.

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cardiomegaly comparison consolidation interstitial_shadowing object possible_diagnosis


Slightly rotated PA view. Large volume emphysematous lungs with flattened hemidiaphragms are noted. There is chronic linear scarring in the left lower zone. There is chronic pleural thickening at the costophrenic angles. No active focal lung lesion. Normal heart size. Soft tissue density from the chest wall is projected over the lower zones as on the previous examination. No change.

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An opacity in the right cardiophrenic angle is partly related to the rib and overlying vessels and is broadly similar to radiograph from 5 June 2014. Normal mediastinum. There is some trivial linear atelectasis in the left lower zone which is new but of doubtful relevance. No malignant appearing lesion in the lungs nor is there any significant collapse or consolidation. There is slight deformity of 7th lateral right rib which was present before in 2014 and in keeping with a past fracture.

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abnormal_non_clinically_important atelectasis comparison consolidation normal rib_fracture


Slightly rotated PA view. There is pulmonary venous congestion with cardiomegaly. The cardiac silhouette and the lower zones of both lungs are partially obscured by a large hiatus hernia. No consolidation or major collapse. Features are in keeping with heart failure.

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PA view. Dual chamber pacemaker with intact leads is in situ. The heart is slightly enlarged. Tortuous descending thoracic aorta. There is mild pulmonary venous congestion. No active focal lung lesion. Right shoulder prosthesis noted. Several old healed left-sided rib fractures.

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There is gross cardiomegaly. There is pulmonary venous congestion suggestive of a degree of heart failure. No focal consolidation or collapse. No pleural effusion. No paratracheal or hilar lymphadenopathy.

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AP erect film. The heart appears enlarged and the lungs are congested suggestive of a degree of heart failure. Please see subsequent chest x-ray report. The bony erosions on the lateral aspects of the clavicles and on the underside of the left acromion. I note a history of hyperparathyroidism.

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sternal wires seen. CTR is 18/30. Mild congestive changes noted in both lung fields.


PA erect rotated view, compared with recent x-ray of 07/06/2016 and CT from 08/05/2014. Persistent patchy airspace shadowing in the lower zones bilaterally. There is chronic scarring in the right upper zone with some pleural thickening. There is underlying emphysema with the large bulla in the right lower zone. No pleural effusion.

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apical_fibrosis bulla comparison consolidation emphysema normal pleural_abnormality


PA view. Comparison was made to previous chest radiographs dating back to 2012. There is longstanding chronic linear scarring laterally in the left upper zone. Large volume lungs appear emphysematous. Bilateral chronic apical pleural thickening. No active focal lung lesion. Normal heart size. Moderate size hiatus hernia is noted. No interval change.

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The heart is enlarged (CT 0.57). Prominence of upper lobe pulmonary vessels keeping with venous hypertension. Minor blunting of the right costophrenic recess suggests small effusion. Minor bronchial wall thickening/inflammatory changes seen in the left base, projected posterior to the heart.

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The heart is enlarged. There is pulmonary congestion associated with bilateral small pleural effusion. Features would be compatible with CCF. No major collapse or consolidation seen. CHEST

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PA view. The tips of a tunnelled dual-lumen right internal jugular line are adequately sited in the mid and distal SVC. There is pulmonary venous congestion with moderate cardiomegaly. Bilateral small pleural effusions, which have slightly decreased in size since previous examination dated 22/02/2016. Features are in keeping with fluid overload/heart failure. No evidence of infection.

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AP erect film. There is a moderate pleural effusion on the right side and small pleural effusion on the left side. The heart appears enlarged despite projection. There is pulmonary venous congestion. Combined appearances are suggestive of heart failure.

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PA view. Comparison was made to previous examination dated 16/06/2016. There is increasing pulmonary venous congestion with moderate cardiomegaly. There are bilateral pleural effusions, enlarging and moderate in size on the right side, small on the left side. Right intercostal drain has been removed since the previous examination. Features are suggestive of worsening heart failure.

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Rotated AP semi-erect view. Comparison to previous examination dated 10/08/2016. Persistent pulmonary venous congestion with cardiomegaly. Enlarging right pleural effusion, persistent small left pleural effusion. Features are in keeping with worsening heart failure. No pneumoperitoneum. Osteoporotic and degenerative changes of the thoracolumbar spine with scoliosis convex to the right.

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Portable slightly rotated AP erect view. The tip of a nasogastric tube is below the diaphragm, but is beyond the lower limit of the film. There is reticulation in the lung peripheries in keeping with extensive pulmonary fibrosis. No active focal lesion in the visualised lungs. There is pulmonary venous congestion with cardiomegaly. There is non-union of old displaced right proximal humeral fracture.

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AP erect view. There is pulmonary venous congestion with moderate cardiomegaly. Features of heart failure are unchanged since previous examination dated 19/12/2015. No evidence of infective consolidation. Cluster of surgical clips in the right breast again noted.

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cardiomegaly comparison consolidation normal object possible_diagnosis


Slightly rotated AP supine view. The lungs and pleural spaces are clear. The heart is enlarged. Calcified thoracic aorta. Osteoporotic and degenerative changes of the thoracolumbar spine with scoliosis. Old healed right-sided rib fractures.

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AP supine view. There is a haemothorax encircling the left lung. Subsequent intercostal drain insertion noted. The right lung is clear. The cardiac silhouette is enlarged. There may be haemopericardium. Evidence of subsequent thoracic surgery noted.

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AP semi-erect view. Cardiac pacemaker with intact leads is in situ. Sternotomy wires are noted. There is pulmonary venous congestion with cardiomegaly. No active focal lung lesion. There is a fracture of the lateral end of the left clavicle. No pneumothorax or rib fracture is identified. Clavicle fracture also reported on subsequent shoulder radiographs.

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AP view. There is linear atelectasis laterally in the right lower zone, possibly due to infection. There is no major collapse or consolidation. The lungs are congested. The heart is slightly enlarged. Old healed fracture of the right ninth posterolateral rib is noted.

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PA view. There is elevation of the left hemidiaphragm. Pleural thickening or small effusion at the left costophrenic angle. Linear atelectasis in the left lower and mid zones. The right lung is clear. Normal heart size. Old healed right lower lateral rib fracture is noted. Resection of the lateral end of the right clavicle. There is no acute oblique fracture of the left proximal humerus, which was separately x-rayed.

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Rotated AP erect view. There is bilateral chronic apical pleural thickening. There is pulmonary venous congestion with cardiomegaly. No consolidation or collapse. Longstanding thickening of the horizontal fissure. No change since previous PA chest radiograph dated 13/10/2010.

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Portable AP semi-erect view. There is pulmonary venous congestion with cardiomegaly. Unfolded and ectatic thoracic aorta. No focal lung lesion. Several old healed bilateral rib fractures are noted. No interval change.

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AP erect film. Compared to previous film dated 20 September 2016, there is slight reaccumulation of the left pleural effusion. There is a large proximal mass at the left hilum with volume loss in the left lung. Multiple ipsilateral lung nodules are consistent metastases.

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Previous sternotomy wires and valve replacement noted. There is blunting of the left costophrenic angle in keeping with minimal pleural effusion. There is perihilar vascular congestion with increased interstitial shadowing in keeping with pulmonary oedema.

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There is mild cardiomegaly (CT ratio: 0.58) with mild prominence of bilateral perihilar lung markings. Small bilateral pleural effusions (left > right). No consolidation or collapse. There is aortic knuckle calcification.

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PA view. Single chamber pacemaker with intact lead is in situ. Sternotomy wires mediastinal surgical clips noted. The heart is slightly enlarged. There is pulmonary venous congestion with interstitial oedema. Small right pleural effusion. Bilateral perihilar ground-glass opacity. Features are suggestive of heart failure with pulmonary oedema. No interval change.

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Left sided intercostal drain has been removed. The patient is now extubated. There is a little left basal consolidation. Widening of the cardiac silohuette is consistent with post operative haematoma. The right lung and pleural space are clear.

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cardiomegaly comparison consolidation normal possible_diagnosis


There is reticular shadowing in both upper zones with a degree of volume loss in the upper lobes. No pleural effusion or mediastinal adenopathy is identified. No bony changes seen, allowing for healing fractures of the left 9th and 10th ribs laterally. Comparison with 4/6/07. Right upper zone essentially unchanged, but now more confluent opacification in the left apex with an apparent 3.5cm mass. This could represent abscess formation. Clinical correlation +/- further investigation may be required. --

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(Chest pain, known smoker. Previous Ca of throat with radiotherapy ?metastasis or infection): There is a 69mm in height x 48mm in width lesion in the right upper lobe which is pleurally based and cavitating. This could either represent a cavitating metastasis or an area of infection with cavitation. The left lung appears clear. Heart size normal. There is bilateral significant rotator cuff disease with erosion of the undersurface of the left acromion and probably the right acromion. The right shoulder is elevated and not entirely visualised on this radiograph. -

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Moderate cardiomegaly, CTD 14cm. There is ring like calcification behind the left side of the heart which probably lies in the mitral valve annulus. There is a small right sided pleural effusion extending into the oblique fissure. This is most likely to be due to cardiac failure. There is a fracture of one of the left lower ribs. -

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