image_name,path,type,report 11156ad1-31ee4c5f-13902b40-f46d2b49-528dfcd5.jpg,test/p15/p15353344/s56359781/11156ad1-31ee4c5f-13902b40-f46d2b49-528dfcd5.jpg,test," FINAL REPORT HISTORY: ___-year-old female with abdominal pain. COMPARISON: Chest radiograph of ___. FINDINGS: Single frontal view of the chest was obtained. Consolidative retrocardiac opacity has increased since ___. Faint right lower lobe opacity is unchanged. Indistinct left costophrenic angle suggests small pleural effusion. No pneumothorax. The right lung appears clear. Heart size and cardiomediastinal contours are normal. IMPRESSION: Worsening left lower lobe pneumonia. Findings were communicated via phone call by Dr. ___ to Dr. ___ ___ on ___ at ___ PM. " 3200c3b8-02ddb5aa-c67a024a-14a6ebc3-d8f00bfc.jpg,test/p17/p17648769/s54052956/3200c3b8-02ddb5aa-c67a024a-14a6ebc3-d8f00bfc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with septic shock d/t cholangitis, new o2 requirement, received 5L fluids // pulm edema pulm edema COMPARISON: Chest radiographs ___ and ___. IMPRESSION: Moderately severe pulmonary edema, worse in the right lung, has developed since ___. Left lower lobe is poorly aerated, either atelectasis or consolidation due to pneumonia or aspiration, worsened since ___. Small left pleural effusion is larger. Right jugular line ends close to the superior cavoatrial junction. No pneumothorax. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone ___ ___ at 11:08 AM, 1 minutes after discovery of the findings. " 94a47844-d164a04c-db7c5737-ce1a1a5b-49d4fa9a.jpg,test/p13/p13019601/s55820987/94a47844-d164a04c-db7c5737-ce1a1a5b-49d4fa9a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Triscuspid regurgitation, shortness of breath. Portable AP radiograph of the chest was compared to ___. Right internal jugular line tip is at the level of cavoatrial junction. There is still present pulmonary edema, with asymmetric appearance, mostly involving the upper perihilar areas. No interval development of pleural effusion is demonstrated. The radiograph is rotated that might explain left mediastinal shift. Pacemaker leads are unchanged in position. " 91e3a629-bacba9ca-50e50983-d7c9f3f7-600d6357.jpg,test/p16/p16571136/s53044230/91e3a629-bacba9ca-50e50983-d7c9f3f7-600d6357.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with metastatic renal cell carcinoma to lung and airways. Metallic stent in place, evaluate stent placement. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding portable single view chest examination of ___. Heart size is unchanged and the same holds for the appearance of the thoracic aorta. Previously described right-sided perihilar mass, grossly unchanged. Within this density one can identify the metallic structures of the stent, which has been placed in the right-sided main bronchus partially seen to occupy portions of the carina. There is no evidence of any airway obstruction through the stent. There is no evidence of new atelectasis distal to the stent which ventilates the area of the right lower and middle lobes. Comparison of the frontal views; however, suggests new local parenchymal density in the central portion of the right middle lobe as can be identified also on the lateral view. The previously identified increased interstitial markings in the left upper lobe persist and may have increased slightly. They are believed to represent interstitial carcinomatosis. The lateral and posterior pleural sinuses remain free, thus there is no evidence of significant pleural effusion. The on multiple previous examinations identified abnormalities and local pleural thickening in the right axillary area remain grossly unchanged. IMPRESSION: No evidence of main bronchus stent occlusion. Some progression of pulmonary abnormalities is, however, noted. " ffcec589-4ce39168-3ec5153b-07f68a0e-4c9600bc.jpg,test/p16/p16890177/s54553116/ffcec589-4ce39168-3ec5153b-07f68a0e-4c9600bc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with step pneumo meningitis, now fever // Evaluate for pneumonia, aspiration, interval lung change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 3.6 cm above the carinal. Right internal jugular line tip is at the level of lower SVC. NG tube tip is in the stomach. Slight lateral pleural effusions and bibasal atelectasis are unchanged. No pneumothorax is seen. " ec7c6310-07089cd2-ff020d06-dda8213a-c0cd58b8.jpg,test/p14/p14690121/s51467606/ec7c6310-07089cd2-ff020d06-dda8213a-c0cd58b8.jpg,test," FINAL REPORT HISTORY: Chest pain after seizure. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, hilar, and mediastinal contours are within normal limits. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 938fd1b5-0f363d08-20633e92-ad8b0bc7-d2ff0766.jpg,test/p15/p15395644/s52841616/938fd1b5-0f363d08-20633e92-ad8b0bc7-d2ff0766.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with bilateral pneumonia.diagnosed in ___ ___. Patient is status post 12 days of antibiotics. Please assess for status. // Please evaluate for bilateral pneumonia FOLLOW UP BILATERAL PNA COMPARISON: Prior chest radiographs most recently ___. IMPRESSION: Patient has had median sternotomy, coronary bypass grafting, and 3 cardiac valve replacements. Lungs are clear. Previous right fissural pleural fluid collection has resolved and there is no appreciable pleural effusion today. " b038da46-ebc72cbb-838b2198-579d5b76-e4bc5d08.jpg,test/p11/p11607177/s51848964/b038da46-ebc72cbb-838b2198-579d5b76-e4bc5d08.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cardiac surgery- initial dob hoff placement- evaluate for advancement // evaluate dob hoff tube TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there has been interval increasing cardiomegaly and increasing bilateral pleural effusions with pulmonary vascular redistribution and hazy alveolar infiltrate consistent with worsening fluid status. The support devices in lines are unchanged. By the end of this series of 3 images, the Dobbhoff tube tip is seen crossing midline, probably in the distal stomach or proximal duodenum IMPRESSION: Increased CHF " 422a179b-e04d1680-a9411157-63e5f821-b74aa460.jpg,test/p11/p11582633/s57244769/422a179b-e04d1680-a9411157-63e5f821-b74aa460.jpg,test," FINAL REPORT HISTORY: Chest pain TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Normal chest radiograph. " 5049fa2b-56f5d0d6-fd24a6ef-205adfa0-dd3b60e0.jpg,test/p17/p17671146/s56963490/5049fa2b-56f5d0d6-fd24a6ef-205adfa0-dd3b60e0.jpg,test," FINAL REPORT INDICATION: History: ___F with cough, fever // ?pna TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. Compared to the prior chest radiograph of ___ the lung expansion has improved. IMPRESSION: No pneumonia. " dd6b1ddc-d53bc87a-637d183e-978203db-367196ba.jpg,test/p18/p18471732/s58733178/dd6b1ddc-d53bc87a-637d183e-978203db-367196ba.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with persistent cough, hypoxia // ?infiltrate COMPARISON: ___ to through ___ IMPRESSION: Elevation of the right hemidiaphragm, with the colon interposed beneath it, is a long-standing finding, not improved since ___. There is probably a component of diaphragmatic eventration. Lungs are clear. Heart size is normal. There is no edema or pleural effusion. Multiple healed left rib fractures are noted. " 63436223-6bd2b076-35d3adb5-452b32d9-19a85e0f.jpg,test/p16/p16261645/s59513332/63436223-6bd2b076-35d3adb5-452b32d9-19a85e0f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute respiratory failure // interval change interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices essentially unchanged. Continued low lung volumes without definite vascular congestion. The right base is clear on this study. Opacification at the left base is consistent with small effusion and atelectatic changes. " db5612fb-89f866be-e4ec38ad-1185bb9b-a4bb3c4a.jpg,test/p15/p15844438/s54957162/db5612fb-89f866be-e4ec38ad-1185bb9b-a4bb3c4a.jpg,test," FINAL REPORT AP CHEST, 4:34 A.M. ON ___ HISTORY: An ___-year-old woman with shortness of breath, suspect pulmonary edema. IMPRESSION: AP chest compared to ___: Lung volumes remain low, reflected in bibasilar atelectasis, but in the interim, moderate cardiomegaly and mediastinal vascular engorgement have increased. There is no pulmonary edema. Small right pleural effusion is presumed. ET tube in standard placement. Right jugular line ends in the mid-to-low SVC. No pneumothorax. No large pneumoperitoneum, but most of the upper abdomen is radiographically obscured. " 5b2dba4b-a611e67d-ec7b03e4-9e27b218-29bbd9af.jpg,test/p19/p19746124/s50904669/5b2dba4b-a611e67d-ec7b03e4-9e27b218-29bbd9af.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain. Pain on the left and ___ chest. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no pneumothorax. The cardiomediastinal silhouette is normal. No displaced fractures identified. IMPRESSION: No acute cardiopulmonary process. No visualized rib fracture on this nondedicated exam, if desired, a dedicated rib series can be performed. " 64006f70-9901b633-da5f7f11-dd7be8ea-06fc5267.jpg,test/p10/p10556445/s52029164/64006f70-9901b633-da5f7f11-dd7be8ea-06fc5267.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with TB screening, prior positive PPD, BCG vaccination // assess for signs of latent TB PRIOR +PPD ? SIGNS OF LATENT TB IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of cardiac decompensation, intrathoracic malignancy, or active infection, including tuberculosis. " 0298274b-96e8ec43-d286222b-e3567794-1b271116.jpg,test/p18/p18704423/s58752805/0298274b-96e8ec43-d286222b-e3567794-1b271116.jpg,test," FINAL REPORT INDICATION: ___M with S/p fall known subdural // eval for sdh TECHNIQUE: Single portable view of the chest. COMPARISON: Previous exam from earlier the same day at 18:48. FINDINGS: ET tube tip is approximately 4.8 cm from the carina. Low lung volumes are seen. Hazy right basilar opacities may be secondary to atelectasis. Surgical chain sutures project over the right mid lung. Left lung is grossly clear. The cardiomediastinal silhouette is within normal limits. Old healed right lateral rib fractures are noted. IMPRESSION: ET tube 4.8 cm from the carina. " e86e184a-c0b8b917-7c1a2109-bd28395e-00bd5f33.jpg,test/p17/p17135687/s57575205/e86e184a-c0b8b917-7c1a2109-bd28395e-00bd5f33.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LLL pneumonia // ? pneumonia ? pneumonia COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Persistent severe consolidation and volume loss left lower lobe due to extensive pneumonia and concurrent atelectasis, and the inapparent large left lower lobe abscess have been chronic problems. There has been no recent improvement, but she accompanying moderate left pleural effusion is larger. Diffuse alveolitis in the right lung, best seen on chest CT ___, has not improved. Worsening consolidation at the right lung base medially, compared to ___ is concerning for pneumonia. Tracheostomy tube it is slightly is ascue and should be evaluated clinically to make sure it is appropriately supported. Feeding tube ends in the upper stomach. Bullet fragments and casings are unchanged in their relative respective positions. " ed7beca4-d4df3d7c-5161ef13-4fbed48f-a6d66809.jpg,test/p14/p14166592/s59908971/ed7beca4-d4df3d7c-5161ef13-4fbed48f-a6d66809.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, new cough, questionable aspiration. COMPARISON: No comparison available at the time of dictation. FINDINGS: Known post-surgical soft tissue lesion at the level of the right upper lobe, creating a large right perihilar opacity on the chest x-ray (comparison performed to ___ chest CT). Mild atelectasis at the left lung bases. No evidence of recent parenchymal changes, notably no evidence of infection. The atelectatic changes are better appreciated on the lateral than on the frontal radiograph. Low lung volumes. Normal size of the cardiac silhouette. " e22c57e6-24eb8193-e424c6e2-3b7bfeea-5512d0a9.jpg,test/p13/p13829507/s58338994/e22c57e6-24eb8193-e424c6e2-3b7bfeea-5512d0a9.jpg,test," FINAL REPORT HISTORY: Chest pain after repeated vomiting, here to evaluate for evidence of pneumomediastinum or pneumothorax. COMPARISON: No prior studies available. Technique: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. There is no evidence of pneumomediastinum. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " feef650c-8aa998f9-8a59af53-fdfef7d4-4a24a975.jpg,test/p11/p11005665/s52692819/feef650c-8aa998f9-8a59af53-fdfef7d4-4a24a975.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p aortic surgery- mediastinal drain d/c'd // evaluate for pneumothorax TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Post sternotomy wires are unchanged in appearance. Left chest tubes are in place. Vascular stent and a right central venous line are unchanged. Interval decrease in left pleural effusion is noted. Left chest wall fixators are in place as well as the adjacent chest wall swelling and sutures. No pneumothorax is seen. " c8776c8d-d3f7b1d7-001ea3ee-e48a8ca0-c75393ec.jpg,test/p11/p11057136/s53228392/c8776c8d-d3f7b1d7-001ea3ee-e48a8ca0-c75393ec.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient with recent pneumonia, right-sided infiltrates, and hemoptysis. Improved clinically after treatment. Assess for interval resolution. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Heart size, status post bypass surgery and partial sternal resection, remaining sternotomy wire are unchanged. Unchanged appearance of thoracic aorta. No increased pulmonary vascular congestion. Radiographic signs of advanced chronic inflammatory pulmonary disease and emphysema as before. Bullous emphysema in right upper lobe area. The next preceding examination identified acute changes described as two heterogeneous opacities in the right middle lobe area have regressed markedly. The more medially located density that had more the appearance of a pneumonic process has actually resolved. Remaining finding includes a linear atelectasis in the lower border of the right middle lobe, probably representing scar formation. When comparison is extended to examinations dated ___ and ___, similar episodes of acute parenchymal infiltrates in somewhat different location existed already and had regressed. No new pulmonary abnormalities are seen on the present examination. IMPRESSION: Advanced COPD and emphysema. Marked regression of acute infiltrates in right middle lobe area. These infiltrates had also been documented on a chest CT dated ___. " 1482cfb1-7eef3d44-b2398533-84522eab-fd3623b0.jpg,test/p10/p10271316/s57309939/1482cfb1-7eef3d44-b2398533-84522eab-fd3623b0.jpg,test," FINAL REPORT INDICATION: Hypoxia, assess for pneumonia. COMPARISONS: CTA chest of the same date. FINDINGS: Frontal and lateral views of the chest demonstrated marked elevation of the right hemidiaphragm. Right lung base opacities likely represent atelectasis. Left lung is essentially clear. No pleural effusion or pneumothorax is seen. The aorta appears tortuous with calcifications. There is no pulmonary edema. Compression deformity of T4 vertebral body is noted. Vertebroplasty changes involving T11 and L1 vertebral bodies are seen. IMPRESSION: 1. Marked elevation of the right hemidiaphragm of unknown chronicity responsible for right lower lobe collapse. 2. Compression deformity of T4 vertebral body of uncertain chronicity. " 67b35fd5-54459f94-ee41eb08-ed61094f-347ac484.jpg,test/p17/p17470135/s57197753/67b35fd5-54459f94-ee41eb08-ed61094f-347ac484.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with small right lung infiltrate, thought to be ___ aspiration pneumonitis, looking for interval improvement // eval interval change eval interval change IMPRESSION: Compared to chest radiographs since ___ most recently ___ and ___. Heterogeneous opacification in a large volume of the right perihilar lung from the axillary to the basal regions has increased since first appearing on ___. Small region of similar abnormality in the left midlung has developed subsequently and also progressed. Because of the asymmetry, aspiration pneumonia and pulmonary hemorrhage are more likely than pulmonary edema, but I note that cardiomegaly increased substantially between ___ and ___ and is larger subsequently suggesting worsening cardiomyopathy. Acute mitral regurgitation, particularly, can produce asymmetric edema this severe. Small bilateral pleural effusions, stable on the right, surprisingly decreased on the left. No pneumothorax. Transvenous right atrial right ventricular pacer leads continuous from the left pectoral generator. " a48b0d05-e89dcded-86ef7efb-1f6a8e80-d3c057a4.jpg,test/p15/p15297415/s57075988/a48b0d05-e89dcded-86ef7efb-1f6a8e80-d3c057a4.jpg,test," WET READ: ___ ___ 8:22 AM Slightly improved aeration of the right lower lobe. WET READ VERSION #1 ___ ___ 10:52 PM Slightly improved aeration of the right lower lobe. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recent ___ // assess for resolution of effusion IMPRESSION: Following right thoracentesis, a moderate right pleural effusion has decreased in size. A tiny right lateral pneumothorax is evident. Otherwise no relevant changes since the recent study of 1 day earlier. " 0b312029-551dc49a-783847fc-fe74e6f1-c6093a53.jpg,test/p13/p13812958/s50097257/0b312029-551dc49a-783847fc-fe74e6f1-c6093a53.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic pancreatic cancer to liver, presenting with confusion // r/o infiltrates TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: ___ and dating back to ___. FINDINGS: An accessed right pectoral MediPort terminates at the superior cavoatrial junction. There is no pneumothorax. Mild prominence with increased density of the right hilus as compared to ___ may be due to mild pulmonary artery dilatation or lymphadenopathy. A faint nodular opacity projecting at the superior aspect of the left hilus may be a small nodule. Moderate cardiomegaly despite the projection is unchanged. Background parenchymal changes consistent with emphysema are unchanged. IMPRESSION: Nodular opacity at the superior aspect of the left hilus may be pulmonary nodule. Stable emphysema. New mild prominence of the right pulmonary artery may be due to pulmonary arterial dilatation or lymphadenopathy. " ab890ba0-c4537fb3-86a7b1b2-e7718400-644de523.jpg,test/p19/p19229277/s54884976/ab890ba0-c4537fb3-86a7b1b2-e7718400-644de523.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest x-ray INDICATION: ___ year old man with toxic ingestion // Pneumonitis vs. pneumonia TECHNIQUE: AP projection. COMPARISON: Portable AP chest x-ray obtained ___. FINDINGS: The cardio mediastinal silhouettes are unchanged in appearance. There are increased interstitial opacities bilaterally, however, there is an overall poor inspiratory effort and low lung volumes which limits interpretation, as this may simply be due to crowding of normal vascular structures. It is recommended to repeat radiograph with improved inspiratory effort for better visualization of lung parenchyma. There is loss of definition of the right lateral costophrenic angle which is likely due to small right pleural effusion. There are no pneumothoraces. IMPRESSION: 1. Limited study due to poor inspiratory effort and low lung volumes with apparent new interstitial process, likely edema. Recommend repeat radiograph with improved inspiration. 2. Small right pleural effusion. " 117d5cb5-2a2862fc-57d11ce9-7e8061b7-0c972080.jpg,test/p12/p12997545/s56076335/117d5cb5-2a2862fc-57d11ce9-7e8061b7-0c972080.jpg,test," FINAL REPORT INDICATION: History: ___F with cough x6 days // evidence of pneumonia TECHNIQUE: PA and lateral views of the chest COMPARISON: Chest radiographs from ___ and ___ FINDINGS: In comparison to the prior study of ___, there is no substantial change. Severe thoracic scoliosis is again noted and cardiomediastinal silhouette is stable. A 7 mm calcified nodule projecting over the right lower lung is stable dating back to ___, likely a granuloma. There is no focal consolidation, pleural effusion, or pneumothorax. Age indeterminate compression deformities in the lower thoracic spine have progressed since ___. IMPRESSION: No evidence of pneumonia. " 6e39787b-4d139d9e-844a2714-d480497f-159a8ab4.jpg,test/p18/p18656167/s58193495/6e39787b-4d139d9e-844a2714-d480497f-159a8ab4.jpg,test," WET READ: ___ ___ ___ 1:16 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with cough, COPD // Eval for infiltrate TECHNIQUE: Portable semi-upright chest radiographs. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Lungs are well-expanded and clear. Cardiomediastinal air and hilar contours are unremarkable. No pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 57e68ba3-082ee6e5-0fe76208-7eea5ed0-27a2732e.jpg,test/p14/p14068639/s57308652/57e68ba3-082ee6e5-0fe76208-7eea5ed0-27a2732e.jpg,test," FINAL REPORT Heart failure and increasing respiratory distress. CHEST AP. The position of the ICD line remains unchanged. Heart is enlarged. Some mild upper zone re-distribution is present. This was not present on the prior chest x-ray and would be consistent with onset of failure. " 443c2643-cbf9d9a0-f8ddcd0f-c42d56d0-4559f362.jpg,test/p13/p13978368/s59236345/443c2643-cbf9d9a0-f8ddcd0f-c42d56d0-4559f362.jpg,test," FINAL REPORT HISTORY: Right pleural effusion. FINDINGS: In comparison with study of ___, there is little overall change. There is still blunting of the right costophrenic angle with stable perihilar and perifissural opacities on the right and apical opacity on the left. " dba4faf3-dffd4147-6bf4dabd-747fda3b-0e7da9f7.jpg,test/p12/p12797228/s51302237/dba4faf3-dffd4147-6bf4dabd-747fda3b-0e7da9f7.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post intubation. COMPARISONS: None. TECHNIQUE: Chest, AP portable supine. FINDINGS: The patient is intubated. The endotracheal tube terminates approximately 2 cm above the carina. An orogastric tube terminates in the stomach. The upper mediastinal contour is widened and indistinct with no clear visualization of a normal aortic arch contour. There is also pleural thickening at the right apex. The right upper to mid lung shows diffuse opacification with volume loss and there is also left basilar opacity that obscures the left hemidiaphragm. There is no evidence for pleural effusion or pneumothorax. IMPRESSION: Status post endotracheal intubation. Mediastinal contour widening with a capped appearance of the right apex. This appearance is nonspecific but includes the possibility of aortic syndrome or mediastinal mass. CT is recommended to evaluate further on an urgent basis when feasible clinically. Nonspecific patchy right upper and left lower lung opacities. Differential considerations are broad and include atelectasis and pneumonia, which is probably the etiology regarding the right upper lobe opacity. These can also be reassessed with CT. Findings discussed with Dr. ___ at 7:45 p.m. at the time of interpretation by telephone. " cc906f19-e55e823a-ab6439a2-8c6a86e8-4b5dab24.jpg,test/p18/p18341715/s54170447/cc906f19-e55e823a-ab6439a2-8c6a86e8-4b5dab24.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Third degree burns, evaluation. COMPARISON: No comparison available at the time of dictation. FINDINGS: Severe scoliosis with subsequent asymmetry of the rib cage. Normal size of the cardiac silhouette. Normal appearance of the lung parenchyma. No pulmonary edema. No pneumonia. No pneumothorax. " 00fb8413-f4f2815b-e7923904-659bab14-325f2f08.jpg,test/p14/p14152923/s54601736/00fb8413-f4f2815b-e7923904-659bab14-325f2f08.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with stroke. Evaluate for abnormality. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There is mild generalized interstitial abnormality which may represent edema.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. IMPRESSION: Likely mild interstitial edema. " ce6bc473-864aa830-25f637a2-2a8c99c0-f7f68138.jpg,test/p18/p18615099/s54265960/ce6bc473-864aa830-25f637a2-2a8c99c0-f7f68138.jpg,test," FINAL REPORT INDICATION: Lethargy and hypotension. COMPARISON: ___ chest radiograph. PA AND LATERAL VIEWS OF THE CHEST: Patient is status post median sternotomy and CABG. Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. The heart remains mildly enlarged but stable. The aorta is unfolded. There is mild pulmonary vascular congestion, which is improved when compared to the prior exam. No new focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes in the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion, improved when compared to the prior exam. " a9510716-02da91b0-61532c26-a65b2efc-c9dfa6f1.jpg,test/p19/p19565388/s54621108/a9510716-02da91b0-61532c26-a65b2efc-c9dfa6f1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hip fracture, acute process. Pre-operative evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Borderline size of the cardiac silhouette without evidence of pulmonary edema or pleural effusions. Small pericardial fat pad on the left. Known and healed left rib fracture. No evidence of pneumonia. Mild tortuosity of the thoracic aorta. " 4bf520b7-406f0c3c-6abdc3bb-ad780e85-f3f84002.jpg,test/p10/p10684279/s52973000/4bf520b7-406f0c3c-6abdc3bb-ad780e85-f3f84002.jpg,test," FINAL REPORT INDICATION: Cough and fever for six days. COMPARISON: ___ from___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal aside from minimal aortic tortuosity. IMPRESSION: No pneumonia, edema, or effusion. Findings discussed with Dr. ___ at 11:37 a.m. on ___ by phone to provide requested wet read. " f7228ac0-8a4df9a5-0ed320d5-395aa1ce-2e32172a.jpg,test/p11/p11352876/s59014584/f7228ac0-8a4df9a5-0ed320d5-395aa1ce-2e32172a.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Portable AP upright view of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Patchy opacity in the right lung base likely reflects atelectasis and crowding of bronchovascular structures. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Patchy opacity in the right lung base likely reflects a combination of crowding of the bronchovascular structures and atelectasis. " df54d84f-817ec911-73868ea7-f7bbaf0e-afc4407f.jpg,test/p16/p16576075/s59190607/df54d84f-817ec911-73868ea7-f7bbaf0e-afc4407f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dobbhoff placement. FINDINGS: On the first radiograph, obtained at ___, there was malposition of the Dobbhoff catheter in the right bronchial system. No evidence of pneumothorax or other complications. On the radiograph performed at ___, the Dobbhoff catheter follows the course of the esophagus, with the tip in the proximal parts of the stomach. Again, no complication such as pneumothorax is seen. " d7cedeb0-6df65c37-1c56b219-3f514d2a-6ee2e9db.jpg,test/p11/p11573149/s56584165/d7cedeb0-6df65c37-1c56b219-3f514d2a-6ee2e9db.jpg,test," FINAL REPORT HISTORY: Position of balloon catheter and degree of pulmonary congestion. FINDINGS: No previous images. There is diffuse, relatively symmetric opacifications bilaterally consistent with substantial pulmonary edema related to the patient's noncardiogenic shock. Right IJ catheter extends to the mid portion of the SVC. The tip of the intra-aortic balloon pump lies just above the left main stem bronchus. " 2858e6b7-a73e404c-73da623e-c492a0ed-98d3f8ce.jpg,test/p12/p12139734/s51945637/2858e6b7-a73e404c-73da623e-c492a0ed-98d3f8ce.jpg,test," FINAL REPORT INDICATION: ___F s/p OLT c/b bile leak requiring ERCP and stent placement here with leukocytosis of unknown etiology and ___ likely secondary to dehydration // ?PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ 01:33 FINDINGS: There has been interval removal of the nasogastric tube. An upper abdomen drainage catheter and biliary stent are in unchanged position. Bibasilar atelectasis persists. Heart size and mediastinal contours are stable. No pleural effusion or pneumothorax. No focal consolidation. Stable S-shaped scoliosis. Small hiatal hernia. IMPRESSION: Overall stable appearance of the chest after removal of NG to with bibasilar atelectasis but no evidence of pneumonia. " dd7044b1-fb9fbd76-2db2b116-20e02b5d-888082f6.jpg,test/p14/p14162476/s53391258/dd7044b1-fb9fbd76-2db2b116-20e02b5d-888082f6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with epigastric chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " ae7fb131-28d05c98-90cbbc4c-f05c219a-1d0fed84.jpg,test/p11/p11607628/s52356321/ae7fb131-28d05c98-90cbbc4c-f05c219a-1d0fed84.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain status post cardiac arrest and CPR a month ago. Question acute process. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate left pectoral single lead AICD with stable position of lead terminating in the right ventricle. The heart appears globular and enlarged, more pronounced as compared to ___, morphology suggestive of pericardial effusion. There is plate-like atelectasis in the left base with associated pleural effusion, which is decreased since preceding exam. There is no pneumothorax or frank edema. Mild blunting of the right costophrenic angle is unchanged. IMPRESSION: 1. Short interval development of massive cardiomegaly with globular configuration, concerning for pericardial effusion. 2. Trace left effusion with plate-like atelectasis. Possible trace right effusion, unchanged. Findings reported to Dr. ___ by phone at 4 a.m. on ___. " d576688d-4c437e80-e48cb0f7-d8331ea3-f2420ed8.jpg,test/p13/p13031024/s50280055/d576688d-4c437e80-e48cb0f7-d8331ea3-f2420ed8.jpg,test," FINAL REPORT INDICATION: ___F with h/o chf with chest pain, SOB // pulm edema? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs remain clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " dfdba126-c61e0f04-e6bce302-43b88b80-52e08f09.jpg,test/p13/p13299285/s54044886/dfdba126-c61e0f04-e6bce302-43b88b80-52e08f09.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Anastomotic leak after Whipple surgery, assessment for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Moderate cardiomegaly with mild-to-moderate pulmonary edema. Likely minimal bilateral pleural effusions. Retrocardiac atelectasis. The monitoring and support devices are constant. " acaabe58-5f19bc71-93e0d46d-b63b60c5-fd3084d6.jpg,test/p14/p14137711/s56022767/acaabe58-5f19bc71-93e0d46d-b63b60c5-fd3084d6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hemothroax and chest tube in place // interval change? interval change? COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Small right pleural effusion is slightly larger and basilar atelectasis may have increased. Right basal pleural drain unchanged in position. No pneumothorax. Left lung clear. Heart size normal. " 2cc10956-05cd1b6f-2b86d0ec-d3a35acc-6bc61eaa.jpg,test/p12/p12729806/s51655856/2cc10956-05cd1b6f-2b86d0ec-d3a35acc-6bc61eaa.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with cough. Clinical concern for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Median sternotomy wires intact and aligned. Left pectoral pacemaker with leads terminating in the right atrium, right ventricle, and left coronary sinus. Stable cardiomegaly with pulmonary vascular congestion. No evidence of acute, focal pneumonia. IMPRESSION: No evidence of pneumonia. NOTIFICATION: Findings communicated to Dr. ___ at 12:35. " e1279b16-08dc68f5-b852fce1-567257d4-edb7ffa8.jpg,test/p16/p16879269/s51210310/e1279b16-08dc68f5-b852fce1-567257d4-edb7ffa8.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old female with congestive heart failure and lower extremity edema. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Linear opacities again seen in the left mid lung laterally suggestive of scarring as they were seen on the previous exam. The lungs are otherwise clear without consolidation or pulmonary vascular congestion. There is no effusion. Cardiomediastinal silhouette is within normal limits. Prior median sternotomy changes are noted. Osseous and soft tissue structures are grossly unremarkable. IMPRESSION: No acute cardiopulmonary process. " b0d45794-1900fe4e-455b7fcd-3e524eaf-5edecfdd.jpg,test/p17/p17081205/s57837926/b0d45794-1900fe4e-455b7fcd-3e524eaf-5edecfdd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ALD and new leukocytosis with coughing // PNA? COMPARISON: Chest x-ray from ___ at 08:20 FINDINGS: An NG type tube is present, extending beneath the diaphragm off the film. A right subclavian PICC line is present, tip over distal SVC. No pneumothorax is detected. The cardiomediastinal silhouette is at the upper limits of normal unchanged, unchanged. The previously seen dense opacity at the right base is less dense, though there remains are relatively coarse patchy consolidation. Probable small right effusion. On the left, there is patchy opacity which is slightly more pronounced, as well as a small left effusion. IMPRESSION: Bibasilar opacities, improved on the right and slightly more pronounced on the left. Small bilateral effusions, improved on the right. Suspect mild cardiomegaly, unchanged. " 97054aea-1720851c-a6b50c3c-a602ad08-513fc40b.jpg,test/p12/p12735009/s57479699/97054aea-1720851c-a6b50c3c-a602ad08-513fc40b.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fever and cough. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. No focal consolidation convincing for pneumonia is identified. Cardiomediastinal and hilar contours are within normal limits. There is no new well or pleural effusion. No air under the right hemidiaphragm is identified. Osseous structures are unremarkable. IMPRESSION: No acute intrathoracic abnormality. " 58562717-bda1089b-4945d853-67461e60-6bb747e5.jpg,test/p18/p18919769/s53529567/58562717-bda1089b-4945d853-67461e60-6bb747e5.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pressure, new atrial fibrillation. Evaluate for acute cardiopulmonary process. TECHNIQUE: PA frontal and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart is normal in size, and there is no pulmonary edema. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 607a74db-f846cb12-33329509-d12277a9-7affd2f7.jpg,test/p14/p14108973/s57072189/607a74db-f846cb12-33329509-d12277a9-7affd2f7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man MI and sCHF // ?interval changes TECHNIQUE: frontal views of the chest COMPARISON: In ___. IMPRESSION: Cardiac size is top-normal. Pulmonary edema has markedly improved. Pacer leads are in standard position. There is no pneumothorax. Small left effusion is probably unchanged and associated with adjacent atelectasis. " 60ba995f-ba87812c-8793bb01-54906599-56dba0da.jpg,test/p16/p16032101/s52051626/60ba995f-ba87812c-8793bb01-54906599-56dba0da.jpg,test," FINAL REPORT HISTORY: Nonischemic cardiomyopathy, presenting with shortness of breath. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: Cardiac silhouette is moderately enlarged, similar to prior examination. Mediastinal silhouette and hilar contours are unchanged. Calcifications are noted within the thoracic aortic arch. There is mild pulmonary vascular congestion with trace interstitial edema. A right apical granuloma is unchanged. Lungs are otherwise clear without focal consolidations. There is no pleural effusion or pneumothorax. The osseous structures are globally demineralized in appearance. There is severe compression deformity of a lower thoracic vertebral body and deformity of the right proximal humerus similar in appearance to prior study. IMPRESSION: Moderate cardiomegaly with vascular congestion and trace pulmonary edema. No focal consolidation worrisome for pneumonia. Unchanged severe compression deformity of the lower thoracic vertebral body. " 3214606d-53c6146d-6820f416-a2a4b9d7-eae6d3da.jpg,test/p10/p10537422/s56682728/3214606d-53c6146d-6820f416-a2a4b9d7-eae6d3da.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, low grade fever and intermittent dyspnea. He has a h/o pneumonia about ___ years ago. Evaluate for pneumonia // Evaluate for pneumonia Evaluate for pneumonia IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Cardiac silhouette again is at the upper limits of normal in size, but there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 445e0013-5b980237-67cfc87e-2d1ac9b9-18a57db4.jpg,test/p13/p13131801/s56444570/445e0013-5b980237-67cfc87e-2d1ac9b9-18a57db4.jpg,test," FINAL REPORT HISTORY: Dry cough with travel history. FINDINGS: In comparison with study of ___, there are lower lung volumes but no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Calcified granuloma is again consistent with old tuberculous disease. " 165f349a-4ed06228-372465bd-e2b5f7fe-b0f99e75.jpg,test/p16/p16479007/s56839078/165f349a-4ed06228-372465bd-e2b5f7fe-b0f99e75.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with R rib pain after fall // rr/o R rib fx TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture seen. However, if clinical concern for rib fracture is high, dedicated rib series or CT is more sensitive. " 9bf93ca3-7dc5a0c8-4767b94b-91388609-c9a78f49.jpg,test/p19/p19608147/s51134963/9bf93ca3-7dc5a0c8-4767b94b-91388609-c9a78f49.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated s/p exlap // ? acute process TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild pulmonary edema has increased. Bibasilar opacity a combination of pleural effusions and atelectasis have increased. Right supraclavicular catheter tip is in the lower SVC. Cardiomediastinal contours are unchanged " aaeb6247-6954a91b-637fc6bf-1106ebcf-67d5b45f.jpg,test/p18/p18291658/s59368374/aaeb6247-6954a91b-637fc6bf-1106ebcf-67d5b45f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with GE junction cancer and new oxygen requirement. // Evaluate for cause of new oxygen requirement. ? aspiration. Evaluate for cause of new oxygen requirement. ? aspiration. IMPRESSION: Comparison to ___. The radiograph shows new bilateral parenchymal opacities at both the left and the right lung bases. In the appropriate clinical setting, the changes are highly suggestive of pneumonia. The presence of a minimal accompanying left pleural effusion cannot be excluded. The size of the cardiac silhouette continues to be at the upper range of normal. The right pectoral Port-A-Cath is in stable correct position. " 84b287b4-9156af96-d631780e-140aa857-98d9ba96.jpg,test/p10/p10788552/s59831960/84b287b4-9156af96-d631780e-140aa857-98d9ba96.jpg,test," WET READ: ___ ___ ___ 5:34 PM Right picc tip is now in the mid to lower svc. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: New right PICC line. Pullback of the PICC line. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right PICC line has been pulled back. The tip of the line now projects over the mid SVC. There is no evidence of complications, notably no pneumothorax. Otherwise, unchanged as compared to the previous radiograph from ___, 3:53 p.m. " 47fe31be-b02d7346-b0b088ab-319f0046-4031b050.jpg,test/p16/p16257241/s57190796/47fe31be-b02d7346-b0b088ab-319f0046-4031b050.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain, question pneumonia, question wide mediastinum. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. The mediastinum is not widened. IMPRESSION: No acute cardiopulmonary process. No evidence of pneumonia. Mediastinum not widened. " 6235548e-b5b478fa-60b6b089-90f9a020-89c79300.jpg,test/p13/p13224377/s54598418/6235548e-b5b478fa-60b6b089-90f9a020-89c79300.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: multifocal pneumonia, evaluation. COMPARISON: ___. FINDINGS: The endotracheal tube has been slightly advanced. The tip of the tube now projects 3.5 cm above the carina. The patient is now after bronchoscopy. Bronchoscopy and potential lavage is likely to explain new relatively widespread alveolar opacities in the right lung. Otherwise, there is no relevant change. Moderate cardiomegaly and left-sided opacities and consolidations are constant. No pneumothorax. A new nasogastric tube has been inserted, the tip is not included on the image, the course of the catheter is unremarkable. " ce163058-938c7dc5-88ecead7-98e5c8b3-ddfe96fa.jpg,test/p12/p12241303/s53749503/ce163058-938c7dc5-88ecead7-98e5c8b3-ddfe96fa.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of cirrhosis, now with fever. COMPARISON: Comparison is made with chest radiograph from ___. FINDINGS: The lungs are well expanded and clear. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Slight calcification of the aortic knob is incidentally noted. IMPRESSION: Essentially normal chest radiograph with no evidence of pneumonia or other acute pulmonary or cardiac pathology. " 5ce36029-16fb5481-baa65ab8-683e61c4-f3dbf6fc.jpg,test/p10/p10113512/s58878874/5ce36029-16fb5481-baa65ab8-683e61c4-f3dbf6fc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with urosepsis s/p nephrostomy tube now with increasing SOB // interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of bilateral parenchymal opacities with air bronchograms, likely reflecting pneumonia in the appropriate clinical setting. Pre-existing signs of mild pulmonary edema have decreased but fluid overload is still present. No larger pleural effusions. " 1bc0886d-bf6904c0-d93c7300-17f33992-d1b1446f.jpg,test/p14/p14065959/s50835679/1bc0886d-bf6904c0-d93c7300-17f33992-d1b1446f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pulmonary edema // progression of pulmonary edema progression of pulmonary edema IMPRESSION: Severe cardiomegaly is unchanged. Vascular congestion is similar or slightly more pronounced than on the prior study. There is no appreciable pleural effusion. There is no pneumothorax. " bc92636c-3a834f5d-2a77c3e4-3ff7d898-434ca23f.jpg,test/p18/p18188204/s57619801/bc92636c-3a834f5d-2a77c3e4-3ff7d898-434ca23f.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of weakness. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. There is minimal basilar atelectasis/scarring. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Minimal basilar linear atelectasis. Otherwise, no acute cardiopulmonary process. " abbb0036-86340fbf-320cbdb1-e4c5eb98-f38a3158.jpg,test/p14/p14912272/s57522787/abbb0036-86340fbf-320cbdb1-e4c5eb98-f38a3158.jpg,test," FINAL REPORT HISTORY: ___-year-old man with non-small cell lung cancer presenting with worsening shortness of breath. COMPARISON: PET-CT ___, chest radiographs ___ FINDINGS: Two portable frontal chest radiograph were obtained. A large right upper lobe mass consistent with known non-small cell lung cancer is grossly unchanged since ___. A small right-sided pleural effusion has reaccumulated since Pleurx catheter placement on ___. Extensive bibasilar opacities compatible with known metastatic disease are similar. Cardiomegaly is unchanged. IMPRESSION: Reaccumulation of small right-sided pleural effusion since ___. Findings were discussed in person with Dr. ___ at 14:40. " a2f96137-c3137df1-2098705a-98aee3fd-fe7665a5.jpg,test/p13/p13042039/s57438411/a2f96137-c3137df1-2098705a-98aee3fd-fe7665a5.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Chest pain, assess pneumonia or CHF. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, pneumothorax. Cardiomediastinal silhouette is normal. No signs of CHF. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " d6cda459-0b79634d-50f54c07-dbd230b1-66392a54.jpg,test/p14/p14885862/s57936334/d6cda459-0b79634d-50f54c07-dbd230b1-66392a54.jpg,test," FINAL REPORT HISTORY: ___-year-old with fever and chills body aches. COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There are low lung volumes with bibasilar atelectasis. Infection cannot be excluded. Pulmonary vasculature is within normal limits. IMPRESSION: Bibasilar atelectasis. Infection cannot be excluded in the correct clinical setting. " cfd8acdf-61cf6bfe-743ee65c-cb556d64-d7021e67.jpg,test/p16/p16038838/s50358447/cfd8acdf-61cf6bfe-743ee65c-cb556d64-d7021e67.jpg,test," WET READ: ___ ___ 6:30 PM No evidence of acute disease. Increased apparent mediastinal widening on the right side with suggestion of lobulation; evaluation with chest CT is suggested when clinically appropriate; differential considerations include a mass, lymphadenopathy or increasing aneurysm. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPHS HISTORY: Congestive heart failure, pneumonia. The patient presents with dizziness. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is again moderately enlarged. The descending aortic contour is again tortuous and there is dilatation of the aorta. In addition, the mediastinum appears wider on the right side than previously seen as well as mildly lobulated. This appearance could be associated with new lymphadenopathy or even a mass in the mediastinum versus primarily increase in the size of the aorta. The lung fields appear clear. There are no pleural effusions or pneumothorax. Mild compression deformities are similar along the mid-to-lower thoracic spine. These include a moderate anterior wedge compression deformity at the thoracolumbar junction that appears similar. IMPRESSION: 1. No evidence of acute disease, including pneumonia or congestive heart failure. 2. Abnormal mediastinal contour including enlarged aorta and increased apparent lobular widening of the right mediastinum. Although the technique is different, this appearance raises concern for lymphadenopathy, mass or possibly increasing aortic aneurysm. Evaluation with chest CT is recommended when clinically appropriate, preferably with intravenous contrast. " a4c4102a-f3090db4-f32cb4ba-292dd795-3efd07b9.jpg,test/p10/p10498472/s57677356/a4c4102a-f3090db4-f32cb4ba-292dd795-3efd07b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with malaise, fatigue and elevated WBC. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 663a8095-614995bd-b728e62c-ce8d6974-f5427a14.jpg,test/p18/p18655830/s59505867/663a8095-614995bd-b728e62c-ce8d6974-f5427a14.jpg,test," FINAL REPORT INDICATION: Right upper quadrant pain and shortness of breath, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___. FINDINGS: Bibasilar opacities are present, left greater than right. The cardiac silhouette has increased since prior study. Small bilateral pleural effusions have accumulated in the interim. Visualized upper abdomen is unremarkable. Osseous structures are grossly intact. Median sternotomy wires and surgical clips are noted projecting over the mediastinum. IMPRESSION: 1. Bibasilar opacities, left greater than right, which could reflect atelectasis versus pneumonia. 2. Small bilateral pleural effusions with mild cardiomegaly. " ee5b1367-1022fa7a-53b78e1b-1075ca51-c61e5282.jpg,test/p18/p18985761/s50707283/ee5b1367-1022fa7a-53b78e1b-1075ca51-c61e5282.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: CT from ___ to which comparison with the scout can be performed. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Mild rightward convex curvature is again centered along the upper thoracic spine. Cholecystectomy clips project over the right upper quadrant of the abdomen. Bony structures are unremarkable otherwise. IMPRESSION: No evidence of acute disease. " 6c78c100-e306d7ad-63cfa0a6-04471cb5-4b54eb47.jpg,test/p13/p13364910/s53713417/6c78c100-e306d7ad-63cfa0a6-04471cb5-4b54eb47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multifocal pneumonia presenting with worsening hypoxia. Assess for interval change. COMPARISON: A series of chest radiographs, most recently from ___. FINDINGS: Support Devices: The patient has been extubated. The right internal jugular central venous line terminates in the low SVC, unchanged. Near confluent consolidation of the right lung is unchanged. Again, there is a retrocardiac opacity obscuring the contour of left hemidiaphragm. Minimal left perihilar opacity has not changed from yesterday. Heart size is enlarged and unchanged. There is no pneumothorax or pleural effusion. IMPRESSION: No significant change from yesterday, with multifocal pneumonia involving the entire right lung and left lower lobe. " 693ce41b-fa409023-56bf3a51-38ac8270-fb21e6e2.jpg,test/p13/p13989115/s50962394/693ce41b-fa409023-56bf3a51-38ac8270-fb21e6e2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with headache and arm numbness TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The aorta is slightly unfolded. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Subsegmental atelectasis is seen in the left lung base. No focal consolidation, pleural effusion or pneumothorax is present. IMPRESSION: No acute cardiopulmonary abnormality. " 94a5280e-7700d7b8-b6c98c13-d1c443dd-26e0033e.jpg,test/p17/p17642642/s50012979/94a5280e-7700d7b8-b6c98c13-d1c443dd-26e0033e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Cough, fever and left-sided chest/ flank pain, progressively worse over the past 6 days. TECHNIQUE: Four total frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. Cardiomediastinal contour is unchanged. There is mild prominence of the central pulmonary vasculature and re- demonstration of mildly increased reticulation with some fluid seen tracking along the right major fissure. There is no dense consolidation. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Mild interstitial pulmonary edema and vascular congestion. No dense consolidation to suggest pneumonia. " 5eb0ef2a-f7913586-ae917386-252e0aff-54c6e8b0.jpg,test/p17/p17663232/s55305986/5eb0ef2a-f7913586-ae917386-252e0aff-54c6e8b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough for a month // cough for a month COMPARISON: ___ IMPRESSION: As compared to the prior radiograph, no relevant change is seen. Normal size of the cardiac silhouette. Normal appearance of the lung parenchyma without evidence of pneumonia or pulmonary edema. No pleural effusions. A double contour at the level of the left hilus is completely unchanged as compared to ___ and likely caused by a slightly enlarged left pulmonary artery. The lateral radiograph shows no abnormalities at the vascular structures of the hilus. Mild thoracic scoliosis. " 4d2a49bc-ad77296e-49828148-df221102-1c19be44.jpg,test/p16/p16784686/s55432642/4d2a49bc-ad77296e-49828148-df221102-1c19be44.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // eval for infiltrate TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no pneumothorax or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " b9f6d23e-fa8de1ca-1144b6a0-d8b4fe4b-9c13592e.jpg,test/p13/p13221453/s52022822/b9f6d23e-fa8de1ca-1144b6a0-d8b4fe4b-9c13592e.jpg,test," FINAL REPORT TECHNIQUE: Single semi-erect portable radiograph of the chest was reviewed in comparison to prior chest x-rays through ___ to ___. FINDINGS: Left transvenous pacemaker leads are in standard position. Top normal heart size, mediastinal and hilar contours are unchanged. New left internal jugular line ends at the mid SVC. Core- valve prosthesis is unchanged in position. Mild bibasilar atelectasis is unchanged. There are no new lung opacities which are concerning for pneumonia. " 6835909e-0429861d-9e5b781d-e09f57b9-773fd22a.jpg,test/p14/p14508231/s53309747/6835909e-0429861d-9e5b781d-e09f57b9-773fd22a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea, wheeze // infiltrate? COMPARISON: ___ FINDINGS: There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. C-spine hardware is partially imaged. IMPRESSION: No acute intrathoracic process. " 280c6d4c-4420d045-ae437688-ea2dbe99-f84d8530.jpg,test/p13/p13224377/s50109654/280c6d4c-4420d045-ae437688-ea2dbe99-f84d8530.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Respiratory failure, \ COMPARISON: ___. Patient has tracheostomy tube in standard position. Mild cardiomegaly is stable. Increasing opacities in the right lung could represent aspiration. Vascular congestion has minimally worsened. There is probably a small right effusion. Lines and tubes are in standard unchanged position. " 9a470204-69c0bab6-b6f3b6e5-d8680a5c-4baccc57.jpg,test/p19/p19642544/s53923155/9a470204-69c0bab6-b6f3b6e5-d8680a5c-4baccc57.jpg,test," FINAL REPORT HISTORY: Right chest tube on suction, to assess for pneumothorax. FINDINGS: In comparison with the study of ___, the right pigtail catheter remains in place and there is no evidence of pneumothorax. Retrocardiac opacification consistent with atelectasis persists. Fracture of the right clavicle is again noted. " 5863da90-17637397-be000768-a7794027-411fad96.jpg,test/p19/p19394285/s50968774/5863da90-17637397-be000768-a7794027-411fad96.jpg,test," FINAL REPORT INDICATION: Motor vehicle collision, right chest pain. COMPARISON: None available. FINDINGS: AP and lateral views of the chest. No focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are normal. There is no fracture identified. IMPRESSION: No acute cardiopulmonary process. If there is a particular area of concern, dedicated views can be done for better assessment of traumatic injury. " 74d52698-ca79b296-55fc1b78-b7399393-8725bde6.jpg,test/p15/p15971330/s59181744/74d52698-ca79b296-55fc1b78-b7399393-8725bde6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Degenerative changes are again noted within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 1ae2a2e5-3f9f919e-fa144bbe-2c157739-e6a51670.jpg,test/p18/p18806584/s51690591/1ae2a2e5-3f9f919e-fa144bbe-2c157739-e6a51670.jpg,test," FINAL REPORT INDICATION: Mr. ___ is a ___ male with a PMHx of CAD s/p CABG (___), AF not on anticoagulation, ICD, HTN, HL, T2DM and PVD c/b R toe amputation, AF on ASA but not on Coumadin (previously on Pradaxa), with recent R MCA stroke s/p tPA here for management of foot infection, UTI, DM, hyponatremia, and edema. // ?pulm edema COMPARISON: Radiographs from ___. IMPRESSION: There has been placement of a feeding tube whose distal tip is at the GE junction. This could be advanced 10 cm for more optimal placement. There is again seen a left-sided AICD. There is again seen a large right-sided pleural effusion and small left-sided pleural effusion.There is a left retrocardiac opacity. There is moderate pulmonary edema. " d39d5a4d-ebf6bd3a-534e0dd3-299070c9-4125147e.jpg,test/p16/p16258846/s58038441/d39d5a4d-ebf6bd3a-534e0dd3-299070c9-4125147e.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain, elevated white count. Assess for pneumonia. COMPARISONS: Chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. The lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. These findings were reported to ___ by Dr. ___ ___ telephone at 4:25 p.m. " 08244103-bd39326f-84677937-f28654af-d17e43c4.jpg,test/p10/p10418908/s54904016/08244103-bd39326f-84677937-f28654af-d17e43c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent ICD placement, now with end-expiratory wheeze // any worrisome lesion? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Mild to moderate cardiomegaly is stable. Pacer lead is in standard position with tip in the right ventricle. . The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities " 1497c68c-081777e0-0e9e6da3-fa62d6dd-42097a8c.jpg,test/p13/p13002303/s58951365/1497c68c-081777e0-0e9e6da3-fa62d6dd-42097a8c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough // Pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 6e6b434e-e6c8242b-7cecb757-f745886e-77768a1c.jpg,test/p15/p15352109/s50813905/6e6b434e-e6c8242b-7cecb757-f745886e-77768a1c.jpg,test," FINAL REPORT CHEST X-RAY INDICATION: Treated right lower lobe pneumonia, evaluation for resolution. COMPARISON: Chest x-ray from ___. FINDINGS: As compared to the previous radiograph, the pre-existing opacity has completely resolved. Currently, no evidence of pathologic parenchymal opacity is seen. The lung volumes are normal. Mild tortuosity of the thoracic aorta. No pleural effusions. Normal hilar and mediastinal structures. " 97d08722-3d3aea03-11b9210b-c49ceafd-c67dd47e.jpg,test/p12/p12537194/s57169516/97d08722-3d3aea03-11b9210b-c49ceafd-c67dd47e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SOB/backpain found to have lung cancer /w R pleural effusion and diffuse mets.***PLEASE SCHEDULE FOR 4:00 am**** // Trend pleural effusion IMPRESSION: In comparison to prior radiograph of 1 day earlier, there has not been a relevant change the appearance of the chest. " b62ba868-d4713af7-8bb8a56e-bd87bb67-6155dd56.jpg,test/p16/p16502265/s51233470/b62ba868-d4713af7-8bb8a56e-bd87bb67-6155dd56.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest CT from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Reported episodes of desaturation, now normal, assess for pneumonia or effusions. FINDINGS: AP upright portable chest radiograph is obtained as well as a lateral view. There are small bilateral pleural effusions with mild compressive bibasilar atelectasis. There is no significant change from prior exam. There is no overt CHF. A mild component of interstitial congestion is impossible to exclude. The aorta is unfolded. Heart size is normal. No pneumothorax. Bony structures are intact. IMPRESSION: Small bilateral pleural effusions with bibasilar compressive atelectasis. Possible mild interstitial edema. " 86c524c7-b077bb9a-d1fe1576-2a628ca9-20f9e558.jpg,test/p12/p12435705/s55673526/86c524c7-b077bb9a-d1fe1576-2a628ca9-20f9e558.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fever and altered mental status. TECHNIQUE: Frontal chest radiographs were obtained with the patient in the supine position. COMPARISON: Radiograph from ___ and ___ and CT from ___ and ___. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or overt pulmonary edema. The cardiomediastinal contours are within normal limits. There has been interval removal of a right PICC. IMPRESSION: No acute cardiopulmonary process. " 935647ac-b1f040ba-1e6cea70-c68f2920-2f80e88a.jpg,test/p15/p15341255/s57747328/935647ac-b1f040ba-1e6cea70-c68f2920-2f80e88a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p CABG // eval (L)PTX, s/p Pigtail pull TECHNIQUE: Portable AP view of the chest. COMPARISON: Multiple chest radiographs the most recent on ___. FINDINGS: A right internal jugular line is seen at the origin of the SVC. A left chest tube is unchanged in position. There is minimal decrease in a left apical pneumothorax. Small bilateral pleural effusions are stable. There is persistent vascular engorgement. No other significant change IMPRESSION: Minimal decrease in left apical pneumothorax. No other significant change " 6ca5a964-c2ca2bd9-65649ae8-f92049bd-64042102.jpg,test/p17/p17318449/s55944918/6ca5a964-c2ca2bd9-65649ae8-f92049bd-64042102.jpg,test," FINAL REPORT INDICATION: Evaluate for resolution of right lower lobe pneumonia diagnosed ___. COMPARISON: Comparison is made to the most recent radiograph available in our system from ___. No radiograph demonstrating pneumonia in ___ is available for comparison. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs, without evidence of right lower lobe consolidation. There is no pleural effusion or pneumothorax. The hilar and cardiomediastinal contours are normal. Pulmonary vascularity is normal. Chronic findings of intact sternal cerclage wires as well as unfolded configuration of the aorta are once again noted. IMPRESSION: No evidence of residual right lower lobe pneumonia. " 7f610b19-a996ddc1-c86f274f-b230d733-32e8ecfd.jpg,test/p14/p14145108/s51854756/7f610b19-a996ddc1-c86f274f-b230d733-32e8ecfd.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. No displaced fracture is identified. IMPRESSION: No acute cardiopulmonary process. " 64244342-a1610364-0e56b1c8-2e0ef3fb-1cd2b911.jpg,test/p17/p17731768/s58252979/64244342-a1610364-0e56b1c8-2e0ef3fb-1cd2b911.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with C5-C6 herniated disc // pre-op pre-op IMPRESSION: Comparison to ___. Lung volumes are low. Borderline size of the cardiac silhouette. Mild elongation of the descending aorta. No pulmonary edema, no pleural effusions. " fbb34a36-3e626db8-af855945-498ccb4c-6ab970a4.jpg,test/p15/p15760813/s50922838/fbb34a36-3e626db8-af855945-498ccb4c-6ab970a4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ILD // any interval change? any interval change? IMPRESSION: Heart size and mediastinum are unchanged. Diffuse interstitial opacities even more pronounced than on the prior study and might represent progression of interstitial lung disease such is acute exacerbation or pulmonary edema. No interval increase in pleural effusion demonstrated. No pneumothorax is seen. Underlying infectious process for example in the patient is immunocompromised such as pneumocystis pneumonia is a possibility. " 5555dedf-1df3a28e-5938b334-016498b2-e5f1dbda.jpg,test/p18/p18427812/s54995324/5555dedf-1df3a28e-5938b334-016498b2-e5f1dbda.jpg,test," FINAL REPORT INDICATION: ___-year-old male presenting for cardiopulmonary evaluation prior to lumbar decompression surgery. COMPARISON: Chest radiograph from ___ PORTABLE SEMI-ERECT FRONTAL CHEST RADIOGRAPH: Patient is rotated on this examination. Lungs are clear without consolidation. There is no pulmonary edema or pleural effusions. Mediastinal and hilar contours are within normal limits. Mild cardiomegaly is stable. There is no pneumothorax. IMPRESSION: No acute cardiopulmonary process " ec1d3e3b-a841b890-243b4438-ce11237a-7549e9e1.jpg,test/p12/p12846293/s58321352/ec1d3e3b-a841b890-243b4438-ce11237a-7549e9e1.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fever/chills, coughing, sore throat, vomiting // eval for infection TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: Lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 0f186f64-e9cbc084-9f8dd565-5cc1ab16-1f9445a9.jpg,test/p14/p14955324/s51237580/0f186f64-e9cbc084-9f8dd565-5cc1ab16-1f9445a9.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___ FINDINGS: AP and 2 lateral chest radiographs were obtained. Lung volumes are low. Moderate cardiomegaly is unchanged. There is no new consolidation, effusion or pneumothorax. IMPRESSION: Stable appearance of low lung volumes and moderate cardiomegaly. " 5fcf61d8-8728f77f-15de9022-e957e7b9-60a7d1d2.jpg,test/p19/p19628737/s50206423/5fcf61d8-8728f77f-15de9022-e957e7b9-60a7d1d2.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with syncope // eval for acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes and mild to moderate pulmonary vascular congestion. Linear left mid to lower lung atelectasis/scarring is again seen. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Low lung volumes with likely pulmonary vascular congestion. " b19240ad-23c6b159-6bfb58ea-24bd5b40-7958b4d3.jpg,test/p12/p12455543/s53649443/b19240ad-23c6b159-6bfb58ea-24bd5b40-7958b4d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with spont ptx // interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. . FINDINGS: The right chest tube appears unchanged in comparison to the prior chest radiograph. There is small amount of subcutaneous emphysema. No pneumothorax. There is bilateral apical pleural thickening, worse on the right. There is bilateral diffuse interstitial thickening, worse at the bases which is unchanged. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pleural effusion is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Chest tube in appropriate positioning without evidence of pneumothorax. 2. Unchanged bilateral diffuse interstitial thickening representing chronic interstitial lung disease. " 1cca3937-927abe2e-93eecf71-1e62bdd2-23eefddf.jpg,test/p13/p13985981/s54775078/1cca3937-927abe2e-93eecf71-1e62bdd2-23eefddf.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of bronchiectasis, upper back pain, rule out pulmonary pathology. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right apical parenchymal opacities, partly fibrotic and partly consolidative, with elevation of the right hilus and likely related to the known history of TB, are completely unchanged. Also completely unchanged is a small right apicolateral calcified granuloma. The minimal changes in the left lung apex are also constant. No additional parenchymal changes, notably no interval appearance of infectious lung pathologies. Normal and unchanged size of the cardiac silhouette. No pleural effusions. " 5d9aae6d-f40bac06-afc95668-a824644e-b4df68d8.jpg,test/p16/p16254124/s54062689/5d9aae6d-f40bac06-afc95668-a824644e-b4df68d8.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with positive PPD, rule out active TB. COMPARISON: None. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are within normal limits. There is no pleural effusion or pneumothorax. CONCLUSION: There is no radiologic evidence of latent or active TB. " d13ec19d-0b80dd80-ed0cbcaa-eb7ccac4-a5cc8f7d.jpg,test/p16/p16254450/s57903503/d13ec19d-0b80dd80-ed0cbcaa-eb7ccac4-a5cc8f7d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p asxc aorta replacement // eval for effusion COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have increased and the signs indicative of pulmonary edema have decreased in severity. Moderate cardiomegaly persists. The alignment of the sternal wires is unchanged. Unchanged right internal jugular vein catheter, unchanged clips projecting over the right axillary region. " 76229891-429142aa-5c02ae39-5b38b74b-1ee25d55.jpg,test/p10/p10157508/s58668367/76229891-429142aa-5c02ae39-5b38b74b-1ee25d55.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of melanoma // please evaluate disease status TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 125926fa-d7e58b9d-fe4f60d7-da1f848d-6a7ad4dd.jpg,test/p19/p19324253/s57557917/125926fa-d7e58b9d-fe4f60d7-da1f848d-6a7ad4dd.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman presenting with cough and shortness of breath. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Chest radiograph dated ___. The lungs are well-expanded and clear. No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. No mediastinal widening. No acute osseous abnormality. IMPRESSION: Normal chest radiograph. No pneumonia. " 03e18d71-2642ccfc-7660f2d4-e6c10856-fbb305ae.jpg,test/p15/p15964158/s56542922/03e18d71-2642ccfc-7660f2d4-e6c10856-fbb305ae.jpg,test," FINAL REPORT INDICATION: ___-year-old male with weakness. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: Lungs remain hyperinflated but clear. The cardiomediastinal silhouette and hilar contours are stable. There is no pleural effusion or pneumothorax. Chronic deformity of right-sided ribs and the right clavicle are again identified. IMPRESSION: Hyperinflated lungs without focal consolidation. " ed463804-15464576-5063cea9-7fc1334c-d1b41c20.jpg,test/p13/p13273041/s50240959/ed463804-15464576-5063cea9-7fc1334c-d1b41c20.jpg,test," WET READ: ___ ___ 8:22 AM Opacification at the right lung base and pleural effusion with loculated component is slightly increased in density compared to the prior study, although size is similar allowing for portable technique. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF s/p 2u blood transfusion // pulmonary edema pulmonary edema IMPRESSION: Comparison to ___. No relevant change. Bilateral pleural thickening is stable. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly persists. The opacity at the right lung base might have increased but the increases minimal at best. " 66e38f40-fdaed3e1-35e0a137-97980826-174bbe8b.jpg,test/p19/p19914235/s58908207/66e38f40-fdaed3e1-35e0a137-97980826-174bbe8b.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Left-sided shaking and leukocytosis. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size with a left ventricular configuration. Mild unfolding and calcification are noted along the aorta. The lung volumes are low. There is no pleural effusion or pneumothorax. Although there is no focal opacity, the interstitium is mildly prominent suggesting slight fluid overload. A crowding of interstitial markings suggests atelectasis associated with low lung volumes and mild elevation of the right hemidiaphragm. A severe lower thoracic compression deformity includes nearly complete collapse of the vertebral body and mild retropulsion, of uncertain chronicity. IMPRESSION: 1. Mild interstitial abnormality suggesting slight fluid overload. 2. Crowding of right basilar lung markings, more suggestive of minor atelectasis than pneumonia. However, if pneumonia is a persistent clinical concern, then short-term followup radiographs may be helpful, preferably with PA and lateral technique, if possible. 3. Severe lower thoracic compression deformity, age-indeterminant on radiography, but with not clear indication of recent chronicity. Correlation with clinical presentation and findings is suggested. " f20a96c0-2a6a7e0a-e9e48672-530babc6-f77ec345.jpg,test/p15/p15579082/s56245340/f20a96c0-2a6a7e0a-e9e48672-530babc6-f77ec345.jpg,test," FINAL REPORT HISTORY: Left lateral chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present. IMPRESSION: Normal chest radiograph. " 99fcf070-ed288b0e-fec8b43a-1f57020a-f6d8376e.jpg,test/p18/p18673496/s53950697/99fcf070-ed288b0e-fec8b43a-1f57020a-f6d8376e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___M with productive cough // r/o pneumonia r/o pneumonia COMPARISON: ___ FINDINGS: The lungs remain clear. The heart and mediastinal structures are unremarkable in appearance as before. The bony thorax is grossly intact. IMPRESSION: No active disease. " d79c1fe5-fff3be99-8b5971ed-1534639f-56cd6fb5.jpg,test/p16/p16151467/s54486905/d79c1fe5-fff3be99-8b5971ed-1534639f-56cd6fb5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with shortness of breath // ?pulm edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is interval development of moderate interstitial edema, new. No substantial pleural effusion or pneumothorax is seen. " 755903b4-5aeccab2-30facd05-14d35f3a-f5f6a520.jpg,test/p10/p10884708/s51255602/755903b4-5aeccab2-30facd05-14d35f3a-f5f6a520.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval IMPRESSION: Compared to chest radiographs since ___, most recently ___. Small right pleural effusion is smaller, basal pleural drainage tube still in place. No pneumothorax. Extensive mediastinal adenopathy has improved and several of many pulmonary nodules are smaller. There is no evidence of pneumonia or cardiac decompensation. Left supraclavicular central venous catheter ends close to the superior cavoatrial junction. " 37ebe251-949f93ed-a058076b-0fe97014-4e118570.jpg,test/p17/p17396346/s53289302/37ebe251-949f93ed-a058076b-0fe97014-4e118570.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CHF, obesity, p/w SOB Chest pain // PNa, pulm edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Cardiac and mediastinal silhouettes are stable with cardiomegaly re- demonstrated. There is mild vascular congestion. Scattered areas of linear atelectasis/scarring are seen. No large pleural effusion. No pneumothorax. IMPRESSION: Scattered areas of atelectasis/ scarring. Mild pulmonary vascular congestion. " bb4599ac-be3c063d-1853f41f-62831d23-3de1f708.jpg,test/p12/p12298542/s52115224/bb4599ac-be3c063d-1853f41f-62831d23-3de1f708.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with cough // ? acute cardiopulm process COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. The heart remains mildly enlarged. Patient rotation somewhat limits assessment. There is subtle opacity in the left lower lobe which could represent pneumonia. No large effusion or pneumothorax. Right lung is clear. The aorta is unfolded. Bony structures are intact. IMPRESSION: Subtle opacity in the left lower lobe is concerning for pneumonia. " 167dc1da-70e22539-f6050d10-a28bf014-8c539702.jpg,test/p13/p13374841/s54442298/167dc1da-70e22539-f6050d10-a28bf014-8c539702.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Evaluate patient for pleural effusion. COMPARISON: ___. FINDINGS: Patient had recent mitral valve repair. Mild pulmonary edema has worsened since ___. Left moderate pleural effusion is unchanged. Right lower lung opacity could be dependent edema or atelectasis. Mediastinal contour and mild cardiomegaly is stable. Degenerative changes are in the left shoulder. CONCLUSION: 1. Mild pulmonary edema has worsened. 2. Left moderate pleural effusion is unchanged. " 53676cb7-8e956503-c0e2741d-1ba85942-cd3bf188.jpg,test/p17/p17477304/s53738730/53676cb7-8e956503-c0e2741d-1ba85942-cd3bf188.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Shortness of breath at dialysis. COMPARISON: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is a mild interstitial abnormality consistent with pulmonary edema. There is no definite pleural effusion or pneumothorax. Sclerotic bones suggest renal osteodystrophy. IMPRESSION: Findings consistent with mild pulmonary edema. " 16f3ab4a-149c6ef1-92566268-8f24b32c-5eb51187.jpg,test/p14/p14809300/s53142860/16f3ab4a-149c6ef1-92566268-8f24b32c-5eb51187.jpg,test," FINAL REPORT INDICATION: ___ year old woman with history of COPD, lung cancer s/p cyberknife s/p fall with hip and R arm fracture and CAP with worsening O2 requirements. // interval change TECHNIQUE: PORTABLE COMPARISON: ___ FINDINGS: Interval development of moderate pulmonary edema. There is also worsening left retrocardiac opacity could be atelectasis/consolidation. New bilateral pleural effusions. No pneumothorax. The heart is mildly enlarged. IMPRESSION: Interval development of moderate pulmonary edema and small effusion. New left retrocardiac opacity can be consolidation/atelectasis. " df11d4ff-00e789ad-4f7d7295-b206942f-66e790e8.jpg,test/p13/p13920956/s57442001/df11d4ff-00e789ad-4f7d7295-b206942f-66e790e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with URI 8 weeks ago, persistent dry cough, left basilar crackles. H/O OSA, CAD, copd // pleas eeval for LLL infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Lungs are clear consolidation, pleural effusion or pneumothorax. Specifically, no left lower lobe consolidation. Cardiomediastinal contours are normal. No acute osseous abnormalities. Surgical clips noted over the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 9b15b10d-edf62f82-6b69d38a-4f562658-ec444b2c.jpg,test/p18/p18785569/s55803757/9b15b10d-edf62f82-6b69d38a-4f562658-ec444b2c.jpg,test," FINAL REPORT HISTORY: New white count, pneumonia. CHEST, TWO VIEWS: The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is mild cardiomegaly, with left a ventricular configuration. The aorta is unfolded. Increased opacity projecting over the heart on the frontal view likely represents a hiatal hernia. The hernia itself was better delineated on a film dated ___. There is atelectasis and/or scarring in the lower lobe posteriorly. Mild eventration of the right hemidiaphragm is noted. No CHF. The mid and upper zones of both lungs remain grossly clear. No definite consolidation. Degenerative changes and ossification of the anterior longitudinal ligament of the spine incidentally noted. IMPRESSION: 1. Background COPD. 2. Cardiomegaly, with unfolded aorta. 3. Moderate-sized hiatal hernia. 4. Bibasilar atelectasis. No definite consolidation. Subtle infiltrate could be obscured by the hiatal hernia, but no air bronchograms are appreciated. 5. No CHF. " bc93b77a-f58d33c5-2b1788f9-0240dbdb-64e27caf.jpg,test/p13/p13349054/s59763650/bc93b77a-f58d33c5-2b1788f9-0240dbdb-64e27caf.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___-year-old man with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiograph ___. FINDINGS: Cardiomediastinal silhouette is unchanged. There is no pneumothorax or pleural effusion. Linear left and right basilar opacities are most consistent with atelectasis. There is no displaced rib fracture. IMPRESSION: Basilar atelectasis. No radiographic explanation for chest pain. " 28bee463-c3b98b39-02310010-67021e55-74bdbb35.jpg,test/p11/p11845452/s50619062/28bee463-c3b98b39-02310010-67021e55-74bdbb35.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain status post stent placement two weeks ago, assess for acute intrathoracic process. FINDINGS: PA and lateral views of the chest were obtained. Heart size is within normal limits. A coronary stent is partially imaged over the left heart border. There is no overt edema, though mild pulmonary interstitial edema is difficult to exclude. No focal consolidation, effusion, or pneumothorax. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Possible mild interstitial edema. Coronary stent visualized. " 69dd0dbb-6abcba23-739f3cde-11bf5318-97f78216.jpg,test/p18/p18144896/s57014136/69dd0dbb-6abcba23-739f3cde-11bf5318-97f78216.jpg,test," FINAL REPORT HISTORY: Perforated appendicitis, with new oxygen requirement, assess for pneumonia. COMPARISON: None available. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes, but clear lungs. The heart is borderline enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Pleural surfaces are normal. IMPRESSION: No evidence of pneumonia. " 5be9387b-d8b88e4c-5b94b346-57adf5a3-6c4b9ad7.jpg,test/p17/p17804936/s56959625/5be9387b-d8b88e4c-5b94b346-57adf5a3-6c4b9ad7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Endotracheal tube placement. TECHNIQUE: Single frontal view of the chest. COMPARISON: ___ 08:44 FINDINGS: Endotracheal tube has been placed terminating 4.5 cm cranial to the carinal. NG tube tip terminates in the stomach outside the field of view. There has otherwise been no short-term interval change compared to less than 1 hour prior. " 0ad9fead-4b8088fb-9f8d417d-7309b1af-2cc6d377.jpg,test/p14/p14809072/s52424611/0ad9fead-4b8088fb-9f8d417d-7309b1af-2cc6d377.jpg,test," FINAL REPORT INDICATION: Cirrhosis, confused. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " c559261a-3730dd73-7e6340ca-27824b52-4978e1be.jpg,test/p15/p15841939/s54799011/c559261a-3730dd73-7e6340ca-27824b52-4978e1be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and ___ CT chest FINDINGS: There has been no interval change in the appearance of the chest compared to the radiograph from ___. Cardiac, mediastinal and hilar contours are unchanged. Multiple clips are again demonstrated in the region of the right hilum. Known pulmonary metastases and mediastinal lymphadenopathy is better assessed on the previous CT chest. No new focal consolidation, pleural effusion or pneumothorax is present. Pulmonary vasculature is normal. There are no acute osseous abnormalities. IMPRESSION: No interval change when compared to the prior chest radiograph from ___. " 6c9cf63b-91446c6c-0bdf9333-4d239e84-d7809df0.jpg,test/p19/p19078744/s53202233/6c9cf63b-91446c6c-0bdf9333-4d239e84-d7809df0.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old male with neck and arm pain. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: Frontal and lateral views of the chest. Linear left base and right perihilar opacities may be due to atelectasis given lower lung volumes. Elsewhere, the lungs are clear. There is no effusion or pulmonary vascular congestion. Surgical clips project over the right lung apex as on prior. The cardiomediastinal silhouette is within normal limits. Posterior fixation hardware is seen at the lower thoracic, upper lumbar region as on prior. No acute osseous abnormality is detected. IMPRESSION: No definite acute cardiopulmonary process. " 2dd45105-6d1bac4d-0dd15541-300bcab4-3b17c82b.jpg,test/p12/p12917695/s55714736/2dd45105-6d1bac4d-0dd15541-300bcab4-3b17c82b.jpg,test," FINAL ADDENDUM ADDENDUM No specific addendum. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with positive PPD // check lungs TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is bilateral apical pleural thickening. The lungs are otherwise clear. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No evidence of past or present TB. " 35caa46e-e1228221-6200ebca-2ca4d308-3569043d.jpg,test/p19/p19444592/s58765566/35caa46e-e1228221-6200ebca-2ca4d308-3569043d.jpg,test," FINAL REPORT INDICATION: New onset seizure. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " d49a1830-d2b83f72-ca514e6a-31fa0ea1-2f4761b1.jpg,test/p19/p19730587/s55590607/d49a1830-d2b83f72-ca514e6a-31fa0ea1-2f4761b1.jpg,test," FINAL REPORT HISTORY: Chest pain. Evaluate for pneumonia, acute process. COMPARISON: Prior chest CT from ___ and chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " a7fa0282-d1b36f76-2d26bd0a-d681d0cc-0cbed18b.jpg,test/p17/p17951860/s52233441/a7fa0282-d1b36f76-2d26bd0a-d681d0cc-0cbed18b.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Cough and hypoxia. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. Lung volumes are low. There is no pleural effusion or pneumothorax. There is new retrocardiac opacification which is fairly streaky in nature. Elsewhere, the lungs remain clear. There is very mild S shaped curvature to the visualized thoracolumbar spine. IMPRESSION: New left lower lobe opacity with morphology more suggestive of atelectasis than pneumonia although infection of lower airways or bronchopneumonia is not excluded. " c2cd7663-c4337ab0-83683cba-fc02e112-ed88f9d9.jpg,test/p19/p19834718/s52550500/c2cd7663-c4337ab0-83683cba-fc02e112-ed88f9d9.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___. HISTORY: ___-year-old woman with melanoma. Evaluate primary disease. IMPRESSION: PA and lateral chest compared to ___ through ___: ___-mm right mid lung nodule at the level of the second anterior interspace is unchanged since ___, but a ___-mm wide nodule inferior to that is new or substantially increased. Soft tissue surrounding expansile lesion of a left middle rib laterally is thicker today than it was in ___. There is no pleural effusion or good evidence for central lymph node enlargement. Heart size is normal. " 06287362-e311091f-43627788-4bcf855f-0f4add3f.jpg,test/p11/p11943612/s58379727/06287362-e311091f-43627788-4bcf855f-0f4add3f.jpg,test," FINAL REPORT HISTORY: ___-year-old HIV positive female with cough and rhonchi. Evaluate for pneumonia. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded clear lungs. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumonia seen within the limitations of chest x-ray. If symptoms persist, CT of the chest can be used to exclude radiographically occult infection. " e65a1bb1-2ed63178-877aa122-d393c4db-3b196db1.jpg,test/p14/p14448993/s59703873/e65a1bb1-2ed63178-877aa122-d393c4db-3b196db1.jpg,test," FINAL REPORT INDICATION: ___M with CP, left shoulder pain, has ppm // r/o cardiopulm abnormality TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Left chest wall dual lead pacing device seen with lead tips in the right ventricular apex and right ventricle. The lungs are clear without consolidation, effusion, or vascular congestion. Cardiomediastinal silhouette is top-normal in size. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " eb589ee7-e6299632-794b54e1-2e5ee0ee-2bab85d7.jpg,test/p11/p11603058/s59686819/eb589ee7-e6299632-794b54e1-2e5ee0ee-2bab85d7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with L chest pan, pls ___ pna vx small ptx COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No findings to account for left chest pain. Specifically no pneumothorax. " 5670e6f2-e05a8983-6675622b-d2969a1f-008b3041.jpg,test/p18/p18049473/s52210706/5670e6f2-e05a8983-6675622b-d2969a1f-008b3041.jpg,test," FINAL REPORT HISTORY: ___-year-old female with end-stage renal disease and tachycardia. COMPARISON: Chest radiograph from ___ and CTA chest from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: There are diffuse hazy opacities, peripheral septal thickening, hilar engorgement, and mild cardiomegaly, findings consistent with new mild pulmonary edema. Tiny bilateral pleural effusions are also likely. There is no pneumothorax. No confluent consolidation is identified. IMPRESSION: New mild pulmonary edema " a26985e9-c5ab9ca0-23699e64-f5925b41-bb4f48e2.jpg,test/p14/p14383658/s59825261/a26985e9-c5ab9ca0-23699e64-f5925b41-bb4f48e2.jpg,test," FINAL REPORT INDICATION: ___-year-old female with MRSA pericarditis and pleural effusion, new requiring assessment for interval change. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: There has been interval improvement in the right basilar atelectasis and bilateral vascular congestion. There are low lung volumes, likely due to poor inspiration. There are no pleural effusions. Cardiac size is unchanged from prior exam. IMPRESSION: Improved vascular congestion and right basilar atelectasis. Stable cardiomegaly. " b3d159b0-8fcca11a-c68dde70-fe7b3e77-323953d6.jpg,test/p15/p15945590/s58280874/b3d159b0-8fcca11a-c68dde70-fe7b3e77-323953d6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with resp distress // intubation TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to___. FINDINGS: There is new white-out of the left hemithorax, with only minimal remaining aeration of the left upper lobe. In the absence of mediastinal shift, this is likely a combination of increasing pleural effusion and collapse. The moderate layering right pleural effusion is stable. The endotracheal tube ends 5.3 cm necrotic, the enteric tube extends outside of the field of view in a decompressed stomach. The right-sided PICC line ends in the mid SVC. IMPRESSION: 1. New white-out of the left hemithorax, likely a combination of pleural effusion and collapse. 2. Stable moderate right pleural effusion. 3. All tubes and lines in satisfactory position. " fea8bc8e-f730d971-edfb98af-db4933cc-413eb7ae.jpg,test/p16/p16584374/s59076763/fea8bc8e-f730d971-edfb98af-db4933cc-413eb7ae.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with right-sided chest pain s/p fall // Eval for PTX, rib fx TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ reference made to chest CTA from ___ FINDINGS: There are relatively low lung volumes. Blunting of the bilateral costophrenic angles suggests trace pleural effusions. Since the prior study, there has been interval increase in interstitial markings bilaterally which may represent worsening of known chronic lung disease with possible overlying acute component. Cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are grossly stable. No evidence of pneumothorax is seen. No definite displaced fracture is seen. There is moderate anterior wedging of a mid thoracic vertebral body, similar since CT from ___ IMPRESSION: Blunting of the bilateral costophrenic angles suggests trace pleural effusions. Since the prior study, there has been interval increase in interstitial markings bilaterally which may represent worsening of known chronic lung disease with possible overlying acute component superimposed, pulmonary edema or infection not entirely excluded. No displaced fracture is identified. If high clinical concern, CT is more sensitive. " 73e590c2-1322e8b7-06c870ce-2ec56414-2728962d.jpg,test/p13/p13186108/s51051097/73e590c2-1322e8b7-06c870ce-2ec56414-2728962d.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Status post fall and seizure. COMPARISONS: None. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is at the upper limits of normal size. There is mild unfolding of the thoracic aorta. There is a 5 mm nodular density projecting over the left lower costophrenic sulcus, suggestive of a calcified granuloma or perhaps a nodular appearance of atelectasis but not fully characterized. A small equivocal nodule is also present at the right lung base. Otherwise, the lungs appear clear. Mild degenerative changes are noted along the lower thoracic spine. IMPRESSION: 1. No evidence of acute disease. 2. Nodular focus projecting over the left costophrenic sulcus and an equivocal right basilar nodule. Correlation with prior radiographs is suggested if available. When clinically feasible, repeat PA and lateral chest radiographs including a view with better coverage of the left costophrenic sulcus is suggested; chest CT could be considered based on the results particularly if prior comparisons are not available. Discussed with Dr. ___ at 9 pm by telephone on ___. " 150c8a37-43695cd8-f7ac350d-cff55b89-f2801aba.jpg,test/p11/p11968605/s57902187/150c8a37-43695cd8-f7ac350d-cff55b89-f2801aba.jpg,test," WET READ: ___ ___ 12:08 AM Right new pleural effusion. No opacity convincing for pneumonia. Heart top normal in size with no evidence of overt pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with hyperglycemia. Evaluate for infection. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrate top-normal heart size. New since prior examination, there is blunting of the right costophrenic angle consistent with a pleural effusion. No evidence of overt pulmonary edema. No focal opacity convincing for pneumonia is seen. Hilar contours are within normal limits. No acute osseous abnormality is identified. IMPRESSION: Right new pleural effusion. No opacity convincing for pneumonia. Heart top normal in size with no evidence of overt pulmonary edema. " 74ab0576-165250aa-5fedc1a0-3f75f2c6-9f87fa70.jpg,test/p10/p10410641/s56031350/74ab0576-165250aa-5fedc1a0-3f75f2c6-9f87fa70.jpg,test," FINAL REPORT INDICATION: Shortness of breath and known pancreatic cancer. Recent paracentesis. Question feasibility of thoracentesis. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Multiple priors, most recently ___. FINDINGS: There is a right pleural effusion, the size of which is difficult to ascertain. There is unchanged bilateral lower lobe and right middle lobe collapse. The small left pleural effusion is unchanged. There is no pulmonary vascular congestion or pneumothorax. The cardiac and mediastinal contours are not well visualized. IMPRESSION: Stable large right pleural effusion and increasing left pleural effusion. Feasibility of of thoracentesis would best be evaluated with decubitus films. Ultrasound guidance can also be considered. " 71867977-7c6dbe12-e0c92ee6-4aeb12ef-25a34482.jpg,test/p16/p16817573/s59770682/71867977-7c6dbe12-e0c92ee6-4aeb12ef-25a34482.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of metastatic RCC, evaluation of pneumothorax. COMPARISON: ___. FINDINGS: compared to the previous radiograph, the right lateral pneumothorax has minimally increased in size. The previously seen air-fluid levels are noted in almost unchanged manner. Unchanged mild-to-moderate right pleural effusion. Unchanged size of the cardiac silhouette. " 4953779b-d8064349-42ba471b-149cf76f-e82bb1c2.jpg,test/p14/p14597978/s59804197/4953779b-d8064349-42ba471b-149cf76f-e82bb1c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ M w Hx COPD // airspace disease? COMPARISON: NO COMPARISON IMPRESSION: The lung volumes are mildly increased. The hemidiaphragms are slightly flattened on the lateral projection, consistent with the clinical history of COPD. No pleural effusions. No pneumonia, no pulmonary edema. The size of the cardiac silhouette is within normal ranges. The hilar and mediastinal structures are unremarkable. Moderate tortuosity of the thoracic aorta. Mild thoracic scoliosis. " b773f4c5-1c9c4c5e-3350dc3d-c4acbff1-92521287.jpg,test/p18/p18567332/s52093626/b773f4c5-1c9c4c5e-3350dc3d-c4acbff1-92521287.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and EKG changes. COMPARISONS: None. TECHNIQUE: Chest, AP and lateral. FINDINGS: The patient is status post sternotomy. The heart is at the upper limits of normal size. There is moderate unfolding of the thoracic aorta. The lungs appear clear. There are no pleural effusions or pneumothorax. Mild degenerative changes involve the lower thoracic spine. IMPRESSION: No evidence of acute disease. " d82157cd-d6d4ec49-b7781cac-66653870-9e31067f.jpg,test/p16/p16823121/s55317239/d82157cd-d6d4ec49-b7781cac-66653870-9e31067f.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: CT abdomen pelvis from ___. FINDINGS: The lungs are hyperinflated. A vague nodularity is noted overlying the right upper lobe on the AP view and most likely representative of costochondral calcifications at the right anterior first rib. There is mild left basilar atelectasis. Otherwise, the lungs are without a focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. No acute fractures identified. Mild degenerative changes are noted throughout the thoracic spine. IMPRESSION: 1. No acute cardiopulmonary process. 2. The lungs are hyperinlated and suggestive of chronic obstructive pulmonary disease. Additionally, a vague nodularity is noted overlying the right upper lobe on the AP view and most likely representative of costochondral calcifications at the right anterior first rib. However, given the patient's smoking history and evidence of COPD, a dedicated Chest CT is recommended in the non-emergent setting is recommended for further characterization. " d00854a6-df8bf2d6-211caaeb-5c14612a-3ccf9b2a.jpg,test/p13/p13942292/s59184622/d00854a6-df8bf2d6-211caaeb-5c14612a-3ccf9b2a.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. The lungs appear clear. There is probably a very small pleural effusion along the left, noting new blunting of the left frontal sulcus on the PA view. There is exaggerated kyphosis associated with a moderate anterior wedge compression deformity along the mid thoracic vertebral body, not significantly changed. The bones also appear demineralized, with multilevel compression deformities along the mid-to-lower thoracic spine, again not significantly changed. IMPRESSION: Suspected trace left-sided pleural effusion; otherwise no significant change. " c7bba0a3-3f314845-8c81a043-5861125c-3b68b1ea.jpg,test/p17/p17507847/s56055455/c7bba0a3-3f314845-8c81a043-5861125c-3b68b1ea.jpg,test," WET READ: ___ ___ ___ 9:08 AM Right pigtail pleural drainage catheter, unchanged and position. No pneumothorax. WET READ VERSION #1 ___ ___ ___ 9:14 PM Right pigtail pleural drainage catheter, unchanged and position. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p fall, with right PTX, right sided rib fx., TP fx., chest tube off suction, to water seal // please evaluate for PTX ( please do x-ray standing, end-expiratory) Please do x-ray at 7:30pm ___ IMPRESSION: Comparison to ___. No no relevant change as compared to the previous examination. The right pleural pigtail catheter is in stable position. On the current image, there is no evidence of pneumothorax. No evidence of tension. Borderline size of the heart. No lung parenchymal abnormalities. " 2ac14bf4-3bf9ff73-b31b734c-bbe0bcb9-3df7cd2a.jpg,test/p13/p13555772/s56148828/2ac14bf4-3bf9ff73-b31b734c-bbe0bcb9-3df7cd2a.jpg,test," FINAL REPORT HISTORY: Transient confusion. COMPARISON: Chest radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Mild left base atelectasis is seen. Cardiac and mediastinal silhouettes are stable. Aorta is mildly tortuous. No acute fractures are identified but bones appear diffusely demineralized. Mild degenerative changes are noted throughout the thoracic spine. IMPRESSION: Mild left base atelectasis. Otherwise, no acute cardiopulmonary process. " 2bd3998a-e66b2e4a-499ca34f-37e18872-990115c0.jpg,test/p15/p15456456/s56630469/2bd3998a-e66b2e4a-499ca34f-37e18872-990115c0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic breast cancer s/p thoracentesis today now with severe right chest pain // ___ etiology chest pain post ___ ___ etiology chest pain post ___ IMPRESSION: Comparison to ___. Slight increase in extent of the bilateral pleural effusions. Mild to moderate pulmonary edema persists. No cardiomegaly. ___, MD, PhD " 3db6fb96-239d91a8-84c66d00-ad0bdcc2-a906beb2.jpg,test/p17/p17907922/s53943266/3db6fb96-239d91a8-84c66d00-ad0bdcc2-a906beb2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumothorax following bronchoscopic lung biopsy s/p chest tube. Chest tube clamped this AM. // Please assess for interval change. Please assess for interval change. IMPRESSION: Comparison to ___. The left chest tube is in unchanged position. Minimal decrease in extent of the left apical pneumothorax that is still approximately 8 mm in diameter. No evidence of tension. Stable appearance of the heart and of the right lung. " a54713ee-60b91170-180aad4e-de016990-fed15123.jpg,test/p17/p17814773/s58470883/a54713ee-60b91170-180aad4e-de016990-fed15123.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, crackles, ___ swelling and DOE. // eval for pulmonary edema, cardiopulmonary process. COMPARISON: NO COMPARISON IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. In the right upper lobe, there is volume loss, associated to likely area of pleural thickening and nodular parenchymal changes. Overall, this could be post infectious or of granuloma toes origin. However, given the absence of comparison, CT is recommended. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. NOTIFICATION: The recommendation was at the to the radiology dashboard. " 1b86cb79-c3f9d6e8-6add9f24-6fb608c6-72f85eed.jpg,test/p13/p13648633/s55246303/1b86cb79-c3f9d6e8-6add9f24-6fb608c6-72f85eed.jpg,test," FINAL REPORT HISTORY: Liver transplantation. FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. The opacification at both bases, especially on the right, is decreasing. " 43e0db86-0ebcb1f1-ef92d313-55a295cb-eacd98d7.jpg,test/p18/p18815377/s55940723/43e0db86-0ebcb1f1-ef92d313-55a295cb-eacd98d7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with cough, fatigue, fever, left lower lobe crackles, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Heart size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No radiographic evidence of pneumonia. NOTIFICATION: The findings were discussed with ___, N.P. by ___ ___, M.D. on the telephone on ___ at 1:13 PM, 5 minutes after discovery of the findings. " 015b1c08-dcab2e78-81ab961b-31c18246-7bfa0454.jpg,test/p10/p10129254/s56509962/015b1c08-dcab2e78-81ab961b-31c18246-7bfa0454.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with persistent fevers, status post complicated hospital course for mesenteric ischemia, and ___ fungemia, evaluate for pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding portable AP single view chest examination obtained four hours earlier during the same day. The patient was now brought in upright position and a PA and lateral chest image could be obtained. Again, high positioned diaphragm probably related to abdominal process, obscured partially the heart shadow. Significant cardiac enlargement is unlikely. Unremarkable appearance of thoracic aorta without evidence of local contour abnormalities. Unchanged position of previously described PICC line terminating in lower third of SVC. The lateral and posterior pleural sinuses are free from any significant fluid accumulation. Again, there are bilateral thin plate atelectasis related to the high positioned diaphragms, but acute infiltrates of pneumonic appearance cannot be identified. No pneumothorax is seen in the apical area. IMPRESSION: No acute pneumonia in patient with history of fungemia in the presence of mesenteric ischemia. " 48041f12-dbdd5985-fc8a65da-de59d395-f8e20fb9.jpg,test/p11/p11740056/s54464608/48041f12-dbdd5985-fc8a65da-de59d395-f8e20fb9.jpg,test," WET READ: ___ ___ ___ 1:05 PM 1. Small left upper lobe opacity, improved since ___ likely representing a resolving pneumonia. 2. New mild prominence of the pulmonary vasculature without overt pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Bilateral crackles more pronounced on the right than the left. Recently hospitalized for pneumonia. Question pneumonia versus pulmonary edema. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Prior chest radiograph from ___ and ___. FINDINGS: As compared to yesterday's chest x-ray, there is a small left upper lobe opacity which has gradually decreased in size since the ___ study. There is new mild prominence of the pulmonary vasculature but without edema. No large pleural effusion or pneumothorax identified. No new focal consolidation is seen. The cardiomediastinal hilar contours are within normal limits. IMPRESSION: 1. Small left upper lobe opacity, improved since ___ likely representing a resolving pneumonia. Followup chest radiograph in ___ weeks recommended to assess for complete resolution. 2. New mild prominence of the pulmonary vasculature without pulmonary edema. " 001b564c-2016f35f-78684810-471cd5ec-0182c00f.jpg,test/p19/p19207509/s53860256/001b564c-2016f35f-78684810-471cd5ec-0182c00f.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with cough and wheezing, febrile TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 4d16832d-0dd4a2b1-e6444414-3fd0652b-4faa651b.jpg,test/p18/p18447299/s57790382/4d16832d-0dd4a2b1-e6444414-3fd0652b-4faa651b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with infected L kidney stone s/p PCN, now appearing septic. // Is there e/o PNA? TECHNIQUE: Portable chest COMPARISON: ___ at 00:40 FINDINGS: Compared to the prior exam there has been interval increase in the amount of hazy opacity in both lower lungs. While some of this is due to volume loss, an early infiltrate in either lower lobe cannot be totally excluded. There is mild pulmonary vascular redistribution. The heart is mildly enlarged. Left IJ line with tip in the mid SVC is unchanged. IMPRESSION: Bilateral lower lobe opacities could be due to volume loss versus infiltrate " 6dfb1256-20580b5c-957a3e1d-cf572804-3f6465a5.jpg,test/p17/p17545517/s56098603/6dfb1256-20580b5c-957a3e1d-cf572804-3f6465a5.jpg,test," FINAL REPORT INDICATION: Falls. COMPARISON: Chest radiograph ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: Mild patient rotation slightly limits evaluation. The heart size appears normal. The mediastinal and hilar contours are unremarkable. Large substernal thyroid goiter is again noted which narrows and deviates the airway to the left. No focal consolidation, pleural effusion or pneumothorax is seen. There is no pulmonary vascular congestion. There are no acute osseous abnormalities visualized including no displaced rib fractures. IMPRESSION: No acute cardiopulmonary abnormality. Thyroid goiter, which narrows and displaces the airway to the left. No definite displaced rib fractures are noted, but if there is continued clinical concern, a dedicated rib series can be obtained. " 54c88e94-9904ee04-efe28d52-a96aa7ec-689c202f.jpg,test/p18/p18680835/s52328921/54c88e94-9904ee04-efe28d52-a96aa7ec-689c202f.jpg,test," FINAL REPORT HISTORY: Chest tube removal. FINDINGS: In comparison with study of ___, the degree of pneumothorax is mildly larger. Left basilar opacification is consistent with atelectasis and effusion, though in the appropriate clinical setting, supervening pneumonia would have to be considered. There is persistent subcutaneous emphysema along the right lateral chest wall. This information was conveyed to Dr. ___. " 57e436da-01230033-373686d6-a9aaf0e8-27309b7a.jpg,test/p11/p11250239/s54707584/57e436da-01230033-373686d6-a9aaf0e8-27309b7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with pleuritic CP and fever, cough // acute pulm process COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Surgical clips noted in the upper abdomen. IMPRESSION: No acute intrathoracic process. " 53a875b2-e607444b-9f38ef96-fd8c9212-ef675054.jpg,test/p13/p13299092/s57227212/53a875b2-e607444b-9f38ef96-fd8c9212-ef675054.jpg,test," FINAL REPORT INDICATION: Question of aspiration. COMPARISON: None available. FINDINGS: AP view of the chest. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 9c280911-54c79d46-11d4b25d-f39630a9-aed465e2.jpg,test/p14/p14659307/s54435581/9c280911-54c79d46-11d4b25d-f39630a9-aed465e2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with l cea. eval pulm status // evaluation TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: There are low lung volumes. Bibasilar opacities could be atelectasis or pneumonia in the appropriate clinical setting. There is no evident pulmonary edema, pneumothorax or large pleural effusions. Cardiac size is top-normal. " 3c987d77-14fab54e-a661d8f9-eb0f7cea-fd299203.jpg,test/p10/p10184173/s58748642/3c987d77-14fab54e-a661d8f9-eb0f7cea-fd299203.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with sob // pna? TECHNIQUE: PA and lateral chest radiograph COMPARISON: None. FINDINGS: Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A left sixth posterior rib deformity appears chronic. IMPRESSION: No acute intrathoracic process. " 8319a988-d29958fe-84f9e52c-27337f18-35ab2332.jpg,test/p18/p18068738/s57090165/8319a988-d29958fe-84f9e52c-27337f18-35ab2332.jpg,test," FINAL REPORT HISTORY: ___-year-old with fever, cough, question pneumonia. COMPARISON: ___. FINDINGS: The lungs are well expanded and are clear. The pleural surfaces, cardiac silhouette, and mediastinal contours are normal. Extensive degenerative changes of the thoracic spine are again noted, including sclerosis within the lower thoracic vertebral body pedicle. IMPRESSION: No acute chest abnormality. " 2c026ccd-b307af92-fb8d2746-d7558e69-e2f3b286.jpg,test/p11/p11900721/s59114767/2c026ccd-b307af92-fb8d2746-d7558e69-e2f3b286.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cirrhosis p/w confusion // r/o PNA, effusion COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Bronchovascular markings are exaggerated by low lung volumes. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 3e2248aa-fadcd991-d4227891-01a43de5-fd31834a.jpg,test/p19/p19720782/s53593299/3e2248aa-fadcd991-d4227891-01a43de5-fd31834a.jpg,test," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with COPD, recent pneumonia in ___. Assess for interval change. PA and lateral chest views were obtained with patient upright position. Analysis is performed in direct comparison with the next preceding available chest examination of ___. The patient is status post right-sided small cell lung cancer and chemotherapy and radiation in ___. The previously described prominence of the hilar structures and elevated position of the right-sided diaphragm including blunting of the left lateral and posterior pleural sinus remains unaltered. No new abnormalities are identified. Heart size and thoracic aorta unchanged. The previously identifiable blunting of the left lateral pleural sinus has disappeared. No new abnormalities are identified when comparison is made between frontal and lateral views of the next preceding available study of ___. If patient had clinical presentation of pneumonia in ___, there is no evidence of any residual following such occurrence. IMPRESSION: Stable chest findings, no evidence of new acute infiltrates. " 8dc77e37-87c12a13-f9cec965-cc99db8b-0e1fd6e1.jpg,test/p10/p10699336/s58649883/8dc77e37-87c12a13-f9cec965-cc99db8b-0e1fd6e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p MCC, arrest x 2 w/ ROSC, s/p cric w/ TBI, C5-___ fxs with vert dissection, T3 vertebral fx, mediastinal hematoma, R ___, ___ and L ___ rib fxs, b/l hemothoraces, R orbital frx, R zygomatic frx s/p C3-T4 fusion (___) s/p trach (___) and PEG (___) with development of SDH c/b seizure disorder s/p R craniotomy, now with chronic respiratory failure requiring less frequent suctioning and bronchoscopy. // interval change interval change IMPRESSION: No relevant change as compared to the previous image. Moderate cardiomegaly. Unchanged position of the right PICC line. Unchanged areas of atelectasis at both the left and the right lung bases. No visible pneumothorax. The known bilateral rib fractures are not visualized on the current image. " 09cd3e85-7f4bd0cd-ade5bd87-44a6be4a-20b1353b.jpg,test/p19/p19550773/s52073571/09cd3e85-7f4bd0cd-ade5bd87-44a6be4a-20b1353b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: A large right pleural effusion is present with compressive atelectasis of the right lung accounting for near complete opacification of the right hemithorax. Mediastinal and left hilar contours appear unremarkable. Heart size cannot be assessed given the presence of the large right pleural effusion. Left lung is clear. No pulmonary vascular congestion is present. There are no acute osseous abnormalities. Clips are seen in the right upper quadrant of the abdomen likely reflective of prior cholecystectomy. IMPRESSION: Large right pleural effusion with associated compressive atelectasis. Clear left lung. " 1b1fcbce-f633be2e-3e3cb673-007603aa-4228f8f0.jpg,test/p11/p11673164/s57110076/1b1fcbce-f633be2e-3e3cb673-007603aa-4228f8f0.jpg,test," FINAL REPORT HISTORY: Chest pain, beriberi, cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The lungs are clear. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " ad3ec82d-f903749e-84943327-b9de401b-eee0ca84.jpg,test/p15/p15481731/s55388931/ad3ec82d-f903749e-84943327-b9de401b-eee0ca84.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dyspnea // eval for pulm edema, aspiration pna, ptx IMPRESSION: As compared to previous radiograph from ___, bilateral multifocal heterogeneous lung opacities consistent with multifocal pneumonia have slightly worsened in the upper and mid lungs but show interval improvement at the lung bases. Moderate to large loculated left hydro pneumothoraces are similar when consideration is made of differences in patient positioning between the 2 exams. No other relevant changes. " 59b4e2b8-fef21cab-00513f66-d81659ee-612ecf75.jpg,test/p10/p10828004/s59655181/59b4e2b8-fef21cab-00513f66-d81659ee-612ecf75.jpg,test," FINAL REPORT HISTORY: Shortness of breath. Evaluate for pulmonary edema. TECHNIQUE: Upright PA and lateral radiographs of the chest. COMPARISON: None FINDINGS: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces appear normal. There is no pleural effusion or pneumothorax. There is no focal opacity to suggest pneumonia. Cervical vertebral fusion hardware in place. IMPRESSION: No acute cardiopulmonary abnormality. " 2ef2d491-90e02996-3267b821-c7c874c3-375ef644.jpg,test/p12/p12119960/s56381986/2ef2d491-90e02996-3267b821-c7c874c3-375ef644.jpg,test," FINAL REPORT HISTORY: Patient with epigastric pain, eval for acute process. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs were obtained. The lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 8fca1bcf-e84c10e3-eb8096da-129158de-bed5a38f.jpg,test/p10/p10717732/s59066365/8fca1bcf-e84c10e3-eb8096da-129158de-bed5a38f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, pulmonary edema, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. There is unchanged evidence of mild pulmonary edema. The edema is not increased as compared to the previous image. Unchanged moderate cardiomegaly, no pleural effusions. No evidence of pneumonia. No pneumothorax. " 146a76b5-ba1a8724-edf4194a-12be779d-3fd5c248.jpg,test/p12/p12457907/s56981104/146a76b5-ba1a8724-edf4194a-12be779d-3fd5c248.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o lung Ca, recent admission for temporal headache, now with a few days of fatigue, new cough, lightheadedness. Please assess for pneumonia // ? pneumonia ? pneumonia COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Patient has had right upper lobectomy. The right breast prosthesis obscures the right lower lung on the frontal view. Configuration the diaphragm reflects severe emphysema. There is no focal pulmonary abnormality, or evidence of central adenopathy or pleural findings. Heart is normal size. " f966cb6e-26fab105-8f3264d3-61a8a2b6-9efe55f9.jpg,test/p16/p16946732/s56569757/f966cb6e-26fab105-8f3264d3-61a8a2b6-9efe55f9.jpg,test," FINAL REPORT INDICATION: ___ year old woman with SDH and intubated // interval change TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: The right-sided Port-A-Cath tip terminated in mid SVC. The endotracheal tube terminates 3 cm above the carina. The NG tube appears to have been pulled back but the side port is below the level of the diaphragm and the tip terminates in the stomach. Surgical clips are seen in the right axilla. There are no complications nor pneumothorax seen. Bilateral lung volumes are low. The heart size is top normal. Diffuse bony sclerosis and hyperdense vertebral bodies consistent with known bone metastasis are again noted and are stable and unchanged from prior study. IMPRESSION: 1. No interval change since ___ chest radiograph 2. Port-A-Cath, ET tube, and NG tube are in stable and unchanged positions. " 4c7621f6-002ff2d5-4dd125d4-62a38d9e-ee837903.jpg,test/p14/p14982705/s51426756/4c7621f6-002ff2d5-4dd125d4-62a38d9e-ee837903.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Biventricular pacemaker placement in a patient with cardiomyopathy. PA and lateral upright chest radiographs were reviewed in comparison to ___. Biventricular pacer has been implanted with the leads terminating over the expected location of right atrium, right ventricle, as well as left epicardial vein, although note is made that the left epicardial lead continues relatively anteriorly as compared to usual location. There is no pneumothorax. Heart size is enlarged but stable. Post-sternotomy wires are unremarkable. Lungs are essentially clear. Left lower lung opacities are unchanged and most likely reflect chronic findings giving their stability since at least ___. " 4193c777-9ab1bd8f-80a7b2fc-538152f4-d23645e8.jpg,test/p10/p10106244/s50711748/4193c777-9ab1bd8f-80a7b2fc-538152f4-d23645e8.jpg,test," FINAL REPORT INDICATION: ___F with cp and dyspnea // assess for worsening cardiac function TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Cardiac silhouette is top-normal in size. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f96ba86c-39a3183f-6332b5cf-00b192d9-11bb68e8.jpg,test/p15/p15972718/s53090759/f96ba86c-39a3183f-6332b5cf-00b192d9-11bb68e8.jpg,test," FINAL REPORT HISTORY: Chest tube placement. COMPARISON: ___ at 5:09 a.m. FINDINGS: Frontal radiograph of the chest shows a new right pleural catheter which is overlying the lung parenchyma. In the interim, there has been an interval improvement in the right pneumothorax with significant apical and medial components still visible. Lung volumes remain low, accentuating the pulmonary vasculature and cardiac contour. No left pneumothorax. IMPRESSION: Interval placement of right chest tube with improvement in right pneumothorax which still contains apical and medial components. " b7d083f7-48c6c6e3-38431fce-f95c5c69-9ad3d1ee.jpg,test/p11/p11668433/s56275300/b7d083f7-48c6c6e3-38431fce-f95c5c69-9ad3d1ee.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess ET tube and NG tube. NG tube tip is in the stomach, the sideport is distal to the EG junction, can be advanced for more standard position. ET tube tip is slightly high, 8 cm above the carina, can be advanced 1 cm for more standard position. There is mild cardiomegaly. There are no other interval changes from prior study performed six hours earlier. " 2a44b236-4bdbb6d6-08d9d7cf-303f9748-da448a53.jpg,test/p15/p15005501/s56051830/2a44b236-4bdbb6d6-08d9d7cf-303f9748-da448a53.jpg,test," FINAL REPORT INDICATION: ___M with MM and ANC-0 p/w fevers, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 27908e92-03307308-3d5b6752-dc8deb2d-1c607c52.jpg,test/p15/p15650109/s56280951/27908e92-03307308-3d5b6752-dc8deb2d-1c607c52.jpg,test," WET READ: ___ ___ ___ 6:58 AM Heterogeneous opacity within lower lobe only seen on lateral projection most likely represents atelectasis however clinical correlation is recommended to assess for early pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Fever. Assess for pneumonia. COMPARISON: Chest radiograph ___. FINDINGS: Cardiomediastinal contours are normal. Lungs are grossly clear on the frontal view. Questionable opacity overlying the lower thoracic spine on the lateral view without silhouetting of the diaphragm contours may be due to superimposition of normal structures due to suboptimal positioning on the lateral radiograph Limited assessment of the upper abdomen is within normal limits. IMPRESSION: No definite pneumonia. If clinical suspicion for infection persists, repeat lateral radiograph with improved positioning may be helpful to fully exclude a lower lobe pneumonia. " c64ba700-d8a34f9d-d387e6d3-b4bf750c-cd9149d6.jpg,test/p13/p13285652/s56532239/c64ba700-d8a34f9d-d387e6d3-b4bf750c-cd9149d6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with epigastric pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is not engorged. Lungs are clear. Minimal scarring is noted in the lung apices. No pleural effusion, focal consolidation or pneumothorax is identified. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 33c5530b-34e715e1-1922e5b8-4e455acc-2245d5fe.jpg,test/p16/p16156625/s56721077/33c5530b-34e715e1-1922e5b8-4e455acc-2245d5fe.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with fall on left side with bruising now mild sob // eval pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. Limited reference is made to CT from ___. FINDINGS: Cortical irregularity and lucency through the lateral seventh left rib may reflect a nondisplaced fracture or chronic fracture as seen on the prior exam. No evidence of pneumothorax. Overall appearance of the lungs is otherwise unchanged. Slight increased opacity in the right mid thorax could reflect a nodular opacity demonstrated on cross-sectional CT from ___. The heart is severely enlarged all including the right heart and left atrium, best appreciated on prior CT and may suggest cardiomyopathy. Elevation of the left mainstem bronchus is overall unchanged, likely related to left heart enlargement. The descending thoracic aorta is tortuous and/or ectatic, unchanged. Scoliosis is also unchanged. IMPRESSION: 1. Left 7th rib deformity may be acute or chronic. Correlate with focal tenderness and dedicated rib films could be obtained to further assess. 2. No pneumothorax. 3. Persistent severe cardiomegaly, concerning for cardiomyopathy. 4. Opacity in right mid hemithorax could correspond to opacity seen on CT from ___ and a dedicated chest CT could be performed to further evaluate, as previously recommended. " 62b670ac-9b5d6832-6efa71d0-86120db8-4c7c99aa.jpg,test/p17/p17201534/s55310327/62b670ac-9b5d6832-6efa71d0-86120db8-4c7c99aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p ct removal // r/o ptx r/o ptx IMPRESSION: Compared to chest radiographs ___ through ___ at 08:59. Moderate pulmonary edema has improved. Concurrent consolidation particular in the right lower lobe is not excluded. No pneumothorax or appreciable pleural effusion or any mediastinal widening following removal of pleural and midline drains. Heart size normal. ET tube and nasogastric drainage tube are in standard placements. " 73428336-53010224-6c99184e-a53fe752-73af809a.jpg,test/p11/p11218867/s53495533/73428336-53010224-6c99184e-a53fe752-73af809a.jpg,test," FINAL REPORT INDICATION: ___-year-old woman status post VATS mediastinal mass biopsy with pneumothorax status post chest tube removal. FINDINGS: PA and lateral chest radiographs were obtained. Small left apical pneumothorax has not gotten bigger since ___. The left pleural effusion is considerably smaller. No new consolidation. There are no abnormal cardiac or mediastinal contours. A Port-A-Cath tip remains in the upper right atrium. IMPRESSION: Stable appearance of small left apical pneumothorax. Decreased pleural effusion. " f60c0da6-1135e487-c0927d25-ca7dc61f-a3d7f277.jpg,test/p17/p17637743/s52000912/f60c0da6-1135e487-c0927d25-ca7dc61f-a3d7f277.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with empyema s/p R vats decortication // eval for interval change TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: There is a knee new ET tube which is 2 low, at the right mainstem bronchus. The right IJ line tip is at the distal SVC . There is increased size of the right pleural effusion layering posteriorly and surrounding the right lung. The 2 right-sided chest tubes are again visualized. There is increased opacity about the right lung centrally. It is unclear how much of this is fluid layering posteriorly and a how much is due to volume loss/infiltrate There is a small left effusion. There is volume loss at both bases. IMPRESSION: Worsened appearance to the lungs. ET tube 2 low, at the right mainstem bronchus NOTIFICATION: At the time of dictating this report at 10:00 on ___ the findings were communicated to the nurse caring for the patient, ___. She stated that that ET tube had already been repositioned at that time " b0ff38be-3d24e5be-705bfa7b-1afa6631-56aaa363.jpg,test/p14/p14371035/s54660673/b0ff38be-3d24e5be-705bfa7b-1afa6631-56aaa363.jpg,test," FINAL REPORT AP CHEST, 12:23 P.M., ___ HISTORY: Previous right upper lobe collapse. IMPRESSION: AP chest compared to ___ through ___ at 3:42 a.m. This morning's right upper lobe collapse has resolved. Bibasilar consolidation persists, not changed appreciably since earlier today, but improved in the left lower lobe since ___: Small right pleural effusion is stable. ET tube and nasogastric tube are in standard placements. Right internal jugular line ends alongside the dual-channel left internal jugular line at the origin of the SVC. No pneumothorax. " 186bf6c8-fd00f1bb-046797cf-38c27f23-1e055c42.jpg,test/p10/p10532853/s57532026/186bf6c8-fd00f1bb-046797cf-38c27f23-1e055c42.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath and edema TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. Heart size remains moderately enlarged. Mediastinal and hilar contours are unchanged, and no pulmonary edema is present. A moderate size right pleural effusion is increased in the interval, and a trace left pleural effusion appears new. Right basilar opacity likely reflects compressive atelectasis. No pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Increased size of bilateral pleural effusions, moderate on the right and small on the left, with right basilar compressive atelectasis. No pulmonary edema. " f52220c5-ade72f1c-fa667ab8-53350743-32c1a9e6.jpg,test/p15/p15002645/s54829151/f52220c5-ade72f1c-fa667ab8-53350743-32c1a9e6.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest were obtained. The heart is normal size and cardiomediastinal contours are stable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 2d1346b8-fd4acf53-9afafc4d-352b9c45-efdc8bf3.jpg,test/p16/p16741854/s54860383/2d1346b8-fd4acf53-9afafc4d-352b9c45-efdc8bf3.jpg,test," FINAL REPORT HISTORY: ___-year-old male with pleural effusion. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: A loculated left pleural effusion appears similar compared to prior. Unchanged left apical density may represent pleural fluid and/or thickening. Left lower lobe atelectasis persists. Calcified pleural plaques are likely related to prior asbestos exposure. No pneumothorax is seen. Heart and mediastinal contours are stable with aortic calcifications. IMPRESSION: Stable appearing left pleural effusion. " d121e50e-d7a8d19b-3afa1c5d-7e86acd3-e2a0a4c2.jpg,test/p18/p18977683/s54406792/d121e50e-d7a8d19b-3afa1c5d-7e86acd3-e2a0a4c2.jpg,test," FINAL REPORT HISTORY: Chest pain for a few seconds with shortness of breath. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___ chest CT and ___ chest radiograph. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vascularity is not engorged. There is no focal consolidation. Chronic interstitial abnormality is noted predominantly in both lung bases and along the periphery. No pleural effusion or pneumothorax is identified. Old displaced fracture involving the left proximal clavicle is again noted. ___ fiducial markers are seen within the liver dome. IMPRESSION: Chronic interstitial abnormality within the lung bases. Otherwise no acute cardiopulmonary abnormality. " 5ad7f712-55e83af3-1e88ef94-6aa6923a-a87609c2.jpg,test/p17/p17990107/s54349207/5ad7f712-55e83af3-1e88ef94-6aa6923a-a87609c2.jpg,test," FINAL REPORT INDICATION: ___-year-old male patient with fever and recent spinal surgery, to rule out pneumonia. COMPARISON: None available. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without focal consolidation, pleural effusion or pneumothorax. Mildly tortuous thoracic aorta is noted. IMPRESSION: No acute cardiopulmonary pathology. " fa436a49-d0fe8e9c-c79a71c6-1982d148-1f044bc3.jpg,test/p12/p12078716/s52106628/fa436a49-d0fe8e9c-c79a71c6-1982d148-1f044bc3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever // Please evaluate for pneumonia Please evaluate for pneumonia COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable in appearance. Replaced aortic valve is in expected position. Interval improvement of left basal atelectasis/ consolidation demonstrated. No new abnormality is seen. " af8b3b3b-83e9d385-7193fa9c-c74ccf5a-2614ef94.jpg,test/p18/p18284792/s54547456/af8b3b3b-83e9d385-7193fa9c-c74ccf5a-2614ef94.jpg,test," FINAL REPORT EXAM: Chest x-ray, frontal and lateral views. CLINICAL INFORMATION: Vertebrobasilar insufficiency, presenting with episode of slurred speech, facial droop and unresponsiveness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and CABG. No focal consolidation is seen. There is slight blunting of the posterior right costophrenic angle which may be due to a very trace pleural effusion or pleural thickening. No pneumothorax is seen. The cardiac silhouette remains mildly enlarged. Mediastinal contours are stable, with the aorta calcified and tortuous. Mild left basilar atelectasis is seen. IMPRESSION: Mild left basilar atelectasis. Possible slight blunting of the posterior right costophrenic angle on the lateral view may be due to trace pleural effusion or pleural thickening. " 478c08e1-e7a57261-02125adf-77d9e924-251135f1.jpg,test/p18/p18079481/s56374996/478c08e1-e7a57261-02125adf-77d9e924-251135f1.jpg,test," WET READ: ___ ___ ___ 10:33 PM Very low lung volumes with large heart and likely bilateral effusions with vascular congestion and basal atelectasis. ______________________________________________________________________________ FINAL REPORT HISTORY: Fall with low saturations. FINDINGS: In comparison with the earlier study of this date, the patient has taken a somewhat better inspiration. Nevertheless, lines are still low. There is enlargement of the cardiac silhouette with vascular congestion and bilateral effusions with compressive atelectasis. Nasogastric tube extends to the distal stomach. " 11e70783-c53b8a9e-63afffdc-27f198ce-79058ea0.jpg,test/p19/p19622209/s53325767/11e70783-c53b8a9e-63afffdc-27f198ce-79058ea0.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Choking episode. Question aspiration. COMPARISON: None. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. There is vague opacity in the lingula but probably due to minor atelectasis, airway inflammation or both. Suspicion for a significant aspiration event is low, although some degree of aspiration is difficult to exclude as an explanation for this appearance. IMPRESSION: Vague streaky opacity at the left lung base. " c7de03b0-8fccff07-1c61c4a5-3a0cb09c-22cac8f0.jpg,test/p12/p12357339/s53660580/c7de03b0-8fccff07-1c61c4a5-3a0cb09c-22cac8f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain COMPARISON: ___ chest radiograph and CT chest. FINDINGS: PA and lateral views of the chest provided. Spinal hardware partially visualized extending from the lower thoracic inferiorly to the lumbar spine. Clips are noted in the upper abdomen. The heart appears top-normal in size. There is prominence of the main pulmonary artery contour which was also seen on prior CT chest and raises concern for pulmonary arterial hypertension. Lungs are clear. No pleural effusion or pneumothorax. IMPRESSION: Top normal heart size with prominence of the main pulmonary artery, correlate for pulmonary arterial hypertension. Otherwise unremarkable exam. " 7f1aa5ad-180daea9-b2d92b76-2cf38a72-d8187772.jpg,test/p18/p18784363/s58143522/7f1aa5ad-180daea9-b2d92b76-2cf38a72-d8187772.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain/dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph and chest CTA ___ FINDINGS: Mild enlargement of the cardiac silhouette is demonstrated. The mediastinal contour is unchanged. There is mild pulmonary vascular congestion. Previously noted focal opacity within the left upper lobe has resolved. There is minimal left lower lobe atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. IMPRESSION: Mild pulmonary vascular congestion. " 0f1d2df7-81a8282c-071a608f-2373aaeb-9f1ef736.jpg,test/p14/p14104022/s58658685/0f1d2df7-81a8282c-071a608f-2373aaeb-9f1ef736.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Gastrointestinal bleed, mediastinal widening. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Moderate cardiomegaly, tortuosity of the thoracic aorta. Minimal apical scarring. The mediastinal ___ and the mediastinal lines and boundaries are unremarkable. No pleural effusions. No pneumonia. No pulmonary edema. " 9ac8d547-d6a83401-09ca648e-c9cc24af-e9689071.jpg,test/p19/p19338591/s57069387/9ac8d547-d6a83401-09ca648e-c9cc24af-e9689071.jpg,test," FINAL REPORT INDICATION: Left chest pain, here to evaluate for pneumothorax or other acute cardiopulmonary process. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs are symmetrically well expanded and well aerated. No focal consolidation concerning for pneumonia, pleural effusion, or pneumothorax is detected. Biapical pleural thickening is noted on the left greater than right. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The trachea is midline. The visualized upper abdomen demonstrates no free air beneath the right hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " bb2696f7-52dc7611-0260e012-d7507862-709daaf5.jpg,test/p12/p12448098/s57392953/bb2696f7-52dc7611-0260e012-d7507862-709daaf5.jpg,test," FINAL REPORT HISTORY: Status post right VATS right lower lobe wedge resection with recent removal of chest tube. TECHNIQUE: PA and lateral chest radiograph, 2 views. COMPARISON: ___. FINDINGS: There has been interval removal of the right chest tube with no appreciable pneumothorax. Lung volumes are persistently low with bibasilar atelectasis and small right effusion. A substantial abnormal opacification is present in the lower lung posteriorly on lateral view without a clear frontal correlate which may represent a hematoma. IMPRESSION: 1. Interval removal of right chest tube without appreciable pneumothorax. 2. Substantial abnormality in the posterior lower lung on lateral view without clear frontal correlate. Bilateral oblique chest radiograph is recommended for localization and further characterization. " f42eaf2a-1312607f-c122b14e-a9d2df14-637e74be.jpg,test/p19/p19700168/s53140329/f42eaf2a-1312607f-c122b14e-a9d2df14-637e74be.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath, wheezing. Evaluate for acute cardiopulmonary process. COMPARISON: ___ and ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are hyperinflated without focal opacities. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Hyperinflated lungs might represent emphysematous disease. Otherwise normal chest radiographic examination. " 637acaed-f7542d86-eb99d614-46270fc5-e01e748c.jpg,test/p10/p10462639/s58996083/637acaed-f7542d86-eb99d614-46270fc5-e01e748c.jpg,test," FINAL REPORT INDICATION: ___-year-old female with abdominal pain, vomiting, bloody bowel movements since paracentesis on ___, patient has a fever to 101, question pneumonia. COMPARISON: Chest radiograph from ___ and a CT of the torso from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show a focal linear opacity in the right middle lobe. The cardiomediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present. There is no free air. IMPRESSION: Linear plate like atelectasis in the right middle lobe. No evidence of free air. " 7d828151-9ecf0eaf-d41908f2-bc224255-15bd5523.jpg,test/p15/p15945073/s52591573/7d828151-9ecf0eaf-d41908f2-bc224255-15bd5523.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post AAA repair. COMPARISON: ___. FINDINGS: As compared to the previous image, pre-existing bilateral parenchymal opacities show a tendency to confluate. Their overall extent, however, has not increased. Unchanged size of the cardiac silhouette. Unchanged monitoring and support devices. Unchanged bullous disease at the right lung apex. " 44308e97-cc015be3-726b3003-f9fcc40e-85bda748.jpg,test/p13/p13562422/s59545983/44308e97-cc015be3-726b3003-f9fcc40e-85bda748.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever // eval for PNA eval for PNA IMPRESSION: In comparison with the study of ___ for, the patient has taken a better inspiration. Continued enlargement of the cardiac silhouette with tortuosity of the aorta. However, the pulmonary vascularity is now essentially within normal limits and there is no evidence of acute focal pneumonia. Prominence of the superior mediastinum is again noted. The underlying cause for this process would require CT for precise characterization. " 0418eb97-60b87354-32af5aa5-7a5d3a67-81ad70d3.jpg,test/p15/p15606157/s55679114/0418eb97-60b87354-32af5aa5-7a5d3a67-81ad70d3.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fall. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 27e3c13f-70332a2b-85812e35-8e4d60c1-d8c9dcba.jpg,test/p16/p16266748/s51281225/27e3c13f-70332a2b-85812e35-8e4d60c1-d8c9dcba.jpg,test," FINAL REPORT INDICATION: Right visual loss and right arm weakness. Assess for pneumonia. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " accb7b33-c43e2e5a-186050bd-425f970a-a4c56112.jpg,test/p14/p14809300/s53916475/accb7b33-c43e2e5a-186050bd-425f970a-a4c56112.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung cancer s/p cyerknife and COPD s/p fall with pelvis and radial fracture with LLL pnemonia and pulmonary edema. // interval change. COMPARISON: ___ IMPRESSION: AS COMPARED TO THE PREVIOUS RADIOGRAPH, THE PRE-EXISTING SIGNS OF PULMONARY EDEMA HAVE SUBSTANTIALLY DECREASED IN SEVERITY. HOWEVER, LIKELY ATELECTATIC OPACITIES AT THE LUNG BASES PERSIST IN ALMOST UNCHANGED MANNER. BORDERLINE SIZE OF THE CARDIAC SILHOUETTE IS STABLE. " d1715f2e-e02dd135-c2b79c0a-7f270fa3-709df225.jpg,test/p11/p11201441/s55955364/d1715f2e-e02dd135-c2b79c0a-7f270fa3-709df225.jpg,test," FINAL REPORT INDICATION: Polytrauma after fall. COMPARISONS: Chest radiograph, ___. Chest CT, ___. FINDINGS: Bilateral chest tubes are unchanged in position. An endotracheal tube is seen 2.7 cm from the carina. The right central line ends at the atriocaval junction. A feeding tube is in place with the tip out of the field of view. In comparison to the prior radiograph, there are lower lung volumes which is likely due to acquisition of the image in a different phase of the respiratory cycle or decrease in PEEP. As a consequence, the right and left lower lobe opacities appear slightly larger, but are likely unchanged in size. There is a small left pleural effusion. There is no pneumothorax. The previously seen deep sulcus sign is not present. Again noted are rib fractures of the seventh and eighth right ribs. IMPRESSION: Decreased lung volumes with no significant change in the right and left lower lobe opacities. " 61b6a787-a7a88682-073096d9-1de0a892-e2884f81.jpg,test/p14/p14263099/s54009356/61b6a787-a7a88682-073096d9-1de0a892-e2884f81.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p cabg // eval for effusion TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior radiographs the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded lungs. There are small bilateral pleural effusions and improving bibasilar atelectasis. There is a small hydro-pneumothorax seen on the lateral view. It is not possible to compare this finding to prior studies given lack of prior lateral radiographs. The patient is status post cardiac surgery with intact median sternotomy wires and an expected postoperative contour. IMPRESSION: 1. Small bilateral pleural effusions; improving bibasilar atelectasis. 2. Small anterior hydro-pneumothorax seen on the lateral view only. " 0b8a2e31-92260300-a039c577-332d74c2-e278686c.jpg,test/p12/p12111976/s58782481/0b8a2e31-92260300-a039c577-332d74c2-e278686c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with heart failure and VT // ?edema, effusion, PNA COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The patient carries a new right pectoral Port-A-Cath. The course of the pacemaker lead is unchanged. Moderate cardiomegaly. Atelectasis in the middle lobe region. No pleural effusions. No overt pulmonary edema. " 6e1f9415-3700d451-ccea7386-80c231f9-9ec7256f.jpg,test/p14/p14785541/s57042084/6e1f9415-3700d451-ccea7386-80c231f9-9ec7256f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, dyspnea on exertion TECHNIQUE: Chest PA and Lateral COMPARISON: ___ FINDINGS: The lungs are hyperinflated with attenuation of vascular markings towards the apices compatible with known emphysema. Lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is normal in size. IMPRESSION: No evidence of acute cardiopulmonary process. Emphysema. " 816c0e3e-878060cd-e0b7fe68-afab38d8-765e8f5b.jpg,test/p15/p15672432/s50509949/816c0e3e-878060cd-e0b7fe68-afab38d8-765e8f5b.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with complex medical history p/w general malaise and intermittent shortness of breath with retching // consolidation TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Vascular congestion is unchanged. The lungs are otherwise clear. The heart is within normal limits. Osseous structures are unremarkable. No pneumothorax. IMPRESSION: Mild vascular congestion is unchanged. " f74ae184-a05f9f39-0e9060bb-902c9b0f-2e240401.jpg,test/p17/p17244595/s54131419/f74ae184-a05f9f39-0e9060bb-902c9b0f-2e240401.jpg,test," FINAL REPORT INDICATION: ___ year old man with copd, lung ca s/p pneumonectomy // please evaluate ETT placement after tube was pushed in TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: In comparison to prior radiograph, there has been no interval change substantial left lung volume loss and associative leftward mediastinal shift. The right lung is fairly hyperexpanded and crosses the thoracic midline. Unchanged atelectatic changes in the right lung. The cardiomediastinal silhouette is not well assessed due to the significant mediastinal shift. There is likely a small right pleural effusion. The ET tube now terminates approximately 6 cm above the carina. The NG tube terminates within the stomach. The left PICC line likely terminates in the cavoatrial junction however it is difficult to assess considering the degree of mediastinal shift. Stable mild thoracic scoliosis. IMPRESSION: The ET tube terminates 6 cm above the carina. Otherwise unchanged study. " 1998f557-9e564157-86c5876a-34dfe978-ff745c39.jpg,test/p17/p17806192/s55190299/1998f557-9e564157-86c5876a-34dfe978-ff745c39.jpg,test," FINAL REPORT HISTORY: Right rib pain status post fall. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. No definite rib fracture is identified. IMPRESSION: No acute cardiopulmonary abnormality. No definite rib fracture identified; however, conventional radiography is limited for the evaluation of chest wall trauma. " f8894be0-6e448f2f-bdcc45e5-a54cc391-3de5da70.jpg,test/p14/p14350419/s54987115/f8894be0-6e448f2f-bdcc45e5-a54cc391-3de5da70.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Mild cardiomegaly is re- demonstrated. Mediastinal and hilar contours are similar. Pulmonary vasculature is not engorged. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. Moderate multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " b72d222e-e0aa4294-ded07983-c93963d4-38479008.jpg,test/p19/p19453522/s56783695/b72d222e-e0aa4294-ded07983-c93963d4-38479008.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypotension/shock // Post internal jugular line placement Post internal jugular line placement COMPARISON: ___ obtained at 04:22 IMPRESSION: Right internal jugular line tip is at the level of lower SVC. Cardiomediastinal silhouette is stable. There is no pneumothorax. There is substantial progression of right basal consolidation concerning for interval development of aspiration or rapidly progressing pneumonia. RECOMMENDATION(S): Short-term follow-up within 6 hr is recommended with chest radiograph to document the dynamic changes in the right basal consolidation. In case of rapid improvement aspiration would be most likely a etiology. Otherwise pneumonia would be a consideration. " cdb4b58a-94c34bb5-5c342297-f6dfa589-fbf21d5c.jpg,test/p16/p16986843/s59674243/cdb4b58a-94c34bb5-5c342297-f6dfa589-fbf21d5c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough. Evaluate for PNA. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is a retrocardiac opacity which is concerning for pneumonia, less likely hiatal hernia. Right lung is clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Left retrocardiac opacity concerning for pneumonia. NOTIFICATION: D/w Dr. ___ at 4:40PM by Dr. ___ " 7c4778e0-36c14e02-9c92b172-00d50488-41ac87b3.jpg,test/p16/p16515399/s52640281/7c4778e0-36c14e02-9c92b172-00d50488-41ac87b3.jpg,test," FINAL REPORT INDICATION: History: ___F with dementia, CAD presenting with SOB, lightheadedness after rollover MVC // R/O ICH, aortic trauma TECHNIQUE: Upright AP and lateral radiographs of the chest COMPARISON: None available FINDINGS: The lungs are mildly hyperexpanded but clear. The heart is not enlarged. There is no mediastinal widening. Aortic contour is grossly normal. There is no pneumothorax or large pleural effusion. Within the limitations of routine chest radiography the included osseous structures are grossly intact. IMPRESSION: No acute cardiopulmonary abnormality. " 9e0b2676-6abf874d-3c2e731b-4cded6b6-bf03d173.jpg,test/p13/p13561687/s57713414/9e0b2676-6abf874d-3c2e731b-4cded6b6-bf03d173.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough and fever on chemotherapy for cholangiocarcinoma. COMPARISON: Chest radiograph dated ___ as well as CT chest dated ___. FINDINGS: Frontal and lateral chest radiograph demonstrates well expanded and clear lungs with no focal consolidation identified. Linear opacity within the left lower lung base consistent with atelectasis. There is no pleural effusion or pneumothorax. Re- demonstration of calcified granuloma projecting over the right midlung and better demonstrated on CT dated ___ (3:20). The cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No pneumonia. These findings were communicated to the ordering physician, ___. ___, by Dr. ___, ___ telephone at ___ on ___ immediately upon reivew of the radiographs. " 11802560-da822969-0a4c3a14-7b6e0949-0baa8df0.jpg,test/p17/p17747028/s59185760/11802560-da822969-0a4c3a14-7b6e0949-0baa8df0.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain, question etiology of pain. FINDINGS: PA and lateral views of the chest were obtained. The lungs are clear and well expanded. No focal consolidation, effusion, or pneumothorax is seen. Heart size is normal. Mediastinal contour is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 5f9db800-c6efaf30-5bdcd51d-f74f5a75-8ec0cf48.jpg,test/p10/p10070592/s58936443/5f9db800-c6efaf30-5bdcd51d-f74f5a75-8ec0cf48.jpg,test," FINAL REPORT HISTORY: ___-year-old man with cough. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs and normal hilar and mediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiographs of the chest. " d20909d7-24c68f9f-d8caafed-4f3732aa-abb5e83b.jpg,test/p13/p13443421/s59098639/d20909d7-24c68f9f-d8caafed-4f3732aa-abb5e83b.jpg,test," FINAL REPORT INDICATION: ___F with intubation // eval tube position TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: Endotracheal tube tip is 3.8 cm from the carina. Enteric tube seen within the stomach, side-port past the GE junction.Lungs are grossly clear. There is no confluent consolidation, large effusion or pneumothorax based on this portable film. Cardiomediastinal silhouette is within normal limits. IMPRESSION: ET tube in appropriate position. " 839ef0d4-2ae1a27b-fbd66ac8-a6ebcfb9-441aedc9.jpg,test/p19/p19058918/s51984020/839ef0d4-2ae1a27b-fbd66ac8-a6ebcfb9-441aedc9.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Crampy chest pain after eating. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. Mild blunting of the left posterior costophrenic sulcus makes it difficult to exclude a trace effusion, but a pleural effusion is doubtful. There is no pneumothorax. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " c11c536a-e4b66ef7-891e3356-57b6a51c-77e36ea4.jpg,test/p13/p13228928/s51008157/c11c536a-e4b66ef7-891e3356-57b6a51c-77e36ea4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Line placement attempt, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a line placement was attempted. There is no evidence of pneumothorax or other complications. The lung volumes remain low. Moderate elevation of the left hemidiaphragm with atelectasis at the left lung bases. Moderate cardiomegaly. No larger pleural effusions. No pneumonia. " 0f880fbe-86f43968-5b896309-ebac11aa-43848763.jpg,test/p12/p12590117/s51695252/0f880fbe-86f43968-5b896309-ebac11aa-43848763.jpg,test," FINAL REPORT INDICATION: Fall. COMPARISON: Radiographs available from ___ through ___. FRONTAL CHEST RADIOGRAPH: An endotracheal tube terminates 7 cm above the carina. A right subclavian central line terminating at the cavoatrial junction and bilateral thoracostomy tubes are unchanged. Mild right chest wall subcutaneous emphysema is stable since ___. Multiple right-sided rib fractures are again seen. There is no pneumothorax or pleural effusion. Mild central pulmonary vascular congestion remains unchanged. Moderate left basilar atelectasis persists. IMPRESSION: 1. Unchanged position of multiple support lines. 2. Persistent moderate left basilar atelectasis and mild pulmonary vascular congestion. 3. No new consolidation, effusion, or pneumothorax. " 19d48311-a678c3c4-83f49b89-3cd4720e-d8208787.jpg,test/p16/p16061352/s56521074/19d48311-a678c3c4-83f49b89-3cd4720e-d8208787.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY ___ year old woman with PMHx of SLE, autoimmune hepatitis with cirrhosis complicated by variceal bleed and hepatic encephalopathy, who is presenting with acute kidney injury and found to have left-sided crackles on exam. // ?pleural effusion, pneumonia ?pleural effusion, pneumonia COMPARISON: ___ FINDINGS: Bronchovascular markings are prominent. The left costophrenic sulcus is blunted as before. This appearance appears improved on the lateral view. The lungs are otherwise clear. The heart is within normal limits in size. The aorta is mildly tortuous and calcified. Mediastinal structures are stable. The bony thorax is grossly intact. Surgical clips are again projected in the anterior chest and left axilla. IMPRESSION: No active pulmonary disease. Evidence of small left effusion which may have decreased slightly in the interval. " fc21edcc-98acf2f9-ca9e5247-cd404bed-b98506ae.jpg,test/p12/p12452029/s54141835/fc21edcc-98acf2f9-ca9e5247-cd404bed-b98506ae.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have decreased. There is a new area of atelectasis in the retrocardiac lung regions. However, the change shows no air bronchograms, which favors atelectasis over pneumonia. No other lung parenchymal changes. Normal appearance of the cardiac silhouette. No larger pleural effusions. " 44a6abcb-365232c5-8cec594f-087df9b4-b3883df9.jpg,test/p10/p10905492/s52142342/44a6abcb-365232c5-8cec594f-087df9b4-b3883df9.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with cough and congestion // evaluate for pneumonia evaluate for pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___ and thyroid ultrasound from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. Again seen is rightward deviation of the trachea, likely reflective of known enlarged thyroid gland. IMPRESSION: No acute cardiopulmonary process. " 24b184a7-e2a15bda-cf76a16c-41fee206-bb122251.jpg,test/p18/p18481645/s54851345/24b184a7-e2a15bda-cf76a16c-41fee206-bb122251.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain and abnormal EKG. COMPARISON: Scout view from CT performed on ___ and chest radiographs from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute disease. " d2509f14-7b4636f3-e87211d7-e281bb08-e0a44f12.jpg,test/p16/p16566006/s50551410/d2509f14-7b4636f3-e87211d7-e281bb08-e0a44f12.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with pna // check ETT COMPARISON: ___. IMPRESSION: left lower lobe collapse, new on ___, accompanied by small to moderate left pleural effusion has not improved. Today lung volumes are lower, interstitial edema is new along with probable small right pleural effusion and heart size, though a normal, is slightly larger. ET tube in standard placement. Left internal jugular line ends in the upper SVC, upper enteric drainage tube passes to the mid portion of the nondistended stomach. " 4ac22406-b679555e-9e8ac587-2f92b4b7-d0ec3eb4.jpg,test/p13/p13247581/s55156378/4ac22406-b679555e-9e8ac587-2f92b4b7-d0ec3eb4.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after sternal debridement. Portable AP radiograph of the chest was compared to ___. The right central venous line tip is not clearly seen, most likely at the cavoatrial junction. Mediastinal drains and new sternal wires are having expected appearance. Lungs are essentially clear with improved aeration of the left lower lung. No appreciable pneumothorax is seen. " 01db5641-3ac900df-81dcda14-925ecaa4-8c39f4ff.jpg,test/p11/p11359188/s58121453/01db5641-3ac900df-81dcda14-925ecaa4-8c39f4ff.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Fever. TECHNIQUE: Chest PA, lateral and repeat lateral. COMPARISON: ___. FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. There is trace left base atelectasis. Blunting is seen posteriorly suggesting a small effusion. Lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Possible small effusion seen on lateral view only, side indeterminate. Otherwise no acute cardiopulmonary abnormality. " b2ea5736-8e0f4b60-e2093c3a-3ad0f24d-0cf298d2.jpg,test/p16/p16139978/s59275589/b2ea5736-8e0f4b60-e2093c3a-3ad0f24d-0cf298d2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx (+) PPD, asympt // screen screen IMPRESSION: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Specifically, no evidence of old healed tuberculous disease. Of incidental note are surgical clips in the lower neck. " 334b6649-53c46734-b2a7e34a-5693b30b-b046d182.jpg,test/p19/p19607572/s53517298/334b6649-53c46734-b2a7e34a-5693b30b-b046d182.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // PTX TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or edema. There is no pneumothorax. Cardiac silhouette is top-normal. Atherosclerotic calcifications are seen at the aortic arch. There are hypertrophic changes in the spine. IMPRESSION: No acute cardiopulmonary process. " 411a70f5-cac14485-cf0baa53-7c7e5e71-cb0edebf.jpg,test/p12/p12238407/s53130259/411a70f5-cac14485-cf0baa53-7c7e5e71-cb0edebf.jpg,test," FINAL REPORT INDICATION: History: ___M with sob // tube placement TECHNIQUE: 2 supine views of the chest. COMPARISON: Radiograph from the same day. FINDINGS: 2 supine views of the chest demonstrate progressive advancement of an NG tube into the stomach. An ET tube has been placed in the interim which resides cm in the carinal. Better evident than on the prior study is a opacity in the right lower lobe concerning for pneumonia. Additional retrocardiac opacities are also noted. Cardiac size remains stable. The remainder the exam is unchanged with no pneumothorax or pleural effusion. IMPRESSION: A NG tube in stomach. Opacity right lower lobe and retrocardiac opacity concerning for multifocal pneumonia. " 26ee4faa-6bbf0409-e678307d-f256340d-61c584ba.jpg,test/p18/p18458646/s57664368/26ee4faa-6bbf0409-e678307d-f256340d-61c584ba.jpg,test," WET READ: ___ ___ ___ 7:11 PM new left lower lobe opacification may represent atelectasis and effusion cannot exclude infectios preocess. unchanged cardiomediastinal contours. ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:27 P.M. ON ___ HISTORY: ___-year-old man with ischemic colitis after sigmoid colectomy. Increasing confusion and agitation, question pneumonia. IMPRESSION: AP chest compared to ___: Lung volumes are lower, so atelectasis is to be expected, nevertheless the large region of consolidation at the base of the left lung raises concern for pneumonia. Small bilateral pleural effusion is new. Opacification of the infrahilar right lower lobe is more readily identified as atelectasis. Interval increase in heart size is a function of the positioning, there is no pulmonary edema or mediastinal vascular engorgement. " 02f391f8-018af30d-39f3a0a6-06d3b30a-4c1ea6aa.jpg,test/p17/p17370561/s50633674/02f391f8-018af30d-39f3a0a6-06d3b30a-4c1ea6aa.jpg,test," FINAL REPORT INDICATION: ___-year-old female with shortness of breath on Coumadin, rule out pneumonia or pulmonary embolism. COMPARISON: CT of the chest from ___ and chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. The cardiac silhouette is top normal. The mediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " 0b1996dc-54aca2f6-5f02efd4-42d8ef1e-7a3c5cb9.jpg,test/p10/p10717732/s50529039/0b1996dc-54aca2f6-5f02efd4-42d8ef1e-7a3c5cb9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with L hemothorax s/p chest tube removal // interval change, please evaluate; please perform at 12:00 noon COMPARISON: ___, 08:35 IMPRESSION: As compared to the previous radiograph, the left-sided chest tubes were removed. There is no evidence of a pneumothorax. Air inclusion in the left soft tissues. Unchanged appearance of the pulmonary parenchyma and the heart. " 6f63e34a-928020fe-5a724108-3c94b460-0a3caef5.jpg,test/p11/p11966397/s59663163/6f63e34a-928020fe-5a724108-3c94b460-0a3caef5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man s/p LUL // increased SOB/congestion COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Although there has clearly been increase in subcutaneous emphysema in the right chest wall since ___, I see no definite right pneumothorax, with an apical pleural tube in place. A small apical pneumothorax could be obscured by the subcutaneous emphysema. Greater opacification at the base of the right lung is also partially obscured, looks like vascular engorgement, rather than atelectasis or pneumonia, but should be followed carefully. Increased caliber to the azygos vein also suggests volume overload. There is no edema in the left lung. " 2ef9308e-5753822e-7daf1c5c-9ece3bd8-52477781.jpg,test/p13/p13847394/s58396801/2ef9308e-5753822e-7daf1c5c-9ece3bd8-52477781.jpg,test," FINAL REPORT HISTORY: Shortness of breath and cough after EGD COMPARISON: None FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal. There is no pneumopericardium. Air is noted in the esophagus. IMPRESSION: 1. No acute cardiopulmonary process. 2. Air is noted in the esophagus. " b738b4b1-c924ff5e-2c720fcb-bdcfaa65-5cde9037.jpg,test/p15/p15350640/s57932085/b738b4b1-c924ff5e-2c720fcb-bdcfaa65-5cde9037.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F s/p thoracentesis, ? pneumo // evidence of pneumothorax COMPARISON: Prior chest radiograph from earlier today. FINDINGS: PA and lateral views of the chest provided. There has been interval right thoracentesis with significant interval decrease in the size of the right pleural effusion. A small right pleural effusion persists with associated right basilar compressive atelectasis. Left lung is clear. No pneumothorax is seen. IMPRESSION: Interval right thoracentesis with small residual right pleural effusion mild right basilar atelectasis. No pneumothorax. " aba00d84-6b8b7415-6e5e1c21-e47f81e3-4ad4a719.jpg,test/p18/p18294701/s50694317/aba00d84-6b8b7415-6e5e1c21-e47f81e3-4ad4a719.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Weakness and fatigue. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is mildly enlarged. Each hilum shows fullness with upper zone redistribution of pulmonary vasculature and hazy predominantly central opacification suggesting mild pulmonary edema. There is no pleural effusion or pneumothorax. IMPRESSION: Findings suggest mild pulmonary edema. " f480e310-2a0df413-3cfc2bf7-6b6db694-e7e39f1e.jpg,test/p16/p16633852/s54661005/f480e310-2a0df413-3cfc2bf7-6b6db694-e7e39f1e.jpg,test," FINAL REPORT INDICATION: Presyncope, here to evaluate for cardiomegaly. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are decreased. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. The pulmonary vasculature is essentially within normal limits. The cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " 03c73940-84a76002-9b5a0387-3edc6067-191448a5.jpg,test/p19/p19822093/s59935295/03c73940-84a76002-9b5a0387-3edc6067-191448a5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recurrent aspirations // Please evaluate for pneumonia Please evaluate for pneumonia COMPARISON: ___ IMPRESSION: Left internal jugular line tip is at the level of mid SVC. Heart size and mediastinum are stable. There is interval development of bibasal opacities most likely consistent with bibasal aspirations. Alternatively interval progression of vascular congestion and mild interstitial pulmonary edema is a possibility, please correlate clinically. No appreciable pleural effusion or pneumothorax is seen. " b6f55fed-d3d4ffde-de57bc63-21378ca7-c831f0e7.jpg,test/p13/p13364829/s58464953/b6f55fed-d3d4ffde-de57bc63-21378ca7-c831f0e7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with EtOH hepatitis, worsening mental status c/f HE vs infection // r/o pneumonia R/O PNEUMONIA AND PLS ASSESS POSITION OF NG TUBE IMPRESSION: Left PICC line tip is at the level of superior SVC. Up of tube passes below the diaphragm terminating in the stomach. Heart size and mediastinum are unchanged. Mild interstitial pulmonary edema is demonstrated. " 637806bc-06c1ae3f-450a276f-f3d8ee55-3e397cf3.jpg,test/p10/p10450519/s58811236/637806bc-06c1ae3f-450a276f-f3d8ee55-3e397cf3.jpg,test," FINAL REPORT HISTORY: COPD and CHF with fever, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is some increasing opacification at the right base. This suggests developing pneumonia superimposed upon a patient with enlargement of the cardiac silhouette, pulmonary vascular engorgement, and small bilateral pleural effusions with compressive basilar atelectasis. " a6393290-09299568-06c9837b-b41bf3e6-5b4e759f.jpg,test/p10/p10663862/s52520141/a6393290-09299568-06c9837b-b41bf3e6-5b4e759f.jpg,test," FINAL REPORT INDICATION: Acute-on-chronic worsening bilateral chest pain at midclavicular line, both above and below breast. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs and normal hilar and cardiomediastinal contours. There are chain sutures in the right upper and middle lobes from prior wedge resection. There are other linear scars in the right lower lobe, which are unchanged. Median sternotomy cerclage wires are intact and surgical clips are seen in the mediastinum from prior CABG. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. No displaced rib fracture is seen. IMPRESSION: 1. No acute cardiopulmonary process. 2. No displaced rib fracture is seen. However, if there is continued clinical concern for rib fracture, a dedicated rib series with a skin marker at the location of the patient's pain is recommended as it is more sensitive than a chest radiograph. " a35dfa28-ca496d97-7c0d96ae-eab657cc-260b946f.jpg,test/p15/p15620990/s56761163/a35dfa28-ca496d97-7c0d96ae-eab657cc-260b946f.jpg,test," FINAL REPORT HISTORY: Postoperative MVR. FINDINGS: In comparison with the study of ___, the patient has taken a slightly better inspiration. Continued opacification is seen at the bases, consistent with atelectasis and effusion. Scattered streaks of atelectasis are seen in the more superior portions of the lungs. There is a small area of increased opacification just above the minor fissure on the right, which could reflect a developing focus of consolidation. Left PICC line remains in place. " 29fd1cfd-ab5fe466-4bac1ae1-ddc4536b-4ca29069.jpg,test/p11/p11958913/s59577875/29fd1cfd-ab5fe466-4bac1ae1-ddc4536b-4ca29069.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with possible CHF. COMPARISON: Portable chest radiograph dated ___. FINDINGS: Compared to the previous exam on ___, the mild interstitial edema and pulmonary edema have resolved. The lungs are clear, without focal consolidation to suggest pneumonia. No pleural effusion or pneumothorax. The heart size is normal. Stable tortuous or dilated descending aorta. Mediastinal contours and hila are unchanged. IMPRESSION: Interval resolution of mild CHF. No acute cardiopulmonary process. " 487548c9-9be02c1e-c6b934a9-dcf7267e-9f7bdc0f.jpg,test/p15/p15975465/s56079662/487548c9-9be02c1e-c6b934a9-dcf7267e-9f7bdc0f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mets NSCLC with pleural effusion being drained 3 days a week ___-F // assess interval change assess interval change IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is opacification involving the lower half of the left lung. The right lung remains essentially clear. " 98ab05ed-a6e5d329-7cec1893-67b7ea1d-229457f2.jpg,test/p17/p17604134/s58061683/98ab05ed-a6e5d329-7cec1893-67b7ea1d-229457f2.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with SOB and cough, r/o infectious process // Infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There has been osseous resorption or resection of the distal right clavicle, with widening of the right acromioclavicular joint to approximately 19 mm. The right coracoclavicular interval is normal in width. IMPRESSION: No acute cardiopulmonary process. " cec6b5d6-670c7a52-6bb0dbce-0b941b2e-ef1005d7.jpg,test/p12/p12294174/s53154860/cec6b5d6-670c7a52-6bb0dbce-0b941b2e-ef1005d7.jpg,test," FINAL REPORT HISTORY: Patient with left-sided rib pain, rule out pathological fracture. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs were obtained. There is an ill-defined, non-calcified focal opacity in the left mid lung. The lungs are otherwise well expanded with no other consolidations. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no rib fracture. IMPRESSION: Ill-defined focal opacity over the left mid lung. Findings were discussed with Dr.___ ___ telephone at 4pm on ___ and in this patient with a smoking history, follow-up imaging with CT scan is recommended. " cbd5234d-5ea30281-9c8b8f46-d4ca3ab2-e66e1b04.jpg,test/p11/p11434519/s50070037/cbd5234d-5ea30281-9c8b8f46-d4ca3ab2-e66e1b04.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 2a10e854-f0d23733-19310fed-e74cdef7-47f225ee.jpg,test/p15/p15620544/s59172210/2a10e854-f0d23733-19310fed-e74cdef7-47f225ee.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of rectal cancer presents with nonproductive cough and dyspnea on exertion. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiographs demonstrate obscuration of bilateral costophrenic angles by moderate sized pleural effusions. The cardiomediastinal silhouette appears stable when compared to prior radiograph dated ___. There are bilateral focal opacifications within the right upper, left upper and left mid lung zones. There is central pulmonary vascular congestion with mild edema. The heart size is top normal, unchanged since the ___ study. Osseous structures are without acute abnormality. IMPRESSION: 1. Central pulmonary vascular congestion with mild edema. 2. Bilateral moderate pleural effusions. 3. Multifocal peripheral opacities which may reflect new consolidations. " bc3b6ce5-2adb43ba-12eb47e1-76069209-a18f9f8c.jpg,test/p11/p11151938/s57389232/bc3b6ce5-2adb43ba-12eb47e1-76069209-a18f9f8c.jpg,test," FINAL REPORT HISTORY: Pacer leads, to exclude pneumothorax. FINDINGS: In comparison with study of ___, the pacer leads are in the region of the right atrium and apex of the right ventricle. Low lung volumes accentuate the prominence of the transverse diameter of the heart. No definite evidence of pneumothorax. " 319df98a-fcc335a3-d5e5b013-8dd10076-12628793.jpg,test/p17/p17637743/s59458819/319df98a-fcc335a3-d5e5b013-8dd10076-12628793.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p right VATS decortication. // S/p chest tube removal S/p chest tube removal IMPRESSION: In comparison with the earlier study of this date, the chest tubes have been withdrawn on the right and there is no evidence of pneumothorax. Otherwise, little change. " ad07af1f-7976d5ff-a5a4424b-83bb6d16-60c8de3d.jpg,test/p12/p12973912/s59249508/ad07af1f-7976d5ff-a5a4424b-83bb6d16-60c8de3d.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Cough, fever, shaking chills, infection, pneumonia. TECHNIQUE: Two views of the chest were obtained. COMPARISON: ___. REPORT: The examination is technically limited. There is blunting of the left costophrenic sulcus, suggesting a small effusion, new from prior study. There is also evidence of increased lung markings projected behind the heart, with focal silhouetting of the left hemidiaphragm. These could reflect atelectasis or pneumonia, but given the symptoms, should be treated as infection. Lateral view is somewhat degraded due to motion artifact. There are increased lung markings as previously noted in the lung bases. There is also evidence of an unchanged dorsal kyphotic fracture with an acute wedge. CONCLUSION: Increased markings behind the heart may reflect some atelectasis or perhaps pneumonia. There is increasing effusion and probably background minor interstitial edema. Unchanged thoracic compression wedge fracture with acute (approximately ___ degrees) angulation. " 08e8be73-cf40dba1-d4d69a2d-c06dfa02-d4944934.jpg,test/p15/p15923118/s55527791/08e8be73-cf40dba1-d4d69a2d-c06dfa02-d4944934.jpg,test," FINAL REPORT INDICATION: ___ year old man history CABG in ___ and POPD1 decortication and open LLL lobectomy with mediastinal lymphadenectomy now complaining of chest tightness // POP changes, tube position, overload signs, signs of TEP TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Massive cardiomegaly. Increased pulmonary vasculature with indistinctness of the vessels suggesting cardiac decompensation and interstitial edema. Left-sided pleural effusion. Adjacent left lower lobe atelectasis. Left chest drain in situ. Surgical emphysema in the left chest wall. No right-sided effusion. IMPRESSION: Massive transverse cardiomegaly. Findings may be in keeping with fluid overload/cardiac decompensation or a pericardial effusion. " f27c7d0d-f35c17ad-f58160cb-a9135f67-bec66438.jpg,test/p15/p15782217/s52104061/f27c7d0d-f35c17ad-f58160cb-a9135f67-bec66438.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chemotherapy for non-Hodgkin's lymphoma with cough and shortness of breath, question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette is enlarged. Mediastinal and hilar contours are stable. No pleural effusion is seen. There is no focal consolidation. There is minimal prominence of the interstitial markings, grossly stable compared to the prior study. There is sclerosis of a vertebral body at the thoracolumbar junction with prior vertebroplasty/kyphoplasty. IMPRESSION: Enlarged cardiac silhouette without definite acute cardiopulmonary process. " e6874f3f-80955b8c-9026417a-b8ee3527-0f2bf324.jpg,test/p19/p19303239/s55164942/e6874f3f-80955b8c-9026417a-b8ee3527-0f2bf324.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with history of recent necrotizing pneumonia with persistent fever and cough. Comparison is made with prior study, CT, ___ and chest ___, ___. There has been interval decrease in size in the cavitary lesion in the right middle lobe, still is of appreciable size. Multifocal opacities elsewhere in the lungs, in the left upper lobe, left lower lobe, and right lower lobe have improved, almost resolved. There are no new lung abnormalities or evidence of pneumothorax. Small bilateral pleural effusions are larger on the right side, unchanged from prior. Cardiomediastinal contours are normal. Left Port-A-Cath tip is in the lower SVC. " aa8d038b-9d7fdc30-46f758f9-aad9b7f1-972bdd77.jpg,test/p17/p17556194/s50284841/aa8d038b-9d7fdc30-46f758f9-aad9b7f1-972bdd77.jpg,test," WET READ: ___ ___ ___ 5:46 AM Interval placement of a right IJ line which ends in the low SVC. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with R IJ placement // Eval R IJ placement TECHNIQUE: Single AP view. COMPARISON: Chest radiograph ___. FINDINGS: Tracheostomy ends in the lower thoracic trachea. A right IJ line ends at the SVC RA junction. A heterogeneous and calcified right lower lobe opacity corresponds to a pleural based mass, unchanged from ___. Lung fields are clear. Heart size is normal. No pneumothorax. IMPRESSION: Interval placement of a right IJ line which ends at the SVC-RA junction. " 2f13aef7-9345c4cb-0b1d8e8f-d81bd821-61f879a2.jpg,test/p14/p14268088/s50487787/2f13aef7-9345c4cb-0b1d8e8f-d81bd821-61f879a2.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pleural effusions // monitor known pleural effusions EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, AP and lateral COMPARISON: Chest radiograph ___ FINDINGS: Decreased lung volume is due to primarily to increasing bilateral pleural effusion, moderate on the right and large on the left. Pulmonary edema is mild. Left lower lobe atelectasis is severe. Moderate cardiomegaly is unchanged. Mitral annulus and aortic valve calcification are heavy. IMPRESSION: Increasing moderate right and large left pleural effusion. Persistent mild pulmonary edema. Moderate cardiomegaly likely due to valvular heart disease, especially aortic stenosis. " 3736a68f-bf6a9913-70681081-a8403023-21922258.jpg,test/p18/p18306592/s58093877/3736a68f-bf6a9913-70681081-a8403023-21922258.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with fever, immunosuppressed. ?pna // ___F with fever, immunosuppressed. ?pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. No focal consolidation to suggest pneumonia. " 7dfd4d57-6531d900-ece7057d-f1ac6abd-8f538e2d.jpg,test/p13/p13153210/s55571233/7dfd4d57-6531d900-ece7057d-f1ac6abd-8f538e2d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with hx of ischemic cardiac changes during exercise stress test presents with CP. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The heart size, mediastinal, and hilar contours are normal. The lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 3486f17c-45cfbc33-8c009484-c3a5ef9a-28651880.jpg,test/p10/p10155766/s56394243/3486f17c-45cfbc33-8c009484-c3a5ef9a-28651880.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p exlap/washout, dyspnea/hypoxia // interval change IMPRESSION: In comparison to ___ radiograph, lung volumes are extremely low, accentuating the cardiac silhouette and bronchovascular structures. Allowing for this factor, bibasilar atelectasis is probably relatively similar to the prior study. Probable small bilateral pleural effusions. " 5395d275-36e2d921-ce5fb690-6f297052-3307b77e.jpg,test/p18/p18855788/s59592720/5395d275-36e2d921-ce5fb690-6f297052-3307b77e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain midsternal x3 hours COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Lung volumes are low limiting assessment. Subtle increased opacity abuts the left heart border which likely reflects crowding of bronchovascular markings in the setting of low lung volumes though an early pneumonia is difficult to exclude. Right lung is clear. No large effusion or pneumothorax. No signs of congestion or edema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Subtle opacity abutting the left heart border which could represent a very early pneumonia in the correct clinical setting. Please note, low lung volumes limits assessment. " a063122f-bbeb2913-33bbb7f5-2772b3ea-992d85a5.jpg,test/p16/p16936839/s51639313/a063122f-bbeb2913-33bbb7f5-2772b3ea-992d85a5.jpg,test," FINAL REPORT INDICATION: ___M w/AMS, please r/o PNA COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Mild cardiomegaly is similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Sternotomy wires, replaced aortic valve, and right chest cardiac device are all grossly unchanged. IMPRESSION: No acute intrathoracic process. " 434f4249-7bbf2196-640e5a38-494d33ee-9214aeb0.jpg,test/p15/p15179179/s50872961/434f4249-7bbf2196-640e5a38-494d33ee-9214aeb0.jpg,test," FINAL REPORT AP CHEST, 9:21 A.M. ON ___ HISTORY: Check NG tube placement. Altered mental status. IMPRESSION: AP chest compared to ___: ET tube is in standard placement, nasogastric tube ends in the mid stomach. Severe cardiomegaly persists. Low lung volumes responsible for vascular crowding, and the large scale consolidation in the left lower lobe is probably atelectasis. Pleural effusions are small if any. No pneumothorax. Right subclavian or PIC line ends in the mid SVC. No pneumothorax. " 05657fa4-f17b5bbc-1667a9e4-188e3441-07cf88c3.jpg,test/p14/p14042268/s55263578/05657fa4-f17b5bbc-1667a9e4-188e3441-07cf88c3.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. Please evaluate for acute process. COMPARISON: No relevant comparisons available. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " 1d961ee4-e5ab7268-05d905db-4f8bbaf4-45e732f4.jpg,test/p16/p16895003/s58155199/1d961ee4-e5ab7268-05d905db-4f8bbaf4-45e732f4.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with resolved AF w/ RVR TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CTA torso ___ FINDINGS: There is no consolidation, pleural effusion or pneumothorax. Note is made of centrilobular emphysema. Heart size is normal. Thoracic aortic stent graft appears unremarkable in position when compared to the more recent CTA dated ___. A compression deformity involving a lower thoracic vertebral body is unchanged. Otherwise, no acute osseous abnormalities. IMPRESSION: Aortic stent in place. No acute intrathoracic process. " 1e2ab182-cc723d9d-f61f5064-0c61c830-5e91e3fe.jpg,test/p16/p16059088/s57857994/1e2ab182-cc723d9d-f61f5064-0c61c830-5e91e3fe.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY OF ___ COMPARISON: Studies dating between ___ and ___. FINDINGS: Lung volumes are low, likely due to extensive fibrotic lung disease, characterized more fully on recent CT torso of ___. Considering the perihilar and upper lobe, extent of fibrotic disease, sarcoidosis is considered a likely etiology. A more confluent area of opacity involving portions of the right middle and right lower lobe could potentially represent a superimposed infectious pneumonia, or asymmetrical involvement of the fibrotic lung disease. " b0da48b8-ba435438-cdb77710-3663ccc3-d296d517.jpg,test/p10/p10476869/s54419366/b0da48b8-ba435438-cdb77710-3663ccc3-d296d517.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with PNA // worsening resp function, pna vs. fluid COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous image. Clips projecting over the left costophrenic sinus. Low left lung volume with diaphragmatic tenting and a small to moderate left pleural effusion. Moderate cardiomegaly. Unchanged monitoring and support devices. Unchanged appearance of the cardiac silhouette and of the right lung. " 2d0e8642-49f9189c-9f7f184f-974ab34d-933ef79d.jpg,test/p16/p16998152/s51852464/2d0e8642-49f9189c-9f7f184f-974ab34d-933ef79d.jpg,test," FINAL REPORT HISTORY: Aspiration with new white count, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there are slightly lower lung volumes but the cardiac silhouette is less prominent. The degree of pulmonary vascular congestion has substantially decreased. No convincing evidence of acute focal pneumonia. There is slight asymmetry of opacification at the bases, but this more probably is reflective of some atelectatic change. " aa9bd1ae-cce89f65-dc7308d7-7348e9be-8d3000eb.jpg,test/p18/p18031120/s54235032/aa9bd1ae-cce89f65-dc7308d7-7348e9be-8d3000eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with possible displaced Swan. // Check Swan TECHNIQUE: Two portable AP radiographs of the chest. COMPARISON: ___. FINDINGS: The radiograph timed stamped ___ hr shows the Swan-Ganz catheter in the distal right pulmonary artery. The radiograph labeled 'AP semi-erect' shows that the Swan-Ganz catheter tip is roughly 2 cm more proximal within the right pulmonary artery. A left pectoral AICD is in place. Moderate pulmonary edema has slightly improved. Moderate cardiomegaly despite the projection is stable. There is no pneumothorax. IMPRESSION: Swan-Ganz catheter tip position described above. Improved moderate pulmonary edema. Stable moderate cardiomegaly. " 939f825b-bf8e72a7-cf28d56f-5e24f728-83182038.jpg,test/p18/p18681022/s53906603/939f825b-bf8e72a7-cf28d56f-5e24f728-83182038.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY OF ___ COMPARISON: Radiograph of ___. FINDINGS: Lung volumes are relatively low, accentuating the cardiac silhouette and bronchovascular structures. With this limitation in mind, heart is upper limits of normal in size. Heterogeneous bilateral lung opacities have partially resolved, with residual opacities most prominent in the right upper and both mid lung regions. These residual lung findings may reflect aspiration or infectious pneumonia. There are no pleural effusions or pneumothoraces. " d6275679-e33372f3-467e33ea-b199396e-8fd32708.jpg,test/p12/p12759187/s57955728/d6275679-e33372f3-467e33ea-b199396e-8fd32708.jpg,test," FINAL REPORT INDICATION: ___ year old female with bradycardia. Evaluate for congestive heart failure or pneumonia. TECHNIQUE: AP and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes have decreased, and the heart continues to be severely enlarged. There is a moderate right pleural effusion with fluid tracking along the minor fissure. The low lung volumes cause crowding of the central bronchovascular structures, and there is central pulmonary vascular congestion. No pneumothorax is seen. IMPRESSION: Cardiomegaly with moderate right pleural effusion and central pulmonary vascular congestion. Low lung volumes. " 0d9756a8-83de6725-3fd4fe06-1590acb3-90521028.jpg,test/p17/p17563756/s53062962/0d9756a8-83de6725-3fd4fe06-1590acb3-90521028.jpg,test," FINAL REPORT CHEST RADIOGRAPH: INDICATION: Mediastinal lymphadenopathy, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing right basal opacity has substantially decreased in extent and severity. Further workup is required. However, there is no evidence of pneumothorax. Borderline size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. " d533989e-6870e198-2191967b-2d1019b2-9be6f4e0.jpg,test/p10/p10691738/s54378762/d533989e-6870e198-2191967b-2d1019b2-9be6f4e0.jpg,test," FINAL REPORT HISTORY: Status post CABG with recurrent effusions. COMPARISON: Chest radiograph ___ and ___. CT a chest ___. FINDINGS: A moderate left pleural effusion and small right pleural effusion, both have increased in size from the prior studies. There is adjacent bibasilar atelectasis. There is no pneumothorax or focal airspace consolidation. The cardiac silhouette is mildly enlarged but unchanged. The mediastinal and hilar contours are unremarkable. A left-sided ICD, sternotomy wires and mediastinal clips are again noted. There are no acute osseous abnormalities. IMPRESSION: Moderate left and small right pleural effusion which a increased from prior and best seen on the lateral view. " 93b57644-13b328ac-dcac0b92-f6e76064-dcddb0a3.jpg,test/p14/p14296329/s55056697/93b57644-13b328ac-dcac0b92-f6e76064-dcddb0a3.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are unchanged and within normal limits. Lungs are clear. The pulmonary vascularity is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 78e5a018-75cdad24-83d8c66e-6b938310-d760a7b1.jpg,test/p15/p15457916/s52043923/78e5a018-75cdad24-83d8c66e-6b938310-d760a7b1.jpg,test," FINAL REPORT INDICATION: Evaluate for retained PICC line, in a patient with dimension loop pulled out her PICC. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal views of the chest demonstrate no radiopaque foreign body to suggest retained PICC fragment. Lung volumes are low, resulting in increased prominence of the cardiac silhouette and bronchovascular crowding. Allowing for this, heart size is likely normal. There is atelectasis in the bilateral lower lobes, without concerning focal consolidation or pleural effusion. There is no pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No radiopaque foreign body to suggest a retained PICC fragment. " c3f3df58-777aa407-00cfc5af-bc03dc6f-9cfcd9f8.jpg,test/p13/p13035993/s57805084/c3f3df58-777aa407-00cfc5af-bc03dc6f-9cfcd9f8.jpg,test," FINAL REPORT HISTORY: Wheezing, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little interval change. Blunting of the left and possibly right costophrenic angles with mild enlargement of the cardiac silhouette and tortuosity of the aorta. However, no acute pneumonia, vascular congestion, or pleural effusion. " 94c981ac-7ef48326-46987043-4e56c344-11efcab7.jpg,test/p13/p13639259/s57896798/94c981ac-7ef48326-46987043-4e56c344-11efcab7.jpg,test," FINAL REPORT INDICATION: Lymphoma, fever and cough, assess for infiltrate. COMPARISON: Chest CT on ___ and chest radiograph on ___. FINDINGS: PA and lateral views of the chest. Bronchiectasis, bronchial wall thickening and architectural distortion consistent with chronic lung disease is seen. There is no evidence of acute pneumonia. Cardiac, hilar, and mediastinal contours are unchanged. There is bronchial wall thickening. There is hyperinflation of the lungs. No pleural effusion or pneumothorax. IMPRESSION: No focal opacities concerning for pneumonia. Chronic bronchiectasis and architectural distortion consistent with chronic lung disease. " 837c1c13-0fa49688-d98a2822-eb8a0960-1c0d5eab.jpg,test/p18/p18479770/s53814927/837c1c13-0fa49688-d98a2822-eb8a0960-1c0d5eab.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea, evaluation for acute process. COMPARISON: ___. FINDINGS: Known left upper lobe mass. In addition, the known pre-existing left pleural effusion has increased in size. Only a small area of lung volume remains ventilated in the left lung. The right lung shows minimal fluid overload. Moderate cardiomegaly. No right pleural effusion. No pneumothorax. " 22d0e41c-8e16da61-b8b8fa3c-2c449c10-ef66b8c2.jpg,test/p19/p19539663/s52683543/22d0e41c-8e16da61-b8b8fa3c-2c449c10-ef66b8c2.jpg,test," FINAL REPORT INDICATION: Presyncope and malaise, here to evaluate for pneumonia. COMPARISON: Chest radiograph last performed on ___. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: A left ventriculoperitoneal shunt catheter is seen coursing along the lower left neck across the left hemithorax towards the abdomen. A slightly rounded nodular airspace opacity projects over the lower lobe on the lateral view and may represent an infectious process. Rounded atelectasis is not excluded. The right lung is relatively clear. Trace pleural fluid layers posteriorly on the lateral view. No pneumothorax is detected. The pulmonary vasculature is not engorged. The cardiac silhouette is enlarged but stable. There is prominence of the mediastinum due to unfolding of the thoracic aorta, which is unchanged. The trachea is midline. IMPRESSION: 1. Rounded nodular airspace opacity in the lower lobe concerning for infectious process. Followup PA and lateral radiographs are recommended in six to eight weeks following appropriate therapy to confirm resolution. 2. Stable cardiomegaly. " ba9ba2e2-065708fe-cbb8731d-2e883219-f9fc6b61.jpg,test/p19/p19149321/s50518376/ba9ba2e2-065708fe-cbb8731d-2e883219-f9fc6b61.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: during blood txf developed sensation of sob // eval for edema eval for edema IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THE ENDOTRACHEAL AND NASOGASTRIC TUBES HAVE BEEN REMOVED. THERE ARE LOWER LUNG VOLUMES WITH BIBASILAR ATELECTATIC CHANGES AND SOME INDISTINCTNESS OF PULMONARY VESSELS THAT COULD REFLECT ELEVATED PULMONARY VENOUS PRESSURE. THERE IS SOME DILATATION OF GAS - FILLED STOMACH, FOR WHICH REPLACEMENT OF THE NASOGASTRIC TUBE COULD BE CONSIDERED IF CLINICALLY NEEDED. " 06ce3b03-b36df8d3-fa379757-29afac3f-a9ad2508.jpg,test/p16/p16838601/s56068459/06ce3b03-b36df8d3-fa379757-29afac3f-a9ad2508.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with 3 days of SSCP // eval ? acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CT ___ FINDINGS: The lungs are hyperinflated. No focal consolidation, pleural effusion or pneumothorax. Nodular opacities in the right lung apex is consistent with scarring, better evaluated on the prior chest CT dated ___. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. No subdiaphragmatic free air. IMPRESSION: No acute intrathoracic process. " df33d117-07f67b66-b162a73e-2a1994c4-47895a43.jpg,test/p19/p19348515/s56186616/df33d117-07f67b66-b162a73e-2a1994c4-47895a43.jpg,test," FINAL REPORT HISTORY: ___ years old man with trapped lung on recent chest CT. Followup film. COMPARISON: Exam is compared to the chest x-ray of ___. FINDINGS: Interval decrease of left pleural effusion, still with band-like opacity compatible with atelectasis. Patchy opacities are still visible in the right upper lung and correlates with ground-glass opacity described in recent chest CT. Left lung is clear without pleural effusion. Heart size is mildly enlarged. There is no pneumothorax. IMPRESSION: Interval decrease of right pleural effusion, with still residual small atelectasis. Persistent patchy opacities in the right upper lobe. " f8f790d6-a623794a-61d263db-c848a5c5-3a62f4e3.jpg,test/p18/p18896198/s58702968/f8f790d6-a623794a-61d263db-c848a5c5-3a62f4e3.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___. HISTORY: ___-year-male with abdominal and chest pain. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. The osseous and soft tissue structures are unremarkable. No free air below the diaphragm. IMPRESSION: Normal chest x-ray. " 2b5fe10b-34e1595a-f58e4a4a-b1231c72-67c73204.jpg,test/p13/p13027858/s57911781/2b5fe10b-34e1595a-f58e4a4a-b1231c72-67c73204.jpg,test," FINAL REPORT INDICATION: ___M with depression, medical clearance needed for ___-psych // evaluate for pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " f2ac7195-38a32866-1595efa5-55ae6d6a-1679ffa6.jpg,test/p17/p17967970/s55760383/f2ac7195-38a32866-1595efa5-55ae6d6a-1679ffa6.jpg,test," FINAL REPORT EXAMINATION: Portable chest x-ray semi-upright INDICATION: ___F w/history of lung CA, s/p left VATS and LUL wedge resection in ___, right VATS w/RUL wedge resection in ___, found to have residual cancer at staple line, now s/p right-sided thoracotomy with RUL resection on ___ with significant intra-operative blood loss. Prolonged and complicated ICU course. // interval eval TECHNIQUE: Chest PA and lateral COMPARISON: Compared to prior chest x-rays dated back to ___ with Neulasta of of ___ FINDINGS: The monitoring and support devices are unchanged, as is the chronic area of increased opacification in the right mid zone. There is a curvilinear up opacification at the right base that was not previously seen with lucency below at. Although this could represent an unusual type of atelectasis, when accompanied with the relatively lucent opacification of soft tissues in the abdomen is worrisome for pneumoperitoneum. IMPRESSION: Repeat chest radiograph in the early afternoon to determine whether the findings suspicious of pneumoperitoneum are still present. RECOMMENDATION(S): This information has been discussed with Dr. ___, ___ was covering for Dr. ___. He relates that the patient is doing well with no evidence of abdominal complaints or recent abdominal surgery or instrumentation. Consequently, he will water a a repeat chest radiograph in the early afternoon. If there is been a change in appearance of the right base, pneumoperitoneum can't be excluded. If there is a similar appearance, the lateral decubitus view with horizontal beam will be obtained to determine whether there is movable free air in the abdomen. At that time, decision will be made whether or not to water a CT scan. " 93a00c24-11ee94f0-004bd351-bbfab386-1c05a141.jpg,test/p16/p16187079/s53871242/93a00c24-11ee94f0-004bd351-bbfab386-1c05a141.jpg,test," FINAL REPORT INDICATION: Odynophagia, stomatitis, cough, and nonadherence to HIV medications. Please assess for evidence of infiltrate, specifically PCP. COMPARISON: Comparison is made to chest radiograph performed, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal contours. Lungs are clear. As before, there is mild blunting of the right lateral costophrenic angle likely reflecting atelectasis or scarring given persistence since ___. No pleural effusion is definitively identified. No pneumothorax is present. No osseous abnormality present. IMPRESSION: No acute intrathoracic pathology. " d5f4516f-9c5eec46-97bc2bf4-0078b241-215db47d.jpg,test/p10/p10884076/s51046035/d5f4516f-9c5eec46-97bc2bf4-0078b241-215db47d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Persistent cough, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal appearance of the lung parenchyma. No focal or diffuse lung disease. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No evidence of pleural effusions or pulmonary edema. " 4b8fcb13-e60d53ff-73ac6c01-7b56c566-31b71813.jpg,test/p15/p15722937/s53495008/4b8fcb13-e60d53ff-73ac6c01-7b56c566-31b71813.jpg,test," FINAL REPORT INDICATION: Post intubation. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal chest radiograph. IMPRESSION: An endotracheal tube terminating 4.0 cm above the carina, left subclavian central venous catheter terminating at the upper SVC, and orogastric tube extending to at least the level of the stomach are unchanged in position. Again seen are is several bilateral central pulmonary vascular congestion and pulmonary edema, unchanged the ___ examination. There is no pneumothorax. " 50293871-3d57a5df-1b7b7a5d-cd78701d-5f399faf.jpg,test/p13/p13999026/s55193739/50293871-3d57a5df-1b7b7a5d-cd78701d-5f399faf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with abdominal pain, distension, cirrhosis // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. No definite consolidation is identified. Linear atelectasis is noted in the right middle and lower lobes. A small left pleural effusion is present. Distended loops of bowel in the upper abdomen are more fully assessed by concurrent abdominal CT. IMPRESSION: Small Left pleural effusion. No definite consolidation identified. " 1c419332-d956a856-009d5213-1a2f64df-e2f9b020.jpg,test/p10/p10592817/s59662790/1c419332-d956a856-009d5213-1a2f64df-e2f9b020.jpg,test," WET READ: ___ ___ ___ 10:41 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with cough x 2 weeks // r/o pna TECHNIQUE: PA and lateral images of the chest. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " f52b6807-99114bee-31353eb6-cea08133-10141208.jpg,test/p11/p11690362/s55655241/f52b6807-99114bee-31353eb6-cea08133-10141208.jpg,test," FINAL REPORT HISTORY: Cough for one week with pleuritic chest pain. FINDINGS: In comparison with the study of ___, there is little change. There is tortuosity of the descending thoracic aorta without evidence of vascular congestion, pleural effusion, acute focal pneumonia or appreciable enlargement of the cardiac silhouette. " 08e0aadc-4d6faf5d-269c476a-8289c3d5-5bf14eab.jpg,test/p10/p10301071/s51652682/08e0aadc-4d6faf5d-269c476a-8289c3d5-5bf14eab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chronic cough // any causes of chronic cough. any causes of chronic cough. IMPRESSION: No previous images. Cardiac silhouette is within normal limits and there is no vascular congestion or pleural effusion. No evidence of acute focal pneumonia. " cc8a8b7b-e62009ad-c1b4d38a-420a8fcb-17e27be1.jpg,test/p13/p13021440/s59071727/cc8a8b7b-e62009ad-c1b4d38a-420a8fcb-17e27be1.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY. INDICATION: Patient with increasing oxygen requirement questioning pneumonia or edema? COMPARISON: ___. FINDINGS: Left-sided PICC line ends in mid SVC. Right lower lung consolidation has increased with probable worsening of the loculated moderate pleural effusion. Pulmonary edema is mild and unchanged. Left-sided dialysis catheter ends in the right atrium. Moderate cardiac and mediastinal enlargement is stable. Tracheostomy is in adequate position. There is no pneumothorax. CONCLUSION: 1. Right lower lung consolidation with probable pleural effusion has worsened since previous exam. 2. Stable mild pulmonary edema. " dc04a5c4-2b23139b-c49f79c9-a321a4f7-94aaabfe.jpg,test/p12/p12780512/s56491352/dc04a5c4-2b23139b-c49f79c9-a321a4f7-94aaabfe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea, hyponea, pleuritic pain // evaluation for pulm edema, effusion evaluation for pulm edema, effusion IMPRESSION: In comparison with the study of ___, there again are relatively low lung volumes, but no evidence of acute pneumonia, vascular congestion, or pleural effusion. The nasogastric tube is been pushed forward and, after coiling on itself in the fundus, extends to the distal stomach. " 02144677-d6402102-16d88420-1dc840f9-6ceae01b.jpg,test/p19/p19658917/s57118446/02144677-d6402102-16d88420-1dc840f9-6ceae01b.jpg,test," FINAL REPORT EXAMINATION: AP and lateral images of the chest. INDICATION: History: ___M with low O2 sat // eval for volume overload TECHNIQUE: AP and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: Lung volumes are low. There is opacity in the bilateral lung bases, likely reflecting atelectasis. Bilateral pleural effusions are seen, right greater than left. Mild hilar prominence is again noted, right greater than left, similar to prior exam. There is no pneumothorax. The cardiomediastinal silhouette is mildly enlarged. No pulmonary edema or pneumothorax. IMPRESSION: Bilateral pleural effusions with associated bibasilar atelectasis, right greater than left, similar to prior exam. Mild prominence of the hila is unchanged. " d9990ca9-1c08b993-982d6918-ca9d5d8b-10125af9.jpg,test/p15/p15971063/s59025441/d9990ca9-1c08b993-982d6918-ca9d5d8b-10125af9.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Interval removal of nasogastric tube. A left chest tube remains in place, with apparent resolution of small left apical pneumothorax and decrease in small left pleural effusion as well as improved atelectasis in the left lung bases. Cardiac silhouette is upper limits of normal in size and accompanied by mild pulmonary vascular congestion and a minimal interstitial edema. " 89804819-bd0ef859-069d627b-4ff7055a-058130e3.jpg,test/p14/p14213883/s51402871/89804819-bd0ef859-069d627b-4ff7055a-058130e3.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with AMS // eval for PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes. There are small to moderate bilateral pleural effusions with overlying atelectasis. Right basilar opacity may represent combination of pleural effusion and atelectasis, consolidation due to pneumonia is not excluded. No pneumothorax is seen. . The cardiac and mediastinal silhouettes are grossly stable. An apparent stent is noted in the left axillary region. IMPRESSION: Small to moderate bilateral pleural effusions with overlying atelectasis. Right basilar opacity may represent combination of pleural effusion and atelectasis, consolidation due to pneumonia is not excluded " 6e0f1ccd-0b7719b9-255102b7-8f09a990-6cb1647b.jpg,test/p13/p13408833/s58648660/6e0f1ccd-0b7719b9-255102b7-8f09a990-6cb1647b.jpg,test," FINAL REPORT HISTORY: Status post fall. Evaluate for fracture. COMPARISON: ___. TECHNIQUE: AP and lateral chest radiograph, two views. FINDINGS: Cardiac silhouette is top normal with tortuosity of the thoracic aortic arch. Prominent central vasculature is suggestive of mild fluid overload. Lungs are otherwise clear. There are trace pleural effusions bilaterally, seen layering posteriorly on the lateral view. There is no pneumothorax. No distracted rib fracture is identified. IMPRESSION: 1. Mild fluid overload with trace pleural effusions. 2. No distracted rib fracture. If there is a focal area of concern, dedicated rib series may be helpful. " abca1a43-54c24a8a-52ed07b0-5cd250c5-afdc7061.jpg,test/p11/p11888614/s56043754/abca1a43-54c24a8a-52ed07b0-5cd250c5-afdc7061.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain, question pneumonia. COMPARISON: ___. FINDINGS: Portable upright chest radiograph demonstrates clear, well expanded lungs. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are normal. IMPRESSION: Normal view of the chest. " 790ef76b-ba85cb3e-3f160bef-ec708f8c-4672524e.jpg,test/p14/p14542957/s50307908/790ef76b-ba85cb3e-3f160bef-ec708f8c-4672524e.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate well-aerated lungs without focal opacity to suggest an infectious process. The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. No bony abnormality is seen. IMPRESSION: Normal chest radiograph. A preliminary read was provided by Dr. ___ to Dr. ___ at ___ on ___. " 782b54b1-c2b20e0a-94453fe3-61fc9571-81c15355.jpg,test/p19/p19700982/s51713187/782b54b1-c2b20e0a-94453fe3-61fc9571-81c15355.jpg,test," FINAL REPORT HISTORY: Pruritus, to assess for lymphoma. FINDINGS: In comparison with study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Specifically, no evidence of mediastinal or hilar lymphadenopathy or enlargement of the spleen. There are bilateral cervical ribs, more prominent on the right. " e9fd4960-b858c91b-944a6bc1-6d24e89a-07b36837.jpg,test/p19/p19092032/s56465043/e9fd4960-b858c91b-944a6bc1-6d24e89a-07b36837.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with central line placement TECHNIQUE: Portable AP upright view of the chest COMPARISON: ___ at 17:49 FINDINGS: Right internal jugular central venous catheter tip terminates in the region of the low SVC. No pneumothorax is identified. There has been interval improvement in aeration of the lung bases with residual patchy bibasilar opacities, likely atelectasis. No large left pleural effusion is present. The right costophrenic angle is excluded from the field of view. Cardiac and mediastinal contours are unchanged. IMPRESSION: Right internal jugular central venous catheter tip terminates in the region of the low SVC. No pneumothorax. " f223d9e6-82dd5347-454b21ed-11760269-896e050c.jpg,test/p10/p10678664/s53681614/f223d9e6-82dd5347-454b21ed-11760269-896e050c.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough, wheeze, decreased breath sounds // any pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. . No pneumonia, no pulmonary edema. No pleural effusions. IMPRESSION: Normal chest radiograph without evidence of pneumonia " 8dd3b9fc-41732b65-0521dc06-a6a23c76-67c583ee.jpg,test/p11/p11596230/s59608381/8dd3b9fc-41732b65-0521dc06-a6a23c76-67c583ee.jpg,test," FINAL REPORT INDICATION: ___ year old man with bilateral chest pain for several weeks // pneumonia, mass, ild TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Top-normal heart size is normal mediastinal and hilar contours. Focal opacity at the right middle lobe is consistent with pneumonia. No pleural effusion or pneumothorax IMPRESSION: Right middle lobe pneumonia. Recommend follow up chest radiograph after treatment to ensure resolution. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:13 PM, 30 minutes after discovery of the findings. " f97a3cfc-72288627-14f2608a-5806db3f-293a557c.jpg,test/p19/p19358609/s50338064/f97a3cfc-72288627-14f2608a-5806db3f-293a557c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ett // ET tube placement TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There has been interval increase in right lower lobe consolidations /pneumonia. Right apical subpleural consolidation is more conspicuous than before, part of it is chronic scarring. There appears to be also vascular congestion. Right pleural effusion has increased. Multifocal opacities in the left lung are grossly unchanged. There is evidence of loss of volume in the left lung, distortion of the lung architecture and shifting of the cardiomediastinal structures to the left. ET tube is in standard position. Right PICC tip is in the lower SVC. NG tube tip is in the stomach " 52035a36-52253cf1-b43f3fd4-393d9cf0-c601d8e5.jpg,test/p16/p16883063/s53460397/52035a36-52253cf1-b43f3fd4-393d9cf0-c601d8e5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dyspnea // ? infection COUGH W/CONGESTION/PHLEGM,DYSPNEA SEVERAL WEEKS NO FEVER R/O INFECTION,ABNORMALITY COMPARISON: There are no prior chest radiographs available. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 44bacb5b-ad94a70d-739ff4bc-f2d253b2-5d85314f.jpg,test/p17/p17527875/s56908403/44bacb5b-ad94a70d-739ff4bc-f2d253b2-5d85314f.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with s/p RML lobectomy, hypoxic with ambulation, effusions // Interval changes, b/l effusions TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dating from ___ through ___. FINDINGS: Mild cardiomegaly is unchanged. The moderate right pleural effusion is stable compared to ___ study. The right lung volume loss and lower lobe atelectasis is unchanged. The left lung is clear. No pneumothorax is seen. IMPRESSION: Stable moderate right pleural effusion with associated atelectasis. " e69803a9-85c9ad07-fdaee764-da4926b7-86172096.jpg,test/p15/p15904137/s50145877/e69803a9-85c9ad07-fdaee764-da4926b7-86172096.jpg,test," FINAL REPORT INDICATION: Intubated with intracranial hemorrhage. Evaluate for tube migration. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Single frontal portable chest radiograph demonstrates endotracheal tube terminating 4.6 cm above the carina. The enteric catheter terminates in the distal esophagus and is coiled in the pharynx. There is mild prominence of the central pulmonary vessels as well as the azygos vein suggesting mild pulmonary vascular congestion. The thoracic aorta is unfolded. Hilar and cardiac silhouettes are unremarkable. Lungs are clear. No pleural effusion or pneumothorax. IMPRESSION: Endotracheal tube 4.5 cm above the carina. Enteric catheter coiled in pharynx and terminating in distal esophagus. Tortuous aorta. Pulmonary vessel engorgement with mild if any pulmonary edema. ___ discussed enteric catheter position w/ Dr ___ at 07:50 on ___ via telephone ___ min after discovery. " e659fd6d-19270abd-321b0912-43fe7f42-e54392f3.jpg,test/p17/p17215355/s52034271/e659fd6d-19270abd-321b0912-43fe7f42-e54392f3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man s/p AVR // eval for ptx with chest tube clamped COMPARISON: Chest radiographs ___ through ___. IMPRESSION: There is no pneumothorax or accumulation of pleural effusion since ___, left basal indwelling pleural drain unchanged in position. Mild pulmonary edema unchanged, accompanied by slight increase small right pleural effusion. Postoperative appearance of the cardiomediastinal silhouette is unremarkable. Right jugular line ends centrally. " 7309fefe-ad53ec0c-a3ba3bd8-2223fdbc-7ee177f5.jpg,test/p10/p10679654/s55218507/7309fefe-ad53ec0c-a3ba3bd8-2223fdbc-7ee177f5.jpg,test," FINAL REPORT HISTORY: Status post assault with chest pain. COMPARISON: None. TECHNIQUE: Single portable view of the chest. FINDINGS: There is an endotracheal tube that terminates approximately 4 cm from the carina. NG tube curls in the stomach. Cardiac size is normal. Hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no evidence of bony injury on these non-dedicated views. IMPRESSION: No evidence of acute intrathoracic process. " 761eb9e2-b0c58265-6ef015c6-7006bfcf-8a347f5a.jpg,test/p16/p16777182/s50081798/761eb9e2-b0c58265-6ef015c6-7006bfcf-8a347f5a.jpg,test," WET READ: ___ ___ 1:01 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with fevers/cough // r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " b8ba1183-2448ea31-0644bea0-1dfbfddb-c8f1d447.jpg,test/p15/p15353701/s55731550/b8ba1183-2448ea31-0644bea0-1dfbfddb-c8f1d447.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with mitral regurg s/p mitraclip // any interval change? any interval change? IMPRESSION: Right internal jugular line tip is at the cavoatrial junction. Left PICC line tip is at the level of the mid SVC. Bilateral pleural effusions have increased. Right mid lung atelectasis is unchanged. Mild pulmonary edema is unchanged. " ce405227-f6c2fff4-7972335d-eb2508f7-8386b4e0.jpg,test/p13/p13365915/s55083734/ce405227-f6c2fff4-7972335d-eb2508f7-8386b4e0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG // predischarge eval COMPARISON: ___ IMPRESSION: The alignment of the sternal wires is unchanged. The right internal jugular vein catheter is constant. Normal size of the cardiac silhouette. No pneumonia, no pulmonary edema. No pleural effusions. " 888290a6-cb15d01c-e8f7eea0-2b69aa11-d34b333b.jpg,test/p16/p16508811/s53845981/888290a6-cb15d01c-e8f7eea0-2b69aa11-d34b333b.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough, fever // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 07:51 FINDINGS: Lines and Tubes: Right IJ line terminates in the SVC. Lungs: Well inflated with unchanged bilateral lower zone linear and hazy opacities. Pleura: Small left pleural effusion. No pneumothorax. Mediastinum: Stable cardiomegaly and prominence of hilar vasculature. Bony thorax: No interval change IMPRESSION: Persistent, unchanged pulmonary edema. " b702cdc0-8b3a3a3d-e9211f8c-2b02c0fc-376ea9e1.jpg,test/p19/p19278266/s51202875/b702cdc0-8b3a3a3d-e9211f8c-2b02c0fc-376ea9e1.jpg,test," FINAL REPORT INDICATION: ___F with acute onset left arm pain/tingling at 11AM // any CPD TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Surgical clips seen in the neck. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f5b3a99d-a9b2ddc8-d8fe9415-21f5f2c4-389b8f6c.jpg,test/p19/p19371782/s55844788/f5b3a99d-a9b2ddc8-d8fe9415-21f5f2c4-389b8f6c.jpg,test," WET READ: ___ ___ ___ 6:20 PM Small bilateral pleural effusions. Left perihilar opacity could be due to consolidation, less likely asymmetric pulmonary vascular congestion, underlying pulmonary lesion not excluded. Recommend follow-up to resolution to exclude an underlying pulmonary lesion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with no PMHx fever of unknown origin // Fever of unknown origin TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There are small bilateral pleural effusions. Left perihilar opacity is most concerning for consolidation possibly from pneumonia, underlying pulmonary lesion not excluded. The cardiac silhouette is top-normal to mildly enlarged. The aorta is tortuous. IMPRESSION: Small bilateral pleural effusions. Left perihilar opacity concerning for consolidation, less likely asymmetric pulmonary vascular congestion, underlying pulmonary lesion not excluded. Recommend follow-up to resolution to exclude an underlying pulmonary lesion. " d3014037-5579a163-71992b49-98b45204-f0a3ee2b.jpg,test/p14/p14105959/s50627937/d3014037-5579a163-71992b49-98b45204-f0a3ee2b.jpg,test," FINAL REPORT HISTORY: ___-year-old man with chest pain. Evaluate for pneumonia. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. Mild cardiomegaly is stable. The hilar and mediastinal contours are otherwise normal. Median sternotomy wires are present as well as mediastinal clips, consistent with prior cardiac surgery. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Again there is concern for prior right ___-___ anterolateral rib fractures. IMPRESSION: No acute cardiopulmonary process. " d0a8f349-1dce49ba-d4e35c6f-ea779f58-c4c85f59.jpg,test/p14/p14709954/s54069389/d0a8f349-1dce49ba-d4e35c6f-ea779f58-c4c85f59.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with exertional chest pain // evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 0b411a83-d27e2f85-652b9503-b598a557-ace3a8f0.jpg,test/p16/p16454913/s52796109/0b411a83-d27e2f85-652b9503-b598a557-ace3a8f0.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with history of pancreatic and renal transplant with tracheobronchoplasty. Evaluate interval change. FINDINGS: Comparison is made to previous study from ___. There is a tracheostomy whose distal tip is 4.6 cm above the carina. There is a feeding tube whose side port is at the GE junction. There is a right-sided IJ line with distal lead tip in the proximal SVC. Heart size is enlarged but stable. There remains some atelectasis at the lung bases. There are no pneumothoraces. Overall, these findings are stable. " 3d5e985b-9cc72edc-142558c3-82f711c5-ea31c038.jpg,test/p18/p18957398/s54760859/3d5e985b-9cc72edc-142558c3-82f711c5-ea31c038.jpg,test," FINAL REPORT INDICATION: Shortness of breath for one week. Evaluation for pneumonia. COMPARISONS: None. FINDINGS: AP and lateral chest radiographs demonstrate a markedly tortuous aorta and widened mediastinum which may represent combination of tortuous aorta and mediastinal lipomatosis/other soft tissue. The pulmonary vasculature is mildly prominent and lung volumes are low. There is no pleural effusion or pneumothorax. " 28a22fe0-c87f0a13-8a7cca52-5deeac8e-b31d3717.jpg,test/p12/p12685249/s55366670/28a22fe0-c87f0a13-8a7cca52-5deeac8e-b31d3717.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ett // ___? IMPRESSION: Interval in dance min of nasogastric tube, which initially coils in the proximal stomach before terminating in the region of the gastroduodenal junction. Exam is otherwise remarkable for bibasilar atelectasis, slightly worse on the right and slightly improved on the left compared to the previous exam. " 0739d307-3f46311d-925987dc-2fa575cc-fcf7eb6e.jpg,test/p13/p13040755/s57002793/0739d307-3f46311d-925987dc-2fa575cc-fcf7eb6e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p pigtail removal (left). Post op CXR showing slight increase of L pneumothorax inferiorly. Please eval interval change // interval change. Please repeat CXR tonight at 23:55 (___). IMPRESSION: As compared to the previous radiograph from earlier the same date, a moderate sized left pneumothorax is unchanged. Remainder of the exam is also similar to the recent study. " 321d7173-d9622fd0-99db0e1d-cdc3c8ca-a53bbb25.jpg,test/p11/p11943612/s55906340/321d7173-d9622fd0-99db0e1d-cdc3c8ca-a53bbb25.jpg,test," FINAL REPORT INDICATION: Two day history of fever and cough; PE shows scattered rhonchi and wheezes // Rule out pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. Chest CT ___ FINDINGS: Prominent left hilar region secondary to enlarged left main pulmonary artery as seen on chest CT ___. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions. IMPRESSION: Prominent left hilar region secondary to large left main pulmonary artery as seen on chest ct ___. No pneumonia. " 462cb95a-93522a0d-dc56636c-a1bb784f-e57a9407.jpg,test/p19/p19919570/s59870726/462cb95a-93522a0d-dc56636c-a1bb784f-e57a9407.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Crackles left side // Crackles left side Crackles left side COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lung volumes have improved, cardiomediastinal silhouette is substantially smaller and both pulmonary vascular engorgement and interstitial edema have resolved. There is no appreciable pleural effusion. No pneumothorax Right supraclavicular central venous catheter ends in the upper right atrium. " 4ee70184-317e7de6-54333b8f-0e5e6b46-a273f6dc.jpg,test/p12/p12297844/s53102784/4ee70184-317e7de6-54333b8f-0e5e6b46-a273f6dc.jpg,test," FINAL REPORT AP CHEST, 11:52 P.M., ___ HISTORY: ___-year-old man after cardiac arrest. Evaluate pneumothorax. IMPRESSION: AP chest compared to earlier examinations on ___, 6:10 a.m. through 7:17 p.m.: Presumed anterior pneumothorax in the left lower chest is smaller, while subcutaneous emphysema in the left chest wall remains stable. Opacification in the left lower lobe is slightly more extensive, presumably atelectasis or contusion. The volume of posteriorly collected left pleural effusion is hard to assess. Cardiomediastinal silhouette is normal aside from mild rightward shift due to left pneumothorax. Nasogastric tube ends in the distal stomach. ET tube and right jugular line are in standard positions respectively, and the right lung is clear. " c0c2e306-824b58a1-cb6e5ce5-e9764fdd-a145d21d.jpg,test/p10/p10610928/s50810427/c0c2e306-824b58a1-cb6e5ce5-e9764fdd-a145d21d.jpg,test," FINAL REPORT AP CHEST, 4:11 A.M., ___ HISTORY: A ___-year-old man with end-stage renal disease and shortness of breath. IMPRESSION: AP chest compared to ___: Increase in both heart size and the caliber of mediastinal and pulmonary vessels between ___ and ___ is due to cardiac decompensation and/or volume overload. Since ___, there is new focal consolidation in the left lower lung and progression of consolidation in the anterior segment of the right upper lobe and in the right lower lobe, probably worsening multifocal pneumonia. Heart size top normal. Right PIC line ends in the SVC. Dr. ___ was paged. " e05da262-7c81c130-67441719-b673c407-69ce32ac.jpg,test/p15/p15340094/s59309224/e05da262-7c81c130-67441719-b673c407-69ce32ac.jpg,test," FINAL REPORT INDICATION: ___-year-old female with shortness of breath. TECHNIQUE: AP and lateral. COMPARISON: Radiograph dated ___. FINDINGS: AP upright and lateral chest radiograph demonstrates no focal opacity convincing for pneumonia. Blunting of the right costophrenic angle is similar in appearance to prior examinations. Cardiac silhouette is stable in appearance as are mediastinal and hilar contours. Aortic arch calcification is noted. There is no pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " f0a432f5-6421dcc6-33339826-440e3fac-f5a38b77.jpg,test/p11/p11902171/s57550200/f0a432f5-6421dcc6-33339826-440e3fac-f5a38b77.jpg,test," FINAL REPORT INDICATION: Dizziness and body aches. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is top normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. Mild left basilar atelectasis is present. IMPRESSION: No acute intrathoracic process. " b5b380f8-bb7d62c7-3a5d2a3d-23927476-ff4799dc.jpg,test/p12/p12414772/s51336509/b5b380f8-bb7d62c7-3a5d2a3d-23927476-ff4799dc.jpg,test," FINAL REPORT INDICATION: Acute on chronic dyspnea. Status post ultrasound-guided thoracentesis. COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are stable. Patient is status post CABG. Again demonstrated is a left pleural effusion, not significantly changed in size on this single frontal view compared to the prior radiograph. There is no pneumothorax. There is no right pleural effusion. There is no focal consolidation concerning for pneumonia. IMPRESSION: No pneumothorax. " 2716883c-05afae64-2e7105ef-99f4b936-262d6aaa.jpg,test/p15/p15021710/s54125118/2716883c-05afae64-2e7105ef-99f4b936-262d6aaa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intra-abdominal bleed s/p nephrectomy // ?interval change, ?ETT placement IMPRESSION: Interval placement of endotracheal tube since the recent radiograph of earlier the same date, with the tube in standard position. Nasogastric tube has also been placed, the but the tip is not confidently visualized beyond the lower thoracic esophagus. Consider additional radiograph centered at the thoracoabdominal junction to confirm location and to help determine need for advancement. Exam is otherwise remarkable for new pulmonary vascular congestion, worsening bibasilar atelectasis and new pleural effusions, moderate on the right and small on the left. " 0d987878-c2cd5f20-94c7f205-47fc42d9-560f22a8.jpg,test/p17/p17560817/s55251754/0d987878-c2cd5f20-94c7f205-47fc42d9-560f22a8.jpg,test," FINAL REPORT INDICATION: Elevated white count, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___. FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. A catheter is partially visualized projecting over the left flank. No acute osseous abnormality is identified. IMPRESSION: No evidence of acute cardiopulmonary process. " 1a6f51f2-acb55e86-6f624dc5-3cfedf81-64032a13.jpg,test/p15/p15487120/s56459815/1a6f51f2-acb55e86-6f624dc5-3cfedf81-64032a13.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ YEAR OLD WITH LOSS OF APPEPTITE, HEAVY SMOKER ?LUNG CANCER IMPRESSION: There are no prior chest radiographs available for review. Lungs are hyperinflated consistent with emphysema or obstructive airways disease. There is no lung mass or other evidence of malignancy however there is interstitial abnormality in the lower lungs which could be early pulmonary fibrosis or other smoking related lung disease. Heart is normal size. There is no pleural effusion or evidence of central lymph node enlargement. " da84fbd8-e08a9a84-2c9f817b-14696eee-8af422e8.jpg,test/p18/p18423141/s57925144/da84fbd8-e08a9a84-2c9f817b-14696eee-8af422e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: COUGH IMPRESSION: No previous images. There is hyperexpansion of the lungs suggesting chronic lung chronic pulmonary disease. However, no evidence of acute focal pneumonia, vascular congestion, or pleural effusion. " da27f9a5-bbbee6f6-f0ec39ae-639ec4ae-c51ecf5d.jpg,test/p15/p15355458/s56235734/da27f9a5-bbbee6f6-f0ec39ae-639ec4ae-c51ecf5d.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with septic shock after pelvic mass finding. COMPARISON: ___. As compared to the prior study, the ET tube tip is approximately 3.4 cm above the carina, unchanged. The left internal jugular line tip is at the level of superior mid SVC. The right internal jugular line tip is at the level of mid SVC. There is slight interval improvement in interstitial pulmonary edema. Bibasal consolidations and bilateral pleural effusions are unchanged. Extensive calcifications of the mitral annulus are redemonstrated. " 364b251e-8fefc4ea-0100e98b-b4568603-07f4312b.jpg,test/p14/p14143688/s50510816/364b251e-8fefc4ea-0100e98b-b4568603-07f4312b.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: A ___-year-old female with history of severe vomiting over the past several days, unable to tolerate any p.o. intake, also reported hemetemesis, severely dehydrated, question infection, free air. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is elevation of the right hemidiaphragm. Relative ___ of the left hemidiaphragm on the frontal view is felt to most likely be due to overlying soft tissue, as it is not substantiated on the lateral view. No definite focal consolidation or pleural effusion is seen. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. No evidence of free air is seen beneath the diaphragm. Curvilinear opacity projecting just right lateral to the lower thoracic spine correlate with osteophyte as seen on prior studies, including ___. IMPRESSION: 1. Elevated right hemidiaphragm. 2. Left base not well evaluated on the frontal view, although no consolidation or pleural effusion seen on the lateral view. " 92139ba0-73b9bd3a-10674ec8-9e443ba4-f9882fda.jpg,test/p17/p17629584/s56464724/92139ba0-73b9bd3a-10674ec8-9e443ba4-f9882fda.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON STUDY: ___. FINDINGS: Cardiomediastinal contours are within normal limits for technique. Lungs are grossly clear and there is no pleural effusion or pneumothorax. " 8eec5a3f-19f80726-1c52b780-dcbb2d49-6410680d.jpg,test/p19/p19437158/s59758312/8eec5a3f-19f80726-1c52b780-dcbb2d49-6410680d.jpg,test," FINAL REPORT INDICATION: ___M with cough, evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 9d4b2215-f94c5225-c21c0c9d-fc93a6eb-8be16570.jpg,test/p19/p19845120/s51273696/9d4b2215-f94c5225-c21c0c9d-fc93a6eb-8be16570.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after Dobbhoff placement. AP radiograph of the chest was compared to ___. The Dobbhoff tube is coiled most likely within the upper esophagus and should be re-positioned. Heart size is enlarged but essentially unchanged since the prior study. Vascular engorgement is unchanged. " 8268902f-6e8f49e0-ff622ab8-c012a54a-4faef0b8.jpg,test/p14/p14951077/s56639554/8268902f-6e8f49e0-ff622ab8-c012a54a-4faef0b8.jpg,test," WET READ: ___ ___ ___ 3:46 PM Since the prior chest radiograph on ___, the right PICC has been removed. Nodular opacities at the right lung apex are similar. No focal consolidation, sizeable pleural effusion or pneumothorax. Heart size is normal. WET READ VERSION #1 ___ ___ ___ 12:20 AM Since the prior chest radiograph on ___, the right PICC has been removed. Nodular opacities at the right lung apex are similar. No focal consolidation, sizeable pleural effusion or pneumothorax. Heart size is normal. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with AML, new bacteremia // eval for pneumonia COMPARISON: ___ IMPRESSION: The previously noted right PICC line has been removed. There is no pneumothorax. There is stable scarring in both lung apices. There is no dense consolidation. There is no effusion. " a6fd4c4a-c06594d4-ed410371-b0b80bd9-804ee7ef.jpg,test/p15/p15816738/s58961539/a6fd4c4a-c06594d4-ed410371-b0b80bd9-804ee7ef.jpg,test," FINAL REPORT HISTORY: Extubation. FINDINGS: In comparison with study of ___, the endotracheal tube has been removed. Severe enlargement of the cardiac silhouette and the main pulmonary artery again consistent with pulmonary hypertension. Mild bibasilar atelectatic changes are seen, without definite vascular congestion or pleural effusion. " 4ad0863b-74bc09b2-68995f9c-1b875e93-0200ce77.jpg,test/p15/p15566987/s59099888/4ad0863b-74bc09b2-68995f9c-1b875e93-0200ce77.jpg,test," FINAL REPORT INDICATION: ___ year old man with feeding tube placement // positive of feeding tube EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal view COMPARISON: Chest radiograph ___ 09:33 FINDINGS: Dobbhoff tube enters the stomach, courses towards the right then coils back to near GE junction. Bibasilar atelectasis is unchanged. Cardiomediastinal silhouette is normal size. IMPRESSION: Dobbhoff tube enters the stomach, courses towards the right then coils back to near GE junction. " 467c915e-bdfe3182-bc328824-0b7cee3b-36c4fb60.jpg,test/p19/p19348515/s51209518/467c915e-bdfe3182-bc328824-0b7cee3b-36c4fb60.jpg,test," FINAL REPORT PATIENT HISTORY: ___ years old man with pleural effusion, assess pleural effusion. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: Right base opacity has minimally improved for reduced pleural effusion. The air described in the right base cavity is not visible in the actual chest x-ray, probably resolved. Stable right lower posterior lung opacity is the round atelectasis described in prior CT of ___. Left lung is clear. Heart size is mildly enlarged but stable since prior chest x-ray. Patient has had cardiac surgery as denoted by sternal wires which are intact and in the midline. No pneumothorax. " eda7c2e7-1482f6d3-3fbabc84-c05dfa04-cb897815.jpg,test/p11/p11648387/s59065031/eda7c2e7-1482f6d3-3fbabc84-c05dfa04-cb897815.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Again seen is nodular opacity overlying the right lower lung on the frontal view, not clearly delineated on the lateral view. The lungs are otherwise clear. There is no consolidation, effusion, or pulmonary vascular congestion. Probable fat pad identified at the right cardiophrenic angle. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. Persistent nodule projecting over the right lung for which nonurgent dedicated chest CT is again suggested. " 781f67ce-f93ec3d2-057dbd2f-92997cc9-2341ff97.jpg,test/p13/p13085886/s56635058/781f67ce-f93ec3d2-057dbd2f-92997cc9-2341ff97.jpg,test," FINAL REPORT INDICATION: ___ febrile neutropenia // r/o PNA TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: A right subclavian central venous catheter tip projects over the cavoatrial junction. An ovoid airspace opacity projects over the right mid lung zone and may reflect a focus of pneumonia. There is no pleural effusions or pneumothorax identified. The size the cardiomediastinal silhouette is within normal limits. IMPRESSION: New airspace opacity in the right mid lung zone may reflect pneumonia in the proper clinical context. " c9d3e072-be851bc5-78659352-f5648080-e92ee4e0.jpg,test/p18/p18038802/s54265103/c9d3e072-be851bc5-78659352-f5648080-e92ee4e0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman at ___ gestation with fever of unknown origin // eval for pulmonary etiology of fever TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities " 7b884bb3-fa2ce66f-3ad6a87f-14dca9e9-1dc6786c.jpg,test/p16/p16675128/s52858979/7b884bb3-fa2ce66f-3ad6a87f-14dca9e9-1dc6786c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with 5days of non-productive cough and PNA exposure ?RLL focal findings // r/o PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Mild prominence of the right hilum is grossly stable. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " bb7d33e9-846314c3-596cbff4-c065f55a-1869d2bb.jpg,test/p13/p13851800/s51930916/bb7d33e9-846314c3-596cbff4-c065f55a-1869d2bb.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M with dyspnea, prior CXR ?devp PNA // ?cpd TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lung volumes have increased since prior exam. The lungs are clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " db2fb2c7-1472af6b-4cec9bc6-2f437cd4-c3301364.jpg,test/p10/p10603452/s56903276/db2fb2c7-1472af6b-4cec9bc6-2f437cd4-c3301364.jpg,test," FINAL REPORT HISTORY: Right middle lobe opacity on CT scan. FINDINGS: 2 views were obtained of the chest. Mild bronchiectasis is seen in the lingula and right middle lobe. Otherwise the lungs are hyperexpanded but clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process with mild right middle lobe and lingular bronchiectasis. " 7c1b462e-5d2b4569-33c169eb-be2d1da9-68fb88df.jpg,test/p17/p17535980/s58908195/7c1b462e-5d2b4569-33c169eb-be2d1da9-68fb88df.jpg,test," FINAL REPORT HISTORY: ___-year-old female with altered mental status. Evaluate for cardiopulmonary process. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart size and cardiomediastinal contours are normal. Indistinct pulmonary vascular markings are compatible with mild pulmonary vascular congestion. No focal consolidation, pleural effusion, or pneumothorax. Rightward deviation and slight narrowing of the trachea is slightly increased since ___. Multilevel thoracic spine degenerative changes are re- demonstrated. No radiopaque foreign body. IMPRESSION: 1. Mild pulmonary vascular congestion. 2. Rightward deviation and slight narrowing of the trachea is slightly increased since ___, compatible with an enlarging goiter. " 720ca92c-40972a56-24d2bbb2-6ddaa9b7-e89e1f68.jpg,test/p14/p14566443/s57864431/720ca92c-40972a56-24d2bbb2-6ddaa9b7-e89e1f68.jpg,test," FINAL REPORT HISTORY: ___-year-old male with left arm pain and intermittent left chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. There is no pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 04d4006f-c8f5842a-700f9d76-43ae2622-021b5a7d.jpg,test/p14/p14973190/s58444681/04d4006f-c8f5842a-700f9d76-43ae2622-021b5a7d.jpg,test," FINAL REPORT CHEST PORTABLE PLAIN FILM ___ AT 22:01 CLINICAL INDICATION: ___-year-old with cough, tachycardia. Evaluate for pulmonary edema. Comparison to prior study of ___ at 9:20. A portable AP semi-erect chest film ___ at 22:01 is submitted. IMPRESSION: 1. Right internal jugular central line has its tip in the distal SVC, unchanged. A nasogastric tube is seen coursing below the diaphragm with the tip projecting over the stomach. There has been interval improvement in aeration but with residual persistent mild-to-moderate pulmonary edema. Right hemidiaphragm remains elevated. There is likely bilateral effusions, left greater than right. Persistent retrocardiac opacity likely reflects compressive atelectasis in the setting of a layering effusion. Superimposed pneumonia cannot be entirely excluded. No evidence of pneumothorax. " 101228ca-e140923e-0321ec8a-08e5d15f-82034523.jpg,test/p15/p15255120/s54188760/101228ca-e140923e-0321ec8a-08e5d15f-82034523.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___/M ESRD (HTN/DM) on HD since ___ s/p cadaveric renal transplant c/b respiratory distress // Interval assesment Interval assesment COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Pulmonary edema developed between ___ and ___, accompanied by increase pulmonary vascular engorgement in the upper lungs. There has been some improvement since ___. Severe cardiomegaly is chronic. Pleural effusions are presumed, but not large. Right jugular line ends in the low SVC. No pneumothorax " b6671987-4dd3c32b-abce2b50-ebbed1ac-b20d5a93.jpg,test/p19/p19667420/s58828131/b6671987-4dd3c32b-abce2b50-ebbed1ac-b20d5a93.jpg,test," FINAL REPORT INDICATION: ___M with dyspnea // pulm edema? TECHNIQUE: AP and lateral views of the chest. COMPARISON: There are bilateral pleural effusions, left greater than right, moderate in size. There is mild pulmonary vascular congestion. Cardiac silhouette is not well assessed as it is silhouetted on the left. Left chest wall dual lead pacing device is again seen. Spinal hardware seen in the thoracolumbar region. Median sternotomy wires are again seen, the superior most wire is fractured as on prior. FINDINGS: Moderate bilateral effusions, left greater than right, with mild pulmonary vascular congestion. " 5969f848-77404b23-e6957f2b-15eda13a-23863b28.jpg,test/p18/p18539425/s52135830/5969f848-77404b23-e6957f2b-15eda13a-23863b28.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are clear, without consolidation, pleural effusion or pneumothorax. No acute osseous abnormality seen. IMPRESSION: No acute cardiopulmonary pathology. " 53fbf20b-2de8c843-21da8e7d-57c364da-00ca6641.jpg,test/p14/p14754762/s52717010/53fbf20b-2de8c843-21da8e7d-57c364da-00ca6641.jpg,test," FINAL REPORT HISTORY: Expiratory wheezes, to assess for pneumonia or congestive failure. FINDINGS: In comparison with study of ___, there is little change. Cardiac silhouette is within normal limits and there is mild tortuosity of the aorta. No pulmonary vascular congestion or acute pneumonia. Substantial loss of height of several dorsal vertebrae again is seen in this patient with generalized skeletal osteopenia. " 9af9c645-21a4a6cb-ef0dce6c-c62d79e7-4f1460ae.jpg,test/p14/p14591676/s56675649/9af9c645-21a4a6cb-ef0dce6c-c62d79e7-4f1460ae.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recurrent left pleural effusion // post thoracentesis post thoracentesis IMPRESSION: Compared to chest radiographs ___ through ___ at 12:31. Large left pleural effusion is smaller. No pneumothorax. Left lower lung still atelectatic, reflected in slight leftward shift of the mediastinum after withdrawal of some left pleural fluid. Right lung clear. Transvenous right atrial right ventricular pacer leads follow their expected courses from the right pectoral generator. " 2c2a973b-fe3acd9a-d62b5e2a-d1516f4d-c04fc7df.jpg,test/p16/p16441183/s51634094/2c2a973b-fe3acd9a-d62b5e2a-d1516f4d-c04fc7df.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: History of congestive heart failure. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The lung volumes are low. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. The bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " f3ce4a72-98340942-f51642bc-af70b270-940a4190.jpg,test/p12/p12457595/s54496682/f3ce4a72-98340942-f51642bc-af70b270-940a4190.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p CT removal // eval for effusion TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Interval removal of left chest tube. Median sternotomy wires intact and aligned. Unchanged, mild cardiomegaly. Stable, small left pleural effusion with underlying basilar atelectasis. No pneumothorax. IMPRESSION: No pneumothorax. Stable small left pleural effusion " d33cfb71-46119812-ee8667ea-0e3bf9c5-3b7d70a9.jpg,test/p14/p14709712/s54353640/d33cfb71-46119812-ee8667ea-0e3bf9c5-3b7d70a9.jpg,test," FINAL REPORT INDICATION: ___ year old man with new ams and leukocytosis // evaluate for pneumonia TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph from ___, ___. FINDINGS: There has been interval removal of a right internal jugular central venous catheter. No pneumothorax. The lungs are well expanded and clear. Mediastinal contours, hila, and cardiac silhouette are stable. There has been resolution of a left-sided pleural effusion since ___. Residual pneumoperitoneum is decreased from ___. IMPRESSION: 1. Persistent pneumoperitoneum, decreased from ___. This finding has persisted longer than expected given abdominal surgery on ___. 2. No evidence of pneumonia. 3. Resolution of the left pleural effusion since ___. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 9:49 AM, 10 minutes after discovery of the findings. " a37e39c0-c8e43bc5-e64c5f1c-a64a1c71-58002a0b.jpg,test/p12/p12221629/s58878574/a37e39c0-c8e43bc5-e64c5f1c-a64a1c71-58002a0b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, pna, known L pleural effusion p/w new onset R side pain, pleuritic, and radiating upwards towards neck. // New onset chest pain, pleuritic. New onset chest pain, pleuritic. IMPRESSION: Comparison to ___. Stable appearance of the known left pleural effusion with subsequent atelectasis. Stable mild atelectasis at the right lung basis. No new parenchymal opacities or other abnormalities are noted in the right hemi thorax. Mild cardiomegaly persists. Stable position of the left pectoral pacemaker. " ca04b59e-cd5990d3-387a0891-4c4df755-79658221.jpg,test/p16/p16527660/s53902396/ca04b59e-cd5990d3-387a0891-4c4df755-79658221.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with advanced fibrosis // Please rule out TB. patient participating in clinical trial. Please ___ to ___ number ___ TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. There are moderate degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities There is no evidence of acute or chronic TB " ee50e953-b11de909-ac942140-278b7a46-73f7d45e.jpg,test/p15/p15808548/s59192912/ee50e953-b11de909-ac942140-278b7a46-73f7d45e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with SOB. Assess etiology. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Moderate left pleural effusion with left lower lobe opacity is noted and is new. Right lower lobe heterogeneous opacity is most consistent with atelectasis. No pneumothorax. Mild cephalization of vasculature is noted. Aortic arch calcifications are present. Visualized cardiomediastinal silhouette is otherwise unremarkable. Visualized osseous structures are unremarkable. No displaced rib fracture. IMPRESSION: 1. Moderate left pleural effusion with left lower lobe opacity is worrisome for pneumonia or aspiration pneumonia in the appropriate clinical setting. 2. Right lower lobe atelectasis. 3. Mild vascular congestion. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 10:47 AM, 5 minutes after discovery of the findings. " 6543bb07-8f3a558f-b76d2cd8-9ac440be-d110b5cd.jpg,test/p16/p16595826/s59650468/6543bb07-8f3a558f-b76d2cd8-9ac440be-d110b5cd.jpg,test," FINAL REPORT INDICATION: ___ year old woman with recent pneumonia and hyponatremia // ? lesion TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The previously described left lower lobe peripheral opacity has resolved. No new airspace opacity. The cardiac silhouette is stable with coarse calcifications of the mitral annulus. No pleural effusions or pneumothorax. Surgical clips related to prior thyroid surgery P IMPRESSION: Interval resolution of left lower lobe opacity, no acute cardiopulmonary process. " 489136e5-81275add-e9a5846a-f50be5cd-74779926.jpg,test/p18/p18236201/s59028734/489136e5-81275add-e9a5846a-f50be5cd-74779926.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of down syndrome, afib, and diastolic heart failure who presented with a one day history of intermittent frontal headache, sinus pressure, one episode of non-bloody, non-bilious vomiting, as well as shortness of breath here with continued hypoxia in setting of antibiotic therapy and diuresis. // pulmonary edema? infiltrates? vascular congestion? pulmonary edema? infiltrates? vascular congestion? COMPARISON: Prior chest radiographs since ___, most recently ___ in ___. IMPRESSION: Combination of nodules and consolidation in both lungs has not improved since ___, most likely multifocal pneumonia. Moderate cardiomegaly is chronic, but there is no clear vascular congestion or pleural effusion. Of note the upper esophagus is persistently distended with air. This may denote either any structural or functional abnormality of the esophagus which predisposes the patient to aspiration. " b330640c-55854ace-6ec0d142-f7092005-19905d8f.jpg,test/p18/p18909627/s51534661/b330640c-55854ace-6ec0d142-f7092005-19905d8f.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough. Assess for pneumonia. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Sternotomy wires are intact. Lung apices are partially obscured by patient's positioning. However, lungs are fully expanded and clear in this limited view. Pleural surfaces are normal. Heart size, mediastinal contour and hila are normal without lymphadenopathy. Aortic arch calcifications are noted as well as a left pigtail catheter with tip in the left upper quadrant. IMPRESSION: No radiographic evidence of acute cardiopulmonary process such as pneumonia. " 7fcf0773-5bdb33d4-c329ae23-ed2a4905-73c26d22.jpg,test/p16/p16727046/s53961821/7fcf0773-5bdb33d4-c329ae23-ed2a4905-73c26d22.jpg,test," WET READ: ___ ___ 10:48 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cough and chest pain, here to evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The inspiratory lung volumes are appropriate. There is slight underpenetration of the lung bases. Within this limitation, there is no focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " f7d314bb-2e4de484-a4b8c0d9-1b8e5f18-332c046c.jpg,test/p15/p15571472/s52717807/f7d314bb-2e4de484-a4b8c0d9-1b8e5f18-332c046c.jpg,test," FINAL REPORT HISTORY: Fever, assess for pneumonia TECHNIQUE: AP upright and lateral radiographs were obtained of the chest. COMPARISON: None FINDINGS: Persistent opacification of the right hemithorax with associated volume loss is consistent with the prior history of right pneumonectomy. The left lung is clear without focal consolidation, pleural effusion or pneumothorax. Heart size is not reliably evaluated with normal appearance of the left mediastinal border. IMPRESSION: No acute intrathoracic process with unchanged postsurgical changes. " 90acb55b-32b6183c-e3950741-343cde65-904b5ff3.jpg,test/p16/p16454913/s50553507/90acb55b-32b6183c-e3950741-343cde65-904b5ff3.jpg,test," FINAL REPORT HISTORY: Worsening hypoxia. FINDINGS: In comparison with the study of ___, the patient has taken a slightly better inspiration. Bilateral pleural effusions with compressive atelectasis persist. Central catheter remains in place. " 8e5fd665-670d9f5c-71032962-18d9d24c-552377c2.jpg,test/p14/p14120635/s58696310/8e5fd665-670d9f5c-71032962-18d9d24c-552377c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NG tube placement // Please evaluate for NG tube TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 8 hours earlier IMPRESSION: Dobhoff tube tip isin the stomach, just distal to the EG junction. No other interval change from prior study. " fd10a950-ac62411e-be46c393-f20d5cdf-9f1ee821.jpg,test/p13/p13391297/s56367137/fd10a950-ac62411e-be46c393-f20d5cdf-9f1ee821.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with copd // ?pneumonia. Patient reports increased sob, sputum production, and one febrile episode. TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable chest radiograph FINDINGS: Lung volumes are somewhat low. Indistinct left lower lung opacity could reflect pneumonia or atelectasis. No other focal opacities. Heart size is top-normal. Cardiomediastinal and hilar silhouettes are unremarkable. Multiple surgical clips project over the right upper quadrant. Proximal left humeral diaphysis hardware is again noted. IMPRESSION: Probable lateral segment left lower lobe pneumonia. RECOMMENDATION(S): Recommend repeat PA and lateral chest radiographs in 4 - 6 weeks to assess for resolution. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 5:01 PM, approximately 60 minutes after discovery of the findings. " 06c82d39-f38dc1b2-e4ba05aa-8a27f6b2-2c868c62.jpg,test/p16/p16370208/s51281208/06c82d39-f38dc1b2-e4ba05aa-8a27f6b2-2c868c62.jpg,test," FINAL REPORT INDICATION: ___-year-old male with febrile neutropenia. Evaluate for pneumonia. COMPARISON: Chest radiograph on ___ and ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiographic examination. " c5e75f04-f5d3e3c4-22e73833-494c98e4-ea1f1284.jpg,test/p12/p12503805/s58768782/c5e75f04-f5d3e3c4-22e73833-494c98e4-ea1f1284.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with multitrauma L ribs ___fx L orbital floor fx, b/l nasal bone fracture // diminshed respiratory sounds on L bse; r/o pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is a newly appeared left dorsal basal parenchymal opacity, consistent with pneumonia. If the patient has no signs of infection, pulmonary embolism is a second differential diagnostic consideration. If this is the case, CT should be performed. The heart is normal. Normal hilar and mediastinal structures. At the time of dictation and observation, 14:26, on ___, the referring physician ___. ___ was paged for notification and ___ min later the findings were discussed over the telephone. In addition, in the interval, the finding was posted on the radiology dashboard and an internal email was generated to the referring physician. " b4286423-3e5ff143-37ecdf43-77eec1d5-95122a89.jpg,test/p10/p10326215/s53938691/b4286423-3e5ff143-37ecdf43-77eec1d5-95122a89.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with lung mass // eval COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the right-sided lung mass is of unchanged size and extent. There is no evidence of a right-sided pneumothorax. Unchanged appearance of the sternal wires and the clips of the CABG. Normal left lung. " ea152590-87ce0923-c8fc510e-72b14faa-d3f8f95a.jpg,test/p16/p16249756/s55524830/ea152590-87ce0923-c8fc510e-72b14faa-d3f8f95a.jpg,test," FINAL REPORT INDICATION: Left-sided pleuritic chest pain after trauma approximately 10 days ago. Decreased breath sounds at the lung base. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: There is left basilar atelectasis. There is no fracture or pneumothorax. There is no focal consolidation or pleural effusion. The heart size is slightly more prominent than ___, but still within normal limits. IMPRESSION: Left basilar atelectasis. No fracture or pneumothorax. " f6c3e917-715e1a0f-78eb878a-4a1a154e-43d00a05.jpg,test/p18/p18001523/s53676202/f6c3e917-715e1a0f-78eb878a-4a1a154e-43d00a05.jpg,test," WET READ: ___ ___ ___ 5:02 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with chest pain // Acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ and ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures. A metallic surgical anchor device is seen in the left humeral head. Degenerative changes are seen in the lower thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 2d0e55e5-3dfa9d33-39fc85fa-2f094aed-27632d6b.jpg,test/p17/p17763712/s58312999/2d0e55e5-3dfa9d33-39fc85fa-2f094aed-27632d6b.jpg,test," FINAL REPORT INDICATION: ___ year old woman with met breast cancer presents for chemo today // Please confirm portacath placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. IMPRESSION: Right Port-A-Cath appears unchanged terminating in the region of the cavoatrial junction without disruption or kinking of the tubing. Small right and moderate-large left pleural effusions are increased from ___, with moderate rate of accumulation. No pulmonary edema or pneumothorax. Left upper lobe opacity appears unchanged. NOTIFICATION: The findings were discussed with ___, N.P. by ___ ___, M.D. on the telephone on ___ at 10:28 AM, 2 minutes after discovery of the findings. " 50659120-16685ccb-b444e9f2-cc1da24b-8ece9881.jpg,test/p17/p17349126/s57086287/50659120-16685ccb-b444e9f2-cc1da24b-8ece9881.jpg,test," FINAL REPORT AP CHEST, 4:57 A.M. ON ___ HISTORY: Respiratory distress after spinal cord injury, evaluate possible pneumonia, effusion and edema. IMPRESSION: AP chest compared to ___: Pulmonary edema previously affecting both lungs has improved since ___. The residual consolidation at the lung bases, particularly the right raises concern for developing pneumonia, but this is difficult to distinguish from atelectasis and the effects of persistent small right pleural effusion. Heart is mildly enlarged. There is no pneumothorax. Right jugular line ends at the origin of the SVC, ET tube is in standard placement and nasogastric tube passes into the stomach and out of view. " c4298a99-172631df-3bb2150a-0a881cb9-2f0430fb.jpg,test/p19/p19740976/s54828253/c4298a99-172631df-3bb2150a-0a881cb9-2f0430fb.jpg,test," WET READ: ___ ___ ___ 11:01 PM Interval placement of the enteric catheter which terminates in the fundus of stomach. Recommend advancement several centimeters to ensure that the side port is beyond the GE junction. Interval increase in and retrocardiac and left lower lung opacification possibly representing increased atelectasis though a component of effusion or infectious process is not excluded. ___ ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess NG tube. Comparison is made with prior study, ___. NG tube tip is in the stomach, though the side port is at the GE junction, should be advanced several centimeters for more standard position. There are low lung volumes. Moderate-to-severe cardiomegaly is stable. Right central catheter tip is in the mid SVC. There is no pneumothorax. Increasing left lower lobe opacities are a combination of increasing focal small effusion and adjacent consolidation. This consolidation could be atelectasis and/or infection/pneumonia. The right lower lobe atelectasis is unchanged. There is no pneumothorax. " f76bbc5f-c726cffb-15af73e8-5b3807f1-1b593f28.jpg,test/p11/p11820695/s53487271/f76bbc5f-c726cffb-15af73e8-5b3807f1-1b593f28.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old female with nausea, vomiting, question port position. FINDINGS: PA and lateral views of the chest are provided. A right chest Port-A-Cath is seen with tip extending into the low SVC region, unchanged. The lungs are clear. No focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. Clips in the right upper quadrant are noted. IMPRESSION: Port-A-Cath in appropriate position with tip in the low SVC. Otherwise normal. " fdf1623c-e22bb43c-1c20b799-659b5860-6c1fc3a2.jpg,test/p15/p15420944/s51175234/fdf1623c-e22bb43c-1c20b799-659b5860-6c1fc3a2.jpg,test," FINAL REPORT HISTORY: Repeat chest after central line, fevers. CHEST, SINGLE AP PORTABLE VIEW Compared with ___ at 11:12 a.m., the ET tube and NG tube are poorly delineated due to underpenetration and slight rotation and can therefore not be localized. A right IJ central line is present, tip over mid/distal SVC. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation and a small left effusion. This is similar or possibly slightly worse compared with ___ at 11:12 am. There is minimal patchy opacity at the right lung base, which appears new. No right-sided effusion. Allowing for low inspiratory volumes, there is slight vascular plethora, but I doubt overt CHF. " 5a8e5ed4-6b0dde45-6e7fe9b3-5b0cdd96-00476552.jpg,test/p15/p15872635/s59845731/5a8e5ed4-6b0dde45-6e7fe9b3-5b0cdd96-00476552.jpg,test," FINAL REPORT INDICATION: ___F with cough // pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process, no focal opacity. " 85e2b9b9-6b5763e2-35942532-dae8f6d7-0c228c73.jpg,test/p19/p19865640/s52726730/85e2b9b9-6b5763e2-35942532-dae8f6d7-0c228c73.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with pleuritic chest pain, cough, fevers // please evaluate for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There are degenerative changes in the spine. IMPRESSION: No pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 12:02 PM, 10 minutes after discovery of the findings. " d30b425a-3046b0eb-34435fc7-a1d65f69-7adfd8b2.jpg,test/p17/p17406178/s52121644/d30b425a-3046b0eb-34435fc7-a1d65f69-7adfd8b2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with renal cell carcinoma // evaluate for mets or other abnormalities evaluate for mets or other abnormalities COMPARISON: Prior chest radiographs since ___, most recently ___. IMPRESSION: Lungs are well expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Leftward deviation of the trachea at the thoracic inlet could be in normal anatomic variant or an indication of displacement by an enlarged right lobe of the thyroid. Clinical correlation advised. RECOMMENDATION(S): Examine the patient for possible right goiter or other cervical mass. " 5280adc4-1012f221-39ab6396-973c799c-a410b6b9.jpg,test/p11/p11131026/s59203388/5280adc4-1012f221-39ab6396-973c799c-a410b6b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea on exertion x 2 weeks, difficulty with gait x several weeks, status post multiple falls with headstrike // Evidence of volume overload, infiltrate, or effusion, evidence of intracranial hermorrhage or acute abnormality, hydrocephalus TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___ FINDINGS: Cardiac silhouette size is mildly enlarged with prominent epicardial fat pads. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Assessment of the lung apices is somewhat obscured by the patient's chin and soft tissues projecting over these regions. Lungs are otherwise clear without focal consolidation. No pleural effusion or pneumothorax is demonstrated. Moderate multilevel degenerative changes are seen within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 8a609d5e-741f5cfb-0be41a43-cec0d442-dadfb7f2.jpg,test/p19/p19338803/s57532110/8a609d5e-741f5cfb-0be41a43-cec0d442-dadfb7f2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest tube placement, followup. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the known left pneumothorax has decreased in extent but is still clearly visible. The apical diameter of the pneumothorax is approximately 1.5 cm. The small left pleural drain is in unchanged position. Mild left atelectasis. No evidence of tension. " 6d48f5b2-5f5dd35b-41aeea53-a16ee149-3f4f08c8.jpg,test/p19/p19294289/s55275354/6d48f5b2-5f5dd35b-41aeea53-a16ee149-3f4f08c8.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Bandemia. There is mild cardiomegaly. Left perihilar and right lower lobe opacities are consistent with atelectasis. There is no pneumothorax or pleural effusion. " fbc38e8e-386006f0-26899427-267959c0-61357843.jpg,test/p10/p10368327/s54755729/fbc38e8e-386006f0-26899427-267959c0-61357843.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with sCHF p/w weakness and desat // Eval infection vs. edema vs. atelectasis COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the right internal jugular vein catheter was removed. The pre-existing pleural effusion on the right is more basal E distributed. A moderate atelectasis at both the right and the left lung base has developed. Minimal fluid overload but no overt pulmonary edema. Unchanged appearance of the cardiac silhouette. " 4ea1cca0-771f3d3c-793a49a4-bc6d85f3-5844fc8f.jpg,test/p19/p19116441/s54046869/4ea1cca0-771f3d3c-793a49a4-bc6d85f3-5844fc8f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with anterior chest discomfort s/p cardioversion // ?cardiopulmonary process ?cardiopulmonary process IMPRESSION: Compared to chest radiographs ___. Lung volumes are lower, accounting in part for interval enlargement of the cardiac silhouette, mostly a function of differences in radiographic positioning. No pneumothorax or pleural effusion. Lungs grossly clear. Mild widening of the upper mediastinum due to vascular congestion and possibly enlarged thyroid, is unchanged. Conventional radiographs recommended when feasible. " cfe02402-0c50d414-577893ea-eb8b4d1d-c866ffb7.jpg,test/p17/p17359302/s57947709/cfe02402-0c50d414-577893ea-eb8b4d1d-c866ffb7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval IMPRESSION: As compared to ___ chest radiograph, previously present right pleural effusion has nearly completely resolved. Cardiomediastinal contours are stable in appearance. Enlarged central pulmonary vessels is suggestive of pulmonary term hypertension. Known is subcentimeter pulmonary nodules have been more fully demonstrated by a recent CT. Healed left rib fractures are incidentally noted. " 3821a630-2006f0ff-9963aa4f-84b5507b-407201f4.jpg,test/p10/p10329555/s58684857/3821a630-2006f0ff-9963aa4f-84b5507b-407201f4.jpg,test," FINAL REPORT INDICATION: ___F with hx of cancer increase fatigue and SOB // r/o PNA TECHNIQUE: PA and lateral views of the chest COMPARISON: Chest x-ray from ___ as well as chest CT from that date. FINDINGS: As on prior, there is increased opacification of the left hemithorax associated with volume loss in a configuration compatible left upper lobe collapse. Known pleural-based metastatic lesions in the left lower lobe are partially visualized. The right lung remains clear. No acute osseous abnormalities identified. IMPRESSION: Persistent findings of left upper lobe collapse and left-sided pulmonary nodules which are better seen on prior exam. No definite superimposed acute cardiopulmonary process. " 127f00d9-9343e292-0576a9c9-7b6d2f58-ada3b50a.jpg,test/p15/p15014371/s59075700/127f00d9-9343e292-0576a9c9-7b6d2f58-ada3b50a.jpg,test," FINAL REPORT EXAMINATION: Chest single view INDICATION: ___ year old man with bradycardia. ?pneumonia // Evaluate for consolidation, opacity. TECHNIQUE: Portable AP COMPARISON: 01:28 same day. FINDINGS: There is better aeration of the right upper lobe. Left lower lobe atelectasis noted. ET tube is above the carina. Left IJ line in distal SVC. IMPRESSION: Improved aeration of the right upper lobe. " 24923957-80e4c657-9e762ce6-97357b52-955d79a6.jpg,test/p13/p13428282/s51117681/24923957-80e4c657-9e762ce6-97357b52-955d79a6.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. There are low lung volumes that accentuate the bronchovascular markings. Subtle bibasilar opacities likely are due to atelectasis in the setting of low lung volumes. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top normal, likely accentuated by AP technique and low lung volumes. Mediastinal contours are unremarkable. IMPRESSION: Low lung volumes, which accentuate the bronchovascular markings. Subtle basilar opacities likely relate to atelectasis in the setting of low lung volumes. " 53057cbe-e0e16d70-10770f82-8f414985-35ee1aeb.jpg,test/p10/p10390732/s51054747/53057cbe-e0e16d70-10770f82-8f414985-35ee1aeb.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with malaise and fevers // evaluate for pneumonia, effusion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Left-sided Port-A-Cath is stable in position, terminating in the low SVC/ cavoatrial junction. Patient is status post median sternotomy and cardiac valve replacement. Right vascular stent is re- demonstrated. There is persistent blunting of the bilateral costophrenic angles, to lesser extent as compared to the prior study. Left base atelectasis/scarring is seen, consolidation due to pneumonia is less likely. No pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Interval improvement in bilateral mid to lower lung opacities with blunting of the bilateral costophrenic angles persisting. Decreased left base patchy opacity,, most likely representing atelectasis/scarring, however, underlying consolidation due to pneumonia is not excluded in the appropriate clinical setting. " 8b71881c-c896b1ec-9e6c08d8-6f61075a-c98e7454.jpg,test/p16/p16826047/s51777321/8b71881c-c896b1ec-9e6c08d8-6f61075a-c98e7454.jpg,test," FINAL REPORT INDICATION: Evaluate chest tube position and residual pneumothorax in the patient who developed hypotension after right thoracoscopy. COMPARISON: A series of chest radiographs dating back to ___, most recently from ___. FINDINGS: A bedside AP radiograph of the chest demonstrates interval clearance of the large right pleural effusion with diffuse opacification of the right middle and lower lobes, likely secondary to re-expansion atelectasis. There is now a new small left pleural effusion which was not present four days ago. There is no pneumothorax. Cardiomegaly is stable. Interval widening of the upper mediastinal silhouette secondary to central venous engorgement is suggestive of hypervolemia. There is no pulmonary edema. A right chest wall central venous catheter is appropriately positioned in the lower SVC. The right chest tube is also appropriately positioned, in the right lower pleural space, including the side port. IMPRESSION: 1. The chest tube is appropriately positioned and there is no pneumothorax. 2. Interval clearance of large right pleural effusion with re-expansion atelectasis of the right middle and lower lobes. 3. New small left pleural effusion not present on the prior study. 4. Findings suggestive of mild hypervolemia. " 242ebe3a-6071014a-a7335018-317cbc79-55226597.jpg,test/p15/p15189906/s56342884/242ebe3a-6071014a-a7335018-317cbc79-55226597.jpg,test," WET READ: ___ ___ 1:14 PM No acute cardiopulmonary abnormality. Mild bibasilar atelectasis ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with chest pain // acute process TECHNIQUE: Chest PA and lateral COMPARISON: CT torso ___. Chest radiograph ___ FINDINGS: The lungs are normally expanded with exception of mild bibasilar atelectasis, left greater than right. Heart size is normal. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The thoracic aorta is tortuous as before. Median sternotomy wires appear intact. IMPRESSION: No acute cardiopulmonary abnormality. Mild bibasilar atelectasis. " aa79218c-568f739f-09910ccb-e3a4a32c-bc30f163.jpg,test/p18/p18446519/s56863668/aa79218c-568f739f-09910ccb-e3a4a32c-bc30f163.jpg,test," FINAL REPORT INDICATION: ___M with left flank pain s/p trauma // eval for left posterior rib injury TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___ and ___ chest x-rays. Chest CT from ___. FINDINGS: The lungs are clear of consolidation. Right lung base pulmonary nodule is similar compared to previous exams from ___. The cardiomegaly cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. If desired, dedicated rib series can be obtained. " cd917df7-d7e0e3dd-f5622c7e-7f0550fe-8b7369fe.jpg,test/p14/p14446098/s59403191/cd917df7-d7e0e3dd-f5622c7e-7f0550fe-8b7369fe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p CABG, CTs d/c'd // evaluate for pneumothorax evaluate for pneumothorax IMPRESSION: In comparison with the study of ___, the chest tubes have been removed and there is no evidence of pneumothorax. Endotracheal and nasogastric tubes have been removed. Swan-Ganz catheter is been removed and replaced with a right IJ sheath. Little overall change in the appearance of the heart and lungs. " eed92a1f-98547cc4-3866c50d-dad8fd95-2b715903.jpg,test/p18/p18143678/s55996047/eed92a1f-98547cc4-3866c50d-dad8fd95-2b715903.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with leukocytosis // PNA? PNA? COMPARISON: Comparison to ___ at 17:18 FINDINGS: PA and lateral views of the chest ___ at 22:07 are submitted. IMPRESSION: There continue to be layering bilateral effusions with interval increase in size of the right effusion. Associated bibasilar opacities, left greater than right. Findings more likely reflect compressive atelectasis given the overall lack of change, although pneumonia cannot be excluded. There is some fluid loculated within the horizontal fissure. A single lead left-sided pacer is unchanged in position with the lead terminating over the expected location of the right ventricle. A right internal jugular large bore catheter is unchanged in position. Stable deformity of the right humeral head with anchor sutures. " 36db51d3-4940fc4b-1419cfc2-dedc60b7-ccb6f68d.jpg,test/p14/p14502109/s58232934/36db51d3-4940fc4b-1419cfc2-dedc60b7-ccb6f68d.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest x-ray. INDICATION: ___ year old woman with history consolidation/PNA ___ // assess for clearing TECHNIQUE: PA and lateral projections, upright positioning. COMPARISON: PA and lateral chest x-ray obtained ___. FINDINGS: The cardiomediastinal silhouettes are normal. The bilateral hila are normal. In comparison to prior radiograph, there has been almost complete resolution of the right upper lobe opacity. There are still some faint residual areas of minimal linear opacification which probably reflects residual fibrotic healing of the involved lung parenchyma. There are no new areas of focal consolidation. There is no pulmonary vascular congestion. There is no pneumothorax or effusion. IMPRESSION: Resolved right upper lobe pneumonia. Minimal residual fibrotic healing of affected lung parenchyma. " 8ba30666-6425f924-af266b41-80891c1e-4f8b43d2.jpg,test/p14/p14733367/s58033381/8ba30666-6425f924-af266b41-80891c1e-4f8b43d2.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fever. COMPARISON: Chest radiograph, ___. FINDINGS: The cardiomediastinal and hilar contours are stable, with moderate cardiomegaly. The lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. There is no evidence of pulmonary edema. IMPRESSION: No acute cardiopulmonary pathology. Chronic, moderate cardiomegaly. " 71a72a0b-94c81e12-10c0069c-05f6e032-95e62764.jpg,test/p11/p11109225/s57123476/71a72a0b-94c81e12-10c0069c-05f6e032-95e62764.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are relatively low lung volumes which likely accentuate the bronchovascular markings. There is increased prominence of the aortic arch as compared to the prior study, although more similar compared to ___ which may be due to differences in inspiration. Chest CT from ___ showed a tortuous aorta. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is enlarged. No overt pulmonary edema is seen. " 879c4ab3-fd30734c-12c1bfc6-e4011eb9-841504c3.jpg,test/p17/p17968028/s56392288/879c4ab3-fd30734c-12c1bfc6-e4011eb9-841504c3.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with increasing ___ edema // eval for volume status TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiographs dated ___, CT chest dated ___. FINDINGS: The heart remains moderately enlarged and demonstrates associated moderate interstitial pulmonary edema. No large pleural effusion is identified. No lobar consolidation or pneumothorax. IMPRESSION: Moderate cardiomegaly and interstitial pulmonary edema. " eed98ce7-695ce192-240a4de4-d06a7de5-7735ccb5.jpg,test/p10/p10855229/s56732043/eed98ce7-695ce192-240a4de4-d06a7de5-7735ccb5.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: A right PICC terminates in the expected location of the lower superior vena cava, and has a similar course and location to the prior study of ___ allowing for differences in lung volumes and the presence of rotation. Low lung volumes accentuate cardiomediastinal contours and result in crowding of bronchovascular structures. There has been apparent slight worsening of bibasilar atelectasis, left greater than right, and a questionable small left pleural effusion. " 197959c3-ef726a42-88b27c44-7179ebe9-8e83de7a.jpg,test/p12/p12553538/s50242804/197959c3-ef726a42-88b27c44-7179ebe9-8e83de7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dyspnea // r/o acute process COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes remain low. The large hiatal hernia is seen in unchanged manner. Also unchanged is the extent and severity of the pre described pulmonary edema and the small pleural effusions. A minimal increase in radiodensity at the level of the right upper lobe likely represents local atelectasis. No pneumothorax. Old left humeral fracture. " b53515d4-e61b07dc-79e677bd-49b5d052-7e5c98e8.jpg,test/p12/p12131141/s57863268/b53515d4-e61b07dc-79e677bd-49b5d052-7e5c98e8.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post abdominal surgery, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous examination, there is mild enlargement of the cardiac silhouette and bilateral areas of atelectasis. These atelectasis are in part caused by bilateral pleural effusions of moderate extent, better appreciated on the lateral radiograph. Both effusions were already present in ___. There currently is no evidence of new focal parenchymal opacity suggestive of pneumonia. No pneumothorax. Known calcified right upper lobe granuloma. " e9d0a9d7-6ecee6e9-fcdd7dfc-8c0e220c-ef94adc7.jpg,test/p19/p19770723/s51815301/e9d0a9d7-6ecee6e9-fcdd7dfc-8c0e220c-ef94adc7.jpg,test," FINAL REPORT HISTORY: Shortness of breath, recent treatment for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The pulmonary vasculature is normal. There is continued patchy opacification within the left lower lobe. No new areas of focal consolidation are seen, and the right lung remains clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Left lower lobe patchy opacity remains concerning for pneumonia, not significantly changed in the interval. Followup radiographs 4 weeks after treatment are recommended to ensure resolution of this finding. " 369cfa5d-69f2be00-bb0fe084-52faa775-006a7ad1.jpg,test/p13/p13877234/s53267090/369cfa5d-69f2be00-bb0fe084-52faa775-006a7ad1.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Chest pain. Question pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are slightly decreased. The cardiomediastinal and hilar contours are within normal limits. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " a975c21c-bb60fd4b-4d077671-5930cd80-c7c08ae6.jpg,test/p12/p12993146/s51889609/a975c21c-bb60fd4b-4d077671-5930cd80-c7c08ae6.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with increased confusion // eval pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs: ___, ___, ___. FINDINGS: The lung volumes are low, with bibasilar atelectasis. The heart is enlarged, as before, with persistent tortuosity of the intrathoracic aorta and enlargement of the pulmonary arteries. There is no overt pulmonary edema, pneumothorax, pleural effusion, or focal consolidation concerning for pneumonia. Surgical clips are again noted over the lower midline neck. IMPRESSION: Persistent cardiomegaly, with low lung volumes and bibasilar atelectasis. " a6d400d1-f4122df1-c4b572f9-612cfdf5-6250096e.jpg,test/p17/p17959674/s53009084/a6d400d1-f4122df1-c4b572f9-612cfdf5-6250096e.jpg,test," WET READ: ___ ___ ___ 7:46 PM No evidence of pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LUL lung nodule, s/p tbbx. // ?PTX ?PTX IMPRESSION: Compared to chest radiograph ___. No pneumothorax, pleural effusion, or evidence of pulmonary hemorrhage. Left lung lesion is barely visible. Lungs otherwise clear. Stable mediastinal widening due to combination of adenopathy and mediastinal fat deposition " 31635123-ea820e05-16c56a4b-e9c904c3-b40d6a35.jpg,test/p14/p14787420/s50903194/31635123-ea820e05-16c56a4b-e9c904c3-b40d6a35.jpg,test," WET READ: ___ ___ ___ 2:47 PM 1. No displaced rib identified; however, conventional radiography is limited in sensitivity and, if there is clinical concern, a dedicated rib series should be obtained. 2. Increased density over the right lung base may represent superimposition of ribs and the right nipple. If there is clinical concern for pneumonia, shallow oblique radiographs could be obtained. ______________________________________________________________________________ FINAL REPORT HISTORY: Status post fall with left flank pain, here to evaluate for rib fractures. COMPARISON: Chest radiograph dated ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are symmetrically well-expanded and well-aerated. Increased density projecting over the right lung base most likely represents superimposition of normal structures including an anterior rib, a posterior rib, and the right nipple. No focal consolidation concerning for pneumonia is detected. There is no significant pleural effusion or pneumothorax. Mild biapical pleural thickening is noted. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. Bilateral pectoral deep brain stimulator devices are in place. No displaced rib are identified. Mild to moderate multilevel degenerative changes of the thoracic spine are re- demonstrated. IMPRESSION: 1. No displaced rib identified; however, conventional radiography is limited in sensitivity and, if there is clinical concern, a dedicated rib series should be obtained. 2. Increased density over the right lung base may represent superimposition of ribs and the right nipple. If there is clinical concern for pneumonia, shallow oblique radiographs could be obtained. " ba6f225a-8699aee4-d8979960-8ffb3fb7-4b0d33b6.jpg,test/p17/p17967970/s56448529/ba6f225a-8699aee4-d8979960-8ffb3fb7-4b0d33b6.jpg,test," FINAL REPORT INDICATION: ___ year old woman with R sided chest tube // Please assess for pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The loculated right apical and right base pneumo thorax/pneumo hydrothorax/empyema are unchanged. Right-sided chest drain in-situ unchanged. Airspace consolidation projecting over the right mid lung zone is unchanged. Surgical material in the right lung in keeping with previous resection. Right-sided PICC line in situ with the tip in the right atrium. Tracheostomy tube in situ in the appropriate position. PEG tube in situ in the stomach. IMPRESSION: No significant interval change in the loculated right-sided hydropneumothorax/empyema. " 72e74e80-51370336-298d0f66-face8834-05c01e1c.jpg,test/p15/p15199994/s58122221/72e74e80-51370336-298d0f66-face8834-05c01e1c.jpg,test," FINAL REPORT HISTORY: ___-year-old male with recurrent seizures. STUDY: Portable AP upright chest radiograph. COMPARISON: ___. FINDINGS: There has been interval removal of the previously placed left-sided PICC line. The heart size and mediastinal contours are within normal limits. The lungs are clear. There is no large pneumothorax and subtle blunting of the left costophrenic angle may represent pleural thickening, especially given the lateral rib irregularities of the left hemithorax, compatible with prior old/healed rib fractures. IMPRESSION: No radiographic evidence of pneumonia. " 8561ba94-90795175-7891342c-6df65bae-8408289e.jpg,test/p15/p15620544/s55703033/8561ba94-90795175-7891342c-6df65bae-8408289e.jpg,test," FINAL REPORT INDICATION: ___ year old man with avr // r/o inf, eff FINDINGS: Since the recent radiograph of ___, a right internal jugular to the vascular sheath has been removed. There is no pneumothorax. Cardiomediastinal contours are stable. Improving aeration at the left lung base, with near resolution of atelectasis and a decrease in pleural effusion. Small to moderate right pleural effusion is unchanged. Bilateral upper lobe subpleural opacities have partially improved and it been more fully characterized by a prior CT of ___ " 6fe49bee-c4febfda-2f8eaf05-ab735239-da43c031.jpg,test/p19/p19228312/s59485475/6fe49bee-c4febfda-2f8eaf05-ab735239-da43c031.jpg,test," FINAL REPORT AP CHEST, 12:11 P.M., ___ HISTORY: ___-year-old man with shortness of breath and new hypoxia. IMPRESSION: AP chest compared to ___. In the interim, pulmonary edema has resolved. Small bilateral pleural effusion, left greater than right, is better seen on today's chest radiograph which also shows a moderate amount of left lower lobe atelectasis, lungs are otherwise clear, also as corroborated by the chest CT. Moderate-to-severe cardiomegaly and the enlarged grafted thoracic aorta are unchanged. Right jugular introducer has been removed. " 301e9a29-d9938187-f76b252f-263e4800-27273788.jpg,test/p16/p16799479/s56277418/301e9a29-d9938187-f76b252f-263e4800-27273788.jpg,test," FINAL REPORT INDICATION: History: ___F with chest pain and SOB // eval pneumonia, other acute process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal hilar contours are normal. There is no pleural effusion or pneumothorax. Lungs are well-expanded and clear without focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. The upper abdomen is unremarkable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " ca42fcd2-01430259-3a0acf93-a89e0632-141657bd.jpg,test/p10/p10708431/s54112149/ca42fcd2-01430259-3a0acf93-a89e0632-141657bd.jpg,test," FINAL REPORT CHEST ON ___ at 03:30 HISTORY: Question change in pneumothorax. REFERENCE EXAM: ___ at 00:29. FINDINGS: Again seen is severe bilateral subcutaneous emphysema which limits the assessment for small pneumothorax. Pneumomediastinum is again visualized. There is a right-sided chest tube. There is mild mediastinal shift to the right. A small left basilar pneumothorax is visualized and probable right medial pneumothorax. " 5e3a0c53-0cd62849-3626a5b6-617a5e4d-735eeec0.jpg,test/p19/p19180532/s51426099/5e3a0c53-0cd62849-3626a5b6-617a5e4d-735eeec0.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 6:20 PM Cardiomegaly and interstitial edema compatible with continued heart failure. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with dyspnea despite diuresis and good oxygen saturations. STUDY: Portable AP upright chest radiograph. COMPARISON: ___ and ___. FINDINGS: Midline sternotomy wires are unchanged. The pacers/defibrillating improved projecting over the left chest with leads in the right ventricle. The heart size is enlarged, similar to prior studies. The lungs demonstrate no consolidation, but mild interstitial edema. There is no large pleural effusion or pneumothorax. IMPRESSION: Stable cardiomegaly and interstitial edema compatible with continued heart failure. " 9dc386eb-754be925-12961c0c-3d677962-a4d79caa.jpg,test/p10/p10883457/s54512146/9dc386eb-754be925-12961c0c-3d677962-a4d79caa.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Bloody sputum. The cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. Mild degenerative changes in the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " 0d9e6d3f-cb2c181f-641cbd48-a4168375-90c0b464.jpg,test/p15/p15938425/s54785118/0d9e6d3f-cb2c181f-641cbd48-a4168375-90c0b464.jpg,test," FINAL REPORT INDICATION: Sharp chest pain radiating to shoulder. Please assess for acute process. COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___. FINDINGS: There is stable moderate cardiomegaly with predominantly left ventricular enlargement. No change in aortic contour. Lungs are clear. No pleural effusion or pneumothorax present. Sternotomy sutures are midline and intact. IMPRESSION: Stable moderate cardiomegaly. " 1dcb40c8-8b15e3d8-18577c0e-e2a70741-81332aec.jpg,test/p18/p18111516/s55708514/1dcb40c8-8b15e3d8-18577c0e-e2a70741-81332aec.jpg,test," FINAL REPORT EXAM: Chest, AP upright and lateral views. CLINICAL INFORMATION: Swelling and pitting edema. COMPARISON: ___. FINDINGS: The patient's overlying arm partially obscures the view on the lateral view. Given this, no definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The aortic knob is calcified. Subtle upper paratracheal opacity is stable. The cardiac and mediastinal silhouettes are stable, with the cardiac silhouette enlarged. Degenerative changes are seen in the partially imaged shoulder joints and the acromioclavicular joints. IMPRESSION: No acute cardiopulmonary process. " 390dd6f8-a15bc321-6d8536f3-ab0cf402-f4d595ec.jpg,test/p16/p16805727/s51179816/390dd6f8-a15bc321-6d8536f3-ab0cf402-f4d595ec.jpg,test," WET READ: ___ ___ ___ 9:23 AM Mild interstitial pulmonary edema. No focal airspace consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with a history of CHF and CAD complaining of hemoptysis and CHF symptoms. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: There is chronic mild cardiomegaly and a vague ground-glass opacity projecting over the left upper lung. There is no pleural effusion or focal airspace consolidation. There is no pneumothorax. AICD and its lead are unchanged. IMPRESSION: Ground-glass opacity projecting over the left upper lung better characterized on the subsequent chest CTA. " 065fafb1-00a448cb-da79568d-beec93c9-62b67a2f.jpg,test/p11/p11540023/s56035472/065fafb1-00a448cb-da79568d-beec93c9-62b67a2f.jpg,test," FINAL REPORT INDICATION: Hypotension, evaluate for infiltrate. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate no acute cardiopulmonary process. The cardiomediastinal and pulmonary structures are unremarkable. Blunting of the posterior costophrenic angle may represent a tiny pleural effusion, which is unchanged from prior studies. Diaphragms are flattened, compatible with chronic obstructive lung disease. The patient is status post median sternotomy and CABG. There is no pneumothorax or consolidation to suggest infection. There are mild degenerative changes of the thoracic spine. The heart size is top normal. IMPRESSION: No acute cardiopulmonary process. " 260c82c2-da7b8218-b887c003-9d949835-1163ad58.jpg,test/p16/p16750031/s53682105/260c82c2-da7b8218-b887c003-9d949835-1163ad58.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " d02bae78-c6084e16-a5321712-02e3dfb6-d6cd1d5e.jpg,test/p15/p15084854/s53449257/d02bae78-c6084e16-a5321712-02e3dfb6-d6cd1d5e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with crohns plan to start remicade but tb testing equivocal. Rule out pulm tub // rule out pulm tb rule out pulm tb IMPRESSION: Compared to prior chest radiographs ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 2873b3b3-cfa1746f-6ecf30e9-0f431a03-0da4318e.jpg,test/p17/p17967970/s59035135/2873b3b3-cfa1746f-6ecf30e9-0f431a03-0da4318e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chest tube. // ? PTx COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, a right pleural drain has been placed. There is mild decrease in extent of the still substantial right pleural effusion. No pneumothorax or other complications. Unchanged appearance of the heart and of the left lung. " 475cae20-bdc2dd02-0ed8840f-845d6372-204a37e2.jpg,test/p18/p18092465/s50244653/475cae20-bdc2dd02-0ed8840f-845d6372-204a37e2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with placement of OGT // eval for placement of OGT COMPARISON: ___ IMPRESSION: The orogastric tube shows a normal course, the tip is located in the middle to distal parts of the stomach. The other findings are described on the chest x-ray performed at 10:26 earlier today. " 0df584a1-a3327e20-cedb1fb7-320404d7-07a07fb7.jpg,test/p15/p15442180/s55765232/0df584a1-a3327e20-cedb1fb7-320404d7-07a07fb7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R BKA with ___ // ? Fluid status TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: Enteric tube has been removed. Improved left basilar opacification. Increased heart size, pulmonary vascularity, similar. Minimally improved right basilar opacity, likely atelectasis. Small bilateral pleural effusions, probably improved. IMPRESSION: Mild interval improvement. " c31adceb-d6558c16-bc63b1f9-a480d98c-fa4733eb.jpg,test/p16/p16473524/s51547222/c31adceb-d6558c16-bc63b1f9-a480d98c-fa4733eb.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man, status post chest tube removal. Evaluate for pneumothorax. FINDINGS: Comparison is made to prior study from ___. The Swan-Ganz catheter has been removed. The endotracheal tube has also been removed. There is cardiomegaly. There remains a right basilar chest tube. There are no pneumothoraces. There is atelectasis at the lung bases and a left retrocardiac opacity. Small bilateral pleural effusions are present. " 493162f0-55a1ad08-eeb81782-8ed8143d-c4e4e730.jpg,test/p10/p10459005/s51831942/493162f0-55a1ad08-eeb81782-8ed8143d-c4e4e730.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LVAD // interval change interval change IMPRESSION: In comparison with the study of ___, the right IJ sheath has been removed. Again there are relatively low lung volumes with severe enlargement of the cardiac silhouette but only mild elevation of pulmonary venous pressure. Continued left and smaller right pleural effusion with underlying compressive atelectasis. No evidence of acute focal pneumonia. " fdc8d8e4-9ab6acaf-2571aa23-a44dc18a-1e42a330.jpg,test/p11/p11634090/s50558030/fdc8d8e4-9ab6acaf-2571aa23-a44dc18a-1e42a330.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea on exertion // PNA? pleural effusion COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Emphysema is again noted. There is subtle reticulonodular opacity in the left lower lung which could represent an early pneumonia. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Chronic left rib deformities are again noted. No free air below the right hemidiaphragm. IMPRESSION: Subtle reticulonodular opacities in the left lower lung could represent an early pneumonia. Underlying emphysema again noted. " 795c8353-08b59925-c47622bc-414eef30-4d240b1c.jpg,test/p17/p17804391/s57642259/795c8353-08b59925-c47622bc-414eef30-4d240b1c.jpg,test," FINAL REPORT INDICATION: Right-sided pneumothorax. Evaluate after removal of the chest tube. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Multiple chest radiographs, including the most recent from ___ at 11:55. FINDINGS: Since the prior exam, the right chest tube has been removed. There is a new opacity present along the chest tube tract. A small right pneumothorax unchanged. There is no left pneumothorax. There is no pulmonary edema or pleural effusion. The cardiomediastinal silhouette is normal. Mildly displaced right-sided rib fractures are unchanged. IMPRESSION: Status post removal of the right chest tube. A small right pneumothorax is unchanged. " f7ff1c81-dbc3b830-2d093e87-89b9028c-55142e5b.jpg,test/p18/p18065731/s55889791/f7ff1c81-dbc3b830-2d093e87-89b9028c-55142e5b.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: AP upright and lateral views of the chest COMPARISON: ___ chest radiograph, ___ CT chest FINDINGS: Lung volumes are low. This accentuates the size of the cardiac silhouette which appears mildly enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Mild to moderate multilevel degenerative changes are noted in the thoracic spine. Multiple clips are again noted within the upper abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 05022c21-6870f1d3-fb7da687-95532f4d-7e5abcde.jpg,test/p17/p17573950/s58153749/05022c21-6870f1d3-fb7da687-95532f4d-7e5abcde.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: ___-year-old man with stroke, question pneumonia. FINDINGS: AP upright and lateral views of the chest provided. There is nodular opacity in the region of the right middle lobe which is new from prior exam and could represent infectious process or possibly aspiration. No effusion or pneumothorax. The heart and mediastinal contours are stable with borderline cardiomegaly. Bony structures are intact. IMPRESSION: Nodular opacity in the right middle lobe concerning for infection or aspiration. " c59ab3e8-09b80a8e-e210dbc3-d1c1c7ff-c15bb2f9.jpg,test/p11/p11988232/s56317058/c59ab3e8-09b80a8e-e210dbc3-d1c1c7ff-c15bb2f9.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old woman with recent hospitalization at ___ for possible pneumonia // cough, f/u pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Portable chest radiograph dated ___ FINDINGS: Lungs are fully expanded and clear without focal consolidations. There is a single, approximately 4 mm nodular opacity projecting over the posterior lungs only appreciated on lateral view. Heart size is normal and cardiomediastinal silhouettes are unremarkable. No pleural effusions or pneumothorax. IMPRESSION: No radiographic evidence of pneumonia or other acute cardiopulmonary abnormalities. Small nodular opacity described above is likely a spinous process tip in this projection, but cannot rule out a pulmonary nodule. Recommend oblique radiographs for further evaluation. RECOMMENDATION(S): Recommend oblique radiographs of the chest for further evaluation of the nodular opacity described above. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___, RN on the telephone on ___ at 2:29 PM, approximately 30 minutes after discovery of the findings. " 72d55d23-84921ec6-99e95337-aeccd52a-50da54bb.jpg,test/p10/p10019003/s58240524/72d55d23-84921ec6-99e95337-aeccd52a-50da54bb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulmonary infiltrates, eval for infectious foci vs. edema vs. metastatic disease // ___ year old woman with pulmonary infiltrates, eval for infectious foci vs. edema vs. metastatic disease TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Left perihilar consolidation is unchanged. Retrocardiac atelectasis have improved. Vascular congestion is stable. There is no evident pneumothorax. Small left pleural effusion is unchanged. Cardiomediastinal contours are stable. Left PICC tip is in the lower SVC " bb639860-a4072caa-be895b26-618fc3d9-3d7033d2.jpg,test/p13/p13292409/s59035895/bb639860-a4072caa-be895b26-618fc3d9-3d7033d2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with asthma now s/p bronchial thermoplasty of bilateral upper lobes. // ptx COMPARISON: Chest radiographs since ___ most recently ___ IMPRESSION: Lung volumes are borderline enlarged, and clear. Heart is normal size. There is no pleural effusion " 6df61be4-528f46b7-bdc2a419-19214c04-188984d0.jpg,test/p19/p19958847/s57506154/6df61be4-528f46b7-bdc2a419-19214c04-188984d0.jpg,test," FINAL REPORT INDICATION: ___M with HIV, ESRD, p/w acute onset CP during dialysis today // eval lung ___, heart size TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or pneumothorax. Nodular opacity projecting over the right lung base is most suggestive of a nipple shadow. Right chest wall central venous catheter seen with tip at the RA SVC junction. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Chronic changes seen at the distal left clavicle. IMPRESSION: No acute cardiopulmonary process. " 7c2d2339-1decbc12-325c8ede-fcabfd8c-febd39e7.jpg,test/p15/p15202542/s55807108/7c2d2339-1decbc12-325c8ede-fcabfd8c-febd39e7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pna, meningitis // interval changes interval changes COMPARISON: Comparison to ___ at 08:44 FINDINGS: Portable AP upright chest film ___ at 749 is submitted. IMPRESSION: Endotracheal tube has its tip approximately 5.5 cm above the carina. The left internal jugular central line is unchanged in position. The nasogastric tube is seen coursing below the diaphragm with the tip not identified. Overall cardiac and mediastinal contours are stable. There are stable layering bilateral effusions with retrocardiac consolidation likely reflecting partial lower lobe atelectasis and patchy opacity at the right base also likely reflecting atelectasis. Other diffuse pulmonary opacities are likely unchanged. No pneumothorax. " 0045f059-da1df199-7eb9124c-41670fc6-4b70cf77.jpg,test/p15/p15270043/s50900056/0045f059-da1df199-7eb9124c-41670fc6-4b70cf77.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fall, head strike // ? fx bleed TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The patient is slightly rotated. The lungs are hyperinflated. Subtle lingular opacity may be due to atelectasis versus consolidation. No large pleural effusion is seen. There are no findings to suggest pneumothorax. The cardiac silhouette is top-normal. The aorta is calcified. The bones are diffusely osteopenic, no gross acute fracture is identified. IMPRESSION: Subtle lingular opacity may be due to atelectasis versus subtle consolidation. " f4596bac-2656320b-150c6401-07046240-79cf110d.jpg,test/p15/p15111021/s54042775/f4596bac-2656320b-150c6401-07046240-79cf110d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SCC of epiglottis, s/p trach placement // interval change? interval change? IMPRESSION: In comparison with the study of ___, the tracheostomy tube appears to be stable. Cardiac silhouette is within normal limits and there is no vascular congestion or pleural effusion or acute focal pneumonia. The medial aspect of the left hemidiaphragm is not sharply seen, suggesting some atelectatic changes at the left base. " 30106a0c-8bf9dc3a-d7df98ee-642d7fd0-7ef00f8b.jpg,test/p12/p12308109/s51460039/30106a0c-8bf9dc3a-d7df98ee-642d7fd0-7ef00f8b.jpg,test," FINAL REPORT HISTORY: IV drug abuse, necrotic wounds, and sepsis. TECHNIQUE: Frontal view of the chest. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: The heart is of normal size with normal cardiomediastinal contours. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. New right IJ central catheter terminates in the low SVC. Left glenoid and humerus screws are incompletely evaluated. IMPRESSION: New right IJ central catheter terminates in the low SVC. No pneumothorax or focal consolidation. " 8a7e9e46-81364781-050a80a7-3b15069d-0f4275a4.jpg,test/p16/p16013292/s53510184/8a7e9e46-81364781-050a80a7-3b15069d-0f4275a4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with presyncopal symptoms, on xarelto // Evidence of bleeding or acute process Evidence of bleeding or acute process IMPRESSION: No relevant change as compared to ___. Status post sternotomy. Borderline size of the cardiac silhouette. No pleural effusions. No pulmonary edema. No pneumonia. " 8dc44d62-70e727ff-4281e39f-b2828273-927757e4.jpg,test/p17/p17037392/s59622287/8dc44d62-70e727ff-4281e39f-b2828273-927757e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with new onset T2DM, HHNK TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Minimal atelectasis is noted in the lung bases without focal consolidation. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 3438293b-658fbd5b-7eb4622d-77b16310-0a64707c.jpg,test/p13/p13152015/s54630526/3438293b-658fbd5b-7eb4622d-77b16310-0a64707c.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Fever and cough. Cardiac size is normal. The aorta is tortuous and elongated. The lungs are clear. There is no pleural effusion. IMPRESSION: No evidence of pneumonia. " 887c1469-cd1650cc-d1dd9c81-a6c133d8-b9f4a6d2.jpg,test/p15/p15676705/s51141518/887c1469-cd1650cc-d1dd9c81-a6c133d8-b9f4a6d2.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // pneumonia, effusion, widened mediastium TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 32e9e0a2-63e2f408-ea595653-2a11f0af-2b61cf2d.jpg,test/p15/p15084992/s55436558/32e9e0a2-63e2f408-ea595653-2a11f0af-2b61cf2d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP/SOB on exertion. // acute process? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are relatively hyperinflated. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Aortic knob calcification is seen. Mediastinal contours unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " bde68ebe-b3f76757-9883ee8c-8203e73a-e090a4e3.jpg,test/p19/p19047476/s56535874/bde68ebe-b3f76757-9883ee8c-8203e73a-e090a4e3.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with bilateral consolidations on chest radiograph. COMPARISON: ___ and ___. The patient is after T8 cage and T5-___ posterior fusion. The appearance of the hardware is unchanged as compared to prior chest radiograph. Heart size and mediastinum are stable. Lungs are essentially clear on the current examination except for right lower lobe opacity, new as compared to prior studies and might reflect area of atelectasis versus infectious process. Attention on subsequent radiographs recommended. " 5e8cc638-187b6193-a9e6d2b3-1e8d9e56-abce3667.jpg,test/p14/p14971343/s59852591/5e8cc638-187b6193-a9e6d2b3-1e8d9e56-abce3667.jpg,test," WET READ: ___ ___ ___ 10:31 AM Medial right apical opacity most likely represents overlap of structures however is more conspicuous than on the prior study. Findings can be confirmed with AP lordotic view. No focal consolidation seen elsewhere ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // Eval for pneumonia TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Medial right apical opacity most likely represents overlap of structures however is more conspicuous than on the prior study. Findings can be confirmed with AP lordotic view. No focal consolidation seen elsewhere. No pleural effusion or pneumothorax. The cardiac silhouette is mildly enlarged. The aorta is tortuous. No pulmonary edema is seen. Degenerative changes are again seen along the spine. IMPRESSION: Medial right apical opacity most likely represents overlap of structures however is more conspicuous than on the prior study. Findings can be confirmed with AP lordotic view. No focal consolidation seen elsewhere " 1fbdc642-50898bd8-ed72ee21-6e85d1c3-8dafce87.jpg,test/p14/p14017108/s57575922/1fbdc642-50898bd8-ed72ee21-6e85d1c3-8dafce87.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with lower left rib pain. Rule out mass. IMPRESSION: PA and lateral chest compared to ___: Left pleural scarring is unchanged. There is no pleural effusion and no rib lesion. Any regions of focal physical findings should be evaluated with detailed rib views. The lungs are fully expanded and clear. The heart size is top normal, mediastinal and hilar silhouettes are otherwise normal. " f844b974-cd7f503f-af64f395-57928718-a3776586.jpg,test/p17/p17284025/s58270729/f844b974-cd7f503f-af64f395-57928718-a3776586.jpg,test," FINAL REPORT STUDY: AP chest, ___ at 4:30 a.m. HISTORY: ___-year-old woman with sepsis, worsening respiratory distress. FINDINGS: Comparison is made to prior study performed four hours earlier. The endotracheal tube has been pulled back and the tip is no longer within the right main stem bronchus and is 2 cm above the carina. The right IJ central venous line has the distal lead tip in the right atrium and again this could be pulled back 3-4 cm for more optimal placement. The orogastric tube tip and side port are within the fundus of the stomach. Biliary stent projects over the right upper abdomen. There are bilateral pleural effusions and the right side has increased slightly. There is persistent moderate pulmonary edema. There is unchanged cardiomegaly. A left retrocardiac opacity is present; likely due to atelectasis and pleural fluid. No pneumothoraces are identified. " a5e4af6a-db7b7903-02cc1d99-a1394e7b-a7bd055f.jpg,test/p15/p15512494/s52461766/a5e4af6a-db7b7903-02cc1d99-a1394e7b-a7bd055f.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Followup left pneumothorax. Comparison is made with prior study performed 10 hours earlier. Tiny left apical pneumothorax has decreased in size. Small left effusion is probably unchanged allowing the difference in positioning of the patient. Small right effusion is also present. Vascular congestion has almost completely resolved. The lungs are better expanded. Bibasilar atelectasis has increased on the left. Left basal pigtail catheter remains in place. Cardiomediastinal contours are unchanged. " 6b74172e-e7ad6797-ee9217de-f0d85b3c-a06e7a7b.jpg,test/p13/p13748151/s56236194/6b74172e-e7ad6797-ee9217de-f0d85b3c-a06e7a7b.jpg,test," FINAL REPORT HISTORY: Altered mental status. FINDINGS: In comparison with the study of ___, there is again some hyperexpansion of the lungs suggesting chronic pulmonary disease. Valve replacements and intact midline sternal wires are again seen. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " f350ce71-69a92d2c-47e6e6de-c9c7f218-e05677fb.jpg,test/p19/p19524140/s54039692/f350ce71-69a92d2c-47e6e6de-c9c7f218-e05677fb.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Most likely pancreatic cancer, worsening shortness of breath. Portable AP radiograph was compared to ___. There is interval progression of multifocal opacities and bilateral pleural effusion. The appearance is more concerning for multifocal infection than for pulmonary edema associated with progressing pleural effusions. Some element of volume overload cannot be excluded. As compared to ___ there is interval progression of the findings demonstrated. " d61f442f-1db93f1d-19f9a0a2-83ab7e25-5b9bb848.jpg,test/p15/p15560336/s58892852/d61f442f-1db93f1d-19f9a0a2-83ab7e25-5b9bb848.jpg,test," FINAL REPORT INDICATION: Shortness of breath, chest tightness, to rule out infiltrate. TECHNIQUE: PA and lateral chest views were read in comparison with prior chest radiograph through ___ to ___. FINDINGS: The thoracic scoliosis with convexity of the thoracic spine to the right side is unchanged. Both lungs are clear, and there are no lung opacities concerning for pneumonia. There is no pleural abnormality. Severe scoliotic deformity. Assessment of cardiomediastinal structure was limited. Moderate-to-large hiatal hernia has been stable since ___. IMPRESSION: 1. No pneumonia. 2. Moderate-to-large hiatal hernia, stable since ___. " 49082a4c-b637a311-06036455-c99c1f1d-0cb2b64c.jpg,test/p11/p11448985/s55340147/49082a4c-b637a311-06036455-c99c1f1d-0cb2b64c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff // eval for dobhoff placement eval for dobhoff placement IMPRESSION: Comparison to ___. The course of the new feeding tube is unremarkable. The tip projects over the middle parts of the stomach. No complications, notably no pneumothorax. The remaining parts of the radiograph are unchanged. " 46be3b81-52207700-9be54d63-79b1840a-59f8c2c3.jpg,test/p13/p13031138/s56300749/46be3b81-52207700-9be54d63-79b1840a-59f8c2c3.jpg,test," FINAL REPORT INDICATION: ___-year-old male with hypotension and hypoxia. COMPARISON: None available. FINDINGS: AP portable upright images of the chest demonstrate an enlarged heart. There is no large pleural effusion but small amount of pleural fluid is most likely present bilaterally. No overt pulmonary edema is present. Lungs are clear bilaterally with no focal consolidation convincing for pneumonia. There is no pneumothorax. Visualized osseous structures demonstrates no acute abnormality. IMPRESSION: Cardiomegaly without overt pulmonary edema. Bilateral pleural effusion, right more than left, small, better appreciated on the lateral view. " 00c48168-9773def5-531f3e5d-0a2c3d36-e88292fd.jpg,test/p12/p12489152/s51263864/00c48168-9773def5-531f3e5d-0a2c3d36-e88292fd.jpg,test," WET READ: ___ ___ ___ 4:06 AM No evidence of acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with cough and cp, evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___ FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. IMPRESSION: No evidence of acute cardiopulmonary process. " 8298f0b9-aebdf106-acf3c5d7-789a7bf8-35541497.jpg,test/p15/p15293245/s50522923/8298f0b9-aebdf106-acf3c5d7-789a7bf8-35541497.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with effusions // ? PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. Large bilateral effusions with adjacent atelectasis are unchanged. The osseous structures are unremarkable. There is no pneumothorax IMPRESSION: Large bilateral effusions with adjacent atelectasis grossly unchanged from prior " 941f33ec-388d149e-f174f94b-08f12552-b31a264a.jpg,test/p10/p10621303/s53635828/941f33ec-388d149e-f174f94b-08f12552-b31a264a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with spondyloarthropathy on humira. Having productive cough x 3 days, chills, rales left posterior lung base. // ? CAP, COMPARISON: Chest radiograph dated ___ FINDINGS: Compared to chest radiographs ___: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. IMPRESSION: No acute intrathoracic process. " 776d3d59-75d0c253-657935db-45c67fc4-5598ae73.jpg,test/p18/p18334048/s51116934/776d3d59-75d0c253-657935db-45c67fc4-5598ae73.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with tracheostomy, new fever, evaluated for acute process. COMPARISON: Chest x-ray of ___ and CT torso of ___. FINDINGS: The lung volumes are low with minimal left lower lobe atelectasis. There is no new consolidation. Mild pulmonary vascular congestion is stable. Left subclavian line ends in upper SVC. Tracheostomy is in adequate position. There is no pneumothorax or pleural effusion. NG tube has been removed. CONCLUSION: There is no evidence of pneumonia. " b665ec67-1aff8fda-48ee5530-99128f2d-f181cd8d.jpg,test/p10/p10781468/s50241197/b665ec67-1aff8fda-48ee5530-99128f2d-f181cd8d.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Cardiac silhouette has decreased in size with associated improved pulmonary vascular congestion and near resolution of interstitial edema. Heterogeneous opacities at left lung base have slightly worsened, and may be due to atelectasis or developing infectious pneumonia. Adjacent small left pleural effusion has also increased in size. " f53fbc6b-3a39a7d1-cb5c1237-6c888fcb-34103354.jpg,test/p10/p10165672/s56328548/f53fbc6b-3a39a7d1-cb5c1237-6c888fcb-34103354.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with fever and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. There is new bilateral increased interstitial markings throughout the lungs. More dense region of consolidation identified in the right lower lobe. There is no pleural effusion. The cardiac silhouette is moderately enlarged, but unchanged. Tortuosity of the descending thoracic aorta is noted. No acute osseous abnormality is identified. IMPRESSION: Increased interstitial markings throughout the lungs with more confluent consolidation at the right lung base. Findings could be seen in the setting of pulmonary edema with possible superimposed right base infection or an atypical infection is possible. " 818c4baa-b62bced1-3419f736-7b844924-91722a58.jpg,test/p11/p11998292/s55289231/818c4baa-b62bced1-3419f736-7b844924-91722a58.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with L ankle FX // Pre Op-Stat Thank you Surg: ___ (ORIF L ankle fx) IMPRESSION: As compared to previous portable radiograph of 1 day earlier, there has been no significant change in the appearance of the chest. Heart is upper limits of normal in size, aorta is tortuous, and lungs and pleural surfaces are grossly clear. " 21cd5b0d-53817892-c452ff42-adf960f6-c0bd0adf.jpg,test/p13/p13273624/s51455913/21cd5b0d-53817892-c452ff42-adf960f6-c0bd0adf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with h/o pulm fibrosis with worsening SOB and hypoxia // eval for pulm edema eval for pulm edema COMPARISON: ___ IMPRESSION: Cardiomegaly is substantial, unchanged. Bibasal opacities in part representing interstitial lung disease (known pulmonary fibrosis) are re- demonstrated. No superimposed abnormality such as pulmonary edema or consolidation demonstrated. Partially imaged is calcification within the soft tissue within the left chest wall. No pleural effusion or pneumothorax appreciated. " b421c137-b9ea2363-890d207a-28215ad9-8dda1559.jpg,test/p14/p14325285/s51952812/b421c137-b9ea2363-890d207a-28215ad9-8dda1559.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with airway obstruction // eval stent placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received a left-sided airway stent. The stent is barely visible on the chest radiograph. Areas of parenchymal opacities have newly appeared in the right upper lobe and at the left lung bases. The morphology and distribution of the changes suggests pneumonia. Post interventional hemorrhage would be an alternative differential diagnosis. The enlarged left hilus is less well appreciated than on the previous image. No pleural effusions. Unchanged normal cardiac silhouette. " aef0cb98-d604dedc-3df9ca00-999c477a-c24bd98e.jpg,test/p17/p17374016/s54344407/aef0cb98-d604dedc-3df9ca00-999c477a-c24bd98e.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Patient with bilateral erythema nodosum. To evaluate for sarcoid. TECHNIQUE: PA and lateral chest radiographs are obtained. COMPARISON: ___. REPORT: Cardiomediastinal silhouettes are unremarkable. Lungs are grossly clear. No clear evidence of paratracheal stripe widening or hilar lymphadenopathy. The visualized osseous structures appear grossly normal. Extensive clips over the central thoracic inlet suggests prior thoracic surgery. Study is compared to prior radiograph dated ___. There has been no significant interval change. CONCUSION No acute findings " ff3f7482-4b8731e3-c6fb2f28-eafa02d8-50376bb9.jpg,test/p15/p15022408/s51502507/ff3f7482-4b8731e3-c6fb2f28-eafa02d8-50376bb9.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient with right-sided ptosis, assess for mass. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is within normal limits. No typical configurational abnormality is seen. Unremarkable appearance of thoracic aorta and mediastinal structures are normal. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present, and the lateral and posterior pleural sinuses are free. Skeletal structures of the thorax are grossly unremarkable. There exists no prior chest examination in our records available for comparison. IMPRESSION: Chest findings within normal limits. " e4495c98-2b4293c3-5400c1cd-f55d26c6-46f0e596.jpg,test/p14/p14709655/s52987432/e4495c98-2b4293c3-5400c1cd-f55d26c6-46f0e596.jpg,test," WET READ: ___ ___ ___ 8:07 PM 1. Atelectasis at the bilateral bases. Increased retrocardiac opacification may represent pneumonia in the appropriate clinical setting. 3. Tiny right pleural effusion. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with worsening ascites and hx of hep cirrhosis c/b hcc // eval for e/o hepatic hydrothorax or pna TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___ and CT chest from ___. FINDINGS: The lungs are well expanded. Bilateral reticular opacities are noted, most notably in the right upper lung, unchanged from prior exams and consistent with known emphysematous changes. There is biapical pleural thickening and thickening of the pleura along the minor fissure, similar to prior exams. Trace pleural effusions are seen, minimally increased from prior exam. The cardiomediastinal silhouette is unremarkable. IMPRESSION: 1. No acute cardiopulmonary process. 2. Bilateral reticular opacities are noted, most notably in the right upper lung, unchanged from prior exams and consistent with known emphysematous changes " 5a3556bc-74b37558-34330460-e05f52f3-4e4a5c1a.jpg,test/p10/p10274714/s55423693/5a3556bc-74b37558-34330460-e05f52f3-4e4a5c1a.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ ___ No prior studies for comparison. FINDINGS: Heart size, mediastinal and hilar contours are within normal limits, and lungs and pleural surfaces are clear. No acute skeletal findings. IMPRESSION: No radiographic evidence of sarcoidosis. " 0867d083-1c3e4a3b-c649f3cb-d34dc8a8-f32a4665.jpg,test/p12/p12043836/s52755908/0867d083-1c3e4a3b-c649f3cb-d34dc8a8-f32a4665.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Questionable pneumothorax or pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Moderate cardiomegaly with signs of mild fluid overload. No larger pleural effusions. Moderate retrocardiac atelectasis. Normal hilar and mediastinal contours. No newly appeared focal parenchymal opacity suggesting pneumonia. " e15ab743-7c97ca17-d0dbdbae-70dd2030-aa32190b.jpg,test/p18/p18350596/s50152962/e15ab743-7c97ca17-d0dbdbae-70dd2030-aa32190b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p MVR/TVR/LV repair // eval infiltrates/opacity TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: ___. FINDINGS: In comparison to the radiograph from approximately 1 day prior, there has been no appreciable change in mild pulmonary edema. Small bilateral pleural effusions have developed. The Swan-Ganz catheter remains at the level of the valve, and could be advanced by at least 4-5 cm to position its tip in the proximal right pulmonary artery. No other relevant change. IMPRESSION: Stable mild pulmonary edema. New small bilateral pleural effusions. Swan-___ catheter tip may be advanced by 4-5 cm to position it in the proximal right pulmonary artery. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___ on the telephone on ___ at 12:16 PM, 5 minutes after discovery of the findings. " e7085e3b-822cf4b9-b27bfe82-c20f0dd0-af0b8894.jpg,test/p19/p19016834/s50975397/e7085e3b-822cf4b9-b27bfe82-c20f0dd0-af0b8894.jpg,test," FINAL REPORT INDICATION: ___-year-old male with recent esophageal stricture, status post dilatation. History of esophageal cancer, status post esophagectomy and gastric pull-through. COMPARISON: PA and lateral chest radiograph, ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: There is a new dense right central opacity approximately 7 cm x 3 cm on frontal view. Given the rapid onset of this finding, the differential is limited to airspace consolidation ___ atelectasis. Given previous radiographic evidence of slow neo-esophageal/gastric emptying, it is possible that patient had aspirated contrast material. This would also explain the dense opacity seen on lateral projection. However, other radiopaque fluid, such as fluid, pus, ___ ___, ___ be filling the airspace in this region. Adjacent to this dense opacity are ill-defined peripheral opacities which is not matched on the contralateral side. The left lung is unremarkable. There is no pleural effusion ___ pneumothorax. There is pronounced flattening of the hemidiaphragms. The cardiomediastinal silhouette is unchanged and within normal limits. The pleural surfaces are unremarkable. IMPRESSION: Large dense right central opacity which ___ represent collapse ___ airspace consolidation with adjacent area of asymmetric pulmonary edema. Given history of lymphadenopathy, collapse could be secondary to nodal compression of an airway. Alternatively, given recent history of oral contrast and poor gastric emptying, opacity ___ represent aspirated contrast material. Consolidation also ___ be secondary to a fistula between the neo-esophagus and the right lung. If this finding represent consolidation, the radiopaque material cannot be identified definitely and ___ represent ___, fluid ___ pus. CT imaging is highly recommended for further evaluation of this finding. These findings were discussed with Dr. ___ at 12:45 p.m. via phone by ___. " ca009081-3298dae6-b96b1cf6-ba33a6a4-2fab5b38.jpg,test/p16/p16191615/s58128425/ca009081-3298dae6-b96b1cf6-ba33a6a4-2fab5b38.jpg,test," FINAL REPORT HISTORY: ___-year-old male with syncope. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are within normal limits. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " ac91dffa-f950845c-8ecf5e7c-754b00a0-bc5b6fcc.jpg,test/p11/p11600572/s57630155/ac91dffa-f950845c-8ecf5e7c-754b00a0-bc5b6fcc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with AML d___ s/p 7+3 with worsening RLL consolidation and hypoxia // eval pulm edema, RLL consolidaiton eval pulm edema, RLL consolidaiton IMPRESSION: In comparison with the study of ___, there has been substantial decrease in the opacification at the right base an the right hemidiaphragm is much better seen. Small effusion could well be present. On the left, there is poor definition of the left hemidiaphragm consistent with pleural fluid and underlying compressive atelectasis. The right central catheter is been removed. There is suggestion of some hazy opacification in the right apical region. Some of this may merely represent overlying bony structures and this area should be carefully Re evaluated on subsequent images. " 371b84ad-bffc3262-b7b7366a-efe9db11-45bff23b.jpg,test/p16/p16878016/s50485941/371b84ad-bffc3262-b7b7366a-efe9db11-45bff23b.jpg,test," FINAL REPORT HISTORY: Tobacco use with rhonchi on examination. FINDINGS: In comparison with study of ___, there are lower lung volumes. Cardiac silhouette remains within normal limits. No evidence of vascular congestion. There is blunting of one of the costophrenic angles posteriorly. No evidence of acute focal pneumonia. " 36d1bc8b-5bd2fcf1-f8c13820-91412ebd-fccd74fa.jpg,test/p11/p11291823/s53778350/36d1bc8b-5bd2fcf1-f8c13820-91412ebd-fccd74fa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypercarbia pulmonary edema, just intubated for respiratory distress // please evaluate for ETT placement TECHNIQUE: Portable chest COMPARISON: ___ at 19:45 FINDINGS: The ET tube is 7 cm above the carina. Otherwise the appearance of the chest is unchanged " c0bc903d-9608cce1-d4ae4025-437cd5e0-c594576f.jpg,test/p14/p14972430/s58992610/c0bc903d-9608cce1-d4ae4025-437cd5e0-c594576f.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left chest tenderness post-fall, history of breast cancer. COMPARISON: Chest radiograph from ___ and CTA chest from ___. CHEST, PA AND LATERAL: Increased opacity is noted in the left lower lobe. There are probable small bilateral pleural effusions. Prominence of the hilar contours suggests central venous congestion and/or lymphadenopathy. Heart size remains moderately enlarged, compatible with known pericardial effusion. Unchanged saccular outpouching of the descending thoracic aorta. No displaced fractures are identified. Moderate degenerative changes in the imaged right acromioclavicular and glenohumeral joints. IMPRESSION: 1. Left lower lobe opacity could represent atelectasis or early infection. 2. Mild congestive heart failure. 3. Stable intrathoracic lymphadenopathy. 4. No visible fractures. If the patient has focal pain, dedicated rib series can be ordered. " 15bff270-097c8be3-5faf06c0-2ee6146e-4d8d3adf.jpg,test/p13/p13282189/s53913529/15bff270-097c8be3-5faf06c0-2ee6146e-4d8d3adf.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with metastatic lung ca s/p Ommaya placement for IT chemo on heparin bridge to warfarin, now unable to draw labs on PICC // Please evaluate PICC positioning TECHNIQUE: Portable upright chest AP COMPARISON: Chest radiograph from ___, ___. CTA of the chest from ___. FINDINGS: Left PICC projects over the left subclavian vein, just beyond the axillary vein junction. Although positioning limits comparison, it appears slightly more lateral than on previous examination. No pneumothorax. Slight interval worsening of right upper lobe post obstructive consolidation with bowing of the fissure. Heterogeneous consolidations in the right middle and lower lobes are also more prominent than on prior examination. Right mediastinal and hilar lymphadenopathy have been more fully evaluated on recent chest CT. A moderate right pleural effusion is unchanged. The left lung is clear except for minimal linear left basilar atelectasis. IMPRESSION: 1. Left PICC projects over the left subclavian vein appearing slightly more proximal in position than on previous examination although positioning differences limits comparison. 2. Slight worsening of extensive right upper lobe consolidation. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 11:43 AM, 5 minutes after discovery of the findings. " 43eeeb20-d1fd50de-90fd5261-1a55c040-c0079a28.jpg,test/p18/p18977683/s54446126/43eeeb20-d1fd50de-90fd5261-1a55c040-c0079a28.jpg,test," FINAL REPORT AP CHEST, 9:22 A.M., ___ HISTORY: ___-year-old man with hepatitis C cirrhosis, severe pulmonary hypertension and worsening dyspnea. IMPRESSION: AP chest compared to ___ and ___: Severely dilated pulmonary arteries are longstanding. Lungs are essentially clear. Heart is normal in size. There is no pleural effusion. " e9ca8358-f2fdc75c-8547663e-ee651182-46b8bc56.jpg,test/p16/p16006682/s54056623/e9ca8358-f2fdc75c-8547663e-ee651182-46b8bc56.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Myeloma, new cough and wheezing. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable. Lungs are essentially clear except for bibasilar linear opacities most likely reflecting areas of atelectasis but more pronounced than on the prior study. It might potentially reflect infectious process. Lateral view demonstrates compression fractures at the multiple levels, better appreciated on the CT of the thoracic spine. There is no pneumothorax. " cedc7afa-4f208bb6-3c21d9ab-334635e3-bb5b5dad.jpg,test/p13/p13999026/s58107688/cedc7afa-4f208bb6-3c21d9ab-334635e3-bb5b5dad.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with alcoholic cirrhosis, a variceal bleed and new fever. Evaluate pleural effusion. IMPRESSION: PA and lateral chest compared to ___ and ___: Moderate left pleural effusion which developed between ___ and ___ is slightly smaller today. Lung volumes remain quite low, but the extent of opacification at the left lung base is consistent with persistent or improving atelectasis. Heart size top normal, unchanged. Upper lungs clear. No pneumothorax, no pneumoperitoneum. " 1369f403-555faec0-74bc8e9a-87675c31-f21dfbe6.jpg,test/p14/p14120635/s51487032/1369f403-555faec0-74bc8e9a-87675c31-f21dfbe6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH pulled out og tube // og tube ? NGT TUBE PLACEMENT IMPRESSION: Comparison to ___, 03:32. The nasogastric tube is now visible in its entire length. The tip projects over the pre-pyloric parts of the stomach. No complications, notably no pneumothorax. Otherwise the radiograph is unchanged. " 08779573-7e51baec-8eda9844-1119a6c3-8825a78a.jpg,test/p11/p11739579/s56601123/08779573-7e51baec-8eda9844-1119a6c3-8825a78a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis and volume overload // infection? pulm edema? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: None IMPRESSION: Heart size is top-normal. Distended azygos vein and widened mediastinum are in conjunction with most likely present volume overload. Bilateral perihilar interstitial opacities are concerning for interstitial pulmonary edema. More focal opacity projecting at the level of the anterior and of the first rib on the left is present and should be reassessed on the subsequent study to exclude the possibility of pulmonary lesion in this location. " 3dc9ccb0-fafb77fe-c359616c-8c0a44d6-67b0126e.jpg,test/p12/p12734486/s58534664/3dc9ccb0-fafb77fe-c359616c-8c0a44d6-67b0126e.jpg,test," FINAL REPORT INDICATION: ___-year-old man with altered mental status, to rule out pneumonia. COMPARISON: Chest radiograph, ___. AP AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are stable, with a tortuous thoracic aorta. Retrocardiac opacity in the left lung base, likely represents atelectasis. No pleural effusion or pneumothorax is seen. Multiple old healed right-sided rib fractures are stable. " d2f3ca46-8acb3e22-648cbc5d-db7450d3-d3a634a6.jpg,test/p16/p16826047/s54140146/d2f3ca46-8acb3e22-648cbc5d-db7450d3-d3a634a6.jpg,test," FINAL REPORT STUDY: AP CHEST, ___. CLINICAL HISTORY: Patient status post pleural effusion and thoracentesis. FINDINGS: Comparison is made to the prior study from ___. There is a right basilar chest tube. There remains a moderate to large right-sided pleural effusion which is stable in size. There is a right-sided Port-A-Cath with distal lead tip in distal SVC. There is stable cardiomegaly. The left lung is clear. Overall, there is no appreciable change. No pneumothoraces are seen. " ee818b6c-3c98ca2a-c6a98a52-19fb2ef0-0e8017f0.jpg,test/p14/p14775533/s57284084/ee818b6c-3c98ca2a-c6a98a52-19fb2ef0-0e8017f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p AAA repair // eval for edema COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are constant. Increasing lung volumes but also increasing soft tissue air collections that create multiple are defects, so that the lung parenchyma cannot be appropriately assessed. Unchanged appearance of the cardiac silhouette. " 1d5bf6b7-289ed016-238b697b-490da43b-59e6aa55.jpg,test/p18/p18699523/s52873245/1d5bf6b7-289ed016-238b697b-490da43b-59e6aa55.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, SOB and fevers x 1 week // r/o pneumonia r/o pneumonia IMPRESSION: Comparison to ___. No relevant change is noted. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " a82851ec-a788008c-dd878921-a9970fb1-237d2927.jpg,test/p14/p14151932/s57031533/a82851ec-a788008c-dd878921-a9970fb1-237d2927.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Study of earlier the same date. FINDINGS: Following left thoracentesis, a left pleural effusion has nearly resolved, and there is no visible pneumothorax. Associated improving aeration at left lung base. Stable mild cardiomegaly accompanied by pulmonary vascular congestion. Worsening heterogeneous opacities in right mid and lower lung regions could reflect asymmetrical edema or infection. Interval slight repositioning of left PICC, with unusual bend at its distal point in the right tracheobronchial angle suggests the possibility of extension into the azygos vein. This could be further assessed by lateral CXR. " c1d0b6de-b0ba21e2-22b0a99a-b6ab137b-a0d48311.jpg,test/p11/p11513638/s54806033/c1d0b6de-b0ba21e2-22b0a99a-b6ab137b-a0d48311.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with fever, dyspnea; in code 1 isolation to rule out MERS // eval for PNA COMPARISON: None FINDINGS: AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process " bdcd67ff-569da922-96842095-0e6fae60-2935704f.jpg,test/p13/p13616762/s50537744/bdcd67ff-569da922-96842095-0e6fae60-2935704f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with cough and chest pain. COMPARISON: Chest radiograph from ___. FINDINGS: There is chronic atelectasis or scarring in the right middle lobe. The lungs are otherwise clear. Minimal cardiomegaly is unchanged. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " e3e154a7-d1af5c4d-facc76ba-257203fb-c56d2e2d.jpg,test/p17/p17210427/s50773949/e3e154a7-d1af5c4d-facc76ba-257203fb-c56d2e2d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with generalized weakness // eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Minimal left base atelectasis/scarring without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. No focal consolidation to suggest pneumonia. " 65c0038d-58f8e368-9ccec9eb-97f1a276-82f28cd7.jpg,test/p10/p10948410/s56232729/65c0038d-58f8e368-9ccec9eb-97f1a276-82f28cd7.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with sensation of chest tightness // please evaluate for acute CP abnormality TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. The hilar pleural surfaces are normal. IMPRESSION: Normal chest. " 9cec2fdb-94caaddc-db7c0e24-6fdc8bdd-8cc887f9.jpg,test/p18/p18590682/s56556557/9cec2fdb-94caaddc-db7c0e24-6fdc8bdd-8cc887f9.jpg,test," WET READ: ___ ___ ___ 11:36 AM Interval removal of right internal jugular central venous catheter. No evidence of pneumothorax. Persistent retrocardiac atelectasis, mildly decreased from prior. Small bilateral pleural effusions. Improved pulmonary edema. COMPARISON: ___ WET READ VERSION #1 ___ ___ ___ 5:41 PM Interval removal of right internal jugular central venous catheter. No evidence of pneumothorax. Persistent retrocardiac atelectasis, mildly decreased from prior. Small bilateral pleural effusions. Improved pulmonary edema. WET READ VERSION #2 ___ ___ ___ 11:24 AM Interval removal of right internal jugular central venous catheter. No evidence of pneumothorax. Persistent retrocardiac atelectasis, mildly decreased from prior. Small bilateral pleural effusions. Improved pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with s/p avr POD 3 // eval for effusion and ptx TECHNIQUE: PA and lateral chest views FINDINGS: The patient is post median sternotomy and aortic valve repair, right IJ sheath is unchanged in position or orientation. The cardiomediastinal silhouette is unchanged. Persistent vascular congestion. Mid-sternal lucency at proximal portion of sternotomy site is unchanged. Bibasilar atelectasis is worse on the right and improved on the left. Tiny right apical pneumothorax is unchanged, but the previously mentioned tiny left pneumothorax is no longer visualized. Small pleural effusions are unchanged. " e753c3f8-b0b39bac-7c8cf6f1-9c6ef77b-cac839cc.jpg,test/p19/p19061156/s56627828/e753c3f8-b0b39bac-7c8cf6f1-9c6ef77b-cac839cc.jpg,test," FINAL ADDENDUM Lateral view shows either a 13mm lobulated retrosternal lung nodule or calicification in a consternal junction or prevascular lymph node. CT scanning will be necessary to make the distinction, as posted in the online of critical imaging findings, for direct communication to the referring physician. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Cough. Possible pneumonia. IMPRESSION: PA and lateral chest reviewed in the absence of prior chest imaging: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Rightward displacement of focal indentation of the mid cervical trachea is most commonly associated with thyroid lesions. History of imaging examinations notes more than one thyroid ultrasound as recently as ___. " 54ea0166-a7102e4f-e975b98b-14d4b545-22279166.jpg,test/p13/p13325402/s54227580/54ea0166-a7102e4f-e975b98b-14d4b545-22279166.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with seizure, fall, head strike // eval acute process TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The patient is rotated to the left. The cardiac silhouette remains enlarged. Mediastinal contours are stable. No definite focal consolidation is seen. There is minimal to no pulmonary vascular congestion. No large pleural effusion or pneumothorax. Chronic change again seen at the right acromioclavicular joint and right shoulder with the humeral head high-riding. No displaced fracture is seen. IMPRESSION: Patient rotated. No definite acute cardiopulmonary process. " 4d3e2207-a63a4134-1453dc52-d96a9553-17612cfb.jpg,test/p13/p13762124/s54943662/4d3e2207-a63a4134-1453dc52-d96a9553-17612cfb.jpg,test," FINAL REPORT PORTABLE CHEST, ___. COMPARISON: Radiograph of earlier the same date. FINDINGS: No acute, displaced rib fractures are evident, but portable radiographs are relatively insensitive for detecting anterior rib fractures. Support and monitoring devices are unchanged in position, including a left PICC that terminates in the left axilla. Cardiomediastinal contours are stable. Diffuse heterogeneous pulmonary opacities have slightly worsened since the recent radiograph of several hours earlier, but they remain improved compared to the earlier study from ___. Bilateral pleural effusions are again demonstrated. " 7452227a-c1758e58-d9d04a83-c38a1e8e-3b7c7d36.jpg,test/p19/p19653727/s52935228/7452227a-c1758e58-d9d04a83-c38a1e8e-3b7c7d36.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Persistent epigastric pain and leukocytosis. Question pneumonia. COMPARISON: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. Intravenous contrast is present within each kidney and collecting system, partly visualized, associated with recent prior CT of the same day. IMPRESSION: No evidence of acute cardiopulmonary disease. " b361a1e1-b9c3ab9d-c2cc8344-2903cfd8-3888d7b9.jpg,test/p18/p18855147/s54043642/b361a1e1-b9c3ab9d-c2cc8344-2903cfd8-3888d7b9.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fluid overload, evaluation for interval changes. COMPARISON: ___, 7:37 a.m. FINDINGS: As compared to the previous radiograph, the lung volumes have increased. There is unchanged evidence of mild interstitial fluid overload. Unchanged size of the cardiac silhouette. No pleural effusions. Unchanged position and course of the right double-lumen catheter. " b1e45b23-900463ae-7ab2849f-737e5594-ab934cc6.jpg,test/p18/p18699864/s54327007/b1e45b23-900463ae-7ab2849f-737e5594-ab934cc6.jpg,test," FINAL REPORT INDICATION: ___M with dyspnea // ? acute cardipulm process TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f6bac395-7d1d0874-ed1fe03d-46092987-ba13d33e.jpg,test/p13/p13769924/s56442569/f6bac395-7d1d0874-ed1fe03d-46092987-ba13d33e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ F w/complicated cardiac hx (notable for CHF w/EF ___%, afib on Coumadin), recent R hip fx presenting from rehab after fall found to have hardware failure and CHF exacerbation // eval pleural effusions IMPRESSION: As compared to ___ chest radiograph, cardiomegaly and pulmonary vascular congestion are similar to the prior study, but bilateral pleural effusions have decreased in size, with residual small pleural effusions, right greater than left. ICD and biventricular pacing leads are unchanged in appearance. " 077b9246-8a6317c2-12bc3d90-32a7542b-8750b3ee.jpg,test/p14/p14213883/s59127645/077b9246-8a6317c2-12bc3d90-32a7542b-8750b3ee.jpg,test," FINAL REPORT INDICATION: ___-year-old man with a history of end-stage renal disease, status post kidney transplant, presents to the clinic with increasing fatigue and dyspnea on exertion and chest congestion. Rule out pulmonary edema. COMPARISON: Preop chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal, and hilar contours are unchanged. Pleural thickening within both lung bases is unchanged from the prior examinations. Opacification in the right lower lung medial base is consistent with right lower lobe pneumonia. Findings were discussed with Dr. ___ at 16:31 on ___ via telephone. " 7e9417d8-39dce73b-f1e7fd90-203f64f7-4a1d13f3.jpg,test/p13/p13989850/s54340460/7e9417d8-39dce73b-f1e7fd90-203f64f7-4a1d13f3.jpg,test," FINAL REPORT HISTORY: Fever and axillary abscess. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. The heart is normal in size and lungs are clear without vascular congestion or pleural effusion. " 7ef0ae91-d1a4a5e4-19b794bb-4aaac781-402e2717.jpg,test/p10/p10247690/s58955257/7ef0ae91-d1a4a5e4-19b794bb-4aaac781-402e2717.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea // ?effusion or pneumonia TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Comparison with chest radiograph from ___, a small right effusion has improved. Left pleural effusion with left retrocardiac atelectasis is grossly unchanged. There is persistent moderate central vascular congestion. Moderate cardiomegaly is unchanged. Patient is status post median sternotomy. IMPRESSION: Grossly stable large left pleural effusion with overlying atelectasis. Trace right pleural effusion appears improved. " ad882700-b12d9367-66bd0d4b-eaaf98c9-8b34b399.jpg,test/p17/p17277045/s51527005/ad882700-b12d9367-66bd0d4b-eaaf98c9-8b34b399.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with afib presenting with dyspnea // please eval for effusions/vascular congestion TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there has been some minimal improvement in the vascular congestion. The heart continues to be moderately enlarged and there is pulmonary vascular redistribution however of the alveolar infiltrates have decreased. There tiny bilateral pleural effusions. IMPRESSION: Slight improvement in vascular congestion. " bbfe5e8e-6b5756c7-290e9122-5e1575fb-fcd30fb1.jpg,test/p10/p10976602/s57753813/bbfe5e8e-6b5756c7-290e9122-5e1575fb-fcd30fb1.jpg,test," FINAL REPORT INDICATION: Chest pain, palpitations, question pneumonia or CHF. COMPARISON: Chest radiograph of ___. FINDINGS: PA and lateral views of the chest. There are mild interstitial opacities bilaterally indicating mild interstitial pulmonary edema. There is increased pulmonary vascular congestion. There is no focal parenchymal opacities concerning for pneumonia. There is no pleural effusion or pneumothorax. The left transvenous pacemaker wires are in appropriate position. The mild cardiomegaly is stable. The mediastinal contours are normal. IMPRESSION: Mild interstitial pulmonary edema consistent with mild congestive heart failure. " afd97253-9f6567f9-e7f7910d-421478b2-af668362.jpg,test/p13/p13505755/s54725400/afd97253-9f6567f9-e7f7910d-421478b2-af668362.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with septic shock and respiratory failure // volume status TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 4 cm above the carinal. Left PICC line tip is at the level of mid SVC. Cardiomediastinal silhouette is unchanged but there is interval progression of parenchymal opacities concerning for progression of pulmonary edema. " 0a1c75fb-d6969d01-702419f6-4f37662a-d411e451.jpg,test/p10/p10068987/s50816251/0a1c75fb-d6969d01-702419f6-4f37662a-d411e451.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___M with RLL wheezing, known IVDU // evaluate for pneumonia, acute process COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Vague linear density in the right lower lung is most compatible with atelectasis. No convincing signs of pneumonia or CHF. No large effusion or pneumothorax is present. The heart size is top-normal. Mediastinal contour is unremarkable. There is no free air below the right hemidiaphragm. Bony structures appear intact. IMPRESSION: Mild right basal atelectasis. Top-normal heart size. " 5b5d38b4-dcf54da5-d2699961-8687096b-5c2f6198.jpg,test/p10/p10498753/s54087017/5b5d38b4-dcf54da5-d2699961-8687096b-5c2f6198.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever, cough, shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Patchy opacity is noted in the right lower lobe concerning for pneumonia. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Right lower lobe pneumonia. Followup radiographs after treatment are recommended to assess for resolution of this finding. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:48 PM, minutes after discovery of the findings. " 4bf66122-794c3fd7-92464d7b-56e28048-ec42f0b6.jpg,test/p17/p17981662/s57442179/4bf66122-794c3fd7-92464d7b-56e28048-ec42f0b6.jpg,test," FINAL REPORT PA AND LATERAL CHEST HISTORY: New ICD, complicated by a small pneumothorax. IMPRESSION: PA and lateral chest compared to ___: A very small left pneumothorax largely or entirely apical has not changed since ___, 8:35 a.m. There is no pleural effusion. Aside from minimal atelectasis in the lingula, lungs are clear. There is no mediastinal widening. Mild cardiomegaly is comparable for different stages in the cardiac cycle. Pulmonary vasculature is unremarkable and there is no edema. Transvenous right atrial and left ventricular pacer and right ventricular pacer defibrillator leads are unchanged in their respective positions. " e03719d9-96f3e072-130ed0dd-2d307fcc-0091f1c6.jpg,test/p11/p11187293/s56648353/e03719d9-96f3e072-130ed0dd-2d307fcc-0091f1c6.jpg,test," WET READ: ___ ___ ___ 9:26 PM Hyperinflated lungs. Focal opacity at the left lung base laterally on the frontal view, potentially pleural-based. Correlation with older films to document stability suggested and if not possible, chest CT is advised for further evaluation on a nonurgent basis. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with new ataxia // ?acute abnormality, infection TECHNIQUE: AP and lateral COMPARISON: None FINDINGS: AP upright and lateral chest radiograph demonstrates hyperexpanded lungs. There is increased opacity projecting over the left lung base laterally with a configuration raising the possibility of extrapleural lesion. Lungs are otherwise clear without a focal consolidation convincing for pneumonia. Heart size is upper limits of normal. There is no evidence of pulmonary edema. No pleural effusion. There is no pneumothorax. Surgical clips project over the left upper outer chest. IMPRESSION: Hyperinflated lungs. Focal opacity at the left lung base laterally on the frontal view, potentially pleural-based. Correlation with older films to document stability suggested and if not possible, chest CT is advised for further evaluation on a nonurgent basis. " a9b15987-5bd1f6c3-19244c5a-e9c423a2-b62ba8de.jpg,test/p19/p19918971/s54361533/a9b15987-5bd1f6c3-19244c5a-e9c423a2-b62ba8de.jpg,test," FINAL REPORT INDICATION: Patient with small bowel obstruction with possible internal hernia, for preop evaluation. COMPARISON: PA and lateral chest radiograph, ___. PORTABLE AP CHEST RADIOGRAPH: There is increased opacification of the left mid lung field compared to the most recent prior examination, which may represent atelectasis; however, infectious etiology cannot be completely excluded in the correct clinical setting. There is unchanged cardiomegaly. Atelectasis within the right lung base has resolved. " 211ab8f8-61ece244-4bc331d6-f61fa2d9-c8225619.jpg,test/p16/p16458160/s50365200/211ab8f8-61ece244-4bc331d6-f61fa2d9-c8225619.jpg,test," FINAL REPORT PORTABLE CHEST FROM ___ AT 10:51 CLINICAL INDICATION: ___-year-old status post right thoracotomy and decortication, question pneumothorax. Comparison is made to the patient's previous study dated ___ at 10:43. Portable AP chest film from ___ at 10:51 is submitted. IMPRESSION: 1. Left-sided single-lead pacer remains in place. A right basilar chest tube is in place with extensive right lateral chest wall and neck subcutaneous emphysema with a stable small right apical pneumothorax. There continues to be a stable airspace abnormality in the right mid and lower lung, possibly representing postinflammatory changes and/or atelectasis, although pneumonia cannot be entirely excluded. The left lung is grossly clear. No evidence of pulmonary edema. " 0b276b2f-d92448f8-2a4308d1-826d0ae9-59e8dd1e.jpg,test/p19/p19858494/s59873585/0b276b2f-d92448f8-2a4308d1-826d0ae9-59e8dd1e.jpg,test," FINAL REPORT HISTORY: Hypercarbic respiratory failure, presumed VAP, sepsis, evaluate for interval change. CHEST, SINGLE AP PORTABLE VIEW. An ET tube is present, tip approximately 3.1 cm above the carina. There is left lower lobe collapse and/or consolidation with increased retrocardiac density and obscuration of left hemidiaphragm. Possible mild vascular plethora. Atelectasis at right base. Small effusions cannot be excluded. Compared with ___ at 4:55 a.m., I doubt significant interval change. " 99318f39-d6a9f0cf-79a4505d-b67677e3-e04f4106.jpg,test/p18/p18242864/s51439177/99318f39-d6a9f0cf-79a4505d-b67677e3-e04f4106.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with dyspnea, on CPAP // acute process TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: There is moderate pulmonary edema. Bibasilar opacities likely combination of pleural effusions and atelectasis, but underlying consolidation not excluded. The cardiac silhouette mild to moderately enlarged. IMPRESSION: Pulmonary edema and cardiomegaly. Bibasilar opacities likely combination of pleural effusions and atelectasis, but superimposed pneumonia or aspiration is not excluded. " b2cf5d1b-b1e5aacb-5601ad69-fdc5cf7d-ad9ab2fb.jpg,test/p10/p10425278/s55148363/b2cf5d1b-b1e5aacb-5601ad69-fdc5cf7d-ad9ab2fb.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: A ___-year-old woman after right lower lobectomy. Chest tube discontinued. IMPRESSION: AP chest compared to ___: A small-to-moderate right apical pneumothorax, level of the third posterior interspace, and the degree of rightward mediastinal shift and small pleural effusion are all stable since ___, 12:30 p.m. Small left pleural effusion also unchanged. Left lower lobe cleared. Left upper lobe may be developing early consolidation. Followup advised. Heart size normal. A volume of pleural fluid at the base of the right hemithorax is largely posterior and could be subpulmonic, but unchanged for the past several days. This is difficult to distinguish from atelectasis in the right middle lobe and if that becomes an issue, then CT scanning would be required. " f6eb0e3b-83781550-e9383e68-a610a58b-4c21a56d.jpg,test/p13/p13505226/s52987827/f6eb0e3b-83781550-e9383e68-a610a58b-4c21a56d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with history of necrotizing pancreatitis, presents with high LUQ pain // please eval for free air TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are normal. Pulmonary vasculature is not engorged. Lungs are clear. No pleural effusion or pneumothorax is present. No subdiaphragmatic free air is seen. Multiple clips are noted in the left upper quadrant of the abdomen. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary abnormality. No subdiaphragmatic free air. " 00b64c6c-fc3a7a78-f1d30e23-3834e02f-97ab2b03.jpg,test/p17/p17284612/s50414542/00b64c6c-fc3a7a78-f1d30e23-3834e02f-97ab2b03.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with a productive cough for two days. Question pneumonia. IMPRESSION: AP chest compared to ___: Due to limitations of imaging in patient of this size, I cannot be sure whether there is new consolidation in the right middle lobe, but that is suggested by both frontal and lateral views. I would treat the patient for pneumonia. Lungs are otherwise clear. The heart is mildly enlarged, and there is some vascular congestion but no pulmonary edema or pleural effusion. " b8ba8926-be573c5f-c19fb104-a042d885-e0259da4.jpg,test/p15/p15388421/s56696131/b8ba8926-be573c5f-c19fb104-a042d885-e0259da4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with esophagectomy, s/p chest tube removal // r/o ptx r/o ptx IMPRESSION: Comparison to ___, 09:43. 1 of the 2 right chest tubes was pulled. There is no evidence for the presence of a pneumothorax. The second right chest tube is in unchanged position. Unchanged esophageal drain and right PICC line. Minimal increase in extent of the pre-existing retrocardiac atelectasis. " b40661f5-47208a5d-4e00b0a5-615d992a-d34f60f1.jpg,test/p13/p13477622/s51635200/b40661f5-47208a5d-4e00b0a5-615d992a-d34f60f1.jpg,test," WET READ: ___ ___ ___ 8:17 AM 1. Status post minimally invasive esophagectomy with expected pneumoperitoneum and small amount of subcutaneous emphysema adjacent to the right lateral rib. 2. Enteric feeding tube tip in distal esophagus. 3. Bilateral lower lobe atelectasis. 4. No pneumothorax. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 6:31 PM, 5 minutes after discovery of the findings. WET READ VERSION #1 ___ ___ ___ 6:42 PM 1. Status post minimally invasive esophagectomy with expected pneumoperitoneum and small amount of subcutaneous emphysema adjacent to the right lateral rib. 2. Enteric feeding tube tip in distal esophagus. 3. Bilateral lower lobe atelectasis. 4. No pneumothorax. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 6:31 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with esophageal ca, now s/p MIE // eval chest and NG tube positions COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The patient has undergone abdominal surgery with expected pneumoperitoneum. No pneumothorax. Left lower lobe atelectasis. No larger pleural effusions. " d37d43d7-dee15e18-557bdbc5-a7e1a2ab-b4c0b8d2.jpg,test/p12/p12265294/s53335846/d37d43d7-dee15e18-557bdbc5-a7e1a2ab-b4c0b8d2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with t8 corpectomy // post op r/o pnthx post op r/o pnthx COMPARISON: Read in conjunction with chest CT earlier in the day. IMPRESSION: Lungs are low in volume, and interstitial pulmonary edema is mild. There is no focal pulmonary abnormality, appreciable effusion or evidence of pneumothorax or mediastinal widening. Heart is normal size. Tip of the endotracheal tube is above the upper margin of the clavicles common at no less than 5 cm above the carina with the chain elevated. It could be advanced 15 mm for more secure positioning. " 9cc3c976-67a90adf-29bc2c1d-57374467-7f49242b.jpg,test/p19/p19704930/s52124712/9cc3c976-67a90adf-29bc2c1d-57374467-7f49242b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain post-catheterization. COMPARISON: ___. CHEST, PA AND LATERAL: Lungs are clear. Cardiomediastinal and hilar contours are normal. There are no pleural effusions or pneumothorax. The appearance of the lung bases suffers from underinflation. IMPRESSION: No acute cardiopulmonary process. " 1c74bd7b-95746d73-4f4d5221-bb7111db-f96c1dad.jpg,test/p14/p14508231/s50215036/1c74bd7b-95746d73-4f4d5221-bb7111db-f96c1dad.jpg,test," FINAL REPORT INDICATION: ___F with shortness of breath and chest pain // eval acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: Improved aeration noted on today's exam when compared to prior. The lungs are clear without focal consolidation, edema, or effusion. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits. Mild thoracic dextroscoliosis is noted. Anterior cervical fixation hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " e565e48c-2c0a8e9e-2cbb4b3f-085d46cd-0e423520.jpg,test/p11/p11388508/s55633123/e565e48c-2c0a8e9e-2cbb4b3f-085d46cd-0e423520.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Altered mental status, question pneumonia. FINDINGS: AP portable upright chest radiograph obtained. Abandoned pacer leads are noted in the left chest wall extending into the heart. A right chest wall pacer is also seen with lead tips extending into the expected location of the right atrium and right ventricle. The heart is top normal in size. There is no focal consolidation, effusion, or definite signs of CHF. No pneumothorax is seen. Mediastinal contour is unremarkable. Bony structures appear grossly intact with chronic deformity of the left mid clavicular shaft. Degenerative changes at the right AC joint noted. IMPRESSION: No definite signs of acute intrathoracic process. " aeaaabbf-1cc5b938-365aa84c-5341adf4-12da74d9.jpg,test/p17/p17575265/s55312713/aeaaabbf-1cc5b938-365aa84c-5341adf4-12da74d9.jpg,test," FINAL REPORT AP CHEST, 9:48 P.M., ___ HISTORY: A ___-year-old man with a small pneumothorax after a fall. IMPRESSION: AP chest compared to ___, read in conjunction with chest CT on ___: There is no detectable pneumothorax or substantial pleural effusion. Ground-glass opacification predominantly in the left lung is probably pulmonary contusion. Developing consolidation in the left lower lobe medially at this early stage after trauma is probably atelectasis, but should be followed. Stomach is severely distended with air and semisolid material. Heart size top normal. " b0c4597b-cf51b6f4-ec4d686e-b0eea53b-242fe454.jpg,test/p10/p10236621/s50975406/b0c4597b-cf51b6f4-ec4d686e-b0eea53b-242fe454.jpg,test," FINAL REPORT INDICATION: ___-year-old man with diffuse weakness, assess for pneumonia. TECHNIQUE: Two views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are well expanded and clear with linear right basal scarring as on the previous examination, perhaps from prior chest tube placement. No pleural effusion or pneumothorax is seen. The heart is normal in size with valvular prosthesis, coronary stent, CABG clips and median sternotomy wires unchanged. IMPRESSION: No acute intrathoracic process. " 1278373a-cc1563a3-4d1fdc23-c3b4801d-ba116087.jpg,test/p12/p12945480/s54213312/1278373a-cc1563a3-4d1fdc23-c3b4801d-ba116087.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with severe abdominal pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. Nodular opacities over the mid-to-lower lungs bilaterally are most compatible with nipple shadows. Cardiomediastinal silhouette is within normal limits. There is no free intraperitoneal air. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 52fb5133-a2f2eb54-c1dd3e8e-177ef421-ad8b20c7.jpg,test/p14/p14958299/s57679343/52fb5133-a2f2eb54-c1dd3e8e-177ef421-ad8b20c7.jpg,test," FINAL REPORT HISTORY: Known right thyroid mass presents with a waking up border breath for the past few nights. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___ and ___. FINDINGS: There has been no significant interval change. There is persistent mild elevation of the right hemidiaphragm. No focal consolidative, pleural effusion, or pneumothorax is seen. A sclerotic focus projecting over the posterior right 6th rib is stable since ___, likely presenting a bone island. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 8f8d61bf-dc0fb33d-82a46be3-e3600195-e0552448.jpg,test/p13/p13578996/s54166188/8f8d61bf-dc0fb33d-82a46be3-e3600195-e0552448.jpg,test," FINAL REPORT HISTORY: Obesity with cough and shortness of breath. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. ___ rod is in place. " b6498634-2e538567-8c1baf4d-825c20ad-13027e3d.jpg,test/p14/p14536465/s54757595/b6498634-2e538567-8c1baf4d-825c20ad-13027e3d.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with respiratory distress. FINDINGS: Comparison is made to prior study from ___. There is again seen moderate cardiomegaly, stable. There is persistent pulmonary vascular congestion and bibasilar atelectasis, left side worse than right. No pneumothoraces are seen. The right-sided pleural effusion has decreased slightly. " cb1d55bf-70978ca8-45e33c24-14cf0180-88d32a62.jpg,test/p12/p12829950/s51731934/cb1d55bf-70978ca8-45e33c24-14cf0180-88d32a62.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NHL, AAA, likely metastatic prostate cancer here w/ t8 compression s/p t8 decompression and t4-___ now w/ worsening neuro exam and new progressive O2 requirement // evaluate for consolidation, Pulmonary edema, TECHNIQUE: Chest single view COMPARISON: ___ 06:10 FINDINGS: Hardware instrumentation of the thoracic spine. Right Port-A-Cath in place. Worsened left basilar consolidation, likely atelectasis in the setting of worsening moderate left pleural effusion. Increased pulmonary vascularity, more prominent. Heart size difficult to evaluate secondary to consolidation shallow inspiration. . IMPRESSION: Interval worsening. Increased left pleural effusion. Worsened left basilar consolidation, likely atelectasis, consider infection in the appropriate clinical setting. " 2fbf6fc4-3ba150ae-d937b563-807bd980-2f53603c.jpg,test/p13/p13205395/s55894148/2fbf6fc4-3ba150ae-d937b563-807bd980-2f53603c.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Shortness of breath, elevated white count, status post laparoscopic appendectomy. FINDINGS: Lung volumes are low, and there is volume loss at both bases, right hemidiaphragm is elevated. The stomach is slightly distended. There are multiple dilated loops of small bowel measuring up to 4 cm with air-fluid levels. Only the superior portion of the abdomen can be visualized, and therefore assessment of small-bowel obstruction versus ileus cannot be made on this film. " 004331c4-5dbabdaa-4263828f-e0933e71-8859988a.jpg,test/p19/p19528443/s59610901/004331c4-5dbabdaa-4263828f-e0933e71-8859988a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with abdominal pain // abdominal pain COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Partially visualized hardware in the cervical spine noted. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with top-normal heart size. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. An IVC filter is partially visualized in the upper abdomen. IMPRESSION: No acute findings. " 2c42909b-41106501-cb474a3f-0095e69f-88fcdbb3.jpg,test/p15/p15490195/s57614987/2c42909b-41106501-cb474a3f-0095e69f-88fcdbb3.jpg,test," WET READ: ___ ___ ___ 4:58 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with sob, ams // pna? TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Right chest wall port catheter terminates in the mid SVC. The lungs are underinflated but clear. Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 5147262c-a7b75116-cec0152b-db84ea02-5facf5f7.jpg,test/p12/p12911473/s53814119/5147262c-a7b75116-cec0152b-db84ea02-5facf5f7.jpg,test," FINAL REPORT HISTORY: Evaluate NG tube position. CHEST, SINGLE AP PORTABLE VIEW. Rotated lordotic positioning. An ET tube is present, the tip lies approximately 5.3 cm above the carina. An NG tube is present. Although the tip overlies the gastric fundus immediately beyond the GE junction, the sideport is superimposed over the lower mediastinum and does not extend lower than the esophagus. Clips noted in the right upper quadrant. There is probable hyperinflation, which could reflect COPD. There is probable mild-to-moderate cardiomegaly. The aorta is unfolded and mildly tortuous. There is upper zone re-distribution, without definite CHF. No gross effusion. Probable left lower lobe atelectasis. Vague hazy density overlies the right upper lung laterally superimposed over the right fourth posterior rib laterally. This was not visualized on the radiograph of ___, ___ a.m. and could represent some superimposed material. However, attention to this area on followup films is requested. IMPRESSION: 1) Lines and tubes, as described. The NG sideport does not extend beyond the lower esophagus. 2) Hazy density right upperlung laterally -- please see comment. " 5ea2d68e-181e3f7c-fd5243ca-b00c8a82-1502d2cf.jpg,test/p15/p15937283/s56512995/5ea2d68e-181e3f7c-fd5243ca-b00c8a82-1502d2cf.jpg,test," FINAL REPORT INDICATION: Urinary tract infection with renal transplant. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " 2c8b6bc9-4da82fe9-0b0e6472-9d3e1898-bc590f69.jpg,test/p15/p15959911/s56382117/2c8b6bc9-4da82fe9-0b0e6472-9d3e1898-bc590f69.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. Evaluate for acute process. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiograph from ___. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 32f8cf00-43211006-d4166175-aace4fb5-2b1754e6.jpg,test/p18/p18156009/s59812173/32f8cf00-43211006-d4166175-aace4fb5-2b1754e6.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old woman with pna - needs a f/u xray in mid ___ // f/u pna TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___, and ___ chest radiographs FINDINGS: Right lower lung opacities have decreased, but remain present. Otherwise, and no significant change. Lungs remain hyperinflated. No new focal opacity. No pleural abnormality. Heart size is normal. Cardiomediastinal and hilar silhouettes are stable. Aortic calcifications are noted. IMPRESSION: Persistent, but improved right lower lung opacity. " 0f0e19aa-cec08140-2d5d0c6c-0e8b2cb8-d46e85a5.jpg,test/p16/p16839550/s51691745/0f0e19aa-cec08140-2d5d0c6c-0e8b2cb8-d46e85a5.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: DOE, question pulmonary edema. FINDINGS: PA and lateral views of the chest obtained. AICD is again seen with lead tips extending into the right atrium and right ventricle. Midline sternotomy wires and mediastinal clips are again noted. There are bilateral small pleural effusions with fluid tracking along the minor fissure. Mild pulmonary interstitial edema is likely present. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Mild interstitial edema with bilateral small pleural effusions. " da6b5bf7-6fae4ef6-73496f5c-6b76a922-0d435653.jpg,test/p11/p11971081/s52633674/da6b5bf7-6fae4ef6-73496f5c-6b76a922-0d435653.jpg,test," FINAL REPORT INDICATION: Renal cell carcinoma with metastases to the lung and prior pleural effusion on the right, now with shortness of breath. COMPARISON: Chest radiograph ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Left-sided Port-A-Cath tip terminates within the deep right atrium. Large right pleural effusion appears increased in size compared to the previous exam. Bilateral hilar and mediastinal masses compatible with known metastatic lymphadenopathy are re-demonstrated. Right basilar opacification likely reflects atelectasis. Left lung demonstrates no focal consolidation. Small left pleural effusion is noted. There is no pneumothorax. No pulmonary vascular congestion is evident. There are multilevel degenerative changes of the imaged thoracolumbar spine. IMPRESSION: 1. Increased size of large right pleural effusion with right basilar compressive atelectasis. Trace left pleural effusion. 2. Unchanged mediastinal and hilar lymphadenopathy. " 9fafddaf-79da6baa-4dc4fe51-9d9c8807-7f039d63.jpg,test/p14/p14150129/s56538449/9fafddaf-79da6baa-4dc4fe51-9d9c8807-7f039d63.jpg,test," FINAL REPORT INDICATION: Evaluate dual-chamber pacemaker leads. COMPARISON: Chest radiographs on ___ and ___. FINDINGS: PA AND LATERAL VIEWS OF THE CHEST. A pacemaker is seen implanted in the left chest wall with appropriate transvenous placement ending in the right atrium and right ventricle. There is no pneumothorax, pleural effusion, or consolidation. The cardiac, mediastinal and hilar contours are normal. Sternotomy wires are seen in appropriate position. IMPRESSION: 1. Appropriate placement of dual-chamber pacemaker leads. 2. Otherwise normal radiographic examination of the chest. " 4998e40c-698af874-8c293856-85757f55-1a4817e4.jpg,test/p19/p19991135/s57096024/4998e40c-698af874-8c293856-85757f55-1a4817e4.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: Right VATS converted to thoracotomy for right upper lobectomy. Rule out pneumothorax. Chest tube removed. IMPRESSION: PA and lateral chest compared to ___ through ___ at 3:59 p.m. Subcutaneous emphysema in the right chest wall has diminished slightly since removal of the right pleural tube. There is still a small pocket of air and fluid, or clot in the right upper chest alongside the surgical rib fracture. Right lung is diffusely edematous, perhaps from hilar lymphatic or venous congestion. Left lung is hyperinflated due to emphysema and clear of any focal abnormality. The heart is normal size. Fullness in the postoperative right hilus has improved since ___. Lateral view shows persistence of an anterior air and fluid collection, which on the frontal view is at the level of the third anterior interspace. " 07a0503e-86380029-40f77b14-2b1c4b6b-3a05cab9.jpg,test/p10/p10216097/s58778699/07a0503e-86380029-40f77b14-2b1c4b6b-3a05cab9.jpg,test," FINAL REPORT Arison: The. EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PMH significant for AFib (on coumadin), CAD, sCHF (LVEF ___% per echo ___) who presents with dyspnea. s/p chest tube placement yesterday. Looking for interval improvement in pleural effusion. // Looking for interval improvement in pleural effusion. Looking for interval improvement in pleural effusion. COMPARISON: Chest radiographs ___. IMPRESSION: \Small right pleural effusion remains, changed in distribution but not in overall volume since ___ following insertion of the small bore pleural drainage catheter. There is no pneumothorax. Moderate enlargement of the cardiac silhouette due to cardiomegaly and/or pericardial effusion is unchanged. Left lung is grossly clear. Normal hilar and upper mediastinal contours. " 10e7623f-8974d1ad-134c73eb-2a96b1e2-145eb631.jpg,test/p15/p15549843/s59824711/10e7623f-8974d1ad-134c73eb-2a96b1e2-145eb631.jpg,test," WET READ: ___ ___ ___ 5:41 PM No definite acute cardiopulmonary process. Nodular opacities in the lungs which have persisted and a dedicated chest CT is suggested ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with new mental status changes/hx of PNA // r/o PNA TECHNIQUE: AP and lateral views of the chest. COMPARISON: Multiple prior chest x-rays dating back to ___ with most recent from ___. FINDINGS: There are multiple nodular opacities in the lungs specifically on the left projecting over the posterior left seventh rib and over the posterior right eighth rib. Linear opacity at the lung bases suggestive atelectasis. The cardiomediastinal silhouette is unchanged. No acute osseous abnormalities are identified although the bones are diffusely osteopenic limiting detailed evaluation. There is tortuosity of the descending thoracic aorta. IMPRESSION: No definite acute cardiopulmonary process. Nodular opacities in the lungs which have persisted and a dedicated chest CT is suggested " e52b659a-4a8e3312-8f2499e3-64ff5a1c-e16a5caa.jpg,test/p14/p14522445/s57652724/e52b659a-4a8e3312-8f2499e3-64ff5a1c-e16a5caa.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: End-stage renal disease with ankle swelling, question pulmonary edema. FINDINGS: PA and lateral views of the chest were provided. The heart appears mildly enlarged, and perhaps minimally increased from the prior exam. There is no overt edema, pneumonia. There is mild indistinctness of the pulmonary hilar vasculature which could indicate mild congestion. No pneumothorax or pleural effusion is seen. Bony structures are intact. " 0dcb92fc-c41a9b87-6955e724-cc0f1500-f025907c.jpg,test/p15/p15964158/s50425561/0dcb92fc-c41a9b87-6955e724-cc0f1500-f025907c.jpg,test," FINAL REPORT INDICATION: ___-year-old man with productive cough for one week associated with chills COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are stable, with mild aortic calcification. Hyperinflated lungs with flattened hemidiaphragms is consistent with emphysema. No consolidation, pleural effusion or pneumothorax is seen. An old right rib fracture and a non-united distal clavicle fracture are redemonstrated. IMPRESSION: Emphysema. No acute cardiopulmonary pathology. " 419a760d-8dc54ef9-e7c865e7-5f8a96f6-f88895ac.jpg,test/p14/p14987576/s50615222/419a760d-8dc54ef9-e7c865e7-5f8a96f6-f88895ac.jpg,test," FINAL REPORT HISTORY: Hypertensive emergency. COMPARISON: ___ through ___. FINDINGS: AP upright and lateral chest radiographs were obtained. Lung volumes accentuate the central pulmonary vasculature. There is mild prominence of the upper lobe pulmonary vessels. Moderate cardiomegaly has significantly worsened since ___. There is no effusion or pneumothorax or consolidation. IMPRESSION: 1. Moderate cardiomegaly is new since ___. 2. Mild central pulmonary vascular congestion. " 818476c5-839d8b5c-14a53ae1-6c187ba0-0e321b20.jpg,test/p11/p11836353/s51346697/818476c5-839d8b5c-14a53ae1-6c187ba0-0e321b20.jpg,test," FINAL REPORT HISTORY: Chest pain COMPARISON: ___ FINDINGS: PA and lateral views of chest. The heart, mediastinum, hilar contours, pleural surfaces and lungs are all normal. IMPRESSION: No acute cardiopulmonary process. " 2ce190f3-d2289714-fc3639fc-a574aee9-7d0271c0.jpg,test/p10/p10232572/s53905996/2ce190f3-d2289714-fc3639fc-a574aee9-7d0271c0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fevers // Please evaluate for acute infectious process Please evaluate for acute infectious process COMPARISON: Chest radiographs ___. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 24d5ab35-63c307f5-4ecff6ab-431a709e-7b6104b9.jpg,test/p11/p11607177/s51280926/24d5ab35-63c307f5-4ecff6ab-431a709e-7b6104b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF s/p swan ganz placement. confirm location // swan ganz placement swan ganz placement IMPRESSION: In comparison with the study of ___, there has and placement of a right IJ Swan-Ganz catheter that extends into the right pulmonary artery at the level of the outer aspect of the cardiac silhouette. Otherwise, little overall change. Enlargement of the cardiac silhouette process with some elevation of pulmonary venous pressure. " 8f2c771e-63f68715-ce144daf-414377c7-c8e8327f.jpg,test/p18/p18427517/s57040660/8f2c771e-63f68715-ce144daf-414377c7-c8e8327f.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Hypoglycemia. Question pneumonia. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There are no pleural effusions or pneumothorax. The lungs appear clear. The bony structures are unremarkable. There has been no significant change. IMPRESSION: No evidence of acute disease. " e2f54ca9-bb7303b7-c189f248-063acbf6-8d78e54c.jpg,test/p15/p15675092/s57253749/e2f54ca9-bb7303b7-c189f248-063acbf6-8d78e54c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ y.o. woman with multiple medical issues most notable for CML on Desatinib, COPD, seizure disorder, adrenal insufficiency, but otherwise not cardiovascular history presenting with exertional dyspnea and productive cough. // Eval for interval change Eval for interval change IMPRESSION: Comparison to ___. The left-sided pleural effusion has slightly increased. The right-sided pleural effusion is constant. Increase in extent of the subsequent right basilar atelectasis. The reticular opacities in the right mid and lower lung zones are constant. Unchanged appearance of the cardiac silhouette. " ff329bcb-da76dd55-83401962-a7d1888d-4c1f68cd.jpg,test/p18/p18616499/s58262674/ff329bcb-da76dd55-83401962-a7d1888d-4c1f68cd.jpg,test," FINAL REPORT HISTORY: ___-year-old male with hepatic and renal failure. COMPARISON: Comparison is made to radiographs of the chest from ___ and this study is read in conjunction with CT of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate unchanged position of pacemaker leads, terminating in the right atrium and the right ventricle. Within the right lung, multiple nodular and branching opacities are identified, which could represent a component of bronchiectasis, although not present previously, and also could be multifocal pneumonia in the appropriate clinical setting. Additionally, there is mild prominence of the right hilar structures, possibly representing lymphadenopathy or vascular structures. There is no pleural effusion or pneumothorax. IMPRESSION: Multiple nodular and branching opacities in the right lung could represent multifocal pneumonia in the appropriate clinical setting, or a component of newly-developed bronchiectasis. Right hilar prominence is non-specific but may due to lymphadenopathy or vascular structures. If further characteriztion is required, a contrast-enhanced CT is recommended. " e35ac71f-01727398-b93607fd-a3003bb3-756e731c.jpg,test/p13/p13680126/s55705600/e35ac71f-01727398-b93607fd-a3003bb3-756e731c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough/syncope // eval for cough TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: There is no focal consolidation or pneumothorax. There is a small left pleural effusion with underlying atelectasis, decreased since ___. Postsurgical changes in the left lung are stable. The cardiomediastinal silhouette is shifted to the left, unchanged since the prior exam and likely due to volume loss. The imaged upper abdomen is unremarkable. The bones are intact. IMPRESSION: Small left pleural effusion and likely minimal underlying left lower lobe atelectasis, decreased since ___. Postsurgical changes in the left upper lobe. Otherwise no significant change since the prior study. " 58693bfd-6891e183-2723ac9a-742f84d1-a26239e4.jpg,test/p14/p14809300/s55211941/58693bfd-6891e183-2723ac9a-742f84d1-a26239e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with inc O2 requirement // ___ year old woman with inc O2 requirement ___ year old woman with inc O2 requirement IMPRESSION: In comparison with the study of ___, there is increasing opacification at both bases with poor definition of the hemidiaphragms, consistent with a combination of pleural effusions and compressive atelectasis. With indistinctness of pulmonary vessels suggests elevated pulmonary venous pressure, which is supported by the enlarging cardiac silhouette. " 55b4e044-46490db0-f92b79d0-3739810e-c5679fae.jpg,test/p13/p13874311/s51075131/55b4e044-46490db0-f92b79d0-3739810e-c5679fae.jpg,test," FINAL REPORT INDICATION: Hypotension. Evaluate for pneumonia. COMPARISONS: Chest radiograph ___. CTA chest ___. FINDINGS: PA and lateral radiographs of the chest show no evidence of consolidation or pneumonia. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Multiple air filled loops of bowel are noted in the left upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 8c4fdcf7-61f76cf5-31527407-b3fc9d7a-21673746.jpg,test/p17/p17788370/s51624001/8c4fdcf7-61f76cf5-31527407-b3fc9d7a-21673746.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural infection s/p chest tube // residual pleural effusion residual pleural effusion IMPRESSION: Compared to chest radiographs ___ through ___. Small right pleural effusion is probably larger common despite the basal pigtail pleural drain which is probably more tightly coiled at the base of the right hemi thorax today than it was earlier. No pneumothorax. Left lung is clear. . Pulmonary vascular congestion has nearly resolved. Heart size top-normal. Left PIC line ends in the mid to low SVC. " 50dbdd7b-67696cbc-63f6b2b0-d5bdb292-1bfcc94e.jpg,test/p16/p16628841/s57909984/50dbdd7b-67696cbc-63f6b2b0-d5bdb292-1bfcc94e.jpg,test," WET READ: ___ ___ 4:58 PM Patchy left lower lobe opacity concerning for pneumonia. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with weakness, hypotension // eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The aorta remains tortuous and diffusely calcified. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Patchy opacity is noted within the left lower lobe which is concerning for an area of pneumonia. No pleural effusion or pneumothorax is seen. Multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: Patchy left lower lobe opacity concerning for pneumonia. " cea9376d-da8049d3-b78626ed-11e46c39-fc9127cf.jpg,test/p13/p13903940/s56353303/cea9376d-da8049d3-b78626ed-11e46c39-fc9127cf.jpg,test," WET READ: ___ ___ ___ 9:10 AM Lung volumes are low and there is heterogeneous opacification of the left lung base, likely representing atelectasis. No strong evidence for pneumonia. No pleural effusion. WET READ VERSION #1 ___ ___ 8:41 PM Lung volumes are low and there is heterogeneous opacification of the left lung base, likely representing atelectasis. No strong evidence for pneumonia. No pleural effusion. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with recent AAA repair, postop course c/b hypercarbic resp failure, w/ recent AMS and ABG Pa02 ___ // assess for PNA, pulm edema, other etiologies for hypoxia COMPARISON: Radiographs from ___ IMPRESSION: There are low lung volumes. There are calcifications of the thoracic aorta. Heart size is upper limits of normal. Cardiomediastinal silhouette is within normal limits. There is atelectasis at the lung bases and likely a left-sided pleural effusion. No pneumothoraces are seen. " ae354f03-73eef900-2ffd50d1-f59996f2-cd570281.jpg,test/p14/p14583219/s58790598/ae354f03-73eef900-2ffd50d1-f59996f2-cd570281.jpg,test," FINAL REPORT INDICATION: Right flank pain. Right lower chest pain. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest. Normal lungs, heart, pleura and mediastinal surfaces. IMPRESSION: Normal chest radiograph. " c14f1586-2a700696-3b43f190-9cdd5b73-bdda1ea4.jpg,test/p18/p18364018/s55671652/c14f1586-2a700696-3b43f190-9cdd5b73-bdda1ea4.jpg,test," FINAL REPORT INDICATION: ___F with epigastric pain + n/v // ro infectious, PE or cardiac process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: There are streaky bibasilar opacities which are most likely due to atelectasis. There is no focal consolidation, effusion, or edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 6f47fd55-56900645-6396eb16-1af10f1d-2afb4b1e.jpg,test/p13/p13733608/s51660699/6f47fd55-56900645-6396eb16-1af10f1d-2afb4b1e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with multiple comorbidities, URI symptoms, requires IVF with baseline CHF. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: Lungs are well inflated and clear. Heart size is top normal. Mediastinal and hilar contours are normal. No pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 710613d0-c23fd9dd-6fa6ef0a-8570adcd-fe054fbc.jpg,test/p17/p17033046/s59685088/710613d0-c23fd9dd-6fa6ef0a-8570adcd-fe054fbc.jpg,test," FINAL REPORT HISTORY: DHT reposition. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___ at 9:11 a.m. A Dobhoff tube is present. The entire DHT is not included on this film, but the radiopaque portion lies in the left upper quadrant, most likely related to the gastric fundus. A portion of the DHT extends beyond the inferior edge of these films so the continuity between the main portion of the line cannot be established on the basis of this film. Compared to ___ at 9:11 a.m., the cardiomediastinal and pulmonary findings are grossly unchanged. IMPRESSION: Based on this view, the Dobbhoff has not passed beyond the pylorus, but overlies the expected location of the fundus. This assumes that the radiopaque portion of the tube is contiguous with the portion extending through the mediastinum, though the entire tube is not contiguously visualized on this film. " 639a7015-621a8ff3-8d341935-0b02efa1-8a7ca5e9.jpg,test/p16/p16142940/s56588861/639a7015-621a8ff3-8d341935-0b02efa1-8a7ca5e9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with R effusion s/p ___ // r/o ptx r/o ptx COMPARISON: Comparison to prior study dated ___ at 16 37 FINDINGS: Portable AP upright chest film ___ at 10:59 is submitted. IMPRESSION: Interval decrease in size but residual small to moderate right pleural effusion status post thoracentesis. No pneumothorax. Heart remains stably enlarged which may reflect cardiomegaly, although pericardial effusion should also be considered. Mediastinal contours are stable. Calcification of the aorta consistent with atherosclerosis. No evidence of pulmonary edema. Streaky opacities at the left base and more focal patchy opacity at the right base likely reflect atelectasis, although superimposed pneumonia cannot be excluded. " 79079413-609ec408-828d7c9d-1e060ae4-6c4afb0a.jpg,test/p13/p13709012/s58617443/79079413-609ec408-828d7c9d-1e060ae4-6c4afb0a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. INDICATION: ___-year-old woman with recent swallowing of a chicken bone, with concern for esophageal perforation, question pneumomediastinum. FINDINGS: PA and lateral views of the chest provided. The lungs are clear bilaterally. There is no consolidation, effusion or pneumothorax. No evidence of pneumomediastinum. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 47720118-3755ab62-c9cab0b4-125dc0a6-33724708.jpg,test/p17/p17637418/s54379554/47720118-3755ab62-c9cab0b4-125dc0a6-33724708.jpg,test," FINAL REPORT INDICATION: ___F with right-sided chest pain s/p fall // Eval for rib fx, pneumothorax TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures identified. IMPRESSION: No acute cardiopulmonary process. " c1c67d4c-b87bea22-635e53c7-cdb351a2-1f2a51c4.jpg,test/p14/p14546527/s55096689/c1c67d4c-b87bea22-635e53c7-cdb351a2-1f2a51c4.jpg,test," WET READ: ___ ___ ___ 11:48 PM 2.0 cm rounded opacity projecting over the lower mid chest seen on the lateral view, not well seen on the frontal view, for which further evaluation with chest CT is recommended. Chest CT recommended to assess for possible enlarging pulmonary nodule. *** ED URGENT ATTENTION *** WET READ VERSION #1 ___ ___ ___ 1:46 PM 2.0 cm rounded opacity projecting over the lower mid chest seen on the lateral view, not well seen on the frontal view, for which further evaluation with chest CT is recommended. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with DDRT w/fevers to 105. // CXR: Is there e/o infection. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and CABG. Mediastinal contours are stable. The cardiac silhouette is stable. There may be minimal left base atelectasis. No focal consolidation is seen. On the lateral view projecting over the lower hemithorax, there is a 2.0 x 1.6 cm rounded opacity, not well appreciated on the frontal view and appears new since ___ There is no large pleural effusion or pneumothorax. No pulmonary edema is seen. IMPRESSION: 2.0 cm rounded opacity projecting over the lower mid chest seen on the lateral view, not well seen on the frontal view, for which further evaluation with chest CT is recommended. " add07327-940acfc0-24da617f-47da89e7-67df8592.jpg,test/p15/p15355458/s52423703/add07327-940acfc0-24da617f-47da89e7-67df8592.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with probable cancer, sepsis and hypotension. FINDINGS: Comparison is made to the previous study from ___. The endotracheal tube, right IJ line, and nasogastric tube appear unchanged in position. There is also a left-sided central line with distal lead tip which is perpendicular to the mid SVC wall. The heart size is enlarged. There are bilateral pleural effusions and left retrocardiac opacity. There are low lung volumes due to poor inspiratory effort since the previous study. Allowing for this, is no significant change. There are no pneumothoraces. " 59622a90-f586ba20-81ee6cdd-a68d6873-08262497.jpg,test/p11/p11281855/s52165947/59622a90-f586ba20-81ee6cdd-a68d6873-08262497.jpg,test," FINAL REPORT HISTORY: Tandem heart, to assess for change. FINDINGS: In comparison with study of ___, there are increasing areas of opacification in the regions previously described in the upper zones adjacent to the mediastinum and extending towards the wall of the chest. The differential diagnosis is essentially unchanged. Monitoring and support devices remain in place. There is some limitation of his ability related to scattered radiation related to the size of the patient. " 8f94b486-352697a0-a75348b9-f7fcf7d1-6af30fa8.jpg,test/p15/p15107382/s58852955/8f94b486-352697a0-a75348b9-f7fcf7d1-6af30fa8.jpg,test," FINAL REPORT INDICATION: Cough and fever. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs ___ lung volumes exaggerating heart size, but no focal consolidation, pleural effusion, or pneumothorax. Lateral view is rotated, making the fatty infiltration of the prevascular mediastinum more abnormal looking than it really is. IMPRESSION: No acute cardiopulmonary process. " 96e0783e-5eec841d-8d847179-a9a00e36-e44eab33.jpg,test/p17/p17078350/s59315170/96e0783e-5eec841d-8d847179-a9a00e36-e44eab33.jpg,test," WET READ: ___ ___ 5:56 PM Moderate right pleural effusion is significantly larger since the prior study of ___. There is likely underlying atelectasis. No new airspace opacity is detected. The right heart border is obscured. The left heart border and mediastinal contours are unchanged. Findings suggest residual infection with parapneumonic effusion. Malignancy should also be considered given apparent treatment failure. These results were discussed by telephone by ___ with ___ at 5:50 pm, ___, 5 minutes after discovery. ______________________________________________________________________________ FINAL REPORT HISTORY: Pneumonia. COMPARISON: ___. FINDINGS: Moderate right pleural effusion is significantly larger since the prior study of ___. There is likely underlying atelectasis. An infiltrate in this region is also possible. The right heart border is obscured. The left heart border and mediastinal contours are unchanged. Impression: Findings suggest residual or recurrent infection with parapneumonic effusion. Malignancy should also be considered given apparent treatment failure. These results were discussed by telephone by ___ with ___ at 5:50 pm, ___, 5 minutes after discovery. " 6950f5f4-9693fcc8-e9d8daad-bc28109f-d17ce4d9.jpg,test/p15/p15958120/s52172973/6950f5f4-9693fcc8-e9d8daad-bc28109f-d17ce4d9.jpg,test," FINAL REPORT HISTORY: Panic attacks, syncope, fatigue. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There are relatively low lung volumes. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: Somewhat low lung volumes, otherwise, no acute cardiopulmonary process. " f517fc62-ea0a0489-f67bc1b9-5ac1d65d-fdfe5717.jpg,test/p10/p10157508/s53992660/f517fc62-ea0a0489-f67bc1b9-5ac1d65d-fdfe5717.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of melanoma // please evaluate disease status please evaluate disease status IMPRESSION: Comparison to ___. No relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pulmonary nodules. No pleural effusions. No pneumonia. " 49ee9212-76abebc8-a4c44ea5-996c70b8-358857f6.jpg,test/p12/p12846283/s51917711/49ee9212-76abebc8-a4c44ea5-996c70b8-358857f6.jpg,test," FINAL REPORT INDICATION: ___ year old woman with ? PNA // Assess for consolidation progression TECHNIQUE: Portable semi-upright AP chest COMPARISON: Chest radiographs ___ through ___ FINDINGS: Right internal jugular central venous catheter remains in the low SVC. Right infrahilar opacity is essentially unchanged. Other smaller multifocal opacities have worsened in the left mid and upper lung and periphery of the right base. Heart size is normal. There is no pleural effusion or pneumothorax. IMPRESSION: Opacities have worsened in the left mid and upper lung. The largest opacity in the right infrahilar region is unchanged from ___ but improved since ___. " 348de7e4-07b1a68e-5ef0b6fa-dcd17965-f960b3f2.jpg,test/p13/p13174810/s50189404/348de7e4-07b1a68e-5ef0b6fa-dcd17965-f960b3f2.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess for pneumothorax after chest tube removal. Comparison is made with prior study performed 11 hours earlier. There is a questionable tiny right pneumothorax. A small left pneumothorax is unchanged. Multifocal lung consolidations are stable. Lines and tubes are in unchanged standard position. Cardiomediastinal contours are unchanged. " 6bd1941b-8d4ca229-7b2bf420-e32854a9-d3c7876d.jpg,test/p11/p11042081/s50378228/6bd1941b-8d4ca229-7b2bf420-e32854a9-d3c7876d.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old male with shortness of breath and seizure. Question pneumonia. FINDINGS: AP and lateral views of the chest. No prior. The lungs are clear of consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " b8b90621-416a4c32-d3054427-5ea2ec42-e2dc5ea0.jpg,test/p13/p13219940/s57014152/b8b90621-416a4c32-d3054427-5ea2ec42-e2dc5ea0.jpg,test," FINAL REPORT INDICATION: Left-sided chest pain with radiation to the left back for the past day. Evaluate for pneumothorax or evidence of mediastinal widening. COMPARISON: None. FINDINGS: The frontal and lateral radiographs of the chest were acquired. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Mild multilevel degenerative changes of the thoracic spine are seen. IMPRESSION: No acute cardiac or pulmonary process. " b508dfd7-9a857314-83931bab-df7da2ec-ca994dda.jpg,test/p16/p16025852/s54950090/b508dfd7-9a857314-83931bab-df7da2ec-ca994dda.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___ year old woman with peristent cough for 3 months // chronic cough COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are clear. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The heart is normal in size. The descending aorta is slightly tortuous or ectatic. The hila and mediastinum are within normal limits. IMPRESSION: No acute intrathoracic process. " 040f8773-ba7cbfda-b72e95cd-6fd6b889-462f09d4.jpg,test/p16/p16992997/s54669094/040f8773-ba7cbfda-b72e95cd-6fd6b889-462f09d4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with DLBCL // coarse crackles throughout w/fever yesterday. please re-evaluate. coarse crackles throughout w/fever yesterday. please re-evaluate. IMPRESSION: Comparison to ___. No relevant change. Right pectoral Port-A-Cath in situ. Severe scoliosis with subsequent asymmetry of the ribcage. Normal size of the heart. No pleural effusions. No pneumonia, no pulmonary edema. " 5e269c44-fb1b3dea-828e9098-b92036f4-65aa5758.jpg,test/p14/p14312973/s59889223/5e269c44-fb1b3dea-828e9098-b92036f4-65aa5758.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia with sudden desat // Evaluate for intrapulmonary process, worse effusion, pneumonia TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: The 2 lead pacemaker is again visualized. There continues to be some increase in interstitial markings and some volume loss at the bases but overall the aeration is improved compared to the study from 1 week prior " fa12ef42-17c81857-b8ca4e95-d33dbff2-738446ba.jpg,test/p19/p19905874/s51507534/fa12ef42-17c81857-b8ca4e95-d33dbff2-738446ba.jpg,test," FINAL REPORT INDICATION: Weakness. Assess for acute process, thymoma. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. Lungs are clear. No pleural effusion or pneumothorax evident. Surgical clip in upper mediastinum is unchanged since ___. No osseous abnormality evident. IMPRESSION: No acute intrathoracic process. " faafca15-80e16245-a62bf915-3a135757-f826f07c.jpg,test/p17/p17055354/s51695459/faafca15-80e16245-a62bf915-3a135757-f826f07c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with a history of primary effusion lymphoma. Please evaluate for change in size of effusion, now after 3 cycles of mini-CHOP. // ___ year old man with a history of primary effusion lymphoma. Please evaluate for change in size of effusion, now after 3 cycles of mini-CHOP. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is a right Port-A-Cath with the tip in the cavoatrial junction. There is a pacemaker overlying the left chest with leads in the right atrium and right ventricle, which appears unchanged in comparison to the prior radiograph. The left pleural effusion has improved, however there is a residual small amount of pleural fluid. The left retrocardiac opacity has also improved. The right lung is clear. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Appropriately positioned right Port-A-Cath and pacemaker. 2. Improvement of left pleural effusion and basilar atelectasis. " bad75ea1-503f92e3-9becc0e8-5ec0683b-98555470.jpg,test/p10/p10267709/s52294346/bad75ea1-503f92e3-9becc0e8-5ec0683b-98555470.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from earlier today. CLINICAL HISTORY: Aspiration, patient intubated, assess ET tube position. FINDINGS: Supine portable AP view of the chest provided. There has been interval intubation with the endotracheal tube tip situated 2.1 cm above the carina. The NG tube courses into the left upper abdomen. There is bronchovascular crowding and atelectasis/aspiration accounting for perihilar opacity in the setting of low lung volumes. There is no significant change from prior study aside from tube placement. " d4efb559-ad7e37b4-7f9b2530-d63a64da-05ebd03d.jpg,test/p17/p17968028/s55026959/d4efb559-ad7e37b4-7f9b2530-d63a64da-05ebd03d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Back pain and chest pain, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a clear improvement. Normal lung volumes. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. No hilar or mediastinal abnormalities. No pulmonary edema. " ef56ed23-ec566d93-c3eb2130-bfd3a47f-8c26e6c1.jpg,test/p19/p19467469/s57976683/ef56ed23-ec566d93-c3eb2130-bfd3a47f-8c26e6c1.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p whipple on ___ complicated by delayed gastric emptying, now with productive cough // Please evaluate for possible pulmonary process (pna/pulmonary edema/atelectasis). TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral chest radiographs demonstrate improved lung volumes relative to prior examination. An enteric tube descends the thorax in an uncomplicated course, its tip not well visualized though appears to course below the level of the hemidiaphragm. A right PICC terminates at or just below the superior vena cava. Cardiomediastinal and hilar borders are within normal limits. A retrocardiac opacity is new relative to prior examination for which infection is difficult to exclude. Bibasilar atelectasis is most pronounced within the left lower lobe. There is a small pleural effusion. There is no pneumothorax or evidence of pulmonary edema. IMPRESSION: New retrocardiac opacity for which infection cannot be excluded. A small left pleural effusion is associated with atelectasis. " e2e91ade-9c10b18b-d21de54e-0ecde93e-fbfca490.jpg,test/p14/p14729260/s50263601/e2e91ade-9c10b18b-d21de54e-0ecde93e-fbfca490.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: A ___-year-old woman being worked up for a bone marrow transplant. IMPRESSION: PA and lateral chest compared to ___: Heart size top normal, unchanged. Upper lobe pulmonary vasculature mildly dilated, new since ___. Although this is often an indication of early cardiac decompensation, there is no pulmonary edema or pleural effusion. Shape of the cardiac silhouette indicates left atrial enlargement. Lungs are clear, pleural surfaces unremarkable. " 02889bd5-0825f715-fa53c6d2-5ffb544c-ebc95040.jpg,test/p10/p10546797/s52272217/02889bd5-0825f715-fa53c6d2-5ffb544c-ebc95040.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chf exacerbation // ? volume overload TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 823811fe-0abc4383-778daf98-d4c76ee5-548a2b83.jpg,test/p17/p17454111/s50853236/823811fe-0abc4383-778daf98-d4c76ee5-548a2b83.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent hospitalization for SOB with CXR abnormalities while inpatient // follow up concern for possible interstitial changes, are they still present? COMPARISON: ___. IMPRESSION: As compared to the previous image, no relevant change is seen. The fibrotic changes at both lung bases are constant in appearance. The reflect either passed infection or a mild form of interstitial lung disease. No new or recent parenchymal changes are noted. Unchanged borderline size of the cardiac silhouette. No evidence of pleural effusions on the lateral image. " 418fc82c-3f034762-36d823da-fcab1d34-0204690a.jpg,test/p10/p10150980/s50956163/418fc82c-3f034762-36d823da-fcab1d34-0204690a.jpg,test," FINAL REPORT HISTORY: Difficulty swallowing. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Linear opacities at the lung bases likely reflect atelectasis. No pleural effusion or focal consolidation is present. There is no pneumothorax. Mild multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: Mild bibasilar atelectasis. " a475192b-b6842c40-c191a9b9-ea9a385c-d928ec07.jpg,test/p14/p14358282/s52380987/a475192b-b6842c40-c191a9b9-ea9a385c-d928ec07.jpg,test," FINAL REPORT HISTORY: ___-year-old male with history of dilated cardiomyopathy presents with palpitations and bring syncope. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Left chest wall pacing device again seen with leads in stable position. The lungs are clear of focal consolidation or effusion. Mild to moderate cardiomegaly is unchanged. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 6f7ce5b5-9f3a9572-f887be49-c395d25b-8b8a0c43.jpg,test/p12/p12594793/s55306130/6f7ce5b5-9f3a9572-f887be49-c395d25b-8b8a0c43.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with as above // s/p CABG w/R sided chest pain-r/o PTX s/p CABG w/R sided chest pain-r/o PTX IMPRESSION: Compared to chest radiographs ___ through ___. Mild to moderate left lower lobe atelectasis and small left pleural effusion are unchanged. No pulmonary edema. Postoperative cardiomediastinal silhouette is unremarkable and unchanged. No pneumothorax or right pleural effusion. " b3e39a5a-543ef900-4bcece19-3d2b9f1a-01b43733.jpg,test/p14/p14590460/s54227251/b3e39a5a-543ef900-4bcece19-3d2b9f1a-01b43733.jpg,test," FINAL REPORT HISTORY: ___-year-old female with cough and fever, rule out acute process. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. No pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 5adcf7ab-e6290ec4-4ce8e1f6-a8fb2f10-d060f7c3.jpg,test/p12/p12572699/s56449794/5adcf7ab-e6290ec4-4ce8e1f6-a8fb2f10-d060f7c3.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Productive cough. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are stable. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No abnormality to suggest interval development of infectious process. " 1c48e18e-f4072aeb-9f28adc4-1f0e74b8-536446de.jpg,test/p17/p17436646/s53740964/1c48e18e-f4072aeb-9f28adc4-1f0e74b8-536446de.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Known lung mass with back pain and dyspnea. FINDINGS: AP upright and lateral views of the chest provided. The known nodule in the right lower lobe is not clearly visualized on chest radiograph. The lungs appear clear without signs of pneumonia or CHF. No effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. Mural calcification along the aortic knob noted. No free air below the right hemidiaphragm. IMPRESSION: Known right lower lobe lung nodule not clearly visualized. No signs of pneumonia or other acute intrathoracic process. " f6941439-db22527d-f5f0b581-d49ce0bf-e9a750e3.jpg,test/p11/p11861605/s55210948/f6941439-db22527d-f5f0b581-d49ce0bf-e9a750e3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Patchy opacities are noted in both lung bases, findings which could reflect atelectasis as the lung volumes are somewhat low, but infection cannot be completely excluded. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with patchy bibasilar opacities, likely atelectasis. Infection however cannot be completely excluded in the correct clinical setting. " 8e59cf51-d4db586e-e4deec75-4e20bda5-c9f8a8d9.jpg,test/p10/p10449408/s53463706/8e59cf51-d4db586e-e4deec75-4e20bda5-c9f8a8d9.jpg,test," FINAL REPORT INDICATION: Patient with history of liver cirrhosis with fatty, black stools. Evaluate for evidence of acute cardiopulmonary process. COMPARISON: Multiple prior chest radiographs, most recent on ___. TECHNIQUE: Frontal upright and lateral chest radiograph. FINDINGS: The lungs are well expanded. No focal opacities are identified. There are bilateral diffuse interstitial opacities, with associated ___ A lines and bilateral hilar indistinctness suggesting interstitial pulmonary edema. There is mild cardiomegaly, stable from prior. Otherwise, cardiomediastinal and hilar contours are unremarkable. There is a small left-sided pleural effusion. There is no pneumothorax. Compression deformity of a mid thoracic vertebra is identified. IMPRESSION: 1. Interstitial pulmonary edema and small left sided pleural effusion in the setting of mild cardiomegaly. 2. Compression deformity of a mid thoracic vertebra is identified. " 31556628-f9e6666b-3c540d22-3d989808-895e51a8.jpg,test/p11/p11648968/s58505242/31556628-f9e6666b-3c540d22-3d989808-895e51a8.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough and chest pain, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has taken a better breath. The lung parenchyma is unremarkable, there is no evidence of pneumonia or other pathologic changes. Normal size of the cardiac silhouette. Normal hilar and mediastinal findings. No pleural effusions. " 5d240dab-57b29c5a-d1b74147-d1c07b29-60f649aa.jpg,test/p18/p18269439/s53063868/5d240dab-57b29c5a-d1b74147-d1c07b29-60f649aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest burning. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lungs are mildly hyperinflated and there is chronic elevation of the right hemidiaphragm. Hyperlucency at the left lung apex corresponds to the known the bulla.The cardiac, hilar and mediastinal contours are normal.No pleural effusion or pneumothorax. IMPRESSION: Hyperinflated lungs with no evidence of acute cardiopulmonary process. " 762c66ff-7e033dcf-14e78d94-fb532b81-114aa55e.jpg,test/p13/p13409291/s53657281/762c66ff-7e033dcf-14e78d94-fb532b81-114aa55e.jpg,test," FINAL REPORT INDICATION: Chest pain and shortness of breath. COMPARISON: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " 124b100c-a739c6ec-49afe4f0-a8576437-f32f7063.jpg,test/p16/p16286577/s53170918/124b100c-a739c6ec-49afe4f0-a8576437-f32f7063.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chills TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 5b81c9d9-8dc06256-fd38d743-9ef2bad3-62e4493e.jpg,test/p13/p13398212/s52787790/5b81c9d9-8dc06256-fd38d743-9ef2bad3-62e4493e.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Palpitations. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are increased interstitial markings bilaterally, suggesting mild interstitial edema. There is blunting of the bilateral costophrenic angle, suggesting trace bilateral pleural effusions. The cardiac silhouette is mildly enlarged. No focal consolidation is seen. The mediastinal and hilar contours are stable. IMPRESSION: Minimal interstitial edema and trace bilateral pleural effusions along with mild cardiomegaly. " 1e798376-dbbb8ca9-1caa4225-11a3897c-2e336266.jpg,test/p14/p14766138/s50927657/1e798376-dbbb8ca9-1caa4225-11a3897c-2e336266.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with chest tube for parapneumonic effusion // interval changes interval changes IMPRESSION: In comparison with the study of ___, there is little overall change. Left chest tube remains in place and there is little difference in the appearance of the extent and severity of the left pleural fluid collection with underlying atelectatic change. The right lung is essentially clear. Cardiomediastinal silhouette is also unchanged. " 3b54656d-52407e66-dad3b65e-2c32c299-ae994486.jpg,test/p16/p16584291/s56444848/3b54656d-52407e66-dad3b65e-2c32c299-ae994486.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pericarditis, cough // ? improvement in atelectasis, effusion COUGH;TIGHTNESS IN CHEST;?IMPROVEMENT IN ATELECTASIS, EFFUSION COMPARISON: Chest radiographs ___ and ___. IMPRESSION: Lung volumes have improved since ___ and previous bands of subsegmental atelectasis have nearly resolved. Lungs are otherwise clear. Diameter of the cardiac silhouette has returned to normal. There is no pleural effusion or distension of either central mediastinal veins or pulmonary vessels. " d3c513dc-644c8f4e-85ad70f3-25200898-6aeb4dab.jpg,test/p18/p18329975/s52092283/d3c513dc-644c8f4e-85ad70f3-25200898-6aeb4dab.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with lower abd pain, chest pain // r/o infiltrates TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " bceb4a49-9cc2065e-23b0da80-d4e1176b-8452b973.jpg,test/p10/p10963981/s52981369/bceb4a49-9cc2065e-23b0da80-d4e1176b-8452b973.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left SDH s/p L craniotomy for SDH evacuation // assess for acute changes COMPARISON: No comparison IMPRESSION: Low lung volumes. Vertebral stabilization devices. Nasogastric tube with normal course, the tip of the endotracheal tube projects approximately 2.8 cm above the carinal but the exact location is difficult to determine given the presence of metallic vertebral devices. Low lung volumes. No pneumothorax. No pleural effusions. No pulmonary edema. Moderate cardiomegaly. " 9a037bcf-8255656a-0c9cdaef-5fd26454-fd153af3.jpg,test/p18/p18705722/s56773191/9a037bcf-8255656a-0c9cdaef-5fd26454-fd153af3.jpg,test," FINAL REPORT INDICATION: History: ___M with cough, sob // infiltrate? TECHNIQUE: Chest PA and lateral COMPARISON: Most recently from ___. FINDINGS: Moderate to severe cardiomegaly, including but not limited to left atrial enlargement , is unchanged compared to the prior exam. Sternotomy wires again noted. The aorta is unfolded, unchanged. The mediastinal and hilar contours are grossly unchanged. There is trace upper zone redistribution, but no other evidence of CHF. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. The visualized osseous structures show degenerative changes, but are otherwise grossly unremarkable. IMPRESSION: Stable moderate-to-severe cardiomegaly. Trace upper zone redistribution. Otherwise, no acute pulmonary process identified. " bf553b3d-3e629dde-a2511dc9-51d92999-dfe75e97.jpg,test/p15/p15755791/s56187490/bf553b3d-3e629dde-a2511dc9-51d92999-dfe75e97.jpg,test," FINAL REPORT HISTORY: Elevated lactate. Rule out infiltrate. CHEST, SINGLE AP PORTABLE VIEW: There are low inspiratory volumes, though the possibility of background hyperinflation/COPD cannot be excluded. Suspect cardiomegaly, though this may be accentuated by low lung volumes. There is upper zone redistribution and mild diffuse vascular blurring, suggesting mild CHF. There is patchy opacity at the left lung base consistent with atelectasis, though an early pneumonic infiltrate would be difficult to exclude. No effusion is identified. At the edge of these films, hardware related to the left shoulder is noted. " 03274396-e2b4a168-d1b88499-3cd479a1-03807b48.jpg,test/p18/p18014061/s53823123/03274396-e2b4a168-d1b88499-3cd479a1-03807b48.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fever and rigors status post kidney transplant on ___. COMPARISON: ___. TECHNIQUE: AP upright and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest radiographic examination. " 54a0b019-301c4725-cc0da86d-f5a40a23-d55db633.jpg,test/p11/p11632236/s51197769/54a0b019-301c4725-cc0da86d-f5a40a23-d55db633.jpg,test," FINAL REPORT HISTORY: Liver disease, poor nutrition, Dobbhoff placement. CHEST, TWO VIEWS. Compared with ___, the NG tube has been removed and a Dobbhoff tube has been placed. The radiopaque tip overlies the expected site of the gastric fundus/body. Tubing also overlies the right upper quadrant of the abdomen, ? stent. A right-sided central line tip overlies the distal SVC/RA junction. As before, there is hyperinflation suggestive of background COPD and moderately severe cardiomegaly. There are diffuse confluent and interstitial opacities in both lungs, most pronounced in the left mid zone and surrounding that and at the right base. There is also increased retrocardiac density, probably with an elevated diaphragm, consistent with left lower lobe collapse and/or consolidation. ? small left effusion. I suspect the presence of a rib fracture at the left chest base. IMPRESSION: 1) Interval placement of Dobbhoff tube, with radiopaque tip overlying the stomach. This does not pass beyond the pylorus. 2) Bilateral pulmonary opacities, left lower lobe collapse and/or consolidation and small left effusion. The lower right chest wall and right costophrenic angle are excluded from the film. 3) Cardiomegaly, similar to prior. 4) Possible rib fracture lower left chest. Clinical correlation requested. " 1df13665-7ca39376-ec99f2aa-4d200515-ce08fd26.jpg,test/p16/p16140962/s51773991/1df13665-7ca39376-ec99f2aa-4d200515-ce08fd26.jpg,test," FINAL REPORT INDICATION: Shortness of breath and pleuritic chest pain. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without focal consolidation, pleural effusions, or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Moderate dextroscoliosis of the thoracic spine is unchanged. IMPRESSION: No acute cardiopulmonary process. " b3024633-53038fb3-9646d94e-cb39fb7a-f1cd00b1.jpg,test/p19/p19767133/s52441376/b3024633-53038fb3-9646d94e-cb39fb7a-f1cd00b1.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man with productive cough. Question infection or CHF. IMPRESSION: PA and lateral chest compared to ___. On two frontal views of the chest, the upper portion of the right heart border is partially obscured. On ___, this was clear, and is therefore concerning for pneumonia even though the findings on the lateral view are somewhat equivocal. If this is not pneumonia, it is due to chronic atelectasis or recurrent pneumonia in the right middle lobe since the right heart border was also obscured on ___. I would recommend CT scanning to evaluate the bronchial airways. Lungs are otherwise clear. Mild cardiomegaly is unchanged. There is no pleural effusion. If the patient declines CT scanning, I would repeat chest radiograph in no more than four weeks in hopes of documenting clearing of the right middle lobe. Dr. ___ was paged at 5:10 p.m. as soon as the findings were recognized and we discussed the findings by telephone 2 minutes later. " 507f9c78-c23ac400-6d6cb1e7-fec04ec3-5a877d97.jpg,test/p17/p17222468/s53214572/507f9c78-c23ac400-6d6cb1e7-fec04ec3-5a877d97.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD p/w sob and tachypnea // interval changes, consolidations interval changes, consolidations IMPRESSION: In comparison with the earlier study of this, there is again evidence of right upper lobectomy with pleural thickening at the apex and retraction of the trachea at to this side. Hyperexpansion of the lungs is again seen consistent with chronic pulmonary disease. No evidence of acute focal pneumonia or appreciable vascular congestion. " 8dd223a4-45cdc353-a267dd72-3b31fb79-cff9cefc.jpg,test/p18/p18211216/s52941795/8dd223a4-45cdc353-a267dd72-3b31fb79-cff9cefc.jpg,test," FINAL REPORT HISTORY: Cough. FINDINGS: In comparison with the study of ___, the left apical region appears to be clear. There is no evidence of acute pneumonia, vascular congestion, or pleural effusion. Of incidental note is the nephrostomy tube again seen on the left. " d579d0b7-71466ce8-46b1a09f-1e64ff35-eb702fe4.jpg,test/p15/p15131783/s55167419/d579d0b7-71466ce8-46b1a09f-1e64ff35-eb702fe4.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea and thoracic rib pain // rib fxs/pneumonia TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture seen. IMPRESSION: No acute cardiopulmonary process. No displaced fracture seen. If clinical concern for rib fracture is high, dedicated rib series or CT is more sensitive. " 971a31dc-31bced4c-d8b53630-f62a73ff-51d2ff5f.jpg,test/p11/p11805066/s52164016/971a31dc-31bced4c-d8b53630-f62a73ff-51d2ff5f.jpg,test," FINAL REPORT INDICATION: ___ year old woman with lung mass now with sudden desat // interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ at 05:17. FINDINGS: Tracheostomy tube is midline without evidence of complication. Bronchus stent is in the same orientation without dislodgement. The right chest tube is the same location. Compare to ___ at 05:17, there is increased opacification of right upper lobe causing decreased right lung volume. This is more likely due to atelectasis than pneumonia considering the acute change from this morning. There is interval increase in bilateral pleural effusion. There is persistent left lower lobe atelectasis. The cardiomediastinal silhouette is unchanged. No pneumothorax. No fractures. IMPRESSION: 1. Interval increase in right lung opacification likely from atelectasis rather than pneumonia. 2. Worsening bilateral pleural effusion and persistent left lower lobe atelectasis. 3. Monitoring and support devices are all unchanged. " 9a9f2c4d-acefcf72-b75eba78-529d80a3-5bbf5228.jpg,test/p17/p17561108/s54502932/9a9f2c4d-acefcf72-b75eba78-529d80a3-5bbf5228.jpg,test," FINAL REPORT HISTORY: ___-year-old man with lymphoma, on chemo, with pneumonitis in the past. Evaluation for resolution of infiltrates on recent x-ray. COMPARISON: Comparison is made to radiograph of the chest from ___. This study is also read in conjunction with recent CT of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate persistent biapical reticular opacities, right greater than left, with pleural thickening or effusion along the right lateral pleural surface at the level of the minor fissure. There is also persistent blunting of the right costophrenic angle. The heart is moderately enlarged, as before, with no evidence of pulmonary edema. Median sternotomy wires and aortic valve repair are stable in appearance. A right Port-A-Cath is also unchanged in position. A healed left seventh rib fracture is again seen. IMPRESSION: No significant change since the prior radiographs from ___. " 328c4898-15a54df3-c97f1134-fd048ae3-d95c0107.jpg,test/p15/p15793456/s52887977/328c4898-15a54df3-c97f1134-fd048ae3-d95c0107.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are hyperexpanded. There are bullous emphysematous changes in the lower lobes increased since ___. There is no focal consolidation, pleural effusion or pneumothorax. The ascending aorta is dilated and tortuous but unchanged since ___. The imaged upper abdomen is unremarkable. IMPRESSION: 1. Bullous emphysematous changes in the lower lobes increased since ___. Consideration to alpha-1- antitrypsin deficiency should be given. " d4223e6e-2febbe89-09ac04ce-f3df9139-4d5ab29b.jpg,test/p12/p12724735/s55050260/d4223e6e-2febbe89-09ac04ce-f3df9139-4d5ab29b.jpg,test," FINAL REPORT INDICATION: ___-year-old after renal transplant. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear, the cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: No acute cardiothoracic process. " cc71af03-eda8b019-482fa207-e517c509-08ee4da1.jpg,test/p10/p10665449/s53791955/cc71af03-eda8b019-482fa207-e517c509-08ee4da1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: s/p exlap w open abd, intubated // please perform prior to 9am. thank you. fluid status TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___. IMPRESSION: ET tube tip I 4.3 cm above the carinal. Right internal jugular line tip is at the level of lower SVC. Cardiomediastinal silhouette is unchanged. Bibasal atelectasis is unchanged. There is no pneumothorax. " 0f229624-e5445f7c-5f0d5193-1527eb9e-d25fccba.jpg,test/p15/p15276416/s58892210/0f229624-e5445f7c-5f0d5193-1527eb9e-d25fccba.jpg,test," FINAL REPORT INDICATION: Near syncope and shortness of breath. Evaluate for pneumonia or cardiomegaly. COMPARISON: Chest radiograph from ___. FINDINGS: Chest, PA and lateral. The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiograph of the chest. " 67a323f4-e6ac3d73-5565b4df-c1eaa9a8-015a9b6a.jpg,test/p14/p14578585/s54765172/67a323f4-e6ac3d73-5565b4df-c1eaa9a8-015a9b6a.jpg,test," FINAL REPORT INDICATION: Patient with leukocytosis. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. IMPRESSION: No evidence of acute cardiopulmonary process. " cfeb6e8b-facf8358-2accba3d-f86ed51f-ce71590c.jpg,test/p10/p10963896/s59875822/cfeb6e8b-facf8358-2accba3d-f86ed51f-ce71590c.jpg,test," FINAL REPORT HISTORY: History of ulcerative colitis with possible TB. FINDINGS: There is an azygous fissure, of no clinical significance. No evidence of pneumonia, vascular congestion, or pleural effusion. " c1ab3ee5-0aa2f624-4ec37e18-3b65227d-fa62480c.jpg,test/p13/p13561687/s54940451/c1ab3ee5-0aa2f624-4ec37e18-3b65227d-fa62480c.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___. CLINICAL HISTORY: Fevers, on chemotherapy, question acute intrathoracic process. FINDINGS: PA and lateral views of the chest were provided. Left basal layer opacity is noted most compatible with plate-like atelectasis. A calcified nodular structure is again noted in the right mid lung most compatible with a calcified granuloma better assessed on prior CT. The cardiomediastinal silhouette is normal. No focal consolidation concerning for pneumonia is seen. No effusion or pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No signs of pneumonia. " 129799e4-1645a30f-b7d72d4b-19e54171-da28c117.jpg,test/p15/p15704389/s50814550/129799e4-1645a30f-b7d72d4b-19e54171-da28c117.jpg,test," FINAL REPORT HISTORY: Fever. Metastatic esophageal cancer. COMPARISON: CT chest, ___, chest radiograph, ___. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: Heart size is normal. The mediastinal silhouette is unremarkable. There is increased right perihilar density with lobular lucencies which correspond to previously identified subpleural consolidation with adjacent cavitation in the posterior right lower lobe. A 2.8 cm nodular opacity in the right lower lobe appears increased in size compared to prior CT. A 7-mm nodule in the left mid lung field and another 8-mm nodule in the AP window correspond to nodules previously identified on CT. There is no focal consolidation worrisome for pneumonia. There is no pleural effusion or pneumothorax. The osseous structures are grossly unremarkable. IMPRESSION: 1. Irregular area of increased density with adjacent lucency in the right perihilar space corresponding to a previously identified cavitary metastatic lesion on prior CT. 2. A 2.8 cm right lower lobe nodule appears increased in size compared to prior CT. Left lung nodules are better characterized on recent prior CT examination. 3. No new focal consolidation worrisome for pneumonia. " f0cad27b-e9c6ea34-02ef52c0-9733eeeb-2782450a.jpg,test/p12/p12795828/s57564595/f0cad27b-e9c6ea34-02ef52c0-9733eeeb-2782450a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with heavy smoking history, chest pain // ?COPD ?COPD IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Specifically, no evidence of hyperexpansion with diaphragmatic flattening to radiographically suggest COPD. No pneumonia, vascular congestion, or pleural effusion. " 0167885a-9a5704b1-7c2a9490-2fcef7a3-bccc48ba.jpg,test/p10/p10318302/s56363845/0167885a-9a5704b1-7c2a9490-2fcef7a3-bccc48ba.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with abdominal pain and placement of the nasogastric tube. AP radiograph of the chest was reviewed. The NG tube tip is in the stomach. The pacemaker leads terminate in the right atrium, right ventricle and most likely left ventricular epicardial vein. As compared to the prior study, there is no change in the appearance of the cardiomediastinal silhouette. The bibasal linear opacities reflect areas of scarring. No appreciable pneumothorax is seen. Small amount of pleural effusion is present on the right. " a0d6ac6a-28a57023-ecdf5841-acff77a6-fd6b7109.jpg,test/p19/p19034608/s53650923/a0d6ac6a-28a57023-ecdf5841-acff77a6-fd6b7109.jpg,test," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old female with headache, dizziness and diminish right-sided proprioception and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 55bbd971-e4a06bdc-452677b7-6d590f00-9c1d151f.jpg,test/p11/p11114467/s51055943/55bbd971-e4a06bdc-452677b7-6d590f00-9c1d151f.jpg,test," FINAL REPORT HISTORY: Worsening mental status. FINDINGS: In comparison with the study of ___, there is little change in the diffuse bilateral pulmonary opacifications. No change in the retrocardiac atelectasis and moderate cardiomegaly and mild bilateral apical thickening. Pacer device remains in place. IMPRESSION: Little overall change. " 6d79b8b0-db8c5d19-e05e0aec-b74da3ce-ff2927a9.jpg,test/p17/p17653729/s51810671/6d79b8b0-db8c5d19-e05e0aec-b74da3ce-ff2927a9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure, thick secretions // Please evaluate for interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the right internal jugular vein catheter was removed. The nasogastric tube was also removed and a left pigtail catheter was inserted into the pleural space. The right pleural effusion is unchanged. No left a right pneumothorax. Moderate cardiomegaly persists. Unchanged signs of mild pulmonary edema. " 41c6cba0-5452bcc5-ff56b85d-ef1b38a3-185a2cbd.jpg,test/p18/p18718102/s57266773/41c6cba0-5452bcc5-ff56b85d-ef1b38a3-185a2cbd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis, s/p self extubation and re-intubation. // assess new ETT tube placement assess new ETT tube placement COMPARISON: Chest radiographs ___ through ___. Impression comparison chest radiographs ___ through ___. IMPRESSION: Generalized increase in radiodensity throughout the lungs is probably due to worsening pulmonary edema, since moderate cardiomegaly has increased, but could be hemorrhage associated with multiple areas of cavitating infection and septic emboli. Pulmonary hemorrhage could be playing a role Small pleural effusions are presumed. ET tube and right internal jugular line are in standard placements and a nasogastric tube passes into the stomach and out of view. No pneumothorax. " 5888a41a-f9dca303-608b44e9-10761494-daeca8dd.jpg,test/p18/p18326030/s51177735/5888a41a-f9dca303-608b44e9-10761494-daeca8dd.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of drug and alcohol abuse, admitted with acute alcoholic hepatitis, here to evaluate for pneumonia. COMPARISON: Chest radiograph, last performed on ___. FINDINGS: Frontal and lateral radiographs of the chest show a Dobbhoff feeding tube coiled within the stomach with the tip now extending upward and terminating at or above the level of the gastroesophageal junction. The Dobbhoff tube should be retracted to better position within the stomach. A small right pleural effusion is unchanged from ___. A small left pleural effusion is greater than the right and new from ___. The lungs are otherwise clear without focal consolidation or pneumothorax. The pulmonary vasculature is not engorged. The mediastinal and hilar contours are within normal limits. The cardiac silhouette is normal in size. IMPRESSION: 1. Dobbhoff feeding tube with tip at the gastroesophageal junction needs to be retracted to better position within the stomach. 2. New small left pleural effusion greater than unchanged right pleural effusion since ___. 3. No focal consolidation. " 25dad6a8-a60d0a25-c80bfab0-4c4d26a6-e4aca5d2.jpg,test/p13/p13390013/s58173524/25dad6a8-a60d0a25-c80bfab0-4c4d26a6-e4aca5d2.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with syncopal episode, altered mental status // pneumonia? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There is mild elevation of the left hemidiaphragm which may in part be positional. IMPRESSION: No acute cardiopulmonary process. " 51063391-aae01141-5dcdbe52-f2c7e6aa-de93f4d0.jpg,test/p13/p13874942/s59890637/51063391-aae01141-5dcdbe52-f2c7e6aa-de93f4d0.jpg,test," FINAL REPORT INDICATION: ___ year old man with LLL PNA // interval change EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: CT chest ___. Chest radiograph ___ FINDINGS: There is small bilateral pleural effusions, left larger than right. The opacification at the left lung base is possibly pneumonia in correct clinical setting. Compared to the prior radiograph from ___, left lung base opacification and pleural effusion is increased. There is no pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. Right-sided dialysis catheter terminates in the right atrium, unchanged in position. IMPRESSION: Mild left lower lobe opacification is increased compared to ___. This may represent progressive pneumonia in correct clinical setting. " 32736b5d-d6cc04d5-a6fbded6-af8669f8-53c76967.jpg,test/p13/p13968659/s58554519/32736b5d-d6cc04d5-a6fbded6-af8669f8-53c76967.jpg,test," FINAL REPORT HISTORY: ___-year-old male with abdominal pain. Evaluate for pneumonia. COMPARISON: Radiograph dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate clear lungs bilaterally. There has been a resection of the left 5th rib posteriorly. Two clips are identified projecting just superior to the left proximal clavicle. The cardiomediastinal silhouette appears stable when compared to prior examination dated ___. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic findings. Prior left 5th rib posterior resection. " c4bbfef6-d1871f98-3e33c378-ad74053a-c751831f.jpg,test/p14/p14150129/s56538449/c4bbfef6-d1871f98-3e33c378-ad74053a-c751831f.jpg,test," FINAL REPORT INDICATION: Evaluate dual-chamber pacemaker leads. COMPARISON: Chest radiographs on ___ and ___. FINDINGS: PA AND LATERAL VIEWS OF THE CHEST. A pacemaker is seen implanted in the left chest wall with appropriate transvenous placement ending in the right atrium and right ventricle. There is no pneumothorax, pleural effusion, or consolidation. The cardiac, mediastinal and hilar contours are normal. Sternotomy wires are seen in appropriate position. IMPRESSION: 1. Appropriate placement of dual-chamber pacemaker leads. 2. Otherwise normal radiographic examination of the chest. " 3873193d-35988cd2-99da9291-5caf7df2-4049db52.jpg,test/p18/p18866492/s59808338/3873193d-35988cd2-99da9291-5caf7df2-4049db52.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with right -sided weakness and altered mental status status post fall TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size remains mild to moderately enlarged. The mediastinal and hilar contours are unchanged. No overt pulmonary edema is demonstrated. Patchy opacities in the lung bases likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are moderate degenerative changes noted in the thoracic spine. Rounded calcifications in the region of the right glenohumeral joint may reflect loose bodies. IMPRESSION: Bibasilar atelectasis. " f0889ff8-2bf2ddc3-18b05357-9c121183-e4652089.jpg,test/p18/p18754895/s50511556/f0889ff8-2bf2ddc3-18b05357-9c121183-e4652089.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with at the gastric and right upper quadrant pain since last night. tenderness to palpation. TECHNIQUE: Portable upright AP view the chest COMPARISON: Chest radiograph ___ FINDINGS: Elevation of the right hemidiaphragm is. The cardiac mediastinal contours are limits. Pulmonary vasculature is normal. Streaky atelectasis is seen in the right lung base. No focal consolidation, pleural effusion or pneumothorax is present. No subdiaphragmatic free air is identified. There are no acute osseous abnormalities. IMPRESSION: Chronic elevation of the right hemidiaphragm with adjacent right basilar atelectasis. No acute cardiopulmonary abnormality otherwise demonstrated and no subdiaphragmatic free air is seen. " 3d33b887-23962456-fcb947ed-6d59a3b7-42ea34a3.jpg,test/p14/p14429763/s58891473/3d33b887-23962456-fcb947ed-6d59a3b7-42ea34a3.jpg,test," FINAL REPORT TWO-VIEW CHEST of ___. COMPARISON: Portable chest of ___. FINDINGS: Cardiac silhouette is mildly enlarged but stable in size. Pulmonary vascularity is normal. Improving opacity in left retrocardiac region is likely due to atelectasis. Small pleural effusions are present bilaterally. Indwelling devices are unchanged in position. IMPRESSION: Improving left basilar atelectasis. Small bilateral pleural effusions. " d833ee67-be28a5af-671e822f-a6467826-62676049.jpg,test/p12/p12734486/s51893496/d833ee67-be28a5af-671e822f-a6467826-62676049.jpg,test," FINAL REPORT EXAM: Chest, single supine AP portable view. CLINICAL INFORMATION: ___-year-old male with new left IJ line status post failed subclavian approach. COMPARISON: ___. FINDINGS: Single supine AP portable view of the chest was obtained. There is interval placement of a left internal jugular central venous catheter, terminating in the distal SVC, without evidence of pneumothorax. Lung volumes are low. Again there are bilateral pleural effusions with overlying atelectasis. Left base retrocardiac opacity may represent combination of effusion and atelectasis although underlying consolidation cannot be excluded. There is prominence of the hila suggesting pulmonary vascular engorgement. Endotracheal and nasogastric tubes remain in same stable position. IMPRESSION: Interval placement of left internal jugular central venous catheter, terminating in the distal SVC, without evidence of pneumothorax. The remainder of the examination remains unchanged. " 125c1df4-0232d043-bcfc00e1-b1a977e0-b4b2623f.jpg,test/p15/p15297941/s50348683/125c1df4-0232d043-bcfc00e1-b1a977e0-b4b2623f.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute process " 91ada81d-d3bf4b0a-bfe8bc3e-55b4fe4c-c4234060.jpg,test/p11/p11529572/s58721161/91ada81d-d3bf4b0a-bfe8bc3e-55b4fe4c-c4234060.jpg,test," FINAL REPORT HISTORY: New onset shoulder pain with deep inspiration. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 2ebfd919-6cd67a6b-4dbfc336-2760c118-2911f6d5.jpg,test/p16/p16498337/s57107877/2ebfd919-6cd67a6b-4dbfc336-2760c118-2911f6d5.jpg,test," FINAL REPORT INDICATION: Cough and fevers to 102 for two days. COMPARISON: No relevant comparisons available. FRONTAL AND LATERAL CHEST: There is no focal consolidation, pleural effusion or pneumothorax. Left basilar atelectasis is noted. Heart size is upper limits of normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: No pneumonia, edema or pleural effusion. " 64927cf0-c9f043ab-48e7a4f3-cc79cc5f-bf614a22.jpg,test/p18/p18855302/s52711132/64927cf0-c9f043ab-48e7a4f3-cc79cc5f-bf614a22.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cervical cancer, presenting with sepsis, now with worsening hypoxia. // assess for hypoxia, ?pulmonary edema assess for hypoxia, ?pulmonary edema IMPRESSION: Comparison to ___. Signs of increasing pulmonary edema present. The size of the cardiac silhouette is stable. Lung volumes have decreased. No pneumonia, no pleural effusions. Stable right internal jugular vein catheter. " 6ba1aef7-aa7e9468-eb73fb00-85306699-4e8834b2.jpg,test/p17/p17244595/s56145043/6ba1aef7-aa7e9468-eb73fb00-85306699-4e8834b2.jpg,test," FINAL REPORT AP CHEST, 8:27 P.M. HISTORY: ___-year-old man with possible cardiogenic shock. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Vascular clips denote left hilar surgery. Mediastinum is shifted entirely into the left hemithorax and the volume of aerated lung on the left is very small, smaller than I would expect if patient has had just a lower lobectomy. Although I do not know the baseline appearance of the patient's chest radiograph, I suspect there is new collapse of the postoperative left lung. Interstitial edema is seen in the hyperexpanded right lung. There is no pneumothorax. Right subclavian line ends in the brachiocephalic vein. There is no appreciable right pleural effusion, although there may be a small amount. " 4e4793d7-8b402b7c-30d24cf8-8daa2ab5-882bd6e9.jpg,test/p18/p18009748/s54477286/4e4793d7-8b402b7c-30d24cf8-8daa2ab5-882bd6e9.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Heart block. Question cardiomegaly. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The heart is at the upper limits of normal size with left ventricular predominance. Patchy left basilar opacity obscuring the left hemidiaphragm suggests minor atelectasis. Elsewhere, the lungs appear clear. There is no definite pleural effusion or pneumothorax. IMPRESSION: Mild left ventricular predominance and minor left basilar atelectasis. " 41168fd3-3b7cb894-6ae54afd-db2a7b98-2adf3bcc.jpg,test/p13/p13486482/s56812305/41168fd3-3b7cb894-6ae54afd-db2a7b98-2adf3bcc.jpg,test," WET READ: ___ ___ 10:19 PM New left basilar opacity, which is linear in configuration and likely atelectasis, though in the proper clinical setting, could be a pneumonia. No edema, pleural effusion or pneumothorax. Stable cardiomediastinal silhouette. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with multiple myeloma, admitted for tachycardia and hypotension. FINDINGS: Comparison is made to prior radiographs from ___. Heart size is within normal limits. There is some atelectasis at the lung bases, left worse than right. There are old healed fracture deformities along the right chest wall. There are no pneumothoraces. No signs for overt pulmonary edema seen. " dd1eaa1d-d60e77d1-6b06d580-8673af05-afbb59d9.jpg,test/p10/p10414523/s59172790/dd1eaa1d-d60e77d1-6b06d580-8673af05-afbb59d9.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with chest pain // Eval for infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " e6aadecf-92c7ca4d-e652d43b-c62a5c09-d0dcb0ae.jpg,test/p17/p17792822/s51331316/e6aadecf-92c7ca4d-e652d43b-c62a5c09-d0dcb0ae.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with pneumothorax after fall. Chest tube removed. IMPRESSION: PA and lateral chest compared to ___: Small right apical pneumothorax unchanged in size since earlier in the day. Small right pleural effusion slightly larger. Stable subcutaneous emphysema in the right chest wall. No change in the disposition of multiple right middle rib fractures. No pulmonary abnormality. Healed left posterior middle rib fractures are chronic. Normal cardiomediastinal silhouette. Hyperinflation of the chest, best appreciated on lateral view suggests emphysema. " 115cbf2d-3eeaf373-c192a724-c56ba45e-933904fe.jpg,test/p18/p18513797/s53532808/115cbf2d-3eeaf373-c192a724-c56ba45e-933904fe.jpg,test," FINAL REPORT INDICATION: Cough and chest pain. COMPARISONS: None. FINDINGS: The lung volumes are low. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The mediastinal contours are normal. The cardiac size is at the upper limits of normal. IMPRESSION: No acute cardiopulmonary process. " 58f6d08a-eef08da4-85391983-4b976ac9-dfe19b94.jpg,test/p10/p10481168/s53927681/58f6d08a-eef08da4-85391983-4b976ac9-dfe19b94.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with metastatic breast cancer with new cough and low grade fevers // R/O pneumonia or other abnormalities COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the appearance of the lung parenchyma is unchanged. Unchanged size of the cardiac silhouette. Unchanged position of the right Port-A-Cath. The diffuse bony metastatic lesions in all visible parts of the skeleton are minimally progressive. " 97638177-10736a1b-69586061-fbb1f842-c492c4b2.jpg,test/p13/p13060009/s51691414/97638177-10736a1b-69586061-fbb1f842-c492c4b2.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with chronic scoliosis, right-sided basilar crackles on examination, evaluate for fluid and atelectasis at the right base. FINDINGS: Patient's chest deformity and clinical condition required examination in sitting position using AP frontal and left lateral views. Comparison is made to the next preceding chest examination of ___. On frontal view, chest presentation resembles a deep left anterior oblique view, demonstrating cardiac contours that indicate mild enlargement. The thoracic aorta appears moderately widened and elongated and follows in its descending portion the markedly scoliosis-deformed thoracic spine. Lungs appear clear without pulmonary congestion and no evidence of acute infiltrates. The lateral pleural sinuses are free. Lateral view is helpful to disclose the posterior dependent area of the pleural sinuses and they appear to be clear from any pleural fluid accumulation on both sides. In comparison with the next previous portable chest examination of ___, the chest findings can be identified as stable. The previously existing marked gas-distended large and small bowel loops are less impressive now. IMPRESSION: No evidence of pleural effusions or atelectasis. Right lung base is clear. " a1f1542f-72506f27-54a47097-d5a1b489-c1f7c04a.jpg,test/p17/p17222468/s53155431/a1f1542f-72506f27-54a47097-d5a1b489-c1f7c04a.jpg,test," FINAL REPORT INDICATION: ___-year-old woman status post right upper lobectomy for lung cancer, check interval changes. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs were obtained. In comparison to the prior study, the right apical pneumothorax is appears larger with pleural air now seen at the right base, creating a new hydropneumothorax. There are no signs of tension. The left lung is clear. No left pleural effusions. The cardiomediastinal silhouette is stable. Subcutaneous emphysema is again noted on the right lateral chest wall. IMPRESSION: Progression of right-sided pneumothorax with development of new right basilar hydropneumothorax, and no evidence of tension. " 42767b67-966b40e9-c56041e6-21abd541-201d3d16.jpg,test/p19/p19343087/s57848514/42767b67-966b40e9-c56041e6-21abd541-201d3d16.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with rib pain // ? Pleural effusion COMPARISON: Prior exam performed earlier today. FINDINGS: PA and lateral views of the chest provided. Bibasilar atelectasis persists. Tiny effusions difficult to exclude. Cardiomediastinal silhouette stable. No pneumothorax. Bony structures appear intact. IMPRESSION: Bibasilar atelectasis unchanged with small bilateral pleural effusions. " c06c77ea-4087738d-ba8ecca4-80feb2eb-45203c95.jpg,test/p14/p14860633/s59139869/c06c77ea-4087738d-ba8ecca4-80feb2eb-45203c95.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough/sob/bibasilar ___/dullness // bibasilar pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. Possible opacity and filling and of the retrosternal clear space, appears more pronounced since ___ could be an anterior mediastinal mass. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No radiographic of acute intrathoracic pulmonary disease. Increasing fullness of the retrosternal clear space, could be underlying anterior mediastinal mass. Suggest correlation with CT thorax. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 16:00 into the Department of Radiology critical communications system for direct communication to the referring provider. " 16884bac-0445517e-80c6f346-cf11e266-83e51988.jpg,test/p18/p18705722/s59020770/16884bac-0445517e-80c6f346-cf11e266-83e51988.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with asthma, worsening cough, fever. Evaluate for pneumonia or pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: Marked cardiomegaly is persistent and unchanged. No new focal consolidation, pleural effusion, or pneumothorax. No evidence of pulmonary edema. Patient is post median sternotomy with intact wires. IMPRESSION: No focal consolidation concerning for pneumonia or evidence of pulmonary edema. " f887000c-fa9e5f5b-bb3619e5-20cbb817-296564df.jpg,test/p16/p16948401/s50218613/f887000c-fa9e5f5b-bb3619e5-20cbb817-296564df.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___-year-old woman with cough, here to evaluate for pneumonia. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: None. FINDINGS: The lungs appear hyperinflated. There is no focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. There is mild tortuosity of the descending thoracic aorta. No acute osseous abnormality is detected. IMPRESSION: No focal consolidation concerning for pneumonia. " b88b29c7-521a0f21-f88c6327-d76127cf-11c23fc2.jpg,test/p15/p15684838/s56473354/b88b29c7-521a0f21-f88c6327-d76127cf-11c23fc2.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with altered mental status who is intubated. TECHNIQUE: Portable AP semiupright radiograph view of the chest. COMPARISON: No prior relevant imaging is available on PACS at the time of this dictation. FINDINGS: The ETT tip terminates approximately 3 cm from the carina, in standard position. Lung volumes are slightly low. Bilateral ill-defined as well as confluent air space opacities can be seen with infection or heart failure. Retrocardiac opacity with silhouetting of the left hemidiaphragm may represent a combination of effusion and/or atelectasis. The heart size is difficult to assess on this portable exam and since the left heart border is obscured. The central pulmonary vessels appear engorged. No pneumothorax. No acute osseous abnormality. IMPRESSION: 1. ETT in standard position. 2. Multifocal pneumonia and/or heart failure, multifocal pneumonia is most likely given the history of leukocytosis. " f468fcee-f65a6551-c0f7b5c1-b958c3b5-e6c52267.jpg,test/p17/p17794482/s55920406/f468fcee-f65a6551-c0f7b5c1-b958c3b5-e6c52267.jpg,test," FINAL REPORT INDICATION: ___M with R calf tenderness/swelling, also mild SOB // CXR: eval for infiltratesLENI RLE: EVal for DVT TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Right chest wall port is seen with catheter tip at the RA SVC junction. The lungs are clear. There is no focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 2aa16a6d-52e1c627-10155e93-1dfe863c-54177603.jpg,test/p12/p12940106/s57582035/2aa16a6d-52e1c627-10155e93-1dfe863c-54177603.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p new L CVL, and OGT advancement // pls eval for ptx pls eval for ptx IMPRESSION: In comparison with the earlier study of this date, there has been placement of a left subclavian catheter with its tip in the lower portion of the SVC. The nasogastric tube again coils within the hiatal hernia. Endotracheal tube remains in good position. Little " bf365dbb-6fb831ec-98eb5cfe-9ac96a6e-12ba3c22.jpg,test/p12/p12784119/s50370229/bf365dbb-6fb831ec-98eb5cfe-9ac96a6e-12ba3c22.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with picc. R power picc 44cm. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, and CT chest from ___. FINDINGS: There has been interval improvement in the right upper lobe opacity and right pleural effusion. There is little change in the left pleural effusion. The left pigtail catheter has been removed. Interval placement of a right PICC line demonstrates its tip at the cavoatrial junction. There is no pneumothorax. IMPRESSION: 1. Right PICC line tip is at the cavoatrial junction. 2. Interval improvement of right upper lobe opacity and right pleural effusion, with interval removal of the left pigtail catheter. " 6d8aa462-2852b5ad-2c85081f-06aeae3f-30c94471.jpg,test/p16/p16087436/s50032755/6d8aa462-2852b5ad-2c85081f-06aeae3f-30c94471.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Respiratory failure. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained the same day two hours prior to the intubation. ET tube tip is 6 cm above the carina. Heart size and mediastinum are grossly unremarkable. There is still present left retrocardiac opacity with improvement of the overall lung aeration and interval improvement of vascular congestion. " 0c83109c-94b44883-97b99d29-f2641bd2-ec3bc9b4.jpg,test/p19/p19391089/s59537796/0c83109c-94b44883-97b99d29-f2641bd2-ec3bc9b4.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___, ___, ___ CLINICAL HISTORY: Metastatic renal cell carcinoma, with history of fall, prior portable chest not fully diagnostic. FINDINGS: PA and lateral views of the chest were obtained. Since the prior exams, there is significant interval increase in the ill-defined opacity involving the majority of right hemithorax which is concerning for disease progression. The possibility of a superimposed contusion given the history of trauma is impossible to exclude. There may be a trace right pleural effusion. There is subtle opacity at the left lung base which is new though most likely represents metastatic disease. In addition a small area of nodularity in the left upper lung is most compatible with metastatic disease. Cardiomediastinal silhouette appears stable. Bony structures appear grossly intact. No definite displaced rib fractures are identified. IMPRESSION: Findings concerning for worsening metastatic disease in the chest. " 35700668-a3375766-a1ca2ed7-ffd76209-02d26d41.jpg,test/p14/p14377197/s54378232/35700668-a3375766-a1ca2ed7-ffd76209-02d26d41.jpg,test," FINAL REPORT HISTORY: Chest pain. Question cardiopulmonary process. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " b1dc4602-5af67754-2dfbd932-c3613b70-2fa52257.jpg,test/p14/p14775533/s52685411/b1dc4602-5af67754-2dfbd932-c3613b70-2fa52257.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with aortic dissection // s/p ct d/c s/p ct d/c IMPRESSION: In comparison with the earlier study of this date, the left chest tube is been removed. No evidence of pneumothorax. Otherwise little change. " cbef3b30-5019d70b-2820a15f-e6eb1467-6381ae2a.jpg,test/p19/p19667420/s58673365/cbef3b30-5019d70b-2820a15f-e6eb1467-6381ae2a.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY COMPARISON: ___ chest x-ray. FINDINGS: Indwelling support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable in appearance. Bilateral small-to-moderate layering pleural effusions are present, with adjacent basilar lung opacities, which probably reflect atelectasis. Allowing for positional differences, this is not appreciably changed. Left anterior rib fractures are again visualized, and have been more fully characterized on recent CT of ___. " 6b12e646-dcc82426-af646c23-4b232f6d-f02d94f0.jpg,test/p17/p17261065/s56632867/6b12e646-dcc82426-af646c23-4b232f6d-f02d94f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with decompensated sCHF, swan in place, on nipride, LVAD/transplant eval pending // eval for interval change in swan, pulm edema TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 5b5a00e5-7e183a94-83726d1a-14214244-f5da7372.jpg,test/p15/p15797232/s55598493/5b5a00e5-7e183a94-83726d1a-14214244-f5da7372.jpg,test," FINAL REPORT HISTORY: Pneumonia. FINDINGS: In comparison with the study of ___, there are lower lung volumes. Bibasilar atelectatic changes persist. There is some prominence of central vessels, raising the possibility of some elevated pulmonary venous pressure. The tip of the endotracheal tube again measures only about 1.5 cm above the carina. Other monitoring and support devices are unchanged. " 18386f55-8c94168d-caaa40fc-56a8f3e1-1eddb21a.jpg,test/p11/p11708364/s50543207/18386f55-8c94168d-caaa40fc-56a8f3e1-1eddb21a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD (on 2L home O2) as well as HTN/HLD/DM-II/gout/hypothyroidism with history of multiple surgical procedures to the abdomen, complicated by SBOs and ventral hernia s/p repair with mesh, with prior hospitalizations for SBO and C.diff colitis who presents with a recurrence of nausea, vomiting, abdominal pain, c/w obstruction. // Please assess for position of NGT, thanks! IMPRESSION: As compared to ___ chest radiograph, mild cardiomegaly is stable. Pulmonary vascular congestion is accompanied by mild interstitial edema and small bilateral pleural effusions. Tip of nasogastric tube terminates in the stomach. " d0e780e5-ec818554-36ae0765-d796d551-2e15f861.jpg,test/p14/p14371035/s58087451/d0e780e5-ec818554-36ae0765-d796d551-2e15f861.jpg,test," FINAL REPORT COMPARISON: ___. FINDINGS: Support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable. A bilateral asymmetrically distributed airspace process has slightly worsened in the interval, with more confluent opacification noted in the right upper lobe and left juxtahilar region. These findings could be due to multifocal infection, asymmetrical edema or clinically suspected ARDS. Small bilateral pleural effusions are also demonstrated. " 69d22bc7-81d9cb01-52f26325-c1efe09d-0fccf092.jpg,test/p17/p17527219/s56201474/69d22bc7-81d9cb01-52f26325-c1efe09d-0fccf092.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HF admitted for tailored HF therapy with swan ganz in place // admitted for HF tailored therapy with swan ganz in place. monitor placement of swan ___ admitted for HF tailored therapy with swan ganz in place. monitor placement of swan ganz IMPRESSION: Comparison to ___. No relevant change. The Swan-Ganz catheter is in stable position. Moderate cardiomegaly. No pleural effusions. No pneumonia, no pulmonary edema. No pneumothorax. " 57c34086-ab27960f-f94d695e-0f1e2b4f-40a356e1.jpg,test/p14/p14642407/s51291430/57c34086-ab27960f-f94d695e-0f1e2b4f-40a356e1.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of diabetes, presenting with bilateral foot pain, elevated lactate on labs. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Loss of height of a lower thoracic vertebral body is stable since the prior study. IMPRESSION: No acute cardiopulmonary process. " db376718-2e7fb152-52a4be77-80d7b1b4-2a9e90e5.jpg,test/p11/p11938332/s51065532/db376718-2e7fb152-52a4be77-80d7b1b4-2a9e90e5.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Fever and chemotherapy. TECHNIQUE: Chest, PA and lateral. COMPARISON: PET-CT from ___. FINDINGS: The heart is normal in size. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 09a6aff4-5caa5b81-134c6b1b-64030838-6fc8dade.jpg,test/p14/p14906095/s50452325/09a6aff4-5caa5b81-134c6b1b-64030838-6fc8dade.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Left hip fracture, pre-op planning. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Mild prominence of the interstitial markings is grossly stable as compared to the prior study, which may be due to chronic underlying lung disease. Minimal left basilar atelectasis/scarring is seen. There is no definite focal consolidation. No pleural effusion or pneumothorax is seen. IMPRESSION: No significant interval change. " 57dc6f0b-ca016eac-2d0bbc28-b9f2cca2-439f0353.jpg,test/p11/p11911807/s52889514/57dc6f0b-ca016eac-2d0bbc28-b9f2cca2-439f0353.jpg,test," FINAL REPORT AP CHEST, 5:09 A.M., ___ HISTORY: Spine surgery. Suspect pneumonia. IMPRESSION: AP chest compared to ___ through ___: The patient has been recently extubated, and mild pulmonary edema has improved. Heart size top normal. Mediastinal veins not engorged. No pneumothorax. Pleural effusion is small if any. Left pleural tube has been withdrawn from the apex to the level of the aortic arch. Right jugular line ends low in the SVC. " b60cf83e-aca4aed5-36741207-e5d3d87b-10a8155e.jpg,test/p19/p19245176/s56550918/b60cf83e-aca4aed5-36741207-e5d3d87b-10a8155e.jpg,test," FINAL REPORT INDICATION: ___ year old man with rib fxs // rib fxs Surg: ___ (tib/fib) TECHNIQUE: Chest PA and lateral COMPARISON: Outside hospital CT torso ___ FINDINGS: Multiple right rib fractures are identified as seen on prior CT. Small pneumothorax seen on prior CT is not appreciated on this study. No consolidation or pleural effusion is identified. Cardiomediastinal and hilar silhouette are normal size. IMPRESSION: No acute cardiopulmonary process. Multiple right rib fractures. " 795193df-dd0256de-ab4b14e3-786e859c-f441be8d.jpg,test/p15/p15558620/s57196621/795193df-dd0256de-ab4b14e3-786e859c-f441be8d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with PNA, atrius pt. SOB // PNA worsening TECHNIQUE: Single frontal view of the chest COMPARISON: No prior chest radiographs available for comparison. Reference made to chest CT from ___ FINDINGS: There is a known large hiatal hernia. The cardiac silhouette is somewhat enlarged. The aorta is calcified. Left base opacity likely relates to consolidation seen on preceding CT. No large pleural effusion is seen. Bilateral ground-glass opacity may be infection versus pulmonary edema. IMPRESSION: Large left base opacity worrisome for pneumonia. Diffuse ground-glass opacity projecting over the lung fields may be due to infection versus pulmonary edema. Known large hiatal hernia. " 6838026c-61b0d906-bac34985-25e57d65-7c9ad3a7.jpg,test/p19/p19262736/s56832281/6838026c-61b0d906-bac34985-25e57d65-7c9ad3a7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia // any interval change? any interval change? IMPRESSION: In comparison with the study of ___, the monitoring and support devices are stable. Cardiac silhouette remains within normal limits. The pulmonary vessels are not as clearly seen, suggesting some possible mild elevation of pulmonary venous pressure. Increased opacification at the right base is consistent with atelectatic changes. There is some coalescent opacification in the left infrahilar region and left base, which was not appreciated on the previous study, consistent with developing aspiration pneumonia. NOTIFICATION: Dr. ___ " 30645fd9-037c80ed-3de3d64a-9a1e08f3-30f853ed.jpg,test/p19/p19147595/s57644633/30645fd9-037c80ed-3de3d64a-9a1e08f3-30f853ed.jpg,test," FINAL REPORT HISTORY: Diastolic dysfunction, now with shortness of breath. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: As compared to the prior examination, there has been no significant interval change. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. Stable, mild cardiomegaly is noted. The aorta is slightly tortuous. Mediastinal and hilar contours are otherwise stable. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. Stable, mild cardiomegaly. " a681f768-b779d6a0-6abe605b-e30e9ef0-4e8a92eb.jpg,test/p11/p11291823/s56370527/a681f768-b779d6a0-6abe605b-e30e9ef0-4e8a92eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxemic respiratory failure, right lower lobe atelectasis, intubated. // Evaluate for interval change. Evaluate for interval change. IMPRESSION: In comparison with the study ___ ___, there is little change in the appearance of the monitoring and support devices. Continued substantial enlargement of the cardiac silhouette with relatively mild elevation of pulmonary venous pressure. Opacification at the right base silhouettes the hemidiaphragm and is consistent with collapse of the right middle and lower lobes. " dbd2dc82-f190d303-c3f383e7-1cc04cc2-fae89774.jpg,test/p12/p12069130/s51744541/dbd2dc82-f190d303-c3f383e7-1cc04cc2-fae89774.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with a port // check for placement TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiograph of ___. FINDINGS: There is a right chest wall port with its tip terminating in the mid SVC. There is no pleural effusion, focal consolidation, or pulmonary vascular congestion. IMPRESSION: 1. Right chest wall port with tip in the mid SVC. 2. No evidence of acute pulmonary process. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___, RN on the telephone on ___ at 3:19 PM, 20 minutes after discovery of the findings. " 53be87ca-af2d1b74-17309034-db7de38e-19c5d746.jpg,test/p11/p11804719/s52174672/53be87ca-af2d1b74-17309034-db7de38e-19c5d746.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM ON ___ AT 9:47 CLINICAL INDICATION: ___-year-old with alcohol withdrawal. Evaluate nasogastric tube placement. COMPARISON STUDIES: Please note that comparison to old films can be helpful to detect subtle interval change. A portable semi-erect chest film on ___ at 9:47 is submitted. IMPRESSION: There is a nasogastric tube seen coursing below the diaphragm with the tip not identified but likely within the stomach. Overall, cardiac and mediastinal contours are likely within normal limits given patient rotation and portable technique. Streaky opacities at the right base may reflect patchy atelectasis, although aspiration or pneumonia should also be considered. No evidence of pulmonary edema. Stable underlying emphysema as there is a suggestion of cystic changes in both apices. No pneumothorax. No large effusions. " 70bfd2d6-f75afd05-c36a9a45-af2dd9e0-e56ae93e.jpg,test/p12/p12238407/s54211949/70bfd2d6-f75afd05-c36a9a45-af2dd9e0-e56ae93e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute liver and renal failure with new fever and increased vent requirements // eval for PNA COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the endotracheal tube, nasogastric tube and right PICC line are in unchanged position. There is a minimal increase in severity and extent of the right basal opacity in the lung parenchyma, whereas the left-sided opacity is constant in appearance. No larger pleural effusions. No pulmonary edema. " c6e02d34-165f23fe-7a587498-2e3201dc-1c046f79.jpg,test/p18/p18865198/s57736779/c6e02d34-165f23fe-7a587498-2e3201dc-1c046f79.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILMS, ___ AT 12:28 CLINICAL INDICATION: ___-year-old status post chest tube removal, question pneumothorax, status post VATS decortication. Comparison is made to the patient's prior study of ___ at 10:01. PA and lateral views of the chest are submitted, ___ at 12:28. IMPRESSION: Interval removal of two right-sided chest tubes. There is now seen a curvilinear line along the lateral mid hemithorax which suggests the presence of a loculated pneumothorax. No pleural line is visible at the apex. There is minimal amount of subcutaneous emphysema in the right chest wall soft tissues. In addition, there is a layering right-sided pleural effusion with some loculated fluid likely within the minor fissure. Left lung is well inflated and grossly clear. There is patchy right basilar opacity most likely representing compressive atelectasis. Overall cardiac and mediastinal contours are likely stable. Followup imaging would be advised to assess for interval change. No evidence of pulmonary edema. Results of this examination were conveyed by phone to ___, the patient's nurse, on ___ at 12:39 p.m. " 6a4d69df-60ef0c34-17358d57-4d7c3436-966fd709.jpg,test/p18/p18116283/s52395310/6a4d69df-60ef0c34-17358d57-4d7c3436-966fd709.jpg,test," FINAL REPORT INDICATION: ___-year-old with dyspnea on exertion and wheezing. Assess for pneumonia. COMPARISONS: ___. TECHNIQUE: Two views of the chest. FINDINGS: The lungs are somewhat low in volume but appear clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal silhouette. IMPRESSION: No acute intrathoracic process. " f6bbfdc5-c32f47ea-2cc86aaa-09ccf408-7170c3b4.jpg,test/p13/p13505226/s51735028/f6bbfdc5-c32f47ea-2cc86aaa-09ccf408-7170c3b4.jpg,test," WET READ: ___ ___ ___ 11:29 PM No acute cardiopulmonary process. Minimally increased opacity at the right hilum is likely projectional. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, productive, low grade fevers // pneumonia? pneumonia? IMPRESSION: Comparison to ___. No relevant change. Low lung volumes. Linear atelectasis at the left lung bases. Minimal enlargement of the right hilus, unchanged to the previous examination. No pneumonia, no pulmonary edema, no pleural effusions. " 6f7b9bc6-5bf765e4-b9856e30-f64ba4c9-a68c6bf3.jpg,test/p12/p12759187/s58626558/6f7b9bc6-5bf765e4-b9856e30-f64ba4c9-a68c6bf3.jpg,test," FINAL REPORT HISTORY: Leukocytosis and dyspnea, to assess for pneumonia. FINDINGS: In comparison with the study of ___, the patient has taken a somewhat better inspiration. There is continued enlargement of the cardiac silhouette without vascular congestion or acute pneumonia. Streaks of atelectasis are seen at the right base. There is substantial wedging of a mid to lower thoracic vertebra that was not well appreciated on the study of ___. " c035deab-a24b48fa-86c4b9df-183365a7-c646915a.jpg,test/p15/p15509023/s50122748/c035deab-a24b48fa-86c4b9df-183365a7-c646915a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with cough, chills blood tinged sputum. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are low. The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " 14134f8b-65758b7a-26431aa4-ddec37a7-a3b4c56c.jpg,test/p14/p14205430/s56509726/14134f8b-65758b7a-26431aa4-ddec37a7-a3b4c56c.jpg,test," FINAL REPORT INDICATION: ___-year-old male with metastatic breast cancer, now with neutropenic fever and pneumonia saturating to the 80s. Evaluate for evidence of fluid overload versus worsening pneumonia. COMPARISON: Chest CT on ___ and chest radiograph on ___. TECHNIQUE: Upright portable chest radiograph. FINDINGS: The lungs are well expanded. Diffuse bilateral alveolar opacities in a perihilar distribution are noted, right worse than left. No discrete focal opacities are observed. The heart and pericardium are unremarkable otherwise. Multiple dense nodularities in the mediastinum correspond to known calcified nodal masses. The aortic knob is heavily calcified. Bibasilar atelectasis is seen. There is no pneumothorax. The pleural sulci are not opacified bilaterally, but the patient is known to have small bilteral pleural effusions from prior CT. IMPRESSION Pulmonary edema not significantly changed compared with prior CT performed approximately 24 hours prior to this exam. No new discrete focal opacities concerning for overlapping inflammatory process. " c1d5ba6f-6b2bd968-932ab0bc-29103dc2-d80ba6df.jpg,test/p17/p17652927/s54375114/c1d5ba6f-6b2bd968-932ab0bc-29103dc2-d80ba6df.jpg,test," FINAL REPORT HISTORY: ___-year-old male with history of cardiomyopathy and heart failure, now presenting with cough and shortness of breath. COMPARISON: Chest radiograph from ___ and CT chest from ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: The lungs are clear. There is no focal consolidation or pneumothorax. There is no vascular congestion or pleural effusions. Mediastinal and hilar contours are within normal limits. Moderately severe cardiomegaly is unchanged compared to prior examination. An AICD generator overlies the left chest wall. The lead appears intact, terminating in the expected location of the right ventricle. IMPRESSION: Moderate-to-severe cardiomegaly consistent with history of known cardiomyopathy. No pulmonary edema, pleural effusion, or focal consolidation to suggest pneumonia. " 35965322-025cf2c1-098b8ce6-553afd04-b642330b.jpg,test/p16/p16566006/s51552881/35965322-025cf2c1-098b8ce6-553afd04-b642330b.jpg,test," WET READ: ___ ___ ___ 9:37 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Dizziness, difficulty swallowing, possibly aspiration. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Status post sternotomy. Borderline size of the cardiac silhouette without pulmonary edema. Known minimal blunting of the left costophrenic sinus, likely caused by a small pleural scar. Moderate tortuosity of the thoracic aorta. No pulmonary edema. No pneumonia. No pneumothorax. " be28beaa-60d08792-7852a78c-fd4200bd-06c9e216.jpg,test/p15/p15167597/s57392725/be28beaa-60d08792-7852a78c-fd4200bd-06c9e216.jpg,test," FINAL REPORT INDICATION: ___-year-old male patient with new ___ and NG tube. Study requested for confirmation of position. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: Portable semi-erect AP chest radiograph. FINDINGS: An ___ tube terminates 5 cm above the carina. An NG tube tip terminates in the gastric fundus. As compared to prior chest radiograph, lung volumes have decreased. There is bibasilar atelectasis and interval increase of pulmonary congestion. Sternotomy wires and surgical hardware are intact. IMPRESSION: 1. ___ tube terminates 5 cm above the carina, NG tube terminates in the gastric fundus. 2. Interval increase of pulmonary congestion and bibasilar atelectasis. " a5be0b26-6b3fdabc-1fe9ca22-de003084-2b08abba.jpg,test/p11/p11117684/s55146260/a5be0b26-6b3fdabc-1fe9ca22-de003084-2b08abba.jpg,test," WET READ: ___ ___ ___ 9:21 PM Left pleural effusion. No pneumothorax. Postoperative appearance of the mediastinum. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG. PA and lateral upright chest radiographs were reviewed in comparison to ___. Left pleural effusion is moderate, unchanged. Heart size and mediastinum are grossly stable. Post-sternotomy wires are unremarkable. No pneumothorax or pneumopericardium is demonstrated. " 03f1cf9d-5db3b233-1ba912bc-5c99cd21-f9e37ec5.jpg,test/p12/p12385889/s58660162/03f1cf9d-5db3b233-1ba912bc-5c99cd21-f9e37ec5.jpg,test," FINAL REPORT INDICATION: ___-year-old female with acute lymphocytic leukemia with non functioning Port-A-Cath, evaluate Port-A-Cath. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___ and single fluoroscopic intraoperative image of port placement dated ___. FINDINGS: The accessed right pectoral subclavian approach Port-A-Cath catheter tip terminates in the distal SVC. The line appears intact. There is no sharp angulation to explain port malfunction. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is normal. IMPRESSION: Normal appearance of the right subclavian Port-A-Cath. Consider port study to exclude fibrin sheath. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 2:00 PM, 17 minutes after discovery of the findings. " 23dd3fdc-7932ada1-dee4585b-e921d717-c3a36984.jpg,test/p12/p12196030/s55040757/23dd3fdc-7932ada1-dee4585b-e921d717-c3a36984.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETT and OGT // Evaluate position COMPARISON: Chest radiograph from ___. FINDINGS: AP portable upright view of the chest. An endotracheal tube terminates 3.9 cm above the carina. An orogastric tube terminates within the stomach. The lung volumes are low. Again seen are widespread bilateral pulmonary opacities, with central vascular engorgement, overall worsened since the ___ examination at 17:11. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Appropriately positioned endotracheal tube and orogastric tube. 2. Worsening widespread pulmonary opacities since the 17:11 study. " 610e8078-4c3ca0b9-2395eb51-f05e400e-73c8aa5a.jpg,test/p17/p17207977/s58110513/610e8078-4c3ca0b9-2395eb51-f05e400e-73c8aa5a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with continued hypoglycemia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 3f3cd0fc-2c82aed4-7dd4580f-c1f29341-dd8d763f.jpg,test/p17/p17212600/s57479625/3f3cd0fc-2c82aed4-7dd4580f-c1f29341-dd8d763f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 8 days of cough, worse over the past few days,? fevers, + sweats and chills. Pain in right chest with deep breath. Lung exam with diffuse wheezing and rhonchi, crackles over RML. PLEASE CALL WET READ TO ___ ___ ___ // r/o PNA FINDINGS: As compared to ___ radiograph, a new subtle opacity in the right middle lobe has developed. Lungs are otherwise clear, and cardiomediastinal contours are normal. IMPRESSION: Subtle right middle lobe opacity, concerning for an early focus of pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:07 PM, 10 minutes after discovery of the findings. " 465de8c1-264d27c8-43e9fb79-f093f40e-97a81001.jpg,test/p10/p10427568/s53610905/465de8c1-264d27c8-43e9fb79-f093f40e-97a81001.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // ?cardiomegaly, pleural effusion, pna TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None. FINDINGS: Lung volumes are low. There is no focal consolidation, effusion, or pneumothorax. There is no central vascular congestion or overt pulmonary edema. Mediastinal and hilar contours are normal. Heart size is normal. IMPRESSION: No acute intrathoracic process. " 36482162-a7e1126d-e738bf92-7d0c9675-61c2de0e.jpg,test/p16/p16627318/s58132825/36482162-a7e1126d-e738bf92-7d0c9675-61c2de0e.jpg,test," FINAL REPORT HISTORY: Elevated white count one week after liver transplantation. FINDINGS: In comparison with study of ___, the right IJ catheter has been removed. There are lower lung volumes. The right hemidiaphragm is not sharply seen, suggesting substantial volume loss in the lower and possible middle lobe with blunting of the costophrenic angles bilaterally. No evidence of pulmonary vascular congestion. " f16df012-7b0f9d0b-f5808bb7-b540f1d7-a70fdb33.jpg,test/p19/p19229277/s53992488/f16df012-7b0f9d0b-f5808bb7-b540f1d7-a70fdb33.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Fevers. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is a new parenchymal opacity at the bases of the left lower lung. The opacity extends to the retrocardiac lung regions. In the appropriate clinical setting, pneumonia is likely. Right basal atelectasis. No pleural effusions. At the time of dictation and observation, the referring physician ___. ___ was paged for notification, 13:25, on the ___. " 5c9c9ab5-cad06f2e-df5fa771-ca2f0701-93373854.jpg,test/p14/p14993494/s58285735/5c9c9ab5-cad06f2e-df5fa771-ca2f0701-93373854.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with overall pain, rheumatoid flare. COMPARISON: Prior exam from ___ and CT chest from ___. FINDINGS: PA and lateral views of the chest provided. Patient with known interstitial lung disease. Allowing for slight differences in technique, there has been no significant interval change in extensive interstitial reticular opacity compatible with known ILD. No convincing evidence of a superimposed pneumonia, effusion or pneumothorax. Overall cardiomediastinal silhouette is stable. Bony structures appear intact. IMPRESSION: Extensive interstitial opacity consistent with interstitial lung disease. " f748581c-1a6b2b31-729ab9d8-5e30f85e-daa4b09f.jpg,test/p16/p16936659/s56071490/f748581c-1a6b2b31-729ab9d8-5e30f85e-daa4b09f.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Shortness of breath. COMPARISON: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. There is a vague left lower lobe opacity although visible in both views. Elsewhere the lungs appear clear. IMPRESSION: Opacity in the left lower lobe suggestive of pneumonia in the appropriate setting. " 18067347-22136f94-3ecde35a-511421ad-e95f6ab5.jpg,test/p14/p14182884/s51040943/18067347-22136f94-3ecde35a-511421ad-e95f6ab5.jpg,test," FINAL REPORT INDICATION: Cough. Evaluate for infiltrate. COMPARISONS: None. FINDINGS: The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. S-shaped scoliosis of the thoracolumbar spine is noted. IMPRESSION: No acute cardiac or pulmonary process. " cf28de18-f5bc149d-aae49d94-2e337e91-72cc4168.jpg,test/p14/p14258645/s53530618/cf28de18-f5bc149d-aae49d94-2e337e91-72cc4168.jpg,test," FINAL REPORT AP CHEST, 8:40 A.M. ON ___ HISTORY: Basal pneumothorax after thoracentesis. IMPRESSION: AP chest compared to three radiographs on ___: If there is left pneumothorax, it is quite small. I do not see enough of change in the relationship of extensive left pleural calcifications with left chest wall to diagnose pneumothorax. Lungs are obscured by pleural calcification. Cardiomegaly is mild. If there is need to exclude pneumothorax with greater certainty, I would suggest either a right decubitus chest radiograph including the left chest wall, or CT scanning. " 7ee62727-a956714b-87153e15-fae4420d-bc9db851.jpg,test/p15/p15938425/s57867315/7ee62727-a956714b-87153e15-fae4420d-bc9db851.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o A Fib on Xarelto, CHF presenting with SOB. // Pulmonary edema? Pulmonary edema? IMPRESSION: Compared to chest radiographs since ___, most recently ___. Moderate cardiomegaly is stable, but pulmonary vascular congestion has decreased. There is no pulmonary edema or appreciable pleural effusion. Lungs are clear. Sternal wires are intact and aligned. " 568ba8fa-dadf0845-ec6c37a4-808f4dae-5e7e1a02.jpg,test/p12/p12420056/s52387484/568ba8fa-dadf0845-ec6c37a4-808f4dae-5e7e1a02.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough x 1 week // r/o acute process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Stable elevation of the right hemidiaphragm noted though there is slight increase in bibasilar atelectasis. No overt signs of pneumonia, edema, effusion or pneumothorax. Cardiomediastinal silhouette appears grossly unchanged though the right heart border is stably effaced due to right hemidiaphragmatic elevation. Bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: Elevator right hemidiaphragm unchanged with bibasilar atelectasis and no convincing evidence for pneumonia. " e6d04753-006119b0-b43a6d2c-3f06d2c1-d8420338.jpg,test/p11/p11658675/s51888479/e6d04753-006119b0-b43a6d2c-3f06d2c1-d8420338.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recurrent aspiration pneumonias, and recent increase in sputum and also more hypoxemia // assess for pneumonic infiltrates or chf COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing bilateral parenchymal opacities, likely caused by recurrent aspiration pneumonias, are minimally more extensive. The true extent of the changes is better appreciated on the lateral than on the frontal radiograph, where the additional fibrotic component of the changes is better appreciated. No pleural effusions. Mild cardiomegaly without pulmonary edema. No pneumothorax. " 85a108aa-b6a36687-3aaf4f15-edab74cd-0ca0726e.jpg,test/p11/p11521301/s59284826/85a108aa-b6a36687-3aaf4f15-edab74cd-0ca0726e.jpg,test," FINAL REPORT HISTORY: A ___-year-old male with chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Hilar contours are within normal limits. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " d85a4631-d9a5427a-23630de6-0cd53a8b-7ff04ad9.jpg,test/p14/p14497007/s59324698/d85a4631-d9a5427a-23630de6-0cd53a8b-7ff04ad9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multiple myeloma with a fever to 101.5 and no localizing symptoms // ?PNA or other acute process TECHNIQUE: CHEST SINGLE VIEW COMPARISON: ___ FINDINGS: Spinal hardware in place, stable. Right Port-A-Cath in place tip low SVC, similar. Small left pleural effusion, more prominent. There is minimal left basilar atelectasis. Indeterminate nodular opacity right lower lung medially, stable, better seen on CT abdomen pelvis ___. There is minimal right basilar atelectasis, similar. Heart size, pulmonary vascularity within normal limits, improved. IMPRESSION: Small left pleural effusion, minimal bibasilar atelectasis. Indeterminate rounded opacity right lung base medially, similar. " 4380a6b9-3e19052a-4ecfcefe-9fe4d613-bbaaec64.jpg,test/p11/p11798125/s59279578/4380a6b9-3e19052a-4ecfcefe-9fe4d613-bbaaec64.jpg,test," FINAL REPORT HISTORY: ___-year-old male with intra-aortic balloon pump and dropping hematocrit. Assess for fluid collection. COMPARISON: Chest radiographs dating back to ___; most recent from ___. SUPINE PORTABLE CHEST RADIOGRAPH: An endotracheal tube is in appropriate position, terminating 2.1 cm from the carina. However, a right Swan Ganz catheter tip is malpositioned, located too far within the right lung periphery. Proximal repositioning by at least 4-5 cm is recommended. An intraaortic balloon pump is a little high and could be pulled back ~2 cm. An enteric catheter courses below the diaphragm, although the tip is incompletely imaged. There is complete left lower lobe collapse with an associated moderate left effusion. A small right pleural effusion is unchanged. There is mild pulmonary vascular congestion, though no overt interstitial edema. Enlargement of cardiomediastinal and hilar contours appears similar to prior examination. No pneumothorax is evident. IMPRESSION: 1. Malpositioned Swan-Ganz catheter. Proximal repositioning by 4-5 cm is recommended. 2. Intra-aortic balloon pump may be a little a high and could be pulled back ~2 cm. 3. Unchanged complete left lower lobe collapse with slightly increased left effusion, now moderate. 4. Unchanged small right pleural effusion. Dr. ___ communicated the above results (#1) to ___ (APN for cardiothoracic surgery), at 11:02 a.m. on ___ by telephone, three minutes after discovery. " 74aaf955-0393e4d5-ea3303c2-a78092c9-5d1e6a22.jpg,test/p17/p17285723/s56007048/74aaf955-0393e4d5-ea3303c2-a78092c9-5d1e6a22.jpg,test," WET READ: ___ ___ ___ 8:52 AM Similar appearance of increased opacity projecting over the lower thoracic spine on lateral view. Given lack of progression since the prior radiograph, these likely represent chronic interstitial changes. WET READ VERSION #1 ___ ___ ___ 10:00 PM Similar appearance of increased opacity projecting over the lower thoracic spine on lateral view. Given lack of progression since the prior radiograph, these likely represent chronic interstitial changes. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, SOB. // evaluate for consolidation COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The bilateral parenchymal opacities, projecting over the spine on the lateral chest x-ray, are constant in appearance. The lack of change since the previous examination suggests the presence of either an infectious or a fibrotic change. Unchanged severe scoliosis. Moderate cardiomegaly without pulmonary edema. No pleural effusion. The fixation devices on the spine are constant. " 86b81516-4cd4ceae-48592be3-5023a276-394f22da.jpg,test/p15/p15301390/s54408946/86b81516-4cd4ceae-48592be3-5023a276-394f22da.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest INDICATION: ___ year old man with L IPH, leukocystosis // Pneumonia TECHNIQUE: Single frontal view of the chest. COMPARISON: CT chest with contrast ___ Portable AP chest radiograph ___ FINDINGS: Compared to ___, there is an increased focal opacity in the left lower lobe, concerning for aspiration. Lung volumes are mildly improved. The cardiomediastinal silhouette is unremarkable. Mild pulmonary vascular congestion remains unchanged. There is scarring and a nodular opacity in the left apex, better evaluated on prior CT. No pneumothorax or pleural effusion. IMPRESSION: 1. Increased focal opacity in the left lower lobe, concern for aspiration. 2. Mild pulmonary vascular congestion with improved lung volumes. " 7522f4c4-a75543e2-1adb6dda-e092f312-ce42c845.jpg,test/p13/p13021440/s56002650/7522f4c4-a75543e2-1adb6dda-e092f312-ce42c845.jpg,test," FINAL REPORT AP CHEST, 7:09 A.M. ON ___. HISTORY: ___-year-old woman. Assess PIC line. IMPRESSION: AP chest compared to ___: Left PIC line ends low in the SVC. Left supraclavicular dual-channel dialysis set ends in the right atrium. Mild pulmonary edema and small right pleural effusion as well as mediastinal venous engorgement are unchanged. Tracheostomy tube in standard placement. " 4f369537-7a360cf9-c4770a64-acd1fa63-4df935d4.jpg,test/p17/p17948222/s54427200/4f369537-7a360cf9-c4770a64-acd1fa63-4df935d4.jpg,test," WET READ: ___ ___ ___ 7:15 PM Tip of the left IJ line is not well visualized due to overlying defibrillator leads. Appears in unchanged position as it enters the SVC in comparison to the prior exam. Right IJ port-a-cath with tip unchanged at atriocaval junction. s/p CABG. No pneumothorax. No consolidation or pleural effusion. ______________________________________________________________________________ FINAL REPORT HISTORY: Confirm left IJ line. CHEST, SINGLE AP VIEW. Left-sided pacemaker is present, with lead tips over right atrium and right ventricle. The patient is status post sternotomy, with mild cardiomegaly. A left IJ central line is present. The tip is partially obscured by overlying pacemaker leads, but appears to overlie the distal SVC. A right-sided indwelling Port-A-Cath type catheter is present, tip over SVC/RA junction. No CHF, focal infiltrate, or effusion is identified. Compared with ___, the IJ line tip is not quite as distal. Otherwise, no significant change is detected. No pneumothorax identified. " 4dc96b27-5eac1461-ad9f35f6-52b4ae97-a9ee1801.jpg,test/p11/p11022501/s53377396/4dc96b27-5eac1461-ad9f35f6-52b4ae97-a9ee1801.jpg,test," FINAL REPORT HISTORY: Shortness of breath, chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " bad04e21-b01404c5-54597330-5bcebc8c-d4c1bbdc.jpg,test/p15/p15353701/s51991876/bad04e21-b01404c5-54597330-5bcebc8c-d4c1bbdc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Mitral regurg // eval for pulm edema eval for pulm edema IMPRESSION: Compared to chest radiographs since ___, most recently ___. Moderate right pleural effusion has worsened. Small left pleural effusion stable or slightly increased. Right upper lobe and consolidation has increased. Perihilar edema is probably present in the left midlung. Heart size top-normal, unchanged. ET tube and right internal jugular line are in standard placements. No pneumothorax. Thoracic aorta is heavily calcified but not focally aneurysmal. " 520645e1-32f88845-d0ecb6e0-5637d1c4-ebeef7e8.jpg,test/p17/p17520239/s50271016/520645e1-32f88845-d0ecb6e0-5637d1c4-ebeef7e8.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: New metastatic malignancy. Presenting with shortness of breath. COMPARISON: Chest CT dated ___. FINDINGS: The heart is normal in size. There is a large right hilar mass since the prior study as well as a new nodule in the right lung worrisome for perhaps a primary or metastatic focus of malignancy. Elsewhere, the lungs appear clear. There no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: Findings consistent with malignancy including suspicious right upper lobe nodule and marked right-sided perihilar lymphadenopathy. Chest CT is recommended to evaluate further when clinically appropriate. " 059285b3-fd122224-f19b61c7-7c8511a5-fc9026f6.jpg,test/p15/p15335912/s50439891/059285b3-fd122224-f19b61c7-7c8511a5-fc9026f6.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Malfunctioning right PICC. TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest CT ___. Chest radiograph ___. FINDINGS: Mild cardiomegaly is unchanged along with tortuosity of the thoracic aorta. Cardiomediastinal silhouette and hilar contours are otherwise unremarkable. Right PICC terminates in the upper SVC. Linear atelectasis in the right mid lung as well as mild eft base atelectasis. Lungs are otherwise clear. No pleural effusion or pneumothorax. Prominent thoracic kyphosis. IMPRESSION: No acute cardiopulmonary abnormality. Appropriate position of the right PICC. " b308879c-4c753d23-0e3946ba-502de07a-72d2116a.jpg,test/p12/p12658040/s56395318/b308879c-4c753d23-0e3946ba-502de07a-72d2116a.jpg,test," FINAL REPORT HISTORY: ___-year-old male with history ___ ___-___ epilepsy presents with increased behavioral outburst. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Increased heterogeneous ill-defined opacities in the right and left lower lobes. No pleural effusion, pneumothorax or pulmonary edema. Heart size, mediastinal contours and hila are normal. No bony abnormality. IMPRESSION: Bilateral pneumonia, likely aspiration given location and history. Results were conveyed via telephone to Dr. ___ by Dr. ___ on ___ at 11:50 a.m. within 15 minutes of observation of findings. " 0871b982-a7a90dff-8ae1a563-e5a2ff0d-b18c50f4.jpg,test/p11/p11105803/s59829591/0871b982-a7a90dff-8ae1a563-e5a2ff0d-b18c50f4.jpg,test," FINAL REPORT HISTORY: Status post ERCP, severe sepsis, now short of breath, chest pain. CHEST, SINGLE AP PORTABLE VIEW COMPARISON: Chest x-ray from ___ at 3:44 a.m. Lordotic positioning. Low inspiratory volumes. There is mild-to-moderate cardiomegaly. The aorta is calcified and slightly unfolded. The right hilum is prominent, though compatible with the appearance on ___. Compared to the prior film, there is blunting of both costophrenic angles, which is slightly more pronounced, and there is new opacity at the left lower lobe, with partial obscuration of the left hemidiaphragm. Borderline upper zone redistribution, but doubt overt CHF. IMPRESSION: 1. Cardiomegaly, similar to prior. 2. Small bilateral effusions, possibly slightly worse. 3. New opacity at the left base suggesting left lower lobe collapse and/or consolidation. 4. Prominent right hilum for which clinical correlation is requested. " a1ee3853-29977946-974ba5ab-ab2dbf90-decba983.jpg,test/p15/p15862442/s59302710/a1ee3853-29977946-974ba5ab-ab2dbf90-decba983.jpg,test," FINAL REPORT EXAMINATION: Frontal and lateral chest radiograph INDICATION: ___F with chest pain // eval for structural process TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Lungs are clear. Nipple shadows project over the lung bases. No pleural effusion. No pneumothorax. Heart size is normal. IMPRESSION: No acute intrathoracic abnormality. " 5ea50771-cdcf7978-4a6760dd-6d5bef68-436a89e7.jpg,test/p15/p15279727/s53389073/5ea50771-cdcf7978-4a6760dd-6d5bef68-436a89e7.jpg,test," FINAL REPORT HISTORY: Abdominal pain, to assess for free air. FINDINGS: In comparison with study of ___, there is no change or evidence of acute cardiopulmonary disease. Specifically, there is no evidence of free intraperitoneal gas. Of incidental note, on the lateral view, there are several elliptical opacifications in the abdomen that could represent pills within the bowel. " ac30899b-f0c0d159-db14533e-5d544a4d-1544da87.jpg,test/p19/p19372257/s53120549/ac30899b-f0c0d159-db14533e-5d544a4d-1544da87.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) CLINICAL HISTORY ___F w/ leukemia/lymphoma undergoing stem cell transplant w/ new fever // evaluate for PNA evaluate for PNA COMPARISON: ___ FINDINGS: The lungs remain clear. Mediastinal structures are unchanged. Bilateral central venous catheters remain in place. IMPRESSION: No acute change. " 99e106cb-1dfd6da6-e1c34ad2-6d3c4764-2f9bbb96.jpg,test/p17/p17473651/s52725633/99e106cb-1dfd6da6-e1c34ad2-6d3c4764-2f9bbb96.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Cardiomediastinal and hilar contours are stable in appearance. Right mediastinal convexity likely reflects mildly dilated or tortuous aorta. There is no pleural effusion. No pneumothorax is seen. Osseous structures demonstrates no acute abnormality. No air is seen the right hemidiaphragm. IMPRESSION: No convincing opacity concerning for pneumonia. " 82eb3e97-63e2854e-cb6db51d-262264bc-3face4a2.jpg,test/p11/p11025320/s59926864/82eb3e97-63e2854e-cb6db51d-262264bc-3face4a2.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with SOB // Eval for infiltrate TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Again noted punctate small calcific nodules as also noted in the prior study. No focal consolidation, pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " dd9522ae-17f3b17a-ac6b9970-68c2832b-5ef0f7f0.jpg,test/p18/p18205513/s52312095/dd9522ae-17f3b17a-ac6b9970-68c2832b-5ef0f7f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough and sob // r/o pna FINDINGS: Normal heart size. Normal-appearing mediastinum. No pneumonia. Small area of rounded atelectasis in the left lower lung field, could also represent anterior end of the rib. Degenerative changes in the thoracic spine. Conclusion: No significant are active disease. " 01451dee-6ad3eecf-deb23ffb-1789632e-61fe5fa2.jpg,test/p18/p18780736/s59791461/01451dee-6ad3eecf-deb23ffb-1789632e-61fe5fa2.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Pleural effusion. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: A Port-A-Cath terminates in the upper superior vena cava, as before. Lung volumes have decreased. There are new opacities at the medial lung bases, more extensive on the left than right. There are also small but increased bilateral pleural effusions, again larger on the left than right. More superiorly, bilateral opacities are suggestive of atelectasis. Mid to upper lungs remain clear. IMPRESSION: New opacities at the lung bases, which are probably due to atelectasis but not entirely specific. Infectious process is difficult to entirely exclude. Increased but small pleural effusions. " 22fced89-03d1877f-6112d294-b6c26b2e-4b3a55c2.jpg,test/p14/p14779022/s56918457/22fced89-03d1877f-6112d294-b6c26b2e-4b3a55c2.jpg,test," WET READ: ___ ___ ___ 12:31 PM No change from ___. Same pattern of diffuse reticular opacity most prominent at lung bases that was thought to represent bronchiectasis and atelectasis or atypical edema. Prelim read issued to ___, NP on ___ at 12:27 pm by ___ ___, MD via phone. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Abnormal chest with bibasilar reticular opacifications. FINDINGS: In comparison with study of ___, there is little overall change in the diffuse bibasilar reticular opacities that have been present sporadically on prior imaging studies. Findings may reflect atypical pulmonary edema, though reaction to periodic environmental or medication exposure would have to be considered. " 356f6518-76ae46e5-5f4fae27-0fbe9af8-fc3f0d72.jpg,test/p11/p11580750/s56989954/356f6518-76ae46e5-5f4fae27-0fbe9af8-fc3f0d72.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pneumonia. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. A minimal left pleural effusion with subsequent atelectasis is present. No opacities that are typical for pneumonia. Borderline size of the cardiac silhouette. Normal hilar and mediastinal structures. " f8839786-dd72307f-5bd9dccb-bedbbe33-5f24e5e2.jpg,test/p10/p10289679/s51706503/f8839786-dd72307f-5bd9dccb-bedbbe33-5f24e5e2.jpg,test," FINAL REPORT HISTORY: Epigastric pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No evidence of free air is seen beneath the diaphragms. IMPRESSION: No acute cardiopulmonary process. " 327e5d72-62478760-2a52d37d-1a75e71d-6a608ee1.jpg,test/p14/p14893593/s56959489/327e5d72-62478760-2a52d37d-1a75e71d-6a608ee1.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old female with intubation. COMPARISON: Film from earlier the same day performed at ___ at 12:51 p.m. FINDINGS: Single portable view of the chest. Relatively low lung volumes are again noted with secondary crowding of the pulmonary vascular markings. Superimposed interstitial edema is possible. Endotracheal tube tip is approximately 3.3 cm from the carina. Enteric tube seen with tip in the gastric body. Right PICC tip in the region of the lower SVC. The cardiomediastinal silhouette is within normal limits for technique. " 76040bd8-c3ab0a77-3c9fb47c-15d50cd3-4aa2d5ee.jpg,test/p15/p15011874/s52821003/76040bd8-c3ab0a77-3c9fb47c-15d50cd3-4aa2d5ee.jpg,test," FINAL ADDENDUM The patient history should state: Cough since today, visual complaints, altered mental status. ______________________________________________________________________________ FINAL REPORT HISTORY: Cough since headache, visual complaints of altered mental status. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: Thoracic scoliosis is again seen. The cardiac and mediastinal silhouettes are stable. No focal consolidation is seen. There is no large pleural effusion or pneumothorax. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " f0bc8eff-ef5949c3-a5291227-cebb5062-614ac744.jpg,test/p15/p15021205/s58101216/f0bc8eff-ef5949c3-a5291227-cebb5062-614ac744.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Non-small cell lung cancer, evaluation for interval change. COMPARISON: ___, 8:17. FINDINGS: As compared to the previous radiograph, there is no relevant change. Subtotal opacification of the left hemithorax. On the right, pre-existing areas of mild opacities are minimally progressive. The right aspect of the heart border is unchanged. " 1c61dd41-10c7c7fd-62aea24c-9a827a47-eb641f71.jpg,test/p16/p16253574/s50903641/1c61dd41-10c7c7fd-62aea24c-9a827a47-eb641f71.jpg,test," FINAL REPORT EXAM: Chest frontal view. HISTORY: LEFT RIB FRACTURES, S/P TINY PTX COMPARE: ___ FINDINGS: Previously seen tiny left apical pneumothorax on prior CT is not well seen on this study, CT is more sensitive. Multiple left-sided rib fractures are again seen. There is left base retrocardiac opacity, which may be due to atelectasis, but underlying infection and/or aspiration may be present. The right lung is clear. The cardiac and mediastinal silhouettes are stable. No pleural effusion is seen. " af273fb6-12514f7c-5b385333-f5df5b78-12aa02d8.jpg,test/p12/p12620123/s55528124/af273fb6-12514f7c-5b385333-f5df5b78-12aa02d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right heart failure in setting of bilateral pulmonary emboli. Intubated. poor gas exchange. // eval for interval change in edema, effusions TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate cardiomegaly is stable. Large bilateral effusions with adjacent right lower lobe atelectasis and left lower lobe collapse are unchanged. Emphysema is better seen on prior CT. ET tube is in standard position. Right IJ catheter tip is in the mid to lower SVC. NG tube tip is out of view below the diaphragm " e6758185-3134ffd9-7cbbda32-ce7f64cd-e21753cb.jpg,test/p14/p14508231/s50908840/e6758185-3134ffd9-7cbbda32-ce7f64cd-e21753cb.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of dyspnea. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Surgical metallic hardware is seen in the lower cervical spine. IMPRESSION: No acute cardiopulmonary process. " d9cfce98-9e6b9b16-4595a3be-ba8fc9b9-7cfefcda.jpg,test/p15/p15997196/s58186406/d9cfce98-9e6b9b16-4595a3be-ba8fc9b9-7cfefcda.jpg,test," FINAL REPORT HISTORY: Dyspnea on exertion. Evaluate for acute process. TECHNIQUE: Upright PA and lateral radiographs of the chest. COMPARISON: Chest radiograph ___. CT chest ___. FINDINGS: There is an increase in interstitial markings in a predominantly peripheral and basilar distribution consistent with known chronic interstitial lung disease which was previously presumed to reflect nonspecific interstitial pneumonia. Increased opacities at the lung bases likely reflect this progressive fibrosis. The cardiomediastinal silhouette and hilar contours are stable without cardiomegaly. There is no pleural effusion or pneumothorax. IMPRESSION: Progression of chronic interstitial lung disease. Worsening opacities at the lung bases likely reflect progression of disease however underlying infection is difficult to exclude. " 0d574086-6dacf0c0-260d5e4e-ec72b1a1-0da90709.jpg,test/p15/p15014371/s50738447/0d574086-6dacf0c0-260d5e4e-ec72b1a1-0da90709.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with renal txp with ___ // CXR: eval for pnaU/S: eval for kidney rejection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiomegaly is stable. A left chest wall pacemaker is present with leads terminating in the right atrium and right ventricle. IMPRESSION: No acute cardiopulmonary process. " 2a1b9b0b-a97bd3e2-3b1534a6-93a517d6-9a5bfebb.jpg,test/p14/p14725980/s57609698/2a1b9b0b-a97bd3e2-3b1534a6-93a517d6-9a5bfebb.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM, ___ AT ___ CLINICAL INDICATION: ___-year-old woman with left septic hip, assess lung fields. Comparison to prior study of ___ at 1:12 a.m. Portable AP upright chest film ___ at 16:03 is submitted. IMPRESSION: 1. Right subclavian PICC line has its tip in the proximal to mid SVC unchanged. Overall, cardiac and mediastinal contours are stable. Lungs are slightly low in volume but without evidence of focal airspace consolidation, pulmonary edema, pleural effusion or pneumothorax. " c0506b90-85fff46a-d177ced4-97722e4a-1c0e6824.jpg,test/p16/p16059088/s58911021/c0506b90-85fff46a-d177ced4-97722e4a-1c0e6824.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the endotracheal tube was removed and replaced by a tracheostomy tube. The nasogastric tube has been removed. The right internal jugular vein catheter is unchanged. Unchanged low lung volumes. No complications, in particular no pneumothorax. The appearance of the lung parenchyma is constant. Unchanged size of the cardiac silhouette. " af7fbce2-6e5a97a1-98b2fd96-5b12207f-db07f59a.jpg,test/p14/p14867487/s59671324/af7fbce2-6e5a97a1-98b2fd96-5b12207f-db07f59a.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with sob // r/o infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___, CT chest dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Pulmonary nodules as described on prior chest CT are not discretely visualized on today's examination. Mild scoliosis is again noted in the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary process. " 1c9c6661-cf16d640-ce84d97c-8f54f67b-ef9b3e00.jpg,test/p13/p13477622/s57593184/1c9c6661-cf16d640-ce84d97c-8f54f67b-ef9b3e00.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p MIE // eval interval change FINDINGS: As compared to ___, the bibasal opacities and associated partially imaged effusion have not significantly changed. No interstitial edema. No pneumothorax. The heart is mildly enlarged. Postoperative mediastinum is unchanged in appearance with normal expected postoperative changes. IMPRESSION: No significant interval change in bibasal atelectasis. " cc71cc53-d34a1265-06c05467-67646ba0-68bc7016.jpg,test/p11/p11345335/s58275387/cc71cc53-d34a1265-06c05467-67646ba0-68bc7016.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Dobbhoff placement. FINDINGS: The Dobbhoff tube has been advanced and is now curved in the stomach with the tip pointing upwards. The appearance of the lungs is unchanged. " ff8d6879-4b77d16f-e39bf9ed-29433b99-e15f1f0a.jpg,test/p13/p13074701/s52481244/ff8d6879-4b77d16f-e39bf9ed-29433b99-e15f1f0a.jpg,test," WET READ: ___ ___ ___ 4:13 PM No acute intrathoracic process. Low lung volumes. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness, s/p fall this AM. Evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: Mild cardiomegaly is unchanged since the prior study. No new focal consolidation, pleural effusion, or pneumothorax. Right lower lobe opacity is likely atelectasis. Lung volumes are low, causing bronchovascular crowding. IMPRESSION: No acute intrathoracic process. Low lung volumes. " e805d49c-27d58176-bafe05c1-bd7ed492-26c814c3.jpg,test/p19/p19727446/s56129083/e805d49c-27d58176-bafe05c1-bd7ed492-26c814c3.jpg,test," FINAL REPORT INDICATION: Cough. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. Mild tortuosity of the aorta is unchanged since ___. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " c733b92a-2220f9d4-ef7f71d9-489c9b0e-fcb2ee7a.jpg,test/p17/p17790232/s52653564/c733b92a-2220f9d4-ef7f71d9-489c9b0e-fcb2ee7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever // Eval for pna COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 66600f8b-f1d10270-7d3269af-0a74d141-19a49f7e.jpg,test/p18/p18691929/s59718688/66600f8b-f1d10270-7d3269af-0a74d141-19a49f7e.jpg,test," FINAL REPORT INDICATION: ___ year old woman with metastatic pancreatic cancer // please assess port for pinch-off syndrome TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Left-sided infusion port catheter with the tip at the cavoatrial junction, similar in appearance. Interval improvement of the left basal opacity with residual surgical suture along the left hemidiaphragm. No pneumothorax. The heart size is not enlarged. IMPRESSION: Left-sided port with the tip at the cavoatrial junction, similar in appearance. Interval improvement of the left basal opacity with residual surgical suture seen along the left hemidiaphragm. " da7d0084-f27c797e-447db451-ff53afed-d2603f88.jpg,test/p18/p18039514/s55214740/da7d0084-f27c797e-447db451-ff53afed-d2603f88.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Gastric carcinoma, vomiting, evaluation for aspiration pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The patient has a known left pleural effusion that is small and better appreciated on the lateral than on the frontal radiograph. There is no evidence of pneumonia, in particular no suggestion of aspiration. Borderline size of the cardiac silhouette. No pulmonary edema. " 3f7c36c7-a267a28f-c7813481-c8e3c4bc-b0d8b8bc.jpg,test/p16/p16566006/s50953577/3f7c36c7-a267a28f-c7813481-c8e3c4bc-b0d8b8bc.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Intubated. Shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, portable AP supine. FINDINGS: The patient has been intubated. The endotracheal tube terminates about 5 cm above the carina. An orogastric tube courses into the stomach. The patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours appear stable. There is a small pleural effusion on the left. No definite pleural effusion is identified on the right side. There is no pneumothorax. Patchy opacities are present at both lung bases, greater on the left than right. IMPRESSION: Status post endotracheal intubation. Patchy opacities at the lung bases and small suspected pleural effusion on the left. Possible etiologies for these include pneumonia or aspiration in addition to atelectasis. " 427eb466-4a6703a8-24830f64-d5587ced-af245f10.jpg,test/p17/p17345538/s59822265/427eb466-4a6703a8-24830f64-d5587ced-af245f10.jpg,test," FINAL REPORT HISTORY: AVR, to assess for consolidation. FINDINGS: In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. Swan-Ganz catheter remains in place, as does the right chest tube. Continued substantial enlargement of the cardiac silhouette with intact midline sternal wires. Retrocardiac opacification with obscuration of the hemidiaphragm is consistent with substantial volume loss in the left lower lobe. Atelectatic changes are seen without definite pulmonary vascular congestion. The possibility of supervening pneumonia, especially in the retrocardiac area, cannot be excluded. " 726be363-12cc5fce-b12e41ff-f29932f4-051f6efd.jpg,test/p19/p19313943/s52904387/726be363-12cc5fce-b12e41ff-f29932f4-051f6efd.jpg,test," FINAL REPORT INDICATION: ___ year old man with fevers // r/o acute pulmonary process COMPARISON: Compared to radiographs from ___. IMPRESSION: Lungs are grossly clear without focal consolidation, pleural effusions, or pneumothoraces. There is no pulmonary edema. Heart size and mediastinal structures are within normal limits. Bony structures are intact. " 74d9e37c-3886d6ab-417e998c-1bc517e8-23bb7fe1.jpg,test/p14/p14659758/s50195228/74d9e37c-3886d6ab-417e998c-1bc517e8-23bb7fe1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with etoh cirrhosis, elevated WBC and encephalopathy // Evaluation of PNA Evaluation of PNA IMPRESSION: Compared to prior chest radiographs, ___ through ___. Most recently ___. Very low lung volumes have improved minimally, with substantial right lower lobe and milder left lower lobe atelectasis slightly better. Upper lungs are clear. Heart size is normal. Pleural effusions small if any. No pneumothorax. " a7ca72b8-beac198c-608a050d-55dda5c7-9ae9f259.jpg,test/p10/p10172358/s56401158/a7ca72b8-beac198c-608a050d-55dda5c7-9ae9f259.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old current female smoker, with wheeze, barrel chest. PF=220 // pleas eval for infiltrate, copd pleas eval for infiltrate, copd IMPRESSION: No comparison. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " dd1f0f4f-c390c1c7-c82145fd-be8d3fe7-09a21a85.jpg,test/p12/p12813790/s59472281/dd1f0f4f-c390c1c7-c82145fd-be8d3fe7-09a21a85.jpg,test," FINAL REPORT INDICATION: ___-year-old female patient with six months of dyspnea on exertion and positive PPD. COMPARISON: None available. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are well expanded and clear. There are no pleural effusions or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process. " 035a4bbd-04295cbd-a6d6dd02-45848274-210c7238.jpg,test/p12/p12969820/s57600000/035a4bbd-04295cbd-a6d6dd02-45848274-210c7238.jpg,test," FINAL REPORT INDICATION: ___M POD#___ s/p lap chole with persistent tachycardia, increased WBC, desats when ambulatory to 80s // Assess for PNA COMPARISON: ___ FINDINGS: Heart size and mediastinum are overall unremarkable. Lung volumes are very low. There is no pulmonary edema. Minimal bibasal atelectasis is noted and potentially left pleural effusion. IMPRESSION: No acute pneumonia. Very low lung volumes. " b9a2a505-579ba9cc-02f1f9e0-edf969ce-c8ec11be.jpg,test/p17/p17627287/s55379327/b9a2a505-579ba9cc-02f1f9e0-edf969ce-c8ec11be.jpg,test," FINAL REPORT HISTORY: Positive PPD. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is normal. Mediastinal contours are normal. No bony abnormality is detected. IMPRESSION: No radiographic evidence for chronic granulomatous or acute cardiopulmonary process. " 26495622-a7eb5ecb-7b35d2bb-e9b22080-ae1b366e.jpg,test/p11/p11900721/s52962347/26495622-a7eb5ecb-7b35d2bb-e9b22080-ae1b366e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with intubation // eval tube TECHNIQUE: Single frontal view of the chest COMPARISON: ___ at 20:15 FINDINGS: Patient rotated somewhat to the left. There has been interval placement of an endotracheal tube, as somewhat low in position, terminating 1 cm above the level of the carina. Enteric tube courses below the diaphragm, inferior aspect not included on the image. There increased bibasilar opacities worrisome for bilateral pleural effusions, left greater than right seen overlying atelectasis. Underlying aspiration is not excluded. Cardiac and mediastinal silhouettes are grossly stable. IMPRESSION: Endotracheal tube somewhat low in position, terminating 1 cm above the level of the carina. Enteric tube courses below the diaphragm, inferior aspect not included on the image. Increased bibasilar opacities, right greater than left pleural effusions with overlying atelectasis, underlying aspiration is not excluded. " ee88078e-84d61fd4-c3e89346-8463b5ed-2146f06f.jpg,test/p15/p15032467/s59261778/ee88078e-84d61fd4-c3e89346-8463b5ed-2146f06f.jpg,test," WET READ: ___ ___ ___ 5:12 AM No pneumothorax. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with CP and back pain // Eval for pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are well-expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumothorax. " 3461de86-ba6eee92-08558746-af545f1f-32b6d054.jpg,test/p12/p12297844/s56722525/3461de86-ba6eee92-08558746-af545f1f-32b6d054.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post cardiac arrest, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the soft tissue air accumulation on the left has almost completely resolved. There is currently no evidence for the presence of a pneumothorax. Slightly increasing parenchymal opacity at the left mid lung and left basal lung zone. The monitoring and support devices are constant. Normal appearance of the right lung. " 0f0d2bee-0efd8ddf-42a82469-04cfe3ff-7e4aa749.jpg,test/p15/p15719598/s57701231/0f0d2bee-0efd8ddf-42a82469-04cfe3ff-7e4aa749.jpg,test," FINAL REPORT HISTORY: Atypical left posterior paraspinal pain. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Hypertrophic spurring is again seen at several mid thoracic levels, but no evidence of compression fracture or displacement of the paravertebral stripe. " 7693d3c7-4dfc87cb-3c1e38ca-bf5a97ef-7e4bc0c9.jpg,test/p14/p14611053/s55706680/7693d3c7-4dfc87cb-3c1e38ca-bf5a97ef-7e4bc0c9.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: Surgical clips project over the lower neck and right upper quadrant of the abdomen, as before. The cardiac, mediastinal, and hilar contours appear unchanged. Streaky right lower lung opacities are most suggestive of minor atelectasis, also seen in the left costophrenic sulcus. Otherwise, however, the lungs appear clear. There are no pleural effusions or pneumothorax. Small left axillary calcifications are unchanged. IMPRESSION: No evidence of acute cardiopulmonary disease. " 5fe71b81-8ce9dcfd-648c0c98-a7a429c6-1fb8c70e.jpg,test/p16/p16584291/s58310560/5fe71b81-8ce9dcfd-648c0c98-a7a429c6-1fb8c70e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleuritic anterior chest discomfort/chest wall tenderness/bibasilar rales, evaluate for pneumonia. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Linear opacities in the bibasilar bases likely reflect atelectasis or scarring. There are no areas of focal parenchyma opacities to suggest pneumonia. Heart size is moderately enlarged, without significant pulmonary edema. There is no pleural effusion. IMPRESSION: 1. No acute pneumonia. 2. Moderate cardiomegaly without pulmonary edema. Differential includes cardiomyopathy versus pericardial effusion. " 1fcfe81c-59a987b9-9fad70bd-f3b491fd-f3b64d88.jpg,test/p10/p10320090/s57562331/1fcfe81c-59a987b9-9fad70bd-f3b491fd-f3b64d88.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with idiopathic cardiomyopathy, CHF on torsemide with 18lb weight gain since last week, evaluate for volume overload. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Severe cardiomegaly is unchanged. No focal consolidation is seen concerning for pneumonia. No convincing evidence for edema. Mild congestion difficult to exclude. There is no pleural effusion or pneumothorax. AICD leads again noted extending to the region the right atrium, right ventricle and coronary sinus. No acute bony abnormality. No free air below the right hemidiaphragm. IMPRESSION: Severe cardiomegaly and possible mild congestion. " 21af9741-a875bf34-55fb2f68-451daf5e-2b07351f.jpg,test/p11/p11814062/s54739013/21af9741-a875bf34-55fb2f68-451daf5e-2b07351f.jpg,test," FINAL REPORT INDICATION: ___-year-old female status post fall. Evaluate for fracture or bleed. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is mildly enlarged, and the mediastinal contours are normal. A left Port-A-Cath is in stable position with the tip terminating at the cavoatrial junction. No displaced rib fractures are noted. IMPRESSION: No acute cardiopulmonary process. Cardiomegaly. " 129add68-012a7015-b3240d85-c84f5407-28829e90.jpg,test/p15/p15691899/s58426804/129add68-012a7015-b3240d85-c84f5407-28829e90.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with wheezing on exam and history of asthma. Evaluate for asthma exacerbation TECHNIQUE: Chest AP and lateral COMPARISON: ___ FINDINGS: Low lung volumes. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear besides linear opacity on the lateral view projecting over the heart, potentially in the middle lobe most suggestive of atelectasis. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process, no focal consolidation. . " 341078a7-07fd1826-7f7b7933-ddc10051-0b21f21e.jpg,test/p16/p16518377/s51898594/341078a7-07fd1826-7f7b7933-ddc10051-0b21f21e.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left lower lung pleuritic pain. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: Multilobular density obscures the right paratracheal stripe. No pleural effusion, pneumothorax, or pulmonary edema is detected. Heart size is top normal. Aortic calcification and tortuosity is noted. IMPRESSION: Multilobular density along the right paratracheal stripe. Further evaluation is recommended with CT. These findings and recommendations were discussed with ___, NP by Dr. ___ by telephone at 12:40 p.m. on ___. " d8ea1c52-41c4a107-a8894206-22f7c0a7-36073b6d.jpg,test/p15/p15754509/s54593795/d8ea1c52-41c4a107-a8894206-22f7c0a7-36073b6d.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Question small right pneumothorax in prior study. Comparison is made with prior study performed five hours earlier. The apparent pleural line seen in prior study is no longer visualized. There are no other interval changes. " 0b6854c2-7c9edd43-ce88a747-e5438331-7d25d9eb.jpg,test/p13/p13011740/s55772900/0b6854c2-7c9edd43-ce88a747-e5438331-7d25d9eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p cabg and ct removal // r/o ptx r/o ptx IMPRESSION: Compared to chest radiographs since ___, most recently ___ through ___. Since ___ patient has been extubated which may account for interval increase in caliber of the cardiomediastinal silhouette as well as persistence of moderately severe left lower lobe atelectasis and new milder atelectasis at the right base. Small right pleural effusion is likely. There is no large left pleural effusion or pneumothorax on either side, following removal of pleural drains. No pulmonary edema. Right internal jugular introducer ends in the low SVC. " ed5f38e4-5f0326c4-8937cceb-f8ce3237-0e414504.jpg,test/p17/p17671565/s58584034/ed5f38e4-5f0326c4-8937cceb-f8ce3237-0e414504.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with prior COP in LUL // Eval for cause of increased cough Eval for cause of increased cough COMPARISON: Compared to chest radiograph ___, read in conjunction with chest CT scan performed earlier today. IMPRESSION: Heart is top-normal size, increased since ___, but there is no pulmonary vascular congestion or edema. Mild and more subtle pulmonary abnormalities are demonstrated on the chest CT scan. There is no pleural abnormality. " 70a70917-c663c98d-f8335533-06799dd5-5f50a643.jpg,test/p15/p15439081/s59510781/70a70917-c663c98d-f8335533-06799dd5-5f50a643.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with difficulty speaking, possible recent assault TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are low. Heart size remains mildly enlarged. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is seen. Minimal atelectasis is noted in the retrocardiac region. No acutely displaced fractures are identified. IMPRESSION: Low lung volumes without acute cardiopulmonary process. " 14d4e289-8e7cf92e-1502754b-5a330f36-b5ae5707.jpg,test/p17/p17740074/s51779225/14d4e289-8e7cf92e-1502754b-5a330f36-b5ae5707.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with recent pneumonia, now improved. Evaluate for resolution of infiltrates. COMPARISONS: Multiple prior chest radiographs, most recently from ___. FINDINGS: PA and lateral chest radiographs were provided. Compared to the most recent prior study, there has been improvement of multifocal opacities in the lower lung with some residual opacities remaining. There is scarring in the right upper lobe with a new opacity in the apex and associated upward retraction of the right hilus, compatible with prior TB. There is no pneumothorax or pleural effusions. The cardiomediastinal silhouette is normal. The imaged upper abdomen is normal. The bones are intact. IMPRESSION: 1. Improved multifocal opacities in the lower lung with some residual opacities remaining. 2. Scarring in the right upper lobe, compatible with prior TB. " 064d4233-c8b5c638-d706c112-21fd9d82-db7b05b3.jpg,test/p12/p12232409/s59161832/064d4233-c8b5c638-d706c112-21fd9d82-db7b05b3.jpg,test," FINAL REPORT HISTORY: Dermatomyositis presenting with syncope, chest pain, and shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. 1.9 cm right lower lung nodular opacity is best seen on the frontal view. No substantial interstitial abnormality. No focal lobar consolidation, pleural effusion, or pneumothorax. IMPRESSION: 1.9 cm right lower lung nodular opacity is concerning for lung malignancy. Nonemergent dedicated chest CT is recommended for further evaluation. " db7471bd-4d227859-4fff7774-b966117c-1d90ad9f.jpg,test/p10/p10900387/s59314412/db7471bd-4d227859-4fff7774-b966117c-1d90ad9f.jpg,test," WET READ: ___ ___ ___ 11:22 PM Increased opacity in the right lung base and overlying the cardiac silhouette on lateral views is concerning for pneumonia involving the right middle and lower lobes. Short interval followup is recommended upon completion of treatment to document resolution. The heart is slightly enlarged when compared to prior examination and there is mild pulmonary vascular congestion. ______________________________________________________________________________ FINAL REPORT HISTORY: Fever and cough. Evaluate for pneumonia. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiograph from ___, there is increased opacity at the right lung base and possible increased density overlying the cardiac silhouette, best seen on lateral views. The heart is moderately enlarged, slightly increased from prior examination. There is mild pulmonary vascular congestion. There is no large pleural effusion or pneumothorax. IMPRESSION: 1. Right lower lung consolidation concerning for pneumonia. Short interval followup is recommended upon completion of treatment to document resolution. 2. Cardiomegaly with mild pulmonary vascular congestion. " 8cf80967-a751a50f-0fd9f7f0-fc47c3a4-168e7eea.jpg,test/p11/p11756780/s56903709/8cf80967-a751a50f-0fd9f7f0-fc47c3a4-168e7eea.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest x-ray. INDICATION: ___-year-old woman with fever and hypoxia, evaluate for pneumonia. TECHNIQUE: AP upright chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: A right-sided Port-A-Cath terminates in the high right atrium versus cavoatrial junction. There are low lung volumes due to a sub-optimal inspiratory effort; accounting for changes due to this, the cardiomediastinal silhouettes are stable and within normal limits. Calcifications are noted in the aortic knob. The bilateral hila are unremarkable. Subtle opacities at the bilateral lung bases likely relates to bibasilar atelectasis. A retrocardiac opacity is compatible with known large hiatus hernia. The lungs are otherwise clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. The osseous structures are again noted to be diffusely sclerotic, compatible with known diffuse metastatic disease. IMPRESSION: 1. Low lung volumes. No acute cardiopulmonary process. 2. Right Port-A-Cath terminating in the high right atrium versus cavoatrial junction. 3. Diffuse osseous sclerotic metastases. 4. Large hiatus hernia. " df8a865b-8ff7ac32-2efdca68-5b4db898-f4f71c9e.jpg,test/p10/p10598199/s52676635/df8a865b-8ff7ac32-2efdca68-5b4db898-f4f71c9e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 700f9a41-52d2fd23-5b9d6438-d61b4163-1e048fc1.jpg,test/p15/p15303810/s56644725/700f9a41-52d2fd23-5b9d6438-d61b4163-1e048fc1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Seizures, likely aspiration, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the Dobbhoff catheter has been removed. The lung volumes are normal. The transparency and structure of the lung parenchyma is unremarkable. There is unchanged bilateral symmetrical apical thickening but no evidence of parenchymal changes suggesting pneumonia. No pulmonary edema. Normal appearance of the cardiac silhouette. Normal hilar and mediastinal contours. The left pectoral pacemaker is in constant position. " a270d48d-fe58cfb1-ac1f4b56-4fc4990a-28d94a2a.jpg,test/p19/p19261699/s51311551/a270d48d-fe58cfb1-ac1f4b56-4fc4990a-28d94a2a.jpg,test," FINAL REPORT INDICATION: ___-year-old man with left anterior chest pain. COMPARISON: None available. TECHNIQUE PA and lateral view of the chest. FINDINGS: The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. Lung volumes are low, but no focal consolidation is seen. There is no acute osseous abnormality. Views of the upper abdomen are unremarkable. IMPRESSION: No radiographic explanation for chest pain. " 7a62d410-e8a20c5e-18ab27ba-06e20cad-825ad6b6.jpg,test/p14/p14755254/s53283652/7a62d410-e8a20c5e-18ab27ba-06e20cad-825ad6b6.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea hx chf // acute process, chf TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Dual lead left-sided pacer device is stable in position. The cardiac silhouette remains stably enlarged. Mediastinal contours are stable. No new focal consolidation is seen. There is no pleural effusion or pneumothorax. There is central vascular engorgement without overt pulmonary edema. IMPRESSION: Central pulmonary vascular engorgement without overt pulmonary edema. Persistent cardiomegaly. " a3e761e0-8be0330d-82c21ef3-c49180ad-11b6f514.jpg,test/p18/p18855302/s54039544/a3e761e0-8be0330d-82c21ef3-c49180ad-11b6f514.jpg,test," FINAL REPORT INDICATION: ___ year old woman with advanced cervical cancer p/w fever // R/o consolidation TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable chest radiograph FINDINGS: The lungs are well inflated. There is a left lower lobe ill-defined peribronchial opacity concerning for pneumonia. There no pneumothorax nor pleural effusion appreciated. The cardiomediastinal and hilar silhouettes are normal . The heart size is normal. There is no acute bony abnormality nor evidence of acute fracture. IMPRESSION: 1. Left lower lobe pneumonia. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 11:50 into the Department of Radiology critical communications system for direct communication to the referring provider. " 8c1ebfc6-b3d0a173-661d03ad-cdf31099-df4ff9fe.jpg,test/p19/p19415089/s52865463/8c1ebfc6-b3d0a173-661d03ad-cdf31099-df4ff9fe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough and wheezing // r/o pna COMPARISON: Chest radiograph ___ FINDINGS: Frontal and lateral views of the chest are obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The hilar contours are stable. Cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute intrathoracic process. " 2f02ca97-b5a265f2-dc7b5544-da6f6a47-68760848.jpg,test/p12/p12718224/s54701123/2f02ca97-b5a265f2-dc7b5544-da6f6a47-68760848.jpg,test," FINAL REPORT HISTORY: Stroke. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There are relatively low lung volumes which accentuate the bronchovascular markings. Relative opacity at the medial right lung base is felt to more likely be due to vascular structures rather than consolidation. The left lung is clear. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Low lung volumes. Medial right base opacity felt to more likely be due to vascular structures rather than consolidation. " 5d5bd882-eea9c33d-51b683dd-e52dbb41-26da1f66.jpg,test/p19/p19372257/s55134685/5d5bd882-eea9c33d-51b683dd-e52dbb41-26da1f66.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute resp failure, now intubated // Interval change? ETT placement? Interval change? ETT placement? IMPRESSION: As compared to ___, the patient has been intubated. The tip of the endotracheal tube is within 12 mm of the carina and the tube should be pulled back by approximately 2 cm. The other monitoring and support devices are in correct position. The tip of the nasogastric tube is not clearly visualized on the current image. Increase in extent of the bilateral pleural effusions and of the subsequent areas of basilar atelectasis. No pneumothorax. The borders of the cardiac silhouette can no longer be visualized. " f6f572c6-ae342ee1-39431da0-f47e5b28-d4c224a6.jpg,test/p12/p12043836/s55571513/f6f572c6-ae342ee1-39431da0-f47e5b28-d4c224a6.jpg,test," WET READ: ___ ___ ___ 10:29 AM Two right pleural drains have been slightly withdrawn. The side ports of the chest tubes are excluded from view. It should be confirmed that the side ports are within the pleural space and not within the chest wall - clinically or by repeat radiograph which includes the right chest wall. Right pleural effusion appears unchanged and there appears to worsening opacity in the right mid lung. There is no pneumothorax. The findings were telephoned to ___ by ___ at 22:35, ___, ___ min after discovery. WET READ VERSION #___ ___ ___ ___ 10:36 PM Two right pleural drains have been slightly withdrawn. The side ports of the chest tubes are excluded from view. It should be confirmed that the side ports are within the pleural space and not within the chest wall - clinically or by repeat radiograph which includes the right chest wall. Right pleural effusion appears unchanged and there appears to worsening opacity in the right mid lung. The findings were telephoned to by ___ at , ___, after discovery. WET READ VERSION #___ ___ ___ ___ 10:51 PM Two right pleural drains have been slightly withdrawn. The side ports of the chest tubes are excluded from view. It should be confirmed that the side ports are within the pleural space and not within the chest wall - clinically or by repeat radiograph which includes the right chest wall. Right pleural effusion appears unchanged and there appears to worsening opacity in the right mid lung. There is no pneumothorax. The findings were telephoned to ___ by ___ at 22:35, ___, ___ min after discovery. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with two chest tubes, pulled back 3 hours ago, please evaluate for positioning and PTX // r/o PTX, chest tube positioning COMPARISON: Chest CT performed ___ as well as chest radiograph performed ___ at 11:27. FINDINGS: Single portable AP chest radiograph was provided. The right hemithorax is incompletely imaged. A left sided central line is identified, its tip which projects over the made superior vena cava. Two right pleural drains have been slightly withdrawn. Side ports are excluded from the few. A large right pleural effusion is unchanged in size relative to prior examination. There is no left pleural effusion. There is no pneumothorax. Cardiomediastinal silhouette is stable. Patient is status post median sternotomy, tricuspid and mitral valve replacement. Imaged osseous structures and upper abdomen are without an acute abnormality. IMPRESSION: Large right pleural effusion not significantly change relative to prior study. Two right pleural drains are identified though are incompletely imaged. Repeat radiograph or clinical correlation is advised to confirm placement of side port within the pleural space. " 53226a05-dfcafce3-32b0f979-3aaa9eea-86cf60a5.jpg,test/p17/p17679495/s57006129/53226a05-dfcafce3-32b0f979-3aaa9eea-86cf60a5.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with c/o SOB // ? PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Subtle increase in interstitial markings bilaterally may be due to technique or chronic lung disease/fibrosis. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. The patient is status post median sternotomy and cardiac valve replacement.. IMPRESSION: No focal consolidation to suggest pneumonia. " 9dcc989e-4775a22a-62f27f0d-31604ec2-a04af960.jpg,test/p13/p13480812/s54532926/9dcc989e-4775a22a-62f27f0d-31604ec2-a04af960.jpg,test," FINAL ADDENDUM ADDENDUM Evolving pneumonia is not excluded, new since the prior study. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with sob // PNA? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ and ___ FINDINGS: The lungs remain hyperinflated, in keeping with history of asthma. Since the prior study, there are streaky opacities in the bilateral lung bases which may be due to bronchial wall thickening, small airways disease without discrete lobar consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Re- demonstrated hyperinflated lungs. New streaky opacities at the lung bases may be due to small airways disease/bronchial wall thickening, without definite lobar consolidation. " 0bf68fb7-63a8a66f-ce368db5-e085214c-b4dd3d55.jpg,test/p13/p13778554/s50517406/0bf68fb7-63a8a66f-ce368db5-e085214c-b4dd3d55.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: Pain. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormality is identified. Surgical clips seen in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 57b866e8-14d32900-a57a192c-a093a24b-c07b1ac7.jpg,test/p18/p18621188/s57541098/57b866e8-14d32900-a57a192c-a093a24b-c07b1ac7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior CT chest dated ___. CLINICAL HISTORY: Metastatic SCC with worsening fatigue, question pneumonia. FINDINGS: PA and lateral views of the chest are provided. A right chest wall Port-A-Cath is seen with its tip extending into the region of the right atrium. Bi-apical pleuroparenchymal scarring is redemonstrated. No focal consolidation suggestive of pneumonia. Chronic consolidation involving the medial segment of the right lower lobe is better assessed on prior CT chest. Known osseous lesions are also better assessed on the prior CT. IMPRESSION: No signs of pneumonia. " 6d0c75fe-809feda3-1294d287-a17d4a53-dcb4bac7.jpg,test/p19/p19228363/s56847015/6d0c75fe-809feda3-1294d287-a17d4a53-dcb4bac7.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough, rule out acute process. COMPARISONS: None. PA AND LATERAL VIEWS OF THE CHEST: The lungs are clear. There is no pleural effusion or pneumothorax. Obscuration of left heart border likely relates to the presence of a fat pad. No consolidation is seen on the lateral view. Heart size is enlarged. The mediastinal contours are normal. Bibasilar atelectasis is noted. IMPRESSION: No acute cardiopulmonary process. Cardiomegaly. " 7c01e7cb-527aed55-e2746232-1a02f634-d9a405dd.jpg,test/p18/p18796351/s57773287/7c01e7cb-527aed55-e2746232-1a02f634-d9a405dd.jpg,test," WET READ: ___ ___ 3:32 PM IMPRESSION: 1. No acute cardiopulmonary process. 2. Vague density at the medial right apex, potentially a lung nodule. Evaluation with chest CT is recommended when clinically appropriate. ______________________________________________________________________________ FINAL REPORT HISTORY: New onset atrial fibrillation and epigastric discomfort, here to evaluate for acute cardiopulmonary process. COMPARISON: Chest radiographs dated ___ and ___. Technique: PA and lateral radiographs of the chest. FINDINGS: There is vague increased density projecting over the medial right apex, which is indeterminant but a nodule is possible at this site. Otherwise the lungs appear clear including unchanged but striking bilateral apical pleural thickening. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. Deformities involving several right lateral ribs are unchanged and compatible with remote prior fractures. IMPRESSION: 1. No acute cardiopulmonary process. 2. Vague density at the medial right apex, potentially a lung nodule. Evaluation with chest CT is recommended when clinically appropriate. Preliminary interpretation placed to ED dashboard at 3:30 pm while the patient was still in the ER. " d75d0f62-81df3659-34ed51f3-36a8d18d-7c20e845.jpg,test/p14/p14295772/s51858824/d75d0f62-81df3659-34ed51f3-36a8d18d-7c20e845.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with intermittent retrosternal chest discomfort radiating to her left arm TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 321d3b6d-f741e9cf-09b650ff-ffb78307-9a091dfc.jpg,test/p10/p10262096/s52730685/321d3b6d-f741e9cf-09b650ff-ffb78307-9a091dfc.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY ___ COMPARISON: Study of earlier the same date. FINDINGS: Radiograph centered at the thoracoabdominal junction was obtained for assessment of a nasogastric tube, which coils within the proximal stomach before terminating within the distal stomach. With the exception of a change in the position of a nasogastric tube, there is otherwise no relevant change in the appearance of the chest since the recent study performed earlier the same date. " 70d344fc-bdc9a7bf-d3c7d6dc-a246ca0f-5851e9e0.jpg,test/p11/p11499203/s59004676/70d344fc-bdc9a7bf-d3c7d6dc-a246ca0f-5851e9e0.jpg,test," FINAL REPORT INDICATION: ___-year-old female reports drinking acetone now with esophageal and chest burning. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate top normal heart size, which is stable. There is mild unfolding of the thoracic aorta. Mediastinal and hilar contours are unremarkable. The lungs are clear. There may be trace subsegmental volume loss in the left base. No pleural effusions, vascular congestion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 3b62b4e2-5b7b5b8f-550beee4-5848306a-841807b6.jpg,test/p14/p14180305/s53308759/3b62b4e2-5b7b5b8f-550beee4-5848306a-841807b6.jpg,test," WET READ: ___ ___ 5:13 AM No free air beneath the right hemidiaphragm. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with vomiting with blood // ? free air TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are well-expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No free air seen beneath the right hemidiaphragm. IMPRESSION: No free air beneath the right hemidiaphragm. " 5aa42bff-fa595a56-546ec8b5-c52943c9-1cb6db52.jpg,test/p13/p13103745/s52910639/5aa42bff-fa595a56-546ec8b5-c52943c9-1cb6db52.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hepatic hydrothorax status post cirrhosis and abnormal right lung findings, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes are near normal. On the right, a relatively large and partly loculated pleural effusion is seen. Effusion has a ventral and dorsal component at the bases of the lungs and an intrafissural component at the level of the minor fissure. Adjacent to the effusion are areas of atelectasis. The well ventilated lung parenchyma, however, is unremarkable. The heart appears to be normal in size. There is no evidence of left pleural effusion. " 0085e8a4-6a661312-3f0de996-be6901b9-e5b94f32.jpg,test/p14/p14495609/s55608548/0085e8a4-6a661312-3f0de996-be6901b9-e5b94f32.jpg,test," FINAL REPORT HISTORY: Productive cough and fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Aorta remains unfolded. Mediastinum and hilar contours are unremarkable. Pulmonary vascularity is normal. Except for mild subsegmental left basilar atelectasis, the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " e48a3b16-4f58b9f8-55d2e5a8-8656defd-989711ce.jpg,test/p17/p17115211/s57325136/e48a3b16-4f58b9f8-55d2e5a8-8656defd-989711ce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with R arm weakness, leukocytosis and ___ s/p fall // evaluation for pneumonia evaluation for pneumonia IMPRESSION: As compared to the previous radiograph, the right than left hilar regions are now unremarkable. No evidence of abnormalities regarding contours or density of the hilar or mediastinal structures. Normal lung volumes. Normal size of the cardiac silhouette. No pulmonary edema. No pneumonia, no pleural effusions. " c7650442-c3ede116-72b3e9fc-42f40b7f-67c1b5a7.jpg,test/p11/p11167079/s52284709/c7650442-c3ede116-72b3e9fc-42f40b7f-67c1b5a7.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with possible aspiration event, bilateral crackles and low-grade fever. IMPRESSION: Opacification at both lung bases has increased since ___ consistent with aspiration, but the lateral view shows that the underlying abnormality in the lower lungs is severe reticulation, which could be bronchiectasis or pulmonary fibrosis, either alone, or in combination. Findings therefore suggest aspiration in the setting of chronic lung disease. There is no pneumonia in the upper lungs and no evidence of congestive heart failure. Heart size is normal. Supraclavicular dual-channel dialysis catheter set ends in the SVC and upper right atrium. No pneumothorax. Pleural effusion is small if any, but the posterior sulci are excluded from the lateral view. No pneumothorax. " 2c974069-0960e521-887f7955-bee0c4c3-c4bfa574.jpg,test/p17/p17995543/s57022809/2c974069-0960e521-887f7955-bee0c4c3-c4bfa574.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with cough, right wheezing and crackles; evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: No prior relevant imaging is available on PACs the time of this dictation. FINDINGS: The lungs are hyperinflated. No focal consolidation, pleural effusion, edema, or pneumothorax. The heart is normal in size. There is possible small calcified granuloma and appropriate apex. IMPRESSION: No acute cardiopulmonary process. " 75714ef9-54d98c8d-2a8614f7-9090b646-1ed9ba81.jpg,test/p14/p14982705/s50540347/75714ef9-54d98c8d-2a8614f7-9090b646-1ed9ba81.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CTA performed earlier the same day. FINDINGS: The patient is status post median sternotomy and CABG. Left-sided AICD/pacemaker device is noted with leads terminating in the region of the right atrium, right ventricle, and coronary sinus. Right-sided dual lumen central venous catheter tip terminates within the right atrium. The heart remains moderately enlarged. The mediastinal and hilar contours are unremarkable. There is no pulmonary vascular engorgement. Left lower lobe patchy opacity is concerning for infection or aspiration. A small left pleural effusion is re- demonstrated. There is no pneumothorax. IMPRESSION: Left lower lobe opacity concerning for pneumonia or aspiration. Small left pleural effusion. " 1532e846-73a3a4fd-54e8c36a-b2a8fa1b-99812d79.jpg,test/p14/p14328996/s51470076/1532e846-73a3a4fd-54e8c36a-b2a8fa1b-99812d79.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with LLQ pain // diverticulitis, pna diverticulitis, pna IMPRESSION: Comparison to ___. No relevant change. Moderate scoliosis with subsequent asymmetry of the ribcage. Calcified granuloma in the right lung apex. Normal size of the cardiac silhouette. Mild elongation of the descending aorta. No pneumonia, no pulmonary edema, no pleural effusions. No free intra-abdominal air. " 54423438-c1f45981-687ffce8-24341cda-c9cedb4a.jpg,test/p16/p16692594/s54929682/54423438-c1f45981-687ffce8-24341cda-c9cedb4a.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 6:42 AM INDICATION: Recent pneumonia, evaluate for interval change. COMPARISON: Chest radiographs dating back through ___, including the most recent study from ___. FINDINGS: Bibasilar heterogeneous opacities are increased compared to ___ but not significantly changed compared to ___. The mid and upper portions of the lungs are clear. The heart size is top normal. The mediastinal contours are normal. A small left pleural effusion is not significantly changed. There is no pneumothorax. IMPRESSION: 1. Bibasilar opacities, concerning for persistent pneumonia, not significantly changed compared to ___. 2. Unchanged small left pleural effusion. ______________________________________________________________________________ FINAL REPORT INDICATION: Recent pneumonia, evaluate for interval change. COMPARISON: Chest radiographs dating back through ___, including the most recent study from ___. FINDINGS: Bibasilar heterogeneous opacities are increased compared to ___, most recently ___. Mild cardiomegaly and pulmonary vascular engorgement are indications of chronic CHF. A large opacity at the base of the left lung, conforming to one of the large convexities in the posterior sulci of both hemithoraces on the lateral view, could be the left component of bilateral pleural effusions, but could also be a lung abscess. If this is clinically suspected, CT scanning should be performed. IMPRESSION: 1. Consider lung abscess as an alternative to dependent pleural effusion. 2. Chronic mild CHF. " c30fd887-3bc4b559-e3c07282-72ce2ae5-3116aee9.jpg,test/p13/p13623186/s55834612/c30fd887-3bc4b559-e3c07282-72ce2ae5-3116aee9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HIV (CD4 ___), here with pneumonia being treated for HCAP and PCP, ___/o TB, now with worsening tachypnea. // Evaluate for interval change, any pulmonary edema or acute process? TECHNIQUE: Single AP view of the chest. Multiple views were likely performed to include the extreme inferior costophrenic sulci. Additional post processed versions present. COMPARISON: Chest x-ray from ___ at 13:52 FINDINGS: Compared with the prior study, the right infrahilar opacity is similar, but slightly less pronounced. Opacity along the left heart border may be slightly less pronounced. Subtle findings at the right lung apex are probably similar, allowing for differences in technique. No gross effusions. Cardiomediastinal silhouette is grossly unchanged. Left-sided PICC line tip lies at the cavoatrial junction. No pneumothorax detected. IMPRESSION: Multifocal opacities again seen. There has been very slight interval improvement of the right and left infrahilar opacities, compared to earlier the same day. No pleural effusions. " 79a8081c-c5a0f533-639bd69b-86634faa-4298cfd3.jpg,test/p10/p10509294/s52581523/79a8081c-c5a0f533-639bd69b-86634faa-4298cfd3.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Shortness of breath for one week, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The heart and mediastinal contours are normal. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 44551945-cf91840d-4b0eb922-d592eceb-acdbfb9c.jpg,test/p10/p10781468/s58066712/44551945-cf91840d-4b0eb922-d592eceb-acdbfb9c.jpg,test," FINAL REPORT HISTORY: ___-year-old male with acute onset shortness of breath. TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position. COMPARISON: ___. FINDINGS: There are new bilateral mid to lower lung pulmonary opacities. No pleural effusion is detected on this frontal view. No pneumothorax is seen. There is mild diffuse interstitial prominence. The aorta is tortuous and calcified, as seen previously. Heart size is top normal and possibly exaggerated by AP technique. IMPRESSION: New bilateral mid to lower lung pulmonary opacities with interstitial prominence. These findings are concerning for edema or infection. Overall, these findings are nonspecific, and if clinically indicated CT may be helpful for further evaluation. Findings and recommendations were discussed with Dr. ___ by Dr. ___ ___ by telephone at 4:50 on ___ at the time of initial review of the study. " 90a1c0c1-44d80d93-e99d57da-585cada8-634c0eb0.jpg,test/p12/p12291041/s58054423/90a1c0c1-44d80d93-e99d57da-585cada8-634c0eb0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with AMS, concern for pneumonia v worse CHF // any new consolidation? interval changes in edema? any new consolidation? interval changes in edema? COMPARISON: Conventional chest radiographs ___ through ___. IMPRESSION: Severe cardiomegaly is chronic, but there is no pulmonary edema or appreciable pleural effusion. Opacification at the right lung base could be atelectasis, especially since it has worsened following tracheal extubation. Lateral view would be helpful in excluding pneumonia. Transvenous right atrial right ventricular pacer leads are in standard placements and a right jugular line ends close to the superior cavoatrial junction. " 7ce8c979-fdbb728f-3778540d-394da91e-ca08f8c2.jpg,test/p19/p19928728/s56205024/7ce8c979-fdbb728f-3778540d-394da91e-ca08f8c2.jpg,test," FINAL REPORT REASON FOR EXAMINATION: New OGT placement. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 2.5 cm above the carina. The NG tube tip passes below the diaphragm, most likely terminating in the stomach. Left PICC line tip is at the level of mid SVC. As compared to prior study obtained several hours earlier, there is no substantial change in the cardiomediastinal silhouette and appearance of the lungs. " 79b27fb1-9c74fada-e68cbeda-072a38ef-dd3a2780.jpg,test/p15/p15816738/s56236743/79b27fb1-9c74fada-e68cbeda-072a38ef-dd3a2780.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Cough and chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Postoperative mediastinum with median sternotomy wires and clips are unchanged. Aortic valve replacement is again seen. Massive cardiomegaly is unchanged with particularly prominent enlargement of the atria bilaterally as well as prominent enlargement of the pulmonary arteries indicative of chronic pulmonary arterial hypertension. There is mild interstitial pulmonary edema. Lungs are otherwise grossly clear. There is no pleural effusion or pneumothorax. Large gallstones project over the right upper quadrant. IMPRESSION: 1. Massive cardiomegaly and mild interstitial pulmonary edema. 2. Cholelithiasis. " 37a77413-1cf3fde6-64b7318d-71bb38b9-9ac6bf9a.jpg,test/p10/p10809830/s53411960/37a77413-1cf3fde6-64b7318d-71bb38b9-9ac6bf9a.jpg,test," FINAL REPORT INDICATION: Cough and mucous plugs. COMPARISONS: Chest radiograph from ___. FINDINGS: The lungs are clear. Elevation of the right hemidiaphragm is chronic. Surgical changes related to CABG are unchanged. There is no pneumothorax or pleural effusion. The pulmonary vascularity is normal. Exaggerated kyphosis of the thoracic spine is unchanged. IMPRESSION: No evidence of pneumonia. " 52e049eb-c3db0c29-b18c38ec-dd25f47f-650073e5.jpg,test/p19/p19310285/s57818456/52e049eb-c3db0c29-b18c38ec-dd25f47f-650073e5.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Tracheal stent, evaluation of the trachea intervention. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No pneumothorax. Borderline size of the cardiac silhouette. Minimal retrocardiac atelectasis. No pleural effusions. No pulmonary edema. No pneumonia. " 6f7a65c5-c5d23b0e-8ae81ba6-286bbcb1-4bf4b1e4.jpg,test/p11/p11658705/s53604006/6f7a65c5-c5d23b0e-8ae81ba6-286bbcb1-4bf4b1e4.jpg,test," WET READ: ___ ___ 7:10 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with chest pain, evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal contour is normal. IMPRESSION: No acute cardiopulmonary process. " 2b75be46-5b87c0b9-ead4c045-a59b77d2-b3818f51.jpg,test/p19/p19978766/s51795065/2b75be46-5b87c0b9-ead4c045-a59b77d2-b3818f51.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph dated ___. CLINICAL HISTORY: Leukocytosis, known gastric ulcer, tender abdomen, question free air. FINDINGS: AP upright portable chest radiograph is obtained. There is no evidence of free air below the right hemidiaphragm. The lungs appear clear bilaterally. Cardiomediastinal silhouette is normal. Bones appear intact. IMPRESSION: No acute findings including no sign of pneumoperitoneum. " d650aeaa-a02a7f4c-a8e54561-4eac21a9-59f811ad.jpg,test/p14/p14755254/s51272996/d650aeaa-a02a7f4c-a8e54561-4eac21a9-59f811ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated w/aspiration pna // any change in infiltrates? TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiographs dated ___. FINDINGS: Compared to chest radiographs from ___, pulmonary edema has significantly improved, now right greater than left and mild to moderate overall. Retrocardiac opacification and opacification in the right mid to lower lung have minimally improved and likely reflect atelectasis, though aspiration or infection cannot be excluded. Small right pleural effusion persist. Trace, if any, effusion on the left. No new focal consolidation. No pneumothorax. Mild central vascular congestion without overt pulmonary edema. Moderate cardiomegaly is stable. Cardiopulmonary support devices are in unchanged standard placement. IMPRESSION: 1. Interval improvement of alveolar pulmonary edema, now right greater than left and overall mild to moderate. 2. Mildly improved retrocardiac opacification and right middle and lower lung opacification, reflecting atelectasis, though infection or aspiration cannot be excluded. 3. Persistent small effusion on the right. Trace, if any, effusion on left. 4. Stable moderate cardiomegaly. Mild central vascular congestion without overt pulmonary edema. " d5dc9255-f4cc642f-8d69ac98-1139323d-7c36842a.jpg,test/p12/p12330461/s50079833/d5dc9255-f4cc642f-8d69ac98-1139323d-7c36842a.jpg,test," WET READ: ___ ___ ___ 12:08 PM 1. Mild rightward tracheal deviation is likely related to patient's known large left lower pole thyroid nodule. Clinical correlation recommended and if concern a non urgent thyroid ultrasound can be obtained for further evaluation 2. No pneumonia or pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with s/p lithotripsy with tachycardia. Assess for pulmonary edema or infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: CT urography ___. FINDINGS: There is tracheal deviation rightwards. The lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: 1. Rightward tracheal deviation is likely related to patient's known large left lower pole thyroid nodule. Clinical correlation recommended and if concern a non urgent thyroid ultrasound can be obtained for further evaluation 2. No pneumonia or pulmonary edema. " c412dc4f-ec258557-74c7716b-8977dcce-1e633727.jpg,test/p13/p13764741/s58603740/c412dc4f-ec258557-74c7716b-8977dcce-1e633727.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough x 2 weeks (with fevers last week 103.4-___ F), rhonchi noted in the LLL. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal opacity, pleural effusion or pneumothorax. The aorta is tortuous and calcified. The heart size is top normal, unchanged. Clips are noted in the neck, likely from prior thyroid surgery. There is clips in the abdomen and spinal hardware. IMPRESSION: No pneumonia. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 3:45 PM, 2 minutes after discovery of the findings. " 24c9c81a-7dc95854-6d152b87-b6288249-2f55859b.jpg,test/p12/p12047822/s57451831/24c9c81a-7dc95854-6d152b87-b6288249-2f55859b.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___ COMPARISON: Study of earlier the same date. FINDINGS: Mild-to-moderate cardiomegaly and tortuosity of the thoracic aorta appear similar. Patchy and linear opacities at the lung bases have worsened, particularly on the left. There are no pleural effusions or pneumothoraces. Bones are diffusely demineralized, consistent with the patient's advanced age. IMPRESSION: Worsening patchy and linear bibasilar opacities are probably due to atelectasis, but aspiration and developing infectious pneumonia are also possible. Short-term followup radiographs may be helpful in this regard. " 93558126-d288f085-6e0f6ec5-a2ce555c-8d71f66a.jpg,test/p12/p12196030/s58509769/93558126-d288f085-6e0f6ec5-a2ce555c-8d71f66a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman admitted for urosepsis, developed ARDS. // Evaluate for edema vs infection Evaluate for edema vs infection IMPRESSION: In comparison with the study ___, there has been substantial resolution of the diffuse bilateral pulmonary opacifications, most likely reflecting significant clearing of pulmonary edema or possibly resolution of ARDS. The left subclavian catheter remains the. Small pleural effusions may persist. " d49b63e7-d7bfdef1-5ddbdd5f-6633a2c7-7b1e5e24.jpg,test/p11/p11586698/s56055788/d49b63e7-d7bfdef1-5ddbdd5f-6633a2c7-7b1e5e24.jpg,test," FINAL REPORT INDICATION: History: ___M with h/o vasculitis presents with fever, cough // ? pneumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Reticulation, bronchiectasis and opacification there has increased since ___ consistent with worsening pulmonary fibrosis. No focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: Pulmonary fibrosis has progressed since ___. No focal consolidation concerning for pneumonia. " 5c615077-aa2736c6-9070de19-1a67834a-8e526059.jpg,test/p17/p17288913/s53413804/5c615077-aa2736c6-9070de19-1a67834a-8e526059.jpg,test," FINAL REPORT INDICATION: ___-year-old man with fall. COMPARISON: chest radiograph and CT ___; CXR ___ FINDINGS: Frontal AP and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion, or pneumothorax. Pulmonary vasculature is normal. Cardiac and mediastinal silhouettes are normal. Increased density in the right hilum is likely due to lymphadenopathy seen on CT ___, unchanged. Widening of the acromioclavicular joints is similar since at least ___. No displaced rib fracture is seen. An anchor in the left humoral head is noted. IMPRESSION: No acute intrathoracic process. " 58dfd11b-7f4a1220-b002a7a5-b5b5c76f-654945b6.jpg,test/p15/p15784637/s50305415/58dfd11b-7f4a1220-b002a7a5-b5b5c76f-654945b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p MIE for locally invasive esphogeal adenocarcinoma // post op COMPARISON: Chest radiographs from___ FINDINGS: Heart size is normal. The pulmonary vasculature is normal. No focal consolidation or pneumothorax. The patient is s/p esophagectomy. Atelectasis adjacent to the neo esophagus is unchanged. Pleural effusion on the right is almost completely resolved. Some of the post surgical changes of the right lung have resolved. IMPRESSION: 1. Atelectasis adjacent to the neo esophagus is unchanged. 2. Pleural effusion on the right is almost completely resolved. " 948b4e05-a6493351-535a1430-3207347b-da3c9591.jpg,test/p11/p11846160/s51470484/948b4e05-a6493351-535a1430-3207347b-da3c9591.jpg,test," FINAL REPORT HISTORY: ___-year-old female with hepatocellular carcinoma status post right thoracentesis. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: There is a large right pleural effusion with adjacent right lower lung collapse. There is no significant mediastinal shift. No pneumothorax is seen. The left lung is clear. Clustered density projecting over the right upper quadrant likely corresponds to site of prior TACE. IMPRESSION: Large right pleural effusion with adjacent right lower lung collapse. Findings discussed with ___ by ___ by telephone at 2:24 p.m. on ___. " d947c413-6b2ac011-645102a8-5028b5da-a0f0584a.jpg,test/p13/p13876660/s57289159/d947c413-6b2ac011-645102a8-5028b5da-a0f0584a.jpg,test," FINAL REPORT INDICATION: ___F with productive cough // rule out infiltrate TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: There streaky retrocardiac opacity which is similar compared to prior. There is also the subtle increased opacity projecting in the retrocardiac region on the lateral view. Elsewhere, lungs are clear. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: Retrocardiac opacity which could be atelectasis however infection cannot be entirely excluded. " 1080489f-e15f334d-a5fd808b-cb124643-22628283.jpg,test/p11/p11825462/s55078322/1080489f-e15f334d-a5fd808b-cb124643-22628283.jpg,test," FINAL REPORT INDICATION: ___-year-old male with tachycardia. COMPARISON: ___. CHEST, PA AND LATERAL: Lung volumes remain low, with bibasilar atelectasis, but no focal consolidation. Mild increase in the cardiomediastinal silhouette since ___. Coronary artery bypass grafting, with mediastinal clips and median sternotomy wires. There are no pleural effusions or pneumothorax. IMPRESSION: Slight enlargement in the cardiomediastinal silhouette. Although this could be due to increased mediastinal fat, please correlate clinically for evidence of acute aortic syndrome. This was discussed with Dr. ___ ___ on ___ at 9:25 a.m. " f4dd2196-9eaf8cd8-4f05c6c2-03997fa9-dc9c9eab.jpg,test/p17/p17794037/s55126741/f4dd2196-9eaf8cd8-4f05c6c2-03997fa9-dc9c9eab.jpg,test," FINAL REPORT INDICATION: Weakness and dizziness. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and clear lungs which are hyperinflated, without focal consolidation. A 4 mm focal area of nodularity is seen in the left lung apex and may be inflammatory, although a parenchymal nodule cannot be excluded. The bilateral hemidiaphragms are flattened. There is no pneumothorax or pleural effusion. IMPRESSION: 1. No acute cardiopulmonary process. 2. A 4 mm focal area of nodularity in the left lung apex may be inflammatory, although a parenchymal nodule cannot be excluded. Comparison to prior studies would be helpful, but if not available, a CT chest or 3 month followup chest radiograph can be obtained. NOTIFICATION: These findings were entered onto the communications dashboard by Dr. ___ at 17:50 on ___. " cdb545cc-48c709fc-81d42016-8f067659-945277cf.jpg,test/p13/p13804556/s58234365/cdb545cc-48c709fc-81d42016-8f067659-945277cf.jpg,test," FINAL REPORT INDICATION: ___ year old man with HIV and cough + shortness of breath, having tachycardia with PACs, has hx of a.fib // acute process TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 40e90700-f54d3c94-c150b14a-a173a56e-c4e51221.jpg,test/p13/p13680126/s57426565/40e90700-f54d3c94-c150b14a-a173a56e-c4e51221.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___. HISTORY: ___-year-old man with severe COPD and cough. Evaluate for pneumonia. IMPRESSION: PA and lateral chest compared to ___: Prior radiation is responsible for distortion of the left upper mediastinal contour and retraction of the right hilus and minor fissure. Lower lungs are clear. There is no pleural effusion. Heart size normal. " 7d948b74-66836aaa-e785f993-9b91b33d-fef41baf.jpg,test/p19/p19683840/s58982469/7d948b74-66836aaa-e785f993-9b91b33d-fef41baf.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with new ETT // ETT? ETT? TECHNIQUE: Frontal views of the chest. . COMPARISON: Prior chest radiograph from ___. FINDINGS: Since prior chest radiograph, there has been interval placement of an endotracheal tube, which terminates proximal to the carina. An orogastric tube courses below the diaphragm, the tip terminates within the stomach. The cardiac silhouette is difficult to assess. Interval decreased opacity at the right lung base could be secondary to interval decrease in right pleural effusion versus positional changes. There is increased opacity at the left lung base, which could be secondary to fluid and atelectasis. A stent projects over the mid upper abdomen. IMPRESSION: Interval placement of an endotracheal tube which appears to terminate just proximal to the carina. Orogastric tube is in adequate position. " 1f30d6c6-dd30be34-d4d0c41d-f6e6d2c3-df9b0055.jpg,test/p13/p13872674/s51477631/1f30d6c6-dd30be34-d4d0c41d-f6e6d2c3-df9b0055.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___:___ PM 1. No evidence of pneumonia. 2. Small amount of subdiaphragmatic free air, possibly postsurgical, although persisting or new perforation/leak cannot be excluded; correlate clinically. 3. 5 cm loop of small bowel, concerning for ileus or SBO ______________________________________________________________________________ FINAL REPORT HISTORY: A ___-year-old male with fever. Also, history of large cell lymphoma status post chemotherapy in ___, as well as prostate adenocarcinoma status post radiation therapy in ___. STUDY: Portable AP upright chest radiograph. FINDINGS: Epicardial pacing wire projects over the left paraspinous region. The heart size is within normal limits. Mediastinal and hilar contours appear unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. A small amount of free air under the right hemidiaphragm, may be from to recent laparotomy, but a small bowel perforation cannot be excluded. Additionally, large loops of small bowel are seen, measuring up to 5 cm, could signal a small bowel obstruction. IMPRESSION: 1. No evidence of pneumonia. 2. Small amount of subdiaphragmatic free air, possibly postsurgical, but bowel perforation is not excluded. 3. Small bowel dilated, could be obstructed; KUB has been ordered. Findings were discussed with Dr. ___ at ___:___ on ___ by ___ ___ over the phone. " 652632ec-b5f0af89-978f5602-5746120b-11b27061.jpg,test/p10/p10021927/s51939213/652632ec-b5f0af89-978f5602-5746120b-11b27061.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure // new ogt placement new ogt placement COMPARISON: Chest radiographs ___ through ___ at 12:13 p.m. Impression IMPRESSION: New upper enteric drainage tube passes into the nondistended stomach and out of view. ET tube in standard placement. Dense consolidation in the left lower lobe, is probably atelectasis. Predominantly perihilar consolidation and more extensive ground-glass opacification involving the upper lungs has worsened slightly since earlier in the day. Differential diagnosis is broad and includes pneumonia and pulmonary hemorrhage. Heart size is difficult to assess but probably not enlarged. Pleural effusion is small, on the left, if any. No pneumothorax. " c5c69a84-407efe78-e075f90d-1d0fe345-df3f18b3.jpg,test/p18/p18828251/s53348686/c5c69a84-407efe78-e075f90d-1d0fe345-df3f18b3.jpg,test," FINAL REPORT HISTORY: ___-year-old man with hypotension, weight gain. COMPARISON: ___ - ___ FINDINGS: AP and lateral chest radiographs were obtained. The lungs are well expanded and the central pulmonary vasculature is more indistinct. Cephalization of the upper lobe pulmonary vasculature has progressed since ___. Small bilateral pleural effusions are new. Moderate cardiomegaly is unchanged. Sternotomy wires and vascular clips are in unchanged positions. IMPRESSION: Indistinct pulmonary vasculature and small pleural effusions are consistent with worsening of mild CHF since ___. " 6c7e85c4-e7368fc5-6afd1e83-f2579d8f-66ca6dde.jpg,test/p17/p17221020/s51283152/6c7e85c4-e7368fc5-6afd1e83-f2579d8f-66ca6dde.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Evaluate for pneumothorax and pleural effusion. Status post pericardial window. Comparison is made with prior study, ___. There is no evidence of pneumothorax. There are persistent low lung volumes. Cardiomediastinal contours are unchanged. Multiple bilateral large lung opacities are unchanged. If any, there is a small left effusion, unchanged. There are no new abnormalities or acute complications. " c8f26843-a42a6876-db1a025e-f87f252a-9f088c8f.jpg,test/p18/p18681732/s56633099/c8f26843-a42a6876-db1a025e-f87f252a-9f088c8f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with food reflux and esophageal spasms. // Evaluate for free air or food bolus in esophagus TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. The pulmonary vasculature is normal. Atelectasis is seen in both lung bases without focal consolidation. No pleural effusion or pneumothorax is seen. Clips from prior cholecystectomy are noted in the right upper quadrant of the abdomen. There is no subdiaphragmatic free air. No acute osseous abnormality is detected. IMPRESSION: Minimal bibasilar atelectasis. No subdiaphragmatic free air. " 4b0a59bc-438adf86-ed5e8ff6-245a5414-dfb5a41c.jpg,test/p10/p10402438/s56568919/4b0a59bc-438adf86-ed5e8ff6-245a5414-dfb5a41c.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Post-cardiac arrest. COMPARISONS: None. TECHNIQUE: Chest, AP portable. FINDINGS: The patient is intubated. The endotracheal tube terminates about 2.5 cm above the carina. An orogastric tube terminates near the inlet to the hemidiaphragm, probably in the distal esophagus. A left internal central jugular venous catheter terminates in the upper superior vena cava. The heart appears mildly rounded and perhaps enlarged. There is a pleural effusion on the left, probably small-to-moderate in size, with retrocardiac opacification, including air bronchograms, which is non-specific but often seen with atelectasis, although potentially aspiration or pneumonia could be considered. The right costophrenic angle is partly excluded, but visualized right lung fields appear clear. IMPRESSION: Left-sided pleural effusion and patchy retrocardiac opacification. Status post endotracheal intubation. Orogastric tube terminating probably in the distal esophagus. " 7647c547-be69d26f-92f01069-54707f21-dc59a285.jpg,test/p15/p15225349/s53298711/7647c547-be69d26f-92f01069-54707f21-dc59a285.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with PNX after Port placement. // Status of PNX after water seal of chest tube. PLEASE PERFORM STUDY AT 11:30am(4 hours after seal). Status of PNX after water seal of chest tube. PLEASE PERFOR IMPRESSION: In comparison with the study of ___, there has been some decrease in the small left apical pneumothorax. Otherwise little change. " b7b043e9-4ba28e5e-ae58e813-9aeb6fd9-10c44d7a.jpg,test/p13/p13299285/s52696095/b7b043e9-4ba28e5e-ae58e813-9aeb6fd9-10c44d7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with please evaluate // Please evaluate IMPRESSION: Compared to prior study of 1 day earlier, pulmonary edema has nearly resolved and bilateral pleural effusions have decreased in size. No other relevant changes since the recent study. " 09ad0b19-f8254459-f750630d-f7236a95-13c5c6de.jpg,test/p16/p16454913/s56417300/09ad0b19-f8254459-f750630d-f7236a95-13c5c6de.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Septic shock, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The size of the cardiac silhouette is constant. Relatively extensive left pleural effusion with subsequent atelectasis. Overall signs of moderate pulmonary edema. The presence of a small right pleural effusion cannot be excluded. No new parenchymal opacities are visualized. " e1dce8ae-bb0325df-7fd5369a-3f732803-219cf6c5.jpg,test/p15/p15199994/s52595616/e1dce8ae-bb0325df-7fd5369a-3f732803-219cf6c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with epilepsy, aspiration // query PNA, other process COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is a massive increase in lung volumes, likely reflecting improved ventilation. An area of not characteristic scarring at the left lung bases thereby becomes visible. Although overlying pneumonia is unlikely, the finding should undergo short term radiographic followup. " 4e10e4a3-ba17adfc-aa5ea624-870e972b-cf713d6e.jpg,test/p13/p13548972/s58586471/4e10e4a3-ba17adfc-aa5ea624-870e972b-cf713d6e.jpg,test," FINAL REPORT EXAM: Chest, single supine AP portable view. CLINICAL INFORMATION: ___-year-old female with history of altered mental status. COMPARISON: ___. FINDINGS: Single supine AP portable view of the chest was obtained. There are low lung volumes, making evaluation suboptimal. There are perihilar opacities, left greater than right, which may be due to asymmetric pulmonary edema, although infectious process is not excluded. Given that the left costophrenic angle is not fully included on the image, no large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Low lung volumes, making evaluation suboptimal. Left greater than right perihilar alveolar opacities could relate to asymmetric edema versus infection. " 46c4c729-09969afe-98269970-65af2c6b-8dba4134.jpg,test/p15/p15081126/s52351783/46c4c729-09969afe-98269970-65af2c6b-8dba4134.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Confusion and paranoia, assess pneumonia. FINDINGS: PA and lateral views of the chest are obtained. Bilateral pleural effusions left greater than right noted. There is associated compressive atelectasis at the left lung base. Upper lungs appear well aerated. The heart size cannot be assessed. Coronary stent is visualized superimposed along the left heart border. The aorta is unfolded with atherosclerotic calcifications noted. Bony structures appear grossly stable. IMPRESSION: Bilateral pleural effusions left greater than right similar to that seen previously. " f68aa559-14b7236c-95cc6900-09b53abd-753c5b6f.jpg,test/p12/p12176298/s53447721/f68aa559-14b7236c-95cc6900-09b53abd-753c5b6f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with right lower lobe collapse after bronchoscopy. AP radiograph of the chest was reviewed in comparison to ___. The tracheostomy tube is 4.5 cm above the carina. The heart size and mediastinum are grossly unchanged as well as there is no substantial change in loculated pleural effusion and right lung consolidation. There is slight interval progression of diffuse left lung opacities that might reflect progression of infectious process, or a combination of infection and pulmonary edema. Left pleural effusion is unchanged. " 8de8572d-81105fba-6b3ae835-a633b2dc-0a80c1d2.jpg,test/p16/p16623281/s57647893/8de8572d-81105fba-6b3ae835-a633b2dc-0a80c1d2.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: None available. FINDINGS: Faint opacity is visualized overlying the right lower lobe. Otherwise, the remainder of the lungs is clear. Cardiomediastinal silhouette is normal. No acute fractures are identified. There are no pneumothoraces or pleural effusions. IMPRESSION: Faint opacity overlying the right lower lobe may be representative of atelectasis versus early developing pneumonia in the proper clinical setting. " fe46742b-34b36fd6-14c50595-275fe9c4-cadd4d09.jpg,test/p13/p13228928/s54618499/fe46742b-34b36fd6-14c50595-275fe9c4-cadd4d09.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman s/p L hip dislocation // pt started on nebs at rehab 2 days ago, unknown reason COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Left lower lobe is largely airless, whether because of atelectasis or, less likely, pneumonia. Chronic elevation of the left hemi diaphragm is probably contributory. Previous examinations have shown either severe diaphragmatic elevation alone or with diaphragmatic hernia, for example ___. Small pleural effusion on the right is unchanged since ___. There may be new small left pleural effusion. Moderate cardiomegaly is stable. Upper lungs are clear. " f3d98211-fd3877d9-351450de-b66fd386-130c190a.jpg,test/p15/p15191136/s58840663/f3d98211-fd3877d9-351450de-b66fd386-130c190a.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. The osseous structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " cdbb08ee-3d35695c-85f7b672-f37d2d82-c5fac8ed.jpg,test/p17/p17520239/s54756882/cdbb08ee-3d35695c-85f7b672-f37d2d82-c5fac8ed.jpg,test," WET READ: ___ ___ ___ 8:45 AM No acute intrathoracic process. Large right hilar mass seen on prior study as well as right lung nodule are unchanged in appearance. No evidence of overt pulmonary edema, pneumothorax, or large pleural effusion. Cardiomediastinal and hilar contours stable. Increased streaky opacity within the left lower lung zone is thought reflective of atelectasis. WET READ VERSION #1 ___ ___ ___ 9:08 PM No acute intrathoracic process. Large right hilar mass seen on prior study as well as right lung nodule are unchanged in appearance. No evidence of overt pulmonary edema, pneumothorax, or large pleural effusion. Cardiomediastinal and hilar contours stable. Increased streaky opacity within the left lower lung zone is thought reflective of atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic cancer of unknown primary. // Is there an acute pulmonary process? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the right apical lung nodule as well as the right hilar mass is unchanged. No new neoplastic structures. Normal size of the cardiac silhouette. No pleural effusions. No pneumonia. " 5dd2e04a-f3743c39-04c5c5ba-b55e889a-e89103a6.jpg,test/p15/p15675092/s51849984/5dd2e04a-f3743c39-04c5c5ba-b55e889a-e89103a6.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with mild shortness of breath. COMPARISON: PA and lateral chest radiograph from ___. FINDINGS: Single AP view of the chest demonstrates a nerve stimulator overlying the left chest wall with a thin lead coursing into the left neck. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal and stable. There are no bony abnormalities. IMPRESSION: No acute cardiopulmonary process. " 75e99a80-36415bff-f08667b8-9caae649-b07f7cb0.jpg,test/p15/p15180359/s56360528/75e99a80-36415bff-f08667b8-9caae649-b07f7cb0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yoM with DLBCL p/w confusion and AMS. any intrathoracic process? // ___ yoM with DLBCL p/w confusion and AMS. any intrathoracic process? TECHNIQUE: Chest PA and lateral COMPARISON: FDG PET-CT ___, and chest radiograph ___ FINDINGS: Since the prior chest radiograph performed on ___, the PICC has been removed. Lung volumes are normal. There is no consolidation, effusion or pneumothorax. Heart size is normal. No subdiaphragmatic free air. IMPRESSION: No evidence of acute cardiopulmonary process. " 33bd9f42-1a8b1bab-a377a955-e3b71a0b-0d05e40a.jpg,test/p19/p19172655/s56238537/33bd9f42-1a8b1bab-a377a955-e3b71a0b-0d05e40a.jpg,test," FINAL REPORT HISTORY: Anterior chest pain. COMPARISON: Comparison is made with chest radiographs from ___, and ___. FINDINGS: PA and lateral views of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is top normal in size. IMPRESSION: No acute cardiopulmonary process. " 59adac36-268280fc-1f207f31-5b25376f-e18b5d13.jpg,test/p16/p16591390/s55729563/59adac36-268280fc-1f207f31-5b25376f-e18b5d13.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with fever // r/o pna COMPARISON: Chest radiograph ___:37 IMPRESSION: Very small right pleural effusion may have developed or increased. Multiple lung nodules look larger but this could be a function of concurrent vascular congestion. Differential diagnosis is metastases, then progressive infection, more likely bacterial than viral or mycobacterial, but conceivably fungal, depending on patient immune status and course Heart size normal. Probable central adenopathy, difficult to distinguish from vascular engorgement. " c07c1bc6-25c39568-a4e96b1c-8c278593-90f1afd1.jpg,test/p12/p12717357/s57899976/c07c1bc6-25c39568-a4e96b1c-8c278593-90f1afd1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Kidney transplant, COPD, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, signs indicative of mild fluid overload as well as an opacity in the left lung base have completely resolved. On the current image, the cardiac silhouette is mildly enlarged. There is tortuosity of the thoracic aorta but no evidence of pneumonia or pulmonary edema. No pleural effusions. Normal hilar and mediastinal contours. " 4003806e-1cd58c65-55b232ab-a50a65ed-8b041aa8.jpg,test/p19/p19398915/s57652266/4003806e-1cd58c65-55b232ab-a50a65ed-8b041aa8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute onset chest pain, shortness of breath, hypoxemia, decreased BS RLL // edema? infiltrates? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the right pleural effusion has minimally increased in extent. Also increased are the subsequent areas of atelectasis at the right lung bases. The left lung is unchanged. The monitoring and support devices, including the right PICC line and the Dobbhoff catheter are in constant position. Constant appearance of the cardiac silhouette. Again visualized is the stent in the right upper quadrant. " cda4ff9b-78ff2ec4-ba663066-5c0d6277-0b4aeee8.jpg,test/p16/p16500918/s53941790/cda4ff9b-78ff2ec4-ba663066-5c0d6277-0b4aeee8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p Mech MVR // follow up ptx follow up ptx COMPARISON: Chest radiographs since ___, most recently ___. Small. IMPRESSION: Small right apical pneumothorax unchanged since ___. Small right pleural effusion increased following removal of the right pleural drainage catheter. Small left pleural effusion stable. Apparent increase in the already moderately enlarged cardiac silhouette is probably a function of lower lung volumes rather than real cardiomegaly. Pulmonary vascular engorgement persists but there is no good evidence for pulmonary edema. Opacification of both Lung bases, increased on the right since ___, is probably atelectasis. Left PIC line ends in the low left SVC. Transvenous right atrial and right ventricular pacer leads in standard placements. " abf32d7f-71e8bc76-7ada3072-aa956d38-022a0567.jpg,test/p15/p15219741/s58479709/abf32d7f-71e8bc76-7ada3072-aa956d38-022a0567.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman pleural effusion tapped today. // r/o pneumothorax. True upright please. r/o pneumothorax. True upright please. IMPRESSION: Comparison to ___, 612 a.m.. The right chest tube is in stable position. There is no evidence for the presence of a pneumothorax. No pneumonia, no pulmonary edema, no pleural effusions. Normal size of the heart. " 4070f639-6be66654-d808822b-05f0d471-0f706bc9.jpg,test/p16/p16261619/s53523892/4070f639-6be66654-d808822b-05f0d471-0f706bc9.jpg,test," FINAL REPORT HISTORY: ___-year-old female with new onset of hyponatremia. Rule out lung process. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs remain clear. There is no effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. The trachea is deviated to the left at the thoracic inlet potentially due to right-sided thyroid enlargement. Atherosclerotic calcifications are noted at the arch of the aorta. Compression deformity in the lower thoracic spine is unchanged. IMPRESSION: No acute cardiopulmonary process. " 415deed8-eaa62a51-8e593fd1-984c1ee8-2f0b5e2d.jpg,test/p17/p17318449/s55484286/415deed8-eaa62a51-8e593fd1-984c1ee8-2f0b5e2d.jpg,test," FINAL REPORT INDICATION: ___-year-old man with weakness and low-grade temperature, to rule out pneumonia. COMPARISON: Chest radiograph ___ CHEST RADIOGRAPHS: There is a new consolidation in the retrocardiac left lung base, concerning for pneumonia or aspiration. No pleural effusion or pneumothorax is seen. There is mild pulmonary vascular congestion. The mediastinal silhouette is unchanged. Multiple intact mediastinal wires relate to prior sternotomy. IMPRESSION: Left lower lobe consolidation, may represent pneumonia or aspiration. " 782a7151-6fdea076-582bec8f-3b5ef9cf-d807e391.jpg,test/p12/p12921573/s51540258/782a7151-6fdea076-582bec8f-3b5ef9cf-d807e391.jpg,test," FINAL REPORT HISTORY: AFib with pacemaker with rapid ventricular response. COMPARISON: None available. FINDINGS: There are mild bibasilar opacities likely representing atelectasis. The upper lung fields are clear. A more focal 9 x 4-mm nodule is noted overlying the left lower lobe. There is likely moderate cardiomegaly. A 2 lead pacemaker is noted. There is mild cephalization of vascular sheath suggesting minimal increased central venous pressures. No acute fractures are identified. There is no pleural effusion or pneumothorax. Moderate degenerative changes are noted at the bilateral glenohumeral joints. IMPRESSION: 1. Mild bibasilar opacities suggesting atelectasis. No acute cardiopulmonary process otherwise identified. 2. 9 x 4-mm nodule is noted overlying the left lower lobe. Further characterization with a dedicated CT is recommended. 3. Moderate cardiomegaly. " 2315c852-f65dd0ab-fdb935f1-3b2c5e84-9b6faa33.jpg,test/p15/p15964158/s55724158/2315c852-f65dd0ab-fdb935f1-3b2c5e84-9b6faa33.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with weakness and history of EtOH abuse. Concern for aspiration. Evaluate for infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Lungs are hyperinflated but clear. There is mild left apical pleural thickening. Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. Chronic deformity of the right sided ribs is again seen. IMPRESSION: Hyperinflated lungs, but no focal consolidation. " 6abf568e-367e5490-a2839f55-947490af-c24f0706.jpg,test/p14/p14105959/s54222071/6abf568e-367e5490-a2839f55-947490af-c24f0706.jpg,test," WET READ: ___ ___ ___ 10:23 PM Little change in comparison to the prior study from the same day with no acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old man with shortness of breath; evaluate for pulmonary edema or consolidation. FINDINGS: Comparison is made to prior study from ___ at 6:50 a.m. There are again seen prior old healed right rib fractures and thoracotomy. The heart size is enlarged but stable. Lungs are grossly clear without focal consolidation, pleural effusions, or signs for overt pulmonary edema. There are no pneumothoraces. Median sternotomy wires are seen. Degenerative changes of the AC joints are present. " 3c23a7e9-45f4a5bd-8230b20c-a6693884-55e5fecb.jpg,test/p13/p13185733/s59494752/3c23a7e9-45f4a5bd-8230b20c-a6693884-55e5fecb.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pleural effusion, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change in extent and distribution of the known left pleural effusion. Effusion is still substantial and occupies around half of the left hemithorax. Subsequent extensive atelectasis at the left lung bases. On the right, the appearance of the lung parenchyma is constant. Unchanged alignment of the sternal wires, unchanged position of the pacemaker and its leads. " cb59b58c-caf428b0-52818369-59f92df8-6686b865.jpg,test/p17/p17996251/s53910294/cb59b58c-caf428b0-52818369-59f92df8-6686b865.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic melanoma with intracranial hemorrhage, also sepsis. NG tube placed today // Please assess NG tube placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. NG tube tip is in the stomach. There is interval substantial improvement of the left retrocardiac atelectasis with only minimal residual still present. Upper lungs are essentially clear. No pneumothorax is seen. " 59e55589-d233c6de-1cba66a9-93284e02-c64cc4e2.jpg,test/p18/p18890285/s55478282/59e55589-d233c6de-1cba66a9-93284e02-c64cc4e2.jpg,test," WET READ: ___ ___ ___ 9:16 PM Interval removal on left-sided chest tube. No pneumothorax. Increased retrocardiac opacification. Also slightly more dense opacification in the left upper lung. Findings may represent atelectasis but cannot exclude an effusion or infectious process. ___ ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Atrial and status post MVR and CT removal. Rule out pneumothorax. Preliminary report typed into PACS reads ""interval removal of left-sided chest tube. No pneumothorax. Increased retrocardiac opacification. Also slightly more dense opacification in left upper lung. Findings may represent atelectasis, but cannot exclude an effusion or infectious process. ___ ___."" FINDINGS: A semi-upright portable chest radiograph shows sternal hardware status post mitral valve replacement with the radiodense portion of the prosthetic valve visible. A Swan-Ganz catheter is in place at the level of the main pulmonary artery, directed slightly to the right. There appears to be more obscuration of the left hemidiaphragm than seen on yesterday's study where subsegmental atelectasis is suggested and there is new or increased streaky consolidation in the left upper lung zone, very slight consolidation in the right costophrenic angle. Endotracheal tube and chest tube seen on yesterday's study has been removed and no pneumothorax is seen. CONCLUSION: 1. Recommend lateral view with followup to evaluate increasing consolidation at left lung base. 2. No visible pneumothorax status post chest tube removal. " 2447b540-01f177a4-89ec85f2-ef1561dd-382e7cc3.jpg,test/p19/p19524873/s52997622/2447b540-01f177a4-89ec85f2-ef1561dd-382e7cc3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new ETT // Eval ETT placement TECHNIQUE: Portable AP chest radiograph. COMPARISON: CTA chest ___ FINDINGS: There is volume loss in the right lung with right basilar atelectasis. With a small right pleural effusion cannot be excluded. A right internal jugular catheter terminates in the mid to distal SVC. An endotracheal tube terminates approximately 3.6 cm above the level the carina. A nasogastric tube terminates with the tip just beyond the gastroesophageal junction, this could be advanced several cm for better seating within the stomach. No consolidation or pneumothorax seen. IMPRESSION: As above. " 9bac2be3-5900b5df-f3056fe7-9cec3d02-6332a7c5.jpg,test/p19/p19603912/s59861307/9bac2be3-5900b5df-f3056fe7-9cec3d02-6332a7c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with BiV pacemaker. // Rule out pneumothorax COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the bilateral parenchymal opacities at the lung bases, right more than left, have decreased in extent and severity and are now less severe. However, they are still clearly visualized. Moderate cardiomegaly persists. Status post CABG and sternotomy, the wires are in correct position. Left pectoral pacemaker. No new focal parenchymal opacities. No larger pleural effusions. A 5 mm rounded calcified structure projects over the ventral aspect of the second right rib and is likely reflecting a sclerotic bone " c30251c2-2e19bc40-3b978350-03701f76-33f85111.jpg,test/p15/p15554865/s56181561/c30251c2-2e19bc40-3b978350-03701f76-33f85111.jpg,test," FINAL REPORT INDICATION: ___ year old woman with right effusion s/p attempted chest tube placement, no air of fluid aspirated once CT in place // ? PTX TECHNIQUE: Portable COMPARISON: ___ FINDINGS: Given for differences in technique, with portable radiograph and poor inspiration, no significant interval change. No pneumothorax. Stable right moderate pleural effusion layering posteriorly with adjacent consolidation. No interstitial edema. IMPRESSION: No pneumothorax. No significant interval change. " 273a1edf-7ed0f15c-153e1516-f262248d-3ecc9ffe.jpg,test/p15/p15586503/s59258262/273a1edf-7ed0f15c-153e1516-f262248d-3ecc9ffe.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Myalgias and wheezing, assess for pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours appear normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 0d21952b-62e3a06c-7fa98353-46abfc4a-cf0ed8b7.jpg,test/p10/p10699336/s59206518/0d21952b-62e3a06c-7fa98353-46abfc4a-cf0ed8b7.jpg,test," FINAL REPORT INDICATION: ___ year old man with prior ptx, desat, // eval for tension ptx FINDINGS: As compared to chest radiograph from earlier today, interval development of a moderate right-sided basal pneumothorax with some mediastinal shift suggestive of tension. Left lower lobe collapse and small to moderate effusion have slightly worsened. Mild cardiomegaly persists. Tracheostomy and right PICC in similar position. IMPRESSION: New moderate tension pneumothorax on the right. " 3dd53487-02837080-596540d7-b5868a44-71d77938.jpg,test/p11/p11116316/s54630687/3dd53487-02837080-596540d7-b5868a44-71d77938.jpg,test," FINAL REPORT AP CHEST, 9:30 A.M. ON ___. HISTORY: Suspect pneumonia. IMPRESSION: AP chest compared to ___ and earlier on ___. Although the distribution is decidedly asymmetric, the abnormalities in the lungs are most readily explained by residual edema, substantially improved since ___, less markedly improved since ___. ET tube is in standard placement, cuff overinflated as generally seen. Suggest clinical correlation to see if this is the optimal visualization. Mild-to-moderate cardiomegaly, improved. Small bilateral pleural effusions presumed. Nasogastric tube ends in the upper stomach. Swan-Ganz catheter ends in the region of the pulmonary arterial bifurcation, and left internal jugular line ends in the mid SVC. No pneumothorax. " 58a21dce-722d926d-916dfff2-90e32bbd-2bd70eb9.jpg,test/p17/p17967970/s53413629/58a21dce-722d926d-916dfff2-90e32bbd-2bd70eb9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS RUL wedge. post op bronchitis vs pna. // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. Chest CT without contrast dated ___. FINDINGS: The patient is status post bilateral upper lobe wedge resections. There is bilateral apical pleural thickening, worse on the right, which reflects a combination of postoperative change and pleural fluid. The right pleural effusion appears unchanged in size in comparison to the prior chest radiograph. There is a focus of linear opacity in the right upper lung, likely representing scarring. The lungs are otherwise clear. Heart size is stable. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Unchanged size of right pleural effusion. 2. No evidence of pneumonia. " bf047230-28150367-e7f05939-cb84747d-2037292e.jpg,test/p12/p12530892/s55976763/bf047230-28150367-e7f05939-cb84747d-2037292e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain // pna COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 6c2c7118-ff6cc7f0-e0478309-50aed3c7-308bd239.jpg,test/p12/p12439321/s57981756/6c2c7118-ff6cc7f0-e0478309-50aed3c7-308bd239.jpg,test," FINAL REPORT REASON FOR EXAM: Thoracic back pain, increasing with breathing, night sweats. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are essentially clear. There is no pleural effusion or pneumothorax. Thoracic osteophytes are noted on the lateral view, unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. " 89091c78-6f789975-838358f0-bbef85d3-d975eb0f.jpg,test/p17/p17004414/s52172537/89091c78-6f789975-838358f0-bbef85d3-d975eb0f.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // acute process? TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. Mild vertebral body height loss of a mid thoracic vertebra is new since ___. No definite acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. Mild mid thoracic vertebral body height loss which is new since ___ although age indeterminate and clinical correlation is suggested. " 9c88a67e-2b9bc50b-64f5676c-431b1b02-9c7f715d.jpg,test/p13/p13176838/s53405471/9c88a67e-2b9bc50b-64f5676c-431b1b02-9c7f715d.jpg,test," WET READ: ___ ___ ___ 11:32 PM Retrocardiac consolidation concerning for pneumonia. The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 11:24 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with neutropenic fever after chemo // evaluate for infection evaluate for infection IMPRESSION: Comparison to ___. Better seen on the lateral than on the frontal image is a retrocardiac parenchymal opacity with air bronchograms, not visualized on the previous image. There also is some mild volume loss in the middle lobe. Overall, the findings are highly suggestive of pneumonia. Borderline size of the cardiac silhouette. No pulmonary edema. Left pectoral Port-A-Cath in situ. " e1e4f9df-492a1c43-464406ff-ddce9313-c049ea39.jpg,test/p12/p12176298/s57176150/e1e4f9df-492a1c43-464406ff-ddce9313-c049ea39.jpg,test," FINAL REPORT AP CHEST, 6:04 A.M., ___ HISTORY: ___-year-old woman with previous hemoptysis. IMPRESSION: AP chest compared to ___ through ___: Moderate pulmonary edema in both lungs has worsened since ___, 7:29 a.m. There is no pneumothorax. Volume of right pleural effusion, substantially loculated in the upper hemithorax, is unchanged. Moderate cardiomegaly is stable. Pulmonary hemorrhage concurrent with edema would be difficult to detect. Tracheostomy tube in standard placement. " fd6d5055-6a2084a6-67b56635-9fa72d2e-000bc84a.jpg,test/p10/p10333385/s58051396/fd6d5055-6a2084a6-67b56635-9fa72d2e-000bc84a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dysphagia x 2 weeks; ? foreign body; now with intermittent fevers // ? FB; ? aspiration ? FB; ? aspiration IMPRESSION: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion or pleural effusion. " b21bbb07-b576a22c-fbb97f1b-bdccaf07-79b4644f.jpg,test/p10/p10291112/s50776680/b21bbb07-b576a22c-fbb97f1b-bdccaf07-79b4644f.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p polytrauma s/p trach now with hypoxia // eval for interval change TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: A tracheostomy tube is present. An enteric tube extends into the stomach. The tip of the right internal jugular central venous catheter extends into the distal SVC. Unchanged left lower lobe consolidation as well as layering bilateral pleural effusions. No pneumothorax identified. IMPRESSION: No significant interval change since the prior radiograph. " 445a8e52-de84a87c-e42c09ee-eb89beb0-12d5fac1.jpg,test/p15/p15731226/s53853704/445a8e52-de84a87c-e42c09ee-eb89beb0-12d5fac1.jpg,test," WET READ: ___ ___ 11:36 PM No acute cardiac or pulmonary findings. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: ___-year-old woman with fever and history of pancreatitis. IMPRESSION: PA and lateral chest compared to ___ and ___: Top normal heart size and azygos distention are chronic findings. Lungs are clear. Pulmonary vasculature is minimally engorged, unchanged and there is no pulmonary edema or pleural effusion. " a6fcfdc7-2878471b-d122bab0-0f507ba8-759e7963.jpg,test/p18/p18150845/s52161547/a6fcfdc7-2878471b-d122bab0-0f507ba8-759e7963.jpg,test," FINAL REPORT HISTORY: Chest pain, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little interval change. Cardiac silhouette is at the upper limits of normal or mildly enlarged. No vascular congestion, pleural effusion, or acute focal pneumonia. " 693848ea-0107b550-3a0b5502-c33b768b-a8d9255a.jpg,test/p14/p14247006/s51886116/693848ea-0107b550-3a0b5502-c33b768b-a8d9255a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Weakness, hypotension, assess for pneumonia. FINDINGS: Portable AP upright chest radiograph obtained. AICD is unchanged. Sternotomy closure device and mediastinal clips are also stable from prior. There is no convincing sign of pneumonia or CHF. No large effusion or pneumothorax. Heart and mediastinal contour appear stable. Bony structures appear grossly intact. IMPRESSION: No acute findings. " 4f4a4620-5f2988f0-0b9881c0-27231131-52ab5e76.jpg,test/p19/p19890943/s56748169/4f4a4620-5f2988f0-0b9881c0-27231131-52ab5e76.jpg,test," FINAL REPORT HISTORY: Pericarditis, pericardial effusion and pleural effusion. TECHNIQUE: PA and lateral chest radiograph, 2 views. COMPARISON: ___ through ___. FINDINGS: Cardiomediastinal silhouette and hilar contours are unchanged from immediate prior exam. The left moderate to large pleural effusion is slightly increased in size with associated atelectasis and either fluid tracking up the left major fissure or bandlike atelectasis present in the left mid lung. The right lung is clear. There is no pneumothorax. IMPRESSION: Stable cardiac silhouette. Increasing left moderate to large pleural effusion with associated atelectasis. " 550ce5a9-4650b8fa-3737dffd-c9e13016-b191b02b.jpg,test/p13/p13446510/s57266202/550ce5a9-4650b8fa-3737dffd-c9e13016-b191b02b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with R pneumothorax post R SCV port s/p pigtail // compare to prior. Please take at 11am compare to prior IMPRESSION: In comparison with the study of ___, the patient has taken a much better inspiration. There is a small apical pneumothorax with the pigtail catheter in place. Mild atelectatic changes are seen at the bases, but no definite pneumonia or vascular calcification or pleural effusion. The tip of the Port-A-Cath is in the upper portion of the right atrium. " c3caf057-b4754841-e7914e96-b8494e5f-249c6758.jpg,test/p19/p19065401/s56035526/c3caf057-b4754841-e7914e96-b8494e5f-249c6758.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Fall. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The left-sided pacemaker is seen with leads extending to the expected position of the right atrium and ventricle. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette top normal. IMPRESSION: No acute cardiopulmonary process. " f4ad7616-c4599a08-70735401-959baa5a-05962917.jpg,test/p16/p16196296/s57298691/f4ad7616-c4599a08-70735401-959baa5a-05962917.jpg,test," FINAL REPORT INDICATION: Shortness of breath and cough. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unchanged mild cardiomegaly. There is a retrocardiac opacity which is concerning for pneumonia. No appreciable pleural effusion or pneumothorax is seen. The visualized upper abdomen is unremarkable. IMPRESSION: Retrocardiac opacity concerning for pneumonia. " 954fce56-e4139d48-f718140c-ef65b17a-f4fc421f.jpg,test/p18/p18695475/s54167525/954fce56-e4139d48-f718140c-ef65b17a-f4fc421f.jpg,test," FINAL REPORT INDICATION: Concern for malnutrition. Evaluate for infiltrate. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia. " d65be852-ec4fd9df-7f497a2c-cff85eae-964f1d40.jpg,test/p18/p18036188/s59486623/d65be852-ec4fd9df-7f497a2c-cff85eae-964f1d40.jpg,test," FINAL REPORT HISTORY: ___-year-old female with leukocytosis on dialysis, cough. COMPARISON: ___. FINDINGS: Single portable view of the chest. Small opacity seen in the right mid lung. Elsewhere the lungs are clear. Cardiomegaly is again noted. Central venous catheter is unchanged in position. Enteric tube passes below the inferior field of view. IMPRESSION: Vague right mid lung opacity, nonspecific potentially infection. This could be better characterized by PA and lateral if the patient is amenable. " 2affe27c-e5edb47e-30a7a72b-2df996d9-b2841863.jpg,test/p15/p15512494/s55429366/2affe27c-e5edb47e-30a7a72b-2df996d9-b2841863.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with left pneumothorax after interval left pigtail catheter placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. The left pigtail catheter is in place. There is a slight interval decrease in currently minimal left apical pneumothorax. Vascular congestion has progressed and might be consistent with volume overload. Left retrocardiac opacity is unchanged. " df8e92fe-d8e6dfeb-875de3f9-b2f3ebbb-a9ba2aff.jpg,test/p14/p14127345/s50009317/df8e92fe-d8e6dfeb-875de3f9-b2f3ebbb-a9ba2aff.jpg,test," FINAL REPORT INDICATION: ___F with unstable angina // chest pain, sob TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f1484ff0-e5fc6435-d32db89c-628a7c45-e4c3914c.jpg,test/p17/p17962792/s53989748/f1484ff0-e5fc6435-d32db89c-628a7c45-e4c3914c.jpg,test," FINAL REPORT HISTORY: Localized renal cancer. Evaluate for new lesions. TECHNIQUE: Frontal and lateral views of the chest (3 exposures). COMPARISON: Chest radiographs ___ and ___. FINDINGS: A calcified granuloma is unchanged in the posterior basal segment of the left lower lobe. There is no pleural effusion, pneumothorax or focal airspace consolidation. There is no evidence of hilar or mediastinal lymphadenopathy. Cardiac and mediastinal contours are normal. There is a tortuous aorta. IMPRESSION: No evidence of metastatic disease. " 95d7d668-da98869e-54866981-ba46dec3-a478f04c.jpg,test/p11/p11875773/s58660310/95d7d668-da98869e-54866981-ba46dec3-a478f04c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M with chest pain // Acute cardiopulmonary process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: Again seen is mild pulmonary edema and trace bilateral pleural effusions, similar to prior. Cardiomegaly is stable. There is no focal consolidation. No pneumothorax. IMPRESSION: Mild pulmonary edema and trace bilateral pleural effusions, similar prior. " 659001b2-a65084eb-731e59b0-ece83f0b-3971c1ae.jpg,test/p16/p16969166/s53321248/659001b2-a65084eb-731e59b0-ece83f0b-3971c1ae.jpg,test," FINAL REPORT HISTORY: Nausea and vomiting with fever. FINDINGS: No previous images. The heart is normal in size and the lungs are clear without vascular congestion or pleural effusion. IMPRESSION: No evidence of pneumonia. " 85b85fc8-a13aa42c-ec6b9109-5a1a9d47-07fd96f3.jpg,test/p16/p16298181/s51315140/85b85fc8-a13aa42c-ec6b9109-5a1a9d47-07fd96f3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with shortness of breath, wheezing. // fluid overload SOB;FLUID OVERLOAD IMPRESSION: Comparison to ___. Mild cardiomegaly persists. Elongation of the descending aorta. No pulmonary edema. No pneumonia, no pleural effusions. " d30da752-2f202d5a-902d9f18-0476a4de-71a8930c.jpg,test/p19/p19349343/s57503279/d30da752-2f202d5a-902d9f18-0476a4de-71a8930c.jpg,test," FINAL REPORT HISTORY: ___-year-old male with skin laceration and possible fall, altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Calcified granuloma again seen in the right midlung. The lungs are clear of consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is stable. No displaced rib fracture is identified on this nondedicated exam. Posterior fixation hardware partially visualized in the lumbar spine. IMPRESSION: No acute cardiopulmonary process. " 897d43c9-d7aef789-3b8744de-85de0f43-945a79d1.jpg,test/p12/p12479049/s53353245/897d43c9-d7aef789-3b8744de-85de0f43-945a79d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with weakness // eval pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " 5448b23a-5276981b-b118bb03-40e1dd63-b1fc59e4.jpg,test/p11/p11201372/s58801281/5448b23a-5276981b-b118bb03-40e1dd63-b1fc59e4.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with cough and positive PPD. FINDINGS: Comparison is made to prior study from ___. Heart size is normal. Lungs are clear. Bony structures are intact. IMPRESSION: No signs for acute cardiopulmonary process. " 0b020686-5f7ba656-789640b0-83ba3d7c-b10f6ef9.jpg,test/p11/p11658675/s53546735/0b020686-5f7ba656-789640b0-83ba3d7c-b10f6ef9.jpg,test," FINAL REPORT INDICATION: Respiratory distress, unresponsiveness, shortness of breath, intubated, check placement of ET tube. COMPARISON: Multiple prior chest radiographs, most recently from ___. FINDINGS: Single portable supine frontal chest radiograph demonstrates low lung volumes. Streaky right basilar airspace opacities are relatively unchanged compared to the prior examination and likely represent vascular crowding and atelectasis; however, an underlying consolidation cannot be entirely excluded. Prominent vascular markings in the upper lungs suggest mild pulmonary edema, unchanged. Cardiomediastinal contours are unremarkable. Calcifications are again noted in the aortic arch. Endotracheal tube terminates approximately 4 cm above the carina. Presumed NG tube courses along the midline passing the diaphragm, tip is not included on the image. There is no pleural effusion and no pneumothorax. IMPRESSION: 1. Unchanged appearance of bibasilar streaky opacification likely due to low lung volumes and atelectasis; however, an underlying consolidation cannot be excluded. 2. Proper positioning of the endotracheal tube. " 1668e87f-ac8be1a3-7e63ab13-bf3f5526-c32fd02a.jpg,test/p15/p15289580/s55537749/1668e87f-ac8be1a3-7e63ab13-bf3f5526-c32fd02a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multi focal pneumonia, now acute hypoxia COMPARISON: Chest radiograph from ___. FINDINGS: AP view of the chest provided. Again seen is multi focal parenchymal opacities consistent with multi focal pneumonia. The left lung opacity has slightly increased since prior study, concerning for worsening disease. Right SVC line is in unchanged position in the low SVC. IMPRESSION: Slightly worsening of multifocal pneumonia since prior study 3 days ago. " 6e9edd2d-41128b07-e5842daa-0e6a6c07-01fefa56.jpg,test/p17/p17030962/s51000241/6e9edd2d-41128b07-e5842daa-0e6a6c07-01fefa56.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hip abscess, respiratory failure, endotracheal tube projection. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tube is touching the carina and must be repositioned. The referring physician, ___. ___, was paged for notification at the time of dictation, ___, at 9:11 a.m. Newly appeared bilateral small pleural effusions with subsequent bilateral areas of atelectasis. No other parenchymal changes. Known destructive right shoulder lesions. " 9274611c-d05369f5-5a625a35-096c9bdd-f7762275.jpg,test/p13/p13990571/s57584524/9274611c-d05369f5-5a625a35-096c9bdd-f7762275.jpg,test," FINAL REPORT INDICATION: Cough and fever. COMPARISONS: Chest radiographs from ___ and ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The under-inflated lungs are clear. There is stable moderate cardiomegaly with a left ventricular pattern. The hilar and mediastinal contours are normal. There is no pneumothorax or pleural effusion. The pulmonary vascularity is normal. Again, multiple clips are demonstrated within the left upper quadrant of the abdomen. Calcification of the aortic arch is also noted. IMPRESSION: 1. No evidence of pneumonia. 2. Stable moderate cardiomegaly with a left ventricular pattern. " 149d824f-0edefc55-f7f5f672-ec93f6b5-293ba74c.jpg,test/p16/p16583629/s56023185/149d824f-0edefc55-f7f5f672-ec93f6b5-293ba74c.jpg,test," FINAL REPORT HISTORY: Chest pain and cough, here to evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. Technique: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation concerning for pneumonia, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. Mild calcification of the aortic knob is re- demonstrated. A mid thoracic vertebral compression fracture deformity is unchanged from ___. IMPRESSION: 1. No acute intrathoracic process, specifically no pneumonia. 2. Chronic mid thoracic spine compression fracture. " 8d83ee73-9347a528-cb94f613-907803d2-f31e84c0.jpg,test/p13/p13561687/s57317916/8d83ee73-9347a528-cb94f613-907803d2-f31e84c0.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cholangiocarcinoma, septic. Please assess for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Prior chest radiograph from ___. FINDINGS: Since prior, there has been interval removal a right sided PICC line. The cardiomediastinal and hilar contours are within normal limits. There is bibasilar atelectasis which has decreased since prior. There is redemonstration of the 11 mm calcified granuloma within the right mid chest. No new focal consolidation, pleural effusion or pneumothorax. Surgical drain projects over the right upper quadrant. IMPRESSION: Interval decrease of bibasilar atelectasis. No new focal consolidation concerning for pneumonia. " 4cc59f0a-e32ddfe9-2efd67bd-fae11405-7c4c2fa4.jpg,test/p17/p17646936/s54029273/4cc59f0a-e32ddfe9-2efd67bd-fae11405-7c4c2fa4.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Lungs are expanded symmetrically. There is no focal opacity concerning for pneumonia. The cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. Osseous structures demonstrate no acute abnormality. IMPRESSION: No acute intrathoracic abnormality. " 5f8b833a-b5c56bb4-c61a72ba-61c0a0ce-9fa8c10a.jpg,test/p14/p14793590/s58364828/5f8b833a-b5c56bb4-c61a72ba-61c0a0ce-9fa8c10a.jpg,test," FINAL REPORT INDICATION: Productive cough for two to three weeks, assess for acute process. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation, or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " 78fda4db-eb264514-c18e2006-417949ae-131ba248.jpg,test/p19/p19367341/s54106565/78fda4db-eb264514-c18e2006-417949ae-131ba248.jpg,test," WET READ: ___ ___ ___ 5:07 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with palpitations x ___ min. Evaluate for pneumonia or other intrathoracic pathology. COMPARISON: Radiograph from ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process. " 7fd82f55-aaba4935-f5b31bae-0288291b-82128657.jpg,test/p15/p15020217/s55057584/7fd82f55-aaba4935-f5b31bae-0288291b-82128657.jpg,test," FINAL REPORT INDICATION: Shortness of breath, evaluate for pneumonia. COMPARISONS: Chest CTA, ___. PA AND LATERAL VIEWS OF THE CHEST: Cardiomediastinal, pleural and pulmonary structures are unremarkable. There is no pneumothorax, consolidation or pleural effusion. Heart size is normal. IMPRESSION: No acute cardiopulmonary process. " 4eb74327-18722a48-0ca9f43e-6f14f253-0945a865.jpg,test/p14/p14262946/s59688853/4eb74327-18722a48-0ca9f43e-6f14f253-0945a865.jpg,test," FINAL REPORT HISTORY: Exertional dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable and the pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " a41f002c-aa798481-a47d6de5-406be122-ec317868.jpg,test/p11/p11495809/s55144631/a41f002c-aa798481-a47d6de5-406be122-ec317868.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p bronch bilateral ___ // ?pneumothorax left ?pneumothorax left IMPRESSION: In comparison with the study of ___, there is no convincing evidence of left apical pneumothorax. Continued enlargement of the cardiac silhouette with opacification at the bases, especially on the left, consistent with pleural effusion and underlying atelectatic change. " 5411b811-4208ec63-7581abab-3b1e9f77-a6b01929.jpg,test/p18/p18143678/s59981688/5411b811-4208ec63-7581abab-3b1e9f77-a6b01929.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with elevated wbc count, cough // eval for infection eval for infection IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is enlargement of the cardiac silhouette with elevated pulmonary venous pressure in bilateral pleural effusions with compressive basilar atelectasis. In view of the extensive pulmonary changes, it is extremely difficult to exclude the possibility of superimposed pneumonia in the appropriate clinical setting, especially in the absence of a lateral view. " 8a596dd4-06629204-d2a94ddd-b0e3dcb8-b1256f7e.jpg,test/p12/p12145024/s55545863/8a596dd4-06629204-d2a94ddd-b0e3dcb8-b1256f7e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx chf, rales r base // ? chf, effusion TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Mild cardiomegaly is present. Bibasal areas of atelectasis are slightly more pronounced than on the prior study and might also represent nonspecific interstitial lung disease. Calcifications along the anterior aspect of the heart are present, new as compared to ___ and potentially neo when compared to ___ might represent left ventricular calcified aneurysm an less-likely pericardial calcifications. No pleural effusion or pneumothorax is seen. " 7ad936c2-9166ab1f-43b66cac-abf49210-6e988882.jpg,test/p12/p12238407/s51256562/7ad936c2-9166ab1f-43b66cac-abf49210-6e988882.jpg,test," FINAL REPORT INDICATION: History: ___M with asthma, respiratory distress // asthma, pneumo TECHNIQUE: Single AP view of the chest COMPARISON: None FINDINGS: Low lung volumes contributes to bibasilar atelectasis, however despite this there is still increased opacities in lower lobes which are concerning for a pneumonia. There is no pleural effusion or pneumothorax. Cardiac silhouette is normal in size. IMPRESSION: Lower lobe opacities concerning for multifocal pneumonia. " 3f674811-c0e140ed-133eb32e-aa373807-0098c632.jpg,test/p17/p17078867/s51185562/3f674811-c0e140ed-133eb32e-aa373807-0098c632.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with fever, confusion // eval pneumonia TECHNIQUE: Upright AP view of the chest COMPARISON: Chest CTA ___ and chest radiograph ___ FINDINGS: Assessment is limited by patient positioning and rotation. Cardiac silhouette size remains mildly enlarged, unchanged. Mediastinal contour is similar. There is mild pulmonary vascular congestion. Bilateral pleural thickening is more pronounced on the left and compatible with mesothelioma, better demonstrated on the most recent CT. Consolidative opacity in the left lower lobe may reflect atelectasis. No pneumothorax or new focal consolidation is present. IMPRESSION: No substantial interval change from the previous CT. Persistent bilateral pleural thickening, worse on the left, compatible with mesothelioma. Mild pulmonary vascular congestion with left lower lobe consolidative opacity potentially atelectasis, but infection is not excluded. " 68a9dec9-436c84d0-572f0df9-18929544-6b237d3b.jpg,test/p11/p11569093/s56084617/68a9dec9-436c84d0-572f0df9-18929544-6b237d3b.jpg,test," FINAL REPORT INDICATION: ___-year-old woman status post right VATS washout. Evaluate for pneumothorax. COMPARISON: ___, CT ___. FINDINGS: A frontal upright view of the chest was obtained portably. Interval removal of the right pigtail catheter with replacement with a right chest tube within the loculated right basilar pneumothorax, which is unchanged. Volume loss in the right lung with surrounding pleural fluid is unchanged. The left lung is well expanded and clear without pneumothorax or effusion. Surgical clips project over the epigastrium. Aortic contour and left heart border are unchanged. IMPRESSION: Unchanged right basilar pneumothorax. " 16ea5994-cf7b5e97-0b46dba3-eeec5080-831a9c78.jpg,test/p17/p17057667/s54743547/16ea5994-cf7b5e97-0b46dba3-eeec5080-831a9c78.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with crepitus and voice changes concern for esophageal/ bronchial tree injury/pneumothorax TECHNIQUE: Portable upright AP view of the chest COMPARISON: CT chest ___, chest radiograph ___ FINDINGS: There has been interval development of pneumomediastinum with air tracking into the fascia planes of the neck. No large pneumothorax is identified. Heart size remains moderately enlarged. The aortic knob is calcified. Coarse diffuse interstitial opacities are noted bilaterally compatible with known fibrosing chronic interstitial lung disease. Increased opacities at the lung bases likely rib reflect superimposed atelectasis. No new large pleural effusion or pulmonary edema is definitively present. Surgical anchor projects over the right humeral head. Moderate multilevel degenerative changes are seen within the thoracic spine. Multiple clips are noted in the left upper abdomen. IMPRESSION: 1. Interval development of pneumomediastinum and subcutaneous gas tracking into the fascia planes of the neck. 2. Fibrosing chronic interstitial lung disease, not substantially changed in the interval, with bibasilar opacities, likely atelectasis. 3. Moderate cardiomegaly, unchanged. " 8a67184b-b470fb1c-7562bc87-0bd0eacf-9dfff010.jpg,test/p10/p10318302/s52221182/8a67184b-b470fb1c-7562bc87-0bd0eacf-9dfff010.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pleural effusion. COMPARISON: ___. PA and lateral upright chest radiographs were reviewed. The patient has a dual ventricle pacemaker with the leads terminating in the expected locations of the right atrium, right ventricle, and epicardium of the left ventricle. A coronary stent is projecting, better appreciated on the lateral view. Heart size is top normal. Mediastinum is unremarkable. The patient is after sternotomy and CABG. Right pleural effusion is noted, small-to-moderate with substantial posterior loculation, better appreciated on the lateral view at least ___ x 5 cm in diameter. No left pleural effusion is demonstrated. No pneumothorax is seen. " 347301e6-47b968e5-569dbaa8-bea560d8-367a3c7a.jpg,test/p18/p18616140/s51247707/347301e6-47b968e5-569dbaa8-bea560d8-367a3c7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain // eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal contours are within normal limits. No acute osseous abnormalities identified. Fusion hardware is noted in the cervical-thoracic spine. IMPRESSION: No acute intrathoracic process. " 4bfe98c4-7a4942df-218856ac-4d1acfef-34f0959b.jpg,test/p17/p17489409/s53425546/4bfe98c4-7a4942df-218856ac-4d1acfef-34f0959b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough // Eval PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " c27fa72a-5ba52a6d-d6af881f-4fe0bc00-70b88d2d.jpg,test/p17/p17043686/s51549011/c27fa72a-5ba52a6d-d6af881f-4fe0bc00-70b88d2d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: rising WBC, white productive cough. Has pulmonary edema and critical aortic stenosis as well as mitral regurgitation // ?signs of pneumonia ?signs of pneumonia IMPRESSION: In comparison with the study of ___, there again is enlargement of the cardiac silhouette, though the pulmonary vascularity is essentially within normal limits. Retrocardiac opacification with obscuration of the left hemidiaphragm is consistent with volume loss in the left lower lobe and pleural fluid. In the appropriate clinical setting, it would be difficult to unequivocally exclude superimposed pneumonia, especially in the absence of a lateral view. " 21e3aa81-61190528-21a3c88d-1c6da5ab-6a47c24a.jpg,test/p17/p17057667/s58340927/21e3aa81-61190528-21a3c88d-1c6da5ab-6a47c24a.jpg,test," FINAL REPORT INDICATION: ___F with AMS PNA? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Increased interstitial markings are seen throughout the lungs, worse at the bases. The appearance is not dramatically different from prior exam. There is no definite superimposed consolidation. Cardiac silhouette is grossly unchanged. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities. Surgical clips project over the abdomen. IMPRESSION: Diffuse abnormality throughout the lungs compatible with patient's history of interstitial lung disease. No definite superimposed acute process noting that subtle changes could easily be obscured. " 83d1af1d-b5e2ba1e-99fe7186-9f255218-35fdd6d3.jpg,test/p14/p14977442/s55824260/83d1af1d-b5e2ba1e-99fe7186-9f255218-35fdd6d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: cough,chest congestion and SOB. r/o pneumonia // cough,chest congestion and SOB. r/o pneumonia cough,chest congestion and SOB. r/o pneumonia COMPARISON: Chest radiographs ___. IMPRESSION: Lungs are well expanded and clear. Cardiomediastinal and hilar silhouettes are normal. Pleura is thickened over bilateral rib fractures in various stages of healing, including a substantially displaced fracture of the right eighth rib posterolaterally. . There is no pleural effusion or pneumothorax. " 76a3bfc0-5634b185-581f8966-2dc939fb-0c43ee11.jpg,test/p15/p15782217/s56176431/76a3bfc0-5634b185-581f8966-2dc939fb-0c43ee11.jpg,test," FINAL REPORT INDICATION: Asthma and dyspnea. COMPARISON: Chest radiograph from ___, CT torso from ___. CHEST, PA AND LATERAL: Moderate-to-severe cardiomegaly and upper lobe vascular congestion are chronic; suggestion of pulmonary edema on the frontal view is a function of overlying soft tissue, not corroborated on lateral view. No pleural effusion is present. Increased retrocardiac opacity could be bronchiectasis, atelectasis, or early infection. Anterior bridging osteophytes throughout the thoracic spine. IMPRESSION: 1. Chronic congestive heart failure, no worse than on ___. 2. Left lower lobe abnormality could be better evaluated with left anterior oblique view. " 25cc48d9-9adf0cc5-77018638-0ca43052-4a467562.jpg,test/p12/p12289464/s57123922/25cc48d9-9adf0cc5-77018638-0ca43052-4a467562.jpg,test," FINAL REPORT HISTORY: Cardiac surgery. FINDINGS: In comparison with the study of ___, there are lower lung volumes. Overlapping of bony structures makes it difficult to assess the previously described tiny left apical pneumothorax. Continued enlargement of the cardiac silhouette with the pulmonary vascularity essentially within normal limits. Retrocardiac opacification at the left base is consistent with substantial volume loss in the left lower lobe and pleural effusion. Central catheter is unchanged in position. " bbb35f21-4c9cf087-cfadd45e-78328411-a3fa780c.jpg,test/p12/p12730395/s59276041/bbb35f21-4c9cf087-cfadd45e-78328411-a3fa780c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with history of metastatic lung cancer on palliative chemo, CAD s/p CABG in ___, HTN, Hypothyroidism, who is being transferred from the floor for acute respiratory failure. // interval change after placing chest tube to water seal COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the right chest tube is now on waterseal. Extent of the right basal pneumothorax is virtually unchanged. Also unchanged are the right perihilar and right basal parenchymal opacities. Constant monitoring and support devices. Constant appearance of the heart and of the left lung. " 91a06600-42ecd9a0-407a11e9-dfc1a4bf-2ad653a5.jpg,test/p13/p13505226/s52823905/91a06600-42ecd9a0-407a11e9-dfc1a4bf-2ad653a5.jpg,test," WET READ: ___ ___ ___ 9:06 AM Low lung volumes. No new focal consolidation concerning for pneumonia. Persistent linear atelectasis at the left lung base. Minimal enlargement of the right hilus again noted. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:26 AM. WET READ VERSION #1 ___ ___ ___ 1:30 AM Low lung volumes. No new focal consolidation concerning for pneumonia. Persistent linear atelectasis at the left lung base. Minimal enlargement of the right hilus again noted. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:26 AM. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with fever, cough \; evaluate for pneumonia. TECHNIQUE: PA and lateral radiograph view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Other than lower lung volumes, no significant interval change in the radiographic appearance of the chest. Linear opacities in the left lung base, are consistent with atelectasis, unchanged. No focal consolidation, edema, effusion, or pneumothorax. The heart is normal in size. Surgical clips projecting over the left abdomen abdomen and tube over the right upper abdomen are unchanged. IMPRESSION: Low lung volumes and atelectasis without evidence of pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:26 AM. " a5458172-113ab715-fc0777ca-14b44851-a65005f5.jpg,test/p18/p18811136/s55702100/a5458172-113ab715-fc0777ca-14b44851-a65005f5.jpg,test," FINAL REPORT INDICATION: ___-year-old female with MVC, restrained. Evaluate for fracture or pneumo. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs are provided. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. There are no displaced fractures. IMPRESSION: No acute cardiopulmonary process. " 2f05300d-16110db5-9ff1bae0-1a937131-f3e35a45.jpg,test/p19/p19442084/s57395571/2f05300d-16110db5-9ff1bae0-1a937131-f3e35a45.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dyspnea // evidence of pneumonia evidence of pneumonia IMPRESSION: In comparison with the study of ___, the atelectatic changes at the bases have decreased. Continued enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure. This discordance raises the possibility of cardiomyopathy or even pericardial effusion. " a0ee9d2c-9eac6609-b2f8aa1e-3e5b1a60-5b6b4407.jpg,test/p11/p11856988/s51787658/a0ee9d2c-9eac6609-b2f8aa1e-3e5b1a60-5b6b4407.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The heart is mildly enlarged. The aortic arch is partly calcified. There is a suspected small left-sided pleural effusion with no definite pleural effusion on the right. There is no evidence for pneumothorax. The lungs appear clear aside from streaky left basilar opacity, probably due to minor atelectasis. IMPRESSION: No evidence of acute disease. " 920e2f88-07cdad88-10e9c45e-32cfec01-49996f39.jpg,test/p17/p17947897/s56348231/920e2f88-07cdad88-10e9c45e-32cfec01-49996f39.jpg,test," FINAL REPORT AP CHEST 8:43 A.M. ___ HISTORY: Chest tubes removed, rule out pneumothorax. IMPRESSION: AP chest compared to 6:34 a.m.: Previous small left pneumothorax is smaller or resolved, basal pleural tube still in place. No appreciable left pleural effusion. Interval increase in caliber of the cardiomediastinal silhouette is probably due to increased intravascular volume, reflected also an increase in mild to moderate pulmonary edema largely localized to the right lower lobe. Findings were discussed by telephone with ___ at the time of dictation. " f528b60f-07fb7c39-4e43803e-9022d312-c4569056.jpg,test/p12/p12868764/s56131065/f528b60f-07fb7c39-4e43803e-9022d312-c4569056.jpg,test," FINAL REPORT INDICATION: ___F with multiple complaints, last CXR with possible nodule vs nipple shadow // Please repeat CXR with nipple markers. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Nodular density projecting over the right lung base corresponds to nipple shadow as demonstrated on the current exam with nipple markers in place. The lungs are clear. The cardiomediastinal silhouette is within normal limits.No acute osseous abnormalities. IMPRESSION: Nodule on previous exam corresponds to a nipple shadow. " a43ef46e-c9da149d-6db2192f-a957cbb8-fcbf6164.jpg,test/p19/p19193882/s54220214/a43ef46e-c9da149d-6db2192f-a957cbb8-fcbf6164.jpg,test," FINAL REPORT INDICATION: ___F with cough // acute process? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 7d79c0cb-3aeb5491-4ff59de0-7bc30a12-a50b2231.jpg,test/p16/p16218486/s50024709/7d79c0cb-3aeb5491-4ff59de0-7bc30a12-a50b2231.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Interval increase in size of cardiac silhouette accompanied by widening of vascular pedicle in keeping with increased volume status of the patient. New pulmonary vascular congestion is accompanied by minimal asymmetrical left perihilar edema. Marked elevation of right hemidiaphragm is unchanged. " 5fdcc01f-f7d1cd9c-abd074ce-f83d3089-2c4ad9a0.jpg,test/p15/p15395644/s56509897/5fdcc01f-f7d1cd9c-abd074ce-f83d3089-2c4ad9a0.jpg,test," FINAL REPORT INDICATION: ___ year old woman sp left thorocentesis // eval left effusion COMPARISON: Radiographs from ___. IMPRESSION: There has been improvement of the left-sided pleural effusion and aeration at the left base. There remains a small amount of fluid in the right minor fissure. There is minimal prominence of the pulmonary interstitial markings without overt pulmonary edema. Heart size is upper limits of normal. No pneumothoraces are present. " df9bea6b-09bd998f-0af3d269-49062542-b10c6c32.jpg,test/p15/p15335912/s50439891/df9bea6b-09bd998f-0af3d269-49062542-b10c6c32.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Malfunctioning right PICC. TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest CT ___. Chest radiograph ___. FINDINGS: Mild cardiomegaly is unchanged along with tortuosity of the thoracic aorta. Cardiomediastinal silhouette and hilar contours are otherwise unremarkable. Right PICC terminates in the upper SVC. Linear atelectasis in the right mid lung as well as mild eft base atelectasis. Lungs are otherwise clear. No pleural effusion or pneumothorax. Prominent thoracic kyphosis. IMPRESSION: No acute cardiopulmonary abnormality. Appropriate position of the right PICC. " ef5fb05f-73becd46-2a7bf1ea-0822da74-90e7e490.jpg,test/p13/p13297743/s56464928/ef5fb05f-73becd46-2a7bf1ea-0822da74-90e7e490.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain and cough and fever. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Low lung volumes seen on the frontal exam. Bibasilar opacities, larger on the left, most likely due to atelectasis, as this is not confirmed on lateral view. Lungs otherwise are clear. Cardiomediastinal silhouette is within normal limits. Surgical clips in the right upper quadrant suggest prior cholecystectomy. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No definite acute cardiopulmonary process. " 6279d705-731cab16-d78697d1-92699f65-bdc03915.jpg,test/p19/p19873891/s51704160/6279d705-731cab16-d78697d1-92699f65-bdc03915.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with abdominal pain // eval infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Small left pleural effusion with overlying atelectasis persists. No right pleural effusion is seen. The right lung appears clear. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Persistent small to moderate left pleural effusion with overlying atelectasis. " 1eb85d94-6afece9c-be1737c8-52194ea1-208e72ab.jpg,test/p10/p10164104/s50073004/1eb85d94-6afece9c-be1737c8-52194ea1-208e72ab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man post op with SOB // ?atelectasis, pneumonia TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph from ___, ___. FINDINGS: Heart size is top-normal. Mediastinal silhouette is unremarkable. There is no focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. There is mild left basilar atelectasis. IMPRESSION: Mild left basilar atelectasis. No evidence of pneumonia. " 67198b2d-23ab8932-73f13962-883d8a2c-9369451c.jpg,test/p16/p16736626/s56707811/67198b2d-23ab8932-73f13962-883d8a2c-9369451c.jpg,test," FINAL REPORT CHEST TWO VIEWS ON ___ HISTORY: Status post cardiac surgery, question pneumothorax. FINDINGS: The right PICC line with tip in the distal SVC is unchanged. There continues to be a small amount of subcutaneous emphysema bilaterally. Sternal wires and cardiac valve are unchanged. There are tiny bilateral pleural effusions. The heart size is mildly enlarged. " d71c1f69-346cced9-56ef2357-8674c347-d0bf3ed3.jpg,test/p17/p17477304/s56372248/d71c1f69-346cced9-56ef2357-8674c347-d0bf3ed3.jpg,test," WET READ: ___ ___ ___:___ PM The RLL opacity has cleared considerably with only a single band of linear atelectasis remaining. - ___ ___ ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic aspiration, three days of cough, assessment of right lower lobe for aspiration pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has taken a substantially deeper breath in. The lung parenchyma is now well expanded. The pre-existing parenchymal opacity at the bases of the right lung is no longer visible. Currently, the lung parenchyma shows normal structure and transparency. There is no evidence of pneumonia. Normal size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. Unchanged dense right upper mediastinum with deviation of the trachea, potentially caused by a retrosternal goiter. " bef40409-b755e307-65df7e50-3ad6a8cd-2a772ea8.jpg,test/p17/p17379189/s55479135/bef40409-b755e307-65df7e50-3ad6a8cd-2a772ea8.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pneumonia, sepsis and transferred from outside hospital. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are stable. As compared to the prior study, there are diffuse parenchymal opacities, bilateral, mainly in the periphery and also low lung fields. Differential diagnosis would include multifocal pneumonia. Element of interstitial edema is a possibility given distention of the azygos vein and some perihilar nature of the finding. That most likely is a combination of pulmonary edema and multifocal pneumonia. " 8dc5e184-64bd859d-e189636f-5bfe1df0-6ed6c276.jpg,test/p12/p12533087/s54941898/8dc5e184-64bd859d-e189636f-5bfe1df0-6ed6c276.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pulmonary hypetension // pre VQ scan pre VQ scan IMPRESSION: Comparison to ___. No relevant change is seen. Low lung volumes. Moderate cardiomegaly. Mild elongation of the descending aorta. No pneumonia, no pulmonary edema, no pleural effusions. " 0fde1ba9-70797926-faf8db43-1c4c3280-81c29b0b.jpg,test/p15/p15588831/s59768100/0fde1ba9-70797926-faf8db43-1c4c3280-81c29b0b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG // eval left effusion FINDINGS: As compared to serial exams dating between ___ and ___, a large conglomerate area by opacification in the left upper hemi thorax has worsened in demonstrates relatively round borders inferiorly. This is most likely predominantly intraparenchymal with adjacent potential loculated fluid component. Remainder of the lungs are grossly clear. Cardiomediastinal contours are stable. Small pleural effusions are again demonstrated bilaterally. IMPRESSION: Worsening large area of opacification in the left upper lung, which has waxed and waned on serial postoperative radiographs. Differential diagnosis includes postoperative infection, hemorrhage, aspiration, and an atypical manifestation of atelectasis. Consider chest CT for further evaluation. RECOMMENDATION: CONSIDER CHEST CT FOR FURTHER EVALUATION OF WORSENING LEFT UPPER LOBE OPACIFICATION. " 07bdcc7f-e7f50dfd-af20e2f0-23272c4b-0ddea112.jpg,test/p16/p16388630/s51010139/07bdcc7f-e7f50dfd-af20e2f0-23272c4b-0ddea112.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval COMPARISON: Multiple chest radiographs since ___, most recent ___. FINDINGS: PA and lateral views of the chest provided. Moderate cardiomegaly is stable. Pulmonary arteries are chronically enlarged but peripheral pulmonary vessels are not engorged and there is no edema or pleural effusion. Homogeneous area of opacification on the lateral view could represent left upper lobe or lingular atelectasis. Tracheostomy tube noted. IMPRESSION: Stable moderate cardiomegaly. Chronically enlarged pulmonary arteries without pulmonary edema or pleural effusion. Questionable left upper lobe or lingular atelectasis. " 2cc5fc08-fad5eeb5-409273fe-92aff7ef-afa3b3b0.jpg,test/p17/p17770682/s51522306/2cc5fc08-fad5eeb5-409273fe-92aff7ef-afa3b3b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with stroke // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are low. There is mild pulmonary vascular congestion. Otherwise no focal consolidation, pleural effusion or pneumothorax. Heart size is top-normal. No acute osseous abnormalities identified. IMPRESSION: Mild perihilar pulmonary edema, without focal pneumonia. " a7863844-ee104e38-abef8d07-8262cc09-2d6983ff.jpg,test/p19/p19635953/s58748595/a7863844-ee104e38-abef8d07-8262cc09-2d6983ff.jpg,test," WET READ: ___ ___ ___ 10:32 PM ETT 4.3 cm above the carina. Chest tube overlying right hemithorax. Left PICC tip in upper SVC, unchanged from prior. Bilateral patchy opacities likely pulmonary edema with multifocal infective process. Increaed opacity at the right upper lung is concerning for worsening pneumonia or pulmonary edema. Trace left pleural effusion. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Endotracheal tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received an endotracheal tube. The tip of the tube projects 4.7 cm above the carina and is slightly too high. The tube could be advanced by 1-2 cm. The pre-existing left subclavian vein catheter is in correct position. The right chest tube, with minimal surrounding pneumothorax around tube, is constant, as are the post-surgical opacities in the right lung. The pre-existing left-sided opacities are constant. Constant mild cardiomegaly. " e6114f27-d0cdef4a-13ef26b5-86198fa7-0890f0be.jpg,test/p13/p13871417/s57421386/e6114f27-d0cdef4a-13ef26b5-86198fa7-0890f0be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with ETT, eval ETT placement COMPARISON: Prior exam from outside hospital performed approximately 1 hr earlier. FINDINGS: AP portable upright view of the chest. Endotracheal tube is seen with its tip residing 1.9 cm above the carina. The NG tube courses into the upper abdomen. Pulmonary edema is unchanged with bilateral small pleural effusions. IMPRESSION: ET tube tip positioned 1.9 cm above the carinal. NG tube positioned appropriately. Unchanged pulmonary edema and small effusions. " 1e003e6c-b369f24c-838bd626-3393aa34-b13fab3b.jpg,test/p11/p11457450/s55057591/1e003e6c-b369f24c-838bd626-3393aa34-b13fab3b.jpg,test," WET READ: ___ ___ 10:19 PM Interval development of mild pulmonary edema since ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with PMH of dCHF, COPD, p/w dyspnea, orthopnea. Please eval pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: Compared with the prior radiograph, pulmonary arteries appear enlarged, with perihilar interstitial markings, compatible with pulmonary edema. The heart size is normal. There is no pneumothorax, large pleural effusion, or focal consolidation. Partially imaged right shoulder hardware is unchanged since the prior chest radiograph. IMPRESSION: Interval development of mild pulmonary edema since ___. " 39a60ebd-e2def2d0-60b31abb-71b7280b-676c425f.jpg,test/p12/p12260873/s51653055/39a60ebd-e2def2d0-60b31abb-71b7280b-676c425f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hep C cirrhosis, ESLD, here with uptrending MELD, concern for infection // eval for pneumonia, please schedule with renal US eval for pneumonia, please schedule with renal US IMPRESSION: In comparison with the study of ___, the cardiac silhouette is within normal limits. No vascular congestion or pleural effusion or acute focal pneumonia at this time. Shunt and embolism coils are again seen in the upper abdomen. " 8626b9ce-54169274-b6cec723-2945f384-fac6c6fb.jpg,test/p19/p19758701/s58726467/8626b9ce-54169274-b6cec723-2945f384-fac6c6fb.jpg,test," FINAL REPORT INDICATION: ___-year-old male with a persistent dry cough and mild hypoxemia who presents for evaluation. COMPARISONS: ___ chest radiograph. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. The lungs are slightly hyperinflated, however appear to be clear. There is no evidence of pneumothorax or pleural effusions. The visualized osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. Specifically, no evidence of an infiltrate suggestive of pneumonia. " 078dbfc9-68b7328d-bd812163-43209c07-17d0a8c1.jpg,test/p15/p15255120/s52100101/078dbfc9-68b7328d-bd812163-43209c07-17d0a8c1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new CVL // confirm position of central line confirm position of central line COMPARISON: Prior chest radiograph ___:22. IMPRESSION: New right internal jugular central venous line NC in the right atrium at a level approximately 2 cm beyond the estimated location of the superior cavoatrial junction. No pneumothorax pleural effusion or mediastinal widening. Mild cardiomegaly is exaggerated by low lung volumes. Aside from calcified right upper lobe granuloma, the lungs are essentially clear. No pleural effusion or pneumothorax. " 6a3c0dfa-ab57850b-984c910d-13bcbb08-315486d3.jpg,test/p17/p17598360/s57965297/6a3c0dfa-ab57850b-984c910d-13bcbb08-315486d3.jpg,test," FINAL REPORT HISTORY: ___M with hypoxia (acute on chronic) and suspected trach leak, CHF / congenital heart disease. COMPARISON: Prior exam is dated ___. FINDINGS: AP portable upright chest radiograph provided. Tracheostomy tube projects over they upper chest midline. Midline sternotomy wires are again seen. There is moderate to severe pulmonary edema with bilateral small pleural effusions. There is atelectasis in the lower lungs left greater than right. The heart size cannot be assessed. The mediastinal contour appears very similar to prior exam. The bony structures are intact. IMPRESSION: Moderate to severe pulmonary edema with small bilateral effusions. " 9ca3bf15-8c173f12-996bfcc5-9bfc0534-44186644.jpg,test/p16/p16413192/s51508576/9ca3bf15-8c173f12-996bfcc5-9bfc0534-44186644.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Sudden onset of double vision today at 11:00 a.m., chills and cough are also noted, question pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Heart and mediastinal contours are normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 88ae0247-241ecf72-44cc2204-09882705-afaa892f.jpg,test/p11/p11963545/s54777127/88ae0247-241ecf72-44cc2204-09882705-afaa892f.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman, intubated, evaluate endotracheal tube position. TECHNIQUE: Portable chest radiograph COMPARISON: None. FINDINGS: An endotracheal tube ends approximately at the carina. A nasoenteric tube is seen coiling within the stomach with the tip adjacent to the GE junction. Cardiomediastinal silhouette is notable for calcifications of the aortic knob. The lungs are grossly clear. There is no pneumothorax or pleural effusion. There is an S-shaped curvature of the thoracolumbar spine. IMPRESSION: Endotracheal tube at the carina, can be withdrawn for more optimal positioning. NOTIFICATION: The findings were paged to ___, M.D. by ___, M.D. on ___ at 3:42 PM, 10 minutes after discovery of the findings. " dfee5f66-1725be54-a727f067-4c6fcea2-00a69ef6.jpg,test/p17/p17477304/s54616225/dfee5f66-1725be54-a727f067-4c6fcea2-00a69ef6.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: Prior exam from ___. CLINICAL HISTORY: Abdominal pain, the patient has end-stage renal disease on dialysis. FINDINGS: AP upright portable and lateral views of the chest are provided. There is mild pulmonary interstitial edema. No large effusion or pneumothorax. The heart and mediastinal contour appears grossly stable. No bony abnormalities are seen. Previously noted dialysis catheter in the IVC and right heart has been removed. IMPRESSION: Mild interstitial edema. " 481215a0-fea932a2-58ca6475-dd29d010-b32919d1.jpg,test/p15/p15750321/s54945893/481215a0-fea932a2-58ca6475-dd29d010-b32919d1.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with dyspnea, evaluate for pleural effusion. TECHNIQUE: Portable chest. COMPARISON: Chest radiograph ___ and ___. FINDINGS: Mild-to-moderate cardiomegaly is unchanged. Vascular congestion and pulmonary edema has mildly increased. There are small bilateral pleural effusions. Increased left basilar opacity is most consistent with atelectasis. No pneumothorax. Median sternotomy wires are intact. IMPRESSION: Moderate pulmonary edema, increased from prior with moderate bilateral pleural effusions. " 8c09b6c2-7dd2ac50-7bba9547-36753c1a-0b17f78e.jpg,test/p16/p16787268/s53190720/8c09b6c2-7dd2ac50-7bba9547-36753c1a-0b17f78e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with stroke, intubated // Eval for ETT placement COMPARISON: None. FINDINGS: AP portable semi upright view of the chest. An endotracheal tube is seen with its tip residing approximately 3.9 cm above the carina. Lung volumes are low. Allowing for this, there is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process. ETT positioned appropriately. " caa4baeb-bb2573bb-c6a67ee6-a30292b6-05d38f30.jpg,test/p19/p19174686/s57132193/caa4baeb-bb2573bb-c6a67ee6-a30292b6-05d38f30.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph PA and lateral INDICATION: ___ year old man with CKD and new fever, diarrhea, cough // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___ FINDINGS: There is new focal consolidation at the left lung base adjacent to the left heart border. Lateral view demonstrates an opacity projecting over the lower thoracic spine, suggesting left lower lobe pneumonia. Right lung is essentially clear. Small bilateral pleural effusions are noted, slightly increased since ___. No pneumothorax or pulmonary edema. Mediastinum and hila are within normal limits. Stable mild to moderate cardiomegaly. IMPRESSION: 1. New left lower lobe pneumonia. Recommend follow-up CXR in ___ weeks after treatment to document resolution. 2. Small bilateral pleural effusions, slightly worse compared to ___. NOTIFICATION: Findings telephoned to Dr. ___ by Dr. ___ on ___ at 4:47PM, time of discovery. " 501fe2ca-8c9ae91d-b8648171-c4438aa6-5ef7c5ef.jpg,test/p14/p14558435/s53547542/501fe2ca-8c9ae91d-b8648171-c4438aa6-5ef7c5ef.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: ___-year-old woman with pleural effusion requiring chest tube placement. IMPRESSION: PA and lateral chest compared to ___: Moderate residual right pleural effusion unchanged since ___ following removal of the right pigtail pleural drain. There is still a drainage catheter in the region of the right diaphragm. Mild degree of right basal atelectasis as expected is still present. Left lung is clear. Heart size top normal, unchanged. " c55d036f-21f4e86e-40aaf0f7-47e7f088-9e418926.jpg,test/p10/p10848515/s52022524/c55d036f-21f4e86e-40aaf0f7-47e7f088-9e418926.jpg,test," FINAL REPORT HISTORY: Cardiac pacer upgrade. Evaluate lead position. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest. A left pacer has leads ending in the right atrium, right ventricle and interventricular vein. There are small bilateral pleural effusions. Interstitial irregularity in the periphery of the right lung likely represents scarring. There is no focal consolidation, pulmonary edema, or pneumothorax. There is moderate cardiomegaly. IMPRESSION: Cardiac pacer leads in appropriate position. Moderate cardiomegaly. " ef59a7f4-11299110-b4f9a5bb-c2d11f44-cd07de93.jpg,test/p10/p10650522/s53963799/ef59a7f4-11299110-b4f9a5bb-c2d11f44-cd07de93.jpg,test," FINAL REPORT INDICATION: ___M with s/p CABG, CHF, paroxismal a-fib, presenting with leg swelling. // eval for acute process TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Since prior, there has been interval progression of bilateral parenchymal opacities, greater at the bases there are small bilateral effusions. . The and Prior right PICC is no longer visualized. The cardiomediastinal silhouette is stable noting median sternotomy wires and mediastinal clips. Atherosclerotic calcifications seen at the arch. IMPRESSION: Bilateral parenchymal opacities and small effusions potentially due to worsening congestive failure and edema noting superimposed infection is possible. " a2045c65-a1017d4a-05e6eb00-5f53454a-035b3194.jpg,test/p17/p17454111/s52618147/a2045c65-a1017d4a-05e6eb00-5f53454a-035b3194.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Hyperglycemia. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. The mediastinal and hilar contours appear unchanged. The lungs appear clear. There are no pleural effusions or pneumothorax. Minimal degenerative change along the mid thoracic spine that is unchanged. There is new sclerosis projecting along the course of the right posterior tenth rib, suggesting a prior fracture, but chronic. IMPRESSION: No evidence of acute disease. Suspected chronic right tenth rib fracture. " 43d34157-46014d06-49756c06-477311bb-57b4f009.jpg,test/p11/p11244468/s58283550/43d34157-46014d06-49756c06-477311bb-57b4f009.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with wheezing, productive cough // please evaluate for PNA, consolidation, interval change in pulm edema please evaluate for PNA, consolidation, interval change in pulm edema IMPRESSION: Comparison to ___. Low lung volumes. The venous introduction sheet on the right was removed. Bilateral areas of atelectasis, right more than left. Mild cardiomegaly persists. No overt pulmonary edema. No pneumothorax. " 454eaaff-2d14a497-4321ad4b-ee4d6d1b-e1c004cd.jpg,test/p17/p17464501/s55645896/454eaaff-2d14a497-4321ad4b-ee4d6d1b-e1c004cd.jpg,test," FINAL REPORT INDICATION: ___ year old woman with sarcoid, evident on ___ CT. CXR for comparison // Sarcoid related opacities TECHNIQUE: Chest PA and lateral COMPARISON: CT thorax dated ___ FINDINGS: Substantial interval improvement, with resolution of the reticular nodular opacities predominantly in the upper lobe. Prior wedge resection in the right upper lobe. Bilateral hila also appear within normal limits. The cardiac silhouette is not enlarged. No pleural effusions or pneumothorax. IMPRESSION: Substantial interval improvement . " c3106c4a-8e4bd4c1-158e3f26-06ed96d4-cf6d624c.jpg,test/p12/p12452731/s54748673/c3106c4a-8e4bd4c1-158e3f26-06ed96d4-cf6d624c.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Fever on and off with night sweats. Heart size is normal. Mediastinum is normal. Questionable increased density and lobular contours of the left hilus are noted that potentially might reflect lymphadenopathy. Lungs are clear and there is no pleural effusion or pneumothorax. Given the patient's history, evaluation with chest CT is highly recommended to exclude the possibility of left hilar lymphadenopathy. Findings submitted to radiology Dashboard by Dr ___ on ___ " 7a744eb6-0cd299b7-4896331f-51a71fde-b0987812.jpg,test/p18/p18143542/s51910259/7a744eb6-0cd299b7-4896331f-51a71fde-b0987812.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with paraesophageal hernia s/p lap repair with anterior fundoplication ___ p/w abd pain and distension. // ?interval change TECHNIQUE: Chest two views COMPARISON: ___ 10:29 FINDINGS: Enteric tube tip well below diaphragm, not included on the radiograph. Endotracheal tube has been removed. There is tiny left pleural effusion, improved. More prominent left basilar consolidation. Right lung is clear. Normal heart size, pulmonary vascularity IMPRESSION: More prominent left basilar consolidation. Tiny left pleural effusion. " 9fcb18b3-477645ad-c1a80921-7bc889da-ca646c51.jpg,test/p17/p17750747/s59238405/9fcb18b3-477645ad-c1a80921-7bc889da-ca646c51.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is persistent elevation of the right hemidiaphragm. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 12607060-0a16c0ab-b39a855f-34bb3b12-bad808b3.jpg,test/p18/p18877436/s51671210/12607060-0a16c0ab-b39a855f-34bb3b12-bad808b3.jpg,test," FINAL REPORT INDICATION: ___-year-old with dyspnea. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrates no focal consolidation. Linear opacity within the left lingula is likely reflective of atelectasis, less likely pneumonia. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are unremarkable. No overt pulmonary edema is seen. There is no large pleural effusion. Osseous structures are without acute abnormality. IMPRESSION: No acute intrathoracic abnormality. Linear opacification within the left lingula thought reflective of atelectasis. " 2475b609-10cf87c4-d1c19623-776bc4b7-4c45170a.jpg,test/p13/p13745545/s51975226/2475b609-10cf87c4-d1c19623-776bc4b7-4c45170a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: ___-year-old-man with left pleural effusion, now status post thoracocentesis, to rule out pneumothorax or residual effusion. TECHNIQUE: AP upright chest view was read in comparison with prior chest radiographs, with the most recent from ___. IMPRESSION: Following thoracocentesis, previously moderate left pleural effusion has decreased. Residual opacity in the left lower lung is mostly combination of residual small effusion and atelectasis and/or consolidation. concurrent lung infection, however, cannot be ruled out. Small right pleural effusion is unchanged since at least ___. There are no other interval changes in the lungs. Two leads from the left pectoral AICD device ends into the right atrium and right ventricle, respectively. Mild-to-moderately enlarged heart size is stable, mediastinal and hilar contours are unchanged. " 89a3fca1-c3e6e8a8-631e5690-d9967141-d8b5cb03.jpg,test/p12/p12760459/s56020959/89a3fca1-c3e6e8a8-631e5690-d9967141-d8b5cb03.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough, to rule out pneumonia. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary pathology. " dee3cde4-bc99873a-f4255d42-192c37a6-31f7f37b.jpg,test/p15/p15557817/s50833143/dee3cde4-bc99873a-f4255d42-192c37a6-31f7f37b.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with dyspnea and hypoxia TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size remains mildly enlarged. The aortic knob is calcified. There is mild pulmonary edema with small bilateral pleural effusions, larger on the left. More focal opacity in the left lung base could reflect atelectasis, but pneumonia is not excluded. No pneumothorax is present. No acute osseous abnormalities detected. IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions, larger on the left. More focal left basilar opacity could reflect atelectasis but infection is not excluded. " cd53a876-1f5c2100-70f1b16b-95d7ba89-0228be4b.jpg,test/p19/p19561931/s59010633/cd53a876-1f5c2100-70f1b16b-95d7ba89-0228be4b.jpg,test," FINAL REPORT INDICATION: ___-year-old female with palpitations and AFib, rule out infectious process. COMPARISON: Chest radiographs on ___. FINDINGS: The lungs are clear. No evidence of pneumonia. There is no pleural effusion. No pneumothorax. Cardiac, mediastinal, and hilar contours are normal and stable. Post-surgical changes of median sternotomy with CABG are again seen. Calcifications in the aortic arch are stable. Stable appearance of wedge deformity of T12. IMPRESSION: No acute cardiopulmonary process. " b0e4ef78-f1af0acf-3c21385c-c59bb8ed-0c677632.jpg,test/p16/p16454913/s55797204/b0e4ef78-f1af0acf-3c21385c-c59bb8ed-0c677632.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. There is bibasilar atelectasis. No discrete focal consolidation is seen. There may be very minimal pulmonary vascular congestion. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Possible very minimal pulmonary vascular congestion. Otherwise, no acute cardiopulmonary process. " 57c5656a-40ecb1c3-f2c867e2-a6b3cf99-3c28d35e.jpg,test/p18/p18539425/s50943095/57c5656a-40ecb1c3-f2c867e2-a6b3cf99-3c28d35e.jpg,test," FINAL REPORT HISTORY: Male with allo bone marrow transplant and pneumonia. Assess for lung graft versus host disease or infectious process. COMPARISON: CT chest, ___, chest radiographs, ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Significant interval improvement in multifocal heterogeneous opacities with residual bibasilar atelectasis. No new focal opacity, pleural effusion, pneumothorax, or pulmonary edema. Heart size, mediastinal contour, and hila are otherwise normal. No bony abnormality. IMPRESSION: Significant interval improvement in multifocal opacities with residual mild bibasilar atelectasis. Results were conveyed via telephone to ___ by Dr. ___ on ___ at 2:30 p.m., within 10 minutes of observation of findings. " 394fca12-419ab2eb-93d107cc-aa594434-8576b9c4.jpg,test/p11/p11047238/s51456809/394fca12-419ab2eb-93d107cc-aa594434-8576b9c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with delirium // eval for PNA COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Retrocardiac atelectasis. A platelike atelectasis at the left lung bases has resolved. The lung volumes remain very low, the cardiac silhouette is mildly enlarged. No new focal parenchymal opacities. No pulmonary edema, no pleural effusions. " fb820e2e-9ec489ba-37cf9377-902cd3e8-e1f2e37b.jpg,test/p17/p17926625/s56958762/fb820e2e-9ec489ba-37cf9377-902cd3e8-e1f2e37b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath; evaluate for acute cardiopulmonary process. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal, and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion, or pneumothorax. " 19699519-49414760-ac6d2f69-c8249c70-f2fed5cb.jpg,test/p19/p19751455/s55231632/19699519-49414760-ac6d2f69-c8249c70-f2fed5cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with history of polymicrobial lung infection, Aspergilloma chronically on Voriconazole, NSCLC s/p VATS converted to open thoracotomy on ___ to LUL, COPD who is admitted to the MICU s/p photodynamic therapy (planned) complicated by post procedure SVT, hypoxic respiratory failure // Evaluate for worsening opacification TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Interval improvement in right lung atelectasis is demonstrated. . Currently the right perihilar opacity2 is present, potentially representing re-expansion of pulmonary edema. Left basal opacity is unchanged as well as left pleural thickening, chronic " 3b052623-6434f446-94e14f71-4500aecf-83811307.jpg,test/p15/p15889331/s52129434/3b052623-6434f446-94e14f71-4500aecf-83811307.jpg,test," FINAL REPORT HISTORY: Status post intubation TECHNIQUE: Frontal view of the chest. COMPARISON: Chest radiograph on ___ at 11:53 FINDINGS: An endotracheal tube is seen terminating 3.0 cm above the level of the carina. An orogastric tube is seen with its tip projected over the stomach. Lung volumes are low. There is minimal bibasilar atelectasis. Again the heart appears enlarged, but this may be due to technique. The mediastinal contours appear within normal limits. The bony structures are intact. IMPRESSION: Endotracheal tube terminates 3.0 cm above the level of the carina and an orogastric tube is seen with its tip projected over the stomach. Minimal bibasilar atelectasis. No other significant change from the prior examination. " 2cc3eb6a-7de196fc-438dff98-21b6a0b3-e3f9fcb5.jpg,test/p17/p17559880/s51751917/2cc3eb6a-7de196fc-438dff98-21b6a0b3-e3f9fcb5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever, cough // ? pneumonia. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. A left central venous line ends at the cavoatrial junction. Lungs are mildly hyperinflated and grossly clear. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. IMPRESSION: 1. No radiographic evidence for pneumonia. 2. A left central venous line ends at the cavoatrial junction. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:45 AM, 5 minutes after discovery of the findings. " 32afecea-8c1ea0a4-61b5f1f1-85e02937-79f22649.jpg,test/p14/p14473214/s50506903/32afecea-8c1ea0a4-61b5f1f1-85e02937-79f22649.jpg,test," FINAL REPORT INDICATION: Productive cough and recent intubation. COMPARISON: Multiple priors, most recently on ___. FINDINGS: The patient has been extubated. Left upper lobe consolidation has improved. This pattern is consistent with an obstructive pneumonia consistent with known lingular mass. There is no pleural effusion or pneumothorax. The heart size is within normal limits. " d5e0fafd-3abd0f50-487a8935-450f6331-a96e8d34.jpg,test/p14/p14426474/s55527552/d5e0fafd-3abd0f50-487a8935-450f6331-a96e8d34.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated with flattening of the diaphragms indicative of COPD. An electronic device pack is noted within the right anterior chest wall. The heart size is normal. The aorta remains tortuous. The pulmonary vasculature is normal. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. Surgical anchor is demonstrated within the right humeral head. IMPRESSION: No acute cardiopulmonary process. " d7f5fc0a-444bfb3f-a92794ca-06903d7d-fa670476.jpg,test/p10/p10914703/s56726548/d7f5fc0a-444bfb3f-a92794ca-06903d7d-fa670476.jpg,test," WET READ: ___ ___ 2:23 PM New consolidation in the right middle lobe, concerning for pneumonia. WET READ VERSION #1 ___ ___ 12:06 PM New consolidation the right mid lung, concerning for pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F w/chest pain, please eval for pna, mediastinal widening // ___F w/chest pain, please eval for pna, mediastinal widening TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There is a new consolidation in the right middle lobe, concerning for pneumonia. There is left basilar atelectasis. No pleural effusion. No pneumothorax. Heart size is normal and unchanged. There are multilevel degenerative changes of the visualized spine. IMPRESSION: New consolidation in the right middle lobe, concerning for pneumonia. " 277309ab-e18838c5-4a895d47-b6e6c590-246cde30.jpg,test/p15/p15465911/s58225877/277309ab-e18838c5-4a895d47-b6e6c590-246cde30.jpg,test," FINAL REPORT INDICATION: ___M with chest pain, history of sickle cell disease, evaluate for acute chest. COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE Frontal lateral view of the chest. FINDINGS: A left chest wall Port-A-Cath type catheter ends in the low SVC. Mild cardiomegaly is unchanged. Upper zone redistribution, without overt CHF. There is bibasilar atelectasis, but no focal consolidation is identified. There is no evidence of pneumothorax or pleural effusion. IMPRESSION: Stable cardiomegaly. Bibasilar atelectasis. No focal consolidation and no definite infiltrate. " 1ce3d49d-bd33732f-52bb2f0b-60484406-63debec3.jpg,test/p16/p16763981/s58309766/1ce3d49d-bd33732f-52bb2f0b-60484406-63debec3.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with right lower lobe rales, cough, fever, and dyspnea. COMPARISON: ___ to ___. FINDINGS: PA and lateral chest radiographs are limited by severe convex left kyphoscoliosis. Small-to-moderate bilateral pleural effusions are again seen and may be slightly smaller since ___. Small amount of fluid in the right minor fissure is new since ___. There is no focal consolidation or pneumothorax. No new abnormal cardiomediastinal contours are noted. IMPRESSION: Trace fluid in the right minor fissure is new. Bilateral effusions may be slightly improved. No discrete consolidation. Findings were discussed via telephone with ___ at 11:15 on ___. " fb24b1e7-15d29dcb-9eac53ad-63b70152-5613bce2.jpg,test/p12/p12868764/s56131065/fb24b1e7-15d29dcb-9eac53ad-63b70152-5613bce2.jpg,test," FINAL REPORT INDICATION: ___F with multiple complaints, last CXR with possible nodule vs nipple shadow // Please repeat CXR with nipple markers. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Nodular density projecting over the right lung base corresponds to nipple shadow as demonstrated on the current exam with nipple markers in place. The lungs are clear. The cardiomediastinal silhouette is within normal limits.No acute osseous abnormalities. IMPRESSION: Nodule on previous exam corresponds to a nipple shadow. " 6cf72c22-ff3c5a82-c853e5d1-a4dffd46-aaa4a0f5.jpg,test/p19/p19550773/s58725630/6cf72c22-ff3c5a82-c853e5d1-a4dffd46-aaa4a0f5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with MPE. lung mass and pleural effusion // Residual pleural effusion Residual pleural effusion IMPRESSION: Compared to chest radiographs ___ through ___. Partially nodular pleural abnormality still encases the contracted lung, but the volume has increased, aeration has improved, and moderate right pleural effusion is smaller. Right hilar mass is more clearly delineated. Infiltrative abnormality in the right lung is probably due to a combination of lymphatic engorgement and tumor infiltration. Left lung is grossly clear. Heart size normal. No pneumothorax. " 36be8e86-63841be3-3875e395-add0fa44-6b4820dd.jpg,test/p14/p14247006/s50961442/36be8e86-63841be3-3875e395-add0fa44-6b4820dd.jpg,test," FINAL REPORT HISTORY: Fever. FINDINGS: In comparison with the study of ___, there is little overall change and no evidence of acute pneumonia, vascular congestion, or pleural effusion. Pacer device remains in place. " 7e6fba69-f71b0a7a-4437e8fd-1e52724a-ae95eabd.jpg,test/p15/p15573773/s54303833/7e6fba69-f71b0a7a-4437e8fd-1e52724a-ae95eabd.jpg,test," WET READ: ___ ___ ___ 1:39 AM 1. OG tube terminates at the distal esophagus. 2. ET tube 3.6 cm above the carina. 3. Right basilar consolidation superimposed on mild interstitial edema. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: Altered mental status, post-intubation. COMPARISON: Radiograph available from 12:02 a.m. FRONTAL CHEST RADIOGRAPH: An endotracheal tube terminates 3.6 cm above the carina. An orogastric tube terminates at the lower esophagus. The heart is enlarged. A right-sided central venous catheter terminates at the low SVC. A right basilar consolidation is again seen, superimposed on a background of mild pulmonary vascular congestion and interstitial edema. Bilateral humeral hardware is incompletely imaged. Old right rib fractures are present. IMPRESSION: 1. OG tube terminating at the distal esophagus. This was placed on the urgent wet read dashboard in the emergency room. 2. ET tube terminating 3.6 cm above the carina. 3. Right lower lobe consolidation superimposed on background of mild pulmonary vascular congestion and interstitial edema. " c3b87de8-9ec5234c-15876b17-c4ccfffd-c1cd3e0f.jpg,test/p16/p16486267/s55054931/c3b87de8-9ec5234c-15876b17-c4ccfffd-c1cd3e0f.jpg,test," FINAL REPORT HISTORY: Persistent fevers. Evaluation for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None FINDINGS: A left-sided PICC line is seen with its tip terminating in the lower SVC. The lungs are clear. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are normal without effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " de292e67-1a77a021-dfb4a00a-1c82e028-3efa05e5.jpg,test/p18/p18376342/s57844378/de292e67-1a77a021-dfb4a00a-1c82e028-3efa05e5.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Epigastric pain. Question free air. COMPARISONS: ___. TECHNIQUE: Chest, AP upright portable. FINDINGS: A dialysis catheter terminates in the upper right atrium. The cardiac, mediastinal and hilar contours appear unchanged, allowing for small differences in technique. Streaky left basilar opacity suggests minor atelectasis. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. There is no evidence for free air. IMPRESSION: No evidence of acute disease or free air. " bbdc1c49-b4988584-05d74829-0e2ea081-dd7ce39c.jpg,test/p17/p17981107/s50063800/bbdc1c49-b4988584-05d74829-0e2ea081-dd7ce39c.jpg,test," WET READ: ___ ___ ___ 1:04 AM Persistent LLL airspace opacity compatible with pneumonia, as seen ___. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Non-small-cell lung cancer, abdominal pain, shortness of breath. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes, borderline size of the cardiac silhouette. The known left lower lobe pneumonia is barely apparent on the frontal radiograph, but is better seen on the lateral radiograph. The extent of the pneumonia has minimally decreased, but is still clearly visible. Unchanged is a band-like parenchymal opacity emanating from the left hilus, at the level of the left upper lobe. In addition, on today's radiograph, a 1 cm rounded opacity has newly appeared in the right upper lobe, projecting over the ventral part of the second rib. Overall, notably given the clinical history of the patient, further short-term radiographic followup may be considered, as multifocal pneumonia, potentially combined with malignancy, as possible. At the time of observation and dictation, 8:05 a.m., the referring physician, ___. ___, was paged for notification on ___. " 33e38047-7ce1736a-1987e836-fee37e7f-176a72a8.jpg,test/p16/p16822208/s55811842/33e38047-7ce1736a-1987e836-fee37e7f-176a72a8.jpg,test," FINAL REPORT INDICATION: ___ year old man with fever, cough, congestion // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. CT of the chest from ___. FINDINGS: The lungs are well-expanded and clear. Mediastinal contours, hila, and cardiac silhouette are normal. Biapical pleural thickening is unchanged. No pleural effusion. IMPRESSION: No evidence of pneumonia. " 29d80f0e-2841a82d-9a0a7bce-cc743fa3-a668bef1.jpg,test/p16/p16787268/s56483425/29d80f0e-2841a82d-9a0a7bce-cc743fa3-a668bef1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old male with left basal ganglia bleed with IVH extention into the ___ and ___ ventricles and hydrocephalus // Intervening change in pulmonary status given increased secretions COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is unchanged malposition of the left PICC line, as previously noted, in the azygos vein. The tracheostomy tube is in unchanged position. Unchanged low lung volumes with platelike areas of atelectasis at both the left and the right lung bases. No pneumothorax. No pneumonia. Borderline size of the cardiac silhouette without overt pulmonary edema. " 7cc76336-995f703d-82f67c72-8a7a78ad-d98956e2.jpg,test/p17/p17293739/s53557141/7cc76336-995f703d-82f67c72-8a7a78ad-d98956e2.jpg,test," FINAL REPORT HISTORY: HIV with PE, now with cough. FINDINGS: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. Specifically, no evidence of interstitial prominence to suggest PCP. No focal pneumonia or vascular congestion. " 217d1743-c8484217-3d4b007d-ce8e8890-820aeede.jpg,test/p11/p11235666/s54152167/217d1743-c8484217-3d4b007d-ce8e8890-820aeede.jpg,test," FINAL REPORT INDICATION: ___-year-old with chest pain. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: ICD leads end in the right atrium and right ventricle. The patient is status post sternotomy. Sternal wires are intact. The cardiomediastinal silhouette and hila are normal. There is a 9-mm right upper lobe linear opacity with a more nodular component inferiorly which was previously described as exostosis of the ribs. IMPRESSION: No acute cardiothoracic process. " 827120c9-595ab5c4-bd605e43-f53103d1-05f1a63f.jpg,test/p18/p18584056/s59630325/827120c9-595ab5c4-bd605e43-f53103d1-05f1a63f.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with concern for stroke TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: Heart size is mildly enlarged. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is not engorged. Lungs are hyperinflated. 8 mm nodular opacity is seen within the left upper lung field. Remainder lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Moderate multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: 1. 8 mm left upper lung field nodular opacity. Comparison with previous imaging is recommended, and if none are available, nonemergent chest CT is recommended for further assessment. 2. No acute cardiopulmonary process. " e81dfd12-2b87092f-42c4bed4-b8e4c893-367058ef.jpg,test/p15/p15245907/s50891636/e81dfd12-2b87092f-42c4bed4-b8e4c893-367058ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with mechanical ventillation. Evaluate interval change. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Radiograph from ___, ___, ___, and CT chest from ___. FINDINGS: The tip of the endotracheal tube terminates 5.4 cm above the carina. The left IJ central catheter terminates in the mid SVC. The left PICC line remains malpositioned with its tip pointed cranially towards the left internal jugular vein. The right upper lobe opacity concerning for pneumonia is unchanged, as is the moderate pulmonary edema. There is a substantial left and a smaller right pleural effusion, which are both increased. Right basilar atelectasis is unchanged. IMPRESSION: Interval increase in bilateral pleural effusions, left greater than right. " 89e0c5f9-8b8ea8a7-4512900f-0846dcbc-419a07e1.jpg,test/p10/p10585182/s58636151/89e0c5f9-8b8ea8a7-4512900f-0846dcbc-419a07e1.jpg,test," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old female with angioedema and shortness of breath. COMPARISON: ___. FINDINGS: Single frontal view of the chest. Linear left mid lung opacity is compatible with atelectasis. The lungs are otherwise grossly clear. The cardiomediastinal silhouette is stable. Lower thoracic dextroscoliosis is again noted. IMPRESSION: No acute cardiopulmonary process. " 18e87c24-cdaf958f-9c1c3e05-a8560cf8-0fd059e6.jpg,test/p14/p14663808/s55334482/18e87c24-cdaf958f-9c1c3e05-a8560cf8-0fd059e6.jpg,test," FINAL REPORT INDICATION: Chest radiograph obtained for preoperative planning. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Degenerative changes are noted along the spine. IMPRESSION: No evidence of acute cardiopulmonary process. " bf028214-cb0835ca-30254541-ed6392a2-5d347a09.jpg,test/p18/p18079481/s56876464/bf028214-cb0835ca-30254541-ed6392a2-5d347a09.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Dyspnea on exertion. COMPARISON: ___. FINDINGS: The cardiomediastinal silhouettes are grossly stable. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The bilateral rib deformities are due to prior fractures. Compression deformities along the thoracic spine are grossly stable compared to ___. " c91a4368-53c26d7f-4f741f7a-783bf8b1-ba697cf6.jpg,test/p16/p16760293/s57472743/c91a4368-53c26d7f-4f741f7a-783bf8b1-ba697cf6.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old female with fever and recently diagnosed from rehab with pneumonia. FINDINGS: AP and lateral views of the chest were compared to previous exam from ___. The lungs are hyperinflated, but clear of confluent consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Severe degenerative changes noted at the shoulders, worse on the right than on the left. Osseous and soft tissue structures are otherwise unremarkable. IVC filter noted within the abdomen. IMPRESSION: No acute cardiopulmonary process. " 50b7d51e-9afd0007-02ed989d-033e348c-637131d1.jpg,test/p12/p12462658/s51776784/50b7d51e-9afd0007-02ed989d-033e348c-637131d1.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man with severe asthma. IMPRESSION: PA and lateral chest compared to ___ and ___: Lung volumes are lower today than when aeration was optimum in ___. There is more heterogeneous opacification at both lung bases today than on ___, even though lung volumes have decreased over the preceding months. Overall findings suggest multifocal atelectasis but a component of mild interstitial edema might be contributing to decreased lung compliance. Heart size is normal. Pleural effusions are minimal if any. " e18f6868-0460da9a-327736fd-7260627b-2cef5801.jpg,test/p19/p19245176/s57654803/e18f6868-0460da9a-327736fd-7260627b-2cef5801.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hemopneumothorax // Interval change in hemopneumothorax IMPRESSION: As compared to previous radiograph of 2 days earlier, multiple right rib fractures are again demonstrated with interval decrease in extent of right pleural fluid and or extrapleural hematoma adjacent to the fracture sites. A small left pleural effusion is also noted. Distended loops of bowel in the imaged upper abdomen are incompletely evaluated on this chest radiograph and could be more fully assessed by dedicated abdominal radiographs if warranted clinically. " 0063ecf4-dc149727-3da5c5fe-e949e244-373efa3c.jpg,test/p10/p10717732/s50011075/0063ecf4-dc149727-3da5c5fe-e949e244-373efa3c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p cardiac surgery- left chest tube inserted for ?hemothorax // evaluate new chest tube COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, a new left-sided chest tube was placed. There is a minimal improvement in the grade of expansion of the left lung but a substantial amount of left pleural fluid persists. The lung volumes have decreased, visually emphasizing the diameter of the vasculature. Nonetheless, mild to moderate pleural edema is present. " c66fea04-80ebb01b-560d2d13-0295662f-f063f083.jpg,test/p18/p18082516/s50583964/c66fea04-80ebb01b-560d2d13-0295662f-f063f083.jpg,test," FINAL REPORT INDICATION: ___-year-old female with elevated systolic blood pressure of 200, fall yesterday on to left shoulder with left chest pain. No prior examinations for comparison. CHEST, PA AND LATERAL: The lungs are hyperexpanded, with flattening of the hemidiaphragms. There is no focal consolidation. No pleural effusions or pneumothorax are identified. The heart is borderline enlarged. Aortic valve prosthesis is noted. The aorta is markedly tortuous and calcified. A rounded opacity along the right superior mediastinum may represent a prominent vascular shadow versus mediastinal lesion; recommend comparison to prior imaging, if none, CT. No displaced rib fractures are identified. Note is made of diffuse idiopathic skeletal hyperostosis. IMPRESSION: 1. Chronic obstructive airways disease. 2. No displaced fractures. If the patient has focal pain, dedicated rib views can be ordered. 3. Rounded opacity along the right superior mediastinum may represent a prominent vascular shadow versus mediastinal lesion; recommend comparison to prior imaging, if none, CT. This finding and recommendation was emailed to the ED QA nurses on ___ at 3:49 p.m. " f5fd15e5-84730522-a852063c-ca646909-76094942.jpg,test/p14/p14659758/s52743126/f5fd15e5-84730522-a852063c-ca646909-76094942.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with previous imaging suggestive of effusion on R, also being treated for PNA. Eval interval change // interval change (was no fluid/effusion on ultrasound today when IP evaluated for thoracentesis so did not get tapped) interval change (was no fluid/effusion on ultrasound today w IMPRESSION: In comparison with the study of ___, there is again substantial elevation of the right hemidiaphragmatic contour. Mild atelectatic changes above the elevated hemidiaphragm are suggested on the lateral view. No evidence of acute pneumonia or vascular congestion. " 77f16453-c5faeed6-649c0405-804e11f9-202b87da.jpg,test/p14/p14304779/s55849428/77f16453-c5faeed6-649c0405-804e11f9-202b87da.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and new scant hemoptysis please screen for tumors // reasons for hemoptysis COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Moderate cardiomegaly with signs of mild fluid overload but no overt pulmonary edema. No evidence of pneumonia. Minimal atelectasis at the right and the left lung bases. No pneumothorax. " ae3d2b04-fd13bf35-8e7036c3-17a76e19-48ce12f1.jpg,test/p11/p11040162/s54820004/ae3d2b04-fd13bf35-8e7036c3-17a76e19-48ce12f1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with recent og placement // please eval og COMPARISON: Chest radiographs 19:05 on ___. FINDINGS: IMPRESSION: The stomach is been decompressed after insertion of a new nasogastric tube ending in the region of the pylorus. Redistribution of the asymmetric infiltrative abnormality throughout most of the right lung suggests a large component of edema, but pneumonia most likely aspiration may be concurrent. . Perihilar abnormality in the left lung is more likely edema but should be followed for second focus. Heart size is normal. Pleural effusions are presumed, but not substantial. ET tube in standard placement. No pneumothorax. " 020b4284-a440bbb6-f4d8328e-00a86f5e-110e6dde.jpg,test/p18/p18014061/s59597532/020b4284-a440bbb6-f4d8328e-00a86f5e-110e6dde.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man coughing with diet // Please assess for evidence of aspiration Please assess for evidence of aspiration IMPRESSION: In comparison with the study of ___, there is little change. The cardiac silhouette is within upper limits of normal in size and there is no evidence of vascular congestion, pleural effusion, or acute pneumonia. Continued low lung volumes. " 42a5a80b-4257b8a2-77697711-4e5f1ad2-2f4f39c2.jpg,test/p16/p16454913/s53712624/42a5a80b-4257b8a2-77697711-4e5f1ad2-2f4f39c2.jpg,test," FINAL REPORT HISTORY: Sepsis, now with decreased breath sounds on the left. TECHNIQUE: Single, AP, portable view of the chest with the patient in a semi-erect position. COMPARISON: Comparison is made to radiographs dated ___. IMPRESSION: Seen again is complete collapse of the left lower lobe. As compared to prior examination, the expanded lungs are now somewhat better aerated. The right lung continues to demonstrate mild pulmonary edema with an associated pleural effusion. A small left effusion is stable. The heart size appears to be slightly enlarged. Mediastinal contours are stable. Two left subclavian catheters are unchanged in position, terminating within the mid SVC. There is no associated pneumothorax. " 8aa44dc4-87911f6a-1526b05b-1f020673-1650f5ea.jpg,test/p14/p14505714/s51574036/8aa44dc4-87911f6a-1526b05b-1f020673-1650f5ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new-onset cough; metastatic neuroendocrine tumor, paraneoplastic limbic encephalitis; immunosuppressed on rituximab + prednisone // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. CTA chest with and without contrast dated ___. FINDINGS: There are multiple pulmonary nodules, the largest in the left imaged hilar region, which appear to have progressed in comparison to the prior chest radiograph. There is biapical pleural thickening. There is bibasilar atelectasis. Heart size is normal. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Multiple pulmonary nodules, which appear to have increased in comparison to the prior chest radiograph and CT, consistent with metastatic disease. 2. Bibasilar atelectasis, but no evidence of pneumonia. " 6f51962d-6822100a-3a2d1667-747fefe6-317a938a.jpg,test/p19/p19891610/s52480678/6f51962d-6822100a-3a2d1667-747fefe6-317a938a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB // r/o PNA COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Opacity in the left lower lung is slightly improved though minimal opacity persists. There is a tiny left pleural effusion. Heart size remains enlarged. Aorta is unfolded. IMPRESSION: As above. " 6b07f517-ec5ab62b-110cc72c-4bd82504-39da314f.jpg,test/p17/p17642642/s53595190/6b07f517-ec5ab62b-110cc72c-4bd82504-39da314f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MSSA endocarditis now has mild hypoxia and sputum production // PNA, effusions, septic emboli COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of mild fluid overload but no overt pulmonary edema. Minimal atelectasis at the right lung bases. No circumscribed focal parenchymal opacity that could suggest pneumonia. No pleural effusions. Normal size of the cardiac silhouette. " 24ed4a76-e08a9cac-e94d9231-dfa52136-e2c7c885.jpg,test/p15/p15385040/s52062010/24ed4a76-e08a9cac-e94d9231-dfa52136-e2c7c885.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pna increasing o2 requirements // interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there is a progression of left lower lobe collapse, currently complete. Bibasal consolidations are present, potentially minimally increased since the prior study. No pneumothorax or increase in pleural effusion demonstrated. NOTIFICATION: Discussed with Dr ___ ___ the phone at 10:18 am ___ min after the findings were made by Dr ___ " 001aab77-00f58710-2f7d060b-33213f2d-dccb8daf.jpg,test/p14/p14277220/s55719848/001aab77-00f58710-2f7d060b-33213f2d-dccb8daf.jpg,test," FINAL REPORT HISTORY: Trauma. COMPARISON: None available. FINDINGS: Bilateral hazy opacities interstitial are visualized and likely representative of fibrotic changes. Otherwise the lungs are without a focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute fractures are identified. IMPRESSION: No evidence of acute injury. Bilateral hazy interstitial opacities are likely representative of fibrotic changes. " 55bc858d-eefbcfd7-ca97f640-805a01f1-56661e3f.jpg,test/p18/p18143326/s51219575/55bc858d-eefbcfd7-ca97f640-805a01f1-56661e3f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chest pain // ? Abnormality INTERMITTENT CHEST PAIN SEVERAL YEARS PER PT,WORSENING BURNING SENSATION R/O ABNORMALITY IMPRESSION: There no prior chest radiographs available for review. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . " 6c2e730d-9a79adcb-657f1fde-86f1f560-34ed37e9.jpg,test/p17/p17619932/s51292125/6c2e730d-9a79adcb-657f1fde-86f1f560-34ed37e9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough pdt of grey sputum, // any e/o PNA? any e/o PNA? IMPRESSION: Comparison to ___. A previously seen left-sided parenchymal opacity has completely resolved. On the current radiograph, there is no evidence of pneumonia or other focal parenchymal abnormality. No pleural effusions. No pulmonary edema. Normal size of the heart, normal contour of the hilar and mediastinal structures. " 210a0d91-4e3e9212-6b5f0c12-77826966-671562db.jpg,test/p10/p10152121/s58219738/210a0d91-4e3e9212-6b5f0c12-77826966-671562db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with esophageal ca s/p esophagectomy. // Assess for interval change. TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: A right-sided chest tube and epidural catheter are unchanged in appearance when compared to the prior study. Lung volumes are also unchanged with a small right pleural effusion, similar when compared to the prior study. There is mild right basilar atelectasis. Superimposed infection cannot be excluded. The left lung appears grossly clear. IMPRESSION: No significant interval change when compared to the prior study. " 727e2aa5-ddfdd2ff-b5723867-520a758e-c81ca8e2.jpg,test/p19/p19991135/s57757467/727e2aa5-ddfdd2ff-b5723867-520a758e-c81ca8e2.jpg,test," FINAL REPORT AP CHEST, 12:08 P.M. ON ___. HISTORY: Emphysema. After EBUS. Rule out pneumothorax. IMPRESSION: AP chest compared to ___: There is no pneumothorax, pleural effusion or evidence of hemorrhage in the lung or mediastinum. Emphysema is severe. Heart size is normal. The complex of nodule and large bullae in the axillary region of the right upper lobe is essentially unchanged. " 8bd97b66-9958ea07-93f29d96-c163f0b3-77b0d23a.jpg,test/p12/p12047910/s52078258/8bd97b66-9958ea07-93f29d96-c163f0b3-77b0d23a.jpg,test," WET READ: ___ ___ ___ 8:57 AM Interval progression of bibasilar interstitial changes, which likely reflect a combination of pulmonary fibrosis and aspiration. Superimposed infection is not excluded. WET READ VERSION #1 ___ ___ ___ 4:55 AM No acute cardiopulmonary process. WET READ VERSION #2 ___ ___ ___ 8:00 AM No consolidation. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with dyspnea/inability to swallow secretions // acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___, and CTA chest dated ___. FINDINGS: Lungs are well expanded. Cardiomediastinal hilar contours are unchanged. Patient is status post median sternotomy, with intact sternotomy wires. Chronic interstitial changes are more pronounced at the bilateral lung bases, and are increased from prior. There is a large hiatal hernia. No pneumothorax, pleural effusion, or consolidation. IMPRESSION: Interval progression of bibasilar interstitial changes, which likely reflect a combination of pulmonary fibrosis and aspiration. Superimposed infection is not excluded. " d4a61f9b-a3a9e66d-e20df05d-bbd02dcb-78283f45.jpg,test/p11/p11958553/s57063454/d4a61f9b-a3a9e66d-e20df05d-bbd02dcb-78283f45.jpg,test," WET READ: ___ ___ 7:07 PM subcutaneous emphysema within right chest wall. bilateral low lung vol with crowding of bronchovascular markings. widened mediastinum may be related to post surgical changes. drains and tubes noted. bibasilar and retrocardiac opacification likely atelectasis vs infection in correct clinica setting. mild pul edema cannot be excluded. ______________________________________________________________________________ FINAL REPORT HISTORY: Esophagectomy, postoperative. FINDINGS: In comparison with study of ___, there are lower lung volumes with evidence of esophagectomy and gastric pull-through. Nasogastric tube tip is at the level of the carina. There is some indistinctness of engorged pulmonary vessels. It is unclear whether this represents elevated pulmonary venous pressure or is merely a manifestation of low lung volumes. Right chest tube is in place without pneumothorax. Subcutaneous gas is seen along the chest wall on the lower and the upper abdomen. Bibasilar atelectatic changes are noted. " fe28eb72-b8664c88-89b0579d-e6e0341b-2ff6e7ef.jpg,test/p13/p13532440/s59900212/fe28eb72-b8664c88-89b0579d-e6e0341b-2ff6e7ef.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: The lungs are hyperinflated, but are clear of focal consolidation, effusion, or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Moderate hiatal hernia is again seen. Hypertrophic changes seen in the spine, without acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. No evidence of pneumonia. " 815d7bec-00b1d5dd-270d18b1-ae001725-a1a12268.jpg,test/p19/p19874473/s59698613/815d7bec-00b1d5dd-270d18b1-ae001725-a1a12268.jpg,test," FINAL REPORT INDICATION: Dyspnea. Evaluate for pneumonia. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs demonstrate right basilar opacification with obscuration of the right heart border and right hemidiaphragm, consistent with pneumonia of the right middle and lower lobes. There is no pleural effusion or pneumothorax. The heart size is normal. IMPRESSION: Right middle and right lower lobe pneumonia. " 52afbe26-22ee4f0a-27c8edda-71344558-c94cbbb4.jpg,test/p15/p15378092/s50972975/52afbe26-22ee4f0a-27c8edda-71344558-c94cbbb4.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___ CLINICAL HISTORY: ___-year-old man with DLBCL, undergoing chemotherapy with fever, assess pneumonia. FINDINGS: PA and lateral views of the chest provided. A Port-A-Cath resides over the right chest wall with catheter tip extending to the level of the high SVC. Lungs are clear without signs of pneumonia or CHF. The cardiomediastinal silhouette is normal. No effusion or pneumothorax. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 9c67a426-facdfd49-5dcab2af-562a9509-60b836fa.jpg,test/p17/p17112351/s51985223/9c67a426-facdfd49-5dcab2af-562a9509-60b836fa.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Dyspnea and cardiomyopathy, for evaluation. TECHNIQUE: Portable AP radiograph was obtained. REPORT: There is significant cardiomegaly. Prominent vasculature at the hila, particularly in the right side is noted. There are generalized congestive changes seen. Findings suggestive of a left-sided pleural effusion are also seen. Comparison is made to same day chest radiograph. This confirms generalized congestive change.Changes in the left costophrenic sulcus likely reflect fat deposition-no effusion of note on CT CONCLUSION: Findings consistent with CHF. " 6cf55157-001d08d5-2ee2ecf5-c54156a4-67f7c5fa.jpg,test/p10/p10326773/s57186986/6cf55157-001d08d5-2ee2ecf5-c54156a4-67f7c5fa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETT position // ETT position ETT position IMPRESSION: In comparison with the earlier study of this date, the tip of the endotracheal tube lies approximately 4.2 cm above the carina. Increased opacification at the left base suggests aspiration or infectious pneumonia. NOTIFICATION: Dr. ___, who suggests that the patient does not have infectious symptoms. " 6859dd9f-2c8f88e1-6859f5ff-264be70e-737c0366.jpg,test/p11/p11658675/s52080767/6859dd9f-2c8f88e1-6859f5ff-264be70e-737c0366.jpg,test," FINAL REPORT AP CHEST, 3:47 A.M., ___ HISTORY: ___-year-old man with dyspnea, fevers and COPD. Suspect pneumonia or influenza. IMPRESSION: AP chest compared to prior chest radiographs since ___, most recently ___ and chest CT scans on ___ and ___: Atelectasis in the superior subsegment of the lingula is chronic accounts for some of the peribronchial opacification in the left lower lung. The remainder of the abnormality in the left lower lung is more pronounced today than it has been from previous times, but it is now symmetric with the right lower lobe which has substantially improved today compared to some prior chest radiographs. Overall, there has been no change since ___, and the most striking is pulmonary vascular congestion and mild pulmonary edema. Overall, the radiographic record demonstrates recurrent bibasilar pneumonias, probably due to reflux and aspiration. Currently, although I cannot exclude bacterial pneumonia, the findings are best explained by congestive heart failure, perhaps with concurrent influenza or even viral pneumonia. There is no appreciable pleural effusion. The heart is not particularly enlarged. Pleural effusion, if present, it is not substantial. I discussed the findings with a physician on the care team to call me, 9:45 a.m. " 834d8690-808c375a-ef9e1260-ac3c1cb5-0dbcd6a1.jpg,test/p10/p10786539/s56531336/834d8690-808c375a-ef9e1260-ac3c1cb5-0dbcd6a1.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Transient ischemic attack. COMPARISONS: ___, and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A single-lead pacemaker device terminates in the right ventricle. The heart is at the upper limits of normal size. The mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 21c1682e-70bcc3c7-d939ee17-b73f3389-86345356.jpg,test/p17/p17021161/s57264489/21c1682e-70bcc3c7-d939ee17-b73f3389-86345356.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with clotted AV graft. Preoperative chest x-ray. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___ FINDINGS: Compared to the prior chest radiograph ___ there is no significant change in a small left retrocardiac opacity which most likely represents atelectasis. No new opacity, pleural effusion and pneumothorax. Mild cardiomegaly is stable. The mediastinal silhouette is stable. IMPRESSION: Left lower lobe atelectasis. Otherwise, clear lungs. " 963a5acf-a6d7b6da-2c8bc5dd-855434d6-087eef65.jpg,test/p10/p10282467/s50756710/963a5acf-a6d7b6da-2c8bc5dd-855434d6-087eef65.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest x-ray INDICATION: ___ year old woman with s/p COLECTOMY RIGHT LAPAROSCOPIC; LYSIS OF ADHESIONS ___ // r/o rib fracture TECHNIQUE: PA and lateral projections, upright positioning. COMPARISON: No priors available for comparison. FINDINGS: There are no rib fractures visualized. The patient has a right cervical rib. The visualized mediastinal structures are unremarkable. There is no cardiomegaly. The lung fields appear clear without evidence of focal consolidation. There are no pneumothoraces or effusions. There is a well circumscribed and calcified lesion which is seen on the PA projection projecting over the left upper mid abdomen. This is not well visualized on the lateral view. This correlates with a calcified splenic cyst/lesion seen on prior CT examination on ___. IMPRESSION: No evidence of acute rib fracture. " 4c69d673-3fd04567-779a3607-cf788527-15d186d2.jpg,test/p12/p12298181/s56847153/4c69d673-3fd04567-779a3607-cf788527-15d186d2.jpg,test," FINAL REPORT HISTORY: Thoracentesis, to assess for right pneumothorax. FINDINGS: In comparison with the study of ___, there is no definite pneumothorax at this time. There could be a small collection of air in the apical region that is obscured by overlying bony structures. Otherwise, there is still evidence of pulmonary vascular congestion and small fluid collections at the bases. " 37031dd3-71dfd4aa-528cdecc-f7c2413a-ab3da73d.jpg,test/p10/p10691749/s55852337/37031dd3-71dfd4aa-528cdecc-f7c2413a-ab3da73d.jpg,test," FINAL REPORT HISTORY: Syncope, seizure. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " c3406ce3-51551e17-b2d4c6a6-416bcd1a-3c271de4.jpg,test/p11/p11022501/s54885535/c3406ce3-51551e17-b2d4c6a6-416bcd1a-3c271de4.jpg,test," FINAL REPORT HISTORY: Shortness of breath, chest pain x. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. A few scattered subcentimeter rounded opacities projecting over the right lung, may be due to calcified granulomas and/or vessels on-end. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 20fdae62-124ead94-81fc39f4-ef5f5c63-d2da5765.jpg,test/p18/p18780736/s51473522/20fdae62-124ead94-81fc39f4-ef5f5c63-d2da5765.jpg,test," FINAL ADDENDUM ADDENDUM: Findings were discussed with Dr. ___ ___ the phone by Dr. ___ at noon on ___. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Increasing cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Port-A-Cath catheter tip is at the level of mid SVC. Heart size and mediastinum are unchanged including cardiomegaly and tortuous aorta. There is questionable increasing right upper lobe relatively lateral opacities that might reflect developing/resolving infectious process. The rest of the lungs are clear with no appreciable change in hyperinflation. Minimal bilateral pleural effusion is appreciated on the lateral view, new as compared to the prior study. " f42c06ca-1bd3d273-4747989a-6b094721-ae9c874b.jpg,test/p19/p19601036/s59393344/f42c06ca-1bd3d273-4747989a-6b094721-ae9c874b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman s/p CT removal // inter change/pneumothorax. Please complete xray at 2pm COMPARISON: Chest radiographs ___ through ___ at 11:24. IMPRESSION: There is no pneumothorax or change in the appearance of the basal and loculated left pleural collections since ___ following removal of the pigtail pleural drainage catheter. Small right pleural is minimally larger, and edema persists at the base of the right lung. Right thoracostomy tube unchanged in position. Right PIC line ends in the mid SVC. Moderate enlarged of the cardiac silhouette is stable. " 03c97902-5e4e811d-8669dc04-35804ed5-f08a7525.jpg,test/p12/p12639945/s51274524/03c97902-5e4e811d-8669dc04-35804ed5-f08a7525.jpg,test," FINAL REPORT HISTORY: Dyspnea. Evaluate for pneumonia or volume overload. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiac silhouette is mildly enlarged not significantly changed from prior examination. There is calcification of the aortic knob. There is mild pulmonary vascular congestion. A possible trace pleural effusion is seen on the right. No focal consolidation or pneumothorax. Severe kyphosis due to compression deformities is again noted in the thoracic spine. IMPRESSION: Mild stable cardiomegaly with mild pulmonary vascular congestion. Possible trace right pleural effusion. " d7252869-d36c38cf-44fd5883-599eb048-bdfeaf14.jpg,test/p11/p11551927/s55525641/d7252869-d36c38cf-44fd5883-599eb048-bdfeaf14.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with acute pancreatitis // interval progression COMPARISON: Chest radiographs since ___, most recently ___ IMPRESSION: Moderate worsening pulmonary edema obscures previous discrete lung nodules or nodular areas of consolidation. Lung volumes are quite low because of upward displacement of the diaphragm, but there is probably a substantial right pleural effusion as well. Heart is top-normal size exaggerated by low lung volumes. Mediastinal veins are dilated. Tracheostomy tube is slightly turned an should be evaluated clinically to see if this is acceptable. Esophageal drainage and feeding tubes can be traced as far as the low esophagus but the tips are indistinct. Right jugular line ends in the upper SVC and a left subclavian or PIC line in the low or. " 8dec4add-f741e007-6c265a13-c548da7b-a71e359e.jpg,test/p15/p15002645/s54829151/8dec4add-f741e007-6c265a13-c548da7b-a71e359e.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest were obtained. The heart is normal size and cardiomediastinal contours are stable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 7abdc230-0e34085b-990d7ce4-19bccb12-e5b370a0.jpg,test/p12/p12882985/s56986471/7abdc230-0e34085b-990d7ce4-19bccb12-e5b370a0.jpg,test," FINAL REPORT EXAMINATION: Chest (PA and lateral) INDICATION: ___-year-old man presenting with fever and cough; evaluate for pneumonia. TECHNIQUE: PA and lateral radiograph views of the chest were obtained. COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes are low. No focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits and overall unchanged from the prior exam. Stable appearance of the hila. Posterior spinal fixation device is incompletely visualized but appears similar to the prior exam. A tubular opacity is seen only on the lateral view and is likely external to the patient. Multi-level degenerative changes in the visualized spine are overall unchanged. IMPRESSION: No acute intrathoracic process. " e0e37d0a-5974ee39-fd808fad-ad6612ef-5ff6d7db.jpg,test/p13/p13247581/s58095046/e0e37d0a-5974ee39-fd808fad-ad6612ef-5ff6d7db.jpg,test," FINAL REPORT HISTORY: COPD on oxygen with productive cough. COMPARISON: Chest radiograph ___ and chest CTA ___. TECHNIQUE: Upright AP and lateral views of the chest. FINDINGS: The patient is status post thoracic aortic graft repair. The mediastinal contours are unchanged. Moderate cardiomegaly persists. There is no pulmonary vascular engorgement, and the hilar contours are normal. Apart from streaky atelectasis at the lung bases, the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. The lungs are hyperinflated with relative paucity of the pulmonary vascular markings towards the apices compatible with mild to moderate centrilobular emphysema. Mild degenerative changes are noted in the thoracic spine. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " fc95fda4-7695b353-8063c170-4545c182-a34b74f6.jpg,test/p17/p17784248/s50388715/fc95fda4-7695b353-8063c170-4545c182-a34b74f6.jpg,test," WET READ: ___ ___ ___ 2:14 PM 1. No pneumonia. 2. Stable chronic left apical scarring 3. Emphysema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Dyspnea on exertion. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Frontal and lateral chest radiographdemonstrates a persistent area of scarring at the left lung apex which is unchanged since previous examination. The lungs are otherwise clear with persistent emphysematous changes. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Surgical clips are again seen within the left axilla. Calcified aortic arch is again noted. IMPRESSION: 1. No pneumonia. 2. Stable chronic left apical scarring 3. Emphysema. " a3f831dc-655e27dd-f26785db-d975699b-1c057fc8.jpg,test/p17/p17540438/s55991693/a3f831dc-655e27dd-f26785db-d975699b-1c057fc8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with who presents s/p fall due to unclear etiology, + headstrike // ? pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is somewhat rotated. There is bibasilar atelectasis. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Previously seen right pulmonary nodule was better assessed on prior studies. IMPRESSION: No significant interval change. " f09d180f-aae55dc5-2e3b2282-d7dddcfa-44ed759d.jpg,test/p16/p16030194/s54463915/f09d180f-aae55dc5-2e3b2282-d7dddcfa-44ed759d.jpg,test," FINAL REPORT INDICATION: Shortness of breath and cough for 10 days. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " e730c17b-52d5bffd-bbab50a5-133c7334-756f8721.jpg,test/p11/p11543398/s50688501/e730c17b-52d5bffd-bbab50a5-133c7334-756f8721.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure, intubated; please eval ETT and for interval change // please eval ETT please eval ETT IMPRESSION: Compared to chest radiographs since ___, most recently ___. Greater opacification in the left chest could be due to increasing pleural effusion or asymmetric pulmonary edema. Moderately severe right basal atelectasis is unchanged. Moderate cardiomegaly stable. Small right pleural effusion stable. Upper lungs grossly clear. No pneumothorax. Left internal jugular line ends at the origin of the SVC. ET tube, esophageal drainage tube, and right internal jugular line have been removed. " 4d89c826-b14da324-16e82d2c-cf03583d-73b66e6a.jpg,test/p14/p14071732/s55240741/4d89c826-b14da324-16e82d2c-cf03583d-73b66e6a.jpg,test," FINAL REPORT INDICATION: Cough and shortness of breath. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 31769f13-139b1b3e-f21744be-153eed5a-c148308f.jpg,test/p13/p13240711/s51858873/31769f13-139b1b3e-f21744be-153eed5a-c148308f.jpg,test," FINAL REPORT HISTORY: ___-year-old man with chest pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Hypertrophic changes are noted in the spine. IMPRESSION: No acute cardiopulmonary process. " 8d96da9a-6ab00bdc-f41af5d9-90040d24-823253e9.jpg,test/p12/p12432054/s54523218/8d96da9a-6ab00bdc-f41af5d9-90040d24-823253e9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sternal fx, rib fx s/p fall // interval change interval change COMPARISON: Comparison to trauma series ___ at 17:23 FINDINGS: Portable AP semi-erect chest film ___ at 05:52 is submitted. IMPRESSION: Patient remains markedly rotated.limiting evaluation of the cardiac and mediastinal contours. Lungs remain well inflated without evidence of focal airspace consolidation, pleural effusions or pneumothorax. No evidence of pulmonary edema. No displaced rib fracture is seen. " d687962e-912dcc7f-8c9d173a-8eecdaa5-eb9448f8.jpg,test/p19/p19997293/s53859051/d687962e-912dcc7f-8c9d173a-8eecdaa5-eb9448f8.jpg,test," WET READ: ___ ___ ___ 8:15 PM Technically limited exam. Mild pulmonary edema. Resolution of the previously seen effusions. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Spinal abscess, stage IV COPD, evaluation for pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated and postoperative clips have been removed. The basal parts of both lungs are missing on the image, left more than right. The visible parts of the lung parenchyma are unchanged and without evidence of pneumonia or pulmonary edema. The presence of small pleural effusions, however, cannot be excluded. Unchanged left-sided PICC line, unchanged vertebral stabilization devices and sternal wires. " 1d0684c9-026ed402-b33079a3-67122828-21bac6df.jpg,test/p17/p17217213/s58760291/1d0684c9-026ed402-b33079a3-67122828-21bac6df.jpg,test," FINAL REPORT HISTORY: Shortness of breath, cough. TECHNIQUE: Chest: AP and lateral views. COMPARISON: ___. FINDINGS: The thorax is under penetrated due to patient body habitus. Given this, there is moderate pulmonary vascular congestion. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable as compared to prior chest radiograph from ___. IMPRESSION: Under penetrated thorax due to patient body habitus. Moderate pulmonary vascular congestion. No definite focal consolidation. " 1affc794-c5e41ab5-fa494fbf-fcb7561c-2c525bd0.jpg,test/p16/p16454913/s53790349/1affc794-c5e41ab5-fa494fbf-fcb7561c-2c525bd0.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after kidney pancreas transplant. Portable AP radiograph of the chest was compared to ___. Overall, the appearance is stable including tracheostomy, left internal jugular line tip, cardiomediastinal silhouette including dilated mediastinum and cardiomegaly as well as widespread parenchymal opacities. " 44ab03eb-9bacfa05-9052d360-78fcf073-e17217c0.jpg,test/p15/p15996479/s55297300/44ab03eb-9bacfa05-9052d360-78fcf073-e17217c0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma exacerbation // eval for consolidation eval for consolidation COMPARISON: Prior chest radiographs ___ and ___. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 3276e0bb-1b204e48-1d07e6f5-63dc196b-7e604efe.jpg,test/p19/p19780620/s53340941/3276e0bb-1b204e48-1d07e6f5-63dc196b-7e604efe.jpg,test," FINAL ADDENDUM ADDENDUM No specific addendum. ______________________________________________________________________________ WET READ: ___ ___ ___ 8:58 PM Tip of the nasogastric tube terminates in the stomach. The side hole is also within the body of the stomach. Dobhoff remains post pyloric. The findings were discussed with Dr. ___ , M.D. by ___, M.D. on the telephone on ___ at 8:56 PM, 3 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with post-pyloric dobhoff and NGT placement. // please evaluate location please evaluate location IMPRESSION: Comparison to ___. Stable monitoring and support devices. 1 of the 2 feeding tubes is in post pyloric position. Mild left basal pleural effusion with subsequent atelectasis. No other relevant change. " 735a1485-25b03048-643fde23-3ee14c1e-165a4ab8.jpg,test/p10/p10883457/s54512146/735a1485-25b03048-643fde23-3ee14c1e-165a4ab8.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Bloody sputum. The cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. Mild degenerative changes in the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " ff8b8730-5ee67c1e-0c040ad9-e0a316da-51c90644.jpg,test/p19/p19700168/s52338544/ff8b8730-5ee67c1e-0c040ad9-e0a316da-51c90644.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with dizziness // eval infiltrate COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. The lungs appear lucent suggesting emphysema. There is mild elevation of the left hemidiaphragm which is unchanged. No convincing signs of pneumonia, edema. No pleural effusion or pneumothorax. The aorta is unfolded. Heart size appears normal. Bony structures are intact. IMPRESSION: No acute findings. " 77fee087-93db9adf-08b5d319-2e72a95c-f37e0310.jpg,test/p11/p11895636/s55054713/77fee087-93db9adf-08b5d319-2e72a95c-f37e0310.jpg,test," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: AP view of the chest, ___. INDICATION: ___-year-old with PICC line manipulation. FINDINGS: There is no visualization of a PICC line or any unexpected foreign body on this radiograph. Right chest port remains in good position, terminating in the mid SVC. The cardiomediastinal and hilar contours are normal. The lungs are hyperinflated but clear. There is no pulmonary edema, pleural effusion or pneumothorax. IMPRESSION: No visualization of the PICC line in the thorax or axilla. Stat read was called to Dr. ___ by Dr. ___ at 12:45 p.m. at time of discovery by telephone. " 581a8013-384988bc-4b2cd710-3390f32a-f35e585f.jpg,test/p18/p18689527/s53578840/581a8013-384988bc-4b2cd710-3390f32a-f35e585f.jpg,test," FINAL REPORT INDICATION: Patient with exertional dyspnea and history of smoking. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate prominent interstitial markings, most pronounced in lower lobes. There is no focal consolidation or pleural effusion. There is no pneumothorax. No pulmonary edema. Hilar, mediastinal and silhouettes are unremarkable. Heart size is normal. Partially imaged upper abdomen is unremarkable. IMPRESSION: Prominent interstitial marking predominantly in the lower lobes. In the setting of high clinical concern for interstitial lung disease, given patient's smoking history, may consider chest CT for further assessment. " 6250398a-90f5a384-3ccb109b-a26fb8e2-cb863f1f.jpg,test/p18/p18151020/s59166351/6250398a-90f5a384-3ccb109b-a26fb8e2-cb863f1f.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: New onset of atrial fibrillation. COMPARISON: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 1a48fcb9-1ba60fd5-37d6cc93-9996cbca-e4a827ee.jpg,test/p13/p13473495/s56817456/1a48fcb9-1ba60fd5-37d6cc93-9996cbca-e4a827ee.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: Multiple prior chest radiographs, most recently ___ and ___. FINDINGS: Frontal and lateral views of the chest. Severe cardiomegaly has increased since ___ with right and left atrial enlargement, consistent with right heart decompensation. Lung volumes are low with a possibly small left pleural effusion. No focal consolidation or pneumothorax. A left subclavian vascular stent is new since the prior exam. IMPRESSION: Increased cardiomegaly. No focal consolidation. " 48a0c87d-e9807120-db20226e-9b488167-b5df7e12.jpg,test/p16/p16733321/s58264794/48a0c87d-e9807120-db20226e-9b488167-b5df7e12.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Incidental note is made of an azygos lobe. The aorta is slightly tortuous. The cardiac silhouette is not enlarged. No pulmonary edema is seen. No displaced fracture is identified. IMPRESSION: No acute cardiopulmonary process. " 856094c7-7c33b6b4-50a9e1e6-62a337a9-4fd19b1f.jpg,test/p13/p13948246/s54093744/856094c7-7c33b6b4-50a9e1e6-62a337a9-4fd19b1f.jpg,test," FINAL REPORT INDICATION: Altered mental status. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs demonstrate low lung volumes resulting in bronchovascular crowding and prominence of the cardiomediastinal silhouette. However, even given low lung volumes, the heart size appears to be mildly increased. There is bibasilar atelectasis, without a focal consolidation. Emphysematous changes are noted bilaterally. There is no edema, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: 1. Low lung volumes with bibasilar atelectasis, without focal consolidation to suggest pneumonia. 2. Mild cardiomegaly. " 208d435e-eaff06b8-e756e641-ba893361-6e0ac2d3.jpg,test/p19/p19151721/s53536754/208d435e-eaff06b8-e756e641-ba893361-6e0ac2d3.jpg,test," FINAL REPORT INDICATION: ___-year-old woman presenting with hypoxia, but no other complaints. Evaluate for pneumonia or signs of COPD. COMPARISON: Chest radiograph from ___. FINDINGS: Chest, PA and lateral. The lungs are hyperinflated and clear. Moderate cardiomegaly, particularly involving the right heart is unchanged. The hilar and mediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Median sternotomy cerclage wires are intact and there are surgical clips in the mediastinum. IMPRESSION: 1. No evidence of pneumonia. 2. Hyperinflation of the lungs is suggestive of COPD. " d1c6e1fa-12e19b3f-3d25cb9d-217de891-7fe0cb7f.jpg,test/p13/p13603311/s51375036/d1c6e1fa-12e19b3f-3d25cb9d-217de891-7fe0cb7f.jpg,test," FINAL REPORT INDICATION: ___ y.o. woman with multiple medical problems most notable for tobacco abuse, breast cancer c/b pericardial effusions s/p pericardial window, Afib on Coumadin, systolic CHF (LVEF ___%), COPD on 3L O2, and PVD presenting with dyspnea and RLE pain and swelling. Pt s/p thoracentesis 1.2L removed ___. Heparin gtt on hold due to bleeding from RLE wound site. Discontinued Lasix gtt this PM on ___ ___ With AMS, concern for PNA TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: A left chest wall Port-A-Cath is present, the tip projecting over the cavoatrial junction. There is new elevation of right hemidiaphragm with hazy opacities projecting throughout the mid to lower right lung zones possibly reflecting combination of pleural fluid and atelectasis/ consolidation. No focal consolidation, pleural effusion or pneumothorax identified in the left lung. The size of the cardiac silhouette is enlarged but unchanged. IMPRESSION: New elevation of the right hemidiaphragm with hazy opacities projecting throughout the mid to lower lung zones. These likely reflect a combination of a pleural effusion and atelectasis/ pneumonia. " 80e95285-b8247433-c0bf55b2-b3a3e183-aae35f64.jpg,test/p17/p17081205/s54728614/80e95285-b8247433-c0bf55b2-b3a3e183-aae35f64.jpg,test," FINAL REPORT INDICATION: ___ year old woman with alcoholic hepatitis and now cough productive of green sputum // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Please take note of the low lung volumes. There has been interval progression of the bibasal airspace opacification over serial radiographs. No associated large effusion. The heart size is normal. Right-sided PICC line in situ with the tip in the distal SVC. The upper lung zones are clear. IMPRESSION: Interval progression of the bibasal airspace opacification which is nonspecific, but most likely represents a combination of atelectasis and pneumonia " bae9bffc-3ca71d41-b26b1145-d1e3904a-a50674fc.jpg,test/p16/p16251549/s50353174/bae9bffc-3ca71d41-b26b1145-d1e3904a-a50674fc.jpg,test," FINAL REPORT INDICATION: ___-year-old male with right-sided chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded. There is a vague opacity in the right mid lung on the frontal view that was not present on prior exam. The remaining right lung and the left lung are clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Vague opacity in the right mid lung might represent early/developing pneumonia in the appropriate clinical setting. " 3fe75b4e-68d6ed8e-bba39566-a1a57c1d-9cb3fca7.jpg,test/p16/p16505030/s57347862/3fe75b4e-68d6ed8e-bba39566-a1a57c1d-9cb3fca7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia on treatment, but rising WBC count // progressive pneumonia? effusion? COMPARISON: ___. IMPRESSION: Status post removal of the right PICC line. Substantial improved ventilation of both lungs. Resolution of pre-existing pulmonary edema. Minimal platelike areas of atelectasis at the left lung bases. " 074c6718-2dfc0ceb-8c1ea931-cd735269-acad43b0.jpg,test/p18/p18782137/s52629089/074c6718-2dfc0ceb-8c1ea931-cd735269-acad43b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is mildly enlarged. The mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is detected. No acute osseous abnormality is present. IMPRESSION: No acute cardiopulmonary abnormality. " b63391db-aae57e2f-5f3c08fe-8a6768d1-6fc6c6e0.jpg,test/p12/p12037734/s53835365/b63391db-aae57e2f-5f3c08fe-8a6768d1-6fc6c6e0.jpg,test," FINAL REPORT HISTORY: Cough and fever x5 days right lower lobar ronchi. COMPARISON: None. FINDINGS: 2 views were obtained of the chest. Moderate hiatal hernia is redemonstrated along with medial right lower lobe opacity with air bronchograms consistent with pneumonia. There is no pleural effusion or pneumothorax. Heart and mediastinal contours are unremarkable aside from a tortuous aortic contour. IMPRESSION: Right lower lobe pneumonia in the context of a moderate hiatal hernia suggests aspiration as a possible source. These findings were discussed with Dr. ___ by Dr. ___ by phone at 14:50 on ___. " 9595c0b5-b0eafd5a-d8160b86-f8832cbf-0617b34a.jpg,test/p12/p12807885/s55000114/9595c0b5-b0eafd5a-d8160b86-f8832cbf-0617b34a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p MVr // eval effusions eval effusions IMPRESSION: In comparison with study of ___, there is continued enlargement of the cardiac silhouette without definite vascular congestion. Bibasilar atelectatic changes are seen with left and possible small right effusion. The pneumomediastinum has almost completely cleared and there is no evidence of pneumothorax. " 701a66da-1e19fd1a-34ff18e7-a505fdb1-9e37ec1f.jpg,test/p12/p12948123/s52391528/701a66da-1e19fd1a-34ff18e7-a505fdb1-9e37ec1f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea. Evaluate for fluid overload. TECHNIQUE: AP upright and lateral chest radiographs COMPARISON: ___ FINDINGS: Since the prior study, there has been interval removal of the right internal jugular central venous line. Cardiomediastinal contour has also improved, although remains moderately enlarged. Lung volumes are slightly reduced and retrocardiac opacification may represent atelectasis, however infection is not excluded. Small left pleural effusion is likely. Peribronchial cuffing is noted in the right hilar region, which is the only residual sign of fluid overload from the prior study from late ___, as the interstitial edema has improved. IMPRESSION: 1. Interval improvement in cardiac size and interstitial edema since ___. 2. Slight decrease in lung volumes and increase in retrocardiac opacity, which likely represents atelectasis, however infection is not excluded. " 0b0852f5-8e2075b8-598d867c-54a476f7-3ae46306.jpg,test/p12/p12658040/s52693290/0b0852f5-8e2075b8-598d867c-54a476f7-3ae46306.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Epilepsy. Comparison is made with prior study ___. Cardiomediastinal contours are normal. There are low lung volumes. Bibasilar opacities larger on the right side have increased on the left and improved on the right, likely atelectasis. There are no new lung abnormalities. " 9602e2e6-d4f2ebcd-3ba98d8a-4fb1d415-ef4b8acd.jpg,test/p16/p16366110/s58733052/9602e2e6-d4f2ebcd-3ba98d8a-4fb1d415-ef4b8acd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p AVR // predischarge eval predischarge eval COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Mild pulmonary edema, mediastinal vascular engorgement, and small bilateral pleural effusions have improved since ___. Heart is mildly enlarged. No pneumothorax. " 0348236c-2f6413c1-f004ef02-5138f357-f4701387.jpg,test/p10/p10835660/s57362044/0348236c-2f6413c1-f004ef02-5138f357-f4701387.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old female with cough x 2 weeks; evaluate for pneumonia. TECHNIQUE: PA and lateral radiograph of the chest from ___. COMPARISON: ___. FINDINGS: New small faint ill-defined opacities in the right mid to lower lung may be due to infection. The left lung is clear. There is no pneumothorax. The heart and mediastinum are within normal limits. There is generalized osteopenia. IMPRESSION: Right mid to lower lung airspace opacities may be due to infection. A dedicated chest CT may be performed for further evaluation if clinically warranted. " d5792540-702b091b-cd619ac0-4bcb732b-4616f541.jpg,test/p19/p19497735/s53564321/d5792540-702b091b-cd619ac0-4bcb732b-4616f541.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new fevers // ?new focal consolidation TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Opacities in the right lower lobe have improved consistent with improving atelectasis, amount of pleural effusion has also improved. Severe cardiomegaly is a stable. Widened mediastinum is stable. Left mid lung consolidations have improved. Left pleural effusion with adjacent probably atelectasis are unchanged. There is no evident pneumothorax. Lines and tubes are in standard position. " 1b5f5dd2-532084f3-06719f38-174a6d70-0f360e53.jpg,test/p18/p18605337/s55780786/1b5f5dd2-532084f3-06719f38-174a6d70-0f360e53.jpg,test," WET READ: ___ ___ ___ 6:13 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with cough*** WARNING *** Multiple patients with same last name! // cough TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___ and ___. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiac size is normal. The aorta is ectatic. There is no free air beneath the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 0238df8f-2100791c-0f677def-e1d62293-cb6cf1fe.jpg,test/p10/p10036086/s58578322/0238df8f-2100791c-0f677def-e1d62293-cb6cf1fe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new onset hypoxia without dyspnea, normal lung exam // ? intrapulmonary process to cause hypoxia ? intrapulmonary process to cause hypoxia IMPRESSION: Comparison to ___. No relevant change is noted. Stable mild platelike atelectasis at the right lung bases. Moderate cardiomegaly with minimal fluid overload but no overt pulmonary edema. No evidence of pleural effusions on the frontal or lateral radiograph. No pneumonia. " ac99536e-effa5be3-81464267-dcb00941-1733a986.jpg,test/p15/p15706912/s56534544/ac99536e-effa5be3-81464267-dcb00941-1733a986.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old male with transient hypoxia. Evaluate for acute process. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Multiple prior chest radiographs, most recent on ___. FINDINGS: There is no significant interval change compared with previous radiograph from ___. The lungs are well inflated and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Old rib fractures are seen in the right. IMPRESSION: No evidence of acute cardiopulmonary process. " e4955488-88296add-38c6b5ef-10903c6d-db29c14e.jpg,test/p11/p11825462/s55078322/e4955488-88296add-38c6b5ef-10903c6d-db29c14e.jpg,test," FINAL REPORT INDICATION: ___-year-old male with tachycardia. COMPARISON: ___. CHEST, PA AND LATERAL: Lung volumes remain low, with bibasilar atelectasis, but no focal consolidation. Mild increase in the cardiomediastinal silhouette since ___. Coronary artery bypass grafting, with mediastinal clips and median sternotomy wires. There are no pleural effusions or pneumothorax. IMPRESSION: Slight enlargement in the cardiomediastinal silhouette. Although this could be due to increased mediastinal fat, please correlate clinically for evidence of acute aortic syndrome. This was discussed with Dr. ___ ___ on ___ at 9:25 a.m. " 7686ca79-d676a9d5-f42f4d36-d2dfd7aa-815cfb65.jpg,test/p11/p11488115/s56388563/7686ca79-d676a9d5-f42f4d36-d2dfd7aa-815cfb65.jpg,test," WET READ: ___ ___ 9:20 PM Suture chain in the left lower lung and clips in the left mid lung are noted. There is no focal consolidation or pleural effusion. Heart is mildly enlarged. There is no pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) CLINICAL HISTORY ___ year old man with elevated WBC // R/O PULMONARY PROCESS R/O PULMONARY PROCESS COMPARISON: None FINDINGS: Radiopaque suture material and surgical clips are projected in the left lung as before. There is mild prominence of the interstitial markings. No focal consolidation is apparent. The patient is rotated to the right. The right costophrenic sulcus is blunted the cardiac silhouette is prominent although it may be exaggerated by AP technique. The aorta is tortuous and calcified. Mediastinal structures are otherwise unremarkable for technique. The bony thorax is grossly intact. IMPRESSION: Prominence of the interstitial markings. The right costophrenic sulcus is blunted which may be due to a small effusion. Prominent cardiac silhouette. Vascular congestion cannot be excluded and clinical correlation is recommended. " 2c3fe999-187e9227-4d2bff2f-3df76b3d-d1c306fd.jpg,test/p13/p13110537/s59114289/2c3fe999-187e9227-4d2bff2f-3df76b3d-d1c306fd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dizziness, cough // r/o infiltrate r/o infiltrate COMPARISON: Comparison to ___. FINDINGS: PA and lateral views of the chest ___ at 14:43 are submitted. IMPRESSION: The heart is stably enlarged which most likely reflects cardiomegaly, although pericardial effusion cannot be entirely excluded. Lungs are without evidence of focal airspace consolidation to suggest pneumonia. No pulmonary edema. No pneumothorax. No pleural effusions. Bones are osteopenic with mild degenerative changes in the visualized thoracolumbar spine. " f07a6519-b7019e3f-e4171f58-7863ffd6-62f59d56.jpg,test/p14/p14068639/s54516556/f07a6519-b7019e3f-e4171f58-7863ffd6-62f59d56.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. History of congestive heart failure. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: There is a single-lead pacemaker device in place. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. Aside from minor basilar atelectasis, lung fields appear clear. There are no substantial pleural effusions. The bones appear demineralized. The patient is status post posterior lumbar fusion, incompletely assessed. Surgical clips project over the left upper quadrant. IMPRESSION: No evidence of acute cardiopulmonary process. " 39b95afb-ad4cdb53-f1deb283-41c7888a-9eac52f1.jpg,test/p17/p17077582/s58610279/39b95afb-ad4cdb53-f1deb283-41c7888a-9eac52f1.jpg,test," FINAL REPORT HISTORY: Palpitations. Evaluation for pneumonia. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate relatively low lung volumes, as before, with no evidence of pneumothorax or pleural effusion. There is prominence of the bilateral hilar vasculature, representing mild congestion with no frank pulonary edema. No focal opacity is identified within the lungs. The cardiomediastinal silhouette is stable in appearance. The patient is status post CABG. IMPRESSION: Mild pulmonary vascular congestion with no frank pulmonary edema. Otherwise, no acute cardiopulmonary process. " c7bd8237-86f9c042-7a750af0-ff7cf359-00689d76.jpg,test/p11/p11198021/s56837016/c7bd8237-86f9c042-7a750af0-ff7cf359-00689d76.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Fever, rule out pneumonia. FINDINGS: PA and lateral views of the chest provided. Mild left basilar atelectasis is noted. Lungs are otherwise clear. No signs of effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures appear intact. IMPRESSION: Mild left basal atelectasis. Otherwise, normal. " eee765fb-5ed042e8-f1dd9ad8-e8b2ec58-15c8cba5.jpg,test/p10/p10021927/s58742316/eee765fb-5ed042e8-f1dd9ad8-e8b2ec58-15c8cba5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxic respiratory failure and interstitial pattern on previous imaging, recently self-extubated, rhonchi // Evolution of pumonary process COMPARISON: ___ IMPRESSION: As compared to the previous image, the patient has been extubated. The nasogastric tube was removed. The lung volumes have decreased, revealing new sounds of parenchymal atelectasis at the lung bases. The pre-existing parenchymal opacity in the perihilar lung regions on the left is overall unchanged. Moderate cardiomegaly persists. No larger pleural effusions. The overdistension of the transverse colon is constant in appearance. " 69373739-8e9d2def-385eef1a-379f4a3f-f90b2277.jpg,test/p15/p15121462/s58466294/69373739-8e9d2def-385eef1a-379f4a3f-f90b2277.jpg,test," FINAL REPORT HISTORY: ___-year-old female with rising white count and delirium. Evaluate for pneumonia or pulmonary edema. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate slightly diminished lung volumes bilaterally. There is a moderate-sized left pleural effusion with possible adjacent opacification, which may be suggestive of consolidation. The cardiac silhouette is top normal in size. There is no pneumothorax. IMPRESSION: Moderate-sized left pleural effusion with possible adjacent opacification, which suggestive of consolidation. " 7d07bdc2-46bf89cc-bd37a8ca-bfd496b9-15a44998.jpg,test/p17/p17649973/s58732917/7d07bdc2-46bf89cc-bd37a8ca-bfd496b9-15a44998.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with lupus, on azathioprine and prednisone with fever to 104. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 1e4f7732-ed5b4823-50df04fe-c6f61163-1aab29c5.jpg,test/p12/p12764457/s53943821/1e4f7732-ed5b4823-50df04fe-c6f61163-1aab29c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with need for repeat liver US.cough, sputum, fever. ? pneumonia // ? pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is an bilateral increase in diameter of the hilar structures. In addition, the right hilus shows a slightly abnormal contour. These observation is confirmed on the lateral radiograph. To rule out the presence of a hilar and mediastinal pathology, CT is recommended. This information was added to the radiology dashboard system. At the time of dictation and observation. At the current time point, there is no evidence for the presence of a lung parenchymal disease. No pneumonia, no pulmonary edema, no pleural effusions. Normal size of the cardiac silhouette. The vertebral fixation devices are constant. " e260e63f-d085da10-79fd15a9-8bf6f03e-a5b9b750.jpg,test/p12/p12572699/s56832915/e260e63f-d085da10-79fd15a9-8bf6f03e-a5b9b750.jpg,test," FINAL REPORT INDICATION: Vomiting. History of Schatzki ring dilation. COMPARISONS: Chest radiograph, ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. There is no pneumomediastinum. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " de0a8719-991a53ea-bf20dec4-16286804-59c46cec.jpg,test/p17/p17155697/s59476706/de0a8719-991a53ea-bf20dec4-16286804-59c46cec.jpg,test," FINAL REPORT HISTORY: ___-year-old man with history of liposarcoma status post excision via right thoracotomy. Evaluate for interval change. COMPARISON: Chest radiographs dated ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a persistent right-sided basilar opacity, likely representing a combination of moderate-sized pleural effusion and atelectasis at the right lung base. The patient is status post recent right thoracotomy. The loculated hydropneumothorax in the upper right lung field has decreased in size from the prior study. The left lung is clear. Patient is status post prior left thoracotomy. " 501ae0de-142999df-e0d5c616-3ca29daf-3849d84f.jpg,test/p16/p16093686/s56585418/501ae0de-142999df-e0d5c616-3ca29daf-3849d84f.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Productive cough. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: There is moderate relative elevation of the right hemidiaphragm. The heart is normal in size. The mediastinal and hilar contours appear within normal limits. Streaky right infrahilar opacities probably reflect atelectasis associated with diaphragmatic elevation. There is no definite evidence for pneumonia or congestive heart failure. There are no pleural effusions or pneumothorax. There is apparently an exostosis or perhaps posttraumatic bony hypertrophy arising from the right posterior eighth rib. IMPRESSION: Streaky right basilar opacities, probably associated with elevation of the right hemidiaphragm, although airway inflammation or infection is difficult to entirely exclude. " 645d4fc3-9162422c-635872b9-16e5c73e-894d0c47.jpg,test/p13/p13616762/s53279691/645d4fc3-9162422c-635872b9-16e5c73e-894d0c47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with low back pain sudden onset // ? obvious fracture TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size appears mildly enlarged but unchanged. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Subsegmental atelectasis is demonstrated in the lung bases without focal consolidation. No pleural effusion or pneumothorax is present. Deformity of a right-sided rib appears chronic. No acute osseous abnormality is otherwise demonstrated. Moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 6732d740-d666cf71-cb16da48-8c623291-424239a6.jpg,test/p13/p13325402/s53420046/6732d740-d666cf71-cb16da48-8c623291-424239a6.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with chest pain, dyspnea, history of congestive heart failure TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size remains moderate enlarged. The mediastinal and hilar contours are grossly unchanged. There is mild pulmonary vascular congestion without focal consolidation. Small bilateral pleural effusions are present. No pneumothorax noted. Marked narrowing of the right acromiohumeral interval indicates underlying rotator cuff disease. IMPRESSION: Mild pulmonary vascular congestion small bilateral pleural effusions. " a8326c4c-0f639e00-ca24c7c1-95d336f2-d9de521f.jpg,test/p10/p10522265/s55120315/a8326c4c-0f639e00-ca24c7c1-95d336f2-d9de521f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman w/ SAH s/p EVD placement s/p extubation ___ // post extubation film; assess for consolidations; please preform on ___ at ___ radiology rounds post extubation film; assess for consolidations; please pref IMPRESSION: In comparison with the study of ___, there again are low lung volumes. The endotracheal tube has been removed. No evidence of acute cardiopulmonary disease. What appears to be some apical pleural thickening is again seen at the right apex laterally. " 21708a5c-7f7f65f4-9c7beba9-f13955e2-87c16408.jpg,test/p18/p18747087/s50613053/21708a5c-7f7f65f4-9c7beba9-f13955e2-87c16408.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath, question pulmonary edema. COMPARISON: Multiple chest radiographs, the latest from ___. ONE VIEW OF THE CHEST: The lungs are low in volume but clear. The cardiac silhouette is mildly enlarged. The mediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. Mild cardiomegaly. " 4d6cc2bd-1b7750b5-4ec89178-507f8b4a-5b78b585.jpg,test/p12/p12367923/s57435697/4d6cc2bd-1b7750b5-4ec89178-507f8b4a-5b78b585.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F who ?swallowed retainer // evaluate for foreign body TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No radiopaque foreign body is seen. There is no definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No radiopaque foreign body seen. " 60dc60cb-5cef88c3-694156a1-3b72c91f-cde67dec.jpg,test/p14/p14947837/s57263526/60dc60cb-5cef88c3-694156a1-3b72c91f-cde67dec.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac, mediastinal, and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities detected. An electronic device is seen within the left chest wall. IMPRESSION: No acute cardiopulmonary abnormality. " 1534272d-6d59c666-fee5dd9e-7db3d588-1f7603fd.jpg,test/p15/p15721149/s50846150/1534272d-6d59c666-fee5dd9e-7db3d588-1f7603fd.jpg,test," FINAL REPORT HISTORY: Persistent cough in a patient with history of lung cancer. FINDINGS: In comparison with study of ___, there is little change. Again there is evidence of prior lobectomy and radiation in the right upper zone, with retraction of the trachea to this side. Juxtaphrenic peak is stable in this patient with right lung volume loss. No evidence of pulmonary vascular congestion. There is no evidence of acute focal pneumonia. " 00d25acd-e7ce2e34-81f38df4-8af7170f-6a7c68bd.jpg,test/p11/p11288058/s54540383/00d25acd-e7ce2e34-81f38df4-8af7170f-6a7c68bd.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fever and cough, here to evaluate for pneumonia. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph, last performed on ___. FINDINGS: There is persistent mild pulmonary edema and increased vascular congestion from ___. No pleural effusion, focal consolidation or pneumothorax is present. The inspiratory lung volumes are appropriate. The cardiac silhouette is mildly enlarged but stable. The mediastinal and hilar contours are unchanged. A right-sided stent is unchanged in position, presumably extending from the right subclavian vein into the superior vena cava. Degenerative changes are again noted in the thoracic spine with right-sided bridging osteophytes. IMPRESSION: 1. No focal consolidation. 2. Persistent mild pulmonary edema with increased vascular congestion since ___. " ecbd831c-97999a29-be96387e-89d0c25d-b66ba448.jpg,test/p13/p13164386/s59811588/ecbd831c-97999a29-be96387e-89d0c25d-b66ba448.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman presenting with substernal chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is top normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild degenerative changes are noted in the imaged thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 26a294e5-2630eeaa-a594e5ff-99734bb0-6f9cb9c5.jpg,test/p11/p11817939/s51773700/26a294e5-2630eeaa-a594e5ff-99734bb0-6f9cb9c5.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with weakness // Pneumonia? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The patient is rotated to the right and there are low lung volumes. No large pleural effusion is seen although trace pleural effusion be difficult to exclude. There is no pneumothorax. There may be mild vascular congestion. No definite lobar consolidation is identified. Multi-level degenerative changes are seen along the spine. The cardiac silhouette is enlarged. IMPRESSION: Low lung volumes and patient rotation limit the examination. Given this, there may be mild pulmonary vascular congestion. No definite lobar consolidation seen. Cardiomegaly. " 3d8cb7de-8a0978b6-1d7c136d-5659961c-94105ec0.jpg,test/p19/p19674970/s52757047/3d8cb7de-8a0978b6-1d7c136d-5659961c-94105ec0.jpg,test," WET READ: ___ ___ ___ 5:48 PM Interval development of mild pulmonary vascular congestion / interstitial edema from ___. Possible small right pleural effusion. ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:06 P.M., ___ HISTORY: ___-year-old man with shortness of breath and renal failure. IMPRESSION: AP chest compared to ___: Mild pulmonary edema is new, mild-to-moderate cardiomegaly increased slightly, pulmonary vasculature more engorged, and small-to-moderate right pleural effusion persist, findings all pointing to worsening cardiac decompensation. No pneumothorax. " afc1cc87-95be33e4-e63f62dd-18c5b6d6-81cb50f9.jpg,test/p11/p11098660/s54432933/afc1cc87-95be33e4-e63f62dd-18c5b6d6-81cb50f9.jpg,test," FINAL REPORT INDICATION: Worsening dyspnea on exertion for six weeks despite increasing lasix, evaluate for acute process. COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___. FINDINGS: Frontal and lateral chest radiographs demonstrate stable cardiomegaly. Mediastinal and hilar contours are unremarkable. The lungs are clear. No pleural effusion or pneumothorax identified. Sternotomy sutures are in place. Prosthetic aortic valve is visualized. No osseous abnormality evident. IMPRESSION: No acute intrathoracic process. " f10014c6-8836c812-bba6acda-4cb9a724-79d6ea32.jpg,test/p13/p13667298/s53028679/f10014c6-8836c812-bba6acda-4cb9a724-79d6ea32.jpg,test," FINAL ADDENDUM ADDENDUM The tip of the Port-A-Cath projects, in unchanged manner, over the right atrium. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with port-a-cath, GPC bacteremia, psoas abscess // - new admission with port-a-cath, confirm appropriate position- ?pneumonia or septic embolic phenomena COMPARISON: ___. IMPRESSION: No change in position of the known right Port-A-Cath. Platelike atelectasis at the right lung bases. Moderate cardiomegaly. No pulmonary edema. No pneumonia. " ac36d183-e10c0a6e-d7f6bf29-1aa1a53e-22c36474.jpg,test/p13/p13417577/s51805387/ac36d183-e10c0a6e-d7f6bf29-1aa1a53e-22c36474.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PTX s/p pigtail placement - eval for interval change // interval change COMPARISON: Chest x-ray from ___ 16:44 FINDINGS: A left sided pigtail catheter is in place. The previously seen basilar pneumothorax is not clearly identified on this film. No obvious pneumothorax is detected at this time. There is a small effusion at the left lung base with underlying collapse and or consolidation which has progressed compared with the prior film. Again seen is some focal density overlying the left lung apex, not fully characterized. Also again seen are sutures in the left upper zone. There is minimal atelectasis at the right base, which is new compared with the prior film. No gross right effusion. There is probable background hyperinflation/ COPD. The heart is not enlarged. No CHF There is an apparent hiatal hernia. IMPRESSION: 1) No definite left pneumothorax. Interval development of small left effusion with underlying collapse and or consolidation. 2) Patchy opacity left apex, not fully characterized. The differential diagnosis includes a focal nodular density, focal scarring, or possibly a focal infiltrate. There are nearby sutures. Clinical correlation with details of the patient's history and any outside chest CTs is recommended for full assessment. In the absence of a known pathology in this location, further assessment with chest CT would be recommended. 3) Background COPD. 4) Hiatal hernia. 5) Minimal atelectasis right base laterally. " 14de0746-a4ea05a4-11939f21-10e33860-cc195ca2.jpg,test/p18/p18539425/s50845729/14de0746-a4ea05a4-11939f21-10e33860-cc195ca2.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man with new cough and elevated white count. IMPRESSION: PA and lateral chest compared to ___: Lungs are hyperinflated due to emphysema and/or small airways obstruction. There is no pneumonia or other focal pulmonary abnormality, no pleural effusion or evidence of central lymph node enlargement. Right PIC line ends in the low SVC as before. Nodular opacity seen on the lateral view projecting over mid thoracic vertebral body as an osteophyte and should not be mistaken for a lung nodule. " 578a176c-ce729c63-ed8441fc-67506d50-e44d920f.jpg,test/p16/p16352630/s59999636/578a176c-ce729c63-ed8441fc-67506d50-e44d920f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Cough, question pneumonia. FINDINGS: PA and lateral views of the chest are provided. There is left basal plate-like atelectasis again noted. The lungs are otherwise clear. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute findings in the chest. Mild left basal atelectasis. " 901b45a0-3426f52e-65906646-9a463c87-6dd729c4.jpg,test/p17/p17223183/s57992938/901b45a0-3426f52e-65906646-9a463c87-6dd729c4.jpg,test," CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: ______________________________________________________________________________ FINAL REPORT INDICATION: History of intubation, please evaluate for aspiration or other acute process. COMPARISONS: None. TECHNIQUE: AP portable exam of the chest, two separate acquisitions. FINDINGS: There were two separate acquisitions for this clip. The first acquisition demonstrates the ETT in the right mainstem bronchus. The subsequent image demonstrates interval retraction of the ETT, which now terminates approximately 2.7-cm above the carina. The diffuse regions of opacification in the left lung are persistent, which could be secondary to component of unresolved atelectasis, however an underlying infectious process is also suspected. Less extensive patchy consolidation ___ at the upper right lung. The heart size is normal. The hilar and mediastinal contours are normal. There is no pleural effusion or pneumothorax. There is thoracic levosoliosis. Note is made of a lap band, which appears to be in appropriate position within the abdomen. IMPRESSION: 1. First acquisition demonstrates the ETT in the right main-stem bronchus, which was retracted by the second acquisition, and now terminates 2.7-cm above the carina. 2. Persistent diffuse regions of opacification in the left lung, which could have component of unresolved atelectasis, however a multifocal infectious process is suspected. 3. Additional opacity overlying the right upper lung suspicious for additonal site of pneumonia. Findings were discussed with Dr. ___, by Dr. ___ by telephone at 4:___p on the day of the exam. " 262b6bd4-a5cde0d9-80c1dfa7-289096b6-09de5a2f.jpg,test/p10/p10312300/s51588198/262b6bd4-a5cde0d9-80c1dfa7-289096b6-09de5a2f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG // eval PTx-post pull eval PTx-post pull IMPRESSION: In comparison with the study of ___, there again is no definite evidence of pneumothorax. Bibasilar atelectatic changes are again seen, with bilateral pleural effusions. No definite vascular congestion. Dilated bowel is seen in the upper abdomen. " 8fbc2348-ca4f43c1-c46c93cc-2c5c6d92-cb09a3a5.jpg,test/p19/p19314531/s56768274/8fbc2348-ca4f43c1-c46c93cc-2c5c6d92-cb09a3a5.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Productive cough, recent URI, somnolence. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are hyperinflated, with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Amorphous calcification projecting over the left upper hemithorax is stable since at least ___. Evidence of hilar calcification is again seen. IMPRESSION: COPD without acute cardiopulmonary process. " e56e6548-d8423bd2-f653581d-8d102d29-d26eecc7.jpg,test/p18/p18977683/s54406792/e56e6548-d8423bd2-f653581d-8d102d29-d26eecc7.jpg,test," FINAL REPORT HISTORY: Chest pain for a few seconds with shortness of breath. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___ chest CT and ___ chest radiograph. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vascularity is not engorged. There is no focal consolidation. Chronic interstitial abnormality is noted predominantly in both lung bases and along the periphery. No pleural effusion or pneumothorax is identified. Old displaced fracture involving the left proximal clavicle is again noted. ___ fiducial markers are seen within the liver dome. IMPRESSION: Chronic interstitial abnormality within the lung bases. Otherwise no acute cardiopulmonary abnormality. " 6710e14e-3801b16e-5b015346-7bd12938-b8582c03.jpg,test/p15/p15406172/s58160239/6710e14e-3801b16e-5b015346-7bd12938-b8582c03.jpg,test," FINAL REPORT INDICATION: ___-year-old female with Dobbhoff tube who presents for evaluation of position. COMPARISON: Chest radiograph from ___, ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The Dobbhoff tube extends below the diaphragm into the fundus of the stomach. The heart size is normal. The hilar and mediastinal contours are normal. There is no pleural effusion, pneumothorax, or evidence of focal consolidations. IMPRESSION: Dobbhoff tube is below the diaphragm in the fundus of the stomach. " adf84363-b2510afd-eb44694e-64920a9a-d6358eb0.jpg,test/p15/p15672432/s59312722/adf84363-b2510afd-eb44694e-64920a9a-d6358eb0.jpg,test," FINAL REPORT INDICATION: Cough, evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph performed earlier on the same day at 20:14 FINDINGS: Lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Visualized upper abdomen is unremarkable. Osseous structures are grossly intact. IMPRESSION: No evidence of acute cardiopulmonary process. " 2dff1f81-10a9bf5a-27bc2fca-33511bd6-db94a774.jpg,test/p18/p18855147/s53707610/2dff1f81-10a9bf5a-27bc2fca-33511bd6-db94a774.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Pulmonary edema and renal failure. AP radiograph of the chest was reviewed in comparison to ___. Since the prior study, there is interval progression of interstitial pulmonary edema. Heart size and mediastinum are unchanged in appearance. There is also no change in the position of the tubes and lines. " 434279b1-a1e62cbb-a53cacd0-dfc6d01f-3c2a8e4e.jpg,test/p19/p19919570/s53932642/434279b1-a1e62cbb-a53cacd0-dfc6d01f-3c2a8e4e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with seizures // assess infection assess infection COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lungs are clear. Heart size is normal. Postoperative widening of the mediastinal silhouette unchanged. No pleural abnormality. Right supraclavicular central venous infusion port ends in the upper right atrium. " 9e26a24b-98322769-00caad1a-5904b81a-b8c838f7.jpg,test/p10/p10476869/s53757256/9e26a24b-98322769-00caad1a-5904b81a-b8c838f7.jpg,test," FINAL REPORT HISTORY: Lymphoma, cough and shortness of breath. COMPARISON: Chest radiograph ___, CT ___, PET-CT ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post left upper lobectomy with an unchanged postoperative appearance of the left lung with mild left hemidiaphragmatic elevation. Small left pleural fluid is similar to the prior study. There is no focal consolidation or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are unchanged. IMPRESSION: No pneumonia or edema. No change from ___. The preliminary findings were conveyed to ___ by phone at 1:30pm on ___. " f4d844c8-ccf1a8d0-be6a7bbb-636b890b-68a2c8c8.jpg,test/p12/p12927984/s51563711/f4d844c8-ccf1a8d0-be6a7bbb-636b890b-68a2c8c8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cabg // tachypnea TECHNIQUE: Portable chest COMPARISON: ___ IMPRESSION: There has been interval removal of the ET tube and NG tube. There is volume loss in the lower lobes. The upper lungs are clear. There is a small left pneumothorax. 2 left-sided chest tubes are visualized. . There is volume loss in both lower lobes. There small bilateral pleural effusions. " 1e3bab4c-5c3afe1a-3e6b048a-b911de7a-9229c0c6.jpg,test/p13/p13534933/s57549596/1e3bab4c-5c3afe1a-3e6b048a-b911de7a-9229c0c6.jpg,test," FINAL REPORT INDICATION: Cough, evaluate for pneumonia. COMPARISONS: None. FINDINGS: PA and lateral radiographs of the chest demonstrate a focal patchy opacity in the mid left lung field that may represent an area of infection. The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. The pulmonary vascularity is normal. IMPRESSION: Focal patchy opacity in the mid portion of the left lung that may represent pneumonia. " a04b88e6-35c3a9fc-dc2e0d1a-4ef90a07-8c68b2f1.jpg,test/p16/p16155134/s52338500/a04b88e6-35c3a9fc-dc2e0d1a-4ef90a07-8c68b2f1.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___M with DM, PVD, ESRD on HD referred for gangrenous foot ulcer, incidentally w/ subacute DOE x several days COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Small to moderate left effusion and small right pleural effusion noted. The heart is likely within normal limits of size. Hilar congestion is noted. There is likely a component of compressive atelectasis of the left lung base. No pneumothorax is seen. The mediastinal contour is normal. There is no overt edema. Bony structures are intact. IMPRESSION: Hilar congestion without overt edema. Bilateral pleural effusions left greater than right. " 7b1413a1-f1ef7923-f3ef1b3d-b44bf11f-9295d8a4.jpg,test/p15/p15244289/s50176330/7b1413a1-f1ef7923-f3ef1b3d-b44bf11f-9295d8a4.jpg,test," FINAL REPORT INDICATION: History of hepatic hydrothorax, decreased breath sounds at the right base. COMPARISON: ___ and ___. AP AND LATERAL VIEWS OF THE CHEST: There is a large right pleural effusion which has increased significantly since the prior film. This has resulted in adjacent compressive atelectasis. The left lung is clear. There are no consolidations or pneumothoraces seen. The mediastinum is unremarkable. The assessment of heart size is limited given large right pleural effusion. The trachea is midline. IMPRESSION: Large right pleural effusion. " 204d5fbb-642e31a3-9413b483-e7f031fd-3ff737a7.jpg,test/p10/p10934419/s54327896/204d5fbb-642e31a3-9413b483-e7f031fd-3ff737a7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Chest pain, question acute intrathoracic process. FINDINGS: PA and lateral views of the chest are provided. Lung volumes are low which limits evaluation. The heart appears moderately enlarged. No large effusion or pneumothorax. No definite signs of pneumonia or CHF. The bony structures appear intact. No free air below the right hemidiaphragm. The mediastinal contour is normal. IMPRESSION: Cardiomegaly, no convincing signs of pneumonia or CHF. Limited evaluation due to low lung volumes. " 674573df-9258aedc-c68ec22a-6da6e59a-a52abc6d.jpg,test/p16/p16244108/s55543539/674573df-9258aedc-c68ec22a-6da6e59a-a52abc6d.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of asthma, now with severe cough. Evaluate for pneumonia. COMPARISON: ___. PA AND LATERAL CHEST: Lungs are well expanded and clear. There is no consolidation to suggest pneumonia. There is no pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. No pulmonary vascular congestion or edema. Surgical clips are seen within the left breast, unchanged. Mild degenerative changes in the thoracic spine. IMPRESSION: No evidence of pneumonia. Discussed with Dr. ___ at 12:15 p.m. on ___ by Dr. ___. " 5952d7f5-0fe85217-57d72072-c87673d8-319f555b.jpg,test/p11/p11002115/s52793213/5952d7f5-0fe85217-57d72072-c87673d8-319f555b.jpg,test," FINAL REPORT INDICATION: ___ year old woman with Hx of bc, now cough // infiltrate? EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: CT torso ___ FINDINGS: There is moderate to large left pleural effusion and small right pleural effusion. There is consolidation of bilateral lung bases, left more than right. Cardiac silhouette is obscured by pleural effusion. Mediastinal and hilar silhouettes are normal size. IMPRESSION: There is moderate to large left pleural effusion and small right pleural effusion. There is consolidation of bilateral lung bases, left more than right. Superimposed pneumonia cannot be excluded. NOTIFICATION: The impression above was entered by Dr. ___ on ___ at 17:20 into the Department of Radiology critical communications system for direct communication to the referring provider. " cf76fbeb-72ce0b9b-740f4252-87622bfa-0dcda43b.jpg,test/p19/p19838947/s55063617/cf76fbeb-72ce0b9b-740f4252-87622bfa-0dcda43b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Two weeks of cough, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has an unchanged scoliosis of the thoracic spine, causing asymmetry of the rib cage. Unchanged normal size of the cardiac silhouette. Unremarkable lung parenchyma, without evidence of pulmonary edema, pneumonia or pleural effusions. In the interval, the patient has undergone thyroid surgery, as documented by multiple clips projecting over the neck. " 1e1e7f68-0c763282-4d640d05-96e96875-bf951a63.jpg,test/p19/p19764001/s57386974/1e1e7f68-0c763282-4d640d05-96e96875-bf951a63.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with presenting with alcohol withdrawal and left patellar fracture currently POD #1 now with fever and tachycardia // Please evaluate for PNA Please evaluate for PNA IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The vasculature is mildly enlarged, suggesting the presence of mild fluid overload. No pleural effusions. Minimal atelectasis at the left lung base. Mild cardiomegaly. No pneumonia. " f77fe321-ef448503-b3348647-a96430aa-2a9eb8f8.jpg,test/p14/p14943143/s51515245/f77fe321-ef448503-b3348647-a96430aa-2a9eb8f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with UC, possibly need to start anti-TNF agent and need to r/o active Tb // evaluate for infiltrates evaluate for infiltrates IMPRESSION: No previous images. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Specifically, no evidence of old tuberculous disease. " f5ef8409-382d2c22-4155231f-00145dbc-7774b421.jpg,test/p10/p10572581/s54369016/f5ef8409-382d2c22-4155231f-00145dbc-7774b421.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after right above-knee amputation with suspected pneumonia. AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are grossly stable. Pulmonary edema is still demonstrated but substantially improved since the prior study. No appreciable increase in pleural effusion is demonstrated. No pneumothorax is seen. The left lung is clear. " 65d8bd5f-a106ce38-3281a0b4-d2af9826-2db4a12b.jpg,test/p12/p12547577/s53332099/65d8bd5f-a106ce38-3281a0b4-d2af9826-2db4a12b.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear within normal limits. There is mild elevation of the left hemidiaphragm and patchy opacification at the left base, but decreased, whereas other portions of the lungs appear clear. However, the left diaphragm is somewhat elevated which may indicate some atelectasis or mild gastric distension, noting new gastric air-fluid levels. There is probably a small pleural effusion on the left, noting posterior costophrenic blunting. IMPRESSION: Improving left basilar opacification. New gastric air-fluid levels with mild distension. " 87ed904f-b3c554d9-3ccb0bc8-9a9869ff-ab965c6a.jpg,test/p18/p18951987/s51412294/87ed904f-b3c554d9-3ccb0bc8-9a9869ff-ab965c6a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: evaluation for tubes and lines. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the vena cava device and the endotracheal tube are in unchanged position. The nasogastric tube is new. The course of the tube is unremarkable, the tip is not included in the image. Extent and severity of the bilateral parenchymal opacities is minimally improved as compared to the previous radiograph. " ac9c0150-cdddc28a-81a4a455-c37aa574-e1dc14b4.jpg,test/p14/p14065397/s59863898/ac9c0150-cdddc28a-81a4a455-c37aa574-e1dc14b4.jpg,test," FINAL ADDENDUM ADDENDUM Left-sided PICC terminates in the upper SVC. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with recent bacteremia, p/w fever // eval for consolidation TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and cardiac valve replacement.No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Chronic rib deformity at the right upper chest. Partially imaged right humeral prosthesis. Again, there is a tubular structure projecting over the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " a45bd334-bba4723d-4bebb997-24a09c8e-d6a7b2b9.jpg,test/p19/p19461413/s57738748/a45bd334-bba4723d-4bebb997-24a09c8e-d6a7b2b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxic respiratory failure and worsening hypotension; // Interval change; please eval for pulm edema or pneumonia; ETT position Interval change; please eval for pulm edema or pneumonia; ETT position IMPRESSION: In comparison with the study of ___, there again are low lung volumes. Endotracheal tube and left subclavian PICC line remain in good position. Cardiac silhouette remains mildly enlarged with evidence of pulmonary vascular congestion and bilateral pleural effusions with compressive basilar atelectasis. " e748c621-bb6be921-1512097b-6da02557-e760fd4a.jpg,test/p11/p11756780/s56903709/e748c621-bb6be921-1512097b-6da02557-e760fd4a.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest x-ray. INDICATION: ___-year-old woman with fever and hypoxia, evaluate for pneumonia. TECHNIQUE: AP upright chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: A right-sided Port-A-Cath terminates in the high right atrium versus cavoatrial junction. There are low lung volumes due to a sub-optimal inspiratory effort; accounting for changes due to this, the cardiomediastinal silhouettes are stable and within normal limits. Calcifications are noted in the aortic knob. The bilateral hila are unremarkable. Subtle opacities at the bilateral lung bases likely relates to bibasilar atelectasis. A retrocardiac opacity is compatible with known large hiatus hernia. The lungs are otherwise clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. The osseous structures are again noted to be diffusely sclerotic, compatible with known diffuse metastatic disease. IMPRESSION: 1. Low lung volumes. No acute cardiopulmonary process. 2. Right Port-A-Cath terminating in the high right atrium versus cavoatrial junction. 3. Diffuse osseous sclerotic metastases. 4. Large hiatus hernia. " abaca1c6-24817f8e-075e97c7-eca1b0c0-92f7f100.jpg,test/p14/p14117743/s55455985/abaca1c6-24817f8e-075e97c7-eca1b0c0-92f7f100.jpg,test," FINAL REPORT EXAMINATION: DX CHEST WITH DECUB INDICATION: ___ year old man with pleural effusions // changes to effusions with position? COMPARISON: ___ IMPRESSION: As compared to the previous examination, the position of the right central venous access line is constant. The lateral view shows a mild right pleural effusion. Otherwise the radiograph is unchanged. Unchanged appearance of the lung parenchyma with bilateral basilar atelectasis, as well as moderate pulmonary edema. " 74329f61-12bf22bd-b8a8c33f-bc946e43-39b4d729.jpg,test/p11/p11172413/s58782286/74329f61-12bf22bd-b8a8c33f-bc946e43-39b4d729.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old man with hypoxia and dyspnea. Evaluate for pulmonary edema. COMPARISON: Chest radiograph from ___ FINDINGS: Moderate cardiomegaly is unchanged. The AICD is unchanged extending into the right ventricle. No focal consolidation, large effusion or pneumothorax is seen. There is mild central hilar engorgement without frank pulmonary edema. Bony structures appear intact. IMPRESSION: Mild hilar engorgement without frank pulmonary edema. " fbd51467-4a151bfb-6c74285f-d978a5e7-b8008a2f.jpg,test/p10/p10177765/s53558594/fbd51467-4a151bfb-6c74285f-d978a5e7-b8008a2f.jpg,test," WET READ: ___ ___ ___ 4:50 PM Clear lungs. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with pulmonary embolism from outside hospital. Evaluate for pneumothorax. TECHNIQUE: Portable upright chest radiograph COMPARISON: Outside hospital radiograph and CT chest the same day. FINDINGS: Lungs are clear, there is no pleural effusion or pneumothorax, and the heart size and mediastinal contours are within normal limits. Osseous structures are intact. IMPRESSION: Clear lungs. " 18c66757-b9ddca4b-12ea8ab0-bffb3eed-c6808491.jpg,test/p15/p15227454/s54640482/18c66757-b9ddca4b-12ea8ab0-bffb3eed-c6808491.jpg,test," FINAL REPORT INDICATION: ___ year old man with hx of low EF and CHF now with SOB // vascular congestions TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The lung volumes are hyperinflated consistent with emphysema seen on prior CT. Multiple right-sided pulmonary nodules are again seen, but better assessed on prior CT. Subtle ground-glass opacities in the right lung identified on prior CT likely represent an element of fibrosis. Vascular congestion is difficult to exclude however there is no overt edema. . Mild cardiomegaly stable. Stable calcification of the aortic arch. Blunting of the right costophrenic angle appears chronic and likely represent scarring. Surgical clips projecting inferior to the aortic bulb and along the left neck. IMPRESSION: 1. Interval improvement of mild pulmonary vascular congestion without overt edema. 2. Stable pulmonary nodules and solid ground-glass opacities of the right lung seen on prior CT. 3. Stable emphysema. " 2f81c9c8-4189103e-18cc45a2-842f1fad-faadf1ea.jpg,test/p19/p19601036/s52478298/2f81c9c8-4189103e-18cc45a2-842f1fad-faadf1ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p cabg // eval for effusion eval for effusion TECHNIQUE: Frontal chest radiograph COMPARISON: Radiographs dating back to ___ FINDINGS: Right-sided pleural effusion appears unchanged. Cardiomegaly is stable. Platelike atelectasis in the mid left hemi thorax and left base, are improving. Median sternotomy wires are unchanged in position, however the inferior most wire has been broken since the first postop radiograph. Left-sided chest tube remains within the basal left lung. Midline drains remain in place. Right IJ sheath appears unchanged. IMPRESSION: Right-sided pleural effusion appears unchanged. " 376d6950-f0cd9a17-3abb7d13-d09995cf-390db6d4.jpg,test/p15/p15426827/s56006520/376d6950-f0cd9a17-3abb7d13-d09995cf-390db6d4.jpg,test," FINAL REPORT AP CHEST, 2:46 P.M., ___ HISTORY: Cirrhosis. Evaluate Dobbhoff tube placement. IMPRESSION: AP chest compared to ___: Lateral aspect of the right chest and upper abdomen are excluded from the study. Greater opacification in the right lower hemithorax suggests posterior layering of a moderate right pleural effusion. Feeding tube with the wire stylet fully inserted is coiled in the upper portion of a non-distended stomach. Dilated bowel loops in the upper abdomen are clustered in the midline, suggesting ascites. Left lung is clear. " 16133999-eff474dd-d9943de4-433c8f87-6c991c3e.jpg,test/p13/p13659269/s55442251/16133999-eff474dd-d9943de4-433c8f87-6c991c3e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // edema vs. infiltrate, intubated edema vs. infiltrate, intubated IMPRESSION: Comparison to ___. No relevant change. Moderate cardiomegaly. Moderate right and small left pleural effusion. Relatively extensive areas of atelectasis. Mild fluid overload but no overt pulmonary edema. " 556cfc1c-e01db781-a3ec1b44-ce8d5b47-2ca94fe0.jpg,test/p19/p19193148/s59063609/556cfc1c-e01db781-a3ec1b44-ce8d5b47-2ca94fe0.jpg,test," FINAL REPORT CHEST, TWO VIEWS. HISTORY: ___-year-old male with cough and back pain. Question pneumonia. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 988d35ce-5318e3d6-1c128c82-ff016a46-e5becda9.jpg,test/p17/p17078867/s52620240/988d35ce-5318e3d6-1c128c82-ff016a46-e5becda9.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man. Evaluate pleural effusion. IMPRESSION: PA and lateral chest read in conjunction with chest CT from ___ Left pleural abnormality is largely in the lower hemithorax with smooth margins interfacing with the left lung. The precise contribution of pleural thickening and pleural effusion is indeterminate, but the overall volume is comparable to that on the chest CT scan in ___ performed in another hospital. Both lungs are clear. There are healed rib fractures on the right. Leftward mediastinal shift reflects the restrictive nature of left pleural thickening inducing loss of volume in the left lung. Right lung is clear. " 2e5e76aa-5f66a6d5-f5cd9a23-840fe992-de69882f.jpg,test/p16/p16588955/s56049766/2e5e76aa-5f66a6d5-f5cd9a23-840fe992-de69882f.jpg,test," FINAL REPORT HISTORY: Cough and shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac silhouette size is borderline enlarged, but is likely accentuated due to slightly low lung volumes. Mediastinal hilar contours are unremarkable. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 9f1fb475-55864689-444396a2-92b2ccb0-f97b486f.jpg,test/p10/p10146281/s52926365/9f1fb475-55864689-444396a2-92b2ccb0-f97b486f.jpg,test," FINAL REPORT INDICATION: Smoker with a remote history of sarcoidosis with worsening shortness of breath. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Multiple priors, most recently on ___. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is within normal limits. The cardiac, hilar, and mediastinal contours are unremarkable. IMPRESSION: No acute or chornic cardiopulmonary process. " e3d8365c-81cda004-38dc63ea-b1b23166-2b183359.jpg,test/p13/p13902459/s54723020/e3d8365c-81cda004-38dc63ea-b1b23166-2b183359.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with seizure. Question pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are grossly clear without consolidation, effusion, or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormality is identified. IMPRESSION: No definite acute cardiopulmonary process. " 11a02849-5eddce59-25f79463-658d903d-543b47ad.jpg,test/p16/p16298181/s51315140/11a02849-5eddce59-25f79463-658d903d-543b47ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with shortness of breath, wheezing. // fluid overload SOB;FLUID OVERLOAD IMPRESSION: Comparison to ___. Mild cardiomegaly persists. Elongation of the descending aorta. No pulmonary edema. No pneumonia, no pleural effusions. " c6b7b1fe-10010b63-9d8c0842-23639380-ddc0382f.jpg,test/p19/p19933545/s58999747/c6b7b1fe-10010b63-9d8c0842-23639380-ddc0382f.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with epigastric and CP, vomiting // eval for PNA, PTX, free air TECHNIQUE: Chest PA and lateral COMPARISON: CT chest dated ___, CT abdomen and pelvis dated ___. . FINDINGS: Mild cardiomegaly is noted. A large paraesophageal hiatal hernia is present with mild adjacent bibasilar atelectasis, and better evaluated on the concomitant CT examination. The upper lung fields are clear. IMPRESSION: Large paraesophageal hiatal hernia with adjacent atelectasis. No acute cardiopulmonary process. " 0beaa202-eac40f5e-2d24dce4-64854f5c-138b200f.jpg,test/p11/p11192888/s53475716/0beaa202-eac40f5e-2d24dce4-64854f5c-138b200f.jpg,test," WET READ: ___ ___ 9:57 AM Aeration of the left lower lobe has improved, although there is considerable persistent atelectasis. Lungs are otherwise clear. No pulmonary edema or pneumothorax. WET READ VERSION #1 ___ ___ ___ 9:06 PM Aeration of the left lower lobe has improved, although there is considerable persistent atelectasis. Lungs are otherwise clear. No pulmonary edema or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with shortness of breath // shortness of breath COMPARISON: ___ IMPRESSION: Improved ventilation of the left lung bases and the retrocardiac lung regions. No other relevant changes. The pacemaker and right PICC line are in constant position. " 8b6c458b-3724677b-793908fe-c40eb92f-04c413a0.jpg,test/p11/p11790326/s56378334/8b6c458b-3724677b-793908fe-c40eb92f-04c413a0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // r/o pulm path TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Stable cardiomegaly and mild tortuosity of the thoracic aorta in this patient status post previous median sternotomy and coronary bypass surgery. . The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are hyperinflated and grossly clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Compression deformities in the spine are similar to the prior study. IMPRESSION: No radiographic evidence of pneumonia. Stable radiographic appearance of the chest. " dd40eeeb-1c0b0479-d8913af4-e8534d7a-902ae2c6.jpg,test/p19/p19437889/s51370226/dd40eeeb-1c0b0479-d8913af4-e8534d7a-902ae2c6.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Seizures. Portable AP radiograph of the chest was reviewed with no prior studies available for comparison. Heart size and mediastinum are unremarkable. Lungs are essentially clear except for left basal linear opacity, most likely reflecting atelectasis, but correlation with PA and lateral view to exclude other underlying process is recommended. Adjacent to this atelectasis, there is semicircular opacity projecting over the diaphragm, potentially can represent nodule, again can be reevaluated in PA and lateral views. If the patient cannot obtain PA and lateral views, chest CT might be recommended. " ed2f5fbc-6b5b5da1-deee063c-d9a827d0-a011cc25.jpg,test/p14/p14335562/s56441614/ed2f5fbc-6b5b5da1-deee063c-d9a827d0-a011cc25.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Fever, question pneumonia. FINDINGS: PA and lateral views of the chest are provided. Lungs are clear without focal consolidation, effusion or pneumothorax. The heart and mediastinal contour is normal. Bony structures are intact. There are DISH related changes of the T-spine noted. IMPRESSION: No signs of pneumonia. " 7d2968fc-45b1adbc-8fc74e87-4b799b8a-2e56cece.jpg,test/p10/p10657848/s55761156/7d2968fc-45b1adbc-8fc74e87-4b799b8a-2e56cece.jpg,test," FINAL REPORT EXAM: CHEST FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: ___-year-old female with history of left upper quadrant pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " c26ae462-ba85bac6-fb7ec77e-c1a831ef-18baaed3.jpg,test/p18/p18747069/s59977564/c26ae462-ba85bac6-fb7ec77e-c1a831ef-18baaed3.jpg,test," WET READ: ___ ___ ___ 9:12 PM Ongoing mild pulmonary edema. Asymmetric opacity in left lung apex may be due to developing infection or asymmetric edema. Close attention to this area on follow-up recommended. No other change from prior. ___ p_________________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with pulmonary edema, new oxygen requirement. Comparison is made with prior study ___. Mild-to-moderate pulmonary edema is unchanged. Cardiac size is top normal. The mediastinal contours are stable. Asymmetric opacity in the left apex suggests developing infection. The lower lobe retrocardiac opacities have increased consistent with increasing atelectasis. Cardiomediastinal contours are unchanged. " 456ecf25-4900467a-9175a1db-e65f5016-b40005b7.jpg,test/p11/p11738518/s59183122/456ecf25-4900467a-9175a1db-e65f5016-b40005b7.jpg,test," FINAL REPORT INDICATION: ___F with intubated. TECHNIQUE: Portable supine chest x-ray. COMPARISON: Multiple prior chest radiographs, the most recent from ___ at 00:36. FINDINGS: There has been interval placement of an ET tube, terminating 3.0 cm above the carina. An enteric tube is also present with tip and side holes in the stomach. Again seen is a right PICC line, with tip terminating in the right brachiocephalic vein. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. New atelectasis is also present in left upper lobe and lingula. Hazy opacity throughout the left lung is again seen, slightly more subtle than on the most recent prior exam. There is no pulmonary edema. IMPRESSION: 1. ETT terminating 3.0 cm above the carina. Retraction by 1-2 cm recommended. Appropriately positioned enteric tube. 2. New atelectasis. " 50ac3351-6434b541-39873ade-d7c891da-68adce59.jpg,test/p14/p14695209/s54559539/50ac3351-6434b541-39873ade-d7c891da-68adce59.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxemic respiratory failure // eval for pleural effusions TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph from ___, ___. FINDINGS: A left-sided central line terminates in the mid to low SVC, unchanged in position compared to prior radiograph. In comparison to the study from ___, there has been substantial decrease in the hazy opacifications previously silhouetting the hemidiaphragms. The cardiomediastinal silhouette is unchanged. No pulmonary edema or focal consolidations. No pneumothorax. IMPRESSION: Improved bibasilar opacifications. This may be related to improved pleural effusion, but could be a manifestation of a more upright positioning of the patient. If the patient's clinical status permits, PA and lateral chest radiograph may be considered for accurate assessment of pleural effusion. RECOMMENDATION(S): PA and lateral chest radiograph for accurate assessment of pleural effusion. " bb3366e3-9f5b8680-0b0f633f-7a71154b-667d364b.jpg,test/p17/p17224335/s50426364/bb3366e3-9f5b8680-0b0f633f-7a71154b-667d364b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p AVR // eval for line position s/p placement of R IJ eval for line position s/p placement of R IJ IMPRESSION: In comparison with the earlier study of this date, there is an placement of a right IJ catheter that extends to the mid to lower portion of the SVC. No evidence of post procedure complication. Little change in the appearance of the heart and lungs. " b008360a-28945db5-7265f115-79f264e2-e4bb05e4.jpg,test/p12/p12913304/s51923783/b008360a-28945db5-7265f115-79f264e2-e4bb05e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with left lung procedure and PTX // PTX after lung biopsy. please do at 1pm. Patient in RCU CC3 PTX after lung biopsy. please do at 1pm. Patient in RCU CC3 IMPRESSION: In comparison with the earlier study of this date, there is probably little overall change in the small to moderate left apical pneumothorax. Remainder of the study is unchanged. " 56910625-9be3069a-1f337255-41406cf0-802a8296.jpg,test/p16/p16988247/s59909132/56910625-9be3069a-1f337255-41406cf0-802a8296.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 0d390664-f40e726f-e68495ee-588913b4-18b839a1.jpg,test/p15/p15739017/s59070818/0d390664-f40e726f-e68495ee-588913b4-18b839a1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old female, s/p fall at home left rib fractures, small hemothorax, small left PTX // please assess for interval change COMPARISON: Clavicle radiographs from___ and ___, chest radiograph from ___ and CT torso from ___ FINDINGS: There are multiple rib fractures in the upper left chest cage. Displaced fractures of the fourth rib anteriorly and posteriorly are similar to prior exam. The anterior second rib fracture should not be mistaken for a lung lesion. Other minimally displaced fractures seen on CT are not seen on this examination. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Moderate dependent left pleural effusion, some of which was probably present on ___. No focal consolidation or pneumothorax is seen. IMPRESSION: 1. No pneumothorax. 2. Moderate left pleural effusion and associated atelectasis. 3. Previously seen multiple left rib fractures appear similar. NOTIFICATION: The findings were discussed with ___ on the telephone on ___ at 10:55 AM. " 889d0ff5-480c7847-3effb79a-ab4cf186-7c1ed983.jpg,test/p14/p14522445/s57849086/889d0ff5-480c7847-3effb79a-ab4cf186-7c1ed983.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with ESRD on HTN TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size remains moderate to severely enlarged, unchanged. Mediastinal contour is stable. Moderate pulmonary edema is present. No large pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Unchanged moderate to severe cardiomegaly with moderate pulmonary edema. " 94e15f36-52b48fdc-58296169-e01f7115-832352b3.jpg,test/p10/p10062617/s59986994/94e15f36-52b48fdc-58296169-e01f7115-832352b3.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Overall appearance of the chest is relatively similar to the recent study except for worsening left retrocardiac opacity which probably represents a combination of small-to-moderate left pleural effusion and adjacent left lower lobe atelectasis and/or consolidation; additionally, patchy and linear opacities at the right lung base have also slightly worsened. Remainder of lungs are clear, and cardiomediastinal contours are stable. " 5f197518-6ab7e169-2ba0ea2f-91ff9210-d2b59321.jpg,test/p17/p17288913/s54299643/5f197518-6ab7e169-2ba0ea2f-91ff9210-d2b59321.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough and shortness of breath. Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures demonstrate no acute abnormality. IMPRESSION: No acute cardiopulmonary process. " 36f17201-9c9552c8-0c097b1f-05f8146a-99661110.jpg,test/p18/p18079481/s50683984/36f17201-9c9552c8-0c097b1f-05f8146a-99661110.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with dyspnea and possible COPD. Increased sputum production. Rule out pneumonia. IMPRESSION: PA and lateral chest compared to ___ and ___. Mild cardiomegaly is chronic. There is no pulmonary edema or vascular abnormality. Lungs are low in volume, but clear of pneumonia. Bilateral healed rib fractures noted. " 54199d2e-20dc1071-2a621ead-bd818632-8b5905ef.jpg,test/p11/p11566151/s50870612/54199d2e-20dc1071-2a621ead-bd818632-8b5905ef.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPHS DATED ___ No prior chest radiographs for comparison. FINDINGS: Heart size is normal. Within the right cardiophrenic angle, a 6.3 cm x 6.7 cm diameter, well defined opacity is identified, and appears relatively lucent, suggesting possible fat content. Mediastinal contours are otherwise unremarkable. Lungs are hyperexpanded with attenuation of pulmonary vessels in the upper and mid lung regions suggestive of emphysema. Minimal linear opacities in the right mid and both lower lung regions are present, but there are no focal areas of consolidation or pleural effusion. Degenerative changes are present within the spine, and note is made of multiple healed left-sided rib fractures as well as degeenrative changes at the left shoulder. Additionally, a fracture of the third lateral left rib is of indeterminate age. There is no visible pneumothorax. IMPRESSION: 1. In addition to multiple healed rib fractures throughout the left hemithorax, there is a fracture of the left third lateral rib, which is of indeterminate age. Correlation with site of trauma and symptoms may be helpful in this regard. If warranted clinically, a dedicated rib series could be obtained with metallic marker at the site of symptoms. 2. 6.6 cm diameter, well defined right cardiophrenic angle mass is most likely a benign process such as a pericardial cyst, enlarged pericardial fat pad, or herniated fat from a Morgagni hernia. However, in the absence of older chest radiographs for comparison, CT is suggested for more complete characterization of this finding. 3. Emphysema. Findings entered into radiology communications dashboard on the date of the study. " 4a38ad35-3e063ba0-bb9ccf2a-4982ca59-08b1005d.jpg,test/p13/p13473495/s57665537/4a38ad35-3e063ba0-bb9ccf2a-4982ca59-08b1005d.jpg,test," FINAL REPORT HISTORY: Nausea, malaise. COMPARISON: Chest radiographs ___, CT torso ___. FINDINGS: AP and lateral views the chest were viewed. The cardiomediastinal and hilar contours are stable with severe cardiomegaly. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. A possible small nodule is the right mid lung zone could be evaluated electively with chest CT if indicated. IMPRESSION: No acute process. Possible nodule in the right mid lung zone. Nonurgent chest CT may be obtained for further evaluation. Dr. ___ ___ this recommendation with Dr. ___ ___ telephone at 10:17 AM on ___. " 319be390-e451f86f-6e7d5656-326359cf-5beb0d8c.jpg,test/p17/p17639440/s58943767/319be390-e451f86f-6e7d5656-326359cf-5beb0d8c.jpg,test," FINAL REPORT HISTORY: ___-year-old male with dizziness. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 11383cca-e4c3d1a7-b11186b3-7252f7ab-c5c7565e.jpg,test/p15/p15233042/s56345471/11383cca-e4c3d1a7-b11186b3-7252f7ab-c5c7565e.jpg,test," FINAL REPORT INDICATION: ___F with copd here for etoh detox // ? ptx, effusion, consolidation TECHNIQUE: 2 portable views of the chest. COMPARISON: Multiple prior exams dating back to ___ with most recent from ___. FINDINGS: There persistent increased interstitial markings throughout the lungs bilaterally which have not significantly changed, potentially combination of chronic underlying interstitial process and mild possible pulmonary edema. Degree of cardiomegaly is similar. Median sternotomy wires including several fractured wire fragments are seen. Right humeral hardware is partially visualized. IMPRESSION: No significant interval change, no focal consolidation. Persistent cardiomegaly and increased interstitial markings likely combination of chronic interstitial process and mild pulmonary edema " 09ad845e-8758ac27-64eaaf77-3b19139a-bf1cd73e.jpg,test/p17/p17288913/s56798862/09ad845e-8758ac27-64eaaf77-3b19139a-bf1cd73e.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain // eval for pna TECHNIQUE: Upright PA and lateral chest COMPARISON: None available FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Small hiatal hernia is unchanged from prior. There is calcification of the aortic arch. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. Small hiatal hernia. " 1facb592-4facf83d-07b2f379-f47db9a9-e263e2d6.jpg,test/p16/p16949700/s56301675/1facb592-4facf83d-07b2f379-f47db9a9-e263e2d6.jpg,test," WET READ: ___ ___ 9:18 AM Stable cardiomegaly with no evidence of pulmonary edema or pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with productive cough, ? PNA // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Dual-chamber pacemaker-ICD leads are in standard location. Heart size is moderately enlarged but stable. The lungs are clear with no evidence of pneumonia, pulmonary edema, or pleural effusion. No pneumothorax. Osseous structures are intact. IMPRESSION: Stable cardiomegaly with no evidence of pulmonary edema or pneumonia. " 2b1b38d3-5c625870-726b298f-6eab1b5c-4075dee8.jpg,test/p10/p10863418/s51973859/2b1b38d3-5c625870-726b298f-6eab1b5c-4075dee8.jpg,test," FINAL REPORT INDICATION: History of right renal cell carcinoma. Assess for metastases. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. Mild asymmetry of the lung bases likely reflects atelectasis. No pulmonary nodules identified. Small left pleural effusion noted. No pneumothorax present. Mild dextroscoliosis of the thoracic spine evident. IMPRESSION: No pulmonary nodules. Small left pleural effusion. " e439987c-0defea1a-e154e831-2b2e5c49-c6564289.jpg,test/p15/p15535789/s56988715/e439987c-0defea1a-e154e831-2b2e5c49-c6564289.jpg,test," FINAL REPORT HISTORY: Sepsis, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there has been a dramatic increase in the pulmonary edema with probable bilateral pleural effusions and continued cardiomegaly. Monitoring and support devices remain in place. The possibility of supervening pneumonia would be impossible to exclude on this study. " 0f429b48-9563c3ad-03a60826-68140a05-93812187.jpg,test/p18/p18594481/s54629581/0f429b48-9563c3ad-03a60826-68140a05-93812187.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: ___-year-old man transferred from outside hospital after having swallowed a large pill which is stuck in the upper esophagus per report, question foreign body. FINDINGS: AP upright portable chest radiograph was provided. There is a radiopaque foreign body projecting over the superior mediastinum measuring approximately 2.6 x 1.7 cm concerning for impacted foreign body within the upper esophagus. Its exact localization is difficult, given single frontal view provided. Lungs appear well aerated. Heart size is within normal limits. The aorta is calcified and unfolded. No bony abnormalities. IMPRESSION: Radiodense foreign body projecting over the superior mediastinum, which could reside within the upper esophagus, less likely trachea. " 35b19b31-8b1a1a6e-d989473c-6211937c-de37eb92.jpg,test/p10/p10900387/s51506744/35b19b31-8b1a1a6e-d989473c-6211937c-de37eb92.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Free intraperitoneal air is present, and may be due to recent PEG. Right PICC is in the lower SVC. Heart is upper limits of normal in size. Lungs are grossly clear with no new areas of consolidation to suggest the presence of pneumonia. " fbffa0be-dbf43d49-bc9c821b-3ba90637-3ed23ba4.jpg,test/p14/p14857506/s55787273/fbffa0be-dbf43d49-bc9c821b-3ba90637-3ed23ba4.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the study of ___, there is little overall change. The Dobbhoff tube opaque tip again is in the upper portion of the stomach, at or just distal to the esophagogastric junction. It should be pushed forward if possible. Slightly lower lung volumes. The pulmonary vessels are less well seen, consistent with some increasing pulmonary venous pressure. Probable atelectatic changes at the bases. " f5818d6d-647338b7-6a5323e8-95b0cda2-d96c3a7b.jpg,test/p12/p12272292/s58759560/f5818d6d-647338b7-6a5323e8-95b0cda2-d96c3a7b.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Lung volumes are low, accentuating the cardiac silhouette and bronchovascular structures. Allowing for this factor, heart size is normal. No focal areas of consolidation are present within the lungs, and there are no pleural effusions. Multiple rib deformities are unchanged and likely relate to congenital fusion anomalies. IMPRESSION: No evidence of pneumonia. " 3346aec6-c83b814d-471d1e4c-6c0eb24c-5d6d20a8.jpg,test/p13/p13031024/s52829057/3346aec6-c83b814d-471d1e4c-6c0eb24c-5d6d20a8.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with new dyspnea on exertion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. There is no consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 750bbe6e-f5c9921f-fa04406e-099b9d22-c231e61c.jpg,test/p19/p19424434/s50285310/750bbe6e-f5c9921f-fa04406e-099b9d22-c231e61c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain // r/o acute process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 7c15bb34-6d120ff9-8a492a6c-e6aba498-44851661.jpg,test/p14/p14150988/s58467247/7c15bb34-6d120ff9-8a492a6c-e6aba498-44851661.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with weight gain, SOB, and dialysis pt // ?pulmonary edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Since the prior study, new perihilar and basilar opacities are worrisome for mild to moderate pulmonary edema. Underlying infection and exclude in the appropriate clinical setting, particularly at the left lower lobe. There may also be small pleural effusions posteriorly. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Perihilar and basilar opacities worrisome for mild to moderate pulmonary edema, underlying infection not excluded in the appropriate clinical setting, particularly at the left lower lobe. " 1f8b25bc-723157ce-8f640f8a-a28ebde6-74cb65f7.jpg,test/p17/p17527219/s55088533/1f8b25bc-723157ce-8f640f8a-a28ebde6-74cb65f7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with swan that was recently repositioned // positioning of ___ positioning of swan IMPRESSION: Compared to prior chest radiographs ___ through ___ and ___. Swan-___ catheter ends in the right upper lobe pulmonary artery. There is no pneumothorax, mediastinal widening, or pleural effusion. Moderate cardiomegaly is chronic. Upper lobe pulmonary vasculature is mildly engorged but there is no edema. Lungs are clear. " 909a22d3-248d3c2b-338309a5-073d8cd0-f4f6aed7.jpg,test/p12/p12668116/s52789592/909a22d3-248d3c2b-338309a5-073d8cd0-f4f6aed7.jpg,test," FINAL REPORT HISTORY: History of pleural effusion and pleurodesis. Renal cell carcinoma with pulmonary metastases. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: Moderate sized right pleural effusion is relatively unchanged in size compared to the prior exam. Adjacent opacification within the right lung base likely reflects atelectasis though infection cannot be completely excluded, and the degree of opacification has slightly worsened compared to the prior exam. Irregular nodular pleural thickening on the right extends to the lung apex and appears progressed in the interval. Multiple left lung nodules are again demonstrated, better seen on the prior CT, compatible with metastases. There is no left-sided pleural effusion, new focal consolidation, or pneumothorax identified. The cardiac, mediastinal and hilar contours are unchanged although the cardiac silhouette size is difficult to assess given the presence of the right-sided pleural effusion. There are no acute osseous abnormalities. IMPRESSION: 1. Unchanged moderate sized right pleural effusion. Nodular pleural thickening in the right hemithorax appears progressed in the interval and likely reflects worsening pleural metastases. 2. Right basilar opacification likely reflects atelectasis though infection is difficult to exclude, and appears minimally worse when compared to the prior exam. 3. Relatively unchanged left lung pulmonary nodules, compatible with metastases. " c18eb6ff-80bbb0e5-bdc37b5b-90f1b00a-7bfec9fe.jpg,test/p14/p14108973/s59346823/c18eb6ff-80bbb0e5-bdc37b5b-90f1b00a-7bfec9fe.jpg,test," FINAL REPORT INDICATION: ___ year old man s/___ CRT-D s/p left axillary vein access // confirm lead placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are hyperexpanded and clear without focal consolidation concerning for pneumonia. A 3 lead pacemaking device is present with leads terminating in the right atrium, right ventricle, and coronary sinus as expected. IMPRESSION: Appropriate position of pacemaker leads, as described above. " 602b49cc-3223f81d-2ac01f25-e879bd33-a10eae1c.jpg,test/p14/p14165118/s52226887/602b49cc-3223f81d-2ac01f25-e879bd33-a10eae1c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p R CEA with persistent O2 requirement // effusion/atelectasis/effusion effusion/atelectasis/effusion IMPRESSION: As compared to the previous image, the nasogastric tube has been removed. No effusion, no pulmonary edema, no pleural effusions. No pneumothorax. " f89af069-8b6b8aab-02dc16fc-811c2253-99d3d8db.jpg,test/p10/p10464228/s56813158/f89af069-8b6b8aab-02dc16fc-811c2253-99d3d8db.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___M with chest pain and SOB // Eval for infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 2e619f64-89aad18a-fa15db10-86ed910e-e1d9fb82.jpg,test/p16/p16508811/s50598243/2e619f64-89aad18a-fa15db10-86ed910e-e1d9fb82.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of renal transplant and chronic heart failure, fever, and cough. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing opacity in the right lung apex has completely resolved. However, opacities at both lung bases are still present. The opacities appear less dense than on the previous image. Currently, no evidence of pulmonary edema is present. The size of the cardiac silhouette is at the upper range of normal. There is no evidence of pleural effusions on the frontal and lateral images. " faeb4334-fdfb2893-ef9650f8-ae2ca238-4b9fd760.jpg,test/p15/p15937283/s56753342/faeb4334-fdfb2893-ef9650f8-ae2ca238-4b9fd760.jpg,test," FINAL REPORT INDICATION: Status post renal and pancreas transplant with dehydration and slight fever. COMPARISON: ___ chest radiograph and ___ high-resolution chest CT. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 9c221d53-3b75b751-398b43c6-fd8583ad-0d9d3ddb.jpg,test/p12/p12455922/s57592227/9c221d53-3b75b751-398b43c6-fd8583ad-0d9d3ddb.jpg,test," FINAL REPORT INDICATION: ___ year old woman with history of smoking, restrictive PFTs, CAD, with shortness of breath, cough, recent bronchitis // any infiltrates or pulmonary edema TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: No acute focal consolidation. Chronic linear opacity along the right heart border, suggestive of right middle lobe partial volume loss. Nodular opacities projecting between the sixth and seventh interspace on the left appears more conspicuous since ___. The mediastinum is widened. The trachea is deviated to the right. Moderate cardiomegaly. Extensive atherosclerotic calcifications and tortuosity of the descending aorta. No pleural effusions or pneumothorax. IMPRESSION: 1. No acute pneumonia. Multiple nodular opacities in the left lung can be calcified granulomas or noncalcified pulmonary nodules and are incompletely assessed. 2. Chronic linear opacity along right middle lobe can be right middle lobe volume loss, also incompletely assessed. 3. Widened mediastinum and trachea shifted to the right likely related to enlargement of the thyroid RECOMMENDATION(S): A CT of the thorax is suggested to assess for pulmonary nodules, thyroid and right middle lobe. " a75db012-a9ee27c6-0a4ff875-3394f301-f602d716.jpg,test/p13/p13620449/s58662533/a75db012-a9ee27c6-0a4ff875-3394f301-f602d716.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with a history of decompensated CHF status post ICD placement. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Left pectoral ICD with a single lead terminating in the right ventricle. Stable cardiomegaly. Pulmonary vessels appear less engorged, although this may simply reflect the differences between an upright PA film and a supine AP film instead of a true improvement in pulmonary vascular congestion. No evidence of pneumonia, pneumothorax, or pleural effusions. IMPRESSION: Stable versus slightly decreased pulmonary vascular congestion. " 7deb5927-77868540-53c53f29-b442b466-0e86cff7.jpg,test/p15/p15008369/s55555458/7deb5927-77868540-53c53f29-b442b466-0e86cff7.jpg,test," FINAL REPORT HISTORY: Cough, to assess for pneumonia. FINDINGS: No previous images. The heart is normal in size, and there is no vascular congestion or pleural effusion. No acute focal pneumonia. Of incidental note is dilatation of loops of apparently large and small bowel. " c44660cd-adcb436c-6711fa4d-7f66c82e-1c0902b4.jpg,test/p18/p18654576/s51791213/c44660cd-adcb436c-6711fa4d-7f66c82e-1c0902b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sickle cell disease with R sided pleuritic chest pain // Concern for acute chest syndrome TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: Heart size is at the upper limits of normal. The trachea is central. The cardiomediastinal contour is normal. No consolidation, pneumothorax or pleural effusion seen. The visualized bony structures are unremarkable in appearance IMPRESSION: No acute cardiopulmonary process seen. " 6744c4f1-d659b0de-9616f798-def4d319-7c248ea7.jpg,test/p18/p18871870/s50832312/6744c4f1-d659b0de-9616f798-def4d319-7c248ea7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: This is a ___ F from ___, recent diagnosis of bilateral cryptogenic pneumonia, PMR, Afib, NSTEMI last week, cath with 4VD, sCHF (EF ___%), who initially presented with fever and respiratory distress to BI-N. // evaluate interval change COMPARISON: None. FINDINGS: ET tube tip in satisfactory position approximately 2.5 cm above the carina. NG tube present, extending beneath diaphragm. The tip overlies the stomach. The sideport likely also overlies the stomach, but may lie just distal to the GE junction. A left IJ central line tip overlies the proximal SVC. No pneumothorax detected. Again seen areextensive diffuse bilateral alveolar opacities and as well as increased retrocardiac density, obscuration of the left hemidiaphragm, and of the extreme lateral right hemidiaphragm. Confluent biapical opacity again noted. The overall appearance is similar to the prior study, allowing for technical differences. The right hemidiaphragm is slightly better defined on today's examination, which could reflect very slight improvement at the right lung base. The possibility of bilateral small effusions cannot be excluded. IMPRESSION: Lines and tubes as described. Extensive diffuse bilateral patchy opacities, overall similar to the prior study, would possible slight clearing at the right lung base. " 2d2321e3-30f00599-20ee8d9d-06b67ee7-8af314d8.jpg,test/p17/p17794482/s51946830/2d2321e3-30f00599-20ee8d9d-06b67ee7-8af314d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LATERAL) INDICATION: ___ year old man with cough, chest pain, post perc bili drain. Evaluate for consolidation. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: There are small bilateral pleural effusions and bibasilar platelike atelectasis, without focal consolidation concerning for pneumonia or pneumothorax. Heart size mediastinum, and hilar contours are stable. IMPRESSION: Small bilateral pleural effusions and bibasilar platelike atelectasis without evidence of pneumonia. " 3afca8a9-9c9f3e68-df89525b-6d42cdb3-6a7265bc.jpg,test/p15/p15426827/s58607819/3afca8a9-9c9f3e68-df89525b-6d42cdb3-6a7265bc.jpg,test," FINAL REPORT HISTORY: ___-year-old man status post thoracentesis. COMPARISON: ___. FINDINGS: A large right-sided pleural effusion has substantially decreased in size. There is no pneumothorax. The left lung remains clear. The right hila remains prominent. IMPRESSION: No evidence of pneumothorax " dc32c30d-88755feb-6148374e-710c570a-9317da9c.jpg,test/p13/p13871678/s53755642/dc32c30d-88755feb-6148374e-710c570a-9317da9c.jpg,test," FINAL REPORT HISTORY: Chest pain. Question cardiopulmonary anomaly. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is top normal in size. There is tortuosity of the descending aorta. There is vascular engorgement of the right hilum. The mediastinal and hilar contours are otherwise within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural fluid effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 0ad31d4d-e95e4157-94b4a3ed-c7a38998-df343725.jpg,test/p17/p17892707/s58683353/0ad31d4d-e95e4157-94b4a3ed-c7a38998-df343725.jpg,test," FINAL REPORT HISTORY: Sepsis. FINDINGS: In comparison with the study of ___, there is again suggestion of some retrocardiac opacification on the frontal view, which is not definitely confirmed on the lateral projection. This could reflect a small focus of consolidation. Remainder of the study is unchanged without acute abnormality. " e7ec544e-58c390a9-a8bacbc8-6495e1dd-9808414a.jpg,test/p15/p15803381/s53819721/e7ec544e-58c390a9-a8bacbc8-6495e1dd-9808414a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: aortic repair, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a minimal improvement of the pre-existing parenchymal opacities, with improved ventilation, notably at the right lung base. The left lung base, including the retrocardiac atelectasis and the small pleural effusion, is unchanged. The previously coiled nasogastric tube is the esophagus has been pulled, a new nasogastric tube can be followed to the level of the mid-to-lower esophagus but is not visible more distally. The other monitoring and support devices are constant. No pneumothorax. " c959cd25-21b88a29-95da8d78-3ab7faa9-6f896ba4.jpg,test/p11/p11868667/s54874602/c959cd25-21b88a29-95da8d78-3ab7faa9-6f896ba4.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomegaly is accompanied by pulmonary vascular congestion, perihilar haziness, and asymmetrically distributed consolidation, predominantly in the right upper lobe and right infrahilar region. Observed findings could be due to clinically suspected pulmonary edema with asymmetrical distribution, but superimposed aspiration or infectious pneumonia in the right lung is also possible, and short-term followup radiographs after diuresis may be helpful in this regard. " 642a082c-56bec640-c636baa5-5c66ce05-94e7839a.jpg,test/p16/p16974136/s51791517/642a082c-56bec640-c636baa5-5c66ce05-94e7839a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with s/p fall // eval rib fxs TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: There is minimal linear bibasilar atelectasis. .There is no focal consolidation to suggest pneumonia. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No rib fractures are identified. IMPRESSION: No evidence of acute intrathoracic traumatic injury. " 368f03e9-426250a4-8ee573ee-d0a10aa7-4536729a.jpg,test/p10/p10226344/s51449120/368f03e9-426250a4-8ee573ee-d0a10aa7-4536729a.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with atrial fibrillation and pleural effusion. FINDINGS: Comparison is made to prior study from ___. The endotracheal tube and feeding tube have been removed. There is a right IJ central line with distal lead tip in the proximal SVC, stable. There is a persistent left retrocardiac opacity and small left-sided pleural effusion. There are no signs for overt pulmonary edema or pneumothoraces. " f39bdebb-4343ebb8-527dd5b5-168d552c-c9b020d1.jpg,test/p17/p17202146/s56230993/f39bdebb-4343ebb8-527dd5b5-168d552c-c9b020d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever, cough // pneumonia COMPARISON: ___ IMPRESSION: No change as compared to the previous image. No evidence of pneumonia or other pathologic lung parenchymal changes. No pleural effusions. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. " 14754dee-1431b931-32e7b5ab-71ac57d4-4b692b11.jpg,test/p17/p17374166/s55625826/14754dee-1431b931-32e7b5ab-71ac57d4-4b692b11.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with low saturation and tidal volume with wheezing, status post TURBT. COMPARISON: Chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: The endotracheal tube terminates 4.5 cm above the carina. The cardiomediastinal and hilar contours are normal. The lung volumes are low, with bibasal subsegmental atelectasis. A small left pleural effusion is seen. No consolidation, pulmonary edema or pneumothorax is seen. IMPRESSION: Bibasilar atelectasis with small left pleural effusion. " 613f1c1a-574497bc-811ca222-92869fb6-46348ff9.jpg,test/p16/p16989522/s52246059/613f1c1a-574497bc-811ca222-92869fb6-46348ff9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // cough COMPARISON: None provided. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. No peribronchial thickening. The cardiomediastinal silhouette is normal. A tiny calcification is seen in the right midzone. IMPRESSION: No acute intrathoracic process. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 1:27 PM, 2 minutes after discovery of the findings. " 1b1f3f11-239d7522-e933f24a-98163489-48b0bc36.jpg,test/p10/p10380296/s56822129/1b1f3f11-239d7522-e933f24a-98163489-48b0bc36.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p endo stent graft repair aortic arch aneurysm ___ with increasing endoleak now s/p EVAR/TVAR and R femoral-axillary bypass graft w/ CP and distention // ?acute process ?acute process COMPARISON: Chest radiographs ___. IMPRESSION: A new endo graft has been placed in the ascending thoracic aorta. The large aortic pseudoaneurysm, projecting over the aortopulmonic window is unchanged since ___. Moderate enlargement of the cardiac silhouette is stable. No pulmonary edema. Atelectasis in the left lower lobe has increased. Pleural effusion small if any. No pneumothorax. Right lung clear. Stomach is incompletely imaged, but is moderately or severely distended . Left subclavian large bore catheter ends in the left brachiocephalic vein. " a74ec833-e4974a64-c024000f-78361aa6-2dc1f0c3.jpg,test/p16/p16033728/s53529719/a74ec833-e4974a64-c024000f-78361aa6-2dc1f0c3.jpg,test," FINAL REPORT REASON FOR EXAM: Patient with oxygen requirement and rising white blood count, assess for aspiration pneumonia. Comparison is made with prior study ___. Large left and moderate right pleural effusions with adjacent atelectasis have minimally increased. Cardiomegaly is stable. The aorta is tortuous. There is no pneumothorax. Moderate vascular congestion has increased. Faint right perihilar opacity is new, could correspond to the clinical concern of aspiration. Followup is recommended. " 057bfc4c-58eb6c50-fb6c5a6c-90aa75b7-0f5f6c0e.jpg,test/p18/p18655830/s55229141/057bfc4c-58eb6c50-fb6c5a6c-90aa75b7-0f5f6c0e.jpg,test," FINAL REPORT HISTORY: ESRD with no hemodialysis in six days presenting with swelling. Evaluate for edema. COMPARISON: ___, ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top normal. Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. Compression deformity of a lower thoracic vertebral body is unchanged. IMPRESSION: No acute cardiopulmonary abnormality. No pulmonary edema. " d7479a96-f50cb6e2-7afa675d-b99b68f1-097ec900.jpg,test/p19/p19997911/s58692542/d7479a96-f50cb6e2-7afa675d-b99b68f1-097ec900.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new NGT placement // Please confirm NGT location Please confirm NGT location IMPRESSION: Compared to prior chest radiographs since ___ most recently ___. Although the obliquely oriented course of the esophageal drainage tube is consistent inferiorly with the lower lobe bronchus, superiorly it is clearly not in the airway and instead the drainage tube ends in a large hiatus hernia. Left lower lobe collapse and milder atelectasis or consolidation at the right lung base are new. Aspiration is suspected. Right upper lobe is clear. Heart is enlarged, but comparing the size is difficult in the setting of left lower lobe collapse. No pneumothorax. " 980e82c6-7ab90cf8-447af6cd-211de789-acc2ab72.jpg,test/p19/p19017919/s58372101/980e82c6-7ab90cf8-447af6cd-211de789-acc2ab72.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG/AVR // eval for infiltrate eval for infiltrate COMPARISON: CHEST RADIOGRAPHS ___ THROUGH ___. IMPRESSION: PULMONARY EDEMA HAS CLEARED SINCE ___, BUT THERE IS STILL SUBSTANTIAL BIBASILAR CONSOLIDATION, PROBABLY ATELECTASIS. MODERATE CARDIOMEGALY IS UNCHANGED. MODERATE BILATERAL PLEURAL EFFUSION, LEFT GREATER THAN RIGHT, STABLE ON THE RIGHT, BUT INCREASED ON THE LEFT. NO PNEUMOTHORAX. LEFT INTERNAL JUGULAR LINE ENDS AT THE ORIGIN OF THE SVC. FEEDING TUBE PASSES INTO THE STOMACH AND OUT OF VIEW. NO PNEUMOTHORAX. . " 9380d63e-8f80f285-4f89aa05-f38a971f-c3affa3f.jpg,test/p15/p15701290/s54422923/9380d63e-8f80f285-4f89aa05-f38a971f-c3affa3f.jpg,test," FINAL REPORT INDICATION: Right-sided chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. The lungs are clear. No pleural effusion or pneumothorax is visualized. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary process. " 9c130b3d-f2086fc5-20e1769d-9d5edf0e-a69c706c.jpg,test/p17/p17419105/s51393644/9c130b3d-f2086fc5-20e1769d-9d5edf0e-a69c706c.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Altered mental status. COMPARISON: None. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is mildly enlarged. There is no definite pleural effusion or pneumothorax. The lungs appear clear. There is moderate rightward convex curvature centered along the lower thoracic spine. The bones are probably demineralized. IMPRESSION: No evidence of acute cardiopulmonary disease. " 0a6f3984-f1848700-ae36354d-949cb218-df6254be.jpg,test/p10/p10576601/s54587673/0a6f3984-f1848700-ae36354d-949cb218-df6254be.jpg,test," FINAL REPORT INDICATION: ___-year-old man with new-onset AFib. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest: There is a marked S-shaped scoliosis which causes a tortuous aorta. The lungs appear clear. Cardiomediastinal silhouette and hilar contours are grossly unremarkable. Bones appear intact. IMPRESSION: No acute process identified. " 432ed566-1554b3dd-04e583fd-fe737399-14fe8e9f.jpg,test/p11/p11738518/s50232950/432ed566-1554b3dd-04e583fd-fe737399-14fe8e9f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with desaturation. Lasix-dependent and recently given a diet. // Effusions? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Left PICC tip is in themid SVC. Severe cardiomegaly, and large bilateral pleural effusions associated with atelectasis are stable. There is mild vascular congestion. There is no pneumothorax. stent projects in the midline of the upper abdomen. Catheters project in the right upper quadrant " d4710e90-03ad2ca8-87a21d8f-d59bf306-15a9db0f.jpg,test/p15/p15945590/s55981767/d4710e90-03ad2ca8-87a21d8f-d59bf306-15a9db0f.jpg,test," FINAL REPORT HISTORY: ___-year-old male with acute shortness of breath with prior CHF. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Relatively low lung volumes are seen. There are indistinct pulmonary vascular markings suggestive of a component of interstitial edema. Bibasilar opacities seen suggestive of atelectasis given low lung volumes versus developing infection. Incidental note is made of an azygos lobe and fissure. Cardiomediastinal silhouette is unchanged. Osseous structures are unremarkable. IMPRESSION: Findings suggestive of mild interstitial edema. Bibasilar opacities potentially due to atelectasis given the low lung volumes although superimposed infection is also possible. " 569f9780-5b62f4d0-b6db9dac-67b3228d-17ea6d9c.jpg,test/p13/p13692674/s54744176/569f9780-5b62f4d0-b6db9dac-67b3228d-17ea6d9c.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of status post full-term pregnancy on ___ with chest pain, mild pleuritic component. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. Minimal left base atelectasis is seen. No focal consolidation, pleural effusion, or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Minimal left base atelectasis. Otherwise, no acute cardiopulmonary process. " 248a3592-f6ec9077-d7e5fe8c-16a72000-6dd851d7.jpg,test/p17/p17966759/s50113969/248a3592-f6ec9077-d7e5fe8c-16a72000-6dd851d7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and fever // ? PNA ? PNA IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is enlargement of the cardiac silhouette with tortuosity of the aorta. However, no acute pneumonia, vascular congestion, or pleural effusion. " e8b724f6-1c6981ae-9cb402ad-b51f655e-9e84b5d8.jpg,test/p17/p17092962/s53391938/e8b724f6-1c6981ae-9cb402ad-b51f655e-9e84b5d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with obstructive jaundice ___ bx proven pancreatic ca, now s/p ps WHIPPLE (___) SICU for intraop atrial dysrhythmia, mild HoTN requiring phenylephrine // Volume overload? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ CT. IMPRESSION: Patient has known emphysema. Bilateral opacities are a combination of small effusions and adjacent atelectasis. Interstitial edema is mild. There is no pneumothorax. There is mild cardiomegaly. NG tube tip is out of view below the diaphragm. " 60d0583b-59157473-2e7b721c-be0da080-7cb7794c.jpg,test/p10/p10909149/s57583403/60d0583b-59157473-2e7b721c-be0da080-7cb7794c.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Follow up pneumonia. Comparison is made with prior study of ___. Mild cardiomegaly is stable. Right middle lobe and right lower lobe pneumonia have almost completely resolved. Minimal opacities remain in the right middle lobe. The lungs are hyperinflated , the hemidiaphragms are flattened consistent with emphysema. There is no pneumothorax or pleural effusion. The aorta is tortuous. There are mild degenerative changes in the thoracic spine. IMPRESSION: 1. Almost complete resolution of pneumonia. 2. Emphysema. " efeb0bb5-7b6f622e-d3454f22-d70b33a3-e75bd750.jpg,test/p11/p11147672/s51662674/efeb0bb5-7b6f622e-d3454f22-d70b33a3-e75bd750.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with acute chest congestion // ck clearing of pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Sternotomy wires are intact and unchanged. IMPRESSION: No acute cardiopulmonary abnormality. " 4545b1e2-fe8e8e20-b5136bae-781347ae-cb7cd390.jpg,test/p11/p11674806/s55938695/4545b1e2-fe8e8e20-b5136bae-781347ae-cb7cd390.jpg,test," FINAL REPORT INDICATION: Fall. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The lungs are hyperinflated with flattening of the diaphragms, compatible with underlying COPD. The heart size is mildly enlarged. The aortic knob is calcified. The mediastinal and hilar contours are within normal limits. Pulmonary vascularity is normal. Subsegmental atelectasis is noted within the lingula. No focal consolidation, pleural effusion, or pneumothorax is present. A 4-mm calcified nodule in the right upper lung field is likely a granuloma. There is no pleural effusion or pneumothorax. Mild degenerative changes of the thoracic spine are noted. No acute osseous abnormality is seen. IMPRESSION: Hyperinflated lungs suggestive of underlying COPD. No acute cardiopulmonary abnormality. " 2da6a5ed-6e2a3e06-eaa1ee10-6b2ef15b-ed1fc148.jpg,test/p18/p18694480/s50167673/2da6a5ed-6e2a3e06-eaa1ee10-6b2ef15b-ed1fc148.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ESRD on PD with hx of HTN. // Pre-kidney transplant evaluation and clearence, r/o cardiopulmonary abnormalities. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Heart size is top normal in size. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " a33c3146-cf79ed51-0e89a1f2-465a9c9d-02ec4144.jpg,test/p19/p19777911/s53294759/a33c3146-cf79ed51-0e89a1f2-465a9c9d-02ec4144.jpg,test," FINAL REPORT INDICATION: AML 15 days out from a bone marrow transplant. Pleuritic chest pain in the setting of neutropenia. COMPARISON: ___. FINDINGS: Portable AP chest radiograph demonstrates an left IJ catheter terminating in the right atrium. The lungs are clear. There is mild cardiomegaly. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Results were relayed to Dr. ___. " f54dbb83-1006aae8-ea452f60-7d4fcd76-5563d578.jpg,test/p19/p19005323/s56469783/f54dbb83-1006aae8-ea452f60-7d4fcd76-5563d578.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest pain s/p thoracentesis // chest pain, pressure TECHNIQUE: Single frontal view of the chest COMPARISON: CT performed 4 hours earlier FINDINGS: Cardiac size is top normal. Bibasilar atelectasis larger on the right have minimally increased. There are low lung volumes. There is no pneumothorax or pleural effusion. IMPRESSION: Bibasilar atelectases no pneumothorax. " 14a68902-e745886e-79d4bcff-324a388a-f7258cfe.jpg,test/p19/p19278792/s51693519/14a68902-e745886e-79d4bcff-324a388a-f7258cfe.jpg,test," FINAL REPORT HISTORY: Shortness of breath on exertion. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There has been interval removal of a right-sided Port-A-Cath. IMPRESSION: No acute cardiopulmonary process. " b186b850-409a1e37-02f5f7aa-10696566-222231b4.jpg,test/p19/p19326866/s51832981/b186b850-409a1e37-02f5f7aa-10696566-222231b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever to 101 // r/o infectious process r/o infectious process IMPRESSION: Comparison to ___. No relevant change. Monitoring and support devices are stable. Mild cardiomegaly. Areas of for basilar atelectasis are stable. No pneumothorax. Borderline size of the cardiac silhouette without pulmonary edema. " bca5941f-f48e6fbb-d663a2ab-5b94f01a-6b9d8b6f.jpg,test/p11/p11828962/s50790837/bca5941f-f48e6fbb-d663a2ab-5b94f01a-6b9d8b6f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the three left-sided chest tubes are in unchanged position. Unchanged evidence of moderate left pleural effusion with associated pleural thickening and relatively extensive atelectasis at the left lung bases. These changes have not changed in the interval. Moderate cardiomegaly, right-sided PICC line, no abnormalities in the left lung. There currently is no evidence for the presence of a pneumothorax. " 9f874da0-910eb3c7-48973c90-22daa5a7-193e5eaa.jpg,test/p18/p18614958/s52660218/9f874da0-910eb3c7-48973c90-22daa5a7-193e5eaa.jpg,test," FINAL REPORT HISTORY: Removal of chest tubes. COMPARISON: ___. FINDINGS: The Swan-Ganz catheter, mediastinal drains, chest tubes have been removed. The heart is moderately enlarged. Sternal wires and mediastinal clips are visualized. There is volume loss/infiltrate in both lower lungs. There is mild pulmonary vascular redistribution. There is no pneumothorax. There is a small bilateral effusions. Compared to the prior exam, the fluid status is slightly improved. " 7fd4b4f0-0378f53b-5f412c72-9c5f13da-2277d199.jpg,test/p10/p10969957/s58485962/7fd4b4f0-0378f53b-5f412c72-9c5f13da-2277d199.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post fall. Please evaluate for evidence of acute trauma. COMPARISON: ___. TECHNIQUE: Upright AP and lateral chest radiograph. FINDINGS: The lungs appear hyperinflated, with flattening of the diaphragms suggesting emphysematous lung disease. A linear radiopacity across the lower right lung represents discoid atelectasis. An ill-defined opacity in the periphery of the lower right lung is in the same location as in prior exam and is likely a summation of structures including the nipple. There are no other focal opacities bilaterally. Cardiomediastinal and hilar contours are unremarkable. Bilateral apical calcified pleural plaques are noted, but there is no pleural effusion or pneumothorax. Fractured sternotomy wires are again seen and the patient is status post CABG surgery. There is a prior resection of the posterior left sixth rib. IMPRESSION: No evidence of acute cardiopulmonary process. If there are concerns for rib fracture, a dedicated rib series is recommended for further assessment. " aff1fbdd-285579a2-a8582fc0-f274647c-d475024f.jpg,test/p11/p11848597/s54246663/aff1fbdd-285579a2-a8582fc0-f274647c-d475024f.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p CABG // eval for pneumothorax s/p chest tube removal COMPARISON: Radiographs from ___. IMPRESSION: Endotracheal tube, feeding tube, chest tubes, Swan-Ganz catheter have been removed. There is persistent cardiomegaly. No pneumothoraces are seen. There is a left retrocardiac opacity and left-sided pleural effusion. " c59a049a-749b9270-7072a25f-9b34d03a-54e66a4f.jpg,test/p12/p12357364/s59448626/c59a049a-749b9270-7072a25f-9b34d03a-54e66a4f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with increased leg swelling, bibasilar wheezing TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Left-sided AICD/pacemaker device is noted with leads terminating in the right atrium, right ventricle, and coronary sinus. Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Minimal degenerate spurring is seen within the imaged thoracic spurring. IMPRESSION: No acute cardiopulmonary abnormality. " 2dc11eab-75e0ddaa-0c63b5cd-7e8091ff-4eb5f6ae.jpg,test/p13/p13576844/s54403740/2dc11eab-75e0ddaa-0c63b5cd-7e8091ff-4eb5f6ae.jpg,test," WET READ: ___ ___ ___ 4:44 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with SOB, post-op hip surgery // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: The lungs are well-expanded and clear. Cardiomediastinal hilar contours are unchanged. The aorta is mildly tortuous. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumonia. " 061cdf3d-824e226a-bec418d5-02273423-c0a5a740.jpg,test/p13/p13163471/s55474366/061cdf3d-824e226a-bec418d5-02273423-c0a5a740.jpg,test," FINAL REPORT HISTORY: Sepsis with fluids, to assess for overhydration. FINDINGS: In comparison with the study of ___, there again are low lung volumes which accentuate the prominence of the transverse diameter of the heart. Bilateral atelectatic changes have increased. There may be mild elevation of pulmonary venous pressure. Central catheter again extends to the upper to mid portion of the SVC. " 5a7dc08e-ec8b5b52-9b47919b-8745f9cd-05489ac0.jpg,test/p14/p14461094/s54713211/5a7dc08e-ec8b5b52-9b47919b-8745f9cd-05489ac0.jpg,test," FINAL REPORT INDICATION: Decreased mental status and oxygen desaturation. COMPARISON: Chest radiograph ___. PORTABLE UPRIGHT AP VIEW OF THE CHEST: The heart size is normal. The aorta demonstrates mural calcifications. The mediastinal and hilar contours are otherwise unremarkable, and there is no evidence of pulmonary vascular engorgement. Ill-defined patchy opacity in the left lung base may reflect an area of atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormality is visualized. IMPRESSION: Left basilar patchy opacity likely reflective of atelectasis, though infection cannot be completely excluded. " 05665070-1eca6aef-5e4d098e-d5509646-4451e00a.jpg,test/p19/p19389879/s51631880/05665070-1eca6aef-5e4d098e-d5509646-4451e00a.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain and shortness of breath. FINDINGS: PA and lateral views of the chest are correlated to chest CTA from ___. The lungs are clear of focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " fc53e207-5c7ce3b1-a20a6d88-c63324f0-cb407e76.jpg,test/p18/p18325012/s56425666/fc53e207-5c7ce3b1-a20a6d88-c63324f0-cb407e76.jpg,test," FINAL REPORT INDICATION: History: ___M with seizures, recent ___ I D // evidence of pneumonia or intracranial abscess TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Right PICC terminates in mid SVC. Prominent pulmonary vessels are similar to before. There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is normal size. IMPRESSION: No acute cardiopulmonary process. " ad03139d-29453ac7-3521fd18-9d5f609d-01a6a4a5.jpg,test/p14/p14106194/s56924935/ad03139d-29453ac7-3521fd18-9d5f609d-01a6a4a5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with severe sudden abdominal pain, guarding rigid abdomen TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No subdiaphragmatic free air is present. IMPRESSION: No acute cardiopulmonary abnormality. No subdiaphragmatic free air identified. " cd8062ea-11b0e9b7-286a1b36-6e586452-c17969a2.jpg,test/p11/p11505705/s59335624/cd8062ea-11b0e9b7-286a1b36-6e586452-c17969a2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities " 96d83622-243f1c33-a34d43d8-70e5cf19-aec8798b.jpg,test/p12/p12947971/s58716883/96d83622-243f1c33-a34d43d8-70e5cf19-aec8798b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hemoptysis // pls eval for concerning lesion TECHNIQUE: CHEST (PA AND LAT) COMPARISON: None IMPRESSION: Heart size is normal. Mediastinal silhouette is unremarkable except for prominence of the azygos vein that might be consistent with volume overload in conjunction with mild upper zone re- distribution. There is no pleural effusion or pneumothorax. No focal lesions that can explain hemoptysis demonstrated. If symptoms persist, correlation with CT chest is to be considered " 3e864ce1-55182ea1-9aa632c2-299a56ad-f2d2f180.jpg,test/p17/p17469724/s56433991/3e864ce1-55182ea1-9aa632c2-299a56ad-f2d2f180.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough and rhonchi. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. " aa594fee-06221205-176fc077-f847fce3-39b0b625.jpg,test/p10/p10585182/s57735125/aa594fee-06221205-176fc077-f847fce3-39b0b625.jpg,test," WET READ: ___ ___ 10:40 AM No significant interval change in appearance of the chest. There are multifocal consolidations, worse in the right upper lobe slightly worse from prior exam. There is a small right pleural effusion. WET READ VERSION #1 ___ ___ ___ 8:16 PM No significant interval change in appearance of the chest. There are multifocal consolidations, worse in the right upper lobe slightly worse from prior exam. There is a small right pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with asthma, here with pneumonia, now with acute respiratory distress // eval for infiltrate TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild cardiomegaly is stable. The aorta is tortuous. Multifocal opacities in the right upper and left perihilar regions are grossly unchanged. Right lower lobe opacities have improved. There is no pneumothorax or pleural effusion. Right port a cath tip is in the cavoatrial junction. " 387d1ffb-71046677-095b3b7e-428c59b7-b2a3d0cc.jpg,test/p11/p11284848/s59534336/387d1ffb-71046677-095b3b7e-428c59b7-b2a3d0cc.jpg,test," FINAL REPORT HISTORY: Chest tube removal. FINDINGS: In comparison with the study of the ___, the left chest tube has been removed. No evidence of pneumothorax. There is now a relatively thick band of atelectasis in the left mid zone without evidence of consolidation. Blunting of the left costophrenic angle is seen. " 52a9d972-ea8852c9-1d40efc5-e07b327f-6889f65f.jpg,test/p11/p11084430/s52700332/52a9d972-ea8852c9-1d40efc5-e07b327f-6889f65f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with CP // eval for infiltrate, COMPARISON: CTA chest ___, chest radiographs ___ FINDINGS: Lung volumes are improved. Patchy right basilar opacities are similar to prior. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is top-normal. No free air below the right hemidiaphragm is seen. The left hilum is prominent, likely due to the enlarged main pulmonary artery seen on prior CT. IMPRESSION: Right basilar atelectasis. No pneumonia. " d32fbc95-8dc0f407-b9ca7962-9dd25f2f-03725784.jpg,test/p14/p14323599/s54848804/d32fbc95-8dc0f407-b9ca7962-9dd25f2f-03725784.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: Chest radiograph from ___. PA AND LATERAL VIEWS OF THE CHEST: There is a homogeneous hazy opacity in the anterior left chest with a sharp horizontal superior border, likely representing a large pericardial fat pad. The lungs are otherwise clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiograph of the chest. " 66a46a3b-99c5bd4d-cefde53b-6281d6c6-67cc5f9f.jpg,test/p13/p13179092/s51203749/66a46a3b-99c5bd4d-cefde53b-6281d6c6-67cc5f9f.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with a history of trauma now POD#2 status post posterior fusion with new fever. TECHNIQUE: Portable AP chest radiograph COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Left IJ catheter ends in the upper SVC. Visualized upper segment of the posterior spinal fusion hardware is intact, but study is not designed for adequate assessment of hardware. Interval removal of endotracheal and nasogastric tubes. Normal cardiomediastinal and hilar contours. Normal pleural surfaces. Lungs are clear. No pneumonia or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " ff26ee7c-c2313c6f-951f15a1-2ee2657e-0fd422bf.jpg,test/p19/p19310285/s55469493/ff26ee7c-c2313c6f-951f15a1-2ee2657e-0fd422bf.jpg,test," FINAL REPORT HISTORY: ___ years old man status post tracheal resection. REASON FOR EXAM: Check interval change. TECHNIQUE: PA and lateral chest x-ray. FINDINGS: Lung is well inflated and clear. Cardiomediastinal silhouette is normal. There is no pericardial, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 989a53c3-ea5afb98-c8e97136-1e097472-5b6e9298.jpg,test/p11/p11314678/s52228601/989a53c3-ea5afb98-c8e97136-1e097472-5b6e9298.jpg,test," FINAL REPORT INDICATION: ___-year-old man with a history ___ ___'s who presents with altered mental status and rhonchi on chest auscultation, evaluate for pneumonia. COMPARISON: None. FINDINGS: AP upright and lateral views of the chest demonstrate low lung volumes. Diffuse bilateral streaky opacities could be related to pulmonary vascular crowding from low lung volumes or mild vascular congestion. Mild peribronchial cuffing is noted. Heart is top normal in size, and cardiomediastinal contour is unremarkable. No large effusions or pneumothorax. IMPRESSION: No evidence of pneumonia. " fe94fa0b-abf43751-4de4bf65-e3d9c2f4-2d27efc7.jpg,test/p16/p16738690/s53776880/fe94fa0b-abf43751-4de4bf65-e3d9c2f4-2d27efc7.jpg,test," FINAL REPORT HISTORY: ___-year-old woman status post rigid bronchoscopy and tumor destruction. Rule out pneumothorax. COMPARISON: CT of the chest from ___. FINDINGS: There is no evidence of pneumothorax. The pulmonary opacities extending from the suprahilar region on the right corresponding to the mass and associated parenchymal abnormalities on the recent CT are again present. The left lung is essentially clear. Cardiomediastinal silhouette and hilar contours are unremarkable. There is no pleural effusion. IMPRESSION: Continued parenchymal opacities in the right upper lobe and mediastinal mass, but no evidence of pneumothorax. " 2d5b2590-df7ed451-e47164e0-a536135f-41e68fd0.jpg,test/p10/p10135376/s57168476/2d5b2590-df7ed451-e47164e0-a536135f-41e68fd0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with HFpEF, AF on AC, severe MR, pulmonary HTN p/w dyspnea and volume overload // c/f pulmonary edema TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and cardiac valve replacement. There is moderate cardiomegaly. Aortic calcification is seen There is moderate pulmonary edema. More confluent opacity involving the left mid to lower lung may relate to fluid overload however, superimposed consolidation due to infection or aspiration not excluded. There is a small right pleural effusion. IMPRESSION: Moderate pulmonary edema. More confluent opacity projecting over the left mid to lower lung may relate to fluid overload, however, consolidation due to infection or aspiration not excluded in the appropriate clinical setting. Cardiomegaly. Small right pleural effusion. " 43662a57-2d3e67f2-2fec1c59-1dca2cf8-6dd4c2b9.jpg,test/p12/p12043836/s58247893/43662a57-2d3e67f2-2fec1c59-1dca2cf8-6dd4c2b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest tube // effusion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the position of the right chest tube is unchanged. Unchanged basal lateral pneumothorax without evidence of tension. Constant appearance of the left lung and of the cardiac silhouette. Unchanged normal alignment of the sternal wires. " 9ee6a80b-624d8eee-9e406e58-145e1dd0-b955bfd5.jpg,test/p13/p13235051/s56762902/9ee6a80b-624d8eee-9e406e58-145e1dd0-b955bfd5.jpg,test," FINAL REPORT HISTORY: Persistent cough. TECHNIQUE: Frontal and lateral views at of the chest. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Partially imaged is surgical hardware along the cervical spine. IMPRESSION: No acute cardiopulmonary process. " 7e045afd-3466a25a-a6916448-cff15f5f-4f6a68b4.jpg,test/p14/p14931729/s50683942/7e045afd-3466a25a-a6916448-cff15f5f-4f6a68b4.jpg,test," FINAL REPORT INDICATION: Pain and tenderness post-fall, evaluate for fracture. COMPARISON: Chest radiographs ___, ___, ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Lungs are well expanded and clear. No displaced rib fracture or other fracture is visualized. Note is made of a probable hiatal hernia, present since ___. IMPRESSION: No acute cardiothoracic process. " 3f80b6ae-fa66c84c-ba203b9c-1c9eb1a8-1fa058c4.jpg,test/p15/p15129288/s58766789/3f80b6ae-fa66c84c-ba203b9c-1c9eb1a8-1fa058c4.jpg,test," FINAL REPORT INDICATION: Atrial fibrillation. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. No focal consolidation, pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. IMPRESSION: No evidence of acute cardiopulmonary process. " 19e55bee-714bb193-0968d683-5bf655a5-7b5caba9.jpg,test/p10/p10001401/s58747570/19e55bee-714bb193-0968d683-5bf655a5-7b5caba9.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with SOB // r/o acute process COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Mild basal atelectasis noted. Hilar congestion noted without frank edema. No large effusion or pneumothorax. Heart size is normal. Mediastinal contour is unchanged. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Hilar congestion without frank edema. No convincing signs of pneumonia. " d2591bb1-9af5484c-d0b9514a-9e15db13-73919d19.jpg,test/p10/p10917306/s59984565/d2591bb1-9af5484c-d0b9514a-9e15db13-73919d19.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent onset of cough. Noted to have rales at lower lung fields bilat. // CHF? FINDINGS: Cardiac silhouette is upper limits of normal in size accompanied by pulmonary vascular congestion, new bronchial wall thickening and scattered interstitial opacities with lower lung predominance. Minimal patchy opacities are also seen in both lung bases. No pleural effusion. Bones are diffusely demineralized, and a compression deformity is observed in the upper lumbar spine, present since ___ lateral chest radiograph. Healed lateral right rib fractures are also noted. IMPRESSION: Findings may be explained by congestive heart failure with interstitial edema, but differential diagnosis includes an atypical pneumonia. If the diagnosis is in doubt clinically, short-term followup radiographs after diuresis may be helpful. " 4a47e57d-627c8f7e-bbf2fd6a-ec5408ba-d1553f26.jpg,test/p17/p17700562/s59031795/4a47e57d-627c8f7e-bbf2fd6a-ec5408ba-d1553f26.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Mild dyspnea and abnormal chest radiograph in ___, re-assessment. COMPARISON: Chest radiograph from ___ and chest CT from ___. Heart size and mediastinum are unremarkable. Previously demonstrated multifocal consolidations have resolved consistent with most likely resolution of infectious process. Within the limitations of the chest radiograph technique, no current abnormalities demonstrated. The prevascular soft tissue lesion seen on the prior CT should be further assessed with chest CT in three months as previously recommended since it cannot be assessed on the chest radiograph. There is no pleural effusion or pneumothorax. " 02e79855-2617438a-0becb024-4b0bf4f6-57e7ea5c.jpg,test/p16/p16139978/s59515354/02e79855-2617438a-0becb024-4b0bf4f6-57e7ea5c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP // any CPD TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " f54c050f-e289f0e3-60c2396e-b30a1fba-7c1757f9.jpg,test/p14/p14775533/s54339614/f54c050f-e289f0e3-60c2396e-b30a1fba-7c1757f9.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p asc ao replacement // eval for pneumothorax s/p asc ao replacementchest tube to water seal TECHNIQUE: Portable chest x-ray. COMPARISON: Prior chest radiographs dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. Extensive subcutaneous emphysema persists, not significantly changed from the prior. There is probable pneumopericardium as well. Bibasilar opacities represent pleural effusions with adjacent atelectasis. A chest tube projects over the left hemithorax. The cardiomediastinal and hilar contours are unchanged. No pneumothorax. IMPRESSION: No penumothorax. " eee6e206-f7bc49c7-563f869c-ee75184d-c81e2907.jpg,test/p10/p10008304/s50053244/eee6e206-f7bc49c7-563f869c-ee75184d-c81e2907.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fever and elevated lactate. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are within normal limits. Aortic arch calcifications are seen. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 63b4b069-9dbbf00e-f3c585d6-5bd7c9dd-4a654a04.jpg,test/p16/p16077947/s54787777/63b4b069-9dbbf00e-f3c585d6-5bd7c9dd-4a654a04.jpg,test," FINAL REPORT INDICATION: ___M with palpitations // Infiltrate? TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or vascular congestion. There is moderate cardiomegaly. No acute osseous abnormalities identified. IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process. " 56560dc0-34075dbd-c15cf322-dfc0ced2-824d7ef5.jpg,test/p16/p16388630/s52978689/56560dc0-34075dbd-c15cf322-dfc0ced2-824d7ef5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Moderate cardiomegaly is stable. Pulmonary arteries are chronically enlarged but peripheral pulmonary vasculature is not engorged and there is no edema or pleural effusion. Tracheostomy tube noted. " 073863b7-dee37594-6ad25704-b14580d9-9828a115.jpg,test/p19/p19170368/s54449069/073863b7-dee37594-6ad25704-b14580d9-9828a115.jpg,test," FINAL REPORT INDICATION: ___ year old man with right pleural pigtail catheter placement, evaluate placement. TECHNIQUE: Chest PA and lateral COMPARISON: Same day chest radiograph performed at 14:16 FINDINGS: There has been interval placement of a right pleural pigtail catheter. There is a persistent large right pneumothorax. Subcutaneous emphysema is also noted. The left lung is clear with suture material projecting over the apex. The cardiac silhouette is unchanged. No pleural effusion is identified. IMPRESSION: Interval placement of a right pleural pigtail catheter with a persistent large right pneumothorax. " 9c4861bd-b9679785-57cdc56e-996df8a8-724a2370.jpg,test/p14/p14527555/s55242704/9c4861bd-b9679785-57cdc56e-996df8a8-724a2370.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with hypoxia, sob // eval for pna TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: The lungs remain hyperinflated. Left base opacity is seen which is new since ___, and which may be due to atelectasis, aspiration, or pneumonia. No pleural effusion is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Hyperinflated lungs suggesting chronic obstructive pulmonary disease. . Left base opacity may be due to atelectasis, aspiration, or infection. Underlying scarring may also be present. " 0b9b8ef3-7c6a6e63-bca22a7a-c28901e4-9070e435.jpg,test/p18/p18035288/s56968003/0b9b8ef3-7c6a6e63-bca22a7a-c28901e4-9070e435.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman presenting with a cough for 2 weeks. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are clear. Focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette, hila, and pleura are within normal limits. IMPRESSION: No acute cardiopulmonary process. No pneumonia. " 072e0b35-771b350a-07e37d9e-312c983f-fdb77ce1.jpg,test/p11/p11124675/s57254512/072e0b35-771b350a-07e37d9e-312c983f-fdb77ce1.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Hypoxic respiratory failure. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is approximately 8 cm above the carina. The NG tube tip is in the stomach. The right PICC line tip is at the level of mid SVC. Cardiomediastinal silhouette is unchanged. There is substantial interval decrease in previously seen interstitial pulmonary edema with currently essentially clear lungs. No appreciable pleural effusion or pneumothorax is seen, although small amount of pleural fluid cannot be excluded. " 402cfe4b-0751d02b-b54c4b75-671a64ca-e1d2a68c.jpg,test/p12/p12111976/s51869458/402cfe4b-0751d02b-b54c4b75-671a64ca-e1d2a68c.jpg,test," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with V tach and history of AICD that did not fire. Evaluate for lead fracture. COMPARISON: ___. FINDINGS: Two portable views of the chest. Left chest wall pacing device is seen with leads projecting over the region of the right ventricular apex. There is no evidence of lead fracture. Median sternotomy wires are identified. Streaky right basilar opacity is identified, potentially atelectasis. Superiorly, the lungs are clear. The cardiac silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No definite acute abnormality, right basilar atelectasis. No visualized discontinuity of the pacing device wire. " d758e391-d82bfe92-c6a10dcc-0297a8c9-a985b0d7.jpg,test/p15/p15451291/s55836342/d758e391-d82bfe92-c6a10dcc-0297a8c9-a985b0d7.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with fall from standing with back pain // r/o fx, effusion COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Subtle bibasilar opacities are noted concerning for pneumonia, increased on the left. No large effusion or pneumothorax. Cardiomediastinal silhouette appears normal. No acute bony abnormalities. IMPRESSION: Subtle opacities in the lower lungs concerning for multifocal pneumonia. " f645b696-7115e4cc-e855a5f9-199b4873-84ffb4f9.jpg,test/p12/p12694700/s50969322/f645b696-7115e4cc-e855a5f9-199b4873-84ffb4f9.jpg,test," FINAL REPORT PORTABLE CHEST ___ ___ COMPARISON: ___. FINDINGS: Interval placement of orogastric tube, with tip terminating within the stomach. Otherwise, no relevant short interval changes since the recent chest radiograph performed one day earlier. " 212f8ffa-b308e72a-bcc5a370-203f9ed3-83a31c98.jpg,test/p19/p19845120/s51273696/212f8ffa-b308e72a-bcc5a370-203f9ed3-83a31c98.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after Dobbhoff placement. AP radiograph of the chest was compared to ___. The Dobbhoff tube is coiled most likely within the upper esophagus and should be re-positioned. Heart size is enlarged but essentially unchanged since the prior study. Vascular engorgement is unchanged. " 694f39f1-5cf6fe16-f3f9431d-f47ab0e8-95eceff7.jpg,test/p16/p16454913/s53689996/694f39f1-5cf6fe16-f3f9431d-f47ab0e8-95eceff7.jpg,test," WET READ: ___ ___ 9:39 PM ET tube is in the midtrachea. Right chest tube is near the apex. No definite pneumothorax on this supine view with subcutaneous air seen along the right lateral chest wall. Marked perihilar left greater than right opacities could reflect vascular congestion and moderate to severe edema particuarly given large cardiac silhouette; however, given the patient's recent procedural history hematoma could also be present. Left greater than right atelectasis is also likely present WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: Patient with chest tube. Evaluate for pneumothorax. FINDINGS: The endotracheal tube is at the midline. The right-sided chest tube is near the apex. No pneumothoraces are seen. There is subcutaneous gas in the right lateral chest wall. There are increased airspace opacities, more prominent in the left lung. This may represent focal consolidation versus areas of fluid overload. Followup to resolution is recommended. There is a nasogastric tube whose side port is just beyond the gastroesophageal junction. " 7bce5c67-9bb2c451-300bb223-df1b9c26-52057b57.jpg,test/p17/p17086932/s52806960/7bce5c67-9bb2c451-300bb223-df1b9c26-52057b57.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH OF ___ COMPARISON: ___ study. FINDINGS: Interval decrease in size of right pneumothorax with very small residual pneumothorax remaining. Cardiomediastinal contours are stable in the postoperative period. Interval improvement in extent of bibasilar atelectasis. Bilateral small pleural effusions are also slightly smaller. " 73fde4b6-ae75d3a6-e4df87ec-264e6dea-154f3660.jpg,test/p16/p16059088/s52510783/73fde4b6-ae75d3a6-e4df87ec-264e6dea-154f3660.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Bilateral diffuse parenchymal opacities are seen in unchanged manner and are of unchanged extent and severity. No new parenchymal opacities. Unchanged appearance of the cardiac silhouette. Unchanged monitoring and support devices. Pleural effusions, if present, are minimal. " 92c2aedc-4065ea88-7038ef14-d27175a5-8a17b2fc.jpg,test/p12/p12696620/s56479987/92c2aedc-4065ea88-7038ef14-d27175a5-8a17b2fc.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Elevating white blood cell count. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable in appearance. Lungs are essentially clear. The orthopedic spinal hardware and the Port-A-Cath catheter are unchanged in appearance as well. There is minimal pleural effusion demonstrated, unchanged since the prior study, bilateral. Overall, no evidence of findings to explain patient's symptoms demonstrated. Sclerotic right scapular and potentially left scapular lesions, consistent with known metastatic prostate cancer. " ba5650fd-87b2b1cc-49c8015d-b59d073d-d55c9699.jpg,test/p15/p15233042/s56272332/ba5650fd-87b2b1cc-49c8015d-b59d073d-d55c9699.jpg,test," FINAL REPORT INDICATION: History of CHF with hyponatremia. Please evaluate for pulmonary edema. COMPARISONS: Chest radiograph from ___ and ___. TECHNIQUE: Portable AP radiograph of the chest. FINDINGS: Prominence of the interstitial markings and of the pulmonary vasculature is consistent with pulmonary edema. There may be small bilateral pleural effusions. The patient is status post sternotomy with the broken sternotomy wires unchanged compared to the prior exam. The bones are intact. Mild cardiomegaly is persistent. IMPRESSION: Mild-to-moderate pulmonary edema. " 4fcaa500-471b8aa9-303ffc38-60dd5c0e-3e45f0dd.jpg,test/p13/p13141248/s55216169/4fcaa500-471b8aa9-303ffc38-60dd5c0e-3e45f0dd.jpg,test," FINAL REPORT INDICATION: ___ year old man with sharp cp lasting seconds, h/o CAD with stents. no cough or fever // please eval for chest abormality TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs ___ FINDINGS: Biapical pleural thickening, stable. Subtle linear scarring bilateral upper lungs, stable since ___. Mild degenerative changes thoracic spine. Remainder normal. IMPRESSION: Stable exam " b7e0a212-fe3d3ff7-4518bc56-2e88f3c6-5651e8be.jpg,test/p18/p18695475/s54167525/b7e0a212-fe3d3ff7-4518bc56-2e88f3c6-5651e8be.jpg,test," FINAL REPORT INDICATION: Concern for malnutrition. Evaluate for infiltrate. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia. " bbf0bdb6-54d54ba4-66cecec5-c8f03d53-e46d056c.jpg,test/p17/p17343150/s55160623/bbf0bdb6-54d54ba4-66cecec5-c8f03d53-e46d056c.jpg,test," FINAL REPORT PA AND LATERAL RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old male with refractory seizures, concerning for aspiration. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: None. FINDINGS: A vagal stimulator is noted projecting over the chest. There is a focal opacity in the right upper lung that reflects aspiration vs. pneumonia. There is no pneumothorax or pleural effusions. The heart is normal in size. There is no evidence of pneumoperitoneum and osseous structures are grossly intact. IMPRESSION: Right upper lung opacity that likely reflects aspiration vs. pneumonia. " 819c2a31-281d5e54-c2151ed5-c7f70e9f-63865a7c.jpg,test/p12/p12514721/s58568013/819c2a31-281d5e54-c2151ed5-c7f70e9f-63865a7c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: This is normal. Diffuse atherosclerotic calcifications are present within the aorta. Hilar contours are unchanged. A moderate to the large hiatal hernia is re- demonstrated. Lungs remain hyperinflated compatible with known emphysema. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is demonstrated. Minimal subsegmental atelectasis is noted in the lung bases. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. Emphysema. Moderate to large hiatal hernia re- demonstrated. " 04cf350f-4ffb9b45-5d2d06ca-3d14237e-90cf8618.jpg,test/p16/p16514111/s53311031/04cf350f-4ffb9b45-5d2d06ca-3d14237e-90cf8618.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough, shortness of breath TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___, ___ and ___. CT from ___. FINDINGS: The heart size continues to be enlarged, and there is cephalization of vascular markings. There is a right pleural effusion, which appears increased in size from ___. IMPRESSION: Congestive heart failure with cardiomegaly, pulmonary vascular congestion and a right pleural effusion. " 5b0b4ab9-644bc95d-a3fa90b2-1fe51817-af474ec7.jpg,test/p17/p17489307/s50637544/5b0b4ab9-644bc95d-a3fa90b2-1fe51817-af474ec7.jpg,test," FINAL REPORT AP CHEST, 4:41 A.M., ___ HISTORY: ___-year-old woman with pneumonia, question interval change. IMPRESSION: AP chest compared to ___: Consolidation developed in the right lower lung between ___ and ___; at the same time, there was an increase in pulmonary vascular and mediastinal venous caliber suggesting cardiac decompensation. Small right pleural effusion developed on ___ and has decreased subsequently, but there is no change in small region of probable right lower lobe pneumonia or in the opacification at the left lung base that has worsened since ___ and could be another focus of pneumonia or atelectasis. There is no pulmonary edema, though pulmonary vascular congestion persists. Small left pleural effusion is also smaller. Heart is mildly to moderately enlarged, unchanged. With the chin down, tip of the ET tube, no less than 3.3 cm above the carina is in standard position. An upper enteric drainage tube passes into the stomach and out of view. A ventriculoperitoneal shunt traverses the right neck, chest and upper abdomen. " 501736de-bae32e8f-67f60c55-b4c7ba62-009fc31b.jpg,test/p12/p12509843/s58379197/501736de-bae32e8f-67f60c55-b4c7ba62-009fc31b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Postoperative below-knee amputation, reassessment. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 4.3 cm above the carina. The NG tube is in the stomach. Heart size and mediastinum are grossly unchanged. Mild pulmonary edema is noted, slightly progressed since the prior study. There is no evidence of pneumothorax. The right PICC line tip terminates most likely at the level of low SVC. " fa412ae9-a4668218-4501b93a-94027894-18d3aa9e.jpg,test/p11/p11045789/s53880213/fa412ae9-a4668218-4501b93a-94027894-18d3aa9e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with fever and chills? // pna? TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The aorta is mildly tortuous and calcified. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 1d502b40-2f0d2e67-9e8d9da4-c04d78a2-a8096e3a.jpg,test/p16/p16447197/s54538654/1d502b40-2f0d2e67-9e8d9da4-c04d78a2-a8096e3a.jpg,test," WET READ: ___ ___ 12:21 AM Subtle deformity of the lateral left seventh rib of indeterminate age. Correlate clinically for acuity and need for additional imaging. Clear lungs. Gaseous distention of the stomach and the bowel in the left abdomen, not fully imaged or well evaluated. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with h/o MVA on ___ and rib pain worsening with pressure and inspiration // Rib fractures TECHNIQUE: Frontal and lateral views of the chest and additional AP view of the left hemi thorax COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable, as are the hilar contours. There is minimal elevation of the left hemidiaphragm with gaseous distention of the stomach and or bowel beneath, not fully imaged. There is subtle deformity of the lateral left seventh rib of indeterminate age IMPRESSION: Subtle deformity of the lateral left seventh rib of indeterminate age. Correlate clinically for acuity and need for additional imaging. Clear lungs. Gaseous distention of the stomach and the bowel in the left abdomen, not fully imaged or well evaluated. " 23cb0a16-4a46b750-e770d1a0-6f2bd436-b032d57f.jpg,test/p14/p14338600/s58588050/23cb0a16-4a46b750-e770d1a0-6f2bd436-b032d57f.jpg,test," WET READ: ___ ___ 7:19 PM New small right pleural effusion. Low lung volumes. No other acute findings. Discussed with Dr. ___ by phone at 7:18 p.m. on ___. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Desaturation, assessment for pneumonia. COMPARISON: ___. FINDINGS: Minimal pleural effusions, better appreciated on the lateral than on the frontal film. Otherwise unchanged radiograph with mild cardiomegaly, low lung volumes and no evidence of parenchymal opacity suspicious for pneumonia. Sternal wires in unchanged position. " 520d4eba-6951b8b6-67d41297-2440511a-b664ef41.jpg,test/p17/p17051420/s50391244/520d4eba-6951b8b6-67d41297-2440511a-b664ef41.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Cough. COMPARISON: Radiographs from ___ and CT from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: New since the prior radiographs but also since the recent prior CT are opacities in the superior segment of the left lower lobe and also more vague but new right upper lobe opacity, all suggesting development of pneumonia. There is no pleural effusion or pneumothorax. Mild to moderate degenerative changes are similar along the thoracic spine. IMPRESSION: New opacities suggesting pneumonia. " 4c02ee88-940fab52-9ed78b3b-744c9a2a-8843668f.jpg,test/p13/p13273041/s56455775/4c02ee88-940fab52-9ed78b3b-744c9a2a-8843668f.jpg,test," FINAL REPORT INDICATION: ___ year old man with respiratory failure and loculated pleural effusion // please eval for interval change TECHNIQUE: 2 Frontal views of the chest COMPARISON: ___ FINDINGS: Prosthetic aortic valve is in unchanged position. Aeration of bilateral lungs are improved compared to 2 days ago. There is persistent bibasilar opacity with moderate right and trace left pleural effusions, similar to before. Enlarged cardiac silhouette is unchanged. Pulmonary vascular congestion is improved. IMPRESSION: 1. Pulmonary vascular congestion is improved. 2. Moderate right lung base opacity and pleural effusion and small left lung base opacity and pleural effusion appear similar to 2 days ago. " 9180bdf5-89e1deaa-6dc1ba7d-ea069564-301ad475.jpg,test/p16/p16295551/s59083008/9180bdf5-89e1deaa-6dc1ba7d-ea069564-301ad475.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Moderate right apical pneumothorax with lateral hydropneumothorax component appears similar to the prior study of earlier the same date. With the exception of slight improved aeration at the lung bases, there has been no appreciable change in the appearance of the chest since the recent study from earlier today. " 11600951-25706cbf-d1f97baa-e9e52d80-7b4c463f.jpg,test/p12/p12095092/s53040336/11600951-25706cbf-d1f97baa-e9e52d80-7b4c463f.jpg,test," FINAL REPORT CLINICAL INDICATION: Line placement. COMPARISON: Chest radiographs, ___ one hour prior. PORTABLE FRONTAL VIEW OF THE CHEST: The endotracheal tube ends 6 cm above the carina. A nasogastric tube enters the stomach and ends off of the radiograph. A new right internal jugular line ends at the cavoatrial junction. Right perihilar opacification represents perihilar ground-glass opacities, better seen on the prior CT torso examination. There is no pleural effusion or pneumothorax. The heart size is normal. IMPRESSION: New right internal jugular line ends at the cavoatrial junction. " 6ec20fc5-09fdb41d-9c8bd8a2-d1fc6192-ed971717.jpg,test/p14/p14657989/s53639093/6ec20fc5-09fdb41d-9c8bd8a2-d1fc6192-ed971717.jpg,test," FINAL REPORT INDICATION: Confusion. History of cirrhosis. TECHNIQUE: Two views of the chest. COMPARISON: Radiographs dated ___ and ___. FINDINGS: No focal opacity to suggest pneumonia is seen. No pleural effusion, pulmonary edema or pneumothorax is present. The heart size is normal. Metallic coils projecting over the mid upper abdomen are unchanged. IMPRESSION: No evidence of acute intrathoracic process. " c398bfe2-0e88716c-80eb38d2-f2d7d16a-b16a3303.jpg,test/p17/p17913240/s56182838/c398bfe2-0e88716c-80eb38d2-f2d7d16a-b16a3303.jpg,test," FINAL REPORT INDICATION: ___ year old man with left pleural effusion // interval change TECHNIQUE: Frontal and lateral radiographs of the chest were acquired. COMPARISON: Chest radiograph from ___. Chest CT from ___. FINDINGS: There is a small to moderate left pleural effusion, unchanged. Left retrocardiac opacification is likely due to atelectasis given the findings on the recent CT from ___. There is mild bandlike right lower lung atelectasis, new compared to the prior study. The heart size is normal. There is no pneumothorax. IMPRESSION: 1. Unchanged small to moderate left pleural effusion. 2. Left retrocardiac opacification, most likely atelectasis. " 028a08c7-c6493634-ae4679cc-879b014d-165d263e.jpg,test/p17/p17047107/s59496273/028a08c7-c6493634-ae4679cc-879b014d-165d263e.jpg,test," WET READ: ___ ___ 9:29 PM Interval development of left basilar opacity compatible with pneumonia on the background of emphysema. Known spiculated right lung nodules better seen on prior CT scan. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with lung CA now with cough and SOB // Eval for pneumonia TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest x-ray and chest CT from ___. FINDINGS: The lungs are hyperinflated. Known right perihilar spiculated nodules are better seen on prior CT, suspicious for malignancy. Since recent exam, there has been development of left basilar opacity. Remaining portions of the lungs are clear. The cardiomediastinal silhouette is stable. S-shaped thoracolumbar scoliosis is again seen. IMPRESSION: Interval development of left basilar opacity compatible with pneumonia on the background of emphysema. Known spiculated right lung nodules better seen on prior CT scan. " 2d1499b5-8fa29d3e-3bd6b6cb-63f71ce0-3ea45c49.jpg,test/p11/p11760589/s56518496/2d1499b5-8fa29d3e-3bd6b6cb-63f71ce0-3ea45c49.jpg,test," FINAL REPORT HISTORY: History of AVR presenting with shortness of breath. TECHNIQUE: PA and lateral chest radiograph, 3 views. COMPARISON: Multiple chest radiographs dating back to ___. FINDINGS: The cardiac silhouette is mildly enlarged. An aortic valve replacement is visualized partcularly on the lateral view. The mediastinal silhouette and hilar contours are unremarkable. Mild bibasilar atelectasis is noted. The lungs are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic process. " 2995e340-13eeb2ef-f2ce775c-4df3cd70-1bb6cd65.jpg,test/p14/p14145527/s53687733/2995e340-13eeb2ef-f2ce775c-4df3cd70-1bb6cd65.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p biv icd // r/o pneumo and lead placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The sternotomy wires appear intact and appropriately aligned in comparison to the prior radiograph. The patient is status post ICD placement with leads in the right atrium, right ventricle, and coronary sinus. The patient is status post mitral valve replacement. There is increased lucency at the left apex, however no pleural line is visualized. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. Lungs are clear. There is an unchanged small left pleural effusion. There are no acute osseous abnormalities. IMPRESSION: 1. Appropriately positioned ICD leads. 2. Absence of lung markings at the left apex, but no pleural line, which could reflect small apical pneumothorax. 3. Unchanged left pleural effusion. RECOMMENDATIONS Recommend follow-up chest x-ray in 4 hours to evaluate for small left apical pneumothorax. NOTIFICATIONS: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:49 AM, 10 minutes after discovery of the findings. " 20c82f1a-7c0af1f5-00aba027-e092b4cb-c8084ad9.jpg,test/p15/p15713062/s51188677/20c82f1a-7c0af1f5-00aba027-e092b4cb-c8084ad9.jpg,test," WET READ: ___ ___ ___ 3:47 PM No acute cardiopulmonary process. No evidence of obvious left rib or scapular fractures on this limited exam. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M s/p assault, now with left sided scapular and rib pain // rib fracture TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are clear. The heart is mildly enlarged. The mediastinal silhouette, hilar contours, and pleural surfaces are normal. No pneumothorax, pleural effusion, or pulmonary edema. No focal consolidations are noted. There are no obvious left rib or scapular fractures on this limited exam although this study has limited sensitivity for the detection of such. IMPRESSION: No acute cardiopulmonary process. No evidence of obvious left rib or scapular fractures ; however if high clinical concern for such, suggest dedicated imaging of the left ribs and/or left scapula. . " c781a0f5-6ec27321-6f3a2503-93edd4cf-355dbe43.jpg,test/p11/p11056036/s54948505/c781a0f5-6ec27321-6f3a2503-93edd4cf-355dbe43.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough and recent surgery. Evaluate for pneumonia. COMPARISON: PA and lateral chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 024ad47d-bce64a05-3013f32a-889f0c5b-cf13c6c5.jpg,test/p14/p14248232/s57927125/024ad47d-bce64a05-3013f32a-889f0c5b-cf13c6c5.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough and shortness of breath. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is increased opacity over the left mid lung in the perihilar region, concerning for pneumonia. Blunting of the right costophrenic angle appears chronic and unchanged compared to ___. No pleural effusion or pneumothorax is detected. Heart size is mildly enlarged and similar compared to prior. The aorta is calcified and tortuous. IMPRESSION: Left mid lung opacity, concerning for pneumonia. Follow-up radiograph after treatment is recommended to ensure resolution and exclude underlying pathology. Findings and recommendations were discussed with ___ by ___ ___ by telephone at 9:10 p.m. on ___ at the time of initial review of the study after attending radiologist review. " 6cb983aa-64b252ae-99834c29-3233ef10-ba21f892.jpg,test/p13/p13473495/s51300469/6cb983aa-64b252ae-99834c29-3233ef10-ba21f892.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // eval infiltrate TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Lateral views are limited due to motion despite repeat image. Relatively low lung volumes are seen with secondary crowding of the bronchovascular markings. There is superimposed interstitial edema. There is no large effusion or definite consolidation. Linear atelectasis seen in the mid lungs bilaterally. The cardiac silhouette is enlarged but not significantly changed. Right-sided central venous catheter tip seen within the right atrium. Left subclavian vascular stent is noted. IMPRESSION: Interstitial edema. " 24e78168-f9ab6010-e54ca56a-4442db4c-449379ac.jpg,test/p15/p15024999/s56672451/24e78168-f9ab6010-e54ca56a-4442db4c-449379ac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M s/p open subtotal chole ___ now w/ perforated appendicitis and ___.8x3.4 intraabdominal fluid collection. New fever // Pls eval any intrathoracic process Pls eval any intrathoracic process IMPRESSION: Comparison to ___. Low lung volumes persist. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly. Small bilateral pleural effusions are better seen on the lateral than the frontal image. No pneumonia. " 1bfdb2fd-6ff900ec-a426db98-a566d026-6f1d6677.jpg,test/p18/p18016444/s56399172/1bfdb2fd-6ff900ec-a426db98-a566d026-6f1d6677.jpg,test," FINAL REPORT INDICATION: History: ___F with fever // Eval for infiltrate COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Normal chest radiographs. " e0dbc68a-1ceb60f3-3c90f9be-f6a65d3f-0e8e9d11.jpg,test/p19/p19025684/s57738454/e0dbc68a-1ceb60f3-3c90f9be-f6a65d3f-0e8e9d11.jpg,test," FINAL REPORT INDICATION: Chest pain. No prior examinations for comparison. CHEST, PA AND LATERAL: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are normal. No pleural effusions or pneumothorax. IMPRESSION: Normal chest. " 52d4887a-a5003884-9f48012b-e37e300d-1d76c9f7.jpg,test/p17/p17699605/s55185345/52d4887a-a5003884-9f48012b-e37e300d-1d76c9f7.jpg,test," FINAL REPORT INDICATION: ___F with anasarca and dyspnea, hypoxia, heavy drinking x 11 months, ddx includes alcoholic cardiomyopathy, cardiac effusion, pulm edema, hepatitis, cirrhosis, perforation // eval ? free air, enlarged cardiac silhouette TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: Exam is limited secondary to portable technique, patient body habitus and low lung volumes. Increased interstitial markings throughout the lungs could be due to be technical factors with superimposed pulmonary edema suspected as well. Cardiopulmonary silhouette is grossly within normal limits for technique. IMPRESSION: Limited exam due to portable technique and patient body habitus, superimposed edema is possible. " 91ffa045-25f40ed6-e73fa15f-6863db95-13459c85.jpg,test/p13/p13615002/s56224050/91ffa045-25f40ed6-e73fa15f-6863db95-13459c85.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with elevated WBC COMPARISON: Prior CT chest from ___ FINDINGS: PA and lateral views of the chest provided. Since the prior exam, the right lower lobe consolidation appears to have resolved. However, there is persistent prominence of the right pulmonary hilum which is concerning for underlying mass. Lungs are clear. No large effusion or pneumothorax. Heart size is normal. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Persistent right hilar prominence is concerning for underlying mass. Right lower lobe consolidation has cleared. " f41b04ea-a3b28366-28161dfd-de383967-bb652347.jpg,test/p19/p19349785/s59889869/f41b04ea-a3b28366-28161dfd-de383967-bb652347.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG // eval for pneumo/effusions eval for pneumo/effusions COMPARISON: Chest radiographs ___ through ___ at 06:53. IMPRESSION: Tiny left apical pneumothorax decreased since ___. Small bilateral pleural effusions probably stable. Normal postoperative cardiomediastinal silhouette. No pulmonary edema. " 2a749890-953fff10-e1ed1157-c2aaef2d-732b5795.jpg,test/p13/p13703589/s51634130/2a749890-953fff10-e1ed1157-c2aaef2d-732b5795.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation, or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 01a5dff0-ac14c792-1ecb5cf9-9439d439-9e19af4d.jpg,test/p10/p10699336/s58563471/01a5dff0-ac14c792-1ecb5cf9-9439d439-9e19af4d.jpg,test," FINAL REPORT EXAMINATION: Portable chest x-ray INDICATION: ___ year old man with C5-___ fxs with vert dissection now quadraplegic // interval cxr TECHNIQUE: Single frontal view COMPARISON: ___ FINDINGS: Lung volumes and cardiomediastinal contour are unchanged compared to the prior study. Persistent right lower atelectasis and left lower lobe collapse, similar in degree when compared to the prior study. A right-sided PICC terminates in the mid to distal SVC. A tracheostomy tube is unchanged in appearance. Surgical hardware in the lower cervical and upper thoracic spine. No new areas of consolidation seen. No pleural effusion seen. IMPRESSION: No significant interval change when compared to the prior study. " d1abf3e8-8a82ffa0-dd4b11c7-aee8a1cd-16363405.jpg,test/p10/p10979480/s55243356/d1abf3e8-8a82ffa0-dd4b11c7-aee8a1cd-16363405.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Breast cancer and right lower lobe pneumonia, evaluation for progression. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the known right basal pneumonia has increased in size and severity. In addition, signs of moderate pulmonary edema have newly occurred. The distribution of the edema is predominantly centralized. There is no evidence of pleural effusions. The lung volumes remain low. Vertebral stabilization devices and a right pectoral Port-A-Cath are seen in unchanged manner. No other relevant changes. At the time of dictation and observation, 8:23 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification. The findings were subsequently discussed over the telephone. " b3d9c8a0-da0d6546-52076e9a-d270780b-97047f5b.jpg,test/p11/p11478363/s59065359/b3d9c8a0-da0d6546-52076e9a-d270780b-97047f5b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with HIV (CD4 470 in ___) with fever to 101. COMPARISON: PA and lateral chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are unremarkable. Linear atelectasis or scarring in the left lung base is unchanged. No focal consolidation, pleural effusion, pneumothorax. " 223468db-fc9f9b33-9e42d517-8226aedf-cbd3c608.jpg,test/p17/p17051420/s55689067/223468db-fc9f9b33-9e42d517-8226aedf-cbd3c608.jpg,test," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. The exam was obtained in the relative AP lordotic view position. Subtle right mid lung opacity may be artifactual; however, underlying consolidation or ground-glass opacity is not excluded. Suggest repeat PA and lateral views for better evaluation. There is minor basilar atelectasis. No pleural effusion is seen. The cardiac silhouette appears relatively globular in configuration. Underlying pericardial effusion is not excluded. Mediastinal contours are unremarkable. No large pleural effusion is seen, although trace right pleural effusion would be difficult to exclude. There is no overt pulmonary edema. IMPRESSION: 1. Relative subtle opacity projecting over the right mid lung may be artifactual, although underlying ground-glass opacity/consolidation is not excluded. Suggest repeat or dedicated PA and lateral views for further evaluation. 2. The cardiac silhouette appears relatively globular which may relate to technique. However, underlying pericardial effusion is not excluded. " e8e0975b-7e50cf85-a6d283d3-c16d66d5-43344ed8.jpg,test/p18/p18931099/s51103446/e8e0975b-7e50cf85-a6d283d3-c16d66d5-43344ed8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hemoptx s/p CT, ? PTX // PLEASE DO AT ___ on ___ COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the right chest tube has been slightly pulled back and the side hole is now located in the chest wall. There is a 1 cm right apical pneumothorax. The known opacities at the right lung base and the retrocardiac lung region are unchanged. Unchanged mild cardiomegaly and mild fluid overload. No evidence of tension. " aac7635d-f359cedb-7fce9c87-a30ae362-b238039a.jpg,test/p12/p12279803/s56683999/aac7635d-f359cedb-7fce9c87-a30ae362-b238039a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o RLL pneumonia on ___. This is f/u film // ?resolution of RLL pneumonia ?resolution of RLL pneumonia IMPRESSION: Images from ___ are not available at this institution. Comparison is made with the study of ___. The cardiac silhouette remains within normal limits and there is mild tortuosity of the aorta. No vascular congestion, pleural effusion, or acute focal pneumonia. " 7fe3991f-2708c122-3300fa0b-5f09d73f-f21ec875.jpg,test/p18/p18961420/s57501863/7fe3991f-2708c122-3300fa0b-5f09d73f-f21ec875.jpg,test," FINAL REPORT INDICATION: ___M with cough // r/o infiltrate TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray and ___ chest x-ray. FINDINGS: Right chest wall port is again noted. Increased and irregular interstitial markings noted with a primarily bibasilar distribution, right greater than left is unchanged from prior exam and is compatible with bronchiectasis. There is no new confluent consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Gastric band is noted in the left upper quadrant. IMPRESSION: Chronic changes in the lungs compatible with known bronchiectasis. No new consolidation to suggest active inflammation noting that one could easily be obscured. " f97b4ef2-5fc81e08-51798f3b-1bb2f9fb-5f1702d2.jpg,test/p13/p13152910/s54183949/f97b4ef2-5fc81e08-51798f3b-1bb2f9fb-5f1702d2.jpg,test," FINAL REPORT INDICATION: End-stage renal disease, on hemodialysis. Preoperative evaluation for kidney transplantation. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. Median sternotomy wires and CABG clips are noted. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 40b48d39-e3ddbd6d-ec59de7b-e6bf258c-ef1ed5e5.jpg,test/p18/p18881392/s55936878/40b48d39-e3ddbd6d-ec59de7b-e6bf258c-ef1ed5e5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/MDS and ___ bacteremia // signs of pneumonia, consolidations, interval changes signs of pneumonia, consolidations, interval changes IMPRESSION: In comparison with the study of ___, the right subclavian PICC line is been removed. Again there are low lung volumes that accentuate the transverse diameter of the heart. There is some fullness of pulmonary vessels that could reflect crowding related to the low lung volumes or possibly mild elevation of pulmonary venous pressure. No definite acute focal pneumonia, though in the appropriate clinical setting this would be difficult to unequivocally exclude, especially in the absence of a lateral view. " f972a9bf-5adbc2aa-0fcb5a90-b713ed45-b7d6ea89.jpg,test/p13/p13234534/s54600519/f972a9bf-5adbc2aa-0fcb5a90-b713ed45-b7d6ea89.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. Evaluate for acute process. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are clear without focal or diffuse abnormality. There is no evidence of pneumothorax or pleural effusion. The osseous structures are unremarkable. No radiopaque foreign bodies. IMPRESSION: No acute cardiopulmonary process. " 44908ef9-3f6e53bd-e0553206-42d0a19d-a40a80d5.jpg,test/p18/p18005274/s54052535/44908ef9-3f6e53bd-e0553206-42d0a19d-a40a80d5.jpg,test," FINAL REPORT INDICATION: Epigastric discomfort. COMPARISON: Comparison made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. Lungs are clear. No pleural effusion or pneumothorax identified. No pneumoperitoneum evident. No osseous abnormality present. IMPRESSION: No intrathoracic process. " 87eebd10-42cb545f-6b884e56-50161b2f-0e2b7eea.jpg,test/p15/p15098557/s54099744/87eebd10-42cb545f-6b884e56-50161b2f-0e2b7eea.jpg,test," FINAL REPORT INDICATION: ___F with palpitations, chest pain // ?cardiomegaly TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d7cd7292-3ed82db5-c25fe791-aa98ecb1-a0c8d271.jpg,test/p11/p11552854/s52006910/d7cd7292-3ed82db5-c25fe791-aa98ecb1-a0c8d271.jpg,test," FINAL REPORT INDICATION: ___F with sob, chest pain described as pressure. recent travel to ___ // eval for pna vs dissection TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is mild cardiomegaly. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Lungs are adequately expanded and clear without focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. The upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. Mild cardiomegaly. " 615640e4-94dbda0d-b9e8bb1e-a5cd32b2-d9a0e582.jpg,test/p13/p13299285/s50985850/615640e4-94dbda0d-b9e8bb1e-a5cd32b2-d9a0e582.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with please evaluate for pigtail placement // please evaluate right sided pigtail TECHNIQUE: Portable semi-upright chest radiograph. COMPARISON: Chest radiograph dated ___ at 04:43. FINDINGS: The right pigtail is barely visualized in the right inferolateral chest wall. It is unclear whether this chest tube is in the pleural cavity. All other lines and tubes are unchanged in comparison to the prior chest radiograph. The right pleural effusion is unchanged in size and appearance. There is a small left pleural effusion. Heart size is stable. The mediastinal and hilar contours are stable. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Right pigtail and right inferolateral chest wall, unclear if this chest tube is in the pleural cavity. 2. Unchanged bilateral pleural effusions, right much worse than left. " defc6762-29e9ea8e-da12c04f-6794ff43-38b3f8f9.jpg,test/p13/p13084683/s52594463/defc6762-29e9ea8e-da12c04f-6794ff43-38b3f8f9.jpg,test," FINAL REPORT HISTORY: Repair of aortic rupture. FINDINGS: No previous images. There are intact sternal wires in place following the surgical procedure. Endotracheal tube tip lies approximately 3.5 cm above the carina. Nasogastric tube extends well into the stomach. Right IJ sheath is in place. There are relatively low lung volumes with evidence of elevated pulmonary venous pressure and some basilar atelectatic changes. No evidence of pneumothorax. " c2a187d5-359fa6c4-464a2dd8-00498e75-3f0af5c6.jpg,test/p14/p14493762/s52293881/c2a187d5-359fa6c4-464a2dd8-00498e75-3f0af5c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with acute severe abdominal pain, peritoneal exam TECHNIQUE: Upright AP view of the chest COMPARISON: CT torso ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. The pulmonary vasculature is normal. Elevation of the right hemidiaphragm is unchanged. Streaky opacities in the lung bases likely reflect areas of atelectasis. Minimal blunting of the left costophrenic sulcus may suggest the presence of a tiny left pleural effusion. No pneumothorax is present. There are no acute osseous abnormalities. A remote fracture of the left fifth lateral rib is noted. Left subdiaphragmatic lucency is concerning for pneumoperitoneum. IMPRESSION: Pneumoperitoneum. Bibasilar atelectasis. Possible trace left pleural effusion. A subsequent CT of the abdomen and pelvis has already been obtained at this time. " 9f952c0c-478f2543-b547501a-20dbf538-ddbc7186.jpg,test/p17/p17288913/s50308264/9f952c0c-478f2543-b547501a-20dbf538-ddbc7186.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged evidence of a left-sided PICC line. The lung volumes are normal. There is no evidence of pneumonia or other pathological changes in the lung parenchyma. Unchanged size of the cardiac silhouette. No evidence of pleural effusions. Normal aspect of the hilar and mediastinal structures. " 06427dfb-995c25dd-7018deae-9edc1f9c-0617f1e2.jpg,test/p12/p12831242/s56684802/06427dfb-995c25dd-7018deae-9edc1f9c-0617f1e2.jpg,test," FINAL REPORT PORTABLE SUPINE CHEST FILM ___ AT 5 A.M. CLINICAL INDICATION: ___-year-old with ESLD, assess for interval changes. Comparison is made to the patient's prior study of ___ at 4:11 a.m. A portable supine chest film ___ at 5 a.m. is submitted. IMPRESSION: 1. Endotracheal tube continues to have its tip approximately 2 cm above the carina. Nasogastric tube is seen coursing below the diaphragm with the tip not identified. Right internal jugular central line has its tip in the superior vena cava. 2. Bibasilar airspace opacity likely reflects a combination of layering effusions and compressive atelectasis and is essentially unchanged in appearance. Perihilar vessels appear cephalized raising the possibility of pulmonary venous hypertension. No overt pulmonary edema. Overall cardiac and mediastinal contours are unchanged. " 602f8e5d-fd0b7610-fe0f4150-ef24f36f-ffc45bb5.jpg,test/p11/p11551927/s54295613/602f8e5d-fd0b7610-fe0f4150-ef24f36f-ffc45bb5.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with history of pancreatic pseudocyst presenting with fevers and leg swelling TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 1fd04abb-75e02a99-460c3b3f-452787d0-4f5af6d8.jpg,test/p13/p13773334/s50236771/1fd04abb-75e02a99-460c3b3f-452787d0-4f5af6d8.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion, pneumothorax. Cardiac and mediastinal contours are normal. The left upper abdominal surgical clips are unchanged. IMPRESSION: Normal chest radiograph. " 43d50463-357b130b-10346f83-e6307608-8eab1714.jpg,test/p16/p16257001/s55306509/43d50463-357b130b-10346f83-e6307608-8eab1714.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with neurosurgery. AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. The ET tube tip is 4 cm above the carina. NG tube tip is in the stomach. Left subclavian line tip is at the mid SVC. Heart size and mediastinum are unremarkable. Lungs are essentially clear. No pleural effusion or pneumothorax is demonstrated. " b0ef3efd-ba145902-28ad1f7b-bcd15765-94f14062.jpg,test/p17/p17275231/s56909169/b0ef3efd-ba145902-28ad1f7b-bcd15765-94f14062.jpg,test," FINAL REPORT INDICATION: ___-year-old man with abdominal pain status post ERCP. COMPARISON: ___ and ___. FINDINGS: Two PA and one lateral chest radiographs were obtained. The lungs are well inflated and clear. Minimal bibasilar atelectasis is present. There is no consolidation, effusion, pneumothorax is present. The heart and mediastinal contour are normal. A surgical drain and biliary stents are visible in the abdomen. There is no free peritoneal air. IMPRESSION: No acute cardiopulmonary process. No pneumoperitoneum. " e464d1c9-5ed3578d-765ff1d2-d28af464-effac303.jpg,test/p15/p15904912/s58589841/e464d1c9-5ed3578d-765ff1d2-d28af464-effac303.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with sore throat, ciough, fever TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CTA chest ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 5ff6c101-06487444-e9224542-3ca0cd6b-6d87c80d.jpg,test/p14/p14977442/s57718730/5ff6c101-06487444-e9224542-3ca0cd6b-6d87c80d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough x months, now sharp pain left side // eval for rib fracture or pneumothorax COMPARISON: Chest radiographs from___ FINDINGS: The right seventh rib is fractured laterally with approximately 5 mm of displacement. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No focal consolidation, pleural effusion, or pneumothorax.Right apical pleural thickening is likely due to fat. IMPRESSION: Fracture of the right seventh rib laterally. No other acute cardiopulmonary abnormality. " 54136eab-bdec1544-d8d5c3af-6471b651-33ab0cac.jpg,test/p12/p12768165/s56395461/54136eab-bdec1544-d8d5c3af-6471b651-33ab0cac.jpg,test," FINAL REPORT INDICATION: Cough and fever, here to evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs are symmetrically well expanded and well aerated without focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax is detected. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The trachea is midline. No acute osseous abnormality is detected. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " ba0d304d-e469c851-ef95ae9c-cdeac7c6-1493de24.jpg,test/p18/p18984847/s51324189/ba0d304d-e469c851-ef95ae9c-cdeac7c6-1493de24.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with nasogastric tube placement. FINDINGS: Comparison is made to a chest radiograph from ___. There has been placement of a nasogastric tube whose tip is in the lower esophagus. This could be advanced several centimeters for more optimal placement. However, the catheter appears to be coursing towards the right side but is not within the right main stem bronchus. The left-sided subclavian catheter has its distal lead tip in the distal SVC. Heart size is upper limits of normal. There is a very large hiatal hernia. No pneumothoraces are identified. " c5aceb76-654bedd0-7fd888f6-183ccb09-ecca4ff1.jpg,test/p19/p19758044/s52813918/c5aceb76-654bedd0-7fd888f6-183ccb09-ecca4ff1.jpg,test," WET READ: ___ ___ 10:15 AM Persistent posterior right apical loculated pleural fluid of with possible air-fluid level, air-fluid level more conspicuous as compared to the prior study, fluid component appear similar. Chest CT would provide further assessment. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fever, chest pain // eval for worsening lung abscess/empyema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ in ___ FINDINGS: Loculated posterior right apical pleural fluid is seen now with likely associated air-fluid level, which may relate to recent drainage. There is persistent blunting of the right costophrenic angle overlying atelectasis there may be a trace right pleural effusion. The left lung is clear. Cardiac and mediastinal silhouettes are stable. There has been interval removal of a right-sided PICC. IMPRESSION: Persistent posterior right apical loculated pleural fluid of with probable air-fluid level, air-fluid level more conspicuous as compared to the prior study, fluid component appear similar. Chest CT would provide further assessment. " d23faa0b-1ae933b6-f0b1f3e9-6e18c191-ae6f4d99.jpg,test/p18/p18116982/s55056174/d23faa0b-1ae933b6-f0b1f3e9-6e18c191-ae6f4d99.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with AML after cord blood transplantation with cough. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size and mediastinum are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph within the limitations of this study technique. If clinically warranted, correlation with chest CT might be considered. " 697482a8-d14d9c34-ba617604-4dd52fd5-d7ebf344.jpg,test/p14/p14449075/s54578762/697482a8-d14d9c34-ba617604-4dd52fd5-d7ebf344.jpg,test," FINAL REPORT INDICATION: History: ___F with syncope // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior radiographs the most recent on ___ FINDINGS: The cardiomediastinal and hilar contours appear unremarkable. There is unchanged calcified atherosclerotic disease of the aortic knob with mild aortic tortuosity, unchanged compared to prior study. The lungs are clear. Of note, there is a poorly defined nodular density projected over the base of the right lung. There is no pleural or pericardial effusion. Clips are noted in the right axilla. IMPRESSION: Nodular opacity projected over the right base may represent an atypical nipple shadow, focal infection or malignant nodule. Recommend repeat CXR wtih nipple markers or CT for further evaluation. RECOMMENDATION(S): These findings were discussed with Dr. ___ ___ telephone at 09:50 on ___ by Dr. ___. " dada1a68-4e6fdc24-f4439ab8-99fedb7d-ceb3444e.jpg,test/p12/p12459180/s55637544/dada1a68-4e6fdc24-f4439ab8-99fedb7d-ceb3444e.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There are low lung volumes. This accentuates the size of the cardiac silhouette which is mild to moderately enlarged. The aorta is tortuous. The hilar contours are normal, and the pulmonary vascularity is not engorged. There is minimal bibasilar atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " 06756895-0c1f8d4a-15ee5817-64e71c90-776101c2.jpg,test/p11/p11958913/s58672422/06756895-0c1f8d4a-15ee5817-64e71c90-776101c2.jpg,test," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with tortuosity of the aorta. Mild hyperexpansion of the lungs is consistent with chronic pulmonary disease, though there is no acute focal pneumonia. Some prominence of interstitial markings could reflect elevated pulmonary venous pressure, chronic lung disease, or both. " 384de1a5-62ca1ada-9e334b3c-cf0d2cf4-54cc091e.jpg,test/p17/p17892707/s51494679/384de1a5-62ca1ada-9e334b3c-cf0d2cf4-54cc091e.jpg,test," FINAL REPORT PORTABLE AP CHEST FROM ___ AT 11:19 CLINICAL INDICATION: ___-year-old with refractory non-Hodgkin's lymphoma now febrile with neutropenia, question pneumonia. Comparison is made to the patient's prior study of ___ at 16:05. Portable semi-upright chest film on ___ at 11:15 a.m. is submitted. IMPRESSION: 1. Left-sided Port-A-Cath remains unchanged in position. There has been a median sternotomy. Given differences in positioning, the overall cardiac and mediastinal contours are likely stable with the heart being stably enlarged. Focal retrocardiac opacity is seen, which could represent an area of patchy atelectasis, although aspiration or pneumonia could also have this appearance. Clinical correlation is advised. Small layering right pleural effusion. No large left effusion is seen. No evidence of pulmonary edema. No pneumothorax. " 806dcf39-b06943f4-b699abcc-ebd84041-a5b34dd1.jpg,test/p15/p15133454/s56293488/806dcf39-b06943f4-b699abcc-ebd84041-a5b34dd1.jpg,test," FINAL REPORT INDICATION: ___M with weakness, // acute cardiopulm process TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___ chest x-ray performed at an outside institution. FINDINGS: The lungs are clear without focal consolidation, effusion, or pulmonary edema. There is enlargement of the cardiac silhouette similar to prior. Median sternotomy wires, mediastinal clips, and left chest wall single lead pacing device are noted. Old healed right posterior sixth rib fracture is noted IMPRESSION: Enlarged cardiac silhouette without acute cardiopulmonary process. " 8f008530-f4d09120-43419b84-9e3a8ab8-ef6ca796.jpg,test/p11/p11658675/s54098838/8f008530-f4d09120-43419b84-9e3a8ab8-ef6ca796.jpg,test," FINAL REPORT HISTORY: Intubated with orogastric tube placed, distal aspect of feeding tube not well seen on the prior chest radiograph. COMPARISON: ___ at 11:27. FINDINGS: Endotracheal tube terminates approximately 5.3 cm above the carina. An enteric tube is seen coursing below the level of the diaphragm into the left upper quadrant, the expected position of the stomach. Lingular and bibasilar opacities persist most likely due to atelectasis, small underlying component of aspiration not excluded. No pleural effusion or pneumothorax is seen. No overt pulmonary edema is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Endotracheal and nasogastric tubes in appropriate position. " e61de6cb-59c902b3-566c145f-f50414e7-3821b827.jpg,test/p17/p17939137/s55153727/e61de6cb-59c902b3-566c145f-f50414e7-3821b827.jpg,test," FINAL REPORT INDICATION: ___-year-old male with recent abdominal surgery, now with fever. COMPARISON: ___. FINDINGS: Lung volumes are slightly low. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are stable. Abdominal surgical clips are noted. IMPRESSION: No acute cardiopulmonary process. " 4f0472a5-6a688588-34d73999-6c0f10cd-e8056e19.jpg,test/p16/p16437315/s50405388/4f0472a5-6a688588-34d73999-6c0f10cd-e8056e19.jpg,test," FINAL REPORT HISTORY: Dyspnea and palpitations. COMPARISON: Comparison is made to CT of the abdomen and pelvis from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. A prominent left epicardial fat pad is noted. The heart size is normal, and the pleural and hilar contours are unremarkable. There is no pulmonary edema or focal consolidation concerning for pneumonia. Mild multilevel degenerative changes are present in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 9ec64294-39874a93-81270b49-f8e51430-0abe4947.jpg,test/p15/p15485426/s54955868/9ec64294-39874a93-81270b49-f8e51430-0abe4947.jpg,test," FINAL REPORT HISTORY: ___-year-old female with history of gastric bypass with left upper quadrant pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Again seen is elevation of the left hemidiaphragm. The lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. No free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process. " 43724e5c-82b6a19c-9a9eb7ad-944541ad-91e1633d.jpg,test/p10/p10135726/s58076077/43724e5c-82b6a19c-9a9eb7ad-944541ad-91e1633d.jpg,test," FINAL REPORT INDICATION: ___ year old woman with POD___ s/p exlap removal of infected mesh with desaturation to 70s. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate low lung volumes results in bronchovascular crowding. There is a large amount of right basilar atelectasis, and more mild left basilar atelectasis. There are small bilateral pleural effusions. The cardiomediastinal contours are unchanged. There is no pneumothorax or consolidation. IMPRESSION: Large amount of right basilar atelectasis, and more mild left basilar atelectasis. " 304f724c-dd70296c-88df82e8-8e332955-6ccf2de1.jpg,test/p18/p18529984/s58649800/304f724c-dd70296c-88df82e8-8e332955-6ccf2de1.jpg,test," FINAL REPORT INDICATION: MVC with back pain. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal allowing for low lung volumes. No displaced rib fracture is seen. No T-spine fracture is seen, although CT is more sensitive for detection of these. IMPRESSION: No evidence of acute thoracic injury. " b8f0527f-0fed4aa4-c07b6830-54a41aea-d0089f3c.jpg,test/p14/p14618137/s59704098/b8f0527f-0fed4aa4-c07b6830-54a41aea-d0089f3c.jpg,test," FINAL REPORT INDICATION: ___ year old man with multiple CAD risk factors, ?CHF, ___, admitted for chest/epigastric pain w/mild trop elev, tender over right anterior ribs/sternum // heart failure? rib fracture? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Low bilateral lung volumes. No focal consolidation or pneumothorax identified. There are suspected trace bilateral pleural effusions. The size of the cardiac silhouette is at the upper limits of normal. Surgical clips project over the left thoracic inlet with slight unchanged rightward deviation of the trachea. IMPRESSION: Suspected trace bilateral pleural effusions. " 23f8aea0-778cbb38-d7024e0d-01872d74-7c8a0463.jpg,test/p19/p19512939/s50543778/23f8aea0-778cbb38-d7024e0d-01872d74-7c8a0463.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with weakness and numbness concern for guillain-___ TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vasculature is not engorged. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 6c765733-7ce15797-9aba62f9-a3285306-10be154e.jpg,test/p11/p11549602/s56817370/6c765733-7ce15797-9aba62f9-a3285306-10be154e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Epidural abscess, status post spinal fusion, assessment for nasogastric tube placement. COMPARISON: ___, 4:33 a.m. FINDINGS: The nasogastric tube shows a normal course. The tip projects over the middle parts of the stomach. There is no evidence of complications, notably no pneumothorax. Unchanged position of the endotracheal tube and the right internal jugular vein catheter. Unchanged appearance of the right pleural effusion with known adjacent rib fractures. Unchanged position of the surgical fixation devices in the spine. " a2cd3746-f5611899-0122ad77-5e134f1c-cd6d8750.jpg,test/p17/p17910433/s52859389/a2cd3746-f5611899-0122ad77-5e134f1c-cd6d8750.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG // eval postop changes IMPRESSION: In comparison to ___ radiograph, postoperative appearance of cardiomediastinal contours is stable. Small bilateral pleural effusions have slightly increased in size in the interval with adjacent bibasilar atelectasis. Lungs are otherwise clear, and there is no evidence of pneumothorax. " 8baef570-7a368ba9-c9c7f127-60b46783-4cdc8803.jpg,test/p17/p17370807/s58250233/8baef570-7a368ba9-c9c7f127-60b46783-4cdc8803.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with seizure, needs infectious workup TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post right pneumonectomy with air and fluid noted in the right hemi thorax, similar to that seen on the prior examination. Heart size is difficult to assess given the postsurgical changes in the right hemi thorax. Mediastinal contour is similar. Streaky opacity in the left lung base may reflect atelectasis, though infection is not completely excluded and appears similar compared to the previous chest radiograph. No left lung consolidation is seen. There is no left-sided pleural effusion or pneumothorax. A clip is seen within the right lateral chest wall along with adjacent subcutaneous emphysema. The right PICC appears to been withdrawn, now terminating in the region the right axilla. IMPRESSION: Continued patchy left basilar opacity may reflect atelectasis though infection is not completely excluded. Status post right pneumonectomy with unchanged postoperative appearance of the right hemi thorax. Right PICC appears withdrawn now terminating in the region of the right axilla. " 8bed9cff-873a1be2-61f97784-f9a23fd5-c1af5652.jpg,test/p13/p13685660/s54403018/8bed9cff-873a1be2-61f97784-f9a23fd5-c1af5652.jpg,test," FINAL REPORT EXAM: CHEST FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Again seen projecting over the lateral right hemithorax is a 5-mm ovoid ossific/calcific structure projecting over the right seventh rib, most likely representing a calcified granuloma. No focal consolidation is seen. There is minimal blunting of the posterior right costophrenic angle which may be due to low lung volumes, although a very trace pleural effusion is not excluded. No pneumothorax is seen. The aorta is calcified and tortuous. The cardiac silhouette is not enlarged. Minimal interstitial edema has improved in the interval. There are partially imaged degenerative changes at the right greater than left shoulder joints and also along the spine. " 66b7eb49-8f3d570f-d054a691-d5d1809c-19238497.jpg,test/p16/p16881590/s57705002/66b7eb49-8f3d570f-d054a691-d5d1809c-19238497.jpg,test," FINAL REPORT INDICATION: Dry cough for several months. COMPARISONS: ___ and ___. FINDINGS: PA and lateral chest radiographs demonstrate mild cardiomegaly, unchanged from ___. There is no pulmonary vascular congestion, pleural effusion, or dilation of the azygos. There is no focal consolidation or pneumothorax. An old right posterior rib fracture is stable from ___. IMPRESSION: No acute cardiopulmonary process. " 4d59bef9-92f0bb62-0c33d9f4-236a755e-c63ef567.jpg,test/p16/p16455067/s56408662/4d59bef9-92f0bb62-0c33d9f4-236a755e-c63ef567.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Increased cough. Patient with COPD. There is moderate cardiomegaly. The lungs are hyperinflated, consistent with emphysema. Ill-defined opacities in the left lower lobe are consistent with pneumonia. There is no evidence of pulmonary edema, pneumothorax, or pleural effusions. The aorta is tortuous. The main pulmonary arteries are enlarged, as before, consistent with pulmonary hypertension. IMPRESSION: Left lower lobe pneumonia. Followup after treatment is recommended in six weeks. Findings were discussed with Dr. ___ by phone on ___ at 4:18 p.m., 2 minutes after the discovery of the findings. " ad769491-6610641b-76182ec1-ce4f99ac-54193d11.jpg,test/p18/p18438381/s59969983/ad769491-6610641b-76182ec1-ce4f99ac-54193d11.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with prostate cancer currently undergoing XRT who presents to the ED with dyspnea on exertion // Eval for infectious process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CT ___ FINDINGS: There are bilateral opacities, projecting over the right infrahilar border and left lung base. Evaluation on the lateral view is slightly limited due to dense sclerotic bones. There are trace bilateral pleural effusions. No pneumothorax. Cardiomediastinal contours are within normal limits. Osseous structures are diffusely mottled and sclerotic, consistent with known metastases. IMPRESSION: 1. Bibasilar opacities may represent atelectasis or pneumonia. 2. Trace bilateral pleural effusions. 3. Diffuse sclerotic metastases. " 60f7f9c7-2b6a03e2-19489362-a3ff17b6-b14922b5.jpg,test/p10/p10509294/s50283471/60f7f9c7-2b6a03e2-19489362-a3ff17b6-b14922b5.jpg,test," WET READ: ___ ___ ___ 11:52 PM ET tube terminates appropriately above the carina approximately 6 cm. The NG tube extends below the diaphragm with the tip out of view of this film. ______________________________________________________________________________ FINAL REPORT AP CHEST, 7:54 P.M., ___ HISTORY: ___-year-old man with endotracheal tube placed. IMPRESSION: AP chest compared to ___: Tip of the endotracheal tube above the upper margin of the clavicles, at least 6 cm from the carina, should be advanced 2 to 3 cm for more secured seating. Lungs low in volume but clear. Heart size normal. No pleural abnormality. Right jugular line ends low in the SVC. " deee5b7f-3f69de75-ce2a9bd3-95d416b1-844147de.jpg,test/p19/p19557250/s53936566/deee5b7f-3f69de75-ce2a9bd3-95d416b1-844147de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with h/o HTN and suspected OSA who is now re-admitted with hypercarbic and hypoxemic respiratory failure // interval change interval change IMPRESSION: Comparison to ___. Monitoring and support devices are in constant position. An atelectasis at the right lung bases has resolved. Moderate cardiomegaly with retrocardiac atelectasis persists. No larger pleural effusions. No pulmonary edema. " 9a24e807-a1a1a62f-46ed6c34-10744bde-e08db811.jpg,test/p13/p13145776/s56292645/9a24e807-a1a1a62f-46ed6c34-10744bde-e08db811.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with tracheobronchial malacia, initially noted ___ but with symptoms since age ___m, s/p recent tracheobronchoplasty, with chest tubes now removed; evaluate for interval changes in lungs. COMPARISON: Chest radiograph dated ___. FINDINGS: Compared to the prior exam, the linear lucency along the apex of the right lung appears similar in size but now demonstrates an air-fluid level, which is consistent with a hydropneumothorax. Mild, linear opacity consistent with atelectasis at the right lung base. Otherwise, the lungs are expanded and clear. There is no pleural effusion or focal consolidation. The cardiomediastinal silhouette and hila are normal. The supraclavicular subcutaneous emphysema is slightly improved from the prior exam. Multiple old left-sided rib fractures with callus formation and mild, multi-level degenerative changes in the visualized thoracic spine are present. IMPRESSION: Small right apicolateral hydropneumothorax. Slight interval improvement in right supraclavicular subcutaneous emphysema. Mild right basilar atelectasis. " 76835169-deca28ee-81d25388-aae8c03d-5698bf7e.jpg,test/p19/p19718601/s51632122/76835169-deca28ee-81d25388-aae8c03d-5698bf7e.jpg,test," FINAL REPORT HISTORY: Fever and neutropenia. FINDINGS: In comparison with the study of ___, the patient has taken a somewhat better inspiration. The heart is within normal limits and the lungs are clear without vascular congestion or pleural effusion. " 5b635ee7-fd2e3100-b5b05159-7cf49833-d4001661.jpg,test/p13/p13411236/s56850821/5b635ee7-fd2e3100-b5b05159-7cf49833-d4001661.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HCC s/p TACE with cough, fever/chills // ? pneumonia vs bronchitis WET READ please to ___ TECHNIQUE: CHEST (PA AND LAT) COMPARISON: Chest CT from ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. Right upper lobe post prior surgery changes are stable. There is no pleural effusion or pneumothorax. There is no evidence of acute process " 7341e380-c1e476aa-6462a60f-91663a5b-4fa1cd0b.jpg,test/p18/p18165044/s52241868/7341e380-c1e476aa-6462a60f-91663a5b-4fa1cd0b.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // Edema, effusion, infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: PA and lateral chest radiograph demonstrate clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion, pneumothorax, or evidence of pulmonary edema. There is no air under the right hemidiaphragm. IMPRESSION: No acute intrathoracic abnormality. " 030e74a0-6ec6f39e-540168d9-f3339d64-8cee5d37.jpg,test/p15/p15854896/s58755487/030e74a0-6ec6f39e-540168d9-f3339d64-8cee5d37.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: A ___-year-old man with recurrent pneumonia, bilateral pleural effusions, history of radiation for lymphoma. Evaluate possible pneumonia and volume of effusions. IMPRESSION: PA and lateral chest compared to ___, ___: Moderate right pleural effusion unchanged since ___. Pleural effusion had increased between ___ and ___. Subsequent torso CT scan, covering the chest showed moderate non-hemorrhagic largely layering right pleural effusion and similar but smaller left pleural effusion. Opacification in the right lower lobe is probably entirely atelectasis. Perihilar radiation fibrosis is also present. The regions of ground-glass opacity in the suprahilar upper lobe seen on that torso CT scan have subsequently nearly resolved, and previous small left pleural effusion is also nearly clear. Differential diagnosis includes atypical edema, or pulmonary drug reaction, less likely viral infection or pulmonary hemorrhage. " b06663cb-5a475b61-3acb876c-641e9ce2-58ad2793.jpg,test/p11/p11638384/s58661524/b06663cb-5a475b61-3acb876c-641e9ce2-58ad2793.jpg,test," FINAL REPORT INDICATION: ___ year old woman with AML. // Interval change. Has the edema, infiltrate cleared? TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: A dual lead left chest wall pacemaker is present. The tip of the right internal jugular central venous catheter projects over the upper right atrium. Interval decrease in the diffuse bilateral airspace opacities. No pneumothorax or pleural effusion. The size of the cardiomediastinal silhouette is within normal limits. IMPRESSION: Interval decrease in extent, but persistence of diffuse bilateral patchy airspace opacities. No new focal consolidation. " 485637dc-31b04775-9a540223-d42a9e74-8cdb5ff5.jpg,test/p12/p12156923/s59735292/485637dc-31b04775-9a540223-d42a9e74-8cdb5ff5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F PMH 6.6 cm juxtrarenal AAA, now s/p open AAA repair c/b LLE ischemia s/p cut-down L iliac thrombectomy/stent c/b compartment syndrome s/p LLE fasciotomies, c/b ischemic colitis w/ fever 102 overnight // interval changes? pna? interval changes? pna? IMPRESSION: Comparison to ___. Lung volumes have increased, likely reflecting improved ventilation. However, signs of moderate pulmonary edema persists. Stable atelectasis in the retrocardiac lung region and at the bases of the left lung. No pleural effusions. In addition, there is a new perihilar opacity on the right, potentially reflecting developing pneumonia. Stable position of the right PICC line. No pneumothorax. " 92ec1b1f-fa63aaa7-a23e00ac-b92399fc-fed2f336.jpg,test/p14/p14450370/s59733570/92ec1b1f-fa63aaa7-a23e00ac-b92399fc-fed2f336.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p L THR, now requiring ___L post-op, crackles noted at bases, evaluate for infectious process // evaluate for infectious process, r/o PNA evaluate for infectious process, r/o PNA IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Bibasilar atelectatic changes are seen, more prominent on the right. Otherwise, no evidence of acute pneumonia or vascular congestion. " 9a4562b1-711c7464-a5f9104e-dba8443d-072349f3.jpg,test/p18/p18628529/s53871993/9a4562b1-711c7464-a5f9104e-dba8443d-072349f3.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Sickle cell disease presenting with lower back pain and chest pain. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A Port-A-Cath terminates at cavoatrial junction. The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. " e1659249-e5a3ca72-581786ba-6584fd03-358f3e20.jpg,test/p16/p16901707/s56365418/e1659249-e5a3ca72-581786ba-6584fd03-358f3e20.jpg,test," WET READ: ___ ___ ___ 10:49 AM Mildly displaced fractures of the left seventh and eighth ribs. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post fall with pain. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: A left-sided dialysis catheter is in place, again terminating in the upper right atrium. The patient is also status post coronary artery bypass graft surgery. The heart is again mild-to-moderately enlarged. The cardiac, mediastinal and hilar contours appear not significantly changed. There is no evidence for pleural effusion or pneumothorax. Streaky opacity in the left mid lung suggests minor atelectasis or scarring, probably located within the lingula. There are new slightly displaced left posterolateral seventh and eighth rib fractures that appear acute. IMPRESSION: Rib fractures. " bdb7804d-6cff6c95-f267986a-3bb72b67-7caee263.jpg,test/p12/p12053870/s52866491/bdb7804d-6cff6c95-f267986a-3bb72b67-7caee263.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Myalgias and non-productive cough. Assess for pneumonia. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. No signs of pneumonia or CHF. The cardiomediastinal silhouette is normal. The imaged osseous structures are intact. No free air is seen below the right hemidiaphragm. " 8a1762fb-3bff834a-4fbb0e6c-0e031b91-c18c6539.jpg,test/p13/p13505755/s53067476/8a1762fb-3bff834a-4fbb0e6c-0e031b91-c18c6539.jpg,test," FINAL ADDENDUM ADDENDUM Addendum to clarify a typo on the initial dictation. The first line should read ""As compared to the previous radiograph, there is now clear evidence of bilateral lower lobe pneumonia."" ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with delirium, prolonged hospitalization for sepsis, liver failure, pancytopenia with productive cough. ? pneumonia // ? pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is no clear evidence of bilateral lower lobe pneumonia, as manifested by ill-defined opacities with air bronchograms, in part better seen on the lateral than on the frontal radiograph. At the time of dictation and observation, 15:20, on the ___, the referring physician ___. ___ was notified by Dr. ___. No pleural effusions. No pulmonary edema. No abscess formation. Unchanged normal position of the left-sided PICC line. " a4b98084-2475b3ea-9017042b-e701af7f-89e71165.jpg,test/p19/p19680450/s50781761/a4b98084-2475b3ea-9017042b-e701af7f-89e71165.jpg,test," WET READ: ___ ___ ___ 6:22 PM No definite acute cardiopulmonary process. Rounded density in the right paramediastinal region, potentially tortuosity of the great vessels, however given lack of prior or other exam to confirm, nonurgent chest CT is suggested. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with right thoracic pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear of focal consolidation or effusion. Cardiac silhouette is mildly enlarged. The thoracic aorta is tortuous. There is increased density adjacent to the superior portion of the mediastinum on the right. This has the appearance of tortuosity of the vessels, especially given that the density is not seen above the clavicle. No acute osseous abnormality identified. IMPRESSION: No definite acute cardiopulmonary process. Rounded density in the right paramediastinal region, potentially tortuosity of the great vessels, however given lack of prior or other exam to confirm, nonurgent chest CT is suggested. " 816ae9b5-5953c657-e0d6b9c9-3ddffbc5-c6236af8.jpg,test/p11/p11900721/s55549857/816ae9b5-5953c657-e0d6b9c9-3ddffbc5-c6236af8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis and new SOB // interval change interval change COMPARISON: Chest radiographs ___. IMPRESSION: Radiographic findings on ___ were clearly pulmonary edema, chronic moderate cardiomegaly, and persistent moderate acute pleural effusions. Edema has worsened since ___. Dense consolidation in the left lower lobe could be atelectasis alone, but pneumonia is not excluded radiographically " 0829e077-ae031c2b-4fd088d1-3e92eea7-5a6f83d2.jpg,test/p14/p14388973/s56608008/0829e077-ae031c2b-4fd088d1-3e92eea7-5a6f83d2.jpg,test," FINAL REPORT INDICATION: Cellulitis of the second toe. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The heart size remains moderately enlarged but unchanged. The mediastinal and hilar contours are unchanged and unremarkable. The pulmonary vascularity is not engorged. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Multilevel degenerative changes are present within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 5357bd06-9a92e3d7-8ac541c4-14d7e880-3dbfdb72.jpg,test/p16/p16843636/s51771332/5357bd06-9a92e3d7-8ac541c4-14d7e880-3dbfdb72.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with chest pain. Evaluate for volume overload. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest demonstrate moderate pulmonary edema as well as moderate cardiomegaly which is worse than on the prior chest radiograph from ___. There are small to moderate bilateral pleural effusions. There is no pneumothorax. IMPRESSION: Moderate cardiomegaly, pulmonary edema, and bilateral pleural effusions, consistent with decompensated congestive heart failure. " 698d15dd-21497003-6dbad20e-4a949009-15c94a72.jpg,test/p16/p16454913/s58539765/698d15dd-21497003-6dbad20e-4a949009-15c94a72.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with tracheobronchomalacia, renal failure, fluid overload and pneumonia. Portable AP radiograph of the chest was reviewed in comparison to ___. Tubes and lines are in unchanged position. Heart size and mediastinum are unchanged. Pulmonary edema is mild-to-moderate, unchanged. Small bilateral pleural effusions have not increased in the interim. " 4810dce4-612e0884-25afa51c-44d05d5b-d22cd3c6.jpg,test/p16/p16046758/s57326327/4810dce4-612e0884-25afa51c-44d05d5b-d22cd3c6.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with pulmonary effusion, status post thoracocentesis on the right, evaluate effusion and look for pneumothorax. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding portable chest examination obtained eight hours earlier during the same day. During the interval, a right-sided thoracocentesis has been performed and the right hemithorax becomes partially translucent again. One can now identify a distorted pattern of the pulmonary vasculature in the right hemithorax suggestive of a mass in the right upper lobe area and elevation of the right-sided hemidiaphragm. Quite obvious there is some degree of mediastinal shift towards the right side suggestive of major atelectatic and obstructive component in the process. A preceding torso CT dated ___ revealed chronic post-surgical changes with associated volume loss as well as radiation fibrosis in the right upper lung. The present findings on the portable chest examination match these findings grossly. " 90ed9b6c-caef5cea-c9de5e69-fdd85c5b-61385f85.jpg,test/p15/p15400263/s57320578/90ed9b6c-caef5cea-c9de5e69-fdd85c5b-61385f85.jpg,test," FINAL REPORT INDICATION: Volvulus and new NG tube. Evaluate placement. TECHNIQUE: Single upright AP view of the chest. COMPARISON: CT of the chest from ___. CT of the abdomen and pelvis from ___. FINDINGS: An NG tube is present with the tip in the stomach. The lungs are clear without a consolidation or edema. There is no pleural effusion or pneumothorax. Note, the left costophrenic angle is not included in the field of view. The cardiomediastinal silhouette is normal. There is no free intraperitoneal air. The air-filled dilated loops of bowel are better evaluated on the recent CT of the abdomen and pelvis. IMPRESSION: NG tube with the tip in the stomach. No acute cardiopulmonary process. " aa23253c-b8512515-135afbac-fad72ac9-c4ec11f4.jpg,test/p17/p17244595/s55100371/aa23253c-b8512515-135afbac-fad72ac9-c4ec11f4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COPD, pneumothorax // please evaluate for interval change please evaluate for interval change IMPRESSION: In comparison with the study of ___, there is little change in the substantial volume loss in the left lung with shift of the mediastinum to that side. Atelectatic changes are again seen at the base of the markedly hyperexpanded right lung. No definite acute pneumonia. Monitoring and support devices are essentially unchanged. " 167475f8-e72bc93f-e54461a8-ce9ef2a5-ea8ff976.jpg,test/p14/p14504982/s54130740/167475f8-e72bc93f-e54461a8-ce9ef2a5-ea8ff976.jpg,test," FINAL REPORT INDICATION: ___-year-old female with possible right pleural effusion and left-sided pleuritic chest pain. Evaluate effusions. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are hyperinflated with flattened diaphragms, suggestive of COPD. No focal consolidation, pleural effusion, or pneumothorax is seen. Median sternotomy wires and mediastinal surgical clips are intact. Compression deformity of upper and mid-thoracic vertebral bodies are age-indeterminate. IMPRESSION: 1. Hyperinflated lungs suggestive of COPD. No definite pleural effusion. 2. Age-indeterminate compression deformities of 2 thoracic vertebral bodies. " 4ef984f7-3cfc60cd-27ea49e0-c233f4bf-d9ea5220.jpg,test/p14/p14871009/s53819658/4ef984f7-3cfc60cd-27ea49e0-c233f4bf-d9ea5220.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pAFIB now with cough, fever // pneumonia pneumonia IMPRESSION: In comparison with the study of ___, there is little change. Again severe scoliosis greatly obscures the study. No definite acute pneumonia is appreciated on this limited examination. " fb0ef608-1815fbf2-cdc12012-87548b55-2eaf1d22.jpg,test/p19/p19960115/s51481085/fb0ef608-1815fbf2-cdc12012-87548b55-2eaf1d22.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Left-sided Port-A-Cath terminates in the mid SVC. Low lung volumes persist. There are seen small bilateral pleural effusions with overlying atelectasis. Mild central pulmonary vascular engorgement is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Low lung volumes and small bilateral pleural effusions with overlying atelectasis. Central pulmonary vascular engorgement. " ead75f8c-c2ac3f19-5d5d0ecf-01c7e5ba-7bd0ae34.jpg,test/p14/p14215609/s56609496/ead75f8c-c2ac3f19-5d5d0ecf-01c7e5ba-7bd0ae34.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old male with head trauma, intoxicated. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Lower lung volumes seen on the current exam. The lungs, however, are clear of confluent consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is unchanged given differences in positioning and technique. No displaced rib fracture is identified. Soft tissues are unremarkable. IMPRESSION: No acute cardiopulmonary process. " b30ddd74-90fe6b69-bb90b11b-b0abf45b-e142ede9.jpg,test/p12/p12637692/s50473229/b30ddd74-90fe6b69-bb90b11b-b0abf45b-e142ede9.jpg,test," FINAL REPORT INDICATION: Cough and fever. COMPARISON: Chest radiograph ___. Chest radiograph ___. FINDINGS: The lungs are hyperinflated with flattened diaphragms, consistent with COPD. This is unchanged from prior exam. At the right base, there is a new somewhat linear hazy opacity, with adjacent blunting of the right costophrenic angle suggestive of a small pleural effusion. There is no pulmonary edema, left pleural effusion, or pneumothorax. The cardiomediastinal silhouette is unchanged with the heart size normal. Mitral annular calcifications are again noted. Multiple compression fractures and severe kyphosis are noted, and not significantly changed from prior exam. The aorta is tortuous and calcified. Biapical scarring is redemonstrated. IMPRESSION: 1. New right basilar opacity concerning for pneumonia, with a small right pleural effusion. 2. Stable hyperinflation suggestive of underlying COPD. 3. Stable multiple thoracic vertebral body compression fractures. " 78c7386f-0b40379c-9b4867ed-3c5cf187-0c4bfe3a.jpg,test/p19/p19791816/s54890659/78c7386f-0b40379c-9b4867ed-3c5cf187-0c4bfe3a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman w/ lymphoma and left lower lobe collapse secondary to mucous secretions vs external compression from cancer in the left lower lobe bronchus on CT ___ ___/ please assess lung status please assess lung status IMPRESSION: In comparison with the study of ___, there is little overall change in the dense pleural calcification on the right and calcifications in the apical region. Continued enlargement of the cardiac silhouette with bilateral pleural effusions and compressive atelectasis at the bases. Cardiac silhouette remains enlarged and there is again evidence of some elevated pulmonary venous pressure " ee28fa21-724bf9c7-2f3306d7-27a5f18d-56b77626.jpg,test/p14/p14099038/s53330410/ee28fa21-724bf9c7-2f3306d7-27a5f18d-56b77626.jpg,test," FINAL REPORT EXAMINATION: Send INDICATION: ___ year old woman with CHF and CAD with fall onto chest yesterday now with worsening pleuritic chest pain. // Please assess for pulmonary edema, pneumonia, fracture, PTX TECHNIQUE: Chest portable AP, upright 08:47 COMPARISON: ___. FINDINGS: The heart is enlarged. The pulmonary vasculature is within normal limits. No consolidation. No signs of CHF. Dual lead pacemaker again seen with the leads ending in the RA and RV. IMPRESSION: Cardiomegaly. No signs of pulmonary edema. " 6b36838c-c1f00418-31e48066-d37bc1b8-760d308a.jpg,test/p18/p18232511/s55641016/6b36838c-c1f00418-31e48066-d37bc1b8-760d308a.jpg,test," FINAL REPORT INDICATION: Status post PSF. Evaluate after extubation. COMPARISON: Chest radiograph ___. Chest radiograph ___. CT chest ___. FINDINGS: A right middle and lower lung consolidation has worsened since prior exams, specifically in the periphery of the right mid lung zone. Small right and left pleural effusions are unchanged. Hazy opacification at the left base is likely atelectasis, although an underlying infectious process cannot be excluded. A left chest tube is unchanged. There is no pneumothorax. The cardiomediastinal silhouette is normal. A left central venous catheter ends in the upper SVC. Spinal hardware is unchanged in appearance. IMPRESSION: 1. Significantly worse right mid and lower lung opacification is likely an infectious process. 2. Stable small bilateral pleural effusions. 3. Probable left basal atelectasis, although infectious process cannot be excluded. " 58ab4801-43b429aa-4eb603c5-2ae85516-68b00784.jpg,test/p15/p15016366/s51082099/58ab4801-43b429aa-4eb603c5-2ae85516-68b00784.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Unusual rash. Question connective tissue disease. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax. The bones appear with normal. IMPRESSION: Normal study. " 6bfb75cc-f6eaeffb-52dfe56e-816bcc95-bbdd9b59.jpg,test/p16/p16262068/s59394786/6bfb75cc-f6eaeffb-52dfe56e-816bcc95-bbdd9b59.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old male with bradycardia and diaphoresis. FINDINGS: Two portable views of the chest. No prior. Lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are notable for degenerative changes of the acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " 5528375b-1c0f8ab1-e3441058-fd76e60f-4516f555.jpg,test/p19/p19601036/s58135347/5528375b-1c0f8ab1-e3441058-fd76e60f-4516f555.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p thoracid duct ligation, now with worsening breathing, desat to mid 80s at rest // respiratory insufficiency, interval changes, aspiration vs pna respiratory insufficiency, interval changes, aspiration vs p COMPARISON: Comparison prior study dated ___ at 07:47 FINDINGS: Portable AP upright chest film ___ 04:57 is submitted. IMPRESSION: Interval near-complete opacification of the left hemithorax likely reflecting increasing pleural effusion or possibly hemorrhage into the pleural space. Clinical correlation is advised. A left basilar chest tube remains in place with the small pneumothorax seen on recent CT dated ___ not appreciated. A right basilar chest tube is again seen and there is a small but stable right apical pneumothorax. Stable small right effusion. Rounded lucency adjacent to the right hemidiaphragm on the previous study does not persist. Right subclavian PICC line is unchanged in position. Cardiac and mediastinal contours cannot be assessed due to the opacity of the left hemithorax. The patient is status post median sternotomy with valve replacement. Patchy opacity at the right lung base persists and may represent an area of atelectasis or pneumonia, less likely hemorrhage. Clinical correlation is advised. No evidence of pulmonary edema. " 66639cd7-4e306801-4ba84bab-498ee59c-ce64296a.jpg,test/p13/p13193136/s58130275/66639cd7-4e306801-4ba84bab-498ee59c-ce64296a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atrial tach, shortness of breath and diaphoresis // assess for CHF assess for CHF IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE IS LITTLE INTERVAL CHANGE. CARDIAC SILHOUETTE IS AT THE UPPER LIMITS OF NORMAL IN SIZE WITH SOME ELONGATION OF THE DESCENDING AORTA. NO EVIDENCE OF ACUTE PNEUMONIA OR VASCULAR CONGESTION. SOME HYPEREXPANSION OF THE LUNGS SUGGESTS CHRONIC PULMONARY DISEASE. DUAL-CHANNEL PACER HAS LEADS IN THE RIGHT ATRIUM RIGHT VENTRICLE. " 920afc45-2cc0c9ee-784019f1-f1402149-2cd884d4.jpg,test/p19/p19932242/s56469033/920afc45-2cc0c9ee-784019f1-f1402149-2cd884d4.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with end stage multiple myeloma with known CHF and COPD. // COntinued wheezing/congestion TECHNIQUE: Chest PA and lateral COMPARISON: Portable chest radiograph dated ___ FINDINGS: In comparison with the chest radiograph obtained 6 days prior, mild to moderate pulmonary vascular congestion and pulmonary edema have resolved. Hazy opacities in the lower right lung are likely due to chronic lateral segment, right middle lobe atelectasis, better appreciated on CT chest dated ___. Lungs are otherwise clear without focal consolidation. Heart size top-normal. No pleural effusions. Cardiomediastinal hilar silhouettes are normal. IMPRESSION: No radiographic evidence of pneumonia or acute cardiopulmonary abnormalities. Chronic atelectasis of the lateral segment, right middle lobe. RECOMMENDATION(S): The findings were discussed by Dr. ___ with ___ on the telephone on ___ at 12:12, approximately 120 minutes after discovery of the findings, but 60 minutes after paging. " a158592d-49d1e915-0848c5d0-3abc9aec-f6c5c317.jpg,test/p15/p15952632/s54161836/a158592d-49d1e915-0848c5d0-3abc9aec-f6c5c317.jpg,test," FINAL REPORT HISTORY: Postop day #2 thoracoabdominal partial nephrectomy. Chest tube removed, question pneumothorax. CHEST, TWO VIEWS. COMPARISON: Chest x-ray dated ___ at 15:15 p.m. Right-sided chest tube has been removed. No right-sided pneumothorax is detected at this time. Again seen is elevation of the right hemidiaphragm with patchy opacity in right greater than left bases. There are low inspiratory volumes, though better than on the prior film. There is some more diffuse hazy opacity in the right lung compared to the left -- this is of uncertain etiology, but could reflect an element of atelectasis. Bilateral surgical clips again noted at the thoracic inlet.Surgical clips also noted in the upper abdomen. The lateral view is difficult to interpret due to overlying soft tissues. No gross effusions are identified. The bibasilar patchy opacities seen on the frontal view likely relate to opacities in lower lobe/lobes, likely representing collapse and/or consolidation. IMPRESSION: 1. No pneumothorax detected status post removal of the right-sided chest tube. 2. Low, but improved, inspiratory volumes, with continued patchy opacity at both bases. 3. Asymmetric hazy opacity in the right lung, new compared with the prior film, is of uncertain etiology, but could reflect an element of atelectasis. " 1ec6c9b0-69958a67-49247964-817dda0b-d22a40f9.jpg,test/p13/p13999137/s51522483/1ec6c9b0-69958a67-49247964-817dda0b-d22a40f9.jpg,test," WET READ: ___ ___ ___ 2:20 PM Increased opacity at the left lower lung is concerning for pneumonia or aspiration. Short interval follow up is recommended upon completion of treatment. ______________________________________________________________________________ FINAL REPORT HISTORY: Hiccups, shortness of breath. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Increased opacity at the left lower lobe is concerning for pneumonia or aspiration. The right lung is clear. There is no pleural effusion or pneumothorax. IMPRESSION: Increased opacity at the left lower lobe is concerning for pneumonia or aspiration. Short interval follow up with chest radiograph is recommended upon completion of treatment to document resolution. " c8058237-027ab90b-22e9edd3-4dacbff0-c17a0620.jpg,test/p10/p10367989/s54511563/c8058237-027ab90b-22e9edd3-4dacbff0-c17a0620.jpg,test," FINAL REPORT HISTORY: Cough, evaluate for infiltrate or edema. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were performed. There is moderate cardiomegaly. Prominence of the interstitium is noted and is thought to reflect changes from chronic lung disease. There is no vascular congestion and or pleural effusion. No pneumothorax is identified. A 4 mm rounded opacity is seen in the right mid lung, only on the frontal view, is likely a calcified granuloma. The thoracic aorta is tortuous. The imaged upper abdomen is unremarkable. IMPRESSION: 1. Moderate cardiomegaly. 2. Diffuse interstial prominence without vascular congestion is thought to reflect changes of chronic lung disease rather than pulmonary edema. " adfa7fcd-a097dd03-718144ce-855cf9eb-b83b6dd0.jpg,test/p13/p13652475/s59192800/adfa7fcd-a097dd03-718144ce-855cf9eb-b83b6dd0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever/cough // r/o infx COMPARISON: ___ IMPRESSION: No change as compared to the prior radiographs. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions. " 488d16db-9104c67c-75c9a1a1-3b58a183-e466951b.jpg,test/p14/p14375008/s56848635/488d16db-9104c67c-75c9a1a1-3b58a183-e466951b.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain and interstitial lung disease. COMPARISON: ___. FINDINGS: Large-bore right-sided central catheter is again seen, unchanged in position, terminating in the right atrium. Minimal increase in opacity at the right lung base, worrisome for increase in size of small right pleural effusion as well as right basilar consolidation. There is diffuse increase in interstitial markings bilaterally, possibly minimally increased as compared to prior study, this could be due to pulmonary edema versus chronic lung disease; however, these were not seen on ___ CT. The cardiac and mediastinal silhouettes are stable. Prominence of the right hilum is stable. No pneumothorax is seen. IMPRESSION: Minimal increase in right basilar opacity which represent combination of worsening pleural effusion and consolidation. Background of pulmonary edema appears slightly increased compared to the prior study. " db2aea6c-e640baed-a0339ddb-087b7562-d78b07aa.jpg,test/p13/p13874311/s58173626/db2aea6c-e640baed-a0339ddb-087b7562-d78b07aa.jpg,test," FINAL ADDENDUM ADDENDUM The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:00 PM. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent coughing and wheezing after tx for bronchitis. h/o renal tx on immunosuppresant therapy. // Any pathology to explain current sxs? Any pathology to explain current sxs? IMPRESSION: In comparison with the study of ___, there are slightly lower lung volumes. The volume loss in the left lower lobe has substantially cleared. Mild atelectatic changes are seen in the retrocardiac region, and there is a streak of atelectasis at the right base. No evidence of vascular congestion or pleural effusion. " 6702a3a9-e62a0b90-ed018ab6-8c8dbe53-ede9b6b5.jpg,test/p19/p19711702/s50795671/6702a3a9-e62a0b90-ed018ab6-8c8dbe53-ede9b6b5.jpg,test," WET READ: ___ ___ ___ 7:18 PM L hemidiaphragm elevation w/ slightly inc LLL opacity, likely atelectasis. ______________________________________________________________________________ FINAL REPORT CHEST X-RAY INDICATION: Status post auto bone marrow transplant with intravascular lymphoma, fever. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes with mild crowding of the basal vascular structures. No evidence of pneumonia, no pleural effusion. No pulmonary edema. Normal size of the cardiac silhouette. Unchanged position of bilateral central venous access lines. " 528b3a72-87c4c173-121695d8-8c8ab04a-a617dfdb.jpg,test/p12/p12000091/s55199984/528b3a72-87c4c173-121695d8-8c8ab04a-a617dfdb.jpg,test," WET READ: ___ ___ ___ 3:25 AM 1. No radiopaque foreign body within the airway or esophagus. 2. Normal chest radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with ?food impaction. Assess for visible foreign bodies, or pneumomediastinum. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: The lungs are symmetrically inflated and clear. No pleural effusion, pneumothorax, or pneumomediastinum. Heart size, mediastinal contour, and hila are unremarkable. No evidence of radiopaque foreign body within the airway or esophagus. Visualized upper abdomen is unremarkable. Stable calcified left thyroid nodule noted with thyroid goiter. Aortic arch calcifications noted. IMPRESSION: 1. No radiopaque foreign body within the airway or esophagus. 2. Normal chest radiograph. 3. Thyroid goiter, similar to previous examination. " 2aa44393-05967112-c0d2f4f4-2a3c128d-9458bd32.jpg,test/p15/p15002645/s53313703/2aa44393-05967112-c0d2f4f4-2a3c128d-9458bd32.jpg,test," FINAL REPORT INDICATION: ___M with CP // r/o acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 4656ec43-0a8d5159-d00482a5-ae8cd50d-3f774d76.jpg,test/p10/p10055694/s59632945/4656ec43-0a8d5159-d00482a5-ae8cd50d-3f774d76.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with shortness of breath, immunosuppression. Question pneumonia. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Given differences in positioning and technique, there has been no significant interval change. There is engorgement of the central pulmonary vasculature with indistinctness of the vessels peripherally, not significantly changed from prior. There is no new confluent consolidation or pleural effusion. Cardiac silhouette is enlarged but stable compared to prior. IMPRESSION: No significant interval change since prior. " 1854876b-d8df19b0-f88d8dcb-3daf5163-8e56a64e.jpg,test/p10/p10765644/s52978610/1854876b-d8df19b0-f88d8dcb-3daf5163-8e56a64e.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Shortness of breath. Question congestive heart failure. COMPARISON: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: There is again a dual-lead pacemaker/ICD device with leads terminating in the right atrium and ventricle. The heart is again moderately enlarged. There is perhaps minimal similar upper zone redistribution of pulmonary vessels without frank pulmonary edema. Noting that the left hemidiaphragm is obscured by a pacer device, the area is not well evaluated, making it difficult to exclude a pleural effusion in particular. There is no evidence for pleural effusion on the right. IMPRESSION: Similar cardiomegaly. No evidence of acute cardiopulmonary disease. " 7a474e51-fcd2afe7-a5adfdce-b07ff918-0522b0e3.jpg,test/p13/p13639861/s59541913/7a474e51-fcd2afe7-a5adfdce-b07ff918-0522b0e3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with pleuritic chest pain // assess for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " e620cb1e-d0a83273-4ebc4857-d2f5caac-f78032db.jpg,test/p10/p10972354/s52232340/e620cb1e-d0a83273-4ebc4857-d2f5caac-f78032db.jpg,test," FINAL REPORT HISTORY: Productive cough with crackles. FINDINGS: In comparison with study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Again, there is bilateral apical pleural scarring with scattered calcified granulomata. However, no evidence of acute pneumonia or vascular congestion. " 000baf86-9442bf40-3d66e3b3-ff306683-c31b2fb6.jpg,test/p19/p19017438/s52450792/000baf86-9442bf40-3d66e3b3-ff306683-c31b2fb6.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable, as are the hilar contours. A subtle 1.8-cm sclerotic focus projecting over the anterior right fifth rib is stable since the prior study and dating back to ___, thus likely benign. Mild degenerative changes are seen along the spine. There is relative lucency projecting over the inferior right scapular spine which may be artifactual, correlate with history of malignancy. If clinical concern at this location, suggest dedicated imaging of the area. IMPRESSION: No acute cardiopulmonary process. Relative lucency projecting over the inferior right scapular spine which may be artifactual, correlate with history of malignancy. If clinical concern at this location, suggest dedicated imaging of the area. The above findings regarding the right scapula were discussed with ___ ___ on ___ at 2 p.m. via telephone. " f3c03466-64638244-0ef852c1-02fae107-b53ab4f8.jpg,test/p10/p10387377/s55473561/f3c03466-64638244-0ef852c1-02fae107-b53ab4f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p mitraclip. Assess ETT. // assess ETT assess ETT IMPRESSION: In comparison with the study of ___, there is now a in endotracheal tube in place with the tip at the upper clavicular level, approximately 6 cm above the carina. My true clip is in place. No evidence of pneumothorax or pneumomediastinum. " 8b79269e-b02f4dc3-0b7aff4b-0c4ab8ac-8a8e2a80.jpg,test/p12/p12032671/s52092418/8b79269e-b02f4dc3-0b7aff4b-0c4ab8ac-8a8e2a80.jpg,test," FINAL REPORT INDICATION: ___M with hypoxia and cp // pna? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Right chest wall port is new since prior. Catheter tip at the RA/SVC junction. The lungs are clear without consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " b950b118-45e1c900-3eea8010-8d29382b-b8204537.jpg,test/p14/p14178898/s57101983/b950b118-45e1c900-3eea8010-8d29382b-b8204537.jpg,test," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient, evaluate effusions. FINDINGS: PA and lateral chest films were obtained with patient in upright position. Comparison is made with the next preceding portable single view chest examination of ___. Patient is not examined in upright position using PA and lateral projections. Moderate enlargement of heart silhouette in comparison with the preoperative chest examination of ___. In addition to the previously existing bypass surgery, the patient has now received an aortic valve prosthesis (metallic components identified suggest porcine valve) located in appropriate position. On the lateral view prostheses replaces the previously identified star shaped heavy aortic valve calcifications. Present cardiac enlargement is likely the result of some postoperative pericardial effusion. The distance between surgical graft clips and outer cardiac contour has increased. On the frontal view, mild blunting of the lateral pleural sinuses is seen. On the right side, some fluid enters also the minor fissure. These findings are rather small and on the lateral view only mild blunting of the posterior pleural sinuses is noted. Linear density in the left lung base in retrocardiac position suggests presence of a left lower lobe posterior atelectasis. It was not present on the preoperative examination. There is no evidence of pneumothorax in the apical area and the pulmonary vasculature demonstrates no evidence of increased congestion at this time. The next preceding portable chest examination of ___ identified basal densities most likely represented pleural effusions that were partially layering in the posterior pleural compartments. IMPRESSION: Porcine aortic valve prosthesis is in place, postoperative enlargement of cardiac contours with no evidence of pulmonary vascular congestion. Bilateral small pleural effusions and partial atelectasis in left lower lobe posterior segment. No pneumothorax. Followup examination in a month or two is recommended to document resolution of these postoperative changes. " f7d9ba23-2f5d88b6-c711b093-3e2461df-c3bd5083.jpg,test/p14/p14995589/s52849078/f7d9ba23-2f5d88b6-c711b093-3e2461df-c3bd5083.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Shortness of breath. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is borderline in size. The cardiac, mediastinal and hilar contours are probably unchanged within the limitations of the technique. Mild perihilar congestion is suspected and appears new. In addition, there are small bilateral pleural effusions with opacities at the lung bases probably attributable to associated atelectasis. Fissures are thickened. IMPRESSION: Findings suggesting mild vascular congestion. Small bilateral pleural effusions with suspected atelectasis. " 9bcdbb2e-0f16df61-58855c79-15032a5e-25691ffe.jpg,test/p17/p17981662/s52983871/9bcdbb2e-0f16df61-58855c79-15032a5e-25691ffe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with AMS s/p I+D // rule out infection TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ and CT of the thoracic spine from ___ IMPRESSION: The patient is after the surgical procedure, most likely related to the thoracic spine, based on the previous imaging. Heart size and mediastinum are stable. Linear scarring in the right mid lung is stable. The pacemaker wires are unchanged in appearance. No pleural effusion or pneumothorax appreciated " 2857df8f-2a9b5d43-381368cd-038e4cb8-b2224954.jpg,test/p13/p13689440/s56614395/2857df8f-2a9b5d43-381368cd-038e4cb8-b2224954.jpg,test," FINAL REPORT INDICATION: ___-year-old male with recent placement of central line. COMPARISON: Radiograph obtained same day ___ approximately 2.5 hr previously. FINDINGS: When compared to prior radiograph obtained 2.5 hr previously, there is been little interval change in the appearance of bilateral lungs. Cardiomediastinal and hilar contours remain stable. There is been interval placement of a right internal jugular central line its tip which appears to project over the right atrium. There is no pneumothorax. No large pleural effusion is seen. IMPRESSION: Interval placement of right internal jugular central line its tip which projects over the right atrium. For placement in the distal SVC, this should be withdrawn 4cm. No pneumothorax. " 2b5e1dd7-0d9a46fb-55c06781-67ddd973-aa2b0d0f.jpg,test/p19/p19461413/s55159682/2b5e1dd7-0d9a46fb-55c06781-67ddd973-aa2b0d0f.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with elevated white blood cell count and weakness. Evaluate for pneumonia TECHNIQUE: Chest AP and lateral COMPARISON: None. FINDINGS: Extremely low lung volumes. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Bibasilar atelectasis. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes without definite acute cardiopulmonary process. " 529cacb4-d904e5aa-e554f0fb-2f50c579-dd3a6b39.jpg,test/p11/p11583280/s56187071/529cacb4-d904e5aa-e554f0fb-2f50c579-dd3a6b39.jpg,test," FINAL REPORT INDICATION: ___-year-old woman status post motor vehicle collision, evaluate for fracture or pneumothorax. COMPARISON: ___, plain radiograph. PA AND LATERAL CHEST RADIOGRAPH: Visualized heart and mediastnum appear unremarkable. Both lungs are clear with no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No displace rib fractures are identified; however, if there is continued concern for rib fracture, then a dedicated rib series can be obtained. " b27e184a-1716d931-d69e6ca6-d3d0a413-a03517ce.jpg,test/p12/p12392213/s55535428/b27e184a-1716d931-d69e6ca6-d3d0a413-a03517ce.jpg,test," FINAL REPORT AP CHEST, 12:59 P.M. ON ___ HISTORY: ___-year-old man with metastatic lung carcinoma, admitted for pain. Question acute aspiration of emesis. New hypoxia. IMPRESSION: AP chest compared to ___: There is a new large right pleural effusion which has probably developed chronically since there is no contralateral mediastinal shift. This abnormality is accompanied by greater atelectasis in the right upper lobe where a large mass was seen previously, and obscures the contours of the heart, right hilus and mediastinum. At the base of the left lung is a large region of new infiltration consisting of tiny and small lung nodules, irregular small opacities as well as a generalized increase in background density of the lung. This may well be acute aspiration pneumonia. Heart is not enlarged. Dr. ___ ___ I discussed the findings by telephone 3:40 p.m., two minutes after findings were recognized. " a64b81c7-8b33a061-6bd45d58-6035532c-617020e3.jpg,test/p17/p17078867/s50283903/a64b81c7-8b33a061-6bd45d58-6035532c-617020e3.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with fever and upper back pain // infection TECHNIQUE: Chest AP and lateral COMPARISON: None. FINDINGS: Assessment is slightly limited due to patient rotation. Mild enlargement of the heart is present. Mediastinal and hilar contours are unremarkable. Small left pleural effusion is noted with associated left basilar opacity likely reflecting compressive atelectasis. No pneumothorax or right-sided pleural effusion is present. Degenerative changes are seen in the imaged thoracic spine. Deformity of the right third rib likely reflects an old healed fracture. IMPRESSION: Small left pleural effusion with associated left basilar opacity likely reflecting atelectasis, although infection is difficult to exclude. " f6326ee1-1dbe643b-51ee0217-09107399-ee90b833.jpg,test/p12/p12104123/s54604532/f6326ee1-1dbe643b-51ee0217-09107399-ee90b833.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cellulitis with new hypoxia. Evaluate for pulmonary edema. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes have improved. The cardiac silhouette is still mildly enlarged. The mediastinal hilar contours are normal. Subsegmental atelectasis persists at both lung bases. Blunting of the left costophrenic angle is likely suggestive of a small left pleural effusion. There is no pneumothorax. No new focal consolidation is noted. There is no frank pulmonary edema. IMPRESSION: Extensive bibasilar subsegmental atelectasis and small left pleural effusion are nonspecific findings. Although attributable to pancreatitis, clinical consideration should be given to acute and/or subacute pulmonary embolism. NOTIFICATION: Dr. ___ reported the findings to Dr ___ by telephone on ___ at 9:04 AM, 15 minutes after discovery of the findings. " 4a0f7fa6-a5919f11-b489223b-2569d5f7-8a6a306d.jpg,test/p16/p16247826/s58023908/4a0f7fa6-a5919f11-b489223b-2569d5f7-8a6a306d.jpg,test," FINAL REPORT INDICATION: Left MCA stroke, aspiration pneumonia, question widened mediastinum on chest x-ray. Evaluate for pneumonia or widened mediastinum. COMPARISON: Chest radiographs on ___ at 9:26 a.m. FINDINGS: PA and lateral views of the chest. Compared to most recent study, the bibasilar atelectasis has decreased. Pulmonary edema has decreased. Mitral valve annular calcifications are seen. No consolidation, pleural effusion or pneumothorax. NG tube is seen ending in the stomach with its last side port adjacent to but below the GE junction. IMPRESSION: 1. Decreased bibasilar atelectasis. 2. Decreased pulmonary edema. 3. Mitral valve annular calcifications. " 59d2c0cf-6f7bdaf8-eef77ee4-3b8246da-a10fe551.jpg,test/p17/p17509107/s55188615/59d2c0cf-6f7bdaf8-eef77ee4-3b8246da-a10fe551.jpg,test," WET READ: ___ ___ ___ 8:20 PM Dobhoff looped in esophagus, out of view in region of pharynx. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Liver injury of unknown etiology, Dobbhoff placement. COMPARISON: ___, 6:15 p.m. FINDINGS: As compared to the previous radiograph, the patient has received a Dobbhoff catheter. The catheter is coiled in the upper third of the esophagus and largely repositioned. At the time of the initial observation the referring patient nurse was notified. No evidence of complications, all other monitoring and support devices are in unchanged position. " e457bcac-37502f08-8c017702-688b112e-1c6ee1ff.jpg,test/p17/p17538292/s59390855/e457bcac-37502f08-8c017702-688b112e-1c6ee1ff.jpg,test," FINAL REPORT INDICATION: ___F with CP, SOB // r/o acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no effusion, consolidation, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 16a80941-1e9c6b93-de358a62-fe49d494-10c17ef7.jpg,test/p14/p14117743/s53723148/16a80941-1e9c6b93-de358a62-fe49d494-10c17ef7.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p TVR/PFO closure, evaluate pleural effusion.. COMPARISON: Comparison is made to multiple chest radiographs dating back to ___. TECHNIQUE Frontal and lateral views of the chest. FINDINGS: A right subclavian central venous catheter ends in the right atrium. A left PICC projects over the low SVC. There are moderate to large bilateral pleural effusions with associated atelectasis. There is mild pulmonary vascular congestion. The cardiomediastinal silhouette is stably enlarged. There is no pneumothorax. IMPRESSION: Moderate to large bilateral pleural effusions with compressive atelectasis. Mild pulmonary vascular congestion. " 162d5fa4-b997ff75-d823edd9-3506d9be-d1f36bde.jpg,test/p11/p11431685/s59416435/162d5fa4-b997ff75-d823edd9-3506d9be-d1f36bde.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and weakness. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear unchanged. A number of calcifications in the central mediastinum suggest a calcified lymphadenopathy which can be seen with prior granulomatous exposure. There is a patchy right infrahilar opacity most suggestive of atelectasis, present before although similar to perhaps slightly increased. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. Small to moderate degenerative changes are noted along the mid to lower thoracic spine. Surgical clips project along the base of the neck. IMPRESSION: Patchy right infrahilar opacity suggestive of atelectasis without definite evidence for pneumonia, although follow-up radiographs could be considered if clinically appropriate. " 4ceb8c45-a51f9b14-f6063ef6-de98a574-629e34a8.jpg,test/p17/p17204536/s55850126/4ceb8c45-a51f9b14-f6063ef6-de98a574-629e34a8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M h/o recurrent epigastric abd pain p/w 12 hrs severe abd pain a/w n/v, choledocolithiasis // eval for intrathoracic process, effusions eval for intrathoracic process, effusions COMPARISON: Prior chest radiographs only ___. IMPRESSION: Patient has had intervening upper abdominal surgery, denoted by skin ___. Borderline cardiomegaly and mild moderate bibasilar atelectasis persist. There is no edema or pulmonary consolidation, no appreciable pleural effusion or evidence of pneumothorax. Right PIC line ends close to the superior cavoatrial junction and esophageal drainage tube ends in the upper portion of a nondistended stomach. " 347f7f3e-fa1536ab-801a65c3-565a74ca-312802ed.jpg,test/p18/p18232511/s52706957/347f7f3e-fa1536ab-801a65c3-565a74ca-312802ed.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Septic shock and pulmonary edema. REFERENCE EXAM: ___. FINDINGS: There has been some interval expansion and improved aeration in the right lower lobe with continued volume loss in this region. Left lung volume loss is similar compared to the prior study. There continues to be moderate cardiomegaly. The pulmonary vascular re-distribution is slightly improved. The ET tube, NG tube, and right-sided PICC line are unchanged. " 2e58022f-55f73351-1409ca09-1a2eaff5-94f68aa3.jpg,test/p14/p14779783/s52650452/2e58022f-55f73351-1409ca09-1a2eaff5-94f68aa3.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with chest pain // chest pain protocol TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 6f9f39b1-8995904e-4d073f29-fe6e534a-bb54bbde.jpg,test/p12/p12594793/s50202728/6f9f39b1-8995904e-4d073f29-fe6e534a-bb54bbde.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p CABG // eval for effusion eval for effusion COMPARISON: Comparison to ___ at 11:08 FINDINGS: Portable semi-erect chest radiograph ___ 08:56 is submitted. IMPRESSION: Interval removal of the right internal jugular central line, chest tube, mediastinal drains, nasogastric tube, and endotracheal tube. Status post median sternotomy for CABG with stable postoperative appearance to the cardiac and mediastinal contours. Lung volumes are low with patchy bibasilar opacities likely reflecting compressive atelectasis. Probable small layering effusions, left greater than right. Crowding of the pulmonary vasculature with resolving mild interstitial edema. No obvious pneumothorax. " 4c73fd6e-6ca075c9-fdb07442-4b400ee6-ac5019e3.jpg,test/p14/p14792353/s57942754/4c73fd6e-6ca075c9-fdb07442-4b400ee6-ac5019e3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with h/o CAD, here w/ chest pain this morning, now resolved COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Volume loss is again noted within the right lung with chronic scarring which appears partially calcified. Right apical opacities also unchanged. Overall pattern of lung opacities unchanged. No new consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures appear intact. IMPRESSION: No acute findings. Chronic volume loss and scarring in the right lung. " 32d9e896-991a1892-6d331697-2f3b0b55-4c42bbd5.jpg,test/p19/p19643415/s57465550/32d9e896-991a1892-6d331697-2f3b0b55-4c42bbd5.jpg,test," WET READ: ___ ___ ___ 10:54 AM No definite focal consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (AP portable) INDICATION: ___-year-old man presenting with shortness of breath, cough, and fever; evaluate for pneumonia. TECHNIQUE: Portable AP radiograph view of the chest. COMPARISON: Chest radiograph dated ___. CT chest dated ___. FINDINGS: No change in the overall position of the left chest a port with its tip terminating in the region of the cavoatrial junction. Lower lung volumes are again demonstrated and overall unchanged. Slight increased opacification in the lower lung bases appear overall similar to the prior exam and suggest chronic atelectasis associated with prominent epicardial fat pad, better seen on CT. No definite focal consolidation to suggest pneumonia. No pneumothorax, pleural effusion, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Multiple known bilateral pulmonary nodules are better seen on prior CT. Stable bilateral rib deformities and associated pleural thickening. IMPRESSION: No acute intrathoracic process. " 6ce46a77-4b24a34b-17aace8e-b91d1a0d-68726f72.jpg,test/p16/p16529096/s52467289/6ce46a77-4b24a34b-17aace8e-b91d1a0d-68726f72.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fevers. // r/o pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Normal lung volumes. No pneumonia, no pulmonary edema. No pleural effusions. Normal size of the cardiac silhouette. Unchanged minimal atelectasis at the right lung bases. " 7d1acbc5-40789ade-c090e25b-1e5da14f-0f67845d.jpg,test/p17/p17177703/s54968893/7d1acbc5-40789ade-c090e25b-1e5da14f-0f67845d.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac silhouette size is mildly enlarged. The patient appears to be status post right lower lobectomy with multiple chain sutures and clips noted in the right hilum. Rightward mediastinal shift is compatible with volume loss in the right lung. Linear opacities within the right mid lung field likely reflects scarring. No focal consolidation, pleural effusion or pneumothorax is identified. Lungs are hyperinflated with flattened diaphragms. There is no pulmonary vascular congestion. Diffuse demineralization of the osseous structures is present. IMPRESSION: Postsurgical changes in the right lung without evidence of acute cardiopulmonary abnormality. Probable COPD. " 1438b16c-3ef2849e-3e1e8c88-4df02d60-45affa80.jpg,test/p17/p17701700/s56716543/1438b16c-3ef2849e-3e1e8c88-4df02d60-45affa80.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Small cell lung cancer, just finished chest radiation with low-grade fever. Comparison is made with prior studies including chest x-ray ___ and CT ___. Cardiomediastinal contours are normal. There is marked decrease in size in right upper lobe lung mass. There are no new lung abnormalities. The patient has known emphysema. Biapical pleuroparenchymal scarring, larger in the right, is again noted. There is no pneumothorax or pleural effusion. A wedge-shaped deformity in a mid thoracic vertebral body is unchanged. " 50771065-97802e9b-5203f926-97759d3b-bbe1ab21.jpg,test/p10/p10760672/s52974882/50771065-97802e9b-5203f926-97759d3b-bbe1ab21.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH // ? fluid status, PNA ? fluid status, PNA IMPRESSION: In comparison with the study of ___, there has been apparent clearing of mucous plug with improved aeration of the left lower lobe.Some residual areas of opacification at the bases probably reflect atelectatic changes. However, in the appropriate clinical setting, a superimposed pneumonia would have to be considered. Monitoring and support devices are unchanged. : " 6a00ba4f-6c74e4cf-5dc256b4-19740ab4-0bc510d6.jpg,test/p17/p17947312/s57621555/6a00ba4f-6c74e4cf-5dc256b4-19740ab4-0bc510d6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with significant cardiac history including CHF, with new weakness, dyspnea on exertion TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is moderately enlarged. The aorta is tortuous and demonstrates atherosclerotic calcifications at the aortic knob. Upper zone vascular redistribution with mild pulmonary vascular engorgement is demonstrated along with small bilateral pleural effusions, right greater than left. Patchy ill-defined opacities in both lung bases could reflect compressive atelectasis but infection cannot be excluded. No pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Mild pulmonary vascular congestion with small bilateral pleural effusions, right greater than left. Patchy bibasilar airspace opacities may reflect compressive atelectasis but infection is not excluded. " a33a7517-6e13cf21-0e93546e-c0aece17-6ff68c6d.jpg,test/p14/p14670441/s59918877/a33a7517-6e13cf21-0e93546e-c0aece17-6ff68c6d.jpg,test," FINAL REPORT INDICATION: Newly placed central line, here to evaluate for position of line. COMPARISON: Chest radiographs performed earlier the same day at 13:28 p.m. and 11:53 and 11:17 a.m. TECHNIQUE: Portable supine frontal radiograph of the chest. FINDINGS: An endotracheal tube is unchanged in position with the tip terminating 4.5 cm above the carina. There has been interval placement of a right internal jugular central venous catheter with the tip terminating in the mid SVC. The appearance of the chest is otherwise unchanged with low lung volumes and opacification at the left lung base greater than the right which may represent underlying atelectasis or consolidation in the appropriate clinical context. No large pleural effusion or pneumothorax is detected. Prominent changes in the left lung apex are stable. Calcification at the aortic knob and tortuosity of the thoracic aorta is stable. The cardiac silhouette is incompletely evaluated. IMPRESSION: 1. Right IJ central line with tip in mid SVC. 2. Otherwise, unchanged appearance of the chest. " 0931349f-ec8c4a2c-2c6b7dbc-0890fdda-2655a88a.jpg,test/p14/p14642114/s51554394/0931349f-ec8c4a2c-2c6b7dbc-0890fdda-2655a88a.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough. Evaluate for pneumonia. COMPARISON: Portable chest radiograph from ___ and PA and lateral chest radiograph from ___. TECHNIQUE: AP and lateral chest radiograph. FINDINGS: The lungs are poorly expanded accounting for vascular crowding. There is increased interstitial thickening bilateral, with upper vascular redistribution but no focal opacities. Moderate-to-severe cardiomegaly is not significantly changed compared with prior exam. There is no evidence of pleural effusion or pneumothorax. Multiple thoracic surgical clips are noted. Sternotomy wires are intact. Leads from a pacemaker in the right hemithorax end in the right atrium and right ventricle in unchanged position compared with prior exam. IMPRESSION: Interstitial pulmonary edema. " 85b9cda6-e94337ed-d30f6011-019621bf-8c1e3eb4.jpg,test/p10/p10207476/s55568332/85b9cda6-e94337ed-d30f6011-019621bf-8c1e3eb4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with tachycardia. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Streaky bibasilar opacities are in keeping with atelectasis. Heart size is top normal but stable. Mediastinal surgical clips are unchanged in location. Irregular contour of the aortic knob is likely secondary to the previously imaged aortic arch aneurysm. No pleural effusion or pneumothorax. IMPRESSION: 1. Mild bibasilar atelectasis. 2. Irregular appearance of the aortic knob in keeping with known saccular aortic arch aneurysm. 3. Otherwise no acute cardiopulmonary process. " d74d717d-56f93a25-256cabd2-c83a0d81-93383ba6.jpg,test/p14/p14653207/s58744390/d74d717d-56f93a25-256cabd2-c83a0d81-93383ba6.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. Comparison is made with a prior study from ___. CLINICAL HISTORY: Syncope with concern for widened mediastinum or rib fractures. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear and well expanded. No focal consolidation, effusion, or pneumothorax is seen. The heart and mediastinal contours appear normal. Tracheobronchial tree calcification is again noted. No bony abnormality is seen. IMPRESSION: No acute traumatic injuries. " be2d5e37-8d7543f3-c64ccf24-c325e4a6-1d0edbef.jpg,test/p16/p16072940/s55611793/be2d5e37-8d7543f3-c64ccf24-c325e4a6-1d0edbef.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Asthma exacerbation. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Aorta is tortuous. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. Focal thickening of the pleura is noted in the left apex. Followup of the patient in three months for documentation of stability of this finding is recommended. " af7f9a97-441fa000-4f8b336a-1909862a-2a1be219.jpg,test/p12/p12538793/s50589359/af7f9a97-441fa000-4f8b336a-1909862a-2a1be219.jpg,test," FINAL REPORT HISTORY: PICC placement. COMPARISON: ___. FINDINGS: There is been interval replacement of a left PICC with the tip projecting over the mid SVC. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Left PICC placement with tip projecting over the mid SVC. " c39693c8-1b37cc4e-bb7b729d-3d5e293d-19572291.jpg,test/p11/p11617224/s56693872/c39693c8-1b37cc4e-bb7b729d-3d5e293d-19572291.jpg,test," FINAL REPORT HISTORY: Lupus on methotrexate and prednisone with cough. TECHNIQUE: AP and lateral chest radiograph, 2 views. COMPARISON: ___. FINDINGS: Cardiomediastinal silhouette and hilar contours are normal without evidence of pericardial effusion. Postsurgical material is unchanged in the right midlung. Lungs are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia. " bf824d9b-58dc5387-0495e596-852aec12-a8ddebd6.jpg,test/p19/p19398915/s57505072/bf824d9b-58dc5387-0495e596-852aec12-a8ddebd6.jpg,test," WET READ: ___ ___ ___ 3:17 AM Tiny right apical pneumothorax, if present, is too small to be seen. Since the ___ study, there has been a significant increase in left lung opacities most consistent with pulmonary edema. Underlying pneumonia in the proper clinical setting cannot be excluded. Findings communicated to Dr. ___ by Dr. ___ ___ telephone on ___ at 03:15, ___ min after discovery. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Moderate to large right pleural effusion appears similar to the recent radiograph with adjacent atelectasis and/or consolidation in the mid and lower lungs. There is no definite pneumothorax. Widespread airspace opacities throughout the left lung have worsened and may reflect a combination of asymmetrical edema and pulmonary infection. " 44afb128-1ccd867f-e0074add-3911c9b7-7178dbde.jpg,test/p14/p14741471/s50618234/44afb128-1ccd867f-e0074add-3911c9b7-7178dbde.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Lung volumes remain low. Cardiomediastinal contours are within normal limits. Persistent linear bibasilar atelectasis. Slightly more confluent opacity projects posteriorly over the spine on the lateral view, obscuring the posterior hemidiaphragms bilaterally, likely corresponding to patchy areas of increased opacity in the retrocardiac area on the frontal view. There are no pleural effusions. Rounded opacity in the right upper quadrant of the abdomen corresponds to post-TACE changes. IMPRESSION: Bibasilar opacities, most likely due to atelectasis, but coexisting aspiration or pneumonia cannot be excluded in the dependent portions of both lower lobes. " de0262b8-33151b0f-94ff3cee-f9e6c297-c8b709d6.jpg,test/p15/p15345462/s56280343/de0262b8-33151b0f-94ff3cee-f9e6c297-c8b709d6.jpg,test," FINAL REPORT HISTORY: Intermittent chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 2ffa4eba-714bc35b-2b5e0aaf-968eb1ed-8551fd81.jpg,test/p19/p19444592/s51888592/2ffa4eba-714bc35b-2b5e0aaf-968eb1ed-8551fd81.jpg,test," FINAL REPORT INDICATION: History: ___F with dyspnea s/p surgery 2 days ago // ? acute process IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. There is a trace amount of free air underneath the right hemidiaphragm consistent with the patient's recent gallbladder surgery. " dbc93b98-f00c759a-8b0dfd82-2f31f772-f4640236.jpg,test/p17/p17574863/s56818945/dbc93b98-f00c759a-8b0dfd82-2f31f772-f4640236.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Left shoulder pain and fever. COMPARISONS: ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. Slight residual left lower lung opacity remains but improved since the prior examination from ___, with no definite new focal opacity. An exostosis along the course of the superior right second rib appears unchanged. IMPRESSION: Substantial improvement in left lower lung opacity. " 8ac47784-ad1df695-485bbb91-56c36b40-c23bdcf2.jpg,test/p10/p10978131/s50529892/8ac47784-ad1df695-485bbb91-56c36b40-c23bdcf2.jpg,test," WET READ: ___ ___ ___ 2:37 PM Multi focal regions of consolidation particularly at the right mid lung medially. Findings could represent multi focal pneumonia with possible bilateral aspiration. With history of fall, contusion would be possible. Followup will be necessary. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with hypoxia, fall // eval for PTX TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: There is dense consolidation in the right mid lung medially. Hazy bibasilar opacities are also noted. Based on this portable film there is no evidence of large effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No displaced fractures. IMPRESSION: Multi focal regions of consolidation particularly at the right mid lung medially. Findings could represent multi focal pneumonia with possible bilateral aspiration. With history of fall, contusion would be possible. Followup will be necessary. " a283e3f2-abc155f9-7a520ab2-3df28d95-b397a434.jpg,test/p11/p11658411/s50537834/a283e3f2-abc155f9-7a520ab2-3df28d95-b397a434.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with left frontal hemorrhagic stroke in ___ s/p evacuation with residual non-fluent aphasia, Seizures disorder, HTN, HLD, Hypothyroidism, CAD, AAA s/p repair, CKD, TAH COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is mild atelectasis in the lower lungs. No convincing evidence for pneumonia or edema. No large effusion or pneumothorax. Cardiomegaly is mild. The hila appear stable and overall contour. Bony structures are intact. No free air below the right hemidiaphragm peer IMPRESSION: Stable mild cardiomegaly. Mild bibasilar atelectasis. " bfb37031-d301ed4f-e248cda1-6663f85e-6599419e.jpg,test/p18/p18056761/s56165567/bfb37031-d301ed4f-e248cda1-6663f85e-6599419e.jpg,test," FINAL REPORT INDICATION: Patient with history of asthma and shortness of breath. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest are provided. Again noted are prominent interstitial markings in the lung bases. There is no focal consolidation, pleural effusions or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. Partially imaged upper abdomen is unremarkable. IMPRESSION: Persistent prominent interstitial markings, which may reflect patient's known history of underlying asthma. No focal consolidation. " bbdc6b34-da4dc707-7ea02592-b9c22da6-8bdae76e.jpg,test/p14/p14464902/s56780215/bbdc6b34-da4dc707-7ea02592-b9c22da6-8bdae76e.jpg,test," FINAL REPORT INDICATION: Hip fracture and hypoxia, assess for intrathoracic process. TECHNIQUE: Portable supine radiograph of the chest. COMPARISONS: Reference chest image from one day prior from ___ ___. FINDINGS: The lungs are low in volume with congested pulmonary vasculature and thickened septal lines which reflect mild pulmonary edema. The heart is mildly enlarged with normal cardiomediastinal silhouette. There is no pleural effusion or pneumothorax. IMPRESSION: Mild pulmonary edema. Findings were discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. " 08eaa49e-1039d889-3f2e7330-fee21499-d885cffd.jpg,test/p17/p17648652/s57696227/08eaa49e-1039d889-3f2e7330-fee21499-d885cffd.jpg,test," FINAL REPORT INDICATION: ___-year-old female with persistent productive cough. Question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: No acute cardiopulmonary process such as pneumonia. " 52198662-e0f2ce2d-bebc9db6-001fb156-7244cbb0.jpg,test/p15/p15914421/s50627373/52198662-e0f2ce2d-bebc9db6-001fb156-7244cbb0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o F with a h/o breast cancer complicated by chemo-induced cardiomyopathy with EF ___%, PE on home therapeutic lovenox, RA, who presented with left sided abdominal pain, found to have a splenic infarct. // assess port placement assess port placement IMPRESSION: In comparison with the study of ___, there again is substantial enlargement of the cardiac silhouette, though without evidence of pulmonary vascular congestion. This discordance raises the possibility of cardiomyopathy. No evidence of acute focal pneumonia or pleural effusion. The Port-A-Cath again extends well into the right atrium. " dc55e9ff-79a2a892-80b633da-627653bb-67b812ff.jpg,test/p19/p19296519/s57037310/dc55e9ff-79a2a892-80b633da-627653bb-67b812ff.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___ No prior studies for comparison. FINDINGS: Cardiac silhouette is mildly enlarged and accompanied by upper zone vascular re-distribution, minimal peribronchial cuffing and slight perihilar haze. Thickening of the fissures is also demonstrated on the lateral view as well as small dependent pleural effusions. No acute skeletal findings. IMPRESSION: Cardiomegaly and mild congestive heart failure. " 0eb05a83-64a0ff20-5ea0cfb1-fc08483f-c34491c9.jpg,test/p10/p10128191/s56054806/0eb05a83-64a0ff20-5ea0cfb1-fc08483f-c34491c9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pulmonary nodule // Pathology? COMPARISON: No comparison IMPRESSION: Moderate overinflation. Borderline size of the cardiac silhouette, elongation of the descending aorta. On the current image, no lung nodules or masses are visible. Comparison with potentially available CT or prior chest x-rays would be helpful. No pneumonia, no pulmonary edema. No pleural effusions. " c270a3bd-febaa199-871c4645-1099dea1-c8a4df9f.jpg,test/p19/p19127072/s58914797/c270a3bd-febaa199-871c4645-1099dea1-c8a4df9f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after MVA and small subarachnoid hemorrhage. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 4.5 cm above the carina. The NG tube tip is in the stomach. Heart size is normal. A left lower lobe consolidation and multiple focal opacities are re-demonstrated. There is also evidence of endobronchial secretions. Those findings should be closely followed on the subsequent studies for documentation of complete resolution in particular of left lower lobe consolidation. Given its absence on the CT torso from ___, chest radiograph from ___ and appearance on ___, it is concerning for pneumonia. Aspiration would be another possibility. " 428ec06b-d3a49b9a-da4df589-e39ea80f-f5bdd08a.jpg,test/p11/p11790339/s56446825/428ec06b-d3a49b9a-da4df589-e39ea80f-f5bdd08a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever 102.5, intubated, ? VAP // ___ year old woman with fever 102.5, intubated, ? VAP COMPARISON: ___ through ___ 15:23. IMPRESSION: ET tube in standard placement. Left PIC line ends at the origin of the SVC. Small left pleural effusion decreased, moderate right pleural decreased slightly since ___. Mild cardiomegaly improved. Upper lungs clear. Lung base is partially obscured by effusion, improving atelectasis on the left. No pneumothorax. " 89d1c9df-d1456b1f-26886a31-35b8a0da-deaea817.jpg,test/p12/p12093780/s56465472/89d1c9df-d1456b1f-26886a31-35b8a0da-deaea817.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation of pleural effusions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is evidence of a newly appeared mild-to-moderate left pleural effusion. On the right, the effusion is small and only appreciated on the lateral radiograph. Unchanged is the appearance of the large hiatal hernia and of the cardiac silhouette. As a consequence of the left effusion, retrocardiac atelectasis is seen. The transparency of the lung parenchyma is otherwise normal. No evidence of pulmonary edema or pleural effusions. No pneumothorax. Unchanged hilar structures. " d715863b-07812cae-19060660-8eaff22c-230a0aff.jpg,test/p19/p19043787/s54339793/d715863b-07812cae-19060660-8eaff22c-230a0aff.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Low-grade fever and cough, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 1a488573-29a97ad7-de89e298-ac64e8a9-ba59b61f.jpg,test/p16/p16352630/s50041059/1a488573-29a97ad7-de89e298-ac64e8a9-ba59b61f.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough, dyspnea. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs. There is an opacity in the left lung base. There is no pleural effusion or pneumothorax. Single lead pacer tip is in the right ventricle. There is no pneumothorax. The cardiomediastinal silhouette is stable. IMPRESSION: New left basilar opacity compatible with pneumonia. NOTIFICATION: Findings were relayed by Dr. ___ to Dr. ___ (covering for Dr. ___) by phone at 13:37 on ___ (10 minutes after discovery). " 3a6a9304-1b8f61ca-f3878995-764c166e-6168a1a4.jpg,test/p15/p15746243/s50544841/3a6a9304-1b8f61ca-f3878995-764c166e-6168a1a4.jpg,test," FINAL REPORT HISTORY: ___-year-old male with metastatic pancreatic cancer, presenting with fever, elevated LFTs, and cough for two to three days. Evaluation for pneumonia. COMPARISON: Chest radiograph from ___ and chest CT from ___. PA AND LATERAL CHEST RADIOGRAPHS: There is no vascular congestion or pleural effusions. Previously identified bilateral atelectasis has improved although there is patchy right infrahilar and left basilar opacities suggestive of minor atelectasis. Bilateral central pulmonary arterial enlargement is unchanged. Mild cardiomegaly is unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. No definite evidence of pneumonia. " 3e71d8b5-a5d98144-ccbccd37-34059ee3-894ee1bb.jpg,test/p18/p18040220/s56437928/3e71d8b5-a5d98144-ccbccd37-34059ee3-894ee1bb.jpg,test," FINAL REPORT INDICATION: History dyspnea on exertion x 8 weeks, please evaluate for intrapulmonary process. COMPARISONS: Chest radiograph from ___ and CT C-spine from ___. TECHNIQUE: PA and lateral radiograph of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. Visualized osseous structures are unremarkable. IMPRESSION: No acute focal consolidations concerning for pneumonia identified. " ce8c6a81-89218ce7-3b66ac3a-9a7f0fe6-2717ae72.jpg,test/p19/p19858494/s56208302/ce8c6a81-89218ce7-3b66ac3a-9a7f0fe6-2717ae72.jpg,test," FINAL REPORT INDICATION: ___-year-old male with postoperative fever. COMPARISON: ___. PA AND LATERAL CHEST: There is a left PICC, which extends to the mid SVC. There is no pneumothorax. Lung volumes are low and there are bilateral pleural effusions, larger on the right, likely in conjunction with atelectasis accounting for basilar opacities. There is no new parenchymal opacity to suggest pneumonia and the upper lung zones remain well aerated. There is no pulmonary vascular congestion or edema. Cardiomediastinal contours are difficult to assess, though appear unchanged. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes, with bilateral pleural effusions and atelectasis. No convincing evidence of pneumonia. " f13d9218-f0bda543-8b01e557-0b53ac9b-d0180aa1.jpg,test/p13/p13377780/s58696680/f13d9218-f0bda543-8b01e557-0b53ac9b-d0180aa1.jpg,test," FINAL REPORT INDICATION: ___F with cough, congestion, syncope // acute cardiopulm disaese TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Mildly increased interstitial markings are again seen throughout the lungs. Linear left basilar opacity most suggestive of atelectasis. The cardiomediastinal silhouette is within normal limits. Chronic deformities of the right lateral ribs are again seen. No acute osseous abnormalities identified. IMPRESSION: Prominent interstitial markings may be due to mild interstitial edema, similar to prior. " bf254cec-ce328511-35f75f87-e012a6ae-f80b58b7.jpg,test/p18/p18009599/s50786647/bf254cec-ce328511-35f75f87-e012a6ae-f80b58b7.jpg,test," FINAL REPORT HISTORY: PICC placement. FINDINGS: The left subclavian PICC line crosses the midline and enters the right brachiocephalic vein. Mild atelectatic changes are seen at the bases. " cc256034-3412ed76-cf677562-77774439-001f2787.jpg,test/p17/p17297399/s53091196/cc256034-3412ed76-cf677562-77774439-001f2787.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p R foot reconstructive surgery with post op fever to 102 // fluid collection fluid collection IMPRESSION: No prior chest radiographs available for review. Aside from a band of subsegmental atelectasis, right lower lung, lungs are clear. Heart size normal. No pleural abnormality. " 5520fa23-23b93682-a4a3cd3e-31800a51-ed05c128.jpg,test/p14/p14013081/s57549209/5520fa23-23b93682-a4a3cd3e-31800a51-ed05c128.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with persistent cough // why PERSISTENT COUGH,HX NON TUBERCULOUS ___ INFECTION,TREATED W/TRIPLE RX RECENTLY R/O ABNORMALITY TECHNIQUE: PA and lateral views COMPARISON: Chest radiographs on ___ and Chest CT on ___ FINDINGS: Necrotizing bronchiectasis appears more extensive in the right upper lung overlying the first rib through the second anterior interspace. There is no pleural effusion. The cardiomediastinal silhouette is normal. Other lung findings on prior Chest CT scans have not been evident on conventional chest radiographs, and the lungs elsewhere still look relatively clear. IMPRESSION: Necrotizing bronchiectasis (read in conjunction with CT dated ___) appears more active. " 2cd257b8-7249cb4d-fde65fca-ac80af2b-645444b5.jpg,test/p14/p14312165/s58845572/2cd257b8-7249cb4d-fde65fca-ac80af2b-645444b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new dual chamber pacemaker // pneumothorax and lead placement. pneumothorax and lead placement. COMPARISON: Chest radiographs ___. IMPRESSION: New transvenous right atrial and right ventricular pacer leads follow their expected courses from the left pectoral generator. No pneumothorax, pleural effusion or mediastinal widening. Lungs are fully expanded and clear. Heart is normal size. The ascending thoracic aorta is tortuous or dilated. " bf6facd2-ca3ca506-d28f72d3-c3771037-32967249.jpg,test/p11/p11948145/s57060558/bf6facd2-ca3ca506-d28f72d3-c3771037-32967249.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Cardiomediastinal and hilar contours remain stable and within normal limits. There is no pleural effusion or pneumothorax. Osseous structures appear intact. Partially imaged cervical spine fusion hardware is noted. IMPRESSION: No acute intrathoracic abnormality. " 2054deed-664627ce-cbdd64f8-48236082-4a4682f2.jpg,test/p10/p10224816/s55367558/2054deed-664627ce-cbdd64f8-48236082-4a4682f2.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: Chest CT dated ___. CLINICAL HISTORY: Fever, assess for pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate left lung base opacity, which is mostly of a linear configuration which suggests atelectasis, though the possibility of an early pneumonia is impossible to exclude. Right mid lung plate-like atelectasis is also noted. No large effusion or pneumothorax. Cardiomediastinal silhouette appears stable and within normal limits. Bony structures are intact. IMPRESSION: Linear opacities in the lower lungs, left greater than right. " 73dfa695-24581d4f-0af1a0c8-b6b2c17c-fc7f9b72.jpg,test/p18/p18866430/s57990967/73dfa695-24581d4f-0af1a0c8-b6b2c17c-fc7f9b72.jpg,test," FINAL REPORT HISTORY: ___-year-old male with altered mental status. COMPARISON: Chest radiograph from ___ FRONTAL AND LATERAL CHEST RADIOGRAPH: Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Mediastinal and hilar contours are within normal limits. Moderate cardiomegaly is unchanged. IMPRESSION: No acute cardiopulmonary process " 4458e805-ddaceaa3-b63b2cf9-11658f83-409fda5d.jpg,test/p16/p16997660/s52763032/4458e805-ddaceaa3-b63b2cf9-11658f83-409fda5d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with weakness // PNA? COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Lungs appear hyperinflated. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 014bc808-ac3dabb6-41e74e62-3160ec6e-e02e0af3.jpg,test/p14/p14317457/s51835853/014bc808-ac3dabb6-41e74e62-3160ec6e-e02e0af3.jpg,test," FINAL REPORT HISTORY: Chest pain and shortness of breath, assess for pneumonia. COMPARISON: None. FINDINGS: 2 views were obtained of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with tortuous aortic contour. Right shoulder arthroplasty is incompletely imaged. IMPRESSION: No acute intrathoracic process. " b120a14c-8b89ffd4-fc1078d2-1814b050-89a88a08.jpg,test/p16/p16891303/s59655262/b120a14c-8b89ffd4-fc1078d2-1814b050-89a88a08.jpg,test," FINAL REPORT HISTORY: New PE, elevated white count, question new pneumonia. CHEST, SINGLE AP PORTABLE VIEW. Lordotic positioning and low inspiratory volumes. A left-sided pacemaker is present, with lead tips over right atrium and right ventricle. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation, worse compared with one day earlier. Upper zone redistribution is likely accentuated by low inspiratory volumes. Otherwise, no evidence for CHF. The right lung is grossly clear, without focal infiltrate or gross effusion.Cardiomediastinal silhouette unchanged. IMPRESSION: Increased retrocardiac density consistent with left lower lobe collapse and/or consolidation, worse compared with ___. " a38b4a62-5deaca1f-e0321ec0-146245c7-e41f6981.jpg,test/p18/p18079481/s54655227/a38b4a62-5deaca1f-e0321ec0-146245c7-e41f6981.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recurrent desaturations // Evidence of pulmonary edema, pneumonia Evidence of pulmonary edema, pneumonia IMPRESSION: In comparison with the study ___, there is little change. The inner low lung volumes with enlargement of the cardiac silhouette and tortuosity of the aorta. No vascular congestion or acute focal pneumonia. Multiple old healed rib fractures are again seen bilaterally. " c946ae87-1eb9b812-8b48c308-031d88d7-c74c2edb.jpg,test/p18/p18743501/s53528662/c946ae87-1eb9b812-8b48c308-031d88d7-c74c2edb.jpg,test," FINAL REPORT INDICATION: Right-sided chest pain. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " eb73bd7b-2ea1378e-a09ae395-f6b3756c-7362d876.jpg,test/p14/p14648269/s58291514/eb73bd7b-2ea1378e-a09ae395-f6b3756c-7362d876.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough, change in sputum, feels warm, no chest pain, oxygen saturation stable TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and chest CTA FINDINGS: Heart size is normal. The mediastinal and hilar contours are unchanged and unremarkable. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Moderate multilevel degenerative changes are seen within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 04d9e47a-07d7ff4e-b2dfbe23-1f5be4f6-f806c4dd.jpg,test/p18/p18333201/s59229914/04d9e47a-07d7ff4e-b2dfbe23-1f5be4f6-f806c4dd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with IPF, pneumonia, volume overload, desatting into 60s. // asess progression of pulmonary disease IMPRESSION: As compared to ___ chest radiograph, there has been little overall change in the appearance of the chest except for slight improved aeration at the lung bases. " 187ef7e6-60f33db7-f0b33f14-a4773432-41ccc605.jpg,test/p17/p17396346/s51806348/187ef7e6-60f33db7-f0b33f14-a4773432-41ccc605.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman presenting with shortness of breath; evaluate for CHF. COMPARISON: Chest radiograph dated ___. FINDINGS: Right lower lung linear atelectasis or scarring. Small bilateral pleural effusions. Moderate cardiomegaly with mild pulmonary edema. No focal consolidation or pneumothorax. The descending aorta is tortuous. Surgical clips are present in the left axilla. No acute osseous abnormality. IMPRESSION: Moderate cardiomegaly with mild pulmonary edema and small bilateral pleural effusions. Atelectasis. " 13f7a022-077eae64-276219e1-286fc63c-c36b8692.jpg,test/p19/p19336651/s53678454/13f7a022-077eae64-276219e1-286fc63c-c36b8692.jpg,test," WET READ: ___ ___ 8:17 AM Mild pulmonary edema is increased compared to ___. Mildly enlarged cardiac silhouette is larger than before. Findings are consistent with volume overload. Small left pleural effusion is persistent. WET READ VERSION #1 ___ ___ ___ 1:02 AM Mild pulmonary edema is increased compared to ___. Mildly enlarged cardiac silhouette is larger than before. Findings are consistent with volume overload. Small left pleural effusion is persistent. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with GI bleed, recent TAVR now with SOB. // ? pulmonary edema, ? pleural effusion COMPARISON: ___. IMPRESSION: New moderate pulmonary edema. Retrocardiac atelectasis. Small left pleural effusion and moderate cardiomegaly. The alignment of the sternal wires is unchanged. " 72b904df-688f1711-e4916b95-c16ea3a7-0ff7585f.jpg,test/p17/p17801051/s59599946/72b904df-688f1711-e4916b95-c16ea3a7-0ff7585f.jpg,test," WET READ: ___ ___ ___ 5:45 PM Right central line in unchanged position with tip in the mid-to-low SVC. Streaky linear opacity at the left base is stable, suggesting chronic atelectasis or scarring. No new focal airspace opacity. No pleural effusion. Normal cardiomediastinal silhouette. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:11 P.M. ON ___ HISTORY: ___-year-old man with multiple myeloma, febrile, prior to stem cell transplant. IMPRESSION: AP chest compared to ___: No definite pulmonary abnormality. Conventional views recommended for greater sensitivity to subtle infection. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. Right subclavian infusion port ends low in the SVC. " 99981157-30388ff8-11530d88-9298b889-d3a90583.jpg,test/p15/p15605860/s54709400/99981157-30388ff8-11530d88-9298b889-d3a90583.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M s/p diaphragmatic hernia repair s/p chest tube removal ___ - eval PTX and pleural effusion // eval interval change eval interval change COMPARISON: Prior chest radiographs ___. IMPRESSION: Both the small left apical pneumothorax and moderate dependent pleural effusion are stable. Heart is shifted to the left, reflecting left lung volume loss, and the left heart border is obscured, probably by pleural fluid.Right lung is clear and there is no right pleural abnormality. " 300a2dd6-48f989c9-976e6b1e-dee82044-44066a42.jpg,test/p11/p11167079/s58667526/300a2dd6-48f989c9-976e6b1e-dee82044-44066a42.jpg,test," FINAL REPORT HISTORY: ___-year-old male with overdose. Intubated. COMPARISON: None. FINDINGS: Single portable view of the chest. Endotracheal tube is seen with tip 4.3 cm from the carina. NG tube seen with tip at the GE junction with side port in the distal esophagus and should be advanced. Dual-lumen right -sided central venous catheter is seen with its distal tip in the right atrium. The lungs are clear of focal consolidation. Cardiomediastinal silhouette is within normal limits. No acute fracture is visualized. There is widening of the right acromioclavicular joint. IMPRESSION: Endotracheal tube in appropriate position. NG tube tip is just at the GE junction and should be advanced. Widening of the right acromioclavicular joint. " 73ac9eed-38d84130-1a99969c-eafc6c8d-fa438387.jpg,test/p16/p16087436/s50432147/73ac9eed-38d84130-1a99969c-eafc6c8d-fa438387.jpg,test," FINAL REPORT AP CHEST, 3:50 AM ON ___ HISTORY: ___-year-old man with previous right lower lobe pneumonia. IMPRESSION: AP chest compared to ___ through ___: At least mild interstitial pulmonary edema is present, increased since ___, stable since ___. Greater opacification on the right may well be due to pneumonia, but there is also contribution of small-to-moderate right pleural effusion. The heart is normal size, but the azygos vein is distended indicating elevated central venous pressure or volume, or both. Nasogastric feeding tube passes into the stomach and out of view. A left-sided central venous line ends in the mid SVC. ET tube in standard placement. " 61a015ae-9c5d33b9-219ee320-79e7ed17-1809fb83.jpg,test/p13/p13747362/s52954501/61a015ae-9c5d33b9-219ee320-79e7ed17-1809fb83.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Portable upright radiograph of chest was reviewed in comparison with prior chest radiographs through ___ with the most recent from ___ acquired 2 and 4 hours apart. FINDINGS: Monitoring and supporting devices are in standard position. Feeding tube is seen to course below the diaphragm into the stomach; however, distal end is beyond the radiographic view. Bilateral lower lung opacities reflecting a combination of atelectasis and pleural effusions have improved over last ___ hours. Enlarged heart size and widened mediastinal contour likely postop is stable. No new relevant findings. Small right apical pneumothorax is unchanged. " ccbe7eaf-8bf1b59b-bb68bca1-7c6506e1-3c2bd5e0.jpg,test/p17/p17894333/s50867159/ccbe7eaf-8bf1b59b-bb68bca1-7c6506e1-3c2bd5e0.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___M with ?CVA // acute process? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The cardiac silhouette is top-normal in size. There is calcification of the aortic knob. The hilar and mediastinal contours are otherwise within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. A metallic stent projects over the expected location of the right brachiocephalic vein and SVC. IMPRESSION: No acute cardiopulmonary process. " 4f80d458-705b1cae-f2596c2e-64af9eb3-93b91a38.jpg,test/p17/p17441758/s59791361/4f80d458-705b1cae-f2596c2e-64af9eb3-93b91a38.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/aphasia, please eval for occult pna // ___M w/aphasia, please eval for occult pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is unchanged. The aorta is tortuous. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is normal. Low lung volumes. Bibasilar atelectasis. Lungs are clear. There is unchanged blunting of the bilateral costophrenic angles. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Bibasilar atelectasis. " 5709b9c0-76b86cf6-1b5c91fc-6f2cc50c-2286ae6c.jpg,test/p15/p15806786/s59000188/5709b9c0-76b86cf6-1b5c91fc-6f2cc50c-2286ae6c.jpg,test," FINAL REPORT INDICATION: Fever and cough. Evaluate for pneumonia. COMPARISONS: None. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia. " c9001c24-8e733604-5d390499-237e1003-4c1e2087.jpg,test/p19/p19015407/s54556418/c9001c24-8e733604-5d390499-237e1003-4c1e2087.jpg,test," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is visualized. There are anterior osteophytes within the visualized thoracic spine. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary process. " a51d5c28-f79ba006-c01dc06b-dfeacd2c-3fc9406b.jpg,test/p13/p13010258/s52032103/a51d5c28-f79ba006-c01dc06b-dfeacd2c-3fc9406b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Neck pain, back pain, status post MVA. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. The imaged osseous structures are intact. IMPRESSION: No acute findings in the chest. " 6cdd7a05-525b6b5d-a3920b6c-21a1f1c6-0481a119.jpg,test/p10/p10207389/s52286027/6cdd7a05-525b6b5d-a3920b6c-21a1f1c6-0481a119.jpg,test," WET READ: ___ ___ ___ 3:35 PM 1. Mild apparent thickening of the right paratracheal stripe could represent a prominent SVC, though mediastinal lymphadenopathy cannot be definitively excluded on the basis of this examination. If there is persistent clinical concern, a chest CT could be performed for further evaluation. 2. Mild cardiomegaly, in the absence of central vascular congestion and pulmonary edema, could represent cardiomyopathy or pericardial effusion. Recommend correlation with physical exam findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with retrosternal chest pain and back pain, mild cough // Eval for acute process, PNA, mediastinal widening TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None. FINDINGS: Lung volumes are normal. No focal consolidation, effusion or pneumothorax. There is no central vascular congestion or overt pulmonary edema. Mild apparent thickening of the right paratracheal stripe could represent a prominent SVC and partly be explained by an unfolded thoracic aorta, though mediastinal lymphadenopathy cannot be definitively excluded. Heart is borderline in size. IMPRESSION: 1. Mild apparent thickening of the right paratracheal stripe could represent a prominent SVC/vasculature, though mediastinal lymphadenopathy cannot be definitively excluded on the basis of this examination. If there is persistent clinical concern, a chest CT could be performed for further evaluation. 2. Borderline heart size. " 005ed39b-c423ad3a-17a6445b-76ea423b-d0bf298b.jpg,test/p19/p19519356/s57398779/005ed39b-c423ad3a-17a6445b-76ea423b-d0bf298b.jpg,test," FINAL REPORT INDICATION: History: ___F presenting after assault. Tender over left knee, right elbow, shoulder, over chest // Any fractures? TECHNIQUE: AP and lateral views of the chest COMPARISON: ___, ___ FINDINGS: Heart size remains mildly enlarged. Mediastinal and hilar contours are unremarkable. Low lung volumes cause crowding of the bronchovascular structures but no overt pulmonary edema is demonstrated. No focal consolidation, pleural effusion or pneumothorax is visualized. Multiple clips as well as a bullet are seen within the posterior aspect of the right upper quadrant pain, unchanged. No acute osseous abnormalities are demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " 7a9fc25b-b20b0446-aef48ddd-012b15cf-12278ae3.jpg,test/p19/p19849557/s52976165/7a9fc25b-b20b0446-aef48ddd-012b15cf-12278ae3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cholecystitis s/p perc chole drain // eval for pulm edema, atelectasis eval for pulm edema, atelectasis IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Moderate right pleural effusion continues to increase. It obscures what is either worsening right perihilar edema or upper and lower lobe pneumonia. Heart size is top-normal and unchanged but mediastinal veins are dilated suggesting increased intravascular volume or pressure or both. Consolidation in the left lower lobe has been present since ___, either pneumonia or more likely atelectasis. Trans subclavian right atrial and right pacer leads continuous from the right pectoral generator follow the same courses since ___. No pneumothorax. NOTIFICATION: Dr. ___ reported the findings to Dr ___ by telephone on ___ at 11:55 AM, 1 minutes after discovery of the findings. " 284b9007-03ece2be-8a6fe572-d5500717-eb8278fe.jpg,test/p19/p19100396/s58759167/284b9007-03ece2be-8a6fe572-d5500717-eb8278fe.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old man with R PICC malpositioned // R PICC repo attempt, ___ ___ ___ R PICC repo attempt, ___ ___ ___ IMPRESSION: Right PICC line tip terminates at the level of lower SVC, in appropriate position. Heart size and mediastinum are stable. Lungs are clear. No appreciable pleural effusion or pneumothorax is seen. " bf7cf67f-03902562-c7d12799-a5697b44-be98189a.jpg,test/p10/p10933807/s55801454/bf7cf67f-03902562-c7d12799-a5697b44-be98189a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cholangiacarcinoma, febrile to 101.___F // please eval PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " b15ba484-517d22ec-67c73480-5eb92560-1e74b110.jpg,test/p12/p12572459/s55461975/b15ba484-517d22ec-67c73480-5eb92560-1e74b110.jpg,test," WET READ: ___ ___ ___ 2:58 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___F with significant cardiac history substernal chest pain and upper back pain lasting 45 minutes this am // acute intrathoracic process TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with chest radiographs from ___, ___, and ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Median sternotomy wires and CABG clips are noted. Mild thoracic vertebral compression deformities are again noted, unchanged from ___. IMPRESSION: No acute cardiopulmonary process. " 61362722-968006fd-259d5671-6e8ea70b-abe9f710.jpg,test/p11/p11845452/s58796764/61362722-968006fd-259d5671-6e8ea70b-abe9f710.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Normal heart, lungs, pleura and mediastinal surfaces. IMPRESSION: No pneumothorax. " 88c56225-8834c353-984a62aa-cebffa74-5a84fbc8.jpg,test/p16/p16945691/s56941055/88c56225-8834c353-984a62aa-cebffa74-5a84fbc8.jpg,test," FINAL REPORT HISTORY: Generalized weakness. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: ___. FINDINGS: Dual lead left-sided pacemaker is seen with leads extending to the expected positions of the right atrium and right ventricle. There is left base atelectasis. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged. The lungs are hyperinflated suggesting chronic obstructive pulmonary disease. Surgical clips are seen over the upper abdomen. IMPRESSION: Likely left base atelectasis. Otherwise, no acute cardiopulmonary process. " c7e9f2f1-5a6b4138-99cf4121-11bea56e-174fb071.jpg,test/p13/p13891491/s54610592/c7e9f2f1-5a6b4138-99cf4121-11bea56e-174fb071.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough and leukocytosis, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a newly appeared parenchymal opacity at the left lung bases. The opacity shows air bronchograms and ascites, suggestive of pneumonia. In addition, on the right, notably in the perihilar and basilar areas, there are increased interstitial markings, potentially reflecting mild interstitial fluid overload. The heart remains at the upper range of normal. There is no evidence of pleural effusion. The lateral radiograph allows to localize the infectious abnormality in the left lower lobe. At the time of dictation, 8:41 a.m., on ___, the referring physician, ___. ___, was paged for notification. " 23c9a6f6-45c8cd3a-7ac5807c-536ae1a7-61b1fe95.jpg,test/p15/p15479525/s52041478/23c9a6f6-45c8cd3a-7ac5807c-536ae1a7-61b1fe95.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with atrial fibrillation // Amiodarone toxicity TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. No conventional chest radiographic evidence of amiodarone lung toxicity. " 7e3f7ef6-e58ac7ba-89826600-066f9b3a-61dc9669.jpg,test/p14/p14538785/s50601788/7e3f7ef6-e58ac7ba-89826600-066f9b3a-61dc9669.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with large left sided pleural effusion s/p chest tube placement // r/o ptx COMPARISON: ___ IMPRESSION: As compared to the previous image, the patient has received a left-sided pigtail catheter in the pleural space. The extent of the left effusion has substantially decreased. No pneumothorax. Lower lung volumes. Moderate cardiomegaly. Unchanged appearance of the right lung. " 4d503922-dceaeb51-6b447f49-f9c46262-954f6ac7.jpg,test/p16/p16190725/s55121996/4d503922-dceaeb51-6b447f49-f9c46262-954f6ac7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p pericardial window // evaluate for effusion evaluate for effusion COMPARISON: Comparison to prior study ___ at 11:41 FINDINGS: PA and lateral views of the chest ___ at 11:16 are submitted. IMPRESSION: There is a stable layering small to moderate left pleural effusion with associated retrocardiac airspace opacity likely reflecting partial lower lobe atelectasis. There is also possibly a small right effusion. There is likely patchy atelectasis at the right medial lung base as well. No pulmonary edema or pneumothorax. Overall cardiac and mediastinal contours are likely unchanged status post median sternotomy. No pneumothorax. " b110adcc-6146f2fe-8c768ed2-492ff68a-aad00c51.jpg,test/p14/p14189406/s54991727/b110adcc-6146f2fe-8c768ed2-492ff68a-aad00c51.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever, // acute process TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinal silhouette is slightly different from the previous study due to opacity surrounding the aortic arch, potentially representing atelectasis. In addition there are multifocal consolidations involving left lung and to lesser extent right lower lobe, concerning for multifocal pneumonia. Small amount of pleural effusion is most likely present. There is no pneumothorax. No definitive evidence of pulmonary edema is present. If clinically warranted, correlation with chest CT is to be considered. " ac21cedb-3a186b21-8a87e102-b44ea457-16b8c9b2.jpg,test/p11/p11875773/s56439455/ac21cedb-3a186b21-8a87e102-b44ea457-16b8c9b2.jpg,test," WET READ: ___ ___ ___ 11:42 AM No acute cardiopulmonary processMild to moderate cardiomegaly. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with on HD with fever // r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Mild to moderate cardiomegaly. The mediastinal and hilar contours are normal. IMPRESSION: Mild to moderate cardiomegaly. Heart size is slightly increased compared to prior exam. " f5c48c61-d59a1899-f625676c-6991e3de-3da67d46.jpg,test/p19/p19004951/s57453951/f5c48c61-d59a1899-f625676c-6991e3de-3da67d46.jpg,test," FINAL REPORT INDICATION: Fever. Evaluate for ""cpd"", infiltrate. COMPARISON: None. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. There is slight indentation of the left side of the trachea. IMPRESSION: 1. No evidence of acute cardiopulmonary abnormality. 2. Indentation of the left side of the trachea possibly from thyroid enlargement. Please correlate with physical exam. Updated results were telephoned to Dr. ___ by ___ at 8:10 am, ___, 10 minutes after discovery. " 89894607-5746ee6d-2da03eee-909220ff-1183741a.jpg,test/p16/p16823121/s55317239/89894607-5746ee6d-2da03eee-909220ff-1183741a.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: CT abdomen pelvis from ___. FINDINGS: The lungs are hyperinflated. A vague nodularity is noted overlying the right upper lobe on the AP view and most likely representative of costochondral calcifications at the right anterior first rib. There is mild left basilar atelectasis. Otherwise, the lungs are without a focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. No acute fractures identified. Mild degenerative changes are noted throughout the thoracic spine. IMPRESSION: 1. No acute cardiopulmonary process. 2. The lungs are hyperinlated and suggestive of chronic obstructive pulmonary disease. Additionally, a vague nodularity is noted overlying the right upper lobe on the AP view and most likely representative of costochondral calcifications at the right anterior first rib. However, given the patient's smoking history and evidence of COPD, a dedicated Chest CT is recommended in the non-emergent setting is recommended for further characterization. " 0580775d-08a8bfb3-6e01dc0c-e82c735e-80468f8d.jpg,test/p11/p11813239/s55654715/0580775d-08a8bfb3-6e01dc0c-e82c735e-80468f8d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP // eval for cardiomegaly TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. The cardiac silhouette is top-normal in size. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. Stable, top-normal in size cardiac silhouette. " 65e59986-750f6dc7-d6301ddd-bdaababa-4e9786a7.jpg,test/p17/p17528875/s57778404/65e59986-750f6dc7-d6301ddd-bdaababa-4e9786a7.jpg,test," FINAL REPORT HISTORY: Coughing blood with chest pain, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 4c3c76d0-ffa18ec9-4ce248fe-5fe87900-851c9b87.jpg,test/p11/p11845452/s54767309/4c3c76d0-ffa18ec9-4ce248fe-5fe87900-851c9b87.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is top normal. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " 86afc0c6-9056aa41-7868432f-9d767383-6aaed0c2.jpg,test/p12/p12241660/s51850820/86afc0c6-9056aa41-7868432f-9d767383-6aaed0c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p mv repair // eval for effusion eval for effusion IMPRESSION: In comparison with the study of ___, the apparent improvement in the left pleural effusion may be simply due to the erect posture of the patient. Mild bibasilar atelectatic changes are seen. No evidence of vascular congestion or acute focal pneumonia. PICC line remains in good position. " 971a86f4-01c9587a-74f464e4-d64ec3a4-73662ebe.jpg,test/p14/p14754762/s51264828/971a86f4-01c9587a-74f464e4-d64ec3a4-73662ebe.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess for evacuation of subdural hematoma. Patient with probable pneumonia. Comparison is made with prior study ___. There is mild cardiomegaly. Small right pleural effusion is unchanged. Left lower lobe opacities have increased. This could be due to atelectasis and/or pneumonia. Right lower lobe opacities are grossly unchanged, a combination of pleural effusion and atelectasis. Right PICC is in the mid-to-lower SVC. " f15e3281-13c23328-e39947d4-33a6882f-dd72ac3c.jpg,test/p11/p11778596/s52620709/f15e3281-13c23328-e39947d4-33a6882f-dd72ac3c.jpg,test," FINAL REPORT INDICATION: Fever and nausea. COMPARISON: ___. PA AND LATERAL CHEST RADIOGRAPHS: The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Normal chest radiographs. " 620e4b29-98e33270-5d32ccb7-efb46295-557358ac.jpg,test/p10/p10208053/s56258185/620e4b29-98e33270-5d32ccb7-efb46295-557358ac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with crackles at both bases // ? fluid COMPARISON: ___ FINDINGS: Left chest cardiac device with lead tips in the right atrium and right ventricle appear similar to prior. Prosthetic heart valve is again seen. Pulmonary vascular congestion is mild. There is no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Sternal wires are intact. Compression deformities of multiple vertebral bodies is similar to prior. IMPRESSION: Pulmonary vascular congestion is mild. " 3959680e-4109191a-31a72347-86e19c64-381fb839.jpg,test/p10/p10078115/s52233115/3959680e-4109191a-31a72347-86e19c64-381fb839.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Intracranial hemorrhage, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the endotracheal tube, the nasogastric tube and the right subclavian catheter are in unchanged position. The mild-to-moderate pulmonary edema is constant. Constant moderate cardiomegaly. Bilateral basal areas of atelectasis. No larger pleural effusions. No parenchymal opacities. No evidence of pneumothorax. " 55abcef7-760b1f7d-20445948-344c77d8-1db3ce9c.jpg,test/p18/p18036188/s58118447/55abcef7-760b1f7d-20445948-344c77d8-1db3ce9c.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Chest tube remains in place, with persistent small left pneumothorax with apical and basilar components. Right chest tube is also present, with a probable persistent small right apical pneumothorax. Overall appearance of the chest is not appreciably changed compared to the recent study. " fbe5db5a-313ac636-bc41fd4f-37387d35-b382efa2.jpg,test/p19/p19525927/s53309998/fbe5db5a-313ac636-bc41fd4f-37387d35-b382efa2.jpg,test," FINAL REPORT INDICATION: Allergic cough. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest. The lungs are clear without evidence of consolidation. There is no pneumothorax. There is slight blunting of the left costophrenic angle seen on the lateral view that may represent pleural thickening. The cardiac, mediastinal, and hilar contours are normal. There is no pulmonary vascular congestion. IMPRESSION: No consolidation. Essentially normal radiographic examination of the chest. " c329f071-a308fad3-5f994717-ab811341-1107654c.jpg,test/p14/p14951077/s58137236/c329f071-a308fad3-5f994717-ab811341-1107654c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/AML with hypotension // signs of consolidation or infxn signs of consolidation or infxn IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is hyperexpansion of the lungs suggesting underlying chronic pulmonary disease. The cardiac silhouette is within normal limits. Bibasilar atelectatic changes, but no definite acute pneumonia. Apical pleural changes are seen bilaterally, consistent with old healed tuberculous disease. " e1730715-bfb6a1ef-2d35515b-01cb92b8-ab21dff2.jpg,test/p18/p18526154/s52430397/e1730715-bfb6a1ef-2d35515b-01cb92b8-ab21dff2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lung cancer // c/o fever and cough. Pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: CT ___ FINDINGS: Cardiomediastinal contours are unchanged. Known left perihilar mass is better seen in prior CT. There is no pneumothorax. There is a small right effusion. There are mild degenerative changes in the thoracic spine IMPRESSION: There is a small right effusion. There are no new lung abnormalities. Known left hilar mass better seen in prior CT. " 9ba9fc2b-43df7a2d-39b5e225-36caa012-bdfe70e5.jpg,test/p17/p17509107/s58673385/9ba9fc2b-43df7a2d-39b5e225-36caa012-bdfe70e5.jpg,test," FINAL REPORT STUDY: Portable AP chest x-ray. COMPARISON EXAM: Portable AP chest x-ray ___, portable AP chest x-ray ___. INDICATION: ___-year-old with acute liver injury and prolonged seizure. FINDINGS: There is an ET tube present in good position. Other support and monitoring devices remain stable. Compared to study from yesterday, there is little overall change with remaining haziness at the bases suggestive of small pleural effusion. IMPRESSION: Unchanged chest radiograph. " 2d5abc10-67604dc5-821acd92-893c85d3-dab36252.jpg,test/p16/p16298181/s50920521/2d5abc10-67604dc5-821acd92-893c85d3-dab36252.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CHF presenting with worsening SOB. // evaluate for change in pulmonary edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pulmonary edema has completely cleared. Borderline size of the cardiac silhouette persists. Mild elongation of the descending aorta. No pleural effusions. No pneumonia. " c0d3b71e-f30d1564-d06c9bb9-d84f571f-813dab5e.jpg,test/p14/p14785541/s58914324/c0d3b71e-f30d1564-d06c9bb9-d84f571f-813dab5e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p right hip hemi with h/o of emphysema // question worsening breathing COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the now available lateral image shows small bilateral pleural effusions, confined to the dorsal aspect of the costophrenic sinuses. No substantial areas of atelectasis. No change in appearance of the normal cardiac silhouette and of the normal lung parenchyma. No pneumonia. Minimal scars at the left lung apex and hyperlucency on the right are likely explained by the known pulmonary emphysema. " 6983af81-ed1b827a-2614b83c-e295d4ca-e50b8559.jpg,test/p18/p18310858/s56697748/6983af81-ed1b827a-2614b83c-e295d4ca-e50b8559.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: ___-year-old woman with COPD, exacerbation to rule out pneumonia. TECHNIQUE: PA and lateral chest views were read in comparison with prior chest radiograph from ___. FINDINGS: Bilateral hyperinflated lungs suggest emphysema. No discrete lung opacities concerning for pneumonia. Biapical and minimal scarring at the left lung base is unchanged. There is no evidence of central or hilar lymphadenopathy. Heart size is normal. Biapical scarring is minimal. IMPRESSION: Bilateral hyperexpanded lungs suggestsf COPD. No discrete lung opacities worrisome for pneumonia. " 6b89f115-2c8581e7-47dd1667-e0bd0f95-e0570a88.jpg,test/p11/p11344336/s57550093/6b89f115-2c8581e7-47dd1667-e0bd0f95-e0570a88.jpg,test," FINAL REPORT INDICATION: History: ___F with chest pain // acute process? TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Normal heart, lungs, pleura and mediastinal surfaces. IMPRESSION: Clear lungs. " 2d07a2b2-49b37b11-efe08e2a-953b92ff-e7b4d574.jpg,test/p11/p11639395/s55949023/2d07a2b2-49b37b11-efe08e2a-953b92ff-e7b4d574.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough x 3 days // eval for consolidation COMPARISON: Multiple chest radiographs, most recent ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No evidence of pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 1:40 PM, 5 minutes after discovery of the findings. " 580d3b52-53768cc8-32ae112c-6c8122bc-72d67d4e.jpg,test/p19/p19785715/s53891693/580d3b52-53768cc8-32ae112c-6c8122bc-72d67d4e.jpg,test," FINAL REPORT INDICATION: Confusion. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Patient is status post median sternotomy and CABG. Vascular stent is noted within the right subclavian artery. Heart size is normal. Coronary arterial vascular stent is also demonstrated. The mediastinal and hilar contours are unchanged. The pulmonary vascularity is normal. There is hyperinflation of the lungs with attenuation of the pulmonary vascular markings towards the apices, compatible with emphysema. Minimal interstitial opacities are seen predominantly within the lung bases, likely reflecting chronic changes. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes of the thoracic spine. Degenerative spurring is also noted within the right acromioclavicular joint. IMPRESSION: Emphysema with chronic interstitial changes, but no evidence for pneumonia or congestive heart failure. " d2956479-a2047f2f-f2bc8d5b-336b48a0-a81178ab.jpg,test/p10/p10087922/s53253214/d2956479-a2047f2f-f2bc8d5b-336b48a0-a81178ab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with seizure // ?infection ?infection IMPRESSION: COMPARED TO PRIOR CHEST RADIOGRAPHS SINCE ___, MOST RECENTLY ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 79857925-e8b97f5d-fcdc9923-e835342d-6c79ba97.jpg,test/p12/p12357339/s57665909/79857925-e8b97f5d-fcdc9923-e835342d-6c79ba97.jpg,test," FINAL REPORT HISTORY: Diastolic congestive heart failure with shortness of breath for several weeks. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present. IMPRESSION: No acute cardiopulmonary abnormality. " a779fd6e-b0d412f5-da43cd21-b6ed055c-0aeb86e1.jpg,test/p17/p17147147/s52567055/a779fd6e-b0d412f5-da43cd21-b6ed055c-0aeb86e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with known right pleural effusion, hemoptysis // eval pleural effusion, known Right Upper lobe parencyhmal changes eval pleural effusion, known Right Upper lobe parencyhmal ch IMPRESSION: In comparison with the study of ___ from an outside facility, there is little change. Areas of opacification are again seen in the right upper zone consistent with some combination of parenchymal and fibrotic changes. Blunting of the right costophrenic angle is again noted in consistent with pleural effusion. The left lung is hyperexpanded and clear. Right Port-A-Cath extends to the lower portion of the SVC. " c160d186-5ae78e70-a6383b2d-fa1bf2cb-d84ccf1e.jpg,test/p10/p10391104/s55385775/c160d186-5ae78e70-a6383b2d-fa1bf2cb-d84ccf1e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with afib with NSVT // assess ET tube placement assess ET tube placement COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Mild pulmonary edema is improved, compared to 01:30. Consolidation in the left midlung, presumably pneumonia, is still present, hard to assess for change because of differences in patient positioning. Pleural effusions are small if any. Moderate cardiomegaly is stable. ET tube in standard placement. Transesophageal drainage tube passes into the stomach and out of view. " 3b500901-0ed2cc08-b31cf65b-9a30ce95-719bbdbf.jpg,test/p15/p15455450/s53884698/3b500901-0ed2cc08-b31cf65b-9a30ce95-719bbdbf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough and dyspnea // eval for pna, effusion COMPARISON: CT heart ___ FINDINGS: AP upright and lateral views of the chest provided. Large left pleural effusion with likely associated atelectasis appears similar to prior, obscuring the left heart border. Hazy right basilar opacity is likely due to atelectasis. There is no pneumothorax. The cardiomediastinal silhouette is normal where seen. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: 1. Large left pleural effusion with associated atelectasis appears similar to prior. Superimposed infection is a possibility. 2. Hazy right basilar opacity is likely due to atelectasis based on prior CT, but superimposed infection is a possibility. " 44aa2ad3-3edf6149-09a78375-49a895ba-da7a9c69.jpg,test/p16/p16179342/s58178755/44aa2ad3-3edf6149-09a78375-49a895ba-da7a9c69.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough and dyspnea and palpitations. PA and lateral upright chest radiographs were reviewed in comparison to ___. Cardiomegaly is moderate, unchanged. Mediastinum is stable. Pacemaker leads terminate in right atrium and right ventricle. The lateral view demonstrates compression fractures of the lower thoracic vertebral body. No pleural effusion or pneumothorax is seen. " 3d38598e-6b5c6625-3d8099ff-21178a58-ea7859a1.jpg,test/p11/p11093593/s50684598/3d38598e-6b5c6625-3d8099ff-21178a58-ea7859a1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with DM, hyperglycemia for 3 weeks with constitutional review of symptoms, possible positive urinalysis, WBC ___->___ after ciprofloxacin started ___. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 9199b0f8-8e927e02-566c97b5-7ee7d839-a3d3dd28.jpg,test/p16/p16098381/s55736574/9199b0f8-8e927e02-566c97b5-7ee7d839-a3d3dd28.jpg,test," FINAL REPORT INDICATION: ___M with hx cutaneous t-cell lymphoma w/ worsening rash, concern for systemic infection // eval ? infiltrate TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray and ___ PET-CT. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Tortuosity of the descending thoracic aorta with atherosclerotic calcifications again noted. Median sternotomy wires with fracture of the superior most wire is unchanged. No acute osseous abnormalities. Surgical clips in the right upper quadrant suggest prior cholecystectomy. IMPRESSION: No acute cardiopulmonary process. " acce3e35-82897a53-f95dbc98-161ff280-10cd6d9a.jpg,test/p13/p13994624/s54345403/acce3e35-82897a53-f95dbc98-161ff280-10cd6d9a.jpg,test," FINAL REPORT INDICATION: ___F with chest pain, current CMV infection // ?cardiomegaly, pna, effusion TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated but clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 53402c69-8d1cf9a3-0e2f1675-0b801d93-6606e6ab.jpg,test/p14/p14394983/s55391037/53402c69-8d1cf9a3-0e2f1675-0b801d93-6606e6ab.jpg,test," FINAL ADDENDUM ADDENDUM No specific addendum ______________________________________________________________________________ FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 642e90f6-0aeece48-69ae53e8-d62fc8e7-f0b14727.jpg,test/p13/p13031024/s51718265/642e90f6-0aeece48-69ae53e8-d62fc8e7-f0b14727.jpg,test," FINAL REPORT INDICATION: Cough, chest pain, and shortness of breath, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 10c8ac36-a2853890-23c30e54-90a676c0-9a66c8eb.jpg,test/p16/p16508811/s58303567/10c8ac36-a2853890-23c30e54-90a676c0-9a66c8eb.jpg,test," FINAL REPORT AP CHEST, 2:45 A.M., ___ HISTORY: COPD and upper GI bleed, evaluate pleural effusion. IMPRESSION: AP chest compared to ___ through ___: Right upper lobe pneumonia continues to develop. Pulmonary edema is clearing. Bibasilar consolidation, unchanged since ___, could be more pneumonia or combination of edema and basal atelectasis. The heart is partially obscured, probably moderately enlarged. Small-to-moderate bilateral pleural effusions unchanged. No pneumothorax. " 83eaba26-18867a42-e0fc9134-960710eb-5070b7da.jpg,test/p13/p13341899/s57140072/83eaba26-18867a42-e0fc9134-960710eb-5070b7da.jpg,test," FINAL REPORT INDICATION: Patient with multiple myeloma and generalized weakness and abdominal pain. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. Osseous structures demonstrate numerous lytic lesions, compatible with known history of multiple myeloma. There are multiple compression deformities, including T9-T10 and L1 vertebral bodies, of uncertain chronicity. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Numerous osseous lytic lesions compatible with patient's known history of multiple myeloma. Multiple compression deformities of uncertain chronicity. " 65ac8531-86d437c7-7a79e5ca-48f25326-8894713c.jpg,test/p18/p18100010/s57772885/65ac8531-86d437c7-7a79e5ca-48f25326-8894713c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p R TKR with elevated white count, elevated temps, r/o infectious process. // r/o infectious process TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiographs from ___, ___, ___, ___. FINDINGS: Since ___, an asymmetrical opacity is seen in the right lower lung, concerning for pneumonia. The left lung is clear. The cardiac mediastinal silhouette, hilar contours, pleural surfaces are normal. No pneumothorax or pleural effusion. IMPRESSION: 1. An asymmetric opacity is noted in the right lower lung, concerning for pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 12:08 PM, 5 minutes after discovery of the findings. " 175ff67d-8419fac2-b0be950f-3f3f9c88-4579b488.jpg,test/p17/p17453200/s55480559/175ff67d-8419fac2-b0be950f-3f3f9c88-4579b488.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with ___'s disease, being treated for perirectal infection. History of spiking fevers, evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in upright position. COMPARISON: None available. FINDINGS: Hiatal hernia is seen on frontal and lateral radiographs, and associated left basilar atelectasis is noted. Moderate pulmonary edema and low lung volumes are seen. Tortuous aorta is noted. IMPRESSION: No focal consolidation to suggest pneumonia is seen. Moderate pulmonary edema and basilar atelectasis. " a0eb152d-2934058f-405f4e9d-074d9c12-8d7d05c9.jpg,test/p12/p12854165/s59002493/a0eb152d-2934058f-405f4e9d-074d9c12-8d7d05c9.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Follow up pulmonary edema. Comparison is made with prior study, ___. Mild pulmonary edema is grossly stable. Persistent consolidation in the left mid lung is consistent with pneumonia. Right perihilar consolidation is also persistent due to pneumonia. The aeration of the left lower lobe has improved. Small bilateral effusions are stable. Right upper lobe opacity has increased, consistent with increasing infectious process. There is no pneumothorax. IMPRESSION: Improved pulmonary edema, worsening pneumonia. " 2e0c943f-c0f7c68d-0a6010ea-3805b0e5-51d65a92.jpg,test/p10/p10282467/s54267240/2e0c943f-c0f7c68d-0a6010ea-3805b0e5-51d65a92.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea COMPARISON: Prior study from ___ and ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Again seen is a rounded calcified structure in the left upper abdomen corresponding to a calcified splenic cyst on prior CT. IMPRESSION: No acute intrathoracic process. " 1a4bb057-22a9eb8a-da41cf93-12383f31-3b01d9e6.jpg,test/p11/p11581260/s54661512/1a4bb057-22a9eb8a-da41cf93-12383f31-3b01d9e6.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Metastatic melanoma, hypoxia. Comparison is made with prior study ___. Widened mediastinum with a known mass, right perihilar mass, and circumferential peripheral thickening of the right lower pleura is unchanged, these findings are better evaluated by prior CT on ___. There are low lung volumes. Cardiomegaly is stable. Small right pleural effusion is unchanged. The left lung is grossly clear. Right lower lobe atelectases have improved. There are no new lung abnormalities. " 44258549-9119df98-ca1c2949-7d7aac8b-020c7d38.jpg,test/p13/p13535833/s58543509/44258549-9119df98-ca1c2949-7d7aac8b-020c7d38.jpg,test," WET READ: ___ ___ ___ 10:26 PM Interval removal of right chest tube and right PICC with interval placement of right pigtail catheter. Slightly decreased right pleural effusion, which is still moderate in size. Left lower lung atelectasis persists. No pneumothorax. ______________________________________________________________________________ FINAL REPORT SINGLE AP PORTABLE VIEW OF THE CHEST REASON FOR EXAM: Assess right pleural effusion status post new pigtail catheter placement. Comparison is made with prior study ___. Right lower lobe collapse is persistent. There is a new right basal pigtail catheter. Right pleural effusion has decreased. Left lower lobe atelectasis has improved. Cardiomediastinal contours are unchanged. Right central catheter tip is in the lower SVC. There is no evident pneumothorax. " 6b5d1417-79912b69-c482a2d9-61e006b0-67b9dbf3.jpg,test/p17/p17558492/s55723514/6b5d1417-79912b69-c482a2d9-61e006b0-67b9dbf3.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: None. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " a0e78208-c7839a28-4cde40da-b9458f8d-bdb71c77.jpg,test/p18/p18046197/s54990869/a0e78208-c7839a28-4cde40da-b9458f8d-bdb71c77.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of left upper chest tenderness to palpation after fall, evaluate rib fracture. COMPARISON: ___. FINDINGS: 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 to mildly-enlarged. Slight obscuration of the right heart border on the frontal view, not seen on the lateral view, may be due to atelectasis. No displaced fracture seen. However, if clinical concern for rib fracture persists, suggest dedicated rib series, which is more sensitive. " e40074a9-3b6b9276-3712e4da-da6ce742-ff705d2d.jpg,test/p15/p15367414/s56687391/e40074a9-3b6b9276-3712e4da-da6ce742-ff705d2d.jpg,test," FINAL REPORT EXAMINATION: Upright AP portable chest radiograph INDICATION: ___ year old man with cont'd SOB s/p CABG // interval chnage TECHNIQUE: Upright AP portable chest radiograph COMPARISON: Chest radiographs from ___ FINDINGS: Compared to prior, there is decreased right lung volume with elevation of the right hemidiaphragm, likely due to increased combination of right basal atelectasis and pleural effusion. No significant pulmonary edema is seen. There is stable appearance of postop cardiomediastinal silhouette. Right introducer has been removed. No pneumothorax is seen. Median sternotomy wires are intact. Left sided single chamber ICD is unchanged in position. IMPRESSION: Interval increased right basal opacity. " 18c094d7-219d86b2-71ec3bc3-5c074895-06cab27e.jpg,test/p17/p17519359/s56006763/18c094d7-219d86b2-71ec3bc3-5c074895-06cab27e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea // please evaluate for acute abnormality TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Hyperinflation with severe upper lobe predominant emphysema. No focal consolidations. Mild interstitial pulmonary edema. Stable appearance of the cardiomediastinal silhouette. No pleural effusion. No pneumothorax. IMPRESSION: 1. No evidence of pneumonia. 2. Hyperinflation with severe emphysema. 3. Mild interstitial pulmonary edema. " bcb5129e-eec6f549-2169472e-77c88efb-febca061.jpg,test/p14/p14601325/s59397557/bcb5129e-eec6f549-2169472e-77c88efb-febca061.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with s/p fall, headache sob // ptx? bleed? c spine fx? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Left basilar atelectasis is seen. No definite focal consolidation. There are relatively low lung volumes. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The patient is status post median sternotomy, CABG, and cardiac valve replacement. . Degenerative changes are partially imaged along the spine. IMPRESSION: No acute cardiopulmonary process. " 6645e226-950f8bab-84443768-282b12c7-0c0b96e7.jpg,test/p16/p16904987/s57044139/6645e226-950f8bab-84443768-282b12c7-0c0b96e7.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with multiple rib fractures. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. The ET tube tip is approximately 6 cm above the carina. NG tube tip is most likely in the stomach. Heart size and mediastinum are grossly unchanged. Left chest tube is in place. The assessment of the lung films reveals no interval development of new abnormalities besides the right middle lobe atelectasis that is apparently new. Bilateral small pleural effusions are better appreciated on the CT torso. Rib fracture is also better seen on the cross-sectional images than on the current chest radiograph. No new pneumothorax is demonstrated. " 8b195ab5-a77a33cd-ddb1a7f5-b77b74aa-67e32afe.jpg,test/p15/p15973689/s59671715/8b195ab5-a77a33cd-ddb1a7f5-b77b74aa-67e32afe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year M with PNA // ? ArDS worsening PNA COMPARISON: Chest radiographs since ___ most recently ___ ___, 18:17 IMPRESSION: Widespread consolidation, right mid and both lower lungs, partially obscures multiple cavitated nodules, probably septic emboli. Pulmonary vascular congestion and mild pulmonary edema have been present concurrently, even though heart size is top-normal. Pleural effusions are small if any. No pneumothorax. Tracheostomy tube in standard placements. NOTIFICATION: Dr. ___ reported the findings to Dr ___ by telephone on ___ at 3:09 PM, minutes after discovery of the findings. " 492c56bd-1017066c-1caf8016-20ddabdc-59e093d1.jpg,test/p11/p11969536/s53019716/492c56bd-1017066c-1caf8016-20ddabdc-59e093d1.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, status post CABG and aortic valve replacement. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. The patient is status post median sternotomy and CABG. Dual-lead left-sided pacemaker is again seen, relatively stable in position. The cardiomediastinal silhouette is stably enlarged. There are small bilateral pleural effusions, left greater than right. Interval removal of previously seen right internal jugular central venous catheter. IMPRESSION: Bilateral pleural effusions. Enlarged cardiac silhouette. No definite focal consolidation, although left-sided consolidation would be difficult to exclude. " 9610ca35-343121af-9cb0b805-b39c0868-58657dd6.jpg,test/p16/p16908932/s58612813/9610ca35-343121af-9cb0b805-b39c0868-58657dd6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: obesity, htn // patient with shortness of breath. no cough. peak flow 400 patient with shortness of breath. no cough. peak flow 400 IMPRESSION: In comparison with the study of ___, the right middle and lower lobe pneumonia have cleared. Cardiac silhouette remains at the upper limits of normal in size, but there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 54923c4d-977c9f44-d4ca8ccd-a171969e-e9e5b45e.jpg,test/p18/p18232058/s53046870/54923c4d-977c9f44-d4ca8ccd-a171969e-e9e5b45e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with epigastric pain radiating to the left jaw TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is demonstrated. Scarring within the apices is unchanged. S-shaped scoliosis of the thoracolumbar spine is again noted. IMPRESSION: No acute cardiopulmonary abnormality. " 70c3b0e4-2fafbcba-0a7935f3-e6f4de6c-2d0f2423.jpg,test/p11/p11607177/s51720015/70c3b0e4-2fafbcba-0a7935f3-e6f4de6c-2d0f2423.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with syncope, cardiac history // eval heart and lungs TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiographs dated ___. FINDINGS: Interval removal of a Swan-Ganz catheter. Left pectoral pacemaker is noted with acute intact leads seen terminating in unchanged locations. Interval increase in the degree of bilateral hilar prominence, pulmonary edema, and small bilateral pleural effusions, compatible with volume overload. There is no pneumothorax. Moderate-severe cardiomegaly is unchanged from prior examination. IMPRESSION: 1. Interval worsening of now moderate-severe diffuse pulmonary edema. 2. Small, bilateral pleural effusions. 3. Stable, moderate-severe cardiomegaly. " f7bdc23d-c3fce764-bda9f784-7b1929c7-70941c96.jpg,test/p12/p12098160/s57104620/f7bdc23d-c3fce764-bda9f784-7b1929c7-70941c96.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. There are small pleural effusions, no focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unchanged. The heart is mildly enlarged. There is mild pulmonary edema. Stable appearance of mid thoracic vertebral body compression deformities. IMPRESSION: Small bilateral pleural effusions, mild cardiomegaly and pulmonary edema. " 8c8b2803-bf1d4b63-32def830-1f8fac7e-f92e4bb2.jpg,test/p16/p16662264/s54148527/8c8b2803-bf1d4b63-32def830-1f8fac7e-f92e4bb2.jpg,test," FINAL REPORT HISTORY: Evaluate ET and OG tube. CHEST, SINGLE SUPINE VIEW. ET tube tip is 5.2 cm above the carina, at the level of the lower medial clavicular heads. An NG tube is present -- tip and side port over the stomach. Again seen are dense alveolar infiltrates in both lungs, densest at the right base and with relative sparing at the left upper zone. No supine film evidence of pneumothorax and no gross effusion identified. " 4b1af4ba-dc2af05b-bc2fb0bb-e601ba53-8891ec3b.jpg,test/p19/p19803391/s58726343/4b1af4ba-dc2af05b-bc2fb0bb-e601ba53-8891ec3b.jpg,test," FINAL REPORT INDICATION: ___M with metastatic anal CA, p/w subacute dyspnea; please eval for PNA // please eval for PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: PET-CT from ___. Subsequent CTA chest from ___. FINDINGS: Right chest wall port is again seen with catheter tip at the lower SVC. Diffuse bilateral pulmonary nodules are partially visualized, particularly overlying the lung bases. There are increased perihilar opacities bilaterally. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: Increased perihilar opacities since prior, better characterized by subsequent CTA as progression of disease. " 2a9e372c-5be08db9-4d90880d-bfde12f9-f3488824.jpg,test/p16/p16741854/s51578726/2a9e372c-5be08db9-4d90880d-bfde12f9-f3488824.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: The patient with end-stage renal disease on hemodialysis, systolic heart failure, evaluation of pleural effusion after chest tube removal. COMPARISON: Chest CT of ___, chest x-ray of ___. FINDINGS: Left chest tube has been removed. There is slightly more fluid at the left lung base, which is minimal and loculated also at the left apex. Multiple calcified plaques are related to previous asbestos exposure. CONCLUSION: There is no pneumothorax after chest tube removal. Small residual pleural effusion has slightly reaccumulated. " 1f1f0208-78f1fa59-22d25639-17774d26-457fa5d3.jpg,test/p19/p19728795/s53740787/1f1f0208-78f1fa59-22d25639-17774d26-457fa5d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ICD // evaluate lead placement evaluate lead placement IMPRESSION: Comparison to ___. The single lead of the left pectoral pacemaker. Projects over the right ventricle. Lung volumes remain low. No pneumothorax or other complications. No pulmonary edema. No pleural effusions. " 46a78510-45c3dcf6-3ae9976b-315065b6-b19cd8aa.jpg,test/p18/p18624005/s55042698/46a78510-45c3dcf6-3ae9976b-315065b6-b19cd8aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right HF and left pleural effusion now on HD for volume control. // f/u to pigtail catheter removal ___ at 10am, please do at 12pm. f/u to pigtail catheter removal ___ at 10am, please do at 12pm. IMPRESSION: In comparison with the earlier study of this date, the left pigtail catheter is been removed. No evidence of definite pneumothorax. Otherwise, little change. " 8b12eb77-415c0d41-7cd7f278-025c1160-736c6efa.jpg,test/p16/p16201645/s54537080/8b12eb77-415c0d41-7cd7f278-025c1160-736c6efa.jpg,test," FINAL REPORT EXAM: Chest, single AP portable view. CLINICAL INFORMATION: Left lower lobe nodule status post biopsy, rule out pneumothorax. COMPARISON: Reference made to chest CT from ___. FINDINGS: The patient is status post right pneumonectomy with complete opacification of the right hemithorax seen. The left hemithorax demonstrates perihilar opacity, raising concern for pulmonary edema. The patient's known left lower lobe pulmonary nodule is better evaluated on CT. No large left pleural effusion is seen. There is no evidence of pneumothorax. IMPRESSION: 1. No evidence of pneumothorax. 2. Pulmonary edema. 3. Known left lower lobe nodule, better appreciated on CT. 4. Status post right pneumonectomy. " fd5ad18c-0e7b299c-27764b39-5595a6ce-718a9ee8.jpg,test/p19/p19650702/s52397496/fd5ad18c-0e7b299c-27764b39-5595a6ce-718a9ee8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p TBP with leukocytosis // Perform at 5:45am on ___. r/o interval change COMPARISON: Multiple chest radiographs, most recent ___ FINDINGS: PA and lateral views of the chest provided. Stable moderate cardiomegaly and widened mediastinum. Opacity adjacent to right thoracotomy site is unchanged and consistent with expected postoperative changes. Stable bibasilar atelectasis. No pneumothorax or pleural effusion. IMPRESSION: Unchanged opacity adjacent to right thoracotomy site, consistent with expected postoperative changes. Stable bibasilar atelectasis. " 2de33af9-4871d2a1-ca0864e1-0a8d7253-126af31c.jpg,test/p12/p12233133/s57155097/2de33af9-4871d2a1-ca0864e1-0a8d7253-126af31c.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Altered mental status with leukocytosis. COMPARISONS: Recent prior outside chest radiograph from earlier on the same day. TECHNIQUE: Chest, portable AP supine. FINDINGS: The patient is intubated. The endotracheal tube terminates approximately 4.5 cm above the carina. An orogastric tube terminates in the stomach. The patient is status post incompletely characterized upper thoracic spinal fusion. The lungs appear clear. There are no pleural effusions or pneumothorax. The cardiac, mediastinal and hilar contours appear within normal limits. The heart is normal in size. There has been no significant change. IMPRESSION: Status post endotracheal intubation. No evidence of acute disease. " 57240755-82dd709a-5201600e-5af1af77-95ee9117.jpg,test/p17/p17890887/s58940598/57240755-82dd709a-5201600e-5af1af77-95ee9117.jpg,test," FINAL REPORT INDICATION: Fever. Evaluate for pneumonia. COMPARISON: None. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Cholecystectomy clips are noted in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 2a2de08c-8846b4f8-8b1cb3ca-1ca9622c-79c5b1a5.jpg,test/p11/p11423795/s59278318/2a2de08c-8846b4f8-8b1cb3ca-1ca9622c-79c5b1a5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ESRD for pre kidney transplant eval // r/o cardiopulmonary abnormalities r/o cardiopulmonary abnormalities IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Mild cardiomegaly is chronic. Lungs are clear. No pleural abnormality. Normal mediastinal and hilar contours " 663fbdf2-59d73e2b-4c53cd6c-1e30b6b5-5935e108.jpg,test/p17/p17212019/s51163766/663fbdf2-59d73e2b-4c53cd6c-1e30b6b5-5935e108.jpg,test," FINAL REPORT CHEST, TWO VIEWS ___ HISTORY: ___-year-old male with productive cough. Question pneumonia. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Lungs are clear of consolidation. Cardiomediastinal silhouette is within normal limits. Posterior right ninth and tenth rib fractures are again seen. Osseous structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " 2d7b07ed-3bdd27be-ff9a2710-c47d0e54-ac2aea77.jpg,test/p15/p15766903/s56113416/2d7b07ed-3bdd27be-ff9a2710-c47d0e54-ac2aea77.jpg,test," FINAL REPORT INDICATION: COPD, presents with low-grade fever, hypoxia and elevated white blood count, crackles on left base. Interval change after hydration. Rule out pneumonia. Evaluate pulmonary nodule at the oblique view. COMPARISON: ___. FINDINGS: There is increased heterogeneous opacification in the left lower lobe and lingula consistent with pneumonia. Previously identified nodular opacity in the right lower lung may correspond with the nipple shadow; however, other nodular opacities are seen in the right lower lung and the left upper lung on oblique views and given the patient's underlying chronic lung disease, would recommend a CT to evaluate. Severe background emphysematous changes are not significantly changed from yesterday. Normal heart size. Tortuous aorta with atherosclerotic calcification at the aortic knob is unchanged. No pneumothorax or pleural effusion. IMPRESSION: 1. Left lower lobe and lingular pneumonia. 2. Previously identified nodular opacity in the right lower lung may represent a nipple shadow; however, other nodular opacities in the right lower lung and the left upper lung are seen on oblique views and given the patient's underlying lung disease, a CT is recommended to evaluate. NOTIFICATION: Telephone notification to Dr. ___ by Dr. ___ at 1:27 p.m. on ___, page was sent at time of discovery of findings. " 46a62d4b-b680e360-cc747e02-d1c7a70f-6f16232c.jpg,test/p18/p18963838/s51239280/46a62d4b-b680e360-cc747e02-d1c7a70f-6f16232c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea, etoh cirrhosis // please eval for acute cp process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Scattered right mid to lower lung linear atelectasis/scarring is seen. There is a small left pleural effusion. No definite focal consolidation is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Small left pleural effusion. Scattered right mid to lower lung linear atelectasis/ scarring. " 41bae2c9-bc8a93af-90740a29-33059e9c-f8160a98.jpg,test/p16/p16619721/s58413371/41bae2c9-bc8a93af-90740a29-33059e9c-f8160a98.jpg,test," WET READ: ___ ___ ___ 7:29 PM No significant change from recent comparison from 14 hours prior. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB decreased breath sounds in left // please eval for interval change please eval for interval change COMPARISON: Chest radiographs ___ through ___ at 04:50. IMPRESSION: Mild interstitial edema has worsened, accompanied by increasing small bilateral pleural effusions. New consolidation in the left lower lobe could be pneumonia or atelectasis. Severe cardiomegaly unchanged " dd2f5d49-2abc590f-ac161e96-9783fe27-a9a49f90.jpg,test/p16/p16304947/s55293942/dd2f5d49-2abc590f-ac161e96-9783fe27-a9a49f90.jpg,test," FINAL REPORT INDICATION: ___-year-old man with left subdural hemorrhage, preop evaluation for acute process. COMPARISON: None. PORTABLE AP CHEST RADIOGRAPH: Sternotomy wires are midline and intact. Surgical clips are noted within the upper mediastinum. The cardiac, mediastinal, and hilar contours are unremarkable. Both lungs are clear with no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " e2d2cbbe-14241847-cf2aebc9-399d9668-9362498d.jpg,test/p17/p17904720/s59194191/e2d2cbbe-14241847-cf2aebc9-399d9668-9362498d.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old man with PICC // pICC placement pICC placement IMPRESSION: In comparison with the study of ___ the right subclavian PICC line extends to the mid portion of the SVC. Relatively low lung volumes with continued enlargement of the cardiac silhouette and pulmonary vascular congestion. Extensive opacification at the left base with extension along the lateral chest wall is consistent with pleural effusion and compressive atelectasis. In the appropriate clinical setting, it would be very difficult to exclude superimposed pneumonia. " 2ea4cd70-f807aaaa-3ee7ff9f-58719714-28dd01a4.jpg,test/p11/p11522912/s50976709/2ea4cd70-f807aaaa-3ee7ff9f-58719714-28dd01a4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with resp failure // ETT COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are constant. Moderate cardiomegaly. Bilateral pleural effusions, left more than right, with subsequent areas of atelectasis. In addition, a basal area at the right lung has minimally increased in density and shows air bronchograms, raising the possibility for aspiration or developing pneumonia. No pneumothorax. Unchanged moderate cardiomegaly. " a9057b0a-455bd8ae-241eb11f-d75e5411-81f9f95b.jpg,test/p18/p18882650/s51393372/a9057b0a-455bd8ae-241eb11f-d75e5411-81f9f95b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PNA and increasing pleural effusion. // please eval effusion, consolidation. IMPRESSION: In comparison to ___ chest radiograph, a right pleural catheter has changed in position in, and a moderate, partially loculated right pleural effusion has apparently minimally increased in size. Multifocal focal bilateral pulmonary opacities have slightly worsened in the interval, particularly in the right juxta hilar region and left retrocardiac area. No other relevant change. " 06113252-33c7bda3-49ee5aff-0c01ab49-49640c01.jpg,test/p12/p12285052/s51076914/06113252-33c7bda3-49ee5aff-0c01ab49-49640c01.jpg,test," FINAL REPORT AP CHEST, 4:48 A.M., ___ HISTORY: A ___-year-old woman. Aspiration and intubation. IMPRESSION: AP chest compared to ___: There has been no worsening of residual consolidation at the base of the right lung since ___ following tracheal extubation. An upper enteric drainage tube passes into the stomach and out of view. Left jugular line ends at the origin of the SVC. At least a small right pleural effusion is presumed, but probably not new. Mild atelectasis persists at the left base. There is no appreciable left pleural effusion. Heart size is normal. " 441e3f27-a6c686da-58e80371-c50c6f2b-d69c2bbe.jpg,test/p12/p12043836/s52233929/441e3f27-a6c686da-58e80371-c50c6f2b-d69c2bbe.jpg,test," FINAL REPORT STUDY: PA AND LATERAL CHEST RADIOGRAPH. INDICATION: ___-year-old male with history of severe pulmonary hypertension, new onset AFib, for evaluation. TECHNIQUE: Two views of the chest were obtained. COMPARISON: ___. REPORT: There is significant cardiomegaly noted. Prominent pulmonary hila are noted and there is some subcarinal splaying. Generalized pulmonary plethora is noted, although this is not as prominent as on the prior study. A few nonspecific interstitial lines are seen at the right lung base, again not as significant as on the prior study. CONCLUSION: Findings of cardiomegaly, pulmonary arterial hypertension and pulmonary plethora suggest a significant cardiac shunt. There is no evidence of consolidation on this study. There is probably mild fluid overload. This, however, is not as pronounced as on prior studies from ___. " 54bdfb34-74d0a015-2c83b578-86d1ea63-a726dd9a.jpg,test/p15/p15511456/s58668448/54bdfb34-74d0a015-2c83b578-86d1ea63-a726dd9a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hx of asthma presenting with cough and SOB // evidence of PNA TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. Specifically, no focal consolidation to suggest pneumonia. " 85994a1e-dfca7519-835444d5-85ec75da-50559882.jpg,test/p16/p16316457/s51872359/85994a1e-dfca7519-835444d5-85ec75da-50559882.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST. REASON FOR EXAM: Paraplegia, COPD . Comparison is made with prior study, ___. Cardiomegaly is obscured by the pleural parenchymal abnormalities. Bibasilar opacities consistent with atelectasis and small effusions have improved. The upper lungs are clear. There is no pneumothorax. Right PICC tip is in mid SVC. Deformity of multiple left upper ribs is again noted . " 3728085c-49d4788b-7a822815-0b80d71a-4a68016c.jpg,test/p19/p19249493/s53529110/3728085c-49d4788b-7a822815-0b80d71a-4a68016c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with shortness of breath, gerd, recent surgery of the left thoracic outlet // ___ year old woman with shortness of breath, gerd, recent surgery of the left thoracic outlet ___ year old woman with shortness of breath, gerd, recent ___ IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Calcified lesion in the left axillary region is unchanged. " 7adf3ea4-bbe2971d-affc6c28-2e21704a-26dd21fb.jpg,test/p15/p15684838/s59508759/7adf3ea4-bbe2971d-affc6c28-2e21704a-26dd21fb.jpg,test," FINAL REPORT INDICATION: ___ year old woman with ARDS in setting of urosepsis. // Please evaluate for interval change. COMPARISON: Radiographs from ___ IMPRESSION: There is artifact projecting over the patient which may be related to the underlying table or bucky board. Support lines and tubes are unchanged. There remains cardiomegaly. There are bibasilar opacities as well as pulmonary interstitial edema which has improved slightly. Bilateral effusions are seen, stable. No definite pneumothoraces are present. " 11eb19ab-697e45f5-3ff2a408-d1b19750-1dc420ad.jpg,test/p15/p15481731/s57820859/11eb19ab-697e45f5-3ff2a408-d1b19750-1dc420ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with klebsiella pna. // Comparison to previous. Comparison to previous. COMPARISON: Chest radiographs since comparison chest radiographs since ___ most recently ___. IMPRESSION: Persistent severe infiltrative pulmonary abnormality has been present for 10 days looks low worse in the upper lungs today than it did on ___ and there is more interstitial abnormality at the lung bases. All the changes can be explained by new mild pulmonary edema or alternatively decrease in positive pressure ventilator support. Heart is normal size and pleural effusions are small and unchanged. ET tube and nasogastric tube are in standard placements and a right jugular line ends in the low SVC. There is no pneumothorax. " 0db32063-8a7550e5-5c1bd44d-04a6978d-b508b553.jpg,test/p12/p12763939/s57955506/0db32063-8a7550e5-5c1bd44d-04a6978d-b508b553.jpg,test," FINAL REPORT INDICATION: ___-year-old man with spiking fevers, status post diaphragmatic repair, who presents for evaluation. COMPARISONS: Chest radiographs from ___, ___, and ___ and CT torso from ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The heart size is normal. The tracheostomy tube is in appropriate position. The hilar and mediastinal contours are normal. There is an enteric tube which traverses below the diaphragm with the tip out of view of the film. There is suprahilar right mid lung subsegmental atelectasis, unchanged compared to the prior exam. No new focal consolidations are seen. There is slight increased density over the left hemithorax, likely secondary to a layering small pleural effusion, better seen on the CT Torso from ___. No pneumothorax is seen. IMPRESSION: No new focal consolidations identified concerning for pneumonia. " b2599dcc-52447a9c-dc90409b-276d047c-88741c6c.jpg,test/p18/p18249843/s59589793/b2599dcc-52447a9c-dc90409b-276d047c-88741c6c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pancreatitis and wheezing on exam. // Please evaluate for pneumonia, other process. TECHNIQUE: Portable chest COMPARISON: Outside film from ___ FINDINGS: The heart is moderately enlarged. Lung volumes are low. There is bilateral pleural effusions right greater than left. There is volume loss at both bases, right greater than left. There is pulmonary vascular redistribution with perihilar haze. IMPRESSION: Pulmonary edema. An underlying infectious infiltrate particularly on the right cannot be excluded. Compared to the outside study from ___ the appearance of the lungs is much worsened " 4d3dcb8e-1eb1ae8a-80ef175a-4f4fbb7f-c8328dcf.jpg,test/p13/p13652986/s52216620/4d3dcb8e-1eb1ae8a-80ef175a-4f4fbb7f-c8328dcf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with enlarging R apical nodule s/p robotic VATS RUL wedge. // Assess for interval change. Please time for 05:00 ___. Assess for interval change. Please time for 05:00 ___. IMPRESSION: In comparison with the study of ___, there are substantially lower lung volumes. Right chest tube remains in place and there is minimal if any residual pneumothorax. Blunting of the costophrenic angles could reflect small pleural effusions, though they may merely be a manifestation of low lung volumes. Little if any elevation of pulmonary venous pressure and no evidence of acute focal pneumonia. " b17d8c12-d2af3767-1088d4af-98ebe910-8e8a5b31.jpg,test/p15/p15282849/s58488504/b17d8c12-d2af3767-1088d4af-98ebe910-8e8a5b31.jpg,test," FINAL REPORT HISTORY: Cough and fever. COMPARISON: None. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well expanded. There is a consolidation in the right lower lobe. There is no effusion or pneumothorax. The left lung is clear. The cardiac and mediastinal contours are normal. IMPRESSION: Right lower lobe pneumonia. Findings were discussed with Dr. ___ ___ telephone at 1 ___ on ___. " cfeb2b94-4f99702b-7ef812f2-9604cc80-b5a340d4.jpg,test/p12/p12568708/s54882047/cfeb2b94-4f99702b-7ef812f2-9604cc80-b5a340d4.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with altered mental status, evaluate heart and lungs. TECHNIQUE: Chest AP and lateral COMPARISON: None available FINDINGS: There is mild pulmonary vascular congestion. No focal consolidation is identified. The cardiac silhouette is within normal limits. There is no pleural effusion or pneumothorax. IMPRESSION: Mild pulmonary vascular congestion. No focal consolidation. " 09b06b49-7d6d28fc-66b464d9-c49e08f0-8aad6c04.jpg,test/p16/p16342554/s51188053/09b06b49-7d6d28fc-66b464d9-c49e08f0-8aad6c04.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HIV (last VL undetectable and CD4 190), seizure disorder, HIV related neurocognitive disorder who presented with altered mental status and hypothermia with unclear history. // interval change, development of pneumonia IMPRESSION: As compared to ___ radiograph, cardiomediastinal contours are normal, and lungs remain clear without focal areas of consolidation. Normal chest radiograph does not exclude the possibility of pneumocystis infection. No pleural effusion. " b6ed7c9f-0b66a4df-7438f8d1-4627c8e2-9a038d1b.jpg,test/p11/p11551927/s54781798/b6ed7c9f-0b66a4df-7438f8d1-4627c8e2-9a038d1b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubationm ETT appears high on ED film // proper ETT position TECHNIQUE: Chest single view . COMPARISON: ___ at ___ 57 IMPRESSION: the ET tube is 5.5 cm above the carina. The NG tube tip is in the stomach. Right IJ line tip is in the right atrium. Lung volumes are low and I cannot exclude small/early infiltrates in the lower lobes " 623faf6a-2c97ec50-e0da6d76-de83513a-aa4cd410.jpg,test/p13/p13350579/s58780206/623faf6a-2c97ec50-e0da6d76-de83513a-aa4cd410.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with copd former tracheal narrowing // increased tracheal narrowing. increased tracheal narrowing. IMPRESSION: Compared to chest radiographs ___, read in conjunction with chest CT ___. Tracheal narrowing cannot be assessed on these conventional chest radiographs. There is more peribronchial infiltration in the lingula, obscuring the left heart border which may represent active infection in a region of chronic bronchiectasis or new pneumonia. Bronchiectasis and emphysema noted in the right lung. Patient has had right upper lobectomy. " e68f19ec-a49d400f-2830fb1b-45f325a1-0698b0fd.jpg,test/p13/p13048289/s59213892/e68f19ec-a49d400f-2830fb1b-45f325a1-0698b0fd.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pneumonia v. scarring // acute infection TECHNIQUE: Frontal and lateral radiographs of the chest were acquired. COMPARISON: CT abdomen and pelvis from ___. FINDINGS: There is bilateral mid to lower lung bandlike atelectasis. The lungs are otherwise clear. The cardiomediastinal silhouette is normal. There is a trace quantity of fluid in the minor fissure. IMPRESSION: 1. Bilateral mid to lower lung bandlike atelectasis. No convincing evidence of pneumonia. 2. Trace quantity of fluid in the minor fissure. " e83fee70-2dc5f759-67160517-f1fb0142-c9ce3e34.jpg,test/p12/p12078716/s54620573/e83fee70-2dc5f759-67160517-f1fb0142-c9ce3e34.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with encephalopathy, spiking temp // ?edema ?edema COMPARISON: ___ IMPRESSION: The above tube tip is in the stomach. Replaced aortic valve is present. Heart size and mediastinum are unchanged. Lungs are overall unchanged in appearance with no new consolidations or pulmonary edema development. Left retrocardiac atelectasis is unchanged with no evidence of new consolidation or progressing consolidation. " ad1e05de-9fb97613-35ed46fe-eab0fb11-dee58f7f.jpg,test/p11/p11455001/s58227757/ad1e05de-9fb97613-35ed46fe-eab0fb11-dee58f7f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with gastric perforation and Dobbhoff tube placement. Portable AP chest radiograph was reviewed in comparison to ___. The Dobhoff tube tip is in the proximal mid stomach. NG tube tip appears to be adjacent to the Dobbhoff tube. Abdominal drain is in place. Right central venous line tip is at the level of cavoatrial junction. ET tube tip is 4.3 cm above the carina. There is interval development of mild-to-moderate interstitial pulmonary edema. Small bilateral pleural effusions are most likely present. Basal consolidations are noted, better appreciated on CT torso from ___. " e04a1398-1db4cbd3-32696ef5-ad30f0b6-eecc4e5a.jpg,test/p19/p19371028/s55010130/e04a1398-1db4cbd3-32696ef5-ad30f0b6-eecc4e5a.jpg,test," FINAL REPORT INDICATION: ___F with afib, CVA, recent admission for cholecystitis complaining of SOB. // Evaluate for pna TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear besides mild left basilar atelectasis. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 5e57bcb5-182279a4-4fa94827-b3fceea4-91660eba.jpg,test/p11/p11126801/s50718154/5e57bcb5-182279a4-4fa94827-b3fceea4-91660eba.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with recent pneumonia, intubated, unresponsive, off sedation with recurrent fever, evaluate for infiltrate. Assess for interval change. FINDINGS: AP single view of the chest has been obtained with patient in supine position. Comparison is made with the next preceding similar study of ___ with patient in semi-upright position. Patient remains intubated, the ETT in unchanged position terminating some 4 cm above the level of the carina. An NG tube exists as before and reaches well below the diaphragm. Unchanged position of previously described right subclavian central venous line. Mediastinal shift towards the right exists and results in reduced pulmonary volume of the right hemithorax. Comparison of the portable frontal view suggests that the amount of pleural effusion of the right side has increased again as now a 1 cm wide dense layer inside the right lateral chest wall is seen. There is no evidence of pneumothorax on either side. IMPRESSION: No significant interval change on these portable chest examinations during the latest one day observation interval. " 5d4d2b44-d56dd646-772295de-dcb588f1-b18aba7a.jpg,test/p12/p12160337/s53756330/5d4d2b44-d56dd646-772295de-dcb588f1-b18aba7a.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: Multiple prior radiographs ranging from chest radiograph from ___ to chest radiograph from ___. FINDINGS: The lungs are clear with no evidence for a consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Incidental note is again made of an anterior right third bifid rib; otherwise, no acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " c09aebf3-22dc5ffc-5ccea55e-536621b5-30f96aac.jpg,test/p17/p17935897/s54030061/c09aebf3-22dc5ffc-5ccea55e-536621b5-30f96aac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypercarbic respiratory failure // PNA/vascular congestion PNA/vascular congestion IMPRESSION: Cardiomegaly is substantial. No pulmonary edema. No pleural effusion. Overall no change since the prior study. " 40af7b32-3c84593c-e3cc80c9-f1924167-96d6e638.jpg,test/p12/p12519991/s54195477/40af7b32-3c84593c-e3cc80c9-f1924167-96d6e638.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain. COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. The heart is mildly enlarged. The aorta is unfolded. There is platelike basal atelectasis noted bilaterally. No focal consolidation concerning for pneumonia. No large effusion or pneumothorax. No congestion or edema. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild cardiomegaly. Platelike lower lung atelectasis. " cc3569eb-90e5e64f-be15cb5e-1e9b2929-b7408be4.jpg,test/p18/p18458646/s50166380/cc3569eb-90e5e64f-be15cb5e-1e9b2929-b7408be4.jpg,test," FINAL REPORT INDICATION: ___ year old man with a history of CLL now with increased SOB please evaluate for new pathology. // ___ year old man with a history of CLL now with increased SOB please evaluate for new pathology. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Multiple prior chest radiographs, most recently ___. FINDINGS: Slight coarsening of the interstitial markings and hyperinflation are likely due to emphysema. There is no focal opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiac contours are normal. Prominence of the right hilus is unchanged over multiple prior studies dating back to ___. There is no free air beneath the right hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " 31867ebd-57b072b4-c505ed8b-761e455e-1c256541.jpg,test/p17/p17415919/s50649755/31867ebd-57b072b4-c505ed8b-761e455e-1c256541.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and CABG. The cardiac and mediastinal silhouettes are stable and unremarkable. There is no widening of mediastinum. There is subtle ground-glass opacification in the right lung base, new/increased since the prior study, which could be due to atelectasis or mucoid impaction, although underlying early consolidation is not excluded. The left lung is clear. There is no pleural effusion or pneumothorax. IMPRESSION: Subtle right base opacity, could be due to atelectasis, vascular structures, or mucoid impaction, although underlying consolidation is not excluded in the appropriate clinical setting. " a49b40db-69b2fcce-315174ec-51846af6-6096c71a.jpg,test/p11/p11451861/s53111501/a49b40db-69b2fcce-315174ec-51846af6-6096c71a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with sob // sob ? reason TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear and there is no pleural effusion or pneumothorax. Minimal linear atelectasis at the left lung base is demonstrated " bc59a6fa-dc615273-65fc85e3-0c3bf87c-984c1ca6.jpg,test/p14/p14788110/s54140465/bc59a6fa-dc615273-65fc85e3-0c3bf87c-984c1ca6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cough, new O2 requirement // ?PNA ?PNA IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Again there is elevation of the right hemidiaphragmatic contour with atelectatic changes above it. Less prominent atelectasis is seen at the left base. No evidence of pulmonary vascular congestion. Although no focal consolidation is seen, in the absence of a lateral view, it is difficult to unequivocally exclude superimposed pneumonia. " 89c59fa1-95f22e89-a3075b84-8c828111-4595391e.jpg,test/p13/p13273041/s54386158/89c59fa1-95f22e89-a3075b84-8c828111-4595391e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with PMH Wegener's presenting c/o gradual onset chest pressure since yesterday // acute cardiopulmonary process COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is again noted. The mediastinal contour appears normal. There are bilateral pleural effusions, moderate on the right and small on the left. There is rib compressive atelectasis in the right lower lung. Difficult to exclude an underlying pneumonia. No signs of edema or congestion. No pneumothorax. Bony structures are intact. IMPRESSION: Bilateral pleural effusions, moderate on the right and small on left. Stable cardiomegaly. Right basal atelectasis, difficult to exclude underlying pneumonia. " 5b0487aa-c8d2edb5-5cec9422-bb785c36-5d6d62d8.jpg,test/p13/p13387125/s54684228/5b0487aa-c8d2edb5-5cec9422-bb785c36-5d6d62d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with left lower chest pain // etiology LT MID-LEVEL/POSTERIOR CHEST PAIN W/INSPIRATION AND MOVEMENT NO INJURY NO COUGH PER PT HX LUPUS,SEIZURES,DDD TECHNIQUE: PA and lateral chest films COMPARISON: ___ FINDINGS: The cardiomediastinal silhouette is unchanged. The lungs are clear bilaterally. No pleural effusion or pneumothorax is seen. IMPRESSION: Normal radiographic examination of the chest. " f9a0ceb0-65291f79-847eff86-5d8c85ed-970d8c9a.jpg,test/p11/p11979534/s57623662/f9a0ceb0-65291f79-847eff86-5d8c85ed-970d8c9a.jpg,test," FINAL REPORT INDICATION: ___M with CKD, HFpEF, CAD presenting w/ nausea, vomiting, lightheadedness. // Please evaluate for pneumonia, signs of volume overload. TECHNIQUE: Single portable view of the chest. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: There are hazy bibasilar opacities. Superiorly, lungs are clear. Moderate cardiac enlargement is unchanged. There is rightward deviation of the trachea at the thoracic inlet due to a known underlying left-sided thyroid enlargement. Tortuosity of the descending thoracic aorta is again noted. No acute osseous abnormalities. IMPRESSION: Hazy bibasilar opacities, potentially atelectasis, infection is not excluded. " 147935b9-3f5ec406-a6932613-f45cd5c5-7337a056.jpg,test/p19/p19231238/s51367041/147935b9-3f5ec406-a6932613-f45cd5c5-7337a056.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with acute on chronic diastolic congestive heart failure, evaluate interval change after diuresis. TECHNIQUE: PA and lateral chest radiographs obtained of the patient in the upright position. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: Previous pulmonary edema has nearly resolved. The cardiac silhouette continues to is mildly enlarged. Small pleural effusions are present, left greater than right. IMPRESSION: Near resolution of pulmonary edema. " fe322af0-968835df-873f274d-2483c6a6-3b2d82a8.jpg,test/p18/p18583455/s55108111/fe322af0-968835df-873f274d-2483c6a6-3b2d82a8.jpg,test," WET READ: ___ ___ ___ 8:37 AM Right PICC line in distal SVC. WET READ VERSION #1 ___ ___ ___ 12:35 AM Right PICC line in distal SVC. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with picc placed on prior admission, presenting w/fever back pain // confirm picc placement confirm picc placement IMPRESSION: In comparison with the study of ___, there is a right subclavian PICC line extends to the lower portion of the SVC. Otherwise, no evidence of acute cardiopulmonary disease. " 5a6098b0-2f13c257-d2cea598-f5c6f1a3-63f62f8d.jpg,test/p17/p17493022/s59349988/5a6098b0-2f13c257-d2cea598-f5c6f1a3-63f62f8d.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with history of sob and cough presenting to the ED for suicidal ideations. Evaluate for pneumonia. TECHNIQUE: AP upright view of the chest COMPARISON: ___ FINDINGS: There is evidence of postsurgical changes with suture material noted in the left mid lung. There is tenting of the left hemidiaphragm and the heart is deviated towards the left secondary to volume loss. There is no focal consolidation, effusion, or pneumothorax. Heart size is normal. Imaged osseous structures are intact. No evidence of free air below the diaphragm. IMPRESSION: 1. No evidence of pneumonia. 2. Postsurgical changes in the left mid lung likely secondary to prior lung resection. The left hemidiaphragm is tented and the heart is deviated towards the left secondary to volume loss. " e369a6a1-094a1813-75ce5fec-ca5862b0-07ce2b71.jpg,test/p18/p18001762/s50779262/e369a6a1-094a1813-75ce5fec-ca5862b0-07ce2b71.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain and shortness of breath since last night // ___F with chest pain and shortness of breath since last night COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes are low limiting assessment. Allowing for this, the lungs are clear. No signs of pneumonia or edema. No large effusion or pneumothorax. Cardiomediastinal silhouette is unchanged. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " be5895bd-18f0f8c9-a589af85-de624609-6aa25320.jpg,test/p12/p12595468/s54339027/be5895bd-18f0f8c9-a589af85-de624609-6aa25320.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Knee year old woman presenting with chest pain. Evaluate for PNA, cHF, PTX. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes remain slightly low. No focal consolidation, edema, effusion, or pneumothorax. The heart is top-normal in size, unchanged. Aortic knob calcifications are mild. Multilevel degenerative changes in the visualized spine are mild. IMPRESSION: No acute findings the chest. " 7e64547a-b2754e3e-77098af4-4c59d5e8-e356d320.jpg,test/p16/p16168889/s52213809/7e64547a-b2754e3e-77098af4-4c59d5e8-e356d320.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, shortness of breath, rhonchi, and expiratory wheeze in left and right lower lobe, to rule out pneumonia, infection. TECHNIQUE: Frontal and lateral chest views were reviewed. No prior chest radiograph was available for comparison. FINDINGS: Small subtle opacity in the left mid lung which is appreciated only on the frontal view is suspicious for early pneumonia. Right lung is clear. Heart size, mediastinal and hilar contours are normal. There is no pleural abnormality. IMPRESSION: Ill-defined, small opacity in left mid lung is concerning for an evolving pneumonia. Dr. ___ ___ these findings with Dr. ___ on ___ at 3:50 p.m. " 2c613e8f-52511b5d-4647c6df-33fc0d41-e7c29a02.jpg,test/p19/p19840128/s54735129/2c613e8f-52511b5d-4647c6df-33fc0d41-e7c29a02.jpg,test," WET READ: ___ ___ 8:48 PM Cardiomegaly, perihilar opacities, indistinctness of the pulmonary vasculature, increased septal thickening (Kerley B lines), and a left pleural effusion, all consistent with decompensated CHF. Underlying pneumonia cannot be excluded. ___ d/w Dr. ___ on ___ at 8:46 pm. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Fever and acute mental status change. FINDINGS: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions, more prominent on the left. No definite acute pneumonia is appreciated. " 7c71237c-5a4c2566-ade6e0a7-0f41669c-60f84906.jpg,test/p17/p17421663/s51547499/7c71237c-5a4c2566-ade6e0a7-0f41669c-60f84906.jpg,test," WET READ: ___ ___ ___ 8:43 PM New interstitial airspace opacities within the right upper lobe, right middle lobe and to a lesser extent in the left upper lobe, would be consistent with acute multi focal pneumonia given the provided clinical history. Aspiration and asymmetric edema are also possibilities. No pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Fever, evaluation for pneumonia. COMPARISON: Outside hospital film from ___. FINDINGS: As compared to the previous radiograph, there are increasing parenchymal opacities in the right upper lobe, the right middle lobe and also the left lower lobe. Multifocal pneumonia is likely. The size of the cardiac silhouette is unchanged. There are no pleural effusions and no pneumothorax. Normal appearance of the mediastinum. At the time of dictation and observation, ___, at 8:27 a.m., the referring physician, ___. ___, was paged for notification. " 230d7ccb-956c24a6-a15f6937-1da293b3-bf6bf56e.jpg,test/p19/p19231238/s56761095/230d7ccb-956c24a6-a15f6937-1da293b3-bf6bf56e.jpg,test," FINAL REPORT INDICATION: History of CHF and hypertension and diabetes, worsening cough and dyspnea. Evaluate for pneumonia or pulmonary edema. COMPARISON: Chest radiograph on ___. FINDINGS: AP and lateral views of the chest. There are new diffuse opacities in both lungs, right greater than left likely due to slight leftward rotation. There are small bilateral pleural effusions, left greater than right. There is mild cardiomegaly. No pneumothorax. IMPRESSION: New diffuse bilateral opacities likely represent moderate pulmonary edema with mild cardiomegaly and small bilateral effusions, most consistent with CHF exacerbation. Underlying pneumonia cannot be excluded. " 8d5b47d5-f3281555-01c6343d-0e0080e7-0ece3fb3.jpg,test/p19/p19601036/s50105186/8d5b47d5-f3281555-01c6343d-0e0080e7-0ece3fb3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with thoracic duct injury s/p repair // eval for pleural effusions eval for pleural effusions COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Small bilateral pleural effusions have been stable since at least ___. The disposition of lymphangiographic contrast agent has not changed since ___, including internal mammary and mediastinal lymph nodes as well as the cisterna chylae and lymphatic duct. Heart size is normal. The ___ x 53 mm pneumatocele in the left lung, almost entirely filled with fluid, was ___ x 55 mm on ___. Lungs are otherwise clear. Hilar and mediastinal contours are unremarkable. " a53c3bd1-f80a29fe-af1f52ac-c4696a79-6a50a3ee.jpg,test/p16/p16200793/s59872599/a53c3bd1-f80a29fe-af1f52ac-c4696a79-6a50a3ee.jpg,test," FINAL REPORT INDICATION: History of shortness of breath. Evaluate for acute process. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Heart size is normal. The pulmonary arteries are mildly prominent. Known superior segment of the left lower lobe mass is seen on both the PA and lateral view is incompletely evaluated on this exam. The lungs demonstrate mild interstitial thickening, and bilateral perihilar haziness. There is also evidence of mild bibasilar atelectasis and mild bronchiectasis, particularly in the lower lobes. Emphysema is substantial. There is no pleural effusion or pneumothorax. Multiple left-sided rib fractures are overall stable compared to the prior exam. IMPRESSION: 1. No focal consolidations concerning for pneumonia identified. 2. Mild bilateral pulmonary edema. Recommend following up to resolution. 3. Known left lower lobe superior segment mass is incompletely evaluated on this exam. " 38d1969f-f3b55816-5d548b03-a231cfde-c1853581.jpg,test/p17/p17634496/s54192780/38d1969f-f3b55816-5d548b03-a231cfde-c1853581.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluation of cardiomegaly. COMPARISON: None. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. The cardiac, hilar, mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 19e5f13a-b4eb1b20-fe1c2f71-385b4ff0-af34e927.jpg,test/p17/p17370807/s51778469/19e5f13a-b4eb1b20-fe1c2f71-385b4ff0-af34e927.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p R pneumonectomy w/ worsening air fluid levels and loculations and elevated WBC // Perform at 5am on ___. r/o interval change TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Loculated air-fluid levels in the right pneumonectomy space have decreased. Large amount of fluid in the right pleural space has increased. Air in the pneumonectomy space is minimally decreased. Cardiomediastinal structures are midline. Left lower lobe opacities are stable. Right chest wall subcutaneous emphysema has improved IMPRESSION: Loculated air-fluid levels in the right pneumonectomy space have decreased. Large amount of fluid in the right pleural space has increased. Air in the pneumonectomy space is minimally decreased " 9657d600-3c5d71b3-723e372b-8b860908-a9fc7739.jpg,test/p11/p11463988/s53811381/9657d600-3c5d71b3-723e372b-8b860908-a9fc7739.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o lung cancer s/p LLL lobectomy, COPD, presents with ?PNA // eval for PNA eval for PNA COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is interval development of mild interstitial edema. No focal consolidation to suggest infectious process currently seen. No pleural effusion or pneumothorax demonstrated. " 2b38aad6-c9b64a4e-e7fadb4e-1e3962de-eb6d51a4.jpg,test/p12/p12483723/s54257819/2b38aad6-c9b64a4e-e7fadb4e-1e3962de-eb6d51a4.jpg,test," WET READ: ___ ___ ___ 7:38 PM 1. No evidence of acute cardiopulmonary process. 2. No displaced rib fracture or sternal fracture. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with chest pain, s/p fall, abrasion to anterior chest, evaluate for rib fracture or PNA TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is within normal limits. There is no displaced rib fracture or sternal fracture. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. No displaced rib fracture or sternal fracture. " 00386a37-759db998-2202f64b-b7f9729e-7564f445.jpg,test/p12/p12457153/s51233483/00386a37-759db998-2202f64b-b7f9729e-7564f445.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with new Dobbhoff tube placement, confirm correct position. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. The Dobbhoff line has been placed and reaches barely into the area of the hiatus. The tip is pointing towards the fundus of the stomach. Further advancement, however, is recommended. Comparison is made with the next preceding portable chest examination of ___, a remarkable progression of the aortic contour widening in the arch area and proximal descending portion is noted. This finding may be exaggerated by the significant tilt of the patient towards the right, but in order to exclude significant drop widening of the thoracic aorta, a repeat study should be obtained. Referring physician, ___, was paged to explore if patient shows clinical symptoms that can be related to the changes of the aorta. " b25051a5-5b1827df-b2081f3c-dbe6222d-6741f2a9.jpg,test/p11/p11472206/s51589307/b25051a5-5b1827df-b2081f3c-dbe6222d-6741f2a9.jpg,test," WET READ: ___ ___ 8:45 PM Irregular air collection projecting over mid mediastinum; question esphageal pathology, possibly inflammation, hernia or even leak? WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dyspnea. History of anemia and congestive heart failure. COMPARISONS: Prior chest radiographs from ___ and ___, as well as CT of the abdomen from ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The patient is status post sternotomy. The heart is moderately enlarged. Projecting over the mid chest, and seen only on the frontal view, is an irregular air collection projecting below the level of the carina. Otherwise, the mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. Mild loss in lower vertebral body heights appears unchanged. The bones may be demineralized to some degree. IMPRESSION: Irregular air collection projecting over the central lower mediastinum, probably referring to the esophagus; the etiology is uncertain. There are variety of possibilities including esophageal pathology, including the possibility of perforation, although dilatation due to dysmotility or inflammation of the esophagus may explain the appearance. " 4c36eb76-2ed1e535-10cc3c3e-863e5c20-ef6d02a0.jpg,test/p17/p17574863/s50623841/4c36eb76-2ed1e535-10cc3c3e-863e5c20-ef6d02a0.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post liver transplant, evaluation for interval change. COMPARISON: ___, 11:42 p.m. FINDINGS: As compared to the previous radiograph, there is unchanged position of the Dobbhoff catheter and the left internal jugular vein catheter. Unchanged size of the cardiac silhouette, low lung volumes, retrocardiac atelectasis. " 4b423782-58190b51-2a12350f-345fa894-ae6b70d3.jpg,test/p19/p19407320/s56175049/4b423782-58190b51-2a12350f-345fa894-ae6b70d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with bloody sputum COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lungs are hyperexpanded with flattened diaphragms and increased retrosternal lucency, findings consistent with chronic pulmonary disease such as chronic bronchitis. There is no focal consolidation. There is no pulmonary edema or pleural effusion. Heart size is normal. Mediastinal, hilar, cardiac contours are normal. IMPRESSION: Findings suggestive of chronic bronchitis. " 77f84489-2bbae3b1-08cc8665-ec7dc2ea-44bb6e13.jpg,test/p17/p17051420/s53239242/77f84489-2bbae3b1-08cc8665-ec7dc2ea-44bb6e13.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old male with chest pain and shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of consolidation, effusion or pulmonary vascular congestion. Cardiac silhouette is mild to moderately enlarged. No acute osseous abnormalities. IMPRESSION: Cardiomegaly without acute cardiopulmonary process. " d1f70373-0ab861e6-e6b5a99e-054c08ad-3d51c641.jpg,test/p13/p13063001/s55554316/d1f70373-0ab861e6-e6b5a99e-054c08ad-3d51c641.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with weakness and lightheadedness. COMPARISON: None available. FINDINGS: The lungs are without a focal consolidation or pneumothorax. A trace right pleural effusion is likely present. Cardiomediastinal silhouette is moderately enlarged. The aorta is tortuous. No acute fractures are identified. IMPRESSION: Moderate cardiomegaly with possible trace right pleural effusion. No overt pulmonary edema. " 20c2c4a6-f5a641e7-3646f055-719848d3-31778248.jpg,test/p18/p18803415/s55870309/20c2c4a6-f5a641e7-3646f055-719848d3-31778248.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with SOB and abdominal pain // ? pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. There is slight blunting of the right costophrenic angle and a trace pleural effusion is not excluded. No large pleural effusion is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No evidence of free air is seen beneath the diaphragms. IMPRESSION: Slight blunting of the right costophrenic angle, trace pleural effusion not excluded. No focal consolidation. " 8042c4fe-6783506a-eda7ddbc-17831fd9-9ca433a1.jpg,test/p10/p10104732/s50569022/8042c4fe-6783506a-eda7ddbc-17831fd9-9ca433a1.jpg,test," FINAL REPORT INDICATION: ___-year-old male with HIV, admitted with altered mental status and seizures. COMPARISON: Chest radiograph from ___ SUPINE CHEST RADIOGRAPH: The endotracheal tube, right approach central venous catheter, and enteric catheter are in expected unchanged position. Overall, aeration of the lungs is similar to prior, though with decrease in edema, now mild. A retrocardiac opacity is similar to prior. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: Expected positions of support devices. Slight decrease in pulmonary edema, now mild. " 724624fd-7795369c-d90b6a91-a64bdebc-bfdf49bf.jpg,test/p12/p12245451/s59046386/724624fd-7795369c-d90b6a91-a64bdebc-bfdf49bf.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ and ___. FINDINGS: The heart size remains mildly enlarged but unchanged. The aorta is tortuous. The mediastinal and hilar contours otherwise are stable. There is no pulmonary vascular congestion. Patchy opacities are demonstrated in both lung bases, right more so than left, which could reflect atelectasis but infection cannot be excluded, particularly in the right lung base. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Bibasilar airspace opacities may reflect atelectasis though infection cannot be completely excluded. " c7c02747-407b813c-c01e9f09-26817e0c-df7581a7.jpg,test/p17/p17517983/s57014359/c7c02747-407b813c-c01e9f09-26817e0c-df7581a7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Hyperglycemia, assess for pneumonia. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. Previously noted PICC line has been removed. " f5a96b51-7e5215da-76dcbdcf-80f9a674-633c94ed.jpg,test/p18/p18006988/s58150781/f5a96b51-7e5215da-76dcbdcf-80f9a674-633c94ed.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of worsening shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The aorta is mildly tortuous with minimal atherosclerotic calcifications noted at the aortic knob. Mediastinal and hilar contours are unchanged, with a large hiatal hernia again noted containing an air-fluid level. There is minimal atelectasis at the lung bases. No focal consolidation, pleural effusion or pneumothorax is present. Mild degenerative changes noted in the mid thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. Large hiatal hernia. " a09683a2-446ce5b7-561229d3-429951d0-150bd5a4.jpg,test/p10/p10880961/s56024873/a09683a2-446ce5b7-561229d3-429951d0-150bd5a4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain, please eval for mediastinal widening TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild degenerative changes are noted in the imaged thoracolumbar spine. IMPRESSION: No acute cardiopulmonary abnormality. " 34c5885a-ab5b27cd-f091521f-32c43502-9f6055d6.jpg,test/p17/p17446597/s54814059/34c5885a-ab5b27cd-f091521f-32c43502-9f6055d6.jpg,test," FINAL REPORT AP CHEST COMPARED TO ___: Feeding tube ends in the stomach. Left PIC line in the low SVC. Moderate right pleural effusion has increased since 9:13 a.m. on ___ and mild pulmonary edema has worsened as well. The heart is chronically moderately enlarged. Mediastinal venous engorgement suggests volume overload or biventricular decompensation. No pneumothorax. " b031be65-2e9d4ca0-bf28c89c-eaaa9452-e7b2abb0.jpg,test/p12/p12580125/s59629751/b031be65-2e9d4ca0-bf28c89c-eaaa9452-e7b2abb0.jpg,test," FINAL REPORT HISTORY: Chest trauma, to assess for injury. FINDINGS: The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. No gross evidence of rib fracture or pneumothorax. On one view, there is slight impression on the right side of the lower cervical trachea. This raises the possibility of thyroid enlargement. " 28ab63f1-12d93be1-5b4c352e-085502dc-59984d8c.jpg,test/p12/p12308681/s58138949/28ab63f1-12d93be1-5b4c352e-085502dc-59984d8c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with SOB // Pneumonia? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 9e95111f-1e0885e8-019a7313-d14c4386-954750b5.jpg,test/p14/p14493762/s53305044/9e95111f-1e0885e8-019a7313-d14c4386-954750b5.jpg,test," FINAL REPORT The are unchanged. EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with elevated bilirubin, altered mental status, elevating WBC. // pneumonia? pneumonia? IMPRESSION: Since ___ mild pulmonary edema has improved revealing areas of heterogeneous opacification in the right lung and possible small nodules. Whether this is active pathology or the residual of what was previously a much more severe pulmonary consolidation and edema is radiographically indeterminate. At some point chest CT scan might be helpful to see if any of these findings is suggestive of pneumonia, abscess, or septic emboli. Heart size is normal. Mild enlargement of the left hilus could be due to adenopathy or just the change in appearance due to mild obliquity of patient position. A dual channel dialysis catheter ends in the right atrium. Pleural effusions are small if any. There is no pneumothorax. " 5f1fffed-b26c3b9a-15d41a9c-eb0915db-05c7c91a.jpg,test/p12/p12694700/s54708218/5f1fffed-b26c3b9a-15d41a9c-eb0915db-05c7c91a.jpg,test," WET READ: ___ ___ 3:40 AM Right-sided PICC in the RA, approximatley 5-6 cm from the cavoatrial junction. The patient is status post median sternotomy and CABG. Small left pleural effusion and atelectasis as well as retrocardiac atelectasis. D/w ___ at 3:40 am ______________________________________________________________________________ FINAL REPORT HISTORY: PICC placement. FINDINGS: In comparison with the study of ___, there has been placement of a right subclavian PICC line that extends into the right atrium, about 6 cm below the cavoatrial junction. There is again substantial enlargement of the cardiac silhouette with retrocardiac opacification and blunting of the costophrenic angle, consistent with volume loss in the lower lobe and left effusion. No definite vascular congestion or acute focal pneumonia. " 3a4f6379-4cbfadf1-ee7525ac-8361c2f3-19564804.jpg,test/p12/p12118473/s53335230/3a4f6379-4cbfadf1-ee7525ac-8361c2f3-19564804.jpg,test," FINAL REPORT HISTORY: ___-year-old male with a newly discovered lung nodule, in need of followup. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: A left-sided pacer unit demonstrates leads in the right atrium, right ventricle, and coronary sinus. A coronary stent is present. The heart size is at the upper limits of normal. The mediastinal contours demonstrate calcified atherosclerotic disease of the aortic knob. The lungs are clear of consolidation. In the lateral lower portion of the right lung, the previously described ill-defined nodular opacity is less apparent and sits over the intersection of tubes and bronchovascular structure, likely reflecting the superimposition of normal structures. IMPRESSION: The previously described nodular opacity is less conspicuous on the current exam and most likely reflects the summation of normal overlapping structures. " 78203d9f-db4a424b-8112ccf1-984c7188-fa03e00c.jpg,test/p12/p12033847/s53721971/78203d9f-db4a424b-8112ccf1-984c7188-fa03e00c.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Three days of fever, assess for pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No signs of pneumonia or other acute intrathoracic process. " 45e99c5b-359ef92a-527fa55a-31ca3092-f81988ea.jpg,test/p15/p15927689/s59187766/45e99c5b-359ef92a-527fa55a-31ca3092-f81988ea.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " e2266373-78e7acf4-b126fa9e-6172df7c-687ac59d.jpg,test/p19/p19143018/s56296259/e2266373-78e7acf4-b126fa9e-6172df7c-687ac59d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cirrhosis, concern for pneumonia // please assess for evidence of pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. Bibasilar atelectasis are minimal increased. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: Minimally increase bibasilar atelectasis " e7dccb6d-129dcf30-9587f4a2-8e291753-f135aa38.jpg,test/p15/p15690303/s56109480/e7dccb6d-129dcf30-9587f4a2-8e291753-f135aa38.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Surgical site infection, preoperative chest x-ray. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a decrease in severity of the pre-existing left lower lung parenchymal opacity. The opacity, however, is still clearly visible and shows a lateral atelectatic and medial consolidative component. The preexisting atelectasis in the upper to mid zones of the left lung is unremarkable. Normal size of the cardiac silhouette. No acute lung changes. Degenerative changes in the right shoulder, status post partial shoulder replacement on the left. " 5bd755a2-59f9e02d-7b3361d2-e56f8906-a6c2babc.jpg,test/p10/p10398856/s53330812/5bd755a2-59f9e02d-7b3361d2-e56f8906-a6c2babc.jpg,test," FINAL REPORT HISTORY: Productive cough, evaluate for pneumonia. COMPARISON: Chest radiograph ___ and ___. FRONTAL AND LATERAL VIEWS OF THE CHEST (4 EXPOSURES): There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart is mildly enlarged. The hilar and mediastinal contours are unchanged. IMPRESSION: No acute cardiopulmonary process. " 9e1112c8-9965168e-c31f73ab-3638e9e4-d2db477b.jpg,test/p16/p16454913/s50525650/9e1112c8-9965168e-c31f73ab-3638e9e4-d2db477b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post septic shock, evaluation of fluid overload. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Huge left pleural effusion with cardiomegaly and areas of atelectasis at both lung bases, left more than right. The extent and severity of the diffuse bilateral parenchymal opacities is also unchanged. No pneumothorax, no new parenchymal changes. " db63106f-cafc90da-6987db96-fde9af27-b23d45e2.jpg,test/p14/p14486034/s52003767/db63106f-cafc90da-6987db96-fde9af27-b23d45e2.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with possible right middle lobe pneumonia following dehydration. IMPRESSION: PA and lateral chest compared to ___: Region of questioned right middle lobe pneumonia has not become more radiodense with the administration of contrast agent. I doubt there is pneumonia there or elsewhere in the lungs. If there is clinical justification for increasing the level of certainty in diagnosing pneumonia--___, for example--___ imaging of this area should start with a left anterior oblique chest radiograph, and as a second step limited CT scanning of the right middle lobe area. There is no pleural effusion or evidence of central adenopathy. Heart size is normal. " 92e08fa1-48c94167-d5daed82-2f7f7ace-47909aeb.jpg,test/p10/p10532853/s55081250/92e08fa1-48c94167-d5daed82-2f7f7ace-47909aeb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with r shoulder/back pain, history of CHF and cirrhosis. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There is interval increase in right pleural effusion now moderate in size with associated consolidation in the right lower lung likely representing atelectasis though difficult to exclude a superimposed pneumonia. The left lung appears clear. Cardiomegaly is again noted. There is no overt evidence for pulmonary edema. The bony structures are intact. IMPRESSION: Persistent cardiomegaly with increasing right pleural effusion and right mid and lower lung atelectasis, difficult to exclude a superimposed pneumonia. " c69563c0-75fee58b-a0264029-b26bea61-d6714231.jpg,test/p19/p19244907/s53297381/c69563c0-75fee58b-a0264029-b26bea61-d6714231.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fever TECHNIQUE: Frontal chest radiographs were obtained with the patient in the semi upright position. COMPARISON: Chest radiograph from ___, ___, ___ and ___ FINDINGS: There is bibasilar atelectasis. The lungs are clear of focal consolidation or pneumothorax. A tracheostomy is stable in position, and a left PICC terminates within the upper SVC. The cardiac and mediastinal silhouette are within normal limits. IMPRESSION: No new consolidation. " 171860ef-cb37fdbc-4425372e-53b838fa-2aeb1751.jpg,test/p16/p16901707/s51717019/171860ef-cb37fdbc-4425372e-53b838fa-2aeb1751.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with cough for two to three weeks, hypoxemia and history of end-stage renal disease. Study requested to rule out pneumonia. COMPARISON: Prior chest radiograph from ___ and prior chest CT from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: A dual-lumen dialysis catheter tip terminates at the level of the cavoatrial junction. There is stable cardiomegaly. There are confluent alveolar opacities along the superior left lower lobe and posterior left upper lobe, as well as additional patchy opacities in the left lower lobe posterior basilar segment. There is no frank pulmonary edema. There are no pleural effusions or pneumothorax. IMPRESSION: Superior segment left lower lobe and posterior segment left upper lobe consolidation consistent with pneumonia. Given the dependent distribution, these findings may represent an aspiration pneumonia. Recommend follow up CXR 4 weeks post treatment to document resolution if warranted clinically. These findings were discussed with ___, Dr. ___ nurse by Dr. ___ ___ telephone on ___ at 10:20 AM, time of discovery. " 867cd0bf-4fff5a7b-f1427ded-eb81e2a0-a8a5f311.jpg,test/p18/p18828209/s55172329/867cd0bf-4fff5a7b-f1427ded-eb81e2a0-a8a5f311.jpg,test," FINAL REPORT INDICATION: History: ___M with hypoxia, SOB // Eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs dated back to ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. There is a small consolidation in the right middle lobe, likely secondary to atelectasis. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. Note is made of chronic elevation of the right hemidiaphragm. IMPRESSION: 1. Right middle lobe atelectasis. 2. In the context patient's symptoms, this study does not suggest, or exclude the possibility of a pulmonary embolism. 3. Chronic elevation of the right hemidiaphragm. " e775f100-510eec9b-34624b1c-7d2a9a94-b7ff8744.jpg,test/p12/p12493668/s53767324/e775f100-510eec9b-34624b1c-7d2a9a94-b7ff8744.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p R VATS decortication, 2 CT's to WS // interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: 2 biapical right chest tubes are in unchanged position. Right IJ catheter tip is in the cavoatrial junction. Cardiomediastinal contours are unchanged. There are low lung volumes. . No definitive pneumothorax. Right lower lobe opacities have improved as well as left lower lobe opacities. Interstitial edema has improved. " fd9cadd5-6642d28b-b7745b05-3fb809ae-ee446c79.jpg,test/p14/p14848780/s53882054/fd9cadd5-6642d28b-b7745b05-3fb809ae-ee446c79.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with t-tube // eval for pna versus atelectasis versus pulm edema COMPARISON: ___. IMPRESSION: No relevant change in extent of the severe bilateral soft tissue and cervical air collections. No pneumothorax is visible. Unchanged alignment of the sternal wires, unchanged appearance of the cardiac silhouette. " 4e66833b-23088721-1ba8120b-995e3f77-adde4e68.jpg,test/p14/p14771174/s59291865/4e66833b-23088721-1ba8120b-995e3f77-adde4e68.jpg,test," FINAL REPORT HISTORY: S/p vomiting. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: PA and lateral images of the chest. Median sternotomy wires and surgical clips in the mediastinum and right axilla are noted. The lungs are well expanded. Pleural calcification is seen along the lateral left lung. The lungs are otherwise clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. The aorta is again noted to be markedly tortuous. The left posterior rib defect is seen, likely postsurgical. IMPRESSION: No acute cardiopulmonary process. " b3c1b3f3-8e124007-ebb9d895-f1e959c3-46d2a6c8.jpg,test/p18/p18815377/s56334409/b3c1b3f3-8e124007-ebb9d895-f1e959c3-46d2a6c8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, chest tightness // ? pna TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. There is left lower lobe superior segment consolidation, concerning for pneumonia. Rest of the lungs are overall clear. There is no pleural effusion or pneumothorax. Impression: Left lower lobe pneumonia, followup of the patient 4 weeks after completion of antibiotic therapy is required " 6fac1de8-3f983bc7-ce45c8eb-d10f6bd8-47e5ac04.jpg,test/p16/p16385283/s59946451/6fac1de8-3f983bc7-ce45c8eb-d10f6bd8-47e5ac04.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF exacerbation, hypoxemia // Please assess for interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Substantial interval progression of pulmonary edema is noted currently also associated with pleural effusions. The patient has been intubated with the ET tube tip being 5.5 cm above the carinal. No pneumothorax appreciated " 4dfc8e68-316b6a95-5bd2c501-d72daef9-63b7f91d.jpg,test/p19/p19022682/s54558048/4dfc8e68-316b6a95-5bd2c501-d72daef9-63b7f91d.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with MVA and low thoracic and upper lumbar pain. Question pneumothorax. FINDINGS: AP and lateral views of the chest. No prior. The lungs are clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures identified. IMPRESSION: No acute cardiopulmonary process. " 1d824099-7a720de4-93e0d531-e4974b20-6a658192.jpg,test/p11/p11798125/s50257452/1d824099-7a720de4-93e0d531-e4974b20-6a658192.jpg,test," FINAL REPORT HISTORY: ___-year-old man status post mitral valve repair. Evaluate for pleural effusions or pneumothorax. COMPARISON: Radiographs of the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate a small right-sided pleural effusion with adjacent atelectasis. There is no vascular congestion. The cardiomediastinal contours are approaching the preoperative baseline. There is no pneumothorax. Incidental note is made of a chronically dislocated right shoulder. IMPRESSION: Small right-sided pleural effusion with adjacent atelectasis. No pneumothorax. " 355e43d2-bc7162e3-9c3436fc-e74a4192-f7389712.jpg,test/p18/p18088903/s51635143/355e43d2-bc7162e3-9c3436fc-e74a4192-f7389712.jpg,test," FINAL REPORT INDICATION: Cough and dyspnea, here to evaluate for pneumonia. COMPARISON: Chest radiographs, last performed on ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes remain low in comparison to the prior study. There is no focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax is present. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The osseous structures are grossly unremarkable, although evaluation is limited secondary to body habitus. IMPRESSION: No acute cardiopulmonary process. " e2edbab5-bd9e10d7-b9d39014-8e33c47b-8f428eba.jpg,test/p15/p15451291/s59777152/e2edbab5-bd9e10d7-b9d39014-8e33c47b-8f428eba.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness // r/o pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " fc5e43bc-210961f4-aa8f516f-60bbe595-a7b1d1ae.jpg,test/p11/p11287191/s52963188/fc5e43bc-210961f4-aa8f516f-60bbe595-a7b1d1ae.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with cp, sob, hypoxia post op 2 weeks // TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: There has been interval removal of a left central venous line. ___ again overlie the right chest. There is slight decrease in opacity in the right mid chest with slight improvement of aeration of the right lung. Again seen is lateral pleural thickening along the staple line. Right greater than left biapical pleural thickening is seen. Cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. IMPRESSION: No pulmonary edema. Slight improvement in aeration of the right lung with slight decrease in opacity in the right mid chest and persistent lateral pleural thickening along the staple line. " fb0f6c35-db1388f9-9fe71fcd-def5b9cc-d088eb40.jpg,test/p13/p13135946/s55603183/fb0f6c35-db1388f9-9fe71fcd-def5b9cc-d088eb40.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post MVR and chest tube removal. Assess for pneumothorax. Comparison is made with prior study ___. There is no pneumothorax. If any, there is a small right pleural effusion. ET tube is in standard position. NG tube tip is in stomach. Swan-Ganz catheter tip is in the right main pulmonary artery. A left chest tube removed in place. Left lower lobe retrocardiac atelectasis is unchanged. Left upper lobe opacity is new consistent with atelectasis. Cardiomediastinal contours are unchanged. " 1eecf043-963ad017-dae72b7f-d2651682-eb349586.jpg,test/p17/p17177703/s54968893/1eecf043-963ad017-dae72b7f-d2651682-eb349586.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac silhouette size is mildly enlarged. The patient appears to be status post right lower lobectomy with multiple chain sutures and clips noted in the right hilum. Rightward mediastinal shift is compatible with volume loss in the right lung. Linear opacities within the right mid lung field likely reflects scarring. No focal consolidation, pleural effusion or pneumothorax is identified. Lungs are hyperinflated with flattened diaphragms. There is no pulmonary vascular congestion. Diffuse demineralization of the osseous structures is present. IMPRESSION: Postsurgical changes in the right lung without evidence of acute cardiopulmonary abnormality. Probable COPD. " 06e63df4-7a4bcd5f-7fa5b697-698ae8ed-180518e8.jpg,test/p16/p16367461/s54238109/06e63df4-7a4bcd5f-7fa5b697-698ae8ed-180518e8.jpg,test," FINAL REPORT INDICATION: Epigastric pain. COMPARISON: None. FINDINGS: PA and lateral chest radiographs. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 813e81b3-799523a3-b8aa2053-e000b5af-c48558e3.jpg,test/p16/p16615356/s59985908/813e81b3-799523a3-b8aa2053-e000b5af-c48558e3.jpg,test," FINAL REPORT HISTORY: ___-year-old male with assault, ETOH intoxicated. Cough with sputum. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is normal. Widening of the right acromioclavicular joint is again seen as well as chronic deformities of the left lateral ribs inferiorly. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " cafed4e7-e4155a44-fb771537-da83b5eb-87e81b7a.jpg,test/p19/p19733613/s56541634/cafed4e7-e4155a44-fb771537-da83b5eb-87e81b7a.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: None. FINDINGS: 2 views were obtained of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with tortuous aortic contour. IMPRESSION: No acute intrathoracic process. " 7ad4dbcb-436698e2-aad62c5a-6f9f61c3-5585e75b.jpg,test/p12/p12986731/s54187749/7ad4dbcb-436698e2-aad62c5a-6f9f61c3-5585e75b.jpg,test," WET READ: ___ ___ 12:42 PM The patient is now intubated and the ET tube is in the right mainstem bronchus and should be withdrawn approximately 3.5 cm. The right IJ has been pulled back but still terminates in the right atrium. Withdrawing approximately 3 more cm should place it in the low SVC. There is significant atelectasis or collapse of the left lower lobe. There is no pneumothorax. The findings were telephoned to Dr. ___ by ___ at 6:30 am, ___, ___ min after discovery. WET READ VERSION #___ ___ 6:30 AM The patient is now intubated and the ET tube is in the right mainstem bronchus and should be withdrawn approximately 3.5 cm. The right IJ has been pulled back but still terminates in the right atrium. Withdrawing approximately 3 more cm should place it in the low SVC. There is significant atelectasis or collapse of the left lower lobe. There is no pneumothorax. The findings were telephoned to Dr. ___ by ___ at 6:30 am, ___, ___ min after discovery. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with STEMI, ESRD in CCU with hypotension // pulled back on IJ - eval change TECHNIQUE: Portable AP supine view of the chest COMPARISON: ___:39 FINDINGS: Endotracheal tube terminates in the right mainstem bronchus. Right IJ line has been pulled back and is now in the proximal right atrium. Enteric tube is in the stomach. Cardiomediastinal silhouette and low volume lungs are unchanged. No large pleural effusion or pneumothorax IMPRESSION: 1. Interval placement of an endotracheal tube terminating in the right mainstem bronchus. It should be retracted by at least 3.5 cm for appropriate positioning. 2. Right IJ line has been retracted but remains in the proximal right atrium. " 65474c86-d7807863-386d495c-246eb4b9-46f8e5b1.jpg,test/p13/p13048971/s50244939/65474c86-d7807863-386d495c-246eb4b9-46f8e5b1.jpg,test," FINAL REPORT HISTORY: Cough. FINDINGS: In comparison with the most recent available study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Mild elevation of the right hemidiaphragmatic contour persists. " 752e2c68-f15d6684-f8b63eb1-5572ca1d-484bff2b.jpg,test/p11/p11438336/s54937437/752e2c68-f15d6684-f8b63eb1-5572ca1d-484bff2b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Confusion and fever, assess for pneumonia. FINDINGS: AP upright and lateral views of the chest were obtained. There is no focal consolidation, effusion, or pneumothorax. There is mild interstitial pulmonary edema with Kerley B lines and cephalization. Cardiomediastinal silhouette is stable with atherosclerotic calcification along the aortic knob. Bony structures appear intact with screws again noted in the left humeral head. IMPRESSION: Findings compatible with mild interstitial pulmonary edema. " c940e4d0-87a9fe76-375abde5-04e141e8-b8004a72.jpg,test/p16/p16502265/s51233470/c940e4d0-87a9fe76-375abde5-04e141e8-b8004a72.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest CT from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Reported episodes of desaturation, now normal, assess for pneumonia or effusions. FINDINGS: AP upright portable chest radiograph is obtained as well as a lateral view. There are small bilateral pleural effusions with mild compressive bibasilar atelectasis. There is no significant change from prior exam. There is no overt CHF. A mild component of interstitial congestion is impossible to exclude. The aorta is unfolded. Heart size is normal. No pneumothorax. Bony structures are intact. IMPRESSION: Small bilateral pleural effusions with bibasilar compressive atelectasis. Possible mild interstitial edema. " ef26f114-85068140-46d98286-d757e8c3-37226758.jpg,test/p10/p10303503/s52338296/ef26f114-85068140-46d98286-d757e8c3-37226758.jpg,test," FINAL REPORT CHEST X-RAY REPORT INDICATION: ___-year-old lady with history of liver transplant complaining of occasional shortness of breath and chills. COMPARISON: Chest radiograph dated ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart appears normal in size and configuration. Trachea is midline, and the lungs are well expanded. Cardiomediastinal contours are unremarkable. Lungs are clear with no evidence of focal infiltrates. No pleural effusions and no pneumothorax. IMPRESSION: Normal radiographic study of the chest. " 409a15e4-45ed5b9c-64a07bed-8277f843-09d2b0e6.jpg,test/p16/p16307595/s57123799/409a15e4-45ed5b9c-64a07bed-8277f843-09d2b0e6.jpg,test," FINAL REPORT HISTORY: ___-year-old female with dyspnea and lower extremity swelling. Evaluation for pneumonia or pulmonary edema. COMPARISON: Chest radiograph from ___ AP AND LATERAL CHEST RADIOGRAPHS: There is increased density in the entire right lung on the frontal projection. Lateral views demonstrate confluent increased radiodensity along the major fissure, findings suggestive of loculated fluid within the right major fissure. Blunting of the bilateral costophrenic angles suggests small effusions. There is also mild interstitial pulmonary edema. No pneumothorax is evident. The aorta remains moderately calcified and tortuous. Mediastinal and hilar contours are within normal limits and unchanged from prior. Moderate enlargement of the cardiac silhouette is stable. IMPRESSION: Mild interstitial pulmonary edema with small bilateral pleural effusions and loculated fluid in the right major fissure. " 10dfe362-616a9569-6baa2446-b2cffab5-9fda4e15.jpg,test/p16/p16037767/s56870969/10dfe362-616a9569-6baa2446-b2cffab5-9fda4e15.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new dx of pancreatic cancer and wheezing // to assess for causes of wheezing to assess for causes of wheezing IMPRESSION: Comparison to ___. Lung volumes have decreased. New platelike atelectasis at the right and left lung basis. Minimal fluid overload but no overt pulmonary edema. Borderline size of the heart. No pneumothorax. No larger pleural effusions. " 7b1ce806-54b8f4ae-fdbc63b1-3e6b4d4c-6aece0ed.jpg,test/p16/p16101197/s57598358/7b1ce806-54b8f4ae-fdbc63b1-3e6b4d4c-6aece0ed.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " b3c52c1b-a9fd0cf9-d7784838-c098b9c8-74414709.jpg,test/p17/p17494268/s55155814/b3c52c1b-a9fd0cf9-d7784838-c098b9c8-74414709.jpg,test," FINAL REPORT INDICATION: Hypoxia, increasing secretions, questionable aspiration. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, plate-like atelectasis has developed at the left lung base. No pleural effusions. Lung volumes remain low. Borderline size of the cardiac silhouette. No evidence of pneumonia. " 695cde1b-3b9d112a-4a1264bc-fa0924a4-c3705f47.jpg,test/p12/p12773009/s59310673/695cde1b-3b9d112a-4a1264bc-fa0924a4-c3705f47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with worsening hypoxia // r/o PNA evaluate effusion TECHNIQUE: Chest single view COMPARISON: ___ 09:43 FINDINGS: Moderate left pleural effusion has worsened. Left basilar consolidation, likely atelectasis, worsened. Right lung is clear. Increased heart size, pulmonary vascularity, more prominent. IMPRESSION: Moderate left pleural effusion has worsened. Left basilar consolidation, likely atelectasis, worsened. Increased heart size, pulmonary vascularity. " bdfcf691-921b5051-85a07cee-9be30795-ab736363.jpg,test/p15/p15957987/s55656319/bdfcf691-921b5051-85a07cee-9be30795-ab736363.jpg,test," WET READ: ___ ___ 1:21 AM No pneumothorax. Small-moderate R loculated effusion, similar. R basal consolidation, worrisome for pneumonia, similar. Stable small left effusion with left basal atelectasis. Esophageal stent in place. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Esophageal adenocarcinoma, bilateral empyema, accidental pull of the right chest tube, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right chest view was accidentally pulled. On the current image, there is no convincing evidence for a right pneumothorax. The left chest tube as well as the Port-A-Cath and the esophageal stent are in unchanged position. There is unchanged evidence of bilateral, right more than left parenchymal opacities at the lung bases. Moderate retrocardiac atelectasis and moderate cardiomegaly. No newly appeared parenchymal opacities. " 6a5f56f3-bbd16196-3a9c9b46-1e094902-2367e5e1.jpg,test/p16/p16788522/s56878580/6a5f56f3-bbd16196-3a9c9b46-1e094902-2367e5e1.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman end-stage liver disease and cough, evaluate for pneumonia TECHNIQUE: AP portable view COMPARISON: Chest radiograph ___ and ___ FINDINGS: Mild cardiomegaly is unchanged. Mediastinal contour is stable. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. Mild pulmonary edema seen previously has improved. IMPRESSION: Overall improvement in mild pulmonary edema. No evidence of pneumonia. " 8c8c2ff5-1dea28de-532b354d-513f9de2-f8938c27.jpg,test/p15/p15610977/s51274133/8c8c2ff5-1dea28de-532b354d-513f9de2-f8938c27.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG/AVR // s/p CT removal eval for PTX- obtain at 11:00 pls COMPARISON: Prior chest radiograph ___. IMPRESSION: Since ___, endotracheal tube has been removed and not surprisingly more atelectasis has developed at the lung bases. On the right however the configuration is more concerning for new pneumonia. Cardiomediastinal silhouette has a normal postoperative appearance. Pulmonary vasculature is engorged but there is no edema. Pleural effusions are small if any. No pneumothorax. Right jugular sheath ends at the thoracic inlet. RECOMMENDATION(S): Careful followup for possible developing right lower lobe pneumonia. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 11:42 AM, minutes after discovery of the findings. " af540e61-2be1008a-952cb8fe-9e333f3a-a072df67.jpg,test/p13/p13494098/s55625342/af540e61-2be1008a-952cb8fe-9e333f3a-a072df67.jpg,test," FINAL REPORT INDICATION: Patient with one week of cough. Evaluate for infiltrate. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiograph. FINDINGS: The lungs are well expanded. There is an opacity occupying the right upper lung region and delineated by the minor fissure, with associated right hilar engorgement. The left lung is clear. Moderate cardiomegaly is present. There is no pleural effusion or pneumothorax. IMPRESSION: Right upper lobe consolidation compatible with pneumonia in the proper clinical setting. Recommend followup after treatment to document resolution. Moderate cardiomegaly. " bb3b6a6b-35b5581b-ed87943b-ce0dd143-4fae7096.jpg,test/p16/p16508811/s56179563/bb3b6a6b-35b5581b-ed87943b-ce0dd143-4fae7096.jpg,test," FINAL REPORT HISTORY: Recent pneumonia with continued cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is top normal. Mediastinal and hilar contours are unchanged. Focal opacities within the superior segment of the left lower lobe and right lung base are relatively unchanged compared to the previous exam and remain concerning for areas of multifocal pneumonia. Small left pleural effusion may be present. There is no pulmonary edema or pneumothorax. Clips are seen projecting over the right neck. There are no acute osseous abnormalities. IMPRESSION: Persistent left lower lobe and right basilar opacities concerning for pneumonia. Possible trace left pleural effusion. " b566edd6-17cee29f-e32cc4dc-da62a5e9-e4797725.jpg,test/p12/p12562031/s51785561/b566edd6-17cee29f-e32cc4dc-da62a5e9-e4797725.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess pneumothorax. Comparison is made with prior study, ___. Cardiac size is top normal. Small left pneumothorax is unchanged. Left mid pigtail catheter is in unchanged position. There are no new lung abnormalities. The lungs are clear. There is no pleural effusion. " 0270997b-5bb283db-e42572be-49a347f5-7e03646b.jpg,test/p18/p18513773/s57125946/0270997b-5bb283db-e42572be-49a347f5-7e03646b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever and cough // ? pneumonia vs flu? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Normal lung volumes. Borderline size of the cardiac silhouette. Normal hilar and vascular structures. No pulmonary edema. No pneumonia, no pleural effusions. " 1889817c-e956642a-85f0d4fb-159bf67f-85e5da0f.jpg,test/p10/p10678758/s52880426/1889817c-e956642a-85f0d4fb-159bf67f-85e5da0f.jpg,test," FINAL REPORT HISTORY: Status post CABG. COMPARISON: ___. FINDINGS: There are rule the patient is status post CABG. Mediastinal and cardiac silhouettes are similar compared to prior given technique. Left-sided PICC line is no longer present. There is blunting of the left CP angle compatible with small left effusion. Small infiltrate in this region cannot be excluded. Otherwise lungs are clear. IMPRESSION: Possible small left effusion. " e30f30d9-5d405f2c-c6e4d93e-1d63445e-71aa97d2.jpg,test/p10/p10691738/s58825705/e30f30d9-5d405f2c-c6e4d93e-1d63445e-71aa97d2.jpg,test," FINAL REPORT INDICATION: History of pleur-x, please evaluate. COMPARISON: Multiple chest radiographs dating back to ___. The left pleural catheter is unchanged in position. There is no evidence of a pneumothorax. There has been interval improvement in the bilateral small pleural effusions. There is stable moderate cardiomegaly. No focal consolidations concerning for infection are identified. There is a left-sided pacer with the lead in appropriate position. IMPRESSION: No evidence of a pneumothorax. Interval improvement in the small bilateral pleural effusions. " 698a83c3-5d365c70-a2ff0db9-f186f6a0-e9a4bcc1.jpg,test/p19/p19420204/s57292322/698a83c3-5d365c70-a2ff0db9-f186f6a0-e9a4bcc1.jpg,test," FINAL REPORT INDICATION: ___ year old man with stage IIIA lung adenocarcinoma with cough and hemoptysis // Pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiomediastinal shadow is normal. Right-sided PICC line in situ with the tip at the mid to distal SVC. Pulmonary overinflation. Mild coarsening of the bronchovascular markings. Nodular airspace consolidation with associated bronchograms seen in the medial basal segment of the right lower lobe. No pleural effusion. No pulmonary edema. IMPRESSION: Nodular airspace consolidation with associated air bronchograms/bronchiectasis seen in the medial basal segment of the right lower lobe. This was also noted on previous imaging. Pulmonary hyperinflation and mild coarsening of the bronchovascular markings: COPD should be excluded. " 4021a2c4-c2788708-d648ffcb-7a0f5e9d-0316104c.jpg,test/p14/p14751058/s52992882/4021a2c4-c2788708-d648ffcb-7a0f5e9d-0316104c.jpg,test," WET READ: ___ ___ ___ 12:34 PM 1. No acute intrathoracic process. 2. Bilateral hilar fullness is better characterized on prior chest CT in corresponded known prominent lymph nodes. WET READ VERSION #1 ___ ___ ___ 9:31 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w pancreatic ca with throat pain and stomach pain // ___M w pancreatic ca with throat pain and stomach pain TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: CT chest with contrast dated ___. FINDINGS: Lung volumes are normal. There is no focal consolidation, effusion, or pneumothorax. There is no central vascular congestion or pulmonary edema. Hilar contours are stable compared to ___ ; there are known underlying prominent lymph nodes. Cardiomediastinal silhouette is normal. IMPRESSION: 1. No acute intrathoracic process. " f9e54824-1cd0c58d-dd5f2d49-7bc81d33-135999be.jpg,test/p15/p15682194/s57632035/f9e54824-1cd0c58d-dd5f2d49-7bc81d33-135999be.jpg,test," WET READ: ___ ___ ___ 3:08 PM IMPRESSION: Findings suggesting mild vascular congestion. Right hilar/infrahilar prominence which could potentially represent early infection, alternative considerations include vascular confluence, adenopathy, or underlying mass lesion. Short-term followup imaging is recommended following appropriate treatment to exclude above-mentioned entities. ______________________________________________________________________________ FINAL REPORT INDICATION: A ___-year-old male with fever. Question pneumonia. COMPARISON: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal heart size and mediastinal contour. There is prominent right hilar/infrahilar opacity which could represent confluence of vascular structures, but can potentially represent early infection or even potentially a mass. A mild interstitial prominence suggests there may be mild congestion. There is no pneumothorax or large effusion. There is trace if any dependent atelectasis. Multilevel thoracic spondylosis is present. IMPRESSION: Findings suggesting mild vascular congestion. Right hilar/infrahilar prominence which could potentially represent early infection, alternative considerations include vascular confluence, adenopathy, or underlying mass lesion. Short-term followup imaging is recommended following appropriate treatment to exclude above-mentioned entities. " ceaa2707-c4eb8cb2-a265b435-34d28ab3-cf560c77.jpg,test/p14/p14459039/s58138557/ceaa2707-c4eb8cb2-a265b435-34d28ab3-cf560c77.jpg,test," FINAL REPORT HISTORY: Asthma flare up, to assess for pneumonia. FINDINGS: In comparison with study of ___, there is little change. Specifically, no evidence of pneumonia, vascular congestion, or pleural effusion. " 584783cf-29266666-9b980d1c-02072ccc-156996ee.jpg,test/p13/p13040755/s54061114/584783cf-29266666-9b980d1c-02072ccc-156996ee.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hydropneumothorax please do early in AM // interval change interval change COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Small apical and medial component of left pneumothorax is unchanged over THE PAST several days. Lateral view suggests the may be some increase in the posteriorly loculated pleural effusion on the left, in the region traversed by the pleural drainage catheter, which has a a sharp and possibly occluded in a kink as it leaves the chest. Small dependent pleural effusions are unchanged. The severely scarred emphysematous and bronchiectatic lungs are not changed since ___. Heart size is normal. " 4b9ef0c5-5e955457-42b88b0c-9659fbbd-3c104543.jpg,test/p18/p18950565/s58058997/4b9ef0c5-5e955457-42b88b0c-9659fbbd-3c104543.jpg,test," FINAL REPORT INDICATION: ___ year old man with new dual chamber ppm // assess lead position COMPARISON: Radiographs from ___ IMPRESSION: There is a new left-sided pacemaker with the distal lead tips in right atrium and ventricle. Heart size is within normal limits. There is mild tortuosity of the thoracic aorta. Lungs are clear. There are no pneumothoraces. " b7e3a366-687500fb-566d64fc-d82355bd-77860238.jpg,test/p14/p14681474/s51543323/b7e3a366-687500fb-566d64fc-d82355bd-77860238.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with mild chronic obstructive asthma // any change in upper lobe nodules. Has bronchiectasis infection that was treated in ___ and has been asymptomaic since COMPARISON: Chest radiographs since ___ most recently ___ IMPRESSION: The tubular opacities extending upward from the left hilus have been present with very little change since ___. I think this is probably a complex of dilated partially impacted bronchi. There may be other tiny impacted bronchi just inferior to it, but evaluation of all of these structures is more reliable on CT scanning. Heart is top-normal size. Leftward deviation of the trachea at the thoracic inlet could be due either to a large and tortuous innominate artery or right thyroid nodule. " 82389efd-ef6db674-5cebc535-a8003549-17c11549.jpg,test/p10/p10807564/s54379705/82389efd-ef6db674-5cebc535-a8003549-17c11549.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with chest pain. Portable AP radiograph of the chest was reviewed in comparison to ___. Bibasal consolidations are demonstrated, unchanged. Heart size and mediastinum are unchanged. The patient was extubated in the meantime interval. Right internal jugular line tip is at the level of superior SVC. " 5298d5ce-50b8d1f7-105f2eaa-4c32f0cd-d5e4cadf.jpg,test/p17/p17593363/s54569340/5298d5ce-50b8d1f7-105f2eaa-4c32f0cd-d5e4cadf.jpg,test," FINAL REPORT HISTORY: Bradycardia. COMPARISON: PET-CT from ___. FINDINGS: PA and lateral radiographs of the chest demonstrates clear but hyperinflated lungs consistent with emphysema. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Enlargement of the aortic root and calcification of the aortic arch are present. The concerning spiculated mass in the left upper lobe seen on the prior PET-CT is not well seen and there are surgical changes indicating that it has been excised. IMPRESSION: No acute cardiopulmonary process. Emphysema. " 5aa0990b-a4943c20-9efd265c-49bf135e-c59d0807.jpg,test/p17/p17517983/s59469225/5aa0990b-a4943c20-9efd265c-49bf135e-c59d0807.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain, question pneumonia or CHF. FINDINGS: PA and lateral views of the chest provided demonstrate mild cardiomegaly with mild pulmonary interstitial edema. No effusion or pneumothorax. The right IJ central venous catheter has been removed. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild cardiomegaly with mild interstitial edema. " 2ac6104a-c3b0665e-6f5c6160-3696dc6e-a07823dd.jpg,test/p17/p17318449/s55484286/2ac6104a-c3b0665e-6f5c6160-3696dc6e-a07823dd.jpg,test," FINAL REPORT INDICATION: ___-year-old man with weakness and low-grade temperature, to rule out pneumonia. COMPARISON: Chest radiograph ___ CHEST RADIOGRAPHS: There is a new consolidation in the retrocardiac left lung base, concerning for pneumonia or aspiration. No pleural effusion or pneumothorax is seen. There is mild pulmonary vascular congestion. The mediastinal silhouette is unchanged. Multiple intact mediastinal wires relate to prior sternotomy. IMPRESSION: Left lower lobe consolidation, may represent pneumonia or aspiration. " 2bbcb70b-401dfb1b-089ede98-e2693513-d7f89ed9.jpg,test/p15/p15341255/s56486874/2bbcb70b-401dfb1b-089ede98-e2693513-d7f89ed9.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post CABG, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the extent of the known left pneumothorax is unchanged, with the pleural gap of approximatively 2 cm. A small air-fluid level is seen at the left lung bases. On the right, unchanged appearance of the lung parenchyma. Unchanged position of the left chest tube. Moderate cardiomegaly. Unchanged position of the right internal jugular vein catheter, unchanged appearance of the cardiac silhouette. " d5822b11-c7ae2ba5-a28e9774-1b08fa12-73c009aa.jpg,test/p17/p17103838/s51907589/d5822b11-c7ae2ba5-a28e9774-1b08fa12-73c009aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough fever , crackles at r base // ? pneumonia COMPARISON: None FINDINGS: PA and lateral views of the chest provided. A metallic density projecting over the right upper lung on the frontal view is not clearly seen on the lateral projection and may represent artifact. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. Metallic density projecting over the right upper lung not seen on lateral view and may represent artifact. " dd841d77-9bc9eae1-22c2b807-90850fd9-7f8865a8.jpg,test/p18/p18377937/s57048760/dd841d77-9bc9eae1-22c2b807-90850fd9-7f8865a8.jpg,test," FINAL REPORT INDICATION: ___-year-old man with Crohn's disease, new bilateral lower extremity swelling, evaluate for cardiomegaly. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. No cardiomegaly. " e9909aab-f34c685d-da5ed8b0-0d13808f-d7fc57ea.jpg,test/p17/p17576736/s53687094/e9909aab-f34c685d-da5ed8b0-0d13808f-d7fc57ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___y F, sepsis most likely secondary to parapneumonic effusion. Currently on broad spectrum Abx. Tapped showing exudative effusion with residual effusion and small PTX. Clinically improving. // f/u pneumothorax, L pleural effusion f/u pneumothorax, L pleural effusion IMPRESSION: Compared to chest radiographs ___ through ___. Tiny left apical pneumothorax unchanged. Moderate left pleural effusion stable since ___, smaller compared to ___ and ___ presumably a function of interval thoracentesis. A small bubble of gas projecting over the left lower lung could either be due to thoracentesis is well or cavitation in pneumonia. Right lung clear. Mild enlargement cardiac silhouette stable. " 280c19ca-4d1dd9c2-4772f11f-4c36e259-d4f760f8.jpg,test/p11/p11020337/s51483695/280c19ca-4d1dd9c2-4772f11f-4c36e259-d4f760f8.jpg,test," FINAL REPORT HISTORY: Pneumonia after antibiotics, to assess for resolution. FINDINGS: In comparison with the study of ___, the patient has taken a much better inspiration. There are several residual streaks of atelectasis, though the basilar opacification is substantially cleared. Upper zones are normal, and there is no evidence of vascular congestion. " b36ac7b9-1a5a2c77-a16c42c7-ace7c1d0-9a93ab1a.jpg,test/p13/p13272142/s57562933/b36ac7b9-1a5a2c77-a16c42c7-ace7c1d0-9a93ab1a.jpg,test," WET READ: ___ ___ ___ 8:20 PM ETT ends 4 cm above the carina after final adjustment. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip pushed forward to approximately 4 cm above the carina. Little change in the appearance of the heart and lungs. " da333379-ce3c81c1-328104b5-04274dcd-8a955d25.jpg,test/p19/p19564630/s51867535/da333379-ce3c81c1-328104b5-04274dcd-8a955d25.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever // r/o pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The lung volumes are normal. Normal size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. Clips projecting over the mediastinum and the left axillary region. No evidence of pneumonia. No pleural effusions. No pulmonary edema. " 16898668-963a750b-fcf6b45d-cb882383-feaa3ccf.jpg,test/p12/p12537194/s55537165/16898668-963a750b-fcf6b45d-cb882383-feaa3ccf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough, dyspnea, tachypnea x months, now worse TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is complete opacification of the right hemi thorax with leftward deviation of mediastinal structures compatible with a large right pleural effusion. The heart size is difficult to assess, but appears to be mildly enlarged. Left lung is hyperinflated without focal consolidation. There appears to be tiny nodular opacities noted throughout the left lung. No pneumothorax is seen. The osseous structures appear diffusely mottled with several lucent expansile lesions in the right lateral ribs. S shaped scoliosis of the thoracic spine is noted. IMPRESSION: 1. Complete opacification of the right hemi thorax with leftward shift of mediastinal structures most compatible with a large right pleural effusion. 2. Scattered osseous lesions and tiny nodular opacities in the left lung concerning for metastatic disease. " 218e5b31-5faa3ec3-462a0782-55fd3800-575922a1.jpg,test/p17/p17194805/s53835575/218e5b31-5faa3ec3-462a0782-55fd3800-575922a1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p lung biopsy now with pain on left side // ? PTX or other acute process COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. 1.6 cm lower lobe nodule is only seen on the lateral projection, however appears unchanged. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. IMPRESSION: 1. No pneumothorax. 2. 1.6 cm left lower lobe nodule appears unchanged from ___ and was better characterized on CT chest ___. " c782488e-5762b0ba-e132d199-364ab931-4c66b189.jpg,test/p17/p17713592/s56452635/c782488e-5762b0ba-e132d199-364ab931-4c66b189.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph from ___. FINDINGS: As before, the patient is status post midline sternotomy and CABG, with intact sternotomy wires. There is minimal left lower lung scarring, along the costophrenic angle, unchanged. The lungs are otherwise clear. The heart size is top normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Multilevel degenerative changes of the thoracolumbar spine are noted. IMPRESSION: No acute cardiac or pulmonary process. " ddc84634-98d90077-add2ae81-8199f305-56e42791.jpg,test/p10/p10229323/s59671764/ddc84634-98d90077-add2ae81-8199f305-56e42791.jpg,test," WET READ: ___ ___ ___ 1:24 AM Multifocal bilateral airspace opacities are new since ___. The appearance is nonspecific but the rapid onset and symmetry suggests pulmonary edema. Findings discussed with Dr. ___ ___ phone at 20:30, 5 minutes of discovery. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: New increasing oxygen requirement. Portable AP radiograph of the chest was reviewed in comparison to ___. The right internal jugular line tip is at the level of cavoatrial junction. Heart size and mediastinum are unchanged in appearance, but there is interval development of multifocal opacities throughout the lungs, extensive, some of them confluent, some of them fairly nodular, highly concerning for interval development of diffuse infectious process such as septic emboli, staph aureus pneumonia or less likely pulmonary edema. Small amount of bilateral pleural effusion is most likely present. There is no evidence of pneumothorax. The findings including the findings on the subsequent chest radiographs were discussed with Dr. ___ ___ the phone by Dr. ___ ___ at 10:30 a.m., 15 minutes after discovering the findings. " b5e46f61-f499525f-fe85669e-883c17d1-f12b6925.jpg,test/p14/p14463099/s58238483/b5e46f61-f499525f-fe85669e-883c17d1-f12b6925.jpg,test," FINAL REPORT INDICATION: History of cough and hemoptysis. Please rule out tuberculosis or pneumonia. COMPARISONS: Multiple chest radiographs dated back to ___, most recently ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidation concerning for pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " d4bbe7cb-0435c451-e40d2566-4ff78b82-055ff871.jpg,test/p18/p18019452/s50739732/d4bbe7cb-0435c451-e40d2566-4ff78b82-055ff871.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with worsening hypoxia, tachycardia. No known left lower lobe pneumonia. FINDINGS: Comparison is made to previous study from ___. The previously seen tiny apical pneumothorax in right side is no longer visualized. There remains a right apical chest tube. There are again seen diffuse airspace opacities and consolidation throughout both lung fields. The pleural effusion on the right side is increased in size as there is less definition of the right hemidiaphragm. Endotracheal tube, feeding tube, and right-sided central line are appropriately sited in unchanged position. " 81c7a378-6a29b856-d53af6e3-d067149f-5fa0a411.jpg,test/p13/p13007657/s51103018/81c7a378-6a29b856-d53af6e3-d067149f-5fa0a411.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Vertigo. Question cerebellar stroke. COMPARISONS: Prior chest radiographs from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. There is mild unfolding along the descending aorta. The mediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Streaky right middle lobe opacity suggests minor atelectasis or scarring. IMPRESSION: No evidence of acute disease. " bd5c5139-b555728c-185f61e5-c35f9573-52f3a8c8.jpg,test/p16/p16254738/s59583574/bd5c5139-b555728c-185f61e5-c35f9573-52f3a8c8.jpg,test," FINAL REPORT HISTORY: Pneumonia. FINDINGS: In comparison with the study of ___, the extent of right upper lobe pneumonia may be somewhat less. There also areas of increased opacification in the left mid and lower lung zones with obscuration of the hemidiaphragm, consistent with multifocal consolidation and possible left effusion. Monitoring and support devices are in unchanged position. " 182cd592-ea8afe5c-adfbe4d0-5ac13587-7847026b.jpg,test/p12/p12868764/s58211252/182cd592-ea8afe5c-adfbe4d0-5ac13587-7847026b.jpg,test," WET READ: ___ ___ ___ 5:24 PM No acute cardiopulmonary process. A 1.5 cm nodular density projecting over the right lung base. This could represent a nipple shadow however repeat with nipple markers suggested to confirm, this can be done on a nonurgent basis. WET READ VERSION #___ ___ ___ ___ 4:34 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: ___F newly started on MTX for RA p/w x1 month CP, headache, abd pain // Eval for acute cardiopulm process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is a 1.5 cm nodule projecting over the right lung base. The lungs are well expanded and otherwise clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. A 1.5 cm nodular density projecting over the right lung base. This could represent a nipple shadow however underlying pulmonary nodule is possible. RECOMMENDATION(S): Repeat chest x-ray with nipple markers suggested to confirm, this can be done on a nonurgent basis. NOTIFICATION: Updated read paged to Dr. ___. " 01f8f67b-813e7312-af120594-049cb564-eee66bd1.jpg,test/p16/p16771607/s52230181/01f8f67b-813e7312-af120594-049cb564-eee66bd1.jpg,test," FINAL REPORT INDICATION: Septic shock. TECHNIQUE: Frontal chest radiograph COMPARISON: ___ FINDINGS: The small bore tube with multiple fenestrations has been removed. The remaining lines and tubes are unchanged. There is no pneumothorax. The examination is not significantly changed. There are bilateral layering pleural effusions with an enlarged heart and vascular congestion. " 0d668022-fc961883-7db3d262-64f481da-fe10684d.jpg,test/p14/p14916430/s56908675/0d668022-fc961883-7db3d262-64f481da-fe10684d.jpg,test," FINAL REPORT HISTORY: Alcohol abuse and end-stage liver disease with abdominal pain, to assess for free air. FINDINGS: In comparison with study of ___, and apparently erect study shows no evidence of free intraperitoneal gas. Dobbhoff tube appears to extend to the region of the ligament of Treitz or even into the jejunum. There is enlargement of the cardiac silhouette with evidence of increased pulmonary venous pressure. No acute focal pneumonia. " 62e9e637-bc9bec53-45f8b3d5-c73398f9-49e95a56.jpg,test/p10/p10699336/s53523599/62e9e637-bc9bec53-45f8b3d5-c73398f9-49e95a56.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p MCC, intubated // interval change interval change COMPARISON: Prior chest radiographs ___, most recently 20:00. IMPRESSION: Bibasilar consolidation, stable on the left, increased on the right. How much of this is atelectasis and how much is pneumonia is radiographically indeterminate. Previous pulmonary edema has cleared. Pleural effusions are minimal if any. Heart size normal. Nasogastric tube is looped in the hypopharynx and then passes into the upper stomach. It should be repositioned. Bilateral pleural drains unchanged in their respective positions, terminating along side the mediastinum. No pneumothorax. RECOMMENDATION(S): Reposition nasogastric tube to reduce the looped in the hypopharynx. " 7bf9e55a-fc13d5ca-7d3fb785-c839a1a0-7bc68aa1.jpg,test/p10/p10427568/s51225744/7bf9e55a-fc13d5ca-7d3fb785-c839a1a0-7bc68aa1.jpg,test," WET READ: ___ ___ ___ 12:23 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with chest pain, evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: Low lung volumes cause mild bronchovascular crowding. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is stable. The osseous structures and upper abdomen are unremarkable. IMPRESSION: No acute cardiopulmonary process. " dcfe0326-ab0da55a-328d8352-95e8dfb4-e02a0008.jpg,test/p14/p14730883/s53616400/dcfe0326-ab0da55a-328d8352-95e8dfb4-e02a0008.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain and hematemesis after drinking. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax. The lungs appear clear. There is no free air or pneumomediastinum. There is a ventriculoperitoneal shunt, which courses across the right anterior chest and terminates in the left upper quadrant of the abdomen. Bony structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " f2fa5689-2f23714a-6259b7e6-8d7c8887-f6827208.jpg,test/p14/p14497007/s56420176/f2fa5689-2f23714a-6259b7e6-8d7c8887-f6827208.jpg,test," WET READ: ___ ___ ___ 9:06 AM 1. Mild vascular congestion and cardiomegaly. 2. A masslike opacity seen on the same day lumbar spine CT is not appreciated on this examination. Recommend dedicated chest CT for further evaluation. WET READ VERSION #___ ___ ___ ___ 5:48 AM No acute ______________________________________________________________________________ FINAL REPORT EXAMINATION: AP and lateral chest radiographs INDICATION: ___F with fevers, weakness // evaluate for pneumonia TECHNIQUE: Chest AP and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Subtle bibasilar opacities likely reflect atelectasis. Lungs are otherwise well expanded. A masslike opacity seen on the same day lumbar spine CT is not appreciated on this examination. There is probably a trace left pleural effusion. No pneumothorax. There is mild cardiomegaly and mild pulmonary vascular congestion. Cardiomediastinal hilar silhouettes are unremarkable. Spinal fusion hardware is grossly unremarkable. A right-sided Port-A-Cath terminates in the low SVC. IMPRESSION: 1. Mild vascular congestion and cardiomegaly. 2. A masslike opacity seen on the same day lumbar spine CT is not appreciated on this examination. Recommend dedicated chest CT for further evaluation. RECOMMENDATION(S): A masslike opacity seen on the same day lumbar spine CT is not appreciated on this examination. Recommend dedicated chest CT for further evaluation. " 9d733146-89ec38e6-a442bee0-5b9a1aaf-3d7c5086.jpg,test/p15/p15016144/s59024268/9d733146-89ec38e6-a442bee0-5b9a1aaf-3d7c5086.jpg,test," WET READ: ___ ___ ___ 9:30 AM Right lower lobe atelectasis. No pneumomediastinum or pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Sudden onset neck pain after vomiting last night. Assess for pneumomediastinum or pleural effusion. COMPARISON: Chest radiograph ___ FINDINGS: Frontal and lateral chest radiographdemonstrates moderately well expanded and clear lungs. Right lower lobe atelectasis is noted. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. IMPRESSION: Right lower lobe atelectasis. No pneumomediastinum or pleural effusion. " 7fda8a4a-23653266-bd407225-c51cc185-849b282a.jpg,test/p13/p13723259/s50424096/7fda8a4a-23653266-bd407225-c51cc185-849b282a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with MM s/p CABG/AVR // post-op changes COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the alignment of the sternal wires is unchanged. The right internal jugular vein catheter has been removed. Decrease in extent of the bilateral pleural effusions that, however, remain clearly visible. Moderate cardiomegaly persists. No pulmonary edema. Bilateral areas of atelectasis are seen in unchanged manner. Known old healed right rib fracture. " 4c1d0e60-2af29580-7905d233-5eb5ec15-55bbd11f.jpg,test/p19/p19650702/s51412828/4c1d0e60-2af29580-7905d233-5eb5ec15-55bbd11f.jpg,test," FINAL REPORT EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old woman status post tracheobronchoplasty with readmission for pneumonia. TECHNIQUE: Chest PA and lateral. COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Interval removal of right-sided PICC. Stable, mild cardiomegaly. Normal mediastinal and hilar contours. Interval resolution of mild pulmonary vascular congestion. Stable postsurgical defect in the right posterior third rib. Interval decrease in size of right apical radiodensity suggests a decreasing postsurgical fluid collection. No pneumothorax or pleural effusion. No convincing radiographic evidence of pneumonia. IMPRESSION: 1. Interval resolution of mild pulmonary vascular congestion. 2. No convincing radiographic evidence of pneumonia. " 9451cd91-c6aa8961-2eb3b957-8e5df49f-3f4ce8dc.jpg,test/p18/p18121111/s51039138/9451cd91-c6aa8961-2eb3b957-8e5df49f-3f4ce8dc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with RUL bleeding with new ET double lumen tube. // Please eval for acute process and interval change. COMPARISON: Chest radiograph ___:16 IMPRESSION: New double-lumen endotracheal tube cannula its the left bronchus to origin of the upper lobe. Proximal port for ventilation is in the low trachea. There has been a slight decrease in the volume of fluid in the air containing right apical space, presumably the pleura. Pulmonary vascular engorgement has increased, but heart size remains normal. There is no appreciable layering pleural effusion or pneumothorax on the left right internal jugular line ends in the low SVC. " e584978e-46f3d95c-c9afa827-55a0cb99-2497eab5.jpg,test/p17/p17528096/s59511300/e584978e-46f3d95c-c9afa827-55a0cb99-2497eab5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with new dyspnea // r/o chf TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " fd0b8a7d-88ebe847-18a6782d-9d80e54f-02bd6a4d.jpg,test/p10/p10735843/s54802979/fd0b8a7d-88ebe847-18a6782d-9d80e54f-02bd6a4d.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___ year old man with atrial fibrillation on amiodarone // Evaluation of amiodarone toxicity TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: No change as compared to the previous image. No lung parenchymal disease, in particular no evidence of fibrosis. No pleural effusions. No pneumonia, no pulmonary edema. Mild elongation of the descending aorta. Borderline size of the cardiac silhouette. IMPRESSION: No radiographic evidence of fibrosis or consolidation. " e225fd2e-1de104b0-70c09091-f7be67a1-f7fc60d0.jpg,test/p16/p16605433/s52627396/e225fd2e-1de104b0-70c09091-f7be67a1-f7fc60d0.jpg,test," FINAL REPORT HISTORY: Cough, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change given the scoliosis of the dorsal spine. Cardiac silhouette is essentially within normal limits without vascular congestion or pleural effusion or acute focal pneumonia. " 0857ac44-5e47624f-89ed33f0-1c611c9d-2aadd22d.jpg,test/p12/p12620123/s53183002/0857ac44-5e47624f-89ed33f0-1c611c9d-2aadd22d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Degenerative changes are notable at the left shoulder. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 49b13cb5-f55928f7-8f44d306-6f7230ea-ec4d0e93.jpg,test/p11/p11589725/s57108499/49b13cb5-f55928f7-8f44d306-6f7230ea-ec4d0e93.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o alcoholism seizures presents as transfer from___ after a fall down 5 stairs and subsequent seizure activity. // interval ICU CXR interval ICU CXR COMPARISON: Chest radiographs ___ through the last twenty___. IMPRESSION: Patient has been extubated. Lower lung volumes, reflected in increasing bibasilar atelectasis exaggerate of mild pulmonary edema and borderline cardiomegaly. Pleural effusions are not appreciable. " 7827e398-ff1c7fc8-0bc6eb41-bf7ea1ea-286558b2.jpg,test/p15/p15284921/s53898103/7827e398-ff1c7fc8-0bc6eb41-bf7ea1ea-286558b2.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with dyspnea cough // Acute cardiopulmonary disease TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pneumothorax, pulmonary edema, or focal consolidation. IMPRESSION: Normal chest. " eea08e87-7533c506-a8257ed2-6e5a56ab-5ade7d3d.jpg,test/p19/p19963140/s57661538/eea08e87-7533c506-a8257ed2-6e5a56ab-5ade7d3d.jpg,test," FINAL REPORT STUDY: PA and lateral chest, ___. HISTORY: ___-year-old man status post left thoracotomy. FINDINGS: Comparison is made to previous study from ___. There is a left-sided chest tube with tip at the apex. There is a small left apical pneumothorax. There is consolidation throughout the left lung and there is apparent air/fluid level at the left base. This is only seen on the AP view and may be technical. Attention to this area is recommended on subsequent exams. There is a prominent amount of air seen throughout the colon underneath the left hemidiaphragm. " 6541489f-bbd2ec1b-8dc3c1c4-57df861b-1194a661.jpg,test/p10/p10110724/s57443261/6541489f-bbd2ec1b-8dc3c1c4-57df861b-1194a661.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with syncopal episode and head strike with new a fib COMPARISON: None FINDINGS: PA and lateral views of the chest provided. The heart is mildly enlarged. The hila appear slightly engorged. There is no convincing evidence for edema or pneumonia. No large effusion or pneumothorax. The mediastinal contour is unchanged. Bony structures appear intact. IMPRESSION: Cardiomegaly with pulmonary vascular congestion. " 8069a21f-82fb5de3-d158db5b-8ff55cf0-5506c92c.jpg,test/p15/p15154432/s55295142/8069a21f-82fb5de3-d158db5b-8ff55cf0-5506c92c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p ___ procedure for perforated diverticulitis c/b septic shock, SB necrosis s/p SB rsxn and multiple abd washoutis; acute respiratory failure s/p trach ___ // inc. vent support. tachypnea inc. vent support. tachypnea IMPRESSION: Comparison ___. No relevant change. The left internal jugular vein catheter has been removed. The other monitoring and support devices are stable. The low lung volumes persist. New platelike atelectasis at the level of the right hilus. Moderate cardiomegaly is unchanged. Mild pulmonary edema has not substantially changed since the previous examination. " 78c14de5-454d75bc-c539b6e4-46cca8cc-fe7a38d5.jpg,test/p14/p14987339/s52516060/78c14de5-454d75bc-c539b6e4-46cca8cc-fe7a38d5.jpg,test," FINAL REPORT HISTORY: History of AIDS now with cough, here to evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. Technique: PA and lateral radiographs of the chest. FINDINGS: Fullness of each hilum persists and probably correlates with mild lymphadenopathy. The only change is an apparent increased in density projecting beneath the carina on the lateral view. This may represent a subtle more parenchymal density or increased lymph node. Mild biapical pleuroparenchymal thickening is noted. The pulmonary vasculature is not engorged. The cardiac silhouette is top-normal in size but stable. The mediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. IMPRESSION: No definite acute process but apparent increase in infrahilar density suggested only by the lateral view. Short-term follow-up radiographs may be helpful to assess further. " 8a9b1e31-5d8e3e23-b394e63c-c897b1c4-335564fc.jpg,test/p10/p10558762/s58073122/8a9b1e31-5d8e3e23-b394e63c-c897b1c4-335564fc.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after stroke. Portable AP radiograph of the chest was reviewed in comparison to prior study from ___. The ET tube tip is approximately 2.6 cm above the carina. The heart size and mediastinum are unchanged since the prior study. Mild interstitial edema is still present. There is prominence of the hila bilaterally, most likely related to vascular engorgement. " 1df8fec4-ebc24c34-4851aade-1105ac7e-0a44fc1a.jpg,test/p10/p10822525/s55204725/1df8fec4-ebc24c34-4851aade-1105ac7e-0a44fc1a.jpg,test," FINAL REPORT CLINICAL INDICATION: Chest pain. Evaluate for pneumonia. COMPARISON: Chest radiograph, ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: The lungs are clear without focal opacity, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. There is no free air beneath the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " e6350288-135f6892-f4fc95e3-e0ac73e4-3157173d.jpg,test/p16/p16046758/s52110578/e6350288-135f6892-f4fc95e3-e0ac73e4-3157173d.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old woman with non-small cell lung cancer status post thoracentesis. Evaluate for pneumothorax. FINDINGS: Comparison is made to the previous study from ___. There is large pleural effusion on the right side and small amount of aerated lung within the mid lung zone. A mass in the right upper lobe is again seen. No pneumothorax is seen. The effusion on the left side has decreased slightly. There are no signs for overt pulmonary edema. " be3a5867-195a2a9c-4c7362aa-920c4f66-12f40645.jpg,test/p19/p19193156/s57834630/be3a5867-195a2a9c-4c7362aa-920c4f66-12f40645.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with new pacemaker // evaluate for lead placement and pneumothorax evaluate for lead placement and pneumothorax COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Moderate bilateral pleural effusion, increased on the right, stable on the left, obscures the heart borders and accounts for moderately severe but stable bibasilar atelectasis if. If the heart is enlarged, it is not severe. Pulmonary vascular caliber has increased but is within normal limits and there is no pulmonary edema. No pneumothorax. Transvenous right atrial right ventricular pacer leads are in standard placements. There is no mediastinal widening or associated " 030f502c-45438f74-1045cb94-02e3f536-6754978e.jpg,test/p15/p15180409/s54908328/030f502c-45438f74-1045cb94-02e3f536-6754978e.jpg,test," FINAL REPORT EXAM: Chest, single semi-erect AP portable view. CLINICAL INFORMATION: Seizure, altered mental status. COMPARISON: ___. FINDINGS: Single semi-erect AP portable view of the chest was obtained. There are low lung volumes. Cardiac silhouette remains top normal to mildly enlarged. There is a subtle right upper lobe opacity projecting where the medial upper right scapula and the posterior right fourth rib overlap. Recommend AP lordotic views or oblique views to assess for underlying pulmonary nodule. No additional evidence of consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Right upper lobe opacity where the medial upper right scapula and the posterior right fourth rib overlap, could be artifactual, however, not well seen on the prior study. Recommend further evaluation with AP lordotic views and/or oblique views to assess for underlying pulmonary nodule. If finding persists on the followup radiographs, chest CT would be indicated. " c8ed94b0-41cdb9cb-12365f66-3959587f-28f64f01.jpg,test/p17/p17059095/s53313474/c8ed94b0-41cdb9cb-12365f66-3959587f-28f64f01.jpg,test," FINAL REPORT HISTORY: Preoperative. FINDINGS: No previous images. The heart is normal in size and there is no vascular congestion or pleural effusion. No acute pneumonia. " bf4b12c6-2aa44934-59b7d62a-57848b73-602f500b.jpg,test/p18/p18730243/s54092394/bf4b12c6-2aa44934-59b7d62a-57848b73-602f500b.jpg,test," FINAL REPORT INDICATION: ___ year old man w/ cirrhosis, worsening encephalopathy // r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. IMPRESSION: Moderate right pleural effusion is stable from ___. Superimposed pneumonia at the right base cannot be excluded. No pneumothorax. The left lung is clear without pleural effusion. No pulmonary edema. Orogastric tube coils in the stomach, courses past the pylorus and out of view. " bd7892a4-fdcdb8f5-80b26df4-291c0e81-5b37dc39.jpg,test/p19/p19994730/s57928428/bd7892a4-fdcdb8f5-80b26df4-291c0e81-5b37dc39.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough and fever, evaluate for infiltrate. COMPARISON: Chest radiograph from ___ and a CT of the chest, abdomen and pelvis from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " ade2284a-575c9c1d-e684ab6d-5b254d02-c80d73fc.jpg,test/p18/p18236201/s50413292/ade2284a-575c9c1d-e684ab6d-5b254d02-c80d73fc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ y/o with COP ___ amiodarone toxicity with drastic radiographic improvement with steroids with increase sputum. // Eval for interval change, opacity Eval for interval change, opacity IMPRESSION: In comparison with the study of ___, there is little interval change. Multiple old healed rib fractures are again seen bilaterally. The cardiac silhouette is at the upper limits of normal in size and there is mild hyperexpansion of the lungs. Some coarseness of interstitial markings could reflect elevated pulmonary venous pressure, chronic lung disease, or both. No evidence of acute focal pneumonia or pleural effusion. No convincing evidence of amiodarone toxicity. " 68182b4f-1b456877-2121696c-9bb4c419-4a3bf0d3.jpg,test/p15/p15675092/s51763315/68182b4f-1b456877-2121696c-9bb4c419-4a3bf0d3.jpg,test," FINAL REPORT INDICATION: ___ year old woman with junky cough and DOE // r/o acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Right PICC is no longer visualized. Moderate right-sided pleural effusion is again noted. There is a small left pleural effusion. Irregular interstitial markings seen in the right lung and at the left lung base. While these may be in part due to chronic underlying COPD, possibility of superimposed interstitial edema is possible. Surgical chain sutures project over the right mid lung. Focal nodular opacities projecting over the lung bases likely to represent nipple shadows. There is apparent increase in size of the cardiac silhouette particularly along the right. This could be due to medially loculated effusion but incompletely characterized. IMPRESSION: Chronic underlying changes in the lungs suggesting COPD with possible superimposed interstitial edema in the right lung and left lung base. Bilateral pleural effusions, right greater than left. New opacity at the right lung base medially could be due to loculated effusion medially. " 19912010-010990d8-eba3f2ea-feb1f973-ea01bef2.jpg,test/p18/p18567979/s52363317/19912010-010990d8-eba3f2ea-feb1f973-ea01bef2.jpg,test," FINAL REPORT INDICATION: Patient with shortness of breath and back pain. Assess for acute process. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volume loss. Confluent right lung base opacity is more conspicuous since prior exam. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. The aortic arch calcifications are again noted. Mild tortuosity of the descending aorta is present. Moderate cardiomegaly is stable. Perihilar vascular congestion is present. Partially imaged upper abdomen is unremarkable. IMPRESSION: 1. Confluent right lung base opacity, increased in conspicuity since ___ exam, which may represent atelectasis, assymetric edema or infection in the appropriate clinical setting. 2. Moderate cardiomegaly and perihilar vascular congestion, unchanged. " 96efadf7-45463d77-cdcfd16b-18b425c0-8acbe029.jpg,test/p10/p10449138/s57713363/96efadf7-45463d77-cdcfd16b-18b425c0-8acbe029.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 169b0b2f-8635ecde-3bde61bf-012823bf-987f9017.jpg,test/p19/p19314531/s56768274/169b0b2f-8635ecde-3bde61bf-012823bf-987f9017.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Productive cough, recent URI, somnolence. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are hyperinflated, with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Amorphous calcification projecting over the left upper hemithorax is stable since at least ___. Evidence of hilar calcification is again seen. IMPRESSION: COPD without acute cardiopulmonary process. " 17027203-f4e56f96-3ccf3256-4fc24eb8-d4663609.jpg,test/p14/p14581354/s51433168/17027203-f4e56f96-3ccf3256-4fc24eb8-d4663609.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: One week of headache, low-grade temp, concern for pneumonia. IMPRESSION: AP and lateral chest compared to ___, 11:04 a.m.: There is no focal pulmonary consolidation. Previously questioned abnormality could have been either atelectasis, or acute aspiration, resolved, or costal pleural calcification seen along the diaphragmatic surface. Lungs are clear and there is no pleural fluid. The heart is at least moderately enlarged, augmented by mediastinal fat, but the hilar and other mediastinal contours are unremarkable. " 02543887-387b52d7-e08f9176-4387e2ed-f1a2d5c2.jpg,test/p12/p12945897/s54823550/02543887-387b52d7-e08f9176-4387e2ed-f1a2d5c2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of smoking, congestion and cough. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal chest radiograph without evidence of pulmonary edema, pleural effusion or pneumonia. Normal size of the cardiac silhouette. " 285ec378-bd6870ce-deaf5c70-b02515e5-af7c0f0f.jpg,test/p16/p16609016/s50111182/285ec378-bd6870ce-deaf5c70-b02515e5-af7c0f0f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea and pain with breathing // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ an chest CT from ___ FINDINGS: Predominantly peripheral and most noted basilar reticular interstitial markings are seen in this patient with suggested diagnosis fibrotic an SI P, chronic interstitial disease appear increased as compared to to chest radiograph from ___, possibly increased compared to ___, suggesting possible acute on chronic process. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Peripheral interstitial opacities with basal predominance, likely increased as compared the prior study, this is a chronic interstitial lung disease with concern for acute process versus progression of disease. " e196077b-bf5a5251-bf493e22-65446261-0a15fd14.jpg,test/p17/p17794482/s56971174/e196077b-bf5a5251-bf493e22-65446261-0a15fd14.jpg,test," WET READ: ___ ___ 8:35 AM Minimal bilateral linear atelectasis. No focal consolidation, pleural effusion or pneumothorax. WET READ VERSION #1 ___ ___ ___ 11:26 PM Minimal bilateral linear atelectasis. No focal consolidation, pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with ? prior infiltrate on admission CXR. Now with fever, cough. // evaluate for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is mild bibasilar atelectasis. No definite focal consolidation is seen. No large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable and stable.. Right-sided Port-A-Cath terminates in the low SVC/ cavoatrial junction. IMPRESSION: Mild basilar atelectasis without definite focal consolidation. " 6d956b70-d1c67f32-80098d2d-af0fdb92-0066147d.jpg,test/p13/p13604162/s59181563/6d956b70-d1c67f32-80098d2d-af0fdb92-0066147d.jpg,test," FINAL REPORT HISTORY: Bilateral pneumonia. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Continued bibasilar opacifications consistent with pleural fluid and volume loss, more prominent on the right. Upper zones remain clear and there is no definite vascular congestion. " 1ec63c04-9ef05a42-1707a0cd-e1c75425-a4c01987.jpg,test/p10/p10865344/s56892218/1ec63c04-9ef05a42-1707a0cd-e1c75425-a4c01987.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with pancreatitis, evaluate for pleural effusions TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: Normal chest radiograph. " 2e4fabd7-50301ce1-8c126599-5347e6d8-8bd94272.jpg,test/p15/p15121721/s50456223/2e4fabd7-50301ce1-8c126599-5347e6d8-8bd94272.jpg,test," WET READ: ___ ___ ___ 11:03 AM 1. No acute cardiopulmonary process. WET READ VERSION #___ ___ ___ ___ 10:28 AM 1. No acute cardiopulmonary process. 2. Age indeterminate compression fractures in the lower thoracic spine, at least progressed since ___. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___F with dyspnea/L arm pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. Aortic arch calcifications are unchanged. IMPRESSION: No acute cardiopulmonary process. " 74718fa3-dc231ec6-0c2a2229-70694fc9-639992df.jpg,test/p17/p17876390/s59647316/74718fa3-dc231ec6-0c2a2229-70694fc9-639992df.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cirrhosis TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are slightly low. Heart size is top normal, unchanged. Mild atherosclerotic calcification is noted at the aortic knob. Pulmonary vasculature is normal. Apart from subsegmental atelectasis in the lingula, the lungs are clear. No focal consolidation or pneumothorax is present. Minimal blunting of the costophrenic angles posteriorly on the lateral view may suggest the presence of trace bilateral pleural effusions. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: Possible trace bilateral pleural effusions and lingular subsegmental atelectasis. " e8a7e572-3d473579-aa1a9e49-97974141-a0e5b584.jpg,test/p13/p13330114/s54547258/e8a7e572-3d473579-aa1a9e49-97974141-a0e5b584.jpg,test," FINAL REPORT INDICATION: History: ___M with concern for stroke // evidence of infection TECHNIQUE: Portable upright radiograph of the chest. COMPARISON: None. FINDINGS: A subtle opacity seen at the right lung base. There is mild enlargement of the pulmonary arteries. There is no evidence pneumothorax. The heart size is normal. The hilar and mediastinal contours are otherwise unremarkable. The visualized osseous structures are unremarkable. IMPRESSION: Subtle opacity at the right lung base concerning for an infectious process. " 43e4cfbf-e06e1cef-f18aae64-7d26e711-deddb285.jpg,test/p17/p17651711/s53319550/43e4cfbf-e06e1cef-f18aae64-7d26e711-deddb285.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with schizophrenia, admitted with hyponatremia, ?concern for pneumonia // please evaluate retrocardiac opacity please evaluate retrocardiac opacity IMPRESSION: In comparison with the study of ___, there are slightly improved lung volumes. Continued enlargement of the cardiac silhouette, probably with mild elevation of pulmonary venous pressure. There again is some increased opacification in the retrocardiac region, which could reflect volume loss in the left lower lung and small pleural effusion. " 1b727124-c5e77214-627ecb4c-15a5dff1-919cd2a9.jpg,test/p18/p18001762/s55929903/1b727124-c5e77214-627ecb4c-15a5dff1-919cd2a9.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with morbid obesity, asthma with productive cough. // pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The cardiac and mediastinal silhouettes are stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. No overt pulmonary edema is seen. IMPRESSION: No significant interval change. No focal consolidation to suggest pneumonia. " 42846124-cd92a85f-29171bcb-1810fba0-e4b14742.jpg,test/p11/p11531307/s52452987/42846124-cd92a85f-29171bcb-1810fba0-e4b14742.jpg,test," FINAL REPORT INDICATION: ___ year old man with PE, s.p cath for NSTEMI, SOB // eval for pulm edema vs COPD TECHNIQUE: AP portable chest radiograph ___ from earlier in the day FINDINGS: The patient is status post prior median sternotomy. The lungs are hyperexpanded. There are small bilateral pleural effusions with overlying atelectasis, greater on the right. There is mild persisting pulmonary edema and enlargement of the cardiac silhouette. No pneumothorax identified. IMPRESSION: Mild pulmonary edema. Small right pleural effusion with overlying atelectasis. Hyperexpanded lungs. " 062a5674-e56388f3-bd870948-d73e4858-b6dbe1da.jpg,test/p18/p18899192/s58205049/062a5674-e56388f3-bd870948-d73e4858-b6dbe1da.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were obtained. Lungs are clear. No pleural effusion or pneumothorax. Heart and mediastinal contour is normal. Bony structures are intact. " a5a669e9-d65d0f78-d4fd5df5-02de6b75-5bfb4350.jpg,test/p18/p18532499/s58404639/a5a669e9-d65d0f78-d4fd5df5-02de6b75-5bfb4350.jpg,test," WET READ: ___ ___ 5:14 AM No evidence of acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with 12 hr of right upper quadrant pain, evaluate for right lower lobe infiltrate or effusion. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: Low lung volumes cause bronchovascular crowding. Moderate cardiomegaly and a prominent contour of the right hilum are unchanged from the prior study suggesting underlying pulmonary hypertension. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. There is a small hiatal hernia. IMPRESSION: No evidence of acute cardiopulmonary process. " cd37c22f-28e5e107-0497bf20-4747c418-351db079.jpg,test/p17/p17070596/s51727224/cd37c22f-28e5e107-0497bf20-4747c418-351db079.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with w/ bronchiestasis since ___ with loculatedleft pleural effusion since ___ , admitted for monitoring after thoracoscopy/biopsy found to have poor differentiated adenocarcinoma (prelim) // pneumothorax recurrance IMPRESSION: In comparison to ___ chest radiograph, a left chest tube remains in place with loculated hydro pneumothoraces in the mid and lower left hemi thorax. Overall appearance is relatively similar except for possible slight increase in amount of pleural fluid. Subcutaneous emphysema in the left chest wall has nearly resolved. No other relevant change. " 29990ca3-b97aaa50-3d88f045-8b6f905a-32addfb3.jpg,test/p15/p15934572/s56066507/29990ca3-b97aaa50-3d88f045-8b6f905a-32addfb3.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with systolic CHF, cholangitis and cellulitis. New hypoxia. IMPRESSION: AP chest compared to ___ and VIII: While pulmonary edema has waxed and waned in the left lung, there has been relatively persistent consolidation at the right lung base, particularly medially. This area has improved since ___, and edema has cleared from the remainder of the right lung. There is new consolidation in the axillary region of the left lung and inferior to the left hilus. Findings suggest new pneumonia. Heart size is top normal. Small bilateral pleural effusions are probably not clinically significant. Dr. ___ was paged. " 72281b64-cb62706d-e2646606-115b24d6-1810fc04.jpg,test/p13/p13006644/s54674694/72281b64-cb62706d-e2646606-115b24d6-1810fc04.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with IDDM, recent humeral fracture, recent NSTEMI who is admitted from ___ for management of DKA, NSTEMI. // please evaluate interval change please evaluate interval change IMPRESSION: Right internal jugular line tip is at the level of cavoatrial junction. Heart size and mediastinum are unchanged but there is interval improvement of pulmonary edema, from severe to moderate associated with interval increase in bilateral pleural effusions. " 014cf1b7-a5ca41ff-5b65ef24-242b31dd-15859e30.jpg,test/p16/p16376570/s59751175/014cf1b7-a5ca41ff-5b65ef24-242b31dd-15859e30.jpg,test," FINAL REPORT INDICATION: ___F with cough x___ year acutely worse x1week // any infection TECHNIQUE: PA and lateral COMPARISON: CT chest dated ___ FINDINGS: PA and lateral chest radiograph demonstrate mildly low lung volumes. With faint opacity posteriorly on the lateral view which is likely atelectasis. Elsewhere, lungs are clear. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. No air under the right hemidiaphragm. IMPRESSION: Mildly low lung volumes. No definite evidence of pneumonia. " c391ff9d-81bb39d7-be52528c-c0bd7239-6efdf607.jpg,test/p15/p15845632/s50990667/c391ff9d-81bb39d7-be52528c-c0bd7239-6efdf607.jpg,test," WET READ: ___ ___ 7:46 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: ___M with c/o fever/chills and fatigue // ? PNA TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made chest radiographs from ___ and ___. FINDINGS: Lungs well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " bc2face1-85a64b14-4131d4c1-9a471b20-b44d198a.jpg,test/p16/p16633733/s56084551/bc2face1-85a64b14-4131d4c1-9a471b20-b44d198a.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Chest pressure? COMPARISON: ___. FINDINGS: Lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: There is no evidence of pneumonia. " c9a3281e-86d4b9cf-8ec287aa-5cccb7f3-cd967761.jpg,test/p18/p18584056/s52464544/c9a3281e-86d4b9cf-8ec287aa-5cccb7f3-cd967761.jpg,test," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old female patient with dyspnea on exertion. Evidence of CHF. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is normal. No configurational abnormalities identified. The thoracic aorta is mildly widened and elongated but no local contour abnormalities or wall calcifications are present. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No pneumothorax in apical area on the frontal view. Mild degree of degenerative changes in the thoracic spine but no evidence of advanced demineralization or vertebral body compression fractures. Increased extrathoracic soft tissue structures suggest adiposity. Our records do not include a previous chest examination available for comparison. IMPRESSION: Chest findings within normal limits. No evidence of CHF or pneumonic infiltrate. " 0a5bc0e8-c2edaf3e-766ba3c5-84aa8df1-468b8af9.jpg,test/p14/p14371035/s58555103/0a5bc0e8-c2edaf3e-766ba3c5-84aa8df1-468b8af9.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fevers. Evaluate for evidence of pneumonia. COMPARISON: Multiple prior chest radiographs, most recent on ___. TECHNIQUE: Frontal upright and lateral chest radiograph. FINDINGS: There is mild dextroscoliosis centered in the mid thoracic spine as well as severe degenerative changes of both shoulders, which is not significantly changed from prior and compatible with neuropathic joints in the setting of known neuromyelitis secondary to SLE. Post-thoracotomy changes are also noted in the right. Otherwise, the lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no cardiomegaly. No pleural effusion or pneumothorax is identified. Small oblong opacity in the left lower lung field projecting over a posterior rib likely relates to bony callus from prior fractures, better assessed in previous CT. IMPRESSION: No evidence of acute cardiopulmonary process. Small oblong opacity in the left lower lung field projecting over a posterior rib likely relates to bony callus from prior fractures, better assessed in previous CT. Findings could be confirmed with oblique views. " 647c3bd0-6e8ea0e4-e367edee-d6eefb00-174fcf42.jpg,test/p15/p15446959/s52616494/647c3bd0-6e8ea0e4-e367edee-d6eefb00-174fcf42.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Fever. Question consolidation. COMPARISON: ___ and ___. TECHNIQUE: Chest, AP semi-upright. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged including mild cardiomegaly. There is similar elevation of the left hemidiaphragm with persistent unchanged vague left mid to lower lung opacity which may indicate some degree of chronic atelectasis and, particularly given lack of change, isnot suspicious for an acute superimposed process. The lungs appear otherwise clear. Old left-sided rib fractures are also unchanged. There has been no significant change. IMPRESSION: No evidence of acute cardiopulmonary disease. " 5b2a1abe-63ba5a3f-82a4a3cc-21b46b65-401a2905.jpg,test/p16/p16050259/s50976627/5b2a1abe-63ba5a3f-82a4a3cc-21b46b65-401a2905.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with several weeks malaise fever cough sob // pls eval for pna pls eval for pna IMPRESSION: No previous images. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 42129961-a797668c-f4eacf6f-7ad83a97-5cd2c4f0.jpg,test/p10/p10326191/s57454068/42129961-a797668c-f4eacf6f-7ad83a97-5cd2c4f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with desaturation, tachypnea // desaturation, tachypnea TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Improved bibasilar opacities is consistent with improving atelectasis. Increased opacities in the left upper lobe could be atelectasis but superimposed infection cannot be excluded and attention in followup is recommended. No other interval change from prior study. " 9f0841e8-579f4af8-c5c0fc43-4cb7a395-70ade3d6.jpg,test/p11/p11422321/s53211156/9f0841e8-579f4af8-c5c0fc43-4cb7a395-70ade3d6.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with valvular dysfunction presenting with shortness of breath. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of consolidation, effusion, or pulmonary vascular congestion. There is, however, moderate cardiomegaly. Osseous and soft tissue structures are unremarkable. IMPRESSION: Moderate cardiomegaly. No acute cardiopulmonary process. " 128b6813-c987f0de-a0366982-7940eca3-bd5b5e31.jpg,test/p12/p12100656/s51169756/128b6813-c987f0de-a0366982-7940eca3-bd5b5e31.jpg,test," WET READ: ___ ___ ___ 8:52 AM Low lung volumes. No definite evidence of pneumonia or edema. No significant change compared to ___ at 14:40. WET READ VERSION #1 ___ ___ ___ 6:18 PM Low lung volumes. No definite evidence of pneumonia or edema. No significant change compared to ___ at 14:40. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with STEMI and high risk lesion, new luekocytosis // r/o pulm edema, pna, cardiomegaly r/o pulm edema, pna, cardiomegaly IMPRESSION: In comparison with the earlier study of this date, side the patient has taken a better inspiration and there is little change in the cardiomediastinal silhouette. There is some indistinctness of the pulmonary vessels raising the possibility of elevated pulmonary venous pressure. More coalescent opacification at the bases, especially on the left, could reflect merely atelectasis. However, in the appropriate clinical setting, superimposed pneumonia would have to be considered. " 4cfd1064-cb2b41fd-4f53fb06-0a9c99a2-11946d8f.jpg,test/p18/p18416120/s52322797/4cfd1064-cb2b41fd-4f53fb06-0a9c99a2-11946d8f.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // acute process? TECHNIQUE: Upright PA and lateral chest COMPARISON: Chest radiographs ___ and ___ FINDINGS: Lung volumes are slightly low but clear. The heart is not enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " a64d2e83-e6a19a37-78cf8add-6d4bf3aa-6068815b.jpg,test/p19/p19389227/s52882911/a64d2e83-e6a19a37-78cf8add-6d4bf3aa-6068815b.jpg,test," FINAL REPORT PA AND LATERAL CHEST FROM ___ AT 07:25 INDICATION: ___-year-old with chest pain, evaluate for cardiopulmonary disease. No comparison studies. Please note that comparison to old films can be helpful to detect subtle interval change. PA and lateral views of the chest ___ at 07:25 are submitted. IMPRESSION: 1. Lungs are well inflated without evidence of focal airspace consolidation, pleural effusions, pneumothorax, or pulmonary edema. Overall, cardiac and mediastinal contours are within normal limits. No acute bony abnormality. " 53e6303c-e38a9811-16091edd-39554fde-d772cdc4.jpg,test/p19/p19917510/s52709355/53e6303c-e38a9811-16091edd-39554fde-d772cdc4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with pleuritic chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Left-sided dual-chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle. Moderate cardiomegaly is re- demonstrated along with tortuosity of the thoracic aorta. Mediastinal and hilar contours otherwise are stable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 66230f7e-0b738b21-7e81bbba-5302d4b4-e5a62dae.jpg,test/p13/p13505755/s56251716/66230f7e-0b738b21-7e81bbba-5302d4b4-e5a62dae.jpg,test," WET READ: ___ ___ ___ 8:18 AM 1. Persistent moderate right pleural effusion and small left pleural effusion. 2. Stable mild vascular congestion. 3. Bilateral lower lobe atelectasis. 4. Stable support lines and tubes. ___ ___. 9PM. WET READ VERSION #1 ___ ___ ___ 9:05 PM 1. Persistent moderate right pleural effusion and small left pleural effusion. 2. Stable mild vascular congestion. 3. Bilateral lower lobe atelectasis. 4. Stable support lines and tubes. ___ ___. 9PM. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with VDRF, new desaturation // Eval for interval change Eval for interval change IMPRESSION: In comparison with the study of ___, the monitor and support devices are unchanged. Again there is enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure. Bilateral pleural effusions with compressive atelectasis at the bases, more prominent on the right. " 0e533a06-c8ce3ffc-0a431043-eee4565a-0c407fbc.jpg,test/p10/p10596591/s55464130/0e533a06-c8ce3ffc-0a431043-eee4565a-0c407fbc.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with altered mental status versus seizure. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. The lungs are clear of focal consolidation or effusion. The cardiac silhouette is enlarged but stable in configuration compared to prior. Atherosclerotic calcification is seen at the aortic arch. The osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 14c5e16e-2c126233-ed1cb573-8fea0d8d-45b7d913.jpg,test/p19/p19178984/s59170517/14c5e16e-2c126233-ed1cb573-8fea0d8d-45b7d913.jpg,test," WET READ: ___ ___ ___ 3:49 AM No evidence of pneumonia. Extensive intrathoracic metastatic disease is better evaluated on chest CT ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with metastatic melanoma on chemo p/w confusion // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. Mild endplate compression deformities of T7 and T8 are unchanged. A 2.3 cm rounded density seen on the lateral view is consistent with a known pulmonary nodule. Intrathoracic metastatic disease is better evaluated on CT chest ___. IMPRESSION: 1. No evidence of pneumonia. Extensive intrathoracic metastatic disease is better evaluated on chest CT ___. 2. Mild endplate compression deformities of T7 and T8 are unchanged. " cfd05e54-de8a5ca2-045cbe4e-69ba1b49-1a5f83d4.jpg,test/p18/p18490309/s53935239/cfd05e54-de8a5ca2-045cbe4e-69ba1b49-1a5f83d4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // PNA IMPRESSION: As compared to ___ radiograph, multifocal on lung nodules consistent with metastatic renal carcinoma appear similar, whereas confluent opacities in the lingula and left lower lobe have slightly improved. No other relevant changes. " 37d67e7b-14a2e2b6-bfe94f2d-55611bfa-acbc844e.jpg,test/p13/p13621487/s52325310/37d67e7b-14a2e2b6-bfe94f2d-55611bfa-acbc844e.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with fevers, chills, question pneumonia. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: Minimal bibasilar streaky opacities likely reflect atelectasis. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is normal. IMPRESSION: Bibasilar streaky opacities, likely atelectasis. Infection cannot be excluded in the correct clinical setting. " 79997656-31856d85-36c79c8a-ccf873c2-efa2efa9.jpg,test/p16/p16627318/s56308742/79997656-31856d85-36c79c8a-ccf873c2-efa2efa9.jpg,test," FINAL REPORT HISTORY: Leukocytosis status post liver transplant, with a pleural effusion drained last week. Evaluate for infiltrate. COMPARISON: Chest radiographs from ___, ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. There is mild linear atelectasis at the left lung base. The upper lungs are clear. Bilateral pleural effusions are small, if any. No pneumothorax is present. IMPRESSION: Bilateral pleural effusions are small, if any, and there is minimal left base linear atelectasis. " 91e45cb7-042f8942-0b1d3f34-2831c97f-8d04d334.jpg,test/p19/p19277070/s53645617/91e45cb7-042f8942-0b1d3f34-2831c97f-8d04d334.jpg,test," FINAL REPORT INDICATION: ___ year old man // eval effusion/opacity TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and mitral valve replacement. Stable postoperative appearance of cardiomediastinal contours and sternal wires. Improving bibasilar atelectasis. Persistent small left pleural effusion and interval resolution of small right pleural effusion. Possible splenic enlargement in left upper quadrant. IMPRESSION: Improving bibasilar atelectasis and resolution of small right pleural effusion. Persistent small left pleural effusion. " 12086af9-4ce15faa-b7d2e6ab-9324bad0-aef7a3f1.jpg,test/p13/p13836780/s52924592/12086af9-4ce15faa-b7d2e6ab-9324bad0-aef7a3f1.jpg,test," FINAL REPORT HISTORY: PleurX placement. FINDINGS: In comparison with the study of ___, there has been placement of a left PleurX catheter with removal of a substantial amount of pleural fluid. No evidence of pneumothorax. Residual opacification could reflect some combination of atelectasis, reexpansion edema, and underlying consolidation. " 316624d6-fcbdb9f5-6666b6be-05e20eb6-3c81a14b.jpg,test/p12/p12462658/s55482298/316624d6-fcbdb9f5-6666b6be-05e20eb6-3c81a14b.jpg,test," FINAL REPORT INDICATION: ___-year-old man with asthma and wheezing who presents for evaluation of pneumonia. COMPARISONS: Chest radiographs from ___, ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is top normal, stable compared to the exam dating back to ___. There is no pulmonary edema. The hilar and mediastinal contours are normal. No focal consolidations, pleural effusions, or pneumothorax is seen. IMPRESSION: No evidence of a pneumonia. " f0983c7e-5edaaa34-04885b30-b260a522-2451e5cb.jpg,test/p16/p16826047/s59633653/f0983c7e-5edaaa34-04885b30-b260a522-2451e5cb.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with HIV and abdominal distention, abdominal pain. History of pleural catheter placement. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Right chest wall port is again seen with catheter tip in the lower SVC. Right-sided pleural catheter is seen which appears to course in the fissure. Significant amount of right-sided pleural effusion has slightly increased since prior with fluid also seen within the major fissure. No pneumothorax seen. There is underlying parenchymal opacity as well, potentially atelectasis; however, infiltrate is also possible. Left lung is grossly clear. Cardiac silhouette is enlarged but stable in configuration. Osseous and soft tissue structures are unremarkable. IMPRESSION: Increase in size of right-sided pleural effusion with pleural catheter in place. Expected associated right base atelectasis with possibility of infection not excluded. " f81683ee-f06baa0a-54e100a3-5cb4728f-0586e720.jpg,test/p18/p18646119/s56623904/f81683ee-f06baa0a-54e100a3-5cb4728f-0586e720.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with ongoing sscp, doe, and ___ edema // r/o acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes are low with some bronchovascular crowding. No focal consolidation, edema, effusion, or pneumothorax. The heart is top-normal in size. The mediastinum is not widened. IMPRESSION: No acute intrathoracic process. " 8d9cd23b-191f825c-72a995cf-bfbd9b34-7edf2dab.jpg,test/p18/p18666022/s54147469/8d9cd23b-191f825c-72a995cf-bfbd9b34-7edf2dab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent umbilical hernia repair // Evaluate for progression of free air COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Interval removal of an orogastric tube. On the lateral view there is poor definition of vessels. No pneumothorax. There is significantly more free air under the right and left hemidiaphragm. Small, bilateral pleural effusions and associated atelectasis are mildly worsened. Hilar and cardiomediastinal contours are normal. IMPRESSION: 1. There is significantly more free air under the right and left hemidiaphragm. 2. On the lateral view, there is poor definition of vessels projecting over the left lower lobe. In the appropriate clinical setting, this may represent superimposed pneumonia. 3. Small, bilateral pleural effusions and associated atelectasis are mildly worsened. NOTIFICATION: Lateral view, poor deifniton of vessels in app clinical setting superimposed consolidation " b85c7a0f-06d03bd9-f52b92ac-e645884c-d6a98d9f.jpg,test/p15/p15154432/s52964601/b85c7a0f-06d03bd9-f52b92ac-e645884c-d6a98d9f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ett // please eval ett please eval ett IMPRESSION: Comparison to ___. The endotracheal tube has been pulled back. The tip of the tube now projects approximately 5.5 cm above the carina, the tube should be advanced by 2-3 cm. The position of the right internal jugular vein catheter and of the nasogastric tube is unchanged. Decrease in extent of the previous bilateral pleural effusions, with subsequent increase in radiolucency at the lung bases. Unchanged moderate cardiomegaly with partial left lower lobe atelectasis. " 8797da90-72691190-748c759a-89433242-99c53a5a.jpg,test/p19/p19635953/s55158903/8797da90-72691190-748c759a-89433242-99c53a5a.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with study of ___, there is now a nasogastric tube in place in the upper stomach. The side hole is poorly seen and the tube should be pushed forward if possible. Slightly better inspiration, but otherwise, little change in the appearance of the heart and lungs. " ab3a355f-5bb7f0e5-b08d6178-a35d5cca-9c40c930.jpg,test/p12/p12734486/s53804893/ab3a355f-5bb7f0e5-b08d6178-a35d5cca-9c40c930.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: This is a ___M with seizure disorder, minimally verbal at baseline, history of DVTs on Lovenox, TBI with mental impairment, urinary retention with chronic indwelling Foley and recurrent UTIs with qSunday Foley change, epilepsy, who presented from nursing home with recurrent septic shock and hemorrhagic shock // plan for extubation today; evaluate interval change with aggressive fluid resuscitation plan for extubation today; evaluate interval change with aggressive fluid resuscitation IMPRESSION: Compared to chest radiographs ___ through ___ at 19:25. Aside from mild left lower lobe atelectasis, lungs are grossly clear. Pleural effusions are small if any. Heart size top-normal. Lines and tubes in standard placements. No pneumothorax. Healed right rib fractures are numerous. " dd44ade6-4ac2977a-ca793711-39a009b6-9a925513.jpg,test/p17/p17981638/s57325577/dd44ade6-4ac2977a-ca793711-39a009b6-9a925513.jpg,test," WET READ: ___ ___ ___ 12:46 PM No pneumonia. WET READ VERSION #___ ___ ___ ___ 11:13 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with pleuritic chest pain. // Is there e/o PNA? TECHNIQUE: AP and lateral views of the chest. COMPARISON: None available FINDINGS: The lung volumes are normal. Top normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Unchanged appearance of the spine on the lateral chest radiograph. No pneumonia, no pulmonary edema. No pleural effusions. IMPRESSION: No pneumonia. " 29d20148-76d0deac-f232ff6b-a33cbcdf-3a8b1396.jpg,test/p18/p18385238/s50990517/29d20148-76d0deac-f232ff6b-a33cbcdf-3a8b1396.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Encephalopathy. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is basilar atelectasis without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " d02b2581-dd51a585-e27ab238-2c8570ac-f0487d98.jpg,test/p18/p18119812/s58686000/d02b2581-dd51a585-e27ab238-2c8570ac-f0487d98.jpg,test," FINAL REPORT INDICATION: ___F with cough s/p chemo // eval for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Right-sided Port-A-Cath is again noted. The lungs remain clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 58486732-601a466c-04f4fd39-26bf4291-8cf57364.jpg,test/p11/p11888614/s57386788/58486732-601a466c-04f4fd39-26bf4291-8cf57364.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with etoh and drug abuse who reports getting punched in the face, has a black eye. COMPARISON: ___. FINDINGS: AP upright and lateral views the chest. Subtle prominence of the right hilar bronchovascular markings may reflect AP technique. No definite consolidation concerning for pneumonia. No effusion or pneumothorax. No overt edema. Cardiomediastinal silhouette appears normal. No acute bony injuries. IMPRESSION: Limited exam, no acute findings. " e352d7e4-55bd762d-3ffffa2d-120933f2-b022adaa.jpg,test/p13/p13483982/s54534971/e352d7e4-55bd762d-3ffffa2d-120933f2-b022adaa.jpg,test," FINAL REPORT INDICATION: ___-year-old man with a 2 day history of chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " a9ca4531-ef3fd76e-24f19b2b-181879d5-754fb2a0.jpg,test/p15/p15835176/s52732009/a9ca4531-ef3fd76e-24f19b2b-181879d5-754fb2a0.jpg,test," FINAL REPORT INDICATION: Hypotension, question pneumothorax or pneumonia. COMPARISON: ___. FINDINGS: Portable frontal semi upright radiograph of the chest demonstrates stable severe cardiomegaly and large right effusion with interval worsening of interstitial edema now moderate. A left PICC ends in the low SVC. No large pneumothorax or left pleural effusion. IMPRESSION: Interval worsening of moderate pulmonary edema. " 005ab9a7-db0d2a70-eed319bc-1e0a3d80-866b2511.jpg,test/p12/p12285052/s58602324/005ab9a7-db0d2a70-eed319bc-1e0a3d80-866b2511.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hx dementia, minimally verbal, presenting with fever. // pneumonia? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Patient is rotated to the left. The patient's hand overlies the lateral left mid to lower hemithorax, partially obscuring the view and limiting evaluation. Given this, no large focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable grossly stable. IMPRESSION: Suboptimal study due the patient's hand overlying the lateral left mid to lower hemi thorax. Given this, no acute cardiopulmonary process seen. " 36abb8c2-6a9b9b84-ee43fe2f-c7eb9975-2d327992.jpg,test/p15/p15911069/s56148081/36abb8c2-6a9b9b84-ee43fe2f-c7eb9975-2d327992.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p CABG - CTs d/c'd // evaluate for pneumothorax evaluate for pneumothorax IMPRESSION: Compared to chest radiographs ___ and ___. Patient has been extubated. Moderate left lower lobe atelectasis has worsened. Small pleural effusions have increased. Normal postoperative cardiomediastinal silhouette. No pulmonary edema or pleural effusion. Swan-Ganz catheter ends in the right pulmonary artery. " 96518c3b-b35fd14b-d092e698-3a0311dd-45a517b9.jpg,test/p18/p18651563/s55580769/96518c3b-b35fd14b-d092e698-3a0311dd-45a517b9.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Dementia, pneumonia, interval followup. AP radiograph of the chest was compared to ___. Multifocal opacities appear unchanged, with no interval development of additional consolidations or increase in currently small bilateral pleural effusion. Heart size and mediastinal silhouettes are stable. As compared to ___, the extent of the abnormality has increased, but overall no substantial change since ___ is demonstrated. " dfdc36bc-45576692-dc724381-2a4e06a8-8fa28cd1.jpg,test/p19/p19960115/s57879909/dfdc36bc-45576692-dc724381-2a4e06a8-8fa28cd1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with increased RR post-op Whipple, received 5L fluid // ?fluid overload TECHNIQUE: AP view COMPARISON: None. FINDINGS: An enteric tube terminates in the proximal stomach and could be advanced for appropriate placement. Lungs are markedly low which accentuates bronchovascular markings. Given that, the cardiac silhouette is enlarged. No focal consolidation or pleural effusion. No pneumothorax. There is mild pulmonary vascular engorgement and mild pulmonary edema. IMPRESSION: Exam limited by technique. Markedly low lung volumes mild pulmonary edema. Enteric tube terminates in the proximal stomach and could be advanced 5-6 cm for appropriate positioning. " 13675ad4-1d7f1370-a4fa4fbe-56334043-e9dd98c6.jpg,test/p10/p10018078/s52632768/13675ad4-1d7f1370-a4fa4fbe-56334043-e9dd98c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dyspnea and chest tightness // eval for pleural effusion or infection TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 4c873b0d-ab45591e-87b1ff72-7a14b0cc-5e409e02.jpg,test/p10/p10808090/s59771898/4c873b0d-ab45591e-87b1ff72-7a14b0cc-5e409e02.jpg,test," FINAL REPORT INDICATION: History of weakness and fevers, evaluate for pneumonia. COMPARISON: Chest radiograph from ___. TECHNIQUE: AP and lateral chest radiographs were provided. FINDINGS: Lung volumes are very low, as seen previously. There is no focal consolidation, pleural effusion or pneumothorax. The aorta is tortuous. Heart size appears slightly smaller than the previous exam. The imaged upper abdomen is unremarkable. IMPRESSION: Low lung volumes but no acute cardiopulmonary process. " 8f1f04d2-1e8b52e2-a2eff63c-27dc49c6-b1bea510.jpg,test/p11/p11272182/s53018614/8f1f04d2-1e8b52e2-a2eff63c-27dc49c6-b1bea510.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lymphoma, now concern for sepsis and crackles. // Please evaluate for infection. Please evaluate for infection. COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Small region of consolidation at the base of the right lung was new or larger on ___, slightly smaller today, could be pneumonia. Lungs otherwise clear. Mediastinal widening due to a generally large and tortuous aorta is chronic. Heart is moderately enlarged chronically. Rightward tracheal deviation thoracic inlet is long-standing, but chest CT on ___ shows no mass or thyroid enlargement. No pleural effusion. Left pic line ends in the low SVC. " 0a3044fd-4c7b108c-c55481c8-04b9a819-1f51933c.jpg,test/p15/p15784637/s50305415/0a3044fd-4c7b108c-c55481c8-04b9a819-1f51933c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p MIE for locally invasive esphogeal adenocarcinoma // post op COMPARISON: Chest radiographs from___ FINDINGS: Heart size is normal. The pulmonary vasculature is normal. No focal consolidation or pneumothorax. The patient is s/p esophagectomy. Atelectasis adjacent to the neo esophagus is unchanged. Pleural effusion on the right is almost completely resolved. Some of the post surgical changes of the right lung have resolved. IMPRESSION: 1. Atelectasis adjacent to the neo esophagus is unchanged. 2. Pleural effusion on the right is almost completely resolved. " 3a255fb6-8ec1021a-748f198c-dff787c1-4bb6bcb8.jpg,test/p15/p15584013/s50030397/3a255fb6-8ec1021a-748f198c-dff787c1-4bb6bcb8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old with MDS conversion to AML s/p Allo transplant in ___ and lypmocyte infusion ___ found to have rising blast in BMB and enrolled in Protocol ___2 of GO-___c being admitted from clinic for ___ chemo to start ___ d/t persistent blasts on BMB. DAY 8 of ___ now with fevers to 102 and ANC of 0 // PNA PNA COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Left PIC line ends at a level 8 cm below the carina and would need to be withdrawn 4 cm to reposition it in the low SVC, if desired. Lungs are clear. There are no findings to suggest pneumonia. Heart size is normal. No pleural abnormality. " 3e403669-60af6f7b-aa5a836a-e53cb6f7-b9041dee.jpg,test/p10/p10706635/s50282610/3e403669-60af6f7b-aa5a836a-e53cb6f7-b9041dee.jpg,test," FINAL REPORT HISTORY: Shortness of breath, to assess for pneumonia. FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. There is a decrease in the areas of opacification, most likely reflecting decreased atelectasis related to the deeper breath. What appears to be a calcified pleural plaque in the left mid zone is seen and could be evaluated further with CT. " a3556608-903517e9-9c21f57b-c4189131-becdd07b.jpg,test/p12/p12968330/s54044876/a3556608-903517e9-9c21f57b-c4189131-becdd07b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with perineal nec fasc, with ARDS // interval change? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Enteric tube courses below the diaphragm, out of the field of view. Otherwise, the remainder of the Support tubes and devices are stable in position. Cardiac and mediastinal silhouettes are stable. Similar appearance of the lung fields. " 33725e00-0f004904-697586c1-71c18ad2-14751c68.jpg,test/p10/p10304362/s50695204/33725e00-0f004904-697586c1-71c18ad2-14751c68.jpg,test," FINAL REPORT INDICATION: History: ___F with cough, fever // presence of infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiomediastinal silhouette is within normal limits. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 2c0da8de-a482856b-b1229557-9937f9a1-79bd877d.jpg,test/p16/p16407286/s54546544/2c0da8de-a482856b-b1229557-9937f9a1-79bd877d.jpg,test," FINAL REPORT INDICATION: ___ year old man with POC in place. Pt feels the port is displaced. Please evaluate placement. // ___ year old man with POC in place. Pt feels the port is displaced. Please evaluate placement. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right-sided Port-A-Cath with the tip at the cavoatrial junction. The lungs are clear. The cardiomediastinal contours are unremarkable. No pleural effusions or pneumothorax. IMPRESSION: Right-sided port in good position at the cavoatrial junction. " 77649edc-2079596e-a9de3c80-b15604b3-79f33ffd.jpg,test/p10/p10361825/s58481436/77649edc-2079596e-a9de3c80-b15604b3-79f33ffd.jpg,test," FINAL REPORT AP CHEST, 4:44 A.M., ___ HISTORY: ___-year-old man with cirrhosis, mechanical AVR, and recent staph bacteremia, now with fever and hypotension. IMPRESSION: AP chest compared to ___: Substantial increase in already severe cardiomegaly and new perihilar consolidation developed between ___ and ___, presumably pulmonary edema. This improved on ___ and has not changed subsequently. Coarse pneumonia could be present concurrently, but the course is more suggestive of edema. Right jugular line ends in the upper SVC. Mediastinal compartment is still widened by dilated veins. Pleural effusions, if present, are small. No pneumothorax. No nasogastric tube is seen and the stomach is mildly distended with air and fluid. " ced26247-a81fda04-e4ca03f1-a1164a33-ef845d7f.jpg,test/p14/p14003502/s58501372/ced26247-a81fda04-e4ca03f1-a1164a33-ef845d7f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with Boerhaave's, s/p repair. // Interval changes concerning for leak or abscess. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: Compared with prior radiographs on ___, there is a new small right apical pneumothorax. There is no evidence of tension. Pneumomediastinum is decreased from prior. There is continued subcutaneous emphysema in the neck and lateral chest walls. Bilateral chest tubes are stable in position. Mild bibasilar atelectasis is stable. There is no new focal consolidation. No pleural effusion. The cardiac and mediastinal silhouettes are unchanged. An NG tube passes below the level of the diaphragm and out of view. IMPRESSION: New small right apical pneumothorax. NOTIFICATION: The findings were discussed by Dr. ___ ___ on the telephoneon ___ at 11:02 AM, 5 minutes after discovery of the findings. " b41bd1bd-de4e186c-7157a314-87f2c4db-e74b973c.jpg,test/p11/p11104911/s54941437/b41bd1bd-de4e186c-7157a314-87f2c4db-e74b973c.jpg,test," FINAL REPORT INDICATION: ___ year old man with new PPM // PPM position TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Dual lead left pectoral generator with 2 leads in the right atrium and right ventricle. Mild degenerative changes of the thoracic spine with osteophyte formation. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions. IMPRESSION: Dual lead left pectoral and subclavian pacemaker with 2 pacer leads in the right atrium and the right ventricle without evidence of pneumothorax or other complications. Mild degenerative changes in thoracic spine. " 8e96883f-0e4863d9-877c5a42-e657e4a6-2986ac45.jpg,test/p15/p15133454/s56293488/8e96883f-0e4863d9-877c5a42-e657e4a6-2986ac45.jpg,test," FINAL REPORT INDICATION: ___M with weakness, // acute cardiopulm process TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___ chest x-ray performed at an outside institution. FINDINGS: The lungs are clear without focal consolidation, effusion, or pulmonary edema. There is enlargement of the cardiac silhouette similar to prior. Median sternotomy wires, mediastinal clips, and left chest wall single lead pacing device are noted. Old healed right posterior sixth rib fracture is noted IMPRESSION: Enlarged cardiac silhouette without acute cardiopulmonary process. " 2072381c-de94ff53-8e14c4d0-1fbffd13-9f54f7ea.jpg,test/p10/p10398981/s59313994/2072381c-de94ff53-8e14c4d0-1fbffd13-9f54f7ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute liver failure, acute renal failure, ARDS. // Eval for interval change. Eval for interval change. IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Mild indistinctness of pulmonary vessels is again seen, consistent with elevated pulmonary venous pressure. The right basilar opacification has substantially decreased. Small pleural effusions with basilar atelectatic changes are again noted on both sides. " 9b8c3f1d-e76169cc-b1b714ec-bf6e3262-206a9cf7.jpg,test/p11/p11586698/s55187073/9b8c3f1d-e76169cc-b1b714ec-bf6e3262-206a9cf7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Wegeners vasculitis, now on immunosuppresion w. improved O2 sat // interval improvement? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the right-sided parenchymal opacities have substantially decreased in extent and severity. The left-sided opacities are constant. Also constant are mild retrocardiac opacities. The size of the cardiac silhouette is unchanged. No larger pleural effusions. Neo new parenchymal changes. " e6bfeb96-7a28ea46-c763cd89-c897ff0d-f480b57c.jpg,test/p12/p12698967/s52480464/e6bfeb96-7a28ea46-c763cd89-c897ff0d-f480b57c.jpg,test," FINAL REPORT INDICATION: History: ___F with chest pain, fall // eval for structural process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. Thoracic spine is severely kyphotic with several anterior wedging compression deformities of multiple thoracic vertebrae similar to before. Multiple old healed rib fractures are noted bilaterally. IMPRESSION: No acute cardiopulmonary process. " e7c3d113-f1e9f7d6-5285649c-c090c053-d1e56adb.jpg,test/p10/p10532853/s53992495/e7c3d113-f1e9f7d6-5285649c-c090c053-d1e56adb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right chest tube in place // Interval change Interval change COMPARISON: Conventional chest radiographs ___. IMPRESSION: Since ___, small right pleural effusion has decreased, and very small right pleural air loculation has increased, right pleural drainage tube unchanged in position. Severe enlargement of cardiac silhouette is unchanged. Pulmonary vasculature is engorged but there is no edema. Opacification at the right lung base is probably atelectasis. " 454c7201-a36a5385-46619aee-51e12b4b-694607ad.jpg,test/p11/p11649904/s50161286/454c7201-a36a5385-46619aee-51e12b4b-694607ad.jpg,test," FINAL REPORT INDICATION: ___ year old woman with CHF and multiple strokes, continued tachypnea // Interval improvement in R pleural effusion, pulm edema? FINDINGS: Stable cardiomegaly accompanied by pulmonary vascular congestion but near resolution of previously present edema. Persistent small pleural effusions with adjacent basilar atelectasis. COMPARISON: ___ " d10e905f-50baa181-3b5737be-62add635-b0510c59.jpg,test/p13/p13845626/s54242671/d10e905f-50baa181-3b5737be-62add635-b0510c59.jpg,test," FINAL REPORT INDICATION: ___-year-old male with recent diagnosis of DVT. Evaluate for presence of pneumonia or pneumothorax. COMPARISONS: None available. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are clear. Cardiomediastinal and hilar contours are unremarkable. There is no evidence of pleural effusion or pneumothorax. IMPRESSION: No evidence of acute chest pathology. " f221ecc4-41195549-e746721f-57a5f316-30c65a47.jpg,test/p15/p15510911/s51089309/f221ecc4-41195549-e746721f-57a5f316-30c65a47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Polytrauma // routine morning CXR routine morning CXR IMPRESSION: In comparison with the study of ___, the monitoring and support devices are stable. The bilateral areas of opacification at the bases are again seen. This could represent merely atelectasis or even contusion, though in the appropriate clinical setting superimposed aspiration or infectious pneumonia could be considered. " 72e3a363-3bf4f0a3-eed63f7a-095ab136-879e8ccf.jpg,test/p12/p12183689/s54894011/72e3a363-3bf4f0a3-eed63f7a-095ab136-879e8ccf.jpg,test," FINAL REPORT INDICATION: Stroke. The OG tube has been replaced. Evaluate positioning. COMPARISONS: Chest radiograph from ___. TECHNIQUE: A single AP supine view of the chest was obtained. FINDINGS: The endotracheal tube is in satisfactory position, 3.5 cm from the carina. An enteric tube is present with the tip curled within the stomach. A right internal jugular central venous catheter is unchanged, with the tip in the low SVC. The lung volumes are low with a small amount of right basilar atelectasis. The lungs are otherwise clear without evidence of focal airspace consolidation or pulmonary edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Satisfactory position of the new enteric tube. " 8a87cd28-028bfb3d-f000f992-44be9ced-43733b49.jpg,test/p17/p17479533/s56439852/8a87cd28-028bfb3d-f000f992-44be9ced-43733b49.jpg,test," WET READ: ___ ___ ___ 6:44 PM Unchanged position of right PICC. Removal of NG tube. Otherwise, unchanged appearance of the chest with low lung volumes, bibasilar atelectasis and mild fluid overload. ______________________________________________________________________________ FINAL REPORT INDICATION: PICC line placement. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged position of the right-sided PICC line. Nasogastric tube was removed in the interval. Otherwise, unchanged appearance of the chest, low lung volumes, bibasilar atelectasis, mild fluid overload. " 11c62073-bdcca50a-879d6f66-6869d86b-f03fcd74.jpg,test/p10/p10933807/s50490323/11c62073-bdcca50a-879d6f66-6869d86b-f03fcd74.jpg,test," FINAL REPORT INDICATION: ___ year old man now s/p ngt placed, evaluate NG tube placement. TECHNIQUE: Single upright AP chest radiograph COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: The new enteric tube courses below the diaphragm and terminates within the stomach. The pre-existing feeding tube is unchanged terminating in the third portion of the duodenum. Embolization coils and a stent projecting over the right upper quadrant are unchanged. Lumbar spinal fusion hardware projects in unchanged position. Low lung volumes cause bronchovascular crowding and bibasilar platelike atelectasis. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation. The cardiomediastinal silhouette is unchanged. IMPRESSION: 1. New enteric tube terminates within the stomach. 2. Low lung volumes causing bibasilar atelectasis. No evidence of acute cardiopulmonary process. " 102fa57b-787076c9-edcfda0c-d0a107fe-24a8099c.jpg,test/p14/p14014950/s50269725/102fa57b-787076c9-edcfda0c-d0a107fe-24a8099c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p CABG, MVRepair // follow up effusions IMPRESSION: As compared to ___ chest radiograph, a moderate to large left pleural effusion is a persistent finding, and a small right pleural effusion is apparently new. Bibasilar atelectasis is similar on the left and slightly worse on the right. No other relevant changes. " ab899ea3-7d246124-9ef59e72-71ba9f27-f1539826.jpg,test/p17/p17463554/s58413688/ab899ea3-7d246124-9ef59e72-71ba9f27-f1539826.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH, intubated // serial monitoring for intubation serial monitoring for intubation IMPRESSION: Comparison to ___. No relevant change. Monitoring and support devices are stable. Borderline size of the cardiac silhouette. No pulmonary edema, no pleural effusions. " b32e8919-5505dfcd-5a83e2d5-f6bc0cb0-79df2096.jpg,test/p16/p16051431/s52211767/b32e8919-5505dfcd-5a83e2d5-f6bc0cb0-79df2096.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pleural effusion s/p thoracentesis on left side // R/O pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Interval decrease in size of the left-sided pleural effusion. No left-sided pneumothorax. Left lower lobe opacification unchanged. Consolidation/scarring in the left upper lobe is unchanged. Right-sided pleural effusion is increased in size. Right lower lobe opacifications again noted. Nasogastric tube in situ, coursing out of sight inferiorly. IMPRESSION: Interval decrease in size of the left-sided pleural effusion. No left-sided pneumothorax. " 24337d0e-9190d190-74f2db3b-93ac1f2b-3284b1ea.jpg,test/p11/p11900721/s58208064/24337d0e-9190d190-74f2db3b-93ac1f2b-3284b1ea.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cryptogenic cirrhosis, presenting with large varus seal bleeding status post Lake more tube and emergent TIPS placement. TECHNIQUE: Chest, portable AP supine. COMPARISON: ___. FINDINGS: The patient is intubated. The endotracheal tube terminates 1.5 cm above the carina. An introducer catheter terminates in the upper superior vena cava. An endoscope passes through the whole esophagus and imaged upper part of the stomach. No inflated balloon is visualized. The lung volumes are low. The heart shows a left ventricular configuration, as before. There is new retrocardiac opacification which is very commonly due to atelectasis. Coinciding small pleural effusion is not excluded on the left. None is demonstrated on the right side. Perihilar opacity suggests mild fluid overload. IMPRESSION: Endoscope traversing the stomach and visualized upper part of the stomach; no inflated balloon visualized. Findings suggests mild vascular congestion and increasing left basilar opacification, probably due to atelectasis. Endotracheal tube seated slightly lower than before; it may be appropriate to retract it slightly. " 1028742f-5fb8fb67-1450ca9c-5516d61a-8446718d.jpg,test/p14/p14502109/s53935046/1028742f-5fb8fb67-1450ca9c-5516d61a-8446718d.jpg,test," FINAL REPORT INDICATION: ___F with cough, dyspnea, evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: 1. CT Chest ___. 2. Chest x-ray ___. FINDINGS: Again seen in the right upper lung is a linear airspace opacity, decreased in conspicuity in comparison to chest x-ray from ___. Otherwise, the lungs are clear without focal consolidation. The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Decreased conspicuity of right upper lung linear airspace opacity as seen on numerous prior studies, better assessed on prior chest CT, possibly reflective of recurrent chronic pneumonitis. 2. Otherwise, clear lungs without focal consolidation. " 9c97f6da-94c99917-008c05b1-7e780f62-36ca2f3b.jpg,test/p19/p19682215/s57868866/9c97f6da-94c99917-008c05b1-7e780f62-36ca2f3b.jpg,test," WET READ: ___ ___ 1:15 PM An endotracheal tube ends in the right mainstem bronchus and should be pulled back. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with resp. distress // ? tube placement TECHNIQUE: Single AP view COMPARISON: Radiograph ___ FINDINGS: An endotracheal tube ends in the right mainstem bronchus. An enteric tube courses below the level of the diaphragm. Lung volumes are low with mild bibasilar atelectasis. A right IJ line ends in the right atrium. IMPRESSION: An endotracheal tube ends in the right mainstem bronchus and should be pulled back. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 1:11 PM, 5 minutes after discovery of the findings. " 900b0a04-3db0fb17-33534402-9f017020-ce789a13.jpg,test/p19/p19794689/s52596873/900b0a04-3db0fb17-33534402-9f017020-ce789a13.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with hemorrhagic right pleural effusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___. FINDINGS: Left chest wall transvenous pacing device with lead ending in the right atrium, as expected. A right pleural effusion has increased from prior, although the exact size is difficult to discern given a probable subpulmonic component. Heart is top-normal in size. Mediastinal contour is normal. Lungs are clear. IMPRESSION: Right pleural effusion, increased from ___. " 0fb09a27-8ed963bf-94b89009-1331a820-fd4ba33d.jpg,test/p15/p15784687/s52768228/0fb09a27-8ed963bf-94b89009-1331a820-fd4ba33d.jpg,test," FINAL REPORT EXAMINATION: Chest Radiograph p.a. - lateral INDICATION: ___ year old man s/p placement of new RV ICD lead and CS lead via L axillary vein // rule out pneumothorax, eval lead position TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Of the new placement of an ICD there is no evidence of pneumothorax. Unchanged appearance of the cardiac silhouette. No larger pleural effusions. No pulmonary edema. IMPRESSION: No abnormalities associated with ICD insertion. " 826afb85-26fc7651-ff132ab2-829874f6-0bfd41ba.jpg,test/p14/p14972005/s53818033/826afb85-26fc7651-ff132ab2-829874f6-0bfd41ba.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with chronic myelocytic leukemia, two weeks of productive cough, evaluate for pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. There is status post sternotomy as before. The presence of multiple surgical clips in the left-sided anterior mediastinum is indicative of previous bypass surgery. The heart size is not enlarged. No typical configurational abnormality is present. Thoracic aorta mildly widened and elongated, but without local contour abnormalities. The pulmonary vasculature is not congested. No signs of pleural effusion as the lateral and posterior pleural sinuses are free. No acute parenchymal infiltrates. Similar as on preceding examination, there is some hazy crowding of the left cardiac contour identified as pleural thickening on the lateral view. These findings are completely unchanged and most likely represent postoperative scar formations related to cardiac surgery. Do not represent any acute pulmonary infiltrate. IMPRESSION: No signs of active pleural or parenchymal abnormalities. No signs of pericardial effusion on lateral view. " 888f9ada-10072766-d7877149-64f032b7-738dfa50.jpg,test/p11/p11812613/s58717833/888f9ada-10072766-d7877149-64f032b7-738dfa50.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with h/o cardiomyopathy, CAD, w/ cough, white phlegm. Says it feels like pneumonia // ?pneumonia TECHNIQUE: Chest: PA Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Moderate cardiomegaly and tortuous aorta stable. Left pectoral pacemaker with single lead position in the right ventricle. IMPRESSION: No acute cardiopulmonary process or evidence of pneumonia. NOTIFICATION: The findings were discussed with Dr. ___, ___D. by ___, ___D. on the telephone on ___ at ___:___ AM, 5 minutes after discovery of the findings. " 92c28a0f-80b42c85-e25286ff-585a5265-7a6b0e8f.jpg,test/p11/p11192888/s51317637/92c28a0f-80b42c85-e25286ff-585a5265-7a6b0e8f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dysphagia, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette. Left pectoral pacemaker with an atrial and chamber lead. The mediastinal and hilar contours are unremarkable, with exception of a pre-existing slight displacement of the trachea towards the left, likely caused by a retrosternal goiter. Unchanged mild blunting of the costophrenic sinus on the left. No evidence of pneumonia or pulmonary edema. Pleural calcifications along the lateral left chest wall are constant in appearance. " 9ae85b3a-7024d12b-f5d513b1-d1f5253f-b5d715b5.jpg,test/p19/p19629472/s58859400/9ae85b3a-7024d12b-f5d513b1-d1f5253f-b5d715b5.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient with recent knee surgery, right arm PICC line placement, check position. FINDINGS: Patient's clinical condition required examination in sitting position using AP frontal and left lateral views. The heart size is within normal limits. The thoracic aorta is mildly widened and elongated, but no local contour abnormalities identified. The pulmonary vasculature is not congested. Lateral and posterior pleural sinuses are free, and no evidence of acute pulmonary infiltrates is present. No pneumothorax exists in the apical area. Accentuated high contrast copies were provided both for frontal and lateral views; one can barely identify a somewhat concordat structure resembling a PICC line to be located in the right axillary area. It cannot be followed into the pulmonary area with certainty. Referring physician, ___ ___, was paged to clarify PICC line technique that has been used. Telephone contact was established with Dr. ___ at 2:30 p.m. It was noted that the patient was referred from another institution where he had the right-sided PICC line for several weeks. Contrast densities of lines can be lost can be lost, but it is also possible that the quality of the PICC line placed at an other institution was of lower density. With this information, one can see a suggestion of a line that continues and terminates in the upper SVC, some 3 cm above the level of the carina. It can be concluded that if good venous blood flow is established in the line, it could continue to be used for the remaining treatment. There is no pneumothorax or any other possible placement-related complication. " 7f335380-0c8a53d8-e6f2a6df-15660104-8ed65936.jpg,test/p11/p11522912/s51337884/7f335380-0c8a53d8-e6f2a6df-15660104-8ed65936.jpg,test," FINAL REPORT PORTABLE CHEST RADIOGRAPH HISTORY: Recently placed tracheostomy, now with fever. Evaluate for pneumonia. FINDINGS: A portable upright chest radiograph shows dense obscuration of the left diaphragm, which has been present since prior films over the past month and does not appear to have progressed. Some of this opacity may be related to left pleural fluid as evidenced by some blunting of the costophrenic angle. There is increasing obscuration of the right hemidiaphragm and while radiographically the changes could be related to a combination of atelectasis and fluid, new pneumonia cannot be excluded. Tracheostomy tube and nasogastric tube are in unchanged position in this patient with scoliosis. CONCLUSION: Obscuration of the left base appears unchanged over recent weeks, but opacity at the right lung base is increasing, question pneumonia. " 7dd409ec-56302086-6406481e-7d289c71-e7b17c6e.jpg,test/p16/p16895003/s58155199/7dd409ec-56302086-6406481e-7d289c71-e7b17c6e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with resolved AF w/ RVR TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CTA torso ___ FINDINGS: There is no consolidation, pleural effusion or pneumothorax. Note is made of centrilobular emphysema. Heart size is normal. Thoracic aortic stent graft appears unremarkable in position when compared to the more recent CTA dated ___. A compression deformity involving a lower thoracic vertebral body is unchanged. Otherwise, no acute osseous abnormalities. IMPRESSION: Aortic stent in place. No acute intrathoracic process. " 170bacef-45f9d3da-3715e719-ca9e5783-ca8356bd.jpg,test/p16/p16074678/s53155182/170bacef-45f9d3da-3715e719-ca9e5783-ca8356bd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pulmonary edema // assess pulmonary edema assess pulmonary edema COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Although there is no pulmonary edema, since tracheal extubation, compared to ___, there has been substantial increase in diameter of both the cardiac and mediastinal vascular contours indicating volume overload or right heart failure. Lungs are grossly clear. There is no appreciable pleural effusion. Indwelling left central venous catheter ends close to the superior cavoatrial junction. " 27559035-763f9da7-194e7101-1f28f3fc-514a5152.jpg,test/p18/p18866430/s53856634/27559035-763f9da7-194e7101-1f28f3fc-514a5152.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with prior study from ___. CLINICAL HISTORY: Lethargy and fever, question infection. FINDINGS: AP and lateral views of the chest were provided. The lungs are clear, though lung volumes are low. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. The heart is mildly enlarged. The aorta is normal in contour. The bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild cardiac enlargement without signs of edema or pneumonia. " a513968f-6367a276-d321e1ef-ffb1fe29-ae6ed3cf.jpg,test/p18/p18696663/s57646261/a513968f-6367a276-d321e1ef-ffb1fe29-ae6ed3cf.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. Question cardiomegaly. COMPARISON: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The thoracic aorta is moderately tortuous. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. Multilevel moderate thoracic spondylosis is present. IMPRESSION: 1. No acute cardiopulmonary process. 2. Normal cardiac size. 3. Tortuous thoracic aorta. " 32c3abb0-63dd87a3-8b87a1bb-4d28d300-50a411eb.jpg,test/p12/p12514721/s53584871/32c3abb0-63dd87a3-8b87a1bb-4d28d300-50a411eb.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Fever and recent pneumothorax, question pneumonia. FINDINGS: AP upright and lateral views of the chest provided. There is retrocardiac density with air-fluid levels compatible with known hiatal hernia. The lungs are clear without signs of aspiration or pneumonia. No pleural effusion or pneumothorax is seen. Heart and mediastinal contours are normal. Bony structures are intact. IMPRESSION: Hiatal hernia again seen. Otherwise, normal. " 183ae346-3056b937-b8255715-95c7c43e-c1663348.jpg,test/p16/p16624661/s50306568/183ae346-3056b937-b8255715-95c7c43e-c1663348.jpg,test," FINAL REPORT INDICATION: Left scapular pain, question of pulmonary pathology. COMPARISON: ___ chest radiograph and lumbar spine radiograph of ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. A lower thoracic vertebral compression fracture is unchanged compared to ___. IMPRESSION: No acute cardiopulmonary process. These findings were discussed with Dr. ___ by Dr. ___ at 3:23 p.m. on ___ by telephone. " fabc582d-1a12e5e2-e6f08171-00f07d2b-6ec6b54e.jpg,test/p16/p16662264/s59606790/fabc582d-1a12e5e2-e6f08171-00f07d2b-6ec6b54e.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with history of end-stage renal disease status post renal transplant, on immunosuppression. Acutely desating with ambulation. Evaluate for pneumonia or edema. COMPARISON: Chest radiograph ___ and chest CT ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Previously seen basal consolidations and diffuse abnormalities in the upper lungs have improved when compared to the ___ study. However, moderate-sized bilateral pleural effusions have worsened from ___ although appear stable from the chest CT of ___. There are no new areas of consolidation or evidence of pulmonary edema. Cardiomediastinal contours are unchanged. " f807adb8-3e0dabe2-511d44f8-3d4aa56c-60799811.jpg,test/p16/p16833478/s59443748/f807adb8-3e0dabe2-511d44f8-3d4aa56c-60799811.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hereditary hemorrhagic telangiectasias, here with fever, cough, LUQ pain // r/o infiltrate COMPARISON: No comparison IMPRESSION: The lung volumes are relatively low. Borderline size of the cardiac silhouette without pulmonary edema. There is no evidence of pneumonia but, better seen on the lateral than on the frontal radiograph, small bilateral pleural effusions are present. No pneumothorax. Normal hilar and mediastinal structures. " b1b64c54-eacd710a-78bfb409-e0592bff-4fd6c81f.jpg,test/p13/p13643894/s50596966/b1b64c54-eacd710a-78bfb409-e0592bff-4fd6c81f.jpg,test," FINAL REPORT INDICATION: ___M with weakness // eval for PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: There are small bilateral effusions, larger on the right than on the left. There is no focal consolidation or overt pulmonary edema. Moderate cardiomegaly is noted. There is no pneumothorax. No acute osseous abnormality is identified, hypertrophic changes noted in the spine. IMPRESSION: Cardiomegaly and small bilateral effusions. No focal consolidation. " aeaf352b-20abe2c1-7d09855e-8dcde264-c8dae3b5.jpg,test/p15/p15793456/s50728268/aeaf352b-20abe2c1-7d09855e-8dcde264-c8dae3b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/COPD, intubated, please eval for interval change // ___M w/COPD, intubated, please eval for interval change ___M w/COPD, intubated, please eval for interval change IMPRESSION: Compared to chest radiographs ___ through ___. ET tube in standard placement. Left PIC line ends in the low SVC. Esophageal drainage tube can be traced as far as the lower esophagus but the tip is indistinct. Emphysema is severe. Small region of left perihilar consolidation developed on ___ is unchanged. This could be atelectasis or pneumonia. There is no pleural abnormality. " c4a3fba1-7e5e515d-08f4b945-fd72e791-dfa238cf.jpg,test/p16/p16088813/s59059610/c4a3fba1-7e5e515d-08f4b945-fd72e791-dfa238cf.jpg,test," FINAL REPORT INDICATION: ___F with dizziness and nausea, suddenly developed tmp to 101.3, evaluate for pneumonia. COMPARISON: None available. TECHNIQUE Portable upright view of the chest. FINDINGS: The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. There is no acute osseous abnormality. IMPRESSION: No evidence of pneumonia. " 9610897c-b8f789ee-6aaeeff3-a27d9eba-d1fce159.jpg,test/p19/p19202595/s59501549/9610897c-b8f789ee-6aaeeff3-a27d9eba-d1fce159.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with c/o sob // lung abnormality, chf TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is upper limits of normal. The mediastinal and hilar contours are remarkable for a tortuous thoracic aorta with possible component of dilation in the ascending region. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild scoliosis is noted. IMPRESSION: Tortuous thoracic aorta with possible component of dilation in the ascending region. No evidence of congestive heart failure or pneumonia. " 0ce3037f-5d0a80f1-9e165cfb-301355eb-5e225c0e.jpg,test/p16/p16619211/s57684539/0ce3037f-5d0a80f1-9e165cfb-301355eb-5e225c0e.jpg,test," WET READ: ___ ___ ___ 6:45 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with chest pain. Assess for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are well inflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Visualized osseous structures are notable for anterior cervical spinal hardware. Visualized upper abdomen is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 8d0a6117-80ae9707-b56c4272-9ec57558-de5dee6f.jpg,test/p15/p15696083/s50500087/8d0a6117-80ae9707-b56c4272-9ec57558-de5dee6f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p AAA repair // pulm edema COMPARISON: Chest x-ray examination from ___ at 20:28 FINDINGS: Again seen is a right IJ sheath overlying the proximal SVC. An NG tube is present the tip likely overlies the gastric fundus. Inspiratory volumes are low. The cardiac silhouette is enlarged, but unchanged sternotomy wires and mediastinal clips are noted there is engorgement of the central vascular sure, upper zone redistribution, diffuse vascular plethora and vascular blurring, and peribronchial cuffing consistent with CHF and interstitial edema. Again seen is increased retrocardiac opacity consistent with left lower lobe collapse and/or consolidation. Is also patchy opacity at the right lung base similar to the prior film. There is a small to moderate left-sided effusion pleural effusion and a small right pleural effusion. These are essentially unchanged, possibly slightly larger on the right. IMPRESSION: CHF with interstitial edema. Allowing for technical differences, this is similar, possibly minimally more pronounced, than on the prior study. Bilateral pleural effusions left-greater-than- right, with underlying collapse and/or consolidation. The effusion on the right may be slightly larger. " 18e303f5-43289752-a1b80731-31574eb8-e630f8a4.jpg,test/p14/p14237047/s59909800/18e303f5-43289752-a1b80731-31574eb8-e630f8a4.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with hyposxia ams // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: A right pleural effusion is moderate with locules of gas projecting over the right lateral hemithorax which may be in the pleural space as seen on prior chest CT and or areas of parenchymal abscess. No definite left pleural effusion. Bilateral lower lobe parenchymal opacities are significantly worse from the prior exam. Cardiologic silhouette cannot be assessed. Aortic knob calcifications are mild. Biliary stents are incompletely imaged. IMPRESSION: 1. Bilateral lower lobe pneumonia and atelectasis. 2. Moderate right pleural effusion. 3. Locules of air projecting over the right lower lateral hemithorax. RECOMMENDATION(S): CT chest to further evaluate. " 4b2b9353-0aaaafa3-bb89c635-e65fee83-f7c075b5.jpg,test/p18/p18145770/s54783101/4b2b9353-0aaaafa3-bb89c635-e65fee83-f7c075b5.jpg,test," FINAL REPORT INDICATION: ___F with rib pain after a fall (L sided T6-9), evaluate for fracture. COMPARISON: None Available. TECHNIQUE PA and lateral view of the chest. FINDINGS: Lungs are clear bilaterally without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. No displaced rib fractures are identified. Thoracic spine aligns normally without compression deformity. IMPRESSION: No acute intrathoracic process. No displaced rib fracture. " f6bb2d0d-99b6758e-d17502af-06803297-d57c0401.jpg,test/p16/p16055506/s59959171/f6bb2d0d-99b6758e-d17502af-06803297-d57c0401.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after chest tube removal. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are unremarkable. The pigtail catheter on the left has been removed. The current examination demonstrates questionable minimal left apical pneumothorax. The anterior loculation of air is suspected on the lateral view. Small amount of pneumoperitoneum is seen, diminished since the prior study. The overall amount of subcutaneous air within the anterior aspect of the left chest appears to be gradually decreasing. No pleural effusion seen. " d6f7585f-720f5bda-fb938293-d7df3f12-8665fad6.jpg,test/p13/p13297244/s50236199/d6f7585f-720f5bda-fb938293-d7df3f12-8665fad6.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with cardiac arrest. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. There is mild prominence of the interstitial markings without confluent consolidation or effusion. The cardiac silhouette is moderately enlarged. Atherosclerotic calcifications are seen at the aortic arch. The ascending thoracic aorta is tortuous. No acute osseous abnormality is identified. IMPRESSION: Mildly prominent interstitial markings, potentially due to chronic interstitial process or mild interstitial edema. Moderate cardiomegaly. No evidence of confluent consolidation. " d57f4d34-4302f4e2-cd80420e-bc483b82-f0a2eec3.jpg,test/p13/p13178429/s54589420/d57f4d34-4302f4e2-cd80420e-bc483b82-f0a2eec3.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain*** WARNING *** Multiple patients with same last name! // ? ptx COMPARISON: Multiple prior exams, most recently chest radiographs of ___. TECHNIQUE: Single frontal view of the chest. FINDINGS: Heart size and cardiomediastinal contours are normal. Ill-defined opacity at the right lung base may represent aspiration or infection. No pleural effusion or pneumothorax. The right costophrenic angle is partially excluded. IMPRESSION: Ill-defined right lung base opacity, consistent with either aspiration or infection. " 53e2bccf-03494bb2-c55028a8-fbe4a04d-18b03e3e.jpg,test/p16/p16615356/s57756987/53e2bccf-03494bb2-c55028a8-fbe4a04d-18b03e3e.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with multiple complaints status post assault with recent chest tube has been pulled. Left-sided chest pain. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Since prior, there has been partial resolution of the left basilar opacity which still partially persists and could be due to atelectasis or scarring. Underlying infection is also possible. There is no visualized pneumothorax. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No displaced rib fracture is identified. IMPRESSION: Partial resolution of previously identified left basilar opacity compatible with resolving effusion with some persistent linear opacities suggestive of scar versus atelectasis, infection not completely excluded. No pneumothorax. " cbbdaecc-fb42947b-5f922eb8-bc915d12-0db0d72d.jpg,test/p11/p11260466/s54253307/cbbdaecc-fb42947b-5f922eb8-bc915d12-0db0d72d.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // r/o acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: Low lung volumes are seen with crowding of the bronchovascular markings. There is no effusion, pneumothorax nor consolidation. Eventration of the right hemidiaphragm is again noted. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 7d054007-4917da28-3f2b3c42-919c90d7-473180b3.jpg,test/p12/p12816661/s53365840/7d054007-4917da28-3f2b3c42-919c90d7-473180b3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with esophageal food impaction // ET TUBE, lung expansion, COMPARISON: Chest radiographs ___ and ___. IMPRESSION: With the chin slightly flexed, tip of the endotracheal tube, approximately a cm from the carina is 2 cm below optimal placement. Opacification at the left lung base is probably atelectasis. Small left pleural effusion may be present. There is no evidence of right pleural effusion. Right lung is low in volume but clear. Heart size is normal. No pneumothorax. " 1c4e8f1b-4e1b2390-e059d719-7448bd13-8f81f063.jpg,test/p16/p16641304/s55555749/1c4e8f1b-4e1b2390-e059d719-7448bd13-8f81f063.jpg,test," FINAL REPORT INDICATION: History of achalasia, chest pain. Please evaluate. COMPARISONS: CT chest from ___ and chest radiograph from ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: There is evidence of mild cardiomegaly, overall stable compared to exam dating back to ___. Linear bibasilar opacities are suggestive of atelectasis versus scarring, slightly increased in size compared to the prior exam. There appears to be interval increase in the density of the right paratracheal region, likely secondary to the dilated esophagus given the patient's history. The mediastinal silhouette is within the upper limits of normal. Atherosclerotic calcifications are noted at the arch. There is no evidence of a pneumothorax. No large pleural effusion. IMPRESSION: Slight interval increase in the bibasilar consolidations, likely secondary to atelectasis. Slight interval widening of the esophagus compared to the prior exam. " 6ea57565-f9ad3a22-b22a35d8-ad84b77a-dce8cf26.jpg,test/p11/p11961710/s52496616/6ea57565-f9ad3a22-b22a35d8-ad84b77a-dce8cf26.jpg,test," WET READ: ___ ___ ___ 9:05 AM 1. No displaced rib fracture. If there is persistent clinical concern, consider dedicated oblique rib views were lateral view to evaluate the sternum. 2. No evidence of acute cardiopulmonary process. WET READ VERSION #1 ___ ___ ___ 9:26 PM 1. No displaced rib fracture. If there is persistent clinical concern, consider dedicated oblique rib views were lateral view to evaluate the sternum. 2. No evidence of acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with psychogenic syncope who is having ongoing chest pain after CPR was performed on him a couple days ago. Also has leukocytosis and ?rigors yesterday. // Infiltrate? Rib fracture? Infiltrate? Rib fracture? IMPRESSION: In comparison with the study ___ ___, there is little interval change. Again there is borderline enlargement of the cardiac silhouette. No evidence of pneumothorax or displaced rib fracture. Mild hyperexpansion of the lungs without acute pneumonia or vascular congestion. " d940e047-bf7157fb-9d3f0e93-992fcb49-15568771.jpg,test/p12/p12893999/s59028207/d940e047-bf7157fb-9d3f0e93-992fcb49-15568771.jpg,test," FINAL REPORT INDICATION: ___-year-old female with positive PPD. Assess for active lung disease. COMPARISON: Comparison is made to radiograph of the chest from ___. FINDINGS: PA and lateral views of the chest are obtained. The lung volumes are low. The heart is top normal in size. There is no evidence of focal consolidation, pleural effusion or pulmonary edema. CONCLUSION: No acute cardiopulmonary disease. " 2d020687-f35541cc-c21bde8b-d0c94122-4b2b1a7e.jpg,test/p13/p13999026/s55126254/2d020687-f35541cc-c21bde8b-d0c94122-4b2b1a7e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s.p liver transplant, some fluid overload, now w/ expectoration of bloody sputum/clots // Etiology of bloody sputum/clots - volume overload/PNA? Etiology of bloody sputum/clots - volume overload/PNA? IMPRESSION: Compared to chest radiographs ___ through ___. Left perihilar consolidation worsened substantially between ___ and ___. It subsequently improved, but now right upper lobe perihilar consolidation has worsened. The explanation for these findings is not obvious. Mediastinal veins no longer suggest elevated central venous pressure or intravascular volume, so I suggest the possibility of recurrent aspiration to alternate upper lobes. Small right pleural effusion is present. Right jugular central venous line ends close to the superior cavoatrial junction. Heart size is top-normal. No pneumothorax. . " d87da0f9-3db731e4-ba8af424-6be0895c-3b936ae3.jpg,test/p16/p16461298/s54557587/d87da0f9-3db731e4-ba8af424-6be0895c-3b936ae3.jpg,test," FINAL REPORT HISTORY: Intubation. TECHNIQUE: Supine AP view of the chest. COMPARISON: ___ at 20:09. FINDINGS: An endotracheal tube tip is in standard position, terminating approximately 6.8 cm from the carina. Orogastric tube tip terminates just below the gastroesophageal junction, with the side port in the distal esophagus, and should be advanced. Remainder of the chest is unchanged with continued patchy ill-defined opacities in the lung bases concerning for aspiration or small airway infection. Pneumoperitoneum is also re- demonstrated. No pneumothorax. IMPRESSION: Endotracheal tube in standard position. Orogastric tube should be advanced further, with the tip only terminating just below the gastroesophageal junction and the side port within the distal esophagus. Persistent pneumoperitoneum. " b1406a32-55be7e14-0c6e2759-d89b54a3-3d707ca2.jpg,test/p11/p11738518/s59324114/b1406a32-55be7e14-0c6e2759-d89b54a3-3d707ca2.jpg,test," FINAL REPORT INDICATION: ___F with AMS, hypotension // ? chf, infiltrate TECHNIQUE: Portable AP view of the chest. COMPARISON: Chest radiograph ___, chest CT ___. FINDINGS: A right PICC line is present with tip in the right brachiocephalic vein. Mild cardiomegaly is present. The mediastinal contours are stable calcifications of the aortic knob. There is no pleural effusion or pneumothorax. Paucity of interstitial markings is consistent with emphysema. There is new hazy opacification of the left upper lobe and lingula, concerning for an infectious process. Surgical clips, CBD stent, and aortic stent graft are noted in the upper abdomen. IMPRESSION: 1. Hazy opacification of the left upper lobe and lingula concerning for pneumonia or aspiration. 2. Right PICC with tip in the right brachiocephalic vein. NOTIFICATION: The findings were discussed by Dr. ___, with Dr. ___ on the telephone on ___ at 2:27 AM, 2 minutes after discovery of the findings. " eb3ac5c1-1031a944-323c3421-8e709e7a-d4b7629c.jpg,test/p17/p17556194/s50856843/eb3ac5c1-1031a944-323c3421-8e709e7a-d4b7629c.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old woman with ___ year old woman with falls, HA, meningitis new found L CVST. Worsening mental statusQuestions to be answered: PLEASE EVALUATE for infarction or progressing hydrocephalus in setting of new CVST L transverse // eval for ETT and NGT placement TECHNIQUE: Portable semi-upright chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: The ETT terminates 3 cm above the carina. There is an NG tube, which is below the diaphragm and curls in the left upper quadrant. There are metallic clips in the supraclavicular region bilaterally. The previously identified partially calcified right lower lobe mass appears unchanged. The lungs are otherwise clear. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Appropriate positioning of the ETT and NG tube. 2. Unchanged partially calcified right lower lobe mass. " 1b171e7b-de25a4a1-b7108a9c-cc309082-c177ab00.jpg,test/p15/p15613908/s50084614/1b171e7b-de25a4a1-b7108a9c-cc309082-c177ab00.jpg,test," WET READ: ___ ___ ___ 8:38 AM 1. Technically limited study with opacification of the left lung base likely representing pneumonia superimposed on diffuse interstitial lung disease. 2. Multiple right-sided rib fractures, which are indeterminate in age. Recommend clinical correlation for tenderness on physical exam. WET READ VERSION #1 ___ ___ ___ 7:31 AM Technically limited study with opacification of the left lung base. Repeat chest radiograph with PA and lateral technique is recommended if possible. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pmh of scheizophrenia, COPD P/W with altered mental status and cough // ?pneumonia ?pneumonia TECHNIQUE: Portable semi-erect frontal view of the chest was obtained. COMPARISON: None. FINDINGS: Evaluation is limited due to patient rotation. Additionally, the inspiratory lung volumes are decreased with resultant bronchovascular crowding and accentuation of the cardiomediastinal silhouette. There is opacification of the left lung base greater than the right superimposed on background diffuse interstitial abnormality. There is no large pleural effusion or pneumothorax. There are multiple right-sided rib fractures without significant callus formation, which are indeterminate in age. IMPRESSION: 1. Technically limited study with opacification of the left lung base likely representing pneumonia superimposed on diffuse interstitial lung disease. 2. Multiple right-sided rib fractures, which are indeterminate in age. Recommend clinical correlation for tenderness on physical exam. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 8:35 AM, 30 minutes after discovery of the findings. " 86fc1940-54ee224f-d00a3452-34d26b3c-427e3e99.jpg,test/p14/p14398455/s53948996/86fc1940-54ee224f-d00a3452-34d26b3c-427e3e99.jpg,test," FINAL REPORT HISTORY: fever and cough. FINDINGS: No previous images. No evidence of pneumonia, vascular congestion, or pleural effusion. " fed85890-1725b11f-8c6ac03b-779974ff-57674468.jpg,test/p19/p19705327/s53190982/fed85890-1725b11f-8c6ac03b-779974ff-57674468.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with acute chest pain and dyspnea // Eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Cholecystectomy clips are seen within the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 06e8249f-55277539-f06e08f8-b17c6ca3-4b1eeb6a.jpg,test/p15/p15707000/s50757516/06e8249f-55277539-f06e08f8-b17c6ca3-4b1eeb6a.jpg,test," FINAL REPORT HISTORY: Fatigue with smoking history. FINDINGS: In comparison with study of ___, there is little change. Heart is normal in size and there is no vascular congestion or pleural effusion. No acute focal pneumonia. " 3315028f-4aa9d56d-02e5a32a-06a3344a-7e2e88cf.jpg,test/p16/p16579686/s58156001/3315028f-4aa9d56d-02e5a32a-06a3344a-7e2e88cf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with high grade b cell lymphoma with cough // ? Pna ? Pna IMPRESSION: Heart size is normal. Mediastinum is normal. Central venous line tip terminates at the level of lower SVC. Lungs are clear. Left hemidiaphragm is elevated, due to pleural thickening potentially due to prior trauma. No effusion or demonstrated. No pneumothorax is seen. " daf35779-90d39c86-043f7f8c-d513a5c7-49254081.jpg,test/p18/p18811847/s50448223/daf35779-90d39c86-043f7f8c-d513a5c7-49254081.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // eval for acute process TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac enlargement is similar compared to prior. No acute osseous abnormalities. IMPRESSION: Cardiomegaly without acute cardiopulmonary process. " c64b35bf-0e8267f3-a0f210a5-c2148983-e5824238.jpg,test/p11/p11167924/s53564850/c64b35bf-0e8267f3-a0f210a5-c2148983-e5824238.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man doboff placement TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: Subsequent images in placement of a Dobhoff tube with the final image demonstrating the tube in the stomach. The tip is not included on this film. Pulmonary edema has improved. Left basilar opacity persists. There is no pneumothorax. IMPRESSION: 1. Dobhoff tube ends in the stomach with the tip not included on this radiograph. Recommend repeat imaging of the abdomen for complete visualization. 2. Improved pulmonary edema. 3. Persistent left basilar opacity. NOTIFICATION: Dr. ___ was paged by Dr. ___ at the time the study was interpreted. " a41a617a-3a38b5da-3a9cc8a5-549e1379-03b2057a.jpg,test/p10/p10735843/s51288806/a41a617a-3a38b5da-3a9cc8a5-549e1379-03b2057a.jpg,test," FINAL REPORT INDICATION: ___-year-old man with fever and cough, evaluate for evidence of pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal silhouette is stable in comparison to multiple prior exams, consistent with a tortuous thoracic aorta. The hilar contours are unchanged, and within normal limits. Apparent hyperdensity at the right hilum is only seen on frontal projection, and was not seen on prior exams as recently as ___, favored to represent superimposition of normal structures versus calcified hilar lymph nodes. There is no focal lung consolidation. There is no pulmonary vascular congestion or pulmonary edema. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. Stable chest x-ray. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 12:15 PM, 5 minutes after discovery of the findings. " d946791f-9cf986df-048eb487-4c8119e0-2430af4c.jpg,test/p11/p11681834/s57136988/d946791f-9cf986df-048eb487-4c8119e0-2430af4c.jpg,test," WET READ: ___ ___ 7:44 PM No acute intrathoracic process WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CLINICAL HISTORY: Prostate and colon carcinoma, urinary tract infection and high fever. CHEST WITH LATERAL COMPARISON FILM: ___. Cardiac size is somewhat enlarged. No evidence of pneumonia is present. No failure or effusions are seen. IMPRESSION: No pneumonia. " edeec580-e8606cba-aa510902-8baaee95-4d81a674.jpg,test/p10/p10585182/s56669745/edeec580-e8606cba-aa510902-8baaee95-4d81a674.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with severe asthma, CHF with EF ___%, h/o breast cancer s/p radiation ___, with recent pneumonia vs. COP, now completed steroids and feeling better. ? new baseline // any change in infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Previously seen opacity in the right upper lobe is decreased and left perihilar opacity unchanged compared to prior study from ___. No pleural effusion or pneumothorax is seen. Moderate cardiomegaly is unchanged. The aorta is tortuous. Postsurgical clips are noted. IMPRESSION: 1. Decreased right upper lobe opacity may represent resolving pneumonia and/or radiation changes. 2. Unchanged left perihilar opacity may represent radiation changes. 3. Stable moderate cardiomegaly. " 1e3f9bdb-517c9f1b-37218089-1522405f-056b0ad1.jpg,test/p15/p15394622/s59698529/1e3f9bdb-517c9f1b-37218089-1522405f-056b0ad1.jpg,test," FINAL REPORT HISTORY: ___-year-old male with syncope. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are clear, but the previously described nodular density in the right lower lung is not well appreciated on the current exam. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process; nonvisualization of previously described right lower lung nodular density, but this may be due to differences in patient potion. " 98aba7fd-3579d285-a8593955-d0ce422e-0442aac1.jpg,test/p16/p16252508/s56851365/98aba7fd-3579d285-a8593955-d0ce422e-0442aac1.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: chest radiographs the latest from ___. FINDINGS: 2 views of the chest: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " b68909bd-ab26c600-5bce4577-31a3f9ad-8bac4c2c.jpg,test/p13/p13473495/s53743811/b68909bd-ab26c600-5bce4577-31a3f9ad-8bac4c2c.jpg,test," FINAL REPORT AP CHEST, 9:18 A.M., ___ HISTORY: ___-year-old man with cough and elevated white count, suspect pneumonia. IMPRESSION: AP chest compared to ___: Moderate-to-severe cardiomegaly is chronic. There is no pulmonary edema today or focal consolidation to suggest pneumonia. Conventional radiographs would probably be more revealing than bedside studies. Pleural effusion minimal if any. No evidence of central lymph node enlargement. " 2eb99afd-73905173-4c8b5b8d-931a7ea5-25a4c972.jpg,test/p10/p10129384/s50852782/2eb99afd-73905173-4c8b5b8d-931a7ea5-25a4c972.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year former smoker with right basilar pneumonia in early ___. // assess for total resolution assess for total resolution IMPRESSION: In comparison with the study of ___, there has been complete resolution of the right lower lobe pneumonia. No evidence of acute consolidation, vascular congestion, or pleural effusion. " f68e738b-5072d2a6-55fdf48d-97d182b5-73aac099.jpg,test/p16/p16454913/s52010975/f68e738b-5072d2a6-55fdf48d-97d182b5-73aac099.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Indwelling tracheostomy tube and vascular catheter are unchanged in position. Interval decrease in extent of cardiomediastinal widening, as well as improving pulmonary edema which is now asymmetrical, involving the right lung to a greater degree than the left. Moderate left pleural effusion is unchanged. Right-sided circumferential pleural opacity appears similar and may reflect the combination of pleural fluid and pleural thickening. Persistent bilateral lower lobe opacities, which may reflect atelectasis, dependent edema or infectious consolidation. " 889d91dc-987e901d-d4a5b79f-6e99fa99-43eaa776.jpg,test/p15/p15193875/s55678349/889d91dc-987e901d-d4a5b79f-6e99fa99-43eaa776.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___M with fever, weakness // pneumonia? COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Right chest wall Port-A-Cath is seen with catheter tip in the region of the lower SVC. The lungs are clear. No signs of pneumonia or edema. Heart and mediastinal contours are stable and normal. No acute osseous abnormality. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. Catheter well positioned. " 1b7116e2-8bbbed05-2146034f-6c084e64-2760d9e6.jpg,test/p14/p14216395/s55574068/1b7116e2-8bbbed05-2146034f-6c084e64-2760d9e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with PNA this ___, now with recurrent low grade fevers, worsened dyspnea // recurrent worsened dyspnea, ? resolution of prior PNA COMPARISON: ___ IMPRESSION: Normal lung volumes. Borderline size of the cardiac silhouette. No pulmonary edema. No pneumonia, no pleural effusion. " 83f4788e-e930e09a-0fd5307f-e4e6119a-be81442a.jpg,test/p17/p17135687/s53042533/83f4788e-e930e09a-0fd5307f-e4e6119a-be81442a.jpg,test," WET READ: ___ ___ 8:35 AM Improved aeration of the left lung. Improved right sided pneumothorax. WET READ VERSION #1 ___ ___ ___ 9:44 PM Improved aeration of the left lung. Otherwise unchanged from prior. WET READ VERSION #2 ___ ___ ___ 10:32 PM Improved aeration of the left lung. Improved right sided pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple gunshot wounds // New CT placement IMPRESSION: Following placement of a new pigtail pleural catheter in the right hemi thorax, a right pneumothorax has decreased in size with residual small to moderate pneumothorax remaining, with apical, lateral and basilar components. Exam is otherwise similar to the recent study except for improving opacities in the left juxta hilar region. " 24cc00d4-f6e51539-fb9f0f1c-ac766604-d943762d.jpg,test/p15/p15949479/s55568975/24cc00d4-f6e51539-fb9f0f1c-ac766604-d943762d.jpg,test," FINAL REPORT INDICATION: ___-year-old man with small bowel obstruction, aspiration pneumonia, evaluate NG tube placement. TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest x-ray earlier same-day ___ at 08:23. FINDINGS: Re-identified is a left chest cardiac device with associated dual leads projecting over the right atrium and ventricle in unchanged, appropriate location. New since the prior exam is an enteric tube with distal tip projecting below the lower limit of the radiograph, however with side port seen projecting over the midline upper abdomen, difficult to definitively located however likely several cm distal to the GE junction. Clip projecting over the left hemithorax is likely extracorporeal. The cardiomediastinal silhouette is stable, consistent with moderate cardiomegaly. The hilar within normal limits. Re-identified are multifocal airspace consolidations, most conspicuously affecting the medial right upper lobe and right lung base, partially visualized. Increased hazy opacification of the left lower lung is noted, possibly technical in nature. There is likely a small left pleural effusion. Findings consistent with mild pulmonary vascular congestion are seen, incompletely evaluated on this study. No pneumothorax is identified. IMPRESSION: In comparison to earlier same-day chest x-ray, new enteric tube is identified with tip projecting below the lower limit of the radiographic and side port projecting over the upper abdomen. Allowing for changes due to patient rotation, side port and tip are likely within the gastric lumen. Given indeterminate location of the GE junction on this study, recommend advancement by 4-5 cm for definitive positioning within the gastric lumen. Other findings are unchanged, as above. RECOMMENDATION(S): Advancement of new enteric tube by 4-5 cm. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 3:50 PM, 1 minutes after discovery of the findings. " d71e5a24-df34e021-658e2e9e-5840f6db-a0cdbcd9.jpg,test/p19/p19557539/s57576874/d71e5a24-df34e021-658e2e9e-5840f6db-a0cdbcd9.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Supine portable of the chest. Comparison was made with prior chest radiograph through ___, to ___. FINDINGS: Endotracheal tube ends approximately 4.4 cm above the carina and is adequately positioned. Orogastric tube is seen coursing into the stomach; however, the distal end is off radiographic view. Since ___, right lower lung opacities have increased and is concerning for aspiration/pneumonia. Increased retrocardiac density suggestive of lower lung atelectasis and presumed small bilateral pleural effusions is similar. Left-sided internal jugular line ends at upper SVC. IMPRESSION: 1. Increased right lower lung opacities since ___ is concerning for aspiration/pneumonia. Clinical correlation is required 2. Left lower lung atelectasis and presumed small bilateral pleural effusions are unchanged since ___. " d965b40b-4c2ece99-6e107b44-4cc5e329-bf690a16.jpg,test/p16/p16388630/s51010139/d965b40b-4c2ece99-6e107b44-4cc5e329-bf690a16.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval COMPARISON: Multiple chest radiographs since ___, most recent ___. FINDINGS: PA and lateral views of the chest provided. Moderate cardiomegaly is stable. Pulmonary arteries are chronically enlarged but peripheral pulmonary vessels are not engorged and there is no edema or pleural effusion. Homogeneous area of opacification on the lateral view could represent left upper lobe or lingular atelectasis. Tracheostomy tube noted. IMPRESSION: Stable moderate cardiomegaly. Chronically enlarged pulmonary arteries without pulmonary edema or pleural effusion. Questionable left upper lobe or lingular atelectasis. " 76806b03-0a0de7f9-5dabc1d5-11266a26-71d14946.jpg,test/p11/p11899569/s52097667/76806b03-0a0de7f9-5dabc1d5-11266a26-71d14946.jpg,test," FINAL REPORT INDICATION: ___ year old man with 10th rib fx, PTX and subq emphysema s/p chest tube placement to waterseal // please eval for resolving PTX, subq emphysema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs since ___ most recently ___. FINDINGS: A small right apical and lateral pneumothorax is unchanged from ___. A right-sided chest tube remains. No left pneumothorax. Right tenth rib fracture appears unchanged. Mediastinal contours, hila, and cardiac silhouette are normal. No pleural effusion. Subcutaneous emphysema is unchanged from ___. IMPRESSION: Small right apical pneumothorax unchanged from ___. " 0a3c9368-6a7a6347-8b366f45-6e274ed4-5b1a2595.jpg,test/p13/p13830268/s51326432/0a3c9368-6a7a6347-8b366f45-6e274ed4-5b1a2595.jpg,test," FINAL REPORT INDICATION: Chest pain, assess for cardiomegaly. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. A 5 mm calcified retrocardiac nodular opacity is consistent with a small calcified granuloma. There is no evidence of pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. Heart size is normal. " b4f992ad-c816faf5-364e6829-7613cd71-b633fbce.jpg,test/p18/p18111516/s58309399/b4f992ad-c816faf5-364e6829-7613cd71-b633fbce.jpg,test," FINAL REPORT PORTABLE CHEST, ___ WITH COMPARISON ___ FINDINGS: Cardiac silhouette is upper limits of normal in size allowing for portable technique and patient rotation. Pulmonary vascularity is normal, and lungs and pleural surfaces are clear. " dd90c2fe-96ae4152-9f28d8e4-52801432-34b3f7b4.jpg,test/p14/p14698539/s55226696/dd90c2fe-96ae4152-9f28d8e4-52801432-34b3f7b4.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman s/p extubation, multiple fails now tachyonic // r/o edema TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs of ___ FINDINGS: Since ___, bilateral perihilar, right greater than left, opacities with associated atelectasis are increased and small to moderate bilateral pleural effusions, left greater than right, are also increased, most likely due to severe pulmonary edema but in the appropriate clinical setting, this could be seen in widespread pneumonia, pulmonary hemorrhage, or ARDS. Cardiomegaly is unchanged. No pneumothorax. The left PICC line terminates in the SVC atrial junction. Abdominal drainage tube is noted. IMPRESSION: 1. Increased bilateral perihilar opacities, right greater than left, and moderate bilateral pleural effusions, left greater than right, are most likely from pulmonary edema. However, in the right clinical setting, this could be seen in widespread pneumonia, pulmonary hemorrhage, or ARDS. NOTIFICATION: The findings were discussed by Dr. ___ with RN ___ on the telephoneon ___ at 12:14 PM, 10 minutes after discovery of the findings. " 83770304-762e1de4-71e50f13-59ab68d3-fe2f7e42.jpg,test/p14/p14445477/s58542884/83770304-762e1de4-71e50f13-59ab68d3-fe2f7e42.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with recent pneumonia, status post antibiotic treatment ending on ___. Assess for resolution of infiltrate. FINDINGS: PA and lateral chest views have been obtained with patient in upright position. Comparison is made with the next preceding chest examination of ___. The on previous examination identified patchy infiltrates in the right lower lobe posterior segment have cleared up and the lungs are now unremarkable without evidence of remaining parenchymal infiltrates, pleural effusions or vascular congestion. The chest findings are now very similar to that obtained on ___ in which they also were deemed to be within normal limits. IMPRESSION: Resolution of right lower lobe infiltrates encountered on chest examination two weeks earlier. " 8f7fee00-3fd4b906-6e5d7c0b-8373ce06-f59453a3.jpg,test/p13/p13840464/s52911851/8f7fee00-3fd4b906-6e5d7c0b-8373ce06-f59453a3.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough, shortness of breath, question infection. FINDINGS: Frontal and lateral views of the chest provided. A single-lead pacer is unchanged in position with lead tip extending to the region of the right ventricle. The previously noted right IJ central venous catheter has been removed. The heart remains moderately enlarged though stable. There are no signs of CHF or pneumonia. No pneumothorax. Bony structures intact. IMPRESSION: Stable cardiomegaly, otherwise unremarkable. " 3d7d5c44-33f9453d-5418976b-3d230795-78c64d4e.jpg,test/p14/p14567555/s55207438/3d7d5c44-33f9453d-5418976b-3d230795-78c64d4e.jpg,test," FINAL REPORT EXAMINATION: CHEST (upright AP AND LAT) INDICATION: ___M with fever, n/vd COMPARISON: None FINDINGS: Upright AP and lateral views of the chest provided. Mild basal atelectasis noted. There is no evidence of pneumonia or edema. No large effusion or pneumothorax. The cardiomediastinal silhouette appears normal. Imaged bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Minimal basal atelectasis, otherwise unremarkable exam. " 111c4bb7-b6488402-90486d7b-dd6954ec-ee71e1c7.jpg,test/p19/p19011388/s59540125/111c4bb7-b6488402-90486d7b-dd6954ec-ee71e1c7.jpg,test," FINAL REPORT CLINICAL HISTORY: Ruptured right aortic balloon, left aortic balloon placed, check position. The tip of the balloon catheter lies at the level of T10 and should be advanced. The position of the endotracheal tube is satisfactory. A Swan-___ catheter is present in the left main pulmonary artery. IMPRESSION: Tip of the balloon catheter at T10 level. " 2ecb6e89-31b0e3ab-32556c4e-0d4a0421-ab5171ac.jpg,test/p17/p17729814/s55290641/2ecb6e89-31b0e3ab-32556c4e-0d4a0421-ab5171ac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SDH s/p evacuation x2, intubated // intubated, serial exam, eval pleural effusions intubated, serial exam, eval pleural effusions IMPRESSION: Compared to chest radiographs since ___, most recently ___ through ___. Uniform opacification of the lower lungs is probably combination of pleural effusions and atelectasis. Pneumonia is not excluded. Lateral view would be helpful in determining the contribution of pleural effusion. Heart size top-normal. Upper lungs clear. No pneumothorax. Indwelling ET tube right internal jugular line, and nasogastric drainage tubes in standard placements. " 3d55f374-4a359d3a-98a635f2-b2e3edf2-2682bb45.jpg,test/p10/p10913302/s52074278/3d55f374-4a359d3a-98a635f2-b2e3edf2-2682bb45.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: AML, graft versus host disease, and pneumonia. Comparison is made with prior study, ___. Bilateral basal multifocal consolidations have worsened on the left. Right Port-A-Cath tip is in the upper right atrium. There is no pneumothorax or increasing effusions. Cardiac size is top normal. There are low lung volumes. " 98fc702a-f872245e-d237e2c9-a25c216a-341e75a9.jpg,test/p14/p14124506/s54169291/98fc702a-f872245e-d237e2c9-a25c216a-341e75a9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with tachypnea and fevers // ?new evolving infection/fluid IMPRESSION: As compared to ___ radiograph, heterogeneous bibasilar opacities have slightly worsened, but they remain in approved compared to ___. Findings are concerning for recurrent aspiration or an evolving aspiration pneumonia. " e6c5bdbe-c454c3c9-9025534f-be2383f4-32a35286.jpg,test/p16/p16666640/s56714971/e6c5bdbe-c454c3c9-9025534f-be2383f4-32a35286.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with right lower lobe mass with biopsy. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar PA and lateral chest examination of ___. Heart size is unchanged and no configurational abnormalities are identified. Thoracic aorta unremarkable. Mediastinal structures within normal limits. On previous examination identified parenchymal mass in the right lower lobe subapical segment persists and has increased in size. No other abnormalities are seen, no pneumothorax is identified. As the patient has undergone interventional procedure on the same date. IMPRESSION: Increased size of apparently indolent pulmonary mass. " 2b72c47d-3365f98d-6602ec2d-bdea990d-15f656c4.jpg,test/p14/p14948967/s52114538/2b72c47d-3365f98d-6602ec2d-bdea990d-15f656c4.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiographs INDICATION: ___ year old woman with resp failure s/p intubatio // ?edema TECHNIQUE: Portable chest COMPARISON: Portable chest radiograph dated ___ at 01:29 FINDINGS: Since approximately 7 hours prior, no significant changes are appreciated. Moderate cardiomegaly and mild pulmonary edema are unchanged. Pleural effusions are small, if any. No pneumothorax. Retrocardiac atelectasis has increased. A right-sided IJ central venous catheter terminates the lower SVC. An ET tube terminates 3.1 cm above the carina. An enteric tube passes into the stomach outside the field of view. IMPRESSION: Unchanged moderate cardiomegaly and mild pulmonary edema with increased retrocardiac atelectasis. " a26e62df-958bf1fa-a3262b88-ed893fa5-ed5b2945.jpg,test/p12/p12553538/s52119968/a26e62df-958bf1fa-a3262b88-ed893fa5-ed5b2945.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: Patient with myelofibrosis and pneumonia, admitted for pulmonary edema. FINDINGS: Comparison is made to previous study from ___. There has been improvement in the pulmonary interstitial edema since the previous study. There is elevation of the right hemidiaphragm with a large gastric air bubble which obscures the lower half of the left lung. There are small bilateral pleural effusions. There is a right-sided PICC line with distal lead tip in the proximal SVC. Calcifications in the thoracic aorta are seen. " 9e57b347-c03ff466-ac5ae8c5-a2915e05-cd8defa7.jpg,test/p18/p18014061/s58890853/9e57b347-c03ff466-ac5ae8c5-a2915e05-cd8defa7.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with weakness/ dizziness and recent transplant TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Patchy opacity in the left lower lobe likely reflects an area of atelectasis. Remainder of the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen. Clips are seen within the left neck. IMPRESSION: Patchy left basilar opacity, likely atelectasis. " a8316c98-e30e4f62-0ac54fd2-057fa54f-30cbfc79.jpg,test/p14/p14174244/s57182338/a8316c98-e30e4f62-0ac54fd2-057fa54f-30cbfc79.jpg,test," FINAL REPORT INDICATION: ___-year-old female with productive cough. COMPARISON: CT dated ___ and radiographs dated ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. Heart and mediastinal contours are within normal limits. IMPRESSION: No radiographic evidence for pneumonia. " b94eec73-cb649388-7099d440-7f1bbf0c-f1a3b98d.jpg,test/p14/p14794396/s51900597/b94eec73-cb649388-7099d440-7f1bbf0c-f1a3b98d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx met RCC with recent pneumonitis after treatment with anti PD1 antibody - now with dyspnea and fatigue // rule out recurrent pneumonitis COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, all pre-existing parenchymal opacities have completely resolved. The lung volumes are low. Borderline size of the cardiac silhouette with no evidence of overt pulmonary edema. No pleural effusions. No pneumothorax. " 753f6633-e9bf9f33-7b065b8c-5a94cef7-3848a274.jpg,test/p13/p13031858/s57627519/753f6633-e9bf9f33-7b065b8c-5a94cef7-3848a274.jpg,test," FINAL REPORT INDICATION: ___ year old woman with AI hepatitis on azathioprine, now with 10d h/o persistent, productive cough // Is there evidence of pna or other pulmonary disease? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. Incidental note of azygos fissure benign variant. The cardiomediastinal silhouette is unremarkable. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute radiographic intrathoracic pulmonary disease. " f67ad59e-95edd826-9bdf1855-e02d2950-3eba1d4a.jpg,test/p12/p12734486/s50878096/f67ad59e-95edd826-9bdf1855-e02d2950-3eba1d4a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Urosepsis, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is minimally increasing atelectasis in the retrocardiac lung regions and a potentially minimally increased left pleural effusion. Unchanged evidence of mild fluid overload. No other relevant changes. The monitoring and support devices are constant. " 6c6ca446-8cff6608-66c86809-acaf2f61-d047bcbf.jpg,test/p17/p17391196/s51250096/6c6ca446-8cff6608-66c86809-acaf2f61-d047bcbf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with n/v/d // acute process? COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are noted. Lower lung and perihilar opacities are noted which could reflect aspiration/pneumonia. Lung volumes are low limiting assessment. Suture material in the right lung is again noted likely related to a prior resection. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Mild hilar congestion is present. Bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: Perihilar and lower lung opacities concerning for aspiration/ pneumonia. Mild hilar congestion. " 04ed529a-b1fb63ff-300a0d99-503c7379-6b098ace.jpg,test/p11/p11215277/s53845076/04ed529a-b1fb63ff-300a0d99-503c7379-6b098ace.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, AP portable single view. INDICATION: ___-year-old male patient with left lung mass, status post bronchoscopy with left transbronchial biopsies. Evaluate for pneumothorax. FINDINGS: AP single view of the chest was obtained with patient in semi-upright position. The heart size is normal. No configurational abnormality is identified. Normal appearance of thoracic aorta with some calcium deposits in the wall at the level of the arch. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present. In the left hilar area, there are two small surgical clips indicative of previous intervention. There is no pneumothorax in the apical area. IMPRESSION: No pneumothorax in patient recently undergoing bronchoscopy and intra-bronchial biopsy. " 464ba0e8-ed41a0cf-27915568-31abf691-ec5ad736.jpg,test/p12/p12501281/s53995530/464ba0e8-ed41a0cf-27915568-31abf691-ec5ad736.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p CABG, Tiss AVR // predischarge eval predischarge eval IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Small right pleural effusion has decreased. Severe left lower lobe atelectasis, moderate left pleural effusion and severe cardiomegaly are stable. No pulmonary edema. Right PIC line " 394096ac-f43d0f3d-f0e0fc90-40a5ca4c-e4796da7.jpg,test/p12/p12466049/s55751437/394096ac-f43d0f3d-f0e0fc90-40a5ca4c-e4796da7.jpg,test," FINAL REPORT HISTORY: Cirrhosis, interstitial lung disease status post fall 4 days ago with continued abdominal pain and back pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Interstitial bibasilar opacities are seen which may relate to chronic lung disease but component of interstitial edema may also be present. No large pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. " 354d73b5-ec2874b3-9ab726df-c4a482c1-731e7675.jpg,test/p11/p11585755/s54772082/354d73b5-ec2874b3-9ab726df-c4a482c1-731e7675.jpg,test," FINAL REPORT INDICATION: ___F with chest pain, previous aortic graft. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Aneurysmal dilation of the aortic arch and descending thoracic aorta appears similar to the prior chest radiograph of ___. The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. Moderate cardiomegaly is stable. IMPRESSION: Stable widening of mediastinum due to known aneurysmal dilation of the aortic arch and descending thoracic aorta. " 78a15839-b558d6b6-0c380d5e-d2fd6b9d-318617d3.jpg,test/p15/p15034985/s52914765/78a15839-b558d6b6-0c380d5e-d2fd6b9d-318617d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with LLL lobectomy now with CT to suction // please assess for ptx. Please do CXR at 1:00pm COMPARISON: ___, 08:19 IMPRESSION: As compared to the previous radiograph, the left chest tube is in unchanged position. There is unchanged evidence of a 3 mm left pneumothorax without evidence of tension. The gastric bubble remains hyperinflated. No change in appearance of the right lung and of the cardiac silhouette " 225d0b30-ebc488ea-9ffca43a-a87a51b4-0ed61dfb.jpg,test/p15/p15553759/s55203264/225d0b30-ebc488ea-9ffca43a-a87a51b4-0ed61dfb.jpg,test," FINAL REPORT HISTORY: ___-year-old male with hypotension. Evaluation for cardiopulmonary process. COMPARISON: None available. FINDINGS: Single upright radiograph of the chest demonstrates free air under the right hemidiaphragm, concerning for perforated viscus. There is a right subclavian central venous catheter in place, terminating in the low SVC. There is no pleural effusion, pulmonary edema, pneumothorax or focal pneumonia. Mild bibasilar atelectasis is present. The heart size is normal. The aorta is tortuous. IMPRESSION: Free intraperitoneal air under the right hemidiaphragm, highly concerning for perforated viscus. Above findings were communicated to Dr. ___ ___ resident) by Dr. ___ ___ telephone at 5:21 a.m., immediately after discovery. " 1ff1b3b3-5a179004-5f282fbf-1a273136-f539f2b6.jpg,test/p12/p12080376/s54617135/1ff1b3b3-5a179004-5f282fbf-1a273136-f539f2b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ M w/ dementia, s/p AVR on coumadin s/p fall down a flight of stairs w/ a 6mm L SDH, R Zygomatic arch fx, R ___ rib Fx's. // interval changes? COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lungs are low in volume exaggerating mild cardiomegaly. There is no definite focal pulmonary abnormality, pneumothorax or pleural effusion. The conventional chest radiograph, particularly bedside, is not sensitive for detecting chest cage trauma generally, but we can see a mildly displaced fractures of the lateral aspects of the right sixth and seventh ribs. Additional fractures are shown by CT scanning. " 05d6a1cd-7f84c7b4-15a7e3dc-e545dba2-b5fd981d.jpg,test/p11/p11790326/s50356223/05d6a1cd-7f84c7b4-15a7e3dc-e545dba2-b5fd981d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with ABD pain, diffuse tenderness, vomiting, chest pain, recent PNA // Eval for acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are relatively low lung volumes. Increased interstitial markings bilaterally suggests mild pulmonary vascular congestion. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged. No pleural effusion is seen. There is no focal consolidation. Hilar contours are stable. Patient is status post median sternotomy. Evidence of DISH is seen along the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion. Persistent cardiomegaly. " 654a3d36-8ba6d0de-623be9c7-8e577ffa-319c3e0d.jpg,test/p10/p10065220/s50984843/654a3d36-8ba6d0de-623be9c7-8e577ffa-319c3e0d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with confusion and fever TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is mildly enlarged. The aorta is mildly tortuous with atherosclerotic calcifications noted at the aortic knob. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Minimal streaky and linear opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion, focal consolidation or pneumothorax is identified. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 66d52b37-09f98a8c-80c1c8e4-2006e8d1-ffe9d9db.jpg,test/p16/p16056234/s54379253/66d52b37-09f98a8c-80c1c8e4-2006e8d1-ffe9d9db.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___. Chest radiograph ___. FINDINGS: The heart size remains within normal limits. Mediastinal and hilar contours are unchanged, with dilatation of the main, right, and left pulmonary arteries compatible with underlying pulmonary arterial hypertension. Pulmonary vascularity is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is identified. Scoliosis of the thoracic spine, convex to the right is noted. IMPRESSION: No acute cardiopulmonary abnormality. Unchanged pulmonary arterial hypertension. " 6b4de5fe-29912f47-d4200762-fb09e9dd-1db1703c.jpg,test/p12/p12763939/s59965702/6b4de5fe-29912f47-d4200762-fb09e9dd-1db1703c.jpg,test," WET READ: ___ ___ ___ 6:29 PM ETT tip is not well seen due to other obscuring overlying tubes/lines, but may be ~1cm from carina. Consider repeat of radiograph at an obliquity to allow discrimination of the other tubes, or correlation with tube position at the teeth. DHT is in the body/antrum of the stomach. Other tubes appear unchanged. Basilar atelectasis unchanged. ___ d/w ___ ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of a Dobbhoff tube that extends to the lower body of the stomach. Otherwise, little change. " f0856720-7165c1b9-dccc870f-5566c23d-b9016a83.jpg,test/p10/p10699336/s53811413/f0856720-7165c1b9-dccc870f-5566c23d-b9016a83.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with trach, quadrpleg // assess lungs TECHNIQUE: AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: A right-sided PICC is in-situ, this terminates in the mid SVC. A tracheostomy tube is unchanged in position compared to the prior study. Lung volumes are unchanged with persistent right basal opacity likely reflecting atelectasis. Left lower lobe atelectasis also noted. No new areas of consolidation seen. No pneumothorax seen. Incidental note is made of an azygos fissure. IMPRESSION: No significant interval change when compared to the prior study. " b75eabab-ea9e151a-f2be8bc4-b4585885-f15d5507.jpg,test/p10/p10705688/s52691492/b75eabab-ea9e151a-f2be8bc4-b4585885-f15d5507.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left-sided chest pain, productive cough, rule out pneumonia. COMPARISON: PA and lateral chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are normal. Lungs are borderline hyperinflated, most often due to emphysema or small airways obstruction, but clear of focal consolidation. No pleural effusion or pneumothorax is present. " 98245659-2b8f28b7-47226f0d-4c37b050-1aec7f72.jpg,test/p14/p14195957/s54977644/98245659-2b8f28b7-47226f0d-4c37b050-1aec7f72.jpg,test," FINAL REPORT INDICATION: Shortness of breath. No comparison studies available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and cardiomediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 96aad0ce-acea8a70-cc68146d-2b668464-87361cbc.jpg,test/p16/p16492376/s55680586/96aad0ce-acea8a70-cc68146d-2b668464-87361cbc.jpg,test," FINAL REPORT HISTORY: Cough with left basilar rhonchi. FINDINGS: In comparison with study of ___, there are lower lung volumes. There is a vague area of increased opacification at the right base, which probably represents either a combination of vessels or mild atelectatic changes. No evidence of left basilar consolidation, vascular congestion, or pleural effusion. " e4e8efd6-ec99f56b-f5e46c69-72306418-c2463047.jpg,test/p12/p12450697/s58324589/e4e8efd6-ec99f56b-f5e46c69-72306418-c2463047.jpg,test," WET READ: ___ ___ 11:09 PM There has been interval placement of a left-sided pigtail catheter which terminates over the base of the left lung. The left-sided pleural effusion is markedly decreased in size. A small right-sided of effusion persists. No focal consolidation, or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion, s/p ___cc pleural fluid removal by chest tube // pneumothorax? TECHNIQUE: CHEST (PORTABLE AP) IMPRESSION: There has been interval placement of a left-sided pigtail catheter which terminates over the base of the left lung. The left-sided pleural effusion is markedly decreased in size. A small right-sided of effusion persists. No focal consolidation, or pneumothorax. " 4d301fbd-a21142a8-37f223bc-e2117516-a428b69f.jpg,test/p13/p13090933/s50176947/4d301fbd-a21142a8-37f223bc-e2117516-a428b69f.jpg,test," FINAL REPORT HISTORY: Spinal stenosis, pre-op. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There is minimal left base atelectasis. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " af2c2a7e-8e1774e5-7f970c77-98c96255-e407d076.jpg,test/p10/p10539412/s58775792/af2c2a7e-8e1774e5-7f970c77-98c96255-e407d076.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with weakness, evaluate for infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette is within normal limits. Aortic arch calcifications are noted. The hila are unremarkable. The lungs are clear without focal consolidation. There is no pulmonary venous congestion or edema. There is biapical pleural-parenchymal scarring. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 9c716b0b-81ed9f75-5abef10b-43ed20a6-5d093075.jpg,test/p13/p13031024/s53740139/9c716b0b-81ed9f75-5abef10b-43ed20a6-5d093075.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with shortness of breath // pulmonary edema pulmonary edema IMPRESSION: Comparison to ___. Stable borderline size of the cardiac silhouette with mild fluid overload but no overt pulmonary edema. No pleural effusions. No pneumonia. No pneumothorax. " b56b8dc7-8bbb47a2-cc09172f-bc572f7e-025fff72.jpg,test/p17/p17535980/s56831151/b56b8dc7-8bbb47a2-cc09172f-bc572f7e-025fff72.jpg,test," FINAL REPORT HISTORY: Fevers and altered mental status. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: ___. FINDINGS: Study somewhat limited by lordotic positioning and the patient's chin obscuring assessment of the lung apices. Low lung volumes are present. This accentuates the size of the cardiac silhouette which is likely within normal limits. Mediastinal contours are unchanged. Crowding of the bronchovascular structures is noted as a result of low lung volumes. No overt pulmonary edema is seen though mild pulmonary vascular congestion is not excluded. Streaky bibasilar airspace opacities which are more pronounced in the left lung base may reflect atelectasis. Infection is not excluded. No large pleural effusion or pneumothorax is seen. Multilevel degenerative changes are seen within the thoracic spine. IMPRESSION: Low lung volumes. Bibasilar airspace opacities, more pronounced on the left, could reflect atelectasis but infection is not excluded. " e8a6b8a6-378d3c5f-7d1a8641-fe4de551-9c060a63.jpg,test/p17/p17672672/s58606017/e8a6b8a6-378d3c5f-7d1a8641-fe4de551-9c060a63.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cardiac arrest, s/p extubation with e/o pulmonary edema on CXR // Evaluation of pulmonary edema Evaluation of pulmonary edema IMPRESSION: In comparison with the study of ___, there are improved lung volumes. The endotracheal and nasogastric tubes have been removed. Cardiac silhouette remains enlarged with mild to moderate elevation in pulmonary venous pressure. " d24690f9-a2d5edfb-ffb78f2f-0bb5cf9c-039859ed.jpg,test/p13/p13265883/s57238981/d24690f9-a2d5edfb-ffb78f2f-0bb5cf9c-039859ed.jpg,test," FINAL REPORT INDICATION: ___-year-old male with occipital stroke, to rule out pneumonia. COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lung volumes are low, but no focal consolidation, pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary pathology. " b4bc235d-9582f487-016fae65-c657abc0-3d50033a.jpg,test/p16/p16887254/s59527718/b4bc235d-9582f487-016fae65-c657abc0-3d50033a.jpg,test," FINAL REPORT HISTORY: ___-year-old male status post aortic arch aneurysm repair. Assess for interval change in pleural effusions. COMPARISON: Chest radiograph from ___ FRONTAL AND LATERAL CHEST RADIOGRAPHS: There is persistent opacification of the left lung base with volume loss, findings consistent with chronic atelectasis. Prior mild pulmonary vascular congestion has decreased in the interval. A previously described relative area of ___ within the right upper lung has resolved and likely reflected asymmetric pulmonary edema. A curvilinear new opacity within the left mid lung, corresponds to pleural fluid layering in the fissure. Overall, aeration of the right lung base appears improved. Postoperative enlargement of the mediastinal contours appears slightly decreased from prior examination. The heart size remains large. Median sternotomy wires appear intact. Surgical clips are again visualized in the region of the aortic arch and in the left axilla. IMPRESSION: Overall decreased pulmonary edema and likely smaller bilateral pleural effusions. " bb97c312-52471933-e67bbf90-2bbc2a31-5c387518.jpg,test/p15/p15831124/s58763851/bb97c312-52471933-e67bbf90-2bbc2a31-5c387518.jpg,test," WET READ: ___ ___ ___ 9:17 AM Interval improvement in the aeration of the left lung. Left costophrenic angle has been omitted from the field of view, however no evidence of a large pleural effusion. Mild pulmonary edema. WET READ VERSION #1 ___ ___ ___ 10:20 PM Interval improvement in the aeration of the left lung. Left costophrenic angle has been omitted from the field of view, however no evidence of a large pleural effusion. Mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman s/p chest tube placement for pleural effusion. // look for resolution of pleural effusion TECHNIQUE: Single view at ___ 6:03 PM COMPARISON: ___ at 441 hr FINDINGS: The left lower lobe atelectasis is substantially improved. There is still some silhouetting of left hemidiaphragm indicating that a degree of continued left basilar disease both pleural and parenchymal. The heart is not enlarged. The osseous structures are normal for age. Nasogastric tube and tracheostomy tubes are unchanged. The the lateral aspect of the left chest is not included this examination. IMPRESSION: Substantial improvement in the left chest. Density and air bronchograms, however, are still seen superimposed upon the left heart indicating residual atelectasis or consolidation in the left lower lobe. " f4809a3b-aaf4e173-181afde7-f7ace54e-33d7defb.jpg,test/p12/p12043836/s58393523/f4809a3b-aaf4e173-181afde7-f7ace54e-33d7defb.jpg,test," FINAL REPORT INDICATION: Cough, here to evaluate for pneumonia. COMPARISON: PA and lateral chest radiographs dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Consolidation and volume loss in the anterior segment of the right upper lobe which developed between ___ and ___ has not cleared. This is either an unresolving pneumonia or an indication of bronchial obstruction (impaction, mass, foreign body or stricture). If the abnormality does not clear with antibiotics and bronchodilators, as evaluated with conventional chest radiographs in two weeks, CT scanning is indicated. Since mediastinal caliber has not decreased, the extensive adenopathy seen on Chest CT in ___ is still present, probably increased in the right lower paratracheal station, and in the right hilus as well. The cardiac silhouette is severely enlarged, but stable compared to prior studies. Pulmonary artery dilatation and moderate peripheral vascular congestion are chronic. No pleural effusion or pneumothorax is detected. Elevation of the right hemidiaphragm is stable. IMPRESSION: Right upper lobe pneumonia or atelectasis failed to clear over more than one month. See discussion above. Chronic adenopathy, probably worsened. Severe cardiomegaly and probable pulmonary hypertension. Findings discussed by telephone with ED attending physician Dr ___ at 8:40AM. " e8ea220f-272fe18a-79637030-72a71e7d-637c024e.jpg,test/p14/p14538785/s57655795/e8ea220f-272fe18a-79637030-72a71e7d-637c024e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with a recent loculated pleural effusion and empyema readmitted with dyspnea and anemia s/p VATS on ___. // Please evaluate for possible reaccumulation of blood in the pleural space. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There has been interval removal of the ET tube and right IJ Cordis. The right-sided PICC line tip is in the mid SVC there continues to be aa layering left effusion. There is hazy alveolar opacity in the left lung that is similar compared to prior.There is a small right effusion. " dabb40b2-8c200209-3f0266cf-474ad96c-99ae41c6.jpg,test/p19/p19666878/s56685050/dabb40b2-8c200209-3f0266cf-474ad96c-99ae41c6.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with leukocytosis, angiosarcoma, hypotension, tachycardia, new focal opacity? FINDINGS: AP single view of the chest has been obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. Comparison of the frontal views does not demonstrate any significant interval change. Thus, no evidence of new focal pulmonary infiltrates as can be identified on AP single chest view examination. " be1bdae0-a73f0bfb-07f40851-9c4dc7a3-fd6bc638.jpg,test/p12/p12909079/s54340462/be1bdae0-a73f0bfb-07f40851-9c4dc7a3-fd6bc638.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hypotension TECHNIQUE: Portable AP view of the chest COMPARISON: CT chest ___, CT chest ___, chest radiograph ___ FINDINGS: Patient is status post partial left upper lobeectomy with volume loss in the left lung again noted. Heart size is mildly enlarged. The aorta is tortuous and demonstrates atherosclerotic calcifications at the aortic knob. Previously demonstrated opacity within the left upper lobe adjacent to the suture lines is likely present, but better assessed on the previous CT. Aeration of the left upper lobe however does appear improved since the previous radiograph. Lungs are hyperinflated with emphysematous changes again noted. Pulmonary vasculature is not engorged. Increased interstitial opacities are most pronounced the lung bases, but not substantially changed from the previous radiograph. No focal consolidation is demonstrated, and there is no pneumothorax. Previously noted small bilateral pleural effusions appear nearly resolved. IMPRESSION: 1. Increased interstitial opacities, particularly in the lung bases, may be reflective of chronic changes with emphysema. A component of this may reflect the previously described peribronchial opacities on CT. 2. Status post partial left upper lobectomy with improved aeration in the left upper lobe. Known opacity adjacent to the suture lines seen on CT is not well assessed on the current study. 3. Near complete resolution of previously noted small bilateral pleural effusions. " 0401a3a1-7a65f8d7-e2b00c82-0763edca-d7c6bd93.jpg,test/p10/p10069423/s59981182/0401a3a1-7a65f8d7-e2b00c82-0763edca-d7c6bd93.jpg,test," FINAL REPORT PORTABLE CHEST ___, ___ COMPARISON: Chest ___ of one day earlier. FINDINGS: Cardiac silhouette is upper limits of normal in size. Mild pulmonary vascular congestion has slightly progressed in the interval, as well as bibasilar lung opacities, left greater than right. The latter likely reflect atelectasis, but differential diagnosis includes aspiration and developing infection in the appropriate clinical setting. Small left pleural effusion is unchanged. " c87209d1-db964e87-903f33fc-0ff3d75e-9975cdcd.jpg,test/p18/p18563023/s59851785/c87209d1-db964e87-903f33fc-0ff3d75e-9975cdcd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intermittent SOB // acute process COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, a minimal right pleural effusion is better seen than on the previous image. Mild cardiomegaly. Retrocardiac atelectasis. No other changes. " c1bd394e-6e6d462f-72af3bf3-2e623c68-0267684b.jpg,test/p12/p12724735/s56704064/c1bd394e-6e6d462f-72af3bf3-2e623c68-0267684b.jpg,test," FINAL REPORT EXAMINATION: Chest single view. INDICATION: ___ year old woman with Alport's s/p transplant now with graft failure and ESRD on HD not able to tolerate HD today. // volume overload? TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There has been interval placement of large bore catheter on the right with tip in the right atrium. The heart is severely enlarged and there is pulmonary vascular redistribution with hazy vascularity compatible fluid overload. There small bilateral pleural effusions there is volume loss/ infiltrate in both lower lungs IMPRESSION: Worsened pulmonary edema. " 6d2e5667-a53e0b1d-42a06d25-6a397c57-6a32dfa6.jpg,test/p16/p16202865/s51346943/6d2e5667-a53e0b1d-42a06d25-6a397c57-6a32dfa6.jpg,test," FINAL REPORT INDICATION: ___M with cough // ?pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. Median sternotomy wires and mediastinal clips are noted. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " e07be419-b5aa136b-48a0c653-aba99af2-3e65729d.jpg,test/p17/p17692815/s53493854/e07be419-b5aa136b-48a0c653-aba99af2-3e65729d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypercarbic respiratory failure s/p reintubation after self extubation // assess placement of ET tube COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has been Re intubated. The tip of the endotracheal tube projects 4.4 cm above the carinal. The other monitoring and support devices are unchanged. Unchanged moderate cardiomegaly with mild fluid overload and a potential minimal right pleural effusion. Bilateral areas of atelectasis. No pneumonia. " d49740bb-25886a7a-ed77203b-95000505-40c1e621.jpg,test/p11/p11004450/s50461712/d49740bb-25886a7a-ed77203b-95000505-40c1e621.jpg,test," FINAL REPORT HISTORY: Leukemia with night sweats. FINDINGS: In comparison with the study of ___, the right PICC line has been removed. Cardiac silhouette remains within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " bdf25507-90026e2c-5681d8ff-0dd4d751-4ea0937d.jpg,test/p14/p14047315/s53702055/bdf25507-90026e2c-5681d8ff-0dd4d751-4ea0937d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH and pleural effusion // r/o evolving cardiopulmonary process IMPRESSION: Compared to ___ chest radiograph, asymmetrically distributed bilateral airspace opacities involving the left lung to a greater degree than the right have worsened in the interval. Small right apical pneumothorax is again demonstrated with right pleural catheter in place. Moderate left pleural effusion and small right pleural effusion appear increased compared to the recent radiograph, although positional differences limit comparison between the studies. " 2ba9b8dc-6beb53bd-ea61414a-d2d210fa-a0915296.jpg,test/p15/p15448035/s55701023/2ba9b8dc-6beb53bd-ea61414a-d2d210fa-a0915296.jpg,test," FINAL REPORT AP CHEST, 6:09 A.M., ___ HISTORY: A ___-year-old man with ischemic bowel after resection. IMPRESSION: AP chest compared to ___: With the chin in neutral position, the tip of the ET tube just above the thoracic inlet and 6 cm above the carina could be advanced 2 cm for more secured seating. Lung volumes remain low, but aside from minimal atelectasis, lungs are clear. The heart is normal size. There is no pleural abnormality. An upper enteric drainage tube passes into the stomach and out of view. " 6b75deb4-d7e1938d-1fcc1e2a-772244ff-233f47a5.jpg,test/p12/p12916556/s51782996/6b75deb4-d7e1938d-1fcc1e2a-772244ff-233f47a5.jpg,test," FINAL REPORT INDICATION: ___ M w/ hx of RLL/RML lung mass c/f lung cancer with 1 wk hx dyspnea, hemoptysis after CT guided lung biopsy, ___% ptx s/p CT placement at OSH ED. // Please eval for pneumothorax, Chest tube clamp trial COMPARISON: Radiographs from ___ at 09:04. IMPRESSION: There is a right-sided chest tube with distal tip is at the apex. No definite pneumothorax is seen. There is some atelectasis at the lung bases, unchanged. Heart size is within normal limits. " 7d875e3f-442f5a13-5b4c655c-c1e89488-0cc1150e.jpg,test/p16/p16685700/s56938991/7d875e3f-442f5a13-5b4c655c-c1e89488-0cc1150e.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: High fever and weakness. History of chronic lymphocytic leukemia. COMPARISON: Radiographs from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: There is mild elevation of the left hemidiaphragm with volume loss. The cardiac, mediastinal and hilar contours appear stable. The right lung is clear. There are a few very small unchanged nodules projecting over the left upper lung, none over 5 mm in diameter, probably calcified granulomas. Vague opacity in the lingula appears new and there is minimal posterior basilar opacity which could be seen with minor volume loss. There is no pleural effusion or pneumothorax. IMPRESSION: Patchy lingular and left lower lobe opacities, more likely due to atelectasis than pneumonia; not a definite source for fever although very early development of pneumonia is not excluded. " b794aaf2-f2d9e626-4e5d0e71-b97a0276-52e5c7e5.jpg,test/p18/p18434782/s57820632/b794aaf2-f2d9e626-4e5d0e71-b97a0276-52e5c7e5.jpg,test," FINAL REPORT INDICATION: ___M with cough TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiomediastinal silhouette is within normal limits. Lungs are clear. There is no pleural effusion or pneumothorax. Bones and the upper abdomen are grossly unremarkable. IMPRESSION: Normal chest radiograph. " 9b25c01b-093308b5-decad499-98094760-89a39329.jpg,test/p18/p18553055/s56349493/9b25c01b-093308b5-decad499-98094760-89a39329.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ s/p CABG/MVR and CT removal // r/o ptx r/o ptx IMPRESSION: Comparison to ___. The chest and mediastinal drains have been removed. Stable mild overinflation of the right lung. The left hemi thorax shows no evidence for the presence of a pneumothorax. Mild cardiomegaly persists. Stable position of the Swan-Ganz catheter, the endotracheal tube and the nasogastric tube. " fcb810aa-e36a9d15-dc926a3e-aa6384d7-02e3bd8a.jpg,test/p14/p14725980/s50410999/fcb810aa-e36a9d15-dc926a3e-aa6384d7-02e3bd8a.jpg,test," FINAL REPORT PORTABLE CHEST RADIOGRAPH, ___. COMPARISON: Radiograph ___. FINDINGS: Right PICC terminates within the mid-to-lower superior vena cava. Lungs are clear except for focal atelectasis in the medial segment of the right middle lobe. Cardiomediastinal contours are stable. " 7754f409-a55867b8-a0cb0069-7ff81d26-25ad6c9d.jpg,test/p16/p16707063/s58209932/7754f409-a55867b8-a0cb0069-7ff81d26-25ad6c9d.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of weakness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is blunting of the left costophrenic angle, consistent with a small pleural effusion. No focal consolidation is seen. There is mild right base atelectasis. No right pleural effusion is seen. There is no evidence of pneumothorax. The aorta is tortuous. The cardiac silhouette is top normal. Mild degenerative changes are seen along the spine. IMPRESSION: Small left pleural effusion. " 733ee464-e9f75652-4b638baf-9033e013-84769f58.jpg,test/p18/p18060047/s51464160/733ee464-e9f75652-4b638baf-9033e013-84769f58.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: A markedly enlarged hiatal hernia is again demonstrated. The cardiac, mediastinal and hilar contours are otherwise unchanged, and the aorta remains markedly tortuous. Heart size is difficult to assess given the presence of the hiatal hernia, but is likely mild to moderately enlarged. Pulmonary vasculature is normal. Streaky atelectasis is seen within the left lower lobe adjacent to the hiatal hernia. Linear atelectasis is also noted within the right lung base. No focal consolidation, pleural effusion or pneumothorax is otherwise demonstrated. There are no acute osseous abnormalities. IMPRESSION: Markedly enlarged hiatal hernia. Otherwise no acute cardiopulmonary abnormality seen. " c2d2c28b-f2fea100-791c5487-418d354a-e2c53c41.jpg,test/p18/p18705722/s51412725/c2d2c28b-f2fea100-791c5487-418d354a-e2c53c41.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG/MVR/TVr // eval pleural effusion/ postop changes TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: Pulmonary edema has markedly improved almost completely resolved. Atelectasis in the mid lungs bilaterally have improved. Bilateral pleural effusions are small associated with adjacent atelectasis. Severe cardiomegaly is a stable. Widening mediastinum has improved. There is no pneumothorax. Right IJ catheter tip is in the cavoatrial junction. " 28cb4653-df4d2fe0-6dcf8d34-729b57f7-3f7f9fb7.jpg,test/p12/p12633029/s59423581/28cb4653-df4d2fe0-6dcf8d34-729b57f7-3f7f9fb7.jpg,test," WET READ: ___ ___ ___ 9:25 PM Dense left basilar opacity compatible with pneumonia in the proper clinical setting. Repeat after treatment suggested especially in light of prior abnormality in the similar location on remote prior. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with fever // pna? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: There is left basilar opacity, best seen on the lateral view. Elsewhere, the lungs are clear within limitation of low lung volumes. The cardiomediastinal silhouette is stable. Median sternotomy wires are again noted. No acute osseous abnormalities. IMPRESSION: Dense left basilar opacity compatible with pneumonia in the proper clinical setting. Repeat after treatment suggested especially in light of prior abnormality in the similar location on remote prior. " e20ed841-601c0ca9-3227e22f-d8ffe2b3-770e9b0f.jpg,test/p12/p12870544/s53922898/e20ed841-601c0ca9-3227e22f-d8ffe2b3-770e9b0f.jpg,test," FINAL REPORT INDICATION: ___M with a h/o sickle cell anemia c/b moyamoya s/p b/l pial synangiosis admitted as unrestrained driver in high speed MVC with GCS 5, intubated at the scene, suffering a large subdural hematoma, LUL collapse, and R ___-11th rib fractures // interval change COMPARISON: Radiographs from ___ IMPRESSION: Support lines and tubes are unchanged in position. There is cardiomegaly which is stable. There has been continued increase in the right-sided pleural effusion. There are no pneumothoraces. " e3616b8d-e9c52f1d-edd70b0f-017f9a0f-6abddac6.jpg,test/p16/p16394177/s56717187/e3616b8d-e9c52f1d-edd70b0f-017f9a0f-6abddac6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough and yellow sputum // eval pneumonia COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 20714972-85c948cd-ac1362b5-307a5c1a-81783938.jpg,test/p14/p14371035/s52632690/20714972-85c948cd-ac1362b5-307a5c1a-81783938.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with RML opacity, b/l bibasilar haziness that appears to be resolving // interval change interval change IMPRESSION: As compared to ___, no relevant change is seen. The monitoring and support devices are constant. The pre described opacity at the bases of the right lower lung is less severe an extensive than on the previous examination. A left basal opacity is unchanged. Mild cardiomegaly persists. No overt pulmonary edema but signs of fluid overload are present. " 3bc98f61-4d5e3522-84f973e8-2f18f53f-f4f3ba4e.jpg,test/p17/p17994170/s50151085/3bc98f61-4d5e3522-84f973e8-2f18f53f-f4f3ba4e.jpg,test," FINAL ADDENDUM ADDENDUM Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state abnormal EKG and tachycardia. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F r/o PNA // ___F r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Normal heart size. Note is made of pectus deformity which causes apparent obscuration of the right heart border. No focal consolidation, pleural effusion or pneumothorax. Surgical clips are seen in the bilateral breasts. IMPRESSION: No evidence of pneumonia. " 8c50d52c-75af9691-8b91214e-829ccf3f-7ad1dcbb.jpg,test/p10/p10010638/s55178098/8c50d52c-75af9691-8b91214e-829ccf3f-7ad1dcbb.jpg,test," FINAL REPORT HISTORY: Chest wall pain and trauma. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lungs are clear. Cardiac silhouette is normal. There is no pleural effusion, pneumothorax, pneumonia or pulmonary edema. These are non-dedicated views of the ribs which demonstrate no evidence of acute fracture. If clinical concern remains, a dedicated series can be obtained. Mild height loss of a mid-thoracic vetebral body is unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. " 4b9a5a1e-c7f8edd5-bf264aaf-0e065812-c0a58422.jpg,test/p16/p16497039/s52422541/4b9a5a1e-c7f8edd5-bf264aaf-0e065812-c0a58422.jpg,test," FINAL ADDENDUM The paperclip is visible on this study, and projects high in the chest, far above the region of the possible swallowed tooth. ______________________________________________________________________________ FINAL REPORT HISTORY: orthopedic injury status post bronchoscopy for question tooth in left lung. Paper clip over skin lesion COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. The radiopacity is still visualized projecting over the left lower chest. IMPRESSION: No significant change. Please note that the paper clip described as overlying a skin lesion is not visible on this study. " b302783f-a74237e8-de92270b-ab5c3ad6-dacbf999.jpg,test/p17/p17267132/s57960622/b302783f-a74237e8-de92270b-ab5c3ad6-dacbf999.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SCLC // eval for interval change eval for interval change COMPARISON: Comparison to ___ at 04:26 FINDINGS: Portable chest film ___ 04:48 is submitted. IMPRESSION: Nasogastric tube is seen coursing below the diaphragm. Endotracheal tube continues to have its tip at the thoracic inlet. There is increasing opacity at the left upper lobe with shift to the left favoring left upper lobe collapse, although superimposed infection or a central mass cannot be excluded. Patchy bibasilar opacities are also seen possibly representing atelectasis, although pneumonia cannot be excluded. There is crowding of the pulmonary vasculature with no overt pulmonary edema. Heart is are stable in size given differences in patient positioning. " 85cd40d2-7176c978-ab6ad446-3e6bc045-5c300cf7.jpg,test/p14/p14887253/s53311764/85cd40d2-7176c978-ab6ad446-3e6bc045-5c300cf7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with hypoxia and fever TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size remains borderline enlarged. Atherosclerotic calcifications are noted at the aortic knob. Moderate size hiatal hernia is re- demonstrated. There is mild pulmonary vascular congestion. Consolidative opacity within the right lower lobe as well as patchy opacity in the left lung base are concerning for areas of pneumonia. There is likely a small right pleural effusion. No pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Multifocal pneumonia. " 3a99d8f3-5dea0bb6-1978ef22-db7f88cb-97d939ef.jpg,test/p10/p10143711/s53622177/3a99d8f3-5dea0bb6-1978ef22-db7f88cb-97d939ef.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with fall, h/o tib frx // ? traumatic injuries TECHNIQUE: AP and lateral views of the chest COMPARISON: Prior radiographs the most recent on ___ FINDINGS: Lung volumes are low which accentuates bronchovascular markings. The heart is moderately enlarged on this AP view. There is mild to moderate vascular congestion and pulmonary edema. No pneumothorax. No pleural effusion. IMPRESSION: Mild to moderate pulmonary edema. " 92a0b949-cd8e20f5-0ec5a9d2-3d722a31-9e1de50a.jpg,test/p17/p17763551/s54856086/92a0b949-cd8e20f5-0ec5a9d2-3d722a31-9e1de50a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p CABG // eval for pneumo eval for pneumo IMPRESSION: Comparison to ___. No relevant change is noted. Low lung volumes. Stable moderate cardiomegaly of the CABG. Minimal fluid overload but no overt pulmonary edema. No larger pleural effusions. Moderate left perihilar and retrocardiac atelectasis. " 5af44f64-18cd23a1-3543ada7-4f36889c-852c63ff.jpg,test/p13/p13560495/s56352214/5af44f64-18cd23a1-3543ada7-4f36889c-852c63ff.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate no focal consolidation, pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. No pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " d66f6d1d-14e5b77d-56c93e23-bacbcce6-81719e7f.jpg,test/p19/p19079238/s56366602/d66f6d1d-14e5b77d-56c93e23-bacbcce6-81719e7f.jpg,test," FINAL REPORT INDICATION: Chest pain and shortness of breath. Evaluate for cardiomegaly. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___. FINDINGS: Patient is status post CABG with sternotomy wires and clips noted. Heart is normal size and unchanged. Mediastinal and hilar contours are normal. Lungs are clear and lung volumes are normal. No pleural effusion, pneumothorax or focal airspace consolidation. The right costophrenic angle was not completely visualized on the frontal view. IMPRESSION: No acute cardiopulmonary process. " c7e97b12-a207f633-87ecead1-86f5a2b5-6f87dd07.jpg,test/p17/p17211281/s55344190/c7e97b12-a207f633-87ecead1-86f5a2b5-6f87dd07.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with altered mental status // ?infection ?infection IMPRESSION: In comparison with the study of ___, there is again hyperexpansion of the lungs with flattening hemidiaphragms consistent with chronic pulmonary disease. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " 2e1f5217-91030379-a15da57f-65e9a967-7a454407.jpg,test/p10/p10078115/s59919639/2e1f5217-91030379-a15da57f-65e9a967-7a454407.jpg,test," FINAL REPORT PORTABLE CHEST ___, ___. COMPARISON: ___ radiograph. FINDINGS: Indwelling support and monitoring devices are remarkable only for slightly proximal location of the endotracheal tube, terminating 5.5 cm above the carina with the neck in a flexed position. Persistent cardiomegaly and pulmonary vascular congestion accompanied by interstitial edema. Worsening left retrocardiac opacity is probably due to a combination of atelectasis and effusion. " 253c7e9a-0cc6ed2c-eabb782b-a09c575d-f3f63137.jpg,test/p15/p15596774/s59894602/253c7e9a-0cc6ed2c-eabb782b-a09c575d-f3f63137.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough, fevers, dyspnea, coarse breath sounds and chest pain, question pneumonia. COMPARISONS: PA and lateral chest radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. There are no acute skeletal abnormalities. IMPRESSION: No acute cardiopulmonary process. " a9256b6e-0d4fc914-016e66fa-598e6cb0-615d96f4.jpg,test/p13/p13535769/s50876538/a9256b6e-0d4fc914-016e66fa-598e6cb0-615d96f4.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " dc48a424-7767e46e-9a066341-fd8410cf-0a21fe1d.jpg,test/p17/p17735461/s56337791/dc48a424-7767e46e-9a066341-fd8410cf-0a21fe1d.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Altered mental status, assess for pneumonia. FINDINGS: AP upright and lateral views of the chest provided. There is a dextroscoliosis of the T-spine and the patient is rotated which limits evaluation. Allowing for this, no signs of pneumonia or CHF. No effusion or pneumothorax. The heart and the mediastinal contour is unchanged in appearance and size. No bony abnormalities. IMPRESSION: No acute intrathoracic process. " 736b4fa1-28c633de-591f2590-ebfc92fc-c23981ef.jpg,test/p19/p19296519/s57478432/736b4fa1-28c633de-591f2590-ebfc92fc-c23981ef.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath and upper abdominal distention. COMPARISON: Chest radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: There is mild increased opacity in the right lung apex which could reflect an apical pneumonia or aspiration in the appropriate clinical setting. No overt pulmonary edema or large pleural effusions are evident. Mediastinal and hilar contours are within normal limits. There is mild stable enlargement of the cardiac silhouette. No pneumothorax is evident. IMPRESSION: 1. Subtle increased density in the right lung apex, possible pneumonia or aspiration. 2. Unchanged mild cardiomegaly Dr. ___ communicated the above findings to Dr. ___ at 10:35 am on ___ by telephone. " a1385a5d-b14fe730-387ae9f1-d66d6759-e1eba14d.jpg,test/p18/p18981235/s55275160/a1385a5d-b14fe730-387ae9f1-d66d6759-e1eba14d.jpg,test," FINAL REPORT INDICATION: ___-year-old female with near syncope post-exercise. Rule out cardiomegaly. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are clear without focal or diffuse abnormality. The pulmonary vasculature is unremarkable. No pleural effusion or pneumothorax. The osseous structures are unremarkable. No radiopaque foreign bodies. IMPRESSION: No cardiomegaly or acute cardiopulmonary process. " 197c4092-442fa259-a0689233-09d56eda-8f9864d9.jpg,test/p18/p18865198/s54330103/197c4092-442fa259-a0689233-09d56eda-8f9864d9.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old woman with right VATS decortication. Evaluate lung expansion. FINDINGS: Comparison is made to previous study from ___. There are two chest tubes seen within the right chest. There is consolidation at the right base. There are no signs for overt pulmonary edema. No pneumothoraces are seen. The heart size is grossly within normal limits. Overall, the findings are stable since the prior study. " a18848e0-9bc1fed8-6cf664ce-2df76fb7-4bc99588.jpg,test/p14/p14714280/s57200981/a18848e0-9bc1fed8-6cf664ce-2df76fb7-4bc99588.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with history of diabetes, hypertension with chest x-ray of ___ with questionable nodule and recommendation for repeat examination. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. Heart size and mediastinal structures are unremarkable. Normal appearance of thoracic aorta. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No pneumothorax in the apical area. In comparison with the next previous study at that time questioned pulmonary parenchymal density overlying the left side sixth rib cannot be identified anymore. IMPRESSION: Chest findings within normal limits. No suspicious nodular lesion. " da7973f5-0e7c98ad-70bfedcb-5eccb146-7ba6f256.jpg,test/p17/p17689317/s58552098/da7973f5-0e7c98ad-70bfedcb-5eccb146-7ba6f256.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with RIJ CVL // placement COMPARISON: Prior exam performed earlier today. FINDINGS: AP portable upright view of the chest. Interval placement of a right IJ central venous catheter with its tip in the mid SVC region. Endotracheal and orogastric tubes are unchanged. IMPRESSION: Right IJ positioned appropriately. Otherwise no change. " 073f5c94-12b7e03c-d63842ba-9f3112da-c3525495.jpg,test/p18/p18143678/s56805803/073f5c94-12b7e03c-d63842ba-9f3112da-c3525495.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC // eval PICC placement IMPRESSION: Interval placement of right PICC terminating in the mid superior vena cava. No other relevant changes since recent radiograph of ___. " 3e426776-c673cf50-daa6c027-10fb0718-374a293d.jpg,test/p14/p14188597/s54140747/3e426776-c673cf50-daa6c027-10fb0718-374a293d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with NSCLC w/ brain mets found to have RML opacity. // Please assess for interval change/pna. COMPARISON: Chest radiographs from___ FINDINGS: Left chest subcutaneous port central venous line tip is in the mid to low SVC. Irregular opacity projecting over the right midlung appears similar to prior. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Bilateral pleural effusions are tiny. No pneumothorax. The aortic knob calcifications appear similar to prior. IMPRESSION: 1. Right midlung opacity appears similar to prior and could be pneumonia or atelectasis. Correlation with previous imaging is needed. After comparison, if uncertainty remains, chest CT would be the next recommendation. 2. Bilateral pleural effusions are tiny. NOTIFICATION: The impression above was entered by Dr. ___ on ___ at 11:15 into the Department of Radiology critical communications system for direct communication to the referring provider. " ecfedc23-40536fe0-3e1981f0-2661a221-c6e61b76.jpg,test/p14/p14749769/s57035849/ecfedc23-40536fe0-3e1981f0-2661a221-c6e61b76.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female ___ weeks pregnant with asthma presents with wheezing and shortness of breath. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation. There is suggestion of minimal right basilar atelectasis. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No definite acute cardiopulmonary process. " 5a6552db-ffb65112-9c076935-25875232-5240d361.jpg,test/p11/p11825462/s50074569/5a6552db-ffb65112-9c076935-25875232-5240d361.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and aortic valve replacement. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Except for minimal subsegmental atelectasis in the right lung base, the lungs are clear without focal consolidation, pleural effusion or pneumothorax. Diffuse sclerotic osseous metastases are again noted within the visualized osseous structures. IMPRESSION: No acute cardiopulmonary abnormality. " d72ee9ed-98b60d85-13cacce2-91802664-876b9611.jpg,test/p17/p17979567/s59520622/d72ee9ed-98b60d85-13cacce2-91802664-876b9611.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Liver disease and fevers, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have decreased. There are no pleural effusions. Moderate cardiomegaly without pulmonary edema. No pneumonia. Minimal left basal atelectasis. Unchanged vertebral stabilization devices. " 207be82e-0fb459d5-ea89f7ba-cf74f3b9-e1caffe1.jpg,test/p10/p10577647/s57867377/207be82e-0fb459d5-ea89f7ba-cf74f3b9-e1caffe1.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left internal jugular vein placement. TECHNIQUE: Single AP portable chest radiograph COMPARISON: Radiograph dated ___ FINDINGS: Single portable AP upright chest radiograph demonstrates clear lungs bilaterally. Cardiomediastinal and hilar contours appear stable. A left internal jugular central venous line is identified, its tip which appears to project over the anticipated location of the superior vena cava. There is no pneumothorax. There is no pleural effusion. IMPRESSION: Status post left internal jugular central venous line. No pneumothorax. " 27836ae0-c248f14e-3980d36d-7aa896a3-958d3727.jpg,test/p16/p16178757/s58702889/27836ae0-c248f14e-3980d36d-7aa896a3-958d3727.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman after TAVR. Evaluate CHF and left lower lobe rales. IMPRESSION: PA and lateral chest compared to ___: Severe cardiomegaly unchanged. TAVR in standard position. No pulmonary edema. Mediastinal contour defined by severe enlargement main pulmonary artery and tortuous enlarged thoracic aorta. No pleural effusion. Severe kyphosis, due largely to multiple mid and lower thoracic vertebral compression fractures. Transvenous right atrial and ventricular pacer leads follow their expected courses from the left pectoral generator. " d2974695-9683c39d-43dccf65-4b259169-73c3f726.jpg,test/p11/p11087914/s50795246/d2974695-9683c39d-43dccf65-4b259169-73c3f726.jpg,test," FINAL REPORT HISTORY: Increased falls at home. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is mildly enlarged. Mediastinal and hilar contours are normal. There is no pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is seen. Minimal streaky retrocardiac and right basilar opacities likely reflect atelectasis. Mild degenerative changes are seen within the thoracic spine. Clips are seen within the right axillary region. IMPRESSION: Mild bibasilar atelectasis. " 29241e6f-87eb4081-0737c7ca-035b952d-ec9eec4c.jpg,test/p16/p16055278/s53732163/29241e6f-87eb4081-0737c7ca-035b952d-ec9eec4c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with chest pain. COMPARISON: None available. FINDINGS: The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiographs of the chest. " 48f51e4c-4dc1498f-f1441ebb-95aeae96-0f30f245.jpg,test/p15/p15320679/s57333362/48f51e4c-4dc1498f-f1441ebb-95aeae96-0f30f245.jpg,test," WET READ: ___ ___ ___ 3:22 PM No focal consolidation concerning for pneumonia. No evidence of pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with history of ESRD on dialysis, worsening cough fatigue. Eval for volume overload, PNA. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs ___ and ___. FINDINGS: Heart is mildly enlarged. No signs of congestion or edema. Mediastinal and hilar silhouettes are unchanged since ___. Left lower lung streaky opacity has been present and unchanged since ___, therefore likely a scar. No new focal consolidation, pleural effusion, or pneumothorax. Note is again made of the right humeral prosthesis. IMPRESSION: Mild cardiomegaly. Stable linear scarring in the left lower lung. No signs of pneumonia or edema. " bf99e665-fc473725-24514c20-d9e9b45c-3a047552.jpg,test/p14/p14247006/s50593826/bf99e665-fc473725-24514c20-d9e9b45c-3a047552.jpg,test," FINAL REPORT INDICATION: Patient with three-day history of shortness of breath and intermittent chest pain. COMPARISONS: ___, ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. AICD device tip projects over right ventricle, unchanged. Sternotomy wires appear intact. Multiple surgical clips project over cardiac silhouette. Small bilateral pleural effusions and mild interstitial pulmonary edema seen on ___ exam has resolved. Heart size is top normal. Mild perihilar vascular congestion persists. There is no pneumothorax. Partially imaged upper abdomen is unremarkable. IMPRESSION: In comparison to ___ exam, small pleural effusions and mild interstitial pulmonary edema has resolved. Mild perihilar vascular congestion persists. " 352f9865-dd4d172b-3824babf-3e79ea7b-665a8de9.jpg,test/p17/p17992323/s51607522/352f9865-dd4d172b-3824babf-3e79ea7b-665a8de9.jpg,test," FINAL REPORT INDICATION: Dyspnea and fever. Evaluate for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Since the prior exam, there is a new dense opacity in the posterior left lower lobe, most consistent with pneumonia. It is difficult to exclude a small amount of pleural fluid on the left. A hazy linear opacity on the right may represent atelectasis or second focus of pneumonia. There is no right pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: New left lower lobe pneumonia and possible new subtle right lower lobe pneumonia. " d7a2a6ef-50f4981b-81ddffa6-70dc76f3-c88a7340.jpg,test/p10/p10030753/s53724703/d7a2a6ef-50f4981b-81ddffa6-70dc76f3-c88a7340.jpg,test," FINAL REPORT INDICATION: Nausea and vomiting. Hyperglycemia. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, most recent dated ___. FINDINGS: No focal opacity to suggest pneumonia is seen. No pleural effusion, pulmonary edema, or pneumothorax is present. The heart size is normal. There is plate-like atelectasis at the right lower hemithorax. Surgical clips are noted in the right upper quadrant. IMPRESSION: No evidence of acute cardiopulmonary process. " 20564549-1cc810d7-bd02494a-ba4a4360-ff7f1e25.jpg,test/p18/p18046178/s52313199/20564549-1cc810d7-bd02494a-ba4a4360-ff7f1e25.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath and failure to thrive. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 76b2976f-318ab1ae-c13de45e-61aae908-8fdc7216.jpg,test/p16/p16380197/s56803789/76b2976f-318ab1ae-c13de45e-61aae908-8fdc7216.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with belly pain, central line placement TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ chest radiograph FINDINGS: Right internal jugular central venous catheter tip terminates at the junction of the SVC and right atrium. Heart size is normal. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No subdiaphragmatic free air is identified. Degenerative changes are seen involving the right glenohumeral and both acromioclavicular joints. IMPRESSION: Right internal jugular central venous catheter tip at the junction of the SVC and right atrium. No acute cardiopulmonary abnormality or subdiaphragmatic free air. " 450584b4-3285177d-b719fc07-65e65c27-27937076.jpg,test/p12/p12263171/s57766335/450584b4-3285177d-b719fc07-65e65c27-27937076.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with slight oxygen requirement // eval for pneumonia, pleural effusions, atelectasis; bs diminished at bases TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There are persistent low lung volumes and elevation of the left hemidiaphragm. Small left effusion has decreased. Left lower lobe atelectasis is grossly unchanged. There is no pneumothorax. Cardiomediastinal contours are unchanged with widened mediastinum and tortuous aorta. Multiple surgical clips and a catheter projects in the right upper quadrant of the abdomen. Multiple surgical clips project in the left axilla. " c77cb042-08e5cc47-1f0576c6-e5e8f389-1da641cf.jpg,test/p17/p17575265/s55312713/c77cb042-08e5cc47-1f0576c6-e5e8f389-1da641cf.jpg,test," FINAL REPORT AP CHEST, 9:48 P.M., ___ HISTORY: A ___-year-old man with a small pneumothorax after a fall. IMPRESSION: AP chest compared to ___, read in conjunction with chest CT on ___: There is no detectable pneumothorax or substantial pleural effusion. Ground-glass opacification predominantly in the left lung is probably pulmonary contusion. Developing consolidation in the left lower lobe medially at this early stage after trauma is probably atelectasis, but should be followed. Stomach is severely distended with air and semisolid material. Heart size top normal. " 473eb900-99df0170-26e93305-db0cc505-5de2ec2f.jpg,test/p15/p15022658/s53141461/473eb900-99df0170-26e93305-db0cc505-5de2ec2f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam dated ___. CLINICAL HISTORY: ___-year-old man with ETOH intoxication and status post fall. Assess for fracture or other acute injury in the chest. FINDINGS: PA and lateral views of the chest provided. The lungs are well expanded and clear. No pneumothorax or effusions seen. Cardiomediastinal silhouette is normal. No bony injuries are seen. " 10a6246b-f2e3ec72-8c956609-ee81d40f-4a962883.jpg,test/p18/p18828251/s50037292/10a6246b-f2e3ec72-8c956609-ee81d40f-4a962883.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The patient is status post median sternotomy and CABG. The heart remains moderate to severely enlarged. The mediastinal contours are stable with aortic knob calcifications visualized. There is consolidative opacity within the right lung, most pronounced within the right upper lobe. Additionally, ill-defined hazy opacity is noted within the left perihilar region. There is no pleural effusion or pneumothorax visualized. Mild degenerative changes are seen within the thoracic spine. IMPRESSION: 1. Consolidative opacity within the right upper lobe is concerning for pneumonia. 2. Hazy opacity within the right lung base as well as within the left perihilar region may reflect superimposed pulmonary edema, though infection within the right lung base also is not excluded. " 9bc78040-aa05ccb6-e7438f19-cea3f67e-835c05a3.jpg,test/p10/p10768040/s50620219/9bc78040-aa05ccb6-e7438f19-cea3f67e-835c05a3.jpg,test," WET READ: ___ ___ 7:28 PM Multi focal right-sided regions of consolidation compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with fever and altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. There is new right basilar opacity as well as streaky linear opacity in the right upper lobe as well. There may be a trace right pleural effusion. The left lung remains clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures demonstrate no acute abnormality. IMPRESSION: Multi focal right-sided regions of consolidation compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. " 314f586b-e3390e68-f256e251-cc55cde6-efb3077d.jpg,test/p18/p18048304/s56904809/314f586b-e3390e68-f256e251-cc55cde6-efb3077d.jpg,test," FINAL REPORT INDICATION: ___-year-old man with history of pulmonary fibrosis, presenting with syncope and likely NSTEMI. COMPARISON: None available. AP AND LATERAL CHEST RADIOGRAPH: The heart is mildly enlarged. The hilar and mediastinal contours are unremarkable, except for moderate calcification in the aortic knob. Extensive interstitial opacities are seen in both lungs, most extensively in the right lung base and left mid lung. While these changes could represent chronic interstitial lung disease, superimposed mild pulmonary edema cannot be excluded without a baseline radiograph for comparison. No large pleural effusions or pneumothorax are seen. IMPRESSION: Extensive interstitial abnormalities in both lungs, with more confluent opacity in the right lower and left mid lung. While these changes likely reflect chronic interstitial lung disease, superimposed mild interstitial edema is difficult to exclude given the lack of baseline studies for comparison. " 137d3d31-3b2afcb9-dcca6963-365d1b9d-552f254b.jpg,test/p12/p12563019/s55121721/137d3d31-3b2afcb9-dcca6963-365d1b9d-552f254b.jpg,test," FINAL REPORT AP CHEST AT 10:04 P.M. ON ___. HISTORY: Cough, question effusion or infiltrate. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Atelectasis in the left lower lobe helps to explain leftward mediastinal shift and downward displacement of the left hilus. Left upper lung and right lung are clear. There is no appreciable pleural effusion. Cardiomediastinal silhouettes are normal. When feasible, conventional radiographs should be obtained to see if there is a need for CT scanning currently or followup eventually. " f4e3ee4b-f9ab470a-7ec360f1-c2583bd1-99a560bb.jpg,test/p19/p19706867/s55201812/f4e3ee4b-f9ab470a-7ec360f1-c2583bd1-99a560bb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with severe AS, CAD, CVA, HTN, HLD, DM, CKD presenting with right sided chest pain, productive cough white sputum. Recent diagnosis LUL mass concerning for primary lung cancer TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Heart size is normal. Atherosclerotic calcifications are seen diffusely within the thoracic aorta. Mild pulmonary edema is new compared to the previous study with small new bilateral pleural effusions demonstrated. Patchy opacities in the lung bases may reflect atelectasis however infection or aspiration is difficult to exclude. More focal ill-defined mass in the left upper lobe was better characterized on the recent chest CT as consistent with lung malignancy. No pneumothorax is present. Moderate multilevel degenerative changes are seen in the thoracic spine. IMPRESSION: Interval development of mild pulmonary edema and small bilateral pleural effusions since the previous chest radiograph. Bibasilar patchy opacities may reflect atelectasis however infection or aspiration cannot be excluded. Re- demonstration of left upper lobe mass concerning for malignancy. " 7ff51290-ed1c673a-e71989e5-3c045ae0-bd25c2e1.jpg,test/p18/p18551287/s51872521/7ff51290-ed1c673a-e71989e5-3c045ae0-bd25c2e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chest tube that was dc'd on ___ // ?pneumothorax ?pneumothorax IMPRESSION: Compared to chest radiographs ___ through ___. Moderate pulmonary edema and mediastinal vascular distention generally improved. Persistent left lower lobe consolidation and small to moderate bilateral pleural effusions. No pneumothorax following removal of the right pleural drainage catheter. Heart size top-normal. Right internal jugular line in central placement. " 554b03ba-620a0825-72af7613-8ce2938b-c1b47bbf.jpg,test/p13/p13383248/s50014324/554b03ba-620a0825-72af7613-8ce2938b-c1b47bbf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // pneumonia pneumonia IMPRESSION: In comparison with the study of ___, there is again mild scoliosis of the thoracic spine convex to the right and mild tortuosity of the aorta. Cardiac silhouette is within normal limits. No evidence of acute focal pneumonia, vascular congestion, or pleural effusion. Probable mild atelectatic changes at the right base. " 2bed34b0-bbd7f5b1-187ac0eb-83ad444d-0e0d9a4d.jpg,test/p13/p13413293/s53742358/2bed34b0-bbd7f5b1-187ac0eb-83ad444d-0e0d9a4d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cerebellar IPH // Evaluate pulmonary status while intubated Evaluate pulmonary status while intubated IMPRESSION: Comparison to ___. Monitoring and support devices are stable. Signs of pulmonary edema have decreased. There currently is no pulmonary edema. Borderline size of the heart. Mild left and right basal areas of atelectasis. No pleural effusions. No pneumothorax. " 991ce8ed-79a7eabb-624f587d-53e24e90-34c26b52.jpg,test/p10/p10598395/s53315794/991ce8ed-79a7eabb-624f587d-53e24e90-34c26b52.jpg,test," FINAL REPORT HISTORY: Right upper quadrant pleuritic pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest were reviewed. Dilation of the ascending aorta is noted, which is concerning for aneurysm or dissection. There is no pleural effusion or pneumothorax. The lungs are well expanded and clear. Pulmonary vasculature is within normal limits. IMPRESSION: Ascending aorta dilation, which may represent aneurysm or dissection. Chest CTA is recommended for further evaluation. Dr. ___ ___ this finding to the ___ nurses at 9:20 AM on ___. " 0f43d6b4-66383c30-c8720771-4a95b42f-d28519d9.jpg,test/p18/p18248840/s57551594/0f43d6b4-66383c30-c8720771-4a95b42f-d28519d9.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with weakness // assess for infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Surgical clips overlie the left axilla. IMPRESSION: No acute cardiopulmonary process. " 8d6065b8-9556c434-2f92905b-b69b0c7a-60bdd9e0.jpg,test/p12/p12406522/s50956155/8d6065b8-9556c434-2f92905b-b69b0c7a-60bdd9e0.jpg,test," FINAL REPORT CLINICAL HISTORY: COPD, recent tracheostomy with ongoing blood loss. Evaluate for interval change. CHEST AP: There has been no change since the prior chest x-ray. The position of the tracheostomy tube and the hemodialysis catheter is unchanged. The position of the PICC line is less easy to determine but is probably slightly retracted since the prior chest x-ray and now lies at the junction of the SVC and left innominate vein. Costophrenic angles are clear. The lungs are clear. " 0b7138af-cbe4df41-1700084d-589dd849-9052edb9.jpg,test/p11/p11210583/s59466370/0b7138af-cbe4df41-1700084d-589dd849-9052edb9.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with hx pancreatitis now with burning epigastric pain radiating to back // please assess for etiologies of abdominal pain TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No evidence of free air is seen beneath the diaphragm. IMPRESSION: No acute cardiopulmonary process. " f737616c-68dea5c3-91da0536-9863fe8b-4cc286ab.jpg,test/p10/p10207476/s57618599/f737616c-68dea5c3-91da0536-9863fe8b-4cc286ab.jpg,test," WET READ: ___ ___ ___ 10:47 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Weakness, nausea, vomiting, palpitations. Assess for acute process. COMPARISON: Chest radiograph ___, ___. FINDINGS: Frontal and lateral chest radiograph demonstrates well-expanded and clear lungs, unchanged in appearance ___. Stable bulge at aortic arch corresponds to patient's known pseudoaneurysm as seen on CT chest dated ___. No pleural effusion or pneumothorax. Heart size, mediastinal contour and hila are unremarkable. IMPRESSION: No pneumonia or CHF. Known aortic pseudoaneurysm. " 297d4638-e12e5a41-31ff19e9-dd99227e-32ec9e39.jpg,test/p17/p17545966/s58959011/297d4638-e12e5a41-31ff19e9-dd99227e-32ec9e39.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. A density seen in the anterior lower chest on the lateral view is external to the patient as verified by the technologist. IMPRESSION: Unremarkable chest radiographic examination. " 06da0c74-94f636f9-f3832226-10b6f2cb-6333d7b5.jpg,test/p19/p19955348/s57122040/06da0c74-94f636f9-f3832226-10b6f2cb-6333d7b5.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with pleural effusion s/p chest tube placement, now with acute pleuritic chest pain radiating up to right shoulder. TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiographs from ___, ___ FINDINGS: Since earlier same day chest radiograph, the right pigtail catheter appears kinked in position. No interval changes are seen in the lungs. No pneumothorax, pneumonia, or pulmonary edema. The heart continues to be enlarged. Positioning of left dialysis catheter is unchanged. IMPRESSION: 1. Since earlier same day chest radiograph, the right pigtail catheter appears kinked in position. Otherwise, no interval changes are seen. NOTIFICATION: The findings were discussed by Dr. ___ with ___ Intern ___ on the telephoneon ___ at 4:50 PM, 1 minutes after discovery of the findings. " 1f410265-c5d71bf6-3b5d6896-d0af8eba-1731c34e.jpg,test/p15/p15703642/s55192690/1f410265-c5d71bf6-3b5d6896-d0af8eba-1731c34e.jpg,test," FINAL REPORT INDICATION: ___ year old man with hx congestive heart failure with SOB // r/o CHF vs infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear and mildly hyperinflated. The cardiac silhouette is mildly enlarged with left atrial enlargement. No pleural effusions or pneumothorax. No interstitial edema or acute pneumonia. IMPRESSION: No acute cardiopulmonary process. " a9ea47c6-aed61d98-aeca315e-8472d9db-0ddd9e0b.jpg,test/p18/p18489691/s53395430/a9ea47c6-aed61d98-aeca315e-8472d9db-0ddd9e0b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RCC, obstructing mass in R mainstem, removed and stent placed // eval for reopening of R lower lobe, R middle lobe COMPARISON: Chest x-ray from ___. Targeted review of chest CT from ___. FINDINGS: Compared with ___, the cardiomediastinal silhouette is unchanged. Opacification of the right middle lobe is similar -- possibly slightly worse. There is upper zone redistribution in the right lung, which appears more pronounced. Based on the ___ CT, the patient has known mediastinal lymphadenopathy and pulmonary nodules, with collapse of the right middle lobe due to interval progression of invasion of the airways. . IMPRESSION: 1. Similar, equivocally slightly worse, right base opacity, related to known right middle lobe collapse. 2. Slight upper zone redistribution, slightly worse compared with ___. 3. Known pulmonary nodules and mediastinal lymphadenopathy not well depicted by radiograph. 4. No new focal opacity and no gross effusion. Mediastinum remains midline. " 512c907e-91ca6074-387d318f-327fe520-8b0c03ec.jpg,test/p19/p19398915/s59755957/512c907e-91ca6074-387d318f-327fe520-8b0c03ec.jpg,test," FINAL REPORT HISTORY: Recent thoracentesis, with subsequent hypoxia and pulmonary edema. Evaluate for interval change in right sided opacities. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal mediastinum and heart size. A moderate right pleural effusion has decreased since yesterday, with interval improvement in the right middle lobe consolidation. An opacity in the superior right lower lobe is improved, and given this rapid improvement likely represented atelectasis or major aspiration which is now resolved. There is no convincing evidence of pneumonia. The left lung is unchanged, and there is no left pleural effusion. No pneumothorax is seen. IMPRESSION: 1. Interval decrease in the right pleural effusion and improvement in the right middle lobe consolidation. 2. Improvement of a superior right lower lobe opacity, which likely represented atelectasis or major aspiration, without convincing evidence of pneumonia. " e7b778bf-a800f1e7-8b6c2beb-dd655344-3d682bb2.jpg,test/p15/p15237353/s58589117/e7b778bf-a800f1e7-8b6c2beb-dd655344-3d682bb2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SAH and intubated // ? ETT placement ? ETT placement IMPRESSION: Compared to chest radiographs ___. Following tracheal extubation, low lung volumes exaggerate mild pulmonary edema. Pleural effusions small if any. Heart size normal. No pneumothorax. Right jugular line ends in the upper SVC. " 2d968188-53f51924-be0e3fd8-d2279ed5-5ab8ea9c.jpg,test/p19/p19218701/s59801561/2d968188-53f51924-be0e3fd8-d2279ed5-5ab8ea9c.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Epigastric discomfort, evaluate for free air. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is minimal right middle lobe atelectasis/scarring without definite focal consolidation, similar to the prior study. No pleural effusion is seen. The aorta remains calcified and tortuous. The cardiac silhouette is not enlarged. Degenerative changes are seen at the acromioclavicular joints. IMPRESSION: No acute cardiopulmonary process. " 7b23fd62-3250cb84-4ac3baf6-1c99b182-479d164f.jpg,test/p17/p17135687/s50747736/7b23fd62-3250cb84-4ac3baf6-1c99b182-479d164f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple GSW, chest tubes in place, nnow R chest tubes x2 clamped // psl eval for interval changes psl eval for interval changes IMPRESSION: In comparison with the earlier study of this date, with the right chest tubes clamped, there is little change in the degree of pneumothorax on this side. Otherwise little change. " 691b6004-c6c8a6c2-1609549c-ae39ef66-f3c5bf20.jpg,test/p13/p13090933/s50176947/691b6004-c6c8a6c2-1609549c-ae39ef66-f3c5bf20.jpg,test," FINAL REPORT HISTORY: Spinal stenosis, pre-op. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There is minimal left base atelectasis. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " ac8c7bc6-f8a97b5c-34f26d77-e01ce95c-acf838c5.jpg,test/p19/p19553622/s58394293/ac8c7bc6-f8a97b5c-34f26d77-e01ce95c-acf838c5.jpg,test," FINAL REPORT HISTORY: Multiple fractures and possible pneumonia. FINDINGS: In comparison with the study of ___, central catheter again extends to the mid-to-lower portion of the SVC. Previously described kink at the skin entrance is not definitely appreciated. Low lung volumes may account for much of the prominence of the transverse diameter of the heart. No evidence of vascular congestion. Minimal bibasilar atelectatic changes. There has been placement of a nasogastric tube that extends to the stomach. However, the side hole appears to lie just above the esophagogastric junction. " 6742d38a-487a8510-dc7f501a-117443b3-427fb8e6.jpg,test/p17/p17561108/s53367626/6742d38a-487a8510-dc7f501a-117443b3-427fb8e6.jpg,test," FINAL REPORT INDICATION: ___-year-old man with interstitial process after chemotherapy, resolving. Evaluate for stability. COMPARISONS: Chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. Compared to the most recent prior study, there is no significant change. Again seen is a right chest wall port with catheter tip in the mid SVC. Right basilar opacities with a component of pleural thickening and a right rib resection are stable. Moderate cardiomegaly is stable. Median sternotomy wires are intact. Valve replacement is noted. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No significant change since the prior study. " c957b217-b875df68-f96f2fdf-a77d5192-828b623a.jpg,test/p15/p15174955/s56793004/c957b217-b875df68-f96f2fdf-a77d5192-828b623a.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever and chills. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 11130e14-aa8be1b8-c5826a90-d98fdc6c-0799212f.jpg,test/p17/p17030279/s56020403/11130e14-aa8be1b8-c5826a90-d98fdc6c-0799212f.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia or other infection in a patient with weakness. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate intact sternal wires and mild cardiomegaly. The lungs are fairly well-aerated common without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. Mild cardiomegaly. " 29b6910a-5ba5f2eb-d315bb96-63002a1c-6516e1a8.jpg,test/p12/p12547577/s58766004/29b6910a-5ba5f2eb-d315bb96-63002a1c-6516e1a8.jpg,test," FINAL REPORT INDICATION Syncope. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. Moderate dextroconvexity of the mid thoracic spine appears slightly increased since ___, may be positional. IMPRESSION: No acute intrathoracic process. " 0ecc924b-ced3b9e5-f1f8dbfc-556afa0e-500c0320.jpg,test/p17/p17142657/s53105449/0ecc924b-ced3b9e5-f1f8dbfc-556afa0e-500c0320.jpg,test," FINAL REPORT INDICATION: ___M with 6 day history of productive cough and subjective fever // ? pneumonia TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. Tortuosity of the descending thoracic aorta is noted. Hypertrophic changes are seen the spine. IMPRESSION: No acute cardiopulmonary process. " f13bb5a5-2de7fe1d-6b8ce689-7d286cb1-3440b55a.jpg,test/p17/p17033324/s59052974/f13bb5a5-2de7fe1d-6b8ce689-7d286cb1-3440b55a.jpg,test," FINAL REPORT HISTORY: Fall, evaluate for infiltrate. COMPARISON: Chest radiograph ___. Chest CTA ___. FINDINGS: FRONTAL AND LATERAL VIEWS OF THE CHEST: Increased opacity at the left lung base likely atelectasis, though, early pneumonia could be considered in the correct clinical setting. Blunting of right costophrenic angle is unchanged over multiple prior studies and consistent with scarring as seen on the prior chest CTA. There is no pleural effusion or pneumothorax. Heart size is normal. There is no pulmonary edema. Mediastinal and hilar structures are unremarkable. " 019e47f1-8e58ed0b-aafe056e-3d2f83fe-134ae3ca.jpg,test/p18/p18246673/s51781123/019e47f1-8e58ed0b-aafe056e-3d2f83fe-134ae3ca.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Rhabdomyolysis, question CHF. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top normal to mildly enlarged. The aorta is tortuous. No overt pulmonary edema is seen. IMPRESSION: Top normal-to-mildly enlarged cardiac silhouette without overt pulmonary edema. No pleural effusions. " 45aa0fe1-701ebb44-36d496d9-58fca3f1-a7777666.jpg,test/p14/p14884535/s57106245/45aa0fe1-701ebb44-36d496d9-58fca3f1-a7777666.jpg,test," FINAL REPORT PATIENT HISTORY: ___-year-old woman with history of alcohol-induced and HCV cirrhosis, with left flank pain by IR today, would like to repeat chest x-ray and assess for effusion for diagnostic tap, please assess pleural effusion. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: Frontal and lateral views of the chest. There are no changes of the small left-sided pleural effusion, stable since yesterday. Lung is otherwise clear, without consolidation or nodule. Cardiomediastinal silhouette is normal. There is no pneumothorax. IMPRESSION: No changes of the left-sided pleural effusion. " 6f160696-5c10c31f-a3bf5c7f-d4b406ef-1855c131.jpg,test/p19/p19928728/s55967938/6f160696-5c10c31f-a3bf5c7f-d4b406ef-1855c131.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure and pneumonia, assessment for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is improved ventilation of the lung parenchyma, notably at the lung bases. Otherwise, the radiograph is unchanged, including the surgical clips, vertebral fixation devices and size of the cardiac silhouette. The support and monitoring devices are constant. " 6153b8ce-e671e644-670bd44e-0cbb72c1-b43bcfeb.jpg,test/p13/p13187486/s59012330/6153b8ce-e671e644-670bd44e-0cbb72c1-b43bcfeb.jpg,test," FINAL REPORT EXAMINATION: Portable chest x-ray INDICATION: ___ year old woman with left frontal hemorrhage and dysphagia // Evaluate NG tube placement TECHNIQUE: Frontal chest radiograph. COMPARISON: ___ at 08:07. FINDINGS: The distal tip of the feeding tube is visualized overlying the stomach. Remainder findings are stable to prior. This preliminary report was reviewed with Dr. ___, ___ radiologist. " 7539f22f-69ee3ff5-e881979a-e2f39743-46b63dda.jpg,test/p12/p12638513/s56932125/7539f22f-69ee3ff5-e881979a-e2f39743-46b63dda.jpg,test," WET READ: ___ ___ ___ 4:55 PM No acute cardiopulmonary process. No evidence of acute trauma in the chest. If suspicion for rib fracture persists, dedicated rib radiographs can be obtained. WET READ VERSION #___ ___ ___ ___ 12:07 PM Mild opacity in the medial right lung base may reflect atelectasis, but cannot exclude aspiration or pneumonia in the right clinical setting. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___F with several recent falls, fine crackles @ lung base on R // eval ? infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. No evidence of acute trauma is seen in the chest. IMPRESSION: No acute cardiopulmonary process. No evidence of acute trauma in the chest. If suspicion for rib fracture persists, dedicated rib radiographs can be obtained. " 2cae2be3-fd1c5ada-9a56a4bc-224cdf8d-5a26a7e4.jpg,test/p11/p11112302/s56033430/2cae2be3-fd1c5ada-9a56a4bc-224cdf8d-5a26a7e4.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with weakness // infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The patient is rotated to the right in the patient's chin overlies the lung apices, partially obscuring the view. Given the above, there is likely a small right pleural effusion with overlying atelectasis. Increased interstitial markings bilaterally suggests mild to moderate interstitial edema. More focal right upper to mid lung opacity is not well assessed due to patient positioning, could be due to consolidation due to pneumonia. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Limited study due to patient rotation in patient's chin overlying the medial lung apices. Given this, small right pleural effusion. Mild to moderate interstitial edema. Right upper to mid lung opacity is not well assessed, but could be due to consolidation due to pneumonia. " 5faa9795-b11ab8a5-b9ce00db-1e91af0f-bea0ff0f.jpg,test/p19/p19230933/s51680090/5faa9795-b11ab8a5-b9ce00db-1e91af0f-bea0ff0f.jpg,test," FINAL REPORT INDICATION: Patient with disseminated lung cancer with tachycardia status post placement of right-sided pleural drainage catheter. COMPARISON: Chest radiographs from ___ and ___. CTA of the chest from ___, taken approximately at the same time as this study. FINDINGS: Bedside AP radiograph of the chest demonstrates near-complete opacification of the right hemithorax with interval development of pneumothorax. The pigtail catheter appears to lie in the expected location of the pleural space. There is increase in the degree of rightward tracheal deviation. Diffuse left lung opacities consistent with disseminated tumor as seen on the CT of the chest obtained at the same time. There is no left-sided pneumothorax or effusion. IMPRESSION: 1. Development of pneumothorax without tension, after chest tube placement, better evaluated on the CT of the chest performed at the same time. 2. Opacification of the right hemithorax, when correlated with the CT findings, is mostly due to infiltration of airspaces with tumor as opposed to significant component of pleural fluid. " af66ec57-e264f9c7-00c6ac00-b542c093-672bbe7c.jpg,test/p10/p10404367/s51141931/af66ec57-e264f9c7-00c6ac00-b542c093-672bbe7c.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of B-cell lymphoma, on chemotherapy, now with fatigue and hallucinations. COMPARISON: Chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPHS: A venous catheter terminates in the lower superior vena cava. The cardiomediastinal and hilar contours are stable, with mild cardiomegaly. There is no longer a mild diffuse interstitial abnormality but persistent opacities are noted at the lung bases with reticulation; scarring or interstitial lung disease could be considered. IMPRESSION: No definite acute process. Findings raising concern for possible underlying mild interstitial disease at the lung bases versus persistent scarring or atelectasis. " 5d2168dc-28a848a6-f8a0737f-73694deb-322e1ca3.jpg,test/p16/p16830759/s58608220/5d2168dc-28a848a6-f8a0737f-73694deb-322e1ca3.jpg,test," FINAL REPORT AP CHEST, 11:47 P.M. ON ___ HISTORY: ___-year-old man postop day 3 liver and kidney transplant. Tube feedings coming out of the drainage tube. IMPRESSION: AP chest compared to ___: Mild atelectasis at the right lung base has been present since ___. Pulmonary vasculature is mildly engorged but there is no edema, pleural effusion or cardiomegaly. A right supraclavicular dialysis catheter ends in the low SVC, right jugular line tip is partially obscured. Drainage tube ends in the upper stomach and would need to be advanced 5 cm to move all the side ports beyond the GE junction, and a feeding tube ends in the region of the pylorus. " cf4509de-e07c9ef6-ac4ef196-5d471150-97723ba4.jpg,test/p16/p16508811/s53632136/cf4509de-e07c9ef6-ac4ef196-5d471150-97723ba4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CHF, Afib on Coumadin, AS/MS, COPD T1DM c/b ESRD s/p DDRT s/p graft failure with fever, cough, malaise // eval for infection, interval change eval for infection, interval change COMPARISON: FINDINGS: IMPRESSION: In comparison with the study ___, there again are patchy areas of increased opacification at both bases, very worrisome for bilateral pneumonia. The remainder of the examination is unchanged. " 28feb5f4-37336d44-5f444082-f55cf894-3deb1b86.jpg,test/p14/p14607686/s51308500/28feb5f4-37336d44-5f444082-f55cf894-3deb1b86.jpg,test," WET READ: ___ ___ 5:16 PM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with dyspnea // ? infiltrate TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear of focal consolidation or effusion. The cardiac silhouette is top normal in size. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 4ed5a64b-2ff4fd62-5b01c289-3d712488-edaa7242.jpg,test/p15/p15838432/s53896093/4ed5a64b-2ff4fd62-5b01c289-3d712488-edaa7242.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chills, vomiting. Hx of similar with PNA per pt. // infiltrate? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal in size, likely exaggerated by AP technique. No pulmonary edema is seen. Mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9cedb411-79b15a7c-1e61e7a5-53d7206c-dbd88dda.jpg,test/p18/p18651563/s59122167/9cedb411-79b15a7c-1e61e7a5-53d7206c-dbd88dda.jpg,test," FINAL REPORT INDICATION: ___F with cough and fever. COMPARISON: Multiple chest radiographs dating back to ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: Compared to the most recent prior radiograph on ___ there has been interval improvement in multifocal lung opacities. There remains increased opacification at the right lung base improved from the most recent prior, but more pronounced compared to the baseline radiograph from ___, possibly related to residual scarring in this region. There is no pleural effusion or pneumothorax. The heart is mildly enlarged. The mediastinal contours normal. IMPRESSION: Improved appearance of the chest compared to prior with residual opacity in the right lower lobe, possibly related to scarring or atelectasis in this region. " 2b447f2a-4ee88942-b22fc2c0-7b99b571-6db84c4e.jpg,test/p12/p12291041/s53978161/2b447f2a-4ee88942-b22fc2c0-7b99b571-6db84c4e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute onset hypoxia leading to intubation and placement of central line // Is the central line in the correct location? Is the central line in the correct location? COMPARISON: CHEST RADIOGRAPH ___:23. IMPRESSION: New right jugular line ends in the low SVC. Tip of the new endotracheal tube is less than 15 mm from the carina an should be withdrawn 2 cm. Transvenous right atrial biventricular leads in standard placements. Nasogastric tube ends in the distal stomach. Moderate cardiomegaly and mild pulmonary edema are unchanged. Pleural effusions small if any. No pneumothorax. " a536e4fe-1b034931-eb7454b5-307014d2-251d9ee5.jpg,test/p14/p14975402/s57315132/a536e4fe-1b034931-eb7454b5-307014d2-251d9ee5.jpg,test," FINAL REPORT HISTORY: Syncope. Evaluate for cardiomegaly. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " c6a54076-59e368e9-b86580df-04fc7440-4cf18b28.jpg,test/p11/p11258377/s50120302/c6a54076-59e368e9-b86580df-04fc7440-4cf18b28.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with new BIV pacemaker upgrade // evaluate for pneumothorax and lead placement evaluate for pneumothorax and lead placement IMPRESSION: In comparison with the study of ___, the pacer device remains in place and there is no evidence of pneumothorax. Little change in the appearance of the heart and lungs. " 77010c20-8fb83ca5-1413a1e6-d37310a9-8635a4e0.jpg,test/p12/p12579975/s55600884/77010c20-8fb83ca5-1413a1e6-d37310a9-8635a4e0.jpg,test," FINAL REPORT INDICATION: ___-year-old male, status post TKA, postop day 2, and fevers to 102.1. Question atelectasis versus infiltrate. COMPARISONS: Preop PA and lateral chest radiographs from ___. FINDINGS: Compared to prior radiographs, lung volumes are low. Retrocardiac opacification is likely atelectasis. There is no focal consolidation or pleural effusion. The cardiomediastinal silhouette is unremarkable. No acute skeletal abnormalities. IMPRESSION: No focal infiltrate. Retrocardiac opacity is likely atelectasis at the left lower lobe. " 552ba066-a3d66245-fbab2ff3-6a0cac63-465a489f.jpg,test/p12/p12032671/s53840852/552ba066-a3d66245-fbab2ff3-6a0cac63-465a489f.jpg,test," FINAL REPORT HISTORY: Right upper quadrant pain, question pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The hilar contours are unremarkable. No displaced fracture is seen. There is no evidence of free air underneath the right hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " 8fc927fb-dc95a195-40491187-794c9973-581859df.jpg,test/p15/p15154432/s51236817/8fc927fb-dc95a195-40491187-794c9973-581859df.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p ___ procedure for perforated diverticulitis c/b septic shock, SB necrosis s/p SB rsxn and multiple abd washoutis; acute respiratory failure s/p trach ___ // interval assessment IMPRESSION: As compared to prior radiograph of 1 day earlier, cardiomegaly and pulmonary vascular congestion persist. Bibasilar atelectasis has slightly improved on the right and worsened on the left, and a small left pleural effusion is a persistent finding. " a53a44fd-f150f026-d16289f0-ed3652cc-d3d36d75.jpg,test/p12/p12788432/s56832620/a53a44fd-f150f026-d16289f0-ed3652cc-d3d36d75.jpg,test," FINAL REPORT INDICATION: ___-year-old man, status post repair of type A aortic dissection with chest tubes removed, assess for changes. COMPARISONS: ___. FINDINGS: Endotracheal tube, nasogastric tube, mediastinal drains and Swan-Ganz catheter have been removed with right IJ sheath in unchanged position at the confluence of brachiocephalic veins. Sternal wires and surgical hardware, from ascending aortic replacement and aortic valve resuspension, are unchanged. Lung volumes remain low with increased left basal atelectasis and trace right effusion without pneumothorax. " fdd7bf87-1b036024-c2d9ba1f-a2aef5fb-09a1da30.jpg,test/p18/p18781799/s50219094/fdd7bf87-1b036024-c2d9ba1f-a2aef5fb-09a1da30.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with a history of lung cancer presenting with weakness. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. PET-CT from ___. FINDINGS: The lungs are clear. Widening of the upper mediastinum and the right hilum is consistent with the patient's known lymphadenopathy and lipomatosis is unchanged from prior study. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Right hilar and mediastinal lymphadenopathy, unchanged from prior studies. No evidence of focal airspace consolidation. " c963fac4-7f414f76-1fe5eb83-2bd75a14-f2dcd77e.jpg,test/p11/p11888614/s53769263/c963fac4-7f414f76-1fe5eb83-2bd75a14-f2dcd77e.jpg,test," FINAL REPORT PORTABLE CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Altered mental status, status post seizure, assess tube position. FINDINGS: Supine portable AP view of the chest was provided. There is an endotracheal tube which is seen terminating approximately 7.6 cm above the carina. An NG tube tip terminates in the left upper abdomen. There is mild prominence of the bronchovascular markings which could reflect technique though possibility of aspiration is not excluded. No definite pneumothorax or effusion is seen. Cardiomediastinal silhouette appears normal. No bony deformities are seen. IMPRESSION: Appropriately positioned ET and NG tubes. Mild bronchovascular prominence could reflect an element of aspiration. " 1d165dea-784e3351-f317ebb5-b57c8dd2-e6f6cf6f.jpg,test/p19/p19453522/s51397621/1d165dea-784e3351-f317ebb5-b57c8dd2-e6f6cf6f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pulmonary edema // ___ year old man with pulmonary edema ___ year old man with pulmonary edema COMPARISON: ___ IMPRESSION: There is interval development of right lower lobe and potentially right middle lobe collapse with small amount of pleural effusion. It is unclear if mucus plaque O central lesion were responsible for this change. Correlation with bronchoscopy is recommended Left lung is clear. Cardiomegaly is substantial. NOTIFICATION: Findings where described to Dr. ___ ___ the phone by Dr. ___ on ___ approximately at 13:14, ___ min after the findings were made. " 953f5249-2384b615-5a9652eb-b20b6619-80cca793.jpg,test/p12/p12028465/s59728794/953f5249-2384b615-5a9652eb-b20b6619-80cca793.jpg,test," FINAL REPORT INDICATION: ___-year-old with dyspnea. Please assess for pulmonary edema or pneumonia. TECHNIQUE: Single frontal radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Moderate cardiomegaly and mild to moderate pulmonary edema have progressed since ___. There is a small left pleural effusion. There is no pneumothorax, and no focal lung consolidation. IMPRESSION: Moderate cardiomegaly and mild pulmonary edema, progressed from ___. " 0fcc3218-84ffb292-62cdd2d9-222ae0d4-eeae1485.jpg,test/p10/p10781100/s54443128/0fcc3218-84ffb292-62cdd2d9-222ae0d4-eeae1485.jpg,test," FINAL REPORT HISTORY: Pneumonia. Evaluation for pulmonary edema. COMPARISON: ___ - ___. FINDINGS: AP and lateral chest radiographs again demonstrate left basilar consolidation, slightly improved from ___. In addition, there is bibasilar atelectasis. There is no pulmonary vascular congestion, widening of the vascular pedicle, or other evidence of pulmonary edema. The cardiomediastinal silhouette is stable. IMPRESSION: Left lower lobe pneumonia, improved from ___. No evidence of pulmonary edema. " 59b72555-220cd0eb-b5c21041-24c13c60-0fad3377.jpg,test/p19/p19417241/s50422657/59b72555-220cd0eb-b5c21041-24c13c60-0fad3377.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with intubated, OG tube // eval for ETT/OGT placement TECHNIQUE: Portable semi supine chest radiograph COMPARISON: ___ at 15:45. FINDINGS: Since the prior radiograph, there has been interval intubation with the endotracheal tube approximately 2 cm from the carina. The orogastric tube terminates in the stomach. There is significant cardiomegaly and calcification of the aortic arch and descending thoracic aorta. Pulmonary vascular congestion and interstitial abnormality, particularly at the right lung base, has progressed since the prior chest radiograph. No strong evidence for pneumonia. IMPRESSION: Satisfactory positioning of the endotracheal tube and orogastric tube, with interval increase in pulmonary vascular congestion since the prior radiograph, but no strong evidence for pneumonia. " 08f604aa-c3b644a5-9e05faeb-2e59c22d-a2cc86ca.jpg,test/p19/p19525927/s53309998/08f604aa-c3b644a5-9e05faeb-2e59c22d-a2cc86ca.jpg,test," FINAL REPORT INDICATION: Allergic cough. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest. The lungs are clear without evidence of consolidation. There is no pneumothorax. There is slight blunting of the left costophrenic angle seen on the lateral view that may represent pleural thickening. The cardiac, mediastinal, and hilar contours are normal. There is no pulmonary vascular congestion. IMPRESSION: No consolidation. Essentially normal radiographic examination of the chest. " 48061295-c552b8b6-a5af6558-0570c4e4-43141165.jpg,test/p19/p19314531/s56518674/48061295-c552b8b6-a5af6558-0570c4e4-43141165.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with COPD, asthma, tracheomalacia, SLE, presenting with dyspnea, diffuse pleuritic chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CT trachea ___ FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged, and the pulmonary vasculature is not engorged. Moderate to severe emphysema is again demonstrated within upper lobe predominance. Calcified left hilar lymph nodes and scattered calcified granulomas are again present compatible with prior granulomatous disease. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. Amorphous calcification projecting over the left medial upper hemithorax is unchanged. IMPRESSION: Emphysema. No acute cardiopulmonary process. " effb043c-f9798e59-039a5dff-284aa4b1-8bddb4fb.jpg,test/p16/p16006840/s53363295/effb043c-f9798e59-039a5dff-284aa4b1-8bddb4fb.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Increasing white cell count. AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are stable. There is a VP shunt projecting over the right hemithorax, terminating most likely in the left upper abdomen. Lungs are essentially clear, and there is no pleural effusion or pneumothorax. " 8342b21d-d50a5dfe-a3ff0ce9-4bf57f58-a5802c4a.jpg,test/p10/p10409913/s59875191/8342b21d-d50a5dfe-a3ff0ce9-4bf57f58-a5802c4a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___ and CTA chest from ___. CLINICAL HISTORY: Cough, question pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm seen. IMPRESSION: No acute findings in the chest. " 63985e9b-3f483ce1-c5be98ba-61e3668a-e39869a9.jpg,test/p15/p15835176/s50655959/63985e9b-3f483ce1-c5be98ba-61e3668a-e39869a9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pulmonary edema and cough // interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pleural effusions, right more than left, are unchanged in extent and severity. Cardiomegaly is also unchanged. There is increasing evidence of pulmonary edema, predominantly in the perihilar lung regions, associated to increasing areas of atelectasis at the lung bases. No pneumothorax. The right internal jugular vein catheter is unchanged. " 7fba9b99-60be338c-e101c1d1-4f85e1ef-35b18a2d.jpg,test/p10/p10529917/s51592203/7fba9b99-60be338c-e101c1d1-4f85e1ef-35b18a2d.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with shortness of breath and history of asthma. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation or effusion. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " ebeefa90-70dd937b-7c6aacda-5a2d53e2-72b4b5ba.jpg,test/p16/p16635089/s54471859/ebeefa90-70dd937b-7c6aacda-5a2d53e2-72b4b5ba.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) IN O.R. INDICATION: ___ year old woman with recent debridement of nec fasc in the left gluteal area. intubated, sedated. // post op CXR, intubated, lines post op CXR, intubated, lines IMPRESSION: In comparison with the study of ___, there has been placement of an endotracheal tube with its tip at the lower clavicular level, approximately 5.7 cm above the carina. Nasogastric tube extends well into the stomach am left IJ catheter tip is in the mid portion of the SVC. No evidence of acute pneumonia, vascular congestion, pleural effusion, or pneumothorax. " 3092667b-ddbcc8ac-0e8f29e1-a83a3d95-060cb1b6.jpg,test/p18/p18961109/s55204413/3092667b-ddbcc8ac-0e8f29e1-a83a3d95-060cb1b6.jpg,test," FINAL REPORT AP CHEST, 9:31 P.M. ON ___ HISTORY: ___-year-old woman with an elevated white count. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Lungs clear. Heart size normal. No appreciable pleural effusion. Shunt catheter tubing traverses the right neck, chest, and upper abdomen. There is discontinuity in the tubing at the level of the mandible. Findings were reported to the house officer who answered the page for Dr. ___ at 11:20 a.m., since the findings were recognized. " 218cdd79-d5cccb6b-90079f14-d96b3064-20e60cdf.jpg,test/p12/p12161901/s55474503/218cdd79-d5cccb6b-90079f14-d96b3064-20e60cdf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dropping HCT/ s/p CABG // eval for hemothorax IMPRESSION: Compared to ___, cardiomediastinal contours are stable on the postoperative. Bibasilar atelectasis is similar on the right and worse on the left. Small left pleural effusion persists, and there is no evidence of pneumothorax. " 1e4fc8e1-e9dbd0c4-1d24a0fb-ee35e62a-ac011f12.jpg,test/p15/p15845271/s52861334/1e4fc8e1-e9dbd0c4-1d24a0fb-ee35e62a-ac011f12.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Left anterior chest pain. COMPARISON: ___. FINDINGS: Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No displaced fracture is identified. IMPRESSION: No acute cardiopulmonary process. " c7832010-025065ee-123ced35-062ca269-a3a2bfc2.jpg,test/p19/p19026714/s55026832/c7832010-025065ee-123ced35-062ca269-a3a2bfc2.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Widespread consolidation in the right lung appears relatively similar to the prior study, except for more well-defined rounded lucencies within the consolidation in the right upper and mid lung regions. This could reflect areas of underlying emphysema or development of necrotizing pneumonia. Predominantly interstitial opacities in the left lung likely represent interstitial edema. Right pleural effusion is unchanged. " 77b52fd8-095b2243-26faaa7c-3fc06c95-43afa706.jpg,test/p11/p11884776/s51015062/77b52fd8-095b2243-26faaa7c-3fc06c95-43afa706.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with etoh intoxication, cough, and consolidation seen on CT abd/pelvis. // eval for pneumonia TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Patchy medial right lung base opacity is seen with consolidation better characterized on preceding CT earlier today. The left lung is clear. No large pleural effusion is seen. There is no pneumothorax. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Patchy medial right base opacity worrisome for pneumonia or aspiration. " c9ca2fa9-bfc6d25f-d0f131b5-31c5bbce-490e06c0.jpg,test/p14/p14437300/s54266710/c9ca2fa9-bfc6d25f-d0f131b5-31c5bbce-490e06c0.jpg,test," FINAL REPORT INDICATION: History of cough. Please let for pneumonia. TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. There is mild bibasilar atelectasis. There is no large pleural effusion or pneumothorax. Apparent leftward displacement of the trachea may be positional. The visualized osseous structures are unremarkable. IMPRESSION: No acute intrathoracic abnormalities identified. Apparent leftward displacement of the trachea is likely due to patient rotation, but correlation with physical exam findings may be helpful to exclude thyroid enlargement if warranted clinically. " 2d69f74e-36f8da3a-383dc92b-f51c09b0-a54d42e0.jpg,test/p12/p12135489/s59643204/2d69f74e-36f8da3a-383dc92b-f51c09b0-a54d42e0.jpg,test," FINAL REPORT HISTORY: Trauma, to assess for change in pneumothorax. FINDINGS: In comparison with the study of ___, the patient has taken a slightly better inspiration. There is similar or even increasing opacification at the left base, consistent with pleural effusion and underlying atelectasis. Cardiac silhouette remains at the upper limits of normal size, though there is no evidence of vascular congestion. " 8cd10792-b613b5e8-c809852f-1801986d-81ac4594.jpg,test/p12/p12278812/s56435493/8cd10792-b613b5e8-c809852f-1801986d-81ac4594.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old woman with a pacemaker and a brain tumor. Check lines and tubes. IMPRESSION: PA and lateral chest compared to ___: Aside from a small nodule in the right lung, at the level of the fourth anterior rib, which may have been present on ___, lungs are fully expanded and clear. Evaluation of the nodule would depend upon other clinical circumstances. The third rib anomaly, with expansion of the anterior cartilage is probably congenital. There is no pleural abnormality or evidence of central lymph node enlargement. Heart size normal. Atrioventricular pacer leads are unchanged in position, continuous from the left axillary generator. " 0b482f43-b2b6f7ea-1f2bfc86-2983d71f-15aa2ec6.jpg,test/p13/p13259221/s56255383/0b482f43-b2b6f7ea-1f2bfc86-2983d71f-15aa2ec6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old male with history of necrotizing pancreatitis complicated by pancreatic pseudocyst; evaluate for PICC position. TECHNIQUE: Single portable AP view radiograph of the chest from ___. COMPARISON: ___ and dating back to ___. FINDINGS: The tip of the left PICC line projects over the superior cavoatrial junction. There is no pneumothorax. There is new right lung base linear atelectasis with otherwise clear lungs. The heart and mediastinum are within normal limits despite the projection. Regional bones and soft tissues are unremarkable. IMPRESSION: Left PICC line in satisfactory position. New right lung base linear atelectasis with otherwise clear lungs. " 3a329b79-09b16182-97e3d04a-685f4395-9ffcb1b3.jpg,test/p11/p11503967/s51207003/3a329b79-09b16182-97e3d04a-685f4395-9ffcb1b3.jpg,test," FINAL REPORT HISTORY: Fever. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: The cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " bc01ac05-47758270-4233c95b-6313ff58-d3c7d744.jpg,test/p18/p18624255/s59842093/bc01ac05-47758270-4233c95b-6313ff58-d3c7d744.jpg,test," WET READ: ___ ___ ___ 8:09 AM New bilateral pulmonary alveolar opacities and increased interstitial lung markings, with persistent cardiomegaly, consistent with pulmonary edema and worsening heart failure. Followup to resolution is recommended following diuresis. WET READ VERSION #1 ___ ___ ___ 2:00 AM New bilateral pulmonary alveolar opacities and increased interstitial lung markings, with persistent cardiomegaly, consistent with pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with SOB. Evaluate for evidence of CHF. TECHNIQUE: Single portable upright view of the chest. COMPARISON: Chest radiograph from ___, ___, and ___. FINDINGS: Compared with the prior radiograph, there are new bilateral pulmonary alveolar opacities, most pronounced in the right lower lung, as well as increased interstitial lung markings, consistent with pulmonary edema. Small bilateral pleural effusions are also seen. Cardiomegaly is unchanged. Central venous catheter is also unchanged is position, with its tip at the level of the right ventricle. A large hiatal hernia is not as well seen as the prior study, but also present. IMPRESSION: Findings are most consistent with asymmetrical edema accompanied by bilateral pleural effusions. Considering the asymmetrical distribution, followup radiographs after diuresis may be helpful to exclude superimposed pneumonia in the right lung if warranted clinically. " 5caa2756-8660518d-37b18e70-58f632b3-f12ea93f.jpg,test/p13/p13747362/s50339701/5caa2756-8660518d-37b18e70-58f632b3-f12ea93f.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Portable upright chest view was compared with prior radiograph from ___. FINDINGS: Minimal right apical pneumothorax is persisting. Monitoring and supporting devices are in standard position. Bilateral lung opacities, likely due to a combination of pulmonary edema and pleural effusions, have improved. Bilateral subcutaneous emphysema is similar in appearance. The enlarged heart size and widened superior mediastinum have stable appearance since ___. " a9406b67-c1fbc0ec-fe16759e-9c35fc65-516562a4.jpg,test/p14/p14614404/s52104058/a9406b67-c1fbc0ec-fe16759e-9c35fc65-516562a4.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Rising white count. IMPRESSION: AP chest compared to ___: Previous pulmonary edema has cleared. Left lower lobe is now collapsed. Small-to-moderate left pleural effusion persists. In addition to fractures of the posterior aspects of left middle ribs, lateral fractures are now more obvious. ___, paged at 4:15 p.m. as soon as the findings were recognized, and I discussed the findings by telephone. " 97b93b07-93f91999-bd9bfcdd-2f03da55-b2615ba9.jpg,test/p13/p13780400/s50122951/97b93b07-93f91999-bd9bfcdd-2f03da55-b2615ba9.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fever cough // ?pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 3963a06e-683a5cf0-974dc296-ba6a89fb-60a1c404.jpg,test/p13/p13644218/s51958857/3963a06e-683a5cf0-974dc296-ba6a89fb-60a1c404.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with history of chest pain COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 3ae34505-09ffb124-9c5fe036-82b07f1e-8705cb06.jpg,test/p19/p19358609/s59338434/3ae34505-09ffb124-9c5fe036-82b07f1e-8705cb06.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with resp failure // intubated TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 1848b3fc-faa5b60e-9901f7b5-804fc8c1-02a75ea6.jpg,test/p18/p18523146/s51881692/1848b3fc-faa5b60e-9901f7b5-804fc8c1-02a75ea6.jpg,test," FINAL REPORT HISTORY: Cough, chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Hyperinflation of the lungs is present with flattening of the diaphragms suggestive of underlying COPD. The cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable. No pulmonary vascular engorgement is seen. Lungs are clear. No pleural effusion or pneumothorax is identified. There are mild degenerative changes in the thoracic spine. IMPRESSION: Hyperinflated lungs suggestive of underlying COPD. No acute cardiopulmonary abnormality. " 0f8ff02a-3a4fe485-29a6cd8c-2a623a58-5b1c3ba9.jpg,test/p17/p17100972/s56743026/0f8ff02a-3a4fe485-29a6cd8c-2a623a58-5b1c3ba9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with weakness and chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is mildly enlarged. Aortic knob calcifications are present. Mediastinal and hilar contours are unremarkable. Ill-defined nodular opacities are seen within the right upper lung field concerning for infection or aspiration. Patchy opacity is also noted within the left lung base which may reflect an additional site of infection. No pleural effusion, focal consolidation or pneumothorax is present there is no overt pulmonary edema identified. Remote bilateral rib fractures are present. There are no acute osseous abnormalities. IMPRESSION: Ill-defined nodular opacities in the right upper lung field are concerning for infection or aspiration. Additional patchy opacity in the left lung base may reflect an additional sites of infection or aspiration. " 0ddfef51-bbf871b3-cce5c8df-edcbe962-96ff28ab.jpg,test/p17/p17533744/s50478225/0ddfef51-bbf871b3-cce5c8df-edcbe962-96ff28ab.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___F with cholecystitis. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT from ___ and chest from ___. FINDINGS: As seen on prior chest radiograph, there is some tortuosity of the descending aorta. The cardiomediastinal and hilar contours are otherwise within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 14ab7e49-221c9d8e-eda44c7c-8aa25377-3b79a9cd.jpg,test/p13/p13767558/s54104371/14ab7e49-221c9d8e-eda44c7c-8aa25377-3b79a9cd.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia. No other parenchymal pathology. No pulmonary edema. No pleural effusions. Normal aspect of the cardiac silhouette. Sternal wires and clips after CABG. " 1ad6bdcc-2ff04387-c843aa10-43493169-7a9f56f4.jpg,test/p15/p15528887/s58780332/1ad6bdcc-2ff04387-c843aa10-43493169-7a9f56f4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with 2 weeks of cough // pneumonia pneumonia COMPARISON: There are no prior chest radiographs. IMPRESSION: Lungs are fully expanded and, aside from minimal linear scarring or atelectasis in the retro sternal lung, lungs are clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Thoracic scoliosis is mild. " f59c5cb6-9c2af67e-4146f956-5cfd0f3b-a77f35e8.jpg,test/p16/p16218486/s52433732/f59c5cb6-9c2af67e-4146f956-5cfd0f3b-a77f35e8.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with chronic kidney disease, on peritoneal dialysis with Clostridium difficile, on vancomycin, IV fluids administration. AP radiograph of the chest was compared to ___. Heart size and mediastinum are stable. Elevated right hemidiaphragm is unchanged. Lungs are essentially clear, and there is no appreciable pleural effusion or pneumothorax seen. " c9200548-9cbb3199-272f5c64-2ca337ea-de40f211.jpg,test/p11/p11303447/s53884863/c9200548-9cbb3199-272f5c64-2ca337ea-de40f211.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain for 10 days. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and a lateral chest radiograph demonstrates well expanded and clear lungs bilaterally. No focal opacities identified. Mediastinal and hilar contours are within normal limits. Osseous structures are without acute abnormality. No evidence of pneumothorax or pleural effusion. IMPRESSION: No acute intrathoracic abnormality. " 0e0ba8de-e4aec46a-90d43937-fbdd1ef8-e78c4812.jpg,test/p12/p12855476/s57984037/0e0ba8de-e4aec46a-90d43937-fbdd1ef8-e78c4812.jpg,test," FINAL REPORT HISTORY: Recent anterior cervical surgery for infection, increasing secretions. Evaluate for pulmonary process. CHEST, TWO VIEWS A left subclavian PIC line tip is poorly visualized, but probably overlies the upper/mid SVC, similar to the prior study. Compared with ___, there is new prominent opacity at both lung bases. This seems to represent a combination of bibasilar collapse and/or consolidation, probably with an associated small amount of pleural fluid on both sides. There is upper zone redistribution and vascular plethora, suggesting early CHF. The heart is mildly enlarged and is probably more pronounced than on the prior film from ___. Again noted is hardware overlying the cervical spine, not fully evaluated. Rounded structure overlying the left upper quadrant could represent a G-tube, best correlated with known clinical history. IMPRESSION: 1. New bibasilar opacities, likely a combination of bibasilar collapse and/or consolidation and small effusions. 2. Mild cardiomegaly, probably increased. 3. Upper zone redistribution and vascular plethora, suggestive of early CHF. " 5e1207f1-484aad07-491cd0d4-2b517891-92ce185f.jpg,test/p12/p12829950/s55449324/5e1207f1-484aad07-491cd0d4-2b517891-92ce185f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever, leukocytosis of unclear etiology // Any interval change or e/o PNA? Any interval change or e/o PNA? IMPRESSION: In comparison with the study of ___, there has been some re-expansion of the left lower lobe and lingula with improved visualization of the left hemidiaphragmatic contour and sharp visualization of the left heart border. . Mild atelectatic changes are again seen in this region. Otherwise, little overall change. Small residual left effusion. " 9a6f96af-f983d37d-6f200830-50eedbcf-79ead809.jpg,test/p15/p15199651/s53797525/9a6f96af-f983d37d-6f200830-50eedbcf-79ead809.jpg,test," WET READ: ___ ___ ___ 5:03 PM The thoracic aorta is tortuous. Platelike atelectasis is noted in the left midlung. Atelectasis is noted at the lung bases bilaterally. No evidence of pneumonia. Heart size is normal. A right IJ line ends in the mid SVC. A right chest port ends in the low SVC. A surgical drain projects over the right upper quadrant. WET READ VERSION #1 ___ ___ ___ 4:54 PM The thoracic aorta is tortuous. Platelike atelectasis is noted in the left midlung. Atelectasis is noted at the lung bases bilaterally. No evidence of pneumonia. Heart size is normal. A right IJ line ends in the mid SVC. A right chest port ends in the low SVC. A surgical drain projects over the right upper quadrant. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ T3N0 rectal cancer metastatic to liver (seg VI) s/p LAR ___ FOLFIRI here for exploratory laparotomy, R hepatic lobectomy, CCY // assess for pneumonia assess for pneumonia IMPRESSION: In comparison with the study of ___, there is a right IJ catheter extending to the mid portion of the SVC a right subclavian PICC line that extends to the cavoatrial junction. Increased opacification at the right base is consistent with pleural fluid and substantial volume loss in the right lower and possibly right middle lobes. Streaks of platelike atelectasis are seen at the left base. No definite vascular congestion. " 74d474a2-ea81c5d8-3219827f-739f7367-9e2580ee.jpg,test/p15/p15485853/s51794380/74d474a2-ea81c5d8-3219827f-739f7367-9e2580ee.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after tracheoplasty Portable AP radiograph of the chest was reviewed in comparison to ___. Chest tubes on the right, ET tube and NG tube are in unchanged position. Subcutaneous air within the right chest wall has decreased. Small amount of pleural effusion has decreased, but substantial amount of pleural effusion is still present. No mediastinal change including the widening of the mediastinum demonstrated. " 9606f889-f0f4f567-e9487c38-fcb3ddad-8095b8b4.jpg,test/p14/p14726463/s55756917/9606f889-f0f4f567-e9487c38-fcb3ddad-8095b8b4.jpg,test," FINAL REPORT AP CHEST, 4:40 A.M., ___ HISTORY: ___-year-old woman, intubated after a seizure. IMPRESSION: AP chest compared to ___: Lung volumes are appreciably lower. Increase in opacification in the left lung is attributable to very mild edema, but on the right the change is more pronounced with a more nodular component which suggests developing aspiration pneumonia. The endotracheal tube ends above the upper margin of the clavicles, no less than 7 cm from the carina and it should be advanced 2-3 cm for more secured seating. Nasogastric tube is coiled in the stomach. The heart is mildly enlarged. There is no pneumothorax or appreciable pleural effusion. Dr. ___ ___ I discussed these findings by telephone at 11:02 a.m., one minute following the recognition of the radiologic findings. " de049a0a-6fd35140-4f0b7d9a-1e401a22-5db2fcd9.jpg,test/p11/p11868667/s53513976/de049a0a-6fd35140-4f0b7d9a-1e401a22-5db2fcd9.jpg,test," FINAL REPORT HISTORY: Postoperative. FINDINGS: In comparison with the study of ___, there is little interval change. Continued enlargement of the cardiac silhouette with dual-channel pacer in place. No congestive failure or acute pneumonia. " 8c41ca6d-adebfb0a-0dc8a021-a6326ebf-17f919a4.jpg,test/p11/p11861017/s50754010/8c41ca6d-adebfb0a-0dc8a021-a6326ebf-17f919a4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with sdh*** WARNING *** Multiple patients with same last name! // acute prpocess . History provided for head CT also ordered today refers to SDH. COMPARISON: None. FINDINGS: The distal tip of the ET tube is not well delineated due to overlying sternal wires, but likely lies approximately 7.3 cm above the carina, just below the medial clavicular heads on this lordotic view. NG tube tip extends beneath the diaphragm and overlies the upper stomach. If a side-port is present, it does not clearly extend beyond the GE junction. Heart is not enlarged. Sternotomy wires are noted. The aorta is calcified and slightly unfolded. No CHF, focal infiltrate or effusion is identified. No pneumothorax detected. IMPRESSION: Lines and tubes as described. If the NG tube has side-port, it does not clearly extend distal to the GE junction. No acute pulmonary process identified. " e882c58c-f7a91dc1-7baaf103-cedf4c00-d41e2bb1.jpg,test/p15/p15439394/s50517446/e882c58c-f7a91dc1-7baaf103-cedf4c00-d41e2bb1.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with cough and rales in right axilla, evaluate for possible pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding chest examination of ___. There is evidence of moderate cardiac enlargement and the thoracic aorta is moderately elongated and shows calcium deposits in the wall. No local contour abnormalities are identified. The pulmonary vasculature demonstrates an upper zone re-distribution pattern and there are increased interstitial structures on both bases. The lateral and posterior pleural sinuses are free from any fluid accumulation. Acute discrete parenchymal infiltrates of pneumonia appearance are not seen. On the preceding chest examination of ___, patient had similar findings. It was at that time interpreted as probably being in pulmonary vascular congestion whereas pneumonic infiltrates were not seen. Findings on the present chest examination are very similar to what existed before and suggest the presence of probably idiopathic pulmonary fibrosis in the lung bases. No new parenchymal infiltrates are seen. As on the previous examination, there is evidence of a left-sided shoulder arthrodesis, unchanged. Our records include a previous chest CT of ___. The report at that time excluded pulmonary emboli, observed bilateral ground-glass opacities most severe on the lung bases, evidence of moderate collapse of the left mainstem bronchus compatible with bronchomalacia. IMPRESSION: No evidence of new parenchymal infiltrates indicative of pneumonia. " 8f39085e-d69cd8d4-40455c20-c5af33af-364056fc.jpg,test/p14/p14213883/s51214797/8f39085e-d69cd8d4-40455c20-c5af33af-364056fc.jpg,test," FINAL REPORT INDICATION: ___M with positive blood cultures // R/O Pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ ___, chest CT ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pneumothorax or pleural effusions. A lateral pleural based opacity at the right lung base corresponds to increase in the subpleural fat as seen on prior CT. There is no new focal consolidation concerning for pneumonia. Right basilar atelectasis is also again seen. The upper abdomen is unremarkable. IMPRESSION: No focal consolidation concerning for pneumonia. " 7611bd7a-b3ea3212-f6499326-9407db68-fa710a55.jpg,test/p14/p14505714/s56305231/7611bd7a-b3ea3212-f6499326-9407db68-fa710a55.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new fever/wbc // new fever IMPRESSION: As compared to ___ radiograph, lungs are clear with no new areas of consolidation to suggest the presence of pneumonia. " 9c702e07-0a81a1a3-af82d42d-c6b2f1b6-263047a4.jpg,test/p10/p10504635/s53213364/9c702e07-0a81a1a3-af82d42d-c6b2f1b6-263047a4.jpg,test," FINAL REPORT HISTORY: ___-year-old male with AML status post allogenic stem cell transplant. Assess for pneumonia. COMPARISON: Chest radiograph from ___ and chest CT from ___. PA AND LATERAL CHEST RADIOGRAPHS: A left approach central venous catheter terminates in the lower SVC, unchanged from prior. There has been interval removal of a right PICC. Consolidation seen in the left lower lobe on recent chest CT from six days prior, may correspond to a subtle opacity seen on the current radiograph. The remainder of the lungs appear clear. There is no pneumothorax. No pulmonary edema or large pleural effusions are evident. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: Subtle left basilar opacity may correspond to findings on recent chest CT. No new opacities. " d4264653-85fba24a-a9df5948-7366c2c2-80ed6e24.jpg,test/p11/p11084536/s52651174/d4264653-85fba24a-a9df5948-7366c2c2-80ed6e24.jpg,test," FINAL REPORT HISTORY: DKA,evaluate for infection. CHEST, SINGLE AP PORTABLE VIEW. No previous chest x-rays on PACS record for comparison. The heart is not enlarged. There is no CHF, focal consolidation, or effusion. Cardiomediastinal silhouette is within normal limits for technique. " 367ba108-3c5d2fcf-d577d108-6b63e5ec-83da8730.jpg,test/p15/p15161526/s53678161/367ba108-3c5d2fcf-d577d108-6b63e5ec-83da8730.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath. Evaluate for pneumonia or CHF. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are clear without focal or diffuse abnormality. The pulmonary vasculature is unremarkable. No pleural effusion or pneumothorax. The osseous structures are unremarkable. No radiopaque foreign body. IMPRESSION: No evidence of acute cardiopulmonary process. " 4b7e3b02-9922ce20-7a275e4a-e86936bc-c05dd048.jpg,test/p17/p17402090/s54888699/4b7e3b02-9922ce20-7a275e4a-e86936bc-c05dd048.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD s/p RENEW trial and coil placement, r/o PTX. // ___ year old woman with COPD s/p RENEW trial and coil placement, r/o PTX. ___ year old woman with COPD s/p RENEW trial and coil placement, r/o PTX. IMPRESSION: Unchanged position of the right-sided coils. Signs of overinflation are stable. No pleural effusions. No pneumonia, no pulmonary edema. " 9dfb2359-8db9efc0-504e1748-1724c9e6-017313fd.jpg,test/p11/p11740056/s51507105/9dfb2359-8db9efc0-504e1748-1724c9e6-017313fd.jpg,test," FINAL REPORT HISTORY: History smoking, persistent cough. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " b765e218-7756cf2c-dcac958d-ebd35ee3-4eae8ff6.jpg,test/p11/p11593760/s57924493/b765e218-7756cf2c-dcac958d-ebd35ee3-4eae8ff6.jpg,test," FINAL REPORT HISTORY: Vomiting and diarrhea x 4 days. Transaminitis, verify port placement. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___ chest x-ray from ___. A right-sided indwelling catheter is present. Tip is partially obscured by pacemaker leads, but appears to overlie the mid SVC. No pneumothorax is detected. A left-sided pacemaker is present, with lead tips over the right atrium and right ventricle. There are low inspiratory volumes. There is upper zone re-distribution, without overt CHF. The heart is not enlarged. The aorta is calcified. The right hemidiaphragm is eventrated. There is some subsegmental atelectasis or scarring in the right cardiophrenic region, unchanged compared with ___. A small area of lobulated soft tissue density abuts the left chest wall inferiorly, new compared with the ___ CXR, and may represent some loculated pleural fluid. Several small opacities project over both lower lungs -- these may represent calcifications within the cartilaginous portions of the ribs, anteriorly. Small density over the right upper quadrant could represent either a calcification or cholecystectomy clips. No free air is seen beneath the diaphragm. IMPRESSION: 1) Indwelling catheter tip over mid-SVC. 2) Stable opacity in right cardiophrenic region, ?atelectasis/scarring. 3) Scattered small densities at both lung bases, not fully characterized, ? calcified nodules. 4) Pleural thickening and/or fluid at left chest wall inferiorly. 5) No focal consolidation to confirm the presence of an aspiration pneumonitis. " b3b213ad-7079d736-aa2e6e83-845d601f-997299db.jpg,test/p15/p15438558/s56566403/b3b213ad-7079d736-aa2e6e83-845d601f-997299db.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough // cough, right midfield ronchi TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: A left chest wall AICD pacemaker is in unchanged position with leads in the expected location of the right atrium, right ventricle and coronary sinus normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute process. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:04 AM, 5 minutes after discovery of the findings. " 381b7202-28068f82-89956381-d3e76a5e-0f62ea6f.jpg,test/p11/p11494804/s55558656/381b7202-28068f82-89956381-d3e76a5e-0f62ea6f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with fevers, s/p central line placement // Please confirm placement of central line TECHNIQUE: Single frontal view of the chest COMPARISON: ___ at 07:26 FINDINGS: There has been interval placement of a right internal jugular central venous catheter, terminating at the cavoatrial junction, without evidence of pneumothorax. Lung volumes remain low and are without focal consolidation. Previously seen right midline is no longer seen and may have been removed in the interval. Cardiac and mediastinal silhouettes are stable. Right upper quadrant biliary stents are noted. IMPRESSION: Interval placement a right internal jugular central venous catheter terminating at the cavoatrial junction without evidence of pneumothorax. " 2922c490-652530fc-dd01428f-8bfef81d-d0b2e521.jpg,test/p13/p13204581/s54161075/2922c490-652530fc-dd01428f-8bfef81d-d0b2e521.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/ esophageal adeno CA s/p esophagectomy ___ // interval change from prior day CXR at ___-0600h ?CXR ABNORMALITIES IMPRESSION: Compared to chest radiographs ___ through ___. Mild bibasilar atelectasis unchanged. Small right pleural effusion has increased, visible at the apex. No pneumothorax. Normal postoperative cardiomediastinal silhouette. Mild cardiomegaly unchanged. " 49d5c433-1f63df75-aa22694c-c8e8079d-d23cdaa9.jpg,test/p19/p19565388/s58520961/49d5c433-1f63df75-aa22694c-c8e8079d-d23cdaa9.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Suspicious lung consolidation with VAP in a ___-year-old woman. TECHNIQUE: Portable semi-erect chest view was read in comparison with prior chest radiographs, with the most recent from ___ acquired approximately 24 hours apart. FINDINGS: Increased retrocardiac density and the left lower lung opacity, which likely represents a combination of atelectasis and/or consolidation has minimally worsened since ___. On single frontal view, if any of this represents infection cannot be ruled out and needs further clinical correlation. Right lung is clear. A right internal jugular line sheath ends at upper SVC. Heart size is mild-to-moderately enlarged and unchanged. Mediastinal and hilar contours are unremarkable. " 4a787b34-4cd061ec-ffcc9e1c-d28dac54-65723bbd.jpg,test/p13/p13417577/s52756007/4a787b34-4cd061ec-ffcc9e1c-d28dac54-65723bbd.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with fever, hypotension // Eval for acute process COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Suture material is noted projecting over the left upper lung as on prior compatible with prior resection. There is focal opacity in the right lower lobe and left mid lung, could represent pneumonia though follow-up to resolution advised. There is a retrocardiac opacity containing a fluid level most compatible with a hiatal hernia. No large effusion or pneumothorax. Cardiomediastinal silhouette is unchanged. Bony structures are intact. IMPRESSION: Right lower and left mid lung opacities, concerning for pneumonia, though follow-up to resolution to exclude underlying mass. " 42f7b0a2-64a17112-84691869-3262696e-897bbaa5.jpg,test/p14/p14648099/s51262802/42f7b0a2-64a17112-84691869-3262696e-897bbaa5.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Resection of spinal cord tumor at T11. The patient is rotated. This limits the evaluation of this study. Allowing this limitation cardiac size is normal. The aorta is very tortuous. Coarse calcifications projecting in the right lower hemithorax could correspond to calcified pleural plaques. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " eab309d2-57a9057a-f748171b-cf387e13-d9aa7733.jpg,test/p10/p10799304/s59378105/eab309d2-57a9057a-f748171b-cf387e13-d9aa7733.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post spinal surgery who now presents for evaluation of a new oxygen requirement. COMPARISONS: Chest radiographs from ___, ___ and CT torso from ___. TECHNIQUE: Single AP portable radiograph of the chest. FINDINGS: There has been significant interval development of a large right-sided pleural effusion layering along the right lateral pleural surface. There also appears to be increased opacification of the right lung which may be secondary to layering fluid. In the context of the increased opacification of the right lung, a new focal consolidation cannot be excluded. The left lung also demonstrates increased peripheral opacities which may be secondary to atelectasis given their development in the last three days, however an infectious etiology cannot be ruled out. The left lung volume is low. The heart size is unchanged. There is no pneumothorax. IMPRESSION: 1. Significant interval development of a large layering right-sided pleural effusion. In the context of the background opacification of the right lung, any focal consolidation of infectious etiology or otherwise cannot be ruled out. 2. Interval development of peripheral left mid-lung focal opacities. This may be secondary to atelectasis; however, again a left-sided focal infectious consolidation cannot be ruled out. These findings were discussed with Dr. ___ at 10:30am by Dr. ___ ___ by telephone on the day of the exam. " b117cc5a-3150e7c7-6027f2fc-6b816dfe-37a9c6c0.jpg,test/p17/p17964176/s58103470/b117cc5a-3150e7c7-6027f2fc-6b816dfe-37a9c6c0.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recurrent ovarian carcinoma, questionable pulmonary edema. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. At the bases of the lateral aspects of the left lung, a pleural scar with subsequent thickening is seen. No larger pleural effusions are noted. Moderate cardiomegaly, no pulmonary edema. No focal parenchymal opacities suggesting pneumonia. Small calcified granulomas in the right upper lobe. No evidence of mediastinal adenopathy. " 9cd21754-410b82ff-8d572d87-02d6755d-19232617.jpg,test/p14/p14244279/s59865771/9cd21754-410b82ff-8d572d87-02d6755d-19232617.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with strong cardiac hx w/ SSCP since ___ this AM // eval ? edema, mediastinal abnormalities TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Stable chronic blunting of the right costophrenic angle most likely reflects pleural thickening. No large pleural effusion is seen. There is no pulmonary edema. No pneumothorax is seen. Subtle haziness over the lateral right mid chest may be due to overlying soft tissue. No definite focal consolidation is seen. The cardiac and mediastinal silhouettes are stable. " ac5915ae-298d4d3a-b22361ae-a2feace7-d0afe444.jpg,test/p14/p14990907/s50478740/ac5915ae-298d4d3a-b22361ae-a2feace7-d0afe444.jpg,test," FINAL REPORT INDICATION: Evaluate pacemaker placement. COMPARISON: Chest radiograph, ___. FINDINGS: There has been interval placement of a left single-lead pacemaker with lead terminating in the right ventricle. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. There is no pulmonary edema or focal consolidation concerning for pneumonia. Redemonstrated are median sternotomy wires. IMPRESSION: Uncomplicated placement of a single-lead pacemaker terminating in the right ventricle. " b065a5c4-6d60c937-997c1b1e-1352e7e1-827f6385.jpg,test/p17/p17946205/s56213886/b065a5c4-6d60c937-997c1b1e-1352e7e1-827f6385.jpg,test," FINAL REPORT INDICATION: Chest pain, fever. Evaluate for cardiopulmonary disease, infiltrate. COMPARISON: Chest radiographs ___, ___, ___ and ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are normally expanded and clear. The heart is top normal but unchanged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Mild rightward curvature of the thoracic spine is unchanged. IMPRESSION: No acute cardiopulmonary abnormality. " 44c712cf-54ccf565-9e471252-af2b7045-cdaeca74.jpg,test/p12/p12784119/s50370229/44c712cf-54ccf565-9e471252-af2b7045-cdaeca74.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with picc. R power picc 44cm. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, and CT chest from ___. FINDINGS: There has been interval improvement in the right upper lobe opacity and right pleural effusion. There is little change in the left pleural effusion. The left pigtail catheter has been removed. Interval placement of a right PICC line demonstrates its tip at the cavoatrial junction. There is no pneumothorax. IMPRESSION: 1. Right PICC line tip is at the cavoatrial junction. 2. Interval improvement of right upper lobe opacity and right pleural effusion, with interval removal of the left pigtail catheter. " d78df19a-5a5c1a8d-decc4093-8b499382-184a160b.jpg,test/p14/p14323599/s58334221/d78df19a-5a5c1a8d-decc4093-8b499382-184a160b.jpg,test," WET READ: ___ ___ ___ 1:49 PM Nodular opacity on lateral in infrahilar region, question atelectasis, pneumonia or lower airway inflammation; possibly true pulmonary nodule, however. Suggest short-term follow-up radiographs to assess for clearance, or chest CT. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPHS HISTORY: Nausea and vomiting. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. On the lateral view, there is a prominent focal infrahilar opacity that has a somewhat oval nodular appearance. It may coincide with patchy streaky left lower lobe opacities and a lingular opacity suggesting minor atelectasis or scarring, but perhaps more likely correlates with streaky right infrahilar opacification. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. IMPRESSION: Nodular infrahilar opacity, which may correspond to streaky right infrahilar opacities. This appearance may be nodular appearance of the lower airway inflammation, infection, or even pneumonia. However, a true pulmonary nodule cannot be excluded. Depending on clinical circumstances, either short-term followup radiographs are recommended in order to see whether it persists or alternatively chest CT could be considered. " 21183560-29d98466-bf39ceb0-74e98ba8-20d379bf.jpg,test/p18/p18520946/s54816933/21183560-29d98466-bf39ceb0-74e98ba8-20d379bf.jpg,test," FINAL REPORT INDICATION: ___-year-old man with pleuritic left-sided chest pain. COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Linear left basal atelectasis is seen. Additionally, there is an 11 mm round left apical nodular opacity, may represent a pulmonary nodule or bone island. Apical lordotic views are recommended for further assessment. " a2d4861c-30b5f1ec-72cb4b01-8a9b0e85-ea5fd98b.jpg,test/p18/p18485280/s57981281/a2d4861c-30b5f1ec-72cb4b01-8a9b0e85-ea5fd98b.jpg,test," WET READ: ___ ___ ___ 7:27 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with chest pain // Eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The patient is status post median sternotomy with wires intact. The aorta is tortuous, unchanged from multiple priors. Multiple mediastinal clips from prior CABG are unchanged. There is likely mild volume loss of the medial in the left lower lobe, unchanged from prior. The lungs are otherwise clear. IMPRESSION: No acute cardiopulmonary abnormality. " f2f65820-670a9609-f01001a5-b2312875-fc78b51d.jpg,test/p15/p15248985/s58615432/f2f65820-670a9609-f01001a5-b2312875-fc78b51d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: R BASILIC PICC LINE IMPRESSION: In comparison with the study of ___, the left subclavian catheter is been removed and replaced with a right subclavian catheter, which extends to the mid to lower portion of the SVC. Bilateral patchy parenchymal opacifications are again seen in the lungs bilaterally. The appearance is consistent with an infectious process. If there is an appropriate heart murmur, echocardiography could be obtained to search for vegetations leading to septic emboli. " a071069e-28ffe429-6a135cc1-9fb8554d-3c5dc3c8.jpg,test/p16/p16507681/s53976226/a071069e-28ffe429-6a135cc1-9fb8554d-3c5dc3c8.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___ and a chest radiograph from ___. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. The heart is top normal in size and the aorta is unfolded. There is no focal consolidation to suggest pneumonia. No signs of CHF, pneumothorax or pleural effusion. The bony structures are intact. IMPRESSION: No acute findings in the chest. Please refer to subsequent CTA chest for further details. " fa066cdb-c91db436-cd2e7dd6-395aefaf-3f3fc571.jpg,test/p10/p10735932/s51494483/fa066cdb-c91db436-cd2e7dd6-395aefaf-3f3fc571.jpg,test," FINAL REPORT HISTORY: Pre-kidney transplant. Evaluate for infection or malignancy. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate clear lungs. The cardiac and mediastinal contours are normal. No pleural abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 4062259b-d55541cc-d1453d84-c8dfb697-3a0b0201.jpg,test/p18/p18009599/s59742391/4062259b-d55541cc-d1453d84-c8dfb697-3a0b0201.jpg,test," FINAL REPORT HISTORY: AAA repair and graft, now with worsening cough and intermittent fever, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. Mild bibasilar atelectatic changes are again seen. No definite discrete consolidation. " a69bfb99-6db10b12-ba4c0c04-51f5d6ea-ecddb834.jpg,test/p15/p15338518/s50410691/a69bfb99-6db10b12-ba4c0c04-51f5d6ea-ecddb834.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Single semi-erect portable radiograph of the chest was compared with prior study from ___. FINDINGS: The newly placed Dobhoff tube reaches till the lower esophagus and loops back all the way up to the cervical esophagus. Consider repositioning the Dobhoff tube. Since ___, there are no relevant changes in the lungs. Minimal left lower lung atelectasis has improved. No new lung opacities concerning for pneumonia. Top normal heart size, mediastinal and hilar contours are stable in appearance. No pleural effusion. Findings were discussed with Dr. ___ on ___ at 5:23 p.m. " ab93ab78-9909e81d-a18027c0-91eb059a-da1a2bf3.jpg,test/p19/p19243413/s50823748/ab93ab78-9909e81d-a18027c0-91eb059a-da1a2bf3.jpg,test," WET READ: ___ ___ ___ 5:59 PM Increasing right middle lobe opacities as compared to the prior study concerning for early infection. Subclavian line terminates in the high SVC. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old man with AML. Febrile. Assess possible pneumonia. COMPARISON: ___ through ___. FINDINGS: IMPRESSION: Lungs clear. Heart size normal. No evidence of central lymph node enlargement. No findings to suggest pneumonia. The left PICC line ends in the mid SVC. " ff7ef531-7a08169a-83a30173-c5a86435-20c429c9.jpg,test/p15/p15240073/s52639799/ff7ef531-7a08169a-83a30173-c5a86435-20c429c9.jpg,test," FINAL REPORT HISTORY: Fevers. Rule out pneumonia. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: There are low lung volumes, which accentuate the cardiac silhouette and bronchovascular structures. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 783b6c08-62259c37-5e80f49d-7dbef040-b0518c4d.jpg,test/p17/p17956682/s55253077/783b6c08-62259c37-5e80f49d-7dbef040-b0518c4d.jpg,test," FINAL REPORT HISTORY: Chest pain. Question pneumonia. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 16d912d7-efa308b5-3dea18ee-8969fec3-0b9ca49b.jpg,test/p10/p10390732/s52784646/16d912d7-efa308b5-3dea18ee-8969fec3-0b9ca49b.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with history of pulmonary edema and loculated pleural effusion. Followup examination. Evaluate for persistent changes. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study ___ ___. Status post sternotomy and evidence of both aortic and mitral valve replacements appear unchanged. Heart has not increased in size and the pulmonary vasculature is not congested. Pleural scars with mild elevation of left-sided diaphragm, unchanged. No evidence of pulmonary congestion or acute infiltrates. Comparison is extended to the preoperative chest examination of ___ and there is no evidence of any significant postoperative change with regard to heart size, pulmonary congestion and pleural scars. " 24b33ac5-c1ca69b1-2de94cb7-5ea4e090-b3ea1ac9.jpg,test/p10/p10535715/s59613325/24b33ac5-c1ca69b1-2de94cb7-5ea4e090-b3ea1ac9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with h/o malignancy, pHTN, now with acute SOB after receiving IVF // flash pulm edema? TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are unchanged compared to the prior study. The cardiomediastinal contour is unchanged with persistent mild cardiomegaly. Mild prominence of the pulmonary vasculature is again noted however there is no frank pulmonary edema. No pleural effusions seen. No pneumothorax seen. Left lower lobe streaky opacities appear improved compared to the prior study. IMPRESSION: Findings consistent with mild congestive heart failure but no frank pulmonary edema is seen. " e148fd40-62924441-38e1bf6c-8ace8e79-4de9b759.jpg,test/p19/p19305367/s58825057/e148fd40-62924441-38e1bf6c-8ace8e79-4de9b759.jpg,test," FINAL REPORT HISTORY: Palpitations evaluate for infiltrate. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest demonstrate no acute cardiopulmonary process. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " d637d917-c96ecff7-4e071667-3971f3c1-cb35620c.jpg,test/p18/p18699523/s57538081/d637d917-c96ecff7-4e071667-3971f3c1-cb35620c.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old woman with picc // s/p right 35cm bard dl non heparin picc s/p right 35cm bard dl non heparin picc IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the heart and lungs, there has been placement of a right subclavian PICC line that extends well into the right atrium. If the desired position of the tip is at or just above the cavoatrial junction, it could be pulled back about 3 cm. " 9b27bd3e-0d215cda-3b93d89b-22ecc854-b66f92db.jpg,test/p13/p13999026/s56459802/9b27bd3e-0d215cda-3b93d89b-22ecc854-b66f92db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p liver transplant. // Interval change? Please perform at ___ on ___ Interval change? Please perform at ___ on ___ IMPRESSION: Comparison to ___. Stable position of the right internal jugular vein catheter. Stable small bilateral pleural effusions. Right upper lobe has slightly decreased in extent and severity. No new opacities are visualized. Borderline size of the cardiac silhouette is stable. " 656a8d7a-caddee3f-c9fade96-9aa09292-2476c93b.jpg,test/p18/p18439312/s59792709/656a8d7a-caddee3f-c9fade96-9aa09292-2476c93b.jpg,test," FINAL REPORT REASON FOR EXAM: Status post MI. Comparison is made with prior study, ___. There are low lung volumes. Moderate cardiomegaly and widened mediastinum are unchanged. Moderate pulmonary edema has improved. Moderate right pleural effusion with adjacent atelectasis is grossly unchanged. Left lower lobe atelectasis has increased. Lines and tubes are in unchanged and standard position. " a192a33d-e3c3c4e1-f79d3186-693c07b5-00de50a5.jpg,test/p17/p17137598/s55347097/a192a33d-e3c3c4e1-f79d3186-693c07b5-00de50a5.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with productive cough, recent fever // ? pneumonia TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There is persistent elevation of the right hemidiaphragm. Mild left basilar atelectasis/ scarring persists without definite focal consolidation seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Persistent anterior wedging of a mid thoracic vertebral body is noted. IMPRESSION: Persistently elevated right hemidiaphragm. Left base atelectasis/ scarring. " 5aa3aa15-7f452fe0-bb59d68a-f99d7259-e95de3f8.jpg,test/p13/p13509135/s54789104/5aa3aa15-7f452fe0-bb59d68a-f99d7259-e95de3f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Clinical symptoms and signs of congestive heart failure FINDINGS: As compared to ___ chest radiograph, pulmonary vascular congestion is new with associated peribronchial cuffing. A new area of left perihilar airspace opacification has developed. Moderate to large right pleural effusion has increased in size with adjacent right middle and lower lung atelectasis and or consolidation. Small left pleural effusion is apparently new. IMPRESSION: New left perihilar airspace opacity which may reflect asymmetrical pulmonary edema or secondary process such as aspiration or infectious pneumonia. Enlarging right pleural effusion. " 45baeab6-ab27bc8e-00ac50ac-d6aa4b4a-08e34f49.jpg,test/p15/p15510911/s56730683/45baeab6-ab27bc8e-00ac50ac-d6aa4b4a-08e34f49.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman polytrauma // ?interval change ?interval change IMPRESSION: Comparison to ___, 05:10. Lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. In the interval, the patient appears to have undergone abdominal surgery, a miniscule amount of free right subdiaphragmatic air is visualized. Minimal retrocardiac atelectasis. Normal size of the cardiac silhouette. Normal position of the monitoring and support devices. " d355c799-24529498-ef73c36f-714c95ab-d2c07858.jpg,test/p10/p10865344/s56892218/d355c799-24529498-ef73c36f-714c95ab-d2c07858.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with pancreatitis, evaluate for pleural effusions TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: Normal chest radiograph. " a9e8bdaa-93d99fd4-8b6f1c8d-bef44857-bd997d53.jpg,test/p16/p16067111/s53493366/a9e8bdaa-93d99fd4-8b6f1c8d-bef44857-bd997d53.jpg,test," FINAL REPORT INDICATION: Right-sided chest pain, tightness after vomiting, question pneumothorax. COMPARISONS: None. TECHNIQUE: Single upright chest radiograph was provided. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " c45ab6b3-8870298a-b40bde5c-73cb12e9-078a680a.jpg,test/p10/p10956814/s56415332/c45ab6b3-8870298a-b40bde5c-73cb12e9-078a680a.jpg,test," WET READ: ___ ___ ___ 3:46 PM No acute cardiopulmonary abnormality. New severe compression deformity of an upper thoracic vertebral body compared to ___. ______________________________________________________________________________ FINAL REPORT HISTORY: Tenderness of the right scapula. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is mildly enlarged but unchanged. The mediastinal and hilar contours are unremarkable. The lungs are hyperinflated, unchanged. Scarring within the lung apices is again noted. No focal consolidation, pleural effusion or pneumothorax is identified. The pulmonary vascularity is normal. Severe wedge compression deformity of an upper thoracic vertebral body is new when compared to the prior exam from ___. Mild loss of height of a mid thoracic vertebral body is unchanged. Old right-sided rib fractures are again noted. IMPRESSION: No acute cardiopulmonary abnormality. New severe compression deformity of an upper thoracic vertebral body compared to ___. " dd11bdac-60f2a5fb-ab188b80-dec40796-231bca17.jpg,test/p10/p10303503/s56642400/dd11bdac-60f2a5fb-ab188b80-dec40796-231bca17.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with hx of liver transplant, sepsis, now s/p hospitalization with pleural effusions and pleuritic chest discomfort. Please assess for remaining pleural effusions. // assess for pleural effusion TECHNIQUE: Chest: Upright PA and Lateral COMPARISON: Chest radiographs since ___ with most recent ___ FINDINGS: Interval removal of right IJ catheter.The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process with no pleural fusion seen. " 1e3052ed-20f24534-0b7c3cd7-180b2c53-05bb2b28.jpg,test/p17/p17805551/s54601974/1e3052ed-20f24534-0b7c3cd7-180b2c53-05bb2b28.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The lowermost portion of the chest is excluded on the AP upright view, particularly the left costophrenic sulcus. The heart shows borderline enlargement with a left ventricular configuration. There is no pleural effusion or pneumothorax. The lungs appear clear. Bones appear demineralized. IMPRESSION: No evidence of acute cardiopulmonary disease. " 1251d06c-639f4fca-77078949-25b62fa0-9104d035.jpg,test/p15/p15711610/s53917648/1251d06c-639f4fca-77078949-25b62fa0-9104d035.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with expiratory wheezing, cough. Evaluate for infectious process vs. neoplasm. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___ most recently on ___. FINDINGS: A stable opacity in the right upper lung medially is likely a combination of calcification in the cartilage of the first ribs and vascular prominence. Otherwise, there is again enlargement of the cardiac silhouette with a pacer device in place. Conspicuity of the interstitial markings and probable mild bronchial cuffing may represent incipient interstitial edema. There is no pleural effusion pneumothorax IMPRESSION: Stable cardiomegaly. Conspicuity of interstitial markings and probable mild bronchial cuffing may represent incipient interstitial edema. " 686f44c6-9ac46ec6-9e344a10-a455208a-9834518f.jpg,test/p10/p10605700/s55944347/686f44c6-9ac46ec6-9e344a10-a455208a-9834518f.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top normal. Mediastinal contours are unremarkable. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " 43bf5ece-4d17237d-305e7a40-3bb7c2ac-171ed520.jpg,test/p12/p12537834/s50360417/43bf5ece-4d17237d-305e7a40-3bb7c2ac-171ed520.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with pain // r/o pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 0712949f-995e364e-8170d4ed-8bfbcbcf-7c0c331c.jpg,test/p13/p13584591/s51876091/0712949f-995e364e-8170d4ed-8bfbcbcf-7c0c331c.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess NG tube. Comparison is made with prior study, ___. NG tube tip is in the stomach. Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. There are low lung volumes. " 32465d5e-f7f59c8b-584730fc-3ef511c2-2a69708d.jpg,test/p13/p13892963/s57789301/32465d5e-f7f59c8b-584730fc-3ef511c2-2a69708d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with seizures // ?Stability COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Normal size of the cardiac silhouette. Normal lung volumes. No pleural effusions. No pulmonary edema. No pneumonia. No pneumothorax. " 38c6f8b9-2c7d2188-e262a52e-e7bd4173-bad69b30.jpg,test/p19/p19277073/s59707338/38c6f8b9-2c7d2188-e262a52e-e7bd4173-bad69b30.jpg,test," FINAL REPORT INDICATION: History: ___M with prolonged cough and wheeze // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph from ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No acute intrathoracic abnormalities identified. " c122d94d-1ccdf953-dea0067f-00edeea3-7345f4b3.jpg,test/p15/p15923118/s53510157/c122d94d-1ccdf953-dea0067f-00edeea3-7345f4b3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M stage IIIA squamous cell ca LLL with completed neoadjuvant treatment s/p decortication and open LLL lobectomy with mediastinal lymphadenectomy // eval for ptx eval for ptx IMPRESSION: Compared to chest radiographs most recently ___. Lung volumes are generally lower, heart size is greater, and pulmonary vasculature more engorged following left thoracotomy, reflecting mild cardiac decompensation or volume overload. Greater opacification at the base of the left lung, is presumably atelectasis or pleural effusion. There is no appreciable pneumothorax, with an apical pleural drainage tube in place but there is new subcutaneous emphysema along the left chest wall. " a960e219-95f1e2eb-d3e9f878-9d979325-09713915.jpg,test/p18/p18683964/s52040172/a960e219-95f1e2eb-d3e9f878-9d979325-09713915.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with metastatic breast cancer and progressive DOE // CXR for a VQ scan COMPARISON: ___. IMPRESSION: As compared to the previous image, no relevant change is seen. Moderate bilateral pleural effusions. Diffuse, mixed nodular and interstitial parenchymal opacities, left more than right, as well as diffuse areas of pleural thickening. No evidence of relevant interval change. The detailed morphology of the pleura and the lungs is documented on the CT examination from ___ " 18c7620b-2503aff5-771e62d2-af9c8529-adf34d9c.jpg,test/p15/p15279651/s54466417/18c7620b-2503aff5-771e62d2-af9c8529-adf34d9c.jpg,test," FINAL REPORT INDICATION: Query interval change, treated for pneumonia based on outside hospital chest x-ray not available in our system. COMPARISON: Chest radiographs ___, ___. FINDINGS: Cardiomediastinal and hilar contours remain stable with moderate cardiomegaly. The patient's head is obscuring the right lung apex, limiting assessment. There is no pleural effusion or large pneumothorax. There is no new focal opacity concerning for pneumonia. There is no pulmonary edema. Upper zone vascular redistribution is likely chronic. IMPRESSION: No acute cardiopulmonary process or new finding concerning for pneumonia. " 622dae37-27b5f367-66f49ccc-0ff72957-b19b0e40.jpg,test/p17/p17725512/s51816182/622dae37-27b5f367-66f49ccc-0ff72957-b19b0e40.jpg,test," FINAL REPORT INDICATION: ___-year-old man with worsening hypoxemia, difficult to ventilate. Evaluate for ET tube placement, pulmonary edema or other interval change. COMPARISON: Portable chest radiograph from ___. FINDINGS: An ET tube is 4.3 cm from the carina. Right IJ central line terminates within the right atrium and should be pulled back 3cm. Since the prior radiograph, there is no significant interval change. There are no pleural effusions or pneumothorax. The cardiomediastinal silhouette is unchanged. NG tube is seen coursing below the diaphragm. IMPRESSION: 1. ET tube 4.3 cm from the carina. Right IJ central line is within the right atrium. Recommend retracting 3cm. These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at 11:50am. " ecd888ba-21a7a4c4-f7ba82aa-182d97bd-021db0c3.jpg,test/p16/p16259867/s50909050/ecd888ba-21a7a4c4-f7ba82aa-182d97bd-021db0c3.jpg,test," FINAL REPORT AP CHEST, 11:30 A.M., ___ HISTORY: A ___-year-old man with shortness of breath, new hypoxia. Suspect pneumonia or pulmonary edema. IMPRESSION: AP chest compared to ___: Generalized bronchial cuffing is still present. Although this can be an indication of pulmonary edema, there are no ancillary findings, specifically the heart is normal size, mediastinal veins not dilated, pulmonary vessels not engorged, and there is no pleural effusion. I would attribute the bronchial findings to diffuse bronchial inflammation, including asthma. Right skinfolds should not be mistaken for pneumothorax. Dialysis catheter ends in the upper right atrium. " d0c540a9-e4a09bfc-350bfd29-3b1672a7-ee4caeb2.jpg,test/p17/p17782175/s57520267/d0c540a9-e4a09bfc-350bfd29-3b1672a7-ee4caeb2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea, history of asthma, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia. No pulmonary edema. No pleural effusions. Normal size of the cardiac silhouette. Normal hilar or mediastinal structures. IMPRESSION: No acute intrathoracic process. " e49066f7-9b74c00b-e82c67a2-d106c3aa-69924460.jpg,test/p14/p14358282/s50688347/e49066f7-9b74c00b-e82c67a2-d106c3aa-69924460.jpg,test," FINAL REPORT HISTORY: Palpitations. COMPARISON: ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Dual lead left-sided pacer device is again seen unchanged in position, with the tip in the expected positions of the right atrium and right ventricle. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " 5a8c1cc1-a2118019-60d90a00-c88a4b6a-df7e0b20.jpg,test/p14/p14027430/s52703993/5a8c1cc1-a2118019-60d90a00-c88a4b6a-df7e0b20.jpg,test," FINAL REPORT INDICATION: Productive cough with unsteady gait. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: Cardiac, mediastinal, and hilar contours are normal. The lungs are clear, and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 69d1e13e-8cf3cb86-d50dc9b0-99d98f08-99806667.jpg,test/p15/p15301390/s55700240/69d1e13e-8cf3cb86-d50dc9b0-99d98f08-99806667.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH, brain mass on dexamethasone and fungemia with witnessed aspiration // evaluation for aspiration pneumonia evaluation for aspiration pneumonia IMPRESSION: Heart size and mediastinum are stable. Double tube tip is in the stomach. Lungs are clear except for right basal opacity concerning for aspiration or infectious process, similar to previous examination. " 27a4d1d1-c5fa16ae-c5985d43-01a67973-6a6c5299.jpg,test/p14/p14323599/s58334221/27a4d1d1-c5fa16ae-c5985d43-01a67973-6a6c5299.jpg,test," WET READ: ___ ___ ___ 1:49 PM Nodular opacity on lateral in infrahilar region, question atelectasis, pneumonia or lower airway inflammation; possibly true pulmonary nodule, however. Suggest short-term follow-up radiographs to assess for clearance, or chest CT. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPHS HISTORY: Nausea and vomiting. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. On the lateral view, there is a prominent focal infrahilar opacity that has a somewhat oval nodular appearance. It may coincide with patchy streaky left lower lobe opacities and a lingular opacity suggesting minor atelectasis or scarring, but perhaps more likely correlates with streaky right infrahilar opacification. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. IMPRESSION: Nodular infrahilar opacity, which may correspond to streaky right infrahilar opacities. This appearance may be nodular appearance of the lower airway inflammation, infection, or even pneumonia. However, a true pulmonary nodule cannot be excluded. Depending on clinical circumstances, either short-term followup radiographs are recommended in order to see whether it persists or alternatively chest CT could be considered. " ee2bf15f-d96a2611-4833d30d-5d9e9058-5f532f50.jpg,test/p11/p11124675/s58331311/ee2bf15f-d96a2611-4833d30d-5d9e9058-5f532f50.jpg,test," FINAL REPORT AP CHEST, 2:38 A.M. ON ___ HISTORY: Persistent ventilator requirement. IMPRESSION: AP chest compared to ___ through ___: Since ___, previous mild pulmonary edema has improved if not cleared. Heart size normal, but decreased. Nevertheless, there is compression of possible left atrial enlargement. ET tube is in standard placement, nasogastric tube passes below the diaphragm and out of view, and a right PIC line ends low in the SVC. No pneumothorax. " 581f86f9-3d4598d5-89b38719-d4b54cde-24e14830.jpg,test/p15/p15623355/s56967791/581f86f9-3d4598d5-89b38719-d4b54cde-24e14830.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HLD, smoking // ?lesions HLD,OCCASIONAL INTERMITTED SHARP PAIN POSTERIOR LEFT CHEST/LUNG HX SMOKER R/O LESIONS,ABNORMALITY IMPRESSION: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. No evidence of pneumothorax. " f42c1a8e-db29753e-9c09ed9a-45d74688-a5cbf74e.jpg,test/p10/p10467237/s54877911/f42c1a8e-db29753e-9c09ed9a-45d74688-a5cbf74e.jpg,test," FINAL REPORT HISTORY: Fever and weakness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. The aorta is unfolded. Aortic knob is calcified. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " ddad115f-20231cc4-72b3ae6c-a3876ee3-f2abeb6b.jpg,test/p10/p10453488/s56265138/ddad115f-20231cc4-72b3ae6c-a3876ee3-f2abeb6b.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fever and right upper quadrant tenderness. COMPARISON: Chest radiograph on ___ and CT of the chest on ___. FINDINGS: AP and lateral views of the chest. Aortic calcifications are again seen. No focal consolidation is seen. There is no pneumothorax. The cardiomediastinal contours are stable. IMPRESSION: No evidence of pneumonia. " 74169153-a7d54671-9535d05a-600ba643-128736bb.jpg,test/p12/p12538793/s50113251/74169153-a7d54671-9535d05a-600ba643-128736bb.jpg,test," FINAL REPORT HISTORY: Assess PICC placement TECHNIQUE: 2 views were obtained of the chest. COMPARISON: ___ FINDINGS: Left PICC terminates as before in the upper SVC. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " 293dff7d-2b620e8a-f7900a61-612d2185-1e128897.jpg,test/p18/p18689527/s53578840/293dff7d-2b620e8a-f7900a61-612d2185-1e128897.jpg,test," FINAL REPORT INDICATION: Patient with exertional dyspnea and history of smoking. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate prominent interstitial markings, most pronounced in lower lobes. There is no focal consolidation or pleural effusion. There is no pneumothorax. No pulmonary edema. Hilar, mediastinal and silhouettes are unremarkable. Heart size is normal. Partially imaged upper abdomen is unremarkable. IMPRESSION: Prominent interstitial marking predominantly in the lower lobes. In the setting of high clinical concern for interstitial lung disease, given patient's smoking history, may consider chest CT for further assessment. " d620ea29-8574bbd1-0bf94273-c4c0a0da-0d6265d5.jpg,test/p16/p16877397/s58420500/d620ea29-8574bbd1-0bf94273-c4c0a0da-0d6265d5.jpg,test," WET READ: ___ ___ ___ 4:53 PM Decreased pulmonary edema with unchanged bilateral pleural effusions. ______________________________________________________________________________ FINAL REPORT INDICATION: Post CABG and AVR, evaluate effusions. COMPARISON: Chest radiograph on ___, ___, and ___. FINDINGS: PA and lateral views of the chest. Compared to most recent study, the previously seen pulmonary edema has decreased. The bilateral pleural effusions, left greater than right, are unchanged. There is no consolidation or pneumothorax. The mediastinal and hilar contours are stable. Sternotomy wires are in appropriate position and surgical clips in the mediastinum are seen. Aortic valve replacement is in appropriate position. IMPRESSION: Decreased pulmonary edema with unchanged bilateral pleural effusions. " 0b059bc9-e6491b09-c8a255e7-6f89f840-8f4011ff.jpg,test/p15/p15797232/s57650213/0b059bc9-e6491b09-c8a255e7-6f89f840-8f4011ff.jpg,test," FINAL REPORT HISTORY: Fever, rule out pulmonary process. CHEST, SINGLE AP VIEW. COMPARISON: Chest x-ray dated ___ at 5:05 a.m. Compared to the prior film, the right subclavian picc line has been removed. Otherwise, no definite change is identified. No pneumothorax detected. Tracheostomy tube again noted. Again seen are low lung volumes, with some patchy opacity at the left base. The extreme left costophrenic angle is less well seen on today's exam, ? due to atelectasis or trace fluid. No gross effusion. Mild prominence of pulmonary vessels is likely related to the low inspiratory volumes. Minimal atelectasis in the right cardiophrenic region. IMPRESSION: 1) Low inspiratory volumes, with bibasilar atelectasis. Possibility of some patchy opacity at the left base cannot be excluded. 2) Given the low lung volumes, no definite CHF. " 485c1cab-ef6b49f5-7516de5b-78f62493-e5390db1.jpg,test/p12/p12676624/s59162191/485c1cab-ef6b49f5-7516de5b-78f62493-e5390db1.jpg,test," FINAL REPORT HISTORY: Post-operative basilar crackles. FINDINGS: In comparison with the study of ___, there are low lung volumes, though the cardiac silhouette is within normal limits and there is no appreciable vascular congestion. Blunting of the left costophrenic angle could reflect atelectasis and small effusion or merely be a manifestation of the lower lung volumes. Of incidental note is old healed fracture of the left clavicle. " 9fde2494-eb7d869f-8137f8b1-bf5e1de6-24e6f7f2.jpg,test/p15/p15906640/s58954934/9fde2494-eb7d869f-8137f8b1-bf5e1de6-24e6f7f2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with port not working // evaluate port placement - requested by line service COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the position and course of the Port-A-Cath is constant and unchanged. No change in appearance of the lung parenchyma. Normal size of the cardiac silhouette. No pneumonia, no pulmonary edema. No pleural effusion. " 26773307-9df3d0cc-8c36d0b2-c3c8f862-85499195.jpg,test/p15/p15404165/s50649329/26773307-9df3d0cc-8c36d0b2-c3c8f862-85499195.jpg,test," FINAL REPORT HISTORY: Left chest pain, to assess for pneumonia. FINDINGS: No previous images. The heart is normal in size and there is no vascular congestion or pleural effusion. Specifically, no convincing evidence of acute pneumonia. " 58b52b02-5c63e8fa-dada970c-d710fde4-782b7082.jpg,test/p10/p10055694/s59844689/58b52b02-5c63e8fa-dada970c-d710fde4-782b7082.jpg,test," FINAL REPORT INDICATION: New shortness of breath with history of congestive heart failure. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is moderately enlarged, but the cardiac silhouette is obscured due to the presence of a moderate-to-large right pleural effusion with right basilar compressive atelectasis. Mild pulmonary edema appears relatively unchanged compared to prior study. No left-sided pleural effusion is visualized. There is no acute osseous abnormality. IMPRESSION: Moderate-to-large right pleural effusion, slightly increased from prior, with right basilar atelectasis. Mild pulmonary edema, unchanged. " f79ee3dd-be0ff319-aa4011d9-5d965b44-9e522678.jpg,test/p11/p11794995/s58802966/f79ee3dd-be0ff319-aa4011d9-5d965b44-9e522678.jpg,test," WET READ: ___ ___ ___ 12:33 AM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radio INDICATION: History: ___F with cough, dyspnea // Eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Lungs are well inflated. There is no focal consolidation, pleural effusion, or pulmonary edema. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. IMPRESSION: No acute cardiopulmonary process " 8d24cc86-5fa867bc-65d31d5a-621397c4-102e887c.jpg,test/p13/p13941266/s52776392/8d24cc86-5fa867bc-65d31d5a-621397c4-102e887c.jpg,test," WET READ: ___ ___ ___ 1:43 PM No defnite pulmonary nodule seen. Linear opacity in the RLL, likely pulmonary vasculature. ______________________________________________________________________________ FINAL REPORT HISTORY: Incidentally noted nodule, nipple markers. AP and lateral views obtained with nipple markers. The nodular opacity seen on the ___ 16:44 p.m. x-ray examination is not definitively identified on the current examination. No acute pulmonary process is identified. Recommend followup radiograph in four to six months to confirm stability. " 61dcbf79-234dc2c2-fbf01bcd-901efc28-3069d095.jpg,test/p12/p12047822/s55823160/61dcbf79-234dc2c2-fbf01bcd-901efc28-3069d095.jpg,test," FINAL REPORT INDICATION: Rib pain status post fall, evaluate for fractures. COMPARISON: ___ chest radiograph. CT torso done on the same day. FINDINGS: No definite fracture. The lungs are grossly clear. There is no pleural effusion or pneumothorax. There is moderate-to-severe cardiomegaly and a tortuous aorta. There are aortic knob calcifications. There is no mediastinal contour abnormality. IMPRESSION: No acute intrathoracic abnormality. " 10ed051f-508bfa71-169a0534-6a97ca6a-36def26a.jpg,test/p19/p19840128/s54137353/10ed051f-508bfa71-169a0534-6a97ca6a-36def26a.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with cough. Assess for pneumonia. FINDINGS: Comparison is made to the previous study from ___. There are diffuse airspace opacities throughout both lung fields, more confluent in the lung bases since the previous study. Findings are worrisome for developing pneumonia. There is also poor visualization of the hemidiaphragms suggestive of underlying pleural effusions bilaterally. The heart size is enlarged, but stable. There are no pneumothoraces. " 478c6888-33f5c3b7-5dd3a588-5f0b52fc-b0ff27f5.jpg,test/p15/p15147932/s57321593/478c6888-33f5c3b7-5dd3a588-5f0b52fc-b0ff27f5.jpg,test," FINAL REPORT AP CHEST, 3:54 A.M., ___ HISTORY: A ___-year-old man with an anastomotic leak. IMPRESSION: AP chest compared to ___: Previous mild pulmonary edema continues to clear since ___. Substantial right pleural effusion and bibasilar atelectasis remain. The heart size is normal. Azygous distention suggests elevated central venous pressure. The tip of the endotracheal tube just below the upper margin of the clavicles with the chin down, is 4.5 cm above the carina, 2 cm above optimal placement for the chin in neutral position. The right subclavian line ends low in the SVC. No pneumothorax. " d720b5e3-aa2f2910-75ddd746-3b0ff782-c4a50897.jpg,test/p18/p18726372/s53018089/d720b5e3-aa2f2910-75ddd746-3b0ff782-c4a50897.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with unsteady gait // evaluate for pneumonia COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are quite low limiting assessment. Mildly increased ground-glass opacities are seen throughout both lungs with relative sparing of the apices which could reflect edema versus atypical infection in the right clinical setting. No large effusion or pneumothorax. Cardiomediastinal silhouette appears grossly stable allowing for differences in technique. Bony structures appear intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Limited exam with subtle ground-glass opacities within the lungs concerning for edema or atypical infection. " f649dab7-0d00b27d-78a24bb8-d76a16b9-ec8b44bf.jpg,test/p17/p17397047/s56636809/f649dab7-0d00b27d-78a24bb8-d76a16b9-ec8b44bf.jpg,test," FINAL REPORT REASON FOR EXAM: ___ years old woman with cough and shortness of breath since three weeks. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: PA and lateral views of the chest show moderate lung volume without consolidation or nodules. Heart size is top normal, heart is elongated and with mild calcification in the aortic arch due to aortosclerosis. There is no pleural effusion or pneumothorax. Large hiatal hernia measures 6.9 cm. IMPRESSION: No acute cardiopulmonary process, large hiatal hernia. " 1c459a8b-e5831783-fd174d98-0815f661-4ebd61cd.jpg,test/p19/p19751455/s50139650/1c459a8b-e5831783-fd174d98-0815f661-4ebd61cd.jpg,test," FINAL REPORT INDICATION: ___ year old man with NSCLC s/p photodynamic therapy, intubated. // evaluate for interval changes COMPARISON: Radiographs from ___. IMPRESSION: The tip of the endotracheal tube is 3.2 cm above the carina, appropriately sited. There is again seen areas of consolidation within the lung bases, right side worse than left. There is persistent elevation of left hemidiaphragm, unchanged. Heart size is within normal limits. There are no pneumothoraces. Left apical pleural thickening is again present, stable. " a78600f2-01bd0a6b-cd4435f3-7434e9b6-5a4a9d81.jpg,test/p11/p11967908/s57120808/a78600f2-01bd0a6b-cd4435f3-7434e9b6-5a4a9d81.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pneumonia, now spiking on levofloxacin // Please evaluate for worsening infiltrate COMPARISON: Radiographs from ___. IMPRESSION: Cardiomediastinal silhouette is within normal limits. Lung fields are somewhat hyperexpanded. There are calcifications projecting over the right upper lobe which are stable. No overt pulmonary edema is seen. There are no large pleural effusions. No pneumothoraces are identified. " 60fb81b4-563c6838-3ba8f9fb-aa4fbe06-908a86eb.jpg,test/p11/p11607177/s52922844/60fb81b4-563c6838-3ba8f9fb-aa4fbe06-908a86eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IABP. // assess IABP placement and for any interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Intra-aortic balloon pump tip is appropriately positioned, 4 cm below the roof of the aortic arch. Swan-Ganz catheter tip is deep in the right lower lobe segmental or subsegmental vein and should be pulled back as previously recommended at least 4 8 cm. Cardiomegaly is substantial and unchanged. Position of the pacemaker leads is unchanged. No pulmonary edema demonstrated " 110ed2e9-f0938d83-addefe5b-646a51a3-8ed04a71.jpg,test/p19/p19900111/s55350458/110ed2e9-f0938d83-addefe5b-646a51a3-8ed04a71.jpg,test," FINAL REPORT INDICATION: Leukocytosis. PEG tube placed on ___. COMPARISON: Chest radiographs from ___. PET-CT, ___. FINDINGS: PA and lateral chest radiographs. Pneumoperitoneum below both hemidiaphragms was present on PET-CT from three days prior. This is most likely from the patient's PEG tube placement. The HD dialysis catheter has been removed. There is no focal consolidation, pleural effusion, or pneumothorax. The lungs are expanded but clear. The cardiomediastinal silhouette is normal. IMPRESSION: 1. Pneumoperitoneum is likely post-procedural from PEG tube placement on ___. 2. No pneumonia. Findings were discussed by Dr. ___ with Dr. ___ by phone at 1:29 p.m. (2 minutes after discovery) on ___. " fbaf21a1-11b9d046-a9d520e0-2b1b2c29-42f5fc01.jpg,test/p16/p16254124/s54062689/fbaf21a1-11b9d046-a9d520e0-2b1b2c29-42f5fc01.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with positive PPD, rule out active TB. COMPARISON: None. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are within normal limits. There is no pleural effusion or pneumothorax. CONCLUSION: There is no radiologic evidence of latent or active TB. " 6fb16819-f146e42b-83fc4427-caa284a8-157c5281.jpg,test/p16/p16072940/s54527297/6fb16819-f146e42b-83fc4427-caa284a8-157c5281.jpg,test," FINAL REPORT CHEST X-RAY HISTORY: ___-year-old woman with pleural thickening seen on chest radiograph. Followup study was recommended. FINDINGS: PA and lateral views of the chest are viewed in comparison with the prior study from ___. Slightly asymmetric pleural thickening at the lateral apices, left greater than right, appears stable. No additional areas of pleural thickening are seen, and the lungs are clear and well expanded with no nodules or focal consolidation. No pleural effusion is seen. There is some uncoiling of the thoracic aorta, but heart size is within normal limits. Osteophytosis is seen in the lower thoracic spine. CONCLUSION: Stable left lateral apical pleural thickening for 18 months. " d07be8db-c5a7cb1c-e40db9ac-405a9720-f3a11e01.jpg,test/p17/p17593711/s55005644/d07be8db-c5a7cb1c-e40db9ac-405a9720-f3a11e01.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Altered mental status. COMPARISON: ___. FINDINGS: Since the prior study, there is diffuse increase in interstitial markings bilaterally, which may relate to fluid overload versus atypical infection. There is a small left and trace right bilateral pleural effusions. Cardiac and mediastinal silhouettes are stable. Hilar contours are relatively stable. Bilateral anterior consolidations described on chest CT from ___ were better assessed on that study. More confluent right base opacity may relate to atelectasis and fluid overload; however, an area of infection is not excluded in the appropriate clinical setting. " 3485d614-bcf8d24e-2c2180f6-bd204836-f3793a44.jpg,test/p14/p14781106/s56505687/3485d614-bcf8d24e-2c2180f6-bd204836-f3793a44.jpg,test," FINAL REPORT INDICATION: Weakness. COMPARISON: Chest radiograph ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 6d3efca2-211db0b6-2c0d9800-5aff6aef-ce460d51.jpg,test/p10/p10169796/s50204785/6d3efca2-211db0b6-2c0d9800-5aff6aef-ce460d51.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Fever, meningitis, uncertain etiology. Desaturations. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable. Lungs are essentially clear. No pleural effusion or pneumothorax noted. " 420bf85d-b981ae10-770364a0-b24e4470-3d70a63d.jpg,test/p14/p14624317/s54149668/420bf85d-b981ae10-770364a0-b24e4470-3d70a63d.jpg,test," FINAL REPORT INDICATION: ___ year old man with bibasilar crackles // assess for atelectasis versus effusion versus infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The ET tube and NG tube have been removed. There is a small amount of volume loss at the bases but otherwise the lungs are clear. There is a 3 mm radiopacity of the left lung laterally well likely represents a small granuloma. This is more apparent than on the prior studies now that the pulmonary edema has resolved. There tiny bilateral effusions. IMPRESSION: Improved appearance to pulmonary edema. " 58752ce5-ef1a90dd-9f768b62-f5eaed02-ac14179f.jpg,test/p12/p12808280/s55970362/58752ce5-ef1a90dd-9f768b62-f5eaed02-ac14179f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man in a motor vehicle collision recently, evaluate for rib fractures. TECHNIQUE: AP and lateral chest radiographs. COMPARISON: None. FINDINGS: There is a mildly tortuous thoracic aorta, with aortic arch calcifications noted. Otherwise, the cardiomediastinal silhouettes are within normal limits. Heart size is top-normal. The bilateral hila are unremarkable. The lungs are clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. No displaced rib fractures are seen. IMPRESSION: No acute cardiopulmonary process. No evidence of a displaced rib fracture. If rib fractures are strongly suspected, dedicated rib radiographs could be obtained to further evaluate for subtle rib fractures. " 955f91c1-3507faab-f226e7c2-3fa49d12-dca81594.jpg,test/p14/p14756599/s57951231/955f91c1-3507faab-f226e7c2-3fa49d12-dca81594.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with mvc, ttp midline c/t spine // eval for acute fracutre/dislocation TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: There are low lung volumes. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal, however, likely exaggerated by low lung volumes. Mediastinal hilar contours are also unremarkable given low lung volumes. No displaced fracture is identified. IMPRESSION: Low lung volumes, but no acute cardiopulmonary process seen. " b41016b0-2cb14bb1-5ca304e8-c9430b85-9df3ad5d.jpg,test/p17/p17137598/s56527243/b41016b0-2cb14bb1-5ca304e8-c9430b85-9df3ad5d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with SOB // CHF? right diaphragm? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs ___, ___. Chest CT ___. FINDINGS: A 2.2 cm, geographic, soft tissue opacity projecting over the right mid lung on the frontal view is new since ___. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A tortuous aorta is again noted. The right pulmonary artery is enlarged likely secondary to pulmonary hypertension. Persistent elevation of the right hemidiaphragm consistent with severe eventration. Multiple chronic anterior compression deformities of the mid thoracic spine result in moderate kyphosis. IMPRESSION: Right lung nodule new since ___. Recommend up chest radiograph in 6 weeks to see if nodule persists and Chest CT therefore necessary. Pulmonary arterial hypertension. Eventration of the right hemidiaphragm. RECOMMENDATION(S): Follow up chest radiograph recommended in 6 weeks. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 17:02 into the Department of Radiology critical communications system for direct communication to the referring provider. " ce91f5dc-1be8722e-2b3738b5-077f65f4-f0e0950c.jpg,test/p17/p17615451/s51240188/ce91f5dc-1be8722e-2b3738b5-077f65f4-f0e0950c.jpg,test," FINAL REPORT HISTORY: Upper lobe biopsy complicated by hemoptysis and spiking fevers. FINDINGS: In comparison with the study of ___, there is little change. Stable enlargement of the cardiac silhouette without pneumothorax or acute focal pneumonia. The right upper lobe spiculated nodule is only well seen on CT. Minimal atelectatic changes are seen at the left base. " 823d59e7-abf0b8a4-a5a7ab03-25703ef7-82d6ba06.jpg,test/p15/p15497616/s58791543/823d59e7-abf0b8a4-a5a7ab03-25703ef7-82d6ba06.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Fever in the patient two days after lumbar surgery. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are unremarkable except for potential prominence of the left pulmonary artery that might reflect evidence of pulmonary hypertension. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No evidence of infectious process in the lungs to explain patient's fever. " 919538c2-4d6bb2f4-d1327e44-76cf16c1-a1f34e1d.jpg,test/p14/p14014948/s59887926/919538c2-4d6bb2f4-d1327e44-76cf16c1-a1f34e1d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // int change int change COMPARISON: Calling chest radiographs ___ through ___. IMPRESSION: Heterogeneous opacification in the left lower lung in the left apex could be atelectasis but is more concerning for pneumonia. Right upper lobe collapse has recurred. Widespread opacification in the right lower lobe has worsened, probably pneumonia. Small right pleural effusion is presumed. Cardiomediastinal silhouette is unremarkable. ET tube in standard placement. Left subclavian line ends in the low SVC. A nasogastric tube ending in the upper stomach should be advanced 5 cm to move all side ports beyond the GE junction. No pneumothorax. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 1:32 PM, 2 minutes after discovery of the findings. " 163dc587-fd12de03-7093006f-90be405e-021e0b0f.jpg,test/p13/p13363704/s52760117/163dc587-fd12de03-7093006f-90be405e-021e0b0f.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " b48df8df-24b8098b-4083f3f2-229459dc-ed803e68.jpg,test/p17/p17925184/s57911538/b48df8df-24b8098b-4083f3f2-229459dc-ed803e68.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with COPD on chronic steroids, multiple medical problems, including AMS and now with increased shortness of breath. Evaluate for possible aspiration. FINDINGS: AP single view of the chest obtained with patient in upright position compared with several preceding chest examinations dated ___ and ___. Bilateral basal densities most on the right again identified in this patient with advanced COPD. These findings persist, thus possibility of multiple aspirations are real. There is some decrease of hazy diffuse densities on the lung bases which raises the possibility of coexisting pleural effusions layering in the posterior pleural compartments. A lateral view not included in the previous chest examinations could give answer to this question. On the last preceding chest CT of ___, pleural effusion was minimal. " 512de8f5-a18f5c3b-f966ec14-5ada4ce2-7e2e99fa.jpg,test/p16/p16650418/s59947455/512de8f5-a18f5c3b-f966ec14-5ada4ce2-7e2e99fa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NG tube // ?NGT placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the position of the nasogastric tube is unchanged. The tip of the tube continues to project over the gastroesophageal junction, the tube should be advanced by approximately 5 cm. The right basal parenchymal opacity is constant in extent and distribution, on the left the elevation of the hemidiaphragm is less pronounced than on the previous examination. Moderate cardiomegaly and bilateral basal areas of atelectasis persist. Unchanged course and position of the left-sided PICC line. " 2bebdf8a-e11542b7-8ea0a4e4-128e6742-5d16de35.jpg,test/p10/p10087981/s55345449/2bebdf8a-e11542b7-8ea0a4e4-128e6742-5d16de35.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with hip fracture, preop chest x-ray. TECHNIQUE: Portable supine view of the chest. COMPARISON: Outside chest radiograph performed on ___. FINDINGS: The lungs are hyperinflated. No focal consolidation is identified. The cardiomediastinal silhouette and hilar contours are normal. Calcifications of the costochondral cartilage is present. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " f375077a-f064d13c-115cf2f4-8d536854-caf9f62b.jpg,test/p15/p15108795/s58544735/f375077a-f064d13c-115cf2f4-8d536854-caf9f62b.jpg,test," FINAL REPORT INDICATION: History of chest pain. Rule out pneumothorax. COMPARISONS: None. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are well expanded and clear of any evidence of focal consolidations, pneumothoraces or pleural effusions. Visualized osseous structures are unremarkable. IMPRESSION: No evidence of pneumothorax. " f501aee3-242414d5-0ed0c002-2b134ac5-8f57cac2.jpg,test/p12/p12392656/s59986465/f501aee3-242414d5-0ed0c002-2b134ac5-8f57cac2.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with dyspnea, cough. Evaluate pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: No significant interval change. The lungs are well-expanded and clear. No focal consolidation, edema, effusion, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila are unremarkable. By a apical pleural thickening and/or scarring appears similar to ___. No acute osseous abnormality. IMPRESSION: No pneumonia. " 2e9aecc6-4396045c-f38e49ed-f1ffbbb7-f318f280.jpg,test/p11/p11459120/s55205549/2e9aecc6-4396045c-f38e49ed-f1ffbbb7-f318f280.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with productive cough // R/O PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Patchy right upper lung opacity, not clearly seen on the prior radiographs, or least significantly increased, is worrisome for pneumonia. Additional ground-glass opacities noted on chest CT from ___ for better appreciated on CT. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Dual lead left-sided pacer is stable in position. Partially imaged left humeral prosthesis is again noted. IMPRESSION: Patchy right upper lung opacity worrisome for pneumonia. Recommend followup to resolution. Additional ground-glass opacities seen on chest CT from ___ are better appreciated on CT. Findings should be followed up with CT. " 37c0ee5c-29b6b95a-98598f65-2f0c9f9e-87532289.jpg,test/p11/p11551927/s54295613/37c0ee5c-29b6b95a-98598f65-2f0c9f9e-87532289.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with history of pancreatic pseudocyst presenting with fevers and leg swelling TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 0924efb1-49767f4f-dc978141-8b248ca6-48984252.jpg,test/p10/p10822800/s50178948/0924efb1-49767f4f-dc978141-8b248ca6-48984252.jpg,test," FINAL REPORT HISTORY: ___-year-old female with left-sided chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiac silhouette and hilar contours are unremarkable. No pleural effusion, edema, or pneumothorax. No nondisplaced rib fractureis seen. IMPRESSION: No evidence of acute cardiopulmonary process. " 8b056528-088635b7-ff3dba0b-1fe67d79-5e92d692.jpg,test/p17/p17894597/s59649831/8b056528-088635b7-ff3dba0b-1fe67d79-5e92d692.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with abdominal pain and elevated lactate // Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CT abdomen and pelvis dated ___. FINDINGS: There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. The heart is top-normal in size. Intravenous contrast material seen within the renal collecting systems from preceding CT. IMPRESSION: No acute cardiopulmonary process. " 2ccf4f9e-9b73319d-b39c4497-ea596678-370dca17.jpg,test/p18/p18083755/s59951532/2ccf4f9e-9b73319d-b39c4497-ea596678-370dca17.jpg,test," FINAL REPORT HISTORY: ___-year-old female with atrial fibrillation status post recent cardioversion with dizziness and lightheadedness for 5 days. Elevated white blood cell count. COMPARISON: ___. CT chest from ___. FINDINGS: PA and lateral views of the chest. Linear right upper lung opacity is compatible with scarring/ resection. Small bilateral effusions have not significantly changed in size noting that they are now seen laterally at the costophrenic angles on the frontal view, more so when compared to prior. There is no definite new focal consolidation. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is detected. IMPRESSION: Essentially unchanged bilateral pleural effusions without superimposed acute cardiopulmonary process. " 53cff833-e3c7b07f-f6fb17b9-604ebb94-37a2b4e2.jpg,test/p13/p13417577/s52704840/53cff833-e3c7b07f-f6fb17b9-604ebb94-37a2b4e2.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with known pneumothorax with chest tube on waterseal and increasing pleuritic pain. PA and lateral upright chest radiographs were reviewed in comparison to ___ obtained at 2:27 p.m. Since the prior study, there has been interval increase in the left pneumothorax. The pigtail is in place. The pneumothorax currently is moderate. Apical thickening is present. A hiatal hernia is redemonstrated, as well as small amount of pleural effusion. " 5bd45327-e50e5784-3389a255-51b9dbeb-c01c9a81.jpg,test/p10/p10086560/s53962945/5bd45327-e50e5784-3389a255-51b9dbeb-c01c9a81.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever, cough // eval for pneumonia COMPARISON: None. FINDINGS: The heart is not enlarged. There is no CHF, focal infiltrate, effusion or pneumothorax. Within the limits of plain film radiography, no hilar mediastinal lymphadenopathy is detected . IMPRESSION: Chest x-ray examination within normal limits. No acute pulmonary process identified. " b22a78b7-d0b73d12-08011853-33690fae-1695ba0d.jpg,test/p18/p18539425/s57152651/b22a78b7-d0b73d12-08011853-33690fae-1695ba0d.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient after allogenic SCT with wheezing and shortness of breath, assess for infiltrates. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. The heart size remains unchanged and is within normal limits. Mild degree of aortic widening and elongation is present but no local contour abnormalities are seen. The pulmonary vasculature is not congested. No evidence of new acute parenchymal infiltrates can be identified. The pleural spaces are free laterally and posteriorly. No pneumothorax is present in the apical area on the frontal view. Review of multiple previous studies indicates that the patient had a left lower lobe atelectasis in retrocardiac position of ___. Chest CT examination two days later demonstrated findings of bronchiectasis in this area compatible with chronic infection. There existed also multiple bilateral patchy confluent infiltrates which most likely represented GVHD in this patient who is undergoing stem cell transplant. As there is presently no evidence on the plain chest examination that the latter type of infiltrates persist in the area of the left lower lobe, a crowded vascular pattern with some interstitial prominent structures remain and most likely represent scar formations after the left lower lobe posterior segment pneumonia. IMPRESSION: No evidence of new acute infectious pneumonic infiltrates. " e8ca9294-851666c0-b0434e14-e23c8c0e-1a692a71.jpg,test/p11/p11444270/s54618390/e8ca9294-851666c0-b0434e14-e23c8c0e-1a692a71.jpg,test," FINAL REPORT HISTORY: Prior pulmonary edema and questionable recent pneumonia with three days of increased dyspnea and wheezing. COMPARISON: Chest radiograph, ___, CTA chest, ___. TECHNIQUE: PA and lateral chest radiographs, three views. FINDINGS: Cardiac silhouette is severely enlarged with tortuosity of the thoracic aorta, similar to prior examination. There is engorgement of the central pulmonary vasculature with mild cephalic redistribution and associated mild interstitial edema which appears similar to ___. There is increased right juxta- and infrahilar opacity with subtle peribronchial cuffing with possible increased density seen in the posterior lower lung field on lateral view which remains suspicious for pneumonia. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Mild pulmonary edema and right juxta- and infrahilar opacity similar appearance to ___ which remains suspicious for pneumonia. Results were conveyed over the telephone to ___ at the office of Dr. ___ by Dr. ___ at 11:20 a.m. on ___, 10 minutes after discovery. " e7b9eab7-be479f50-51b4dcef-2f22abdb-060faef4.jpg,test/p11/p11552741/s56284895/e7b9eab7-be479f50-51b4dcef-2f22abdb-060faef4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with endotrachial intubation TECHNIQUE: Supine AP view of the chest COMPARISON: ___ at 12:23 FINDINGS: There has been interval intubation with the endotracheal tube tip terminating approximately 3 cm from the carina. The heart size remains moderately enlarged. Mediastinal contours are unchanged with the aorta appearing tortuous and likely dilated. Widening of the superior mediastinal contour also may in part be due to the presence of lymphadenopathy. Hazy opacifications of both lungs likely indicate the presence of moderate-sized layering bilateral pleural effusions. Bibasilar airspace opacities could reflect atelectasis, but infection is difficult to exclude. Peripheral wedge-shaped opacity in the left upper lung field is re- demonstrated. There appears to be mild pulmonary edema. Assessment for pneumothorax is limited on this supine exam though no large pneumothorax is detected. IMPRESSION: Endotracheal tube tip in standard position. Mild pulmonary edema. Layering moderate size bilateral pleural effusions. Bibasilar airspace opacities persist as does a wedge-shaped opacity in the left upper lung field. Tortuous and likely dilated aorta with probable mediastinal lymphadenopathy. " 655f345b-e08f94e2-85e1788d-b9889a33-59ff10c9.jpg,test/p18/p18909627/s53639828/655f345b-e08f94e2-85e1788d-b9889a33-59ff10c9.jpg,test," FINAL REPORT HISTORY: Chest tube removal. COMPARISON: ___ at 00:20. FINDINGS: Left-sided chest tube has been removed. There is a small left lateral and inferior pneumothorax. there is some linear atelectasis in the left lower lobe. the left subclavian line is unchanged. feeding tube tip in the proximal stomach is unchanged. cervical hardware is unchanged. IMPRESSION: small left pneumothorax. " 2101d92a-6fa5edc0-08713fd2-51ff44da-51fddac7.jpg,test/p17/p17641554/s58041797/2101d92a-6fa5edc0-08713fd2-51ff44da-51fddac7.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. Heart and mediastinal contours are within normal limits. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 88543a89-d6245065-ee4ae6e4-1c5b9a20-8b439463.jpg,test/p19/p19228066/s55268167/88543a89-d6245065-ee4ae6e4-1c5b9a20-8b439463.jpg,test," FINAL REPORT INDICATION: ___-year-old female with new hypotension and tachypnea status post trauma. COMPARISON: Outside hospital chest radiograph dated ___ at approximately 5 p.m. and CT chest dated ___ at approximately 9:00 p.m. TECHNIQUE: Single frontal chest radiograph was obtained portably. Per technologist's report, the patient was unable to cooperate for the exam and was stabilized by the ED resident, who approved the image. FINDINGS: Very limited view of the chest without obvious pneumothorax or edema. The patient is rotated, limiting evaluation of the cardiomediastinal silhouette, but an enlarged calcified aorta is again noted. Right lower lung nodule is obscured. Note is made of a large right calcified thyroid nodule. IMPRESSION: Very limited study due to patient rotation without evidence for large pneumothorax. " 1c3fa343-08b50d0f-9a055876-469228ea-e9fc5a35.jpg,test/p17/p17826428/s51514725/1c3fa343-08b50d0f-9a055876-469228ea-e9fc5a35.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with severe sepsis fromuti and pna // evolving ___? COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Left lower lobe consolidation improving rapidly, accompanied by return of the mediastinum to the midline suggests previous consolidation was mostly atelectasis, but conceivably due to aspiration. Right lung is grossly clear. Heart size normal. No appreciable pleural abnormality. " 121e3b6c-29e5927f-cdef08b0-d1b0b188-957bbf37.jpg,test/p11/p11147672/s52124235/121e3b6c-29e5927f-cdef08b0-d1b0b188-957bbf37.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fall with left anterior rib pain // assess for rib fx /pneumo TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: Lungs are hypoinflated. No acute infiltrates, edema, effusion or pneumothorax are seen. Multiple sternotomy wires again noted. The cardio-mediastinal silhouette is unremarkable. IMPRESSION: No acute pulmonary disease. " 90151810-3754967e-2cdb25b6-dc402d1a-1ac18ffc.jpg,test/p18/p18494866/s50367408/90151810-3754967e-2cdb25b6-dc402d1a-1ac18ffc.jpg,test," WET READ: ___ ___ ___ 11:23 AM 1. No focal consolidation or pulmonary edema. 2. Blunting of the left costophrenic angle may represent a small left pleural effusion or thickening of the pleura. When clinically feasible, PA and lateral radiographs are recommended. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with dyspnea, hypoxia, evaluate for PNA, pulmonary edema. TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: None. FINDINGS: Blunting of the left costophrenic angle may represent a small left pleural effusion or thickening of the pleura. There is no focal consolidation, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. No focal consolidation or pulmonary edema. 2. Blunting of the left costophrenic angle may represent a small left pleural effusion or thickening of the pleura. When clinically feasible, PA and lateral radiographs are recommended. " 63937b0b-38e716e9-504a8ed2-ae3f0b60-45101962.jpg,test/p13/p13445140/s52494724/63937b0b-38e716e9-504a8ed2-ae3f0b60-45101962.jpg,test," WET READ: ___ ___ ___ 1:28 PM Minimal perihilar bronchial cuffing. Otherwise, no acute cardiopulmonary process. No pneumothorax WET READ VERSION #1 ___ ___ ___ 11:47 AM No acute cardiopulmonary process. No pneumothorax. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. Minimal perihilar bronchial cuffing. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: Minimal perihilar bronchial cuffing. Otherwise, no acute cardiopulmonary process. No pneumothorax. " f6c02e1e-61f37b5a-7497605f-100a0061-42ec68a2.jpg,test/p18/p18523146/s59510119/f6c02e1e-61f37b5a-7497605f-100a0061-42ec68a2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // ? pneumonia ? pneumonia IMPRESSION: In comparison with the study of ___, there is again hyperexpansion of the lungs with flattening hemidiaphragms, consistent with underlying COPD. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 2c1c13cf-af63e068-1491d5b2-757d9b43-5157b05c.jpg,test/p11/p11902171/s50261607/2c1c13cf-af63e068-1491d5b2-757d9b43-5157b05c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with picc line eval // picc placement TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Again noted is a left-sided PICC, with its tip terminating in the mid SVC. The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. The lungs are clear. IMPRESSION: Left-sided PICC terminating in the mid SVC. " 9e2732ff-c41c3602-b32cdbe8-964e2254-98cfb9fa.jpg,test/p16/p16149472/s51948369/9e2732ff-c41c3602-b32cdbe8-964e2254-98cfb9fa.jpg,test," WET READ: ___ ___ ___ 12:34 PM Normal chest radiographs. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with history of CF, chest pain evaluate for pneumonia or pneumothorax. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs from ___ and chest CT dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: Normal chest radiographs. " 02aa804e-bde0afdd-112c0b34-7bc16630-4e384014.jpg,test/p10/p10000032/s50414267/02aa804e-bde0afdd-112c0b34-7bc16630-4e384014.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with new onset ascites // eval for infection TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Bilateral nodular opacities that most likely represent nipple shadows. The cardiomediastinal silhouette is normal. Clips project over the left lung, potentially within the breast. The imaged upper abdomen is unremarkable. Chronic deformity of the posterior left sixth and seventh ribs are noted. IMPRESSION: No acute cardiopulmonary process. " b3a360ed-c6a74b7b-53f4370e-dc0e97ef-cfbfd4cb.jpg,test/p17/p17284612/s54741517/b3a360ed-c6a74b7b-53f4370e-dc0e97ef-cfbfd4cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pneumonia, new fever // interval change TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiographs ___ through ___ FINDINGS: Lung volumes remain low, particular in the left side were there is left lower lobe atelectasis. Even allowing for the projection, the heart appears mildly enlarged. There is evidence of pulmonary vascular congestion. Platelike atelectasis at the right lung base is similar in appearance when compared to multiple prior studies. No pneumothorax seen. A right internal jugular catheter appears bent at the skin however this is unchanged compared to multiple prior studies. IMPRESSION: No significant interval change when compared to the prior study. " 2a4799a3-096012d7-8950301f-7e26c346-45c81616.jpg,test/p17/p17910941/s55125259/2a4799a3-096012d7-8950301f-7e26c346-45c81616.jpg,test," FINAL REPORT HISTORY: Positive PPD. TECHNIQUE: PA and lateral chest radiograph, 3 views. COMPARISON: ___. FINDINGS: Heart size is top normal with a mildly tortuous aorta. Hilar contours are normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute or chronic tuberculous disease. " 85f34267-5ea455b5-aafc6a35-71028706-6b84784a.jpg,test/p19/p19501510/s50280098/85f34267-5ea455b5-aafc6a35-71028706-6b84784a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with heart failure, dramatic ___ edema, orthopnea // r/o pulm edema COMPARISON: Chest radiographs from___ and CT chest from ___ FINDINGS: Heart size is top normal. The mediastinal contour is normal. Right hilar prominence is stable and consistent with known lymphadenopathy seen on prior CT. Mild edema is stable. Small to moderate right pleural effusion is larger than the left. No focal consolidation or pneumothorax is seen. Emphysema is severe. IMPRESSION: 1. Mild edema is stable. 2. Small to moderate right pleural effusion is larger than the left. " c56a1ede-322e650a-f3863d1d-0ea43d91-fdd675d6.jpg,test/p15/p15284302/s59614830/c56a1ede-322e650a-f3863d1d-0ea43d91-fdd675d6.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Left chest pain radiating to the left arm with recent stress test. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. Interstitial opacification is mildly prominent including peribronchial cuffing. Mild degenerative changes are similar along the lower lumbar spine. IMPRESSION: Mild interstitial prominence. Correlation with clinical factors is suggested. Possibilities include mild pulmonary vascular congestion but an inflammatory process involving the airways could also be considered. " 4e0a6aef-45019a79-5190f627-703a4cde-6ad4db1b.jpg,test/p11/p11528387/s58263220/4e0a6aef-45019a79-5190f627-703a4cde-6ad4db1b.jpg,test," FINAL REPORT HISTORY: CLL; cough. TECHNIQUE: PA and lateral chest radiograph 4 views. COMPARISON: ___. FINDINGS: Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph; specifically, no evidence of pneumonia. " 423b0ce1-ef7f5b67-16df5b37-65d2048a-33e2cb4e.jpg,test/p12/p12112694/s50710792/423b0ce1-ef7f5b67-16df5b37-65d2048a-33e2cb4e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Right-sided numbness and tingling, assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained. Lungs are clear and hyperinflated. No focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " 65fb692c-1a1187e5-5b03021c-69e3424c-5ebb921a.jpg,test/p19/p19263843/s54272748/65fb692c-1a1187e5-5b03021c-69e3424c-5ebb921a.jpg,test," WET READ: ___ ___ ___ 11:27 AM Hyperinflation of the lungs suggesting emphysema. Nodular opacity projecting over the right upper lung for which a nonurgent chest CT is suggested. No displaced fractures identified on this nondedicated exam. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with no PMHx here with atraumatic left side pain, no fever // Eval for left lower rib fractures vs pneumonia TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated. There is a 6 mm nodular opacity projecting over the right upper lung. The lungs are otherwise clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures identified. IMPRESSION: Hyperinflation of the lungs suggesting emphysema. Nodular opacity projecting over the right upper lung for which a nonurgent chest CT is suggested. No displaced fractures identified on this nondedicated exam. " eaa268ec-5c63dbc0-f306b0af-889d7457-03bfa08b.jpg,test/p11/p11234339/s54387918/eaa268ec-5c63dbc0-f306b0af-889d7457-03bfa08b.jpg,test," WET READ: ___ ___ 6:53 AM Normal chest radiograph. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with CP. Assess for pneumonia. TECHNIQUE: Chest PA and lateral. Slightly limited lateral view due to respiratory motion. COMPARISON: None FINDINGS: The lungs are well-expanded and clear. No pleural effusion, pneumomediastinum, or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Visualized upper abdomen is within normal limits. IMPRESSION: Normal chest radiograph. No pneumonia. " 91bb896e-4ef217b1-732a7080-168ce426-8725d5e0.jpg,test/p10/p10414036/s52488573/91bb896e-4ef217b1-732a7080-168ce426-8725d5e0.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation is seen. There is minor bibasilar atelectasis/scarring. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Mild bibasilar atelectasis/scarring. Otherwise, no acute cardiopulmonary process. " 556cc81b-2b22f57a-266618ad-596135ae-ec472e2e.jpg,test/p19/p19739493/s56793943/556cc81b-2b22f57a-266618ad-596135ae-ec472e2e.jpg,test," WET READ: ___ ___ 8:11 AM 1. Persistent hyperlucency of the left hemi thorax with leftwards mediastinal shift is worrisome for anterior pneumothorax with signs of tension. 2. Small right apical pneumothorax, slightly increased from ___ 1 PM study. 3. Mild improvement in left lower lobe atelectasis with developing right upper lobe opacity is worrisome for pneumonia or pulmonary contusion. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:36 PM, 5 minutes after discovery of the findings. Of note at time of conversation of findings patient had expired. WET READ VERSION #1 ___ ___ 12:27 AM 1. Persistent hyperlucency of the left hemi thorax with leftwards mediastinal shift is worrisome for anterior pneumothorax with signs of tension. 2. Small right apical pneumothorax, slightly increased from ___ 1 PM study. 3. Mild improvement in left lower lobe atelectasis with developing right upper lobe opacity is worrisome for pneumonia or pulmonary contusion. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:36 PM, 5 minutes after discovery of the findings. WET READ VERSION #2 ___ ___ ___ 12:39 AM 1. Persistent hyperlucency of the left hemi thorax with leftwards mediastinal shift is worrisome for anterior pneumothorax with signs of tension. 2. Small right apical pneumothorax, slightly increased from ___ 1 PM study. 3. Mild improvement in left lower lobe atelectasis with developing right upper lobe opacity is worrisome for pneumonia or pulmonary contusion. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:36 PM, 5 minutes after discovery of the findings. Of note at time of conversation of findings patient had expired. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple GSW // interval cxr, evaluate for pneumo/hemothorax interval cxr, evaluate for pneumo/hemothorax IMPRESSION: In comparison with the earlier study of this date, there is again increased opacification involving substantial amount of the left lower lung consistent with some combination of volume loss and pulmonary contusion with shift of the mediastinum to this side. There is a small pneumothorax on the left with chest tube in place. Little change in the hyperexpansion it right hemithorax. However, there is increasing prominence of the superior mediastinum on this side with displacement of the trachea to the left. This is worrisome for increasing hemorrhage in an area where there had been some hemorrhage on previous CT scan. NOTIFICATION: This information was directly communicated to the resident taking care the patient (___) at 8:18 AM on ___, immediately upon discovery. " 8babe31d-3767861f-b5eb9987-2e951135-89f66fdd.jpg,test/p12/p12577091/s54773172/8babe31d-3767861f-b5eb9987-2e951135-89f66fdd.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. There is no displaced fracture identified. IMPRESSION: No acute cardiopulmonary process. " 79744fce-598e857c-b0dfa919-6a4b31d3-1daee5a9.jpg,test/p13/p13410750/s54416721/79744fce-598e857c-b0dfa919-6a4b31d3-1daee5a9.jpg,test," WET READ: ___ ___ ___ 9:46 PM Mild pulmonary vascular congestion, improved from prior. Persistent moderate left pleural effusion and stable cardiac silhouette. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure, assessment for interval change. Evaluation for pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a minimal improvement of the pre-existing pulmonary edema. Moderate cardiomegaly, however, persists, as do the pleural effusions, left more than right. No pneumothorax. No interval appearance of parenchymal opacities. The left pectoral Port-A-Cath is in constant position. " fc907f90-e23398f2-79909077-c0513f15-ee751214.jpg,test/p19/p19643415/s55348942/fc907f90-e23398f2-79909077-c0513f15-ee751214.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // r/o acute CPD TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. CT chest from ___. FINDINGS: Left dual lumen chest wall Port-A-Cath is seen with catheter tip in the mid SVC. Opacity at the left lung base is compatible with prominent fat pad. The lungs are otherwise clear without consolidation, effusion, or edema. Known pulmonary nodules are better seen on prior dedicated chest CT. The cardiomediastinal silhouette is within normal limits. Multiple healed right lateral rib fractures are noted as well as hypertrophic changes in the spine. IMPRESSION: No acute cardiopulmonary process. " 454772ce-b8d1125a-c4b9f3dc-4116fb28-e8673319.jpg,test/p13/p13492875/s55260342/454772ce-b8d1125a-c4b9f3dc-4116fb28-e8673319.jpg,test," FINAL REPORT HISTORY: Polyarthralgias and myalgias. Evaluate for hilar lymphadenopathy or infiltrates. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate clear lungs with no acute infiltrate. The hila are not enlarged compared to prior radiograph, and the mediastinal and cardiac contours are normal. Chronically elevated left hemidiaphragm is noted all the way back to ___. No pleural effusion or pneumothorax is seen. IMPRESSION: No evidence of acute infiltrate or hilar lymphadenopathy. " 4dca7af9-be1b2eb4-9e664f09-5203390c-b7f31bb4.jpg,test/p19/p19601036/s59249673/4dca7af9-be1b2eb4-9e664f09-5203390c-b7f31bb4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chylopericardium // pericardial and pleural effusion progression? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Dobbhoff tube is projecting over the expected location of the stomach. Additional loop of the Dobbhoff tube is still within the stomach, unchanged in appearance. Evidence of prior lymphography is demonstrated. There is interval increase in left pleural effusion and a adjacent consolidation. Right pleural effusion is moderate and unchanged. No pneumothorax is clearly seen. Left PICC line tip is at the level of mid SVC " 779341fa-0ac0ed01-703d117e-6f13b46f-8562b7bb.jpg,test/p15/p15002645/s56406765/779341fa-0ac0ed01-703d117e-6f13b46f-8562b7bb.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Atypical chest pain, assess for pneumonia or pneumothorax. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " b421093e-d611ac7f-b26e5530-8f03d23b-1087ef7d.jpg,test/p15/p15614588/s54033983/b421093e-d611ac7f-b26e5530-8f03d23b-1087ef7d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with constitutional sxs x 3 days, L sided flank and back ""bloating"", parasthesia COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 72551349-ab702f32-3acbeba8-ce7a4761-96ee2171.jpg,test/p17/p17641212/s58994587/72551349-ab702f32-3acbeba8-ce7a4761-96ee2171.jpg,test," FINAL REPORT INDICATION: Weakness. No comparison studies available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is top normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 5746ff65-678b353c-d48c0c81-2a18effa-20bc6836.jpg,test/p13/p13687936/s52273181/5746ff65-678b353c-d48c0c81-2a18effa-20bc6836.jpg,test," FINAL REPORT INDICATION: ___F with weakness // acute cardiopulm disease TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Lung volumes are relatively low. Linear right basilar opacity is most likely atelectasis. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " aaf4f1fd-18352526-e7cc474f-6fe2476f-b43dffae.jpg,test/p14/p14900954/s54359828/aaf4f1fd-18352526-e7cc474f-6fe2476f-b43dffae.jpg,test," FINAL REPORT HISTORY: Chest pain and shortness of breath. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " e4193842-4b989f8c-c55b9ee0-ece57ab3-f63fcf2a.jpg,test/p16/p16767824/s55387845/e4193842-4b989f8c-c55b9ee0-ece57ab3-f63fcf2a.jpg,test," FINAL REPORT INDICATION: ___M with c/o fever/chills with cough // ? PNA TECHNIQUE: FRONTAL AND LATERAL VIEWS THE CHEST. COMPARISON: NONE. FINDINGS: Patchy regions of consolidation are identified at the lung bases bilaterally, more extensive on the right. Cardiomediastinal silhouette is within normal limits given low lung volumes. Tortuosity of the thoracic aorta is noted. No acute osseous abnormalities. IMPRESSION: Bibasilar patchy consolidation worrisome for pneumonia. Repeat after treatment suggested to document resolution. " c85199e9-1194a345-84af6a46-c9f8e77e-a3d2252e.jpg,test/p15/p15938702/s58406133/c85199e9-1194a345-84af6a46-c9f8e77e-a3d2252e.jpg,test," FINAL REPORT HISTORY: Right-sided pleuritic chest pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiac silhouette is normal in size. Hilar and mediastinal contours are normal. No pleural effusion. No evidence of pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " a0d19d65-febcb522-a6271f87-34c76ba1-05f09f9b.jpg,test/p12/p12639585/s56151069/a0d19d65-febcb522-a6271f87-34c76ba1-05f09f9b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p ng tube replacement after partially pulling it out // Assess for proper ngt placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is improvement with larger lung volumes, improved ventilation and absence of new parenchymal opacities. Minimal atelectasis at the right lung bases persists. The monitoring and support devices are constant. Unchanged appearance of the cardiac silhouette. " 45b648b9-fac6df91-90015417-31d04c80-79d60101.jpg,test/p18/p18259094/s50175276/45b648b9-fac6df91-90015417-31d04c80-79d60101.jpg,test," FINAL REPORT HISTORY: Fever, cough, question pneumonia. CHEST, TWO VIEWS. Assessment of fine detail is considerably limited by overlying soft tissues and underpenetration. Allowing for this, there is marked enlargement of the cardiomediastinal silhouette, similar to ___ at 7:35 a.m. Possibility of a patchy opacity at the right base, with involvement of the lower lobe, cannot be excluded. Doubt gross effusion. Possible mild vascular plethora, though this appears improved compared with the earlier film. IMPRESSION: Limited exam due to overlying soft tissues. Severe cardiomegaly persists. Possibility of a right lower lobe pneumonic infiltrate cannot be excluded. Small right effusion cannot be excluded. " 58018114-255686bd-8dc7b4ce-49a70993-557b8c25.jpg,test/p16/p16244108/s52979566/58018114-255686bd-8dc7b4ce-49a70993-557b8c25.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness and chills h/o bronchietasis // r.o infiltrate COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Clips are noted in the left chest wall. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " f9cb8331-20320398-c1afcc67-8aac478e-71c36537.jpg,test/p14/p14072871/s56218573/f9cb8331-20320398-c1afcc67-8aac478e-71c36537.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p Sigmoid ___ to my with shallow breathing // ? Effusion TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There are low lung volumes. Cardiac size is normal. Bibasilar atelectasis are larger on the left. If any there is a small left pleural effusion. There is no pneumothorax. There is pneumoperitoneum. There is residual contrast material in the colon " 065d5373-a68f85c1-a46c1c2d-96c7a72f-080a9ed0.jpg,test/p11/p11586698/s54613663/065d5373-a68f85c1-a46c1c2d-96c7a72f-080a9ed0.jpg,test," WET READ: ___ ___ ___ 2:00 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with ILD and vasculitis presenting with fevers, chills and cough for past 6 days // evidence of infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___, and CT of the chest dated ___. FINDINGS: There are low lung volumes, which results in bronchovascular crowding. The degree of interstitial prominence, bronchiectasis, and opacification is grossly unchanged. There is no focal consolidation concerning for pneumonia. The cardiac and mediastinal contours are normal. No pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 8d9d72dc-8a9733f5-5a408a79-fb1c42cc-371045fc.jpg,test/p13/p13875890/s59846277/8d9d72dc-8a9733f5-5a408a79-fb1c42cc-371045fc.jpg,test," FINAL REPORT INDICATION: ___ year old woman with brain tumor resection, intubated // eval OGT placement TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: The tip of the endotracheal tube projects 2.4 cm from the carina. An enteric feeding tube is new and extends into the stomach. Diffuse patchy bilateral airspace opacities likely reflect pulmonary edema. No large pleural effusion or pneumothorax identified. The size of the cardiomediastinal silhouette is within normal limits. IMPRESSION: The tip of the endotracheal tube projects 2.4 cm from the carina. New patchy bilateral airspace opacities likely reflect pulmonary edema. " f2d49e7a-fc4c65b5-d699f080-57e6f546-9f445ac5.jpg,test/p14/p14916430/s56607168/f2d49e7a-fc4c65b5-d699f080-57e6f546-9f445ac5.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with alcoholic hepatitis and alcoholic cirrhosis, Dobbhoff tube placement assessment. Portable AP radiograph of the chest was reviewed in comparison to ___ obtained at 10:18 a.m. and ___. The Dobbhoff tube tip is coiled in the stomach with its tip being in the prepyloric location. Cardiomegaly is moderate, unchanged. The patient is in pulmonary edema, grossly unchanged since ___:18 a.m. " d8cf59b5-d144f064-b13b98b1-ee9a2402-332c571c.jpg,test/p16/p16074663/s55932522/d8cf59b5-d144f064-b13b98b1-ee9a2402-332c571c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with ams. Hx of cirrhosis // Pneumonia? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Subtle left lower lobe opacity is not well substantiated on the lateral view, is again seen which may be due to atelectasis ;however, as also noted on the prior study, pneumonia is not excluded in the appropriate clinical setting. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Hilar contours are stable. IMPRESSION: Subtle left lower lobe opacity is not well substantiated on the lateral view, is again seen which may be due to atelectasis ;however, as also noted on the prior study, pneumonia is not excluded in the appropriate clinical setting " 4e00f201-44ecb092-e9384f36-c19396c5-adf436fc.jpg,test/p10/p10206502/s51209765/4e00f201-44ecb092-e9384f36-c19396c5-adf436fc.jpg,test," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: CT chest ___, AP chest radiograph ___. INDICATION: ___-year-old male with dyspnea on exertion and mild hypoxemia. FINDINGS: PA and later chest x-ray were obtained and compared to the immediate preceding chest radiograph. There is presence of median sternotomy wires. There is a biventricular pacing system with leads terminating in the right atrium, right ventricle, and left anterior oblique marginal vein. There are also wires from a previously placed and removed right pacer. The cardiomediastinal and hilar contours are stable. There are stable increased interstitial markings at the bilateral bases, but no new lung parenchymal opacity. There is mild blunting of the costophrenic sulci consistent with small pleural effusions; however, there is no evidence of interstitial edema. IMPRESSION: Small bilateral pleural effusions, otherwise no acute cardiopulmonary abnormality. " 1e75170f-0fff4777-6ade97a9-ba13836c-61843de2.jpg,test/p14/p14835135/s54006194/1e75170f-0fff4777-6ade97a9-ba13836c-61843de2.jpg,test," FINAL REPORT INDICATION: ___ year old woman with breast cancer undergoing chemotherapy now neutropenic // r/o acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The right Port-A-Cath terminates in the cavoatrial junction, unchanged. The lungs are well expanded and clear. The hila and pulmonary vasculature are normal. No pleural effusions or pneumothorax. The cardiomediastinal silhouette is normal and unchanged. IMPRESSION: No acute cardiopulmonary process. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 3:39 PM, 5 minutes after discovery of the findings. " ff848540-5aeb4780-e59acfab-1bd0c578-1b17bc7b.jpg,test/p18/p18773704/s58752175/ff848540-5aeb4780-e59acfab-1bd0c578-1b17bc7b.jpg,test," WET READ: ___ ___ ___ 7:58 PM Endotracheal tube terminates 9 cm cranial to the ___ at the level of the thoracic inlet and should be advanced. Right IJ Port-A-Cath terminates at the cavoatrial junction. NG tube terminates in the proximal stomach with side port at the GE junction. This is acceptable as this tube is being used for decompression only per primary team. No evidence for pleural effusion or aspiration. Scattered chronic appearing changes are similar to ___. WET READ VERSION #1 ___ ___ ___ 7:06 PM Right IJ central venous catheter terminates at the cavoatrial junction. NG tube terminates in the proximal stomach with side port at the GE junction and should be advanced. No evidence for pleural effusion or aspiration. Scattered chronic appearing changes are similar to ___. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___. FINDINGS: Tip of endotracheal tube terminates 9 cm above the carina and could be advanced approximately 4 to 5 centimeters for standard positioning. Tip of nasogastric tube terminates in proximal stomach with side port above GE junction and could also be advanced. Exam is otherwise remarkable for a large mass-like area of opacification above the right hilum with adjacent surgical sutures, as well as right upper lobe volume loss and asymmetrical right apical thickening. Although similar to recent radiographs, this is a change from baseline radiograph of ___. Surgical sutures are also present in the left mid lung. Further evaluation with dedicated chest CT is suggested when the patient's clinical status permits, in order to assess for possible lung malignancy. Dr. ___ was successfully paged to discuss these findings at 8:15 a.m. on ___ at time of discovery. " a228e776-2b8b3237-0d162a45-2fca1fa1-1b65edf1.jpg,test/p12/p12620105/s51558581/a228e776-2b8b3237-0d162a45-2fca1fa1-1b65edf1.jpg,test," CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: No contraindications for IV contrast ______________________________________________________________________________ FINAL REPORT HISTORY: Syncope, possible seizures today. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are relatively hyperinflated, but clear. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Some degenerative changes are again seen along the spine. IMPRESSION: No significant interval change. Relatively hyperinflated lungs without focal consolidation seen. " 850d65a9-c8f358b1-cf7acdd2-31311dd5-33b4855d.jpg,test/p10/p10013569/s53365004/850d65a9-c8f358b1-cf7acdd2-31311dd5-33b4855d.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with multiple medical problems, possible right lower lobe pneumonia and worsening shortness of breath and hypervolemia. Portable AP radiograph of the chest was compared to ___ and demonstrates slight interval progression of pulmonary edema, currently moderate to severe with the rest of the findings being unchanged. " 76a76ae7-57960e4d-18664b36-eb481293-2cc4641b.jpg,test/p13/p13920956/s57442001/76a76ae7-57960e4d-18664b36-eb481293-2cc4641b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with URI 8 weeks ago, persistent dry cough, left basilar crackles. H/O OSA, CAD, copd // pleas eeval for LLL infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Lungs are clear consolidation, pleural effusion or pneumothorax. Specifically, no left lower lobe consolidation. Cardiomediastinal contours are normal. No acute osseous abnormalities. Surgical clips noted over the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 8920f33b-d83a293d-4946019c-c94e2f03-c524ef0e.jpg,test/p16/p16887254/s56651883/8920f33b-d83a293d-4946019c-c94e2f03-c524ef0e.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT ___ CLINICAL INDICATION: ___-year-old with left-sided effusion, atelectasis, question increasing. Comparison to prior study of ___ at ___. PA and lateral views of the chest dated ___ at ___ is submitted. On the frontal projection, the left costophrenic angle is not entirely included. IMPRESSION: Right internal jugular central line has its tip in the distal SVC near the cavoatrial junction. The left pleural effusion, which likely has a loculated component, is stable since the previous study. There is persistent airspace consolidation in the left mid and lower lung, likely representing compressive atelectasis, although pneumonia cannot be excluded. In addition, patchy opacity at the right base is again seen, is suggestive of atelectasis. No evidence of pulmonary edema. Status post median sternotomy, persistent widening of the superior mediastinum in this patient status post aortic aneurysm repair. Multiple surgical clips are seen overlying the aortic knob as well as overlying the right axillary region. There is interval improvement in aeration in the right upper lung. No pneumothorax is seen. " a512bf73-f1376325-f7e17aac-58c21142-e3efd0e7.jpg,test/p16/p16560053/s58275625/a512bf73-f1376325-f7e17aac-58c21142-e3efd0e7.jpg,test," FINAL REPORT HISTORY: Cardiac surgery. FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with bilateral pleural effusions, more prominent on the right, and pulmonary vascular congestion. Bibasilar atelectatic changes are seen and there is no evidence of pneumothorax. Midline sternal wires appear intact. " a3b9bc72-e5f34491-b2b346bd-f3c06465-5a0a84f4.jpg,test/p14/p14813830/s54510308/a3b9bc72-e5f34491-b2b346bd-f3c06465-5a0a84f4.jpg,test," FINAL REPORT HISTORY: Intermittent hypoxia. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. . FINDINGS: Bibasilar atelectasis is noted. No lobar consolidation, pleural effusion, pneumothorax, or overt pulmonary edema is seen. Minimal biapical scarring is noted. The heart size is normal. Mediastinal contours are normal. Multiple, bilateral, chronic rib fractures are seen again. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " bee08472-b23eed9d-65beb236-d81c31e2-06dadae5.jpg,test/p16/p16934455/s51937021/bee08472-b23eed9d-65beb236-d81c31e2-06dadae5.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Screening for pre-kidney transplant. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4b636128-7ec65e93-d554bf72-f53067ba-28e33fec.jpg,test/p16/p16334734/s57081181/4b636128-7ec65e93-d554bf72-f53067ba-28e33fec.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe MR ___ intubation on pressors afib with RVR found to have pneumo // pneumothorax, interval change pneumothorax, interval change IMPRESSION: Comparison to ___, no relevant change as compared to ___. The extent of the pre-existing left pneumothorax is stable. No evidence of tension. Unchanged moderate cardiomegaly. Monitoring and support devices are stable. Decrease in extent of a pre-existing right pleural effusion. " ce498af8-aa329fb0-68db6ce0-9454f081-f7f676e1.jpg,test/p11/p11702253/s56581050/ce498af8-aa329fb0-68db6ce0-9454f081-f7f676e1.jpg,test," FINAL REPORT AP CHEST, 5:57 A.M., ___ HISTORY: Foreign body removed. Question free air. IMPRESSION: AP chest compared to ___: ET tube in standard placement. Lung volumes generally low, with mild-to-moderate bibasilar subsegmental atelectasis. No pneumothorax or pleural effusion. Normal cardiomediastinal silhouette. No appreciable pneumoperitoneum. An upright conventional chest radiograph is recommended if looking for small amounts of subdiaphragmatic free air. " 2f0cb256-f8a4af05-0a5d4727-e422eb8d-dbcbcc84.jpg,test/p18/p18977683/s52648396/2f0cb256-f8a4af05-0a5d4727-e422eb8d-dbcbcc84.jpg,test," FINAL REPORT HISTORY: Liver failure and hypertension. COMPARISON: ___. FINDINGS: The lungs are somewhat low in volume but clear aside from mild basal atelectasis. Mild pulmonary vascular congestion is seen without overt edema. The heart and mediastinal contours are unremarkable. IMPRESSION: Mild pulmonary vascular congestion. " e76a2cd3-c0e28755-f799781c-ec79a870-5552f8ae.jpg,test/p15/p15957987/s54703161/e76a2cd3-c0e28755-f799781c-ec79a870-5552f8ae.jpg,test," FINAL REPORT HISTORY: Recurrent esophageal adeno-CA, monitoring of left-sided Pleurx catheter. CHEST, TWO VIEWS. Compared with ___ at 12:02 p.m., again seen is a left apical pneumothorax, essentially unchanged. Left-sided catheter again noted. Again seen is the esophageal stent; opacification in the right mid and lower zones, with underlying collapse and/or consolidation; and patchy opacity in the retrocardiac region with minimal pleural thickening along the left base. A small amount of pleural fluid at the left base is new. Otherwise, no significant change is detected. IMPRESSION: 1) Left apical pneumothorax, unchanged compared with one day earlier. 2) Small left effusion appears new. Otherwise, no significant interval change. " b58fc178-4ab7aba9-e502d79b-a7f2f69c-ccbf0bde.jpg,test/p10/p10307557/s52477488/b58fc178-4ab7aba9-e502d79b-a7f2f69c-ccbf0bde.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Extensive upper extremity injuries with new Dobbhoff tube placement. AP radiograph of the chest was obtained demonstrating attempt to place Dobbhoff tube which appears to be coiled in the esophagus. Heart size and mediastinum are unchanged as compared to prior study obtained the same day earlier. The tip of the right internal jugular line is at the level of mid SVC. There is interval minimal change in bilateral pleural effusions and bibasal atelectasis. " d8164619-f95b383b-0b2ad772-f0c95c8f-b63cf392.jpg,test/p13/p13031858/s57627519/d8164619-f95b383b-0b2ad772-f0c95c8f-b63cf392.jpg,test," FINAL REPORT INDICATION: ___ year old woman with AI hepatitis on azathioprine, now with 10d h/o persistent, productive cough // Is there evidence of pna or other pulmonary disease? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. Incidental note of azygos fissure benign variant. The cardiomediastinal silhouette is unremarkable. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute radiographic intrathoracic pulmonary disease. " d56430a1-fc31861a-47ca187b-ba719467-95f84d45.jpg,test/p18/p18088619/s58595084/d56430a1-fc31861a-47ca187b-ba719467-95f84d45.jpg,test," FINAL REPORT INDICATION: ___-year-old female with dementia, found walking outside. Question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiac silhouette allowing for low lung volumes but vascular engorgement ant and mild basal edema reflect cardiac decompensation. The thoracic aorta is unfolded with dense arch calcifications. The lung volumes are low, accentuating bronchovascular crowding. However, the lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: Mild heart failure. Dr. ___ ___ I discussed these findings by telephone at the time of report approval. Low lung volumes. " eb0de59c-8dd3af9e-371f1f02-cc2b868b-34b120cf.jpg,test/p10/p10292574/s52152049/eb0de59c-8dd3af9e-371f1f02-cc2b868b-34b120cf.jpg,test," FINAL REPORT INDICATION: ___F with a fib and shortness of breath // evaluate for CHF . COMPARISON: None Available. TECHNIQUE Portable view of the chest. FINDINGS: Lung volumes are low. There is mild pulmonary edema. Cardiomediastinal silhouette is mildly enlarged, which likely reflects AP position and low lung volumes. There is no pneumothorax or pleural effusion. The stomach is air-filled and distended. Degenerative changes are noted of the right acromioclavicular joint. IMPRESSION: Low lung volumes. Mild pulmonary edema. NOTIFICATION: Findings discussed with Dr. ___ by Dr. ___ ___ the telephone on ___ at 16:00, 2 hr after they were made. " 7a0960e9-5bb27391-d1ee0308-647c6ec1-d2c62ae0.jpg,test/p11/p11312914/s56400917/7a0960e9-5bb27391-d1ee0308-647c6ec1-d2c62ae0.jpg,test," FINAL REPORT INDICATION: Two-three-week history of cough and inspiratory crackles at the left base, treated with antibiotics. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: There is no consolidation, pleural effusion, vascular congestion or pneumothorax. There is mild cardiomegaly and the aorta is tortuous, unchanged. IMPRESSION: No evidence pneumonia or volume overload. Findings were relayed by Dr. ___ to Dr. ___ by phone at 10:33 a.m.. " f4b6d78f-d355faf7-00146e5c-00f98f16-80f02e2e.jpg,test/p14/p14508231/s57408242/f4b6d78f-d355faf7-00146e5c-00f98f16-80f02e2e.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with multiple ED visits for CP, h/o PE, p/w CP and SOB but sating well. // evidence of pneumonia or volume overload, pt presenting w/ CP and SOB TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are clear. There is no focal consolidation, pleural effusion or pneumothorax. Surgical hardware from prior anterior cervical spine fusion is present. IMPRESSION: No acute cardiopulmonary process. " e3c3b084-fce3bf6f-7766aaf3-927aa03f-b301b509.jpg,test/p13/p13417577/s52217997/e3c3b084-fce3bf6f-7766aaf3-927aa03f-b301b509.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with L PTX // R/O PTX post CT removal TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs the most recent on ___ at 00:38 FINDINGS: There has been interval removal of a left-sided pigtail catheter. There is decrease in a small left pneumothorax. Small left pleural effusion is decreased in size from the prior study. There is evidence of emphysema. Cardiomediastinal and hilar contours are unchanged. The right lung is clear. Hiatal hernia is unchanged IMPRESSION: 1. Small, stable left apical pneumothorax. 2. Decreased small left pleural effusion. " 17c62d50-e3c2036e-1bc0fd7e-0aacf603-69a4a392.jpg,test/p12/p12878438/s51102861/17c62d50-e3c2036e-1bc0fd7e-0aacf603-69a4a392.jpg,test," FINAL REPORT INDICATION: Back pain. TECHNIQUE: Two views of the chest. COMPARISON: Radiographs dated ___. FINDINGS: The lungs are clear. No pleural effusion, pulmonary edema, or pneumothorax is present. The cardiomediastinal silhouette and pleural surface contours are normal. No free air beneath the diaphragm. No displaced fracture identified. IMPRESSION: No evidence of acute cardiopulmonary process. No free air. " ecf331bb-7c2aada6-2759b24e-883c1235-8d96bcd7.jpg,test/p18/p18905861/s56585861/ecf331bb-7c2aada6-2759b24e-883c1235-8d96bcd7.jpg,test," FINAL REPORT HISTORY: CABG. FINDINGS: In comparison with the study of ___, there is little overall change. Again there are low lung volumes that accentuate the prominence of the cardiac silhouette. Bibasilar opacifications are consistent with pleural effusion and compressive atelectasis and are more prominent on the left. No definite pulmonary vascular congestion. Right IJ catheter extends to the upper to mid portion of the SVC. " da308e9d-ae569c33-a4dee36d-c13f14e4-7d1ad419.jpg,test/p18/p18279430/s53233428/da308e9d-ae569c33-a4dee36d-c13f14e4-7d1ad419.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chf exacerbation // eval for pulm edema eval for pulm edema COMPARISON: Prior chest radiographs ___. IMPRESSION: Severe cardiomegaly is chronic, but there is no pulmonary edema and pleural effusions are small, decreased since ___ when pulmonary edema was present. Small region of right infrahilar opacity could be pneumonia or atelectasis. Transvenous right atrial biventricular pacer leads are unchanged in their respective positions since ___, continuous from the left pectoral generator. No pneumothorax or mediastinal widening. " 57b5b3dd-29e5ee12-d13d33d4-53dcd5a1-ebd33a9a.jpg,test/p18/p18448597/s55719219/57b5b3dd-29e5ee12-d13d33d4-53dcd5a1-ebd33a9a.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old man with MCA stroke. Shortness of breath. FINDINGS: Comparison is made to previous study from ___. The heart size is within normal limits. There is development of some vague densities at the lung bases which may represent atelectasis or early infiltrate. This may also be due to aspiration. The lung apices are clear. There are no pneumothoraces. Bony structures are intact. " be7e2ffe-878c818b-61763a7b-be5edc0a-b54bf3ad.jpg,test/p14/p14832532/s50105912/be7e2ffe-878c818b-61763a7b-be5edc0a-b54bf3ad.jpg,test," FINAL REPORT INDICATION: Recent diarrhea and vomiting. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. Distal resection of the right clavicle and multiple anterior chest clips are again seen. A healing right 3rd rib fracture is new since the ___ examination. IMPRESSION: No acute intrathoracic process. Healing right 3rd rib fracture is new since ___. " e3ce249d-70c5df8e-920bba23-4040590a-d0b1ef47.jpg,test/p15/p15220389/s54781847/e3ce249d-70c5df8e-920bba23-4040590a-d0b1ef47.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs since ___ most recently ___. CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with leukocytosis. // r/o PNA - if down in xray please perform as PA/LAT, otherwise portable OK at bedside. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. Right supraclavicular infusion port ends in the upper SVC. " 96bcff77-b5897465-e116741b-d8ced09e-91ba9589.jpg,test/p16/p16777182/s56257399/96bcff77-b5897465-e116741b-d8ced09e-91ba9589.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with shortness of breath. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. And ___. FINDINGS: The lungs are clear. No edema, effusion, or pneumothorax. The heart is top-normal in size, not significantly changed. The mediastinum is not widened. No acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " 27775024-3bdb64fe-c97cdb36-b53f640c-524ea223.jpg,test/p15/p15693812/s53173881/27775024-3bdb64fe-c97cdb36-b53f640c-524ea223.jpg,test," FINAL REPORT EXAMINATION: AP chest, 4:17 a.m., ___. HISTORY: ___-year-old man with sepsis and respiratory failure. IMPRESSION: AP chest compared to ___:29 p.m.: Moderately severe pulmonary edema has not improved, but there has been a substantial increase in the volume of moderate bilateral pleural effusion. ET tube is in standard placement. Nasogastric tube is coiled in a non-distended stomach. There is no pneumothorax. Cardiomediastinal silhouette has a benign appearance aside from heavy calcification in the aortic knob. ET tube in standard position. " 02f28d77-1db8f57c-c622f1b6-50bcdbc5-40776499.jpg,test/p13/p13364829/s57401997/02f28d77-1db8f57c-c622f1b6-50bcdbc5-40776499.jpg,test," FINAL REPORT HISTORY: Respiratory failure and cirrhosis with endotracheal tube. FINDINGS: In comparison with the study of ___, the intestinal tube now extends well into the stomach. Endotracheal tube and central catheter in good position. There is some increased opacification at the left base, most likely reflecting volume loss in the left lower lobe. In the appropriate clinical setting, pneumonia would have to be a diagnostic possibility. " c00de8fc-aa6ac4c1-e83007d6-7a016ee5-dfdadd45.jpg,test/p19/p19057052/s59022736/c00de8fc-aa6ac4c1-e83007d6-7a016ee5-dfdadd45.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoxia, rule out effusion or pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is increasing atelectasis at the left and right lung base. No other parenchymal abnormalities. Overall, the lung volumes have decreased. The lung parenchyma is otherwise unchanged. Minimal increase of the cardiac silhouette. No pneumothorax. " 66848b90-bdc5a08b-1da1b5c1-b0684ac8-7fb08f17.jpg,test/p15/p15180359/s52706560/66848b90-bdc5a08b-1da1b5c1-b0684ac8-7fb08f17.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new secretions // ?volume over load?infection TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: NG tube tip isout of view, below the diaphragm. ET tube is in standard position. Central catheters are in unchanged standard position. Cardiomegaly is stable. The aorta is tortuous. Large bilateral effusions with adjacent atelectasis are unchanged. Moderate pulmonary edema is minimally improved. " 3b589ad6-55aeed87-8d8011fe-c66da0f0-3dfa7ffc.jpg,test/p11/p11065430/s58819773/3b589ad6-55aeed87-8d8011fe-c66da0f0-3dfa7ffc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with severe TR and left side pleural effusion // please evaluate for interval change please evaluate for interval change COMPARISON: Prior chest radiograph one ___ IMPRESSION: No appreciable change since one ___. Persistent elevation of the left lung base, could be due to moderate, subpulmonic pleural effusion and/or diaphragmatic elevation with a small left pleural effusion. Left lower lobe is probably substantially atelectatic. Right lung is clear. Heart shadow is mildly enlarged. No pneumothorax. " 4380af21-1e1fdd85-316ee3ce-19f98279-d22bffce.jpg,test/p13/p13715870/s53940823/4380af21-1e1fdd85-316ee3ce-19f98279-d22bffce.jpg,test," FINAL REPORT HISTORY: Dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. The inferior-most sternotomy wire is fractured without evidence of displacement. Heart size remains mild to moderately enlarged. The aorta is unfolded. There is mild pulmonary vascular congestion. No focal consolidation or pneumothorax is seen. Minimal blunting of the right costophrenic sulcus could suggest the presence of a trace pleural effusion. Small amount of fissural thickening due to pleural fluid is present. There are no acute osseous abnormalities. IMPRESSION: Mild pulmonary vascular congestion with trace right pleural effusion. " b81fbc65-2cd78a50-ed211f13-27df65aa-4c4b3477.jpg,test/p16/p16476559/s53321963/b81fbc65-2cd78a50-ed211f13-27df65aa-4c4b3477.jpg,test," FINAL REPORT INDICATION: ___M with sob // ? chf COMPARISON: Multiple prior exams, most recently of ___. TECHNIQUE: Single frontal view of the chest. FINDINGS: Moderate cardiomegaly and upper mediastinal contours are stable. There is prominence of the pulmonary vasculature, consistent with congestion. No overt pulmonary edema. No large pleural effusion or pneumothorax. Sternotomy wires are intact. IMPRESSION: Central pulmonary vascular congestion with stable moderate cardiomegaly. " 8eb7e7dc-6d38e63d-d37a5f5c-a057d341-5ca3e485.jpg,test/p10/p10373862/s51064128/8eb7e7dc-6d38e63d-d37a5f5c-a057d341-5ca3e485.jpg,test," FINAL REPORT HISTORY: Unsteady gait. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are well-expanded. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8c8ed4f2-6795e796-6e84f815-72b82d95-a043f539.jpg,test/p14/p14921998/s54221860/8c8ed4f2-6795e796-6e84f815-72b82d95-a043f539.jpg,test," FINAL REPORT HISTORY: Weakness,fall. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. The aorta is mildly tortuous with mild atherosclerotic calcifications noted. The pulmonary vasculature is normal and the hilar contours are unremarkable. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is visualized. There are degenerative changes noted within the left acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " 92894b70-5240e15d-b160e452-69ef3750-e8e5ad76.jpg,test/p14/p14249822/s59455177/92894b70-5240e15d-b160e452-69ef3750-e8e5ad76.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with ___ swelling and shortness of breath, history of lymphoma. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. PET-CT ___. FINDINGS: The cardiomediastinal and hilar contours are stable with calcification of the aortic knob. There is no pneumothorax or pleural effusion. The lungs are well-expanded. A small peripheral left base opacity may represent atelectasis or scarring and was present on the most recent prior chest radiograph. Moderate degenerative changes are present throughout the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 910d2293-927b948d-6d20971f-92870a61-96651da0.jpg,test/p17/p17965724/s53610487/910d2293-927b948d-6d20971f-92870a61-96651da0.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___-year-old woman with shortness of breath on BiPAP; evaluate for pneumonia. TECHNIQUE: AP portable frontal radiograph view of the chest was obtained. COMPARISON: No prior chest radiograph is available. FINDINGS: Lung volumes are low. The lateral contour of the descending aorta and inferior left heart border are indistinct, which may be secondary to technique and body habitus as well as low lung volumes with atelectasis; however, focal consolidation and pneumonia cannot be definitely excluded in the appropriate clinical situation. No pleural effusion. No pneumothorax. The heart size appears enlarged, which may in part be secondary to technique. There is mild cardiovascular congestion. IMPRESSION: 1. Mild vascular congestion and probable mild cardiomegaly. 2. Retrocardiac opacity, may be atelectasis with low lung volumes and secondary to technique/body habitus, but focal consolidation suggesting pneumonia cannot be excluded in the appropriate clinical situation. " ca4a50d8-a6b71c07-920fe285-2e4ce6e4-09a1751f.jpg,test/p19/p19138636/s54084583/ca4a50d8-a6b71c07-920fe285-2e4ce6e4-09a1751f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fevers, evaluation for pneumonia. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. No focal parenchymal opacity suggesting pneumonia. No pulmonary edema, no pleural effusion. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " 1aabb13b-f56ae9ff-f3ea78c6-c6ab2c2a-283c7bc1.jpg,test/p16/p16222235/s52081406/1aabb13b-f56ae9ff-f3ea78c6-c6ab2c2a-283c7bc1.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with sob // eval for overload TECHNIQUE: Single portable upright frontal image of the chest. COMPARISON: None. FINDINGS: The lungs are well expanded. Bilateral hazy opacities and bilateral pleural effusions with cardiomegaly are suggestive of moderate pulmonary edema. No pneumothorax is seen. IMPRESSION: Bilateral hazy opacities and bilateral pleural effusions with cardiomegaly, suggestive of moderate pulmonary edema. " d0535e9f-5d96b0fb-ab1aa3e9-b7744760-c89201cb.jpg,test/p15/p15619921/s56042987/d0535e9f-5d96b0fb-ab1aa3e9-b7744760-c89201cb.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with possible volume overload. Has there been any interval change. IMPRESSION: PA and lateral chest compared to ___: Previous mild-to-moderate vascular congestion has improved, and there is no pulmonary edema. Moderate bilateral pleural effusions are comparable in size. Heart size is top normal. No pneumothorax. " 8b8c1446-9ff5e005-198f4a5e-b195cfd1-0d9977c5.jpg,test/p19/p19219767/s54834495/8b8c1446-9ff5e005-198f4a5e-b195cfd1-0d9977c5.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Shortness of breath for 10 days. FINDINGS: PA and lateral views of the chest are provided. Lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " fa0189ec-0db46f35-14119298-9f8012c7-4f8733b9.jpg,test/p13/p13994624/s50799245/fa0189ec-0db46f35-14119298-9f8012c7-4f8733b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fevers and myalgia // fevers and myalgia r/o infiltrate fevers and myalgia r/o infiltrate IMPRESSION: In comparison with the study of ___, there is little change. Again there is substantial hyperexpansion of the lungs consistent with chronic pulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 90d3077f-94fc4893-710c417d-e177d4e0-96ee2e4f.jpg,test/p11/p11296936/s55718502/90d3077f-94fc4893-710c417d-e177d4e0-96ee2e4f.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough and shortness of breath. COMPARISON: Chest radiograph ___ AP PORTABLE UPRIGHT CHEST RADIOGRAPH: The hilar and mediastinal contours are stable, with a mildly tortuous thoracic aorta. Again, seen is a moderate-sized right pleural effusion with mild right basal atelectasis. Bilateral perihilar and pulmonary alveolar opacities are most suggestive of moderate-to-severe pulmonary edema. Left IJ approach central venous dialysis catheter ends in the right atrium. There is no pneumothorax. IMPRESSION: Moderate-sized right pleural effusion with moderate pulmonary edema. " a807a361-4289586b-92ab25fa-31399d10-35b133d0.jpg,test/p19/p19674970/s54586045/a807a361-4289586b-92ab25fa-31399d10-35b133d0.jpg,test," FINAL REPORT HISTORY: ___-year-old male with end-stage renal disease, pre kidney transplant evaluation. Rule out abnormality. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in the upright position. COMPARISON: None. FINDINGS: Bibasilar atelectasis and lung volume loss is seen both on the PA and lateral radiographs. Right lung basilar atelectasis is seen with right pleural effusion. Left lower lung volume loss is seen with triangular opacity overlying the posterior left lung base. This opacity may represent pneumonia versus chronic infectious change. No pulmonary edema is noted, and the cardiac silhouette and mediastinal contours are within normal limits. IMPRESSION: There is bibasalir lung volume loss. The right-side has an associated pleural effusion. The left lung base has a posterior triangular opacity which may represent a pneumonia versus chronic infectious change. " 0aa118e0-68f7485d-9338cdaf-49eb0279-667c6c94.jpg,test/p18/p18823492/s54101727/0aa118e0-68f7485d-9338cdaf-49eb0279-667c6c94.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Swallowed toothbrush. Question foreign body. COMPARISON: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. No radiopaque foreign body is identified. IMPRESSION: No evidence of acute cardiopulmonary disease. No evidence of radiodense foreign body. " 2a6acaf0-cb4f65b5-8b8fbbed-b73ed8ec-09ba59f2.jpg,test/p14/p14866491/s57117652/2a6acaf0-cb4f65b5-8b8fbbed-b73ed8ec-09ba59f2.jpg,test," FINAL REPORT INDICATION: Chest pain and fever. Evaluation for pneumonia. COMPARISONS: ___. FINDIGNS: PA and lateral chest radiographs demonstrate lower lobe streaky opacities seen best on the lateral view, though not well localized on the frontal view. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Likely lower lobe atelectasis seen best on the lateral view. Pneumonia cannot be excluded though, and clinical correlation is recommended. " 4a5861f5-3319b76b-d41031f7-750c3fe0-43ca0f03.jpg,test/p14/p14538785/s52095292/4a5861f5-3319b76b-d41031f7-750c3fe0-43ca0f03.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o pleural effusions // assess for infx, edema, effusions assess for infx, edema, effusions COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lungs are clear. Left pleural effusion minimal if any. Heart size normal. Thoracic aorta is generally large and tortuous but not focally aneurysmal. " 87e6fd89-31470561-535ac69d-10dad327-e573d22c.jpg,test/p17/p17734689/s55438143/87e6fd89-31470561-535ac69d-10dad327-e573d22c.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Left-sided chest tube, rule out pneumothorax. COMPARISON: No comparison available at the time of dictation. FINDINGS: The patient carries a left-sided chest tube. There is no evidence of pneumothorax on the left. Atelectasis at the right lung bases. Borderline size of the cardiac silhouette. Partially imaged vertebral stabilization devices. " 54e8929e-7e97e4f7-bdf42819-b0d5c864-999b8339.jpg,test/p11/p11545493/s53168819/54e8929e-7e97e4f7-bdf42819-b0d5c864-999b8339.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with severe abdominal pain, AMS, history of HIV. pain out of proportion to exam*** WARNING *** Multiple patients with same last name! // eval for mesenteric ischemia, intracranial mass TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 2cdd3652-a541f15e-179289ff-05216c3e-e1b684af.jpg,test/p10/p10926537/s55054913/2cdd3652-a541f15e-179289ff-05216c3e-e1b684af.jpg,test," FINAL REPORT INDICATION: ___-year-old woman presenting with initial concern for status epilepticus (R arm/face weakness> leg)found to have basilar artery thrombus with bilateral pontine infarcts L > R. // assess placement of NGT TECHNIQUE: Two AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: The tip of the gastric tube extends into the body of the stomach. A left PICC line tip extends to the mid to distal SVC. No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiac silhouette is enlarged but unchanged. IMPRESSION: The tip of the feeding tube extends into the body of the stomach. " d32c0fb5-a7cb00c7-8ddf0006-b56fabb5-71909ff0.jpg,test/p16/p16151261/s52608317/d32c0fb5-a7cb00c7-8ddf0006-b56fabb5-71909ff0.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p MVC w/ c5 cord injury, intubated planning for trach // interval change COMPARISON: ___ FINDINGS: ET tube is in good position and the left PICC remains in the right atrium. No pneumothorax. New right upper lobe collapse. The lung volumes remain low, with worsening left and improving right basilar atelectasis. The heart is mildly enlarged. No pleural effusions. IMPRESSION: New right upper lobe collapse. Worsening left basilar and improved right basilr atelectasis. " ce7d144a-a25d1ffe-15d7e41a-43d29356-d22d4ebc.jpg,test/p16/p16142940/s51625976/ce7d144a-a25d1ffe-15d7e41a-43d29356-d22d4ebc.jpg,test," FINAL REPORT INDICATION: Pneumothorax. TECHNIQUE: Frontal chest radiograph. COMPARISON: ___ FINDINGS: Again seen is the right PleurX catheter. The small right-sided pleural effusion is stable. The pneumothorax is stable. The heart remains enlarged. There is linear lingular atelectasis. IMPRESSION: Stable right-sided pneumothorax and pleural effusion. " 4afd7bb8-e1b6c40e-c8049f3c-b4b305e2-72d2dd83.jpg,test/p16/p16132910/s57907715/4afd7bb8-e1b6c40e-c8049f3c-b4b305e2-72d2dd83.jpg,test," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old female patient with left lower lobe mass, status post CT-guided biopsy performed on ___, assess for interval change. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. Heart size is unchanged. Moderate widening and elongation of the thoracic aorta as before. No local contour abnormalities. The pulmonary vasculature is not congested. The previously identified post-interventional parenchymal density in the left lower lobe posterior area has now regressed and the density assumed the size of the previously identified suspicious lesion. No remaining pneumothorax or new pleural effusion is identified. IMPRESSION: Normalization of post-interventional infiltrate with residual density identical preoperative local rounded lesion in left lower lobe posterior segment. No new pulmonary abnormalities are present, no pleural effusion and no pneumothorax. " c3b9a143-94ba9dde-568466e7-7aa475bc-16a62e5c.jpg,test/p12/p12492854/s58837764/c3b9a143-94ba9dde-568466e7-7aa475bc-16a62e5c.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___M with left sided chest pain // rule out PE TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiograph dated ___, CT chest dated ___. FINDINGS: Lung volumes are low leading to crowding of the bronchovascular structures. Allowing for this, there is no focal consolidation, pleural effusion, or pneumothorax. Allowing for projection and low lung volumes, the cardiomediastinal silhouette is unchanged from prior examination. IMPRESSION: No acute cardiopulmonary process. Low lung volumes with crowding of the vasculature. " abdbede2-13052828-c7d343eb-8964dda3-ae756581.jpg,test/p12/p12006266/s55374832/abdbede2-13052828-c7d343eb-8964dda3-ae756581.jpg,test," FINAL REPORT INDICATION: ___-year-old man with left effusion status post thoracentesis, rule out pneumothorax. COMPARISON: AP portable radiograph from ___. FINDINGS: There has been improvement of the left pleural effusion and slightly increased right-sided pleural effusion since the prior radiograph. There is no focal consolidation or pneumothorax. The Cardiomediastinal silhouette is unchanged. A left PICC line is seen coursing through the brachiocephalic vein; however, the tip cannot be definitely identified on this study. IMPRESSION: Improved left-sided pleural effusion with slightly increased right-sided pleural effusion. No pneumothorax. " 6561dab1-f94f49a1-26cda065-05063831-95be86c0.jpg,test/p17/p17747028/s59977582/6561dab1-f94f49a1-26cda065-05063831-95be86c0.jpg,test," FINAL REPORT HISTORY: Syncope. Evaluate for pneumonia. TECHNIQUE: AP and lateral radiographs of the chest. COMPARISON: Radiographs of the chest most recent ___. FINDINGS: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 687ddcff-01fd8612-30d62cd7-f4c3b25b-cf72e642.jpg,test/p15/p15493655/s56395912/687ddcff-01fd8612-30d62cd7-f4c3b25b-cf72e642.jpg,test," FINAL REPORT HISTORY: Fever and cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The lungs are clear. The pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality seen. IMPRESSION: No acute cardiopulmonary process. " df2e22d8-6548bccf-c95df904-bb4da287-feb4b1db.jpg,test/p16/p16896608/s54052790/df2e22d8-6548bccf-c95df904-bb4da287-feb4b1db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Motor vehicle collision TECHNIQUE: Supine AP view of the chest COMPARISON: None. FINDINGS: Overlying trauma board limits assessment. Lung volumes are low. Cardiac silhouette size is mildly to moderately enlarged. Mediastinal and hilar contours are otherwise unremarkable. There is crowding of the bronchovascular structures without overt pulmonary edema. No gross focal consolidation, large pleural effusion or pneumothorax is detected on this supine exam. No displaced fractures are visualized. IMPRESSION: No grossly acute cardiopulmonary abnormality. " a4d1b32f-05220269-ddc112c0-6a1313f7-389cf1d4.jpg,test/p13/p13141248/s52978464/a4d1b32f-05220269-ddc112c0-6a1313f7-389cf1d4.jpg,test," FINAL REPORT INDICATION: ___-year-old with chest pain. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear, cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. Unchanged fibronodular scarring at the lung apices. IMPRESSION: No acute cardiothoracic process. " 091a8135-a5561cce-1215f853-d946fe9f-0d445709.jpg,test/p12/p12878814/s54848217/091a8135-a5561cce-1215f853-d946fe9f-0d445709.jpg,test," FINAL REPORT INDICATION: Fever and immunocompromise. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiographs ___ and ___. FINDINGS: A right central venous catheter courses to the level of the cavoatrial junction. Heart is not enlarged. Aorta is unfolded. No overt CHF. Although the retrocardiac consolidation has improved from ___, a retrocardiac opacity persists with air bronchograms. Otherwise, no focal infiltrate or consolidation identified. Left pleural effusion has resolved. No right pleural effusion is seen. No pneumothorax. IMPRESSION: Interval improvement in previously seen retrocardiac consolidation, though some degree of retrocardiac opacity persists, which could reflect pneumonia in the correct clinical setting. No new infiltrate identified. Interval resolution of left pleural effusion. " f57683b8-ff90af19-48229b37-c25f0b2e-c906562b.jpg,test/p12/p12168822/s59378926/f57683b8-ff90af19-48229b37-c25f0b2e-c906562b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with 3 weeks of cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 56a10249-2158c293-00dec61b-e19d6300-d9ef56fd.jpg,test/p17/p17370561/s56982397/56a10249-2158c293-00dec61b-e19d6300-d9ef56fd.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Headache and blood-tinged sputum. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The heart appears mildly enlarged. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There no pleural effusions or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. " fc5a373b-c1d1e0f2-7d1faef0-de3981e1-01ecc441.jpg,test/p14/p14541551/s52261809/fc5a373b-c1d1e0f2-7d1faef0-de3981e1-01ecc441.jpg,test," FINAL REPORT HISTORY: Stroke with fever. FINDINGS: In comparison with study of ___, the opacification at the left base has substantially cleared, though the lung volumes have decreased. Nasogastric tube again extends well into the stomach. No evidence of vascular congestion. " f43a354a-f0579f73-648d9fc4-0306133e-4d7534d2.jpg,test/p11/p11201441/s56890943/f43a354a-f0579f73-648d9fc4-0306133e-4d7534d2.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM, ___ AT 20:50 CLINICAL INDICATION: ___-year-old status post right chest tube placement. Please assess position. Comparison to prior study dated ___ at 5:20. Single portable supine chest film ___ at 9:10 p.m. is submitted. IMPRESSION: 1. Tracheostomy tube in unchanged position. Right subclavian central line with its tip in the mid-to-distal SVC, unchanged. Interval placement of a right chest tube, which has its tip crossing the midline approximately 3 cm lateral to the vertebral bodies. Repositioning is advised. The patient subsequently had the chest tube pulled back on subsequent imaging performed on ___ at 1:36 a.m. 2. Layering right effusion and left effusion with more focal airspace consolidation at the left base with the presence of air bronchograms. Although this may represent compressive atelectasis, pneumonia should also be considered. Linear opacity in the left mid lung likely reflects subsegmental atelectasis. Cardiomediastinal contours are difficult to assess given marked patient rotation to the left. " 5f7680b4-9998db45-0c58c889-9586c06c-65e76a46.jpg,test/p15/p15045479/s54613777/5f7680b4-9998db45-0c58c889-9586c06c-65e76a46.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILMS, ___ AT 11:48 CLINICAL INDICATION: ___-year-old with right lateral pleuritic chest pain one day after an interventional-guided thoracic vertebral biopsy. Evaluate for right pleural effusion or hemorrhage following the procedure. Comparison is made to the patient's previous study dated ___. PA and lateral views of the chest are submitted obtained ___ at 11:48. IMPRESSION: Lungs are hyperinflated with bullous emphysematous changes involving the apices and crowding of the vasculature at both lung bases consistent with underlying emphysema. No pleural effusions are seen. Linear opacities at the left base are felt to represent subsegmental atelectasis. No pulmonary edema. Overall stable cardiac and mediastinal contours. Left subclavian PICC line remains in place with its tip in the mid SVC. " 033fe978-a7ae5178-30c2d642-eb0c46b1-15ede063.jpg,test/p19/p19960115/s52724268/033fe978-a7ae5178-30c2d642-eb0c46b1-15ede063.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with DHT placement // please eval DHT placement for 2 step advancement into stomach. please eval DHT placement for 2 step advancement into stomac IMPRESSION: The tip of the Dobhoff tube is within the esophagus. However, subsequent image dictated previously shows the tube well within the stomach. " 7124d673-9cece2ba-cb7054b1-ad25590e-d3ab8a5a.jpg,test/p18/p18280086/s56683356/7124d673-9cece2ba-cb7054b1-ad25590e-d3ab8a5a.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Shortness of breath. TECHNIQUE: Chest, portable AP upright. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is new confluent retrocardiac opacification with a probable small pleural effusion on. Otherwise, the lungs appear clear. IMPRESSION: New left basilar opacification, typical for atelectasis, in association with suspected pleural effusion; infectious process is not excluded but less likely, however. " ffbd2604-770c9d9f-de92c5a1-3f4ee627-c2d98572.jpg,test/p14/p14798363/s54126871/ffbd2604-770c9d9f-de92c5a1-3f4ee627-c2d98572.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old female with altered mental status. COMPARISON: None. FINDINGS: AP and lateral views of the chest. The lungs are clear without focal consolidation, effusion or pulmonary vascular congestion. There is moderate cardiomegaly. Atherosclerotic calcifications seen in the thoracic aorta. No visualized acute osseous abnormality. IMPRESSION: Moderate cardiomegaly without visualized acute cardiopulmonary process. " b66d0fc2-53296428-f8a88654-6f1fce7d-3a51a1de.jpg,test/p19/p19751455/s58713975/b66d0fc2-53296428-f8a88654-6f1fce7d-3a51a1de.jpg,test," FINAL REPORT INDICATION: ___ year old man with NSCLC s/p photodynamic therapy with NG tube placement. // Evaluate NG tube placement COMPARISON: Compared to prior study from ___. IMPRESSION: There has been placement of a nasogastric tube whose tip and side port are below the GE junction. The endotracheal tube tip is unchanged, 5.3 cm above the carina. There is elevation of left hemidiaphragm. There is mild improved aeration of the consolidation at the right base. No pneumothoraces are present. " afdc46aa-77a0469e-72bd1b2e-69a4ffac-7c8008dc.jpg,test/p18/p18933552/s51430606/afdc46aa-77a0469e-72bd1b2e-69a4ffac-7c8008dc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with NSCLC and h/o MPE now with worsened SOB // ? reaccumulation of effusion ? reaccumulation of effusion IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Opacification at the left base is consistent with pleural effusion and compressive atelectasis. Minimal change is seen at the right base. Loss of height is again seen involving several vertebral bodies in the mid thoracic region. " 45686d96-286096f9-72c6e6c8-d063e953-ad6ad856.jpg,test/p19/p19169852/s55509892/45686d96-286096f9-72c6e6c8-d063e953-ad6ad856.jpg,test," FINAL REPORT INDICATION: ___F with end-stage CHF, increased ___ edema, dyspnea, evaluate for acute change, attention to pulmonary edema. TECHNIQUE: AP and lateral chest radiographs. COMPARISON: Chest x-ray ___. FINDINGS: A right chest cardiac device is an unchanged orientation, and associated leads demonstrate a stable configuration in comparison to prior radiograph from ___. There is stable severe cardiomegaly. The mediastinal contours are unchanged. Lung volumes are low. There is pulmonary vascular congestion and likely moderate pulmonary edema. A retrocardiac opacity may represent atelectasis in the setting of low lung volumes, however infection cannot be excluded by radiograph. There is probably a trace left pleural effusion. There is no prior right pleural effusion. There is no pneumothorax. IMPRESSION: 1. Stable severe cardiomegaly. Pulmonary vascular ingestion and likely moderate pulmonary edema. 2. Likely small left pleural effusion. 3. Low lung volumes. Retrocardiac opacity likely reflects atelectasis, however infection cannot be excluded by radiograph in the appropriate clinical setting. " e1471d41-3bfe1020-5373d672-b0c14a98-1718ab2e.jpg,test/p17/p17970764/s50659762/e1471d41-3bfe1020-5373d672-b0c14a98-1718ab2e.jpg,test," FINAL REPORT INDICATION: Cough with shortness of breath. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Lung volumes are normal and lungs are clear. No pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. Mediastinal and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " a0cf2cc9-eaa80343-c40c03cb-811cd879-d81c9b56.jpg,test/p15/p15487342/s50653156/a0cf2cc9-eaa80343-c40c03cb-811cd879-d81c9b56.jpg,test," FINAL REPORT HISTORY: Intubated in the setting of likely overdose now presenting with fever. Evaluate for interval change or infiltrate. TECHNIQUE: Single portable frontal view of the chest. COMPARISON: Chest radiographs ___, ___ and ___. Chest CT dated ___. FINDINGS: An endotracheal tube is 5.7 cm above the carina. The course of the enteric tube has cannot confidently be identified secondary to overlying soft tissues. A right internal jugular catheter terminates in the mid SVC. There is improved aeration at the right lung base, however, persistent perihilar and bibasilar atelectasis is noted. There is no pleural effusion or pneumothorax. Cardiac silhouette and mediastinal contours are normal. IMPRESSION: 1. Improved, albeit persistent, atelectasis. 2. Enteric tube course cannot be confidently visualized. If confirmation is required, conventional radiographs would be recommended. " 9fd9e9de-838c0f47-821b5247-7de7b9ae-29f5bce6.jpg,test/p19/p19398915/s58421427/9fd9e9de-838c0f47-821b5247-7de7b9ae-29f5bce6.jpg,test," WET READ: ___ ___ ___:___ PM 1. Possible tiny right apical pneumothorax. 2. Interval improvement in moderate right pleural effusion. 3. Worsening of left lung opacities likely secondary to atelectasis. D/w Dr. ___ by Dr. ___ by phone on the day of the exam at ___:___p. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hepatic hydrothorax s/p ___ ?pneumo // ?pneumothorax COMPARISON: Chest radiographs ___. IMPRESSION: As recently as ___ the patient had bilateral pneumonia, most severe in the left lung. This has never cleared, and is more pronounced in the left lung today than it was on ___. A large right pleural effusion which recurred have any after drainage on ___, is unchanged. The absence of contralateral mediastinal shift demonstrates the slow progression of the effusion with concomitant atelectasis. Miniscule right apical pneumothorax is clinically insignificant. " 1d5c8997-64d5f32d-7cdf846f-4cde329a-1e97cf0f.jpg,test/p15/p15389391/s56123500/1d5c8997-64d5f32d-7cdf846f-4cde329a-1e97cf0f.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Multilobar pneumonia. Comparison is made with prior study performed a day earlier. Cardiomegaly and widened mediastinum are unchanged. Right PICC tip is in the lower SVC. ET tube is in standard position. NG tube tip is out of view below the diaphragm. There is no evident pneumothorax. Widened mediastinum is stable. Large left pleural effusion is probably unchanged allowing the difference in positioning of the patient with adjacent atelectasis. The right lung is grossly clear. Pulmonary edema has improved, almost resolved. " a875e80f-06da317c-54e6369f-51713fca-ae4a9cc7.jpg,test/p10/p10143711/s53622177/a875e80f-06da317c-54e6369f-51713fca-ae4a9cc7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with fall, h/o tib frx // ? traumatic injuries TECHNIQUE: AP and lateral views of the chest COMPARISON: Prior radiographs the most recent on ___ FINDINGS: Lung volumes are low which accentuates bronchovascular markings. The heart is moderately enlarged on this AP view. There is mild to moderate vascular congestion and pulmonary edema. No pneumothorax. No pleural effusion. IMPRESSION: Mild to moderate pulmonary edema. " 4eb4c5a6-1bd5cce8-f4ec880e-91728465-50defd0b.jpg,test/p10/p10825934/s50456646/4eb4c5a6-1bd5cce8-f4ec880e-91728465-50defd0b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of syncope, elevated d-dimer // ?PE ?PE TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs of___. FINDINGS: The heart is top-normal in size, and the aorta is mildly tortuous.There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " 7d1c6146-c79a6396-487aa78f-86b88c61-009d809d.jpg,test/p11/p11128013/s58918656/7d1c6146-c79a6396-487aa78f-86b88c61-009d809d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Central line placement // ___ year old woman with Central line placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained earlier IMPRESSION: Intra-aortic balloon pump tip terminates 3.6 cm above the carinal. The temporary pacemaker tip is in the right ventricle. There is no pneumothorax. There is interval progression of pulmonary edema. Left lower lobe mass and a right lower lobe mass are better appreciated on the recent CT from ___. Hardware is unchanged in appearance. Left pleural effusion appears to be slightly increased. " c20a090b-76f2dcbd-6d8186de-c6318364-2f931103.jpg,test/p17/p17211281/s54602373/c20a090b-76f2dcbd-6d8186de-c6318364-2f931103.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and WBC count // eval for PNA, viral infection eval for PNA, viral infection IMPRESSION: Compared to prior chest radiographs ___. Hyperinflation is not as pronounced today as it was on ___ suggesting improvement in bronchospasm. Lungs are clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 15759689-5083e001-59549586-78cc41aa-d37cce59.jpg,test/p17/p17382835/s54471506/15759689-5083e001-59549586-78cc41aa-d37cce59.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax IMPRESSION: No acute intrathoracic abnormality. " c11d6887-c063967c-53ddc746-aa067d8a-5fc2b888.jpg,test/p11/p11296439/s51695502/c11d6887-c063967c-53ddc746-aa067d8a-5fc2b888.jpg,test," FINAL REPORT INDICATION: ___F with dyspnea, palps // ? acute cardipulm process TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no effusion, consolidation, or edema. Cardiomediastinal silhouette is within normal limits. Left chest wall dual lead pacing device is again noted. No acute osseous abnormalities. Gastric band is partially visualized. IMPRESSION: No acute cardiopulmonary process. " 35e64d05-660a1eef-e01a078b-c0ef1401-23e28521.jpg,test/p13/p13230225/s55443911/35e64d05-660a1eef-e01a078b-c0ef1401-23e28521.jpg,test," FINAL REPORT INDICATION: ___ year old man with a flutter, chf, new dyspnea/hypoxia, evaluate for pulmonary edema. TECHNIQUE: Single frontal portable view radiograph of the chest. COMPARISON: Prior chest radiographs dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette, including moderate cardiomegaly, is unchanged. IMPRESSION: No acute cardiopulmonary process. " 2eac2f24-6805616a-b45a02a1-1a5ddf72-14e69c65.jpg,test/p12/p12706319/s54169343/2eac2f24-6805616a-b45a02a1-1a5ddf72-14e69c65.jpg,test," WET READ: ___ ___ ___ 8:30 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___F with cough, hypoxemia // ? acute cardiopulm process TECHNIQUE: Upright PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " cebd6672-edb81221-89cfae4d-0a5b458a-7a55ca09.jpg,test/p13/p13085886/s58328831/cebd6672-edb81221-89cfae4d-0a5b458a-7a55ca09.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with high risk AML fevers, night sweats // pna? effusion? pna? effusion? IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . Left subclavian catheter ends in the low SVC. " 874d1213-6f920cad-7a705ff5-60108891-c1321990.jpg,test/p15/p15405842/s50047835/874d1213-6f920cad-7a705ff5-60108891-c1321990.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, fever, EGD on ___. // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No evidence of pneumonia. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 3:47 PM, 5 minutes after discovery of the findings. " f32290a2-1ba0d86a-20ecf165-ea1466be-2ec4ff89.jpg,test/p14/p14395528/s59999729/f32290a2-1ba0d86a-20ecf165-ea1466be-2ec4ff89.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___ year old man with BiV PPM upgrade. // rule out pneumothorax and change lead position rule out pneumothorax and change lead position TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: A left-sided biventricular pacemaker remains in unchanged position. The heart is enlarged. There is unchanged right pleural thickening. No focal consolidation concerning for pneumonia. No pneumothorax. IMPRESSION: Unchanged position of a left sided biventricular pacemaker. No acute cardiopulmonary process. " 587b59c5-17e56489-6f0457a4-943601ce-6042d687.jpg,test/p13/p13689440/s58788167/587b59c5-17e56489-6f0457a4-943601ce-6042d687.jpg,test," FINAL REPORT INDICATION: ___ year old man with SOB // assess pleural effusions COMPARISON: Radiographs from ___. IMPRESSION: There is a dual lead left-sided pacemaker with intact leads. There is again seen a right perihilar infiltrate and a right pleural effusion. There remains a tiny right apical pneumothorax. " 80161dd3-61e8b021-997ca2a0-6eb947df-98d1bce9.jpg,test/p10/p10608802/s59719765/80161dd3-61e8b021-997ca2a0-6eb947df-98d1bce9.jpg,test," WET READ: ___ ___ ___ 4:38 PM Vague nonspecific left midlung opacity. Consider short-term follow-up with PA and lateral if patient is amenable. Compression deformity of a lower thoracic vertebral body, had been present on prior CT from ___ although demonstrates interval height loss. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with pain s/p fall // rib fx?, acute process TECHNIQUE: AP and lateral views of the chest. COMPARISON: CT of the thoracic spine from ___. PET-CT from ___. FINDINGS: There is left mid lung opacity adjacent to the hilum. Elsewhere, lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is grossly within normal limits. No acute displaced fractures identified. Deformity of the left scapula is compatible with prior fracture. Thoracolumbar S-shaped scoliosis is noted. Compression deformity of the T9 vertebral body appears to have progressed since prior CT scan from ___. IMPRESSION: Vague nonspecific left midlung opacity. Consider short-term follow-up with PA and lateral if patient is amenable. Compression deformity of a lower thoracic vertebral body, had been present on prior CT from ___ although demonstrates interval height loss. " 4679618e-0a6ff71d-487c2016-fbdfe60a-e5b2b1b0.jpg,test/p12/p12510726/s52304537/4679618e-0a6ff71d-487c2016-fbdfe60a-e5b2b1b0.jpg,test," FINAL REPORT INDICATION: ___-year-old female status post fall with low back pain and right lower chest wall pain. Evaluate for evidence of rib fracture. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Pulmonary vascularity is normal. No rib fractures are identified. IMPRESSION: No acute cardiopulmonary abnormality. No rib fractures are identified, although this study is not tailored for detection of rib fractures. If pain persists, dedicated rib views should be obtained. " 2f71c5fc-65bb8aeb-91fa6f09-cd9947d7-5437e261.jpg,test/p12/p12704304/s50723961/2f71c5fc-65bb8aeb-91fa6f09-cd9947d7-5437e261.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Bibasilar opacities on chest x-ray, right upper quadrant abdominal pain with deep inspiration, question acute abnormality. FINDINGS: PA and lateral views of the chest are provided. There are plate-like lower lung opacities which are most compatible with atelectasis. No convincing signs of pneumonia. No large effusion or pneumothorax. The heart appears within normal limits of size. Mediastinal contour is unremarkable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Plate-like lower lung opacities persist, which are similar to that which was seen on most recent prior study, though new from remote priors dated ___ and ___. CT should be considered to further assess given the associated symptom of pain. " 5723a1cc-3e87c470-38a1c812-f6b56f1e-e95cd8fc.jpg,test/p17/p17051420/s56480031/5723a1cc-3e87c470-38a1c812-f6b56f1e-e95cd8fc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, hemoptysis // evaluate for pneumonia, mass COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the left PICC line has been removed. Unchanged moderate scoliosis of the thoracic spine. Borderline size of the cardiac silhouette. No pleural effusions. No pulmonary edema. No pneumonia. " 96a9ce7d-d85d143e-0e15d11b-7f4ba5dc-28c4b251.jpg,test/p13/p13224377/s57771301/96a9ce7d-d85d143e-0e15d11b-7f4ba5dc-28c4b251.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ year old woman with AML with hypoxic respiratory failure // trach placement and NG placement TECHNIQUE: Single portable view of the chest was obtained. COMPARISON: Comparison is made to chest radiograph from yesterday. FINDINGS: A tracheostomy tube, right internal jugular tunneled central venous line, left internal jugular central venous line and nasoenteric tube are unchanged, in appropriate position. Right lung parenchymal opacities are not significantly changed compared to the prior study, possibly aspiration or asymmetric pulmonary edema. Mild cardiomegaly is stable. Left basilar atelectasis is stable. IMPRESSION: No significant change in appearance of the chest since the prior study. Appropriate position of monitoring and support devices. " 480321b0-69e3bf00-f53b37a7-52b45f17-cce4e823.jpg,test/p11/p11252741/s53762381/480321b0-69e3bf00-f53b37a7-52b45f17-cce4e823.jpg,test," FINAL REPORT HISTORY: Fluid overload. FINDINGS: In comparison with study of ___, the monitoring and support devices remain in place. There is again some enlargement of the cardiac silhouette with layering right pleural effusion and compressive atelectasis at the base. Opacification at the left base is consistent with some volume loss in the left lower lobe and small pleural effusion. Pulmonary vascularity is difficult to assess, though it may be mildly elevated. " c7f3249a-68d00c56-a79fd427-4f28338b-ab0670eb.jpg,test/p19/p19960115/s55347999/c7f3249a-68d00c56-a79fd427-4f28338b-ab0670eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p Whipple // please repeat am chest CXR, pt rotated COMPARISON: ___. IMPRESSION: As compared to the previous image, the bilateral pleural effusions are no longer visible. Low lung volumes. Mild cardiomegaly and mild pulmonary edema. No pneumonia. Minimal atelectasis at the right lung basis. The monitoring and support devices are in constant position. " 4d01bdbe-6d142afc-ddae5a16-5e3613b3-e7197b87.jpg,test/p14/p14925997/s52953373/4d01bdbe-6d142afc-ddae5a16-5e3613b3-e7197b87.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with subjective fever and sob. // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CT abdomen and pelvis on ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Subtle bibasilar opacities most likely reflect subsegmental atelectasis. There is mild vascular congestion without frank edema. No focal consolidation, pleural effusion or pneumothorax is identified. IMPRESSION: Subtle bibasilar opacities most likely represent minimal subsegmental atelectasis however infection should be considered in the appropriate setting. Mild vascular congestion without frank edema. " e06a19c0-42d991c0-665f1472-1079f4df-be959cb7.jpg,test/p18/p18704423/s53446408/e06a19c0-42d991c0-665f1472-1079f4df-be959cb7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with known free air // Progression in subdiaphragmatic air Progression in subdiaphragmatic air Progression in subdiaphragmatic air IMPRESSION: In comparison with the study of ___, there is little overall change in the appearance of the subdiaphragmatic gas consistent with pneumoperitoneum. No evidence of acute pneumonia or vascular congestion. " 10e5cd27-a616b885-4985f639-0021eb1f-f692850b.jpg,test/p16/p16578947/s52860454/10e5cd27-a616b885-4985f639-0021eb1f-f692850b.jpg,test," FINAL REPORT INDICATION: History: ___F with six days ago // ? Fracture,? Pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are clear and the heart mediastinal contours are within normal limits in size and shape. No pneumothorax or pleural effusion is seen. No fracture is visible, however if there is concern for nondisplaced vertebral body or rib fracture, specific bone films should be obtained. IMPRESSION: No plain film findings of acute cardiopulmonary disease or visible fracture " d55c6b51-65e4f4a5-f6c5f31b-242bc079-e670c382.jpg,test/p18/p18456328/s57947948/d55c6b51-65e4f4a5-f6c5f31b-242bc079-e670c382.jpg,test," FINAL REPORT HISTORY: Leukocytosis, crackles on exam. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. The heart size is mild to moderately enlarged but unchanged. The mediastinal and hilar contours are stable, with the thoracic aorta appearing mildly tortuous. Mild pulmonary edema appears relatively similar compared to the prior study. Subsegmental atelectasis is noted in both lung bases. Possible trace bilateral pleural effusions are present. There is no pneumothorax. Right PICC has been removed. Degenerative changes of the imaged thoracic spine and right acromioclavicular joint are noted. IMPRESSION: Mild pulmonary edema with trace bilateral pleural effusions. Bibasilar atelectasis. " efb4d176-b70f2e1a-4068df90-f446f204-ba980145.jpg,test/p11/p11434374/s57032615/efb4d176-b70f2e1a-4068df90-f446f204-ba980145.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with heart failure // evaluate for interval change IMPRESSION: Since a recent radiograph of 1 day earlier, a Swan-Ganz catheter is been placed, with tip of the catheter projecting approximately 3.7 cm distal to the central right hilum, likely within a segmental branch. Exam is otherwise remarkable for improving pulmonary edema, with residual heterogeneous lower lung opacities worse on the left than the right. Although potentially due to asymmetrical edema, coexisting infection in the left lower lobe should also be considered in the appropriate clinical setting. Right pleural effusion is nearly resolved, and a small to moderate left pleural effusion persists with possible loculation laterally. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 9:27 AM, 5 minutes after discovery of the findings. " 9c120433-25b1108c-0c975af3-6ea99b55-f42b0092.jpg,test/p15/p15970954/s52384924/9c120433-25b1108c-0c975af3-6ea99b55-f42b0092.jpg,test," FINAL REPORT HISTORY: Pneumothorax, to assess for change. FINDINGS: In comparison with the study of ___, there are substantially lower lung volumes. The right apical pneumothorax persists. Otherwise, little overall change in the appearance of the heart and lungs. Subcutaneous gas is again seen along the right upper abdomen, and there is an adynamic ileus pattern. " ca7627f7-b34a6a97-dc689693-af8b920f-16783ad4.jpg,test/p12/p12698907/s54238804/ca7627f7-b34a6a97-dc689693-af8b920f-16783ad4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Spiking fevers, atelectasis. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated. The appearance of the lung parenchyma is unchanged. A zone of slightly increased radiodensity is seen in the right upper lobe and likely to be caused by patient position. Unchanged borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. " 01002cc4-49142490-213752d7-c92f597d-c0fe6a33.jpg,test/p11/p11106897/s59253900/01002cc4-49142490-213752d7-c92f597d-c0fe6a33.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after mitral valve replacement for line position. Portable AP radiograph of the chest was reviewed in comparison to ___. Right internal jugular line tip is at the level of mid SVC. The replaced mitral valve is in place. Slight interval increase in bilateral pleural effusions is noted, but overall there is slight improvement in the basal aeration. There is no pneumothorax. " 23dea5b7-5555f275-eb29803d-e648edff-91f9f735.jpg,test/p13/p13050559/s59095215/23dea5b7-5555f275-eb29803d-e648edff-91f9f735.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with sob s/p bronch // eval for ptx COMPARISON: Chest radiographs since ___ through ___ at 17:16. IMPRESSION: There is no pneumothorax or pleural effusion. Consolidative atelectasis in the right upper lobe due to bronchial obstruction is unchanged since the pre bronchoscopy chest radiograph on ___. Aeration has improved since the earliest postprocedure radiograph 6 hr ago. Left lung is clear. Heart size is normal. " a5a02626-a1701193-328e8d37-edd2918d-d49754ac.jpg,test/p14/p14740722/s50867778/a5a02626-a1701193-328e8d37-edd2918d-d49754ac.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with study of ___, there has been placement of a nasogastric tube that extends to the antrum of the stomach. Continued substantial enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure. Retrocardiac opacification most likely reflects substantial volume loss in the left lower lobe. No evidence of acute focal pneumonia, though the region behind the heart could easily hide a consolidation. " 3c263af4-1f99d1bb-ca3abfff-197a9877-66b75f1f.jpg,test/p12/p12105841/s50611368/3c263af4-1f99d1bb-ca3abfff-197a9877-66b75f1f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with atypical chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 73947ce3-70cc2f40-17c9c8af-9cb0ce03-0662212f.jpg,test/p12/p12358216/s56296300/73947ce3-70cc2f40-17c9c8af-9cb0ce03-0662212f.jpg,test," FINAL REPORT AP CHEST, 5:03 A.M., ___ HISTORY: ___-year-old woman. Pneumothorax and pneumomediastinum found after seizure. IMPRESSION: AP chest compared to ___: Small midline left pneumothorax or pneumomediastinum persists. Other pleural surfaces are apposed, following repositioning of the left pleural tube to a lateral costal position. Lung volumes are considerably lower today exaggerating any differences in the lungs, but there does appear to be extensive atelectasis or asymmetrically distributed edema. Moderate right pleural effusion is larger. Mediastinal vascular engorgement suggests increased central venous pressure and/or volume. ET tube is in standard position. Right PIC or subclavian line ends in the upper right atrium and would need to be withdrawn 3 cm to place it low in the SVC. Nasogastric tube ends in the stomach. ET tube in standard placement. " 64a8ee61-90123216-41dff344-29f0621d-a67c1ee8.jpg,test/p18/p18309059/s52974931/64a8ee61-90123216-41dff344-29f0621d-a67c1ee8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever chills and SOB pls eval for pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " bfc1bfd1-3e3fc5e7-810a0077-65ed650f-995144d7.jpg,test/p11/p11122882/s52465599/bfc1bfd1-3e3fc5e7-810a0077-65ed650f-995144d7.jpg,test," FINAL REPORT INDICATION: ___M with acute chest pain // Acute thoracic process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are slightly low in volume but clear without focal consolidation concerning for pneumonia. Pulmonary vascularity is within normal limits. The upper abdomen is unremarkable. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " f5044552-5289abdd-778bf4df-ce318d25-4d44eb77.jpg,test/p19/p19661672/s55199385/f5044552-5289abdd-778bf4df-ce318d25-4d44eb77.jpg,test," FINAL REPORT HISTORY: Weakness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is top normal and unchanged. The mediastinal and hilar contours are stable and within normal limits. The pulmonary vascularity is not engorged. A trace left pleural effusion is likely present. There is minimal bibasilar atelectasis. No pneumothorax is present, and no acute osseous abnormalities seen. IMPRESSION: Small left pleural effusion and mild bibasilar atelectasis. " 7676c54f-76b7b686-2650267f-318f5b78-ded7b69c.jpg,test/p17/p17545050/s59270811/7676c54f-76b7b686-2650267f-318f5b78-ded7b69c.jpg,test," WET READ: ___ ___ 9:24 AM 1. No evidence of acute cardiopulmonary process. 2. No displaced rib fracture. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with s/p MVC, chest and knee pain, evaluate for fracture or pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: Low lung volumes cause bronchovascular crowding. There is no pneumothorax, pleural effusion, pulmonary edema, or focal consolidation. There is no displaced rib fracture. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. Low lung volumes. No evidence of acute cardiopulmonary process. 2. No displaced rib fracture. " 42bacdda-a7ae44a2-1eb9b59d-326dc383-ad3d9368.jpg,test/p13/p13594538/s57411410/42bacdda-a7ae44a2-1eb9b59d-326dc383-ad3d9368.jpg,test," FINAL REPORT INDICATION: ___ year old woman with tbm sp tracheobronchoplasty // ptx COMPARISON: Radiograph dated ___. FINDINGS: Single portable chest radiograph demonstrates there is no large pleural effusion or pneumothorax. Multiple right rib fractures are again seen. A right chest tube is identified. No air under the right hemidiaphragm is seen. IMPRESSION: Clear lungs with no evidence of pneumothorax. " 0e456aed-1980a892-2b536f89-964445ea-1b309bdf.jpg,test/p13/p13179215/s59949272/0e456aed-1980a892-2b536f89-964445ea-1b309bdf.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of right-sided chest pain. COMPARISON: No prior radiographs are available for comparison. Reference made to PET-CT performed on ___. FINDINGS: Frontal and lateral views of the chest were obtained. Pulmonary emphysematous changes are better assessed on CT. Prominence of the interstitial markings may be related to patient's underlying emphysema. There is mild bibasilar atelectasis/scarring. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Prominence of interstitial markings most likely relates to pulmonary emphysema seen on prior PET-CT. Mild bibasilar atelectasis/scarring. No definite consolidation or opacities to suggest mass, however, CT is more sensitive and if this is of concern, should be considered. " 623a6317-f937dd59-37bad883-b5f5d033-20a1889a.jpg,test/p15/p15652922/s57337164/623a6317-f937dd59-37bad883-b5f5d033-20a1889a.jpg,test," WET READ: ___ ___ ___ 8:45 PM No density to suggest avulsed tooth. Endotracheal tube remains somewhat high in position as on prior study. Mild vascular congestion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with shock, respiratory failure and avulsed teeth // please eval for avulsed tooth please eval for avulsed tooth IMPRESSION: No comparison. The patient is intubated. The tip of the endotracheal tube projects approximately 7 cm above the carina. The tube could be advanced by 2-3 cm. Feeding tube in situ. Borderline size of the cardiac silhouette. No pulmonary edema, no pleural effusions. No pneumonia. " db04dca1-062f1601-d3c19739-19c38abe-1e6936ec.jpg,test/p19/p19302735/s51301706/db04dca1-062f1601-d3c19739-19c38abe-1e6936ec.jpg,test," FINAL REPORT AP CHEST, 12:14 A.M., ___ HISTORY: ___-year-old man after CABG with hypercarbia. Rule out pneumothorax. IMPRESSION: AP chest compared to ___, 12:41 p.m.: Previous vascular engorgement, mild pulmonary edema, and mediastinal widening have all cleared following extubation. There is no pneumothorax or appreciable atelectasis. Only a tiny left pleural effusion remains following removal of the pleural tube. Swan-Ganz catheter ends in the proximal main pulmonary artery. " 4c5018dd-5884dd1f-a2a81264-8f8254b5-1beed18d.jpg,test/p12/p12315713/s54055370/4c5018dd-5884dd1f-a2a81264-8f8254b5-1beed18d.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Cough and shortness of breath. COMPARISONS: ___ and CT abdomen from ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: There is a persistent lower lingular opacification that appears increased and new elevation of the left hemidiaphragm compared to the prior radiograph and CT. Background coarsening of lung markings suggests widespread chronic airway inflammation. There is no pleural effusion or pneumothorax. The cardiac, mediastinal and hilar contours appear unchanged including moderate unfolding of the thoracic aorta. IMPRESSION: New volume loss and increased opacification at the left lung base, which may be seen with atelectasis associated with exacerbation of severe background chronic airway inflammation versus bronchopneumonia. " c7a22dda-57d61596-848d2fce-fde8f904-cffc1182.jpg,test/p13/p13273624/s53453988/c7a22dda-57d61596-848d2fce-fde8f904-cffc1182.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with sob, hypoxia // infiltrate? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Severe cardiomegaly is noted with mild pulmonary edema. There may be a component of underlying interstitial pulmonary fibrosis. No large effusion is seen. There is a retrocardiac opacity containing gas most likely a large hiatal hernia. No pneumothorax or large effusion is seen. Bony structures are intact. IMPRESSION: Severe cardiomegaly with mild edema. Probable pulmonary fibrosis. Large hiatal hernia. " a191cec3-dc89bfc6-8f048307-02a190b7-399d544a.jpg,test/p14/p14451331/s55921032/a191cec3-dc89bfc6-8f048307-02a190b7-399d544a.jpg,test," FINAL REPORT INDICATION: Chest pain. No comparison studies available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is mild tortuosity of the aorta. There is no pneumothorax, focal consolidation, or pleural effusion. Minimal degenerative changes are seen throughout the thoracic spine. IMPRESSION: No acute intrathoracic process. " 8b3f6175-f7740e2e-f1b06374-862e6aaf-3fa7e2e5.jpg,test/p15/p15687638/s57370125/8b3f6175-f7740e2e-f1b06374-862e6aaf-3fa7e2e5.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: ___-year-old female with history of asthma and complains of inability to stop shivering. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There may be minimal pulmonary vascular congestion. The cardiac silhouette is top normal. The aortic knob is calcified. IMPRESSION: No focal consolidation. Possible minimal pulmonary vascular congestion. Top normal cardiac silhouette. " 5df477ae-b64b9fcd-eb5122f3-f61d4f3f-d432f190.jpg,test/p17/p17653729/s54206882/5df477ae-b64b9fcd-eb5122f3-f61d4f3f-d432f190.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph from ___. CLINICAL HISTORY: ___-year-old female with wheezing, question consolidation or pulmonary edema. FINDINGS: AP upright and lateral views of the chest are provided. Subtle retrocardiac opacity is seen best on the lateral projection which could represent a lower lobe pneumonia, likely right-sided. Aside from this, the lungs appear clear. The cardiomediastinal silhouette is stable. Bony structures are intact. A calcified density is again seen projecting over the left shoulder in a somewhat different position, suggesting mobility. IMPRESSION: Findings concerning for pneumonia in the right lower lobe. " 0ddab17f-8480c092-62cf1d5d-a70e2e5d-7b14ec4e.jpg,test/p12/p12833242/s52145562/0ddab17f-8480c092-62cf1d5d-a70e2e5d-7b14ec4e.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Prolonged neutropenia and fever. Comparison is made with prior study ___. Cardiomediastinal contours are normal. There is no evidence of pneumonia, pleural effusion or pneumothorax. There are moderate degenerative changes in the thoracic spine. " ff603139-aa0c9bc9-328b9aab-18f6f3a1-1ce816e8.jpg,test/p13/p13857873/s55142345/ff603139-aa0c9bc9-328b9aab-18f6f3a1-1ce816e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent cyberknife radiation for lung cancer now has cough // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs since ___, most recently performed ___; CT thorax ___; PET-CT ___ FINDINGS: Patient's right upper lobe lung mass in visualized with an adjacent fiducial seed. There are no focal consolidations, pleural effusions or evidence of pneumothorax. The hila, mediastinum, and heart are within normal limits. The saccular aneurysm in the descending thoracic aorta is again visualized, unchanged in appearance compared to the chest radiograph performed ___. No osseous abnormalities. IMPRESSION: No acute pulmonary process. " 6305a23a-61e4891b-af3ce0b2-4b168183-5e91632c.jpg,test/p18/p18511815/s52354827/6305a23a-61e4891b-af3ce0b2-4b168183-5e91632c.jpg,test," FINAL REPORT INDICATION: ___-year-old man status post assault. COMPARISONS: None. FINDINGS: The lungs are well inflated and clear. No effusion, pneumothorax, consolidation, or nodule is present. The cardiac and mediastinal contours are normal. No displaced rib fracture is identified. IMPRESSION: No acute cardiopulmonary process. " c95b3888-0f3b84cf-eb82587d-ac5f3829-5e45f3c9.jpg,test/p18/p18708817/s57129024/c95b3888-0f3b84cf-eb82587d-ac5f3829-5e45f3c9.jpg,test," FINAL REPORT INDICATION: Altered mental status, evaluate for an acute process. COMPARISON: Chest radiograph ___ and ___. PORTABLE, SEMI-ERECT FRONTAL CHEST RADIOGRAPH: The cardiac silhouette remains severely enlarged. This has remained stable from ___. Enlargement of the pulmonary arteries bilaterally is consistent with pulmonary arterial hypertension. There is no pleural effusion or pneumothorax. An opacity overlying the left hemidiaphragm could represent pneumonia, and further evaluation could be performed with a lateral view. There is mild pulmonary vascular engorgment. " 80c84c12-8c5bda89-e437fbb3-b1946773-193f1659.jpg,test/p15/p15751952/s54494660/80c84c12-8c5bda89-e437fbb3-b1946773-193f1659.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with rash and fever. // Please evaluate for consolidation, acute process. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are hyperinflated but clear. Scarring within the lung apices is symmetric and unchanged. No focal consolidation, pleural effusion or pneumothorax is detected. There are no acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary abnormality. " 0b5943f3-d6f5fa25-52db6927-1e26922b-de35c051.jpg,test/p11/p11688793/s56335823/0b5943f3-d6f5fa25-52db6927-1e26922b-de35c051.jpg,test," FINAL REPORT INDICATION: ___-year-old female with sudden onset substernal chest pain, question pneumothorax. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs were obtained. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. There are no acute skeletal abnormalities. IMPRESSION: No acute cardiopulmonary process. " c8f5e95b-eb9009e5-9d378530-b9580e41-41c13724.jpg,test/p11/p11837162/s54576368/c8f5e95b-eb9009e5-9d378530-b9580e41-41c13724.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx organizing PNA on R now with tachycardia, LLL infiltrate, probably aspiration // eval LLL infiltrate, any other areas that could be aspiration vs. pna? TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is interval resolution of right mid and lower lung consolidation. No new consolidations as seen. Linear opacity in the left lower lobe is re- demonstrated, potentially corresponding to resolving infectious process, minimally better as on the prior study although not entirely resolved Large Bochdalek's hernia is projected posteriorly on the right as previously. No appreciable pleural effusion or pneumothorax seen. " bfefdf0b-b9a3283a-9b734579-c8ac4d17-a0719841.jpg,test/p13/p13812710/s57368912/bfefdf0b-b9a3283a-9b734579-c8ac4d17-a0719841.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest x-ray. INDICATION: ___ year old woman with history of ""walking PNA"", has had productive cough x2 months. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are lower causing bronchovascular crowding. Cardiomediastinal silhouette is otherwise normal. On lateral view, increased opacity posterior lower lungs may be due to the patient's body habitus. No correlate is present on the frontal view. No effusion or pneumothorax. IMPRESSION: Increased opacity of the posterior lower lungs on lateral view usually indicates underlying pathology such as infection, as the classic radiological ""spine sign."" However, in this case, it may be due to underpenetration of the x-ray due to the patient's body habitus. Oblique radiographic views may be helpful for further evaluation. NOTIFICATION: The above findings were entered by Dr. ___ ___ the ___ Imaging Findings Dashboard for communication to the ordering clinician at 16:11 on ___. " be6bad74-3fc3b6d5-f757d7df-f482765c-4a5ff435.jpg,test/p14/p14237047/s52662741/be6bad74-3fc3b6d5-f757d7df-f482765c-4a5ff435.jpg,test," WET READ: ___ ___ ___:___ AM New homogeneous layering opacity in the right hemi thorax is most consistent with a new pleural effusion. The left lung is clear. Small lucency projecting at the right lung base, difficult to determine whether it is below the diaphragm. If clinical concern lateral decubitis or dedicated standing views can be obtained to further clarify. The findings were discussed with Dr. ___, ___D. by ___, ___D. on the telephone on ___ at ___:___ AM, ___ minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cholangitis, s/p ercp // r/o free air r/o free air IMPRESSION: Comparison to ___. New relatively extensive right basal opacity. The appearance of the change is suggestive of a pleural effusion, combines to a right basilar atelectasis. Stable calcifications at the left lung apex. Unchanged appearance of the cardiac silhouette. " f865cfdf-69b5e5ea-c1353482-33b42c62-5adbd827.jpg,test/p17/p17202838/s51306829/f865cfdf-69b5e5ea-c1353482-33b42c62-5adbd827.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pHTN with respiratory failure iso tachyarrythmia // Evaluate for effusion, edema, infiltrate. Evaluate for effusion, edema, infiltrate. IMPRESSION: Heart size and mediastinum are stable. Bilateral pleural effusions are moderate, unchanged. Right basal consolidation is unchanged. " 71836ad3-c65f5072-d88d098b-00ab4c24-98994b02.jpg,test/p18/p18855147/s54353466/71836ad3-c65f5072-d88d098b-00ab4c24-98994b02.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: To rule out pneumothorax. Acute shortness of breath. TECHNIQUE: A single semi-erect portable chest view was read in comparison with multiple prior radiographs with the most recent from ___. FINDINGS: Mild pulmonary edema is present. Left lower lung opacity is likely a combination of small atelectasis and probably a small effusion. Right small pleural effusion is presumed. Heart size is mildly enlarged, and the pulmonary vasculature is minimally congested. A right central line tip ends at lower SVC. IMPRESSION: Mild pulmonary edema. Left lower lung opacity is likely a combination of atelectasis and effusion and right lung base atelectasis is minimal. There is no evidence of pneumothorax. " 963f7d89-16dc5e81-ff816153-8d939001-f878f14f.jpg,test/p15/p15002645/s56406765/963f7d89-16dc5e81-ff816153-8d939001-f878f14f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Atypical chest pain, assess for pneumonia or pneumothorax. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " fb39cf9c-efe61f2d-aa5157c1-fca313b4-d2c95dfc.jpg,test/p13/p13035993/s52138478/fb39cf9c-efe61f2d-aa5157c1-fca313b4-d2c95dfc.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain, question pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. Again seen is a prominent epicardial fat pad. There are no focal consolidations. There is no pleural effusion or pneumothorax. Again seen is kyphosis of the thoracic spine. The cardiomediastinal silhouette is stable. Calcified granuloma in right lower lobe is unchanged. IMPRESSION: No acute cardiopulmonary process. " fba57782-cf35ea73-ad85b7bc-4a4ec3bf-af93c831.jpg,test/p14/p14693474/s52914987/fba57782-cf35ea73-ad85b7bc-4a4ec3bf-af93c831.jpg,test," FINAL REPORT HISTORY: History of COPD with recent pneumonia and left-sided pleuritic chest pain. COMPARISON: The multiple prior studies with the most recent chest radiograph ___ most recent chest CT from ___. FINDINGS: Lungs appear hyperinflated and hyperlucent consistent with chronic obstructive pulmonary disease with severe biapical emphysema. Previously noted bibasilar opacities appear improved and likely represent an improving infectious process. No new opacities are identified. Left apical pleural thickening is again noted. Pulmonary arteries appear enlarged consistent with pulmonary arterial hypertension. Cardiac contour appears within normal limits. There is no pleural effusion or pneumothorax. There is no acute fracture or dislocation. IMPRESSION: Findings consistent with severe COPD, pulmonary arterial hypertension, and improving bibasilar interstitial process. " cdd67cf3-ec295d86-8997cfea-dc726c6b-d78cf7d2.jpg,test/p14/p14247006/s54723762/cdd67cf3-ec295d86-8997cfea-dc726c6b-d78cf7d2.jpg,test," WET READ: ___ ___ ___ 9:31 PM Progression of right mid/upper lung opacity concerning for pneumonia or aspiration. No other change from recent prior. ___ p_________________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with V tach and AFib. Comparison is made with prior study performed eight hours earlier. There has been mild interval worsening of right upper, right lower and left lower lobe opacities, worrisome for pneumonia or aspiration. There is no pneumothorax or pleural effusion. Mild-to-moderate cardiomegaly is unchanged. Transvenous pacemaker leads terminate in the right ventricle. " d3b418b8-dc22ffc2-dbadfd83-709181b5-d654efb1.jpg,test/p16/p16514111/s55359858/d3b418b8-dc22ffc2-dbadfd83-709181b5-d654efb1.jpg,test," FINAL REPORT HISTORY: ___-year-old man with cirrhosis and confusion. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest are provided. The lungs are clear. The hilar and mediastinal contours normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Two surgical clips are noted in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary process. " 2e082e6c-56d11e42-3c9fb7cb-735bb482-22e8ed33.jpg,test/p10/p10286475/s50678161/2e082e6c-56d11e42-3c9fb7cb-735bb482-22e8ed33.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with altered mental status, ABD pain // Eval for acute process COMPARISON: Prior exam from ___ and CT abdomen pelvis from earlier today. FINDINGS: AP upright and lateral view of the chest were provided. Cardiomegaly is noted with partially layering bilateral pleural effusions. Pulmonary edema is noted. No pneumothorax. Bony structures intact. IMPRESSION: Cardiomegaly with bilateral pleural effusions and pulmonary edema. " 029a1fba-a8cec19e-1b6ab36c-9216f7db-4a6cd2f1.jpg,test/p15/p15133460/s55978177/029a1fba-a8cec19e-1b6ab36c-9216f7db-4a6cd2f1.jpg,test," WET READ: ___ ___ 8:25 AM THERE IS INCREASED OPACITY IN THE RIGHT LUNG BASE, COULD REFLECT ATELECTASIS OR SUPERIMPOSED BRONCHOVASCULAR STRUCTURES, HOWEVER IF THERE IS CLINICAL CONCERN FOR INFECTION, STANDARD PA AND LATERAL CHEST RADIOGRAPHS ARE RECOMMENDED. IN ADDITION TO ATTENTION ON FOLLOWUP. FINDINGS DISCUSSED WITH DR ___ BY NSR VIA PHONE ON ___ AT 17:36. WET READ VERSION #1 ___ ___ ___ 5:41 PM THERE IS INCREASED OPACITY IN THE RIGHT LUNG BASE, COULD REFLECT ATELECTASIS OR SUPERIMPOSED BRONCHOVASCULAR STRUCTURES, HOWEVER IF THERE IS CLINICAL CONCERN FOR INFECTION, STANDARD PA AND LATERAL CHEST RADIOGRAPHS ARE RECOMMENDED. IN ADDITION TO ATTENTION ON FOLLOWUP. FINDINGS DISCUSSED WITH DR ___ BY NSR VIA PHONE ON ___ AT 17:36. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with open TMA, persistent fevers // rule out pneumonia COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Heterogeneous opacification at the base of the right lung has increased since ___ consistent with pneumonia, vertically aspiration. Lungs are otherwise clear. Heart size normal. No pleural abnormality. " 263f352e-017e229f-af349b4d-b9829c00-ed11ce2a.jpg,test/p14/p14764016/s55647449/263f352e-017e229f-af349b4d-b9829c00-ed11ce2a.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old man with chest pain. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded. Mild opacity at the right lung base is likely atelectasis but could represent early pneumonia in the appropriate clinical setting. No other opacity is seen. There is no pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. No acute osseous abnormality or displaced rib fracture is seen. IMPRESSION: Right basilar opacity likely represents atelectasis but could be early or developing pneumonia in the appropriate clinical setting. " 55997684-7424e92f-644a4d6e-4a1914c2-21df3ea1.jpg,test/p17/p17006872/s57444639/55997684-7424e92f-644a4d6e-4a1914c2-21df3ea1.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left pneumothorax, now with chest tube to waterseal. COMPARISON: ___ at approximately 1 a.m. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is a persistent right apical pneumothorax. No focal consolidation, pleural effusion, or pulmonary edema is detected. Heart and mediastinal contours are within normal limits. IMPRESSION: Persistent small right apical pneumothorax. " d07f2686-2605577a-ff3b2d30-4e29e4a3-a9a4e985.jpg,test/p17/p17677443/s57295964/d07f2686-2605577a-ff3b2d30-4e29e4a3-a9a4e985.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: Heart size is normal. Cardiomediastinal silhouette is unremarkable. Hilar contour is stable. The lungs are clear without focal consolidation, effusion or pneumothorax. No acute bony changes identified. IMPRESSION: No acute intrathoracic process. " 79ba1d2b-bfe4a0da-84859a19-fe6c90b2-4ef25fab.jpg,test/p11/p11725800/s50213561/79ba1d2b-bfe4a0da-84859a19-fe6c90b2-4ef25fab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with edema pneumonia // change in pneumonia change in pneumonia IMPRESSION: Compared to chest radiographs ___ through ___. Moderate bilateral pleural effusion increased. Moderate bibasilar atelectasis or probably unchanged. Heart size normal. Upper lungs clear. " 77f1f3aa-e4ea0236-ce86e331-ccd442e6-640f9b93.jpg,test/p13/p13616286/s57046463/77f1f3aa-e4ea0236-ce86e331-ccd442e6-640f9b93.jpg,test," FINAL REPORT INDICATION: ___M with no significant PMH p/w left-sided CP // ? acute cardiopulm process TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no effusion nor pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 2a7c34b9-4325e5d1-050e6328-0b2306f3-42dc0795.jpg,test/p15/p15034985/s51591517/2a7c34b9-4325e5d1-050e6328-0b2306f3-42dc0795.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with LLL lung cancer s/p lobectomy // eval interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the gastric bubble is over distended. The patient would likely benefit from insertion of a nasogastric tube. Status post left thoracic surgery, the left chest tube is in unchanged position. There is evidence of the minimal left apical lateral pneumothorax. No signs of tension. Unchanged normal appearance of the right lung. " 8a1bfde0-70147427-acf9817c-8331f14b-4545da55.jpg,test/p16/p16296993/s52180961/8a1bfde0-70147427-acf9817c-8331f14b-4545da55.jpg,test," WET READ: ___ ___ ___ 8:53 PM heart size raises ? of cardiomegaly vs pericardial effusion; low lung volumes, but no evdience of pneumonia, edema, or pleural effusion. ______________________________________________________________________________ FINAL REPORT HISTORY: Severe asthma, continued dyspnea. CHEST, TWO VIEWS. There is moderately severe cardiomegaly. The aorta is calcified and unfolded. There is upper zone redistribution, without overt CHF. There is small amount of pleural thickening and/or fluid at both costophrenic angles. Mild superior endplate scalloping of multiple thoracic vertebral bodies noted. IMPRESSION: 1. Cardiomegaly. Possibility of a pericardial effusion cannot be entirely excluded. 2. Upper zone redistribution, without overt CHF. 3. Small bilateral pleural effusions. 4. No focal infiltrate identified. " 96ee8a4d-7e411ece-aae06020-4fc37483-5cbaec0a.jpg,test/p12/p12151772/s52392758/96ee8a4d-7e411ece-aae06020-4fc37483-5cbaec0a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with upper gastrointestinal bleeding after intubation. Assessment for ET tube placement. Portable AP radiograph of the chest was reviewed. The ET tube tip is 4.3 cm above the carina. The right internal jugular line tip is at the level of superior SVC. Heart size and mediastinum are grossly unremarkable. Left pleural effusion and left basal consolidation is demonstrated with effusion being most likely loculated. The right lung is demonstrating right upper lung opacity, with broad differential diagnosis starting with infection, with potentially neoplasm present. Correlation with outside cross-sectional imaging is recommended if available. Otherwise, close followup with subsequent chest radiographs is required. Cystic lesion within the right proximal humerus is noted, partially imaged and may be correlated with dedicated views. " a3bc6b76-fd1ef603-b4aeab2b-2c946c37-fd35eaa2.jpg,test/p12/p12122558/s50873664/a3bc6b76-fd1ef603-b4aeab2b-2c946c37-fd35eaa2.jpg,test," FINAL REPORT HISTORY: Hyperglycemia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present. IMPRESSION: No acute cardiopulmonary process. " 83190a49-a3eae4bf-d8056033-a980164f-b577280c.jpg,test/p10/p10286475/s52005402/83190a49-a3eae4bf-d8056033-a980164f-b577280c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CML, heart failure and sepsis with placement of right chest tube ___. Please perform at 6am on ___. // ? pneumothorax, ? reaccumulation of pleural fluid, ? chest tube placement ? pneumothorax, ? reaccumulation of pleural fluid, ? chest t COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Slowly increasing opacification at the base the right lung over the past several days raises the possibility of pneumonia. The small bore pleural drainage catheter is unchanged in position at the right lung base. Re accumulated right pleural effusion is small if any. No pneumothorax. Moderate to severe cardiomegaly is chronic. Large pulmonary arteries suggest pulmonary hypertension. Moderate left pleural effusion and associated atelectasis are unchanged since ___, decreased since ___. " 311fe989-a14b1dc7-b70186c7-b8d5e74e-2ee31b26.jpg,test/p19/p19065401/s54936161/311fe989-a14b1dc7-b70186c7-b8d5e74e-2ee31b26.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends at least to the lower stomach. The dilatation of the gas-filled stomach has resolved. Otherwise, little change. " 0e212b85-b84f9d08-70844ffb-b1dc790a-70762b67.jpg,test/p11/p11453884/s53318775/0e212b85-b84f9d08-70844ffb-b1dc790a-70762b67.jpg,test," FINAL REPORT INDICATION: ___F with acute onset dizziness // eval for ICH, pneumonia, CHF TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without consolidation, effusion, or edema. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 3d24c591-f32218c1-53ea94c4-fadea358-c1c4e349.jpg,test/p13/p13330114/s54811992/3d24c591-f32218c1-53ea94c4-fadea358-c1c4e349.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with subtle opacity at the right lung base concerning for an infectious process on portable film. // eval for pneumonia eval for pneumonia IMPRESSION: In comparison with the earlier study of this date, there is again elevation of the right hemidiaphragmatic contour, though the opacification immediately above it is not seen at this time. Remainder the study is unchanged. " 68cfd76e-2922d264-8b4bdf48-6d4262be-49d0f505.jpg,test/p19/p19445196/s54046124/68cfd76e-2922d264-8b4bdf48-6d4262be-49d0f505.jpg,test," FINAL REPORT INDICATION: Cough and congestion. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Left-sided dual-chamber pacemaker with leads terminating in the right atrium and right ventricle is again noted, with leads in unchanged positions. The cardiac silhouette size is stable and top normal. The mediastinal and hilar contours are unremarkable. The lungs are clear. No pleural effusion or pneumothorax is seen. There are linear opacities in the lung bases compatible with subsegmental atelectasis. No pulmonary vascular congestion is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 626812fc-cac8e04c-54b72ce0-7b42f701-a2f20a6c.jpg,test/p15/p15426827/s54233286/626812fc-cac8e04c-54b72ce0-7b42f701-a2f20a6c.jpg,test," FINAL REPORT AP CHEST 10:27 P.M. ON ___ HISTORY: ___-year-old man with end-stage liver disease due to hemochromatosis and alcohol. Bloody ascites. New elevated white count. IMPRESSION: AP chest compared to ___ at 6:43 a.m.: Moderate right pleural effusion was much larger on ___, presumably the patient has had an intervening thoracentesis. No pneumothorax. The feeding tube follows a course more recognizable as the esophagus into the stomach and out of view. Aside from mild-to-moderate atelectasis at the base left lung is clear. Mild cardiomegaly is stable. " cf964419-9afb7557-9ddfde28-32a57ce0-eaf75286.jpg,test/p13/p13840464/s58668965/cf964419-9afb7557-9ddfde28-32a57ce0-eaf75286.jpg,test," FINAL REPORT INDICATION: History of tricuspid repair, CHF and AFib, presenting with chest pain, question pleural effusion or pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate stable moderate enlargement of the cardiac silhouette. Pulmonary vascular congestion without overt pulmonary edema is unchanged. Epicardial pacer leads are in unchanged position. The tricuspid valve is also in unchanged position. No focal consolidation, pleural effusion or pneumothorax. " fe5e1d03-69fe1182-3c060951-e7b1e711-d2d544c5.jpg,test/p11/p11199429/s50031409/fe5e1d03-69fe1182-3c060951-e7b1e711-d2d544c5.jpg,test," FINAL REPORT INDICATION: Palpitations and atrial fibrillation. Evaluate for pulmonary edema or cardiomegaly. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are mildly hyperinflated, best appreciated on the lateral view. The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart size is normal. Mediastinal and hilar structures are unchanged. IMPRESSION: No acute cardiopulmonary process. " 9978aff2-eb8813d0-c53a399b-56d82a2c-da984c22.jpg,test/p19/p19275261/s59181765/9978aff2-eb8813d0-c53a399b-56d82a2c-da984c22.jpg,test," FINAL REPORT INDICATION: Asthma, wheezing, cough, question infiltrate. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs are provided. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. An azygos fissure is noted on the right. Cardiomediastinal silhouette is normal. The osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 35bab69b-8b46b3db-ddcdaaf6-60c954d1-fb61d916.jpg,test/p17/p17935897/s52186437/35bab69b-8b46b3db-ddcdaaf6-60c954d1-fb61d916.jpg,test," FINAL REPORT INDICATION: Mr. ___ is a ___M w/ past medical history of bicuspid aortic valve status post mechanical AVR in ___, as well as AVNRT s/p ablation ___ who presented ___ with hypoxia and volume overload, now on CHF service s/p CCU stay x2 with respiratory failure improved after diuresis and initiation of BiPAP for sleep apnea. // ?pulmonary edema TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: No focal consolidation, pleural effusion or pneumothorax identified. No pulmonary edema. The size of the cardiomediastinal silhouette is enlarged but unchanged. IMPRESSION: Enlarged cardiac silhouette, unchanged. No radiographic evidence of acute cardiopulmonary disease. " 19be2352-1c9537dc-ef4c0a30-043fabfe-a412e16c.jpg,test/p16/p16753046/s51474219/19be2352-1c9537dc-ef4c0a30-043fabfe-a412e16c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with hypoglycemia and AMS // infiltrate? COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Mild elevation of the right hemidiaphragm is noted. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Partially visualized cervical spinal hardware noted. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " d9f53c0a-6dcd541f-7b82c3a6-9c45fc72-d29c8878.jpg,test/p15/p15573773/s57931344/d9f53c0a-6dcd541f-7b82c3a6-9c45fc72-d29c8878.jpg,test," WET READ: ___ ___ ___ 8:44 PM OGT still w tip in lower esophagus, similar as compared to preceding exam. Other lines and tubes satisfactory. Cardomegaly and bilateral lung opacities unchanged. dw Dr. ___ by ___ at 8p on ___ via phone. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Orogastric tube recently placed, evaluation. COMPARISON: ___, 0:49 a.m. FINDINGS: As compared to the previous radiograph, the orogastric tube is still in the lower esophagus, comparable to the position on the previous examination. All other monitoring and support devices are in expected correct position. Unchanged moderate cardiomegaly and bilateral parenchymal opacities. " 1c08183b-d926599e-843bd12f-541cf935-39961d76.jpg,test/p12/p12056448/s57473507/1c08183b-d926599e-843bd12f-541cf935-39961d76.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with weakness, dyspnea on exertion. Evaluate for pulmonary abnormalities or CHF. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Again mild cardiac enlargement is present. The thoracic aorta is moderately widened and elongated and shows calcium deposits in the wall mostly at the level of the arch. A permanent pacer is again noticed in left anterior axillary position connected to dual intracavitary electrodes, one of which is an ICD device. Termination points of electrodes are unchanged. The pulmonary vasculature demonstrates features of mild-to-moderate degree of chronic congestion with upper zone redistribution, perivascular haze and some increased interstitial markings mostly on the bases. New discrete parenchymal abnormalities cannot be identified and the lateral and posterior pleural sinuses remain free from any significant fluid accumulation. No pneumothorax has developed in the apical area. Skeletal structures of the thorax also remain unchanged. Comparison is extended to a chest examination of ___ at which time the patient was somewhat more congested. Review was also undertaken of the chest CT ___ ___ which confirmed the described chronic pulmonary changes but excluded any local abnormalities. IMPRESSION: Mild-to-moderate cardiac enlargement stable, unchanged position of permanent pacer and ICD device, mild degree of chronic pulmonary congestion but absence of new acute infiltrates or significant pleural effusion. " e211efa8-d8216c0e-09f97857-f0861041-080304d9.jpg,test/p17/p17763551/s59918328/e211efa8-d8216c0e-09f97857-f0861041-080304d9.jpg,test," FINAL REPORT EXAMINATION: Portable chest x-ray INDICATION: ___ year old woman with newly placed chest tube // verifying chest tube placement TECHNIQUE: Single portable frontal view of the chest. COMPARISON: Compared to prior dated ___ at 18:38 FINDINGS: When compared to prior, there has been interval insertion of a right chest tube with its tip in the right lung apex. There has been interval improvement of size of the right pneumothorax. No other significant interval change. This preliminary report was reviewed with Dr. ___, ___ radiologist. " c373ffd3-98be9171-b772fe1f-15bafb24-3e02bb8d.jpg,test/p13/p13628037/s52162865/c373ffd3-98be9171-b772fe1f-15bafb24-3e02bb8d.jpg,test," WET READ: ___ ___ ___ 6:37 PM New bi-basilar airspace opacicites concerning for infection in a neutropenic patient. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: New hypoxemia, evaluation for interval changes. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there are subtle bilateral parenchymal opacities at both lung bases. Although the asymmetry of the changes could suggest atelectasis, early pneumonia must be considered as a differential diagnosis in this neutropenic patient. Mild fluid overload. Borderline size of the cardiac silhouette. Unchanged position of the CVAL. " a7117cfd-b85c79dd-966e27ea-1ddc48cb-147cad8e.jpg,test/p11/p11842879/s57851159/a7117cfd-b85c79dd-966e27ea-1ddc48cb-147cad8e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Omental patch, assessment for support devices. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. The tip of the endotracheal tube continues to project 4 cm above the carina. The nasogastric tube has been removed, a second nasogastric tube remains in unchanged position. Unchanged left internal jugular vein catheter. Unchanged appearance of the heart, the retrocardiac atelectasis, the small pleural effusion and the atelectasis at the right lung base. " 00768144-dfeb6fc1-56e7b784-7441d569-b86bc4fa.jpg,test/p15/p15768537/s52545368/00768144-dfeb6fc1-56e7b784-7441d569-b86bc4fa.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with long smoking history with finger injury pre-op x-ray. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without consolidation, effusion or pulmonary vascular congestion. Cardiomediastinal silhouette is normal. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 7519b573-123d9dbc-7d112633-0cf5329d-b6e2e2ce.jpg,test/p15/p15505660/s57414428/7519b573-123d9dbc-7d112633-0cf5329d-b6e2e2ce.jpg,test," WET READ: ___ ___ ___ 7:57 AM No evidence of pleural effusions or focal consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with pancreatitis. Eval for pleural effusion. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Compared to the prior study, there is persistent aortic tortuosity and mild cardiomegaly. Lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No evidence of pleural effusions or focal consolidation. " fd9f23ef-d1d962c6-9068d1d6-41c5868f-5a75549e.jpg,test/p12/p12667651/s54624153/fd9f23ef-d1d962c6-9068d1d6-41c5868f-5a75549e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with leukocytosis, wheezing on exam, concern for pneumonia // Evidence of pneumonia Evidence of pneumonia IMPRESSION: Compared to chest radiographs ___ and ___. The upper paramedian chest has a very abnormal appearance, suggesting either a very large esophageal hernia or prior esophagectomy and gastric pull-up surgery or hilar or lung masses, mucoid impactions or fissural pleural fluid loculations. Unfortunately the explanation is not clarified by the lateral view and CT scanning is recommended if the accurate clinical history is not known. Thickening of the left lateral costal pleural margin and deformity of the adjacent ribs suggest prior trauma, perhaps recent. Heart is moderately enlarged. I do not see pneumonia or pulmonary edema and pleural effusion if any is small. No pneumothorax. Left PIC line ends in the mid SVC. " 7dd3e95a-56c7fbe4-7722df5f-4b3a485e-f0e53a9f.jpg,test/p13/p13914896/s50309962/7dd3e95a-56c7fbe4-7722df5f-4b3a485e-f0e53a9f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/?brain mass and seizures, neurology requesting cxr // ___M w/?brain mass and seizures, neurology requesting cxr TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. There is no focal consolidation. Mild interstitial abnormality is noted, most commonly seen in smokers. There is no pleural effusion or pneumothorax. IMPRESSION: Mild interstitial abnormality is noted, which is most commonly seen in smokers. " f9f2994d-0072f6aa-32cf61c7-af016a0a-5e32b37a.jpg,test/p10/p10750092/s52347962/f9f2994d-0072f6aa-32cf61c7-af016a0a-5e32b37a.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old male intubated with thick secretion and fever to 102. FINDINGS: Comparison is made to previous study from ___. There is an endotracheal tube whose tip is 3.3 cm above the carina. This could be pulled back 1-2 cm for more optimal placement. There is a nasogastric tube whose side port is near the GE junction. This could be advanced several centimeters for more optimal placement. There is stable cardiomegaly and tortuosity of the thoracic aorta. There is some slight prominence of pulmonary vascular markings and some atelectasis versus developing infiltrate at the right base. No pneumothoraces are present. " 1ac02f04-3fb4ef33-c12197d0-1826fdba-1c4fcd12.jpg,test/p13/p13501962/s57276593/1ac02f04-3fb4ef33-c12197d0-1826fdba-1c4fcd12.jpg,test," FINAL REPORT HISTORY: Hypotension and abdominal distention. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unchanged with tortuosity of the thoracic aorta again noted. There is no pulmonary vascular congestion. Streaky linear opacities in the bases are compatible with subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Interposition of the colon between the diaphragm and liver is noted on the right. Distended bowel loops are partially imaged within the upper abdomen. IMPRESSION: Mild bibasilar atelectasis. " 269a6018-3df323aa-2f7f6c18-db0284f8-595a127f.jpg,test/p14/p14601638/s57593595/269a6018-3df323aa-2f7f6c18-db0284f8-595a127f.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with cough, shortness of breath, COPD. Rule out infiltrate. COMPARISON: Chest x-ray from ___ to ___. Chest CT of ___. FINDINGS: The patient is known with severe upper lobe predominant emphysema. There is no new lung consolidation. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: 1. There is no evidence of pneumonia. 2. Severe emphysema. " 440b8a1b-c4ab2a6e-881d16ce-5154cfd3-590f1763.jpg,test/p12/p12910092/s50575620/440b8a1b-c4ab2a6e-881d16ce-5154cfd3-590f1763.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. A left-sided PICC is seen, distal aspect not well seen, but appears to at least enter the SVC. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. A cervical hardware is seen. IMPRESSION: No acute cardiopulmonary process. " 3c682027-da266f5b-1ccf78f2-0bbcf080-f0d3fda8.jpg,test/p13/p13299285/s55616259/3c682027-da266f5b-1ccf78f2-0bbcf080-f0d3fda8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new bilateral chest tubes // r/o PTX r/o PTX COMPARISON: Chest radiographs ___ through ___ at 04:50. IMPRESSION: Previous moderate right pleural effusion has resolved, and very small low, right anterior pneumothorax has developed since insertion of a pigtail pleural drain ending at the right lung base medially. A new left pigtail drainage catheter has been inserted deep in the lateral pleural sulcus with no apparent change in the appearance of the left hemi thorax. There is no pneumothorax and any pleural effusion was not detectable on conventional radiographs although a small left pleural effusion was shown on the abdomen CT ___. Previous mild pulmonary edema has improved. Heart size is top-normal, but smaller. Right supraclavicular central venous infusion port and a right PIC line both end close to the superior cavoatrial junction. " 7e978dff-59c5a558-d1419693-c9af2188-ecd1e6a7.jpg,test/p18/p18232511/s57000590/7e978dff-59c5a558-d1419693-c9af2188-ecd1e6a7.jpg,test," FINAL REPORT AP CHEST 5:33 A.M. ON ___: HISTORY: Spinal fusion. Evaluate interval change. IMPRESSION: AP chest compared to ___: Bibasilar consolidation could represent atelectasis or pneumonia, particularly aspiration. Upper lungs show persistent chronic pulmonary vascular congestion and only mild pulmonary edema. Severe cardiomegaly and mediastinal vascular engorgement are less pronounced today than it was over the past week. No pneumothorax. Nasogastric tube can be traced only as far as the mid esophagus where its course is obscured by spinal hardware, not fully evaluated by this study. No pneumothorax. " 9f38b35b-37d52c7a-fdb51538-3b412153-b92c8fb3.jpg,test/p11/p11250458/s56530883/9f38b35b-37d52c7a-fdb51538-3b412153-b92c8fb3.jpg,test," FINAL REPORT HISTORY: History of syncopal episode. Evaluate for acute process. COMPARISON: Chest radiographs from ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. The lung volumes are low. Note is made of bibasilar atelectasis. No focal consolidations concerning for infection is identified. There are no pleural effusions or pneumothoraces. The visualized osseous structures are unremarkable. IMPRESSION: No focal consolidations concerning for infection. Bibasilar atelectasis. " 09bb51f7-1dc64ed3-1894c5d7-a7a56f7d-ab2e8f94.jpg,test/p10/p10708431/s52227353/09bb51f7-1dc64ed3-1894c5d7-a7a56f7d-ab2e8f94.jpg,test," FINAL REPORT AP CHEST, 10:20 A.M., ON ___ HISTORY: Right chest tube removed. IMPRESSION: AP chest compared to ___ through ___, 5:24 a.m.: There is no large right pneumothorax or appreciable pleural fluid collection following removal of the right pleural tube, although a small amount of pleural air would be difficult to detect in the setting of persistent severe subcutaneous emphysema and pneumomediastinum. Left basal atelectasis has cleared. Emphysema is severe. There is probably a small to moderate left pneumothorax, which has remained stable since the earliest chest radiographs here on ___. Heart is not enlarged. " 1d0e6d19-bc421c9d-192dd15e-54e37967-5c1e3cf7.jpg,test/p10/p10477899/s59576797/1d0e6d19-bc421c9d-192dd15e-54e37967-5c1e3cf7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with unexplained rising WBC // evaluate for acute cardiopulmonary process TECHNIQUE: Chest radiographs dated ___. COMPARISON: Chest radiographs dated ___. FINDINGS: Compared to chest radiographs from ___, bibasilar atelectasis and retrocardiac opacity have improved. Lung volumes remain low. There is no focal consolidation. Probable trace bilateral effusions persist. No pneumothorax. Mediastinal and hilar contours are stable. Heart is top-normal in size, stable. IMPRESSION: 1. No evidence of pneumonia. Improved bibasilar atelectasis and retrocardiac opacity. 2. Stable top-normal heart size. " 132a15ef-5f8376d2-3971f69e-4b098bbb-a0d3a9ac.jpg,test/p13/p13576844/s54403740/132a15ef-5f8376d2-3971f69e-4b098bbb-a0d3a9ac.jpg,test," WET READ: ___ ___ ___ 4:44 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with SOB, post-op hip surgery // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: The lungs are well-expanded and clear. Cardiomediastinal hilar contours are unchanged. The aorta is mildly tortuous. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumonia. " 5b710ea6-65098123-5ec0ac5d-7029fc5f-77fe920c.jpg,test/p16/p16973278/s54530483/5b710ea6-65098123-5ec0ac5d-7029fc5f-77fe920c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever // ?pna TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " ed56f344-cfcf6a1f-d0eb0991-96d4b863-dbcdfcfd.jpg,test/p11/p11334677/s55414327/ed56f344-cfcf6a1f-d0eb0991-96d4b863-dbcdfcfd.jpg,test," FINAL REPORT HISTORY: Past medical history of PCOS, complaining of left upper quadrant abdominal pain and left rib pain. Rule out pneumothorax. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is no focal consolidation concerning for pneumonia. Lucency along the the lateral right lung likely represents a skin fold. There is no pneumothorax or pleural effusion. There is no evidence of free air. IMPRESSION: No pneumothorax or focal consolidations concerning for pneumonia. " bf689441-0e138c0c-c536b274-45633af5-30e1a4e1.jpg,test/p14/p14497007/s55028182/bf689441-0e138c0c-c536b274-45633af5-30e1a4e1.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fever and agitation. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is no radiographic evidence for focal consolidation, pleural effusion, or pneumothorax. New fissural density may represent atelectasis. Evidence of calcified mediastinal lymph nodes again seen. Cardiac silhouette is top normal to mildly enlarged. Spinal hardware appears similar. IMPRESSION: Top normal to mildly enlarged cardiac silhouette. No focal consolidation. " ef767113-748c55ff-263f1a05-f46c176f-b31892e8.jpg,test/p17/p17421530/s51548688/ef767113-748c55ff-263f1a05-f46c176f-b31892e8.jpg,test," FINAL REPORT INDICATION: ___F with left chest wall pain after fall. COMPARISON: None available. TECHNIQUE PA and lateral view of the chest. FINDINGS: The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. No focal lung consolidation. No displaced rib fracture seen. IMPRESSION: No evidence of displaced rib fractures. Normal chest radiograph. " 8bc6dfd9-8d0ee8cf-57a4b274-6e397589-a898d028.jpg,test/p18/p18519417/s56980744/8bc6dfd9-8d0ee8cf-57a4b274-6e397589-a898d028.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, ascites, bibasilar crackles. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are low. Areas of atelectasis are seen at the left lung bases. The changes do not have a morphology suspicious for pneumonia. No pleural effusions. Borderline size of the cardiac silhouette without pulmonary edema. No pneumothorax. " f0f0a3fd-fb039b69-3de2ac4d-086dff92-ce29fa40.jpg,test/p15/p15782217/s52104061/f0f0a3fd-fb039b69-3de2ac4d-086dff92-ce29fa40.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chemotherapy for non-Hodgkin's lymphoma with cough and shortness of breath, question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette is enlarged. Mediastinal and hilar contours are stable. No pleural effusion is seen. There is no focal consolidation. There is minimal prominence of the interstitial markings, grossly stable compared to the prior study. There is sclerosis of a vertebral body at the thoracolumbar junction with prior vertebroplasty/kyphoplasty. IMPRESSION: Enlarged cardiac silhouette without definite acute cardiopulmonary process. " 233ae6e9-21ef4f5c-08ebd83a-326c33fd-b7f7223c.jpg,test/p15/p15782217/s57387012/233ae6e9-21ef4f5c-08ebd83a-326c33fd-b7f7223c.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with cough and fever. FINDINGS: PA and lateral views of the chest were correlated to chest CT from ___. There is patchy opacity identified at the right lung base. Elsewhere, the lungs are clear. The cardiac silhouette is slightly enlarged but stable. Slight aortic tortuosity again noted. Left lateral rib fractures appear old. Osseous and soft tissue structures are otherwise grossly unremarkable. IMPRESSION: Right lower lobe consolidation compatible with pneumonia in the appropriate clinical setting. Recommend repeat after treatment to document resolution. " a1e744a3-9ab7e6ff-11c27240-185ea967-3e796c8c.jpg,test/p14/p14067088/s55681108/a1e744a3-9ab7e6ff-11c27240-185ea967-3e796c8c.jpg,test," WET READ: ___ ___ 11:19 PM No focal parenchymal opacity identified. ______________________________________________________________________________ FINAL REPORT HISTORY: SVT earlier today. COMPARISON: None. FINDINGS: The lungs are clear without infiltrate or effusion. The cardiac and mediastinal silhouettes are normal. The bony thorax is normal. IMPRESSION: Normal chest. " b6937ffe-e69185ff-ab2635ce-4c63fffc-715f10f9.jpg,test/p13/p13365915/s54285412/b6937ffe-e69185ff-ab2635ce-4c63fffc-715f10f9.jpg,test," FINAL REPORT INDICATION: ___ year old man with s/p cabg // s/p bronchoscopy TECHNIQUE: Single portable supine AP image of the chest. COMPARISON: Comparison is made with chest radiographs from earlier the same day, ___, and ___. FINDINGS: The lungs are well expanded. Previoius atelectasis has improved. . Pulmonary vascular congestion is seen, new from prior exam. Increased bilateral pleural effusions, left greater than right. The cardiomediastinal silhouette is unremarkable. IMPRESSION: 1. Increased bilateral pleural effusions, left greater than right. 2. Improved atelectasis. 3. Pulmonary vascular congestion, new from prior exam. " b00fe94e-0c9a9850-34849f28-553eeb07-21e804d2.jpg,test/p11/p11911760/s59002945/b00fe94e-0c9a9850-34849f28-553eeb07-21e804d2.jpg,test," FINAL REPORT AP CHEST, 9:37 A.M., ___ HISTORY: Hypoxia after knee surgery. Question atelectasis infiltrate or effusion. IMPRESSION: AP chest compared to ___: Wedge-shaped areas of opacity at both lung bases, are generally due to atelectasis, but these plain radiographic findings neither specifically suggest nor exclude the diagnosis of acute pulmonary embolism. Mediastinal convexity in the region of this ascending thoracic aorta or azygous vein is new since ___, but should be corroborated with conventional chest radiographs when feasible, to see if additional imaging is necessary. Upper lungs are clear and there is no appreciable pleural effusion. " f15fa920-164dc599-6c373498-63bfe100-47e15f3d.jpg,test/p19/p19736038/s55236880/f15fa920-164dc599-6c373498-63bfe100-47e15f3d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with L empyema sp decort // sp decort sp decort IMPRESSION: In comparison with the earlier study of this date, there have been 2 left chest tubes inserted as part of a decortication procedure. The pigtail catheter is been removed. The area of increased opacification in the left mid-zone is not definitely present. There are some streaks of opacification in the left upper zone that could represent areas of volume loss. Atelectasis is also seen at the left base. Continued enlargement of the cardiac silhouette with retrocardiac opacification consistent with volume loss in the lower lobe and pleural fluid. " c87b9ae3-b6b5697b-895e5c71-fbbd8da3-77e79151.jpg,test/p10/p10500801/s54115982/c87b9ae3-b6b5697b-895e5c71-fbbd8da3-77e79151.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient with recent right pigtail catheter for pneumothorax treatment. Pre-clinic visit examination on ___. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. The heart size is normal. No configurational abnormalities are identified. Thoracic aorta unremarkable. The pulmonary vasculature is not congested. As shown on previous examination, there is evidence of bilateral, mostly basal, emphysema with rarefied vasculature, flattened diaphragms, and increased translucencies rather typical for bilateral basal emphysema. Lateral pleural sinuses as well as the posterior sinuses are free from any remaining pleural effusion. No new parenchymal infiltrates are identified, and no residual pneumothorax is seen in the right hemithorax apical area. In comparison with the next preceding examination, the small right-sided pleural effusion has now disappeared and the same holds for some parenchymal infiltrates in the right upper lobe area which now have cleared. Skeletal structures of the thorax are grossly within normal limits with the exception of some minor degenerative changes in the mid portion of the thoracic spine. IMPRESSION: Normalization of chest findings in patient with previous right-sided spontaneous pneumothorax. Rather marked bilateral basal emphysematous changes remain. " e2d1cb7e-2a664a9c-313b1300-1c6be8f0-8b2267c0.jpg,test/p12/p12953693/s52176310/e2d1cb7e-2a664a9c-313b1300-1c6be8f0-8b2267c0.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // ? acute cardipulm procss TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 562e57bd-505e504e-0fc4543c-3f65f24b-75d7b54d.jpg,test/p12/p12791976/s50459368/562e57bd-505e504e-0fc4543c-3f65f24b-75d7b54d.jpg,test," FINAL REPORT HISTORY: ___-year-old female status post thoracentesis. COMPARISON: Multiple films from earlier the same day. FINDINGS: PA and lateral views of the chest. There is increased opacity at the right lung base compared to most recent exam but significantly improved from earlier exam. This is likely due to a combination of atelectasis and some residual pleural fluid. The left lung remains clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. There is no pneumothorax. IMPRESSION: Mild persistent right pleural effusion with underlying likely residual atelectasis in the right lower lung. " c402bb14-72915f9d-f761f309-3f801cd9-b2dc0b5b.jpg,test/p10/p10979480/s57023089/c402bb14-72915f9d-f761f309-3f801cd9-b2dc0b5b.jpg,test," WET READ: ___ ___ ___ 7:01 PM Again seen is left basilar consolidation consistent with pneumonia. No change since ___ at 15:22. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old woman, with pneumonia, now hemoptysis. Assess for acute pulmonary process. COMPARISON: Chest radiograph on ___. SINGLE PORTABLE CHEST RADIOGRAPH: The patient is status post extensive thoracolumbar fusion with ___ rods. There is interval opacification of the stomach and proximal small bowel, in keeping with the recent upper GI barium study. The right-sided Port-A-Cath terminates at the cavoatrial junction. There is a partially calcified aortic knob. The lung volumes remain low. Compared to the most recent chest radiograph, there is interval moderate improvement of the extensive left lower lung opacity. There is no pneumothorax or pleural effusion. There are prominent bilateral hilar opacities, unchanged. IMPRESSION: No pneumothorax or pleural effusion. Interval moderate improvement of the extensive left lower lung opacification. " cd091855-52e12931-c7cb186e-f8ce32cc-f68195f4.jpg,test/p13/p13777829/s54784377/cd091855-52e12931-c7cb186e-f8ce32cc-f68195f4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval COMPARISON: ___ IMPRESSION: Heart size is normal. Tortuous aorta and mild dilatation of the left atrium are present. Right chest tube is in place. There is no interval accumulation of pleural effusion or pneumothorax. Nodules projecting over the right lower lung are unchanged. " dfdf1074-f3ad519a-02f7b049-a8c4d97e-f7786993.jpg,test/p10/p10338508/s59788877/dfdf1074-f3ad519a-02f7b049-a8c4d97e-f7786993.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with AMS // Eval for infiltrate COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. There is improved interval aeration at the right lung base. No signs of pneumonia or CHF. No effusion or pneumothorax. Cardiomediastinal silhouette is stable. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process " ef92fcbd-5b63725e-3c1bd2fd-8f46d96d-0e8332e5.jpg,test/p10/p10866613/s55766852/ef92fcbd-5b63725e-3c1bd2fd-8f46d96d-0e8332e5.jpg,test," FINAL REPORT HISTORY: Asthma and cough. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Cardiac silhouette is within normal limits, and there is no acute pneumonia or vascular congestion or pleural effusion. " 16e0c5f2-8f30bbed-b28bbc40-79101ba0-150332d6.jpg,test/p18/p18230852/s55634911/16e0c5f2-8f30bbed-b28bbc40-79101ba0-150332d6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with epistaxis and respiratory failure // evaluate for interval change IMPRESSION: In comparison to prior radiograph of 1 day earlier, bibasilar opacities have improved on the right and worsened on the left. The such rapid shift favors atelectasis or aspiration over infectious pneumonia. No other relevant change. " 61632a65-13de7b10-923fb9a4-615c77f4-7bc29804.jpg,test/p19/p19017172/s57955978/61632a65-13de7b10-923fb9a4-615c77f4-7bc29804.jpg,test," FINAL REPORT HISTORY: ___-year-old man with increased cough for 3 months, pain in the right anterior ribs, and wheezing. Evaluate for pneumonia or lung cancer changes. COMPARISON: Prior radiographs the test chest dated ___ through ___, as well as is CT of the chest dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate persistent large right perihilar mass, which is slightly larger as compared to the prior study. This is in a region of prior fiducial seed placement, and may correspond to post-radiation changes; however, recurrence of malignancy cannot be excluded. Again seen are heterogeneous opacities at the right base, with a small right-sided pleural effusion. The left lung is essentially clear. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax or focal consolidation. IMPRESSION: 1. Persistent large right perihilar mass, which is slightly larger as compared to the prior study. This is in a region of prior fiducial seed placement, and may correspond to post-radiation changes; however, recurrence of malignancy cannot be excluded. Recommend dedicated CT of the chest for additional evaluation. 2. No pneumonia. " f214337a-0472aae7-4bc1969c-be20c8d5-3017e25f.jpg,test/p18/p18016603/s52182625/f214337a-0472aae7-4bc1969c-be20c8d5-3017e25f.jpg,test," FINAL REPORT INDICATION: History: ___F with n/v, abd pain, recent hospitalization pls eval pna on cxr and ventral hernia/ diverticulitis on ct a/p // History: ___F with n/v, abd pain, recent hospitalization pls eval pna on cxr and ventral hernia/ diverticulitis on ct a/p TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Compared to the prior study the pulmonary edema and cardiomegaly has improved with persistent mild enlargement of the cardiac silhouette. Lung volumes are low and there is a linear opacity in the left lower lobe likely reflecting atelectasis. No pneumothorax. No free air under the diaphragms. IMPRESSION: Low lung volumes with linear left lower lobe atelectasis. " d66599b5-8ea4b1ae-1b473e27-f18bb434-6044332b.jpg,test/p18/p18578486/s56919263/d66599b5-8ea4b1ae-1b473e27-f18bb434-6044332b.jpg,test," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Peritoneal abdomen, question free air. COMPARISON: None. FINDINGS: There are relatively low lung volumes, which accentuate the bronchovascular markings. Given this, no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No definite evidence of free air is seen beneath the diaphragms. IMPRESSION: 1. Low lung volumes, but clear lungs. 2. No definite evidence of free air beneath the diaphragms. " 8699a33e-4dfe71bf-bdb264ce-b047fbdf-a95b3c53.jpg,test/p13/p13562596/s52273446/8699a33e-4dfe71bf-bdb264ce-b047fbdf-a95b3c53.jpg,test," FINAL REPORT HISTORY: ___-year-old female with altered mental status. Question pneumonia. COMPARISON: None. FINDINGS: Single portable view of the chest. There are bibasilar opacities, right greater than left. Superiorly the lungs are clear. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormality detected. IMPRESSION: Bibasilar opacities potentially due to atelectasis however infection is noted excluded. If further evaluation is desired, PA and lateral can be performed if patient is amenable. " 7aef6fb4-e7ab478d-324dc85a-c0abd4d9-e67217f2.jpg,test/p10/p10903446/s54717639/7aef6fb4-e7ab478d-324dc85a-c0abd4d9-e67217f2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p polytrauma MVC, lung contusion with continued dyspnea // cardiopulmonary changes? development of previous pulmonary contusion TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change, with the exception of removal of the right-sided PICC lung. . IMPRESSION: No change. " 4c49d1b4-f36fd452-72665576-d34b569e-189a63dc.jpg,test/p14/p14185111/s55713975/4c49d1b4-f36fd452-72665576-d34b569e-189a63dc.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Cough, weakness and confusion. TECHNIQUE: AP and lateral view of the chest. COMPARISON: ___. FINDINGS: Median sternotomy wires and mediastinal clips are again noted. Lung volumes are low accentuating the cardiac silhouette. Moderate cardiomegaly is likely unchanged. Hilar contours are unremarkable. There is mild retrocardiac atelectasis. Lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. Chronic deformity of the proximal left humerus is again noted. IMPRESSION: No acute cardiopulmonary abnormality. " 85a5f9ac-6a7c30f8-a7a94492-5726acf2-d0b87401.jpg,test/p10/p10019003/s55125544/85a5f9ac-6a7c30f8-a7a94492-5726acf2-d0b87401.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with septic vs hypovolemic shock, now with worsening tachycardia, SOB/cough // ?pneumonia, pulm edema ?pneumonia, pulm edema IMPRESSION: In comparison with the study of ___, the cardiac silhouette is within normal limits. The pulmonary vascular congestion has improved. Bibasilar atelectatic changes are again seen. The right IJ catheter again extends to the mid portion of the SVC. " d94ce53d-3e5c633e-653db149-6b943faf-3bf0cc99.jpg,test/p17/p17295095/s52439895/d94ce53d-3e5c633e-653db149-6b943faf-3bf0cc99.jpg,test," FINAL REPORT HISTORY: ___-year-old female with pleuritic left upper quadrant pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " a404af11-e5720020-3114ee72-9fe96944-f3144039.jpg,test/p16/p16006840/s56319315/a404af11-e5720020-3114ee72-9fe96944-f3144039.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dobbhoff placement. COMPARISON: ___, 5:43 a.m. FINDINGS: As compared to the previous radiograph, the patient has received a Dobbhoff catheter. The course of the catheter is unremarkable, the tip located in the middle parts of the stomach. No evidence of complications. Unchanged appearance of the heart and the lungs. " 7f3854e8-995cb844-c92e8083-00e12099-fb37218c.jpg,test/p18/p18977683/s58179273/7f3854e8-995cb844-c92e8083-00e12099-fb37218c.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: 2 views of the chest. COMPARISON: ___. FINDINGS: The lungs are well expanded with increased interstitial markings which likely reflect chronic changes due to a nonspecific fibrotic lung disease as on the prior CT. Increased bibasilar opacities may reflect superimposed atelectasis; however aspiration would be difficult to exclude. There is no pleural effusion or pneumothorax. The heart is normal in size with normal mediastinal and hilar contours aside from enlarged pulmonary arteries consistent with provided history of pulmonary hypertension. Proximal left clavicular fracture is redemonstrated. IMPRESSION: Chronic fibrotic changes with superimposed increased basilar opacities which could reflect atelectasis or aspiration. " 80687b55-2302eaed-01d8d3bf-c0366329-b05878b0.jpg,test/p12/p12764457/s58967006/80687b55-2302eaed-01d8d3bf-c0366329-b05878b0.jpg,test," WET READ: ___ ___ ___ 7:00 PM - given overlying leads, the tip of the right sided catheter is not definitively identified. repeat chest xray with overlying material removed is recommended. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with a port // port placement port placement COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: New right supraclavicular central venous infusion port catheter ends in the region of the superior cavoatrial junction. No pneumothorax pleural effusion or mediastinal widening. Heart size normal. Lungs clear. " ca5b3600-2d002a48-c5f0acd5-d2381c88-3990cf64.jpg,test/p15/p15722937/s57061835/ca5b3600-2d002a48-c5f0acd5-d2381c88-3990cf64.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia // int change int change IMPRESSION: In comparison with the study of ___, the left subclavian catheter has been removed. Monitoring and support devices are otherwise unchanged. The diffuse bilateral opacifications persist. " 827b3c4e-632a9e57-bb71d1c1-96f3d060-b6e6c4a0.jpg,test/p17/p17459404/s55408286/827b3c4e-632a9e57-bb71d1c1-96f3d060-b6e6c4a0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NSCLC and pleural effusion with chest tube placement. // Evaluate pleural effusion and chest tube. Please do at 5am. Evaluate pleural effusion and chest tube. Please do at 5am. IMPRESSION: Comparison to ___, 22:06. Unchanged position of the left pigtail catheter. Unchanged pleural air inclusions in the left pleural space. Moderate cardiomegaly with partial left lower lobe collapse persists. No evidence of tension. Unchanged normal appearance of the right lung. " 97cde197-75043bc4-cad79d1f-0884fe07-cab53aac.jpg,test/p10/p10285455/s58307852/97cde197-75043bc4-cad79d1f-0884fe07-cab53aac.jpg,test," FINAL REPORT HISTORY: Left hip pain. Evaluate for pneumonia. COMPARISON: None. FRONTAL AND LATERAL VIEWS OF THE CHEST (4 EXPOSURES): The lungs are mildly hyperexpanded. There is no pleural effusion, pneumothorax or focal airspace consolidation. There is prominence of the central pulmonary vasculature with mild pulmonary edema. The heart size is mildly enlarged. The mediastinum is unremarkable. Density projecting over the lower spine is presumed to be a confluence of shadows. IMPRESSION: Mild cardiomegaly with mild pulmonary edema. " cb909040-cef48f9c-9d9edd90-b823ee6d-27fe599f.jpg,test/p12/p12308681/s58138949/cb909040-cef48f9c-9d9edd90-b823ee6d-27fe599f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with SOB // Pneumonia? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 859387a6-93244d37-625941ec-a3b8ce82-6d4b00bb.jpg,test/p19/p19343087/s50699128/859387a6-93244d37-625941ec-a3b8ce82-6d4b00bb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval IMPRESSION: In comparison with the study of ___, there again is left pleural effusion with underlying compressive atelectatic changes. Much less prominent changes are seen at the left base. No evidence of acute pneumonia or vascular congestion. Of incidental note is a moderate hiatal hernia with air-fluid level. " 52f575d4-f39a3822-f1e35d87-06a8bdc2-40999dae.jpg,test/p16/p16444272/s50211253/52f575d4-f39a3822-f1e35d87-06a8bdc2-40999dae.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY OF ___ COMPARISON: ___ chest radiograph. FINDINGS: Right-sided chest tube remains in place with persistent small-to-moderate right pleural effusion with loculated intrafissural component, but no visible pneumothorax. Moderate left pleural effusion has minimally increased since the previous study. Pulmonary vascular congestion is accompanied by mild interstitial edema. Persistent left retrocardiac opacity is likely a combination of atelectasis and effusion. Worsening sharply demarcated opacity in right lower lung may reflect post-operative atelectasis in the right middle lobe in this patient reportedly status post the right lower lobe resection. Cardiac silhouette is enlarged but stable in size. Left PICC continues to terminate inferiorly within the right atrium. " 76bdf9ea-2abb90bf-9bb776b6-1098f7e2-1223fe56.jpg,test/p13/p13833217/s56204028/76bdf9ea-2abb90bf-9bb776b6-1098f7e2-1223fe56.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " de041ff0-8694747f-30c98ca3-3be3f95a-30ff3eee.jpg,test/p11/p11636304/s58373586/de041ff0-8694747f-30c98ca3-3be3f95a-30ff3eee.jpg,test," WET READ: ___ ___ ___ 7:53 AM 1. Endotracheal tube is high, terminating 9.5 cm above the carina. Advancement is recommended. 2. Low lung volumes. Streaky left retrocardiac opacity most likely represents atelectasis. WET READ VERSION #1 ___ ___ ___ 9:49 PM 1. Endotracheal tube is high, terminating 9.5 cm above the carina. Advancement is recommended. 2. Low lung volumes. Streaky left retrocardiac opacity most likely represents atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p intubation // ETT placement IMPRESSION: Tip of endotracheal tube terminates approximately 10 cm above the carina and should be advanced by several cm for standard positioning. Cardiomediastinal contours are stable compared to recent CT of earlier the same date. Patchy and linear bibasilar atelectasis are present with otherwise clear lungs. Please see CT report for additional findings including possible left fifth anterior rib fracture and bilateral small pulmonary nodules. " bf07a8c6-24870a1b-b33fc2fe-a0a99c30-947425b8.jpg,test/p18/p18123897/s50911713/bf07a8c6-24870a1b-b33fc2fe-a0a99c30-947425b8.jpg,test," WET READ: ___ ___ 7:22 PM Right internal jugular central venous catheter terminates at the cavoatrial junction without evidence of pneumothorax. Enteric tube has withdrawn somewhat, with side port now in the distal esophagus, distal tip in the proximal stomach. Suggested advancement so that the side port is well within the stomach. Subtle left perihilar and left basilar patchy opacities are nonspecific could be due to atelectasis or aspiration. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F intubated, sedated now with central line placement // ? central line placement TECHNIQUE: Single frontal view of the chest COMPARISON: ___, earlier today, at 17:06 FINDINGS: Endotracheal tube terminates 3.9 cm above level the carina. Enteric tube courses in the left upper quadrant terminating in the proximal stomach, however, side port appears in the distal esophagus. There has been interval placement of right internal jugular venous catheter which terminates at the cavoatrial junction without evidence of pneumothorax. There are low lung volumes. Patchy left perihilar and left basilar opacities are nonspecific but could be due to atelectasis or aspiration. Subcentimeter left upper lobe calcified nodules likely present calcified granulomas. No pleural effusion is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Right internal jugular central venous catheter terminates at the cavoatrial junction without evidence of pneumothorax. Enteric tube has withdrawn somewhat, with side port now in the distal esophagus, distal tip in the proximal stomach. Suggested advancement so that the side port is well within the stomach. Subtle left perihilar and left basilar patchy opacities are nonspecific could be due to atelectasis or aspiration. " a25cb8d2-ae135614-8801734c-d76b8204-110e0179.jpg,test/p11/p11124675/s54867867/a25cb8d2-ae135614-8801734c-d76b8204-110e0179.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with increased SOB, hx of COPD // eval for PNA COMPARISON: ___ and ___. FINDINGS: AP portable semi upright view of the chest. Underpenetration limits assessment. There is suggestion of mild pulmonary edema. Low lung volumes limits assessment. Evaluation for small pleural effusions is limited given absence of lateral projection. No large effusion or pneumothorax is appreciated. Heart size appears grossly stable as does the mediastinal contour. No acute bony injuries seen. IMPRESSION: Limited exam with probable mild pulmonary edema. " 62627ea4-2685941f-812a9875-fbc3be4a-83147b35.jpg,test/p11/p11888596/s51332013/62627ea4-2685941f-812a9875-fbc3be4a-83147b35.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // Eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. IMPRESSION: No acute cardiopulmonary process. " 31ce1089-64535692-0e2c2d94-7204a737-f26d2d58.jpg,test/p13/p13350579/s58205468/31ce1089-64535692-0e2c2d94-7204a737-f26d2d58.jpg,test," FINAL REPORT HISTORY: Pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. Persistent right basilar opacification primarily seen anteriorly, though there is also parenchymal opacification seen in the posterior portion on the lateral view. The findings are most consistent with pneumonia and pleural fluid. Postoperative changes are again seen in the right apex and in the region of the left hilus. There could be a somewhat ill-defined area of increased opacification in the left mid-to-lower zone that could also be a focus of consolidation. " 90a10f07-12f3d444-2c5d4aee-e043cfe4-cd517fe6.jpg,test/p16/p16458160/s51383891/90a10f07-12f3d444-2c5d4aee-e043cfe4-cd517fe6.jpg,test," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old male with history of pleural effusion and chest pain. COMPARISON: ___. FINDINGS: When compared to prior, there has been no significant interval change. The size of the right-sided pleural effusion has not significantly changed. Volume loss in the right hemithorax is as on prior. Component of the right basilar opacity medially is likely due to persistent right lower lobe atelectasis. Left lung is clear where not obscured by the left chest wall single-lead pacing device. There is no left-sided pleural effusion. The cardiomediastinal silhouette is stable. IMPRESSION: Persistent right-sided effusion, not significantly changed since ___. " 037608c6-d11245b4-89e47bf2-7bbafca0-c0b7cfac.jpg,test/p10/p10373824/s57544854/037608c6-d11245b4-89e47bf2-7bbafca0-c0b7cfac.jpg,test," FINAL REPORT INDICATION: Cough and shortness of breath. Concern for pneumonia. COMPARISON: ___, CT of the C-spine on ___. FINDINGS: The lungs are clear. There is moderate dextroscoliosis, unchanged. Pleuroparenchymal scarring at the apices, worse on the right, is unchanged. The heart size is top normal. An old left lateral rib fracture is stable. IMPRESSION: No acute cardiopulmonary process. Results were discussed with Dr. ___. " 1b7a1fd8-48f781cd-cfc90264-35a449ae-08876b38.jpg,test/p14/p14062965/s51174399/1b7a1fd8-48f781cd-cfc90264-35a449ae-08876b38.jpg,test," WET READ: ___ ___ ___ 3:08 PM Persistent bilateral perihilar opacities and interstitial pulmonary vascular markings suggestive of congestive heart failure. In the appropriate clinical setting, superimposed infection cannot be excluded. Recommend short interval followup after treatment to document resolution. ______________________________________________________________________________ FINAL REPORT HISTORY: ___ year old woman with CAD, worsening dyspnea. Rule out infiltrate, edema, effusion. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: Portable AP chest radiograph. FINDINGS: As compared to prior chest radiograph from ___, lung volumes remain low. There has been interval improvement of a linear opacity at the right minor fissure. However, bilateral perihilar opacities with indistinct pulmonary vascular markings persist. Blunting of bilateral costophrenic angles could be related to pleural fluid. The cardiac silhouette remains enlarged. There is no pneumothorax. IMPRESSION: Persistent bilateral perihilar opacities and indistinct pulmonary vascular markings suggestive of congestive heart failure. In the appropriate clinical setting, superimposed infection cannot be excluded. Recommend short interval followup after treatment to document resolution. " 7711d892-786575a2-60ab33a7-080af742-8d51bfd7.jpg,test/p18/p18326030/s50220905/7711d892-786575a2-60ab33a7-080af742-8d51bfd7.jpg,test," WET READ: ___ ___ ___ 8:22 PM dobhoff tip within the stomach. ______________________________________________________________________________ FINAL REPORT A PORTABLE AP CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with alcohol and drug abuse, presents with acute alcoholic hepatitis, check Dobbhoff tube position. Comparison is made to ___ at ___. A portable upright chest film ___ at ___ is submitted. IMPRESSION: 1. Dobbhoff feeding tube is seen coiled within the stomach. There is a stable small layering right effusion with a likely smaller left effusion. Patchy linear opacities at both bases are again seen, likely reflecting patchy atelectasis, although pneumonia or aspiration cannot be entirely excluded. Lungs are otherwise clear. No pneumothorax. Cardiac and mediastinal contours are within normal limits. " 37093a32-e286f3b5-cb693555-4dd415cf-1105e89e.jpg,test/p19/p19438264/s54342925/37093a32-e286f3b5-cb693555-4dd415cf-1105e89e.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with question of some dyspnea. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. There is left base linear atelectasis/scarring. Chronic left-sided pleural opacity/thickening is again seen. There is no new focal consolidation, large pleural effusion, or evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. There has been interval removal of a left-sided PICC. IMPRESSION: Interval removal of a left-sided PICC. Otherwise, no significant interval change. " 6a152e3f-e63e8bd2-624736f4-dee31cd3-4288c53d.jpg,test/p16/p16909232/s57802509/6a152e3f-e63e8bd2-624736f4-dee31cd3-4288c53d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hematemesis, elective intubation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient was intubated. The tip of the endotracheal tube projects 3.5 cm above the carina. The pre-existing bilateral small pleural effusions are now moderate. Unchanged left subclavian catheter. Unchanged left retrocardiac atelectasis. No pneumothorax or other complication. " fe1d74e3-cc00a106-50b467a0-807d9e2c-2a11b072.jpg,test/p14/p14247006/s53089556/fe1d74e3-cc00a106-50b467a0-807d9e2c-2a11b072.jpg,test," WET READ: ___ ___ ___ 7:01 PM Malpositioned NG tube coiled in the esophagus. Recommend repositioning. ETT position okay. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: status post intubation and endotracheal tube placement, assess line position. TECHNIQUE: Supine portable AP chest. COMPARISON: Prior study from 16:30 same day PROCEDURE: FINDINGS: There has been interval placement of an endotracheal tube with its tip residing approximately 3 cm above the carina. The NG tube is coiled in the distal esophagus with its tip in extending superiorly not within the imaged field. Repositioning is advised. AICD unchanged. Lung volumes are low though overall unchanged from prior. IMPRESSION: As above. NOTIFICATION: A preliminary report was provided and flat on the ED dashboard at the time of initial review. " 2578456d-0c46c2e0-0128f6c8-f2ecf481-0ce1197a.jpg,test/p12/p12291041/s53978161/2578456d-0c46c2e0-0128f6c8-f2ecf481-0ce1197a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute onset hypoxia leading to intubation and placement of central line // Is the central line in the correct location? Is the central line in the correct location? COMPARISON: CHEST RADIOGRAPH ___:23. IMPRESSION: New right jugular line ends in the low SVC. Tip of the new endotracheal tube is less than 15 mm from the carina an should be withdrawn 2 cm. Transvenous right atrial biventricular leads in standard placements. Nasogastric tube ends in the distal stomach. Moderate cardiomegaly and mild pulmonary edema are unchanged. Pleural effusions small if any. No pneumothorax. " 73cd4fc1-779c1920-b9c97454-4276bebd-f110a54c.jpg,test/p14/p14339198/s55250281/73cd4fc1-779c1920-b9c97454-4276bebd-f110a54c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with chest pain. Evaluate for acute coronary syndrome and pulmonary embolus. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. CT chest ___ FINDINGS: Left basilar atelectasis is minimal. No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. Fullness of the left hilum appears unchanged. The descending thoracic aorta is tortuous. IMPRESSION: No acute cardiopulmonary process. " fefbf4a7-a95ef553-a9fbe6ed-52a42980-e6b42064.jpg,test/p15/p15239201/s56304660/fefbf4a7-a95ef553-a9fbe6ed-52a42980-e6b42064.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o EtOH cirrhosis hepatorenal syndrome and portal htn and pleural effusion // pleural effusion changes from yesterday pleural effusion changes from yesterday IMPRESSION: In comparison with the study of ___, the endotracheal tube has been pulled back to above the clavicular level, approximately 7 cm above the carina. The other monitoring and support devices are essentially unchanged. Again there is substantial left pleural effusion with compressive basilar atelectasis. The degree of pulmonary vascular congestion appears to have improved " 44877eb1-d1536865-37936f83-3088e28e-bab5eb78.jpg,test/p12/p12442121/s57266437/44877eb1-d1536865-37936f83-3088e28e-bab5eb78.jpg,test," FINAL REPORT HISTORY: Right ptosis and bilateral pedal edema, question of cancer cardiomegaly. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal hilar contours are normal. Stable elevation of the left hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. Stable elevation of the left hemidiaphragm. " 5aec8c31-8bd6879f-1095d9b9-c4f53a6c-ca523c8a.jpg,test/p17/p17545050/s59270811/5aec8c31-8bd6879f-1095d9b9-c4f53a6c-ca523c8a.jpg,test," WET READ: ___ ___ 9:24 AM 1. No evidence of acute cardiopulmonary process. 2. No displaced rib fracture. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with s/p MVC, chest and knee pain, evaluate for fracture or pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: Low lung volumes cause bronchovascular crowding. There is no pneumothorax, pleural effusion, pulmonary edema, or focal consolidation. There is no displaced rib fracture. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. Low lung volumes. No evidence of acute cardiopulmonary process. 2. No displaced rib fracture. " f6b91048-ed32d358-1a3db770-5527d1f0-5666b64e.jpg,test/p17/p17047906/s54522562/f6b91048-ed32d358-1a3db770-5527d1f0-5666b64e.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough, dyspnea when lying flat // Eval for PNA or CHF exacerbation TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Mild degenerative changes are seen along the spine, partially imaged IMPRESSION: No acute cardiopulmonary process. " 30fb18e7-030f7091-af091229-581378e8-a8fef885.jpg,test/p15/p15889331/s54037963/30fb18e7-030f7091-af091229-581378e8-a8fef885.jpg,test," FINAL REPORT INDICATION: ___M w/ basilar and L vertebral artery occlusion and L cerebellar stroke, s/p trach, now with desatuaration to mid ___'s and increasing suctioning requirements. // eval for interval change TECHNIQUE: Portable frontal view of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: The tracheostomy tube is unchanged in position. Right PICC ends at the low SVC. Compared to the prior study, performed 1 day prior there is increased atelectasis in the right upper lobe, new linear opacities in the mid left lung and the previously present left basilar opacities have increased. The new left lung opacities likely represent atelectasis and less likely aspiration. No pneumothorax or large pleural effusion is identified. The mediastinal contours are stable. Mild cardiomegaly is unchanged. IMPRESSION: Interval increase in right upper lobe atelectasis. New left lung opacity likely represents atelectasis and less likely aspiration. " d67c43c6-87f67705-2656b673-d2489bc2-bcf00794.jpg,test/p15/p15129288/s58766789/d67c43c6-87f67705-2656b673-d2489bc2-bcf00794.jpg,test," FINAL REPORT INDICATION: Atrial fibrillation. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. No focal consolidation, pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. IMPRESSION: No evidence of acute cardiopulmonary process. " 7783eb74-ad76ad40-a3c1b962-2cb983fd-81232988.jpg,test/p17/p17763551/s50106512/7783eb74-ad76ad40-a3c1b962-2cb983fd-81232988.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p cabg with Rt pleural CT to water seal // r/o ptx r/o ptx IMPRESSION: In comparison with study of ___, with the right chest tube on water seal there is no evidence of pneumothorax. The right Swan-Ganz catheter has been exchanged for a sheath that extends to the mid portion of the SVC. Substantial enlargement of the cardiac silhouette with some elevation in pulmonary venous pressure. Opacification at the left base obscuring the hemidiaphragms consistent with pleural effusion and underlying compressive atelectasis. " d9873fb6-4fa1f60b-594ff8bd-d8395b1e-9140f2fd.jpg,test/p15/p15405794/s56553834/d9873fb6-4fa1f60b-594ff8bd-d8395b1e-9140f2fd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pericardial cyst s/p resection on ___ // evaluate for effusion COMPARISON: ___. IMPRESSION: NORMAL HEART, LUNGS, HILA, MEDIASTINUM, AND PLEURAL SURFACES. NO EVIDENCE OF OPERATIVE COMPLICATIONS. " 9fcc34f2-99af1268-4fa055cf-ba9ecba7-9cc0c037.jpg,test/p17/p17328613/s54530973/9fcc34f2-99af1268-4fa055cf-ba9ecba7-9cc0c037.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p evar repair, position of lines/tubes COMPARISON: Comparison is made to chest radiograph from ___. All TECHNIQUE A portable view of the chest. FINDINGS: There is a right mainstem bronchus intubation with collapse of the right upper and left lower lobe. The nasoenteric tube tip ends in the stomach. There are low lung volumes. There is no pneumothorax. IMPRESSION: Right mainstem bronchus intubation with collapse of the right upper and left lower lobe. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:58 AM, 5 minutes after discovery of the findings. " 1a928d91-0350a9da-34880db3-09be998b-63964819.jpg,test/p11/p11391664/s50321534/1a928d91-0350a9da-34880db3-09be998b-63964819.jpg,test," FINAL REPORT HISTORY: Pneumonia follow up. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. FINDINGS: There has been significant interval improvement in the now subtle right middle and lower lobe airspace consolidation, compatible with resolving pneumonia. Additionally, there has been improvement in a now minimal right pleural effusion. The remainder of the lungs are essentially clear without pneumothorax, pulmonary edema, or additional focus of consolidation. The cardiomediastinal silhouette is stable. IMPRESSION: Resolving right middle and lower lobe pneumonia. Minimal right pleural " 800d4cdd-b8ac7dd4-e84f1671-8b9ea19c-f3769de4.jpg,test/p12/p12598063/s56699413/800d4cdd-b8ac7dd4-e84f1671-8b9ea19c-f3769de4.jpg,test," FINAL REPORT HISTORY: Pre-operative. FINDINGS: In comparison with the study of ___, there is again hyperexpansion of the lungs without evidence of acute pneumonia, vascular congestion, or pleural effusion. Port-A-Cath extends to the lower portion of the SVC. There are multiple old rib fractures with adjacent pleural thickening. The questioned nodule in the left mid lung laterally is still seen related to a posterior rib and could represent a bone island. " 7ae80c38-cb1c53fc-fcb0bd90-ed0e1c44-e9e3631b.jpg,test/p15/p15219741/s54475214/7ae80c38-cb1c53fc-fcb0bd90-ed0e1c44-e9e3631b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ woman with h/o HCV cirrhosis c/b HCC s/p TACE and ascites requiring weekly paracenteses who initially p/t ___ w/SOB and found to have hepatic hydrothorax. Evaluate recurrent pleural effusion. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiographs of ___, ___, and ___. FINDINGS: Previous small right apical pneumothorax is no longer visualized. The right pleural effusion has increased with compressive basilar atelectasis causing silhouetting of the right heart border. Fluid tracking within the minor fissure is re- demonstrated. Cardiomediastinal silhouette is stable. The left lung is clear. IMPRESSION: 1. Right-sided pleural effusion has increased, with adjacent compressive atelectasis. 2. The previous small right apical pneumothorax is no longer visualized. " 524c601c-a96d3a8f-3b028d8d-37eed844-250e97ac.jpg,test/p13/p13774492/s56011692/524c601c-a96d3a8f-3b028d8d-37eed844-250e97ac.jpg,test," FINAL REPORT INDICATION: ___F with dyspnea, cough, evaluate for pneumonia. TECHNIQUE: AP chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. No focal lung consolidation. " e8bed161-a58038d5-f72f6813-f0207d58-a2837125.jpg,test/p13/p13747362/s50339701/e8bed161-a58038d5-f72f6813-f0207d58-a2837125.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Portable upright chest view was compared with prior radiograph from ___. FINDINGS: Minimal right apical pneumothorax is persisting. Monitoring and supporting devices are in standard position. Bilateral lung opacities, likely due to a combination of pulmonary edema and pleural effusions, have improved. Bilateral subcutaneous emphysema is similar in appearance. The enlarged heart size and widened superior mediastinum have stable appearance since ___. " b99a6566-784d6289-09ac7e15-05a94d2d-9d3b5afd.jpg,test/p14/p14184291/s54809006/b99a6566-784d6289-09ac7e15-05a94d2d-9d3b5afd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormalities are seen. Pectus excavatum deformity is noted. IMPRESSION: No acute cardiopulmonary abnormality. " 3c28ba8e-fd8943b8-aadd91f4-b6a3550c-0b1f5ba4.jpg,test/p11/p11877234/s58050010/3c28ba8e-fd8943b8-aadd91f4-b6a3550c-0b1f5ba4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC line // ?PICC line in place ?PICC line in place COMPARISON: Comparison to prior study dated ___ at 13 25 FINDINGS: Portable semi-erect chest film ___ at 16 42 is submitted. IMPRESSION: Right subclavian PICC line has its tip at in the proximal SVC. A single lead left-sided pacer is incompletely visualized but the lead appears intact and unchanged in overall position. The heart remains markedly enlarged which may reflect cardiomegaly, although pericardial effusion could also have this appearance. The left costophrenic angle is not entirely included on the current study but there do appear to be layering bilateral effusions with associated patchy airspace disease likely reflecting compressive atelectasis. There has been interval appearance of mild perihilar and interstitial edema. No pneumothorax is seen. " 05ca1ed7-7ec81d3c-6da89884-4ef8c1c4-bd319ece.jpg,test/p14/p14648269/s54790345/05ca1ed7-7ec81d3c-6da89884-4ef8c1c4-bd319ece.jpg,test," FINAL REPORT INDICATION: ___-year-old male with dyspnea. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: Streaky bibasilar opacities likely reflect atelectasis. No focal consolidation is seen to suggest pneumonia. No pleural effusion pneumothorax seen. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 0bb522a4-d8334fad-0aff415d-7d24d446-2ee6c2c4.jpg,test/p14/p14916430/s53580594/0bb522a4-d8334fad-0aff415d-7d24d446-2ee6c2c4.jpg,test," FINAL REPORT INDICATION: Cirrhosis and ischemic colitis. Evaluation for interval change. COMPARISON: ___, ___. FINDINGS: Portable AP chest radiograph. Nasoenteric feeding tube remains post-pyloric. Right IJ catheter tip terminates in the right atrium. Moderate layering right pleural effusion is stable. The lungs are otherwise clear. Moderate cardiomegaly has not changed. IMPRESSION: Stable moderate right pleural effusion. " 3223d09b-5287782f-ca087e77-0a5bdbb9-bf1572a7.jpg,test/p19/p19646078/s54043220/3223d09b-5287782f-ca087e77-0a5bdbb9-bf1572a7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p mvr // eval for ptx chest tube on water seal eval for ptx chest tube on water seal IMPRESSION: Comparison to ___. The right chest tube has been removed. Minimally increasing right basilar atelectasis. Moderate cardiomegaly persists. No change in appearance of the known left atelectasis. No overt pulmonary edema. " a9311053-859d479d-c2181c10-9e8908ad-a61d82c0.jpg,test/p18/p18651563/s54576164/a9311053-859d479d-c2181c10-9e8908ad-a61d82c0.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Low-grade temperature in a patient with pneumonia, assessment of progression. PA and lateral upright chest radiographs were reviewed in comparison to ___ and ___. As compared to both prior examinations, there is interval increase in multifocal opacities concerning for gradual progression of multifocal infection. There is minimal amount of pleural effusion. Potentially bibasal atelectasis are present, but those opacities might also be part of widespread consolidations. Heart size and mediastinum are stable. There is no pneumothorax. IMPRESSION: Progression of multifocal consolidations. " 3c1968c6-a664c31f-71a9f2b6-a7acbfce-108b2770.jpg,test/p15/p15626336/s52795577/3c1968c6-a664c31f-71a9f2b6-a7acbfce-108b2770.jpg,test," FINAL ADDENDUM ADDENDUM: Final impression was communicated via phone call by Dr. ___ to Dr. ___ on ___ at 9:39 a.m. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with cough and shortness of breath. COMPARISON: Multiple prior radiographs, most recently of ___. FINDINGS: Heart size and cardiomediastinal contours are normal. A small, layering left pleural effusion is new. Lungs are grossly clear; a healed fracture of a proximal right lower rib should not be mistaken for a lung nodule. There is no pneumothorax. Rightward deviation of the cervical trachea is chronic due to a Zenkers diverticulum of the upper esophageal sphincter or a goiter. IMPRESSION: New small left pleural effusion, but no definite pneumonia. Consider acute pulmonary embolus or left upper abdomina pathology. Chronic probable Zenkers diverticulum or left thyroid lesion. " b632f40f-445195d8-523bd54c-74f4ddec-6705b5c2.jpg,test/p19/p19432472/s59699910/b632f40f-445195d8-523bd54c-74f4ddec-6705b5c2.jpg,test," FINAL REPORT HISTORY: Patient with history of pancreatic cancer, treated for pneumonia two weeks ago, evaluate for resolution. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. A right chest Port-A-Cath terminates in the cavoatrial junction. The lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of consolidation in the left upper lobe. No acute cardiopulmonary process. Findings were communicated with ___ by Dr.___ at 4:10pm on ___. " 3a1c5816-ee09548f-54e270fd-698165af-a1bcfd5a.jpg,test/p15/p15442180/s57158413/3a1c5816-ee09548f-54e270fd-698165af-a1bcfd5a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with worsening bronchial breath sounds left base and rising WBC. // evolving pneumonia in left lung base? evolving pneumonia in left lung base? IMPRESSION: In comparison with the study of ___, the pulmonary vascular congestion has decreased. Continued bibasilar opacifications consistent with pleural fluid and compressive atelectasis in the lower lung zones. In the appropriate clinical setting, the basilar changes could reflect developing pneumonia. " 1a8bceda-6ca90639-e04602b0-a3b23913-6a55a6e3.jpg,test/p19/p19751455/s53651197/1a8bceda-6ca90639-e04602b0-a3b23913-6a55a6e3.jpg,test," FINAL REPORT INDICATION: ___ year old man with NSCLC and CIS now s/p photodynamic therapy with repeat bronchoscopies for sloughing endobronchieal tissue. // evaluate for interval changes COMPARISON: Radiographs from ___. IMPRESSION: The tip of the endotracheal tube is 6.2 cm above the carina, appropriately sited. There are persistent airspace opacities predominate involving the bases and the left upper lobe. Small right-sided pleural effusion is also likely. Heart size is within normal limits. There is left apical pleural thickening. No pneumothoraces or pneumomediastinum is seen. Overall, these findings are stable. " 02512b87-8ba43115-bdcf8b69-3b658aa0-2465e489.jpg,test/p11/p11806528/s56488328/02512b87-8ba43115-bdcf8b69-3b658aa0-2465e489.jpg,test," FINAL REPORT INDICATION: Altered mental status. COMPARISON: Chest radiograph from ___ dated ___ at 17:44. CHEST, PA AND LATERAL: Prior pulmonary edema has resolved. Lungs are clear. Heart size is normal. No pleural effusions or pneumothorax. IMPRESSION: Resolved pulmonary edema. " 82c035f5-5a578684-2df7188a-425df796-7e77e428.jpg,test/p12/p12618344/s59011334/82c035f5-5a578684-2df7188a-425df796-7e77e428.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) FINDINGS: A portable supine frontal chest radiograph demonstrates mild cardiomegaly and bronchovascular crowding, which is exaggerated by low lung volumes. The thoracic aorta is generally large and tortuous. Left base opacity is likely atelectasis. There is no edema, appreciable effusion, or pneumothorax. COMPARISON: Chest radiograph from ___. INDICATION: ___ year old woman with oxigen desaturation, resolved with O2 // INTERVAL CHANGES INTERVAL CHANGES Evaluate for interval change in a patient with oxygen desaturation. IMPRESSION: Mild cardiomegaly, exaggerated by low lung volumes. No edema or appreciable effusion. " c3cfda81-be3e39e8-2902fb0a-61c292d1-53b0a363.jpg,test/p13/p13724158/s54264779/c3cfda81-be3e39e8-2902fb0a-61c292d1-53b0a363.jpg,test," FINAL REPORT INDICATION: ___-year-old man with pleuritic chest pain, assess for acute process. COMPARISONS: None. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " 66be6fe0-5d0af1f7-8f87fa3a-76c7618d-edfaa4a1.jpg,test/p16/p16030116/s51643514/66be6fe0-5d0af1f7-8f87fa3a-76c7618d-edfaa4a1.jpg,test," FINAL REPORT HISTORY: ARDS. FINDINGS: In comparison with the study of ___, the monitoring and support devices are unchanged. Continued pulmonary vascular congestion with poor definition of the right hemidiaphragm consistent with layering effusion and volume loss in the lower lobe. Some atelectatic changes are also seen at the left base. " 70fed67f-acee1263-03f17db2-b4ed2ce9-f05adf50.jpg,test/p18/p18121111/s55211471/70fed67f-acee1263-03f17db2-b4ed2ce9-f05adf50.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD and hemoptysis, intubated for IR bronchial artery embolization // Please eval ET tube placement COMPARISON: Chest radiographs from___ FINDINGS: ET tube tip is approximately 4.5 cm above the carina. Heart size is normal. The pulmonary vasculature is normal. Allowing for differences in patient positioning, the right apical cavitary process with previously seen air-fluid level is probably not significantly changed, as the size of the cavitation appears similar. The air-fluid level is probably no longer seen due to the patient being supine. No pneumothorax. IMPRESSION: ET tube tip is approximately 4.5 cm above the carina. " e8860937-5677a5c6-7e4eb6b1-09156ba6-ec3b9be9.jpg,test/p15/p15454331/s55821648/e8860937-5677a5c6-7e4eb6b1-09156ba6-ec3b9be9.jpg,test," FINAL REPORT CLINICAL HISTORY: Altered mental status. Evaluate for pneumonia. CHEST, AP AND LATERAL COMPARISON FILM: ___. Heart is not enlarged. Some tortuosity of the aorta is present. Some flattening of the diaphragms is seen consistent with COPD. No evidence of active disease present. IMPRESSION: No active disease. " 7e013a34-2a484476-8abf6a88-24ae168e-b835b76d.jpg,test/p15/p15568805/s56455765/7e013a34-2a484476-8abf6a88-24ae168e-b835b76d.jpg,test," WET READ: ___ ___ 11:17 PM Please advance ETT for more optimal positioning. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with intubation for status epilpeticus // assess for ETT placement. COMPARISON: None FINDINGS: AP portable semi upright view of the chest. ETT is in place with its tip located high in the trachea approximately 6 point 4 cm above the carina. Recommend advancement. Orogastric tube extends into the left upper abdomen with its tip excluded from view. Lung volumes are low limiting assessment with bronchovascular crowding in lower lung atelectasis. Difficult to exclude a component of aspiration the lower lungs. No large effusion or pneumothorax. Cardiomediastinal silhouette is grossly unremarkable. Bony structures appear intact. IMPRESSION: As above. Please advance ETT for more optimal positioning. " 28144f3c-4e6be962-70663f8d-c706b309-bcf80d37.jpg,test/p19/p19229277/s51731139/28144f3c-4e6be962-70663f8d-c706b309-bcf80d37.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumothorax // change in pneumothorax? COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Small volume of pleural fluid in the left lower chest and atelectasis in the left lower lung have both improved. Very small apical pneumothorax is slightly smaller. The absence of fluid levels suggests that the major the components of air and fluid are not in free communication, due to loculations. Lung volumes have improved generally but there is still platelike atelectasis in the right lower lobe as well. Heart size is normal. " fea358f6-f0c9b365-48c3d524-78cf4eb3-21121675.jpg,test/p19/p19763545/s54135537/fea358f6-f0c9b365-48c3d524-78cf4eb3-21121675.jpg,test," FINAL REPORT INDICATION: Tachycardia. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary abnormality. " fc0357b0-4d3737fa-935e5edf-da9528fe-16fc366b.jpg,test/p16/p16518377/s59700117/fc0357b0-4d3737fa-935e5edf-da9528fe-16fc366b.jpg,test," FINAL REPORT INDICATION: ___ year old woman with chronic cough // eval for hyperinflation TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Since ___ the right peritracheal upper mediastinal extension of the very large goiter has not changed detectably, nor is there appreciable tracheal embarrasment. The thoracic aorta is tortuous, the heart size is top normal. There is no pulmonary vascular congestion, no edema, nor effusions nor pneumothorax. The lungs are normal volume and clear. IMPRESSION: 1. The lungs are not hyperinflated. 2. Very large cervicothoracic goiter unchanged since ___ could be the cause of patient's chronic cough. " 1f939bd2-3e24d39b-1ec772f3-70dfd2b5-179a8585.jpg,test/p10/p10643827/s59867585/1f939bd2-3e24d39b-1ec772f3-70dfd2b5-179a8585.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, AP portable single view. INDICATION: ___-year-old female patient, status post mitral valve replacement with pneumothorax after chest tube removal, assess pneumothorax. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of ___. The bilaterally seen apical pneumothoraces persist. The right-sided apical pneumothorax is of similar size and measures up to 2.5 cm in width. The left-sided remaining pneumothorax has decreased markedly and only 0.5 cm apical pleural separation is remaining. Other findings including moderate cardiac enlargement, and metallic structures of mitral valve prosthesis in place as before. Pulmonary vascular congestive pattern has not increased. " 4a96e84d-3bbd5ecf-d512d53b-4b39ab6f-6b2379d3.jpg,test/p19/p19029866/s51737852/4a96e84d-3bbd5ecf-d512d53b-4b39ab6f-6b2379d3.jpg,test," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Epigastric pain. COMPARISON: None. FINDINGS: Single AP upright portable view of the chest was obtained. The patient is rotated slightly to the right. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No evidence of free air is seen beneath the diaphragms. IMPRESSION: No acute cardiopulmonary process. No evidence of free air beneath the diaphragms. " 46ece3e2-3c7cdfd5-e77a5686-efdb3f8e-d6702e64.jpg,test/p16/p16056611/s59316339/46ece3e2-3c7cdfd5-e77a5686-efdb3f8e-d6702e64.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: VATS right lower lobe wedge resection, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have substantially increased, potentially reflecting improved ventilation. As a consequence, areas of atelectasis that pre-existed at the right and left lung bases have partially or completely resolved. Soft tissue defect in the left chest wall. Borderline size of the cardiac silhouette with tortuosity of the thoracic aorta. The hilar and mediastinal structures are normal. No evidence of acute lung disease such as pneumonia or pulmonary edema. The lateral radiograph shows extensive degenerative vertebral disease. " 193c57d8-806f361a-12059d08-4d29b297-19e8a6eb.jpg,test/p16/p16137583/s52965837/193c57d8-806f361a-12059d08-4d29b297-19e8a6eb.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with sarcoidosis history. Evaluate for acute infiltrates. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Heart size is borderline but has not increased in comparison with the previous study. No typical configurational abnormality is noted. The thoracic aorta is significantly widened and elongated, marked in the area of the arch. No new contour abnormalities have developed, and no walled calcifications are seen. The on previous examination identified rather extensive peritracheal and mediastinal sizable lymph node calcifications are again seen and appear completely unchanged. There is no evidence of new acute parenchymal infiltrates, and no evidence of new pleural effusions. Also, the frontal view does not indicate any pneumothorax. IMPRESSION: Stable chest findings in patient with history of sarcoidosis. Rather typical extensive prominent peritracheal and peribronchial calcifications are seen and are unchanged. No evidence of new acute pulmonary abnormalities. " 97328976-2f761938-402caff8-7850c55d-cc555cc2.jpg,test/p17/p17159286/s56218871/97328976-2f761938-402caff8-7850c55d-cc555cc2.jpg,test," WET READ: ___ ___ ___ 7:58 PM Interval placement of a ETT terminating 7.0 cm above the carina. A nasogastric tube courses into the stomach. Lungs appear relatively well expanded and clear. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESRD, seizure, intubated // ET Tube placement ET Tube placement COMPARISON: ___ IMPRESSION: ET tube tip is 7 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are stable. Lungs are well expanded. There is interval improvement of the left basal consolidation. No vascular congestion demonstrated. " 8c32ce73-53b456ba-81487dbc-3fd0a3ea-3204a880.jpg,test/p17/p17717614/s56324731/8c32ce73-53b456ba-81487dbc-3fd0a3ea-3204a880.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chills // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: CT chest dated ___, single view of the chest dated ___ FINDINGS: The cardiac silhouette and pulmonary vasculature are unchanged since the prior examination and unremarkable. Median sternotomy wires are intact and well aligned. In the right base, there is a new vague opacity, which in the appropriate clinical context, may represent pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: Right basilar opacity, which in the appropriate clinical context, may represent pneumonia. " 6a7c21fc-9ab505b5-c2dbf97a-68ca8d99-31472531.jpg,test/p14/p14338126/s57458655/6a7c21fc-9ab505b5-c2dbf97a-68ca8d99-31472531.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, cardiomyopathy TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Minimal atelectasis is noted in the bases, as seen previously. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 7c3b448f-1228f5aa-868a1703-5284acd2-3c9d0f7a.jpg,test/p15/p15173403/s55857812/7c3b448f-1228f5aa-868a1703-5284acd2-3c9d0f7a.jpg,test," FINAL REPORT HISTORY: Recent fall with a right pneumothorax. Re-evaluate after chest tube removal. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: CT torso ___ and chest radiograph ___. FINDINGS: A right chest tube has been removed with a tiny residual pneumothorax identified. There is new consolidation in the left lung base. There are small bilateral pleural effusions. The cardiac and mediastinal contours are unchanged. Obliquely oriented linear opacities project over the right hemithorax. While some may represent displaced rib fractures, others are thought to be external. A small amount of subcutaneous air along the right lateral chest wall persists. The bones are diffusely osteopenic which limits evaluation of the known compression fractures. IMPRESSION: 1. Tiny remnant pneumothorax after chest tube removal. 2. New consolidation of the left lower lobe is likely atelectasis. 3. Repeat radiograph with removal of bandages is recommended to further evaluate linear opacity overlying the right chest. These findings were paged to Dr. ___ by Dr. ___ at 16:11 on ___ at the time of discovery. " 1cab9e63-27d24c2f-b166268c-2a849633-c911461a.jpg,test/p18/p18279430/s50215888/1cab9e63-27d24c2f-b166268c-2a849633-c911461a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, now presents with mild fever. // fever in cirrhotic patient. R/O PNA fever in cirrhotic patient. R/O PNA IMPRESSION: In comparison with study of ___, there is little overall change. Again there is enlargement of the cardiac silhouette with intact sternal wires and pacer device in place. There may be mild elevation of pulmonary venous pressure. No evidence of acute focal pneumonia. " b2fa1590-d969dcac-8f8bc2a8-755d39c7-2bd779b5.jpg,test/p15/p15481731/s56532304/b2fa1590-d969dcac-8f8bc2a8-755d39c7-2bd779b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PTX s/p chest tube placement. Please do ___ AM // change in PTX? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Left pigtail catheter is in place. Pneumothorax is still large, slightly increased since the prior study. Pneumoperitoneum appears to be minimally decreased since previous examination. Consolidations in both lungs are unchanged. " f2674670-76e34cd5-c22bc166-4704d629-9e3179e5.jpg,test/p19/p19453133/s57438575/f2674670-76e34cd5-c22bc166-4704d629-9e3179e5.jpg,test," FINAL REPORT HISTORY: Cough and 1 week of fever. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: ___ through ___. FINDINGS: The lungs are well expanded and clear. There is no focal consolidation, effusion or pneumothorax. Extensive calcifications of the thoracic aorta and its branches are unchanged. A left subclavian stent is in stable position. Mild cardiomegaly is stable. A previously seen right mid lung pulmonary nodule is not appreciated on this exam. IMPRESSION: No acute cardiopulmonary process. " 82a154ca-9a0e3269-1924188f-06818cd4-00ac0a1d.jpg,test/p19/p19566772/s50124270/82a154ca-9a0e3269-1924188f-06818cd4-00ac0a1d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH on resp // Resp failure COMPARISON: ___. IMPRESSION: Borderline pulmonary edema. Has cleared since ___ and mediastinal vascular engorgement has decreased. Mild to moderate cardiomegaly is stable. Pleural effusion is minimal if any. Mild left lower lobe atelectasis probably unchanged. Lungs otherwise clear. No pneumothorax. ET tube is in standard position and an upper enteric drainage tube passes into the nondistended stomach and out of view. NOTIFICATION: WET READ: " 3d5c327d-ae79bc1f-c3f8d4ce-99db5218-91d7f235.jpg,test/p17/p17967970/s50792179/3d5c327d-ae79bc1f-c3f8d4ce-99db5218-91d7f235.jpg,test," FINAL REPORT EXAMINATION: AP chest INDICATION: ___F w/history of lung CA, s/p left VATS and LUL wedge resection in ___, right VATS w/RUL wedge resection in ___, found to have residual cancer at staple line, now s/p right-sided thoracotomy with RUL resection on ___ with significant intra-operative blood loss. Prolonged and complicated ICU course with strep pneumo pneumonia, bacteremia meningitis // daily eval daily eval IMPRESSION: Compared to chest radiographs ___ through ___ at 23:25. Large air collection at the base of the right lung has not changed since ___ last night. Abnormality in the right midlung is stable. No appreciable right pleural effusion. Small left pleural effusion unchanged. No left pneumothorax. Heart size normal. Previously questioned area of consolidation at the left lung base is less pronounced. Tracheostomy tube in standard placement. Right PIC line ends in the right atrium. " 9c37dcc6-d234f09c-c94fa9c8-1d39ef81-0c1d0112.jpg,test/p18/p18489691/s57099033/9c37dcc6-d234f09c-c94fa9c8-1d39ef81-0c1d0112.jpg,test," FINAL REPORT INDICATION: ___ year old man with wheeze, cough, evaluate for pneumonia.. COMPARISON: Comparison is made to chest CT from ___ and chest radiographs dating back to ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: There is complete opacification of the right lower lung zone projecting over the cardiac silhouette on lateral view and expanding the fissures. There is no pleural effusion or pneumothorax. There is widening of the a right peritracheal stripe, likely secondary to lymphadenopathy. Cardiomediastinal silhouette is stable. IMPRESSION: Right middle lobe pneumonia and collapse, persistent since ___, concerning for a postobstructive process. . " eb4155e5-c5c24403-53fc09a0-4ecd66c5-f3900373.jpg,test/p13/p13626213/s54954301/eb4155e5-c5c24403-53fc09a0-4ecd66c5-f3900373.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F presenting with fevers, diffuse myalgias, right sided upper back pain. // PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 0c42809e-9daaf5c8-80c7704b-381c97df-72a05d92.jpg,test/p19/p19149321/s55140486/0c42809e-9daaf5c8-80c7704b-381c97df-72a05d92.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with IDDM, Protein C/S deficiency c/b PE on Lovenox, NASH cirrhosis, short gut syndrome, CKD p/w necrotizing fasciitis in setting of DKA now s/p L hemipelvic/RP exploration debridement with VAC placement, in hemorrhagic septic shock // eval for interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Minimal decrease in lung volumes with minimal increase in areas of bilateral basal atelectasis. No overt pulmonary edema. Unchanged borderline size of the cardiac silhouette. The monitoring and support devices are constant. " 264a9ce5-d871e923-53233175-4bef516e-b9267729.jpg,test/p11/p11551927/s55487107/264a9ce5-d871e923-53233175-4bef516e-b9267729.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new dobhoff // eval dobhoff placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the Dobbhoff catheter was inserted. While the first image shows the Dobbhoff catheter malpositioned in the right bronchial system, the second image documents the tip of the Dobbhoff catheter projecting over the stomach. The catheter, however, could be advanced by approximately 5 cm to be securely positioned in the middle parts of the stomach. No complications, notably no pneumothorax. The right subclavian catheter and the tracheostomy tube are unchanged. No pneumothorax. " bc809e89-8e3b3b60-4a9f6e5f-c1499a29-bfdf2b2b.jpg,test/p13/p13077594/s51591296/bc809e89-8e3b3b60-4a9f6e5f-c1499a29-bfdf2b2b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent extubation and re-intubation // tube placement tube placement IMPRESSION: In comparison with the earlier study of this date, the endotracheal tube is been removed a new tube has been placed, with the tip approximately 3.5 cm above the carina. Otherwise, the monitoring and support devices remain in good position. No acute pneumonia or vascular congestion. " 74fcde4e-c624a58d-9b70a9fe-bbd1e6ba-ff347473.jpg,test/p18/p18046197/s55953038/74fcde4e-c624a58d-9b70a9fe-bbd1e6ba-ff347473.jpg,test," WET READ: ___ ___ ___ 7:26 PM Right PICC terminates in mid SVC. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT HISTORY: PICC placement. FINDINGS: In comparison with the study of ___, the right subclavian PICC line tip is in the region of the mid portion of the SVC. Relatively low lung volumes may account for some of the prominence of the transverse diameter of the heart. No evidence of pneumonia, vascular congestion, or pleural effusion. Widening of the superior mediastinum is consistent with lipomatosis as shown on the CT study of ___. " 5fc11289-cac22739-fc822903-5fe513e5-80f7be0a.jpg,test/p15/p15197176/s51595792/5fc11289-cac22739-fc822903-5fe513e5-80f7be0a.jpg,test," FINAL REPORT EXAMINATION: Chest PA and lateral INDICATION: ___ year old woman with worsening shortness of breath and productive cough x 2 weeks. Evaluate for evidence of pnuemonia or pulmonary edema. COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes are slightly low, similar to the prior exam, perhaps secondary to lack of inspiratory effort. No focal consolidation suggest pneumonia. No edema, pleural effusion, or pneumothorax. No change in the appearance of the cardiomediastinal silhouette and hila. Elevation of the right hemidiaphragm is unchanged. IMPRESSION: No acute intrathoracic process. NOTIFICATION: The findings were conveyed by Dr. ___ with Dr. ___ ___ text ___ on ___ at 3:10 PM, after discovery of the findings. " 27ee331d-94e74ae4-c035f83f-218f6e5c-60fe09d1.jpg,test/p10/p10080695/s52418569/27ee331d-94e74ae4-c035f83f-218f6e5c-60fe09d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dyspnea on exertion. Fine inspiratory crackles throughout both lung fields with hypoxemia (___% POX on RA) at rest. // Interstitial lung disease? Interstitial lung disease? IMPRESSION: In comparison with the previous study of ___, the patient has taken a better inspiration. Cardiac silhouette is unchanged. There is some prominence of interstitial markings at the bases. This could be a manifestation of pulmonary vascular congestion, though it also would be consistent with interstitial lung disease as suggested in the clinical history. CT would be necessary to make the diagnosis of interstitial lung disease. Bibasilar opacification with obscuration of the hemidiaphragms suggests atelectatic change with possible pleural fluid or thickening. Single lead pacer extends to the apex of the right ventricle. No evidence of acute focal pneumonia. " eb1a39a9-a5453e65-69549c72-49385d8d-f31bd274.jpg,test/p16/p16019229/s51657771/eb1a39a9-a5453e65-69549c72-49385d8d-f31bd274.jpg,test," FINAL REPORT HISTORY: ___ years old man status post incisional hernia repair, history of recurrent pleural effusion. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: Lung is well inflated, without consolidation or nodules. Cardiomediastinal silhouette is normal. There is no pneumothorax or pleural effusion. Large right subdiaphragmatic air collection is likely related to recent abdominal surgery. IMPRESSION: Pneumoperitoneum, but no sign of acute cardiopulmonary process. " 873cea2e-19c153d8-c53e93fb-49022c90-62c9d156.jpg,test/p18/p18695609/s55193759/873cea2e-19c153d8-c53e93fb-49022c90-62c9d156.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SBO, s/p NGT placement // ?NGT placement, aspiration event? TECHNIQUE: Sequential portable AP radiographs of the chest from ___. COMPARISON: ___. FINDINGS: The initial radiographs show that the sideport of the nasogastric tube ends in the midesophagus, and the tube terminates proximal to the GE junction. The final radiograph shows the tube terminating in the stomach. The left subclavian central venous catheter ends in the lower SVC. The ET tube is in the mid trachea. Small bilateral layering pleural effusions with associated bibasilar subsegmental atelectasis are unchanged. There is no pneumothorax. Imaged portions of the upper abdomen are unremarkable. IMPRESSION: Tube terminates in stomach. No other relevant change. " 65b6064e-c023f07e-ef891398-65a79bab-5bc37c3c.jpg,test/p17/p17758020/s56971933/65b6064e-c023f07e-ef891398-65a79bab-5bc37c3c.jpg,test," FINAL REPORT HISTORY: Reported pneumonia. COMPARISON: ___ and more remote exams dating back to ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: While the patient always has had some prominence of his vasculature in the right hemithorax, on today's exam it appears to be more consolidative than on the prior exams. In addition, near the costophrenic angle on the frontal view, there is a halo-like opacity with a central clearing. The left lung is clear. Calcifications of the aortic knob are stable. Heart size is normal. There is no pneumothorax or pulmonary edema. IMPRESSION: Multiple prior studies demonstrate increased bronchovascular markings in the right hemithorax, but on today's exam these appear to be slightly more consolidative. In addition, there is a new halo-like opacity near the costophrenic angle which is worrisome for possible cavitation. Overall, these findings are concerning for pneumonia and/or aspiration. " 0f43b18a-97b87886-457150e6-e658d54d-d33219c3.jpg,test/p17/p17211281/s53531579/0f43b18a-97b87886-457150e6-e658d54d-d33219c3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cough // ?pna IMPRESSION: In comparison to prior radiograph of 1 day earlier, there has not been a relevant change in the appearance of the chest. There is no evidence of new or progressive consolidation to suggest the presence of pneumonia. " 5a8fe408-8fb54733-a37cee03-916615b2-aa643cdf.jpg,test/p13/p13748847/s56325639/5a8fe408-8fb54733-a37cee03-916615b2-aa643cdf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with labored breathing // eval for infiltrate, pneumothorax eval for infiltrate, pneumothorax IMPRESSION: Compared to chest radiographs ___ and ___. Feeding tube ends in the upper stomach. Borderline cardiomegaly unchanged. No appreciable pleural effusion. No pulmonary edema or pneumonia. No pneumothorax. Thoracic aorta is heavily calcified and tortuous, but not focally dilated. " 459c6f7f-74401f34-943ebf40-e16491c5-8707b9be.jpg,test/p15/p15225349/s50997484/459c6f7f-74401f34-943ebf40-e16491c5-8707b9be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p pericardial window and bilateral chest tubes // post-op film post-op film IMPRESSION: In comparison with this study of earlier in this date, there has been placement of bilateral chest tubes. There has been decreased opacification at the left base with some residual consistent with a volume loss left lower lobe and pleural fluid. There is a small left apical pneumothorax. On the right, there is no evidence of pneumothorax. " 51356fab-8f076a2e-2d204a97-8c47b3ca-0b015c10.jpg,test/p17/p17617589/s57385565/51356fab-8f076a2e-2d204a97-8c47b3ca-0b015c10.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Heart failure, evaluation for tube position. COMPARISON: ___, 5:59 a.m. FINDINGS: As compared to the previous radiograph, the previously malpositioned endotracheal tube has been pulled back. The tip of the tube now projects approximately 3.5-4 cm above the carina. The course of the nasogastric tube is unchanged. Unchanged appearance of the moderately enlarged cardiac silhouette and of the preexisting parenchymal opacities. These have not changed in extent and severity. " 99a46bd0-b78494b3-18caba15-d04cb6ca-116cdfbe.jpg,test/p10/p10855616/s59766806/99a46bd0-b78494b3-18caba15-d04cb6ca-116cdfbe.jpg,test," FINAL REPORT INDICATION: Patient with cough and crackles. COMPARISON: Multiple prior studies with the most recent being a chest radiograph from ___. FINDINGS: There is prominence of the pulmonary vasculature suggestive of mild-to-moderate increased in central pulmonary pressure. Additionally, there is silhouetting of the left hemidiaphragm likely due to a small pleural effusion with adjacent atelectasis. The cardiac silhouette appears moderately enlarged. The lungs are otherwise without a focal consolidation. No acute fractures are identified. IMPRESSION: Enlarged cardiomediastinal silhouette with left pleural effusion and prominence of central pulmonary vasculature suggestive of acute heart failure. " 695b96bb-12ff585c-f6cb670e-78b48991-b933d8de.jpg,test/p16/p16466609/s55107916/695b96bb-12ff585c-f6cb670e-78b48991-b933d8de.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with sob // sob COMPARISON: Prior study from ___. FINDINGS: AP supine and lateral views of the chest provided. Cardiomegaly is mild and unchanged. There is hilar congestion and mild interstitial edema. No supine evidence for effusion or pneumothorax. Mediastinal contour is unchanged. Bony structures are intact. IMPRESSION: Mild interstitial edema and mild cardiomegaly. " f4c292ee-57e896a0-b3fb349d-8c08894b-17dca938.jpg,test/p12/p12108578/s54856842/f4c292ee-57e896a0-b3fb349d-8c08894b-17dca938.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with hyponatremia // eval for CHF/pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___, CT chest dated ___ FINDINGS: The cardiomediastinal silhouette is overall similar to prior examination. There is a persistent right-sided pleural effusion, apparently decreased in size comparison to most recent exam. No definite consolidation is identified. Right basilar opacity may represent atelectasis. IMPRESSION: Right-sided pleural effusion, apparently decreased in size since ___ " 645e6a22-cdf905e1-f83beb5b-9085982a-d53249ee.jpg,test/p11/p11069015/s59009157/645e6a22-cdf905e1-f83beb5b-9085982a-d53249ee.jpg,test," FINAL REPORT HISTORY: ___-year-old male with persistent cough and known bronchoalveolar recurrence status post right lower lobectomy. COMPARISON: CTA chest ___. FINDINGS: There has been interval progression of airspace opacity in the left lung from ___. There is no large pleural effusion, or pneumothorax. The cardiac silhouette remains normal in size, and mediastinal contours demonstrate calcification of the aortic knob, and tortuosity of the thoracic aorta. Median sternotomy wires remain in place. A right chest ___-___ tip terminates in the lower SVC. IMPRESSION: Interval progression of airspace opacity within the left lung from ___ concerning for progression of BAC. Known right lung disease is not well seen. " 3e345855-cdda1fcd-90a0bebe-ff5c020a-71e1f7f8.jpg,test/p19/p19244907/s51113945/3e345855-cdda1fcd-90a0bebe-ff5c020a-71e1f7f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with catastrophic SAH, grim neuro prognosis. // ?trach placement ?trach placement IMPRESSION: In comparison with the study of ___, the endotracheal tube has been removed and replaced with a tracheostomy tube. No evidence of pneumothorax or pneumomediastinum. Remainder of study is unchanged. " 8f71f8ce-3ead5090-5394e096-be704553-a8d2296b.jpg,test/p19/p19231238/s51267686/8f71f8ce-3ead5090-5394e096-be704553-a8d2296b.jpg,test," FINAL REPORT INDICATION: History of small-bowel obstruction. Please evaluate location of NG tube. COMPARISONS: Chest radiograph from ___. TECHNIQUE: Single AP portable radiograph of the chest. FINDINGS: Mild cardiomegaly has been stable compared to exams dated back to at least ___. There may be mild pulmonary vascular congestion, otherwise the hilar and mediastinal contours are normal. There is a small left pleural effusion. NG tube extends below the diaphragm with the tip likely in the proximal stomach. There is no evidence of pneumothorax. IMPRESSION: NG tube side hole terminates in the proximal stomach. Mild pulmonary vascular congestion. ___ d/w Dr. ___ by Dr. ___ by phone at 7A on the day of the exam. " 11cade08-f3599874-91df70b3-22b93f09-be148302.jpg,test/p19/p19385130/s51370385/11cade08-f3599874-91df70b3-22b93f09-be148302.jpg,test," FINAL REPORT INDICATION: Evaluate pre-operatively prior to hip reduction. COMPARISON: Chest radiograph from ___. TECHNIQUE: A single semi-upright view of the chest was obtained. FINDINGS: The lungs are hyperinflated with coarse interstitial markings, likely representing COPD. There is blunting of the bilateral costophrenic angles likely from small bilateral pleural effusions. A retrocardiac opacity is likely atelectasis. There is no pulmonary edema or pneumothorax. The mediastinal contours are normal. The heart is massively enlarged, and unchanged. Clips in the left axilla are noted. IMPRESSION: 1. Chronic changes of COPD. 2. Bilateral small pleural effusions. 3. Severe stable cardiomegaly. " 4d0251eb-cc875c55-fde85f43-3a9d7888-c62772b8.jpg,test/p19/p19991135/s58283482/4d0251eb-cc875c55-fde85f43-3a9d7888-c62772b8.jpg,test," FINAL REPORT HISTORY: Right VATS converted to thoracotomy and right upper lobectomy. FINDINGS: In comparison with the study of ___, one of the right chest tubes appears to have been removed. No definite pneumothorax is appreciated. Post-surgical changes persist in the right hemithorax and there is extensive subcutaneous gas along the right lateral chest wall. " 77a515fa-74dda91f-77c668bf-edf12577-2c8df204.jpg,test/p18/p18119812/s58686000/77a515fa-74dda91f-77c668bf-edf12577-2c8df204.jpg,test," FINAL REPORT INDICATION: ___F with cough s/p chemo // eval for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Right-sided Port-A-Cath is again noted. The lungs remain clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 217ff908-77611d0b-1312ab57-f662a4e2-4ae13967.jpg,test/p10/p10406570/s54693901/217ff908-77611d0b-1312ab57-f662a4e2-4ae13967.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with dyspnea // acute process? TECHNIQUE: AP, upright view of the chest COMPARISON: Chest radiographs on ___ FINDINGS: The the heart is moderately enlarged but stable from the prior exam in ___. There is moderate pulmonary vascular congestion and as well as moderate pulmonary edema with small bilateral pleural effusions. There is no evidence of pneumothorax . IMPRESSION: Cardiomegaly, moderate pulmonary edema and small bilateral pleural effusions " 78bb1bd3-e07c8ab9-0acb8164-bfaf1c6c-985bf02d.jpg,test/p10/p10153427/s55231084/78bb1bd3-e07c8ab9-0acb8164-bfaf1c6c-985bf02d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, chest pain // eval for consolidation TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. No focal consolidation to suggest pneumonia. " dd70e8ab-9b95813e-519a1934-c8d86129-6898ebb1.jpg,test/p14/p14916430/s55628506/dd70e8ab-9b95813e-519a1934-c8d86129-6898ebb1.jpg,test," FINAL REPORT INDICATION: End-stage liver disease, presents with hypervolemia, edema, and acute kidney injury. Assess for infiltrate, edema. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Stable cardiomegaly. Mediastinal and hilar contours are unremarkable. The lungs are clear. No pleural effusion or pneumothorax is evident. Multiple stable compression deformities of the thoracic spine are again identified. IMPRESSION: No acute cardiopulmonary process. Stable cardiomegaly. " 2f5f7ec9-b593d473-515de7bb-8c207e3e-88f01463.jpg,test/p11/p11692070/s51327307/2f5f7ec9-b593d473-515de7bb-8c207e3e-88f01463.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with 40-pack-year smoking history who presents with four weeks of cough and shortness of breath. Assess for consolidation or lesions. Two views of the chest were obtained. Compared to the study from ___. The lungs are well expanded and clear aside from linear right basal atelectasis. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " 78001b1e-d278d8f8-f51b7be2-ba171fb0-1d07e020.jpg,test/p10/p10352831/s51399802/78001b1e-d278d8f8-f51b7be2-ba171fb0-1d07e020.jpg,test," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Palpitations. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. There are numerous old left-sided rib fractures/old rib deformities again seen. There is blunting of the left costophrenic angle suggesting a small left pleural effusion. The cardiac and mediastinal silhouettes are unremarkable. There is also old right clavicular fracture. A left retrocardiac opacity may relate to atelectasis, although underlying consolidation is not excluded. IMPRESSION: 1. Blunting of the left costophrenic angle suggests a small left pleural effusion. Underlying patchy left retrocardiac opacity may relate to atelectasis, although underlying consolidation is not excluded. 2. Old left-sided rib fractures and right clavicle fracture. " edccc8a4-838fc075-15cd2b55-7d97de84-1101e2e6.jpg,test/p14/p14092601/s57133095/edccc8a4-838fc075-15cd2b55-7d97de84-1101e2e6.jpg,test," FINAL REPORT INDICATION: Vomiting. Assess for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary process. " 227ea176-dd1ec21c-a4f29831-cf784ce3-064ffb71.jpg,test/p11/p11094463/s58718716/227ea176-dd1ec21c-a4f29831-cf784ce3-064ffb71.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain // ?pneumonia COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " e0b5f4f2-46908873-5cf7bc37-2c9ce5d5-9f336cbf.jpg,test/p19/p19057990/s56559931/e0b5f4f2-46908873-5cf7bc37-2c9ce5d5-9f336cbf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with DKA and possible infection // interval change interval change IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Small, peripheral consolidative opacities, most readily visible in the upper lungs, increased from ___ through ___, subsequently unchanged. Differential diagnosis includes pneumonia, eosinophilic pneumonia, even septic emboli. Mild pulmonary edema is still present. There is more opacification at the base of the right hemi thorax today. Some of that is due to pleural effusion, but either pneumonia or atelectasis is worsening. Left lower lobe consolidation is stable, not as severe as the right, but the differential diagnosis is the same. ET tube, esophageal drainage tube, left internal jugular line, are all in standard placements. There is no pneumothorax. " d13e27f3-78a1ff66-ffbd81a0-e2ab72ab-f25ab659.jpg,test/p14/p14244969/s52008068/d13e27f3-78a1ff66-ffbd81a0-e2ab72ab-f25ab659.jpg,test," FINAL REPORT INDICATION: Malaise, on chemo. COMPARISON: Chest radiograph ___. FINDINGS: There is mild cardiomegaly. Apparent mediastinal widening is due to mediastinal lipomatosis. There is no pleural effusion or pneumothorax. Note is made of a left central venous catheter with tip terminating in the mid SVC. There is no focal consolidation concerning for pneumonia. IMPRESSION: No acute cardiopulmonary process. " d1b77408-ec2aa0ed-e398f4c1-2a46686a-1e2bc9ca.jpg,test/p10/p10498753/s54087017/d1b77408-ec2aa0ed-e398f4c1-2a46686a-1e2bc9ca.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever, cough, shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Patchy opacity is noted in the right lower lobe concerning for pneumonia. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Right lower lobe pneumonia. Followup radiographs after treatment are recommended to assess for resolution of this finding. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:48 PM, minutes after discovery of the findings. " 4766b3f9-f102ee45-d0c54cb2-e0a12cd1-82794167.jpg,test/p16/p16389191/s55593058/4766b3f9-f102ee45-d0c54cb2-e0a12cd1-82794167.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with well-controlled HIV, with prolonged productive cough, CBC with mild leukocytosis with left-shift. Assess for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The aorta is markedly tortuous. The lungs are clear. No pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 2f4c9220-2ab30be4-2ff14b6c-0480cc01-d7d641db.jpg,test/p15/p15403852/s55048250/2f4c9220-2ab30be4-2ff14b6c-0480cc01-d7d641db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p redo AVR with likely PNA // change after bronch change after bronch IMPRESSION: Comparison to ___. Minimal improvement of the consolidation, likely reflecting a parenchymal opacity combines to a small pleural effusion at the level of the left lung base. No change in appearance of the heart and of the right lung. The tracheostomy tube and the hemodialysis catheter are in constant position. Unchanged alignment of the sternal wires. " 54972057-74758959-7d5097e0-163125ce-3d14f761.jpg,test/p12/p12135489/s50007411/54972057-74758959-7d5097e0-163125ce-3d14f761.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: A ___-year-old man with a grade 3 spleen laceration and acute onset of shortness of breath. IMPRESSION: AP chest compared to ___: Small to moderate left hydropneumothorax could be residual of large left pleural effusion and a small apical pneumothorax seen on ___. Left lower lobe is largely collapsed. Right lung is clear. Heart size is normal. Findings were discussed by telephone with Dr. ___ at 1:24 p.m. " a276f476-547e6837-c221c357-85b6e0a7-cdf163a6.jpg,test/p13/p13299285/s58633146/a276f476-547e6837-c221c357-85b6e0a7-cdf163a6.jpg,test," FINAL REPORT HISTORY: ___-year-old male status post right-sided thoracentesis. STUDY: Portable AP upright chest radiograph. COMPARISON: ___. FINDINGS: Sternotomy wires are unchanged. A left-sided PICC tip terminates at the lower SVC. The course of the PICC projects over the aortic knob and has a slightly atypical course as it extends more centrally. Otherwise, the heart size is normal. The lungs are clear of consolidation. The previously described pulmonary edema has improved. There is no large pleural effusion or pneumothorax detected. IMPRESSION: 1. No evidence of pneumothorax and improving pulmonary edema. 2. Left PICC course likely within normal limits; if clinical concern for an intra-arterial line exists, correlate with pulsatility of flow or an ABG. " 61033b42-d59f6d82-d2f94dfd-bd5e1a1c-40ddb8f4.jpg,test/p16/p16081144/s55998212/61033b42-d59f6d82-d2f94dfd-bd5e1a1c-40ddb8f4.jpg,test," FINAL REPORT INDICATION: Change in behavior. COMPARISON: ___. SINGLE PORTABLE AP VIEW OF THE CHEST: There are low lung volumes. The cardiac, mediastinal and hilar contours are normal. Crowding of the bronchovascular structures is noted, but no pulmonary edema is present. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Left-sided vagal stimulator device is noted with lead terminating in the region of left apex medially, unchanged. Cholecystectomy clips are seen in the right upper quadrant in the abdomen. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes but no acute cardiopulmonary abnormality. " 5609b9d3-cb7cd47e-800ad832-c1ca6568-51842617.jpg,test/p18/p18271325/s51715967/5609b9d3-cb7cd47e-800ad832-c1ca6568-51842617.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with severe COPD after a Whipple procedure. Increased cough. Possible aspiration or pneumonia. IMPRESSION: PA and lateral chest compared to ___ through ___: Bibasilar atelectasis is nearly cleared. Small bilateral pleural effusions have improved since ___. Upper lungs are entirely clear. Heart size normal. Right jugular line ends at the upper SVC. Patient has had median sternotomy and coronary bypass grafting. No pneumothorax. " 4d146e6f-3b6dcbfe-55237df7-e2d2402d-a48f168c.jpg,test/p11/p11119218/s55833482/4d146e6f-3b6dcbfe-55237df7-e2d2402d-a48f168c.jpg,test," FINAL REPORT INDICATION: Seizure or syncope, here to evaluate for acute cardiopulmonary process. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral upright radiographs of the chest. FINDINGS: The lungs are symmetrically well expanded and well aerated without focal consolidation concerning for pneumonia, pleural effusion, or pneumothorax. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The pulmonary vasculature is not engorged. IMPRESSION: No acute cardiopulmonary process. " f43e2de2-80ac0512-3a1a7281-1ac6786d-fc67a9e1.jpg,test/p10/p10832658/s57601600/f43e2de2-80ac0512-3a1a7281-1ac6786d-fc67a9e1.jpg,test," FINAL REPORT INDICATION: Fever. Evaluation for infectious process. COMPARISONS: ___. FINDINGS: Portable AP chest radiograph demonstrates clear lungs. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 8d8203fa-dd4a2644-08e05ea7-57a6ea16-72b5d2d8.jpg,test/p10/p10667727/s52245157/8d8203fa-dd4a2644-08e05ea7-57a6ea16-72b5d2d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chest tube // ?interval changes TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There has been interval marked worsening of atelectasis in the right lower lobe and right middle lobe. Right chest tube is kinked at the skin entrance. Moderate left effusion has increased. Cardiomegaly and widened mediastinum are unchanged. NG tube tip is out of view below the diaphragm. Right PICC tip is in the upper SVC. " 9a6dbbff-c651868e-71eb2365-2136d465-75164805.jpg,test/p15/p15191759/s53272668/9a6dbbff-c651868e-71eb2365-2136d465-75164805.jpg,test," FINAL REPORT HISTORY: Diffuse wheeze, hypoxia, likely asthma. Assess for focal process. COMPARISON: ___. FINDINGS: Normal heart, lungs, mediastinum, hila and pleural surfaces. IMPRESSION: Normal chest radiograph. NOTIFICATION: Telephone notification of Dr. ___ by Dr. ___ ___:15 on ___. " c82dfa5e-1693f085-e13b376c-0c3597af-23c174f4.jpg,test/p11/p11228114/s56383370/c82dfa5e-1693f085-e13b376c-0c3597af-23c174f4.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain, assess for pneumothorax. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 206d6dc5-2aa91269-6d8aa5e1-9af39c6e-ed639946.jpg,test/p15/p15760834/s50032803/206d6dc5-2aa91269-6d8aa5e1-9af39c6e-ed639946.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with swelling and history of congestive heart failure. COMPARISON: Chest radiograph from ___. FINDINGS: The cardiac silhouette is moderately enlarged and slightly bigger than before. Bilateral small pleural effusions are increased in comparison to prior study from ___. No focal consolidation or pneumothorax, but bilateral atelectatic changes are visualized with pleural effusions. No acute fractures identified. IMPRESSION: 1. Moderate cardiomegaly, increased in comparison to the prior study. Pericardial effusion could be present. 2. Bilateral small pleural effusions, also increased in size in comparison to the prior study. " 4e81a494-1ef7690d-5870cb2b-c0a4052c-829cbd9a.jpg,test/p15/p15180359/s52706560/4e81a494-1ef7690d-5870cb2b-c0a4052c-829cbd9a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new secretions // ?volume over load?infection TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: NG tube tip isout of view, below the diaphragm. ET tube is in standard position. Central catheters are in unchanged standard position. Cardiomegaly is stable. The aorta is tortuous. Large bilateral effusions with adjacent atelectasis are unchanged. Moderate pulmonary edema is minimally improved. " 0f485b28-55f57637-3e5d037e-cc57cb4f-92202d6c.jpg,test/p19/p19955235/s52998581/0f485b28-55f57637-3e5d037e-cc57cb4f-92202d6c.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with hypoxia, evaluate for pulmonary edema. TECHNIQUE: Chest AP and lateral COMPARISON: None available FINDINGS: Lung volumes are low which leads to bronchovascular crowding. There is bibasilar atelectasis without focal consolidation. The cardiac silhouette mildly enlarged. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Bibasilar atelectasis without focal consolidation. 2. Mild cardiomegaly. " 814ead0b-5f754c70-12a50b56-f11eaad8-4102695f.jpg,test/p11/p11274067/s57995856/814ead0b-5f754c70-12a50b56-f11eaad8-4102695f.jpg,test," FINAL REPORT HISTORY: ICD placement. FINDINGS: In comparison with the study of ___, there has been placement of a dual-channel ICD device with the leads in the region of the right atrium and apex of the right ventricle. Lower lung volumes without definite vascular congestion. Vague suggestion of some opacification at the left base that could represent atelectasis or area of aspiration. " b2283c2c-1e417d01-c8b5a464-4f75a42a-ecd72c24.jpg,test/p13/p13240424/s54297500/b2283c2c-1e417d01-c8b5a464-4f75a42a-ecd72c24.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with amphetamine use, dyspnea // eval for cause of dyspnea COMPARISON: None. FINDINGS: The heart is not enlarged. No CHF, focal consolidation, effusion, or pneumothorax is detected. Minimal patchy opacity at the right lung base most likely represents minimal atelectasis. An ovoid area of lucency is seen abutting the left side of the trachea, immediately above the aortic arch, measuring ___.7 x ___.6 mm. This is not fully characterized, but may represent a bulla or bleb in the medial portion of the left lung. A 5.6 mm focal density overlying the anterior left third and posterior left fifth ribs may represent artifact due to overlying rib shadows. No free air seen beneath the diaphragm. IMPRESSION: Patchy opacity right lung base, likely representing minimal atelectasis. An early pneumonic infiltrate area of aspiration is considered less likely. Vertical ovoid lucency along the left trachea--___ full or bleb in the medial left lung. 5.6 mm density overlying left lung laterally --? Artifact due to overlapping rib shadows. If clinically indicated, oblique views of the chest could help for further assessment. RECOMMENDATION(S): 5.6 mm density overlying left lung laterally --? Artifact due to overlapping rib shadows. If clinically indicated, oblique views of the chest could help for further assessment. " 52d68a5e-28c699b0-a332fc74-6cdc0409-ddaa01c4.jpg,test/p18/p18087801/s56490403/52d68a5e-28c699b0-a332fc74-6cdc0409-ddaa01c4.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough and fever. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is normal. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " d030c19c-2fe3a93b-14764214-5032e7d3-d9f38009.jpg,test/p11/p11884069/s57654965/d030c19c-2fe3a93b-14764214-5032e7d3-d9f38009.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Acute shortness of breath, desaturation, patient with known lung cancer. Comparison is made with prior studies from ___. There is no evidence of pneumothorax, enlarging pleural effusions or new lung abnormalities. Right upper and right middle lobe mass, small right pleural effusion and multifocal lung opacities consistent with pneumonia are stable. There is elevation of the right hemidiaphragm as before. The cardiac size is normal. Mediastinal widening is obscured by the right upper lobe lung mass. " cb6ab08a-07d426a3-3d22f29f-bcc4738f-576053f6.jpg,test/p14/p14353305/s52663876/cb6ab08a-07d426a3-3d22f29f-bcc4738f-576053f6.jpg,test," FINAL REPORT HISTORY: Spontaneous pneumothorax. COMPARISON: ___. PA and lateral views of the chest. The lungs are clear. Cardiac silhouette is normal in size. Hilar and mediastinal contours are normal. There is no evidence of pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary process. " ca59a344-61def5b3-5a6cc789-f363e59b-7305e796.jpg,test/p11/p11812613/s56970259/ca59a344-61def5b3-5a6cc789-f363e59b-7305e796.jpg,test," WET READ: ___ ___ ___ 12:37 PM Left upper lobe and lingular opacities are worrisome for pneumonia. WET READ VERSION #1 ___ ___ ___ 11:45 AM Left upper lobe opacity could represent an infectious process in the proper clinical setting with lesser consideration to asymmetric pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough, sputum, and malaise, with crackles on the right, evaluate for pneumonia. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: Opacity in the left upper lobe and lingula could represent an infectious process in the proper clinical setting with lesser consideration to asymmetric pulmonary edema. There is no pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is stably enlarged. A left pectoral single lead pacemaker projects in unchanged position. IMPRESSION: Left upper lobe and lingular opacities are worrisome for pneumonia. " 224714c8-76cedd3f-860cb953-80b79151-f09f8cd3.jpg,test/p10/p10110764/s58865809/224714c8-76cedd3f-860cb953-80b79151-f09f8cd3.jpg,test," FINAL REPORT HISTORY: ___ year old female with resolving sepsis and NG tube re-positioning. COMPARISON: Comparison is made to radiograph of the chest from three hours prior. FINDINGS: The nasogastric tube courses through the esophagus, below the diaphragm and terminates in the fundus of the stomach, in appropriate position. The previously seen NG tube coil in the hypopharynx is not imaged on this study. Otherwise, the lungs, mediastinum, and heart are unchanged in appearance. IMPRESSION: NG tube is in appropriate position, terminating in the stomach. " 0789149c-daef2089-2df4a01f-909069f4-772db944.jpg,test/p15/p15777048/s56223672/0789149c-daef2089-2df4a01f-909069f4-772db944.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest provided. Lung volumes are low with bibasilar bronchovascular crowding. No signs of pneumonia or CHF. The heart is moderately enlarged, though incompletely characterized given low lung volumes. The mediastinal contour is normal. No effusion or pneumothorax. Bony structures are intact. IMPRESSION: Cardiomegaly without evidence of pulmonary edema. " 9582f952-337e240c-395484a9-955770dd-d6846793.jpg,test/p19/p19398915/s56081299/9582f952-337e240c-395484a9-955770dd-d6846793.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, with active UGI bleed // ___ position COMPARISON: ___, 14:53 IMPRESSION: As compared to the previous radiograph, the plaque more device is now in correct position. No evidence of complications. The lung bases have unchanged appearance. The lung apices are not included in the image. " 44492b23-7b8ede65-186035fe-18b0d023-062931d2.jpg,test/p18/p18148913/s51204916/44492b23-7b8ede65-186035fe-18b0d023-062931d2.jpg,test," FINAL REPORT HISTORY: ___-year-old female with tachypnea. Evaluation for pneumonia. COMPARISON: Comparison is made to radiographs of the chest from ___, ___, and ___. FINDINGS: Semi-upright portable radiograph of the chest demonstrates moderate enlargement of the cardiac silhouette, not significantly changed compared to prior studies, allowing for somewhat oblique patient positioning and semi-upright technique. The lung volumes are low, with bibasilar atelectasis. No overt pulmonary edema, pleural effusion or pneumothorax is identified. No focal consolidation concerning for pneumonia is seen. Dilated loops of colon are again present, as before. IMPRESSION: Stable moderate cardiomegaly. Otherwise, no acute cardiopulmonary process. " 7963b06a-c3556c84-a0a1b0b1-dcaf8333-d5cc33c8.jpg,test/p13/p13194374/s52026913/7963b06a-c3556c84-a0a1b0b1-dcaf8333-d5cc33c8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with abd v/d, recent pna. Please r/o PNA and ?sbo // pna? sbo? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs remain hyperinflated. Slight blunting of the costophrenic angles posteriorly may be due to trace pleural effusions. Mild bibasilar atelectasis is seen. No definite focal consolidation. There is no pneumothorax. The cardiac silhouette is mildly enlarged. The aorta is somewhat tortuous. Mediastinal contours are stable. IMPRESSION: Slight blunting of the posterior costophrenic angles raises concern for trace to small pleural effusions. Mild cardiomegaly. " 35d06b4f-701bee93-3cdb29c6-79989575-7b882184.jpg,test/p15/p15795581/s56391689/35d06b4f-701bee93-3cdb29c6-79989575-7b882184.jpg,test," FINAL REPORT INDICATION: History of smoking, pneumonia. Please evaluate. COMPARISONS: None. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No intrathoracic abnormalities identified. " 95648123-b9429f05-33f8bce5-291cdfe0-51ad4097.jpg,test/p10/p10570398/s57999527/95648123-b9429f05-33f8bce5-291cdfe0-51ad4097.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with s/p fall // eval for pneumothorax TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and CABG. The cardiac and mediastinal silhouettes are stable. . Mild bibasilar atelectasis without focal consolidation. No pleural effusion or pneumothorax. The lateral view is limited due the patient's overlying arm. Again seen chronic deformity at the distal right clavicle. IMPRESSION: Limited lateral view due to the patient's overlying arm. Otherwise, no acute cardiopulmonary process seen. No evidence of pneumothorax. " 0808a350-e3357e06-0d0022b3-843a5116-7dd573c8.jpg,test/p14/p14274761/s59129181/0808a350-e3357e06-0d0022b3-843a5116-7dd573c8.jpg,test," WET READ: ___ ___ ___ 6:54 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with chest pain, left sided wheezing // pna? TECHNIQUE: Chest PA and lateral COMPARISON: NONE FINDINGS: Lung volumes are low. The cardiomediastinal silhouette is within normal limits. Lung fields are clear. There is no pleural effusion. There is no pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 4116dcd9-c4246381-950b714a-16656baa-d9f11e60.jpg,test/p17/p17165725/s54430634/4116dcd9-c4246381-950b714a-16656baa-d9f11e60.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Empyema, evaluation for chest tube position and pulmonary edema and effusion. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a new nasogastric tube. The other monitoring and support devices, including the right pleural pigtail catheter are in unchanged position. The pigtail catheter shows several areas of kinking along its course. The extent of the right pleural fluid collection is without relevant change. Areas of atelectasis at the left lung bases have slightly increased in extent and severity. " 5ff73c65-f193469b-2d024f89-44bb6db6-1fd1d646.jpg,test/p10/p10373824/s50181369/5ff73c65-f193469b-2d024f89-44bb6db6-1fd1d646.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Asymmetric opacity in the right apex, has possibly increased since ___, although this may be related to patient rotation. This increase may reflect superimposed acute pneumonia or increasing apical thickening. If there is a strong clinical concern for malignancy, a CT thorax should be considered. // f/u cxr COUGH;F/U CHEST XRAY IMPRESSION: In comparison with studies dating back to ___, the area of increased opacification in the right apical region has not substantially change. The less prominent opacification in the left apex also appears stable. The findings most likely reflect pleural thickening consistent with old tuberculous disease. Remainder the examination is unchanged. " 092a3fbb-9a9c5182-6e1d86c4-6bac90ad-3d630057.jpg,test/p19/p19239122/s52854899/092a3fbb-9a9c5182-6e1d86c4-6bac90ad-3d630057.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with fever, evaluate for infiltrate. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion or pneumothorax. " e54f7640-5d2c381d-1caa6134-c033f5c0-1e8e15c7.jpg,test/p18/p18624005/s52411037/e54f7640-5d2c381d-1caa6134-c033f5c0-1e8e15c7.jpg,test," FINAL REPORT INDICATION: ___-year-old female with recent pacemaker placement and left upper extremity swelling. TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___. FINDINGS: Two transvenous pacemaker leads, continuous from the left pectoral generator, are unchanged in position since ___ when they were newly inserted. The right atrial lead follows the usual course. The right ventricular lead is oriented obliquely upward to the anterior wall of the right ventricle at the origin of the pulmonary outflow tract. Moderate right pleural effusion and thickening, are chronic, accounting for stable volume loss in the right lung since ___. There is no left pleural effusion, pneumothorax, or mediastinal widening. Mild cardiomegaly is chronic. Previous mild pulmonary edema in the right lung has changed in distribution but not entirely cleared, and pulmonary vascular congestion persists. IMPRESSION: No change since ___ in non standard position of right ventricular transvenous pacemaker lead close to the pulmonary outflow tract. No evidence of complications related to lead insertion. Mild pulmonary edema persists in the right lung, probably influenced by restrictive pleural thickening. Chronic mild cardiomegaly and pulmonary vascular congestion. " 0be9fe2e-1c014d6f-8c8b7075-45a54ac1-4a34eeb3.jpg,test/p15/p15510106/s58422728/0be9fe2e-1c014d6f-8c8b7075-45a54ac1-4a34eeb3.jpg,test," FINAL ADDENDUM ADDENDUM There was a ___ image in this study in which the Dobbhoff tube extends well into the stomach. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alcoholic hepatitis // re-placement of dob hoff tube TECHNIQUE: CHEST (PORTABLE AP) IMPRESSION: DOBBHOFF TUBE CURRENTLY IS IN THE DISTAL ESOPHAGUS AND SHOULD BE FURTHER ADVANCED. HEART SIZE AND MEDIASTINUM ARE UNREMARKABLE. LUNGS ARE CLEAR. THERE IS NO PLEURAL EFFUSION OR PNEUMOTHORAX. LUNGS ARE HYPERINFLATED. " 37b5d4f7-b4aeb9af-16f37996-e1d12125-282f00ed.jpg,test/p17/p17890887/s56386263/37b5d4f7-b4aeb9af-16f37996-e1d12125-282f00ed.jpg,test," FINAL REPORT HISTORY: Right IJ placement. COMPARISON: Comparison is made with chest radiographs from earlier the same day, ___ and ___. FINDINGS: Portable semi erect frontal image of the chest. There has been interval placement of right IJ line, which terminates at the cavoatrial junction. The lungs are well expanded. There are heterogeneous peribronchial markings in the lungs bilaterally, which could represent an atypical pneumonia or less likely pulmonary edema from heart failure. The lungs are otherwise clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: 1. Right IJ terminating in the superior cavoatrial junction. 2. Heterogeneous peribronchial markings in the lungs bilaterally, which could represent an atypical pneumonia or less likely pulmonary edema from heart failure. Recommend clinical observation for development of characteristic symptoms. " 82164ba0-9f11ae5f-39c86d85-62a7b7a7-4445bf89.jpg,test/p16/p16649269/s55727407/82164ba0-9f11ae5f-39c86d85-62a7b7a7-4445bf89.jpg,test," FINAL REPORT INDICATION: ___-year-old female with right-sided chest pain. Evaluate for pleural effusion or right rib fracture. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The pulmonary vasculature is unremarkable. The lungs are clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. Osseous structures are unremarkable without evidence of rib fracture. No radiopaque foreign body. IMPRESSION: No acute cardiopulmonary process. No pleural effusion or rib fracture. " 8e5a3e01-dfb154d4-029978f2-bc594efe-d998e4f0.jpg,test/p12/p12287756/s51734959/8e5a3e01-dfb154d4-029978f2-bc594efe-d998e4f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SAH, worsening SOB and hypoxia after recent seizure // Progression of pulmonary edema vs aspiration pneumonitis COMPARISON: ___ IMPRESSION: As compared to the previous image, bilateral opacities on the right and consolidation on the left have increased in extent and severity. These increase is suggestive of either pneumonia or aspiration. No pleural effusions are noted. Mild fluid overload but no pulmonary edema. No pneumothorax. Unchanged course and position of the left subclavian vein catheter. " f685d154-f3e225e4-6bba422d-580abd7f-e3e071c1.jpg,test/p17/p17374166/s51829873/f685d154-f3e225e4-6bba422d-580abd7f-e3e071c1.jpg,test," FINAL REPORT HISTORY: Postoperative oxygen requirement. FINDINGS: In comparison with study of ___, there is an area of increased opacification at the right cardiophrenic angle. It is difficult to determine whether this merely reflects pulmonary vessels in a patient with low lung volumes, or whether this could represent a developing consolidation. If the condition of the patient would permit, lateral view would be most helpful. The left base is clearer than on the previous study. " b6c57f09-0504983c-c8031624-c21adc40-cda8b11c.jpg,test/p13/p13628037/s56947221/b6c57f09-0504983c-c8031624-c21adc40-cda8b11c.jpg,test," FINAL REPORT AP CHEST, 12:43 P.M., ___ HISTORY: ___-year-old man with new hypoxia. Suspect pneumonia. IMPRESSION: AP chest compared to ___: Pulmonary vascularity is mildly engorged in the upper lobes and mediastinal veins are borderline dilated. I do not see pulmonary edema, but this might be very early stage of cardiac decompensation. There are no focal findings to suggest pneumonia and no pleural effusion. Heart size is normal. " bd71ccdd-e031b16d-51734f9a-f96d13d1-4ee0544e.jpg,test/p11/p11658675/s53518463/bd71ccdd-e031b16d-51734f9a-f96d13d1-4ee0544e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M intubated TECHNIQUE: Upright AP view of the chest COMPARISON: ___ at 08:46 FINDINGS: An endotracheal tube has been placed in the interval with tip approximately 6 cm from the carina. An enteric tube tip is within the distal esophagus, and needs to be advanced by approximately 15 cm to lie satisfactory within the stomach. Persistent low lung volumes with bibasilar atelectasis are re- demonstrated. The cardiac and mediastinal contours are unchanged. No pneumothorax is clearly seen. . IMPRESSION: 1. Endotracheal tube in standard position. 2. Suboptimal positioning of the enteric tube within the distal esophagus, and should be advanced by at least 15 cm for satisfactory positioning. " 650fc250-d9a7d770-4b47cdb7-bc3c0293-ed78dc56.jpg,test/p18/p18826698/s54856379/650fc250-d9a7d770-4b47cdb7-bc3c0293-ed78dc56.jpg,test," FINAL REPORT INDICATION: Weakness. COMPARISON: Chest radiograph, ___. FINDINGS: PA and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Lungs are well expanded with no focal consolidation concerning for pneumonia. IMPRESSION: No acute cardiopulmonary process. " b3414af9-abdedba5-07b0b706-1cd664b9-7dd7801d.jpg,test/p13/p13429025/s53478270/b3414af9-abdedba5-07b0b706-1cd664b9-7dd7801d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough // eval infiltrate COMPARISON: No priors. FINDINGS: AP upright and lateral views of the chest provided. There is ill-defined consolidation in the right lower lobe concerning for pneumonia. No large effusion is seen. Lung volumes are somewhat low. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Ill-defined consolidation in the right lower lobe is concerning for pneumonia. " b4271847-0078f8ba-cc752dd3-039d1c7d-44439aef.jpg,test/p18/p18997544/s58367930/b4271847-0078f8ba-cc752dd3-039d1c7d-44439aef.jpg,test," FINAL REPORT INDICATION: Dyspnea. COMPARISON: None available. FINDINGS: Minimal right basilar atelectasis. Otherwise, the remainder of the lungs are clear. There is no evidence of an effusion or pneumothorax. Cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " d271788e-037c04bb-c329f2c2-c103e0c0-0a32c12b.jpg,test/p10/p10534795/s55037406/d271788e-037c04bb-c329f2c2-c103e0c0-0a32c12b.jpg,test," WET READ: ___ ___ ___ 9:48 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with cough ili // chest congestion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___ FINDINGS: Lungs are well-expanded and clear. Cardiomediastinal and hilar contours are unremarkable. No pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumonia. " 795a8bac-8ea27f0d-236d791d-8e36abee-2a82f091.jpg,test/p18/p18176683/s52548636/795a8bac-8ea27f0d-236d791d-8e36abee-2a82f091.jpg,test," WET READ: ___ ___ 8:47 PM Bilateral moderate pleural effusions, slightly increased on the left. No confluent opacity to suggest pneumonia. No pneumothorax. ___ p___WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Leucocytosis and hepatic encephalopathy. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Mild interstitial prominence is demonstrated, unchanged since the prior study. Bilateral pleural effusions are moderate, slightly decreased since prior examination but minimally. Upper lungs are essentially clear. There is no pneumothorax. " 7216f031-37e90b45-7f05774d-c725b987-fbf7cc23.jpg,test/p17/p17620982/s55837204/7216f031-37e90b45-7f05774d-c725b987-fbf7cc23.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Cirrhosis, back pain, new ascites, decreased breath sounds in the right lung. There are no prior studies available for comparison. There is a moderate-to-large pleural effusion associated with adjacent atelectasis. There is no pneumothorax. Cardiac size cannot be evaluated. There is mild interstitial edema, better seen in the base of the left hemithorax. There are moderate degenerative changes in the thoracic spine. " 2e19a528-ca380e7d-244baa19-12893ed1-c3b631b0.jpg,test/p15/p15297415/s56799291/2e19a528-ca380e7d-244baa19-12893ed1-c3b631b0.jpg,test," WET READ: ___ ___ 9:02 AM Dobbhoff tube is within the distal esophagus and should be advanced to place it within the stomach. Right subclavian line terminating in the right atrium is unchanged. Stable large right pleural effusion and likely small left pleural effusion. Stable appearance of cardiomediastinal silhouette. The findings were discussed by Dr. ___ with Dr. ___ on ___ at 8:49 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new dobhoff // Dobhoff placement Dobhoff placement IMPRESSION: On the files image, the Dobbhoff tube extends to the mid body of the stomach. In comparison with the earlier study of ___, there is little overall change in the appearance of the heart and lungs. " ef8d67d9-353577b8-d5710013-3abfc59a-a4d45205.jpg,test/p11/p11239660/s59655382/ef8d67d9-353577b8-d5710013-3abfc59a-a4d45205.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with slurred speech x15 minutes TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Moderate cardiomegaly is re- demonstrated. The aorta is diffusely calcified and slightly tortuous. Mediastinal and hilar contours are otherwise. The pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. Streaky atelectasis is noted right lung base. IMPRESSION: Streaky right basilar atelectasis without focal consolidation to suggest pneumonia. " fd28546f-8255f0cc-83cf3e2c-adc154b4-10eabc4e.jpg,test/p10/p10449408/s52874412/fd28546f-8255f0cc-83cf3e2c-adc154b4-10eabc4e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Septic shock, questionable ARDS, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have increased, potentially caused by increasing ventilatory pressures. As a consequence, the widespread bilateral parenchymal opacities have minimally decreased in extent and severity but are likely to be overall unchanged. No pleural effusions. No pneumothorax. Borderline size of the cardiac silhouette. " ec24e513-cad2ad1c-ad926447-a9f77010-13940239.jpg,test/p12/p12284549/s52777948/ec24e513-cad2ad1c-ad926447-a9f77010-13940239.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT 16:03 CLINICAL INDICATION: ___-year-old status post CABG, assess for effusion atelectasis. Comparison to prior study of ___ at 10:51. PA and lateral views of the chest ___ at 16:03 are submitted. IMPRESSION: 1. Status post median sternotomy for CABG with stable postoperative cardiac and mediastinal contours. Calcification of the aorta consistent with atherosclerosis. Small bilateral pleural effusions with patchy bibasilar air-space disease, left greater than the right, consistent with compressive atelectasis, although pneumonia cannot be excluded. No evidence of pulmonary edema. Bilateral calcifications within the neck soft tissues, which may be carotid in etiology. Clinical correlation is advised. Clips in the right upper quadrant consistent with prior cholecystectomy. " d49bba73-aa3943df-4db1e138-0bf18547-ad7dd2ec.jpg,test/p14/p14910766/s58926224/d49bba73-aa3943df-4db1e138-0bf18547-ad7dd2ec.jpg,test," FINAL REPORT HISTORY: Weakness. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded. There is a hazy opacity in the base of the right lung, raising concern for aspiration or infection vs atelectasis. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: Hazy opacity in the base of the right lung could be due to aspiration or infection. " 6f2ab2f7-5aab1f71-05aa7eb0-fe9edaf2-fdefd055.jpg,test/p17/p17063094/s57097974/6f2ab2f7-5aab1f71-05aa7eb0-fe9edaf2-fdefd055.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. Question pneumothorax. COMPARISON: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 2ae1b96a-df48d9d7-5a32733d-960380ce-3bd8a517.jpg,test/p19/p19778971/s58782000/2ae1b96a-df48d9d7-5a32733d-960380ce-3bd8a517.jpg,test," WET READ: ___ ___ 6:11 PM Pig tail catheter in the left basal pleural space. Decreased left pleural effusion with partial re-expansion of the left lung. Right lung is clear. No pneumothorax. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post pigtail placement for pleural effusion. COMPARISONS: Earlier on the same day. TECHNIQUE: Chest, semi-upright AP portable. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. A pigtail drainage catheter has been placed in the lower left pleural space. The large majority of a loculated pleural effusion has been drained with a moderate residual quantity and parenchymal opacity which can probably be attributable to atelectasis, although an infectious etiology is not excluded by this study. Elsewhere, the lungs remain clear. A small pleural effusion on the right is unchanged. There is no pneumothorax. IMPRESSION: Marked improvement in left pleural effusion following placement of catheter. " eb7217ff-a851f307-6a1f75d3-ba09a105-919a0e6e.jpg,test/p10/p10989799/s53136675/eb7217ff-a851f307-6a1f75d3-ba09a105-919a0e6e.jpg,test," FINAL REPORT INDICATION: History of pancreatic cancer with new bilateral lower extremity DVT. Cough and crackles at the bases bilaterally. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: ___ and ___. FINDINGS: There is a small pleural effusion, present on ___, but not on ___. There is no focal consolidation or pneumothorax. Bibasilar atelectasis is noted. The heart is normal in size. The cardiac, mediastinal, and hilar contours are within normal limits. IMPRESSION: Small left pleural effusion, unchanged from ___. Bibasilar atelectasis, no evidence of pneumonia. " 82e4a2b4-b103eea0-db7b8228-31013848-51fdba15.jpg,test/p15/p15863098/s57785902/82e4a2b4-b103eea0-db7b8228-31013848-51fdba15.jpg,test," FINAL REPORT INDICATION: ___ year old male patient with left pneumothorax s/p pigtail now to suction. Study requested for evaluation of interval change. COMPARISON: Prior chest radiographs from ___ through ___. TECHNIQUE: Portable AP chest radiograph. FINDINGS: As compared to prior chest radiograph, there has been interval improvement of a large left pneumothorax. The apical visceral pleural line is at the level of the inferior aspect of the left third posterior rib. There is a small loculated hyropneumothorax. Pigtail catheter remains in place in the left hemithorax. Right lung is clear. The cardiomediastinal contours are within normal limits and are midline. IMPRESSION: Improving left pneumothorax. " 170fca9a-e66b6405-026be1e0-27b12500-8ad35127.jpg,test/p14/p14044945/s50175002/170fca9a-e66b6405-026be1e0-27b12500-8ad35127.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with renal failure and new JVP // baseline. baseline. IMPRESSION: No comparison. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pleural effusions. No pneumonia, no pulmonary edema. " d4b5094b-0aba72f6-6aea118e-d88ec4f9-1328c7db.jpg,test/p11/p11708364/s57397078/d4b5094b-0aba72f6-6aea118e-d88ec4f9-1328c7db.jpg,test," FINAL REPORT INDICATION: ___ year old woman with non-obstructive ileus and suddenly became dyspneic and desated to 80s. // Please eval for e/o pneumonia vs ptxPlease eval for free air under the diaphragm TECHNIQUE: Chest radiograph frontal view COMPARISON: Chest radiograph ___ FINDINGS: Mild bibasilar opacification is likely secondary to atelectasis. Small bilateral pleural effusion is noted. There is likely some associated basilar atelectasis. There is no pneumothorax or pulmonary edema. Cardiac silhouette is within normal size. No intraperitoneal free air is identified underneath the diaphragm. Dilated bowel loops are noted. Incidental note is made of the right posterior lateral sixth rib minimally displaced fracture which appears new from prior exam. Remodeling of left proximal humerus compatible with an old fracture. IMPRESSION: 1. No radiographic evidence of pneumonia. 2. Incidental right posterior lateral sixth rib fracture. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 6:30 PM, at the time of discovery of the findings. #2 of impression above was entered by Dr. ___ on ___ at 10:24 into the Department of Radiology critical communications system for direct communication to the referring provider. " 7b848ca0-b3feedc0-ee59a88b-3e260593-8a9782b3.jpg,test/p14/p14868639/s55129535/7b848ca0-b3feedc0-ee59a88b-3e260593-8a9782b3.jpg,test," WET READ: ___ ___ ___ 10:02 PM 1. There is a right chest Port-A-Cath with distal tip terminating in the mid SVC. 2. Stable cardiomediastinal silhouettes. 3. Stable appearance of the lungs with diffuse interstitial prominence, possibly age related. Probable left basilar atelectasis. No focal consolidation. 4. No right pleural effusion. Difficult to exclude a trace left pleural effusion. 5. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new/worsening O2 requirement, has decreased breath sounds on right side // effusion? edema effusion? edema COMPARISON: Chest radiographs since ___, most recently ___ IMPRESSION: Mild pulmonary edema which developed on ___ has improved. Small bilateral pleural effusions remain. Heart size has returned to normal. Right subclavian central venous infusion port catheter ends in the low SVC. No pneumothorax. " c9bc94d1-1decad89-0bd54e26-5f81f26c-28c241c5.jpg,test/p11/p11607177/s58252915/c9bc94d1-1decad89-0bd54e26-5f81f26c-28c241c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with severe CHF // PTX? Swan position? PTX? Swan position? IMPRESSION: In comparison with the earlier study of this date, there is little change in the appearance of the heart lungs and " c43b201a-fdc9889f-9d407ab3-67a804ad-a7006c54.jpg,test/p16/p16742247/s50254232/c43b201a-fdc9889f-9d407ab3-67a804ad-a7006c54.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with AML undergoing MRD with increased cough // r/I pneumonia r/I pneumonia COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: New right internal jugular venous catheter ends close to the superior cavoatrial junction. No pneumothorax, mediastinal widening, or pleural effusion. Lungs fully expanded and grossly clear, although it should be noted that chest CT scanning is more sensitive than conventional chest radiographs, particularly bedside radiographs, in detecting early infection, particularly in patients with leukemia. Heart is normal size. There is no pleural effusion or evidence of central lymph node enlargement. ___, MD " 477cdd18-3427cde3-a085f755-4cfd1715-ba660b9c.jpg,test/p16/p16805727/s56870170/477cdd18-3427cde3-a085f755-4cfd1715-ba660b9c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p ICD placement, new RV lead // ptx, leads ptx, leads TECHNIQUE: PA and lateral chest views COMPARISON: ___ FINDINGS: Satisfactory RV lead placement is seen, no pneumothorax. Mild cardiomegaly, the cardiomediastinal silhouette is otherwise unchanged (allowing for changes in position). The lungs are clear bilaterally. IMPRESSION: The ICD leads are intact, no pneumothorax. " 88b73929-708fc5d6-4948ec07-a6b86047-acbf5fed.jpg,test/p17/p17413636/s57615803/88b73929-708fc5d6-4948ec07-a6b86047-acbf5fed.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with hypoxia and known rib fracture, now with cough for one day. COMPARISON: Chest radiograph ___ PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. Asymmetric interstitial opacities in the right lung base, seen better on the frontal radiograph, likely represent chronic interstitial disease. No consolidation, pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary pathology. " ba5b8776-f2666864-68e22398-3dbf8817-9af31dfa.jpg,test/p11/p11621672/s51656933/ba5b8776-f2666864-68e22398-3dbf8817-9af31dfa.jpg,test," FINAL REPORT INDICATION: ___-year-old man with iritis, loss of vision in the right eye, left eye involved as well, looking for pulmonary sarcoid? COMPARISON: No prior images available. FINDINGS: PA and lateral chest radiographs was obtained. Heart is normal size and cardiomediastinal contours are unremarkable. No discrete hilar lymphadenopathy. Lungs are well expanded and clear with normal pulmonary vasculature and no focal consolidation. No pleural effusion. No pneumothorax. IMPRESSION: No evidence of pulmonary sarcoid. " 9c96b99f-bc06a6b9-f2ed64b5-be00dff9-a0ecea06.jpg,test/p13/p13261938/s58969709/9c96b99f-bc06a6b9-f2ed64b5-be00dff9-a0ecea06.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___F s/p PEA arrest after fall from standing with C2 dens fracture and multiple rib fracture // confirm NGT confirm NGT IMPRESSION: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends well into the mid body of the stomach. The endotracheal tube again lies close to the orifice of the right mainstem bronchus. NOTIFICATION: This information was telephoned to ___, the nurse taking care the patient in the trauma ICU, on ___ at 13:00 immediately after discovery. " 0121bc37-2ed8a362-8f9cdb83-edfbd075-1e86a1d6.jpg,test/p11/p11607628/s55693697/0121bc37-2ed8a362-8f9cdb83-edfbd075-1e86a1d6.jpg,test," WET READ: ___ ___ ___ 12:04 AM New ICD generator overlies the left chest wall. Lead is intact and terminates in the region of the right ventricle. No pneumothorax. Small left basilar opaciteis - may reflect atelectasis and a small effusion - though aeration of the left base improved from prior from ___. Lateral view limited due to the arm positioned down. Otherwise clear lungs. No edema of vascular congestion. ___ p_________________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with cardiomyopathy and prior VR arrest. ICD implant. IMPRESSION: PA and lateral chest compared to ___: Small left pleural effusion has decreased substantially since ___. Small right pleural effusion or more likely right pleural scarring, unchanged. New transvenous right ventricular pacer defibrillator lead in standard placement. Moderate cardiomegaly, unchanged. No pulmonary or mediastinal vascular engorgement. No pneumothorax or mediastinal widening. Lungs are grossly clear. " 1277c5d0-e9b89217-81ba0263-1972ff4e-4e3dafb4.jpg,test/p12/p12607853/s54860074/1277c5d0-e9b89217-81ba0263-1972ff4e-4e3dafb4.jpg,test," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old man with right-sided pleuritic chest pain. Evaluate for pneumonia. FINDINGS: Comparison is made to previous study from ___. The heart size is enlarged but stable. There are small bilateral pleural effusions best seen on lateral view. Bony structures are intact. There are no signs for acute pulmonary edema. No pneumothoraces are present. " 08f534a5-a3df02bb-5d1d950a-358a2d22-7db84142.jpg,test/p17/p17041835/s53300947/08f534a5-a3df02bb-5d1d950a-358a2d22-7db84142.jpg,test," FINAL REPORT HISTORY: Dyspnea on exertion. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiac silhouette is normal in size. There is no pleural effusion, pneumothorax, pulmonary edema or pneumonia. Numerous surgical clips are scattered throughout the abdomen. IMPRESSION: No evidence of acute cardiopulmonary process. " 93194cf9-a45ea8da-fd23501b-be40f16c-e67985c6.jpg,test/p15/p15993209/s59180934/93194cf9-a45ea8da-fd23501b-be40f16c-e67985c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lung abscess on antibiotics, now with worsening hemoptysis // changes from prior changes from prior IMPRESSION: In comparison with the study of ___, there is increasing opacification at the left base, consistent with worsening pleural effusion and volume loss in the left lower lobe. The generalized opacification obscures the region of the lung abscess. Opacification just above the effusion could represent site of infection. " 43d1ac51-75a8ac30-c55a0006-dcbf0072-bf681380.jpg,test/p11/p11865423/s55944670/43d1ac51-75a8ac30-c55a0006-dcbf0072-bf681380.jpg,test," FINAL REPORT HISTORY: Diffuse back pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No the pulmonary edema is seen. No displaced fracture is seen although please note that this study is not optimal in assessing back pain. If there is high clinical concern for back injury, should consider cross-sectional imaging. IMPRESSION: No acute cardiopulmonary process. If high clinical concern for back injury, cross-sectional imaging is more sensitive. " d5adfb8e-6e65e7e8-1b8a8018-3c7cd406-c824e43e.jpg,test/p12/p12607933/s51650661/d5adfb8e-6e65e7e8-1b8a8018-3c7cd406-c824e43e.jpg,test," WET READ: ___ ___ ___ 12:12 AM The Dobbhoff is in the stomach. ______________________________________________________________________________ FINAL REPORT HISTORY: Normal Dobbhoff placement. COMPARISON: ___. FINDINGS: The Dobbhoff tube is in the stomach. There continues to be retrocardiac opacity consistent volume loss/infiltrate/effusion. Right IJ Cordis is again visualized. Aeration in the right lung is improved. " d0636801-fb925923-535e6431-9f8168e4-147b2cf0.jpg,test/p18/p18387472/s59917895/d0636801-fb925923-535e6431-9f8168e4-147b2cf0.jpg,test," FINAL REPORT INDICATION: ___M with cough // infiltrate TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " bb8c753e-6e7361f7-87168bb5-6f866cb9-d688307b.jpg,test/p12/p12483723/s59813227/bb8c753e-6e7361f7-87168bb5-6f866cb9-d688307b.jpg,test," FINAL REPORT INDICATION: ___-year-old man with intermittent shortness of breath and leg edema, rule out CHF. COMPARISONS: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. There is no evidence of pulmonary congestion. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process or evidence of heart failure. " 469ddde9-062d0845-e6547fc5-f690b482-333914a9.jpg,test/p13/p13877204/s51658401/469ddde9-062d0845-e6547fc5-f690b482-333914a9.jpg,test," FINAL REPORT HISTORY: Fever. FINDINGS: In comparison with study of ___, there are again low lung volumes, but no definite evidence of acute focal pneumonia. Monitoring and support devices remain in place. " 3eba82db-7cde40d8-df2bedad-03128b27-d071bc55.jpg,test/p13/p13107111/s55698620/3eba82db-7cde40d8-df2bedad-03128b27-d071bc55.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with h/o diastolic heart failure s/p elective salpingo-oopherectomy c/b intraop hemorrhage with hypoxia // eval for acute process TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiographs from ___, ___, ___ FINDINGS: Increased prominence of main pulmonary artery again seen, concerning for pulmonary hypertension. Lungs are grossly clear but remain low. The heart size is unchanged. Moderate compressive atelectasis is noted. Small bilateral pleural effusions are possible. No pneumothorax. IMPRESSION: 1. Increased prominence of main pulmonary artery, concerning for pulmonary hypertension. As noted previously, a CT Chest could be obtained for further evaluation. 2. Moderate compressive atelectasis and possible small bilateral pleural effusions. " 87d8719b-1e90cfd7-2d49362a-2cca628e-5bbf01f1.jpg,test/p14/p14422845/s59390137/87d8719b-1e90cfd7-2d49362a-2cca628e-5bbf01f1.jpg,test," FINAL REPORT INDICATION: Pulmonary mucormycosis, post right middle lobectomy and upper lobe wedge resection. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: A new air-fluid level within a moderate-sized anterior upper right hemithorax reflects upright positioning of this examination; this collection appears is a right perihilar opacity on recent radiographs, and is roughly similar in size. A persistent loculated fluid collection near the right apex is minimally changed since the most recent ___ radiograph. The left lung remains clear. The heart size is unchanged. An intrathecal line and right IJ central venous catheter are unchanged in position. A subcutaneous surgical drain overlies the right hemithorax. IMPRESSION: Moderate sized loculated collection of gas and fluid within the right anterior hemithorax is more easily demonstrated on this dedicated upright view, and is similar in size in comparison to recent radiographs. A second loculated right apical collection is stable. " 341816b5-a8734cfb-9da4a8c4-61ee6e84-29498e09.jpg,test/p16/p16976120/s55338120/341816b5-a8734cfb-9da4a8c4-61ee6e84-29498e09.jpg,test," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with hypotension and ETOH abuse. Question infection. FINDINGS: Single portable view of the chest is compared to previous exam from ___. The lungs are clear of consolidation or large effusion. There is prominence of the interstitial markings within the infrahilar region on the left which have remained stable dating back to ___ and may be due to scarring. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. TIPS is partially identified in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 87e8222c-5261fd6f-2a4949f3-8135af2b-5475f552.jpg,test/p19/p19185965/s59374648/87e8222c-5261fd6f-2a4949f3-8135af2b-5475f552.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic urothelial cancer to the lungs with worsened hypoxia in the setting of initiating chemotherapy now transferred to the ICU // pulm edema pulm edema COMPARISON: Chest radiographs ___ through ___ at 18:30. IMPRESSION: Moderately severe infiltrative pulmonary abnormality, unchanged since ___, partially obscuring multiple pulmonary metastases comment there is either edema or hemorrhage. Small right pleural effusion there is likely. Heart is normal size. No pneumothorax. " ae54f1c8-c71c4347-2363ae0c-7a52af0c-52b23518.jpg,test/p15/p15255120/s51381824/ae54f1c8-c71c4347-2363ae0c-7a52af0c-52b23518.jpg,test," WET READ: ___ ___ ___ 10:06 PM The heart size is within normal limits. No evidence of pulmonary edema. Lung fields are clear. No pneumothorax or pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p kidney transplant with worsening pulmonary status this afternoon // Assess for effusion, exudate, follow up to chest xray last week showing pleural effusion Assess for effusion, exudate, follow up to chest xray last week showing pleural effusion COMPARISON: Prior chest radiograph ___ through ___. IMPRESSION: Pulmonary edema was moderate and improving on ___. There may be a small residual at the right base and pulmonary vasculature is still engorged, but edema is much improved over the past several days. Moderate cardiomegaly is stable. It was also more pronounced earlier. Pleural effusion if any is small. No pneumothorax. No pulmonary consolidation. " 7fc167b8-69c85f35-bec5788b-c572440e-bf9d02bd.jpg,test/p10/p10413783/s55402082/7fc167b8-69c85f35-bec5788b-c572440e-bf9d02bd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with breakthrough seizure // r/o infx TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. Lungs are hyperinflated, and note is made of a saber sheath configuration of the trachea, findings that can be seen in the setting of COPD. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. Possible COPD. Clinical correlation suggested. " 79c8aed1-e4f1c175-60d1cc57-302ea612-14ad819b.jpg,test/p11/p11778596/s51454316/79c8aed1-e4f1c175-60d1cc57-302ea612-14ad819b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with CKD, h/o pericarditis with chest pressure RECOMMENDATION: One year follow-up mammography is recommended. // eval for effusion, consolidation eval for effusion, consolidation IMPRESSION: Comparisons ___. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " 34fc4469-e3c940f5-681273b0-9605c762-156bb2de.jpg,test/p17/p17477304/s59292553/34fc4469-e3c940f5-681273b0-9605c762-156bb2de.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with dyspnea. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: A portable frontal chest radiograph again demonstrates a normal cardiomediastinal silhouette. The lungs are relatively well aerated, with mild vascular congestion and pulmonary edema which is improved compared to ___. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. Generalized increased density of the osseous structures is compatible with renal osteodystrophy and unchanged dating back to ___. IMPRESSION: No evidence of pneumonia. Mild vascular congestion and pulmonary edema is persistent but improved compared to ___. " acfcf9f5-35b6066b-f2167284-576917cb-9f7ae2c6.jpg,test/p16/p16383099/s58241926/acfcf9f5-35b6066b-f2167284-576917cb-9f7ae2c6.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with a history of asthma, now with cough and back pain at T3-6. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Normal mediastinal and hilar contours. Normal heart size and prominent pericardial fat pads. Normal pleural surfaces and fully expanded, clear lungs. No acute pneumonia, pneumothorax, or pleural effusion. IMPRESSION: No acute pneumonia. " bb2faf21-7fbe3765-307288c8-1c7a45cd-a97c12cc.jpg,test/p18/p18628529/s54767613/bb2faf21-7fbe3765-307288c8-1c7a45cd-a97c12cc.jpg,test," FINAL REPORT HISTORY: Chest pain, dyspnea, sickle cell disease. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Left-sided Port-A-Cath tip terminates within the low SVC. The cardiac, mediastinal and hilar contours are normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There is no pulmonary vascular engorgement. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary process. " 64c67b5c-a70af9cb-39ea2b79-55357679-8dce7ea2.jpg,test/p10/p10716312/s55837453/64c67b5c-a70af9cb-39ea2b79-55357679-8dce7ea2.jpg,test," WET READ: ___ ___ ___ 3:58 PM Bilateral lower lobe pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest (AP and lateral) INDICATION: ___-year-old man with syncope and cough; evaluate for pneumonia. TECHNIQUE: AP and lateral radiograph views of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: New bilateral lower lobe opacities suggest atelectasis vs. pneumonia in the appropriate clinical setting. Otherwise, no significant interval change. Stable top-normal heart size. Stable mediastinal and hila appearance. Unchanged position of the dual lead pacemaker device. No pneumothorax, pleural effusion, or pulmonary edema. IMPRESSION: Bilateral lower lobe opacity concerning for atelectasis vs. pneumonia. " 65d67456-58c734bf-ef24b6f4-9af8cc61-eacc060d.jpg,test/p16/p16700191/s51325054/65d67456-58c734bf-ef24b6f4-9af8cc61-eacc060d.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain and interscapular shoulder pain, cough. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear consolidation or pulmonary vascular congestion. There is no effusion or pneumothorax. Cardiomediastinal silhouette and within normal limits. Atherosclerotic calcifications noted at the aortic arch. Hypertrophic changes in the spine. Surgical clips seen in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 9dad4329-5e7c3998-78bedf87-25ccf9e3-189cfe6d.jpg,test/p18/p18153530/s53078056/9dad4329-5e7c3998-78bedf87-25ccf9e3-189cfe6d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with new RV lead // evaluate for lead placement and pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs through most recent on ___. FINDINGS: A left-sided pacemaker generator with a single lead overlying the right atrium and 2 leads overlying the right ventricle is in appropriate position. The cardiomediastinal and hilar contours are normal. There is no evidence of pneumothorax or pleural effusion. There is no evidence of focal consolidation. There is stable calcification of the aortic arch. IMPRESSION: Pacemaker and leads in appropriate position. No other significant change from the prior study. " eb93c5d3-0a026dbf-cff7914c-a4ab5cc0-c5987d9d.jpg,test/p17/p17170189/s51765372/eb93c5d3-0a026dbf-cff7914c-a4ab5cc0-c5987d9d.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of total colectomy for ulcerative colitis, fevers. COMPARISON: ___. CHEST, PA AND LATERAL: Changes of CABG are noted, with mediastinal clips and sternotomy wires. Pulmonary aeration has improved, with residual mild left lower lobe atelectasis, but no focal consolidation. Heart size is normal. No pleural effusions or pneumothorax. IMPRESSION: CABG changes. No acute cardiopulmonary process. " 5956cfc5-1b380c3c-a16b0da2-c1182809-fffc3216.jpg,test/p16/p16574669/s57182715/5956cfc5-1b380c3c-a16b0da2-c1182809-fffc3216.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old woman with cough, wheeze. Question infiltrate. FINDINGS: PA and lateral views of the chest were compared to previous exam from ___. Low inspiratory volumes seen on the frontal exam. That being said, there is no large confluent consolidation identified nor pleural effusion. Cardiomediastinal silhouette is within normal limits as are the osseous and soft tissue structures. Surgical clips in the right upper quadrant suggest prior cholecystectomy IMPRESSION: No evidence of acute cardiopulmonary process based on low inspiratory effort on the frontal exam. No evidence of large confluent consolidation. " d083cfab-531cc338-b5226724-8d942597-c5e15773.jpg,test/p17/p17534365/s53804852/d083cfab-531cc338-b5226724-8d942597-c5e15773.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: CT torso ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Low lung volumes. Bibasilar atelectasis. Known pulmonary nodule in the left upper lobe is better seen on prior CT from ___. No pleural effusion or pneumothorax is seen. There is a partially visualized biliary stent. IMPRESSION: Bibasilar atelectasis. " cc95ac20-d7fe9a24-afb52084-c9708602-4e85b44b.jpg,test/p15/p15692257/s50716852/cc95ac20-d7fe9a24-afb52084-c9708602-4e85b44b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with malignant melanoma // r/o PNA underyling infection COMPARISON: Chest CT from ___. FINDINGS: PA and lateral views of the chest provided. Lung volumes are low. Allowing for this, no convincing signs of pneumonia or CHF. No large effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Low lung volumes without definite signs of pneumonia or CHF. " 279c05fd-c51cb11d-d57b6362-dca3bac2-649fbf25.jpg,test/p17/p17527875/s54839464/279c05fd-c51cb11d-d57b6362-dca3bac2-649fbf25.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p R VATS wedge resection and CT D/C'd, still lethargic, unable to wean O2 // Please eval for interval change COMPARISON: Radiographs of ___ IMPRESSION: There is no interval change. There is a moderate right-sided pleural effusion with likely right middle lobe atelectasis as well. There is also subsegmental linear atelectasis at the lung bases. There are no pneumothoraces. " 376cb74c-4102cce1-c2c9cf07-91fb0bdb-4811d380.jpg,test/p18/p18718102/s54078645/376cb74c-4102cce1-c2c9cf07-91fb0bdb-4811d380.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new picc, now with CVL pulled. new dyspnea, worse hypoxemia // PICC placement, volume status? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Right PICC tip is in thelower SVC. Cardiac size is top normal. There are low lung volumes. Extensive bilateral opacities larger on the left side are unchanged. There is no pneumothorax or enlarging pleural effusion. " f4bdd6fb-d2db07b7-339f5848-8ec771e4-8e010d59.jpg,test/p15/p15341255/s58109531/f4bdd6fb-d2db07b7-339f5848-8ec771e4-8e010d59.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Legionella PNA, intubated // PNA PNA IMPRESSION: In comparison with the study of ___, there again is extensive opacification in the right hemithorax consistent with the known pneumonia. Monitoring and support devices are unchanged. Cardiac silhouette remains within upper limits of normal and there may be some element of over hydration. The left hemidiaphragm is not sharply seen, raising the possibility of small pleural effusion with underlying compressive atelectasis. " 19227392-f57e561a-6aec57a3-2db741ae-22e6df12.jpg,test/p15/p15442180/s50982619/19227392-f57e561a-6aec57a3-2db741ae-22e6df12.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with h/o intubtaton, PNA, Dohboff, worsened chest pain. // interval change, tube placement. IMPRESSION: In comparison to previous radiograph of ___, a Dobhoff tube has reportedly been replaced, and it courses below the diaphragm with distal tip beyond the field of view. A second portion of the catheter overlies the midline of the chest and is presumably external to the patient. Clinical correlation suggested. No other relevant changes since recent study. " 66efafc1-4fe58606-0756f0ce-dce80e65-b5316919.jpg,test/p11/p11585485/s56139937/66efafc1-4fe58606-0756f0ce-dce80e65-b5316919.jpg,test," FINAL REPORT EXAMINATION: Chest PA and lateral INDICATION: ___ yo man with lymphoma, with h/o pleural effusions s/p pleurodesis, need re-eval of pleural effusion // ___ yo man with lymphoma, with h/o pleural effusions s/p pleurodesis, need re-eval of pleural effusion. Compare to prior TECHNIQUE: Chest PA and lateral COMPARISON: Chest PA and lateral ___. CT chest with contrast ___ FINDINGS: The right pleural effusion with pleural thickening is mildly improved. There has been interval removal of a right pleural catheter.No pneumothorax is seen. Mild cardiomegaly is stable. There is 15 mm rounded opacity overlying the right anterior sixth rib not well visualized on prior chest x-ray or seen on most recent chest CT. A follow-up chest x-ray is recommended at 3 months. If the lesion persists, then chest CT is recommended to further characterize. IMPRESSION: 1. Mildly improved right pleural effusion. 2. There is a 15 mm rounded opacity overlying the right anterior sixth rib. A follow-up chest x-ray is recommended at 3 months. If the lesion persists, then chest CT is recommended to further characterize. RECOMMENDATION(S): There is a 15 mm rounded opacity overlying the right anterior sixth rib. A follow-up chest x-ray is recommended at 3 months. If the lesion persists, then chest CT is recommended to further characterize. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 16:45 into the Department of Radiology critical communications system for direct communication to the referring provider. " 39790325-40ce6edd-0bbc2215-2685f672-6aed7885.jpg,test/p18/p18025486/s52351349/39790325-40ce6edd-0bbc2215-2685f672-6aed7885.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old with history of cough for five days. Evaluate for pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Surgical clips are noted in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 7ba7961b-a727c1e5-5e15cc09-1ba85ddc-6973b135.jpg,test/p16/p16253241/s55461161/7ba7961b-a727c1e5-5e15cc09-1ba85ddc-6973b135.jpg,test," FINAL REPORT INDICATION: ___F with cp // acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " c1f0cf00-94b0101a-aa1c0550-1d0ee81b-b19f7193.jpg,test/p15/p15753793/s51088033/c1f0cf00-94b0101a-aa1c0550-1d0ee81b-b19f7193.jpg,test," FINAL REPORT INDICATION: ___F with lethargy // acute process? TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Lung volumes are relatively low. Left chest wall single lead pacing device obscures visualization of the left lung base. Overall, the appearance of the lungs demonstrates interval improvement. There is persistent abnormal interstitial opacity which suggests mild edema. More dense opacity in the retrocardiac region is again seen. Cardiomediastinal silhouette is stable. IMPRESSION: Slight interval improvement from previous exam from ___ of bilateral interstitial opacities suggesting pulmonary edema. Retrocardiac opacity could be any combination of effusion, atelectasis and/or infection. " caa1467b-d8fa08d2-41464142-349bb4bb-345e8643.jpg,test/p12/p12226373/s56094555/caa1467b-d8fa08d2-41464142-349bb4bb-345e8643.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with recurrent eosinophilic pneumonia in upper lobes. Assess for any regression on prednisone. COMPARISON: ___ to ___. FINDINGS: Biapical opacities, left more than right, has completely resolved. There is no new lung opacification. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: Biapical opacities have completely resolved. There is no new lung consolidation. " f3bf0b72-a86d98c4-8cb9403a-e8d2e63f-1f77885f.jpg,test/p12/p12637238/s51920684/f3bf0b72-a86d98c4-8cb9403a-e8d2e63f-1f77885f.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fevers // Rule out acute process TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiomediastinal silhouette is within normal limits. IMPRESSION: No radiographic evidence of acute cardiopulmonary disease. " e352f72e-69248df7-5d30294c-fe471186-1b05e908.jpg,test/p17/p17465057/s54409529/e352f72e-69248df7-5d30294c-fe471186-1b05e908.jpg,test," FINAL REPORT INDICATION: Immunodeficiency with cough x2 weeks and hypoxia, evaluate for pneumonia. COMPARISONS: ___. PA AND LATERAL VIEWS OF THE CHEST: On the lateral view, an opacification overlies the lower thoracic spine, but is difficult to localize on the frontal projection. Linear opacity near the left lung base likely represents atelectasis. There is a tiny right pleural effusion. Again noted is slight prominence of the central pulmonary arteries, which is unchanged from prior. The heart size is normal. Old right rib fractures are again noted. IMPRESSION: Opacity seen overlying the spine may represent pneumonia in the appropriate clinical setting. It is difficult to localize, as it is not conspicuous on the frontal view, but may be in the right lower lung as seen on previous radiographs. " 53c65ee0-99767e54-512be069-db4be3c4-77faf844.jpg,test/p17/p17850903/s51171376/53c65ee0-99767e54-512be069-db4be3c4-77faf844.jpg,test," FINAL REPORT HISTORY: ___-year-old female with left upper quadrant pain, lethargy COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is persistent flattening and scarring at the left lung base, with postsurgical changes seen status post thoracotomy. No focal consolidation, pleural effusion, evidence of a pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Surgical clips are noted projecting over the left upper quadrant. IMPRESSION: No acute cardiopulmonary process. " b2605609-ec1165d7-a2bbebcb-92d39118-a21e29d3.jpg,test/p14/p14848780/s57714933/b2605609-ec1165d7-a2bbebcb-92d39118-a21e29d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent T tube placement, now with crepitus // r/o free air in mediastinum COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a substantial increase in severity in extent of the known bilateral air collections in the soft tissues, predominating in the cervical regions, both superficially and more centrally. No pneumothorax or new more mediastinum is identified. Unchanged appearance of the lung parenchyma, at slightly higher lung volumes. " b682c26f-4585beb5-ce3062e5-b54b0097-c5080352.jpg,test/p16/p16989439/s50575609/b682c26f-4585beb5-ce3062e5-b54b0097-c5080352.jpg,test," WET READ: ___ ___ ___ 2:18 PM 1. Faint posterior costophrenic sulcus of airspace opacity may represent very early pneumonia or atelectasis depending on the clinical setting. No other acute cardiopulmonary process. 2. Hyperexpansion suggesting emphysema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with shortness breath, evaluate for pneumonia. TECHNIQUE: Chest AP and lateral COMPARISON: None. Please note that comparison to old studies can be helpful to detect subtle interval change. FINDINGS: Mild hyperexpansion suggests emphysema. Faint airspace opacity in the posterior costophrenic sulcus may represent very early pneumonia or atelectasis depending on the clinical setting. There is no pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is normal. Right hemidiaphragm eventration is incidentally noted. IMPRESSION: 1. Faint posterior costophrenic sulcus of airspace opacity may represent very early pneumonia or atelectasis depending on the clinical setting. No other acute cardiopulmonary process. 2. Hyperexpansion suggesting emphysema. " 707eed57-c2da2d7e-1ba7e407-b3432ff0-a8db59d1.jpg,test/p16/p16736626/s57322298/707eed57-c2da2d7e-1ba7e407-b3432ff0-a8db59d1.jpg,test," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: The right-sided PICC line has been repositioned and the tip is now in the mid SVC. There continues to be cutaneous emphysema bilaterally, but no pneumothorax is identified. There is volume loss in the left lower lobe. Small retrocardiac infiltrate cannot be excluded. Sternal wires and valve replacement are unchanged. " 50ea0803-d3a44a0f-3a2b4d09-b548d47b-a0e81c90.jpg,test/p14/p14880886/s50743847/50ea0803-d3a44a0f-3a2b4d09-b548d47b-a0e81c90.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Left rib pain for 2 weeks after fall. Now with recurrence of pain after bending at work. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. No overt traumatic abnormality. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. No overt traumatic abnormality. " da31c092-366c5d64-14981fe6-1edbdb9e-f7bd668b.jpg,test/p10/p10940805/s58397286/da31c092-366c5d64-14981fe6-1edbdb9e-f7bd668b.jpg,test," FINAL REPORT INDICATION: History: ___F HD patient with shortness of breath // edmea? COMPARISON: ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Lung volumes are low, exaggerating moderate cardiomegaly and the vascular pedicle. Mildly increased diffuse interstitial markings are consistent with mild pulmonary edema. There are probable small bilateral pleural effusions with adjacent atelectasis. No pneumothorax. IMPRESSION: Moderate cardiomegaly with mild interstitial edema and probable small pleural effusions. " edb6a902-717a8d84-6f1f0dda-55d55d5b-9049f48b.jpg,test/p12/p12043836/s59855567/edb6a902-717a8d84-6f1f0dda-55d55d5b-9049f48b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M ESRD on HD MWF, multiple failed transplants, MRSA endocarditis, mech MR with new 4+ MR (?clotted off or endocarditis). // interval change interval change COMPARISON: Comparison to ___ at 21:28 FINDINGS: Portable semi-erect chest film ___ at 03:53 is submitted. IMPRESSION: The right-sided chest tubes remain in place. There is stable scarring and volume loss within the right hemithorax with no obvious residual basilar right hydropneumothorax appreciated. No pulmonary edema. Streaky opacity at the left base likely reflects scarring or subsegmental atelectasis. Stable cardiac enlargement status post median sternotomy with valve replacement. " 5f9cb1d6-6b17929e-5e1d1f8c-20ae80b8-028869bf.jpg,test/p18/p18616499/s52425461/5f9cb1d6-6b17929e-5e1d1f8c-20ae80b8-028869bf.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Hemoptysis, assess for acute intrathoracic process. FINDINGS: PA and lateral views of the chest provided demonstrate AICD device in the left chest wall with lead tips extending into the expected location of the right atrium and right ventricle. Lungs appear clear aside from mild opacity in the posterior costophrenic recess which could represent small effusion. The cardiomediastinal silhouette appears grossly unremarkable. There is mild hilar congestion which could indicate mild edema. Bony structures intact. IMPRESSION: Mild pulmonary vascular congestion and small bilateral pleural effusions. " 1dea55fd-c82f6009-9b3bb68a-55b81282-1aba3782.jpg,test/p15/p15844438/s52471875/1dea55fd-c82f6009-9b3bb68a-55b81282-1aba3782.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Patient with esophageal tear with the patient on G tube, now with bile preparation of colonoscopy, status post ex lap sigmoid colectomy and colostomy. For evaluation. TECHNIQUE: Portable AP radiograph was obtained. COMPARISON: ___. Current radiograph is dated ___, timed at 5:54 a.m. REPORT: A right-sided subclavian line lies in unchanged position. The ET tube lies pretty close to the carina and should be retracted 3-4 cm. It is in overall relatively unchanged position; however, from prior study. There is tracheobronchial and aortic calcification. Again identified are low lung volumes. There are some bibasilar pleural effusions with worsening interstitial pulmonary edema. The left-sided pleural reaction appears to have lessened somewhat, however. CONCLUSION: Probably worsening pulmonary edema. The ET tube is hovering just above the carina and should be retracted 2 cm. This was telephoned to and discussed with ___ at the time of reporting. " 4f3a6e7d-b40a83a1-7b06a3e3-f28c05d3-849dc63c.jpg,test/p17/p17340385/s51099478/4f3a6e7d-b40a83a1-7b06a3e3-f28c05d3-849dc63c.jpg,test," FINAL REPORT INDICATION: ___ year old man with MI // pulm edema, pna? FINDINGS: As compared to ___, lung volumes remain low. No consolidation, pneumothorax or pleural effusion. The cardiomediastinal contours unremarkable. IMPRESSION: No acute cardiopulmonary process. " bd711768-6e80e73a-6b20667b-53271411-3d13507f.jpg,test/p12/p12183689/s50816619/bd711768-6e80e73a-6b20667b-53271411-3d13507f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with stroke and new left internal jugular line. AP radiograph of the chest was reviewed with comparison to ___. The ET tube tip is 4.2 cm above the carina. The NG tube tip is in the stomach. The right internal jugular line tip is at the level of cavoatrial junction. The left subclavian line tip is at the level of mid SVC. Bilateral right more than left pleural effusions are noted, unchanged, most likely small. " 1f98ee7e-3dc825a8-82fac7df-b8734a07-e749e6d6.jpg,test/p15/p15541055/s50544483/1f98ee7e-3dc825a8-82fac7df-b8734a07-e749e6d6.jpg,test," FINAL ADDENDUM ADDENDUM Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state confusion. ______________________________________________________________________________ WET READ: ___ ___ ___ 2:07 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with MVC // r/o trauma TECHNIQUE: Portable supine chest radiograph. COMPARISON: None. FINDINGS: Lungs are well-expanded and clear. Cardiomediastinal hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures identified. IMPRESSION: No acute cardiopulmonary process. Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referrable focal findings should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning. " 30aa221b-ae6512b8-5a6db6df-10a91b6f-9648bd21.jpg,test/p13/p13894338/s55206724/30aa221b-ae6512b8-5a6db6df-10a91b6f-9648bd21.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p tracheobronchoplasty // perform at 5:30am on ___. r/o interval change perform at 5:30am on ___. r/o interval change IMPRESSION: Compared to prior chest radiographs, ___ through ___. Small bilateral pleural effusions unchanged. Minimal collection of air at the apex of the right hemi thorax is been present for several days, not clinically significant. Lungs are well expanded. Cardiomediastinal silhouette has a normal postoperative appearance. " 43acf525-c5c02f3b-24e3cd8b-58895ed3-6fe6228f.jpg,test/p16/p16183583/s55051795/43acf525-c5c02f3b-24e3cd8b-58895ed3-6fe6228f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F p/w respiratory failure, found to have diffuse nodular densities, s/p L lung VATS biopsy // Interval assesment ; ___ year old woman with hypoxemic respiratory failure, s/p VATS ___ with L chest tube // eval post op change following VATS wedge resection TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: ___. FINDINGS: The radiograph time stamped 21:46 shows a low-lying endotracheal tube which enters the right mainstem bronchus. The left PICC line terminates in the right atrium. Withdrawal by 3 cm would position its tip near the cavoatrial junction. A left apical chest tube remains in place. Lung volumes are low. There is no pneumothorax. Worsening bilateral airspace and interstitial opacities are most likely due to worsening pulmonary edema. There is no pleural effusion. Mild cardiomegaly despite the projection is unchanged. The followup radiograph time stamped 22:49 shows interval repositioning of the ET tube, which now terminates in the mid trachea. There is also a new tiny left apical pneumothorax with a left apical chest tube in place. The left PICC line has been slightly withdrawn, but still enters the upper right atrium. Withdrawal by 2 cm would position its tip at the cavoatrial junction. No other relevant change. The most recent radiograph of 03:57 hrs shows a slight change in the position of the left PICC line, which just barely enters the right atrium. Withdrawal by 1-2 cm with position its tip in the low SVC. There is no definite pneumothorax. Bandlike opacities at both lung bases are likely due to atelectasis. Mild pulmonary edema has slightly improved. A persistent retrocardiac airspace opacity may be due to atelectasis or aspiration. IMPRESSION: Previously low lying ET tube entering the right mainstem bronchus now terminates in the mid trachea. Slightly low lying left PICC line terminates in the upper right atrium. Withdrawal by 1-2 cm would position its tip at the superior cavoatrial junction. Tiny left apical pneumothorax not seen on the most recent exam. Improved mild pulmonary edema, right basilar subsegmental atelectasis, and a left basilar airspace opacity which may be due to atelectasis or aspiration. NOTIFICATION: The covering clinician could not be immediately reached by telephone, therefore the impression and recommendation above was entered by Dr. ___ on ___ at 10:06 into the Department of Radiology critical communications system for direct communication to the referring provider. " f9352023-b463a2f9-7cd6c601-f3ecdde3-77af29e5.jpg,test/p19/p19004951/s57453951/f9352023-b463a2f9-7cd6c601-f3ecdde3-77af29e5.jpg,test," FINAL REPORT INDICATION: Fever. Evaluate for ""cpd"", infiltrate. COMPARISON: None. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. There is slight indentation of the left side of the trachea. IMPRESSION: 1. No evidence of acute cardiopulmonary abnormality. 2. Indentation of the left side of the trachea possibly from thyroid enlargement. Please correlate with physical exam. Updated results were telephoned to Dr. ___ by ___ at 8:10 am, ___, 10 minutes after discovery. " 1dd89a33-2b06ed45-f61b5762-6dfd9b90-ef87ee9e.jpg,test/p12/p12390274/s52344934/1dd89a33-2b06ed45-f61b5762-6dfd9b90-ef87ee9e.jpg,test," FINAL REPORT INDICATION: ___-year-old female with intermittent chest pain since ___, evaluate for acute process. COMPARISON: Chest x-ray of ___. TECHNIQUE: AP and lateral views of the chest. FINDINGS: Mild-to-moderate cardiomegaly is unchanged. The tortuous aorta is unchanged. There is no focal consolidation. There is no pleural effusion or pneumothorax. There is mild pulmonary vascular congestion. IMPRESSION: Mild-to-moderate cardiomegaly and mild pulmonary vascular congestion. No focal consolidation. " b24fa87b-e83a08fb-e59df77a-0423dd0d-27b2984f.jpg,test/p14/p14972005/s56426840/b24fa87b-e83a08fb-e59df77a-0423dd0d-27b2984f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CL on TKI therapy. Had pleural effusion. FOllow up xray. // Follow up pleural effusions. On TKI therapy for CML dx. COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided.Patient is status post median sternotomy. Lungs are grossly clear. No pneumothorax. Minimal right pleural effusion is unchanged from ___. Hilar contours are normal. The aorta is mildly tortuous and there is mild cardiomegaly. IMPRESSION: Minimal right pleural effusion is unchanged from ___. Otherwise, no evidence of acute cardiopulmonary process. NOTIFICATION: The findings were discussed by Dr. ___ with NP ___ on the telephone on ___ at 11:28 AM, 20 minutes after discovery of the findings. " 57f33bd5-795a5828-15b6cc36-5b8dab96-1dbeb7f6.jpg,test/p13/p13417577/s51558745/57f33bd5-795a5828-15b6cc36-5b8dab96-1dbeb7f6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with possible pneumothorax // ?pneumo COMPARISON: Chest radiographs ___ IMPRESSION: Loculated left apical hydro pneumothorax may be filling with fluid and the overall volume of the pleural loculation and post bullae chin changes involving the left upper lobe mass have not changed of the several days. Consolidation at the base of the right lung could be atelectasis alone, but is concerning for pneumonia. Small right pleural effusion accompanies it. Heart is top-normal size. Left lower lung is grossly clear. " 83ae53cf-699772cc-098c0944-8158c387-3ad36ebf.jpg,test/p10/p10679975/s55558674/83ae53cf-699772cc-098c0944-8158c387-3ad36ebf.jpg,test," FINAL REPORT INDICATION: Cough, evaluate for pneumonia. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. Lungs are clear. Small hiatal hernia identified. There is exaggerated kyphosis of the lower thoracic spine without significant vertebral compression deformity. IMPRESSION: Small hiatal hernia, unchanged since ___. Correlate with symptoms of reflux. Exaggerated kyphosis of the thoracic spine without compression deformity. " c2c5e48b-110820f7-05a8e580-1c3904f9-17d6c144.jpg,test/p15/p15481731/s53188204/c2c5e48b-110820f7-05a8e580-1c3904f9-17d6c144.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with VAP/aspiration PNA. // Comparison to previous Comparison to previous COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Patient has been extubated. There has been a appreciable decrease in pulmonary hyperinflation, probably due to COPD. Biapical consolidation and mild interstitial abnormality elsewhere are unchanged. Heart size normal. Pleural effusions are small if any. No pneumothorax. Left PIC line ends in the low SVC. " 5e9f2abb-09f34f92-08a69b7a-e08e4917-44c5a7d4.jpg,test/p13/p13350579/s55118132/5e9f2abb-09f34f92-08a69b7a-e08e4917-44c5a7d4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, bronchomalacia, status post right main stem bronchus stent. Evaluation for resolution of right lower lobe pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing right lower lobe pneumonia has almost completely resolved. Resolution is more impressive on the lateral than on the frontal radiograph. However, at the right anterior lung bases, areas of scarring and pleural thickening persist. The left lung is better inflated than on the previous examination. The right PICC line has been removed. Status after right adenocarcinoma and subsequent surgery. Unchanged size of the cardiac silhouette. " 8b5ff630-e29f0f0b-5d9719e2-00479d7b-1e903449.jpg,test/p17/p17958052/s52190647/8b5ff630-e29f0f0b-5d9719e2-00479d7b-1e903449.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with recent aortic valve replacement who is now presenting with several days of worsening DOE and orthopnea. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is difficult to assess given the presence of small bilateral pleural effusions, left greater than right. The pleural effusion on the left appears slightly increased in size while the effusion on the right is unchanged. Mediastinal contour is unchanged with mild atherosclerotic calcification noted at the aortic knob. Prosthetic aortic valve is again demonstrated. The pulmonary vasculature is normal. There is compressive atelectasis at the lung bases. No pneumothorax is detected. No acute osseous abnormality is identified. IMPRESSION: Small bilateral pleural effusions, increased in size on the left, and unchanged in size of the right with associated compressive bibasilar atelectasis. " e5c3ee8f-55970921-b111fa13-27f6ee76-eff18ec0.jpg,test/p18/p18628529/s57526947/e5c3ee8f-55970921-b111fa13-27f6ee76-eff18ec0.jpg,test," FINAL REPORT HISTORY: ___-year-old male with sickle cell crisis and chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Left chest wall port is seen with catheter tip at the RA SVC junction. Linear opacity at the right lung base only on the frontal exam is more conspicuous than on prior and is thought to be due to atelectasis. There is no large confluent consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No definite acute cardiopulmonary process. " ded4e309-4efecc73-c23ccb27-1242bb40-bee14732.jpg,test/p18/p18156009/s59834260/ded4e309-4efecc73-c23ccb27-1242bb40-bee14732.jpg,test," FINAL ADDENDUM ADDENDUM There is bilateral pneumonia. The previous report contents typo. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD exacerbation, prior xray w concern for concurrent PNA vs atelectasis // repeat assessment to attempt better characterization if PNA is present repeat assessment to attempt better characterization if PNA is present IMPRESSION: Comparison to ___. Better visualized than on the previous examination are bilateral basal parenchymal opacities with air bronchograms, likely reflecting pneumonia in the appropriate clinical setting. The lateral radiograph also shows mild pleural effusions. No pneumonia, no pulmonary edema. Signs of overinflation persists. " 7afedeb8-8e62e4f6-4a33c6b1-b225dc28-735387d8.jpg,test/p12/p12397992/s58635989/7afedeb8-8e62e4f6-4a33c6b1-b225dc28-735387d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new Dobhoff tube. // Please evaluate Dobhoff placement. TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: None IMPRESSION: Dobbhoff tube tip is in the stomach. Heart size and mediastinum unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. " e7f70f26-1ef466ea-152788be-c0140c22-f41da51a.jpg,test/p18/p18458646/s59236224/e7f70f26-1ef466ea-152788be-c0140c22-f41da51a.jpg,test," FINAL REPORT INDICATION: History: ___M with CLL and weakness, hx of CHF and ostomy s/p SBO pls eval cxr for pna and edema. TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs dated back to ___ FINDINGS: Top-normal heart size is stable compared to the prior exams dated back to ___. The the aorta is tortuous, otherwise the hilar and mediastinal contours are unremarkable. Note is made of mild bibasilar atelectasis. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No acute intrathoracic abnormalities identified. Mild bibasilar atelectasis. " 318f8f59-252e3402-116b4143-b598a70e-d9970377.jpg,test/p14/p14566443/s57558604/318f8f59-252e3402-116b4143-b598a70e-d9970377.jpg,test," WET READ: ___ ___ ___ 7:10 PM The left chest tube, mediastinal drain, and right IJ catheter have been removed. The tiny left apical pneumothorax appears unchanged, and is harder to appreciate on this exam. Unchanged bilateral pleural effusions and bibasilar consolidations. Stable mild vascular congestion. Unchanged cardiomedistinal silhouette. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: CT chest tube removal, to assess for pneumothorax. FINDINGS: In comparison with the study of ___, the monitoring and support devices have been removed. There again may be a tiny apical pneumothorax on the left. The appearance of the heart and lungs is otherwise essentially unchanged. " c9522e40-87b4b450-94dd9681-bd30f119-288b54f7.jpg,test/p14/p14065397/s56319910/c9522e40-87b4b450-94dd9681-bd30f119-288b54f7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Parkinsons and sepsis s/p Dobhoff placement // Staged Dobhoff placement TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Sequential chest radiographs demonstrate advancement of the nasogastric tube into the distal esophagus with some coiling in the back of the throat. Again there is a mild-to-moderate vascular congestion in a patient with intact midline sutures and prosthetic right shoulder. There is no focal consolidation, effusion, or pneumothorax. Cardiomediastinal contours are stable. IMPRESSION: Nasogastric tube with tip terminating in the distal esophagus. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 4:15 PM, 3 minutes after discovery of the findings. " a0d0923b-aea4de43-be3f6dd2-353bcf9e-9d19aa81.jpg,test/p15/p15831124/s57943680/a0d0923b-aea4de43-be3f6dd2-353bcf9e-9d19aa81.jpg,test," WET READ: ___ ___ ___ 8:54 AM Complete opacification of left hemithorax with ipsilateral shift of the mediastinum, consistent with complete lung collapse is unchanged compared to the prior exam. There has been a slight interval increase in the layering right pleural effusion, as well as increased subtle opacification of the right lung base likely secondary to atelectasis. WET READ VERSION #1 ___ ___ ___ 8:22 PM Complete opacification of left hemithorax with ipsilateral shift of the mediastinum, consistent with complete lung collapse is unchanged compared to the prior exam. There has been a slight interval increase in the layering right pleural effusion, as well as increased subtle opacification of the right lung base likely secondary to atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with multiple abd surg and septic shock. underwent bronch today // s/p bronchoscopy COMPARISON: Chest radiographs ___ through ___ at 10:27, read in conjunction with chest CT on ___. IMPRESSION: Left lung collapse unchanged since earlier in the day, has progressed since left lower lobe collapse on ___, is responsible for complete opacification of the left hemi thorax obscuring any left pleural effusion, and severe leftward mediastinal shift. The right lung is well-aerated. Early interstitial edema may be present. Tracheostomy tube, upper esophageal drainage tube, and right subclavian catheter are in standard placements respectively. There is no pneumothorax. " a81c2754-b1525b6c-4dc41c7d-63e5e810-55854639.jpg,test/p14/p14642407/s51730690/a81c2754-b1525b6c-4dc41c7d-63e5e810-55854639.jpg,test," FINAL REPORT HISTORY: ___-year-old female with cough, recent travel, night sweats with shortness of breath and pleuritic chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. Mild height loss of a lower thoracic vertebral body is again noted. IMPRESSION: No acute cardiopulmonary process. " e42b4605-f902c4ae-7379b10b-bb8897a0-0a74f22a.jpg,test/p15/p15793456/s58666598/e42b4605-f902c4ae-7379b10b-bb8897a0-0a74f22a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hx asthma and pneumonia with several days of productive cough and decrease breath sounds on left. // RO infiltrate on left RO infiltrate on left IMPRESSION: In comparison with the study of ___, there is again substantial hyperexpansion of the lungs consistent with chronic pulmonary disease. There is increased prominence of the hila, which appears to represent vascular structures and raises the possibility of pulmonary artery hypertension. No evidence of acute pneumonia or vascular congestion. " e674ff7d-a23d841d-5ca68774-e5a5a50d-1644af00.jpg,test/p13/p13790721/s58632473/e674ff7d-a23d841d-5ca68774-e5a5a50d-1644af00.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chest pain after fall // ?rib fracture/abnormality COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process " 02d4ff73-7939be60-c4b50709-162af513-97a11918.jpg,test/p15/p15367414/s53982860/02d4ff73-7939be60-c4b50709-162af513-97a11918.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with s/p CABG- increasing SOB with leukocytosis // evaluate for infiltrate/acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiographs from ___. FINDINGS: There is new minimal, linear right basal opacity, likely atelectasis. Left lingular atelectasis is minimal. Otherwise, the lungs are clear. Moderate cardiomediastinal silhouette has decreased since postop, and has appropriate postop appearance. There is no pleural effusion, pulmonary edema or pneumothorax. Median sternotomy wires are aligned and intact. Left-sided single chamber pacemaker is unchanged in position. IMPRESSION: New minimal, linear right basal atelectasis. No pneumonia. " 6aa21df4-3384beaf-1490e25a-fa73e87d-3fd44e76.jpg,test/p18/p18679861/s54845509/6aa21df4-3384beaf-1490e25a-fa73e87d-3fd44e76.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Shortness of breath and cough. COMPARISON: Chest radiographs from ___ and more recent CT of the chest dated ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. Nipple shadows are visible bilaterally. Elsewhere, the lungs fields appear clear. The chest is mildly hyperinflated. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute disease. Mild hyperinflation. " a1e16264-b74d9cce-20a2d651-2d74afa9-fa753ee0.jpg,test/p10/p10161042/s54453880/a1e16264-b74d9cce-20a2d651-2d74afa9-fa753ee0.jpg,test," FINAL REPORT HISTORY: COPD with hypertensive emergency. FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices are unchanged. Again there are relatively low lung volumes. Bibasilar opacifications suggest effusions and compressive atelectasis. No definite vascular congestion or pneumothorax. " 32eb577e-0f0e67d7-6b3b9801-62094b0b-8cb597e3.jpg,test/p11/p11214611/s57848134/32eb577e-0f0e67d7-6b3b9801-62094b0b-8cb597e3.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Esophageal cancer As compared to the previous radiograph, the patient continues to carry the left and the right chest tube. A minimal left apical pneumothorax is now visible. Unchanged subdiaphragmatic air on the right. The monitoring and support devices are constant. The neoesophagus is of unchanged appearance. Unchanged size of the cardiac silhouette. " 2b74a297-7b5410b9-ffc1a4be-247fe1c6-31708f18.jpg,test/p13/p13961236/s57121381/2b74a297-7b5410b9-ffc1a4be-247fe1c6-31708f18.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pacemaker placement, to assess for the lead position. TECHNIQUE: PA and lateral chest views were reviewed and read in comparison with the prior radiograph from ___. FINDINGS: Patient has received a new left pectoral pacemaker with a single lead ending into the right ventricle. There is no pneumothorax. Mildly elevated left hemidiaphragm is mostly secondary to gas-distended bowel. Pleural effusion if any is small on the left side. Since ___, moderately severe pulmonary edema has completely resolved. There is no pleural effusion on the right side. No discrete lung opacities of concern. Mild to moderately enlarged heart is stable. The thoracic aorta is moderately calcified and tortuous. " b99d1e7a-cdf7282d-593b0d7a-49f004a2-4d87c664.jpg,test/p14/p14017669/s53442199/b99d1e7a-cdf7282d-593b0d7a-49f004a2-4d87c664.jpg,test," WET READ: ___ ___ ___ 3:55 PM No definite acute cardiopulmonary process. Nodular opacity projecting over the right mid lung for which dedicated PA and lateral suggested. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST: ___ HISTORY: Right-sided chest pain. FINDINGS: Single portable view of the chest. There is a rounded opacity projecting in the right midlung. Elsewhere, the lungs are clear. There is no visualized pneumothorax. The cardiomediastinal silhouette is within normal limits. Osseous structures are grossly unremarkable. IMPRESSION: No definite acute cardiopulmonary process. Nodular opacity projecting over the right mid lung for which dedicated PA and lateral suggested. " dd0a63e7-8114d9a0-d4124f60-98cb594f-845b1093.jpg,test/p14/p14692525/s57009664/dd0a63e7-8114d9a0-d4124f60-98cb594f-845b1093.jpg,test," WET READ: ___ ___ ___ 5:51 PM Subtle retrocardiac opacity on the lateral projection only raising concern for an early pneumonia in the right or left lower lobe. Please correlate clinically. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with c/o CP with palpitations // ? PNA COMPARISON: No priors FINDINGS: PA and lateral views of the chest provided. Lung volumes are low limiting assessment. There is an apparent retrocardiac opacity on the lateral projection which obscures the posterior heart border raising potential concern for an early pneumonia in the right or left lower lobe though not clearly visualized on the frontal view. No large effusion or pneumothorax. No convincing signs of edema. The cardiomediastinal silhouette appears within normal limits. Bony structures are intact. IMPRESSION: Subtle retrocardiac opacity on the lateral projection only raising concern for an early pneumonia in the right or left lower lobe. Please correlate clinically. " 2444cd8d-db6f81df-a88fe8bb-2eeeb831-bfa4df20.jpg,test/p10/p10597404/s58236201/2444cd8d-db6f81df-a88fe8bb-2eeeb831-bfa4df20.jpg,test," FINAL REPORT HISTORY: Cough for a few weeks. Evaluate for infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate hyperinflated lungs with flattened diaphragms and vascular deficiency at the apices, consistent with chronic lung disease. A small hiatal hernia is again noted. No acute consolidation is seen. No pleural effusion or pneumothorax is detected. The cardiomediastinal contours are normal. IMPRESSION: No pneumonia. " d5bf3048-7bd07f12-81cb987f-7eafeac0-31b40795.jpg,test/p14/p14962643/s54663175/d5bf3048-7bd07f12-81cb987f-7eafeac0-31b40795.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears normal. The imaged osseous structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " cc3c2a6b-98ab1798-11bfce41-bd83d680-e2ef86f8.jpg,test/p18/p18944791/s58703753/cc3c2a6b-98ab1798-11bfce41-bd83d680-e2ef86f8.jpg,test," FINAL REPORT HISTORY: ___ years old man with substance ingestion, intubated. INDICATION: New consolidation? TECHNIQUE: Portable AP single view chest x-ray in semi-upright position. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: The ET tube ends at 5 cm from carina. The NG tube is below the diaphragm with side wall in proximal gastric cavity and tip not visualized. The lung volumes are lower with consolidation of the right middle and right lower lobe suspicious for pneumonia. Left lung is clear. Cardiomediastinal silhouette is normal with mild vascular congestion. IMPRESSION: New right base consolidation suspicious for pneumonia but without pleural effusion. Mild vascular congestion. " 3803a86d-29238665-9fb7a070-2d73e8b7-32f53149.jpg,test/p13/p13807999/s56043234/3803a86d-29238665-9fb7a070-2d73e8b7-32f53149.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with cough, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " f5d820d4-4f13a380-49437b7d-3d2a7ea4-6c514dbc.jpg,test/p16/p16251651/s57531985/f5d820d4-4f13a380-49437b7d-3d2a7ea4-6c514dbc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with R chest pain s/p MVC days prior. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No displaced rib fracture is seen. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. No displaced rib fracture. If there is further concern dedicated rib series may be performed to further assess. " d83b33ca-31ba46f0-84cc5758-db01ccee-533254ec.jpg,test/p19/p19441625/s55013418/d83b33ca-31ba46f0-84cc5758-db01ccee-533254ec.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with sob; hx of pna, feels like same COMPARISON: Prior exam dated ___. FINDINGS: AP upright and lateral views of the chest provided. Hazy consolidation is seen within the right lower lung which is concerning for pneumonia. Mild left mid and lower lung atelectasis is present. The upper lungs appear relatively well aerated. The hila are slightly prominent which could reflect reactive nodal prominence. Cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Findings concerning for right lower lung pneumonia. " a9ed2f53-346c7556-7cf19ec1-1480938b-34c368db.jpg,test/p17/p17535980/s57613920/a9ed2f53-346c7556-7cf19ec1-1480938b-34c368db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever, altered mental status, cough. TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Study is slightly limited due to patient rotation. Lung volumes are low. Cardiac and mediastinal contours are unchanged. Crowding of bronchovascular structures is likely due to low lung volumes. There is minimal atelectasis at the lung bases without focal consolidation. No pleural effusion or pneumothorax is seen. Rightward deviation of the trachea is re- demonstrated and due to a left-sided thyroid nodule. Multilevel degenerative changes are seen in the thoracic spine. IMPRESSION: Low lung volumes with bibasilar atelectasis. " e1365a76-6c8698ef-d83968ae-1555c0a3-73160d41.jpg,test/p13/p13462383/s59081481/e1365a76-6c8698ef-d83968ae-1555c0a3-73160d41.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with substernal chest tightness. Evaluate for pneumonia, fracture, mediastinal widening. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded. No focal consolidation, edema, effusion, or pneumothorax. The heart is normal in size. The mediastinum is not widened. No hilar lymphadenopathy. No acute osseous abnormality. There may be an 8 mm pulmonary nodule projecting between the fifth and sixth left posterior rib space versus is a but did not from overlying clothing. IMPRESSION: 1. No focal pneumonia or mediastinal widening. 2. No evidence of fracture. Please note that this exam is not dedicated for evaluation of bony structures. If there is clinical concern for sternal fracture or rib fractures, dedicated bone radiographs corresponding to focal exam findings is recommended. 3. 8-mm possible pulmonary nodule between the left fifth and sixth posterior ribs could be a clothing artifact. RECOMMENDATION(S): Return for repeat chest radiograph with overlying clothing removed. Referring physician should request that the image be shown to radiologist before the patient leaves the radiology department. " ad29c401-06048ed3-e97d38de-e52c94f6-3c273f1d.jpg,test/p10/p10249554/s55477057/ad29c401-06048ed3-e97d38de-e52c94f6-3c273f1d.jpg,test," FINAL ADDENDUM ADDENDUM: The indication for the examination should state ""Baseline chest radiograph for employment purposes"". The patient did not have a positive PPD test. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Positive PPD. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " bdfdbe78-8678a951-409f3706-b464d737-c2f88c31.jpg,test/p16/p16805727/s54214493/bdfdbe78-8678a951-409f3706-b464d737-c2f88c31.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o MI ___, VT ___, Lad + Lcx stents ___, EF ___%. Riata lead explanted ___. // Pt is S/p ICD implant with new RV lead ___, today increased lead threshold please lead position for possible lodgement. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Both pacemaker leads are intact and both tips appear to be positioned in the right ventricle. No pneumothorax. Borderline size of the cardiac silhouette. No pulmonary edema. No pleural effusion. " f4d45fdc-800b8873-ebe1193c-07d3b10e-5ba5afe3.jpg,test/p16/p16771184/s59260571/f4d45fdc-800b8873-ebe1193c-07d3b10e-5ba5afe3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with myalgias and fevers // ?infection TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lung volumes are slightly low. No focal areas of consolidation are identified to suggest the presence of pneumonia. . No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 57836083-e95db382-27dd34a2-df79474a-3cbbce86.jpg,test/p10/p10963981/s58194755/57836083-e95db382-27dd34a2-df79474a-3cbbce86.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute anemia, s/p multiple fluid boluses and transfusions, now tachypnic // eval for pulm edema or other cause of tachypnea eval for pulm edema or other cause of tachypnea IMPRESSION: Compared to chest radiographs since ___, most recently ___. Right hemidiaphragm is chronically elevated, probably responsible for right basal atelectasis. Mild pulmonary vascular engorgement is chronic, and although there is probably no pulmonary edema. Moderate cardiomegaly has increased over the past 2 days. Pleural effusions small if any. No pneumothorax. Transesophageal drainage tube passes into the stomach and out of view. " 17632744-5671149c-0c5fb6a1-2a2117a4-fdb5124f.jpg,test/p19/p19217413/s50641782/17632744-5671149c-0c5fb6a1-2a2117a4-fdb5124f.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain // ?pna TECHNIQUE: Chest PA and lateral COMPARISON: Available. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded lungs. Linear atelectasis is seen in the left base. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: Linear atelectasis at the left base. " f396a2ac-3e8ccf76-c1471d52-6bff1127-e36f1227.jpg,test/p10/p10466068/s52305562/f396a2ac-3e8ccf76-c1471d52-6bff1127-e36f1227.jpg,test," FINAL REPORT INDICATION: History: ___F with congested cough > 1 week with low grade fevers // ? infiltrate COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: There is small area of patchy density in the right lower lobe. There is no pneumothorax or effusion. There is cardiomegaly, but there is no CHF. There is incomplete fusion of the left midclavicular fracture. Degenerative changes are present in both shoulders and the spine. " 2f6dd303-6b446845-df6d62f8-580fe3aa-a1b99ec2.jpg,test/p15/p15613908/s52307949/2f6dd303-6b446845-df6d62f8-580fe3aa-a1b99ec2.jpg,test," WET READ: ___ ___ ___ 10:48 AM Increased interstitial markings throughout the lungs with superimposed bibasilar opacities. Findings could be due to chronic underlying interstitial process with superimposed infection and/or atelectasis. Chronic deformity of the proximal right humerus with right glenohumeral joint dislocation. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with altered mental status and cough // ?pneumonia TECHNIQUE: AP and lateral views the chest. COMPARISON: Portable chest x-ray from ___ at 06:38. FINDINGS: Increased interstitial markings are seen throughout the lungs bilaterally. More confluent opacity at the left lung base is less conspicuous when care compared to prior but persists. There is also patchy opacity at the right lung base as well. Small bilateral pleural effusions are noted. The cardiomediastinal silhouette is within normal limits. Deformities of the right ribs suggest prior fractures. There is also deformity of the proximal right humerus and dislocation of the glenohumeral joint which is age indeterminate. IMPRESSION: Increased interstitial markings throughout the lungs with superimposed bibasilar opacities. Findings could be due to chronic underlying interstitial process with superimposed infection and/or atelectasis. Chronic deformity of the proximal right humerus with right glenohumeral joint dislocation. " ef50a458-72a6d811-424c76ac-25320ba3-ce74da1c.jpg,test/p12/p12043836/s54631370/ef50a458-72a6d811-424c76ac-25320ba3-ce74da1c.jpg,test," FINAL REPORT INDICATION: Staph bacteremia. Evaluate for infiltrate, signs of viral pneumonia. COMPARISON: ___. IMPRESSION: Severely enlarged cardiac silhouette is not significantly changed from prior. However, there is increase in right pleural effusion and increase in moderate pulmonary edema. Linear opacity in the right mid lung is unchanged dating back to ___ compatible with atelectasis. No left pleural effusion or pneumothorax is present. IMPRESSION: Stable severe cardiomegaly with new pulmonary edema and increasing right pleural effusion. No evidence of pneumonia. " b827b7cd-aca64283-e1996850-1ea7e62b-018ecfd2.jpg,test/p16/p16594585/s56165757/b827b7cd-aca64283-e1996850-1ea7e62b-018ecfd2.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Dry cough for two weeks. PA and lateral upright chest radiographs were reviewed in comparison to ___ chest radiograph and CT chest obtained on ___. Heart size and mediastinum are stable in appearance. Bilateral perihilar bronchiectasis associated with linear opacities are stable. No new focal consolidation to suggest interval development of infectious process seen. No pleural effusion or pneumothorax is demonstrated. " 765fdbd8-7687b102-865141f9-7db8ca1e-0dfb3fe8.jpg,test/p15/p15320852/s54373993/765fdbd8-7687b102-865141f9-7db8ca1e-0dfb3fe8.jpg,test," WET READ: ___ ___ 9:11 AM Moderate bilateral pleural effusions and perihilar alveolar opacities are concerning for pulmonary edema. Moderate to severe cardiomegaly. ___ ___. WET READ VERSION #1 ___ ___ 10:13 PM Moderate bilateral pleural effusions and perihilar alveolar opacities are concerning for pulmonary edema. Moderate to severe cardiomegaly. ___ ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___F with past medical history significant for CAD, CHF, CKD, and anemia who initially presented to ___ for chest pain, shortness of breath and weakness, found to be profoundly anemic and have pulmonary edema concerning for CHF exacerbation. // evaluate pulmonary edema COMPARISON: There are no prior chest radiographs. IMPRESSION: Moderate bilateral layering pleural effusions, mild to moderate cardiac enlargement, opacification of the lower lobes and vascular congestion in the upper lobes reflect cardiogenic pulmonary edema. " 0c1af34a-145e2eb0-897bab5d-01a531cd-b68da1dd.jpg,test/p10/p10229323/s50246653/0c1af34a-145e2eb0-897bab5d-01a531cd-b68da1dd.jpg,test," FINAL REPORT CHEST RADIOGRAPH. INDICATION: ARDS, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have increased, potentially resulting from increased ventilatory pressure. The overall extent of the parenchymal opacities is not substantially changed. An atelectatic region in the retrocardiac lung areas, both on the left and on the right, has slightly increased in extent. Unchanged size of the cardiac silhouette. " e42caa79-a252d6a1-5e440fe5-d9114e84-3d15e767.jpg,test/p17/p17255106/s58028553/e42caa79-a252d6a1-5e440fe5-d9114e84-3d15e767.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with left sided chest pain*** WARNING *** Multiple patients with same last name! // eval for cardiopulm process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Minimal left basilar atelectasis is seen without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " f606cdd6-10ca7f4a-6f24ba90-03c7fe41-a458c46b.jpg,test/p17/p17212600/s57323085/f606cdd6-10ca7f4a-6f24ba90-03c7fe41-a458c46b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent cough s/p pneumonia tx in ___ in the setting of infiltrate on CXR // Pneumonia? Interval change? TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is top-normal unchanged. Mediastinum is stable. Right hilar fullness appears to be minimally progressed as compared to ___ although unchanged as compared to ___. In the light of previous right lower lobe infection assessment with chest CT is recommended to exclude the possibility of post obstructing lesion in the right hilus or in its proximity. Currently only minimal atelectasis is present but no other abnormality seen in the lungs and there is no pleural effusion or pneumothorax. Lower thoracic mild compression fracture is unchanged " 2dcaeb75-7e2af122-ef5d01ee-99d09664-d064e034.jpg,test/p13/p13912710/s52261490/2dcaeb75-7e2af122-ef5d01ee-99d09664-d064e034.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man w/ liver failure s/p NGT placement // eval NGT placement TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed the same day earlier in the morning IMPRESSION: NG tube tip isin the stomach. ET tube has been removed. No other interval change from prior study. " de663353-1f172483-f4301f08-d2d14173-2a6d7273.jpg,test/p11/p11635649/s57179687/de663353-1f172483-f4301f08-d2d14173-2a6d7273.jpg,test," FINAL ADDENDUM Addendum: The previously transcribed reported was for the ___ study. The following is the report for the ___ chest radiograph study. Frontal can't lateral views of the chest are obtained. There is a left perihilar/upper lobe consolidation worrisome for pneumonia. Left base atelectasis is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouette unremarkable. IMPRESSION: Left upper lobe consolidation worrisome for pneumonia. Recommend followup to resolution. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with cough, shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. Previously seen pulmonary nodules on chest CT were better evaluated on CT, which is more sensitive. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " aedcd729-c808c8f4-2423d369-8d4d19b5-9d8ccc3a.jpg,test/p14/p14065959/s52780433/aedcd729-c808c8f4-2423d369-8d4d19b5-9d8ccc3a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p PEA arrest, now extubated, evaluating volume status and ? aspiration. // ___ year old man s/p PEA arrest, now extubated, evaluating volume status and ? aspiration. ___ year old man s/p PEA arrest, now extubated, evaluating volume status and ? aspiration. IMPRESSION: Compared to chest radiographs ___ through ___. Previous pulmonary edema has resolved. Severe cardiomegaly is stable. No appreciable pleural effusion. No pneumothorax. Left internal jugular line probably cannulates persistent left-sided superior vena cava. Right jugular dual channel catheter ends in the right atrium. " d36e6717-ff14baf6-3fc760c0-f52b3791-b644f712.jpg,test/p13/p13711253/s50929667/d36e6717-ff14baf6-3fc760c0-f52b3791-b644f712.jpg,test," WET READ: ___ ___ 9:22 AM No pulmonary edema. Increased opacity at the right base may reflect atelectasis or a developing infectious process. WET READ VERSION #1 ___ ___ ___ 9:34 PM No pulmonary edema. Increased opacity at the right base may reflect atelectasis or a developing infectious process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M Child's A EtOH cirrhotic w choledocholithiasis/ cholangitis/ cholecystitis s/p ERCP x 2 (___, ___) now s/p open CCY ___ now sob // assess for pulmonary edema assess for pulmonary edema IMPRESSION: In comparison with the study of ___, there is increased opacification at the right base posteriorly. Although this could represent merely atelectasis, in the appropriate clinical setting, superimposed pneumonia must be seriously considered. " 6c3d6d09-ef78f72a-b6004e65-32b9490e-5f437528.jpg,test/p11/p11145160/s54344075/6c3d6d09-ef78f72a-b6004e65-32b9490e-5f437528.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with tight aortic stenosis for TAVR. // pulmonary edema? TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Patient is status post median sternotomy and CABG. Mild to moderate enlargement of the cardiac silhouette is noted. Atherosclerotic calcifications are noted within the aortic knob. Mediastinal contour is otherwise unremarkable. There is mild pulmonary edema with small bilateral pleural effusions. Airspace opacities in the lung bases likely reflect compressive atelectasis. No pneumothorax is identified however the medial aspect of the lung apices is obscured by the patient's neck and chin projecting over these regions. IMPRESSION: Mild to moderate cardiomegaly with mild pulmonary edema and small bilateral pleural effusions. Probable bibasilar compressive atelectasis. " 155c8582-f7b9fc3b-301ff36e-e8977be3-0a2e7461.jpg,test/p11/p11339108/s57541036/155c8582-f7b9fc3b-301ff36e-e8977be3-0a2e7461.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // r/o infiltrate r/o infiltrate IMPRESSION: Comparison to ___. Moderate scoliosis. No pleural effusions. No pneumonia, no pulmonary edema. " 76b6c13d-3f9759ef-1d39fa4a-0c2f6d97-78acdbd3.jpg,test/p13/p13638768/s58989622/76b6c13d-3f9759ef-1d39fa4a-0c2f6d97-78acdbd3.jpg,test," FINAL REPORT INDICATION: ___-year-old man with right basilar crackles and fever, evaluate. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest were obtained. Heart is normal in size and cardiomediastinal contour is unremarkable. Lungs are symmetrically expanded. There is increased density in the posterior basal segment of the left lower lobe. No pleural effusion or pneumothorax. A nodular density projecting over the lateral aspect of the left 3rd rib may be external to the patient as a similar density is present on the opposite side. IMPRESSION: Increased opacification in the posterior basal segment of the left lower lobe may represent early pneumonia. Follow up radiographs are recommended 4 to 6 weeks after treatment to assess for resolution. Nodular opacities in upper lungs, possibly external to the patient, can also be re-evaluated at that time. Findings were discussed with Dr. ___ by Dr. ___ at 8:15 am on ___ via telephone. " 63971789-b2b7e374-a15fac9e-5a3b43c1-2e762411.jpg,test/p10/p10596010/s52319822/63971789-b2b7e374-a15fac9e-5a3b43c1-2e762411.jpg,test," FINAL REPORT INDICATION: History: ___F with syncope // eval cardiomegaly TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. IMPRESSION: No acute cardiopulmonary process " b11fa514-03e96b2d-522b9c4e-2198437d-ba0e59d1.jpg,test/p16/p16342554/s59068273/b11fa514-03e96b2d-522b9c4e-2198437d-ba0e59d1.jpg,test," FINAL ADDENDUM The ED QA nurses were notified of the final interpretation at ___ on ___. ______________________________________________________________________________ FINAL REPORT HISTORY: Confusion, HIV. COMPARISON: ___, ___. FINDINGS: PA and lateral chest radiographs were obtained. Low lung volumes can be attributed to bibasilar atelectasis which exaggerates new mild pulmonary vascular congestion. Heart is slightly larger, but not to the point of cardiomegaly; mediastinal contours are otherwise normal. IMPRESSION: Early cardiac decompensation. " 6a17accd-f4a1259c-75e0242c-fe69c3c2-75e613f4.jpg,test/p16/p16502265/s58863608/6a17accd-f4a1259c-75e0242c-fe69c3c2-75e613f4.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Erect portable radiograph of the chest was reviewed in comparison with prior chest radiographs through ___ with the most recent from ___. IMPRESSION: Feeding tube is coiled in the upper esophagus. Consider repositioning the feeding tube. Low lung volumes, mild pulmonary edema and bi-basal atelectasis, left side more than right side, are unchanged. Top normal heart size, mediastinal and hilar contours are stable. Presumed small left pleural effusion is similar. No pleural effusion on the right side. Finding related to the positioning of feeding tube was communicated to the clinical team on ___ at 12:00 p.m. " 38333765-799600ef-cee213a0-52f1482f-bb3a0b45.jpg,test/p17/p17349126/s53922174/38333765-799600ef-cee213a0-52f1482f-bb3a0b45.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with spinal cord injury. Difficulty weaning ventilation. Comparison is made with prior study performed a day earlier. Mild pulmonary edema has improved. Bibasilar opacities larger on the left side are stable consistent with atelectasis. There is probably a small left effusion. Lines and tubes are in unchanged position . The NG tube tip is not well visualized. Enlargement of the pulmonary arteries consistent with pulmonary hypertension is again noted. " 31d192ee-6ccc5bfb-77daab7a-5536b6f2-53b6f551.jpg,test/p17/p17454111/s50781266/31d192ee-6ccc5bfb-77daab7a-5536b6f2-53b6f551.jpg,test," FINAL REPORT HISTORY: Dyspnea, question pneumonia. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___. Lordotic positioning. There is probable background hyperinflation suggestive of COPD. There is mild cardiomegaly with a left ventricular configuration. The aorta is calcified and unfolded. There is upper zone redistribution. There are streaky opacities at left greater than right base. No frank consolidation or gross effusion is identified. Previously identified old healed rib fractures are less well demonstrated on the current exam due to slight differences in positioning. Compared to ___ and allowing for differences in technique, I doubt significant interval change. IMPRESSION: 1. Probable COPD. Cardiomegaly and upper zone redistribution, but no overt CHF. 2. Streaky opacities at left greater than right bases, similar to ___. No frank consolidation identified. If there is high concern for a focal infiltrate, then a lateral view may help to more completely assess the lower lobes. " 771a3065-b77f569c-9f0ed5e8-11dce643-1946fa4e.jpg,test/p16/p16030116/s57853287/771a3065-b77f569c-9f0ed5e8-11dce643-1946fa4e.jpg,test," FINAL REPORT HISTORY: ARDS, intubated. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___ at 4:40 a.m. An ET tube is present, the tip lies approximately 4.0 cm above the carina. An NG tube is present, the tip is not well seen but appears to extend beneath diaphragm. A right IJ central line is present, tip over upper right atrium. There are low inspiratory volumes. Prominence of the cardiomediastinal silhouette, upper zone redistribution and diffuse vascular blurring, consistent with CHF. There focal patchy opacities at both bases. No gross effusion. Compared with film from ___, right base opacity may be slightly worse, but is accentuated by underpenetrated technique. Opacity of the left base is overall similar, possibly slightly improved. Appearance of vascular plethora is similar to the prior film. " 755aae99-2cd5d306-f060b266-012d871c-9dc38730.jpg,test/p12/p12313845/s50733978/755aae99-2cd5d306-f060b266-012d871c-9dc38730.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with R SAH, SDH and multiple facial fxs // improvement RUL collapse? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: Resolved right upper lobe collapse. " 173df963-38e9780d-e077b07f-811f233b-57053916.jpg,test/p16/p16980011/s52507867/173df963-38e9780d-e077b07f-811f233b-57053916.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with seizure, question of infection TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Moderate to severe enlargement of the cardiac silhouette is unchanged. The mediastinal and hilar contours are similar. Lung volumes remain low. No focal consolidation, pleural effusion or pneumothorax is visualized. Pulmonary vasculature is normal. No acute osseous abnormalities demonstrated. Clip is seen projecting within the upper abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " cc462838-df00d9ff-ea24479e-54f9409d-afea6850.jpg,test/p11/p11816734/s57695113/cc462838-df00d9ff-ea24479e-54f9409d-afea6850.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, wheezing // ? CHF, PNA COMPARISON: ___ IMPRESSION: No change as compared to the previous examination. Moderate cardiomegaly. Tortuosity of the thoracic aorta. No pleural effusions. No pneumonia, no pulmonary edema. " 07a65fb6-2fd4af15-72013298-c09b8706-539235b0.jpg,test/p17/p17397284/s57534176/07a65fb6-2fd4af15-72013298-c09b8706-539235b0.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: COPD presenting with dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Outside chest CT from ___. FINDINGS: As seen on prior chest CT, there is increased density and opacification of the left hemidiaphragm consistent with loculated pleural effusion. Increased densities at the right lower lung are also noted an correlate to findings in the chest CT, in the appropriate clinical setting, these findings were reflect an infectious process evaluation of the cardiac silhouette is somewhat limited. There is no pneumothorax pneumothorax. IMPRESSION: Moderate to large left-sided loculated pleural effusion on seen on outside chest CT. Increased density of the right lower lobe could reflect infectious process in the appropriate clinical setting. " 58d1958b-12934612-8f92ed48-fc26eb35-ce6830e1.jpg,test/p17/p17946916/s55874080/58d1958b-12934612-8f92ed48-fc26eb35-ce6830e1.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present. IMPRESSION: Normal chest radiograph. " 77e5a94a-b42b8a80-4fff21f7-ec6ed28c-0ac2be50.jpg,test/p11/p11431685/s58091576/77e5a94a-b42b8a80-4fff21f7-ec6ed28c-0ac2be50.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with SOB // eval for consolidation COMPARISON: Prior CT of the chest from ___ FINDINGS: AP upright and lateral views of the chest provided. Lungs are clear though volumes are low. Cardiomediastinal silhouette appears stable and normal. Multiple calcified mediastinal lymph nodes are noted. No large effusion or pneumothorax. No signs of congestion or edema. The aorta is slightly unfolded. Bony structures are intact. IMPRESSION: As above. " b66e0a16-b9fec86e-814212b8-221caa09-d31c9e60.jpg,test/p18/p18526154/s50320793/b66e0a16-b9fec86e-814212b8-221caa09-d31c9e60.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PCP ___ // Assess for improvement vs worsening? COMPARISON: Chest x-ray from ___ FINDINGS: The cardiomediastinal silhouette is unchanged. The hila are prominent, with prominent patchy opacities surrounding the left hilum and atelectasis at left-greater-than-right bases. Small faint opacities may also be present on the right lung laterally . There is minimal atelectasis at the right base, with possible minimal blunting of the right costophrenic angle. No gross effusion. The left costophrenic angle is clear. Doubt CHF. IMPRESSION: Abnormal, but overall similar to ___. Minimal atelectasis at the right base laterally and possible minimal blunting of the right costophrenic angle is new. " c0ba8abb-6017816c-df091a61-fe99e6b6-361abf6f.jpg,test/p16/p16887016/s56660037/c0ba8abb-6017816c-df091a61-fe99e6b6-361abf6f.jpg,test," FINAL REPORT INDICATION: ___M with chain saw trauma to face, missing tooth // ?tooth in lungs TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. There is no radiopaque density to suggest a missing tooth fragment. IMPRESSION: No visualized tooth fragment identified. " d951de2f-d8a7beb7-a77f9a13-5dac4fff-10dd3d6a.jpg,test/p19/p19217413/s55593182/d951de2f-d8a7beb7-a77f9a13-5dac4fff-10dd3d6a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with 1 day CP, SOB, hx HIV. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " d03751ec-103036fd-862a8e65-cd28f82f-051e6903.jpg,test/p19/p19842175/s52656656/d03751ec-103036fd-862a8e65-cd28f82f-051e6903.jpg,test," WET READ: ___ ___ ___ 4:05 PM Right middle lobe atelectasis, less likely infection. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain. Evaluate for infiltrate. COMPARISONS: None. FINDINGS: Frontal and lateral radiographs of the chest were acquired. Ill-defined opacities in the right lower lung are not well seen on the lateral projection and likely represent mild atelectasis, although infection cannot be excluded. The lungs are otherwise clear. The heart is mild to moderately enlarged. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Mild wedging of a lower thoracic vertebral body is noted. Note is made of a left side pacemaker with right atrial and ventricular leads. IMPRESSION: 1. Mild right lower lung atelectasis, less likely infection. 2. Mild to moderate cardiomegaly. " e313beb8-4ce8f351-689bba8b-c7f391e7-c89c80aa.jpg,test/p15/p15619921/s54566105/e313beb8-4ce8f351-689bba8b-c7f391e7-c89c80aa.jpg,test," WET READ: ___ ___ 9:11 AM Small bilateral pleural effusions are persistent. No definite evidence of pulmonary edema. Interval progression of left lower lobe atelectasis. WET READ VERSION #1 ___ ___ ___ 7:19 PM Small bilateral pleural effusions are persistent. No definite evidence of pulmonary edema. Interval progression of left lower lobe atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx dCHF admitted with acute pancreatitis // Please eval for volume overload COMPARISON: Chest radiographs since ___ most recently ___ IMPRESSION: Substantial increase in opacification in the left lower lobe accompanied by volume loss is probably due to worsening atelectasis, but preexisting or concurrent pneumonia is not excluded. Small bilateral pleural effusions have increased since ___, even though previous mild interstitial edema has improved and heart size is top normal and unchanged. No pneumothorax. " d5005cbe-d820c1b4-1d919f08-f772c1c9-dbf13908.jpg,test/p10/p10303503/s56642400/d5005cbe-d820c1b4-1d919f08-f772c1c9-dbf13908.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with hx of liver transplant, sepsis, now s/p hospitalization with pleural effusions and pleuritic chest discomfort. Please assess for remaining pleural effusions. // assess for pleural effusion TECHNIQUE: Chest: Upright PA and Lateral COMPARISON: Chest radiographs since ___ with most recent ___ FINDINGS: Interval removal of right IJ catheter.The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process with no pleural fusion seen. " 1d5689ad-891f8835-51480678-4434c115-858d1bfe.jpg,test/p19/p19349343/s57503279/1d5689ad-891f8835-51480678-4434c115-858d1bfe.jpg,test," FINAL REPORT HISTORY: ___-year-old male with skin laceration and possible fall, altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Calcified granuloma again seen in the right midlung. The lungs are clear of consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is stable. No displaced rib fracture is identified on this nondedicated exam. Posterior fixation hardware partially visualized in the lumbar spine. IMPRESSION: No acute cardiopulmonary process. " 8e778655-765fb917-dde1fb08-d03c9494-8e399404.jpg,test/p15/p15390441/s56929824/8e778655-765fb917-dde1fb08-d03c9494-8e399404.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___F with fall // ro rib fractures, infection TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with concurrently obtained radiographs the right shoulder, as well as radiographs of the chest from ___. FINDINGS: There is hyperexpansion of the lungs, with flattening of both hemidiaphragms, compatible with COPD. Right upper lobe scarring and pleural thickening is likely unchanged compared to the prior study, given differences in patient positioning. There is no overt pulmonary edema, pneumothorax, or focal consolidation worrisome for pneumonia. There is likely a small left pleural effusion and/or pleural thickening at the left lung base. Irregular calcification in the right lateral breast is better assessed on prior mammogram. Right proximal humeral fracture is again noted. No displaced rib fractures are identified. IMPRESSION: No evidence of pneumonia. Findings compatible with COPD. Right proximal humeral fracture is better characterized on separately dictated shoulder radiographs. No displaced rib fractures seen. " e4086506-599e9286-2cf3ff53-bcc22621-888ad636.jpg,test/p13/p13483571/s59424945/e4086506-599e9286-2cf3ff53-bcc22621-888ad636.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dyspnea, lower extremity edema, crackles on exam. COMPARISON ___. FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead left-sided pacemaker is again seen with leads appear in the expected positions of the right atrium and right ventricle. Eventration of the left hemidiaphragm. Mild vascular congestion is seen. More focal basilar opacity on the right may be due to prominent vascular structures, though underlying consolidation is not excluded in the appropriate clinical setting. There is minor left basilar atelectasis. Mitral calcification may be present. The cardiac silhouette is mildly enlarged. The aorta is calcified and tortuous. The patient is status post median sternotomy and CABG. IMPRESSION: 1. Mild vascular congestion. 2. More focal opacity at the right lung base which may relate to vascular congestion, although consolidation is not excluded in the appropriate clinical setting. " f230497a-bfec1b24-762c4b1a-bb49d263-e7915370.jpg,test/p16/p16059088/s51973730/f230497a-bfec1b24-762c4b1a-bb49d263-e7915370.jpg,test," FINAL REPORT HISTORY: Pulmonary edema, to assess for change. FINDINGS: In comparison with the study of ___, the left PICC line has been pulled back so that the tip of the straightened catheter is in the axillary region. Little change in the diffuse bilateral pulmonary opacifications that are exacerbated by the lower lung volumes. Monitoring and support devices otherwise remain in place. " f16924ea-163a666a-51897acf-3fcdfe0b-cf00397e.jpg,test/p18/p18806584/s51259334/f16924ea-163a666a-51897acf-3fcdfe0b-cf00397e.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 2 EXAMS INDICATION: ___ year old man with new NGT // NGT placement NGT placement IMPRESSION: Compared to chest radiographs most recently ___. 2 frontal views show a new transesophageal feeding tube, wire stylet in place, advanced from the mid esophagus to the upper stomach. Moderate cardiomegaly moderate right pleural effusion moderate pulmonary edema all unchanged. No pneumothorax. Right trans jugular dual channel catheter ends in the right atrium. Transvenous right ventricular pacer lead continuous from the left pectoral generator to distal right ventricle. " 3197ec53-e98729b4-40ddb430-8da92ab5-8e74535b.jpg,test/p14/p14787590/s56619183/3197ec53-e98729b4-40ddb430-8da92ab5-8e74535b.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion or evidence of pneumothorax is seen. The patient is status post median sternotomy. The cardiac and mediastinal silhouettes are stable. Aortic knob calcification is seen. IMPRESSION: No acute cardiopulmonary process. " 004ed711-7026b8ac-39c51a3f-00f1d0a8-b17163f6.jpg,test/p14/p14957416/s57269684/004ed711-7026b8ac-39c51a3f-00f1d0a8-b17163f6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with abdominal pain nausea vomiting. Evaluate for pneumomediastinum or pneumoperitoneum. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. No evidence of pneumomediastinum or pneumoperitoneum. IMPRESSION: No acute cardiopulmonary process. " 527aca4d-d710e474-91ac12be-566c6211-81f16012.jpg,test/p18/p18539425/s54573027/527aca4d-d710e474-91ac12be-566c6211-81f16012.jpg,test," FINAL REPORT HISTORY: Status post bone marrow transplant with weakness, fatigue, syncope. Evaluate for pneumonia. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiograph from ___, there has been interval removal of a right-sided PICC line. The cardiomediastinal and hilar contours are within normal limits. The lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. No acute osseous abnormality. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process. " a2b0f79b-50e1c0fa-ea353d04-47a038f1-39f80467.jpg,test/p15/p15091054/s54853375/a2b0f79b-50e1c0fa-ea353d04-47a038f1-39f80467.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dizziness // ? acute cardiopulm process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiac silhouette is borderline enlarged. No focal consolidation, pleural effusion, or pneumothorax is identified. IMPRESSION: No acute intrathoracic abnormality. " 1d99e6c3-5521874d-4417f7d8-7bc03abf-0886c1a9.jpg,test/p16/p16042873/s51685626/1d99e6c3-5521874d-4417f7d8-7bc03abf-0886c1a9.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Study of earlier the same date. FINDINGS: Right PICC terminates deep within the right atrium, approximately 5.5 cm below the cavoatrial junction. Exam is otherwise similar to the recent study except for improving atelectasis at the lung bases. " 96dcb9ff-4923f5c5-979506ea-bc2c59a1-13f59658.jpg,test/p17/p17175688/s57212870/96dcb9ff-4923f5c5-979506ea-bc2c59a1-13f59658.jpg,test," WET READ: ___ ___ 2:09 PM Mild pulmonary vascular congestion without overt edema, improved from ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with SOB, hx chf // infiltrate? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: In comparison to the previous examination, cardiomediastinal silhouette is unchanged. There is re- demonstrated moderate cardiomegaly. There is mild prominence of the pulmonary vasculature which is improved from ___. No focal consolidation is seen. No pneumothorax. The visualized abdomen is unremarkable. IMPRESSION: Mild pulmonary vascular congestion without overt edema, improved from ___. " 6f3c32b6-4dac89b2-a3a625ac-55afbc32-6ba440ca.jpg,test/p14/p14001478/s56028899/6f3c32b6-4dac89b2-a3a625ac-55afbc32-6ba440ca.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Calcium channel blocker overdose, intubated. Comparison is made with prior study ___. Mild-to-moderate cardiomegaly is stable. Widened mediastinum is due to engorgement of the vessels. There has been continued improvement in aeration in both lungs with remaining opacities in the lower lobes bilaterally, left greater than right. There are no new lung abnormalities, there is no pneumothorax or pleural effusion. Right IJ catheter tip is in the upper right atrium. ET tube is in standard position. NG tube tip is out of view below the diaphragm. " 498f43e7-9c9059db-c4f94b31-51bd9182-61b7174c.jpg,test/p12/p12260873/s59113845/498f43e7-9c9059db-c4f94b31-51bd9182-61b7174c.jpg,test," WET READ: ___ ___ ___ 6:20 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with hyprbili // acute process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary abnormality. " bb916399-363a81de-f3712e43-79986c88-01184f0a.jpg,test/p13/p13280760/s57968602/bb916399-363a81de-f3712e43-79986c88-01184f0a.jpg,test," FINAL REPORT INDICATION: Dyspnea. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 23f1cc98-50d7afee-3a1c4458-1839d2ed-eedb206d.jpg,test/p14/p14637100/s51578621/23f1cc98-50d7afee-3a1c4458-1839d2ed-eedb206d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with weakness // eval for PNA COMPARISON: Prior exam is dated ___. FINDINGS: AP upright and lateral views of the chest provided. There has been interval removal of the dialysis catheter appearing there is mild pulmonary edema. No large effusion or pneumothorax. No overt signs of pneumonia though subtle opacity at the left lung base is noted which is thought to represent atelectasis. Heart is mildly enlarged with subtle mitral annular calcifications noted. The aorta is unfolded with atherosclerotic calcifications again seen. The imaged bony structures appear grossly stable with multilevel degenerative changes in the imaged portion of the spine. There is a chronic compression deformity in the lower thoracic spine better assessed on prior CT abdomen pelvis. IMPRESSION: Mild cardiomegaly, mild pulmonary edema. " 4cf8ca31-d8e083d1-3d0d6d63-148cd698-31f2b76b.jpg,test/p14/p14037772/s57764199/4cf8ca31-d8e083d1-3d0d6d63-148cd698-31f2b76b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with septic right knee and sudden lower extremity weakness after laminectomy and new hypoxia. Portable AP radiograph of the chest was reviewed in comparison to ___. Cardiomediastinal silhouette is unchanged and mediastinum appears to be stable. No interval substantial increase in pleural effusion is demonstrated. No pneumothorax is seen and lungs are essentially clear. " 137af978-affd72e3-7d4094f0-27ffbd34-c6ff981e.jpg,test/p13/p13021836/s56065767/137af978-affd72e3-7d4094f0-27ffbd34-c6ff981e.jpg,test," FINAL REPORT HISTORY: Severe ___'s and aspiration history. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: There is blunting of the posterior costophrenic angles seen on the lateral view, raising concern for trace pleural effusions. Left mid lung atelectasis/scarring is seen. There is mild pulmonary vascular congestion. Streaky right base opacity, best seen on the frontal view, may in part relate to vascular congestion, however, underlying consolidation from aspiration or infection is not excluded. The cardiac silhouette is mildly enlarged. The aorta is calcified and tortuous. Degenerative changes are partially imaged at the right shoulder. IMPRESSION: Blunting of the posterior costophrenic angles seen on the lateral view could be due to trace pleural effusions. Mild pulmonary vascular congestion. Patchy right base opacity may be partly due to vascular congestion, underlying consolidation from aspiration or infection not excluded. " 842a869a-b45e6ecc-5fc6478f-23a421f4-94ae1155.jpg,test/p14/p14219343/s51285842/842a869a-b45e6ecc-5fc6478f-23a421f4-94ae1155.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with influenze +/- pneumonia // portable report recommended follow up PA/Lat portable report recommended follow up PA/Lat COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Small bilateral pleural effusions, right greater than left, are larger today. Mild cardiomegaly is stable or decreased. The right heart obscures the right lower lobe where there was some peribronchial infiltration on ___. This could be residual pneumonia. The remainder of the lungs cleared. There is no pneumothorax. Transvenous right atrial right ventricular pacer leads in standard placements. " 285059b6-f80b1d8a-2d4ac002-c7fd6b9e-25ef8a47.jpg,test/p18/p18545924/s53666167/285059b6-f80b1d8a-2d4ac002-c7fd6b9e-25ef8a47.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with weakness // ? infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " f1ac004a-c26b030e-2ab15e50-e50eb3a4-de5c43e4.jpg,test/p17/p17888374/s51221355/f1ac004a-c26b030e-2ab15e50-e50eb3a4-de5c43e4.jpg,test," FINAL REPORT INDICATION: ___F with sob // eval for pulm edema TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray and chest CT from ___. . FINDINGS: Increased interstitial markings in the lungs, similar compared to remote exam from ___ and likely due to chronic underlying interstitial process. There is no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. Old healed left lateral rib fractures are again noted. IMPRESSION: Chronic interstitial abnormality without superimposed acute cardiopulmonary process. Known pulmonary nodules seen on prior chest CT are not identified by chest x-ray. " cb2a9750-2e51ffaa-cfe7615f-99677d25-4795bfa9.jpg,test/p19/p19671045/s55938111/cb2a9750-2e51ffaa-cfe7615f-99677d25-4795bfa9.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are within normal limits. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " d83503ae-6ff189f8-dabc4c4a-bb19ad0a-99f18d2b.jpg,test/p18/p18644892/s51458634/d83503ae-6ff189f8-dabc4c4a-bb19ad0a-99f18d2b.jpg,test," FINAL REPORT INDICATION: ___F with abdominal pain, AMS // Eval for free air TECHNIQUE: Single supine view of the chest. COMPARISON: None. FINDINGS: There are bibasilar opacity silhouetting the hemidiaphragm is bilaterally. There is also hazy opacity over the periphery of the right lung and superiorly. This could be due to layering or loculated effusion. Elsewhere the lungs are clear. Cardiac silhouette is enlarged at least moderately. Atherosclerotic calcifications noted at the aortic arch. Degenerative changes noted in the spine. IMPRESSION: Bibasilar opacities likely at least in part due to pleural effusions, potentially with layering for loculation more superiorly on the right. Cardiomegaly. PA and lateral, if patient is amenable, may offer additional detail. " 5b75a4d0-798aed34-1f58f5d1-632786a8-82002559.jpg,test/p13/p13897408/s50441797/5b75a4d0-798aed34-1f58f5d1-632786a8-82002559.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cholecystitis; pre-op TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The aorta is mildly tortuous. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 251c182d-abf5bfdf-e3e807f2-15f36ff3-2a6506d6.jpg,test/p11/p11957975/s52014661/251c182d-abf5bfdf-e3e807f2-15f36ff3-2a6506d6.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old male with palpitations. TECHNIQUE: PA and lateral chest radiographs COMPARISON: None available FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 83dba590-e32d0f6d-66b86d31-47b32d39-4fd35be4.jpg,test/p11/p11283326/s52140736/83dba590-e32d0f6d-66b86d31-47b32d39-4fd35be4.jpg,test," FINAL REPORT INDICATION: ___-year-old male with left substernal chest pain. COMPARISON: None. PA AND LATERAL CHEST: The lungs are clear. There is no focal consolidation, no effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. The pleural surfaces are smooth. There is no pulmonary vascular congestion or edema. Mild degenerative changes are seen in the upper thoracic spine. No acute compression deformities. No free air in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 1270e5ab-278b530b-4ee6a6bc-f4a8295d-e49ba3e5.jpg,test/p15/p15619921/s57578044/1270e5ab-278b530b-4ee6a6bc-f4a8295d-e49ba3e5.jpg,test," WET READ: ___ ___ ___ 8:29 AM Interval removal of Dobbhoff and placement of NG tube, which is coiled in the mid esophagus. Mild to moderate pulmonary edema. No other significant changes. WET READ VERSION #1 ___ ___ 9:48 PM Interval removal of Dobbhoff and placement of NG tube, which is coiled in the mid esophagus. Mild to moderate pulmonary edema. No other significant changes. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new ng placement // please assess new ng placement COMPARISON: ___ IMPRESSION: Interval removal of Dobbhoff catheter placement of a nasogastric tube. The tube is coiled in the mid esophagus and needs to be repositioned. Otherwise, the radiograph is unchanged. " d3f464da-d29bc27e-862fb226-94898b8d-5d5e55f3.jpg,test/p16/p16296993/s52180961/d3f464da-d29bc27e-862fb226-94898b8d-5d5e55f3.jpg,test," WET READ: ___ ___ ___ 8:53 PM heart size raises ? of cardiomegaly vs pericardial effusion; low lung volumes, but no evdience of pneumonia, edema, or pleural effusion. ______________________________________________________________________________ FINAL REPORT HISTORY: Severe asthma, continued dyspnea. CHEST, TWO VIEWS. There is moderately severe cardiomegaly. The aorta is calcified and unfolded. There is upper zone redistribution, without overt CHF. There is small amount of pleural thickening and/or fluid at both costophrenic angles. Mild superior endplate scalloping of multiple thoracic vertebral bodies noted. IMPRESSION: 1. Cardiomegaly. Possibility of a pericardial effusion cannot be entirely excluded. 2. Upper zone redistribution, without overt CHF. 3. Small bilateral pleural effusions. 4. No focal infiltrate identified. " a1f22b07-5a247a04-75f4dd39-bbbd3a79-c15339f3.jpg,test/p19/p19396070/s53699844/a1f22b07-5a247a04-75f4dd39-bbbd3a79-c15339f3.jpg,test," FINAL REPORT INDICATION: ___M with sob // r/o Pna/chf TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: The lungs are clear focal consolidation, effusion, or pulmonary edema. Obscuration of the right cardiophrenic angle is compatible fat pad seen on prior CT scan. Cardiac silhouette is enlarged, similar compared to prior. Lower thoracic dextroscoliosis is noted. No acute osseous abnormalities. Fractures of the pedicle screws at T1 appear are again seen. IMPRESSION: No acute cardiopulmonary process. " c1b0d86a-13b12ed5-bda436ca-48eaa17a-32b887f6.jpg,test/p13/p13118875/s52405444/c1b0d86a-13b12ed5-bda436ca-48eaa17a-32b887f6.jpg,test," FINAL ADDENDUM ADDENDUM A nodular opacity projecting over the left lower lobe could be in the skin, but further evaluation with shallow oblique views with a nipple marker is recommended. Updated finding/recommendation was communicated via telephone by Dr. ___ ___ to Dr. ___ at ___ on ___, upon attending review. ______________________________________________________________________________ FINAL REPORT INDICATION: Altered mental status. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs demonstrate a heart which is top normal in size and fairly well-aerated lungs which are clear. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " fe25ca50-8caa4329-0f214c20-bfa7eef1-7698dc8f.jpg,test/p13/p13613806/s55545550/fe25ca50-8caa4329-0f214c20-bfa7eef1-7698dc8f.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: New shortness of breath. Patient with history of right thoracotomy, diaphragmatic tumor resection and right lower lobe wedge resection. Comparison is made with prior study, ___. Cardiac size is top normal. The aorta is elongated. Port-A-Cath is in standard position. There is a decreasing small right effusion. Right lower lobe atelectasis has markedly improved. The left lung is grossly clear. Atelectasis in the right middle lobe has also improved. On the lateral view, there appear to be tiny focal areas of air-fluid levels, which suggests the presence of a small pneumothorax associated with a small effusion. Findings were discussed with Dr. ___ by phone on ___ at 4:33 p.m., two minutes after the discovery of the finding. " a368cdf7-c4a774ff-dff2229c-a230fd29-e963f5b6.jpg,test/p19/p19374067/s57050708/a368cdf7-c4a774ff-dff2229c-a230fd29-e963f5b6.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with bilateral leg swelling. Is there hilar adenopathy COMPARISON: FINDINGS: IMPRESSION: PA and lateral chest reviewed in the absence of prior chest radiographs: Normal heart lungs hila mediastinum and pleural surfaces. No evidence of intrathoracic adenopathy. " 8189440e-effc5363-cbf584a6-1b9fbe15-b274035c.jpg,test/p10/p10075034/s55538863/8189440e-effc5363-cbf584a6-1b9fbe15-b274035c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Status post inguinal hernia repair 5 days ago with pain and fever. TECHNIQUE: Chest AP and lateral COMPARISON: None. FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " e7133764-ffb33a2a-3852a93f-ea4249a8-c5556302.jpg,test/p14/p14997223/s58085922/e7133764-ffb33a2a-3852a93f-ea4249a8-c5556302.jpg,test," FINAL REPORT INDICATION: ___-year-old man with shortness of breath but stable O2 sats, ? effusion versus opacity. FINDINGS: PA and lateral chest radiographs are obtained. Heart is moderately enlarged. Cardiomediastinal contours are normal. The opacity seen in the right lower lobe is stable. Right hemidiaphragm is not readily visilble and the opacity extends to the edge of the right major fissure on the lateral view, reflecting collapse of the lower lobe with possible sparing of the superior segment. The minor fisure is not readily itenfied raising the possibility of right middle lobe collapse as well. Mild left pleural effusion. No pneumothorax. IMPRESSION: Stable RLL and possibly RML collapse. " 50d7e459-3afee835-e82ed8f1-0355da71-0f1e6f36.jpg,test/p13/p13770989/s53519042/50d7e459-3afee835-e82ed8f1-0355da71-0f1e6f36.jpg,test," FINAL REPORT HISTORY: ___-year-old female with fall. COMPARISON: None. FINDINGS: Single frontal view of the chest was obtained. Overlying trauma board limits detailed evaluation. The heart size and cardiomediastinal contours are normal. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. No displaced rib fracture. IMPRESSION: No displaced rib fracture. " b9cf5259-796876e8-72bf8bbc-481ae53d-8fcb2ba7.jpg,test/p16/p16076355/s52753347/b9cf5259-796876e8-72bf8bbc-481ae53d-8fcb2ba7.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // Evaluate for ACS TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well expanded and clear. No evidence of pulmonary edema or pneumonia. Mediastinal contours, hila, and cardiac silhouette are normal. No pneumothorax or pleural effusion. IMPRESSION: Normal chest radiograph. " 47fd2e15-65618b51-490b20f7-33d2e249-e4341bc2.jpg,test/p19/p19807980/s58393720/47fd2e15-65618b51-490b20f7-33d2e249-e4341bc2.jpg,test," FINAL REPORT HISTORY: Pulmonary congestion, to assess for consolidation. FINDINGS: In comparison with study of ___, there may be mild improvement of the substantial fluid overload and sequela of pulmonary hypertension. The retrocardiac opacification persists consistent with substantial volume loss in the left lower lobe and there are bilateral pleural effusions. Given the extensive pulmonary changes, it is impossible to exclude supervening pneumonia in the appropriate clinical setting. " 30dd4bcc-15dfbb61-1492a21c-68ad792f-cafe6673.jpg,test/p18/p18705722/s56283156/30dd4bcc-15dfbb61-1492a21c-68ad792f-cafe6673.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY ___ year old man with s/p CABG/MVR/TVr // eval shortness of breath eval shortness of breath COMPARISON: ___ 4 FINDINGS: Lung volumes are somewhat low. Increased density bilaterally suggests worsening edema, however. There is evidence of persistent small pleural effusions as well. The patient is status post median sternotomy CABG and MVR. The heart appears enlarged. A right internal jugular catheter remains in place. IMPRESSION: Continued evidence of pulmonary edema which may be worse. Persistent small pleural effusions. " 1051c705-99deee48-9c4cadb6-91a72abe-00237cf8.jpg,test/p13/p13013733/s56874328/1051c705-99deee48-9c4cadb6-91a72abe-00237cf8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with UGIB, intubated/sedate // verify placement of ETT and OGT COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has undergone esophageal surgery. The nasogastric tube is in expected position. The patient is intubated and the tip of the endotracheal tube projects approximately 4.7 cm above the carinal. Platelike atelectasis at the left lung bases. No abnormalities on the right. Normal size of the cardiac silhouette after CABG. Several of the lower sternal wires are ruptured. " ab70a7d4-2b577825-76694ad3-fdc7489b-4a2ddf6a.jpg,test/p14/p14137711/s57776874/ab70a7d4-2b577825-76694ad3-fdc7489b-4a2ddf6a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with large right pleural effusion s/p chest tube // ? PTX ? PTX IMPRESSION: In comparison with the study of ___, there has been substantial decrease in the amount of right pleural effusion with pigtail catheter in place. No evidence of pneumothorax. Mild atelectatic changes is seen at the right base. No definite congestion or acute focal pneumonia. " 7da52c62-cc9fb53a-23cdc4c7-d4e9ede4-f9a3aba1.jpg,test/p16/p16799832/s58417107/7da52c62-cc9fb53a-23cdc4c7-d4e9ede4-f9a3aba1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic lung cancer c/b pathologic hip fracture and DVT with hypertensive urgency and respiratory distress // eval flash pulm edema/dyspnea eval flash pulm edema/dyspnea COMPARISON: Chest radiographs ___ through ___. IMPRESSION: No pulmonary edema. Moderate right and small left pleural effusions have increased since ___, unchanged since ___. Elevation of the right hemidiaphragm probably due to phrenic nerve palsy. Huge right hilar and adjacent mediastinal mass. Aside from mild to moderate atelectasis at the base, left lung is clear. " 9e2daaac-60aca2a3-88cf277d-d1585155-55f01d76.jpg,test/p12/p12555865/s51682149/9e2daaac-60aca2a3-88cf277d-d1585155-55f01d76.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH // New OGT TECHNIQUE: Chest single view COMPARISON: ___ 13:08 FINDINGS: Endotracheal tube tip in good position. Enteric tube tip in the distal stomach. Central line tip low SVC. Minimal interstitial prominence left lower lung. IMPRESSION: Enteric tube tip in the distal stomach. " cef9e892-8204779e-65d65050-2b6ef6e3-5ad4f6e6.jpg,test/p19/p19016834/s53302258/cef9e892-8204779e-65d65050-2b6ef6e3-5ad4f6e6.jpg,test," FINAL REPORT CHEST HISTORY: Esophageal stent placement, oxygen-dependent, cough. REFERENCE EXAM: ___. FINDINGS: The esophageal stent is again visualized and is more superiorly located than on the exam from five days prior. There is new increased opacity at both bases, right greater than left, with the right side being most suggestive of an infiltrate. The left could be due to volume loss. There is small right-sided effusion as well. " c75323c0-0d8cff33-9c643828-f8f349e8-c06a03ab.jpg,test/p16/p16296993/s50372742/c75323c0-0d8cff33-9c643828-f8f349e8-c06a03ab.jpg,test," FINAL REPORT INDICATION: History: ___F with delirium // r/o infitlrate, r/o ich TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___, ___ FINDINGS: Heart size is mildly enlarged, unchanged. The aorta is diffusely calcified. Mediastinal contours otherwise are unremarkable. There are low lung volumes with crowding of the bronchovascular structures. Mild pulmonary vascular engorgement is noted. Streaky bibasilar opacities likely reflect atelectasis. No pleural effusion or pneumothorax is identified. Diffuse demineralization of the osseous structures is noted with unchanged compression deformity at the thoracolumbar junction. IMPRESSION: Mild pulmonary vascular engorgement and bibasilar atelectasis. " cee95766-049b1d85-78b513df-41611bd2-b6a71c92.jpg,test/p13/p13750116/s54382694/cee95766-049b1d85-78b513df-41611bd2-b6a71c92.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: ___-year-old man with right upper quadrant pain, negative belly workup, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " afef30fc-a851f2dc-efcf2db0-e2be3f17-e00548ef.jpg,test/p18/p18186439/s59974401/afef30fc-a851f2dc-efcf2db0-e2be3f17-e00548ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new pacemaker placement // evaluate for pneumothorax and leads evaluate for pneumothorax and leads IMPRESSION: In comparison with the study of ___, there is an placement of a dual-channel pacer with leads extending to the right atrium and apex of the right ventricle. No evidence of post -procedure pneumothorax. Otherwise, little overall change. " 43850fca-f2d4eda3-44d01bfe-b3ee32e2-3523c847.jpg,test/p11/p11334064/s59815611/43850fca-f2d4eda3-44d01bfe-b3ee32e2-3523c847.jpg,test," FINAL REPORT INDICATION: History: ___M with Brain Mass // ? Mass TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Frontal and lateral radiographs of the chest demonstrate low lung volumes which results in bronchovascular crowding. The heart is mildly enlarged. The hilar contours are unremarkable. There is no pneumothorax, pleural effusion, mass or consolidation. IMPRESSION: 1. No evidence of mass. 2. Mild cardiomegaly. " 5143767e-35e7a34e-cd6ebe84-161ba3dd-ec440993.jpg,test/p10/p10250159/s56975666/5143767e-35e7a34e-cd6ebe84-161ba3dd-ec440993.jpg,test," FINAL REPORT HISTORY: HIV, fever, cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Mediastinal and hilar contours are normal. Pulmonary vascularity is normal. The lungs are clear. No pleural effusion, focal consolidation or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " e9344915-231b6fc2-299737c7-0a02986f-e0faad23.jpg,test/p18/p18704491/s59717163/e9344915-231b6fc2-299737c7-0a02986f-e0faad23.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with sudden onset headache after lifting boxes, syncope w/ fall and subsequent neck pain // ? SAH, ? cervical fx COMPARISON: None FINDINGS: AP semi upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 14def5fd-e29882ac-9d9d7e9e-23bb6b3c-02cd91b2.jpg,test/p17/p17051420/s55613131/14def5fd-e29882ac-9d9d7e9e-23bb6b3c-02cd91b2.jpg,test," WET READ: ___ ___ 8:00 PM No substantial change from prior. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF. // assess interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is no evidence of pulmonary edema. There is no appreciable pleural effusion or pneumothorax. " 4c25db17-10f0e8de-9058b81b-233617aa-8585b196.jpg,test/p15/p15721773/s52591378/4c25db17-10f0e8de-9058b81b-233617aa-8585b196.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of confusion, altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. The patient is rotated to the left and the patient's chin overlies the left lung apex obscuring the view. There are low lung volumes. In the interval since the prior study, there has been development of a small-to-moderate left pleural effusion with overlying atelectasis. Underlying consolidation cannot be entirely excluded. Bibasilar areas of atelectasis are seen. There is mild pulmonary vascular congestion as well. TIPS is noted projecting over the right upper quadrant, unchanged in position since the prior study. Left upper quadrant coils/clips are also seen. The cardiac and mediastinal silhouettes demonstrated a top normal cardiac silhouette and a somewhat tortuous aorta. IMPRESSION: Low lung volumes. Interval development of small-to-moderate left pleural effusion with overlying atelectasis, underlying consolidation cannot be excluded. Pulmonary vascular congestion. " 83ad8e27-92d248ef-e13a7e1b-4a3ea87b-8af5b61a.jpg,test/p17/p17850903/s51266776/83ad8e27-92d248ef-e13a7e1b-4a3ea87b-8af5b61a.jpg,test," FINAL REPORT INDICATION: Weakness, concerning for infarction. Evaluation of the chest. TECHNIQUE: Two views of the chest. COMPARISON: Examinations dated ___ and ___. FINDINGS: The lungs are clear without focal consolidation, pulmonary edema or pleural effusion. No pneumothorax is present. Elevation of the left hemidiaphragm, presumably dating from left thoracotomy and posterior rib resection is unchanged. Surgical clips project over the left upper abdomen. IMPRESSION: No evidence of acute cardiopulmonary process. " a1b57470-6aa7027f-cc41674f-5da8e7da-b539037d.jpg,test/p13/p13637699/s53711441/a1b57470-6aa7027f-cc41674f-5da8e7da-b539037d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with diffuse pulmonary edema s/p massive transfusion // interval change interval change IMPRESSION: In comparison with the study of ___, there are improved lung volumes. Monitoring and support devices remain in place. Apparent dense streak of atelectasis is seen in the right mid zone. Hazy opacification at the right base is consistent with pleural fluid. Upper abdominal drains are again seen bilaterally. " 3bacdc25-5235abb4-74aec23d-eff88d6d-7424c44a.jpg,test/p16/p16036071/s56684261/3bacdc25-5235abb4-74aec23d-eff88d6d-7424c44a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Dobbhoff placement, assess position. FINDINGS: AP upright portable chest radiograph provided. The Dobbhoff tube descends through the thoracic midline with its tip in the lower abdomen, excluded from view. The lungs are clear. Cardiomediastinal silhouette is normal. No effusion or pneumothorax. No free air below the right hemidiaphragm. Bony structures are intact. " 82b2f084-343218f1-237c52ae-50513f27-a6fb4b88.jpg,test/p10/p10740350/s56517723/82b2f084-343218f1-237c52ae-50513f27-a6fb4b88.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with malaise, night sweats // R/o lymphoma TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. An old posterolateral right fifth rib fracture is unchanged. IMPRESSION: No evidence of hilar or mediastinal lymphadenopathy. No acute cardiopulmonary abnormality. " 0e3c2a84-d293dc06-15b86ebb-5c4c57e7-5a8b3262.jpg,test/p19/p19310285/s54333131/0e3c2a84-d293dc06-15b86ebb-5c4c57e7-5a8b3262.jpg,test," WET READ: ___ ___ 10:20 PM Nearly complete right lung expansion. Right mid lung opacities may be due to focal post-expansion edema. ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Tracheal resection, to assess for pneumothorax. FINDINGS: In comparison with the earlier study, there has been almost complete re-expansion of the right hemithorax. Small areas of opacification in the right mid zone could reflect post-expansion edema. " 664b8240-b7672f61-18531adb-811c815f-555a11d4.jpg,test/p12/p12803765/s52445593/664b8240-b7672f61-18531adb-811c815f-555a11d4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p GSW to head s/p left craniectomy. // interim eval COMPARISON: None. FINDINGS: ET tube tip lies above the level of the clavicular heads approximately 7.0 cm above the carina. NG tube tip lies in the region of the GE junction, not clearly beyond it. The cardiomediastinal silhouette is within normal limits. No CHF, focal infiltrate, effusion, or pneumothorax is detected. IMPRESSION: No acute pulmonary process identified. ET and NG tubes as described. Clinical correlation regarding advancement of both ET and NG tubes is requested. " a830c4fd-03d5f4e0-75e5494d-37b6c264-dd860e90.jpg,test/p11/p11522912/s55472808/a830c4fd-03d5f4e0-75e5494d-37b6c264-dd860e90.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recurrent mucus plugging and none episode of desaturation on vent // Evaluate for new lobe collapse TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Enteric tube has been advanced and now courses below the diaphragm, inferior aspect not included on the image. Endotracheal tube remains in appropriate position, terminating approximately 4.6 cm above the level of the Carina. Bilateral pleural effusions and overlying atelectasis persist, underlying right basilar consolidation not excluded. No overt pulmonary edema. Persistent cardiomegaly. . " 5929bfdb-9d90c83e-7522b861-d3bc707e-87104f9f.jpg,test/p18/p18406213/s59727941/5929bfdb-9d90c83e-7522b861-d3bc707e-87104f9f.jpg,test," FINAL REPORT INDICATION: ___F with ___, now with hypoxia. // assess for ARDS, edema, vs atelectasis TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: There are low lung volumes and bibasilar opacities which are likely atelectasis. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities pain IMPRESSION: Low lung volumes with bibasilar opacities which are most likely atelectasis although infection is not entirely excluded. " fc3bbe0f-6473cd65-66cd70a5-5d1cfac3-f97b0b8d.jpg,test/p19/p19931382/s57983063/fc3bbe0f-6473cd65-66cd70a5-5d1cfac3-f97b0b8d.jpg,test," FINAL REPORT HISTORY: ___-year-old man with history of alcoholism now with cough, question pneumonia. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. No pleural effusion or pneumothorax. Atherosclerotic calcifications line the aorta. IMPRESSION: No acute intrathoracic process. " d31bcfbc-cb5c1386-f850ad3d-5d753c9b-16a13053.jpg,test/p16/p16047967/s55854697/d31bcfbc-cb5c1386-f850ad3d-5d753c9b-16a13053.jpg,test," FINAL REPORT INDICATION: ___M with morbid obesity and SLE presenting with chest tightness/SOB. // cardiopulmonary abnormality? TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or overt pulmonary edema. The cardiomediastinal silhouette is stable, within normal limits for technique. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 87ecba0d-73566b04-50f80b5c-964ccddc-956e60c0.jpg,test/p17/p17404599/s51302031/87ecba0d-73566b04-50f80b5c-964ccddc-956e60c0.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPHS OF ___ COMPARISON: Rib series of ___. FINDINGS: Again demonstrated is fullness and lobulation of the right infrahilar region. Heart size and mediastinal contours are normal. Lungs and pleural surfaces are clear. IMPRESSION: Right infrahilar fullness and lobulation, concerning for lymphadenopathy or juxtahilar mass. Recommend further evaluation with contrast-enhanced CT as entered into radiology communications dashboard on ___. " 6093ce4f-5e96cfc4-d18c861a-15ad9568-f25b407e.jpg,test/p11/p11643401/s52789000/6093ce4f-5e96cfc4-d18c861a-15ad9568-f25b407e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with ulcerative colitis flare, dyspnea on exertion TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 74a9489d-ca4deb43-431e1f9e-6bd70c31-bd24ca7b.jpg,test/p13/p13948093/s50557722/74a9489d-ca4deb43-431e1f9e-6bd70c31-bd24ca7b.jpg,test," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___. FINDINGS: There is a moderate left effusion has increased compared to the prior study. The right-sided central line with tip in the right atrium is unchanged. There has been some interval improved aeration of right lower lobe and left mid lung. " e19fb684-a352fffa-31075966-78aa6218-1f5aa42e.jpg,test/p15/p15937415/s53942711/e19fb684-a352fffa-31075966-78aa6218-1f5aa42e.jpg,test," FINAL REPORT HISTORY: Stage III rectal cancer with partial small bowel obstruction requiring NG decompression. Evaluate placement of NG tube to evaluate if we are able to give contrast CT for CT scan. COMPARISON: ___ in conjunction with PET-CT scan from ___. FINDINGS: The NG tube is seen ending in the stomach, including the sideport below the diaphragm. A left Port-A-Cath is in unchanged position at the cavoatrial junction. Multiple nodular opacities in the right mid lung are consistent with the patient's known pulmonary metastases. There is left basilar opacity which may represent a combination of pleural effusion and atelectasis. Left basilar scarring is unchanged. The cardiomediastinal silhouette is unchanged. No pneumothorax is present. No free air is seen below the left hemidiaphragm. IMPRESSION: NG tube extends into the stomach including the side port. " 8a247efb-5375bed2-f6658ab4-4f4e3e9f-2cf69cd0.jpg,test/p12/p12131616/s59884876/8a247efb-5375bed2-f6658ab4-4f4e3e9f-2cf69cd0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with asc aortic graft // follow up effusions COMPARISON: Chest x-ray from ___ at ___ FINDINGS: An ET tube is present, tip approximately 4.5 cm above the carina. An OG type tube is present, tip extending beneath diaphragm, off film. A left IJ central line tip overlies the upper right atrium. Again seen is moderate to moderately severe cardiomegaly, similar to the prior film. Sternotomy wires and prosthetic valve again noted. Increased opacity at the left lung base with obscuration of the left costophrenic angle is similar to the prior film. The previous film showed some patchy alveolar opacity at in the left mid zone laterally. This area is obscured by overlying iatrogenic structures on the current film --___, it appears at least partially improved if not completely resolved. There is a small to moderate layering right pleural fusion, which is probably slightly larger, allowing for differences in technique. There is upper zone redistribution with diffuse vascular blurring, and atelectasis the right lung base. IMPRESSION: Lines and tubes as described. Note is made that the left IJ line overlies the upper right atrium unchanged. Cardiomegaly, sternotomy wires, and prosthetic valve again noted, unchanged. Patchy opacity left base with left pleural effusion unchanged. Previously seen left lateral mid zone opacities are obscured by overlying materials, but have probably improved. Layering right pleural effusion may be slightly larger. Atelectasis at the right base is similar. CHF, minimally improved. " aa4c2ae5-685beb32-c8334dda-37f7ba52-5c148aed.jpg,test/p16/p16296993/s58588653/aa4c2ae5-685beb32-c8334dda-37f7ba52-5c148aed.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Shortness of breath and crackles. History of congestive heart failure. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The heart is mildly enlarged. The aortic arch is again calcified with similar unfolding. The cardiac, mediastinal and hilar contours appear unchanged. There is again a small eventration of the right hemidiaphragm. Streaky left basilar opacity suggests minimal atelectasis. The lungs appear otherwise clear. There is no definite pleural effusion, although small pleural effusions would be difficult to exclude. There is no pneumothorax. IMPRESSION: No evidence of acute disease. " d0cff4a0-3ac760e1-a518aa1c-e0792944-dedbe765.jpg,test/p16/p16156464/s58320038/d0cff4a0-3ac760e1-a518aa1c-e0792944-dedbe765.jpg,test," FINAL REPORT HISTORY: Lung cancer with pleural effusions. FINDINGS: In comparison with the study of ___, there is increasing opacification at the right base consistent with further accumulation of pleural fluid. Less prominent opacification is seen on the left. Bibasilar atelectatic change is present, and there is little change in the degree of cardiomegaly. Pulmonary vascular congestion may be increasing. Nodular lesions in the lungs are again noted, consistent with metastases. " f69b54a4-7332caa0-f8b4c94d-7d2bccfe-c669a161.jpg,test/p11/p11632236/s59168856/f69b54a4-7332caa0-f8b4c94d-7d2bccfe-c669a161.jpg,test," FINAL REPORT COMPARISON: ___ earlier REASON FOR EXAMINATION: Assessment of the NG tube placement. AP radiograph of the chest demonstrates that the NG tube tip is currently in the proximal stomach. There is no substantial change in the cardiomediastinal appearance as well as parenchymal lung opacification. " 93a5d984-6f7ccd72-1c91757a-3d8ae01b-df65c458.jpg,test/p11/p11845452/s51922777/93a5d984-6f7ccd72-1c91757a-3d8ae01b-df65c458.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. The bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " e86ae4f7-63edf545-44a43b01-823cb6a7-49c2f4b5.jpg,test/p15/p15693235/s51119241/e86ae4f7-63edf545-44a43b01-823cb6a7-49c2f4b5.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with sob and prod cough // eval pneumonia TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: Lung volumes are low leading to crowding of the bronchovascular structures. Streaky bibasilar and right middle lobe airspace opacities l are noted. There is no large pleural effusion, pneumothorax, or frank pulmonary edema. The cardiac silhouette is mildly enlarged allowing for AP view. IMPRESSION: 1. Bibasilar and subtle right middle lobe opacities, suggestive of atelectasis although superimposed pneumonia is difficult to exclude. 2. Stable, mild cardiomegaly. " dcbf1064-1d431211-3781e952-7d1d758b-705e1c11.jpg,test/p10/p10481160/s52265092/dcbf1064-1d431211-3781e952-7d1d758b-705e1c11.jpg,test," WET READ: ___ ___ ___ 3:53 PM 1. Focal opacity occupying the right upper lobe, presumed to be compatible with known non-small cell lung cancer. 2. Small right-sided pleural effusion not significantly changed since prior chest CT from ___. Linear lucency at the right lung base appears to be below the diaphragm, and could relate to a small amount of free air for prior intervention in ___. However clinical correlation is advised. 3. Left lung is clear. No focal consolidation concerning for pneumonia. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cough, weakness on chemotherapy for non-small cell lung cancer. Question pneumonia and or other intrathoracic process. TECHNIQUE: PA and lateral views of the chest. COMPARISON: CT intervention from ___ and chest CT from ___. FINDINGS: Focal opacity occupying the right upper lobe is again seen, reflecting known non-small cell lung tumor. There is a small right-sided pleural effusion which does not appear significantly changed from prior chest CT. The cardiomediastinal and hilar contours are stable. There is no new focal consolidation. A curvilinear lucency several cm below the right hemidiaphragm likely reflects a small amount of bowel gas. IMPRESSION: 1. Right upper lobe opacity, likely reflecting known non-small cell lung cancer. 2. Small right-sided pleural effusion not significantly changed since prior chest CT from ___. 3. No superimposed consolidation. " 0064cc10-d8bbd920-340a850f-e064b286-0586a377.jpg,test/p19/p19181318/s52325038/0064cc10-d8bbd920-340a850f-e064b286-0586a377.jpg,test," FINAL ADDENDUM ADDENDUM Request was made to attempt to evaluate the location of the tip of small catheter. On the review, the tip of small catheter appears to be in the distal SVC. This is best seen on the lateral view, but also confirmed on the frontal view. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. As on prior, there is dense consolidation at the left lung base obscuring hemidiaphragm. This may be due to a combination of consolidation, atelectasis and effusion. Hiatal hernia suspected. The right lung remains clear. 2 separate right subclavian lines are identified with the larger catheter seen with tip terminating in the right atrium. The smaller catheter tip is not clearly delineated on the current exam. Degenerative changes in the spine without acute abnormality. IMPRESSION: Dense left basilar opacity similar to previous exam which may be due to a combination of effusion, atelectasis and consolidation. " 6c0733f7-3ff976f2-4ba399a4-f779c3e8-918fb8a6.jpg,test/p18/p18572896/s55160514/6c0733f7-3ff976f2-4ba399a4-f779c3e8-918fb8a6.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Cough. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. " e7a5303f-055104b2-526c2cee-9d32e46f-b007f635.jpg,test/p16/p16119159/s54225556/e7a5303f-055104b2-526c2cee-9d32e46f-b007f635.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent ablation, c/o cough, dyspnea with stairs. // pneumonia pneumonia IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are essentially clear. There is minimal amount of pleural effusion better appreciated on the lateral view, new as compared to previous examination. No appreciable consolidations or other findings to explain cough and dyspnea demonstrated. Of note is that the cardiac silhouette appears to be slightly increased as compared to ___, does either interval development of cardiac enlargement or pericardial effusion is a possibility and does correlation with echocardiography is recommended. " 0f8b1623-76ddcd46-97c1e21f-17f80865-d7e7ab18.jpg,test/p18/p18303550/s53495430/0f8b1623-76ddcd46-97c1e21f-17f80865-d7e7ab18.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with left pleural effusion s/p thoracentesis // r/o ptx COMPARISON: Chest radiograph ___ ; CT chest ___ FINDINGS: PA and lateral views of the chest provided. Moderate left pleural effusion and moderate compressive atelectasis are improved from the prior study on ___. There is no pneumothorax. The left hilum is enlarged, better evaluated on CT ___, however is unchanged from prior study on ___. Atelectasis in the left lower lung obscures lung lesions better evaluated on CT ___. IMPRESSION: 1. No pneumothorax. 2. Moderate left pleural effusion is moderately improved from prior study on ___. 3. Central adenopathy and evaluation of masses was better evaluated on CT ___. " ab7a3e4c-62b8262a-c71d5a75-f02f3475-24379634.jpg,test/p16/p16203451/s56473272/ab7a3e4c-62b8262a-c71d5a75-f02f3475-24379634.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever // r/o infiltrate COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " 2474724a-bda1416c-96ecfe94-c9863018-9c69e341.jpg,test/p19/p19054786/s55265513/2474724a-bda1416c-96ecfe94-c9863018-9c69e341.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough and wheezing // eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Previously seen right lower lobe pneumonia has essentially resolved in the interval. No focal consolidation is seen currently. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " e71e5851-5f1c93ce-15a81d10-a945cc25-af5e6f8b.jpg,test/p12/p12938515/s52930960/e71e5851-5f1c93ce-15a81d10-a945cc25-af5e6f8b.jpg,test," FINAL REPORT PORTABLE CHEST FILM, ___ AT 4:21 CLINICAL INDICATION: ___-year-old with increased work of breathing, question pulmonary process. Comparison is made to the patient's previous study ___ at 4:37. Portable semi-supine chest film ___ at 4:23 is submitted. IMPRESSION: 1. Feeding tube is seen coursing below the diaphragm with the tip not identified. Right internal jugular central line and left internal jugular large-bore catheter are unchanged in position. Overall cardiac and mediastinal contours are stable. There continues to be a bilateral diffuse interstitial abnormality which appears more prominent when compared to prior studies dating back to ___ and therefore likely reflects an element of mild interstitial edema. More focal patchy opacity at the right base is again noted and not significantly changed. There is likely a layering right effusion. No pneumothorax. " ee7e145d-4e95d0e5-2550b83d-27c6c109-dfa737c6.jpg,test/p15/p15179179/s52558987/ee7e145d-4e95d0e5-2550b83d-27c6c109-dfa737c6.jpg,test," FINAL REPORT HISTORY: CVA with fever. FINDINGS: In comparison with the study of ___, there is little overall change. Extremely low lung volumes may account for much of the prominence of the transverse diameter of the heart. Again it is difficult to visualize the Dobbhoff catheter. No definite vascular congestion or acute focal pneumonia. " 5d9fc441-2c7b133c-2f658bf8-ca7f67a3-084a9109.jpg,test/p13/p13666088/s54939929/5d9fc441-2c7b133c-2f658bf8-ca7f67a3-084a9109.jpg,test," FINAL REPORT INDICATION: ___M with chest pain. h/o pericardial and pleural effusions // ?acute cardiopulmonary process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without consolidation, edema or pneumothorax. Small bilateral pleural effusions persist, slightly smaller when compared to prior. Cardiac silhouette is stable. No acute osseous abnormalities. IMPRESSION: Persistent residual but smaller bilateral pleural effusions. " a512c671-96e8ac67-af4fc782-288f86ec-e6e33d9f.jpg,test/p11/p11585755/s51467400/a512c671-96e8ac67-af4fc782-288f86ec-e6e33d9f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o Takasayu's arteritis s/p aortic arch repair presents with severe AR and dyspnea. // Pulmonary edema vs infiltrate. Pulmonary edema vs infiltrate. IMPRESSION: Comparison to ___. No relevant change is noted. Sternotomy wires are in correct position. Moderate elongation of the descending aorta. Moderate cardiomegaly without pulmonary edema. No pleural effusions. No pneumonia. " 60a3c038-71de128e-249dc3ef-4ac735da-7c161c72.jpg,test/p14/p14921998/s56491105/60a3c038-71de128e-249dc3ef-4ac735da-7c161c72.jpg,test," FINAL REPORT HISTORY: Severe sepsis without clear source, question pneumonia after IV fluid resuscitation. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___. Compared with the prior study, there is a more distinct opacity with air bronchograms in the right cardiophrenic region, likely reflecting a pneumonic infiltrate. Patchy opacity at the left base medially in the region of the cardiac silhouette is slightly more distinct, but not significantly changed. Cardiomediastinal silhouette is similar to the prior film. There is minimal blunting of the right costophrenic angle which is new, without other evidence of effusion. Doubt CHF. IMPRESSION: More indistinct opacity in the right cardiophrenic region is concerning for a pneumonic infiltrate. Patchy opacity at the left base could reflect either atelectasis or a small infiltrate, and is more distinct, but grossly unchanged. Both opacities appear significantly progressed compared with ___. " fc76556f-ca691da2-5bd7eefe-ed1b48f7-385bba9d.jpg,test/p19/p19550773/s53135722/fc76556f-ca691da2-5bd7eefe-ed1b48f7-385bba9d.jpg,test," FINAL REPORT INDICATION: ___ year old man with CAD, pneumothorax s/p chest tube, now with chest pain. // Please evaluate for interval worsening of pneumothorax and CT placement. TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier today FINDINGS: The right pleural pigtail catheter is present. No discrete pneumothorax identified. There is a small right pleural effusion tracking along the lateral chest wall. Right basilar atelectasis. There is a persistent prominence of the right hilum. The left lung is clear. The size of the cardiac silhouette is within normal limits. IMPRESSION: No discrete pneumothorax identified. Unchanged appearance of the right pleural pigtail catheter. Small right pleural effusion. Persisting right hilar prominence. " 939f0c38-a07c94b6-c3c98f42-59237d03-9ffdf2d8.jpg,test/p16/p16171334/s55720050/939f0c38-a07c94b6-c3c98f42-59237d03-9ffdf2d8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There are relatively low lung volumes, which accentuate the bronchovascular markings. Given this, there may be mild pulmonary vascular congestion. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. Minor basilar atelectasis may be present. Cardiac silhouette is top-normal. Mediastinal contours are unremarkable. IMPRESSION: Low lung volumes which accentuate the bronchovascular markings. Given this, there may be mild pulmonary vascular congestion. No definite focal consolidation. " 930822e2-7af46197-af94d804-c8db0ac0-bea25f17.jpg,test/p18/p18049473/s50068822/930822e2-7af46197-af94d804-c8db0ac0-bea25f17.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hemoptysis // Worsening pulmonary edema? IMPRESSION: As compared ___ chest radiograph, bilateral asymmetrically distributed alveolar opacities have slightly worsened in the right lung inner minimally improved at the left base. Small bilateral pleural effusions are unchanged. " c44b8966-ebb1f572-5befd33b-46600280-64c90e45.jpg,test/p15/p15335912/s58863544/c44b8966-ebb1f572-5befd33b-46600280-64c90e45.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with CP // evidence of pneumonia COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Increased elevation of the right hemidiaphragm noted with right basal compressive atelectasis. There is also mild left basal atelectasis. Previously noted right upper extremity access PICC line is been removed. Right hilum appears somewhat prominence likely due to crowding of bronchovascular markings. The heart appears top-normal in size. Mediastinal contour is unchanged. No pneumothorax or large effusion. Bony structures are grossly intact. IMPRESSION: Bibasilar atelectasis with elevated right hemidiaphragm. No convincing evidence for pneumonia. " ae12061c-e93d648a-2a72fb45-f9a1c194-7ab35d7a.jpg,test/p11/p11667512/s51529670/ae12061c-e93d648a-2a72fb45-f9a1c194-7ab35d7a.jpg,test," FINAL REPORT INDICATION: Altered mental status, question pneumonia. COMPARISON: Chest x-ray from ___. FINDINGS: AP upright and lateral views of the chest were obtained. A port overlies the left chest with the tip terminating in the mid SVC. There has been interval increase in right basal atelectasis with elevation of the hemidiaphragm. The left lung is clear. There is no effusion or pneumothorax. There is no evidence of CHF. Cardiomediastinal silhouette is normal. Bony structures appear intact. IMPRESSION: 1. Interval increase in right basilar atelectasis. 2. Unchanged appearance of port overlying the left chest with tip in the mid SVC. " 260ceb43-8349c02b-68e54f73-68c198cd-46016022.jpg,test/p14/p14597448/s53982422/260ceb43-8349c02b-68e54f73-68c198cd-46016022.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with L hilar mass s/p TBNA on left // ptx TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is a left perihilar new opacity most likely representing combination of known lung mass and post procedure hemorrhage. There is no pneumothorax. Heart size and mediastinum are stable. Multiple pulmonary nodules are better appreciated on the CT chest from ___ " 91c710f0-7261c161-8192c48c-f27e3236-8fa16c42.jpg,test/p16/p16023137/s56029312/91c710f0-7261c161-8192c48c-f27e3236-8fa16c42.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p CT removal // eval for ptx eval for ptx IMPRESSION: Comparison to ___. The patient is extubated, the nasogastric tube is removed and the chest and mediastinal tubes are also removed. There is no evidence for the presence of a pneumothorax. No larger pleural effusions. The Swan-Ganz catheter has been advanced and the tip is now in the more peripheral parts of the right pulmonary artery. Stable postoperative appearance of the heart. Mild fluid overload but no overt pulmonary edema. " bcf42c28-d75a2e18-a41ed49a-7db01e5c-c63278e0.jpg,test/p17/p17463370/s58423048/bcf42c28-d75a2e18-a41ed49a-7db01e5c-c63278e0.jpg,test," FINAL REPORT INDICATION: ___ year old man with PTX/rib fractures // interval change EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Chest radiograph, frontal view COMPARISON: Chest radiograph ___ FINDINGS: There is a small left apical pneumothorax. The pneumothorax is not appreciated in the prior exam from ___, likely due to suboptimal patient position. Left chest tube is in unchanged position. Small opacities surrounding the chest tube entrance site is stable. There is no new focal opacity. There is no large pleural effusion. Left clavicular surgical hardware is intact. IMPRESSION: Small left apical pneumothorax. " 89ccce4a-05c2e124-6aa4c9f8-46069b48-0c591b8b.jpg,test/p14/p14021217/s58175999/89ccce4a-05c2e124-6aa4c9f8-46069b48-0c591b8b.jpg,test," WET READ: ___ ___:___ AM 1. Left internal jugular central venous line ends in the right brachiocephalic vein. This should be repositioned prior to use. 2. Left greater than right bibasilar opacities appear slightly more prominent as compared to the prior study. Pneumonia cannot be excluded in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with hemodialysis line placement // eval line placement TECHNIQUE: Portable supine chest x-ray. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Lung volumes are low, resulting in bronchovascular crowding. The cardiac silhouette is enlarged. There is upper zone redistribution and diffuse vascular blurring the some confluent opacity at the right base. Allowing for technical differences, this is likely similar to the film from ___ at ___:___ and is compatible with CHF. Again seen is increased retrocardiac density with obscuration left hemidiaphragm, consistent with left lower lobe collapse and/or consolidation. Probable small to moderate left and at least small right pleural effusions appear similar to prior. Bibasilar opacities, greater on the left, appear more prominent as compared to the prior study. A right internal jugular Swan-___ catheter is present, with the tip ending in the region of the right main pulmonary artery, similar to prior. There has been interval placement of a left internal jugular central venous line, with the tip ending in the right brachiocephalic vein. The endotracheal tube ends approximately 2.8 cm from the carina. IMPRESSION: 1. Left internal jugular central venous line ends in the right brachiocephalic vein. This should be repositioned prior to use. 2. Findings compatible with CHF. 3. Left greater than right bibasilar opacities appear slightly more prominent as compared to the prior study. Pneumonia cannot be excluded in the appropriate clinical setting. NOTIFICATION: The findings were discussed with Dr. ___, ___D. by ___ ___, ___D. on the telephone on ___ at 5:___ AM, ___ minutes after discovery of the findings. " 6519abee-8722be95-f7b0305d-bf0d183d-aab13d51.jpg,test/p14/p14706324/s58160328/6519abee-8722be95-f7b0305d-bf0d183d-aab13d51.jpg,test," FINAL REPORT HISTORY: Right anterior chest pain with nighttime fever. FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. The lungs are clear, and there is no vascular congestion or pleural effusion. " da814ae2-a172f505-560cd12e-90701a65-2c773fae.jpg,test/p15/p15872837/s54440196/da814ae2-a172f505-560cd12e-90701a65-2c773fae.jpg,test," WET READ: ___ ___ ___ 3:54 PM Normal chest radiograph ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with cough/chest pain x ___ days with fever and decreased R lower lobe lung sounds // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal. Visualized osseous structures are unremarkable. IMPRESSION: Normal chest radiograph " f205a8d7-f2840740-8e882615-d11c9ea8-aabe1384.jpg,test/p12/p12969820/s52452163/f205a8d7-f2840740-8e882615-d11c9ea8-aabe1384.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities seen. IMPRESSION: No acute cardiopulmonary abnormality. " 6d72848d-a6ddfaf3-dead1c37-176b28f7-48a3f539.jpg,test/p17/p17492278/s56823563/6d72848d-a6ddfaf3-dead1c37-176b28f7-48a3f539.jpg,test," WET READ: ___ ___ ___ 10:20 AM Tiny opacity projecting over the right lower lung is new from ___ and is likely confluence of shadows, but a tiny infectious focus cannot be excluded. Recommend repeat radiograph after treatment. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old woman with dyspnea and cough for three days. COMPARISON: CXR ___, ___; CT ___. FINDINGS: Frontal and lateral views of the chest were obtained. A 10mm small density projecting over the right lower lung without a correlate on the lateral view may represent confluence of shadows, but a small infectious focus cannot be excluded. The remainder of the lungs is clear. There is no pleural effusion or pneumothorax. Left volume loss after left lower lobectomy is similar to the prior study. Increased interstitial markings suggest chronic lung disease with emphysema as seen on CT. Bi-apical scarring is unchanged. Cardiac and mediastinal silhouettes and hilar contours are stable. No acute osseous abnormality is identified. IMPRESSION: New tiny opacity projecting over the right lower lung is likely confluence of shadows, but a tiny infectious focus cannot be excluded. Recommend follow up radiographs after treatment. " 539c0d27-472a180e-5b860cd4-e8ad645a-b93655bd.jpg,test/p15/p15812383/s55974183/539c0d27-472a180e-5b860cd4-e8ad645a-b93655bd.jpg,test," FINAL REPORT HISTORY: Nausea, vomiting, chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities detected. IMPRESSION: Normal chest radiograph. Specifically, no evidence of pneumomediastinum. " b4c18b37-37ef6aa1-04c3d456-5604cf43-28e427a3.jpg,test/p15/p15021013/s50548338/b4c18b37-37ef6aa1-04c3d456-5604cf43-28e427a3.jpg,test," FINAL REPORT INDICATION: ___ year old man with seizure concerning for aspiration PNA // Evaluate for resolution of opacities concerning for infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The lungs are fully expanded and clear. Resolution of bilateral pulmonary infiltrates. Cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal. A left upper lobe calcified granuloma once again visualized. IMPRESSION: No acute cardiopulmonary process. " f97c0aa4-3d988475-d5602d0e-06715b8e-09c71c89.jpg,test/p13/p13552561/s54111577/f97c0aa4-3d988475-d5602d0e-06715b8e-09c71c89.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with sah s/p fall // interval change COMPARISON: Chest radiographs ___. IMPRESSION: Tip of the endotracheal tube is just above the upper margin of the clavicles no less than 6 cm from the carina with the chin elevated. It could be advanced 2 cm without concern for unilateral intubation with any change in head and neck position. Left subclavian line ends low in the SVC. Left pleural drain unchanged in position crossing the left mid lung to the mediastinal contour no pneumothorax or pleural effusion. Heart size normal. Nasogastric tube ends in the nondistended upper stomach. " 2fe0cd45-967ec04d-cfbb9859-c9058255-b6342414.jpg,test/p11/p11856988/s57678952/2fe0cd45-967ec04d-cfbb9859-c9058255-b6342414.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o M with a history of Waldenstrom's macroglobulinemia, RA on hydroxychloroquine, recent right hip replacement, COPD, and h/o prostate cancer who presented from___ clinic after he was found to have a Hg of 5.0 likely secondary to upper GI bleed. // please rule out infection TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: Multiple prior radiographs, most recently ___. FINDINGS: There is no new consolidation or pleural effusion. Prominent interstitial lung markings with slightly hyperinflated lungs are in keeping with the provided history of COPD. Minimal left basilar linear atelectasis is unchanged. No pneumothorax. Mild cardiomegaly despite the projection is unchanged. Bones and soft tissues are unremarkable. IMPRESSION: No acute pulmonary disease. Stable mild cardiomegaly. COPD. " 53d6fb99-a2033a80-f08a6eb9-a14dae3b-90e94b76.jpg,test/p13/p13272142/s55057236/53d6fb99-a2033a80-f08a6eb9-a14dae3b-90e94b76.jpg,test," FINAL REPORT HISTORY: Intubated, evaluate tube placement. COMPARISON: None available. TECHNIQUE: Portable semi-erect chest radiograph. FINDINGS: Endotracheal tube terminates 6 cm above the carina. An orogastric tube courses below the diaphragm, tip is not included on this examination. The cardiomediastinal and hilar contours are within normal limits. There is no large pleural effusion or pneumothorax. There is bronchial cuffing and a subtle intersitial abnormality is noted in the right upper lobe. IMPRESSION: 1. Endotracheal tube terminates 6 cm above the carina, in adequate positioning. 2. Subtle interstitial abnormality in the right upper lobe, for which attention to follow up is recommended as it could represent aspiration. 3. Compete evaluation of orogastric tube positioning could also be obtained with future imaging. Findings discussed with ___ by ___ via telephone on ___ at 8:00 AM. " 7bb7384b-74e0e064-024f4fa9-0fe552c9-04416788.jpg,test/p17/p17365126/s56522666/7bb7384b-74e0e064-024f4fa9-0fe552c9-04416788.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY DATED ___ No prior studies for comparison. FINDINGS: Allowing for low lung volumes and rotation, cardiac silhouette is probably mildly enlarged. Aorta is tortuous. Lungs are clear except for minor atelectasis at the lung bases. IMPRESSION: No pneumothorax or acute rib fracture detected on this portable examination, but correlation with subsequently performed CTA of the chest is suggested for more complete assessment given the limited sensitivity of portable radiographs for assessing rib injuries. Correlation with CTA results is also recommended for more complete assessment of the thoracic aorta. " efae23f8-93e2bf7d-b2223c18-1a858646-686e2860.jpg,test/p12/p12900408/s53192217/efae23f8-93e2bf7d-b2223c18-1a858646-686e2860.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough, assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. Clips are noted in the right upper quadrant. IMPRESSION: No acute intrathoracic process. " ffb59b74-564b15ad-c13e5cbb-d65f3d23-eddbc3b5.jpg,test/p15/p15002645/s50982992/ffb59b74-564b15ad-c13e5cbb-d65f3d23-eddbc3b5.jpg,test," FINAL REPORT INDICATION: Acute onset chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are within normal limits. The pulmonary vascularity is normal. The lungs are clear. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Normal chest radiograph. " 02f98af7-41226143-fe4011bf-c446dbaa-376f7483.jpg,test/p12/p12773009/s50846231/02f98af7-41226143-fe4011bf-c446dbaa-376f7483.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. Small residual blunting at the right CP angle likely reflects a small pleural effusion and mild basilar atelectasis. Otherwise, the lungs are clear. Cardiomediastinal silhouette is normal. Bony structures appear intact. IMPRESSION: Minimal residual right pleural effusion and basilar atelectasis. " 96eeb331-f4e77d1d-e8b7837e-e987193a-014b0f24.jpg,test/p10/p10788120/s55149545/96eeb331-f4e77d1d-e8b7837e-e987193a-014b0f24.jpg,test," FINAL REPORT INDICATION: Nausea, vomiting and lightheadedness. COMPARISON: None. FINDINGS: PA and lateral chest radiographs. No focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 8bed42e3-744bf918-469cb9b1-d88d03d8-6a2e3cda.jpg,test/p14/p14713689/s57782585/8bed42e3-744bf918-469cb9b1-d88d03d8-6a2e3cda.jpg,test," FINAL REPORT HISTORY: Possible stroke. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Overall, there are low lung volumes, which accentuate the bronchovascular markings. Given this, there is mild right basilar opacity which may be due to atelectasis although underlying infection or aspiration is not excluded in the appropriate clinical setting. No focal consolidation is seen on the left. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are unremarkable. The patient is rotated somewhat to the left. IMPRESSION: Low lung volumes. Subtle right basilar opacity may be due to atelectasis although mild infection or underlying aspiration is not excluded in the appropriate clinical setting. " a715415a-98e33d9a-19b5b6f0-96a256d2-315c2f13.jpg,test/p12/p12524401/s53981375/a715415a-98e33d9a-19b5b6f0-96a256d2-315c2f13.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with right flank pain and fevers, evaluate for pneumonia. COMPARISON: None. FINDINGS: PA and lateral views of the chest were obtained. Heart is normal in size and cardiomediastinal contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " 0c01ef90-20f6be1a-f8fcbf07-8d5d8f88-593fd90e.jpg,test/p11/p11306899/s58522677/0c01ef90-20f6be1a-f8fcbf07-8d5d8f88-593fd90e.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Study of one day earlier. FINDINGS: Stable cardiomegaly. Worsening confluent bibasilar opacities involving the left lower lobe to a greater degree than the right. In the appropriate clinical setting, this could be due to aspiration or infectious pneumonia. Small bilateral pleural effusions are similar to the recent study. " fa9c0236-c9cf6c80-23324f3a-a68d4590-79a88cd7.jpg,test/p10/p10584297/s59328619/fa9c0236-c9cf6c80-23324f3a-a68d4590-79a88cd7.jpg,test," WET READ: ___ ___ ___ 9:06 AM Moderate cardiomegaly and mild interstitial edema. No pleural effusion or pneumothorax. WET READ VERSION #1 ___ ___ ___ 8:05 PM Moderate cardiomegaly and mild interstitial edema. No pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M hx bicuspid AV s/p mAVR who presents as a planned admission prior to re-do AVR, for cardiac catheterization. He also noted subtherapeutic INR at home, and presents for heparin bridging. Complains of CP and SOB // eval for pulmonary edema, pleural effusion, acute processes COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: For there is cardiomegaly, upper zone redistribution and mild blurring of vascular detail suggesting CHF. There is no pneumothorax or consolidation. There may be a tiny effusion on left. " 492e8a11-8972926f-1ec72ac3-6109a20d-300570dc.jpg,test/p10/p10989799/s51643519/492e8a11-8972926f-1ec72ac3-6109a20d-300570dc.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: This is a ___-year-old woman with fever and cough. IMPRESSION: PA and lateral chest compared to ___: There is no real change since ___ in subsegmental atelectasis at the right lung base, otherwise clear lungs. Heart size normal. No pleural effusion or evidence of central lymph node enlargement. Infusion port ends in the low SVC. " 4da15e2b-8387c8eb-b09195be-eaeeebfe-eb2dc2c0.jpg,test/p15/p15573773/s53335968/4da15e2b-8387c8eb-b09195be-eaeeebfe-eb2dc2c0.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Worsening shortness of breath, assess for pulmonary edema or effusion. Comparison is made with prior study ___. There is new mild interstitial pulmonary edema. There is chronic consolidation of the right lower lobe and atelectasis in the left lower lobe. There is no pneumothorax. Stable cardiomegaly is moderate to severe. Right Port-A-Cath tip is in the low SVC/cavoatrial junction. " 4e4e33ee-28e8b1f3-91adf26e-101a7dc2-a107b74f.jpg,test/p19/p19961925/s57375417/4e4e33ee-28e8b1f3-91adf26e-101a7dc2-a107b74f.jpg,test," FINAL REPORT HISTORY: HIV and altered mental status. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is mildly enlarged. The mediastinal and hilar contours are unremarkable. There is no pulmonary vascular congestion. Minimal streaky opacities in the lung bases are compatible with atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 0fd46d0b-5b9547e9-14818c0a-be895f4e-529b6cc8.jpg,test/p15/p15005501/s57651699/0fd46d0b-5b9547e9-14818c0a-be895f4e-529b6cc8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with AMS COMPARISON: Prior exam is dated ___ FINDINGS: PA and lateral views of the chest provided. A left upper extremity access PICC line is again seen with its tip in the low SVC. The lungs are clear bilaterally without focal consolidation, large effusion or pneumothorax. No signs of congestion or edema. The cardiomediastinal silhouette appears normal. The imaged bony structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: PICC line positioned appropriately. No acute intrathoracic process. " fea1f933-d8b98813-fe48481b-19d0f8b5-945a6da3.jpg,test/p15/p15389391/s56140131/fea1f933-d8b98813-fe48481b-19d0f8b5-945a6da3.jpg,test," FINAL REPORT AP CHEST, 1:29 A.M., ___ HISTORY: Alcoholic cirrhosis. Left pleural effusion after thoracentesis. IMPRESSION: AP chest compared to ___, and ___ at 12:13 a.m.: Lung volumes have improved since ___:13 a.m. This may account in part for improvement in pulmonary edema, now mild, as seen in the left lung. Multifocal consolidative abnormalities in the right lung are concerning for concurrent infection, particularly septic emboli since they appear to be discrete lesions. Small-to-moderate left pleural effusion is stable. Smaller right pleural effusion has decreased. Mediastinal vascular distention has improved, but the contour of the periaortic hemiatoma widening the left upper mediastinum is unchanged. ET tube in standard placement. Right jugular line ends in the SVC and a nasogastric tube ends in the mid stomach. No pneumothorax. " d537d9cc-cd8a9133-7f2ef244-01e43761-ca0987b1.jpg,test/p11/p11424857/s51683875/d537d9cc-cd8a9133-7f2ef244-01e43761-ca0987b1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/sob, please eval for occult pna, pulm edema // ___M w/sob, please eval for occult pna, pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lung volumes are relatively low. Apparent elevation of the right hemidiaphragm with peaking laterally suggests a subpulmonic effusion. The lungs are otherwise clear. There is no left effusion. Cardiac silhouette appears enlarged but not well assessed due to silhouetting on the right. IMPRESSION: There is apparent elevation of the right hemidiaphragm, likely due to a subpulmonic effusion. " 132ef03d-410e1183-8ade7923-011d5679-333f887f.jpg,test/p16/p16733321/s58227573/132ef03d-410e1183-8ade7923-011d5679-333f887f.jpg,test," FINAL REPORT HISTORY: Recent pneumonia, followup for resolution. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Frontal and lateral views of the chest demonstrate near resolution of a right middle lobe pneumonia. The lungs are hyperinflated but otherwise clear. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Pleural surfaces are unremarkable. IMPRESSION: Near resolution of right middle lobe pneumonia. " 569e6d59-417ec3c0-da59e349-690e9fb1-f9b7638e.jpg,test/p10/p10882916/s59712502/569e6d59-417ec3c0-da59e349-690e9fb1-f9b7638e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Shoulder pain, abdominal pain, right upper extremity swelling, question DVT. FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires are again noted. The previously noted NG tube has been removed. Linear opacities in the right upper lobe are again noted, which could represent scarring or atypical infection. Please note this opacity was not seen dating back to x-rays from earlier this year. A stent projects over the left subclavian region. Aside from findings in the right upper lobe, the lungs appear clear. Cardiomediastinal silhouette is normal. Bony structures are intact. There are small surgical clips noted in the right upper lung/superior mediastinal region. IMPRESSION: Subtle linear opacities in the right upper lobe could represent atypical pneumonia or scarring. Recommend followup to resolution. " 872d577a-7cb6f263-505e321e-384ac858-c9b624e6.jpg,test/p15/p15137973/s59115128/872d577a-7cb6f263-505e321e-384ac858-c9b624e6.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Drop in hematocrit. AP radiograph of the chest was reviewed in comparison to prior study obtained a day before. There is again interval increase since 5 p.m. on ___, of right pneumothorax, moderate. Right basilar opacity is unchanged. Cardiomediastinal silhouette is unchanged in the short interim. The left chest tube is in place. The right internal jugular line tip is at the level of the junction of internal jugular vein and right brachiocephalic vein. " 8bac5976-9c323eca-440be24a-30291cc4-1c877698.jpg,test/p13/p13549706/s51511895/8bac5976-9c323eca-440be24a-30291cc4-1c877698.jpg,test," FINAL REPORT INDICATION: ___M with fever/abd distention recent admission // r/o acute process TECHNIQUE: Single portable view of the chest. COMPARISON: ___. Correlation also made to concurrent CT the abdomen and pelvis. FINDINGS: Low lung volumes are noted. Bibasilar opacities are likely secondary to atelectasis. Superiorly, the lungs are clear. Cardiomediastinal silhouette is within normal limits for technique. No acute osseous abnormalities. There is no free intraperitoneal air. IMPRESSION: Low lung volumes without definite acute cardiopulmonary process. " 0fa748ba-83fc5b52-96b6dd32-26a4b345-1aab9005.jpg,test/p10/p10826816/s59137955/0fa748ba-83fc5b52-96b6dd32-26a4b345-1aab9005.jpg,test," FINAL REPORT INDICATION: Encephalopathy, NG tube placement. COMPARISON: Comparison made to chest radiogrpah performed same day. FINDINGS: Portable chest radiograph demonstrates interval placement of a Dobbhoff tube which is coiled within the oropharynx. Unchanged cardiomediastinal silhouette. Prominence of the right hilum is of uncertain significance. Stable hazy pulmonary vasculature suggesting pulmonary edema. Unchanged bibasilar consolidations likely represent a combination of edema, atelectasis and small bilateral pleural effusions, right greater than left. IMPRESSION: 1. Dobbhoff tube coiled in pharynx. ___ communicated these findings to ___ at 13:30 on ___ via telephone. 2. Stable mild pulmonary edema with small bilateral pleural effusions. 3. Prominent right hilum of unclear significance. " 5a0a56a5-aa3fa02f-14694a0d-ead6cf2f-5399266b.jpg,test/p19/p19826583/s50616506/5a0a56a5-aa3fa02f-14694a0d-ead6cf2f-5399266b.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with weakness. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are low and exaggerate pulmonary vascular markings. The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. The aorta appears tortuous, but stable. Degenerative changes are again noted at bilateral glenohumeral joints. IMPRESSION: No acute cardiopulmonary process. " 5899453a-3f218c30-04db1d6e-77de5c70-5e0d0618.jpg,test/p14/p14069959/s50596054/5899453a-3f218c30-04db1d6e-77de5c70-5e0d0618.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Presyncope. COMPARISON: ___ at ___. FINDINGS: There is persistent marked enlargement of the cardiac silhouette. There is minimal blunting of the left costophrenic angle and a trace pleural effusion is not excluded. The mediastinal contours are stable with a calcified tortuous aorta. There is no overt pulmonary edema. No definite focal consolidation. There is no pneumothorax. IMPRESSION: Persistently enlarged cardiac silhouette. Possible trace left pleural effusion. " c6947a28-4f237c53-8d2616aa-84cba1c9-a715b318.jpg,test/p18/p18056358/s52676644/c6947a28-4f237c53-8d2616aa-84cba1c9-a715b318.jpg,test," FINAL REPORT INDICATION: Confusion, evaluate for fracture. No prior examinations for comparison. CHEST, PA AND LATERAL: There is moderate elevation of the right hemidiaphragm, with multiple interposed colonic loops. No focal consolidation. Heart size is top normal. The aorta is tortuous and calcified. Mild degenerative changes in the thoracolumbar spine and acromioclavicular joints. IMPRESSION: 1. No acute intrathoracic process. 2. Moderate elevation of the right hemidiaphragm. " 73ca80db-3bc86fa3-f1d122c4-4492ab66-2e70a3b2.jpg,test/p12/p12960885/s53822917/73ca80db-3bc86fa3-f1d122c4-4492ab66-2e70a3b2.jpg,test," FINAL REPORT INDICATION: History: ___F with fall, poor historian, R shoulder pain, R elbow skin tear, R ring and small fingers swelling/ecchymosis // Eval for evidence of acute trauma COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette isenlarged . Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Aortic calcifications are significant. IMPRESSION: No acute intrathoracic process. " aa7475bf-8b86773e-7f42faa2-6e2459b2-fc43ca7c.jpg,test/p14/p14702995/s56778086/aa7475bf-8b86773e-7f42faa2-6e2459b2-fc43ca7c.jpg,test," FINAL REPORT INDICATION: History: ___F with L flank pain // rib fx or infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volume is low. Mild bibasilar opacities likely reflect atelectasis, although pneumonia is not fully excluded at the left base. Small left pleural effusion is noted. Cardiac silhouette is difficult to assess due to low lung volumes. No displaced rib fracture is identified. Compression deformities of the spine appear similar to before. IMPRESSION: Evaluation of lung bases is limited due to low lung volumes. The repeat radiograph with improved inspiratory level may be helpful to more fully evaluate left lower lobe opacities to help distinguish atelectasis from infectious pneumonia. " 40058bea-c2898007-26ecb648-96374a4e-e7edf322.jpg,test/p18/p18263400/s51349495/40058bea-c2898007-26ecb648-96374a4e-e7edf322.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is normal. Hypertrophic changes seen in the spine. IMPRESSION: No acute cardiopulmonary process. " 1e34a01e-2d3c388d-1bc55828-a1ca6a53-82c86641.jpg,test/p11/p11967908/s52133674/1e34a01e-2d3c388d-1bc55828-a1ca6a53-82c86641.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with history of prior PNA, now with worsening cough and dyspnea. Prior CXR with ? RUL COMPARISON: CT of the chest from ___ as well as a chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Diffuse hazy ground-glass opacity is noted which is concerning for interval development of pulmonary edema. Pleural effusions are noted bilaterally which are small. The cardiomediastinal silhouette is stable. Clips are noted in the right axilla. Also noted, is clustered calcification within the right breast projecting over the right upper lung. Imaged osseous structures appear intact with chronic deformity of the right humeral neck. There is a stent projecting over the left axilla. IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions. " fd52a629-f39d89a2-6feef709-3f7eaa64-2b1e7cda.jpg,test/p11/p11057136/s51070262/fd52a629-f39d89a2-6feef709-3f7eaa64-2b1e7cda.jpg,test," FINAL REPORT INDICATION: Pneumothorax. COMPARISON: Chest radiographs from ___. TECHNIQUE: Frontal chest radiographs. IMPRESSION: Severe subcutaneous emphysema throughout the chest wall is minimally changed since ___. Right thoracostomy tubes are unchanged in position. No obvious pneumothorax is detected. Mild pulmonary vascular congestion and interstitial edema has slightly worsened. There is a new trace left pleural effusion. The heart size remains normal. The hilar and mediastinal contours are unchanged. " c1b200b0-0e4f8ea7-8cfee281-934e4230-fcfc86fd.jpg,test/p17/p17294217/s53298708/c1b200b0-0e4f8ea7-8cfee281-934e4230-fcfc86fd.jpg,test," FINAL REPORT HISTORY: ___-year-old female, with mental status changes. Assess for pneumonia. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPH: The cardiomediastinal silhouette is top normal in size. There is a tortuous aortic knob with calcification. In the lateral view, there is a lenticular opacity in the posterior lung bases, likely the left lung base. There is no pneumothorax or pulmonary edema. There is marked dextroconvex thoracolumbar scoliosis. There is eventration of the right hemidiaphragm. A severe compression deformity is noted in the mid thoracic spine, of uncertain age but likely chronic. There is no gross malalignment. The osseous structures are diffusely osteoporotic. There is significant shortening of the acromiohumeral distance bilaterally, representing rotator cuff injuries. IMPRESSION: 1. A small opacity in the posterior lung base (likely the left lung base), non-specific but could represent a small loculated pleural effusion. Differential diagnosis includes focal consolidation, atelectasis, but cannot exclude neoplastic process. Recommend follow-up chest radiograph to ensure clearance or otherwise chest CT. 2. Diffuse osteopenia with a severe mid-thoracic compression deformity, likely chronic. " 14bfee35-d572bb3d-5f08f02e-fcbf291f-115f71b0.jpg,test/p18/p18551287/s55623256/14bfee35-d572bb3d-5f08f02e-fcbf291f-115f71b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HBV/ETOH cirrhosis, currently Childs class C, c/b prior variceal bleed ___ requiring TIPS (last EGD ___ showed 2 cords of grade I varices), ascites, HCC who is s/p RFA of HCC lesion that was complicated by massive intercostal artery bleed requiring chest tube, and IR embolization. Chest tube still in place. // ?change in R-sided hemothorax s/p chest tube placement ?change in R-sided hemothorax s/p chest tube placement IMPRESSION: Comparison to ___. The right chest tube and the right internal jugular vein catheter are in stable position. A small to moderate left pleural effusion with subsequent left basilar atelectasis is stable. The severity of pulmonary edema has increased in the interval. There is no convincing evidence for the presence of a pneumothorax. Embolic material seen in the liver, embolization of intercostal artery. " 1e4dc484-27112ae0-4904a92d-32f3b518-f922c3cd.jpg,test/p10/p10373824/s55074352/1e4dc484-27112ae0-4904a92d-32f3b518-f922c3cd.jpg,test," FINAL REPORT INDICATION: History: ___F with cough // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Compared to the study from 4 days prior there is new pulmonary edema and small bilateral pleural effusions. Left lower lobe opacity likely reflects a combination of atelectasis and effusion though superimposed infection is possible. Mild enlargement of the cardiac silhouette is stable. The chronic right shoulder fracture is unchanged. IMPRESSION: 1. New pulmonary edema with small bilateral pleural effusions and stable cardiomegaly 2. Left lower lobe opacity likely reflects a combination of atelectasis and effusion, though superimposed infection is possible. " 5fa7ae8c-66f0be91-96259da4-2a0bbaa8-a0ccdc41.jpg,test/p19/p19301174/s53673782/5fa7ae8c-66f0be91-96259da4-2a0bbaa8-a0ccdc41.jpg,test," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old male with left lower lobe crackles. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Relatively low inspiratory effort on the frontal view accentuates the cardiac silhouette which is likely within normal limits. The lungs are clear of consolidation. There is no effusion. Mild hypertrophic changes seen in the spine. IMPRESSION: No acute cardiopulmonary process. " aee196d4-0fd7927d-6de41e89-4c2eae46-d7191e6b.jpg,test/p13/p13010258/s52032103/aee196d4-0fd7927d-6de41e89-4c2eae46-d7191e6b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Neck pain, back pain, status post MVA. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. The imaged osseous structures are intact. IMPRESSION: No acute findings in the chest. " 27b3213c-4a39ebbf-65a39e41-41f2ee52-ee9d527b.jpg,test/p10/p10364180/s51147640/27b3213c-4a39ebbf-65a39e41-41f2ee52-ee9d527b.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old female with dyspnea. Rule out infiltrate. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Diffuse interstitial abnormalities along with micronodular opacities in the lung peripheries likely represent scaring. Previously seen left upper lobe nodule is not well appreciated on today's film. There is no consolidation or pleural effusion. There is no pneumothorax. Heart size is normal. No hilar or mediastinal enlargement. Aortic knob is again calcified. IMPRESSION: No acute intrathoracic process. Given the patient's history, a chest CT to better delineate nodular opacities and interstitial abnormalities as seen on prior CT should be considered. " 5e9deac5-60379d8e-9ab80c17-6228873c-2a7a4a26.jpg,test/p18/p18089076/s59661287/5e9deac5-60379d8e-9ab80c17-6228873c-2a7a4a26.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // Eval for acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " 17b73449-f3a5bb7e-2937fba9-66e130c3-fd5f226d.jpg,test/p14/p14206167/s55106924/17b73449-f3a5bb7e-2937fba9-66e130c3-fd5f226d.jpg,test," FINAL REPORT HISTORY: Influenza like illness, cough and back pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. Chest CTA ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is not engorged. Calcified pleural plaques are noted bilaterally, which limit assessment of the underlying pulmonary parenchyma. No new focal consolidation however is identified. There is no pleural effusion or pneumothorax. No acute osseous abnormality is visualized. IMPRESSION: Calcified pleural plaques compatible with prior asbestos exposure. No acute cardiopulmonary abnormality otherwise visualized. " 158579b7-64e7c52a-384cfbe4-fce86a64-010cf72a.jpg,test/p14/p14767018/s59301030/158579b7-64e7c52a-384cfbe4-fce86a64-010cf72a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman extubated, new NG tube // NG tube position NG tube position IMPRESSION: Comparison to ___, 04:44. The course of the nasogastric tube is unchanged. The tip is not included on the image. The other monitoring and support devices are constant, with the exception that the patient has been extubated in the interval. Minimal improvement of the still very extensive and severe bilateral parenchymal opacities. " 2ddda7b2-66d0a152-cb3131a7-1f6a9702-246997e8.jpg,test/p17/p17159661/s53464215/2ddda7b2-66d0a152-cb3131a7-1f6a9702-246997e8.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough, rule out infiltrate. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 6338a4b0-30a50680-7acfb1ed-82dc34e3-f15eb19c.jpg,test/p15/p15588831/s56895405/6338a4b0-30a50680-7acfb1ed-82dc34e3-f15eb19c.jpg,test," WET READ: ___ ___ 7:58 AM 1. Low lung volumes. New since prior study from ___ are two (2) left-sided chest tubes which are in grossly appropriate location projecting over the left hemithorax. 2. Stable masslike opacity in the left upper lung. 3. Interval resolution of right pleural effusion. WET READ VERSION #1 ___ ___ ___ 8:13 PM 1. Low lung volumes. New since prior study from ___ are two (2) left-sided chest tubes which are in grossly appropriate location projecting over the left hemithorax. 2. Stable masslike opacity in the left upper lung. 3. Interval resolution of right pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s.p L vats decortication evacuation of hematoma // eval ct placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, 2 chest tubes were inserted. The opacity at the left lung apex has substantially decreased. The right lung base is substantially better ventilated than on the previous radiograph. Unchanged course of the sternotomy wires. Unchanged mild cardiomegaly with mild fluid overload. " 6445cbe3-7d3a6175-072e1557-5ba2a326-54729923.jpg,test/p10/p10877695/s58540262/6445cbe3-7d3a6175-072e1557-5ba2a326-54729923.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, diffuse rhonchi on exam. // ? pna ? pna IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. The heart is normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " f19ad1f1-622f12db-702f8d09-d6111ba8-3f17905f.jpg,test/p17/p17788370/s59609921/f19ad1f1-622f12db-702f8d09-d6111ba8-3f17905f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R empyema s/p VATS decortication and chest tube placement // eval chest tube placement, effusion TECHNIQUE: Portable chest radiograph COMPARISON: Multiple prior chest radiographs, most recently performed on ___ at 23:05 ; chest CT ___ FINDINGS: Two right-sided chest tubes enter the thoracic cage laterally and adjacent towards the head of the clavicle, terminating at the level of the aortic arch. Anterior-posterior location cannot be assessed by frontal radiography. Left-sided PICC terminates near the mid SVC. Notable improvement in opacification of the right hemithorax in the short interval since the prior radiograph, most consistent with resolving pulmonary edema. Mild background pulmonary edema on the left is stable. Other than minimal atelectasis at the right lung base, there is no focal consolidation. Small amount of fluid in the right minor fissure has increased. Stable mild cardiomegaly. No pneumothorax. IMPRESSION: 1. Mild generalized interstitial edema, improved on the right. 2. Stable positioning of the right-sided chest tubes, although anterior-posterior location is unknown. A lateral CXR could be considered for clarification of their position. " f7b8ceb4-c84ba4bd-782d2320-adee3a4d-c90c1ef2.jpg,test/p19/p19898586/s52428994/f7b8ceb4-c84ba4bd-782d2320-adee3a4d-c90c1ef2.jpg,test," FINAL REPORT HISTORY: Fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The aorta is tortuous. The mediastinal and hilar contours are otherwise unchanged, and no pulmonary vascular congestion is present. Except for mild bibasilar atelectasis, the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. Diffuse demineralization of the osseous structures is re- demonstrated. Degenerative changes of both glenohumeral joints are partially imaged. IMPRESSION: Mild bibasilar atelectasis. No focal consolidation to indicate pneumonia. " 7f078c53-d7f81b05-a881d2bb-853ecd26-2e56ff9a.jpg,test/p19/p19973404/s56110136/7f078c53-d7f81b05-a881d2bb-853ecd26-2e56ff9a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever, cough, facial cellulitis TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. Mild degenerative changes are seen in thoracic spine. Clips are noted in the right upper quadrant of the abdomen compatible with prior cholecystectomy. IMPRESSION: No acute cardiopulmonary abnormality. " a1804f64-cec75c72-a8f92442-c8865e34-064dc3f9.jpg,test/p13/p13259221/s55000247/a1804f64-cec75c72-a8f92442-c8865e34-064dc3f9.jpg,test," FINAL REPORT HISTORY: Leukocytosis, question acute pulmonary process. CHEST, TWO VIEWS. COMPARISON: Chest x-ray dated ___. Compared to the prior film, the left-sided PICC line has been removed. The heart is not enlarged. There is upper zone re-distribution, without overt CHF. Minimal atelectasis at the right base is again noted, slightly improved. No focal infiltrate is detected. No gross effusion is detected. Minimal blunting of the posterior right costophrenic angle is noted. Slight eventration of the left hemidiaphragm is probably unchanged. Hyperinflation and flattened diaphragms suggest background COPD. Nodular density seen adjacent to the hilum on the lateral view most likely represents a vessel seen on end. IMPRESSION: 1) Minimal blunting of the posterior right costophrenic angle consistent with minimal pleural fluid and/or thickening. 2) Minimal atelectasis, right base, improved. 3) Otherwise, no acute pulmonary process identified. " d89b7861-e4d884a3-582f0796-e72e9fe3-065d90be.jpg,test/p18/p18925222/s52755939/d89b7861-e4d884a3-582f0796-e72e9fe3-065d90be.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 2c64dabf-1427e606-c0245464-d8991c10-3d44ad63.jpg,test/p10/p10504635/s53745904/2c64dabf-1427e606-c0245464-d8991c10-3d44ad63.jpg,test," FINAL REPORT HISTORY: Left PICC placement. TECHNIQUE: PA and lateral chest radiograph, 2 views. COMPARISON: Multiple studies dating back to ___. FINDINGS: There has been interval placement of a left subclavian PICC with the tip projecting over the cavoatrial junction. Heart size, cardiomediastinal silhouette and hilar contours are normal. The left cardiophrenic angle is excluded however the lungs are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: Left subclavian PICC with tip projecting over the cavoatrial junction. Results were discussed with the ___ over the telephone by Dr. ___ at 13:17 on ___ at time of initial review. " f1dbc0ae-cd4f86cc-ba41c425-bf5a77c0-049a2252.jpg,test/p16/p16042873/s56895584/f1dbc0ae-cd4f86cc-ba41c425-bf5a77c0-049a2252.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Mucus plugs, atelectasis. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a tracheostomy tube. The tube is in correct position. Unchanged left central venous access line. The lung volumes have substantially decreased, with areas of atelectasis at both lung bases and signs indicative of mild-to-moderate fluid overload. Moderate cardiomegaly. No larger pleural effusions. No pneumonia. " ac7fe2df-df186d77-8ce909a4-ff9a86f8-3077870b.jpg,test/p17/p17445268/s55657396/ac7fe2df-df186d77-8ce909a4-ff9a86f8-3077870b.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient admitted with pneumonia, with hemoptysis, recently extubated. Comparison is made with prior study performed a day earlier. Mild cardiomegaly, tortuous aorta are unchanged. Bibasilar opacities, a combination of pleural effusions and adjacent consolidations have minimally improved. There are no new lung abnormalities or pneumothorax. NG tube tip is out of view below the diaphragm. " 06abe4ce-76d0d0aa-a897ba85-f675ce5c-5ce0a5f2.jpg,test/p12/p12831242/s55831089/06abe4ce-76d0d0aa-a897ba85-f675ce5c-5ce0a5f2.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 2:56 PM 1. Lines and tubes as described above. 2. Small left pleural effusion with basilar atelectasis. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male status post open AAA repair, now with leukocytosis. STUDY: Portable AP semi-upright chest radiograph. COMPARISON: ___. FINDINGS: There has been interval removal of the endotracheal tube. Two endogastric tubes course into the stomach; one of which side port is well below the GE junction; the other of which tip sits in the gastric antrum or early duodenum. The left-sided PICC tip sits in the mid SVC. The right-sided central line tip sits in the lower SVC. The heart size is within normal limits. The mediastinal and hilar contours appear unremarkable. The lungs show no lobar consolidation. Additionally, indistinctness of the left hemidiaphragm suggests small amount of pleural fluid and atelectasis. There is no pneumothorax. IMPRESSION: 1. Lines and tubes as described above. 2. Small left pleural effusion with basilar atelectasis. " 270cf98f-90cc6fec-7b00b3b1-108f08cc-da5b326b.jpg,test/p13/p13158420/s56514904/270cf98f-90cc6fec-7b00b3b1-108f08cc-da5b326b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with SOB // r/o infectious process TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There is mild bibasilar atelectasis without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Mild bibasilar atelectasis without definite focal consolidation, however, and the appropriate clinical setting an early pneumonia is difficult to entirely exclude. " ef94a7d2-84c221c1-3780c22d-2fa3c1eb-1b16656d.jpg,test/p17/p17598360/s51766093/ef94a7d2-84c221c1-3780c22d-2fa3c1eb-1b16656d.jpg,test," FINAL REPORT HISTORY: Pneumonia, respiratory failure, and CHF, now with concern for aspiration. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal views of the chest. Swan-Ganz catheter remains deployed in the descending pulmonary artery. Endotracheal tube terminates 4.9 cm above the carina. Left IJ central venous catheter terminates at the thoracic inlet. Sternotomy wires are intact. Slight interval worsening of moderate pulmonary edema. Moderate left pleural effusion is enlarged and small right pleural effusion is stable. No pneumothorax or new consolidation. Heart size and mediastinal contours are stable. IMPRESSION: 1. Moderate pulmonary edema with enlarging moderate left and small right pleural effusions. 2. Stable lines and tubes. " 417cdcc4-1b3dbff4-c06072aa-7b162f0a-53187e26.jpg,test/p18/p18940953/s57368724/417cdcc4-1b3dbff4-c06072aa-7b162f0a-53187e26.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF, currently diuresing, with dyspnea and prior CXR with large R pleural effusion // eval right pleural effusion progression eval right pleural effusion progression IMPRESSION: In comparison with the study of ___, the left PICC line is been pulled back to the axillary region. Continued enlargement of the cardiac silhouette with worsening pulmonary edema. Substantial bilateral pleural effusions, more prominent on the right with underlying compressive atelectasis at the bases. " 936116f7-99412772-5bebd500-0ef2beee-a1fd50c5.jpg,test/p11/p11301172/s56942427/936116f7-99412772-5bebd500-0ef2beee-a1fd50c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with neutropenia, RLL focal wheeze COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " e6551a0b-1b3bb26c-a880ed2f-cf7d83a0-6b320e9b.jpg,test/p13/p13745545/s51276270/e6551a0b-1b3bb26c-a880ed2f-cf7d83a0-6b320e9b.jpg,test," FINAL REPORT CHEST, TWO VIEWS ON ___ HISTORY: Bronchiolitis obliterans with increased dyspnea. REFERENCE EXAM: ___. FINDINGS: Again seen is severe cardiomegaly and a dual-lead pacemaker. There are bilateral pleural effusions, left greater than right. However, the aeration in the lower lobes is slightly improved compared to the study from one week prior. There continues to be patchy bilateral lower lobe infiltrates and an underlying infectious infiltrate cannot be excluded. Overall, the previously described lung nodules are better visualized on the CT from ___ and diffuse increase in lung markings consistent with the patient's history of chronic lung disease are again seen. " 7cbf3227-eedcf611-0849fcba-0c93b356-df4f57c7.jpg,test/p18/p18656167/s58775324/7cbf3227-eedcf611-0849fcba-0c93b356-df4f57c7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M which shortness of breath that feels like COPD exacerbation, TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are hyperinflated. No focal consolidation, pleural effusion or pneumothorax is seen. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " ccccd88c-1afaef38-0de8f3ad-646ba187-70001290.jpg,test/p16/p16057835/s55798033/ccccd88c-1afaef38-0de8f3ad-646ba187-70001290.jpg,test," WET READ: ___ ___ ___ 2:48 PM New regions of consolidation in the left mid and upper right lung suspicious for pneumonia in the proper clinical setting. Bibasilar opacities potentially atelectasis, infection not excluded. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with hypoxia // Acute cardiopulmonary disease TECHNIQUE: Single portable view of the chest. COMPARISON: Chest x-ray and chest CT from ___ FINDINGS: There are new regions of consolidation in the left lung, particularly over the left lung apex and left midlung. Linear streaky bibasilar opacities may be secondary to atelectasis. The cardiomediastinal silhouette is unchanged, atherosclerotic calcifications again noted at the aortic arch. Vertebroplasty changes are noted in the mid thoracic spine. IMPRESSION: New regions of consolidation in the left mid and upper right lung suspicious for pneumonia in the proper clinical setting. Bibasilar opacities potentially atelectasis, infection not excluded. " 3728945f-3c3b892c-5b9ac2ca-9b08cb95-f21fedb5.jpg,test/p17/p17574863/s51959696/3728945f-3c3b892c-5b9ac2ca-9b08cb95-f21fedb5.jpg,test," FINAL REPORT INDICATION: Four-day history of hiccups. Assess for pneumonia. COMPARISONS: CT abdomen and pelvis of the same date. Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Small right lung base consolidation is better assessed on the CT exam of the same date. Dual-chamber dialysis catheter terminates in the right atrium. Right-sided PIC catheter has been removed. IMPRESSION: Small right lung base consolidation is better demonstrated on CT exam of the same date, concerning for aspiration or infection in the appropriate clinical setting, although alternatively the residual of larger atelectasis when subphrenic infection was present. " d2cbb60f-817651e5-a5f46935-582db635-04bfa001.jpg,test/p15/p15677235/s50850948/d2cbb60f-817651e5-a5f46935-582db635-04bfa001.jpg,test," FINAL REPORT HISTORY: Shoulder pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. Lung volumes are low. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " cb6fad0d-1eac3e32-ffdc7c9d-3c505dbe-5c6a19d5.jpg,test/p19/p19419696/s58109005/cb6fad0d-1eac3e32-ffdc7c9d-3c505dbe-5c6a19d5.jpg,test," FINAL REPORT INDICATION: ___M with sob // ? pna TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear, without focal consolidation, effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " ad20192c-55f535ef-ece0451b-ce622996-604fb9ac.jpg,test/p19/p19398915/s53104789/ad20192c-55f535ef-ece0451b-ce622996-604fb9ac.jpg,test," FINAL REPORT INDICATION: Cirrhosis and recurrent hepatohydrothorax status post thoracentesis, assess for interval change. COMPARISON: ___. FINDINGS: Portable frontal radiograph of the chest demonstrates interval decrease in size of right pleural effusion status post thoracentesis with now small remaining right pleural effusion. There is diffuse opacification of the right lower lobe concerning for pneumonia. Pulmonary edema is slightly increased. A small left pleural effusion is present. Stable cardiomediastinal contours. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:30 PM, 10 minutes after discovery of the findings. " 54441aa8-e9ff5ef3-c01735bd-ec16a25b-2fff6bfa.jpg,test/p18/p18049473/s52059155/54441aa8-e9ff5ef3-c01735bd-ec16a25b-2fff6bfa.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___ year old woman with HIV, afib, ESRD, with recent pneumonia. Evaluate for recurrent pneumonia in the setting of cough. TECHNIQUE: PA and lateral views the chest. COMPARISON: Chest radiograph dated ___, CT chest dated ___. FINDINGS: Lung volumes remain low and a severe, global infiltrative pulmonary abnormality persists. As compared to the most recent prior examination dated ___, there are multiple new bilateral opacities, most notably in the right upper and left lower lobes, although other regions have improved. There is no evidence of pleural effusion or large pneumothorax. The cardiomediastinal silhouette is unchanged. IMPRESSION: Interval development of multiple new bilateral airspace opacities, compatible with multifocal pneumonia or pulmonary hemorrhage. " 1b67d54b-6f2cd6eb-3b0a4883-786ab0fe-4b5567d6.jpg,test/p18/p18483313/s57109455/1b67d54b-6f2cd6eb-3b0a4883-786ab0fe-4b5567d6.jpg,test," FINAL REPORT INDICATION: ___-year-old female with end-stage renal disease, on peritoneal dialysis. Evaluate for infection. COMPARISON: Chest radiograph from ___. TWO VIEWS OF THE CHEST: There is right basal opacity compatible with effusion and consolidation likely compressive atelectasis. The cardiac silhouette is poorly assessed. The left lung appears clear though lung volume is low. No pneumothorax. IMPRESSION: Right pleural effusion with compressive atelectasis in the right lower lung. Please refer to subsequent CT abd for further details. " b768aa9e-45a1a43c-f6346e22-bb4e6927-91dadfae.jpg,test/p18/p18879982/s50790966/b768aa9e-45a1a43c-f6346e22-bb4e6927-91dadfae.jpg,test," FINAL REPORT INDICATION: Pleural effusion, now status post Pleurx catheter. Assess for pneumothorax. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Single frontal chest radiograph demonstrates stable moderate loculated left pleural effusion. No pneumothorax identified. Pleurex catheter not identified.Mediastinal and hilar contours are unremarkable. Unable to assess heart size given adjacent effusion. Lungs are clear. No right-sided pleural effusion. IMPRESSION: Unchanged examination. Stable loculated left effusion. No pneumothorax. PleurX catheter not identified. " 78087ac6-1edbaad8-61cd8c35-67994f9f-514e03be.jpg,test/p15/p15386262/s52949502/78087ac6-1edbaad8-61cd8c35-67994f9f-514e03be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RLL PE and pulmonary infarct // effusion effusion IMPRESSION: In comparison with the study of ___, there is again increased opacification at the right base consistent with pleural effusion and compressive atelectasis. No additional abnormalities are identified. " 8f31230a-6793fd43-f78cdeca-c43236b4-d89445c6.jpg,test/p16/p16864674/s52410114/8f31230a-6793fd43-f78cdeca-c43236b4-d89445c6.jpg,test," FINAL REPORT EXAMINATION: Scratch the CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with pleural effusion, question infection // Please assess for interval change COMPARISON: ___ IMPRESSION: Moderate right pleural effusion unchanged since ___. Left basal atelectasis mild and unchanged. No pneumothorax. No pulmonary edema. " 2f0a0312-d015a403-b4a74950-61e18c25-8d4f332d.jpg,test/p19/p19765588/s54527469/2f0a0312-d015a403-b4a74950-61e18c25-8d4f332d.jpg,test," FINAL REPORT INDICATION: ___M with altered mental; status // r/o bleed TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. Nodular opacities projecting over the lung bases are compatible with nipple shadows. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 5d232c11-8fc7dfd2-708cf2fc-ee081267-813bfcb5.jpg,test/p11/p11091044/s52141631/5d232c11-8fc7dfd2-708cf2fc-ee081267-813bfcb5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man h/o L PTX after fall 4 weeks ago // check interval change check interval change IMPRESSION: Comparison to ___. Today's image shows no evidence of pneumothorax. Pre-existing opacities at the left lung bases have completely cleared. No pneumonia, no pulmonary edema. " 0731116b-135dbe0b-6192f64a-74979047-05e46fb7.jpg,test/p11/p11812613/s55724064/0731116b-135dbe0b-6192f64a-74979047-05e46fb7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with RUL pna. // please assess for resolution F/U RUL PNEUMONIA,ASSESS FOR RESOLUTION IMPRESSION: Comparison to ___. A pre-existing perihilar right opacity has completely resolved in the interval. Mild overinflation persists. Unchanged moderate cardiomegaly with elongation of the descending aorta. The left pectoral pacemaker is in stable position. " 39634be1-f1b8b223-1c685521-034f7ef6-aa84f159.jpg,test/p15/p15939762/s51496570/39634be1-f1b8b223-1c685521-034f7ef6-aa84f159.jpg,test," FINAL REPORT INDICATION: ___-year-old man with increased WBC count and cough, treated for pneumonia from ___ to ___ to assess for new pneumonia. COMPARISONS: CT torso with contrast from ___, AP chest radiograph from ___. FINDINGS: There is no focal consolidation or pneumothorax. There is mild cardiomegaly which is stable. Streaky opacities seen only on the lateral likely due to atelectasis. There are minimal bibasilar pleural effusions which are much improved from the prior CT. Osseous structures are notable for spinal fixation hardware. There is a nerve stimulator seen in the left lateral chest wall. IMPRESSION: 1. No evidence of pneumonia. 2. Significantly improved small bilateral pleural effusions. " faa12663-4b6a315e-22e9008c-23b91c4e-48c7949b.jpg,test/p13/p13680126/s54113101/faa12663-4b6a315e-22e9008c-23b91c4e-48c7949b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with productive cough and shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unchanged. Patient is status post left upper lobe superior segmentectomy with chain sutures and expected postoperative changes noted in the left hilum. Lungs are hyperinflated with marked upper lobe a dominant emphysema. Pulmonary vasculature is not engorged. Chronic left lateral and costophrenic angle pleural thickening is re- demonstrated. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is demonstrated. Multiple clips are noted within the left upper quadrant of the abdomen. Deformity of the left rib cage is likely from prior thoracotomy. IMPRESSION: No acute cardiopulmonary abnormality. Postoperative changes in the left upper lobe. Severe upper lobe predominant emphysema. " cecf6e3f-d889fa91-6c1a6a7f-dbc5f94b-ed411be3.jpg,test/p14/p14340564/s50809333/cecf6e3f-d889fa91-6c1a6a7f-dbc5f94b-ed411be3.jpg,test," FINAL REPORT INDICATION: ___-year-old female with right upper extremity PICC, concern about placement. Evaluate for PICC placement. COMPARISONS: PA and lateral chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. A right PICC terminates in the upper SVC. Lung volumes are low. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The bones are intact. The imaged upper abdomen is unremarkable. IMPRESSION: 1. Right PICC terminates in the upper SVC. 2. Low lung volumes, but no acute process. " 39f9434b-61036f2d-46004bc7-8112f50c-089ac3aa.jpg,test/p15/p15974908/s57921801/39f9434b-61036f2d-46004bc7-8112f50c-089ac3aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with productive cough and decreased breath sounds. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: There is increased opacification of the lingula and right lower lung. There is likely a background of interstitial lung disease P The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Lingular and right lower lung opacities concerning for multifocal pneumonia given the clinical presentation. There is likely a background of interstitial lung disease. " 1ee313d1-da527dfb-f321e9a2-edb20cf9-181c85f2.jpg,test/p10/p10699336/s54402905/1ee313d1-da527dfb-f321e9a2-edb20cf9-181c85f2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETT/?PNA // Interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Evaluation of the a tracheostomy tube is limited due to overlying external devices. Cardiomediastinal contours are unchanged. Left PICC tip appears to be in the azygos vein. Mild fluid overload has minimally improved. Right lower lobe atelectasis has increased. Retrocardiac atelectasis and bilateral effusions are unchanged. " b9b7596b-8d913b6b-9e858692-da963efa-6ceb2a30.jpg,test/p19/p19931382/s53875074/b9b7596b-8d913b6b-9e858692-da963efa-6ceb2a30.jpg,test," FINAL REPORT HISTORY: ___-year-old male with increasing leg swelling and dyspnea. COMPARISON: Chest x-ray from ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of consolidation effusion, or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unchanged noting degenerative changes at the acromioclavicular joints. IMPRESSION: No acute cardiopulmonary process. " 929afa59-c86cf3ee-c178e593-fd6dd4c6-deeefa06.jpg,test/p12/p12362634/s52082083/929afa59-c86cf3ee-c178e593-fd6dd4c6-deeefa06.jpg,test," FINAL REPORT INDICATION: ___-year-old female with pleuritic chest pain, cough, and dyspnea on exertion. Evaluate for acute process. COMPARISONS: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The pulmonary vasculature is unremarkable. The lungs are slightly hyperinflated with chronic-appearing bibasilar interstitial lung markings. There is no focal consolidation, pneumothorax, or pleural effusion. The osseous structures are unremarkable. No radiopaque foreign body is present. IMPRESSION: Slightly hyperinflated lungs with chronic-appearing bibasilar interstitial lung markings. " a2b5f4e8-bfa7e11b-5d380cf1-f0aced7c-48248d5e.jpg,test/p13/p13155727/s55073084/a2b5f4e8-bfa7e11b-5d380cf1-f0aced7c-48248d5e.jpg,test," FINAL REPORT INDICATION: Cough and fever for one week. No prior examinations for comparison. CHEST, PA AND LATERAL: The lungs are well expanded and clear. The cardiomediastinal and hilar contours are normal. No pleural effusions or pneumothorax. IMPRESSION: Normal chest. " ad8acd47-3b6f3c90-a3de0212-95eed992-743fa860.jpg,test/p15/p15549843/s52667471/ad8acd47-3b6f3c90-a3de0212-95eed992-743fa860.jpg,test," FINAL REPORT INDICATION: ___-year-old female with syncope. Question cardiomegaly. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate similar cardiac prominence as compared to ___. Thoracic aorta is persistently tortuous with atherosclerotic calcifications in the arch. The lungs are clear. There is no pneumothorax, vascular congestion, or large effusion. There may be mild dependent atelectasis posteriorly in the lower lung on the lateral view. IMPRESSION: Stable mild cardiomegaly. No definite acute cardiopulmonary process. " 47fed25c-46c2fc49-0a32048b-b5244e3e-e773b903.jpg,test/p15/p15463031/s55336758/47fed25c-46c2fc49-0a32048b-b5244e3e-e773b903.jpg,test," FINAL REPORT HISTORY: Right rib pain. TECHNIQUE: Portable AP view of the chest. COMPARISON: None. FINDINGS: The heart size is normal. The aorta is mildly tortuous. The pulmonary vasculature is normal. The hilar contours are unremarkable. Patchy bibasilar airspace opacities may reflect atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. No displaced fractures are identified. IMPRESSION: Mild bibasilar atelectasis. No displaced fractures are identified. If there is continued concern for rib fracture, then a dedicated rib series is recommended. " 10d1ff54-0e789ea2-4d698518-88fae30c-a9822c2b.jpg,test/p15/p15844438/s56393997/10d1ff54-0e789ea2-4d698518-88fae30c-a9822c2b.jpg,test," FINAL REPORT HISTORY: Hemodynamic instability, to assess for pneumonia. FINDINGS: In comparison with the study of ___, the monitoring and support devices are unchanged. Continued low lung volumes, which exaggerate the size of the transverse diameter of the heart. There is again pulmonary vascular congestion with opacification at the left base consistent with pleural effusion and volume loss in the left lower lobe. The right lung is clear than on the previous study. " 453a4e80-81545f17-a93b2b20-7f9ce7b3-64a0ee73.jpg,test/p14/p14603544/s57530960/453a4e80-81545f17-a93b2b20-7f9ce7b3-64a0ee73.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/ h/o R fem to PT bypass and multiple stents/PTA of L side now p/w nonhealing ulcer and erythema of L foot s/p angio ___ ___/ Please evaluate for fluid overload. Thanks Please evaluate for fluid overload. Thanks COMPARISON: Chest radiographs since ___ most recently one ___. IMPRESSION: Lungs are mildly hyperinflated, consistent with emphysema. Chain suture denotes prior resection from the left midlung. Irregularly shaped calcifications project over both lung apices have been present since at least ___. It is not clear whether they are calcified granulomas or more bulky atherosclerotic calcifications in the subclavian arteries. Lateral view confirms heavy calcification at the origins of the branches of the aortic arch. A lordotic view of the chest would clarify the nature the apical calcifications. A 6 mm well-circumscribed nodular opacity projecting over the right fifth anterior interspace might be present on prior studies. I would repeat conventional chest radiographs in 6 months to document its contain stability. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 0d693ff6-23b2be68-53bc8832-1ef8b16f-532bfce9.jpg,test/p14/p14171423/s53478868/0d693ff6-23b2be68-53bc8832-1ef8b16f-532bfce9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESRD on HD, afib, found to have pulmonary embolism and pneumonia // evaluate pneumonia and infiltrates, volume status; assess RU chest PORT evaluate pneumonia and infiltrates, volume status; assess RU COMPARISON: Prior chest radiograph ___:29. IMPRESSION: Small areas of consolidation have progressed in both lungs. Whether these are infarction or pneumonia is radiographically indeterminate. Heart size is top-normal. Small right pleural effusion is larger. No pneumothorax. Right jugular catheter ends in the mid SVC. Transvenous right ventricular pacer lead in standard " 1260ea7f-6df18b08-89962f0a-03aed4e8-74571cbd.jpg,test/p11/p11433061/s52189234/1260ea7f-6df18b08-89962f0a-03aed4e8-74571cbd.jpg,test," FINAL REPORT INDICATION: ___ year old woman with met breast // on long-term trastuzumab therapy, pain at POC site radiating to back. Please evaluate if line has migrated? TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___. FINDINGS: A right chest wall subclavian approach port is noted with tip terminating in standard position at or just below the cavoatrial junction. The line does not appear to have migrated, although is somewhat difficult to assess given absence of conventional chest radiograph after placement of the port. Cardiomediastinal and hilar contours are normal. Elevation of the right hemidiaphragm is persistent. There is no pleural effusion. Lucency at the right lung apex with an apparent pleural line is noted, which may represent a small pneumothorax. There is no focal consolidation concerning for pneumonia. Right lower lobe atelectasis is present. The visualized upper abdomen is unremarkable. Degenerative changes are seen in the thoracic spine. Surgical clips are present in the right breast with asymmetric increase of the right breast tissue, consistent with breast reconstruction. Sclerosis with compression deformity in the T2 vertebral body is again seen, stable compared to the chest CT from ___. IMPRESSION: 1. Right chest port in standard position. 2. Possible small right apical pneumothorax. Repeat chest radiograph with expiration views is recommended. During this repeat exam, care should be taken to ensure that nothing is overlying the patient. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 12:21 into the Department of Radiology critical communications system for direct communication to the referring provider. " a958e3de-279030e2-7bc6d958-4c3d875a-60df89c4.jpg,test/p11/p11888614/s56839405/a958e3de-279030e2-7bc6d958-4c3d875a-60df89c4.jpg,test," FINAL REPORT INDICATION: ___-year-old male with seizures. COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: An endotracheal tube terminates 5.8 cm above the carina. The heart size is normal. Multifocal consolidations persist since ___. Mild superimposed pulmonary edema has improved and a small left pleural effusion is unchanged. There is no pneumothorax. IMPRESSION: 1. Unchanged multifocal pneumonia. 2. Improved background mild pulmonary edema. 3. Unchanged small left pleural effusion. " 650177f5-ced8b39c-5dcf663f-a604dcd1-37554235.jpg,test/p14/p14893593/s50354421/650177f5-ced8b39c-5dcf663f-a604dcd1-37554235.jpg,test," FINAL REPORT PORTABLE CHEST: ___ AT 4:21 P.M. COMPARISON: Film from earlier the same day at 3:01 p.m. HISTORY: ___-year-old female, intubated with right IJ placement. FINDINGS: Single portable view of the chest. ET, enteric, and right PICC are in stable positions. New right IJ line is seen with tip at the SVC/RA junction. There is no pneumothorax. Low lung volumes again noted, with crowding of the bronchovascular markings. More focal opacity at the left lung base is likely due to atelectasis. IMPRESSION: New right IJ central venous catheter at the RA/SVC junction. No pneumothorax. " 272aa661-14741819-7981cdb3-1f5565b9-0a746b27.jpg,test/p10/p10983729/s53649742/272aa661-14741819-7981cdb3-1f5565b9-0a746b27.jpg,test," FINAL REPORT HISTORY: ___-year-old male with dyspnea on exertion and history of prostate cancer with bladder extension. PSA is rising despite treatment, question underlying pathology. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate clear well expanded lungs, with minimal scarring at the left base, unchanged from ___ years prior. There is new atelectasis and small effusion on the right. There is no pleural effusion, or pneumothorax. The cardiac silhouette is top normal, and unchanged from ___. The mediastinal contours are normal. IMPRESSION: No acute chest abnormality, with interval appearance of right basal atelectasis and small effusion. " a31dd24a-fa9f21bf-e3d57567-bd7890b1-4cb38c9f.jpg,test/p10/p10021927/s55422556/a31dd24a-fa9f21bf-e3d57567-bd7890b1-4cb38c9f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with new o2 requirement // eval for pulm edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Low lung volumes persist. New since the prior study is interstitial opacity over the right lung worrisome for asymmetric pulmonary edema or infection. Right base atelectasis is seen. No large pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are grossly stable. The right colon is again interposed anterior to the liver. IMPRESSION: New opacity projecting over the left lung could be due to very asymmetric pulmonary edema although more concerning for infectious or inflammatory process. " 7a4528f5-15fb2398-60d26e47-fa88b6bc-d1008b42.jpg,test/p18/p18704055/s50350208/7a4528f5-15fb2398-60d26e47-fa88b6bc-d1008b42.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, all monitoring and support devices, including the chest tubes, have been removed, with exception of a right internal jugular vein catheter. There are minimal areas of atelectasis at both the left and the right lung base. In addition, a mild increase in diameter of the pulmonary vasculature could suggest mild fluid overload. Borderline size of the cardiac silhouette. No convincing evidence for the presence of a pneumothorax. A hyperlucent paracardiac line on the right was present on yesterday's image in unchanged manner. No pleural effusions. " c3740973-da4131ac-479992ae-d2984d4f-41df5de8.jpg,test/p15/p15354831/s54614399/c3740973-da4131ac-479992ae-d2984d4f-41df5de8.jpg,test," FINAL REPORT INDICATION: ___ year old woman with left pleural effusion s/p thoracentesis // s/p thoracentesis on left TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: Mild interval decrease in size of the left pleural effusion. There is overlying atelectasis/consolidation. No pneumothorax is identified. No focal consolidation, pleural effusion or pneumothorax identified in the right lung. There is persisting mild pulmonary edema. The size of the cardiac silhouette is enlarged but unchanged. IMPRESSION: Minimal interval decrease in size of the left pleural effusion. Persisting retrocardiac opacity likely reflects atelectasis and/or consolidation. Mild pulmonary edema. " f2b2e7fe-0562d5f8-55949267-27054098-403659bf.jpg,test/p15/p15985339/s57256039/f2b2e7fe-0562d5f8-55949267-27054098-403659bf.jpg,test," FINAL REPORT INDICATION: ___ year old man with pleural effusion after R stab wound // eval for interval change TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right-sided pleural effusion is slightly increased in size. Suspected right posterior basal atelectasis. No pneumothorax. No cardiomegaly. Left lung is clear. No left-sided pleural effusion. IMPRESSION: Right pleural effusion is slightly increased in size. " e1ead1e5-28a88af1-14302fb5-cf2be84a-47c4854e.jpg,test/p10/p10855190/s57581801/e1ead1e5-28a88af1-14302fb5-cf2be84a-47c4854e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with shadow on right lung as seen on xray dated ___ // evaluate prominent shadow on the right lung along the right heart border as seen on xray from ___ TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. FINDINGS: Cardiomediastinal silhouette is unchanged. The heart is not enlarged. Chronic elevation of the left hemidiaphragm is again noted. There is no focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. Right shoulder arthroplasty is again noted. Severe kyphosis with a chronic compression deformity lower thoracic spine again noted and not significantly changed compared to prior study from ___. Postsurgical clips are again noted in the right upper abdomen possibly secondary to cholecystectomy. IMPRESSION: 1. Previously seen opacity along the right heart border is not seen on the current study. 2. Chronic elevation of the left hemidiaphragm. " 99d40eca-a6fe3e87-4c9af394-0284bd01-2f060537.jpg,test/p12/p12459180/s57597560/99d40eca-a6fe3e87-4c9af394-0284bd01-2f060537.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ AT 2:27 P.M. HISTORY: ___-year-old man with Wegener's granulomatosis. IMPRESSION: PA and lateral chest compared to ___: Consolidation in the right lower lobe which developed between ___, has improved since ___, and pulmonary edema which developed on ___ has not recurred. The heart is mildly to moderately enlarged. Thoracic aorta is extremely tortuous but not clearly dilated. There is no appreciable pleural abnormality. " a27c219a-895984d7-eb6a4b68-f0e1a526-71c9bbe1.jpg,test/p19/p19928285/s50211363/a27c219a-895984d7-eb6a4b68-f0e1a526-71c9bbe1.jpg,test," FINAL REPORT INDICATION: Evaluation of patient status post liver biopsy with syncope. COMPARISON: Chest radiograph from ___, Ct abdomen ___. FINDINGS: There is mild bibasilar atelectasis; otherwise, the lungs are clear with no evidence of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No acute fractures are identified. No free air is noted under the hemidiaphragms. A tube is visualized overlying the sternum in the lateral projection, is likely external to the patient, but clinical correlation is recommended. Nodular opacity over left lung base is likely nipple as this area of lung is clear on CT performed the same day. Calcific densities are again noted in the region of the pancreatic tail and consistent with patient's history of chronic pancreatitis. IMPRESSION: No acute cardiopulmonary process. " d27cf3be-71977e8b-5cc137db-6026a5e4-65ccf8b7.jpg,test/p18/p18027598/s58932254/d27cf3be-71977e8b-5cc137db-6026a5e4-65ccf8b7.jpg,test," WET READ: ___ ___ 12:20 PM New retrocardiac opacity on the lateral view potentially due to atelectasis however it was not seen on prior film with similar inspiratory effort, consolidation would also be possible. Please correlate clinically. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. On the lateral view, there is increased opacity in the retrocardiac clear space. There is no clear correlate for this finding on the frontal and it was not clearly identified on the prior exam. While this may be due to atelectasis, given that it is new from prior exam with similar inspiratory effort consolidation is also possible. There is no effusion. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: New retrocardiac opacity on the lateral view potentially due to atelectasis however it was not seen on prior film with similar inspiratory effort, consolidation would also be possible. Please correlate clinically. " dcdce119-89da5868-13dcfe10-9aca4ee2-5491f08b.jpg,test/p19/p19451806/s50533293/dcdce119-89da5868-13dcfe10-9aca4ee2-5491f08b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pressure and dyspnea, evaluate for pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 5ca27ae5-1f4ab9cf-8bf74fd1-922a6d58-feefc5ce.jpg,test/p14/p14798598/s50983321/5ca27ae5-1f4ab9cf-8bf74fd1-922a6d58-feefc5ce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with massive right effusion s/p pigtail placement // ? PTX ? PTX IMPRESSION: In comparison with the study of ___, there has been removal of a moderate amount of free pleural fluid from the right hemithorax. Specifically, there is no evidence of appreciable pneumothorax. Otherwise little change. " 69e3b49b-41ece6c3-3b6fa53c-0384821c-0e965c31.jpg,test/p14/p14246614/s58374256/69e3b49b-41ece6c3-3b6fa53c-0384821c-0e965c31.jpg,test," FINAL REPORT HISTORY: End-stage renal disease on hemodialysis, shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Right-sided central venous catheter tip terminates in the upper SVC. The cardiac, mediastinal and hilar contours are unremarkable with the heart size within normal limits. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 991be44b-cac44c6d-76e24956-fdae4521-a836999d.jpg,test/p19/p19405755/s56941512/991be44b-cac44c6d-76e24956-fdae4521-a836999d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with cough TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 8174aa30-7c85e590-7f45b77c-946836c2-5e694106.jpg,test/p19/p19005323/s53784218/8174aa30-7c85e590-7f45b77c-946836c2-5e694106.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old male with hepatic cellular carcinoma presenting with shortness of breath. TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: No prior chest x-ray available for comparison. Correlation made to chest CT dated ___. FINDINGS: Lung volumes are low. There is mild elevation of the right hemidiaphragm with new right lower lobe subsegmental atelectasis. The left lung is clear. IMPRESSION: New right lower lobe subsegmental atelectasis. " f02ea178-9a48d596-6e9a85bc-a78a849f-9e0712be.jpg,test/p13/p13855365/s52765501/f02ea178-9a48d596-6e9a85bc-a78a849f-9e0712be.jpg,test," WET READ: ___ ___ ___ 11:46 PM 0.8 cm rounded opacity projecting over the posterior right ninth rib at the right lung base which is most likely artifactual, however, recommend oblique radiographs for further evaluation. ______________________________________________________________________________ FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Syncope, head strike, left shoulder pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy, CABG, and aortic valve replacement. The lateral view is suboptimal due to the patient's overlying arm projecting over the posterior lung fields. On the frontal view, there is mild blunting of the right costophrenic angle, which could be due to a trace pleural effusion or pleural thickening. No left pleural effusion is seen. There is no focal consolidation or evidence of pneumothorax. The cardiac silhouette is not enlarged. The aorta is calcified and tortuous. No overt pulmonary edema is seen. There is a 0.8 cm rounded opacity projecting over the posterior right ninth rib at the right lung base which is most likely artifactual, however, recommend oblique radiograph for further evaluation. IMPRESSION: 1. Suboptimal lateral view due to patient's arm overlying the posterior chest. On the frontal view, there is blunting of the right costophrenic angle, may be due to a small pleural effusion versus pleural thickening. 2. 0.8 cm rounded opacity projecting over the posterior right ninth rib at the right lung base, however, recommend oblique radiographs for further evaluation. " 382f009b-21718c41-9b8666e0-1416b3a0-6ffc83cc.jpg,test/p17/p17527219/s57733153/382f009b-21718c41-9b8666e0-1416b3a0-6ffc83cc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cardiogenic shock s/p diuresis // evaluate for pulmonary edema evaluate for pulmonary edema IMPRESSION: Swan-Ganz catheter tip terminates at the level of the right main pulmonary artery, more distal than on the previous study for approximately 2.5 cm and should be pulled back. Cardiomegaly is substantial. Mediastinal silhouette is stable. There is no evidence of pulmonary edema. There is no appreciable pleural effusion. Right PICC line tip is at the level of cavoatrial junction. " 9386962c-e0fc3d90-2ab713f3-fe91334a-6c8eaedf.jpg,test/p10/p10481190/s50547430/9386962c-e0fc3d90-2ab713f3-fe91334a-6c8eaedf.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hx copd, chf, now with doe // eval heart and lungs TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Oblong sclerotic focus is again seen projecting over the anterior right second rib, stable since earlier this month. The lungs remain hyperexpanded but clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Hilar contours are stable. IMPRESSION: Oblong sclerotic focus is again seen projecting over the anterior right second rib, stable since earlier this month. The lungs remain hyperexpanded but clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Hilar contours are stable. " 3bdf8d3b-8f432d69-96083643-51793ab0-199ede9f.jpg,test/p10/p10691738/s51238546/3bdf8d3b-8f432d69-96083643-51793ab0-199ede9f.jpg,test," FINAL REPORT CHEST RADIOGRAPH COMPARISON: ___. INDICATION: Pleural effusions, evaluation. FINDINGS: As compared to the previous radiograph, there is a minimal increase in extent of the left pleural effusion and a constant situation and appearance of the right pleural effusion. The areas of subsequent atelectasis are constant in appearance. Constant position of sternal wires, clips the left pectoral pacemaker. No evidence of pneumothorax. No pneumonia, unchanged mild cardiomegaly. " 7d8854fc-6d9e667a-24854d46-9a184cf5-b765c202.jpg,test/p18/p18092465/s57772071/7d8854fc-6d9e667a-24854d46-9a184cf5-b765c202.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with as above // s/p ECMO for ARDS evaluate lung fields COMPARISON: Chest radiographs since ___ most recently ___ at 08:36. IMPRESSION: Severe pulmonary consolidation has improved since ___. Right hand somewhat smaller left pleural effusion are unchanged. Heart size is normal. ET tube tip is approximately 3 cm from the carina an should not be further advanced. A large bore cannula traverses the main, right atrium common inferior vena cava and passes out of view. No pneumothorax. " 3546e5cf-a2fa06f3-5bb4385e-f138f2cd-88e4aeed.jpg,test/p11/p11573149/s51191172/3546e5cf-a2fa06f3-5bb4385e-f138f2cd-88e4aeed.jpg,test," FINAL REPORT HISTORY: ___ years old man postoperative day ___ status post CABG, high diuresis day 4 with increased pulmonary secretion, possible pneumonia and urosepsis. Please confirm Dobbhoff placement. COMPARISON: Exam is compared to chest x-ray of the same day at 8:10 a.m. FINDINGS: The Dobbhoff tube is looped in the lower esophagus and should be repositioned. Lung volumes are low with interval improvement of bilateral opacification due to reduced pulmonary edema. Persistent reticular opacity due to pulmonary fibrosis. There is no pleural effusion or pneumothorax. Heart size is mildly enlarged. IMPRESSION: Looping of the Dobbhoff tube in lower esophagus. Improvement of pulmonary edema. " b373d705-1b01f997-23ce4891-4740da19-82847812.jpg,test/p12/p12106204/s58027451/b373d705-1b01f997-23ce4891-4740da19-82847812.jpg,test," FINAL REPORT AP CHEST, 7:21 A.M., ___ HISTORY: ___-year-old man after AVR with a fever. IMPRESSION: AP chest compared to ___: Greater consolidation at the lung bases could be due to atelectasis alone or concurrent pneumonia as well. Small left pleural effusion is unchanged. Normal cardiomediastinal silhouette is stable. No pneumothorax. ET tube in standard placement. Feeding tube ends in the mid stomach, and a right subclavian line or PIC line ends in the low SVC. " 424f1198-85fd0968-2df886ca-f5550d51-b39c75c4.jpg,test/p14/p14497007/s59363092/424f1198-85fd0968-2df886ca-f5550d51-b39c75c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with relapsed multiple myeloma. Increase cough. R/O infiltrate // Increase cough. On chemotherapy for relapsed myeloma. R/O infiltrate Increase cough. On chemotherapy for relapsed myeloma. R/O in IMPRESSION: In comparison with the study of ___, the blunting of the left costophrenic angle has cleared. No evidence of acute focal pneumonia or vascular congestion. " 3b434ba1-340c04fa-f577efd9-d7076eb0-1db33315.jpg,test/p11/p11966397/s51769812/3b434ba1-340c04fa-f577efd9-d7076eb0-1db33315.jpg,test," FINAL REPORT HISTORY: ___-year-old man with history of coronary artery disease, ___, ___% of the LAD, hypertension, iHLD, PVD status post bilateral femoral endarterectomies, right profundoplasty and left superficial femoral endarterectomy on ___, one infection and enterococcal bacteremia, admitted from the ED. COMPARISON: Exam is compared to ___. FINDINGS: Lung volume is lower with persistent left upper lobe large opacification in area of previous surgery, likely scarring. There are no sign of new consolidation. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No sign of acute cardiopulmonary process. Persistent left apical scarring after lung surgery. " 43574601-0cbea137-ca2b03ff-f4d98ee5-323b132a.jpg,test/p14/p14358282/s53151470/43574601-0cbea137-ca2b03ff-f4d98ee5-323b132a.jpg,test," FINAL REPORT INDICATION: Lightheadedness and weakness. Known coronary artery disease with AICD. COMPARISONS: ___. FINDINGS: PA and lateral chest radiographs again demonstrate moderate cardiomegaly without pulmonary vascular congestion, representing improvement ___ ___. The lungs are clear and there is no pneumothorax or pleural effusion. Left-sided pacer leads are in stable position. IMPRESSION: No acute cardiopulmonary process. " 3219f002-8c975b90-fd829468-01b104f2-a23d934d.jpg,test/p16/p16830759/s52096038/3219f002-8c975b90-fd829468-01b104f2-a23d934d.jpg,test," WET READ: ___ ___ ___ 7:49 PM Lung volumes are low. Left lower lobe opacities are presumably atelectasis and are unchanged. ______________________________________________________________________________ FINAL REPORT HISTORY: Pre-operative possible pneumonia. FINDINGS: In comparison with the study of ___, there are continued low lung volumes. Increased opacifications at the left base with blunting of the costophrenic angles could well represent post-operative atelectasis and small pleural effusions. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. No evidence of pulmonary vascular congestion. The enteric tube remains in place. " b9eb3126-77be9bb2-e78fe6f4-6a4735dd-80801a89.jpg,test/p11/p11029146/s58459193/b9eb3126-77be9bb2-e78fe6f4-6a4735dd-80801a89.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever // eval for infiltrate TECHNIQUE: Chest single view COMPARISON: ___ FINDINGS: Normal heart size, pulmonary vascularity. No effusion. Minimal scarring at the left lung base stable. No pneumothorax. Stable exam. IMPRESSION: No acute changes. " 2fe54825-17515af0-1e1a30e0-556d4ccd-ea57610a.jpg,test/p16/p16569295/s50646329/2fe54825-17515af0-1e1a30e0-556d4ccd-ea57610a.jpg,test," FINAL REPORT INDICATION: History: ___F preop // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There are small bilateral pleural effusionll. Cardiac silhouette is mildly enlarged. There is no pneumothorax. Opacity in the right lower lobe medially obscures lower thoracic spine anteriorly on the lateral view. There is pulmkany vascular redistribution and increased interstitial lines. IMPRESSION: Pulmonary edema. Opacity in the right lower lobe may represent pneumonia and/or aspiration in correct clinical setting. " 92f3e478-51189765-0d6cf2d1-b0c42df5-65c05603.jpg,test/p15/p15692257/s58420421/92f3e478-51189765-0d6cf2d1-b0c42df5-65c05603.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of melanoma, evaluation for disease status. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal chest radiograph without evidence of lung nodules or masses. No metastatic disease. " b2cd5f9e-83daa093-4947a271-5d292d10-2c65b54f.jpg,test/p18/p18259094/s50909608/b2cd5f9e-83daa093-4947a271-5d292d10-2c65b54f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea, AFib, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged evidence of massive cardiomegaly, potentially caused by pericardial effusion and low lung volumes. The pre-existing signs indicative of mild pulmonary edema have minimally progressed. Blunting of the costophrenic sinuses could be caused by mild bilateral pleural effusions. At the time of dictation and observation, 9:05 a.m., on ___, the referring physician, ___. ___, was paged for notification. Findings were discussed two minutes later over the telephone. " b77c4091-14993164-a170ce10-35db0c0e-07af3335.jpg,test/p10/p10892549/s55344992/b77c4091-14993164-a170ce10-35db0c0e-07af3335.jpg,test," WET READ: ___ ___ ___ 10:06 PM Left-sided chest tube has been removed. No residual pneumothorax. Streaky opacities at the left lung base compatible with the patient's empyema status post drainage. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with empyema s/p chest tube removal. // Comparison to previous, chest tube removed. TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: HEART SIZE AND MEDIASTINUM are stable. After removal of the left pigtail catheter there is no evidence of pneumothorax. Thickening of the left costophrenic angle is present. Right lung is clear. " 0add9b29-2a7e8143-746cff09-0129bbfc-ea8d56ae.jpg,test/p14/p14522445/s57330720/0add9b29-2a7e8143-746cff09-0129bbfc-ea8d56ae.jpg,test," FINAL REPORT HISTORY: Hypertension, chronic kidney disease with hyperkalemia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is mild enlargement of cardiac silhouette. The mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities present. IMPRESSION: No acute cardiopulmonary abnormality. " ac7ca705-2d646144-01365107-3f1f9eff-9e942e3c.jpg,test/p12/p12947673/s51471222/ac7ca705-2d646144-01365107-3f1f9eff-9e942e3c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with white count and decr BS left base // r/o pneumonia, effusion r/o pneumonia, effusion IMPRESSION: In comparison with the study of ___, there again are low lung volumes which accentuates the transverse diameter of the heart. Minimal residual atelectatic changes at the left base with continued elevation of the right hemidiaphragmatic contour and blunting of the costophrenic angle. No evidence of acute pneumonia or vascular congestion. " 2e83fac5-b9630b1c-4633afbb-321ffef3-65c10340.jpg,test/p12/p12907891/s58456875/2e83fac5-b9630b1c-4633afbb-321ffef3-65c10340.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with new onset diabetes, fatigue TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " a65251f0-ce1235f0-ac7feeed-1a4512d2-a328cf1b.jpg,test/p17/p17973921/s55916640/a65251f0-ce1235f0-ac7feeed-1a4512d2-a328cf1b.jpg,test," WET READ: ___ ___ ___ 2:04 PM No free intraperitoneal air. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: AP AND LATERAL CHEST X-RAY INDICATION: ___-year-old man with nausea, vomiting, epigastric pain, evaluate for free intraperitoneal air. TECHNIQUE: AP and lateral upright chest radiographs. COMPARISON: Chest x-ray ___. FINDINGS: There is no free air under the diaphragm. The cardiomediastinal silhouettes are stable and within normal limits. The bilateral hila are unremarkable. The lungs are clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No free air under the diaphragm. . No acute cardiopulmonary process. " 472c857f-1d2e89e1-0df02c51-0d19f938-359353a5.jpg,test/p16/p16667413/s51655767/472c857f-1d2e89e1-0df02c51-0d19f938-359353a5.jpg,test," FINAL REPORT HISTORY: Chest pain, dyspnea, dizziness. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " df6fad8a-1dceb247-f1ddbf5e-8f99cea2-1c3c2c85.jpg,test/p13/p13292409/s51144455/df6fad8a-1dceb247-f1ddbf5e-8f99cea2-1c3c2c85.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with wheezing, dyspnea // ? acute cardio pulm process TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs most recent on ___ FINDINGS: The lungs are mildly hyperinflated however are clear and similar in appearance to prior examination on ___. The cardiomediastinal and hilar contours are within normal limits. There is no evidence of pneumothorax, focal consolidation or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 54d0f885-62beed24-d37d4441-dd29ffe1-1062ab2c.jpg,test/p11/p11391664/s51733131/54d0f885-62beed24-d37d4441-dd29ffe1-1062ab2c.jpg,test," FINAL REPORT INDICATION: ___-year-old man with hypertension worse than baseline, evaluate for widened mediastinum. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___. FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette and hilar contours are stable. A rounded contour adjacent to the right heart border was previously characterized as a pericardial cyst. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. No mediastinal widening. " 0beed589-c7c74e1b-a635770c-4c324a29-f286b2cd.jpg,test/p12/p12462675/s55421426/0beed589-c7c74e1b-a635770c-4c324a29-f286b2cd.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the earlier study of this date, the tip of the nasogastric tube extends to the upper stomach with the side hole just distal to the esophagogastric junction. Bilateral pulmonary opacifications persist. " 4c6219d6-017d0d50-2b8b5811-69d20ea6-2fabd3a7.jpg,test/p16/p16130746/s59066173/4c6219d6-017d0d50-2b8b5811-69d20ea6-2fabd3a7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumonia // follow-up pneumonia follow-up pneumonia IMPRESSION: In comparison with the study of ___, there has been substantial decrease in the opacification at the right base. A small residual process, much of which may merely represent fibrous healing. No evidence of vascular congestion. " 100b6130-18f1b9ff-cfd75fb1-97fa461a-03f929fc.jpg,test/p16/p16454913/s53625846/100b6130-18f1b9ff-cfd75fb1-97fa461a-03f929fc.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Tracheobronchomalacia, and clinical signs of right lower lung pneumonia. FINDINGS: AP upright portable chest radiograph obtained. Dialysis catheter is in unchanged position. There is slight increased consolidation at the right lung base, which could reflect effusion and/or consolidation/pneumonia. There is stable appearance at the left lung base. No pneumothorax. Evaluation for mild fluid overload is limited, though likely present. Bony structures are intact. Heart and mediastinal contours overall unchanged. IMPRESSION: Increasing opacity at the right lung base which may represent a combination of effusion and pneumonia. " 83539ce4-a50179bf-2f68beda-1c6c2f07-4a3a4747.jpg,test/p14/p14912272/s53363678/83539ce4-a50179bf-2f68beda-1c6c2f07-4a3a4747.jpg,test," FINAL REPORT INDICATION: ___-year-old male with basilar crackles, rule out congestive heart failure. COMPARISON: ___. CHEST, PA AND LATERAL: Two large pulmonary masses have developed in the right upper lobe, measuring 6.7 x 5.9 and 3.9 x 2.6 cm. Several additional nodular opacities are noted in both lower lobes. Bibasilar atelectasis, obscures both hemidiaphragms. Mild cardiomegaly, with central venous congestion and small bilateral effusions, suggest mild cardiac decompensation. The aortic arch is tortuous and calcified. IMPRESSION: New lung masses and smaller nodules most likely metastases, alternative vasculitic masses. Borderline cardiac decompensation. Please refer to subsequent CT for further details. This was discovered on ___ at 1 p.m., and called to Dr. ___ at 1:02 p.m. " 51b76e3a-98c4205d-cbb8f642-5620a204-b72f1a61.jpg,test/p18/p18706064/s50571374/51b76e3a-98c4205d-cbb8f642-5620a204-b72f1a61.jpg,test," FINAL REPORT HISTORY: ___-year-old male with wheezing and fevers, rule out pneumonia. COMPARISON: None. FINDINGS: Two views of the chest demonstrate clear lungs without effusion, or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are normal. IMPRESSION: Normal chest. " 559071aa-9bb7bd58-5c3e6b47-b3401e4c-9bc8d1c8.jpg,test/p10/p10236222/s56747124/559071aa-9bb7bd58-5c3e6b47-b3401e4c-9bc8d1c8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with tachycardia, nausea // Please eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 31f32229-ce74c3f6-0f2444ee-dfb037a1-f7f9ff7c.jpg,test/p17/p17910433/s59093986/31f32229-ce74c3f6-0f2444ee-dfb037a1-f7f9ff7c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man with IABP for MI. TECHNIQUE: Single portable frontal chest radiograph. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The lungs are hypoinflated with crowding of vasculature and left basilar atelectasis. Small left and likely small right pleural effusions are stable. Mild cardiomegaly is stable, and unchanged since prior examination. No pneumothorax. Prominence of the left hilum is due to patient rotation. Mediastinal contour is unremarkable. Intra-aortic balloon pump is 3 cm below the aortic groove, unchanged since prior. A left PICC tip is at the mid SVC. IMPRESSION: 1. Hypoinflated lungs with crowding of vasculature and left basilar atelectasis. 2. Stable small left and likely small right pleural effusions 3. Stable mild cardiomegaly. 4. Support lines unchanged since prior examination. Specifically, intra-aortic balloon pump 3 cm below the aortic groove in appropriate position. " e46135f2-fb6f3e9f-03d8baca-0a9e005c-69c4f707.jpg,test/p16/p16697958/s56182087/e46135f2-fb6f3e9f-03d8baca-0a9e005c-69c4f707.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ AT 19:38 HOURS. HISTORY: Fever. COMPARISON: None. FINDINGS: There are low lung volumes with bronchovascular crowding at the lung bases. Ill-defined densities noted particularly in the retrocardiac left lower lobe. No further consolidation or edema is evident. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The visualized osseous structures are unremarkable. IMPRESSION: Density at the lung bases, particularly in the left lower lobe is presumed atelectasis given volume loss. However, an early developing pneumonia cannot be entirely excluded. Repeat with improved depth of inspiration would be helpful, otherwise empiric treatment with short interval followup. " 4bcb9974-dfa42b4c-6d8ddce0-232d2292-a3bbc1c0.jpg,test/p18/p18238341/s56890494/4bcb9974-dfa42b4c-6d8ddce0-232d2292-a3bbc1c0.jpg,test," FINAL REPORT INDICATION: ___ year old woman with subacute cognitive decline // Interval change, evaluate for ?opacity in RLL TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: As low lung volumes accentuate the bronchovascular markings. No right lower lobe opacity. Mild eventration of the diaphragm is causing right lower lobe rounded opacity. Mild cardiomegaly. Significant scoliosis. IMPRESSION: No acute cardiopulmonary process " 914c11d7-cb691ed0-1d193dc7-44c92d78-c7788987.jpg,test/p14/p14347948/s52952108/914c11d7-cb691ed0-1d193dc7-44c92d78-c7788987.jpg,test," FINAL REPORT AP CHEST, 4:49 A.M. ON ___ HISTORY: Pleural effusion. Cholangitis. IMPRESSION: AP chest compared to 8:01 p.m. on ___: Moderate right pleural effusion is enlarging despite the right basal pleural pigtail drain. There is also a drain in the right upper abdominal quadrant. No pneumothorax. Right upper and left upper lung clear. Mild left basal atelectasis worsened. Heart size top normal. No pneumothorax. " 6be5e6d6-1b20fff5-4d9b4538-0a8d4032-afb54bd3.jpg,test/p19/p19858494/s59575186/6be5e6d6-1b20fff5-4d9b4538-0a8d4032-afb54bd3.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluate for interval progression. History of hemorrhagic pancreatitis and respiratory failure. TECHNIQUE: Semi-erect portable chest view was read in comparison with most recent radiograph from ___. FINDINGS: Endotracheal tube tip is 3.4 cm above the carina and right PICC line ends at lower SVC, appropriately positioned. Increased left lower lung opacity which is likely combination of atelectasis and/or consolidation and mild-to-moderate left pleural effusion is unchanged over last 24 hours. Minimal right lung base atelectasis is also similar. Upper lungs are clear. Heart size, mediastinal and hilar contours are unremarkable. IMPRESSION: Left lower lung opacity from atelectasis and/or consolidation and mild-to-moderate left pleural effusion and minimal right lung base atelectasis are unchanged over last 24 hours. " 1cd2ae46-0d2a1ae2-d9e85b95-3bf45026-9b3519ae.jpg,test/p19/p19837032/s52824096/1cd2ae46-0d2a1ae2-d9e85b95-3bf45026-9b3519ae.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p lead extraction // chest tube on water seal - please do xray at ___ chest tube on water seal - please do xray at ___ IMPRESSION: Left chest tube is in place. Right internal jugular line tip is at the cavoatrial junction. Mediastinal drain are in place. Heart size and mediastinum are stable. Lungs are overall clear. Left upper lobe opacity is slightly more pronounced than on the prior study, and might potentially represent developing infectious process. " 90b566ae-0d2d15ef-d517f023-1d0d7924-27ecbfd7.jpg,test/p12/p12441181/s55096100/90b566ae-0d2d15ef-d517f023-1d0d7924-27ecbfd7.jpg,test," FINAL REPORT INDICATION: ___-year-old female with questionable right upper lobe opacity on chest radiograph. COMPARISON: ___. CHEST, AP UPRIGHT AND LATERAL: Right PICC has been retracted, and now terminates in the mid-to-lower SVC. There is no significant pleural effusion or pneumothorax. Heart size is normal. Focal right upper lobe opacity is unchanged. Rightward deviation of the trachea and elevation of the right hemidiaphragm again suggests volume loss. IMPRESSION: Persistent right upper lobe opacity with volume loss. Please follow radiographically as patient's symptoms resolve; if findings do not clear, chest CT should be ordered. " 98afa267-c17843f4-15f13b87-b0379bbb-6f3cd32a.jpg,test/p11/p11522912/s55252289/98afa267-c17843f4-15f13b87-b0379bbb-6f3cd32a.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___M with seizure, CXR yesterday w concern for opacity pls re assess for pna. TECHNIQUE: AP upright view of the chest. COMPARISON: Chest radiograph ___, ___. FINDINGS: The cardiomediastinal and hilar contours are stable with prominent epicardial fat pads. There is no pneumothorax. Opacity at the left lung base is again noted, which reflects a small pleural effusion and chronic consolidation. There is no overt pulmonary edema. IMPRESSION: Chronic consolidation at the left lung base with small pleural effusion. No overt pulmonary edema. " 748f1625-3c9b110c-7da163d5-9220a493-5e078567.jpg,test/p19/p19172342/s53990665/748f1625-3c9b110c-7da163d5-9220a493-5e078567.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough, abdominal pain, weight loss, leukocytosis. Evaluate for pneumonia. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well-expanded and clear lungs. Cardiomediastinal and hilar contours are unremarkable. The aorta is tortuous. There is no pneumothorax, pleural effusion or consolidation. IMPRESSION: No pneumonia. " 58c9d205-47d46455-d25914ac-f64362c7-243b8516.jpg,test/p18/p18699864/s50440582/58c9d205-47d46455-d25914ac-f64362c7-243b8516.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old male presenting for evaluation of asthma exacerbation TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Lungs are are clear of consolidation, pleural effusion or pneumothorax. Cardiomediastinal contours are normal. No subdiaphragmatic free air. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " df821b87-f9d3e948-7ae37f84-a84dd944-279e3a1d.jpg,test/p17/p17517983/s57014359/df821b87-f9d3e948-7ae37f84-a84dd944-279e3a1d.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Hyperglycemia, assess for pneumonia. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. Previously noted PICC line has been removed. " b50eb3b6-75dd8880-2c31d303-ec26235f-c99d717e.jpg,test/p11/p11852347/s57592722/b50eb3b6-75dd8880-2c31d303-ec26235f-c99d717e.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4dd74164-a510cf17-6e683494-5ee8c9c7-21407266.jpg,test/p14/p14213883/s51214797/4dd74164-a510cf17-6e683494-5ee8c9c7-21407266.jpg,test," FINAL REPORT INDICATION: ___M with positive blood cultures // R/O Pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ ___, chest CT ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pneumothorax or pleural effusions. A lateral pleural based opacity at the right lung base corresponds to increase in the subpleural fat as seen on prior CT. There is no new focal consolidation concerning for pneumonia. Right basilar atelectasis is also again seen. The upper abdomen is unremarkable. IMPRESSION: No focal consolidation concerning for pneumonia. " 0e97d187-e3d88f0c-3436f998-2d171649-ebc3189a.jpg,test/p19/p19170368/s55531691/0e97d187-e3d88f0c-3436f998-2d171649-ebc3189a.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiograph. INDICATION: ___ year old man s/p R VATS blebectomy, pleurodesis // please do at 2PM with CT's on waterseal, R/O PTX COMPARISON: Chest radiograph dated ___. FINDINGS: Three chest tubes project over the right hemithorax. The right pneumothorax is tiny, decreased from the prior. No hemothorax/effusion. Interval improvement in subcutaneous emphysema in the right lateral chest wall. The lungs are clear and well-expanded. Suture in the left apex is unchanged. The heart is normal in size. The mediastinum is not widened. The hila and normal limits. No pulmonary edema or focal consolidation. IMPRESSION: Tiny right apical pneumothorax with the chest tubes to water seal. " 76e5c4d4-0772ae78-4437f7de-75556856-4b94c197.jpg,test/p14/p14500958/s58373615/76e5c4d4-0772ae78-4437f7de-75556856-4b94c197.jpg,test," FINAL REPORT INDICATION: Altered mental status. Evaluate for infectious process. COMPARISON: Chest radiographs, ___. FINDINGS: Lung volumes are lower in comparison to the prior radiograph. There is a small region of linear atelectasis at the right base. There is no consolidation, edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. An IVC filter is seen in the mid abdomen and unchanged in position from the prior study. IMPRESSION: Right basilar linear atelectasis. No evidence of pneumonia. " 62743dee-b899081c-94535b33-561f39e5-5d0db0ce.jpg,test/p11/p11277436/s52369951/62743dee-b899081c-94535b33-561f39e5-5d0db0ce.jpg,test," FINAL REPORT INDICATION: Motor vehicle collision. COMPARISON: None. SUPINE AP VIEW OF THE CHEST: Overlying trauma board limits evaluation. Cardiac, mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is not engorged. No pleural effusion or pneumothorax is visualized. No displaced rib fractures are identified. IMPRESSION: No acute cardiopulmonary abnormality. " d6279f25-44db01d5-e5e0dfa6-194f2ee7-77fd50bf.jpg,test/p12/p12945037/s52255855/d6279f25-44db01d5-e5e0dfa6-194f2ee7-77fd50bf.jpg,test," FINAL REPORT INDICATION: Right lower quadrant pain. COMPARISON: Radiograph available from ___ and CT from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. Bibasilar densities are present, corresponding to rounded atelectasis within the right lower lobe and linear atelectasis within the left lower lobe, as seen on the CT examination performed on the same day. There is no pneumothorax or pleural effusion. Linear bibasilar densities reflect atelectasis, better visualized on the CT examination performed today. IMPRESSION: Bibasilar opacites, seen as rounded atelectasis at the right base and linear atelectasis at the left base on the CT performed earlier this evening. " b1d3e488-169abdfe-78b5a623-26b0f889-f36db9c9.jpg,test/p11/p11250426/s56642719/b1d3e488-169abdfe-78b5a623-26b0f889-f36db9c9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bronchoscopy, increased o2 requirement // consolidation, congestion, interval change consolidation, congestion, interval change IMPRESSION: Compared to preprocedure chest radiograph ___. Patient has severe asbestos related pleural thickening, heavily calcified, and large areas of rounded atelectasis. Compared to ___, previous mild pulmonary edema and pulmonary vascular congestion have improved and small left pleural effusion is smaller. Heart is normal size. No pneumothorax. Transvenous pacer leads in standard placements. " cd6a2752-6c891134-672ffdb2-396a94fb-c79d78e2.jpg,test/p13/p13272752/s50022440/cd6a2752-6c891134-672ffdb2-396a94fb-c79d78e2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with NSCLC admitted with tachypnea. New PE and bilateral pleural effusions. S/p Right CT placement and drainage of left pleurX // Eval interval change of effusions Eval interval change of effusions COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: The apical component of the moderate to large left pleural effusion has been replaced by air and the basal component is smaller relative to ___. There is no appreciable right pleural effusion and the right apical pneumothorax has decreased to the very small volume the. Right basal pigtail than left PleurX catheters are in place. Heart size is normal. Micro nodulation and interstitial abnormality in the right lung is presumably metastatic malignancy. Right subclavian infusion port ends at the origin of the SVC. And some of the basal component have decreased since " 5eba00c4-d247a39e-92789fce-46a6dbc6-6c20f372.jpg,test/p17/p17463554/s54064765/5eba00c4-d247a39e-92789fce-46a6dbc6-6c20f372.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SAH s/p trauma, intubated, to be extubated today // serial monitoring aspiration pneumonia, ?post-extubation serial monitoring aspiration pneumonia, ?post-extubation IMPRESSION: Right PICC line tip is at the level of cavoatrial junction. NG tube tip is in the stomach. Heart size and mediastinum are stable. There is interval improvement in pulmonary edema/ bibasal opacities potentially representing aspiration. Still present are bibasal opacities and a left lingular most likely atelectasis. There is no pneumothorax. " ab0439af-3242ccf1-25aa11e9-fcc68271-291452d7.jpg,test/p15/p15378092/s54516474/ab0439af-3242ccf1-25aa11e9-fcc68271-291452d7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Suspected lymphoma and fever, questionable pneumonia. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are low. No evidence of focal parenchymal opacity suggesting pneumonia. No pulmonary edema. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " c6a75c26-6d576d5e-e0ac460b-e106ee5b-44190f8f.jpg,test/p15/p15973689/s54923264/c6a75c26-6d576d5e-e0ac460b-e106ee5b-44190f8f.jpg,test," WET READ: ___ ___ ___ 9:11 AM Left chest tube has been removed. There is no large pneumothorax. Obscuration of the left hemidiaphragm with blunting of the costophrenic sulcus likely reflects a small pleural effusion. This is unchanged from the study 1 hr prior but worse from the study this morning at 05:40. WET READ VERSION #___ ___ ___ 7:25 PM Left chest tube has been removed. There is no large pneumothorax. Obscuration of the left hemidiaphragm with blunting of the costophrenic sulcus likely reflects a small pleural effusion. This is unchanged from the study 1 hr prior but worse from the study this morning at 05:40. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with left hemo/pneumo resolved s/p chest tube removal // eval left hemo/pneumo. chest tube just removed. COMPARISON: Chest radiographs and CT scans since ___ IMPRESSION: Multiple cavitating septic emboli have developed in both lungs over the past several days. Consolidation at the lung bases is most likely pneumonia, also progressing. Pleural effusions small if any. No pneumothorax. Heart size normal. " 4ea30cea-d2c8f148-3d1dae32-e9c5c74a-e83a0f26.jpg,test/p11/p11581260/s51650674/4ea30cea-d2c8f148-3d1dae32-e9c5c74a-e83a0f26.jpg,test," WET READ: ___ ___ ___ 7:24 PM IMPRESSION: No definite change in metastatic masses in the right hemithorax. Tracheal narrowing by a dominant mass, although present before and not necessarily changed, in the setting of known recent growth of metastases. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness and dyspnea. History of metastatic disease. COMPARISONS: Radiographs from ___ and CT from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged including right perihilar masses. The contours of the mid to lower trachea are indistinct on the right corresponding to known tracheal narrowing associated with a dominant mass involving the upper mediastinum. There is a more distinct round mass than before visualized in the right lower lung, possibly reflecting an increase in metastatic disease versus loculated pleural effusion since the prior radiographs, although necessarily changed when differences in technique are considered. There is persistent mild elevation of the right hemidiaphragm. Patchy right basilar opacity suggests atelectasis in addition to extensive pleural-based metastatic disease in the right lower hemithorax. The left lung remains clear. IMPRESSION: No definite change in metastatic masses in the right hemithorax. Tracheal narrowing by a dominant mass, although present before and not necessarily changed, in the setting of known recent growth of metastases. " 16d5224c-31ce8625-73cf9620-a5b71c16-9fd366b2.jpg,test/p11/p11374240/s53135897/16d5224c-31ce8625-73cf9620-a5b71c16-9fd366b2.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever, chills, congestion. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 6a41afe7-2f5ece17-d12e164f-9c82292a-c8f56045.jpg,test/p13/p13948246/s58668943/6a41afe7-2f5ece17-d12e164f-9c82292a-c8f56045.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man treated for PNA at ___ ___ // Assess for PNA resolution Assess for PNA resolution IMPRESSION: In comparison with the study of ___, there is again mild enlargement of the cardiac silhouette without definite vascular congestion. Opacification at the left base could reflect mild atelectasis and effusion. No definite acute focal pneumonia is appreciated. " 5cf481b3-31e1e5e0-b4a4bab5-8ca0acb0-a733f4d6.jpg,test/p19/p19100245/s55883584/5cf481b3-31e1e5e0-b4a4bab5-8ca0acb0-a733f4d6.jpg,test," FINAL REPORT INDICATION: Diabetes and Fournier's gangrene. Postoperative day 3. COMPARISON: Chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show mild interstitial opacities. The cardiomediastinal silhouette and hilar contours are normal. There is a small left sided pleural effusion. IMPRESSION: Mild edema with small left-sided effusion. " 2cd48e98-3258a4cc-89fee090-9a7aa6b5-cc5499d3.jpg,test/p13/p13922124/s52590785/2cd48e98-3258a4cc-89fee090-9a7aa6b5-cc5499d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with refractory DLBCL s/p allo w/ sclerodermatoid GVHD s/p ___ gastric advancement // Please confirm placement of ___ tube. Please confirm placement ___ ___ tube. IMPRESSION: Comparison to ___. The feeding tube is projecting with its tip over the central parts of the stomach. No complications, notably no pneumothorax. The hemodialysis catheter on the right is stable. " 93932047-5f5c6146-660c1029-7c468efb-42ff1ea6.jpg,test/p13/p13648633/s50805078/93932047-5f5c6146-660c1029-7c468efb-42ff1ea6.jpg,test," WET READ: ___ ___ ___ 8:15 PM Right central line terminates in the mid to distal superior vena cava. Location of the Dobbhoff tip cannot be reliably assessed given body habitus. Repeat abdominal radiograph would be helpful. Improved bilateral lower lobe opacities without focal consolidation worrisome for pneumonia. No pneumothorax. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, central line placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a right-sided central venous access line. The tip of the line projects over the mid to lower SVC. The Dobbhoff catheter is unchanged, the tip cannot be reliably visualized. The pre-existing parenchymal opacities at the lung bases have almost completely resolved. The size of the cardiac silhouette is unchanged. There is no evidence of pneumothorax. " 3fb3721d-96a5e722-348605b8-5d81b64f-3d1a27fc.jpg,test/p15/p15367414/s59502255/3fb3721d-96a5e722-348605b8-5d81b64f-3d1a27fc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ptx s/p chest tube which has now been removed. // assess for any recurrence of PTX TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There is a tiny right apical pneumothorax. The alveolar infiltrate has partially cleared on the right but there continues to be alveolar infiltrates centrally more marked in the upper than lower lobe. There is volume loss in both lower lungs with some platelike atelectasis in the left lower lobe. The right IJ line is been removed. IMPRESSION: Tiny right apical pneumothorax. " 9efb3d93-02bb44b4-e84e2b36-1820ac31-1f53c5d5.jpg,test/p15/p15811084/s57218849/9efb3d93-02bb44b4-e84e2b36-1820ac31-1f53c5d5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p MIE, w/ h/o wound infection and aspiration pneumonia now febrile to 101.7 // ?pnuemonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The lung volumes remain normal. There are platelike atelectasis at the right lung bases. Borderline size of the cardiac silhouette. A pre-existing parenchymal opacity at the right lung base is almost completely resolved. Resolution is seen on both the frontal and the lateral radiograph. Unchanged position of the right pectoral Port-A-Cath. " b31b77df-c936c7e2-8d5a9823-41ede30d-1cf6d0af.jpg,test/p13/p13855132/s50331092/b31b77df-c936c7e2-8d5a9823-41ede30d-1cf6d0af.jpg,test," WET READ: ___ ___ 2:35 AM 1. Unchanged moderate pulmonary vascular congestion and mild associated interstitial edema. 2. Ill-defined right lower lung airspace opacities may represent asymmetric edema, atelectasis, or focal consolidation. 3. No pneumothorax. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with replaced trach, resp distress, evaluate for pneumothorax. TECHNIQUE: Single portable frontal semi-upright view radiograph of the chest. COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: The tracheostomy tube is been advanced compared with the prior study, now terminating 5.1 cm from the carina. Moderate pulmonary vascular congestion with mild associated interstitial pulmonary edema is similar to the prior study. Right lower lung airspace opacities may represent asymmetric edema, atelectasis, or consolidation, depending upon the clinical setting. There is no pleural effusion or pneumothorax. Calcification of the aortic arch is noted. Apparent moderate to severe degenerative changes of the right shoulder are partially evaluated. IMPRESSION: 1. Unchanged moderate pulmonary vascular congestion and mild associated interstitial edema. 2. Ill-defined right lower lung airspace opacities may represent asymmetric edema, atelectasis, or focal consolidation. 3. No pneumothorax. " 03c8aaa6-ba438074-c8f85190-18cabf07-9e312539.jpg,test/p17/p17967970/s55250072/03c8aaa6-ba438074-c8f85190-18cabf07-9e312539.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atypical chest discomfort consitent with reflux. History of lung CA, pleaase assess // assess for mass COMPARISON: No comparison. IMPRESSION: No comparison is available at the time of dictation. The lung volumes are normal. The left lung apex shows surgical suture lines, presumably of the resection for a clinically known lung cancer. The lung volumes are normal. Normal hilar and mediastinal structures. Minimal right apical thickening. No intrapulmonary nodules or masses are visualized. Borderline size of the cardiac silhouette with minimal tortuosity of the thoracic aorta. No pleural effusions. " 63e439b3-79840f86-98fd9726-67f3ac00-f1a1aa62.jpg,test/p16/p16490898/s51870800/63e439b3-79840f86-98fd9726-67f3ac00-f1a1aa62.jpg,test," WET READ: ___ ___ ___ 8:46 PM No focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Incidental note of a distended loop of bowel in the left upper quadrant. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest INDICATION: ___ year old woman with eating disorder here with hyponatremia. // CXR is part of eating disorder initiation protocol CXR is part of eating disorder initiation protocol IMPRESSION: No prior radiographs available for review. Lungs are clear. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. Elevation left hemidiaphragm is probably due to colonic distention. " a52c7b9f-aec64d98-6b5da658-544dcc5c-8f2015d8.jpg,test/p16/p16726712/s52161757/a52c7b9f-aec64d98-6b5da658-544dcc5c-8f2015d8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with first time seizure. // pneumonia? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There are relatively low lung volumes with possible right base atelectasis. No definite focal consolidation is seen.No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Relatively low lung volumes with possible right base atelectasis. " 10e5e4bd-9964c5a1-00b02724-1b5c5e79-edecee95.jpg,test/p18/p18633532/s51116572/10e5e4bd-9964c5a1-00b02724-1b5c5e79-edecee95.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after TEVAR. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are stable. The descending aortic stent is stable. Lungs are essentially clear. No interval increase in pleural effusion is seen. No pneumothorax is seen. " a85a6616-606d0c2b-318b3f0c-6b595ce3-9f4dd94f.jpg,test/p14/p14541859/s53589599/a85a6616-606d0c2b-318b3f0c-6b595ce3-9f4dd94f.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with chest pain. History of VSD repair. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest again demonstrate relatively low lung volumes. Lungs are grossly clear without consolidation, effusion or vascular congestion. The cardiomediastinal silhouette is stable. Median sternotomy wires are again noted. IMPRESSION: No acute cardiopulmonary process. " 6f4246f0-5ecc2ce0-041c7082-339ed214-3e7e58a3.jpg,test/p17/p17518119/s56758754/6f4246f0-5ecc2ce0-041c7082-339ed214-3e7e58a3.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Brain mass. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The lung volumes are low. The cardiac, mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. Aside from minimal posterior opacification suggesting minor atelectasis, the lungs appear clear. Mild degenerative changes are noted along the lower thoracic spine. Prominent facet hypertrophy is noted along the right side at the C4-C5 interspace of the cervical spine. IMPRESSION: No evidence of acute disease. " 63411e7f-01486e42-2725cddd-9d71cd06-e971b1da.jpg,test/p17/p17910433/s59334901/63411e7f-01486e42-2725cddd-9d71cd06-e971b1da.jpg,test," WET READ: ___ ___ 4:57 AM Pulmonary vascular congestion without frank edema. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with b/l rales, hx of CHF, recent fall // ?pleural effusion, pna TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is pulmonary vascular congestion, without frank edema, and mild distention of mediastinal veins compared to ___. The heart is moderately enlarged. Mediastinal contours are unchanged. No pneumothorax, pleural effusion, or consolidation. IMPRESSION: Pulmonary vascular congestion, suggesting volume overload or early cardiac decompensation. " 473807bd-2bc24351-a20b9d02-9299c6b3-8ec3752d.jpg,test/p16/p16650861/s55750709/473807bd-2bc24351-a20b9d02-9299c6b3-8ec3752d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with altered mental status, shortness of breath TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Heart size is top normal. Atherosclerotic calcifications are noted at the aortic knob. Mediastinal and hilar contours are unremarkable. Lungs are hyperinflated without focal consolidation. Symmetric scarring is noted the lung apices. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. Moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " c071b1e9-be81391f-5b765579-456eb07a-bb599bf2.jpg,test/p12/p12707756/s53918057/c071b1e9-be81391f-5b765579-456eb07a-bb599bf2.jpg,test," WET READ: ___ ___ ___ 9:23 AM 1. Small pleural effusions seen on the lateral view, likely left-sided. 2. Interval improvement in previously seen pulmonary vascular congestion. 3. Ill-defined right lung base airspace opacities likely represent atelectasis. WET READ VERSION #1 ___ ___ 9:59 PM 1. Small pleural effusions seen on the lateral view, likely left-sided. 2. Interval improvement in previously seen pulmonary vascular congestion. 3. Ill-defined right lung base airspace opacities likely represent atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman POD6 CABG // effusion/atlectasis effusion/atlectasis IMPRESSION: In comparison with the study ___ ___, the pulmonary vascular congestion has decreased, though the pulmonary venous pressure is still above normal. Probable small bilateral pleurally fusions with mild basilar atelectatic changes. Right IJ catheter again extends to the lower SVC. " f7073665-37d520c0-aa4832db-9a030d79-6a5e3866.jpg,test/p11/p11077662/s57601984/f7073665-37d520c0-aa4832db-9a030d79-6a5e3866.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Hypoxia. Question pneumonia. COMPARISON: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. Within the limitations of technique, the lungs appear clear aside from questionable vague increased posterior density suggesting minor atelectasis or crowding of bronchovascular structures. Evaluation is somewhat limited, however, by low lung volumes. IMPRESSION: No definite evidence of acute cardiopulmonary disease. Low lung volumes. " 545c9d71-fc658a10-44dba323-080941ba-5dec473c.jpg,test/p13/p13138475/s52332322/545c9d71-fc658a10-44dba323-080941ba-5dec473c.jpg,test," FINAL REPORT REASON FOR EXAM: Assess OG tube. Comparison is made with prior study performed six hours earlier. NG tube tip is out of view below the diaphragm in the stomach. There are no other interval changes. " c492beba-9eb78569-c5fefd10-481c9f55-8d8f0046.jpg,test/p12/p12471831/s57159224/c492beba-9eb78569-c5fefd10-481c9f55-8d8f0046.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough and subjective fever. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest. The heart is mildly enlarged, similar to prior, with stable cardiomediastinal contours. Left apical scarring is similar to prior. Lungs are otherwise clear without focal or diffuse abnormality. No pleural effusion or pneumothorax is visualized. The pulmonary vasculature is unremarkable. Left humeral head screws are incompletely imaged. IMPRESSION: No acute cardiopulmonary process. " f4898892-2a983969-7c95e457-fe505a61-392850be.jpg,test/p16/p16074678/s59469447/f4898892-2a983969-7c95e457-fe505a61-392850be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hx UC s/p colectomy/end ileostomy in ___, h/o GIB ___ no clear source p/w 4days BRB in ostomy now s/p exlap revision stoma (___), exlap resite ostomy (___) in SICU for management of septic shock. // please eval for interval change TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: Supportive a monitoring equipment is unchanged in appearance when compared to the prior study. Assessment of the cardiomediastinal contour is limited by technique but appears grossly unchanged. Lung volumes remain low. The previously demonstrated mild pulmonary edema appears to have improved slightly however there is persistent prominence of the pulmonary vascular consistent with mild congestive heart failure. IMPRESSION: CT mild improvement in the interstitial pulmonary edema, otherwise no significant interval change when compared to the prior study. " 428b47b7-c686a6b9-a2f29477-ad64cdc5-c78c22e0.jpg,test/p13/p13256635/s59737037/428b47b7-c686a6b9-a2f29477-ad64cdc5-c78c22e0.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Right rib pain after a fall. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear IMPRESSION: No evidence of acute cardiopulmonary disease. " 14111b30-c25c414e-02a06853-35428b36-33cc37a4.jpg,test/p10/p10878573/s56972401/14111b30-c25c414e-02a06853-35428b36-33cc37a4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: New ICD placement. Evaluation for lead position. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no change in position of the leads in the right atrium and right ventricle. No evidence of pneumothorax. Borderline size of the cardiac silhouette. Mild retrocardiac atelectasis. No edema, no pleural effusion. " b14e8d34-b652ef20-3df54201-6891838a-02d8d5ad.jpg,test/p10/p10374536/s55518667/b14e8d34-b652ef20-3df54201-6891838a-02d8d5ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dyspnea // r/o CHF r/o CHF IMPRESSION: In comparison with the study of ___, there is little interval change. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Single lead pacer again extends to the region of the apex of the right ventricle. " 91c8101b-05aa989d-2d87cfec-bff93887-dd60f5d9.jpg,test/p17/p17917665/s53431428/91c8101b-05aa989d-2d87cfec-bff93887-dd60f5d9.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with ICD device, congestive heart failure, 20lb weight gain recently. TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Left-sided AICD device is noted with lead terminating in the right ventricle, unchanged, with numerous epicardial leads again demonstrated as well as an abandoned pacer lead to the right atrium. Patient appears to be status post CABG. Severe cardiomegaly is re- demonstrated. Mediastinal contours are similar with tortuosity of thoracic aorta again noted and diffuse atherosclerotic calcifications. The hila are enlarged bilaterally suggestive of pulmonary arterial enlargement with mild pulmonary edema. Small bilateral pleural effusions are also demonstrated. No pneumothorax or focal consolidation is present. Moderate multilevel degenerative changes are seen throughout the thoracic spine. IMPRESSION: Mild pulmonary edema and small bilateral pleural effusions. " 0955cb6c-6d369908-88d1d716-009bb56b-b3e1d848.jpg,test/p13/p13603221/s58870620/0955cb6c-6d369908-88d1d716-009bb56b-b3e1d848.jpg,test," FINAL REPORT EXAMINATION: AP portable chest radiograph INDICATION: ___M history of HCV genotype 2-B cirrhosis now with HCC dx ___ now on C1D3 gem/doxil presenting with abdominal pain, now with confusion // r/o pneumonia, infiltrates COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are clear and well-expanded. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The heart is normal in size. The descending thoracic aorta is slightly tortuous or ectatic. The mediastinum and hila are within normal limits. IMPRESSION: No acute intrathoracic process. No pneumonia. " 6658a652-fc0bc282-c9926d10-e059a5b9-455e38a2.jpg,test/p13/p13874311/s51075131/6658a652-fc0bc282-c9926d10-e059a5b9-455e38a2.jpg,test," FINAL REPORT INDICATION: Hypotension. Evaluate for pneumonia. COMPARISONS: Chest radiograph ___. CTA chest ___. FINDINGS: PA and lateral radiographs of the chest show no evidence of consolidation or pneumonia. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Multiple air filled loops of bowel are noted in the left upper quadrant. IMPRESSION: No acute cardiopulmonary process. " ae63fe99-ce0139aa-79390280-b729a1b9-0b39ce03.jpg,test/p18/p18302453/s54026200/ae63fe99-ce0139aa-79390280-b729a1b9-0b39ce03.jpg,test," WET READ: ___ ___ 1:32 PM No acute intrathoracic findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with left upper chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No acute intrathoracic findings. " 865e9da9-05da3693-3124a566-8b06a476-e63794a6.jpg,test/p18/p18773704/s55335076/865e9da9-05da3693-3124a566-8b06a476-e63794a6.jpg,test," FINAL REPORT INDICATION: ___ year old man with COPD with cough and poor secretion mobilization // ?Aspiration TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison made with chest radiographs from ___, ___, and ___ and MR cervical, thoracic, and lumbar spine from ___. FINDINGS: A right-sided central line terminates in the superior cavoatrial junction. The lungs are well expanded. There is a mass in the right upper lobe, partially imaged on recent MR and similar to recent prior radiographs but new since radiographs from ___. There are small bilateral pleural effusions. No definite focal consolidation is seen, however cannot exclude a small opacity in the posterior lungs, which could be obscured by the pleural effusions. There is no pneumothorax. The cardiomediastinal silhouette is unremarkable. A compression deformity is noted in an upper thoracic vertebra. IMPRESSION: 1. No definite focal consolidation, however cannot exclude a small opacity in the posterior lung, which could be obscured by the pleural effusions. 2. Right upper lobe mass, partially imaged on recent MR and similar to recent prior radiographs but new since radiographs from ___. Further evaluation by CT is recommended. " bd2a335a-bafc38a5-caa6dea7-308109cd-3f13dc94.jpg,test/p11/p11900721/s53325629/bd2a335a-bafc38a5-caa6dea7-308109cd-3f13dc94.jpg,test," WET READ: ___ ___ ___ 8:14 AM New increased retrocardiac opacity, concerning for left lower lobe pneumonia with a probable overlying small left-sided pleural effusion. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___F with new confusion please eval for fluid overload, pna // ___F with new confusion please eval for fluid overload, pna ___F with new confusion please eval for fluid overload, pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: The heart is enlarged. There is a new retrocardiac opacity with increased opacity also projecting projecting over the left lower lobe, seen best on the lateral view, concerning for lower lobe pneumonia. There is a probable overlying small left-sided pleural effusion. There is no pneumothorax. IMPRESSION: New increased retrocardiac opacity, concerning for left lower lobe pneumonia with a probable overlying small left-sided pleural effusion. " 79ee9525-fc5219ae-a63461d3-42964b91-63dc397f.jpg,test/p19/p19810919/s59090068/79ee9525-fc5219ae-a63461d3-42964b91-63dc397f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with 3 weeks cough, blood tinged sputum, smoker (___ ppd). also smokes marijuana. Lung exam shows localized wheezing on right side. No known h/o asthma or COPD. // r/o pneumonia or lung abnormality r/o pneumonia or lung abnormality COMPARISON: There are no prior chest radiographs available for review. Impression. IMPRESSION: Lungs are well expanded and there is no pneumonia. Lateral view suggests a 6 x 11 mm elliptical nodule projecting over the heart. There are no other focal pulmonary abnormalities. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. RECOMMENDATION(S): Repeat conventional chest radiographs in ___ weeks, shown to the radiologist before the patient leaves the department to see if additional views are needed. " 23cabd4c-6a279b5c-e51c8c2e-4796a04d-1e74f884.jpg,test/p18/p18933552/s58640860/23cabd4c-6a279b5c-e51c8c2e-4796a04d-1e74f884.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with NSSCL and metatastic disease to lung, liver and adrenals s/p right PleurX. // Evolution COMPARISON: CHEST RADIOGRAPHS ___. IMPRESSION: A PleurX catheter is barely visible at the base of the right lung, extending upward across the midline, impinging on the mediastinum, unchanged since ___, but nevertheless the previous small to moderate right pneumothorax has decreased substantially. There is new interstitial abnormality at the base of the right lung, which may be edema induced by negative pressure. Followup is advised to monitor what could be pneumonia or pulmonary hemorrhage instead. Previous consolidation in the right upper lobe is clearing. Moderate left pleural effusion and marked atelectasis around left hilar mass, obscuring the left heart border, is unchanged. " d8a656ef-21f15997-459800a0-5d6f4b41-9340d5f9.jpg,test/p15/p15793456/s56965263/d8a656ef-21f15997-459800a0-5d6f4b41-9340d5f9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory distress // Interval changes Interval changes IMPRESSION: Compared to chest radiographs since ___, most recently ___ and ___. Bullous emphysema is severe. Today's study shows possible rightward mediastinal shift and new opacification in the right lower lobe, possibly atelectasis. This is commonly due to aspiration or retention of secretions. Follow-up chest radiograph available at the time of this review, performed 04:09 showed improvement in right lower lobe consolidation and decrease in rightward mediastinal shift suggesting interval clearing of the airway. Followup advised. " 99af0b70-b7c629b4-02f839c9-dcc185c6-bdfa29ef.jpg,test/p16/p16568220/s51240431/99af0b70-b7c629b4-02f839c9-dcc185c6-bdfa29ef.jpg,test," FINAL REPORT HISTORY: Chest pain TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No overt pulmonary edema is seen. Surgical clips are again seen in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 5c71ed09-d94d331b-9d7ac3e5-868f0d12-f1c22d70.jpg,test/p19/p19023440/s54846709/5c71ed09-d94d331b-9d7ac3e5-868f0d12-f1c22d70.jpg,test," FINAL REPORT INDICATION: Patient with an episode of slurred speech, which lasted for three hours. COMPARISONS: CT torso of ___. FINDINGS: Single portable view of the chest demonstrates normal lung volumes. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Retrocardiac opacity with rounded rounded lucencies, represents diaphragmatic hernia containing stomach and large bowel loops, better demonstrated on CT torso of ___. No pulmonary edema. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Large right-sided diaphragmatic hernia. " b31b1b62-36bee1cc-1751eb12-ee32b878-5e8f08cf.jpg,test/p11/p11146299/s50868810/b31b1b62-36bee1cc-1751eb12-ee32b878-5e8f08cf.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation of known right upper lobe opacity. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change in appearance of the right upper lobe opacity, partly caused by a known mass and partly by local hemorrhage after biopsy. The lung volumes have overall decreased, explaining the increased radiodensity at both lung bases. No pleural effusions are seen. The pre-existing minimal interstitial fluid overload has resolved. " d7f25394-6317dcb5-797f7f1c-21fee0c4-e7d1656f.jpg,test/p19/p19849930/s57176957/d7f25394-6317dcb5-797f7f1c-21fee0c4-e7d1656f.jpg,test," FINAL REPORT INDICATION: History: ___M with CHF, worsening DOE // ?pulm edema TECHNIQUE: Upright PA and lateral chest COMPARISON: Chest radiographs ___ through ___. FINDINGS: Left chest wall pacemaker has two leads terminating in the right atrium and right ventricle in stable position. Median sternotomy wires appear intact. There is a chronic left retrocardiac opacity. The lungs are otherwise clear. Mild to moderate cardiomegaly is unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Stable mild to moderate cardiomegaly. 2. Chronic opacities in the retrocardiac region are of unclear etiology, possibly atelectasis. If patient's symptoms persist a CT should be considered. " 7daa8718-0d0adec8-5c16d8dd-cf7b412f-c565ce2f.jpg,test/p17/p17913240/s57301688/7daa8718-0d0adec8-5c16d8dd-cf7b412f-c565ce2f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The small left pleural effusion has decreased, revealing a bandlike area of linear atelectasis at the left base. The right lung is clear. There is no pneumothorax. The heart and mediastinum are within normal limits. IMPRESSION: Decreased small left pleural effusion with new left basilar linear atelectasis. " 1867560c-77fae858-4ef5004d-26afee0f-8ddea9b4.jpg,test/p13/p13258755/s56007082/1867560c-77fae858-4ef5004d-26afee0f-8ddea9b4.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with multiple medical problems, hypotension, bacteremia for interval change. COMPARISON: Chest radiograph from ___. FINDINGS: A new left PICC is visualized with tip obscured by the hemodialysis catheter at the level of the left brachiocephalic vein. A left hemodialysis catheter is visualized with the catheter tip at the superior cavoatrial junction. Aortic valve replacement and median sternotomy wires are again noted. Lung volumes remain low. Right lower lobe atelectasis is again noted. Previously visualized retrocardiac atelectasis has improved. Mild pulmonary edema is again noted. " f73ea509-d6de8181-a61b1392-27f50efc-4c52e2fb.jpg,test/p17/p17699605/s52822277/f73ea509-d6de8181-a61b1392-27f50efc-4c52e2fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with leukocytosis // eval for pnuemonia TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: Multiple prior studies most recent dated ___ FINDINGS: A temporary dialysis catheter as no been exchanged for a tunneled right internal jugular catheter. The tip is in the right atrium. Compared to the prior study there is improved aeration of the bilateral lungs with resolution of the frank pulmonary edema. There is persistent prominence of the pulmonary vasculature consistent with fluid overload. There is linear atelectasis of the bilateral lung bases. An airspace opacity adjacent to the right heart border may reflect atelectasis versus consolidation. IMPRESSION: Pulmonary vascular congestion without frank pulmonary edema. Atelectasis versus infection at the right lung base. " 7b2f89fb-1ec6174e-dd3ff9df-b443aa90-8ad0bbe2.jpg,test/p19/p19456470/s52221261/7b2f89fb-1ec6174e-dd3ff9df-b443aa90-8ad0bbe2.jpg,test," FINAL REPORT HISTORY: Male with question of perihilar fullness on recent spine radiograph. Please assess. COMPARISON: Cervical and thoracic spine radiograph ___, CT chest ___, chest radiograph ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Left hilar fullness related to prominent pulmonary artery with rotation from scoliosis. Bilateral linear scars in the mid left lung and both lower lung regions. Cystic structure in the left lower lobe as seen on CT. Heart size and mediastinal contour are normal. IMPRESSION: 1. Left hilar fullness is likely related to prominent pulmonary artery accentuated by slight rotation from mild scoliosis. 2. Cystic structure in left lower lobe as seen on CT on ___. 3. Bilateral linear scarring in the left mid lung and both lower lung regions. Results were conveyed via telephone to Dr. ___ by Dr. ___ on ___ at 11:50 a.m. within 10 minutes of the results. " 20550afe-89ed699a-a9b41eaa-90027274-2298d4ea.jpg,test/p11/p11091044/s52141631/20550afe-89ed699a-a9b41eaa-90027274-2298d4ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man h/o L PTX after fall 4 weeks ago // check interval change check interval change IMPRESSION: Comparison to ___. Today's image shows no evidence of pneumothorax. Pre-existing opacities at the left lung bases have completely cleared. No pneumonia, no pulmonary edema. " 1c432bbe-cbb835d7-c0bdde89-0eea3df1-45006235.jpg,test/p19/p19785654/s57719522/1c432bbe-cbb835d7-c0bdde89-0eea3df1-45006235.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is widespread patchy opacity in the left lower lobe consistent with pneumonia. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. The bony structures are unremarkable. IMPRESSION: Findings suggesting pneumonia in the left lower lobe. " 56b654df-963be57e-0bd55884-b7d22d00-4a9a8db9.jpg,test/p11/p11804719/s52116731/56b654df-963be57e-0bd55884-b7d22d00-4a9a8db9.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old man with chest pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. There is no pneumothorax or effusion. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8a04be83-4e5f317c-8fa948da-d1aa791d-2f73eac7.jpg,test/p17/p17608808/s52969080/8a04be83-4e5f317c-8fa948da-d1aa791d-2f73eac7.jpg,test," WET READ: ___ ___ ___ 8:27 AM 1. No acute cardiopulmonary process. 2. Unchanged right infrahilar opacity compared with ___, however this finding is new from ___ and older studies and a nonemergent chest CT is recommended for further characterization. WET READ VERSION #1 ___ ___ ___ 1:59 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with cough, and fever, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: A right infrahilar opacity is unchanged from the immediate prior study and may represent subsegmental atelectasis related to low lung volumes. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. IMPRESSION: 1. No acute cardiopulmonary process. 2. Unchanged right infrahilar opacity compared with ___, however this finding is new from ___ and older studies and a nonemergent chest CT is recommended for further characterization to exclude a pulmonary nodule. RECOMMENDATION(S): Nonemergent chest CT is recommended for further characterization of a right infrahilar opacity. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 7:48 AM, 15 minutes after discovery of the findings. " d2f60bdc-432e86f0-83eb4065-e53629f1-227d0c41.jpg,test/p15/p15439394/s53638275/d2f60bdc-432e86f0-83eb4065-e53629f1-227d0c41.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with lightheadedness and cough. Question pneumonia. COMPARISON: ___. FINDINGS: Relatively low lung volumes are noted. Increased interstitial markings are again seen throughout the lungs, although somewhat increased since prior. There is no large effusion. Cardiomediastinal silhouette is stable. Left shoulder hemiarthroplasty is again noted. Surgical clips seen in the upper abdomen. Calcific densities projecting over the right scapula are likely intra-articular bodies, similar to prior. IMPRESSION: Low lung volumes with increased interstitial markings, some of which is chronic, although the degree of which is increased since prior and could represent superimposed edema or infection. " 47565704-2b2b2bd5-8e4faeac-6d806a80-1b8a3571.jpg,test/p17/p17547554/s59632016/47565704-2b2b2bd5-8e4faeac-6d806a80-1b8a3571.jpg,test," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Left pleural effusion, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the left chest tube is in unchanged position. The left pleural effusion is unchanged in appearance as is the atelectasis in the retrocardiac lung areas. On the right, the pre-existing effusion might have minimally increased. No other interval changes. " 5cde9ecb-315a94af-5fcafa65-d5a599b6-090f7268.jpg,test/p13/p13272142/s51538518/5cde9ecb-315a94af-5fcafa65-d5a599b6-090f7268.jpg,test," WET READ: ___ ___ ___ 8:16 PM NG tube in place. ETT ends 10 cm above the carina after final adjustment. RLL opacity stable. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Seizures and respiratory failure. FINDINGS: In comparison with the earlier study of this date, the nasogastric tube has been pushed forward so that tip lies at least in the lower body of the stomach where it crosses the lower margin of the image. The endotracheal tube tip lies well above the clavicles, approximately 10 cm above the carina. Right basilar consolidation persists. " a5f6bb53-ea00c3d0-3ef1fe3c-baa95cd1-362be990.jpg,test/p17/p17465349/s54097536/a5f6bb53-ea00c3d0-3ef1fe3c-baa95cd1-362be990.jpg,test," FINAL REPORT HISTORY: ___-year-old male with confusion. COMPARISON: Chest radiograph from ___. PORTABLE SEMI-ERECT AP CHEST RADIOGRAPH: There is increased density within the right mid and lower lung which could reflect aspiration or pneumonia in the appropriate clinical circumstance. Relative linear opacity in the left lower lung may represent atelectasis. There is no pulmonary vascular congestion, overt edema, or large pleural effusions. There is no pneumothorax. Cardiomediastinal and hilar contours are within normal limits and unchanged from prior. IMPRESSION: Increased density in the right lung base may reflect aspiration or pneumonia in appropriate clinical circumstance. " 81c57863-f5457883-11f73e4d-80e4e76b-c5d7e484.jpg,test/p17/p17070596/s51505898/81c57863-f5457883-11f73e4d-80e4e76b-c5d7e484.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval IMPRESSION: Left pigtail catheter has been discontinued. Nodularity along the pleura is stable. Lungs overall clear. There is overall decrease in left pleural effusion amount. No pneumothorax is seen. " d6c8d282-e6b21c68-060dac9d-1f9438fc-54ad084e.jpg,test/p14/p14960437/s55502090/d6c8d282-e6b21c68-060dac9d-1f9438fc-54ad084e.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fall. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead left-sided pacemaker is again seen with again the second lead slightly superior than expected for ventricular position, stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable and grossly stable in configuration given differences in lung volume. Partially imaged right humeral prosthesis is seen. Thoracolumbar scoliosis is seen. No displaced fracture is seen. IMPRESSION: Clear lungs. " 46a42551-983aaa0d-f2bd3876-7db41c40-9c8526bd.jpg,test/p12/p12401831/s51068079/46a42551-983aaa0d-f2bd3876-7db41c40-9c8526bd.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Central line placement. COMPARISON: ___. TECHNIQUE: Chest, semi-upright AP portable. FINDINGS: A right internal jugular central venous catheter terminates in the lower superior vena cava. The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax. As before, the lower thoracic spine curves mild to moderately to the right side. IMPRESSION: Central line terminating in the superior vena cava. No evidence of acute cardiopulmonary disease. " a78712c5-748996a5-d0b2b6ca-5cfa579d-ed15c4b0.jpg,test/p17/p17145985/s55751990/a78712c5-748996a5-d0b2b6ca-5cfa579d-ed15c4b0.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___ and ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " df9f4901-79f72acd-231663da-f84f2bfb-2b069af2.jpg,test/p19/p19349785/s55214082/df9f4901-79f72acd-231663da-f84f2bfb-2b069af2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cabg // eval for ptx s/p ct removal eval for ptx s/p ct removal IMPRESSION: As compared to ___, the left chest tube was removed. The patient now shows a mild left pneumothorax without evidence of tension. Minimal atelectasis at the left lung base. Normal appearance of the right lung. Moderate cardiomegaly persists. Unchanged alignment of the sternal wires. " 46d4bf07-83eb2b1e-db8b4fb6-cc987d4e-3a927e49.jpg,test/p17/p17615451/s54111865/46d4bf07-83eb2b1e-db8b4fb6-cc987d4e-3a927e49.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Refractory AML, prolonged neutropenia and hemoptysis after lung biopsy. Comparison is made with prior study ___. Mild cardiomegaly is stable. Right PICC tip is at the cavoatrial junction. There is no pneumothorax or pleural effusion. Left lower lobe atelectasis have increased. Right upper lobe spiculated nodule is better seen in prior CT from ___. Right lung peripheral opacities have improved. " 814506dc-b4206766-ee9f2c10-8ee087ae-e85b138c.jpg,test/p12/p12304672/s54145371/814506dc-b4206766-ee9f2c10-8ee087ae-e85b138c.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 3 EXAMS INDICATION: ___ year old man with hepc cirrhosis and dobhoff tube (slipped out slightly) o/n. // assess dobhoff tube position assess dobhoff tube position COMPARISON: ___ IMPRESSION: The studies demonstrate the process of Dobhoff tube placement with the last study demonstrating couple tube being in the stomach. Cardiomediastinal silhouette is unchanged. Interval increase in opacities in the both lungs might potentially represent a combination of pulmonary edema and aspiration. " e8ead34f-4ad62f0e-8ad3d292-01fabf17-8a410d8a.jpg,test/p15/p15860820/s58013415/e8ead34f-4ad62f0e-8ad3d292-01fabf17-8a410d8a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: New dyspnea on exertion, evaluation for acute process. COMPARISON: No comparison available at the time of dictation. FINDINGS: The abdominal changes are described in detail on the abdominal radiograph performed today at 11:19 a.m. In the lungs, no acute process is visualized. Relatively extensive bronchial wall calcifications. No pleural effusions. No pneumothorax. No pulmonary edema. Normal size of the cardiac silhouette. " f0c46165-29575645-cd158e0c-770043a0-c740b74a.jpg,test/p15/p15071748/s57446307/f0c46165-29575645-cd158e0c-770043a0-c740b74a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with possible CVA symptoms, rule-out respiratory process TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Lung volumes are lower compared to the previous examination. This accentuates the cardiac silhouette size which is borderline enlarged. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy and linear opacities in the lung bases may reflect areas of atelectasis. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Patchy and linear opacities in the lung bases, likely atelectasis in the setting of lower lung volumes. " 6ddbf342-528d64ee-a1206709-965bdf99-e2a5c005.jpg,test/p10/p10787013/s53635057/6ddbf342-528d64ee-a1206709-965bdf99-e2a5c005.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough and fever TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is normal. The aorta is tortuous, unchanged. Lungs are hyperinflated. There is no pulmonary edema. Mild coarse interstitial markings are seen bilaterally which could suggest chronic interstitial lung disease. No focal consolidation, pleural effusion or pneumothorax is demonstrated. Multilevel degenerative changes are noted along with S-shaped scoliosis of the thoracolumbar spine. Clips are seen in the upper abdomen from prior cholecystectomy. IMPRESSION: No focal consolidation to suggest pneumonia. " acc8d3f8-59fe1578-7d8f341c-874aa404-8b63fd64.jpg,test/p16/p16578228/s58537796/acc8d3f8-59fe1578-7d8f341c-874aa404-8b63fd64.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Elevated INR, evaluate for infection. COMPARISON: ___ FINDINGS: Frontal and lateral views of the chest were obtained. There is patchy opacity in the right mid to right lower lung which raises concern for infection. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable, with the aorta tortuous and calcified, and the cardiac silhouette top normal to mildly enlarged. IMPRESSION: Patchy right mid-to-lower lung opacity raises concern for infection and/or aspiration. " f2c3415b-e2481459-d185b956-495daae0-db28118f.jpg,test/p19/p19451806/s53442977/f2c3415b-e2481459-d185b956-495daae0-db28118f.jpg,test," FINAL REPORT HISTORY: History of cancer with cough productive of rusty sputum. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal with a left ventricular predominance. Mediastinal and hilar contours are unremarkable. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Moderate multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " f1483795-c6bc54c9-7d044e7e-8e74345f-62b5fb14.jpg,test/p11/p11343910/s58527075/f1483795-c6bc54c9-7d044e7e-8e74345f-62b5fb14.jpg,test," FINAL REPORT INDICATION: ___ year old woman with hx multiple myeloma, low grade fever and cough, assess for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate fully expanded and clear lungs. Heart is stably enlarged. Mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Old fracture of the right clavicle is noted. IMPRESSION: No evidence of pneumonia. " 376dd376-e95fa1c9-2309515d-bb954edd-721fe07b.jpg,test/p19/p19616613/s58640219/376dd376-e95fa1c9-2309515d-bb954edd-721fe07b.jpg,test," WET READ: ___ ___ ___ 11:48 AM Bibasilar opacities, likely representing atelectasis on the right, however the opacities in the left lower lung are slightly more confluent and may represent atelectasis or pneumonia. Mild to moderate cardiomegaly. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with dyspnea // PNA? TECHNIQUE: AP view of the chest. COMPARISON: ___. FINDINGS: There is bibasilar opacities, likely representing atelectasis on the right, however the opacities in the left lower lung are slightly more confluent and may represent atelectasis or pneumonia. No large pleural effusion or pneumothorax. Mild to moderate cardiomegaly. The cardiomediastinal and hilar contours are stable. IMPRESSION: Bibasilar opacities, likely representing atelectasis on the right, however the opacities in the left lower lung are slightly more confluent and may represent atelectasis or pneumonia. Mild to moderate cardiomegaly. " cfec09d0-b6bde2e8-c44e0edb-a63f2a65-e33f4cf9.jpg,test/p16/p16449190/s53347889/cfec09d0-b6bde2e8-c44e0edb-a63f2a65-e33f4cf9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o empyema s/p chest tube placement and antibiotic therapy // evaluate for improvement in R sided infection evaluate for improvement in R sided infection IMPRESSION: Compared to chest radiographs since ___, most recently one ___. Since ___ following removal of the right thoracostomy tube, there has been no appreciable change in the right hemi thorax, including possible small residual pleural effusion at the base, and thickening of the lateral costal pleural margin extending into the fissures. Lung volume in the small right lower lobe may have improved slightly. Left lung is clear. Cardiomediastinal and hilar silhouettes are normal. " 685e01a3-bbaa4d7a-a9a8e34b-df3caa4a-6b5d4811.jpg,test/p14/p14663313/s54259474/685e01a3-bbaa4d7a-a9a8e34b-df3caa4a-6b5d4811.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Epigastric pain, hematemesis. FINDINGS: AP upright and lateral views of the chest were provided. Low lung volumes noted. Lungs appear clear. No signs of pneumonia or CHF. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute findings in the chest. " 5df69e3a-ff62e20b-179c4032-08a0cfbe-43476f3e.jpg,test/p10/p10809830/s52676780/5df69e3a-ff62e20b-179c4032-08a0cfbe-43476f3e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with amiodarone routine screening // exclude amiodarone toxicity exclude amiodarone toxicity COMPARISON: Prior chest radiographs since ___, most recently ___. IMPRESSION: Patient has had median sternotomy. Wires are intact and the alignment is unchanged since ___. Right hemidiaphragm is severely chronically elevated. Lungs are clear. Heart size is top- normal. There is no pulmonary vascular abnormality or pleural effusion. " 5473326e-24e3051f-c157e144-951fe3ac-d22322e9.jpg,test/p14/p14308660/s55969307/5473326e-24e3051f-c157e144-951fe3ac-d22322e9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fevers TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 17c51a11-7e0fc910-0de00519-ea679ecb-74aaf3e2.jpg,test/p13/p13791874/s50345511/17c51a11-7e0fc910-0de00519-ea679ecb-74aaf3e2.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY. INDICATION: Patient with AFib, tachycardia, complex ablation on ___, shortness of breath, hemoptysis. COMPARISON: ___. FINDINGS: There is mild cardiac congestion superimposed to emphysema. There is no pneumothorax or pleural effusion. Moderate cardiomegaly is unchanged. There is no focal consolidation. Pleural effusions are small. CONCLUSION: Mild pulmonary edema. " e52fc7c2-f46b2606-db977f6a-aac76f16-73c289b1.jpg,test/p12/p12241303/s53749503/e52fc7c2-f46b2606-db977f6a-aac76f16-73c289b1.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of cirrhosis, now with fever. COMPARISON: Comparison is made with chest radiograph from ___. FINDINGS: The lungs are well expanded and clear. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Slight calcification of the aortic knob is incidentally noted. IMPRESSION: Essentially normal chest radiograph with no evidence of pneumonia or other acute pulmonary or cardiac pathology. " 1ff9992b-193d3b01-749d06a6-3c5ca53f-56854792.jpg,test/p10/p10408919/s57701160/1ff9992b-193d3b01-749d06a6-3c5ca53f-56854792.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with left sided chest pain // R/O CHF, pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None similar. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation. Posterior left fifth rib irregularity represents a healed fracture. No displaced acute rib fracture identified. IMPRESSION: No acute cardiopulmonary process. " f025dded-a654a58c-d348de31-6780afa9-28126659.jpg,test/p11/p11830275/s58459179/f025dded-a654a58c-d348de31-6780afa9-28126659.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CHF and shortness of breath // Fluid overload or pneumonia? COMPARISON: ___ IMPRESSION: As compared to the previous image, no relevant change is seen. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly with areas of atelectasis, notably in the retrocardiac lung region. Mild tortuosity of the descending aorta. No pneumonia. No pleural effusions. " b03eabf6-9979e505-c99d23af-c3bab6e8-6106ae65.jpg,test/p10/p10377016/s51464989/b03eabf6-9979e505-c99d23af-c3bab6e8-6106ae65.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p AVR // predischarge eval IMPRESSION: As compared to ___ chest radiograph, cardiomediastinal widening is stable in the postoperative period. Although stable compared to recent postoperative radiograph, enlargement of cardiac silhouette compared to preoperative radiograph of ___ suggests the possibility of postoperative pericardial effusion. Interval worsening of bibasilar atelectasis and persistent small bilateral pleural effusions. No visible pneumothorax. " 8c4cbec6-7d8f7ec9-5c62fe27-0540677c-116b9479.jpg,test/p14/p14163729/s56584952/8c4cbec6-7d8f7ec9-5c62fe27-0540677c-116b9479.jpg,test," FINAL REPORT INDICATION: ___-year-old female with generalized weakness. Question pneumonia. COMPARISON: Multiple chest radiographs, the latest from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. The cardiac silhouette is mildly enlarged. The mediastinal silhouette shows aortic calcifications. The hilar contours and pleural surfaces are normal. No pleural effusion or pneumothorax is present. Cholecystectomy clips are noted in the right upper quadrant, unchanged. A hyperdense focus is noted overlying the L1 vertebral body, which could represent a bone island, unchnaged from prior. A healed rib fractures is unchanged in the left hemithorax. IMPRESSION: No acute intra-thoracic process. " fe0abe66-7db79921-a5833302-c9c8eaba-ff105722.jpg,test/p13/p13648633/s57465247/fe0abe66-7db79921-a5833302-c9c8eaba-ff105722.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, evaluation for respiratory distress and septic shock, known hematemesis. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a further progression in extent and severity of the pre-existing and known bilateral parenchymal opacities. The nasogastric tube is unchanged. The right internal jugular vein catheter is barely visible on the current study. Unchanged moderate cardiomegaly. No larger pleural effusions. Mild elevation of the left hemidiaphragm. " 6b765879-4774fadb-0a1a810a-af1901fc-31c4b8af.jpg,test/p17/p17436646/s58617348/6b765879-4774fadb-0a1a810a-af1901fc-31c4b8af.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with altered mental status and epigastric pain. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, ___ chest CT FINDINGS: Cardiac, mediastinal and hilar contours are unchanged and the heart size is within normal limits. Pulmonary vasculature is normal. Fiducial marker within the right lower lobe is re- demonstrated with adjacent opacity, unchanged. Lungs are otherwise clear without focal consolidation, pleural effusion or pneumothorax. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary process. Fiducial marker within an unchanged right lower lobe opacity, better assessed on recent CT. " ad622030-f610d84d-e674dadc-eeee05bc-e6649bad.jpg,test/p10/p10848515/s52022524/ad622030-f610d84d-e674dadc-eeee05bc-e6649bad.jpg,test," FINAL REPORT HISTORY: Cardiac pacer upgrade. Evaluate lead position. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest. A left pacer has leads ending in the right atrium, right ventricle and interventricular vein. There are small bilateral pleural effusions. Interstitial irregularity in the periphery of the right lung likely represents scarring. There is no focal consolidation, pulmonary edema, or pneumothorax. There is moderate cardiomegaly. IMPRESSION: Cardiac pacer leads in appropriate position. Moderate cardiomegaly. " 710aa813-8bdb13d2-e2696ce9-ab230f92-f636349f.jpg,test/p18/p18031120/s57433034/710aa813-8bdb13d2-e2696ce9-ab230f92-f636349f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with heart failure. // Please eval for interval change. Please eval for interval change. COMPARISON: ___ obtained at 22:34 IMPRESSION: Since the prior study there has been interval improvement in interstitial edema with only vascular congestion currently seen. Pacemaker defibrillator is in unchanged position terminating in the right ventricle. Right PICC line tip terminates most likely at the level of lower SVC. " c95e0d4f-21bfb8eb-850e5b47-ad591faa-ff14d396.jpg,test/p14/p14538144/s54930135/c95e0d4f-21bfb8eb-850e5b47-ad591faa-ff14d396.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chest pain // r/o acute process, fluid overload? COMPARISON: ___. IMPRESSION: As compared to the previous image, the right central venous access line was removed. Unchanged lung volumes. Borderline size of the cardiac silhouette. No pulmonary edema. No pneumonia, no pneumothorax, no pleural effusions. " d5089a86-9cedff5c-77e58836-358cce2d-64711107.jpg,test/p11/p11632236/s55321474/d5089a86-9cedff5c-77e58836-358cce2d-64711107.jpg,test," FINAL REPORT HISTORY: Status post thoracotomy with placement of 3 right-sided chest tubes. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___, at ___. FINDINGS: Redemonstrated are 2 apical and 1 basal right-sided chest tubes, unchanged in position. Stable, subcutaneous emphysema is again noted. There is currently no visualized pneumothorax or pleural effusion. The right lung demonstrates decreased lung volumes, with an associated diffuse increase in density. The left lung is grossly normal in appearance. The heart size is normal. Mediastinal contours are stable. IMPRESSION: Unchanged appearance status post right thoracotomy with placement of 3 right-sided chest tubes. No evidence of pneumothorax or pleural effusion. " bc9616bb-1432977f-b9641233-84567a69-d33357c6.jpg,test/p14/p14130631/s59770097/bc9616bb-1432977f-b9641233-84567a69-d33357c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stroke and pna and resp distress // concern for worsening PNA concern for worsening PNA IMPRESSION: In comparison with the study of ___, there is little change in the extensive bilateral pulmonary opacifications consistent with severe multifocal pneumonia. " 66dcdb05-4b64b895-52710caf-6f9f2e3f-fdf7cd14.jpg,test/p16/p16535066/s56496159/66dcdb05-4b64b895-52710caf-6f9f2e3f-fdf7cd14.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: ___-year-old man with fever and cough and dullness at the right base. IMPRESSION: PA and lateral chest compared to ___ and ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. No evidence of central lymph node enlargement. ___ was paged as requested. " 00e27c46-8af32cfe-239afbed-c70de73e-58ea9b2f.jpg,test/p11/p11165038/s52257683/00e27c46-8af32cfe-239afbed-c70de73e-58ea9b2f.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest tightness and occasional shortness of breath. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " eb58bbba-1b668c78-49ad8142-aaa0a0bc-0d1f42ba.jpg,test/p11/p11423154/s53302503/eb58bbba-1b668c78-49ad8142-aaa0a0bc-0d1f42ba.jpg,test," FINAL REPORT HISTORY: ___-year-old female with shortness of breath and chest pain. COMPARISON: None available in the ___ system. PA AND LATERAL CHEST RADIOGRAPHS: The lungs are clear. There is no focal consolidation or pneumothorax. There is no vascular congestion or pleural effusions. Mediastinal and hilar contours are within normal limits. Mild enlargement of the left ventricular contour is identified. IMPRESSION: 1. No acute cardiopulmonary process. 2. Possible left ventricular enlargement. Correlation with non-emergent echocardiogram is recommended. " 186fee64-91a6d0f4-c1eb2c6c-89b04e52-2c9513c2.jpg,test/p17/p17908240/s50435197/186fee64-91a6d0f4-c1eb2c6c-89b04e52-2c9513c2.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fall. Question infection. FINDINGS: Frontal and lateral views of the chest. No prior. The lungs are hyperinflated with flattening of the diaphragms, but they are clear of consolidation or large effusion. There is no pulmonary vascular engorgement. Cardiac silhouette is at upper limits of normal. Atherosclerotic calcifications noted in the thoracic aorta. Osseous and soft tissue structures are unremarkable. IMPRESSION: Hyperinflation without acute cardiopulmonary process. " effce852-3920378e-d53ad095-59131628-5a34033f.jpg,test/p10/p10356845/s57288355/effce852-3920378e-d53ad095-59131628-5a34033f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: New NG tube placement. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are grossly stable. The left subclavian line tip is at the level of mid SVC. Lungs are essentially clear except for basal areas of atelectasis. Skinfold is projecting over the right upper chest. " 351d95c2-0b9d039e-d10ed726-70e5613f-e8472196.jpg,test/p13/p13516001/s51595225/351d95c2-0b9d039e-d10ed726-70e5613f-e8472196.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with R lower posterior rib cage pain. WOrse with palpation, twisting at waist and raising arm over head // r/o rib fracture r/o rib fracture IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal or mildly enlarged and there is again tortuosity of the aorta. Hyperexpansion of lungs with flattening hemidiaphragms is consistent with chronic pulmonary disease. No acute pneumonia, vascular congestion, or pleural effusion. No rib abnormality is seen on this study, though oblique views could be obtained if clinically warranted. No evidence of pneumothorax. " df94c744-3ddac734-a606d483-24f0da45-699d5e4b.jpg,test/p11/p11600572/s59815545/df94c744-3ddac734-a606d483-24f0da45-699d5e4b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with AML // pre bmt pre bmt IMPRESSION: In comparison with the study of ___, the questioned opacification in in the right upper zone is no longer present. Again there are relatively low lung volumes with show enhance the prominence of the transverse diameter of the heart. No pulmonary vascular congestion or pleural effusion. " d5371d5f-da4caead-7e33ce5c-ec54b880-70314385.jpg,test/p18/p18202111/s59474774/d5371d5f-da4caead-7e33ce5c-ec54b880-70314385.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Small right pleural effusion has recurred. There is no pneumothorax. Nodules in the left lung are long-standing, attributed to rheumatoid arthritis. There is no pneumonia or appreciable atelectasis. Cardiomediastinal and hilar silhouettes and right pleural surfaces are normal. " 91bc7680-3a163afe-07054426-45b08b6b-854c5eb4.jpg,test/p14/p14603544/s53090894/91bc7680-3a163afe-07054426-45b08b6b-854c5eb4.jpg,test," FINAL REPORT INDICATION: ___-year-old male with hypotension and cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pulmonary edema. Atelectasis is seen in the left lung base. The heart size is normal, and the mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 3ccfb649-580aa1d2-4da6e888-05a90a9d-1cfd0313.jpg,test/p16/p16668735/s59350943/3ccfb649-580aa1d2-4da6e888-05a90a9d-1cfd0313.jpg,test," FINAL REPORT INDICATION: Fever. COMPARISON: Right clavicular radiograph from ___. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Again noted is a healed proximal one-third right clavicular fracture. Otherwise, no acute osseous abnormalities are identified. IMPRESSION: No acute cardiopulmonary process. " f288f73e-e2401c22-602ed755-2a12e079-7f2406e2.jpg,test/p14/p14045504/s52324370/f288f73e-e2401c22-602ed755-2a12e079-7f2406e2.jpg,test," WET READ: ___ ___ ___ 10:08 PM Post-operative left-sided volume loss, left subcutaneous emphysema, and two left chest tubes. Two surgical clips project over left lung base. No acute findings in right lung. Levoconvex thoracolumbar scolosis. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after left upper lobectomy. Portable AP radiograph of the chest was reviewed in comparison to ___. Elevated left hemidiaphragm is related to the performance of lobectomy. Two left chest tubes are in place. There is small amount of left pneumothorax. The right lung is essentially clear. Minimal left mediastinal shift is present. No appreciable pleural effusion is demonstrated. " 8ec23316-8c5dc9de-a5bc049f-1a39c393-7e03f2c9.jpg,test/p18/p18136485/s55384993/8ec23316-8c5dc9de-a5bc049f-1a39c393-7e03f2c9.jpg,test," WET READ: ___ ___ ___ 11:30 PM 1. No focal consolidation identified. 2. Mild cardiomegaly and possible small bilateral pleural effusions. WET READ VERSION #1 ___ ___ ___ 11:01 PM 1. Accentuation of the ascending aortic contour, possibly representing aneurysm, although difficult to conclude without prior chest radiographs. If priors are available, recommend comparison to those exams. 2. No focal consolidation identified. 3. Mild cardiomegaly and possible small bilateral pleural effusions. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radio INDICATION: ___F with nausea/vomiting diaphoresis // ?cardiomegaly TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: No focal consolidation is identified. There is mild bibasilar atelectasis. There is no pneumothorax or pulmonary edema. Bibasilar atelectasis is noted. There may be small bilateral pleural effusions. The heart size is mildly enlarged. IMPRESSION: 1. No focal consolidation identified. 2. Mild cardiomegaly and possible small bilateral pleural effusions. " fada18cf-229f4f5f-f1b5af18-c7daade9-93881957.jpg,test/p12/p12773009/s50846231/fada18cf-229f4f5f-f1b5af18-c7daade9-93881957.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. Small residual blunting at the right CP angle likely reflects a small pleural effusion and mild basilar atelectasis. Otherwise, the lungs are clear. Cardiomediastinal silhouette is normal. Bony structures appear intact. IMPRESSION: Minimal residual right pleural effusion and basilar atelectasis. " 6b57c1e0-b16c0ded-e345e3b0-5d15537a-6d707afa.jpg,test/p17/p17155697/s51350457/6b57c1e0-b16c0ded-e345e3b0-5d15537a-6d707afa.jpg,test," FINAL REPORT HISTORY: ___-year-old male status post right thoracotomy and resection of pleural mass. Evaluate for lung expansion. COMPARISON: Chest radiograph dated ___. Chest CT dated ___. FINDINGS: AP portable chest radiograph demonstrates 2 right chest tubes with no pneumothorax identified. There is low lung volumes with mild vascular congestion. Opacification of the right lower lobe is most likely a combination of pleural effusion and atelectasis. There is some gas noted in the subcutaneous tissues along the right lateral chest wall. There is increased vascular congestion right greater than left but no overt pulmonary edema. IMPRESSION: No pneumothorax. " 04a2c326-a40230fc-660ade4a-5b6660e6-3e4fad32.jpg,test/p10/p10866397/s50061435/04a2c326-a40230fc-660ade4a-5b6660e6-3e4fad32.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with intermittent CP radiating into back, dyspnea COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " bdc815ca-af22a068-a2f64abd-512a5441-3c55322e.jpg,test/p13/p13035993/s55499036/bdc815ca-af22a068-a2f64abd-512a5441-3c55322e.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain, question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. There may be very mild central pulmonary vascular engorgement. There are degenerative changes along the spine. IMPRESSION: Mild central pulmonary vascular engorgement without focal consolidation seen. " b1283d38-8d64bb27-00dca50a-d0e1addf-646d3907.jpg,test/p15/p15154432/s57982756/b1283d38-8d64bb27-00dca50a-d0e1addf-646d3907.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sepsis // ?edema ?edema IMPRESSION: In comparison with the study of ___, there are lower lung volumes. The monitoring and support devices are unchanged. Opacification at the right base is consistent with pleural fluid and atelectasis. Similar changes are seen at the left base. There again is mild enlargement of the cardiac silhouette with little if any vascular congestion. " 8887c71e-280172b3-2f0a7056-175389b2-50f015e2.jpg,test/p11/p11677206/s56464767/8887c71e-280172b3-2f0a7056-175389b2-50f015e2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with RUL lobectomy // ? interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Status post right upper lobectomy. The cord Ding by postoperative rib fractures and in pneumothorax on the right. , drained by 2 chest tubes. The patient is intubated. The left lung is slightly overinflated and shows mild areas of scarring. Unchanged appearance of the cardiac silhouette. " 844ecceb-cd67079f-d9bc2b69-a8fc8a2a-833cf912.jpg,test/p19/p19685014/s51208988/844ecceb-cd67079f-d9bc2b69-a8fc8a2a-833cf912.jpg,test," WET READ: ___ ___ ___ 2:36 PM Mild effacement of the right cardiac border, seen only on the frontal view, could relate to resolving/known pneumonia. However recent radiographs are unavailable for comparison. Otherwise, no definite focal consolidation identified. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History of pancreatic and renal transplant for diabetes type 1, presenting with severe headache, neck pain and nausea with recent diagnosis of pneumonia on ___ (patient evaluated at urgent care ___ at ___). TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___ and ___. No additional recent radiographs available for comparison. FINDINGS: There is mild effacement of the right cardiac border and faint opacification within the right lower lobe, which could relate to resolving/known pneumonia, however recent radiographs are unavailable for comparison. The cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. IMPRESSION: Mild right lower lobe opacity reflecting either resolving or evolving pneumonia. No effusions. " 0b765bef-80c1670f-62b56eb1-0eb63e15-d06bc7f2.jpg,test/p19/p19427735/s51396160/0b765bef-80c1670f-62b56eb1-0eb63e15-d06bc7f2.jpg,test," WET READ: ___ ___:___ PM Left upper lobe pneumonia. Comm to Ms ___ ___ by Dr ___ on ___ at ___ pm via phone. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: ___-year-old woman with severe mitral regurgitation and prolapse. Preoperative assessment. IMPRESSION: PA and lateral chest compared to ___: Severe heterogeneous opacification in the left mid lung extending from the hilus to the lateral chest wall, new since ___ is most likely pneumonia, and the interval enlargement of the left hilus and fullness in the prevascular mediastinum would be due to reactive adenopathy. However if the patient does not manifest pneumonia, aggressive malignancy should be considered and investigated with CT scanning. The extent of cardiac decompensation judged by pulmonary vascular caliber is stable although moderate enlargement of the heart is slightly larger. There is no pleural effusion. This interpretation was discussed by telephone with a member of the cardiac surgery care team at ___AM, ___. " 8f67da19-25ef0628-363b2918-7e44e1e6-372c6506.jpg,test/p13/p13876014/s54977527/8f67da19-25ef0628-363b2918-7e44e1e6-372c6506.jpg,test," FINAL REPORT HISTORY: Resting chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The aorta is tortuous. The cardiac silhouette is not enlarged. Mild degenerative changes are seen along the spine. IMPRESSION: Clear lungs without findings to suggest pneumonia. " d3de8063-becdefe4-3bf55e1d-2b0d05e7-c87c9b9d.jpg,test/p15/p15968244/s57874176/d3de8063-becdefe4-3bf55e1d-2b0d05e7-c87c9b9d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p CABG with left upper chest pain // eval for pneumo/effusion COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has developed a minimal left pleural effusion, combines to a left basilar atelectasis. The right lung is unremarkable. The postoperative appearance of the cardiac silhouette is normal. No pneumothorax. " 2d60fd19-1a1b1e1a-16c89737-8ecd4d18-4da4610a.jpg,test/p19/p19551627/s54958864/2d60fd19-1a1b1e1a-16c89737-8ecd4d18-4da4610a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with moved lines. // assess lines assess lines IMPRESSION: In comparison with the earlier study of this date, the endotracheal tube has been removed. Nasogastric tube and pacer leads appear unchanged. No change in the appearance of the heart and lungs. " de0938ad-0d303cd2-c0b6ec8e-b1fc789d-51624973.jpg,test/p18/p18218394/s50155006/de0938ad-0d303cd2-c0b6ec8e-b1fc789d-51624973.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with asthma/copd and worsening cough/CP // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Slight blunting of the right costophrenic angle may be due to a trace pleural effusion versus pleural thickening. Mild right base atelectasis is seen. There is no focal consolidation. No evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There is no pulmonary edema. Chronic appearing rib deformity at the lateral left ninth rib. IMPRESSION: Blunting of the right costophrenic angle could be due to a trace pleural effusion versus pleural thickening. No focal consolidation to suggest pneumonia. " 527e60a5-d1a59773-ae514895-0484ed53-7c54d7d1.jpg,test/p12/p12538793/s52068877/527e60a5-d1a59773-ae514895-0484ed53-7c54d7d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F complex history hepatic and ileacus abscesses, colectomy followed by multiple ex-laps, enterocutaneous fistula and chronic RLQ fluid collection being treated with vancomycin/cefepime with drain in place, who presented to the ED with fevers and chills found to be fungemic. Also bony mets, new metastatic adenocarcinoma. Now with rising WBC. // Assess for new infectious source Assess for new infectious source IMPRESSION: Compared to chest radiographs since ___, most recently ___. Previous interstitial abnormality has resolved, probably mild pulmonary edema. Lungs are fully expanded and clear. Heart size normal. Probable small bilateral pleural effusion. No pneumothorax. Ascending thoracic aorta is tortuous or mildly dilated. " 9bebe0ed-dbc81c25-6faddef7-f8476d9a-7434c374.jpg,test/p18/p18785003/s54334469/9bebe0ed-dbc81c25-6faddef7-f8476d9a-7434c374.jpg,test," FINAL REPORT AP CHEST 4:43 A.M., ___ HISTORY: ___-year-old man with hemicolectomy for perforated colon, now with pulmonary edema. IMPRESSION: AP chest compared to ___. I see pulmonary vascular engorgement, unchanged over the past 24 hours, but no pulmonary edema. There is at least a moderate right pleural effusion, depending on the location of the right hemidiaphragm which prior to surgery was very elevated. The pleural abnormality has not worsened since ___ when the patient was in very mild pulmonary edema. Since that time, mediastinal venous distention has improved. Heart size is normal. Right-sided central venous line, probably a PIC, ends at the origin of the SVC. " 937c9462-229a760d-479204bd-e3cf8223-5b6cac5d.jpg,test/p11/p11967908/s51605422/937c9462-229a760d-479204bd-e3cf8223-5b6cac5d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ?PNA but subtle findings on CXR // assess for interval worsening of infiltrate COMPARISON: ___ radiograph IMPRESSION: Recently questioned early pneumonia in right lower lobe is no longer evident. Remainder of exam is unchanged except for resolution of pulmonary vascular congestion. " a42111e5-235b4b08-a0c05bf9-d8dff53e-a2e4a7ef.jpg,test/p14/p14916430/s52067207/a42111e5-235b4b08-a0c05bf9-d8dff53e-a2e4a7ef.jpg,test," WET READ: ___ ___ ___ 8:27 PM DHT coils twice in the stomach with tip most likely terminating in the fourth part of duodenum. Left basal pleural effusion and consolidation, partially imaged. ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess Dobbhoff placement. Comparison is made with prior study, ___. Dobbhoff tube coils twice in the stomach with tip most likely in the third portion of the duodenum. Moderate-to-severe cardiomegaly is stable. Moderate vascular congestion has increased. Left lower lobe opacity is new, a combination of small pleural effusion and adjacent lung consolidation worrisome for aspiration/pneumonia. " 2d1e79d3-16e056ce-6cee716d-4831560e-d5b6c6af.jpg,test/p19/p19795174/s59112317/2d1e79d3-16e056ce-6cee716d-4831560e-d5b6c6af.jpg,test," FINAL REPORT INDICATION: ___ year old man withmultiple myeloma // pre bmt eval TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Interval decrease in heart size, now normal with stable tortuosity of the aorta. No focal consolidation, pleural effusion or pneumothorax. No pulmonary edema. IMPRESSION: No acute process " eabad421-07ec5dda-c05a43b9-f18d664c-2e0ec145.jpg,test/p11/p11069015/s53676224/eabad421-07ec5dda-c05a43b9-f18d664c-2e0ec145.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Study of earlier the same date. FINDINGS: Following left thoracentesis, a left pleural effusion has substantially decreased in size, with no visible pneumothorax. Associated improved aeration at left lung base. Otherwise, no relevant short interval change since prior study of approximately two hours earlier. " e4d6bbf6-b3c890d0-083efb11-da181528-27a089b7.jpg,test/p18/p18998679/s51603961/e4d6bbf6-b3c890d0-083efb11-da181528-27a089b7.jpg,test," FINAL REPORT HISTORY: Dyspnea on exertion, cough, fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Compared to the previous exam, there are worsening bibasilar airspace opacities concerning for progression of pneumonia. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Worsening bibasilar airspace opacities concerning for progression of pneumonia. " c18faea9-d7097027-68aa04f0-80aab0b5-3fd60170.jpg,test/p19/p19576360/s58723019/c18faea9-d7097027-68aa04f0-80aab0b5-3fd60170.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman w/ Monocytic leukemia on 7+3 day ___. Newly febrile to 100.8. // Evidence of PNA? Evidence of PNA? IMPRESSION: In comparison with the study of ___ an, the cardiac silhouette remains enlarged without appreciable vascular congestion, pleural effusion, or acute focal pneumonia. Right IJ catheter again extends to the upper right atrium. " 23ace2a5-79e12a83-2e2a1793-b4dca9be-3f3327df.jpg,test/p18/p18785003/s52024098/23ace2a5-79e12a83-2e2a1793-b4dca9be-3f3327df.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with abdominal distension // NGT placement, has been advanced. TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph ___ 14:14 performed earlier on the same day FINDINGS: Tip of the NG tube again is not well visualized past the diaphragm and likely is in the GE junction. Otherwise there is no significant interval change since chest radiograph performed earlier on the same day. Cardiac size is normal. There is no pneumothorax or pleural effusion. Unchanged collapse of the right middle lobe and right lower lobe with elevation of left hemidiaphragm again noted. Severely distended bowel loops again noted. IMPRESSION: NG tube tip is still not well visualized past the diaphragm and is likely in the GE junction " d039268f-061a9463-66ea39a6-116da09e-af048fc1.jpg,test/p17/p17702558/s57708924/d039268f-061a9463-66ea39a6-116da09e-af048fc1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NSCLC now with hemoptysis // ?interval change ?interval change IMPRESSION: In comparison with the earlier study of this date, there is little change. Stable opacification in the left mid and lower zones consistent with pleural effusion and compressive basilar atelectasis. Pigtail catheter remains in place. The right lung is clear. " 5c213959-ea63d159-552b9820-7ab956de-91acd75b.jpg,test/p16/p16783674/s53939702/5c213959-ea63d159-552b9820-7ab956de-91acd75b.jpg,test," FINAL REPORT TECHNIQUE: PA and lateral chest views were compared with prior radiographs from ___ to ___. FINDINGS: Minimal left pleural effusion and left lower lung atelectasis unchanged since ___. Left upper and right lungs are clear. Mild lower lung atelectasis is similar. Normal heart size, mediastinal and hilar contours are stable. Status post median sternotomy with intact sternal sutures. IMPRESSION: Mild bibasal atelectasis and minimal left pleural effusion, stable since ___. " d4b16034-698f60ae-3bb6b3c3-f7c7826c-bf4724a8.jpg,test/p12/p12056305/s57238652/d4b16034-698f60ae-3bb6b3c3-f7c7826c-bf4724a8.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with new stroke, evaluate for nodules. FINDINGS: PA and lateral chest views were obtained with patient in upright position. There is cardiomegaly. The enlargement appears to involve mostly the left ventricle which is prominent to the left and posteriorly. Thoracic aorta is moderately widened but markedly elongated and shows some calcium deposits in the wall at the level of the arch. Pulmonary vasculature is presently not congested. There exists some prominence of the central pulmonary artery, the hilar regions, but the periphery does not show perivascular haze nor is there evidence of interstitial or alveolar edema. The lateral and posterior pleural sinuses are free, excluding significant pleural effusion. No acute parenchymal infiltrates are identified. Comparison can be made with the frontal view of a preceding chest examination, outside institution. On this image, poor inspirational effort resultant in crowded appearance of the pulmonary vasculature. It is conceivable that one may have interpreted this to include multiple nodular densities but this cannot be confirmed by today's chest examination with improved inspirational effort. IMPRESSION: Cardiomegaly, thoracic aortic elongation in patient with history of stroke. No signs of acute CHF or acute infiltrates. " eacf022e-e2554b5c-0b64d175-4823896b-aaeafdc1.jpg,test/p16/p16557374/s50473313/eacf022e-e2554b5c-0b64d175-4823896b-aaeafdc1.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old male with vomiting blood. FINDINGS: Single portable view of the chest is compared to previous exam from ___. The lungs are clear of focal consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. No free intraperitoneal air seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " a180df8f-28bbbc03-8c986100-8d14e73d-9e1b17f6.jpg,test/p14/p14256884/s53115194/a180df8f-28bbbc03-8c986100-8d14e73d-9e1b17f6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with concern for stroke with 2 aphasic episodes, per neuro workup requesting CXR TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is top normal. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Faint patchy opacity in the retrocardiac region most likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Moderate multilevel degenerative changes are noted in the imaged thoracic spine. IMPRESSION: Retrocardiac atelectasis. " 4f81e9fe-b7d1d3fe-d20f8b96-81d12683-c8cf8264.jpg,test/p19/p19912620/s50324062/4f81e9fe-b7d1d3fe-d20f8b96-81d12683-c8cf8264.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior CT torso from ___. CLINICAL HISTORY: Recent cancer diagnosis with weakness, question pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. Lung volumes are low, though the lungs remain clear. The heart size is normal. Dual-lead pacer is unchanged. No pneumothorax or pleural effusion is seen. On the lateral view, a metallic stent is visualized in the right upper abdomen. IMPRESSION: No signs of pneumonia. Low lung volumes limit evaluation. " 4b96c8ad-bb67b06f-22538733-ba3821e1-9d45af07.jpg,test/p11/p11201441/s59086678/4b96c8ad-bb67b06f-22538733-ba3821e1-9d45af07.jpg,test," FINAL REPORT RADIOGRAPHS OF THE CHEST AND PELVIS. INDICATIONS: Trauma. COMPARISONS: None. TECHNIQUE: Chest and pelvis, single AP view of each. FINDINGS: The patient is intubated. A orogastric tube courses into the stomach, its distal extent not visualized. The mediastinum is widened, including about the periaortic region. A chest tube terminates in the right hemithorax. There is potentially a small pneumothorax on the right. There is extensive retrocardiac opacity in the left lower lobe which may be due to partial collapse of the left lower lobe. Pleural effusions are difficult to exclude, particularly on the left, but not explicitly demonstrated. Substantial subcutaneous emphysema about the course of the right-sided chest tube is noted along the right lateral chest wall. IMPRESSION: 1. Perhaps trace residual right-sided pneumothorax, although evaluation is limited on an AP portable supine view such as this. 2. Chest tube in situ on the right. 3. Widening of the mediastinum for which CT evaluation is indicated (apparently already performed at an outside institution). " 81803911-c2f666ec-cb247adb-2930e9ce-0498acdb.jpg,test/p10/p10065383/s58507709/81803911-c2f666ec-cb247adb-2930e9ce-0498acdb.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: Study of earlier the same date. FINDINGS: Following placement of a left pigtail pleural catheter, a left pneumothorax has substantially decreased in size, with residual small pneumothorax remaining, and associated reexpansion of the left lung. Widespread bilateral lung opacities are in keeping with history of ARDS, and may be accompanied by pulmonary interstitial emphysema. Various support and monitoring devices including ECOM canula remain in place. Within the imaged portion of the upper abdomen, moderate to marked gastric distention is present. This is more fully evaluated on separately dictated abdominal radiograph on the same date under clip ___. " db47dcb4-d7f09941-a7216c2b-e56ea994-cfc3b799.jpg,test/p15/p15633489/s51081532/db47dcb4-d7f09941-a7216c2b-e56ea994-cfc3b799.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Dyspnea. TECHNIQUE: Chest, AP semi-upright portable. COMPARISON: ___ and ___. FINDINGS: The lung volumes are low. The cardiac, mediastinal and hilar contours appear stable including prominence of central mediastinal pulmonary arteries. There is no definite pleural effusion or pneumothorax. There is again striking upper zone redistribution of pulmonary vasculature suggesting pulmonary venous hypertension although not significantly changed. Otherwise, aside from slight suspected atelectasis at the left lung base, the lungs appear clear. IMPRESSION: Findings suggest pulmonary venous hypertension. Enlarged central pulmonary arteries. " 090a6ba6-79671241-5cb93a8f-08672dd0-42e99d90.jpg,test/p16/p16955701/s59050142/090a6ba6-79671241-5cb93a8f-08672dd0-42e99d90.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Presyncope. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " d01541e4-6930686b-ae5482f5-a9120c25-ecccbfd3.jpg,test/p16/p16116458/s53284471/d01541e4-6930686b-ae5482f5-a9120c25-ecccbfd3.jpg,test," FINAL REPORT INDICATION: Altered mental status. Evaluate for an acute cardiopulmonary process. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Again, there is a mild diffuse interstitial abnormality, which can be seen in the setting of chronic lung disease. There is a 3.5 cm cystic lesion in the right upper lobe, unchanged. No pneumothorax, pleural effusion or focal airspace consolidation worrisome for pneumonia. Heart is normal size. Mediastinal and hilar contours are unremarkable. There are severe degenerative changes of the right glenohumeral joint. Deformity of the right humerus may reflect prior fracture, however, this is incompletely evaluated. IMPRESSION: 1. No acute cardiopulmonary process. 2. Increased interstitial abnormality likely reflects colonic lung disease, however, nonemergent high-resolution chest CT could be considered. The right upper lobe cystic abnormality could be evaluated at that time as well. " 5c20833a-538616e5-8d5fe63d-863a3b80-b781767a.jpg,test/p10/p10018169/s56519856/5c20833a-538616e5-8d5fe63d-863a3b80-b781767a.jpg,test," WET READ: ___ ___ 5:09 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with headache, leukocytosis // Eval for PNA TECHNIQUE: PA and lateral images of the chest. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " b79083e0-dd5b65d6-cafc1ca6-bad04bb5-6b6faa2f.jpg,test/p14/p14237047/s51945440/b79083e0-dd5b65d6-cafc1ca6-bad04bb5-6b6faa2f.jpg,test," FINAL REPORT INDICATION: ___ year old man with multifocal PNA, aspiration // interval change? COMPARISON: Radiographs from ___ IMPRESSION: Endotracheal tube has been removed. There is a right IJ central line with the distal lead tip at the cavoatrial junction. There is again seen consolidation at the lung bases, right worse than left, stable. There are no pneumothoraces. " 202a6b4d-f34b5813-a017c447-59c711f2-3b3921c0.jpg,test/p11/p11434374/s56287232/202a6b4d-f34b5813-a017c447-59c711f2-3b3921c0.jpg,test," FINAL REPORT INDICATION: ___-year-old man status post intubation, confirm endotracheal tube location. TECHNIQUE: Single AP chest radiograph. COMPARISON: Earlier same-day chest radiograph ___ at 09:36. FINDINGS: New since prior same-day radiograph is an endotracheal tube with distal tip projecting approximately 4.1 cm above the carina. A new enteric tube courses inferiorly in the midline, with distal side port projecting over the gastric body, tip not visualized. The cardiomediastinal contours are stable, including moderate enlargement of the cardiac silhouette. Diffuse, bilateral consolidative airspace opacities are unchanged. There is biapical pleural parenchymal scarring. There is no pneumothorax or large pleural effusion. IMPRESSION: ET tube in appropriate location ending 4 cm above the carina. New enteric tube in appropriate location. Otherwise, unchanged chest radiograph. " 3b7e4e2b-58718cbc-c6710e41-dec70113-ce943495.jpg,test/p15/p15704389/s56443635/3b7e4e2b-58718cbc-c6710e41-dec70113-ce943495.jpg,test," FINAL REPORT HISTORY: Esophageal cancer, for NG tube placement. FINDINGS: In comparison with study of ___, the nasogastric tube coils within the stomach. The large nodular opacifications seen previously on the right and in the perihilar region are substantially less prominent at this time. Patchy area of opacification at the left base could reflect a developing aspiration or pneumonia. There is marked dilatation of loops of small bowel, consistent with the clinical question of possible obstruction. " c3aed0f8-8e65afb3-bd11c234-edc737a3-bdd97006.jpg,test/p17/p17635650/s59483605/c3aed0f8-8e65afb3-bd11c234-edc737a3-bdd97006.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis // Please evaluate for pneumonia Please evaluate for pneumonia COMPARISON: Comparison to ___ at 13:49 FINDINGS: PA and lateral views of the chest ___ at 17:03 are submitted. IMPRESSION: Status post median sternotomy with mitral valve replacement and stable cardiac and mediastinal contours. There are stable chronic interstitial changes in the lungs. No developing airspace consolidation is seen to suggest pneumonia. No pulmonary edema. No pneumothorax. Minimal blunting of both posterior costophrenic angles which could reflect tiny effusions or chronic pleural thickening. " d6ffd210-51d071c0-1e337554-d4837024-cae400a9.jpg,test/p17/p17051420/s54033085/d6ffd210-51d071c0-1e337554-d4837024-cae400a9.jpg,test," FINAL REPORT HISTORY: ___-year-old male with productive cough and shortness of breath. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 394590a1-5ebf526a-4d915258-2c5dacb4-d6b7a2fa.jpg,test/p11/p11729047/s56308734/394590a1-5ebf526a-4d915258-2c5dacb4-d6b7a2fa.jpg,test," WET READ: ___ ___ ___ 11:16 PM Intact sternomy wires. Aortic valve prosthesis. Unchanged L hemidiaphragm elevation and atelectasis. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG with sternal drainage. PA and lateral upright chest radiographs were reviewed in comparison to ___. The patient is after removal of the Swan-Ganz catheter. Heart size and mediastinum are unchanged in appearance. Post-sternotomy wires are unchanged. The patient is after aortic valve replacement. Left lower lobe opacity is noted, unchanged and most likely consistent with atelectasis in combination with small effusion. No pulmonary edema is seen. " 4037e95b-93ffbb99-fd878e5e-a54e0f1a-9d890e74.jpg,test/p12/p12870544/s50074708/4037e95b-93ffbb99-fd878e5e-a54e0f1a-9d890e74.jpg,test," WET READ: ___ ___ ___ 9:15 PM Small to moderate layering right pleural effusion is unchanged from ___. Underlying consolidation cannot be excluded. Left lung is essentially clear. No pneumothorax. Heart size remains enlarged. Support lines and devices are unchanged in position. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with a h/o sickle cell anemia c/b moyamoya s/p b/l pial synangiosis admitted as unrestrained driver in high speed MVC // pneumonia, acute chest pneumonia, acute chest COMPARISON: Chest radiographs ___. IMPRESSION: Moderate to large right pleural effusion is stable or slightly larger. Severe cardiomegaly is unchanged. Pulmonary and mediastinal vascular engorgement have increased. No pneumothorax. ET tube and feeding tube are in standard placements. Right subclavian line ends at the superior cavoatrial junction. An esophageal probe ends at the gastroesophageal junction. " c52b6fd2-adf350d0-78765d80-049c9b2f-2b79fd82.jpg,test/p18/p18624005/s52042187/c52b6fd2-adf350d0-78765d80-049c9b2f-2b79fd82.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: CHR, history of radiation to the chest, shortness of breath, edema. COMPARISON: ___ to ___. FINDINGS: The patient had prior history of right breast cancer and radiation therapy. Pulmonary edema has improved and the right basal more confluent opacity has also improved. Chronic right apical pleural effusion and right basal pleural effusion is unchanged. Prior sternotomy was done for CABG. There is no pneumothorax. " 724a29c4-4498b8c8-33a1c08a-bc88d455-040b75fb.jpg,test/p11/p11644142/s59545031/724a29c4-4498b8c8-33a1c08a-bc88d455-040b75fb.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Unspecified. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. At the bases, partially in the retrocardiac lung area, a relatively large parenchymal opacity is seen. This opacity is located in the left lower lobe, as documented by the lateral image. The opacity is ill defined and has subtle air bronchograms. There is blunting of the lateral costophrenic sinus, potentially representing a small pleural effusion. Overall, the morphology is suspicious for pneumonia. If the clinical history is not typical for an infectious disease, pulmonary embolism could also be considered as a differential diagnosis. At the time of observation and dictation, 1:41 p.m., on ___, the referring physician was contacted by telephone and the findings were discussed between Dr. ___ ___ Dr. ___. " 7d576aa0-aa1d0db0-54549ec9-a6f2fdbf-c8089279.jpg,test/p11/p11740539/s59959483/7d576aa0-aa1d0db0-54549ec9-a6f2fdbf-c8089279.jpg,test," FINAL REPORT HISTORY: Status post CABG. COMPARISON: ___. FINDINGS: One the right IJ line with tip in the right atrium is unchanged. The continues to be a small amount of volume loss in both lower lungs although aeration is slightly better than the film from 2 days prior. There is a small left apical pneumothorax similar in size compared to the prior study. " 19b27bf0-71c9fedb-001e6ba5-2e5dda70-8c6ed8b4.jpg,test/p19/p19358609/s57935686/19b27bf0-71c9fedb-001e6ba5-2e5dda70-8c6ed8b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PNA with increasing O2 requirement and right chest pain // eval for effusion, PTX eval for effusion, PTX IMPRESSION: In comparison with the earlier study of this date, there is increased opacification at the left base with poor definition of the hemidiaphragm. This is consistent with developing pneumonia, possibly associated with some volume loss in the left lower lobe and pleural effusion. Increased opacification at the right base could reflect either atelectatic changes or a multifocal infiltrate. " 046fa4f9-dc5f0898-e3c4efc0-b215e321-799810bc.jpg,test/p13/p13014961/s58425675/046fa4f9-dc5f0898-e3c4efc0-b215e321-799810bc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with lightheadedness // evalk for pna COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. Tiny clips project over the right breast and left upper quadrant. Hilar congestion and mild interstitial edema noted. Tiny effusions are likely present. Cardiomediastinal silhouette is unchanged. Bony structures are intact. IMPRESSION: Mild edema/congestion. " 68a63148-b6bc3fca-98640f50-0cbf1054-cbb86c20.jpg,test/p19/p19398915/s52648615/68a63148-b6bc3fca-98640f50-0cbf1054-cbb86c20.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: FOR EARLY AM ___ year old man with cirrhosis, recurrent right hepatic hydrothorax, hypoxemia, and prominent LUL consolidation of unclear etiology, getting bronch ___ // FOR EARLY AM ___ - eval LUL opacification, pre-bronchoscopy for ___ COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the extent and severity of the right pleural effusion, combines to areas of relatively extensive right basilar atelectasis are unchanged. The extent and severity of the left upper lobe parenchymal opacity with air bronchograms has improved but remnant opacities in this location are still clearly seen. Likewise, the left lower lung is better ventilated but still shows evidence of parenchymal opacities, similar in morphology to the left upper lobe. Moderate cardiomegaly without overt pulmonary edema persists. " 044e86c3-00a5e8c9-ac34626f-948cd65b-5580095a.jpg,test/p10/p10229778/s51815039/044e86c3-00a5e8c9-ac34626f-948cd65b-5580095a.jpg,test," FINAL REPORT INDICATION: ___ year old man with hx of atrial fibrillation, on amidarone therapy. Rales left base and mild edema // annual evaluation on amiodarone therapyR/o CHF TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The right lung volume is stable with chronic eventration of the hemidiaphragm. Interval decrease and left lung volume with development of a small left pleural effusion. No pulmonary edema. No pneumothorax. The heart is top-normal in size. The mediastinal and hilar contours are normal without dilation of the SVC or pulmonary veins. .Median sternotomy clips are intact. The left pacemaker is intact with leads terminating in the appropriate positions of right atrium and right ventricle. IMPRESSION: Interval development of small left pleural effusion. Otherwise no acute cardiopulmonary process. " d1d8992c-f86b1ca8-23d9a4b4-b87ba230-a44fc7b2.jpg,test/p13/p13473495/s53720613/d1d8992c-f86b1ca8-23d9a4b4-b87ba230-a44fc7b2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Morbidly obese patient, shortness of breath. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes and moderate cardiomegaly without evidence of pulmonary edema or pleural effusions. Moderate retrocardiac atelectasis. No evidence of pneumonia. " b9b9cd80-8ff4dd98-aea5ccd6-d04a8cbe-597b438f.jpg,test/p16/p16858396/s54861092/b9b9cd80-8ff4dd98-aea5ccd6-d04a8cbe-597b438f.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: None. PORTABLE UPRIGHT AP VIEW OF THE CHEST: The heart size is mildly enlarged. The aorta is tortuous. The hilar contours are normal. Pulmonary vascularity does not appear engorged. Diffuse calcified bilateral pleural plaques are noted, which limits assessment of underlying lung parenchyma. No definite focal consolidation is visualized. There is no large pleural effusion or pneumothorax. Mild degenerative changes of the left acromioclavicular joint are noted. IMPRESSION: Diffuse calcified bilateral pleural plaques are compatible with prior asbestos exposure. These pleural plaques limit assessment of underlying lung parenchyma, but no definite large focal consolidation is seen. No congestive heart failure. " 2b1a5138-f3160270-992271a6-a4c40f13-eadcb090.jpg,test/p14/p14727722/s54416722/2b1a5138-f3160270-992271a6-a4c40f13-eadcb090.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with a fever. Suspect pneumonia. IMPRESSION: PA and lateral chest compared to ___: Moderate cardiomegaly is chronic, and improved since ___. Lungs are low in volume but clear. Definition of the airway to the left lower lobe bronchus is poor, as it was on ___, but a torso CT on ___ showed the bronchus displaced by the large heart, but patent. Normal mediastinal and hilar contours and pleural surfaces. " 87596a09-0a0d5ff2-883ad32d-b20af4df-b2e35d87.jpg,test/p19/p19001503/s56011616/87596a09-0a0d5ff2-883ad32d-b20af4df-b2e35d87.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Wheeze. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 1f591de0-bda0fcc5-a2c6a2b2-7073cb9c-3fdaace1.jpg,test/p16/p16033427/s58364627/1f591de0-bda0fcc5-a2c6a2b2-7073cb9c-3fdaace1.jpg,test," WET READ: ___ ___ 9:03 PM 1. Moderate right pneumothorax with partial collapse of the right lower lobe. No signs of tension. Recommend chest tube placement. 2. Large hiatal hernia. 3. Severe emphysema. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with wheezing, copd sent in with pneumothorax without disk coarse breath sounds throughout // eval pnx COMPARISON: None FINDINGS: AP upright and lateral views of the chest were provided. There is a right pneumothorax which is moderate in size with associated partial collapse of the right lower lobe. No signs of tension. No large effusion. A large hiatal hernia is noted. Left lung is clear. There is background severe emphysema. Cardiomediastinal silhouette is mildly prominent. IMPRESSION: 1. Moderate right pneumothorax with partial collapse of the right lower lobe. No signs of tension. Recommend chest tube placement. 2. Large hiatal hernia. 3. Severe emphysema. " ccb5cee6-1b19cca8-b0740804-a36b0029-ce586235.jpg,test/p16/p16556132/s50410076/ccb5cee6-1b19cca8-b0740804-a36b0029-ce586235.jpg,test," FINAL REPORT INDICATION: ___-year-old male with leg swelling and known CHF. COMPARISON: Comparison is made with chest radiograph from earlier the same day, ___, and ___. FINDINGS: There is new minimal interstitial edema since prior exam and and stable mild-to-moderate cardiomegaly. These findings suggest the patient is in early heart failure. There is no pleural effusion or pneumothorax. There is a possible right lower lobe medial opacity which could represent an aspiration pneumonia versus atelectasis. IMPRESSION: Early/mild heart failure. Possible right lower lobe medial opacity which could represent aspiration pneumonia versus atelectasis. " b96d4add-e99644c8-e27b3abb-f8fe1466-bda7ab10.jpg,test/p18/p18506918/s58837137/b96d4add-e99644c8-e27b3abb-f8fe1466-bda7ab10.jpg,test," FINAL REPORT INDICATION: Evaluate for acute cardiopulmonary process in a patient being evaluated for possible seizure. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and hyperinflated lungs without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. Possible small airway obstruction or emphysema, chronicity indeterminate. " a2689704-4fa1352f-6c1b34a3-b4846b54-fecae90f.jpg,test/p13/p13999026/s55751448/a2689704-4fa1352f-6c1b34a3-b4846b54-fecae90f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with abd pain, umbilical hernia // evidence of umbilical hernia strangulation TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is a small pleural effusionNo focal consolidation is seen. No pneumothorax identified. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Small pleural effusion. " a9d85c30-a8def42d-8deedfed-1980fecc-2a59447b.jpg,test/p16/p16074663/s52782835/a9d85c30-a8def42d-8deedfed-1980fecc-2a59447b.jpg,test," FINAL REPORT HISTORY: Hypotension and hepatitis, to assess for pneumonia. FINDINGS: No previous images. Single frontal view shows some enlargement of the cardiac silhouette without vascular congestion or pleural effusion. This raises the possibility of cardiomyopathy or pericardial effusion. No evidence of acute focal pneumonia. " 98e50f09-ec232bae-e258a3b2-d384996c-5efcbf7d.jpg,test/p10/p10336855/s52004348/98e50f09-ec232bae-e258a3b2-d384996c-5efcbf7d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with vent // ETT placement ETT placement IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. Retrocardiac opacification is again seen, consistent with volume loss left lower lobe and possible small effusion. The volume loss in the right lower lobe has decreased. " fd81d37a-b0635751-f2f9b4c3-e5aea00a-8149816c.jpg,test/p16/p16646670/s51958315/fd81d37a-b0635751-f2f9b4c3-e5aea00a-8149816c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M c PMH of bladder CA s/p TURBT/mitomycin ___ and L femur osteosarcoma s/p resection ___ with pulmonary nodules s/p R VATS wedge x4 // please evaluate for interval change please evaluate for interval change IMPRESSION: In comparison with the study of ___, there is further increase in the number in size of the multiple pulmonary metastases. Otherwise little change. " 9263f80f-e3742d59-74c5451e-e359910d-3524c977.jpg,test/p15/p15207296/s51173929/9263f80f-e3742d59-74c5451e-e359910d-3524c977.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with flail chest, recent intubation // proper endotracheal placement proper endotracheal placement COMPARISON: Chest radiographs ___ through ___ at 12:54 p.m. IMPRESSION: Patient has been intubated, ET tube in standard placement. Left lower lobe is still collapsed, but aeration is improved at the right lung base, now essentially clear. No pulmonary edema, no pleural effusion or pneumothorax. Heart size normal. " cc6da84c-63b99f39-13baec3f-95af8d03-05e15bd2.jpg,test/p14/p14428253/s56569355/cc6da84c-63b99f39-13baec3f-95af8d03-05e15bd2.jpg,test," FINAL REPORT HISTORY: Tumor debridement. FINDINGS: No previous images. There is extensive opacification in the right mid zone with prominence of right paratracheal tissues. This would be consistent with a large mass and hilar adenopathy. Areas of less opacity are seen in the lower zone. There is some apparent shift of the mediastinum to the right, though this may merely reflect some obliquity due to patient. CT would be necessary to properly characterize the pathologic process in the right lung. The left lung is essentially clear. " 14a13550-4930baab-eb0c58b1-b371881f-654e6d23.jpg,test/p12/p12526273/s55602658/14a13550-4930baab-eb0c58b1-b371881f-654e6d23.jpg,test," WET READ: ___ ___ ___ 10:11 AM 1. Large left perihilar mass causing mass effect on the trachea and rightward deviation. This was better characterized on outside CT chest performed on ___. Opacity in the left upper lobe is likely due to postobstructive pneumonia. 2. Consolidation at the left lung base with air bronchograms as well as the right lung base concerning for multi focal pneumonia. 3. Moderate left pleural effusion with mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with reported infiltrate, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Same date chest radiograph performed earlier at 02:38 and chest radiograph from ___. FINDINGS: There is consolidation at the left lung base with air bronchograms. There is opacification of the left upper lobe. There is also opacity in the right lung base. There is mild pulmonary edema. The cardiac silhouette is mildly enlarged. There is a large left perihilar mass causing mass effect on the trachea with rightward deviation. There is a moderate left pleural effusion. No pneumothorax is identified. IMPRESSION: 1. Large left perihilar mass causing mass effect on the trachea and rightward deviation. This was better characterized on outside CT chest performed on ___. Opacity in the left upper lobe is likely due to postobstructive pneumonia. 2. Consolidations at the left lung base with air bronchograms as well as the right lung base concerning for multi focal pneumonia. 3. Moderate left pleural effusion with mild pulmonary edema. " d3b1f8f2-153e6a2a-3b6d848a-9bbf75d3-8a1d4361.jpg,test/p16/p16742247/s56503118/d3b1f8f2-153e6a2a-3b6d848a-9bbf75d3-8a1d4361.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of AML, s/p allo with right sided hickman line that is not working. Please assess placement. // ___ year old man with hx of AML, s/p allo with right sided hickman line that is not working. Please assess placement. ___ year old man with hx of AML, s/p allo with right sided hi TECHNIQUE: Upright PA and lateral chest radiographs were obtained. COMPARISON: Frontal chest radiograph ___. FINDINGS: The cardiomediastinal silhouette, pulmonary vasculature, and aorta are within normal limits. The lungs are clear. There is no pleural effusion. There has been placement of a right internal jugular line with tip terminating in the low superior vena cava. There is no pneumothorax. Visualized osseous structures are unremarkable. IMPRESSION: Unremarkable right central venous line. No evidence of pneumothorax. " 616465d4-8d4a68f2-ebcfd91b-853ca6b3-b94d1d53.jpg,test/p19/p19028690/s53266756/616465d4-8d4a68f2-ebcfd91b-853ca6b3-b94d1d53.jpg,test," WET READ: ___ ___ 8:01 PM No acute cardiopulmonary pathology ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with cirrhosis and ___-pound weight gain. Assess for pulmonary edema. IMPRESSION: PA and lateral chest compared to ___: Heart is normal size. There has been an increase in pulmonary vascular plethora and mild interstitial abnormality, could be early edema, but there is no evidence of pleural or pericardial effusion. No focal pulmonary abnormality is present. " 9c2e3088-1309b2aa-002fd881-c281c490-4a0fadb2.jpg,test/p12/p12599505/s50097958/9c2e3088-1309b2aa-002fd881-c281c490-4a0fadb2.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " c8a966c8-8f79eca4-b6d655c5-eaa5df69-cc267d4c.jpg,test/p18/p18275181/s53778826/c8a966c8-8f79eca4-b6d655c5-eaa5df69-cc267d4c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with concern for thalamic bleed/mass with altered mental status. Evaluate for acute cardiopulmonary process. TECHNIQUE: Single upright portable AP chest radiograph COMPARISON: None. FINDINGS: Low lung volumes and there is bibasilar atelectasis. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 7a2868ad-aa243b30-3f1be46e-b566ca73-195d99b8.jpg,test/p15/p15554865/s54864099/7a2868ad-aa243b30-3f1be46e-b566ca73-195d99b8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with malignant pleural effusion, recovering from pneumonia, mild hypoxemia new lung adenoaca dx // is there recurrence of effusion to degree we may need to re drain it TECHNIQUE: AP and lateral chest radiographs. COMPARISON: Chest radiograph ___ FINDINGS: There is a right-sided PICC in-situ, this terminates in the mid SVC. There is a small to moderate right-sided pleural effusion with fluid extending into the horizontal fissure. No definite left-sided pleural effusion seen. Bilateral lower lobe airspace opacities likely reflect the consolidation seen on the prior CT and chest radiographs. No pneumothorax seen. " aa24e351-3d48e92d-a666dc9c-808678b7-9d740b90.jpg,test/p18/p18446519/s59216762/aa24e351-3d48e92d-a666dc9c-808678b7-9d740b90.jpg,test," FINAL REPORT INDICATION: HIV, cough. COMPARISON: Chest radiograph ___. CT abdomen and pelvis ___. CT torso ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. Pulmonary vascularity is normal. 16 mm nodular density in the right lower lobe is unchanged, and has been relatively stable in size since the CT of the abdomen and pelvis from ___. Lungs are otherwise clear without focal consolidation. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. 16 mm nodule within the right lower lobe is unchanged dating back to CT from ___, but is new compared to the prior CT from ___. Further evaluation with contrast-enhanced chest CT or PET-CT is recommended. " 12ecd8a6-9ca7a6cf-522ade22-1d61b05c-c721f7fc.jpg,test/p10/p10307557/s52477488/12ecd8a6-9ca7a6cf-522ade22-1d61b05c-c721f7fc.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Extensive upper extremity injuries with new Dobbhoff tube placement. AP radiograph of the chest was obtained demonstrating attempt to place Dobbhoff tube which appears to be coiled in the esophagus. Heart size and mediastinum are unchanged as compared to prior study obtained the same day earlier. The tip of the right internal jugular line is at the level of mid SVC. There is interval minimal change in bilateral pleural effusions and bibasal atelectasis. " a39d9a77-2fcad442-0882018a-dad98933-5db65037.jpg,test/p13/p13032235/s52817056/a39d9a77-2fcad442-0882018a-dad98933-5db65037.jpg,test," FINAL REPORT INDICATION: Worsening asthma with coarse breath sounds. Evaluate for an acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The lungs are clear and lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. The mediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " b1e67bde-305116e7-38872dbd-8a4a6817-d8fd21c8.jpg,test/p19/p19174295/s52339219/b1e67bde-305116e7-38872dbd-8a4a6817-d8fd21c8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with e. coli bacteremia, unclear source with persistent dry cough and wheezing // eval for PNA COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the size of the cardiac silhouette has increased. There is an increase in vascular markings and vascular diameters, strongly suggesting the presence of mild to moderate pulmonary edema. No pleural effusions. Mild retrocardiac atelectasis but no evidence of pneumonia. " 8d4f4144-2b7e5fd5-187e0df3-14aa5083-9bb81e0d.jpg,test/p17/p17217213/s53996161/8d4f4144-2b7e5fd5-187e0df3-14aa5083-9bb81e0d.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with fracture, preop. COMPARISON: ___. FINDINGS: Except for mild bibasilar atelectasis, the lungs are otherwise clear. Slight elevation of left hemidiaphragm is chronic. There is no pleural effusion or pneumothorax. Mediastinal and cardiac contours are normal. CONCLUSION: Except for minimal bibasilar atelectasis the remaining of the exam is unremarkable. " 812c25fa-2a4c3490-7b6d2de7-0c9890b7-56508099.jpg,test/p15/p15301390/s52423279/812c25fa-2a4c3490-7b6d2de7-0c9890b7-56508099.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with Lt IPH, mass now with cough // Pneumonia, Aspiration? TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiographs from ___, ___ CT chest with contrast of ___ FINDINGS: Since ___, no new focal consolidations are noted. The lung volumes remain low with mild compressive atelectasis. The heart size is stable. Mild pulmonary congestion is noted. No pneumothorax. IMPRESSION: Mild pulmonary congestion with mild compressive atelectasis. No pneumonia or evidence of aspiration. " 456795b4-6c950e65-5b0d1b7b-5552a3ae-6310d008.jpg,test/p19/p19953778/s52290333/456795b4-6c950e65-5b0d1b7b-5552a3ae-6310d008.jpg,test," WET READ: ___ ___ ___ 5:22 AM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with dyspnea // ? cardiopulmonary abnormality TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " ed076c83-bfe5ba64-06508328-fd928015-bf5ee135.jpg,test/p16/p16262068/s59394786/ed076c83-bfe5ba64-06508328-fd928015-bf5ee135.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old male with bradycardia and diaphoresis. FINDINGS: Two portable views of the chest. No prior. Lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are notable for degenerative changes of the acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " e8b39a20-e7ce328c-6a3ba9d9-593116d5-87c170cb.jpg,test/p13/p13859181/s54051265/e8b39a20-e7ce328c-6a3ba9d9-593116d5-87c170cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubated with concern for septic shock. // compare to prior COMPARISON: Chest radiograph from ___. FINDINGS: AP portable upright view of the chest. External pacer wires are present. An endotracheal tube, left IJ catheter, Swan Ganz catheter, and orogastric tube are unchanged in position. A small left pleural effusion remains stable. Bibasilar opacities likely reflect atelectasis. There is continued mild pulmonary vascular congestion, with improvement of mild pulmonary edema since the ___ study. There is no pneumothorax. IMPRESSION: Improvement of mild pulmonary edema and vascular congestion since ___. Unchanged small left pleural effusion. " 554832f3-4985ee9f-b9f266e4-82386436-4c0fae50.jpg,test/p13/p13314483/s55761573/554832f3-4985ee9f-b9f266e4-82386436-4c0fae50.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with exertional dyspnea, right-sided edema. Rule out pulmonary or intrathoracic vascular lesion. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient upright position. COMPARISON: None available. FINDINGS: No consolidation, pleural effusion or pulmonary edema is seen, and the cardiac and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary disease. " bc4c092a-b669280d-80610c5b-1645136e-761c4296.jpg,test/p17/p17190208/s53380680/bc4c092a-b669280d-80610c5b-1645136e-761c4296.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with shock and respiratory failure // tubes/lines placement, acute intrapulmonary process TECHNIQUE: Portable chest radiograph COMPARISON: Portable chest radiograph dated ___ FINDINGS: In comparison to the chest radiograph obtained 1 day prior and allowing for changes in patient positioning, no significant changes are appreciated. ETT, 2 enteric tubes, right-sided IJ, and VP shunt are unchanged and appropriate in position. Increased, small, left pleural effusion and decreased, small, right pleural effusion. Substantial bibasilar atelectasis unchanged. Moderate cardiomegaly unchanged without pulmonary edema. Calcified mediastinal and hilar lymph nodes unchanged. IMPRESSION: Above-described lines and tubes appropriately positioned. Increased, small, left pleural effusion and decreased, small, right pleural effusion - atelectasis unchanged. No radiographic evidence specifically suggestive of pneumonia or pulmonary edema. " 7a1fb414-33b2f493-196154c8-61d6380e-07c88975.jpg,test/p17/p17527875/s51119245/7a1fb414-33b2f493-196154c8-61d6380e-07c88975.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion s/p ___, assess for pneumo // assess for pneumothorax TECHNIQUE: Chest single view COMPARISON: ___ 09:57 FINDINGS: Right pleural effusion has mildly improved since prior. No pneumothorax. Stable right basilar opacity, likely atelectasis, consider pneumonitis in the appropriate clinical setting. Improved left perihilar, basilar opacity. Possible tiny left pleural effusion. Improved heart size, pulmonary vascularity, likely secondary to better inspiration. IMPRESSION: No pneumothorax. " 5ac3d10d-9a7341ed-8d95cf8c-6148dbd9-4491b4e7.jpg,test/p13/p13160434/s52803701/5ac3d10d-9a7341ed-8d95cf8c-6148dbd9-4491b4e7.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with altered mental status. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. Calcified granulomas are noted in the left upper lobe. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 5adccf35-fbb33015-f91c4169-02ec9b5c-2d61be4c.jpg,test/p14/p14775533/s55171639/5adccf35-fbb33015-f91c4169-02ec9b5c-2d61be4c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man // eval effusion COMPARISON: Chest radiographs since ___, most recently ___ at 12:02. IMPRESSION: Large right pleural effusion is increasing making it difficult to determine the extent of edema if any in the right lung. . Moderately enlarged cardiac silhouette is also larger. There has been no change in the contour of the mediastinum attributed to left lower lobe atelectasis on the prior examination ET tube, Swan-Ganz catheter, pleural and midline drains are unchanged in their respective positions. Extremely severe subcutaneous emphysema has not improved, in the wall of the chest upper abdomen or in the neck. Pneumothorax is difficult to assess, probably still small on the left. NOTIFICATION: Dr. ___ reported the findings to ___ by pager on ___ at 4:05 PM, 1 minutes after discovery of the findings. " 669d147f-a1b946a4-858a2508-bfe8924d-72548818.jpg,test/p16/p16590876/s57862133/669d147f-a1b946a4-858a2508-bfe8924d-72548818.jpg,test," FINAL REPORT HISTORY: Runny nose, intense dizziness, nausea and vomiting. TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The heart size remains moderately enlarged but unchanged. The aorta is tortuous and diffusely calcified. The hilar contours are normal. The pulmonary vasculature is not engorged. Calcified granulomas within the lungs bilaterally are unchanged. Patchy bibasilar airspace opacities likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. Remote right-sided rib fractures are again noted. IMPRESSION: Mild bibasilar atelectasis. " 17302776-db67cfaa-d5fc3415-343e7b56-4ff84bb0.jpg,test/p11/p11549535/s53889453/17302776-db67cfaa-d5fc3415-343e7b56-4ff84bb0.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: In the right lower lobe, overlying the ___ posterior rib, there appears to be a nodular density; this may be related to the patient's nipple. Otherwise, the lungs are clear. Cardiac silhouette is normal in size. Aorta is tortuous. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. Possible right lower lobe nodule, likely nipple. Recommend repeat radiographs with nipple markers. Findings communicated to the ED QA nurses. " 7d8c6fff-4e7905a6-df659adb-cb1e2778-5fc86523.jpg,test/p11/p11822564/s51818532/7d8c6fff-4e7905a6-df659adb-cb1e2778-5fc86523.jpg,test," FINAL REPORT INDICATION: Liver failure, Dobbhoff placement. COMPARISON: ___ at 5:10 a.m. FINDINGS: AP views of the chest taken at different times. The first image demonstrates the Dobbhoff tube in the upper esophagus, and the second image demonstrates the Dobbhoff tube in the stomach. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: Dobbhoff tube was originally in the upper esophagus and repositioned into the stomach. No acute cardiopulmonary process. " 100d05f5-19587ac6-025a2a42-95be23db-20f7c8ae.jpg,test/p15/p15535789/s54737095/100d05f5-19587ac6-025a2a42-95be23db-20f7c8ae.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with respiratory failure, pancreatitis and sepsis. FINDINGS: Comparison is made to prior study from ___. There are again seen diffuse airspace opacities throughout both lung fields. This is likely due to a combination of pulmonary edema and multifocal pneumonia. There is fluid in the right minor fissure, increased from prior. Tracheostomy is seen. Median sternotomy wires are also present and unchanged. There is persistent unchanged cardiomegaly. Bilateral pleural effusions are seen. " 13133b66-906ca1b7-966b3a17-cf393c29-ebc8b380.jpg,test/p11/p11723660/s58305643/13133b66-906ca1b7-966b3a17-cf393c29-ebc8b380.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___ year old woman with dizziness, history of malignancy TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___, CT chest ___, CT intervention ___ FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable and unchanged. The pulmonary vasculature is not engorged. Ring-like 5.5 cm opacity within the right lower lobe is compatible with the known malignancy, and contains ___ fiducial markers within it. Compared to the previous radiograph, the central portion of this mass is now radiolucent. No new focal consolidation, pleural effusion or pneumothorax is present. There mild degenerative changes seen in the thoracic spine IMPRESSION: 5.5 cm right lower lobe mass compatible with known malignancy contains 2 fiducial markers within it and now demonstrates central lucency, new from the previous radiograph. No acute cardiopulmonary abnormality otherwise demonstrated. " 7962e300-923a0558-7cf1e847-99b2e4ee-0654945d.jpg,test/p11/p11607177/s52682285/7962e300-923a0558-7cf1e847-99b2e4ee-0654945d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF // ___ position? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: There has been intra-aortic balloon pump inserted with its tip being too high, approximately 12 mm below the roof of the aortic arch and should be pulled back at least 1 cm. Swan-Ganz catheter tip is at the level of the right lower lobe pulmonary artery. Severe cardiomegaly is noted. There is interval development of mild pulmonary edema as well as potential additional layering of pleural effusions. " f0b4fedb-9d59ef62-669f97cf-4835af3c-200bdf60.jpg,test/p13/p13966009/s52680858/f0b4fedb-9d59ef62-669f97cf-4835af3c-200bdf60.jpg,test," FINAL REPORT INDICATION: ___-year-old man with cough and fever, evaluate for pneumonia. COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No evidence of pneumonia. " dc3c091e-f803ee53-029b2906-988b0d31-2ab5a2e0.jpg,test/p11/p11881943/s52501759/dc3c091e-f803ee53-029b2906-988b0d31-2ab5a2e0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p cabg // eval for effusion or infiltrate eval for effusion or infiltrate IMPRESSION: In comparison with the study of ___, the left chest tube is been removed and there is no definite pneumothorax. Right IJ sheath is also been removed. The patient has taken a better inspiration. There again are bilateral small pleural effusions with compressive atelectasis at the bases. Enlargement of the cardiac silhouette without definite pulmonary vascular congestion. " f2376f52-0d24cd4b-54eeb927-dd7ab799-16c498d3.jpg,test/p18/p18403514/s59532707/f2376f52-0d24cd4b-54eeb927-dd7ab799-16c498d3.jpg,test," FINAL REPORT INDICATION: ___ year old woman with non specific chest pain. // Assess for consolidation/rib fracture TECHNIQUE: Chest PA and lateral COMPARISON: No prior studies for comparison FINDINGS: Lung inflation is top-normal. The round hyperdense focal region at the the right heart border represents the right ninth costovertebral joint. There are no consolidation, opacities, masses, pneumothorax, or pleural effusion appreciated. The cardiomediastinal silhouette and hilar silhouettes are normal size. The heart size is normal. There is no acute bony abnormality nor evidence of acute fracture. IMPRESSION: 1. No acute cardiopulmonary process and no acute fractures seen. " f9f2c9a7-8a4de03f-ca002aa5-a9975bff-b77bce68.jpg,test/p17/p17421663/s55523094/f9f2c9a7-8a4de03f-ca002aa5-a9975bff-b77bce68.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Multifocal pneumonia, evaluation of interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are in constant position, including the endotracheal tube, the nasogastric tube and the left PICC line. The radiodensity of the pre-existing multifocal parenchymal opacities has minimally decreased. No new opacities are visible. The size of the cardiac silhouette is constant. No pleural effusions. " 8ebcd1a4-2df278ce-ac883f56-044d35c9-93232ded.jpg,test/p14/p14353305/s59929054/8ebcd1a4-2df278ce-ac883f56-044d35c9-93232ded.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT) INDICATION: ___-year-old man with h/o multiple spontaneous pneumothoraces s/p left VATS apicalblebectomy and mechanical and chemical (1 g doxycyclinepleurodesis performed ___. Evaluate for interval change. COMPARISON: Chest radiograph dated ___. FINDINGS: No significant change since the prior chest radiograph. Left apical sutures from recent surgery are unchanged in position. The lungs are well expanded and clear. There is no pneumothorax, focal consolidation, pleural effusion, or pulmonary edema. The cardiomediastinal silhouette, hila, and pleural are normal. IMPRESSION: No significant change since ___. " 436a33ef-05436b90-941301ea-3e5c29aa-85fa6307.jpg,test/p11/p11888614/s52382255/436a33ef-05436b90-941301ea-3e5c29aa-85fa6307.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new ET tube // new ET tube TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___. IMPRESSION: The patient is a currently intubated with the ET tube tip being 4.3 cm above the carinal. NG tube tip is in the stomach. Widespread parenchymal opacities are demonstrated, most likely representing pulmonary edema but reassessment after diuresis is recommended. Underlying infection is a possibility " 1dadb83e-97537486-6b5ce75d-1a3c2c6b-f241d121.jpg,test/p14/p14394983/s54671986/1dadb83e-97537486-6b5ce75d-1a3c2c6b-f241d121.jpg,test," FINAL REPORT INDICATION: Shortness of breath and recent treatment for tuberculosis. Evaluate for infection or effusion. COMPARISON: Chest radiograph ___, and ___. FINDINGS: Frontal and lateral views of the chest were performed. There is no pleural effusion, pneumothorax, or focal airspace consolidation. The cardiac and mediastinal contours are normal. The hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4a820757-bbfd1c8b-2de5e6f3-483e8c36-6a471fa7.jpg,test/p14/p14497007/s58323895/4a820757-bbfd1c8b-2de5e6f3-483e8c36-6a471fa7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with multiple myeloma with fever and hypotension. Assess for infection. TECHNIQUE: Single portable semi upright frontal chest radiograph. COMPARISON: Chest radiograph ___, ___, ___, ___. FINDINGS: The lungs are well inflated with bibasilar atelectasis. There is a persistent small left pleural effusion with left lower lobe opacity, unchanged since prior examination. Stable mild cardiomegaly. Mediastinal contour and hila are unremarkable. Patient is status post thoracic spine fusion with multiple surgical screws, vertical rods, and intervertebral disc spacers which is unchanged since prior examination. Right Port-A-Cath tip is within the right atrium. IMPRESSION: 1. Persistent small left pleural effusion with slowly progressive left lower lobe opacity may represent atelectasis or pneumonia in the appropriate clinical setting. 2. Right lower lobe atelectasis. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 9:08 AM, 5 minutes after discovery of the findings. " d15d23df-da865840-fe28b89c-3beef997-d743b4d1.jpg,test/p13/p13417577/s53737853/d15d23df-da865840-fe28b89c-3beef997-d743b4d1.jpg,test," FINAL REPORT INDICATION: Left upper lobe lesion status post RFA, assess pneumothorax. COMPARISON: Chest radiograph dated ___ and CT from the interventional procedure done ___ at 11:11. FINDINGS: Portable frontal radiograph of the chest demonstrates a small left apical pneumothorax which is likely stable allowing for differences in technique. Opacification in the left upper lung likely relates to recent RFA. Stable appearance of the cardiomediastinal silhouette. No pleural effusion or right pneumothorax. IMPRESSION: Small left apical pneumothorax likely stable allowing for differences in technique with postprocedure changes in the left upper lung. " fbf03b4c-96912174-3ce5f166-c90e45b7-416eb242.jpg,test/p10/p10476869/s57997921/fbf03b4c-96912174-3ce5f166-c90e45b7-416eb242.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiograph. INDICATION: ___ year old man with lymphoma and history left upper lobectomy and history of effusions, now presenting with increasing shortness of breath; Assess for changes. COMPARISON: Chest radiograph dated ___. FINDINGS: Sutures in the left apex are unchanged with expected left upper lobectomy changes. Moderate left pleural effusion and atelectasis are overall unchanged or minimally increased. The heart is top-normal in size, slightly increased from the prior exam. No pulmonary edema or focal consolidation to suggest pneumonia. Small right pleural effusion is new. No pneumothorax. Mediastinum and hila are unchanged. IMPRESSION: Overall stable small-moderate left pleural effusion. New small right pleural effusion. " 1f5c3cc8-65519859-1333daee-ba003bd6-3943614c.jpg,test/p12/p12189597/s51962902/1f5c3cc8-65519859-1333daee-ba003bd6-3943614c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB over 3 month period COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Lungs are hyperinflated and lucent likely reflecting underlying emphysema. Prominent costal cartilage accounts for para nodularity projecting over the left lower lung. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. COPD. " b730e350-ba2442e3-894938c1-9cd86950-1d5684fd.jpg,test/p13/p13040858/s58103787/b730e350-ba2442e3-894938c1-9cd86950-1d5684fd.jpg,test," FINAL REPORT INDICATION: History: ___M hx cirrhosis with fever // acute intrathoracic process? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Slightly increased left lower lobe opacity is likely atelectasis. There is no pneumothorax or pleural effusion. Cardiac silhouette is top normal size. IMPRESSION: No radiographic evidence of pneumonia. " 475e2544-14705520-85c97c42-afb6a2ba-ff41c25a.jpg,test/p19/p19175407/s53449711/475e2544-14705520-85c97c42-afb6a2ba-ff41c25a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PVCs. Had pacer placed on ___, presented with PVCs ? RV irritation // check lead placements TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Compared to the prior study there is no interval change in cardiac lead positioning. The heart size is enlarged but stable. Lung parenchyma is clear. No pleural abnormality. IMPRESSION: No interval change since ___ " 4097e401-36ed6760-d4fe748a-59ad7920-7cd8df66.jpg,test/p19/p19695893/s52923087/4097e401-36ed6760-d4fe748a-59ad7920-7cd8df66.jpg,test," FINAL REPORT HISTORY: Chest pain, rule out acute process COMPARISON: ___ FINDINGS: Frontal and lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours. The lungs are clear. No pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " c76ab4d2-c7114668-32da2494-8c70d6ce-fc8c91a4.jpg,test/p15/p15180359/s55888698/c76ab4d2-c7114668-32da2494-8c70d6ce-fc8c91a4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with extubation // ?interval worsening IMPRESSION: As compared to previous radiograph of 1 day earlier, the patient has been extubated. Previously present pulmonary edema has resolved along with a right pleural effusion. Small left pleural effusion and adjacent left basilar opacification have also decreased in extent. " 675f8dee-84047bf3-b2a33338-d7366770-fae4df04.jpg,test/p13/p13405890/s51375228/675f8dee-84047bf3-b2a33338-d7366770-fae4df04.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with AMS, acute onset confusion, no fever COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Overlying EKG leads noted. Cardiomegaly and hilar congestion persist with mild interstitial pulmonary edema again noted. Small bilateral pleural effusions likely present. There is increased bibasilar patchy opacity which may reflect a superimposed pneumonia or sequelae of aspiration. No pneumothorax. High-riding humeral heads bilaterally reflect chronic rotator cuff disease. IMPRESSION: As above. " 37dfd33e-7002119a-3cf5664e-d97a5407-5abe75cc.jpg,test/p14/p14640173/s57759941/37dfd33e-7002119a-3cf5664e-d97a5407-5abe75cc.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Cough, shortness of breath, ex-smoker, baseline. COMPARISON: None. FINDINGS: Lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: Normal chest x-ray. " eba2bc5e-8b41a4d8-11d8b9db-3c80451b-b5718a9a.jpg,test/p11/p11438336/s54844120/eba2bc5e-8b41a4d8-11d8b9db-3c80451b-b5718a9a.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Generalized weakness. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is mildly enlarged. The aortic arch is calcified. The mediastinal and hilar contours do not appear significantly changed. The lungs are clear. There are no pleural effusions or pneumothorax. Post-traumatic changes are incompletely characterized in the proximal left humerus, but there is no suggestion of substantial change. IMPRESSION: No evidence of acute disease. " 14ae47dd-32b26d62-442e78f1-560a9181-0abcee65.jpg,test/p14/p14500958/s52743144/14ae47dd-32b26d62-442e78f1-560a9181-0abcee65.jpg,test," FINAL REPORT Chest radiograph performed ___. Comparison with a prior study from ___ and a CT torso from ___. CLINICAL HISTORY: Mental status, history of malignancy, brain tumor, assess for acute intrathoracic process. FINDINGS: AP upright portable chest radiograph is obtained. The lungs are clear. No pleural effusion or pneumothorax. Heart and mediastinal contours are normal. Bony structures are intact. An IVC filter is partially visualized in the upper abdomen. IMPRESSION: No acute intrathoracic process. " ae7c48ec-46dff31f-cc060ee3-d6f7ecac-7c936584.jpg,test/p19/p19491045/s51745265/ae7c48ec-46dff31f-cc060ee3-d6f7ecac-7c936584.jpg,test," FINAL REPORT INDICATION: Altered mental status, weakness, and decreased p.o. intake for one week. Assess for acute process. COMPARISON: Comparison is made to radiograph performed ___. FINDINGS: AP and lateral radiographs obtained. Examination is limited by motion and body habitus. Within this limitation, cardiomediastinal and hilar contours are unchanged. Dense calcifications are noted within the aortic arch. Limited assessment of the lung bases due to body habitus on the frontal view. There is no definite opacification evident on the motion-degraded lateral views. No pleural effusion or pneumothorax is present. A wedge deformity of the mid thoracic, age indeterminate. IMPRESSION: Limited assessment given body habitus and motion. No definite lung opacification identified. No pleural effusion. Age-indeterminate mid thoracic compression deformity. " 523f0786-4425e063-2a866769-4a947c23-b79b00b4.jpg,test/p15/p15116583/s56530516/523f0786-4425e063-2a866769-4a947c23-b79b00b4.jpg,test," FINAL REPORT CHEST HISTORY: Hypoxemia. REFERENCE EXAM: ___. FINDINGS: Again seen is moderate cardiomegaly and diffuse bilateral patchy alveolar infiltrates. The pulmonary vasculature is ill-defined. It is unclear how much of this represents underlying infectious infiltrate and how much is pulmonary edema. Compared to the prior study, the pulmonary status is slightly worse. " 72f9d43b-b0a1c484-cb4fd49e-5290016b-a9a9df9c.jpg,test/p15/p15501234/s58976764/72f9d43b-b0a1c484-cb4fd49e-5290016b-a9a9df9c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with an episode of diaphoresis his AM, feels congested. Exam WNL // Pls assess for left sided PNA DIAPHORESIS, FEELS CONGESTED ? LEFT SIDED PNA IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Midline sternal wires are intact. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 9de2de78-38c7ea3a-fc526000-cab9135d-95f2afcc.jpg,test/p17/p17333412/s53611454/9de2de78-38c7ea3a-fc526000-cab9135d-95f2afcc.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough and chest pain with presyncope. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. There is a patchy density obscuring the left hemidiaphragm to a slight degree, although not specific. IMPRESSION: Patchy left basilar density obscuring the left hemidiaphragm. Pneumonia could be considered versus atelectasis. Short-term followup PA and lateral radiographs may be useful if needed clinically. " 99ace743-c148e601-914b5291-a98a4372-5123ec41.jpg,test/p12/p12553538/s58658071/99ace743-c148e601-914b5291-a98a4372-5123ec41.jpg,test," WET READ: ___ ___ 7:20 PM Slight interval improvement in bilateral, heterogeneous lung airspace opacities, right greater than left, which may represent asymmetric edema versus multifocal aspiration. Small bilateral pleural effusions are unchanged. A large, left, para-median hiatal hernia and mild cardiomegaly are stable. ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with altered mental status and pneumonia. FINDINGS: Comparison is made to prior study from ___. There is a large air bubble projecting over the left base consistent with a large hiatal hernia with extension of much of the stomach into the left chest. This is well seen on the prior CT scan from ___. There is a right-sided PICC line with distal lead tip at the distal SVC. There has been improvement of the pulmonary interstitial edema. There remain small bilateral pleural effusions. " c8fbb35e-1b7f466e-cb268c12-1c4bf31c-418a34c5.jpg,test/p15/p15485853/s56391468/c8fbb35e-1b7f466e-cb268c12-1c4bf31c-418a34c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man here for surgery // port placement confirmation port placement confirmation IMPRESSION: In comparison with the study of ___, of the porta cath tip is at the level of the low SVC. Hemidiaphragms are now sharply seen and there may be minimal atelectatic changes at the bases. Continued low lung volumes accentuate the transverse diameter of the heart. No evidence of pulmonary vascular congestion. " 43d3766f-ebf2a6b0-04447a9b-1ea70656-c841e57d.jpg,test/p10/p10481168/s56603710/43d3766f-ebf2a6b0-04447a9b-1ea70656-c841e57d.jpg,test," FINAL REPORT INDICATION: History: ___F with confusion // eval for pna/bleed TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: A right chest wall Port-A-Cath is in unchanged position ending in the right atrium. No focal consolidation, pleural effusion or pneumothorax. Normal heart size, mediastinal and hilar contours. Diffuse osseous metastatic disease not significantly changed from prior. Calcified mass in the left chest wall also unchanged. IMPRESSION: No acute process. Diffuse osseous metastatic disease, unchanged from prior " 4bedb278-b855a6aa-790a8327-62d5117b-168793a7.jpg,test/p15/p15687550/s57128116/4bedb278-b855a6aa-790a8327-62d5117b-168793a7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with lightheadedness x1 day TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiac silhouette size is normal. The aorta is mildly tortuous. Mediastinal and hilar contours are otherwise unchanged. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is identified. Mild degenerative changes are noted in the thoracic spine which demonstrates a mild S-shaped scoliosis. IMPRESSION: No acute cardiopulmonary abnormality. " b5c07912-7ae17085-50066989-559e9758-198cd6ed.jpg,test/p14/p14716808/s52355000/b5c07912-7ae17085-50066989-559e9758-198cd6ed.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough, sob // Assess for PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal shadow is unchanged. Unfolding of the thoracic aorta. Linear airspace opacification seen in the posterior basal aspect on the lateral view. This correlates with the linear opacities in the lower lung zones bilateral. Abdominal aortic stent in situ. Sclerotic appearance of the medial aspect of the right clavicle in keeping with a previous fracture. Old right-sided rib fractures. Wedge-type compression fractures involving the lower thoracic and superior lumbar vertebral bodies with a resultant kyphotic deformity is unchanged compared to prior. Osteopenic changes of the bony elements. IMPRESSION: Linear opacity in the lower lung zones bilateral most likely represents atelectasis, but in the correct clinical setting this could also represent pneumonia. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 3:36 PM, 10 minutes after discovery of the findings. " b8f3cb75-0fea47c1-e0565788-4db40c4f-5ad95eaa.jpg,test/p19/p19096912/s57711478/b8f3cb75-0fea47c1-e0565788-4db40c4f-5ad95eaa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chronic cough, non-smoker // any infiltrate or lesion any infiltrate or lesion IMPRESSION: In comparison with the study of ___, there is little interval change. No evidence of acute pneumonia, vascular congestion, or pleural effusion. Atelectatic changes are again seen at the left base. " 27a5bb7f-2e8be2c2-20606e94-7412444f-c61bb229.jpg,test/p12/p12734486/s57219318/27a5bb7f-2e8be2c2-20606e94-7412444f-c61bb229.jpg,test," FINAL REPORT INDICATION: ___M with urosepsis and hypotension. // Please evaluate for pulmonary edema, acute process, and interval change. COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: The central line is unchanged and there is no pneumothorax. There is linear atelectasis in both lung bases. There is cardiomegaly but no CHF. There is no significant interval change. " 64cd3272-52ced41b-22e5e220-4f17d730-fbe5d2bc.jpg,test/p16/p16968751/s54664956/64cd3272-52ced41b-22e5e220-4f17d730-fbe5d2bc.jpg,test," FINAL REPORT HISTORY: Syncopal episode, head strike. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Subtle patchy right basilar opacity most likely relates to atelectasis. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal. Mediastinal hilar contours are unremarkable. Degenerative changes are noted at the acromioclavicular joints. No acute fracture is seen. IMPRESSION: Subtle right basilar opacity most likely relates to 0 atelectasis. No definite focal consolidation. " 01344647-f9ab6f8f-c9ee7c27-44cf4ba0-10ed5242.jpg,test/p14/p14810396/s58440758/01344647-f9ab6f8f-c9ee7c27-44cf4ba0-10ed5242.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new crackles on exam post-cath // ? new intrathoracic process compared to previous TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there has been interval development of perihilar interstitial and lower lobe interstitial and alveolar opacities. The findings are most likely consistent with interstitial pulmonary edema. Infectious process is less likely. Small amount of pleural effusion is most likely present on the left. Assessment of the patient after diuresis is recommended. " 96959ff8-1a37c879-7042e3f6-24e6fc10-50f27493.jpg,test/p18/p18204836/s58326997/96959ff8-1a37c879-7042e3f6-24e6fc10-50f27493.jpg,test," FINAL REPORT AP CHEST 4:52 A.M. ON ___ HISTORY: ___-year-old man after intubation. Assess mucus plugs. IMPRESSION: AP chest compared to ___: Atelectasis has finally cleared, but now heart size is appreciably larger and mild pulmonary edema has developed. In addition there is more confluent consolidation at the right lung base which could be a developing pneumonia, needs to be followed carefully. Pleural effusions are small if any. Endotracheal tube ends above the upper margin of the clavicles, no less than 4.5 cm from the carina. It could be advanced 2 cm for more secured seating. Nasogastric tube is coiled in the stomach. Dr. ___ was paged. " 535d087f-e6b7d2df-ba7fd545-899a2e23-c02e6c3b.jpg,test/p11/p11456281/s52151220/535d087f-e6b7d2df-ba7fd545-899a2e23-c02e6c3b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with RUL infiltrate on prior ___, ___ be hair tie. PLEASE ASK TO TAKE OFF HAIR BRAID prior to ___ // eval RUL infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Earlier today, ___ at 14:41 FINDINGS: The lungs are clear without focal consolidation. Pre seen opacity projecting over the right upper hemi thorax is no longer seen, consistent with external artifact/hair on the prior study. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. Previous seen opacity projecting over the upper right hemithorax is no longer present, consistent with external artifact on the prior study. " 09e3034b-98437344-7b92264f-08257cf8-48302c0a.jpg,test/p15/p15566010/s58328933/09e3034b-98437344-7b92264f-08257cf8-48302c0a.jpg,test," FINAL REPORT HISTORY: Fever and history of lobectomy for lung cancer. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph from ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unchanged, with diffuse calcification of the thoracic aorta again noted. The patient is status post right upper lobectomy with evidence of volume loss again noted in the right hemithorax with elevation right hemidiaphragm. Right apical thickening and right lateral pleural thickening in the is unchanged, as well as linear scarring within the right lung base. Streaky opacity in the left lung base likely reflects atelectasis. No new focal consolidation, pleural effusion or pneumothorax is present. Right-sided rib cage deformities are unchanged. IMPRESSION: No significant interval change from the prior exam with post surgical changes in the right lung. No new areas of consolidation to indicate pneumonia. " c32f537b-1e531bdf-dc94439f-516792e2-c4933220.jpg,test/p14/p14062229/s55856355/c32f537b-1e531bdf-dc94439f-516792e2-c4933220.jpg,test," WET READ: ___ ___ ___ 6:07 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain. R/o pna. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___. FINDINGS: Compared with the prior radiograph, cardiomediastinal silhouette is grossly unchanged. Lungs are hyperinflated, but clear, without evidence of focal consolidation, pleural effusion, or pneumothorax. Small area of parenchymal sparing in the left upper lobe is unchanged. Mild degenerative changes of the thoracic spine again seen. IMPRESSION: No acute cardiopulmonary process. " 5ca329ce-6912fb6a-af681962-ac73d49d-fc482a52.jpg,test/p16/p16377954/s57313441/5ca329ce-6912fb6a-af681962-ac73d49d-fc482a52.jpg,test," FINAL REPORT HISTORY: AML with neutropenic with low-grade fevers, assess for pneumonia. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Frontal and lateral views of the chest demonstrate a subtle retrocardiac opacity. The lungs are otherwise clear. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. A left PICC ends in the upper to mid SVC. IMPRESSION: New retrocardiac opacity is concerning for an early left lower lobe pneumonia. Findings were discussed with Dr. ___ by Dr. ___ ___ the telephone on ___ at 15:40, ___ min after findings were made. " b6ac5ecc-3e2b4c7a-15b2931c-52c24f17-06391705.jpg,test/p12/p12835005/s58268398/b6ac5ecc-3e2b4c7a-15b2931c-52c24f17-06391705.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with right pleural effusion, biopsy, pleurodesis, interval change? COMPARISON: ___. FINDINGS: Right pneumothorax has increased in size, going from 9 mm to 14 mm. The chest tube is unchanged at the right lung base. Left lung base minimal atelectasis has slightly improved. Mediastinal and cardiac contours are normal. CONCLUSION: Increase in right pneumothorax going from 9 to 14 mm. This was discussed with the medical team at 9 a.m. " 094e398a-f92f00bd-ad4ea598-6fd07898-9b460189.jpg,test/p19/p19372257/s50360744/094e398a-f92f00bd-ad4ea598-6fd07898-9b460189.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HTLV leukemia, D+___ after alloSCT, now w cough // any acute lung process to explain new cough? TECHNIQUE: Portable semi upright chest radiograph. COMPARISON: Chest radiograph dated ___. . FINDINGS: There is a right Port-A-Cath and left subclavian with both tips in the mid SVC. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Appropriately positioned right Port-A-Cath and left subclavian. 2. No evidence of pneumonia. " 4b560080-88248c3f-faadbf6e-54e10d73-5d4b9797.jpg,test/p10/p10193065/s52593905/4b560080-88248c3f-faadbf6e-54e10d73-5d4b9797.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF, recent admission for CHF exacerbation, presented with agitation and ___ // please eval for volume overload, infection please eval for volume overload, infection IMPRESSION: Comparison to ___. Minimal decrease in size of the moderately enlarged cardiac silhouette. Elongation of the descending aorta. No pneumonia, no pulmonary edema, no pleural effusions. " d8f5f136-4e2a5079-7b46c7f4-ab412297-2bf20169.jpg,test/p17/p17300600/s58325519/d8f5f136-4e2a5079-7b46c7f4-ab412297-2bf20169.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with foreign body sensation in esophagus. // Eval for cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. No radiopaque foreign body is identified. IMPRESSION: No evidence of acute cardiopulmonary process. No evidence of radiopaque foreign body. " 245eccb8-f5efcc0a-e932ea52-36ef21d8-5c84b857.jpg,test/p17/p17165725/s53099666/245eccb8-f5efcc0a-e932ea52-36ef21d8-5c84b857.jpg,test," FINAL REPORT HISTORY: ___ years old male with ESRD, History of AVF, HD and DM-2 who presents with Staphylococcus aureus bacteremia on recent MRI thoracic and lumbar spine discitis and osteomyelitis as well as pneumonia empyema status post chest tube. INDICATION: Interval change in empyema. TECHNIQUE: Portable chest x-ray in supine position. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: All the monitoring device are unchanged There are no major changes on the chest findings. In particular, lung volume is still low especially on the right for right base atelectasis and effusion. Left lung is better ventilated, especially at the base with reduced opacification. Heart size is still enlarged with aortosclerosis. IMPRESSION: There are no major changes in atelectasis and pleural effusion of the right lung. Better ventilation of the left base with reduced atelectasis. All the monitoring device are unchanged. " 56569cc2-d8921374-30213188-60d76a46-73f23bc9.jpg,test/p18/p18688402/s52226388/56569cc2-d8921374-30213188-60d76a46-73f23bc9.jpg,test," WET READ: ___ ___ ___ 4:32 PM ETT tip low (11mm above carina) - pls retract by 1-2cm. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Status post fall, syncope, assess position of the endotracheal tube. FINDINGS: Portable AP upright chest radiograph obtained. The endotracheal tube is seen with its tip residing just 11 mm above the carina. Retraction by at least 1-2 cm is advised. The NG tube courses into the left upper abdomen with its tip not within the imaged field. The heart is moderately enlarged. The lungs appear grossly clear. Bony structures appear intact. IMPRESSION: Low position of endotracheal tube positioned 11 mm above the carina. Recommend retraction by 1-2 cm for more optimal positioning. NG tube appears appropriately positioned. Finding flagged to ED dashboard. " a7c01a21-7b1ec87d-fd78c6cc-7b1c0191-37b21275.jpg,test/p16/p16780540/s55612623/a7c01a21-7b1ec87d-fd78c6cc-7b1c0191-37b21275.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with shortness of breath and fever. TECHNIQUE: PA and lateral chest radiographs COMPARISON: None available FINDINGS: The left lung is well-expanded and clear. There is elevation of the right hemidiaphragm, which results in crowding of the right cardiophrenic angle by hilar vessels limiting assessment. However, there may be patchy opacity in this region as the degree of opacification is felt to be more than expected. There is leftward shift of the mediastinum due to elevated right hemidiaphragm. Otherwise cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Findings raise concern for possible pneumonia of the right middle or lower lobe pneumonia although elevation of the right hemidiaphragm results in crowding of the right cardiophrenic angle by right hilar structures, limiting assessment. " 4fa7a14e-4e48c318-981f3ac6-8b5e3e28-e563acc8.jpg,test/p14/p14065827/s58757100/4fa7a14e-4e48c318-981f3ac6-8b5e3e28-e563acc8.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with stroke // elevated white count, ?infection TECHNIQUE: Portable chest COMPARISON: ___ portable chest radiograph FINDINGS: Compared to the prior examination, pulmonary edema has resolved. Lungs are fully expanded and clear. No pleural abnormalities. Mild cardiomegaly. Heavy calcification of the mitral annulus is noted. Prominence of the central pulmonary arteries is noted. . Cardiomediastinal and hilar silhouettes are otherwise normal. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. Prominence of the central pulmonary arteries likely reflects pulmonary hypertension, as reported in an echocardiogram performed ___. " 1369ca3a-595fe143-e7f1d4d3-b427cc6d-970f7a2f.jpg,test/p18/p18487867/s53416959/1369ca3a-595fe143-e7f1d4d3-b427cc6d-970f7a2f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: ___-year-old female status post MVA with right shoulder pain. Assess for fracture. FINDINGS: AP supine portable chest radiograph obtained. The lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. The imaged portion of the right shoulder appears unremarkable. " b59346cf-5be2614c-a28579a4-cf7a8ec3-aaae9a50.jpg,test/p10/p10459005/s57083109/b59346cf-5be2614c-a28579a4-cf7a8ec3-aaae9a50.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recurrent ventricular tachycardia s/p ICD // interval changes interval changes IMPRESSION: In comparison with the study of ___, there are improved lung volumes. Again there is huge enlargement of the cardiac silhouette in a patient with intact midline sternal wires. There is minimal vascular congestion, producing a discordance that raises the possibility of cardiomyopathy or possibly even pericardial effusion. Blunting of the right costophrenic angle suggests small pleural effusion. Dual-channel pacer remains in place. The tip of the right atrial lead has been slightly change since the previous study. " eda73a8a-2e189f49-4b693824-78c41e54-5a73394b.jpg,test/p13/p13075096/s53703463/eda73a8a-2e189f49-4b693824-78c41e54-5a73394b.jpg,test," FINAL REPORT INDICATION: History of colonoscopy yesterday with abdominal pain and right rib pain. Please evaluate for air. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There is subdiaphragmatic free air. The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: New large amount of subdiaphragmatic free air. Critical findings were discussed with Dr. ___ ___ the department of surgery by Dr. ___ in person at 2:___ a.m. immediately after discovery. " 23a102d6-16aaf8ad-d115fc52-608e6e2e-c6718500.jpg,test/p12/p12226373/s56612958/23a102d6-16aaf8ad-d115fc52-608e6e2e-c6718500.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of eosinophilic pneumonia, rapidly improved with steroids, now off steroids but with cough and fever. COMPARISON: Comparison is made with chest radiograph from ___ and ___. FINDINGS: PA and lateral images of the chest demonstrate well expanded lungs. There has been interval development of right upper lobe hazy opacity as well as a right lower lobe and small left upper lobe opacity. This distribution is consistent with eosinophilic pneumonia and is worse in appearance than on previous imaging. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Visualized osseous structures are unremarkable. IMPRESSION: Worsening opacities in the right upper lobe, right lower lobe, and left upper lobe concerning for worsening eosinophilic pneumonia. " 817d1304-5849446e-8a4bcdf1-aec2e7f3-97f1749b.jpg,test/p16/p16549914/s51725973/817d1304-5849446e-8a4bcdf1-aec2e7f3-97f1749b.jpg,test," FINAL REPORT HISTORY: ___-year-old male with nausea and vomiting after EGD. Assess for free air. COMPARISON: None available FRONTAL AND LATERAL CHEST RADIOGRAPHS: Lungs are essentially clear. There is no pneumothorax. No pulmonary edema or pleural effusions are evident. Cardiomediastinal and hilar contours are within normal limits. No subdiaphragmatic free air is identified. IMPRESSION: No acute cardiopulmonary process. No free air. " 372a18c1-41105a8c-a32a027d-73e85620-96b5b6d3.jpg,test/p19/p19635953/s56598570/372a18c1-41105a8c-a32a027d-73e85620-96b5b6d3.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiographs through ___ with the most recent from ___. FINDINGS: Bilateral multifocal pneumonias are in a similar distribution and extent as compared to prior radiograph from ___. However, some of these cavitations are showing central lucencies which is concerning for cavitation. Bilateral small pleural effusions are present, which are unchanged. Top normal heart size, mediastinal and hilar contours are stable. IMPRESSION: 1. Bilateral multifocal pneumonia persist, some of them demonstrating focal lucencies which is concerning for a cavitation. 2. Small bilateral pleural effusions, stable. " 8d2a2e94-78899297-15e099fc-802e0db4-4aeab876.jpg,test/p18/p18379244/s59078729/8d2a2e94-78899297-15e099fc-802e0db4-4aeab876.jpg,test," FINAL REPORT HISTORY: CABG, postoperative. FINDINGS: In comparison with the study of ___, there is little overall change. Again there is substantial enlargement of the cardiac silhouette with a single-lead pacer extending to the apex of the right ventricle. Continued small right pleural effusion with compressive atelectasis at the base. Smaller left effusion. " 7fc39a8f-f06d7e10-a3f71ddf-48c25b48-377e1577.jpg,test/p16/p16388630/s50969160/7fc39a8f-f06d7e10-a3f71ddf-48c25b48-377e1577.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Status post tracheostomy presenting with fever. Question pneumonia. TECHNIQUE: Chest, AP upright and lateral. COMPARISON: ___. FINDINGS: The patient is status post tracheostomy. The cardiac, mediastinal and hilar contours appear stable including cardiomegaly. Although less striking than before there are central congestive changes, and in addition, focal opacity in the right lower lung best seen on the anterior view. Pleural effusions have resolved. IMPRESSION: Focal opacity in the right lower lung, probably in the right lower lobe; differential considerations include pneumonia versus atelectasis. Correlation with clinical presentation is suggested. Findings also suggesting mild vascular congestion. " dc7833bb-20b2de77-ec7c056f-160efcf6-77f62bb1.jpg,test/p15/p15084854/s55517838/dc7833bb-20b2de77-ec7c056f-160efcf6-77f62bb1.jpg,test," FINAL REPORT INDICATION: Pain and shortness of breath. Evaluate for pulmonary embolism. TECHNIQUE: Chest PA and lateral. COMPARISON: None. FINDINGS: The cardiac and mediastinal silhouettes appear within normal limits. There no focal pulmonary opacities, pleural effusions, or evidence of pneumothorax. Osseous structures appear unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. Note that chest radiographs have limited utility in assessing for pulmonary embolism. " 1f9fb323-4bc2627d-6a1fc8a6-6a006574-30ca2da9.jpg,test/p12/p12278812/s55400927/1f9fb323-4bc2627d-6a1fc8a6-6a006574-30ca2da9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pacemaker, brain tumor // check placement of pacemaker IMPRESSION: As compared to ___ radiograph, positioning of the lead pacemaker is unchanged. Overall appearance of the chest is similar to the prior study, with normal heart size and well-expanded and clear lungs. " 346afe5e-8a302194-d1aa96f0-223d0eea-78a579a6.jpg,test/p10/p10610275/s55709519/346afe5e-8a302194-d1aa96f0-223d0eea-78a579a6.jpg,test," FINAL REPORT INDICATION: ___-year-old male with stroke and leukocytosis. Evaluate for pneumonia. EXAMINATION: Single frontal chest radiograph. COMPARISONS: ___. FINDINGS: The lungs are essentially clear. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " 34d05c09-769fec6e-be0eb2de-f95fffd7-eacc59ff.jpg,test/p14/p14002189/s58703300/34d05c09-769fec6e-be0eb2de-f95fffd7-eacc59ff.jpg,test," FINAL REPORT HISTORY: ___-year-old man with productive cough and shortness of breath. Rule out acute process. COMPARISON: ___ radiograph. FINDINGS: Sutures again overlie the left lung apex. The lungs are hyperinflated consistent with COPD. No focal opacities concerning for pneumonia. No pleural effusions or pneumothorax. Vertebral findings compatible with DISH are again seen. No free air. Callus formation over the right clavicle and ribs is present. IMPRESSION: No evidence of infectious process. " 70aa0880-3ce32e92-def6007f-202419cb-9944c8ef.jpg,test/p10/p10503045/s51524201/70aa0880-3ce32e92-def6007f-202419cb-9944c8ef.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: A ___-year-old male with history of shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is no overt pulmonary edema. The cardiac silhouette is top normal. The mediastinum and hilar contours are unremarkable. Degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " 615eea48-22b6bc5c-892ddbc8-ce2fd74a-61dd6444.jpg,test/p10/p10426710/s58557190/615eea48-22b6bc5c-892ddbc8-ce2fd74a-61dd6444.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with asymptomatic bradycardia // r/o pneumonia TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed the same day earlier in the morning IMPRESSION: Severe cardiomegaly is a stable. The aorta is tortuous. Vascular congestion has improved. There is no pneumothorax or enlarging pleural effusions. The lungs are hyperinflated suggesting COPD. There is no evidence of pneumonia " 007c6389-20c7ebd0-e34dfed9-e3a61b48-572a4598.jpg,test/p15/p15221070/s51952123/007c6389-20c7ebd0-e34dfed9-e3a61b48-572a4598.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and fever // High fever, likely flu, r/o pneumonitis TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Cardiac size is normal. There is blunting of the AP window, this warrants further evaluation with CT The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities. Obliteration of the AP window, these warrants further evaluation with CT " c5c2aa04-f50ad751-5d9f5d09-ac366038-506e1622.jpg,test/p14/p14552554/s52084140/c5c2aa04-f50ad751-5d9f5d09-ac366038-506e1622.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with shortness of breath. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Multiple prior chest radiographs, most recent on ___. FINDINGS: In comparison with prior radiographs, again seen is near complete opacification of the left hemithorax owing to lower lobectomy and total collapse of the residual upper lobe as well as leftward mediastinal shift. The right lung however shows increased vascular congestion and interstitial thickening as well as a probable small pleural effusion. Lucency projecting over the mid chest, best seen on the latera view, is of unclear etiology, but could related to dilated, air filled esophagus. Minimal fibrotic changes are unchanged. Lumbar spine hardware is redemonstrated. Stable severe compression of a lower thoracic vertebra. IMPRESSION: Findings compatible with interstitial pulmonary edema in the right lung. Again seen near complete opacification of the left hemi thorax with complete collapse of the residual left upper lobe and lefward mediastinal shift. Lucency projecting over the mid chest, best seen on the latera view, is of unclear etiology, may have been present previosuly and possibly related to dilated, air filled esophagus. " e61f3c3e-9e04b385-b9730b4a-1eb094a4-a6902704.jpg,test/p12/p12945037/s54178560/e61f3c3e-9e04b385-b9730b4a-1eb094a4-a6902704.jpg,test," FINAL REPORT INDICATION: History: ___F with RUQ pain likely cholangitis w/ R diaphragmatic insp pain, ? R axillary pain // r/o acute CP process, R pleural effusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pneumothorax. There may be a small left pleural effusion. Streaky bibasilar opacities likely representing atelectasis or scarring are similar to the prior exam. There is no new focal consolidation concerning for pneumonia. There is no pneumoperitoneum. IMPRESSION: No acute cardiopulmonary process. Bibasilar atelectasis or scarring. " 723ad935-1f03d5b3-92354c34-af713003-714bd462.jpg,test/p17/p17517983/s52994143/723ad935-1f03d5b3-92354c34-af713003-714bd462.jpg,test," FINAL REPORT HISTORY: End-stage renal disease, chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size remains mildly enlarged. The mediastinal and hilar contours are unchanged and within normal limits. Bibasilar interstitial opacities have minimally improved compared to the previous exam but persist. Small bilateral pleural effusions have also nearly resolved. No new focal consolidation is present and there is no pneumothorax. There are no acute osseous abnormalities. IMPRESSION: Slight interval improvement in bibasilar interstitial opacities likely reflecting mild pulmonary edema with near resolution of small bilateral pleural effusions. " d0295b02-811b97ab-4dfd2db0-d807b0fa-b4787f4a.jpg,test/p13/p13687044/s52288926/d0295b02-811b97ab-4dfd2db0-d807b0fa-b4787f4a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, intubation. COMPARISON: ___, 11:29 a.m. FINDINGS: As compared to the previous radiograph, the right lung shows no relevant change. On the left, there is increasing atelectasis, notably at the left lung bases and, potentially, occurrence of a small left pleural effusion. The tip of the left PICC line is difficult to visualize but could still be malpositioned. The re-position is required. The other monitoring and support devices are constant. The overall size of the cardiac silhouette is also unchanged. There is no evidence of pneumothorax. " d5b65ccc-5009a599-bcf1b0d5-70349e6b-21cb665b.jpg,test/p12/p12108423/s57203502/d5b65ccc-5009a599-bcf1b0d5-70349e6b-21cb665b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo woman with a history of CAD, prior NSTEMI, Alzheimer's disease, HFpEF, who presented initially to___ with one day of nausea and vomiting, and is transferred to the ___ CCU for hyperglycemia, acidosis, respiratory failure, and altered mental status found to have NSTEMI with severe multi-vessel coronary artery disease in cardiogenic shock s/p impella placement // increasing vent requirements increasing vent requirements IMPRESSION: In comparison with the study of ___, there are lower lung volumes. The monitoring and support devices are stable. Left basilar opacification again is consistent with pleural fluid and atelectasis, though in the appropriate clinical setting superimposed pneumonia would have to be considered. Mild right basilar atelectatic changes. " 1de015eb-891f1b02-f90be378-d6af1e86-df3270c2.jpg,test/p11/p11052935/s57171514/1de015eb-891f1b02-f90be378-d6af1e86-df3270c2.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath. COMPARISON: ___. FINDINGS: Single portable view of the chest. The lungs are hyperinflated but clear of consolidation. The cardiomediastinal silhouette is within normal limits. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " e2c2595e-039b2df5-f92b4843-66265dc7-b82fab55.jpg,test/p14/p14101623/s54447439/e2c2595e-039b2df5-f92b4843-66265dc7-b82fab55.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. The lungs are clear of focal consolidation or effusion. Cardiomediastinal silhouette is stable. Osseous and soft tissue structures are unchanged noting significant degenerative changes at the right glenohumeral and acromioclavicular joints. IMPRESSION: No acute cardiopulmonary process. " b7ac441c-bfa3e567-a1e30d27-c9601d37-ace5650a.jpg,test/p12/p12523062/s51214652/b7ac441c-bfa3e567-a1e30d27-c9601d37-ace5650a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea on exertion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, PET-CT ___ FINDINGS: Left-sided AICD device is noted with single lead terminating in the right ventricle. Right-sided Port-A-Cath tip terminates in the mid/ low SVC. Heart size is normal. Multiple coronary artery stents are noted. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is not engorged. Lungs are clear. No pleural effusion or pneumothorax is seen. Mild to moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 83739edf-fd070d89-124790bb-2e66d495-8d6bb48d.jpg,test/p11/p11381413/s53088489/83739edf-fd070d89-124790bb-2e66d495-8d6bb48d.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess NG tube. NG tube tip is in the stomach. Cardiomediastinal contours are normal. There are minimal bibasilar atelectases. There is no pleural effusion. Of note, the apices of the lungs were excluded from these films. Markedly distended bowel loops are seen in the upper abdomen. " 841e82ce-f1dcf53e-5fd6d3ee-b5dc8aa9-6ded201e.jpg,test/p12/p12823036/s54480820/841e82ce-f1dcf53e-5fd6d3ee-b5dc8aa9-6ded201e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with asthma exacerbation TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lungs are hyperinflated. The cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " 9ea99292-9c34e082-60a1ec1c-09f38bb5-b25e7118.jpg,test/p11/p11629328/s56053382/9ea99292-9c34e082-60a1ec1c-09f38bb5-b25e7118.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain, assess for pneumonia or CHF. FINDINGS: PA and lateral views of the chest were provided. There is slight elevation of the left hemidiaphragm. There is left mid and lower lung atelectasis, plate-like and likely compressive. The right lung is clear. No definite signs of pneumonia or CHF. There is a metallic density projecting over the posterior soft tissues in the mid back, possibly representing a foreign body measuring 1.5 x 1.0 x 1.1 cm. Faint aortic calcifications are present. The imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process. Mild left hemidiaphragmatic elevation with associated left lower lung atelectasis. Apparent foreign body in the soft tissues of the mid back appears metallic, measuring 1.5 x 1.0 x 1.1 cm. Correlate for prior injury in this region. " 72998346-df2bf288-e920d547-00abba70-11a378e8.jpg,test/p12/p12828138/s59261874/72998346-df2bf288-e920d547-00abba70-11a378e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with tachycardia. Evaluate for effusion. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is at the upper limits of normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Prominent gas is noted in the visualized bowel loops in the upper abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " d9002f6b-aae37a62-e6071000-ef7e8153-6a530240.jpg,test/p12/p12912986/s55536486/d9002f6b-aae37a62-e6071000-ef7e8153-6a530240.jpg,test," FINAL REPORT INDICATION: ___-year-old male with wheeze since ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 9e578207-c3deb052-d8ae424f-970b7c4c-58842e34.jpg,test/p10/p10851962/s52161459/9e578207-c3deb052-d8ae424f-970b7c4c-58842e34.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M with chest pain. Evaluate for pneumonia or acute cardiopulmonary abnmormalities. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 0e88a5d3-dbe0039c-04d1e57c-7c7aa39f-eb21545c.jpg,test/p13/p13593747/s56425347/0e88a5d3-dbe0039c-04d1e57c-7c7aa39f-eb21545c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hemochromatosis, hypogammaglobulinemia, now with long bone pain // eval for lung mass/nodule eval for lung mass/nodule IMPRESSION: Comparison to ___. No relevant change is noted. Stable appearance of the ribcage. Mild cardiomegaly. No pneumonia, no pulmonary edema. No pulmonary nodules or masses. " ee38d03f-8c6040c0-917b013d-46e019be-b2cc0b2b.jpg,test/p19/p19461413/s58812436/ee38d03f-8c6040c0-917b013d-46e019be-b2cc0b2b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alc hep with AMS, intubated and sedated // interval change interval change IMPRESSION: Comparison to ___. Lung volumes have minimally increased but bilateral areas of atelectasis persist. The presence of small pleural effusions cannot be excluded. A left lower lobe atelectasis has minimally increased in severity. No change in correct position of the monitoring and support devices. No pneumothorax. " 1a657453-cbf80d99-f3eb2092-d2bc1d14-6a267769.jpg,test/p12/p12299028/s50288786/1a657453-cbf80d99-f3eb2092-d2bc1d14-6a267769.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with myelodysplasia syndrome and fever, rule out pulmonary process. COMPARISON: ___. FINDINGS: There is no new lung consolidation. Obscuration of left cardiac border is explained by a fat pad as shown on abdominal CT of ___. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: There is no evidence of pneumonia. " 5aed9e24-7a9392b6-dfcc78ed-13df871f-655a515d.jpg,test/p19/p19815601/s57563558/5aed9e24-7a9392b6-dfcc78ed-13df871f-655a515d.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of sharp stabbing chest pain for two days. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Increased right base opacity may be due to atelectasis although in the appropriate clinical setting, an early consolidation cannot be excluded. Minimal left base atelectasis is seen. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Minimal right base opacity may represent atelectasis, although in the appropriate clinical setting an early consolidation would not be excluded. " 12e9b241-c7c6a34b-3a9d09b9-45970098-3ea10b4e.jpg,test/p14/p14699882/s52426700/12e9b241-c7c6a34b-3a9d09b9-45970098-3ea10b4e.jpg,test," FINAL REPORT INDICATION: History: ___M with dyspnea // acute cardiopulm disease COMPARISON: Chest radiographs on ___ at 03:___. FINDINGS: Frontal chest radiograph. Lung volumes are low with mild bibasilar atelectasis. There is no pneumothorax or large pleural effusion. The cardiac silhouette is not completely imaged, but does not appear enlarged. " 4d0f64fd-00187874-05e89595-0eb0135d-e31802cb.jpg,test/p10/p10878573/s50926223/4d0f64fd-00187874-05e89595-0eb0135d-e31802cb.jpg,test," FINAL REPORT INDICATION: ___-year-old man with new ICD placement. COMPARISON: Chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: Left chest wall AICD device is seen with leads in the right atrium ans right ventricle. A third lead likely coursing through the right ventricle but has an unusual wavy configuration. A lateral view would be helpful for better assessment of the position of the cardiac leads. A new small to moderate left pleural effusion and left basilar atelectasis are new. There is no pulmonary edema. The cardiomediastinal and hilar contours are stable, with mild cardiomegaly. Multiple intact sternotomy wires and mediastinal surgical clips relate to prior CABG. " e2fb1ee0-ee568fc9-aa2e8ad3-95d2de9b-92b9f6cb.jpg,test/p16/p16952127/s58300753/e2fb1ee0-ee568fc9-aa2e8ad3-95d2de9b-92b9f6cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF and aortic stenosis s/p TAVR, on IABP // Interval changes Interval changes IMPRESSION: Comparison to ___. Improvement in severity of the pre-existing pulmonary edema. Moderate cardiomegaly persists. Stable monitoring and support devices, the pre-existing minimal pleural effusions have slightly increased in extent. " ed5b06da-35eed4bc-90bd8fa3-b9e82fd7-95defcd8.jpg,test/p13/p13610624/s59729548/ed5b06da-35eed4bc-90bd8fa3-b9e82fd7-95defcd8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough, fever, history of cancer TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and chest CT ___ FINDINGS: A left-sided Port-A-Cath tip terminates at the junction of the SVC and right atrium. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is identified. Minimal scarring is seen in the lung apices. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 708f4084-23127d56-0abbb1e4-6c5e27b1-2cd744c2.jpg,test/p19/p19966568/s56404642/708f4084-23127d56-0abbb1e4-6c5e27b1-2cd744c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cabg // eval left lung - please do around 2 pm thank you eval left lung - please do around 2 pm thank you IMPRESSION: Comparison to ___, 07:56. The left lung is minimally better ventilated than on the previous image. In particular, the areas of atelectasis behind the heart have decreased in extent. Otherwise no relevant change is noted. No new focal parenchymal abnormalities. Stable position of the right venous introduction sheet. " 4f307e12-344e0348-a171ddde-b3a3daa7-dee67bf2.jpg,test/p15/p15924201/s58447609/4f307e12-344e0348-a171ddde-b3a3daa7-dee67bf2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with tachycardia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. Mild widening of the superior mediastinal contour may be due to mediastinal lipomatosis. Hilar contours are unremarkable. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities seen. Mild to moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 2d2c8167-a2027954-a58acc51-e2594f75-5825605e.jpg,test/p19/p19049935/s51947103/2d2c8167-a2027954-a58acc51-e2594f75-5825605e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 7e2e695d-78a5a81b-35d1993d-ab12ebd9-d3939230.jpg,test/p10/p10221648/s51813940/7e2e695d-78a5a81b-35d1993d-ab12ebd9-d3939230.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: None available. FINDINGS: AP and lateral views of the chest. Sternotomy wires are intact. There is no focal consolidation, pleural effusion, or pneumothorax. Coarsened interstitial markings may represent mild fibrosis/emphysema. There are aortic calcifications. The cardiomediastinal and hilar contours are within normal limits. There is a mild vertebral compression deformity noted in the lower T-spine. IMPRESSION: No acute cardiopulmonary process. " 00070613-ea444275-19917990-3a18440d-0c68318e.jpg,test/p17/p17501651/s59399124/00070613-ea444275-19917990-3a18440d-0c68318e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ett // please eval ett please eval ett IMPRESSION: Compare to prior chest radiographs ___ through ___:45. Bibasilar consolidation has worsened since ___, stable since ___. Small pleural effusions are presumed. Heart size normal. Lines and tubes in standard placements. " 837ad046-5d9bd7b4-f24f4866-99409819-523118cf.jpg,test/p14/p14471647/s50552523/837ad046-5d9bd7b4-f24f4866-99409819-523118cf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with bifascicular block s/p PPM // lead placement lead placement IMPRESSION: In comparison with the study of ___, the pacer leads again extend to the right atrium and apex of the right ventricle. No evidence of post - procedure pneumothorax. The patient has taken a better inspiration. Cardiac silhouette remains at the upper limits of normal or mildly enlarged. No definite vascular congestion or acute focal pneumonia. " 5e3a1f8c-3838c7e5-6783f89c-114bd31c-14af814f.jpg,test/p10/p10956814/s51051089/5e3a1f8c-3838c7e5-6783f89c-114bd31c-14af814f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxia, CHF // Eval for interval change in pulmonary edema, effusions TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: As compared to the prior study there is interval resolution of pulmonary edema. Bilateral pleural effusions have developed in the interim as part of the resorption of the pulmonary edema. Left retrocardiac atelectasis is unchanged as well as cardiomegaly. " e39daf91-b2a11a31-1c1f0b96-bcc8ce42-21e60a4e.jpg,test/p14/p14074396/s57048175/e39daf91-b2a11a31-1c1f0b96-bcc8ce42-21e60a4e.jpg,test," FINAL REPORT INDICATION: ___F with pleural effusion, s/p thoracentesis // eval pleural effusion, s/p thoracentesis TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ at 13:20. FINDINGS: There is persistent increased opacity in the right hemithorax. There is however improved aeration of the underlying right lung when compared to prior. There is no pneumothorax. There is no mediastinal shift. The left lung remains clear. No acute osseous abnormalities. IMPRESSION: Large right pleural effusion although improved aeration of the right lung when compared to exam from earlier the same day. " f8949c87-2a677a55-05ae99d3-413679fd-267057df.jpg,test/p14/p14630468/s58629643/f8949c87-2a677a55-05ae99d3-413679fd-267057df.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Tracheostomy tube remains in standard position, and cardiomediastinal contours are stable. Interval improvement in left lower lobe atelectasis, but slight worsening in right basilar atelectasis. Small-to-moderate pleural effusions are partially layering on this semi-upright study. " e83b1c46-ffb696e6-f707ddfe-54d292ce-c5c9e210.jpg,test/p17/p17354468/s56338491/e83b1c46-ffb696e6-f707ddfe-54d292ce-c5c9e210.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG // eval postop changes IMPRESSION: Since the prior radiograph of 3 days earlier, a right internal jugular vascular sheath has been removed, with no visible pneumothorax. Cardiomediastinal contours are stable in the postoperative setting. Improving left basilar atelectasis and slight decrease in small left pleural effusion. Small right pleural effusion is also noted. " 042577b8-29e4340b-a94fc859-88d4dfd0-910b18ac.jpg,test/p11/p11459120/s51348531/042577b8-29e4340b-a94fc859-88d4dfd0-910b18ac.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Productive cough and wheezing, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing parenchymal opacities have completely cleared. On the current radiograph, there is no indication for pneumonia. Both the frontal and the lateral radiographs show normal lung parenchyma. Moderate-to-severe degenerative spinal changes with subsequent increased kyphosis. No pleural effusions. No hilar or mediastinal abnormalities. " 16b2977a-2a9eb4f6-8b2c9699-c770892c-e72bb827.jpg,test/p12/p12449557/s54239861/16b2977a-2a9eb4f6-8b2c9699-c770892c-e72bb827.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are unchanged, with mild tortuosity of the thoracic aorta again noted. Heart size is normal. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities seen. IMPRESSION: No acute cardiopulmonary abnormality. " 1cfbf797-774fd3bf-5db60fca-177de573-bba5884d.jpg,test/p11/p11884069/s52664900/1cfbf797-774fd3bf-5db60fca-177de573-bba5884d.jpg,test," FINAL REPORT INDICATION: Cough, fevers, known lung cancer, infection. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs were provided. There is a large central mass in the right upper and mid lung zones, likely involving the mediastinum consistent with patient's known history of lung cancer. There is associated collapse of the right upper lobe. A small cavity in the left mid lung zone, as seen on MRI, is likely a metastasis. There is prominence of the interstitial markings. Elevation of the right hemidiaphragm suggests phrenic nerve involvement from the large lung mass. There is no pleural effusion or pneumothorax. IMPRESSION: Large right upper lung mass involving the mediastinum, specifically the phrenic nerve, also responsible for right upper lobe collapse. Likely left lung metastasis. " 391b8a4d-a7274a2b-2bd7b8f6-bde74b8d-d4b8c8c8.jpg,test/p13/p13050559/s55062789/391b8a4d-a7274a2b-2bd7b8f6-bde74b8d-d4b8c8c8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with febrile neutropenia // Source for infection like pneumonia IMPRESSION: As compared to ___ chest radiograph, postoperative alterations in the right hemi thorax are stable. Left sided porta catheter has been placed in the interval, with tip terminating in the expected location of the lower superior vena cava. Cardiomediastinal contours are stable in appearance, and there are no new areas of consolidation to suggest the presence of pneumonia. " eb6e4ab8-38dd5235-92946509-ec16621f-472067e9.jpg,test/p18/p18892958/s58158107/eb6e4ab8-38dd5235-92946509-ec16621f-472067e9.jpg,test," FINAL REPORT INDICATION: ___-year-old female with aphasia and dysphagia, to rule out pneumonia or aspiration. COMPARISON: Chest radiograph ___. PORTABLE AP AND LATERAL CHEST RADIOGRAPHS: The patient is significantly rotated to the right. There is mild widening of the upper mediastinum, which is likely due to a tortuous and dilated thoracic aorta. The heart size is normal. The lungs are well expanded and clear, without consolidation or pneumothorax. A small right pleural effusion is seen. IMPRESSION: Dilated tortuous thoracic aorta. Small right pleural effusion. " 8a93f295-55b42356-f8ea4b0f-1e6c7276-0fd9d9cf.jpg,test/p19/p19657612/s52912984/8a93f295-55b42356-f8ea4b0f-1e6c7276-0fd9d9cf.jpg,test," WET READ: ___ ___ 9:31 PM Low lung volumes and atelectasis. No definite PTX. Consider left lateral decubitus radiographs if there is continued suspicion. Normal cardiomediastinal silhouette. W/r ___. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Trauma patient with probable pneumothorax. Please reassess. FINDINGS: Lung volumes are low. There is no definite pneumothorax. This would be better assessed with the lateral decubitus radiograph if there is continued concern. " 93baa675-b18f3ecd-def37a2d-1e538f2e-6f832339.jpg,test/p16/p16454913/s52429329/93baa675-b18f3ecd-def37a2d-1e538f2e-6f832339.jpg,test," WET READ: ___ ___ ___ 6:07 AM Increased right lower lobe heterogeneous opacities concerning for developing infection. Mild interstitial pulmonary edema, not significantly changed. Small left pleural effusion with left lower lobe atelectasis versus infection, not significantly changed. Findings were discussed with Dr. ___ by Dr. ___ at 06:05 the telephone on the day of the study, ___ min after discovery of the findings. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Septic shock, mesenteric ischemia, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes have slightly decreased. Moderate cardiomegaly with mild-to-moderate left pleural effusion with subsequent retrocardiac atelectasis. Pre-existing signs of moderate fluid overload and opacities at the right lung base are constant in appearance. The monitoring and support devices are constant. No new parenchymal opacities. No pneumothorax. " f0c82b94-bd91f2a1-b07f1bab-a63c1796-88683af4.jpg,test/p14/p14614062/s58581831/f0c82b94-bd91f2a1-b07f1bab-a63c1796-88683af4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Strokes, dysphagia, possibly aspiration. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are low. Borderline size of the cardiac silhouette. Calcified valvular annulus. Densities of calcific nature are seen at both hilar regions, right more than left and likely reflect calcified lymph nodes. There is minimal increase in density in the lung apices, right more than left, with peribronchial and linear appearance, suggesting the presence of a fibrotic upper lobe change, potentially caused by exposure to granulomatous disease. This could be consistent with the calcified right hilar lymph nodes. No acute changes. No pneumothorax. No pleural effusions. " 189951de-c5c0b41a-d14bcfd4-1e257166-1f89b5d0.jpg,test/p15/p15846912/s55127146/189951de-c5c0b41a-d14bcfd4-1e257166-1f89b5d0.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Mastocytosis and elevated white blood cell count. Question pneumonia. COMPARISONS: ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. Mildly prominent opacity in the right infrahilar region appears unchanged and is suspected to represent normal descending vascularity, which is unchanged and associated with slight leftward rotation of the heart. There are no pleural effusions or pneumothorax. IMPRESSION: No evidence of acute disease. " a6cc71e9-d8cc0109-c6841670-b380265e-1b1a2ed0.jpg,test/p13/p13235049/s55148467/a6cc71e9-d8cc0109-c6841670-b380265e-1b1a2ed0.jpg,test," WET READ: ___ ___ ___ 9:31 PM no significant change in left lung base opacity from study obtained 15 hours prior. ______________________________________________________________________________ FINAL REPORT HISTORY: Hepatic encephalopathy with altered mental status. FINDINGS: In comparison with the earlier study of this date, there is little overall change. Continued low lung volumes may account for much of the prominence of the transverse diameter of the heart. Mild residual retrocardiac atelectasis is seen at the left base with elevation of the right hemidiaphragm. Right humeral deformity is again noted, consistent with remote injury. Sequela of prior fracture is also seen in the right shoulder. " e8cc34f9-972d9d49-6057f4f3-31381855-cd368131.jpg,test/p10/p10716312/s51258262/e8cc34f9-972d9d49-6057f4f3-31381855-cd368131.jpg,test," FINAL REPORT INDICATION: New pacemaker. Evaluate lead position. COMPARISON: Chest radiograph ___. FINDINGS: PA and lateral views of the chest show a new pacemaker in place within the left chest wall. Leads are seen in proper position in the right atrium and left ventricle. The heart size is at the upper limits of normal. There is mild increased pulmonary vascular prominence. There are small bilateral pleural effusions. There are no consolidations. There is no pneumothorax. The osseous structures are unremarkable. IMPRESSION: 1. Pacemaker leads seen in the proper position. 2. Small bilateral pleural effusions. " 7d21ca07-592c0e75-5977cd94-da187f72-d14f03c5.jpg,test/p16/p16040005/s55613853/7d21ca07-592c0e75-5977cd94-da187f72-d14f03c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with ETOH intoxication in restraints, possible traumatic injury and shortness of breath TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Lung volumes are low. Patchy bibasilar airspace opacities likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. No displaced fractures are evident. IMPRESSION: Low lung volumes with bibasilar atelectasis. " 913e2703-e828e5de-444ac2bf-d833dd89-f8df922f.jpg,test/p19/p19243413/s58515024/913e2703-e828e5de-444ac2bf-d833dd89-f8df922f.jpg,test," FINAL REPORT AP CHEST, 9:12 PM, ___ HISTORY: ___-year-old man with post-operative wheezing and retraction, check interval change. IMPRESSION: AP chest compared to ___: Increase in heart size and azygos diameter since ___ suggests volume overload and/or cardiac decompensation, but there is no pulmonary edema or pleural effusion. No pneumothorax. Left subclavian line ends in the mid SVC. " fc9ec59f-0a4d8bfc-743f666a-4d337461-ccea7eae.jpg,test/p19/p19057052/s52103541/fc9ec59f-0a4d8bfc-743f666a-4d337461-ccea7eae.jpg,test," FINAL REPORT STUDY: Portable chest radiograph. COMPARISON EXAM: Portable chest radiographs ___ through ___. INDICATION: ___-year-old woman with hypoxia. FINDINGS: The right lower lung zone atelectasis and pleural effusion are improved today; however, the right lower lobe is still not fully re-expanded. In addition, the appearance of the left lower lobe consolidation and pleural effusion is also improved. There is a new focal bulge below the level of the aortic knob, which may represent atelectatic lung compressed against the hilum. There is no pneumothorax. Support devices remain in good position. IMPRESSION: 1. Improved appearance of right and left lower lobe consolidation and pleural effusions. 2. Slight change in mediastinal contour of unclear significance. Conventional PA and lateral chest radiograph to be obtained when the patient is stable to better evaluate this finding. " d0599844-1dbc5d30-02162a43-1c6701fb-32a662ad.jpg,test/p12/p12462658/s58957794/d0599844-1dbc5d30-02162a43-1c6701fb-32a662ad.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluation for evidence of CHF. COMPARISON: Multiple prior chest radiographs, most recently on ___. CT chest, ___. FINDINGS: Portable frontal chest radiograph demonstrates low lung volumes and bibasilar atelectasis. There is no focal consolidation, pleural effusion, or pneumothorax. There is no evidence of pulmonary vascular congestion. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " cb7bae9c-62b8a4b4-5ff007fd-b168f5ef-4ebd7098.jpg,test/p16/p16896926/s51702295/cb7bae9c-62b8a4b4-5ff007fd-b168f5ef-4ebd7098.jpg,test," FINAL REPORT INDICATION: 11 days postpartum, presenting with leg swelling, abdominal pain, headache and hypertension. Evaluate for cardiomyopathy. COMPARISON: Multiple chest radiographs dating back to ___. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: Heart size is top normal. The cardiomediastinal silhouette and hilar contours are unremarkable. The lungs are clear without focal consolidation, effusion, or pneumothorax. IMPRESSION: No acute intrathoracic process. " 6789ce72-4225a2e6-585cca81-d8633d95-bb31f667.jpg,test/p10/p10755736/s57678252/6789ce72-4225a2e6-585cca81-d8633d95-bb31f667.jpg,test," WET READ: ___ ___ ___ 9:33 AM Extensive, diffuse bilateral consolidations are similar in distribution, and minimally improved in severity compared to prior. No other significant change since ___:06. WET READ VERSION #1 ___ ___ ___ 12:30 AM Extensive, diffuse bilateral consolidations are similar in distribution, and minimally improved in severity compared to prior. No other significant change since ___:06. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chf s/p diuresis // ?Improving or worsening bilateral infiltrates TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 6 hours earlier IMPRESSION: After diuresis there has been mild improvement of extensive bilateral peribronchial consolidations right greater than left. There is a small left pleural effusion. No other interval change from prior study. " 948dfc65-01eeb362-9a6ff3c3-511f8eaf-df97de1f.jpg,test/p14/p14736565/s52221546/948dfc65-01eeb362-9a6ff3c3-511f8eaf-df97de1f.jpg,test," FINAL REPORT INDICATION: ___-year-old male with hiatal hernia, now with right upper quadrant pain. Evaluate for subdiaphragmatic air. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no evidence of subdiaphragmatic free air. A spinal stimulator is noted at the level of the lower thoracic spine. IMPRESSION: Unremarkable chest radiographic examination. No evidence of subdiaphragmatic free air. " 3f9e950a-dfeff77d-9cd7a9d4-46c53ae1-75854f91.jpg,test/p17/p17222468/s58480415/3f9e950a-dfeff77d-9cd7a9d4-46c53ae1-75854f91.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Breast cancer status post radiation and chemotherapy, presenting with right-sided chest pain, shortness of breath, and tachycardia. COMPARISONS: Prior chest radiographs are available from ___. CT imaging is available from ___. PET-CT imaging from ___ and recent thoracic spine radiographs from ___ are also available. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal, and hilar contours appear unchanged. There are streaky new posterior basilar opacities, probably in the right lower lobe and suggestive of minor atelectasis, but otherwise the lungs appear clear aside from scattered unchanged small calcified granulomas. The bony structures are unremarkable. IMPRESSION: Streaky new posterior right lower lobe opacities. Although an infectious process is difficult to completely exclude, the appearance would be compatible with atelectasis. Correlation with clinical findings is suggested. If symptoms were to persist, then follow-up radiographs might be appropriate. " 1bbc5aaf-93f7bbe4-d62932f9-9aa199e3-4be12f5b.jpg,test/p19/p19553987/s57257643/1bbc5aaf-93f7bbe4-d62932f9-9aa199e3-4be12f5b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with back pain, worse with inspiration, associated with SOB // Acute process in chest? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart is top normal in size, but may be accentuated by AP technique. The hilar contours are within normal limits. Lung volumes are low but no focal consolidation is seen. There is no evidence of pleural effusion or pneumothorax. IMPRESSION: Low lung volumes, but not definite focal consolidation. " e389e9a4-8b1f67c1-87c9abd4-25436b7f-c97c0c6e.jpg,test/p18/p18108260/s50965213/e389e9a4-8b1f67c1-87c9abd4-25436b7f-c97c0c6e.jpg,test," FINAL REPORT INDICATION: ___-year-old male with acute onset chest pain, question widened mediastinum or pneumothorax. COMPARISON: No relevant comparisons available. ONE VIEW OF THE CHEST: The costophrenic angles on both sides are excluded from view. Within these limits, the lungs are well expanded and show pulmonary vascular cephalization. The cardiac silhouette is top normal. The mediastinal silhouette and hilar contours are normal. No large pleural effusion or pneumothorax is present. IMPRESSION: Mild pulmonary vascular congestion. These findings were communicated to ___ MD via telephone at 9:44 am on ___. " e73d26f2-b30b8cb7-0e658731-49a70a2e-b8d37334.jpg,test/p10/p10250358/s56010602/e73d26f2-b30b8cb7-0e658731-49a70a2e-b8d37334.jpg,test," FINAL REPORT HISTORY: Metastatic cancer with new oxygen requirement. COMPARISON: CT from ___. outside exam. FINDINGS: the right hemidiaphragm is mildly elevated. There is volume loss at both bases. Heart size is normal. The aorta is slightly calcified. There is mild pulmonary vascular redistribution. Old rib fractures are noted on the right. There is hazy increased opacity in the right lung which could be due to volume loss or infiltrate. Is increased opacity at the left CP angle could represent metastatic disease or small infiltrate or effusion. The known metastatic disease with multiple lung nodules are better visualized on the prior CT. IMPRESSION: ? infiltrate vs. atelectasis right mid lung. " ba0660a2-cfdddf3a-9c8d3626-6ba7d4bf-49b80b35.jpg,test/p13/p13126641/s58499535/ba0660a2-cfdddf3a-9c8d3626-6ba7d4bf-49b80b35.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with GIB and MG with increased work of breathing // please assess for interval change. pulm edema TECHNIQUE: Single frontal view of the chest COMPARISON: Prior radiographs on ___ FINDINGS: Compared with prior radiographs on ___, there has been interval increase in right basilar and right upper lung zone opacities. There is no pneumothorax. The left lung is clear. There is no edema. Cardiomediastinal silhouette is unchanged. A right PICC is stable in position IMPRESSION: Interval increase in right basilar and upper lung zone opacities, likely reflecting multifocal pneumonia. " 398c7fbc-05a76ec1-cf5e6d2f-7e467d9b-cf59e2b1.jpg,test/p12/p12948123/s59576204/398c7fbc-05a76ec1-cf5e6d2f-7e467d9b-cf59e2b1.jpg,test," FINAL REPORT INDICATION: ___-year-old male with hypertension and shortness of breath. COMPARISON: None available. FINDINGS: Portable single AP chest radiograph was obtained. Although suboptimal technique, the heart appears enlarged obscuration of the left hemidiaphragm may reflect atelectasis though a focal infectious consolidation cannot be excluded. Obscuration of bilateral costophrenic angles is consistent with bilateral pleural effusions. Vascular congestion is noted as well as cephalization of vessels. Hilar and mediastinal contours are otherwise unremarkable. Osseous structures demonstrates no acute abnormality. IMPRESSION: Mild pulmonary edema " e2411483-840028df-9ba94a00-6a6b6ec2-27fcdced.jpg,test/p17/p17008145/s53472396/e2411483-840028df-9ba94a00-6a6b6ec2-27fcdced.jpg,test," FINAL REPORT INDICATION: History dermatomyositis and new fever. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, interstitial opacity or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 466ed8a3-95a44b8e-291300cb-0a76b8f7-9f57feda.jpg,test/p15/p15964158/s56495653/466ed8a3-95a44b8e-291300cb-0a76b8f7-9f57feda.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with chest pain. Assess for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The lungs are hyperinflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: 1. No acute cardiopulmonary process. 2. Findings suggestive of emphysema and chronic obstructive pulmonary disease. " 6fdaa552-051d9c9a-9af72b7e-0a1fbb4c-28fcd950.jpg,test/p11/p11110395/s55252543/6fdaa552-051d9c9a-9af72b7e-0a1fbb4c-28fcd950.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with acute chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 08049bdf-1e627998-65839d02-3838d4e0-18ce0dce.jpg,test/p18/p18624255/s51095951/08049bdf-1e627998-65839d02-3838d4e0-18ce0dce.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with CHF exacerbation, inconclusive AP portable at OSH. 1 wk cough, 1x night dyspnea. Crackles to apex // evaluate for PNA evaluate for PNA TECHNIQUE: PA and lateral views of the chest. COMPARISON: Radiographs of ___. FINDINGS: Bibasilar opacities have increased since prior examination, right worse than left, likely a component of atelectasis and pleural effusion. There is also persistent retrocardiac opacity. An overlying infectious process cannot be entirely exclude. The heart is enlarged, stable. There is mild pulmonary vascular congestion. There is no pneumothorax. There are degenerative changes of the thoracic spine. IMPRESSION: Bibasilar opacities, right worse than left, slightly worsened since prior examination, likely a combination of pleural effusion and atelectasis. However an overlying infectious process cannot be entirely excluded. " d048c339-510cb730-421245db-3e5e78ed-8ba07001.jpg,test/p16/p16087436/s50908406/d048c339-510cb730-421245db-3e5e78ed-8ba07001.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post subarachnoid hemorrhage and coiling, respiratory failure, pneumonia, to look for interval change. TECHNIQUE: Portable semi-erect chest view was read in comparison with prior chest radiographs, with the most recent from ___. FIDINGS: There are no significant interval changes in the lungs since ___. Very mild pulmonary edema is similar. Previously appreciated discrete opacity in the left lower lung adjacent to the descending thoracic aorta, which was presumably a part of the thoracic aortic shadow is no more appreciated on the current radiograph. There is no pleural effusion or pneumothorax. Endotracheal tube tip is approximately 6.4 cm above the carina and is adequately positioned. Left-sided PICC line tip ends at mid SVC. A feeding tube courses below the diaphragm and ends into the stomach; however, the distal end is off the radiograph view. IMPRESSION: Very mild pulmonary edema unchanged since ___. " c828f98b-1a123860-ded82ca3-61cfd759-a67b5f3d.jpg,test/p16/p16033427/s50619450/c828f98b-1a123860-ded82ca3-61cfd759-a67b5f3d.jpg,test," FINAL REPORT INDICATION: ___ year old man R PTX and pneumostat in place // check interval change EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, AP and lateral views COMPARISON: Chest radiograph ___ FINDINGS: Right pigtail pleural catheter is in unchanged position. Small to moderate right pneumothorax is unchanged in size. There is persistent collapse of right lower lobe. Emphysematous changes are seen throughout bilateral lungs. Left mid to low lung linear atelectasis is noted. Borderline enlarged cardiac silhouette is stable. IMPRESSION: No notable change compared to ___. Small to moderate right pneumothorax is stable. Persistent right lower lobe collapse. " 5c9dd1bc-d2b96afd-e9f8599d-77a17fc1-b2742443.jpg,test/p17/p17307272/s53542566/5c9dd1bc-d2b96afd-e9f8599d-77a17fc1-b2742443.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old female with generalized weakness. Question pneumonia. COMPARISON: Chest x-ray from ___ and CT chest from ___. FINDINGS: Frontal and lateral views of the chest. There is new streaky right basilar opacity, likely due to right middle and lower lobe atelectasis. Superiorly, the lungs are clear. There is no pleural effusion. The left paramediastinal mass is compatible with previously seen cystic structure on chest CT. Cardiomediastinal silhouette is stable given differences in positioning. No acute osseous abnormality is identified. No free intraperitoneal air. Biliary stents are partially visualized. IMPRESSION: Mostly linear right basilar opacity, most likely due to atelectasis, noting that infection cannot be entirely excluded. " 0762369f-af8531f3-09fc45b2-f00d90c9-88e6ff7d.jpg,test/p16/p16508811/s53845981/0762369f-af8531f3-09fc45b2-f00d90c9-88e6ff7d.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough, fever // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 07:51 FINDINGS: Lines and Tubes: Right IJ line terminates in the SVC. Lungs: Well inflated with unchanged bilateral lower zone linear and hazy opacities. Pleura: Small left pleural effusion. No pneumothorax. Mediastinum: Stable cardiomegaly and prominence of hilar vasculature. Bony thorax: No interval change IMPRESSION: Persistent, unchanged pulmonary edema. " 3b36849c-50b9c113-e71ba498-18b990de-a64525c5.jpg,test/p13/p13487512/s56350597/3b36849c-50b9c113-e71ba498-18b990de-a64525c5.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cp // eval for pain TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 57d9462f-aa765e42-36b98b35-5fb73da2-c91ff747.jpg,test/p18/p18965171/s51371132/57d9462f-aa765e42-36b98b35-5fb73da2-c91ff747.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior exam from ___. CLINICAL HISTORY: Hypertension, assess for cardiomegaly. FINDINGS: PA and lateral views of the chest were provided. The heart size is normal and stable from prior exam. No focal consolidation, effusion or pneumothorax is seen. No signs of pulmonary edema. The mediastinal contour is stable. The bony structures appear intact. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute findings, specifically normal heart size. " e0bd2dae-f05b6e59-26577fff-1d2eaf34-10bdd446.jpg,test/p17/p17085388/s53456778/e0bd2dae-f05b6e59-26577fff-1d2eaf34-10bdd446.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with lt periscapular pain, s/p uri // r/o mass r/o mass IMPRESSION: Heart size is normal. Descending thoracic aorta is mildly tortuous. Lungs are clear. There is no pleural effusion. There is no pneumothorax " a60d0de5-cabb3610-492f869a-8cc226c4-2a205d67.jpg,test/p15/p15970954/s56234815/a60d0de5-cabb3610-492f869a-8cc226c4-2a205d67.jpg,test," FINAL REPORT AP AND LATERAL CHEST RADIOGRAPH DATED ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Interval placement of nasogastric tube, terminating within the distal stomach, with associated decrease in gastric distention. Cardiomediastinal contours are stable in appearance. Small right apical pneumothorax is present, and has apparently increased in size since the previous radiograph, but may have been less visible on that study due to supine positioning. Multifocal areas of patchy and linear atelectasis in the mid and lower lungs have slightly improved. More confluent opacity is present in the right lower lobe posteriorly, partially obscuring the right hemidiaphragm. Multiple rib fractures are again demonstrated on the right as well as subcutaneous emphysema in the chest wall and supraclavicular regions, slightly improved. IMPRESSION: 1. Nasogastric tube terminates in the stomach; decreased gastric distention following placement. 2. Small right apical pneumothorax and multiple contiguous right-sided rib fractures. 3. Multifocal atelectasis and small pleural effusions. More confluent opacity in right lung base posteriorly could reflect atelectasis, aspiration or infection. " 0875b511-b8523ae1-08ef3104-8ecf82e5-de40d14b.jpg,test/p10/p10577647/s59614236/0875b511-b8523ae1-08ef3104-8ecf82e5-de40d14b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with rapid heart rate, cough. has port // eval port position, CHF, pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: A left port tip is seen in the right atrium/ cavoatrial junction, unchanged in position since prior examination. The lungs are clear. There is no pleural effusion or pneumothorax. The heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: No acute intra thoracic process. " 611c0b54-c089a246-27adb2f0-4294be3b-0632de6e.jpg,test/p15/p15245907/s52865176/611c0b54-c089a246-27adb2f0-4294be3b-0632de6e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p open cholecystectomy, diaphragamatic hernia, G-tube resiting // Eval new pulm edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is improvement of the pre-existing left pneumothorax. The pneumothorax is now millimetric and no evidence of tension is seen. Newly appeared small bilateral pleural effusions, combines to signs of mild pulmonary edema. Moderate cardiomegaly and retrocardiac atelectasis. No evidence of pneumonia. " 6d83ac0f-f0eee1b9-c67a1bec-c894f1e7-71d8f7be.jpg,test/p12/p12176298/s51054383/6d83ac0f-f0eee1b9-c67a1bec-c894f1e7-71d8f7be.jpg,test," FINAL REPORT PORTABLE AP CHEST CT X-RAY INDICATION: Right upper lobe lobectomy, reaccumulation, chest tube removal. COMPARISON: ___. FINDINGS: Right-sided chest tube has been removed. Residual moderate apical pneumothorax with air-fluid level is unchanged. Interstitial bilateral lung opacities are due to pulmonary edema superimposed on emphysema. Mediastinal and cardiac contours are normal. NG tube is in the stomach. There has been some rib resection on the right side. CONCLUSION: 1. Residual hydropneumothorax in the surgical cavity is unchanged after chest tube removal. 2. Stable interstitial pulmonary edema. " ca9348c1-48e2e643-7b21dff5-31d62845-0e4b6374.jpg,test/p11/p11958913/s59577875/ca9348c1-48e2e643-7b21dff5-31d62845-0e4b6374.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with possible CHF. COMPARISON: Portable chest radiograph dated ___. FINDINGS: Compared to the previous exam on ___, the mild interstitial edema and pulmonary edema have resolved. The lungs are clear, without focal consolidation to suggest pneumonia. No pleural effusion or pneumothorax. The heart size is normal. Stable tortuous or dilated descending aorta. Mediastinal contours and hila are unchanged. IMPRESSION: Interval resolution of mild CHF. No acute cardiopulmonary process. " fc06279e-751b70a8-ea6ad5db-3da9a7c7-1f6a13d2.jpg,test/p14/p14127042/s59285504/fc06279e-751b70a8-ea6ad5db-3da9a7c7-1f6a13d2.jpg,test," FINAL REPORT HISTORY: Intracerebral hemorrhage, preoperative evaluation. TECHNIQUE: Portable frontal chest radiograph. COMPARISON: Chest radiograph 14:14 today___. FINDINGS: The lungs are clear. The is no pleural effusion, pneumothorax or focal airspace consolidation. There is likely an epicardial fat pad. The cardiac silhouette is mildly enlarged. The pulmonary vasculature is normal. The mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 7d5432dc-06037c66-31049104-fe9cf987-3e33b0a8.jpg,test/p15/p15648678/s55401854/7d5432dc-06037c66-31049104-fe9cf987-3e33b0a8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for 3 weeks. // r/o pneumonia COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous examination. No evidence of pneumonia, no pulmonary edema. No pleural effusions. A 2-3 mm rounded structure in the right upper lobe reflect a vascular cross section, visible on the frontal image only. " a7f7334a-90d88beb-84b2b6e7-77f63eee-cc687e50.jpg,test/p16/p16108772/s57816107/a7f7334a-90d88beb-84b2b6e7-77f63eee-cc687e50.jpg,test," FINAL REPORT INDICATION: History of CHF now with acute chest pain, here to evaluate for acute cardiopulmonary process. COMPARISON: Chest radiographs dated ___, ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The chest cage is distorted by moderate S-shaped scoliosis of the imaged thoracolumbar spine. There is mild pulmonary vascular congestion and edema, increased from the most recent prior study. Retrocardiac opacification is unchanged, likely reflecting atelectasis in the setting of low lung volumes. No significant pleural effusion or pneumothorax is detected. The cardiac silhouette is accentuated by under-inflation of the lungs, but likely within normal limits. The thoracic aorta is tortuous causing prominence of the mediastinum, which is unchanged from prior studies. The hilar contours are within normal limits. IMPRESSION: Mild pulmonary interstitial edema, which is new from the most recent prior study. " 182e4ef7-7cdff3df-6dcddf57-eb98eb48-798a516d.jpg,test/p14/p14044601/s59223312/182e4ef7-7cdff3df-6dcddf57-eb98eb48-798a516d.jpg,test," FINAL REPORT INDICATION: ___M with increased seizures // Eval for PNA TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: Lateral view is obscured by patient's arms. Lungs are clear without focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " b7a9b177-664060fa-7dc8cf8c-91b470dc-17e35689.jpg,test/p18/p18686554/s57397725/b7a9b177-664060fa-7dc8cf8c-91b470dc-17e35689.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Left low thoracic back pain. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. The imaged osseous structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 76c57ce9-920ed829-65ebcf47-b75f3129-47fcc25a.jpg,test/p10/p10799662/s53182627/76c57ce9-920ed829-65ebcf47-b75f3129-47fcc25a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after liver transplantation with fluid overload and right apical pneumothorax. AP radiograph of the chest was reviewed in comparison to ___. There is interval increase in apical pneumothorax. Currently, it is small to moderate. Bilateral opacities and perihilar areas are concerning for pulmonary edema associated with bilateral at least moderate, if not large pleural effusions. " 89754dc7-589d0b7f-ade6c875-3c054768-8ea4d6cf.jpg,test/p15/p15964158/s53683652/89754dc7-589d0b7f-ade6c875-3c054768-8ea4d6cf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old male with shortness of breath and right-sided chest pain. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Lungs are hyperinflated. There is no consolidation, effusion or pneumothorax. Heart size is normal. No subdiaphragmatic free air. Fractures of the right eighth, ninth and tenth ribs are chronic. Old healed lateral left rib and lateral right clavicular fractures are also noted. IMPRESSION: Hyperinflated lungs, without evidence of pneumothorax. " 74de8efd-5ab7288f-3e9791c1-f2065d7f-29336915.jpg,test/p14/p14591676/s55426814/74de8efd-5ab7288f-3e9791c1-f2065d7f-29336915.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with repeated thoras for fluid here w/ sob // ? effusion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is a new large left pleural effusion with overlying atelectasis. No right pleural effusion is seen. No focal consolidation is seen on the right. There is no evidence of pneumothorax. Dual lead right-sided pacer device is similar in position. The cardiac silhouette size is difficult axially assessed due to the large left-sided opacity. Mediastinal contours are grossly unremarkable. IMPRESSION: Large left pleural effusion. " ede96981-bf7bd885-1709bb1c-ea0d8b8e-4bfc929f.jpg,test/p19/p19534417/s55612665/ede96981-bf7bd885-1709bb1c-ea0d8b8e-4bfc929f.jpg,test," WET READ: ___ ___ ___ 11:52 AM Slight prominence of the hila bilaterally may be due to central pulmonary vascular engorgement although underlying lymphadenopathy is not excluded. If this is of clinical concern, follow-up chest CT would provide further evaluation. Hyperinflated lungs without focal consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with blurry vision // eval infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are relatively hyperinflated, which can be seen with COPD. No focal consolidation is seen. . No pleural effusion or pneumothorax is seen. The cardiac silhouette is not enlarged. Slight prominence of the hila bilaterally may be due to central pulmonary vascular engorgement although underlying lymphadenopathy is not entirely excluded. Multi-level degenerative changes along the spine. IMPRESSION: Slight prominence of the hila bilaterally may be due to central pulmonary vascular engorgement although underlying lymphadenopathy is not excluded. If this is of clinical concern, follow-up chest CT would provide further evaluation. Hyperinflated lungs without focal consolidation. " 81ae7529-5486a647-e7f5fce9-1788922c-1a4f09ba.jpg,test/p12/p12773009/s55688374/81ae7529-5486a647-e7f5fce9-1788922c-1a4f09ba.jpg,test," FINAL REPORT HISTORY: Pleural effusion. Pre-thoracentesis. FINDINGS: In comparison with the study of ___, there is little change in the moderate bilateral pleural effusions. Somewhat ill-defined area of increased opacification in the left apical region again may reflect developing pneumonia. " 28c62c43-bdaf8d96-4d7896f3-426bbf6c-86b78006.jpg,test/p19/p19765588/s54527469/28c62c43-bdaf8d96-4d7896f3-426bbf6c-86b78006.jpg,test," FINAL REPORT INDICATION: ___M with altered mental; status // r/o bleed TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. Nodular opacities projecting over the lung bases are compatible with nipple shadows. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 964d210e-ae7cb1ca-17638732-f19cb031-4df2869b.jpg,test/p10/p10696644/s59683455/964d210e-ae7cb1ca-17638732-f19cb031-4df2869b.jpg,test," WET READ: ___ ___ ___ 10:17 PM Left IJ in upper SVC. OG coursing below the diaphragm overlying stomach. The tip is out of the field of view. Slight improvement in pulmonary edeam. Probable small bilateral effusions. ______________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST FROM ___ AT 19:48. CLINICAL INDICATION: ___-year-old with CHF, pulmonary hypertension, evaluate orogastric tube placement. Comparison is made to the patient's prior study of ___ at 15:51. A portable supine chest film dated ___ at 19:48 is submitted. IMPRESSION: 1. Orogastric tube is seen which courses below the diaphragm and the tip projects over the expected location of the stomach. Left internal jugular central line with its tip in the proximal SVC. There has been some interval improvement in bilateral airspace process associated with layering effusions. Given the interval change, this would favor resolving pulmonary edema, but superimposed pneumonia cannot be entirely excluded. Cardiac and mediastinal contours are likely stable. No pneumothorax is seen, although the sensitivity to detect pneumothorax is diminished given supine technique. " e60cc24b-1179a9e3-ec055412-7809a2e2-d89ca47b.jpg,test/p17/p17033203/s54631605/e60cc24b-1179a9e3-ec055412-7809a2e2-d89ca47b.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain, intermittent for one month. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 8ef16698-c45b0c82-e11ea9eb-87417634-1fe7f18b.jpg,test/p14/p14733367/s56903401/8ef16698-c45b0c82-e11ea9eb-87417634-1fe7f18b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough and chills. COMPARISON: Comparison is made with chest radiograph from ___. FINDINGS: PA and lateral images of the chest demonstrate well-expanded lungs. There is a minimal amount of atelectasis at the left mid zone. Otherwise, the lungs are clear. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Visualized osseous structures are unremarkable. IMPRESSION: Unremarkable chest radiographs. " 40eea8db-95760e0b-6a03cc9d-7e7a2638-feb578ce.jpg,test/p17/p17106498/s56682539/40eea8db-95760e0b-6a03cc9d-7e7a2638-feb578ce.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. Degenerative changes are seen at the acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " a133f742-28f1dc82-da864859-c30e5a59-468f6846.jpg,test/p15/p15805011/s58744635/a133f742-28f1dc82-da864859-c30e5a59-468f6846.jpg,test," FINAL REPORT INDICATION: ___-year-old man with syncope. COMPARISON: Chest radiograph ___. FINDINGS: Frontal AP and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding. Bibasilar atelectasis is seen. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is within normal limits allowing for low lung volumes and technique. Mediastinal silhouette is normal. There is no free air under the diaphragm. No acute osseous abnormality is identified. IMPRESSION: No acute intrathoracic process. " 6c9da5c7-61b0b075-805a21ad-43e1b97a-76d359c5.jpg,test/p17/p17086932/s56998771/6c9da5c7-61b0b075-805a21ad-43e1b97a-76d359c5.jpg,test," WET READ: ___ ___ ___ 6:23 PM No pneumothorax status post right chest tube removal. Interval development of right greater than left small pleural effusions. Similar appearing interstitial edema. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph one day earlier. FINDINGS: Following removal of right chest tube, a small-to-moderate right apical pneumothorax has developed. This has subsequently been followed on separately dictated chest radiograph performed after this time. Endotracheal tube has been removed. Swan-Ganz catheter has been slightly withdrawn, now terminating in right ventricular outflow tract. Cardiomediastinal contours are stable except for resolution of pneumomediastinum. Mild-to-moderate pulmonary edema has slightly worsened, and note is also made of increased right pleural effusion with adjacent worsening atelectasis in the right mid and lower lung regions. Left basilar atelectasis has also slightly worsened and is accompanied by a small left pleural effusion. " d1229843-51def18d-53ae234f-e0d45b73-4b7d0ffd.jpg,test/p17/p17894020/s57708637/d1229843-51def18d-53ae234f-e0d45b73-4b7d0ffd.jpg,test," FINAL REPORT HISTORY: CNS lymphoma treated with methotrexate and Rituximab now with a congested cough. Evaluate for pneumonia. COMPARISON: Chest radiograph ___ and ___. CT chest ___. FRONTAL LATERAL VIEWS CHEST: A right port is unchanged in position, terminating within the right atrium. There is no evidence of catheter malfunction. Lungs remain mildly hyperinflated. Streaky atelectasis in the right mid lung is unchanged. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. A small right lower lobe nodule is better evaluated on the prior chest CT. The cardiac and mediastinal contours are normal. The hilar structures are unremarkable. " 15929790-c5857e35-f8608c13-254fe65e-c17aa0c5.jpg,test/p10/p10251182/s52434441/15929790-c5857e35-f8608c13-254fe65e-c17aa0c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with spinal cord compreswsion, NGT in place // evaluate NGT placement TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. The NG tube tip is in the stomach " d111326a-be04f1e9-1adc73ad-72c90da4-9341c246.jpg,test/p17/p17452296/s59518661/d111326a-be04f1e9-1adc73ad-72c90da4-9341c246.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with new ICD placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. The left-sided pacemaker leads terminate in the expected location of the right atrium and right ventricle. Heart size and mediastinum are stable. Large hiatal hernia is redemonstrated. There is no evidence of pneumothorax. Lungs are essentially clear with no pleural effusion or pneumothorax seen. " 2a96802f-013af890-882bdafe-4716fdf5-1cba7179.jpg,test/p15/p15630567/s50025517/2a96802f-013af890-882bdafe-4716fdf5-1cba7179.jpg,test," FINAL REPORT HISTORY: Chest pain, pneumothorax. Evaluate chest tube placement. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: None. FINDINGS: Lung volumes are low. Left-sided chest tube is noted with tip projecting over the left upper lung field. Small amount of subcutaneous emphysema is demonstrated within the left lateral chest wall. No pneumothorax is clearly visible on this exam. Heart size is accentuated due to low lung volumes, but likely mildly enlarged. The mediastinal and hilar contours are unremarkable. Crowding of the bronchovascular structures is noted. Small left pleural effusion is demonstrated. Bibasilar airspace opacities, more pronounced in the retrocardiac region, may reflect atelectasis though infection is not excluded. There are no acute osseous abnormalities detected. IMPRESSION: 1. No definite pneumothorax seen on this single semi upright AP view. Left chest tube in place with a small amount of subcutaneous emphysema in the left lateral chest wall. 2. Low lung volumes with bibasilar airspace opacities, likely atelectasis, but infection is difficult to exclude. Small left pleural effusion. " 8710d941-c5aca6d1-fe39cbbf-61b8f94a-0079ed59.jpg,test/p13/p13052287/s51315618/8710d941-c5aca6d1-fe39cbbf-61b8f94a-0079ed59.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old female with left femoral fracture. IMPRESSION: PA and lateral chest compared to chest radiograph performed elsewhere earlier in the day: Lungs are hyperinflated, suggesting small airway obstruction or emphysema, but clear of any focal abnormality. There is no pneumonia, evidence of cardiac decompensation or pleural abnormality. " 0952c978-e97763ff-375a951e-9e704fce-074a2ad2.jpg,test/p17/p17288913/s56807730/0952c978-e97763ff-375a951e-9e704fce-074a2ad2.jpg,test," FINAL REPORT INDICATION: History of chest pain, tachycardia. Please evaluate for cardiopulmonary process. COMPARISON: Chest radiographs dated back to ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No acute intrathoracic abnormalities identified. " 35194759-5a29507c-df2ffb2d-9ae9e40b-ee7225bb.jpg,test/p11/p11884069/s55975961/35194759-5a29507c-df2ffb2d-9ae9e40b-ee7225bb.jpg,test," FINAL REPORT HISTORY: Cancer. Shortness of breath. COMPARISON: CT torso on ___ and chest radiograph of ___. FINDINGS: PA and lateral views of the chest. Again seen is a large right upper lobe mass with elevation the right hemidiaphragm. There are 3 large pulmonary nodules in the left lung, similar prior CT. New diffuse ground glass opacities are seen throughout both lungs, new from prior study. Heart size is unchanged. No pleural effusion. No pneumothorax. Small right pleural effusion. IMPRESSION: Known large right upper lung mass and 3 large left pulmonary nodules. New diffuse ground glass opacities in the right middle and lower lobes may represent post-obstructive pneumonia or metastatic progression. " 9d0a13fd-a90e6cf0-a79ae11e-3fbb4f13-134e5cda.jpg,test/p14/p14050547/s59484802/9d0a13fd-a90e6cf0-a79ae11e-3fbb4f13-134e5cda.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with resp distress, hypoxia, altered mental status // Post-ETT placement Post-ETT placement IMPRESSION: In comparison with the earlier study of this day, there has been placement of a endotracheal tube with its tip approximately 2.8 cm above the carina. Nasogastric tube ends extends to the stomach although the side port is within the distal esophagus. Bilateral pulmonary opacifications are again seen. " c0f613a8-4e3406f7-59b5097c-54dfde44-cd9b4f7e.jpg,test/p17/p17598360/s52116602/c0f613a8-4e3406f7-59b5097c-54dfde44-cd9b4f7e.jpg,test," FINAL REPORT HISTORY: ___-year-old man with pulmonary hypertension, ARDS, with new orogastric tube placement. Evaluate for position of orogastric tube. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates persistent diffuse bilateral parenchymal opacities consistent with pulmonary edema, which is stable as compared to the prior study. The cardiomediastinal and hilar contours are unchanged. The endotracheal tube ends 4.1 cm from the carina. A left-sided internal jugular central venous line ends at the persistent left SVC. An orogastric feeding tube courses into the stomach and out of the field of view. IMPRESSION: Orogastric tube courses into the stomach and out of the field of view. " 91579265-6841868b-99b7a98b-f30c4806-7874d956.jpg,test/p19/p19132344/s55716202/91579265-6841868b-99b7a98b-f30c4806-7874d956.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with CP // R/O PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 27c67352-e3e189db-11e153f1-8c517492-c1aea3ff.jpg,test/p12/p12698907/s53251780/27c67352-e3e189db-11e153f1-8c517492-c1aea3ff.jpg,test," FINAL REPORT INDICATION: Fever and crackles in the right lower lobe. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 52c97088-93329e5c-c7dfa7c4-d13f458a-27cf9660.jpg,test/p12/p12476587/s54410070/52c97088-93329e5c-c7dfa7c4-d13f458a-27cf9660.jpg,test," FINAL REPORT CHEST, ___ HISTORY: Status post right thoracentesis, question pneumothorax. FINDINGS: There has been interval decrease in size of the right pleural effusion. However, there is residual right pleural effusion and also small left pleural effusion. There continues to be pulmonary vascular redistribution and patchy areas of alveolar infiltrate. These have increased compared to the prior exam. There continues to be bilateral lower lobe volume loss. There is a possible small right apical pneumothorax. " 5a145c2d-49da4d3f-e5af0ac1-4c8dd6e8-86c82e6d.jpg,test/p18/p18971123/s57080641/5a145c2d-49da4d3f-e5af0ac1-4c8dd6e8-86c82e6d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with anorexia with dobhoff in place and sore throat // confirm dobhoff placement confirm dobhoff placement COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Dobhoff feeding tube passes to the distal stomach. The portion of the tube the neck, in in the upper esophagus and hypopharynx, is not imaged on the chest radiograph. Right PIC line ends in the low SVC. Lungs clear. Heart size normal. No pleural abnormality. " 17e5ef5e-ce5c4197-4203a668-ed099ae9-252111a2.jpg,test/p10/p10610928/s57672501/17e5ef5e-ce5c4197-4203a668-ed099ae9-252111a2.jpg,test," FINAL REPORT AP CHEST, 11:06 P.M. ON ___ HISTORY: ___-year-old man with worsening shortness of breath and volume overload. IMPRESSION: AP chest compared to ___ through ___. There was substantial increase in size of the cardiac silhouette developed between ___ and ___ and has not subsequently improved. Mild pulmonary edema has changed in distribution, now more dependent, accompanied by increasing right basal consolidation, presumably atelectasis, accompanying the increasing small-to-moderate right pleural effusion. Left lower lobe has been grown airless over the preceding 24 hours and remains atelectatic. No pneumothorax. Right jugular line ends in the mid SVC. " 266b4457-a5bd90db-ccf1f781-69b6308f-3618f875.jpg,test/p18/p18714676/s55287221/266b4457-a5bd90db-ccf1f781-69b6308f-3618f875.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with recent right upper lobe collapse, followup. PA and lateral upright chest radiographs were reviewed in comparison to ___. Current study demonstrates on both AP and aaaaLAT views complete resolution of previous right upper lobe collapse. Lungs are grossly clear. There is no pleural effusion or pneumothorax. " d5a1f8f8-07a9a61c-c74013cf-1981ff38-cee5bb2e.jpg,test/p15/p15885921/s56879331/d5a1f8f8-07a9a61c-c74013cf-1981ff38-cee5bb2e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Increased dyspnea on exertion, evaluation for post-ORIF a pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a substantial increase and improvement in lung ventilation. There is no evidence of pneumothorax. The perifocal opacities around the fiducial seed in the right lung have substantially decreased in extent. No other parenchymal abnormalities. Port-A-Cath in situ. " cad6d7e2-c8356fc6-3e78f286-626f2c92-23913410.jpg,test/p13/p13562477/s58627539/cad6d7e2-c8356fc6-3e78f286-626f2c92-23913410.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Seizure disorder, hypotensive, and bradycardic. Comparison is made with prior study, ___. Mild cardiomegaly is stable. Tortuous aorta is unchanged. There are low lung volumes. Left lower lobe retrocardiac opacity has worsened, consistent with increasing atelectasis and small left pleural effusion. There is mild increase in mild vascular congestion. If any, there is a small right pleural effusion. ET tube is in standard position. NG tube tip is at the fundus of the stomach. The tube is coiled in the stomach. Left peripherally inserted catheter tip is in the left axillary vein. " d4cd1d15-6ff11d62-1ac10750-e3349b4c-f12ef7ee.jpg,test/p15/p15794450/s59517385/d4cd1d15-6ff11d62-1ac10750-e3349b4c-f12ef7ee.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with IPH, intubated. Comparison is made with prior study ___. There are persistent lower lung volumes. Bibasilar atelectasis larger on the right side are grossly unchanged. There are no new lung abnormalities, pneumothorax or pleural effusion . NG tube tip is out of view below the diaphragm. Cardiac size is top normal. " be25da2f-28f6631d-e7ccf270-e5a7e561-8bbacb26.jpg,test/p19/p19034608/s55082309/be25da2f-28f6631d-e7ccf270-e5a7e561-8bbacb26.jpg,test," FINAL REPORT INDICATION: ___F with chest pain and SOB. Evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: Lungs are hyperinflated but clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are within normal limits. There is no pleural effusion or pneumothorax. Degenerative changes are seen at the bilateral acromioclavicular joints. IMPRESSION: Hyperinflated lungs without acute cardiopulmonary process. " 284f2e00-48b40153-a953d322-7eef72d5-92310361.jpg,test/p10/p10820726/s57463659/284f2e00-48b40153-a953d322-7eef72d5-92310361.jpg,test," FINAL REPORT HISTORY: Dizziness and acute kidney injury. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low. Heart size is normal. Mediastinal and hilar contours are unchanged and within normal limits. The pulmonary vasculature is normal. Minimal fluid is demonstrated within the minor fissure. There are minimal atelectatic changes in the lung bases. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. Multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. Low lung volumes. " 8644b59c-34355410-695e2d6f-e0669a29-58203e6c.jpg,test/p19/p19442084/s57119002/8644b59c-34355410-695e2d6f-e0669a29-58203e6c.jpg,test," WET READ: ___ ___ ___ 8:57 PM Hyperexpanded lungs suggest COPD. Tortuous aorta obscures evaluation of right hilum without clear evidence of adenopathy. Cardiomegaly. ___ x 15 mm nodule in the right lung- given chart description of a chest CT from a nearby hospital- acquisition of this would be helpful in determining timing of appropriate follow up or role of further workup. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: history of hilar lymphadenopathy and lung nodule. Evaluation. COMPARISON: No comparison available at the time of dictation. FINDINGS: There is mild overexpansion of the lungs, potentially consistent with a clinical picture of COPD. Borderline size of the cardiac silhouette without pulmonary edema. Tortuosity of the thoracic aorta. At the bases of the right lung, a well defined ___ x 23 mm dense lung nodule is seen. The nodule could partly be calcified. CT would be the next imaging choice in determining the nature of this nodule. Other lung nodules are not visualized. There are no pleural effusions. No atelectasis or pneumonia. " cf008fd4-b6aa3ab8-e246f2c5-0f6b3261-551f4701.jpg,test/p14/p14162476/s58293865/cf008fd4-b6aa3ab8-e246f2c5-0f6b3261-551f4701.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with pain in L chest since ___ + recent cold s/s COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 6285c6c3-a105ad08-e956fd70-b71ef9f7-b455c018.jpg,test/p17/p17585359/s57155630/6285c6c3-a105ad08-e956fd70-b71ef9f7-b455c018.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, hemoptysis. Rule out lung bleeding. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is minimally decreased lung volume on the left. No acute parenchymal changes. No evidence of bleeding or other acute lung parenchymal pathology. Unchanged normal size of the cardiac silhouette with minimal tortuosity of the thoracic aorta. No pneumothorax. " 8a71cb04-82644c15-2e28153d-bcfd2083-7a610e2f.jpg,test/p11/p11897028/s53492109/8a71cb04-82644c15-2e28153d-bcfd2083-7a610e2f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with crackles right base // eval for pulm edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The cardiac silhouette is top-normal. Mediastinal contours are unremarkable. No large pleural effusion is seen. There is no pneumothorax. Peripheral reticular opacities bilaterally and at the lung bases bilaterally suggest chronic lung disease. No priors available for comparison, but no definite consolidation aside from what is felt to be chronic, to suggest acute pneumonia. IMPRESSION: Likely chronic lung disease, given lack of priors for comparison. " 5383e66f-1d05b649-c6473065-a0fef91e-f2c5a5e2.jpg,test/p19/p19193156/s53602380/5383e66f-1d05b649-c6473065-a0fef91e-f2c5a5e2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with mitral valve endocarditis with concern for multifocal PNA // Please evaluate for consolidations or pulmonary edema TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there has been slight interval clearing of portions of the infiltrate however there continue to be dense bilateral lower lobe infiltrates in bilateral pleural effusions. " 662e47ff-24f161cb-ed87dcb8-1affbbb1-f6a16789.jpg,test/p12/p12479159/s52908082/662e47ff-24f161cb-ed87dcb8-1affbbb1-f6a16789.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old male with prior stroke, presents with right leg weakness and aphasia. Question pneumonia. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Linear opacities at the lung bases are most suggestive of atelectasis as they are not seen on the lateral view. Lungs are otherwise clear and there is no effusion. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unchanged. IMPRESSION: No acute cardiopulmonary process. " 27474c5b-360f05d6-bbe7ce4e-aac0ff44-6600c2c0.jpg,test/p12/p12001936/s52382317/27474c5b-360f05d6-bbe7ce4e-aac0ff44-6600c2c0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with small bowel obstruction // NGT tube placement COMPARISON: Chest radiographs ___ and ___:38. IMPRESSION: Consolidation in the left mid and lower lung has increased substantially over the past 10 hr consistent with an aggressive pneumonia. There may be a small volume of new left pleural effusion. Right lung and right pleural space are unremarkable. Borderline cardiomegaly is stable. Right IJ line ends close to the superior cavoatrial junction. Nasogastric tube ends in the mid to distal stomach. " 86e2a306-b15d5efd-860df514-7324dcc9-b3459acd.jpg,test/p15/p15877362/s51858737/86e2a306-b15d5efd-860df514-7324dcc9-b3459acd.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Acute pulmonary embolism and pneumonia, chest pain. AP radiograph of the chest was reviewed in comparison to ___. The right internal jugular line has been discontinued. Heart size and mediastinum are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax demonstrated on the current examination. The previously seen right middle lobe consolidation appears to be improved since the prior study. It might reflect interval improvement of pulmonary infarct. Alternatively, it could be less prominent due to different rotation of the patient. " 9b579a89-aad4fba6-c5306dde-05f8640b-232176c6.jpg,test/p16/p16537897/s57449451/9b579a89-aad4fba6-c5306dde-05f8640b-232176c6.jpg,test," FINAL REPORT INDICATION: History: ___F with cough // acute process? TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute process. " 52b0f72e-c238182d-9eed064f-4eac813b-c02b0233.jpg,test/p13/p13140362/s51769049/52b0f72e-c238182d-9eed064f-4eac813b-c02b0233.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: In OR. Missing item count. TECHNIQUE: Single portable supine intraoperative frontal chest radiograph and single portable supine intraoperative left hemithorax and abdomen radiograph. COMPARISON: Chest radiograph ___. FINDINGS: Endotracheal tube is seen 1.2 cm above the level of the carina. A right porta cath tip is in the right atrium. 2 left-sided drains project over the left hemithorax. No unexplained radiopaque foreign body, specifically subtle linear density seen along the left upper abdomen is consistent with a bowel loop rather than radiopaque foreign body. The lungs are hypoinflated with crowding of vasculature. No pleural effusion or pneumothorax. Heart size is top normal, likely accentuated due to patient positioning. Mediastinal contour and hila are unremarkable. Mild left basilar opacity, likely atelectasis. IMPRESSION: No radiopaque foreign body. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 7:04 PM, 55 minutes after discovery of the findings. " 693a687d-cb975d86-137c07d0-498db21b-bad56f79.jpg,test/p18/p18866430/s53856634/693a687d-cb975d86-137c07d0-498db21b-bad56f79.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with prior study from ___. CLINICAL HISTORY: Lethargy and fever, question infection. FINDINGS: AP and lateral views of the chest were provided. The lungs are clear, though lung volumes are low. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. The heart is mildly enlarged. The aorta is normal in contour. The bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild cardiac enlargement without signs of edema or pneumonia. " 0f8a14fe-69919b64-5b5d7133-670c399a-e8677cf9.jpg,test/p15/p15751809/s54958197/0f8a14fe-69919b64-5b5d7133-670c399a-e8677cf9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chest tube d/c'd ___ ___/ Evaluate for PTX TECHNIQUE: AP and lateral views of the chest were obtained. COMPARISON: ___ FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable and unchanged since most recent examination. The lungs are clear aside from bibasilar atelectasis. Again noted is a small left apical pneumothorax. Minimal subcutaneous emphysema is noted. The stomach is distended. IMPRESSION: Persistent, small left apical pneumothorax. " 63bbd2c0-916d5912-351ec2cf-3938751b-f748a4dc.jpg,test/p19/p19108098/s53709475/63bbd2c0-916d5912-351ec2cf-3938751b-f748a4dc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sacroidosis s/p RUL TBBX // r/o Right PTX COMPARISON: No comparison IMPRESSION: Status post right-sided bronchoscopy for suspected sarcoid. No pneumothorax or other complications. " e185cbd6-ba8c6a76-ab7b0f59-9d484566-08034c66.jpg,test/p14/p14394983/s55892038/e185cbd6-ba8c6a76-ab7b0f59-9d484566-08034c66.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old man with diffuse abdominal pain and hematemesis. Evaluate for air under the diaphragm. TECHNIQUE: Single portable erect AP view of the chest. COMPARISON: Chest radiographs of ___, ___, ___, and ___. FINDINGS: Compared with the prior radiograph, no significant interval change. There may be mild right basilar atelectasis. No focal consolidation, pleural effusion, or pneumothorax detected. The cardiomediastinal silhouette is unremarkable. No evidence of free subdiaphragmatic air on this limited single view. IMPRESSION: No evidence of free subdiaphragmatic air on limited single chest radiograph. No other acute cardiopulmonary process. " fdb3623a-7cfeb04c-40114995-2642321d-d77d4760.jpg,test/p18/p18350751/s52993255/fdb3623a-7cfeb04c-40114995-2642321d-d77d4760.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain, cough and left lower lung rales. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded with a very subtle opacity projecting over the lower thoracic spine. The border of the left posterior diaphragm is also somewhat indistinct. These findings together are suggestive of an early left lower lobe pneumonia. Otherwise, the lungs are clear with no pleural effusion, masses, lesions, or pneumothorax. The aorta is tortuous and calcified. Wedge compression of a lower thoracic vertebra of unknown chronicity is noted. IMPRESSION: Subtle opacity suspicious for early left lower lobe pneumonia. " 88c021de-e9beb8c6-eadf13c6-f5f3c31d-20f7e3e3.jpg,test/p18/p18845699/s58824658/88c021de-e9beb8c6-eadf13c6-f5f3c31d-20f7e3e3.jpg,test," FINAL REPORT INDICATION: ___ year old man with hypoxia, intubated respiratory distress // eval for interval change TECHNIQUE: Single view at ___ 5:40 AM COMPARISON: ___ FINDINGS: Lungs: The lungs are well inflated and free of consolidation. Pleura: There is no pleural effusion. Mediastinum: No mediastinal mass is seen on this AP examination. Heart: The heart is not enlarged. Osseous structures: The osseous structures are normal for age. Additional findings: Endotracheal tube and nasogastric tube noted. Monitor leads are again seen. IMPRESSION: Lungs clear. No change " e4ba6dcc-01c7df94-a9e3212f-f7331a6f-4392a25c.jpg,test/p19/p19313943/s53270105/e4ba6dcc-01c7df94-a9e3212f-f7331a6f-4392a25c.jpg,test," FINAL REPORT HISTORY: Evaluation for acute pathology. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Outside chest radiograph from ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are normal without effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 53178443-0a637df8-d526af70-d44b3af2-eef50f30.jpg,test/p11/p11674660/s51039513/53178443-0a637df8-d526af70-d44b3af2-eef50f30.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cp COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 7b23ff2b-edfb66d4-05dd9139-92011aae-03690022.jpg,test/p14/p14798598/s57971777/7b23ff2b-edfb66d4-05dd9139-92011aae-03690022.jpg,test," FINAL REPORT INDICATION: ___M with sob // effusion? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Moderate right-sided pleural effusion is seen, larger when compared to prior and likely partially loculated laterally. Associated atelectasis is noted at the right lung base. The left lung is clear, there is no effusion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: Right-sided pleural effusion has increased in size and is likely partially loculated laterally. " 8ce2d5e1-2ba04782-1f04539d-6c846df0-8a4fd820.jpg,test/p19/p19963140/s57661538/8ce2d5e1-2ba04782-1f04539d-6c846df0-8a4fd820.jpg,test," FINAL REPORT STUDY: PA and lateral chest, ___. HISTORY: ___-year-old man status post left thoracotomy. FINDINGS: Comparison is made to previous study from ___. There is a left-sided chest tube with tip at the apex. There is a small left apical pneumothorax. There is consolidation throughout the left lung and there is apparent air/fluid level at the left base. This is only seen on the AP view and may be technical. Attention to this area is recommended on subsequent exams. There is a prominent amount of air seen throughout the colon underneath the left hemidiaphragm. " 74d95d14-93e4c08e-5b7a66d6-852cec9c-1751fcc8.jpg,test/p11/p11760589/s59288094/74d95d14-93e4c08e-5b7a66d6-852cec9c-1751fcc8.jpg,test," WET READ: ___ ___ ___ 6:56 PM Small bilateral pleural effusions are new from ___. The heart is slighlty larger and pulmonary vasculature less distinct than prior. Findings suggest mild CHF. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old man with worsening dyspnea on exertion, rule out pneumonia versus pulmonary edema. COMPARISONS: Pre-op PA and lateral chest radiograph from ___. FINDINGS: Since most recent prior radiograph, there has been development of small bilateral pleural effusions. Increased haziness at the left base is likely atelectasis. There is no other focal consolidation or pneumothorax. Additionally, there has been increase in size of the cardiac silhouette which may be due to a pericardial effusion. The aorta remains tortuous. Osseous structures are normal for degenerative changes of the spine. IMPRESSION: 1. Small new bilateral pleural effusions. 2. Enlarged cardiac silhouette. Recommend further evaluation with echocardiogram to evaluate for pericardial effusion " 4a99f8bf-895cb09d-69bf1096-7c642f65-196e0ac5.jpg,test/p13/p13046589/s53148496/4a99f8bf-895cb09d-69bf1096-7c642f65-196e0ac5.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with fever and increased sputum production, question pneumonia. COMPARISON: ___ CT. TECHNIQUE: PA and lateral views of the chest. FINDINGS: In comparison to prior radiograph and CT, there is no relevant change. The lungs are clear but hyperinflated. Cardiomediastinal silhouette and hilar contours are unremarkable. Multiple wedge-shaped compression deformities of the thoracic spine are unchanged. IMPRESSION: Hyperinflation without evidence of pneumonia. " aa27a88b-a9cc160f-48701c9f-5e5fc236-e9894a0b.jpg,test/p11/p11124675/s58581997/aa27a88b-a9cc160f-48701c9f-5e5fc236-e9894a0b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, OSA, increasing sob // eval for signs of PNA, edema TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Cardiomegaly is substantial, unchanged. Mild interstitial prominence is present. Extensive lymphadenopathy and mediastinal lipomatosis contribute to abnormal: Tore of the mediastinum on the left. Overall no substantial change since the prior study noted. " 2fb31f71-84426deb-738916d9-0601ad45-c3074b45.jpg,test/p16/p16388630/s58116183/2fb31f71-84426deb-738916d9-0601ad45-c3074b45.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxia, hypercarbia on trach mask // ?acute change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Tracheostomy is in place. NG tube tip is in the stomach. Parenchymal opacities, large bilateral pleural effusions and bibasal consolidations are similar to previous examination with no substantial change demonstrated " 933997d1-eac8a362-c25d53ea-3c25fd99-74caaeac.jpg,test/p15/p15180359/s51423189/933997d1-eac8a362-c25d53ea-3c25fd99-74caaeac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with DLBCL with CNS disease // r/o effusion, supratherapeutic MTX level TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are stable with cardiac size normal and tortuous aorta. The lungs are hyperinflated and clear. There is no pneumothorax or pleural effusion. There are moderate degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities. COPD " b1ab2eb3-03fda6c0-e7ec9fc3-92e98654-3a041617.jpg,test/p18/p18371833/s50177637/b1ab2eb3-03fda6c0-e7ec9fc3-92e98654-3a041617.jpg,test," FINAL REPORT INDICATION: Left Port-A-Cath placement TECHNIQUE: Portable AP chest radiograph. COMPARISON: None. FINDINGS: The projection is somewhat lordotic. There is an equivocal density along the left apex which may represent a pneumothorax. The left Port-A-Cath terminates in the upper SVC. There is no focal consolidation or pleural effusion. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. Left apical linear density is equivocal for a small pneumothorax. Suggest repeating with a less lordotic view. 2. Left Port-A-Cath terminates in the upper SVC. " 3b640e57-a7bd92dd-4437a43c-beae62c7-cc1fc950.jpg,test/p19/p19457417/s55289084/3b640e57-a7bd92dd-4437a43c-beae62c7-cc1fc950.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Three weeks of nausea and vomiting, question acute abnormalities in the chest. FINDINGS: PA and lateral views of the chest provided. The lungs are clear without signs of pneumonia or CHF. No pleural effusion or pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact. A mild dextroscoliosis of the spine at the TL junction noted. No free air below the right hemidiaphragm. IMPRESSION: No pneumonia or other acute intrathoracic process. " 0a4566da-ade6b9b4-c341abed-21b38fa3-bc007e21.jpg,test/p11/p11770965/s57850861/0a4566da-ade6b9b4-c341abed-21b38fa3-bc007e21.jpg,test," FINAL REPORT INDICATION: Known left apical pneumothorax in the setting of aortic valve replacement, mitral valve replacement, and CABG. COMPARISON: Multiple priors from ___. FINDINGS: Portable AP chest radiograph. Small left apical pneumothorax is stable. Again noted are median sternotomy wires, surgical ___, left-sided chest tube, double-lumen right IJ catheter, and left subclavian central venous catheter. Diffuse parenchymal opacities that likely reflect pulmonary edema are unchanged from ___. The cardiomediastinal silhouette is slightly enlarged, but this may be due to lower lung volumes. " 0ac6600b-5f14054e-f96c1d6d-300894ce-5bb63fb1.jpg,test/p16/p16952127/s58296861/0ac6600b-5f14054e-f96c1d6d-300894ce-5bb63fb1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with bradycardia, shortness of breath, weakness TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Mild to moderate cardiomegaly is unchanged. The aorta remains tortuous and diffusely calcified. Mild pulmonary edema appears slightly worse in the interval with perihilar haziness and vascular indistinctness. Patchy bibasilar opacities may reflect areas of atelectasis. There are likely trace bilateral pleural effusions. Elevation of the left hemidiaphragm is unchanged. No pneumothorax is present. Multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: Mild pulmonary edema, slightly worse in the interval with probable trace bilateral pleural effusions and bibasilar atelectasis. " d7bc3924-81fc4f4f-23ecd4cc-f28d24d4-bbdbb8af.jpg,test/p17/p17370807/s59311619/d7bc3924-81fc4f4f-23ecd4cc-f28d24d4-bbdbb8af.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of lung CA s/p R lobectomy please assess change from prior // Please assess change from prior Please assess change from prior IMPRESSION: Compared to prior chest radiographs ___ through one ___. Severe consolidation and volume loss in the right lung has worsened since ___. An indeterminate volume of right pleural effusion, at least moderate, has not decreased. Subcutaneous emphysema in the right chest wall and perhaps in the right pleural space has decreased. The right bronchial tree is occluded close to the carina. Heart is normal size. Left lung is clear. " 84b1456c-6f4af0ae-fdaeeabb-b18af93c-ef18bd6f.jpg,test/p12/p12553538/s58054446/84b1456c-6f4af0ae-fdaeeabb-b18af93c-ef18bd6f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with neutropenic fever, dyspnea // infiltrate COMPARISON: Chest radiographs ___ through ___ IMPRESSION: Mild to moderate pulmonary edema and small right pleural effusion have worsened. Large hiatus hernia, transmits at least the stomach, which now occupies greater portion of the left lower chest, displacing the lung. Heart size is indeterminate but probably quite large. No pneumothorax. " 96f1d744-6c147667-4e2c7a14-da832fdb-7f522147.jpg,test/p13/p13674844/s56008545/96f1d744-6c147667-4e2c7a14-da832fdb-7f522147.jpg,test," FINAL REPORT HISTORY: Renal transplant with cough, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " b5a106fc-d638e544-63a785e5-719783a2-2dbbfb26.jpg,test/p16/p16556728/s50184181/b5a106fc-d638e544-63a785e5-719783a2-2dbbfb26.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with with worsening dyspnea unclear cause // eval for abnormality eval for abnormality IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Substantial degenerative changes are again seen in the thoracic spine. " 3ae6e531-b3459334-b8bc7532-cba4bded-f90d4605.jpg,test/p12/p12317856/s56332284/3ae6e531-b3459334-b8bc7532-cba4bded-f90d4605.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with cough for years that seems to start in lungs and keeps her awake at night. // ? parenchymal infiltrate. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4c0968c2-4b28d9b9-b94f0532-f7be3588-dad69fb8.jpg,test/p16/p16481153/s57298772/4c0968c2-4b28d9b9-b94f0532-f7be3588-dad69fb8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p left lung sequestration // eval for change eval for change IMPRESSION: Heart size is normal. Mediastinum is normal. Postsurgical changes in the left upper lung are stable. No pleural effusion or pneumothorax is seen. No consolidation demonstrated. " daef5c8d-33432701-c4fa2009-47c65424-a8f9fb61.jpg,test/p18/p18605505/s53149530/daef5c8d-33432701-c4fa2009-47c65424-a8f9fb61.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cardiac arrest. COMPARISON: None available. FINDINGS: Single AP supine radiograph demonstrates an enlarged heart. Obscuration of the left hemidiaphragm is suggestive of a pleural effusion. Bilateral perihilar patchy opacities may reflect mild pulmonary edema. There is no pneumothorax. Patient is status post tracheostomy. A right PICC is identified, its tip terminating within the mid SVC. No acute osseous abnormalities detected. IMPRESSION: Cardiomegalyperihilar opacities suggestive of mild pulmonary edema. Left pleural effusion. " 83a59816-1255144d-73c9e9d5-4ec14af1-cc6b0b55.jpg,test/p19/p19901104/s53047478/83a59816-1255144d-73c9e9d5-4ec14af1-cc6b0b55.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o dilated cardiomyopathy with EF <___%, temperature yesterday of 102.___ F assoc with chronic dry cough, hypotension, palpitations // evidence of PNA vs CHF COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is unchanged moderate cardiomegaly without evidence of pulmonary edema. No pneumonia, no pleural effusions. Normal hilar and mediastinal contours. " 00a0d5f4-65436642-bcef1eb6-fa3c6daf-d93ecfb0.jpg,test/p17/p17608002/s52989376/00a0d5f4-65436642-bcef1eb6-fa3c6daf-d93ecfb0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulmonary hypertension // ? edema ?infection TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes are unchanged compared to the prior study. The cardiomediastinal contour is also unchanged with moderate cardiomegaly. The right hilum appears enlarged, likely reflecting pulmonary arterial hypertension. The central pulmonary vasculature is also prominent. No frank pulmonary edema however. No new airspace opacity seen. No definite pleural effusion or pneumothorax. IMPRESSION: No significant interval change when compared to the prior study. " e54eff37-583b5873-b1948fd0-dde81f21-4f2d795a.jpg,test/p12/p12172254/s53819272/e54eff37-583b5873-b1948fd0-dde81f21-4f2d795a.jpg,test," FINAL REPORT HISTORY: Hypoxia and tachycardia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. The aorta is mildly unfolded with atherosclerotic calcification seen diffusely throughout the aorta. The hilar contours are normal. Linear opacities in both lung bases are compatible with subsegmental atelectasis. No focal consolidation, pneumothorax, or pleural effusion is present. There are multilevel moderate degenerative changes in the imaged thoracic spine. IMPRESSION: Bibasilar subsegmental atelectasis. No radiographic evidence for pneumonia. " faf12e9d-31cdc4ca-5d731ab7-e601962d-9bfdda86.jpg,test/p18/p18574976/s58937241/faf12e9d-31cdc4ca-5d731ab7-e601962d-9bfdda86.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ No prior radiographs for comparison. FINDINGS: Tip of nasogastric tube terminates within the stomach. Cardiomediastinal contours are normal, and imaged portions of the lungs are clear. Extreme lung apices have been excluded from the study limiting evaluation of the apical lung parenchyma and evaluation for apical pneumothorax. " b10bc72b-d9197b3a-7ad4b9db-4bcf00a0-6cf601d9.jpg,test/p14/p14497007/s53345085/b10bc72b-d9197b3a-7ad4b9db-4bcf00a0-6cf601d9.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with productive cough // ? pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There has been no significant interval change. The lungs remain hyperinflated and there is minimal basilar atelectasis/scarring. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Bilateral spine hardware is again seen. Right Port-A-Cath terminates in the low SVC. IMPRESSION: No acute cardiopulmonary process. " e01421e0-bd45baac-1d4083a0-b7156355-6311275b.jpg,test/p18/p18985055/s55738598/e01421e0-bd45baac-1d4083a0-b7156355-6311275b.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with PE, renal transplant and increasing hypoxia. Comparison is made with prior study performed 10 hours earlier. Mild cardiomegaly and tortuous aorta are unchanged. There are lower lung volumes with adjacent associated opacities left greater than right likely are due to atelectasis. These opacities have increased in the right. There is no pneumothorax or large effusion. Cardiac size is top normal. " 7994e3db-7d0c33d9-a18bd0b2-8d2a7598-73bddcfa.jpg,test/p11/p11552741/s54312147/7994e3db-7d0c33d9-a18bd0b2-8d2a7598-73bddcfa.jpg,test," WET READ: ___ ___ ___ 4:06 PM 1. Moderate size bilateral pleural effusions with bibasilar atelectasis. Infection or aspiration cannot be completely excluded in the correct clinical setting. 2. Peripheral wedge-shaped opacity in the left upper lung field is concerning for an area of infarction. Further assessment with chest CTA is recommended. *** ED URGENT ATTENTION *** WET READ VERSION #1 ___ ___ ___ 1:34 PM 1. Small to moderate size bilateral pleural effusions with bibasilar atelectasis. Infection or aspiration cannot be completely excluded in the correct clinical setting. 2. Peripheral wedge-shaped opacity in the left upper lung field is concerning for an area of infarction. Further assessment with chest CTA is recommended. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with hypoxia, fatigue TECHNIQUE: Portable upright AP view of the chest COMPARISON: None. FINDINGS: Cardiac silhouette size is at least moderately enlarged. The aorta is tortuous, and potentially dilated. There may be mild pulmonary vascular congestion. Lung volumes are low. Bibasilar airspace opacities with moderate size bilateral pleural effusions are demonstrated, likely reflective of compressive atelectasis though infection or aspiration is not excluded. A peripheral wedge-shaped opacity in the left upper lung field may reflect an area of infarction. No large pneumothorax is detected though assessment is limited as the patient's neck and chin project over the left apex. No acute osseous abnormality is visualized. Degenerative changes are seen involving both shoulders and within the imaged thoracic spine. IMPRESSION: 1. Moderate size bilateral pleural effusions with bibasilar atelectasis. Infection or aspiration cannot be completely excluded in the correct clinical setting. 2. Peripheral wedge-shaped opacity in the left upper lung field is concerning for an area of infarction. Further assessment with chest CTA is recommended. RECOMMENDATION(S): Chest CTA is recommended for further assessment for pulmonary embolism. " 71664f46-7099492d-540dd6f2-1d3488ec-fc54df3e.jpg,test/p18/p18499893/s57495049/71664f46-7099492d-540dd6f2-1d3488ec-fc54df3e.jpg,test," FINAL REPORT INDICATION: ___M w/cough TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 5aea1d32-16d2e6d7-b8a06ec0-919b8aa0-118f8721.jpg,test/p13/p13031024/s57440674/5aea1d32-16d2e6d7-b8a06ec0-919b8aa0-118f8721.jpg,test," FINAL REPORT INDICATION: History: ___F with dyspnea and chest pain // eval for pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs dated back to ___, and CT from ___. FINDINGS: Mild cardiomegaly has been stable compared to exams dated back to at least ___. The hilar and mediastinal contours are normal. No focal consolidation turning for pneumonia are identified. Diffuse bilateral interstitial abnormality has been stable compared to exams dating back to at least ___. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: 1. No acute intrathoracic abnormalities identified. Stable, mild cardiomegaly. 2. Chronic interstitial lung disease. " 4ddc43a6-fb4698fc-1ab4d9e0-9b4d33fb-0cc9655f.jpg,test/p19/p19209496/s58024788/4ddc43a6-fb4698fc-1ab4d9e0-9b4d33fb-0cc9655f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever and sob. // Please evaluate etiology of fever and sob. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are hyperinflated, patient has known emphysema. Ill-defined peribronchial opacities in the lower lobes and in the left mid lung likely represent multifocal pneumonia. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: Emphysema Findings are consistent with multifocal pneumonia given the clinical history " bcb24f5f-9fc4655a-df300dd9-cfab6150-e1344575.jpg,test/p19/p19695893/s52972361/bcb24f5f-9fc4655a-df300dd9-cfab6150-e1344575.jpg,test," FINAL REPORT INDICATION: ___F with asthma history, p/w wheezing and SOB after being exposed to indoor chemical cleaning agents. // Volume, infiltrate, effusion. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Surgical clips in the right upper quadrant suggest prior cholecystectomy. IMPRESSION: No acute cardiopulmonary process. " fb8e8ff3-947d7934-fdf76628-32884745-924c59d6.jpg,test/p15/p15379558/s54740574/fb8e8ff3-947d7934-fdf76628-32884745-924c59d6.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___. CLINICAL HISTORY: Cough, malaise, mild shortness of breath with exertion, assess for acute intrathoracic process. FINDINGS: PA and lateral views of the chest were provided. Lung volumes are low, though the lungs appear clear without focal consolidation, effusion or pneumothorax. No pulmonary edema. The cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. " 509192b0-e22a8b48-462c1c21-74be9358-e6cb81ec.jpg,test/p17/p17651711/s58359707/509192b0-e22a8b48-462c1c21-74be9358-e6cb81ec.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, hypotension // pna? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. There may be mild, central pulmonary vascular congestion. The cardiac silhouette is stably enlarged. Again noted are aortic arch calcifications. There appears to be an opacity in the retrocardiac region. Evaluation of the lateral film is limited due to patient positioning and poor inspiratory effort. Possible small right pleural effusion is present. There is no pneumothorax. IMPRESSION: Retrocardiac opacity which could be consistent with pneumonia in the appropriate clinical context. " 6ca85c48-129f907e-30e3d7b0-c42bd724-69e981b4.jpg,test/p18/p18137182/s53835399/6ca85c48-129f907e-30e3d7b0-c42bd724-69e981b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with Pt with SOB and cough, history of connective tissue disease and interstitial lung disease. COMPARISON: ___, ___, ___, CT of the chest from ___. FINDINGS: PA and lateral views of the chest provided. When compared with the most recent prior chest radiograph, the pattern of pulmonary opacity appears grossly unchanged which suggests chronic lung disease. No acute interval change. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Lung volumes are low. Bony structures are intact. IMPRESSION: Similar pattern of pulmonary opacity likely related to chronic lung disease. " 7e7c9d5d-11d3d885-648a5d70-4cf51e18-2e24e8b6.jpg,test/p15/p15080504/s54855352/7e7c9d5d-11d3d885-648a5d70-4cf51e18-2e24e8b6.jpg,test," FINAL REPORT HISTORY: Pneumonia followup. FINDINGS: In comparison with study of ___, there has been substantial clearing of the consolidation in the right mid zone as well as at the right base. Most of the residual opacification probably represents fibrotic scarring in the patient with hyperexpansion of the lungs with flattening of the hemidiaphragms. " e4d21023-99329dfd-dddf9aff-26713e25-0dbe66ac.jpg,test/p16/p16600923/s58073886/e4d21023-99329dfd-dddf9aff-26713e25-0dbe66ac.jpg,test," FINAL REPORT INDICATION: ___M with chest pain, hx aortic arch repair for bicuspid // r/o infiltrate, pna TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: Heart is top normal size and cardiomediastinal silhouette is stable. Sternotomy wires are again noted. Lungs are symmetrically expanded and clear. There is no pulmonary edema or pneumothorax. Minimal blunting of the posterior costophrenic angles on lateral projection may reflect small effusions versus chronic pleural thickening. IMPRESSION: No evidence of pneumonia. " a9cbd90d-0f556052-8552f26e-aec3bf57-7eb79532.jpg,test/p16/p16253574/s51733857/a9cbd90d-0f556052-8552f26e-aec3bf57-7eb79532.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Possible pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Known left-sided rib fractures. No evidence of pneumothorax. Unchanged atelectasis at the left lung base. No new parenchymal opacities. No pleural effusions. Unchanged size of the cardiac silhouette. " 071e54b6-5b29baad-668c277b-7d2f7f64-6697ca8f.jpg,test/p16/p16178321/s56852530/071e54b6-5b29baad-668c277b-7d2f7f64-6697ca8f.jpg,test," FINAL REPORT INDICATION: ___ -year-old man with recent stroke and slurred speech. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. The heart size is normal. There are aortic knob calcifications. IMPRESSION: No pneumonia. " 4f1d7085-9322417a-2be9bd46-b87fb559-b6fe22fb.jpg,test/p19/p19915260/s51966409/4f1d7085-9322417a-2be9bd46-b87fb559-b6fe22fb.jpg,test," FINAL REPORT HISTORY: Epigastric and chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Left upper lobe tiny calcified granuloma is unchanged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There is no free air under the diaphragms. Leftward deviation of the trachea is unchanged. A left sided rib deformity is old. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary abnormality. " 0a2c6c7b-299cbefe-7d55d215-4ad0fec1-cddcefa2.jpg,test/p14/p14246614/s56924364/0a2c6c7b-299cbefe-7d55d215-4ad0fec1-cddcefa2.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after intubation. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is high, approximately 7 cm above the carina and should be advanced. NG tube tip is in the stomach. Right internal jugular line tip is at the cavoatrial junction. Cardiomegaly and bilateral pleural effusions and left retrocardiac atelectasis are unchanged. Since the prior study, there is no substantial change in interstitial pulmonary edema. " 4d1d7401-af45c79e-5125d6c3-dee62d16-2ee9d976.jpg,test/p17/p17445535/s57558889/4d1d7401-af45c79e-5125d6c3-dee62d16-2ee9d976.jpg,test," WET READ: ___ ___ ___ 10:19 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M with syncope, allergic reaction. Evaluate for mediastinal widening, free air or consolidation. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lung volumes are low.The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There is no free air under the diaphragm. IMPRESSION: No acute cardiopulmonary process. " b4db21f3-8e9bb9b1-a5ffa499-3454e0ed-3a5e4e4a.jpg,test/p18/p18708817/s54337629/b4db21f3-8e9bb9b1-a5ffa499-3454e0ed-3a5e4e4a.jpg,test," FINAL REPORT HISTORY: Altered mental status, evaluate for hilar adenopathy. CHEST, TWO VIEWS. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is severe cardiomegaly, with evidence for marked left atrial enlargement and right as well as left heart enlargement. The hila are prominent, partially obscured by the cardiomediastinal contour. There is upper zone re-distribution. There are increased interstitial markings at both lung bases, in the setting of upper zone re-distribution. Small effusions are present. IMPRESSION: 1. COPD. 2. Marked cardiomegaly. 3. Likely hilar adenopathy, not optimally visualized due to the cardiomegaly and therefore not fully characterized. 4. UZRD and increased interstitial markings in both mid and lower zones, with small pleural effusions. Compared with ___ at ___ p.m., the interstitial markings are less pronounced, suggesting some interval improvement in CHF findings. " 8ebf49e0-2c8e6063-a867155b-1c903b61-e43ff599.jpg,test/p13/p13042664/s54549431/8ebf49e0-2c8e6063-a867155b-1c903b61-e43ff599.jpg,test," FINAL REPORT HISTORY: Prior RCC with mild hemoptysis. FINDINGS: In comparison with the study of ___, the left hemidiaphragm is not sharply seen on the frontal projection. There are bibasilar atelectatic changes. Dual-pacer device remains in place. " 8f6e06fb-62d56641-2884a6bc-0d5a542b-352acca3.jpg,test/p11/p11724294/s50504564/8f6e06fb-62d56641-2884a6bc-0d5a542b-352acca3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cardiac surgery- CT d/c'd, NG d/c'd, dob hoff placed // evaluate for pneumothorax and new dob hoff tube evaluate for pneumothorax and new dob hoff tube COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Patient is still intubated, ET tube in standard placement. Right jugular introducer ends at the thoracic inlet. Feeding tube with the wire stylet in place is crural than the nondistended stomach. Mild left basal atelectasis and small left pleural effusion persist following removal of the left basal pleural tube. No appreciable pneumothorax. Right lung clear. " 532bef6c-a1f9631a-44a7267c-1602b61a-831bf612.jpg,test/p18/p18019452/s52392135/532bef6c-a1f9631a-44a7267c-1602b61a-831bf612.jpg,test," FINAL REPORT HISTORY: Right-sided pneumothorax and bibasilar pneumonia. Evaluation for interval change. COMPARISON: Multiple priors from ___. FINDINGS: AP chest radiograph again demonstrates moderate right pneumothorax, slightly larger from 3:19 a.m.. Increasing subcutaneous emphysema is seen tracking up the right hemithorax into the supraclavicular fossa. Supraclavicular approach right subclavian line is in stable position as is the ET tube and NG tube. Bibasilar opacification is worse now on the left. There is no large pleural effusion. IMPRESSION: 1. Slightly enlarged right pneumothorax. Increasing subcutaneous emphysema in right hemithorax. 2. Bibasilar opacificaiton, most consistent with pneumonia has worsened on the left. Impression item #1 was discussed by Dr. ___ with Dr. ___ at 11:08 a.m. on ___. " 605e8557-f6af7c69-a0cca032-c235ef60-499f5a35.jpg,test/p14/p14717200/s57435217/605e8557-f6af7c69-a0cca032-c235ef60-499f5a35.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: ""Passed out,"" assess for acute abnormality. FINDINGS: PA and lateral views of the chest were provided. Lungs are clear without focal consolidation, effusion, or pneumothorax. The heart and mediastinal contour is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 8b3b2891-57fe1a29-5630d620-943973b9-93bfc9e7.jpg,test/p15/p15244289/s59355982/8b3b2891-57fe1a29-5630d620-943973b9-93bfc9e7.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with edema, pneumonia; to rule out PNA COMPARISON: ___ to ___. FINDINGS: Right moderate pleural effusion has slightly increased since previous exam with compressive atelectasis. In the aerated portion of the lung, there is no evidence of pneumonia. The lung volumes are low. Mediastinal and cardiac contours are unremarkable. There is no pneumothorax. CONCLUSION: 1. Right moderate pleural effusion has increased since previous exam with compressive atelectasis. 2. The aerated portion of the lungs shows no evidence of pneumonia. " f45e33c9-ad090981-d2eec447-7be616c8-732af300.jpg,test/p15/p15534855/s52736105/f45e33c9-ad090981-d2eec447-7be616c8-732af300.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Patchy right basilar opacity appears similar compared to the previous examination. Left lung is clear. No new focal consolidation is demonstrated. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. S- shaped thoracolumbar scoliosis is re- demonstrated. IMPRESSION: No interval change in patchy right basilar opacity which remains concerning for pneumonia. No new focal consolidation. " f2cd226a-aeb47fa3-c77ead02-e16a073e-ae341933.jpg,test/p13/p13060184/s57793746/f2cd226a-aeb47fa3-c77ead02-e16a073e-ae341933.jpg,test," FINAL REPORT INDICATION: Evaluate for edema, effusion, or pneumonia in a patient with dyspnea on exertion. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a heart which is top normal in size, slightly increased compared to ___. The lungs are well aerated, without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 2a364a71-26114d4d-94b2ee05-d0679ce1-be432a59.jpg,test/p15/p15664962/s58970586/2a364a71-26114d4d-94b2ee05-d0679ce1-be432a59.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and low o2 sat, hx breast cancer // eval for mass eval for mass IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Cardiac silhouette remains at the upper limits of normal in size. No vascular congestion, pleural effusion, or acute focal pneumonia. The limited resolution of plain radiography, there is no evidence of pulmonary or skeletal metastases. " 79f5d4a9-b8b1b524-abb8e959-5f2cfc4b-f8718d4b.jpg,test/p16/p16905057/s55747223/79f5d4a9-b8b1b524-abb8e959-5f2cfc4b-f8718d4b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cp // R/O INFE CTIOUS PROCESS COMPARISON: None FINDINGS: There is no focal consolidation, effusion, or pneumothorax. There is scarring or atelectasis in the right perihilar region. Heart size is normal. Imaged osseous structures are intact. Sternotomy wires and surgical clips are seen in the anterior mediastinum. Degenerative changes are seen in the spine. IMPRESSION: No acute intrathoracic process. " 4f40e613-d49e625e-3b71adf0-ada76f62-d3671bd0.jpg,test/p17/p17479533/s58247400/4f40e613-d49e625e-3b71adf0-ada76f62-d3671bd0.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the study of ___, there is little change in the appearance of the heart and lungs except for some mild atelectatic changes at the left base. There has been placement of a nasogastric tube with its tip in the fundus of the stomach and the side hole probably at or just distal to the gastroesophageal junction. Again there is evidence of previous cervical fusion. " 5db5bec9-0b90d213-19825f6e-65b86b3f-3c71bec2.jpg,test/p16/p16413192/s50689898/5db5bec9-0b90d213-19825f6e-65b86b3f-3c71bec2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with myeloma and new URI // ? infiltrate ? infiltrate IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . " 8799313f-0d1992f4-4895c5a4-5a9764fd-483e159d.jpg,test/p15/p15248985/s50395887/8799313f-0d1992f4-4895c5a4-5a9764fd-483e159d.jpg,test," WET READ: ___ ___ ___ 7:08 PM Nodular opacities particularly in the left upper lung and at the left base are concerning for infectious process. CT can be obtained for further evaluation. No pleural effusions or pneumothorax. The findings were discussed by Dr. ___ with Dr. ___ on ___ at 7:06 PM, 10 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with AML presenting with fever, cough // Please evaluate for infectious process TECHNIQUE: CHEST (PA AND LAT) COMPARISON: None IMPRESSION: Heart size is normal. Mediastinum is normal. Assessment of the lung parenchyma demonstrate multiple nodular opacities predominantly in the left upper and left lower lobe and potential in the right lower lobe. The findings might be consistent with infection but alternatively other etiologies such as neoplasm are a possibility and assessment with chest CT is required. There is no pleural effusion and there is no pneumothorax. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on ___ at 7:06 PM, 10 minutes after discovery of the findings. " f319082c-21685ae4-afe8719c-bdddcd30-ebc0e885.jpg,test/p17/p17102468/s54070542/f319082c-21685ae4-afe8719c-bdddcd30-ebc0e885.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPHS COMPARISON: ___ chest radiograph. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs and pleural surfaces are clear. There are no pleural effusions or concerning skeletal findings. IMPRESSION: No radiographic evidence of intrathoracic lymph node enlargement. " 282ae59d-b5fcc6c1-98186af0-70740b89-da750c24.jpg,test/p14/p14219343/s51720462/282ae59d-b5fcc6c1-98186af0-70740b89-da750c24.jpg,test," FINAL REPORT HISTORY: CHF exacerbation. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___ at 20:01 p.m. Compared to the earlier film, the position of the battery pack for the pacemaker has changed, now lying slightly closer to the midline and in a more horizontal orientation. Background COPD is unchanged. Cardiac contour appears to be larger and there is suggestion of new small effusions, with underlying collapse and/or consolidation. Opacity of the right base is probably essentially unchanged. There is upper zone redistribution and mild vascular plethora, similar to the prior film. Degree of opacity at the left base appears to have increased in the interim. IMPRESSION: 1. Apparent interval increase in the degree of cardiomegaly. 2. Suspect background COPD. Enlarged pulmonary arteries are consistent with pulmonary hypertension. 3. New bilateral effusions with worsening underlying collapse and/or consolidation. Previously seen right base opacity is not as well seen, but is probably unchanged. 4. Mild vascular plethora is grossly unchanged. 5. Change in position of the pacemaker, please see comment above. " e75f09b8-e1325dd0-872d2cdd-d86d825f-72ccb24e.jpg,test/p14/p14092601/s57074263/e75f09b8-e1325dd0-872d2cdd-d86d825f-72ccb24e.jpg,test," FINAL REPORT HISTORY: Cough and chest pain. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " c5c20f45-d4a59046-a66774f9-61bd1832-596f0991.jpg,test/p13/p13471890/s56354656/c5c20f45-d4a59046-a66774f9-61bd1832-596f0991.jpg,test," FINAL REPORT INDICATION: ___F with q pancreatitis // assess for pleural effusion TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Excreted contrast is noted within the renal pelves, likely from recent CT scan. IMPRESSION: No acute cardiopulmonary process. " fa7127ce-82840885-23c76618-8d3870cf-29b3cbd4.jpg,test/p18/p18975148/s51358266/fa7127ce-82840885-23c76618-8d3870cf-29b3cbd4.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with hyperglycemia, no obvious signs of infection. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Somewhat linear opacity in the right upper lobe is most suggestive of scarring and is unchanged from prior. Biapical scarring is also noted. There is no superimposed new region of consolidation nor effusion. Cardiomediastinal silhouette is unchanged. Right hilum is tented superiorly likely from scarring detailed above. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 88cebaed-36923a1f-2bed0e7d-a1b155d3-90708a23.jpg,test/p18/p18788733/s55009283/88cebaed-36923a1f-2bed0e7d-a1b155d3-90708a23.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with hypertension and persistent cough. IMPRESSION: PA and lateral chest reviewed in the absence of prior chest radiographs: Lungs are low in volume but clear of any definite pulmonary abnormality. There is no good evidence for pneumonia or any for pulmonary edema. The heart is normal in size and there is no pleural effusion or evidence of central lymph node enlargement. Subcostal fat thickens the lateral costal pleural margins in a symmetric fashion. " 9c7984d4-6590b453-7f7dd450-a3192c26-6cd0c63e.jpg,test/p17/p17782175/s57520267/9c7984d4-6590b453-7f7dd450-a3192c26-6cd0c63e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea, history of asthma, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia. No pulmonary edema. No pleural effusions. Normal size of the cardiac silhouette. Normal hilar or mediastinal structures. IMPRESSION: No acute intrathoracic process. " fab19152-44bfe20e-fa26c5d5-a71235d7-2fa525c2.jpg,test/p11/p11585485/s53576192/fab19152-44bfe20e-fa26c5d5-a71235d7-2fa525c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with medical thoracoscopy // pleurodesis s/p TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Mild cardiomegaly is is a stable. Right pleural effusion has markedly decreased now small. There is a right basal chest tube. Right pneumothorax is moderate. Right middle lobe atelectasis has worsened. Left central catheter tip is in the lower SVC IMPRESSION: Moderate right pneumothorax. Marked decrease in right pleural effusion. Increased in right middle lobe atelectasis " 8484f7a6-e4512d1a-51774d76-3cf91cc2-eae04c7d.jpg,test/p13/p13267974/s58055822/8484f7a6-e4512d1a-51774d76-3cf91cc2-eae04c7d.jpg,test," FINAL REPORT HISTORY: Fever and shortness of breath with exotic travel. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " a026c3d0-d23fab29-2209f3c1-7a9eacb4-686cf154.jpg,test/p10/p10157508/s57274973/a026c3d0-d23fab29-2209f3c1-7a9eacb4-686cf154.jpg,test," FINAL REPORT HISTORY: Melanoma, to assess for disease status. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. There is some hyperexpansion of the lungs consistent with chronic changes. However, no evidence of skeletal or pulmonary metastases. " 395d9bcf-338e6123-53c1b1cb-c2fbb699-c39a0059.jpg,test/p12/p12385889/s50156655/395d9bcf-338e6123-53c1b1cb-c2fbb699-c39a0059.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of ALL, s/p allo on immunosuppression now with recurrent cough. Please r/o PNA and compare to prior study. // ___ year old woman with hx of ALL, s/p allo on immunosuppression now with recurrent cough. Please r/o PNA and compare to prior study. ___ year old woman with hx of ALL, s/p allo on immunosuppress IMPRESSION: In comparison with the study of ___, there has been substantial clearing of the bilateral parenchymal opacities consistent with pneumonia. Small residual is seen at the left base. " d78141ea-b8b1bff8-faf14eb4-29037709-03a04f6f.jpg,test/p13/p13686671/s51997935/d78141ea-b8b1bff8-faf14eb4-29037709-03a04f6f.jpg,test," FINAL REPORT Single semierect portable radiograph of chest was compared with prior radiograph from ___. FINDINGS: The endotracheal tubes terminate approximately 4 cm above the carina, left subclavian line ends at mid SVC and orogastric tube ending into stomach are all appropriate. Both lung volumes are low. Mild to moderate right pleural effusion and mild bi-basal atelectasis is new since ___. Pleural effusion if any is mild on the left side. " aecb4d60-0bcca2a8-f2e5870d-90449d2b-a8c49642.jpg,test/p11/p11149673/s58248458/aecb4d60-0bcca2a8-f2e5870d-90449d2b-a8c49642.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with left lower lobe resolving pneumonia. IMPRESSION: PA and lateral chest compared to ___: Small bilateral pleural effusions are new or substantially increased on both sides of the chest, hard to explain if the patient had unilateral pneumonia. Heart is slightly larger, but the pulmonary vasculature is normal and there is no pulmonary edema. Perhaps the patient received volume resuscitation or has issues with hypervolemia. There is no evidence of pneumonia or cardiac decompensation currently, but the lateral film shows there is a very small pericardial effusion. " 678c7026-7dfd26af-98b96d5e-ff3ca840-69a85c2a.jpg,test/p10/p10299070/s54308436/678c7026-7dfd26af-98b96d5e-ff3ca840-69a85c2a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with lung cancer, ESRD, status epilepticus // Evaluate for infection, edema COMPARISON: Chest radiographs since ___ most recently ___ IMPRESSION: Slightly larger. Right lung is clear. Heart, strongly shifted into the left hemi thorax, is probably mildly enlarged. No pneumothorax Tip of the endotracheal tube, at the upper margin of the clavicles, is 5 cm from the carina with the chain elevated. It should not be advanced more than 1 cm. Right internal jugular line ends at the origin of the SVC. NG tube ends in the mid portion of the nondistended stomach. " dcd87c81-87284eee-80b788fa-6923d187-bb446a29.jpg,test/p11/p11068569/s57717477/dcd87c81-87284eee-80b788fa-6923d187-bb446a29.jpg,test," WET READ: ___ ___ ___ 9:52 PM ETT appears in standard position, although precise location of carina is difficult to assess. Tubular opacity projecting over left lung apex may be a new LIJ line, if so, it remains in the left internal jugular vein. Cardiomediastinal and hilar contours stable. Mild pulmonary edema. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the ET tube placement. AP radiograph was reviewed in comparison to ___ obtained at 09:36 a.m. The ET tube tip is approximately 3.5 cm above the carina. Cardiomediastinal silhouette is unchanged. There is mild progression of the left lung opacities that might reflect asymmetric pulmonary edema, attention on the subsequent studies is required. The left central venous line tip terminates at the level of cavoatrial junction. " 28be9c59-41a4152f-5e772933-71a51f24-9d77349c.jpg,test/p13/p13709414/s54473496/28be9c59-41a4152f-5e772933-71a51f24-9d77349c.jpg,test," FINAL REPORT INDICATION: History: ___M with substernal CP // eval for consolidation TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs the most recent on ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion, pulmonary edema or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " f10f8e16-2253d8bd-18ed59d2-8a393f19-d199c5ad.jpg,test/p13/p13421348/s58251542/f10f8e16-2253d8bd-18ed59d2-8a393f19-d199c5ad.jpg,test," FINAL REPORT INDICATION: ___-year-old male from ___, with a positive PPD who presents for evaluation. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. The lungs are well expanded and clear. There is no evidence of a pneumothorax or pleural effusion. The visualized osseous structures are unremarkable. IMPRESSION: Normal chest x-ray. Specifically, no pulmonary evidence of TB. " 09af746e-cb8b79c8-ce1f9031-d149b832-397cf884.jpg,test/p16/p16088589/s56963710/09af746e-cb8b79c8-ce1f9031-d149b832-397cf884.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with cirrhosis c/b hepatic hydrothorax with recent CT tube removal. // evaluate for pleural effusion TECHNIQUE: Portable chest COMPARISON: Portable chest radiographs dated ___ FINDINGS: In comparison to the chest radiograph obtained 1 day prior, no significant changes are appreciated. No pneumothorax. No new focal parenchymal opacities. Heart size is normal. No pulmonary vascular congestion or pulmonary edema. Small right pleural effusion is probably unchanged. Old right rib fractures are again identified. Inferior most median sternotomy wire has a small, unchanged fracture with leftward displacement of the sternotomy wire immediately superior. IMPRESSION: Small right pleural effusion is unchanged. " e0463354-ed3a466a-646bc48e-af2d0fbf-be1054bc.jpg,test/p13/p13501962/s57368981/e0463354-ed3a466a-646bc48e-af2d0fbf-be1054bc.jpg,test," FINAL REPORT HISTORY: Check NG tube. COMPARISON: FINDINGS: By tubing overlies the patient but the NG tube is not visualized within the patient the lungs have an unchanged appearance compared to prior. There is no focal infiltrate. The right hemidiaphragm is elevated. " e43c9598-8898d229-cbdadf4b-f98a5ecf-6539a371.jpg,test/p10/p10312413/s57432491/e43c9598-8898d229-cbdadf4b-f98a5ecf-6539a371.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with fever // evaluate for pna evaluate for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 967414c8-2bcdbf6e-573ea0f7-93c342c8-3ae7965b.jpg,test/p13/p13772123/s59350125/967414c8-2bcdbf6e-573ea0f7-93c342c8-3ae7965b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough and nasal drip, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Status post sternotomy. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Moderate tortuosity of the thoracic aorta. No pneumonia, no pulmonary edema. No pleural effusions. " 744f6963-13bdcccd-a6303978-f715dc3d-0bbe2ed9.jpg,test/p11/p11708854/s50618156/744f6963-13bdcccd-a6303978-f715dc3d-0bbe2ed9.jpg,test," FINAL REPORT INDICATION: ___ year old woman with 4 days of SOB with activity, cough, wheezing. // ?infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: There is a focal dense consolidation obscuring the right diaphragmatic surface, posterior thoracic spine, and right cardiac border which is consistent with a right lower lobe and right middle lobe pneumonia. Left lung is grossly clear. There are no pleural effusions. Cardiomediastinal border is and hilar structures are normal. IMPRESSION: Right lower lobe and probable right middle lobe pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:04 PM, 5 minutes after discovery of the findings. " 3e3cb968-c8c9eea0-617b8fc2-59d46a35-4f30a5c5.jpg,test/p13/p13549706/s55490248/3e3cb968-c8c9eea0-617b8fc2-59d46a35-4f30a5c5.jpg,test," FINAL REPORT INDICATION: ___M with hyperglycemia // eval heart and lungs TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear noting relatively low lung volumes. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 265d5fb0-717193ea-8212d0dc-e6d16668-f3be2291.jpg,test/p14/p14147907/s56541932/265d5fb0-717193ea-8212d0dc-e6d16668-f3be2291.jpg,test," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with the study of earlier in this date, there is the appearance of even further enlargement of the cardiac silhouette with relatively mild vascular congestion. There is some increased opacification at the right base. Although this could merely reflect atelectatic change, the possibility of supervening pneumonia must be considered in the appropriate clinical setting. This information was conveyed to Dr. ___. " 809123a3-3a8ec764-0d6f069f-d1b0935b-161bfff4.jpg,test/p17/p17398573/s50918803/809123a3-3a8ec764-0d6f069f-d1b0935b-161bfff4.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with a positive PPD. IMPRESSION: PA and lateral chest compared to ___ and ___: Moderate cardiomegaly has improved. Combination of mediastinal fat and possible middle lobe atelectasis should not be mistaken for pneumonia. Lungs are otherwise clear. There may be a very small new right pleural effusion. Thoracic aorta is generally large and tortuous but not focally aneurysmal. No evidence of tuberculosis. " 65393e6c-5512de5b-c54044c7-da980747-c07ce9a1.jpg,test/p19/p19931382/s57983063/65393e6c-5512de5b-c54044c7-da980747-c07ce9a1.jpg,test," FINAL REPORT HISTORY: ___-year-old man with history of alcoholism now with cough, question pneumonia. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. No pleural effusion or pneumothorax. Atherosclerotic calcifications line the aorta. IMPRESSION: No acute intrathoracic process. " 0bc01f02-c9b68769-bd5cc7de-023f4a28-5e2d7e17.jpg,test/p16/p16196296/s51940901/0bc01f02-c9b68769-bd5cc7de-023f4a28-5e2d7e17.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with PMHx of diastolic CHF/pulmonary hypertension/COPD, with >___ day Hx of productive cough // please assess cardiopulmonary architecture please assess cardiopulmonary architecture IMPRESSION: Comparison to ___. No relevant change. Borderline size of the heart. Mild fluid overload but no overt pulmonary edema. No pneumonia, no pleural effusions. No pneumothorax. " c99dcf9d-2b09f808-e78e2f38-f0c4f621-7ea421cf.jpg,test/p18/p18153746/s57513245/c99dcf9d-2b09f808-e78e2f38-f0c4f621-7ea421cf.jpg,test," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old male with brain tumor, on chemotherapy and has thrombocytopenia, now with cough and chest congestion. FINDINGS: Comparison is made to prior study from ___. Cardiac silhouette and mediastinum is normal. Lungs are clear. There is no focal consolidation, pleural effusions, or signs for overt pulmonary edema. Bony structures are intact. IMPRESSION: No acute cardiopulmonary process. " bd630825-49a543ba-9ca99a43-2974773f-1cd30d88.jpg,test/p13/p13696039/s59951543/bd630825-49a543ba-9ca99a43-2974773f-1cd30d88.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with LLL opacity 6 weeks ago with PNA // eval for resolution of LLL opacity eval for resolution of LLL opacity COMPARISON: Chest radiographs ___ and ___ IMPRESSION: Left lower lobe consolidation has resolved cleared since the to studies in ___, consistent with resolving pneumonia. Lungs are otherwise clear. Mediastinal contours particularly in the aortopulmonic window are concerning for adenopathy. Reactive lymph node enlargement should have resolved of the past 6 weeks. Unless the patient has a known cause of benign adenopathy, like sarcoidosis, any prior imaging needs to be obtained to see if this is indeed a new finding warranting further investigation with chest CT. Heart is normal size. There is no pleural abnormality. RECOMMENDATION(S): Unless the patient has a known cause of benign adenopathy, like sarcoidosis, any prior imaging needs to be obtained to see if this is indeed a new finding warranting further investigation with chest CT. NOTIFICATION: Pertinent critical findings were posted by Dr. ___ on ___ at 13:07 to the Department of Radiology online critical communications system for direct communication to the referring provider. " 030386c3-957d8539-4a89742b-f0a86131-fb686dd4.jpg,test/p12/p12835005/s54329433/030386c3-957d8539-4a89742b-f0a86131-fb686dd4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Followup of pneumothorax. FINDINGS: As compared to the previous radiograph, the ___ of the right pneumothorax are constant. In the interval, the right chest tube has been removed. No evidence of tension. Unchanged left lung. Unchanged cardiac silhouette. " 5a12f32b-cbfd95e7-753a3baf-5e070f21-3269f8d5.jpg,test/p14/p14472994/s50741143/5a12f32b-cbfd95e7-753a3baf-5e070f21-3269f8d5.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with syncope // ?cardiomegally TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4bc280e5-d335aa81-80bd369f-6113da8d-84a56560.jpg,test/p13/p13762124/s54886008/4bc280e5-d335aa81-80bd369f-6113da8d-84a56560.jpg,test," FINAL REPORT HISTORY: CAD with CHF exacerbation. FINDINGS: In comparison with the earlier study of this date, the aberrant NG tube has been removed. Little change in the appearance of the heart and lungs with bibasilar opacifications consistent with pleural effusion and atelectasis at the bases. " b6f873c6-c1ece8dc-d98aa8ba-de92d39d-afdd4345.jpg,test/p11/p11190372/s55398323/b6f873c6-c1ece8dc-d98aa8ba-de92d39d-afdd4345.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: Chest radiograph from ___ and CT chest from ___. FINDINGS: Biapical pleural thickening is again noted. Multiple bilateral small pulmonary nodules noted on chest CT are not clearly delineated on this study. Otherwise, the lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. No acute fractures are identified. Mild degenerative changes are noted throughout the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " f7a39040-a3fa3aaa-b646c305-7b03f957-35e05c9e.jpg,test/p14/p14206167/s57078236/f7a39040-a3fa3aaa-b646c305-7b03f957-35e05c9e.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of asbestos exposure and known pleural plaques, here to assess for interval changes. COMPARISON: Chest radiographs, last performed on ___. FINDINGS: Frontal and lateral radiographs of the chest show appropriate inspiratory lung volumes. Multiple ill-defined opacities corresponding to known pleural plaques are not appreciably changed from ___ with predominance in the right hemithorax and diaphragm consistent with asbestos pleural disease. The lungs are clear without pleural effusions, pneumothorax, or focal consolidation. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. Mediastinal and hilar contours are within normal limits and unchanged from the preceding radiograph. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: Stable asbestos pleural disease. No acute cardiopulmonary process. " 75b20e82-11dbc9bd-60292cd8-6a15216b-d39b36c3.jpg,test/p16/p16498795/s59916176/75b20e82-11dbc9bd-60292cd8-6a15216b-d39b36c3.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Chest pain. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are slightly hyperinflated, but essentially clear. No pleural effusion or pneumothorax is seen. Pectus excavatum is demonstrated. Pacemaker leads terminate in the expected location of right atrium and right ventricle. " 71f73247-785e923d-66734b34-a5d9c1b6-bb426718.jpg,test/p18/p18302268/s52964067/71f73247-785e923d-66734b34-a5d9c1b6-bb426718.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and fever // r/o pna r/o pna IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. The cardiac silhouette is within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " b96ab4f2-5e4851d6-9e06fbb0-35785b63-043ab97f.jpg,test/p15/p15227454/s54467234/b96ab4f2-5e4851d6-9e06fbb0-35785b63-043ab97f.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old man with cough and wheeze s/p lung bx. Infection, pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: PET-CT from ___. FINDINGS: The heart size is normal with a tortuous aorta. There is no focal consolidation concerning for pneumonia or pneumothorax. The previously described right paraspinal lower lobe lesion on PET-CT from ___ cannot be seen on the current x-ray. No large pleural effusions are identified. Multiple mediastinal and left upper lung surgical clips correlate with findings on the PET-CT. IMPRESSION: 1. No evidence of pneumothorax or focal consolidation concerning for pneumonia. 2. Previously described right paraspinal lower lobe lesion on PET-CT cannot be seen on the current radiograph. " fec6477d-139531e1-4ba0fa75-182c4eed-1dccd86d.jpg,test/p12/p12537194/s57203771/fec6477d-139531e1-4ba0fa75-182c4eed-1dccd86d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with widespread Mets and R pleural effusion. Evaluate effusion. TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph from ___, ___, ___. Chest CT from ___ FINDINGS: The pleural drainage catheter at the right lung base is unchanged in position. The partially visualized heart appears mildly enlarged, unchanged compared to most recent prior studies. The partially visualized mediastinal silhouette also appears unchanged. The right hemithorax is near completely opacified, unchanged compared to prior radiograph from ___ and increased compared to prior radiograph from ___, consistent with known pleural effusion. Lucency in the right lung apex without evidence of lung markings consistent with known pneumothorax. There is mild leftward mediastinal shift. There is no pulmonary edema or focal consolidation in the left lung. IMPRESSION: Large right hydropneumothorax, unchanged compared to prior radiograph from ___. " ff06e107-67536b19-4fde98e2-d6098ac8-3d4c7b72.jpg,test/p13/p13983645/s54563949/ff06e107-67536b19-4fde98e2-d6098ac8-3d4c7b72.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:29 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: Altered mental status. Evaluate for pneumonia. COMPARISONS: Chest x-ray on ___. FINDINGS: AP supine radiograph of the chest demonstrates a normal cardiomediastinal silhouette. There is no definite consolidation, pleural effusion, or pneumothorax. A TIPS is noted in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " f4d624ff-cd0fcf7e-3d055b85-9c6a5983-a69e8d3d.jpg,test/p17/p17907922/s50335374/f4d624ff-cd0fcf7e-3d055b85-9c6a5983-a69e8d3d.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with lung nodule s/p biopsy // ? PTx TECHNIQUE: Portable chest COMPARISON: Same day intraoperative fluoroscopic images FINDINGS: Small left apicolateral pneumothorax is new. Bibasilar atelectasis. The known pulmonary nodule in the superior segment left lower lobe is seen to better detail on recent CT. Lungs are otherwise clear. Heart size is normal. Cardiomediastinal hilar silhouettes are unremarkable. IMPRESSION: Small left apicolateral pneumothorax. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 2:15 PM, approximately 5 minutes after discovery of the findings. " 1efb0e8b-0b3c5d31-04d505fe-fc355aac-a1ad5806.jpg,test/p11/p11218867/s51830539/1efb0e8b-0b3c5d31-04d505fe-fc355aac-a1ad5806.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with Hodgkin disease. IMPRESSION: PA and lateral chest compared to ___: Widened contour of the left upper mediastinum, seen on the frontal view, is minimally narrowed than it was on ___. Previous left pleural effusion and pneumothorax have both resolved. Lungs are well expanded and clear. Heart size is normal. Right central venous infusion port ends at the level of the superior cavoatrial junction. " 560891f1-ef3ffc23-1aaa27b0-312c4f71-c23e42f9.jpg,test/p13/p13164386/s59811588/560891f1-ef3ffc23-1aaa27b0-312c4f71-c23e42f9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman presenting with substernal chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is top normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild degenerative changes are noted in the imaged thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " f29081fc-1b1901bd-463df14c-40d1b874-1b2d2a60.jpg,test/p19/p19662220/s52978847/f29081fc-1b1901bd-463df14c-40d1b874-1b2d2a60.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with syncope TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Clips in the right upper quadrant of the abdomen indicate prior cholecystectomy. IMPRESSION: No acute cardiopulmonary abnormality. " d654423b-31bb6611-ca25a40e-81dd994a-647e00ed.jpg,test/p13/p13391297/s51606726/d654423b-31bb6611-ca25a40e-81dd994a-647e00ed.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH, ___ COMPARISON: Chest radiograph of ___ and ___ as well as chest CTA of ___. FINDINGS: Heart size is normal. Aorta is tortuous without change. Bibasilar linear atelectasis has improved since ___ radiograph. However, on the lateral view, there is an increased opacity overlying the lower thoracic spine, which represents a change from a baseline lateral radiograph of ___. This is not definitively localized on the frontal radiograph, but is probably in the right retrocardiac area. There are no pleural effusions. Mild elevation of right hemidiaphragm is unchanged. IMPRESSION: Possible early right lower lobe pneumonia. Followup chest radiographs are suggested to document resolution. " 6fc09ff9-0324e76b-103c166c-10569689-0c9a79c3.jpg,test/p12/p12044893/s50937604/6fc09ff9-0324e76b-103c166c-10569689-0c9a79c3.jpg,test," FINAL REPORT HISTORY: Left thoracic pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is top normal. Mediastinal and hilar contours are unremarkable. Apart from minimal atelectasis in the right lung base, the lungs are clear. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute displaced fractures are demonstrated. IMPRESSION: Minimal right basilar atelectasis. No displaced fractures are seen. If there is continued concern for rib fracture, then a dedicated rib series is recommended. " 0c7a60db-70136336-a68e2ebd-3096ef0e-fc222f76.jpg,test/p10/p10145553/s55199151/0c7a60db-70136336-a68e2ebd-3096ef0e-fc222f76.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of asthma, with 2 months non-productive cough, no change on baseline peak-flow COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are mildly overinflated. Lungs are clear. Pulmonary vasculature is normal. Mediastinal and hilar contours are normal. Bilateral apical pleural thickening is unchanged. There is no pleural effusion. IMPRESSION: No acute intrathoracic process. " f7547ac1-53cd5275-50b82899-5dd4ef1c-fdbe500a.jpg,test/p16/p16595826/s57889364/f7547ac1-53cd5275-50b82899-5dd4ef1c-fdbe500a.jpg,test," FINAL REPORT INDICATION: ___ year old woman with new crackles left lower lobe, cough, fever. Hyponatremia // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Within the left lower lobe peripherally there is a new small nodular opacity. This could represent lung focal consolidation/atelectasis in the appropriate clinical setting. There is coarse reticular interstitial opacities in the lung bases likely representing chronic scarring. The cardiomediastinal silhouette is unchanged in appearance with coarse calcifications of the mitral annulus. No pneumothorax. Severe degenerative changes of the right glenohumeral joint are seen. IMPRESSION: A new focal peripheral left lower lobe opacity. Although very nonspecific, in the appropriate clinical setting, it could represent a developing/early pneumonia. The remainder of the lungs are otherwise unchanged in appearance. RECOMMENDATION(S): A follow-up chest radiograph in 4 weeks is suggested to ensure resolution. " f3a9be20-cbf48c53-5c7ff73f-e4805528-66b2fc8e.jpg,test/p12/p12006266/s54596433/f3a9be20-cbf48c53-5c7ff73f-e4805528-66b2fc8e.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Hypoxia. Portable AP radiograph of the chest was reviewed in comparison to ___. There is interval increase in bilateral pleural effusions and most likely present are pulmonary edema at least partially obscured by the large amount of fluid. Left PICC line tip is at the level of mid SVC, but potentially can be pointing towards the azygos vein given the medial-upward direction of the tip. Heart size and mediastinum are difficult to assess given obscuration by pleural effusion. " f4bb8765-72736cf3-b2ec98e6-4521b5fe-3df4b80a.jpg,test/p19/p19337519/s58185364/f4bb8765-72736cf3-b2ec98e6-4521b5fe-3df4b80a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough, HIV, cd4 of 23 // please eval for signs of cmv lung involvement COMPARISON: Prior study dated ___ FINDINGS: PA and lateral views of the chest provided. Vague scattered opacities in the lungs are concerning for multifocal pneumonia. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Mild hilar prominence may reflect prominence of hilar nodes. Bony structures are intact. IMPRESSION: Scattered vague opacities concerning for multifocal pneumonia with hilar prominence likely due to prominent lymph nodes. Recommend followup to resolution. " 5fddf0ca-ae8e43d3-5581e30b-45d65e76-254fb7c2.jpg,test/p13/p13030232/s50837543/5fddf0ca-ae8e43d3-5581e30b-45d65e76-254fb7c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new dual chamber PPM // assess lead position TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is a new dual lead pacemaker. On the frontal film slowed leads project over the expected locations of the heart. However, on the lateral film 1 of the leads projects posteriorly which is unexpected. The heart is upper limits normal in size. Sternal wires and mediastinal clips are again seen. There is no focal infiltrate or effusion. There is no pneumothorax. IMPRESSION: 1 of the pacemaker wires projects posteriorly on the lateral film. This is likely the atrial lead. NOTIFICATION: This finding was discussed with the electrophysiology fellow, Dr. ___ at the time of discovery by Dr. ___ at 11:30 on ___ at the time of dictating this report " 4865219c-a09315be-6f9cc5fd-e9d427b5-b4e1f3d7.jpg,test/p13/p13396234/s58696706/4865219c-a09315be-6f9cc5fd-e9d427b5-b4e1f3d7.jpg,test," FINAL REPORT HISTORY: ___-year-old female status post aortic valve repair. Evaluate for pleural effusions. COMPARISON: Chest radiographs dated through ___. FINDINGS: Frontal and lateral chest radiographs demonstrate interval removal of right internal jugular line. There is no pneumothorax. There has been additional removal of feeding tube. When compared to prior radiograph dated ___, there has been resolution of pulmonary edema as evidenced by decreased interstitial edema. While the right pleural effusion has decreased, a left sided pleural effusion persists and is slightly larger. A left lower lobe opacity is most likely atelectasis. The cardiomediastinal silhouette has a normal postoperative appearance. Sternotomy wires are intact. IMPRESSION: Improved pulmonary edema. " c1619889-53450408-59fca466-2fe2185e-ae59fd66.jpg,test/p16/p16720812/s58506834/c1619889-53450408-59fca466-2fe2185e-ae59fd66.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of melanoma // please evaulate disease status please evaulate disease status COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Small bilateral pleural effusions, left greater than right, are minimally larger today than in ___. Borderline cardiomegaly is stable. Lungs are clear. Healed right humerus fracture and surgical stabilization noted. " 3b55c00c-79f6ae95-f8ced15b-fba46b1e-80e2132d.jpg,test/p18/p18651563/s52713163/3b55c00c-79f6ae95-f8ced15b-fba46b1e-80e2132d.jpg,test," FINAL REPORT HISTORY: ___-year-old female with cough and fever for three days. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs demonstrate subtle wispy opacity in the left upper lobe, not present on prior exam. Flattened hemidiaphragms suggest chronic obstructive disease. There is no pleural effusion or pneumothorax. Bilateral glenohumeral joint degenerative changes are noted. IMPRESSION: Subtle wispy opacity in the left upper lobe may represent early pneumonia; recommend follow-up to resolution to exclude underlying mass. " 6180ffb7-bf9fa559-cb87070f-213530af-3079a786.jpg,test/p13/p13558006/s53394634/6180ffb7-bf9fa559-cb87070f-213530af-3079a786.jpg,test," FINAL REPORT AP CHEST 3:48 A.M., ___ HISTORY: Atrial fibrillation. Cauda equina syndrome, left lower extremity weakness. IMPRESSION: AP chest compared to ___ through ___: Marked elevation of the left hemidiaphragm is longstanding, was accompanied by left lower lobe collapse on ___. It cannot be sure whether it has improved, but there is now strong suggestion of new consolidation in the left upper lobe or an unusual collection of pleural fluid. I would recommend repeat chest radiograph with careful attention to removing all appliances both in front and behind the patient's chest in order to get a better imaging of the left upper lobe particularly. Examination should be performed with the patient erect to detect new pleural effusion. Right lung is low in volume, but clear. Heart is top normal size, but mediastinal veins are dilated, suggesting volume overload. ET tube is in standard position and a nasogastric tube ends looped in the upper stomach. " e5c4c998-6e9fd73a-1a537b3f-3a695d3a-e6d2feb1.jpg,test/p10/p10148145/s54466841/e5c4c998-6e9fd73a-1a537b3f-3a695d3a-e6d2feb1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man possible PE // pre- V/Q scan TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: Lungs are clear. Normal heart. No pleural effusions. No change since prior exam. IMPRESSION: Normal chest " 77943676-6778235b-eb3c0d0a-c0ffc43e-14b4665c.jpg,test/p19/p19065401/s50201703/77943676-6778235b-eb3c0d0a-c0ffc43e-14b4665c.jpg,test," FINAL REPORT INDICATION: Altered mental status, here to evaluate for acute cardiopulmonary process, specifically pneumonia. COMPARISONS: Chest radiograph, last performed on ___. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: A left pectoral pacemaker is unchanged with dual leads terminating in the right atrium and right ventricle. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The cardiomediastinal and hilar contours are within normal limits with mild tortuosity of the thoracic aorta. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 03152cea-6116cfcd-65c13554-9a7bd9f0-6beae4a3.jpg,test/p13/p13533747/s57762041/03152cea-6116cfcd-65c13554-9a7bd9f0-6beae4a3.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Preop evaluation. Patient has brain lesion. Cardiac size is top normal. There is a small left pleural effusion. Bibasilar atelectases are larger on the left. There is no pneumothorax. " afa10238-e2724a4f-9fd44b8e-505ffbe2-7a45c95d.jpg,test/p17/p17173041/s54263866/afa10238-e2724a4f-9fd44b8e-505ffbe2-7a45c95d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p pacemaker // confirm lead placement TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable pacer leads in a standard position IMPRESSION: Pacer leads are in standard position in the right atrium and right ventricle. Resolved pulmonary edema " 1221bce6-bf5059f4-db63f948-43ff8ede-424a9f88.jpg,test/p11/p11312927/s51577259/1221bce6-bf5059f4-db63f948-43ff8ede-424a9f88.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with hypertension, obstructive sleep apnea, presents with leukocytosis and flank pain. Has possible renal mass. Evaluate for possible pneumonia. FINDINGS: PA and lateral chest views are obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. The heart size is within normal limits. Sizable apical fat pad is observed on the left base does not obscure the diaphragmatic contour or the left lateral pleural sinus. Aorta is unremarkable and unchanged in comparison. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No pneumothorax in the apical area. Mild degree of degenerative changes mostly in the mid portion of the thoracic spine, but no other remarkable skeletal abnormalities are identified. Comparison with the next preceding study of ___, demonstrates stable chest findings. Thus, no evidence of new acute infiltrates. " 3d24ce48-74d9f683-d2f9af58-c1c3675a-d3934375.jpg,test/p19/p19012124/s59491482/3d24ce48-74d9f683-d2f9af58-c1c3675a-d3934375.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB and weight gain. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___ and ___. FINDINGS: Compared with the prior radiograph, the left chest wall pacer device leads projecting to the right atrium, left ventricle, and right ventricle are intact and unchanged in position. Marked cardiomegaly and bilateral hilar enlargement are unchanged since ___. There is no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: 1. No evidence of pulmonary edema. 2. Marked cardiomegaly due to enlargement of the left atrium. " e70a21a0-f9e8691b-2f8a8e85-90690ae4-6e8ec28d.jpg,test/p16/p16289699/s55836042/e70a21a0-f9e8691b-2f8a8e85-90690ae4-6e8ec28d.jpg,test," FINAL REPORT INDICATION: Exudative right-sided pleural effusion tapped on ___ with persistent minimally productive cough. Evaluation for reaccumulation. TECHNIQUE: Portable AP chest radiograph. COMPARISON: Multiple priors, most recently on ___ at 1:10 p.m. FINDINGS: There is no recurrence of the right pleural effusion nor is there a left pleural effusion. A tiny linear density at the right apex may represent a small apical pneumothorax. Left-sided pacer leads are in the standard position. A median sternotomy wire and CABG clips are noted. There is obscuration of the right heart border that most likely represents atelectasis in the right middle lobe though pneumonia cannot be completely excluded. Cardiac size is within normal limits. The case was discussed by Dr. ___ with Dr. ___ by phone at 12:01 p.m. on ___. " 24fca961-0dd6516c-2dcf3b04-5585132c-695aac1c.jpg,test/p17/p17288913/s56798862/24fca961-0dd6516c-2dcf3b04-5585132c-695aac1c.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain // eval for pna TECHNIQUE: Upright PA and lateral chest COMPARISON: None available FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Small hiatal hernia is unchanged from prior. There is calcification of the aortic arch. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. Small hiatal hernia. " a025606d-697ab0e4-79a33c9e-37d34b2d-e1ba1319.jpg,test/p13/p13046313/s55615309/a025606d-697ab0e4-79a33c9e-37d34b2d-e1ba1319.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Shortness of breath and COPD in a patient after open repair of aortic endoleak. AP chest radiograph As compared to ___ there is interval improvement of the left mid and lower lung consolidations consistent with gradual decrease in suspected aspiration. Right basal aeration has improved as well. Everything else appears to be stable. " 751a441d-85c03098-26ac6c81-60a4e611-023a3598.jpg,test/p14/p14605976/s53577301/751a441d-85c03098-26ac6c81-60a4e611-023a3598.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, cough, hx pneumonia // r/o pneumonia r/o pneumonia IMPRESSION: In comparison with the study ___ ___, the cardiac silhouette remains within normal limits. Mild atelectatic changes are seen at both bases. However, in the appropriate clinical setting, it would be difficult to unequivocally exclude superimposed pneumonia in this region. Cardiac silhouette is within normal limits and there is no vascular congestion. Blunting of what appears to be the left costophrenic angle on the lateral view could reflect pleural fluid. " 93b0926f-873157cc-af0c2cdb-b3608835-da883a13.jpg,test/p13/p13264941/s56083729/93b0926f-873157cc-af0c2cdb-b3608835-da883a13.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with cough // pna? TECHNIQUE: Portable upright radiograph view of the chest COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded and clear. No focal consolidation, effusion, edema, or pneumothorax. The consolidation in the right mid lung has resolved. The heart is normal in size. The mediastinum is not widened. IMPRESSION: No acute intrathoracic process. " b823309d-41d4f0de-8020f63b-4e1e2303-f2983dfb.jpg,test/p12/p12525488/s51438717/b823309d-41d4f0de-8020f63b-4e1e2303-f2983dfb.jpg,test," WET READ: ___ ___ ___ 12:53 AM A right-sided PICC terminates in the mid SVC. No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___M with knee replacement on IV abx through right PICC after surgical infection. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. A right sided PICC terminates in the upper SVC. There is a probable healed anterior right fourth rib fracture. IMPRESSION: A right-sided PICC terminates in the upper SVC. No acute cardiopulmonary abnormality. " 8a86b2e2-b494a862-52db62eb-adbd7ea0-f31985af.jpg,test/p15/p15604842/s52226278/8a86b2e2-b494a862-52db62eb-adbd7ea0-f31985af.jpg,test," FINAL REPORT HISTORY: Diabetes and cough with left lower lobe crackles, assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are low in volume but clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal mediastinal and hilar contours. IMPRESSION: No acute intrathoracic process. Findings discussed with Dr. ___ by Dr. ___ by phone at ___ on ___, 1 minute after discovery. " 22bf3f88-83ae202c-05dd7b99-d0ed324d-38a145a9.jpg,test/p11/p11345335/s50359711/22bf3f88-83ae202c-05dd7b99-d0ed324d-38a145a9.jpg,test," FINAL REPORT INDICATION: Chronic alcoholic hepatitis, presenting with worsening confusion, evaluate for infiltration. COMPARISONS: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: Lungs are well expanded. Streaky left lower lobe opacities are likely atelectasis. There is no pneumothorax or pleural effusions. Cardiomediastinal silhouette is top normal. The imaged upper abdomen is unremarkable. IMPRESSION: Left basilar opacity, likely atelectasis. " 9639df04-8013e276-e18691b3-450e93e2-2206166d.jpg,test/p18/p18553055/s55916063/9639df04-8013e276-e18691b3-450e93e2-2206166d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p emergent CABG // eval for ETT position s/p chest closure COMPARISON: Chest x-ray from ___ at 16 23 FINDINGS: Compared to the prior study, there is now near complete opacification of the left chest, with multiple small lucent foci in the upper half of the lung which likely represent small areas of aerated long versus focal air within fluid. New compared to the prior study, sternotomy wires and midline mediastinal skin ___ are now visualized, compatible with interval surgery. There has been leftward shift of the mediastinum, likely contributing to the left chest opacity. The left chest tube, mediastinal drains, and 2 Swan-Ganz catheter have all shifted leftward. The plane of imaging of the prosthetic valve is also slightly different. The right chest tube remains in place, canal lying slightly lower over the lower right lung. The carina is not well delineated, but I suspect the ET tube tip lies approximately 3.6 cm above the carina. An NG tube is present, tip and side-port overlying the upper stomach. Aside from mild plethora of upper zone vessels in the right lung, the right lung is grossly clear. Large rounded calcification, likely a large gallstone, again noted in the right upper abdomen IMPRESSION: Interval surgery, with marked leftward shift of the mediastinum into the left chest, together with associated drains, catheters and prosthetic valve, with resultant near-complete opacification of the left lung. This presumably suggests significant left-sided atelectasis. The right lung remains grossly clear, with only mild upper zone redistribution. NOTIFICATION: Findings, including the atypical postoperative appearance of the findings, were discussed with, covering clinician, APN ___, by Dr ___ by phone at 18:14 on ___, ___ min after discovery. By report, the patient is stable at this time. " ff429dbd-73710d8d-cfd67bba-aee8c81a-72b3de16.jpg,test/p10/p10040631/s51708526/ff429dbd-73710d8d-cfd67bba-aee8c81a-72b3de16.jpg,test," WET READ: ___ ___ ___ 1:08 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with exertional dyspnea // Eval for acute abnormality TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___ FINDINGS: The lungs are clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are unremarkable. Surgical clips are again seen within the right neck. There is no pneumothorax, pulmonary edema, or pleural effusion. No focal consolidation is identified. Old healed right posterolateral and left rib fractures are unchanged compared to prior exams. IMPRESSION: No acute cardiopulmonary process. " 6a18301e-65902da0-3766cbdb-6e6c0cc1-a459e4ec.jpg,test/p14/p14766138/s57896653/6a18301e-65902da0-3766cbdb-6e6c0cc1-a459e4ec.jpg,test," FINAL REPORT INDICATION: Evaluate after intubation and left central venous catheter. COMPARISON: Chest radiograph from ___. TECHNIQUE: A single AP supine view of the chest was obtained. FINDINGS: The endotracheal tube is in satisfactory position, approximately 2.2 cm from the carina. A left internal jugular central venous catheter is present with the tip in the upper SVC. A right hemodialysis catheter is unchanged with the tip at or just beyond the cavoatrial junction. An enteric tube is present coursing below the diaphragm with the tip out of the field of view. Since prior exam, the lung volumes have improved, likely due to mechanical ventilation. There is a persistent dense opacity in the right base consistent with pneumonia. Mild pulmonary edema is not significantly changed. The cardiomediastinal silhouette is normal. IMPRESSION: 1. Satisfactory position of multiple lines and tubes. 2. Persistent right basilar pneumonia and mild pulmonary edema. " 8013fdd7-45866590-115c1c68-e4fc2d51-0ecf0d8c.jpg,test/p18/p18906833/s54172830/8013fdd7-45866590-115c1c68-e4fc2d51-0ecf0d8c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Neck and bilateral wrists lacerations. Evaluate for thoracic injury. TECHNIQUE: Single frontal view of the chest. COMPARISON: None. FINDINGS: Right internal jugular central venous catheter terminates at the cavoatrial junction. Heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. Lung volumes are low but lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. There are no traumatic findings. IMPRESSION: No acute cardiopulmonary abnormality. No traumatic findings. " c3456cc2-11926921-964233f7-6fec293f-0e72eb81.jpg,test/p14/p14395025/s52918249/c3456cc2-11926921-964233f7-6fec293f-0e72eb81.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypercarbic respiratory failure, intubated // assess for progression of RLL infiltrate COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is noted. The pre-existing parenchymal opacities, notably in the right than left. Lower lobe as well as in the right upper lobe, constant in severity and extent. No new opacities are noted. Severe overinflation and moderate cardiomegaly persists. " bcc3f4e4-b738eb07-3ec62576-98d963f8-d96610f5.jpg,test/p11/p11226141/s54346060/bcc3f4e4-b738eb07-3ec62576-98d963f8-d96610f5.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with history of metastatic lung cancer with chest discomfort and palpitations. COMPARISON: CT torso from ___, CT chest from ___, and chest radiograph from ___. FINDINGS: In comparison to prior study from ___, there has been in increase in both size and number of multiple bilateral pulmonary nodules. While the right upper lobe opacity with volume loss has remained stable, there is a new, confluent, consolidative left perihilar opacity. This new opacity is centered in the lingula but also involves the left upper lobe. Again visualized is a collapsed T11 vertebral body as noted previously. However, multiple known metastatic lesions throughout osseous structures are not clearly visualized on today's study. IMPRESSION: 1. There is a new, confluent, consolidative left perihilar opacity centered in the lingula with involvement of the left upper lobe. This opacity is most consistent with a lingular pneumonia. 2. Multiple small bilateral pulmonary nodules have increased in both size and number and are suspicious for worsening of metastatic lung disease. 3. Right upper lobe atelectasis appear stable. These findings were discussed by Dr. ___ with Dr. ___ via telephone at 2:40 pm on ___. " 8814c29c-90d4e938-e8b9eb0e-0915f786-3d834f46.jpg,test/p18/p18926074/s56944494/8814c29c-90d4e938-e8b9eb0e-0915f786-3d834f46.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Bladder cancer. PA and lateral upright chest radiographs were reviewed with comparison to chest CT from ___. Heart size is normal. Mediastinum is normal. The pulmonary nodules seen on the prior chest CT are better appreciated on the previous chest CT as compared to the chest radiograph. Previously seen right apical nodule is not clearly depicted on the current examination, unclear if decreased in size or just not projected on the current radiograph. No new abnormalities demonstrated. " d846ec9c-afa412cd-c0a36884-785e9b92-9a30e5bd.jpg,test/p11/p11020816/s54128850/d846ec9c-afa412cd-c0a36884-785e9b92-9a30e5bd.jpg,test," FINAL REPORT HISTORY: Confusion. Evaluate for interval progression of opacities. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion or pneumothorax. Mild right basilar atelectasis is unchanged. The previously seen left lower lung opacity is not with well visualized. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: No pneumonia, edema, or effusion. " e1b3a4a6-cc9baab3-3735aaf6-2970890d-c8b25dbc.jpg,test/p12/p12388314/s56868789/e1b3a4a6-cc9baab3-3735aaf6-2970890d-c8b25dbc.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with status post fall on Coumadin TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Left-sided dual-chamber pacemaker device is in unchanged position. Mild to moderate cardiomegaly is similar. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is not engorged. Patchy bibasilar opacities likely reflect areas of atelectasis. No pleural effusion or pneumothorax is present. There are mild degenerative changes noted within the shoulders and imaged thoracolumbar spine. IMPRESSION: No acute cardiopulmonary abnormality. " 0a325830-33f45754-e9b478f1-c6a24019-273688c4.jpg,test/p15/p15848257/s50087324/0a325830-33f45754-e9b478f1-c6a24019-273688c4.jpg,test," WET READ: ___ ___ ___ 3:05 AM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with h/o MS, optic neuriis, ? flare / precipitant // ? acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Heart size is top normal, otherwise, the cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 74a3f692-a92ca54c-19b5fba1-afa17786-3e3b58da.jpg,test/p19/p19818283/s56113028/74a3f692-a92ca54c-19b5fba1-afa17786-3e3b58da.jpg,test," WET READ: ___ ___ ___ 3:55 AM Right basilar pneumothorax is stable to slightly increased from ___ at 7:59pm allowing for patient position. Otherwise no significant change. -___ d/w ___ by phone at 3:54am ___. ______________________________________________________________________________ FINAL REPORT HISTORY: Thoracentesis with small pneumothorax. FINDINGS: Stable small area of pneumothorax loculated at the right base laterally. Otherwise, little overall change. " 6a6ab0b5-64a1c428-d2aa9b10-e9f76618-14eff4e8.jpg,test/p18/p18933476/s52911788/6a6ab0b5-64a1c428-d2aa9b10-e9f76618-14eff4e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with bilateral chest tubes // ?interval change COMPARISON: ___ IMPRESSION: The left and right chest tube as well as the left PICC line are in unchanged position. The right pneumothorax is unchanged. New is a millimetric pneumothorax on the left. Neither left nor right pneumothorax show evidence of tension. The bilateral basal areas of atelectasis are constant. Constant appearance of the cardiac silhouette. " 0d957f22-c2e78efb-1b2a5df0-dc8ed6db-c766e36f.jpg,test/p16/p16557374/s53954286/0d957f22-c2e78efb-1b2a5df0-dc8ed6db-c766e36f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p C4-7 ACDF now with respiratory congestion // pna COMPARISON: ___ IMPRESSION: As compared to the previous image, no relevant change is seen. The lung volumes have increased, with near complete resolution of the pre-existing platelike atelectasis at the lung bases. No evidence of pleural effusions. No pneumonia, no pulmonary edema. Borderline size of the cardiac silhouette. " 1d339d68-ce5cb30b-720e2318-e041eb9d-93d870cd.jpg,test/p15/p15355483/s54078298/1d339d68-ce5cb30b-720e2318-e041eb9d-93d870cd.jpg,test," WET READ: ___ ___ ___ 12:15 AM No pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with fever. TECHNIQUE: Frontal radiograph of the chest was obtained. COMPARISON: None. FINDINGS: Pectus excavatum. The lungs are clear, cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: No pneumonia. " 9d56c39a-699b589f-31136b83-bacf92bf-5ce72e43.jpg,test/p13/p13306576/s54256246/9d56c39a-699b589f-31136b83-bacf92bf-5ce72e43.jpg,test," FINAL REPORT HISTORY: Chest discomfort and cough. COMPARISON: Multiple prior exams, most recently of ___. FINDINGS: Frontal and lateral views of the chest. Slight increase in background density could be technical or represent difference in patient position or chest wall. No focal consolidation, pleural effusion, or pneumothorax. Heart size and cardiomediastinal contours are normal. IMPRESSION: No focal consolidation. " d0ac2777-048ae5a2-b47a289d-57dcd3e8-b69a33b5.jpg,test/p17/p17734241/s52120882/d0ac2777-048ae5a2-b47a289d-57dcd3e8-b69a33b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of colon cancer, excised, and hypertension // r/o lung lesion. Evaluate ASCVD COMPARISON: ___. IMPRESSION: No relevant change as compared to the previous image. Large hiatal hernia. Borderline size of the cardiac silhouette. Mild elongation of the descending aorta. No pleural effusions. No pneumonia. " 2c0e5fe7-08f98c2b-82189377-c4a33626-8ec50da0.jpg,test/p15/p15801557/s53023372/2c0e5fe7-08f98c2b-82189377-c4a33626-8ec50da0.jpg,test," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Status post left thoracoscopy, wedge resection of a right upper lobe nodule, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pneumothorax on the left has decreased, but is still clearly visible. The surgical staple lines in the left apex are constant in appearance. Unchanged evidence of a mild lateral pleural adhesion. Normal appearance of the remaining lung parenchyma. Unchanged appearance of the heart. Known tortuosity of the thoracic aorta. " a3fff811-d318a634-0f25baa5-3136f194-f2f7e41b.jpg,test/p14/p14895079/s54062672/a3fff811-d318a634-0f25baa5-3136f194-f2f7e41b.jpg,test," WET READ: ___ ___ ___ 7:19 PM There has been interval placement of a left sided pigtail pleural drain. A previously moderate left pleural effusion is significantly decreased from the prior examination. A moderate to large right pleural effusion persists with diffuse lung consolidation. Pericardial drain is unchanged in position. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo F with breast cancer s/p mastectomy and axillary node dissection, metastatic disease to the chest, bones, and brain in ___ s/p palliative whole brain radiation therapy, history of upper extremity DVT not on anticoagulation due to anemia presenting with 1 week of chest pain and shortness of breath, found to have pericardial effusion and temponade, also found to have new left sided pleural effusion // evaluated left side effusion size evaluated left side effusion size IMPRESSION: Interval placement of a left pigtail catheter. The left-sided effusion is almost completely resolved. The pericardial drain remains in situ. No pneumothorax or other complications. The subtotal collapse of the right lung is constant. " 867c8401-4934e30e-031eadda-11b13ebb-ef0bbd06.jpg,test/p17/p17962792/s53989748/867c8401-4934e30e-031eadda-11b13ebb-ef0bbd06.jpg,test," FINAL REPORT HISTORY: Localized renal cancer. Evaluate for new lesions. TECHNIQUE: Frontal and lateral views of the chest (3 exposures). COMPARISON: Chest radiographs ___ and ___. FINDINGS: A calcified granuloma is unchanged in the posterior basal segment of the left lower lobe. There is no pleural effusion, pneumothorax or focal airspace consolidation. There is no evidence of hilar or mediastinal lymphadenopathy. Cardiac and mediastinal contours are normal. There is a tortuous aorta. IMPRESSION: No evidence of metastatic disease. " 474af087-03e9fcff-b5e80ad1-47ec60d8-fe19059b.jpg,test/p10/p10747970/s50192795/474af087-03e9fcff-b5e80ad1-47ec60d8-fe19059b.jpg,test," FINAL REPORT INDICATION: Altered mental status and hypotension. COMPARISON: None. FINDINGS: AP chest radiograph. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 02b8a89a-7d2c464f-99e7dc0e-4d442847-f7347058.jpg,test/p18/p18395216/s54946000/02b8a89a-7d2c464f-99e7dc0e-4d442847-f7347058.jpg,test," FINAL REPORT PORTABLE CHEST OF ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Cardiac silhouette is mildly enlarged. Moderate-to-marked pulmonary edema has slightly worsened in the interval, and small-to-moderate pleural effusions have apparently slightly increased in size, although positional differences could potentially contribute to the latter apparent change. " ed42f8df-b31fde52-8e4af5ef-cff0a2a1-5530b00c.jpg,test/p19/p19557250/s53448142/ed42f8df-b31fde52-8e4af5ef-cff0a2a1-5530b00c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chf, htn here with sob // eval for effusion edema eval for effusion edema COMPARISON: ___ IMPRESSION: Heart size and mediastinum are unchanged. Bibasal areas of atelectasis are unchanged. Subcutaneous air within the left chest wall appears to be decreased in the interim. No pulmonary edema is appreciated on the current study. " b1ae3d25-c18c0797-f499c706-dcdc797c-478ecb3a.jpg,test/p11/p11607584/s56264359/b1ae3d25-c18c0797-f499c706-dcdc797c-478ecb3a.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Dyspnea and fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and CABG. In the interval from the prior study, there has been development of patchy opacity in the right mid-to-lower lungs and as well as in the left lower lobe, worrisome for multifocal pneumonia. No large pleural effusion is seen. There is no pneumothorax. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Multifocal pneumonia. " 24328417-cc0309fb-2f44e5ff-2bff44be-013897ef.jpg,test/p19/p19621452/s58342616/24328417-cc0309fb-2f44e5ff-2bff44be-013897ef.jpg,test," FINAL REPORT INDICATION: ___ year old man with R lung mass, ? pneumatocele, now s/p ebus and biopsy of RLL // ptx TECHNIQUE: Semi-erect AP view of the chest. COMPARISON: Chest CT ___. FINDINGS: Prominence of the right hilum corresponds to the known right lower lobe lesion, as seen on prior chest CT. The cardiomediastinal and left hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs are well-expanded with hazy opacity at the right lung base, likely post procedural. Gaseous distension of the stomach is noted. The visualized portion of the upper abdomen is otherwise unremarkable. IMPRESSION: 1. No pneumothorax. 2. Fullness of the right hilum corresponds to the known right lower lobe lesion. " c5723f40-21bb8b41-2e1ef820-3f62ece8-8e950c9a.jpg,test/p10/p10335334/s53766051/c5723f40-21bb8b41-2e1ef820-3f62ece8-8e950c9a.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Nausea, vomiting and diarrhea. Question air in the mediastinum. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no evidence for pneumothorax or pneumomediastinum. No pleural effusions are demonstrated. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 46a86ca3-1f2ff8e4-e21eb78c-65fd6e9f-aa836897.jpg,test/p19/p19699616/s58345377/46a86ca3-1f2ff8e4-e21eb78c-65fd6e9f-aa836897.jpg,test," FINAL REPORT HISTORY: Chest tube removal. FINDINGS: In comparison with study of ___, the left pigtail catheter has been removed. There is no definite evidence of pneumothorax. Continued pleural effusion with atelectatic changes in the retrocardiac region. The central catheter tip again extends to the mid portion of the SVC. " 97877c73-e6483976-9ea84ccd-1c42a5e8-f0fda736.jpg,test/p10/p10405305/s56431447/97877c73-e6483976-9ea84ccd-1c42a5e8-f0fda736.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p R thoracotomy, multiple wedge resection // check interval change IMPRESSION: As compared to prior radiograph of 1 day early her, left retrocardiac atelectasis has worsened. No other relevant change since recent study. " 58cd96ab-1b8b7afd-ff6ababa-320a6f6b-3b152975.jpg,test/p18/p18969321/s59088595/58cd96ab-1b8b7afd-ff6ababa-320a6f6b-3b152975.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with shortness of breath. FINDINGS: PA and lateral views of the chest are compared to previous two-view chest x-ray from ___. Exam is slightly limited secondary to patient body habitus. There is hazy increased opacity at the left lung base which is likely due to overlying soft tissues and prominent pericardial fat pad. There is no evidence of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Left shoulder arthroplasty is again seen in addition to hypertrophic changes in the spine. IMPRESSION: No definite acute cardiopulmonary process. " 22784e87-df71a73b-b33c5b9c-1fc65e6f-99ab65b4.jpg,test/p16/p16074663/s51168988/22784e87-df71a73b-b33c5b9c-1fc65e6f-99ab65b4.jpg,test," WET READ: ___ ___ 8:37 AM Low lung volumes without evidence for acute cardiopulmonary process. WET READ VERSION #1 ___ ___ ___ 8:36 PM Low lung volumes without evidence for acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis with slight worsening confusion and ___ // PNA r/o COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Low lung volumes. Borderline size of the cardiac silhouette. No pleural effusions. No pneumonia. No pulmonary edema. " 538d335d-8a5df950-13683155-75ffbb86-fd47c76f.jpg,test/p13/p13626140/s58914773/538d335d-8a5df950-13683155-75ffbb86-fd47c76f.jpg,test," FINAL REPORT CLINICAL HISTORY: Patient with heart block, pacemaker placed. Evaluate position. A single-chamber pacemaker is present, the tip lies within the left ventricle in a satisfactory position. No evidence of a pneumothorax is seen. The lung fields are clear. IMPRESSION: Satisfactory placement of pacemaker lead. " 7714f9c2-897c85c2-15f6468d-15dcfebd-58fc632a.jpg,test/p17/p17055354/s51203870/7714f9c2-897c85c2-15f6468d-15dcfebd-58fc632a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: 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. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___ and dating back to ___. FINDINGS: 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 ___. 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. IMPRESSION: Increased moderate left pleural effusion with adjacent left lower lobe opacification which is likely due to atelectasis, but left lower lobe pneumonia is possible in the appropriate clinical context. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:00 PM, 5 minutes after discovery of the findings. " 5f020f2b-3fb08519-9a373a8c-0142a48e-5c878a96.jpg,test/p14/p14197574/s57097979/5f020f2b-3fb08519-9a373a8c-0142a48e-5c878a96.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dobhoff tube placement // dobhoff position COMPARISON: Chest x-ray from ___ at 05:56 FINDINGS: Multiple views of the chest, obtained to assess Dobhoff placement. On view # 2, the radiopaque portion of the Dobhoff tube overlies the expected region of the GE junction, with the tip probably overlying the gastric fundus. On view # 3, the tube is been advanced. The radiopaque portion extends beyond the inferior edge of the film and is not localized. Note is made of an ET tube, with tip relatively low lying, approximately ___.3 -___.2 cm above the carina. Of note, however, the inferior edge of the clavicular heads is is only ___.7 mm above the carina. A right IJ central line is again noted, overlying the right atrium. Again seen is increased retrocardiac density with obscures the left hemidiaphragm and left costophrenic angle. Probable subsegmental atelectasis at the right lung base. IMPRESSION: Successive views obtained to assess Dobhoff tube placement. On the third/final view, the radiopaque portion of the Dobhoff tube extends beyond the inferior edge of this film and is not visualized. The course of the visualized portion of the tube is compatible with extension into the stomach. Films are centered lower than the typical chest x-ray. Allowing for this, the tip of the ET tube lies relatively low, approximately ___-15 mm above the carina. Clinical correlation is requested. Please see comment above. Increased retrocardiac opacity consistent with left lower lobe collapse and/or consolidation again noted. " 1fded352-8cb0221a-94f2520c-3c11e59d-d82a80dd.jpg,test/p16/p16100213/s56551971/1fded352-8cb0221a-94f2520c-3c11e59d-d82a80dd.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with dizziness TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph FINDINGS: Mild to moderate enlargement of the cardiac silhouette is unchanged. The aorta remains diffusely calcified, with unchanged prominence of the right paratracheal contour, possibly due to tortuous vessels. Pulmonary vasculature is not engorged. Hilar contours are normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Patient is status post left lumpectomy with clips seen projecting over the left chest wall and left axilla. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 1a4b1a30-4a902394-ddead9ad-4d4f013c-312a0a26.jpg,test/p16/p16085322/s51385178/1a4b1a30-4a902394-ddead9ad-4d4f013c-312a0a26.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Generalized weakness. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is mildly-to-moderately enlarged. There is a new hazy bilateral lung opacification with indistinct pulmonary vascularity, most consistent with moderate pulmonary edema. There is no definite pleural effusion or pneumothorax. Moderate degenerative changes involve each shoulder including effacement of the right acromiohumeral interval, which may relate to rotator cuff pathology. IMPRESSION: Findings consistent with moderate pulmonary edema. " 9a6751b3-4fde52c7-679d292d-42800920-e3e4feb0.jpg,test/p15/p15832720/s58343705/9a6751b3-4fde52c7-679d292d-42800920-e3e4feb0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS blebectomy; please schedule for 12:00 // s/p chest tube removal: ? pneumothorax; please schedule for 12:___ s/p chest tube removal: ? pneumothorax; please schedule for 12:00 IMPRESSION: Small right apical pneumothorax has decreased as compared to ___. Right chest tube has been removed. Lungs are clear. No pleural effusion. " 3d4f11c7-a39f3e10-3b3d93df-25556353-bb106311.jpg,test/p10/p10161112/s55496537/3d4f11c7-a39f3e10-3b3d93df-25556353-bb106311.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: A ___-year-old woman after left upper lobe sleeve resection. IMPRESSION: Lateral chest compared to ___: Aeration in the post-resection left lung has improved slightly, but the large persistent anterior pleural space is no smaller, and now contains a little more fluid. Subcutaneous emphysema in the left neck and chest wall is minimally improved. Right lung grossly clear. Severe leftward mediastinal shift and elevation of the left hemidiaphragm are still pronounced. " 38374e82-772a12c6-4f394d8b-2d722176-19bf0a1b.jpg,test/p10/p10377016/s58488426/38374e82-772a12c6-4f394d8b-2d722176-19bf0a1b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever // pna? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " d875e5f8-a7304a24-7a86c2e4-59dbd53e-3949d475.jpg,test/p13/p13299285/s50210830/d875e5f8-a7304a24-7a86c2e4-59dbd53e-3949d475.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man post-extubation // ?interval change ?interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lung volumes of remained the same following tracheal extubation, but mild pulmonary edema and moderate right pleural effusion have increased. Mild cardiomegaly and small left pleural effusion are stable. No pneumothorax. Feeding tube passes below the diaphragm and out of view. Left jugular line ends in the upper SVC. Right jugular line ends near the cavoatrial junction. " b4304149-2e11fb83-eacf286e-0278e5a7-8f98e193.jpg,test/p10/p10368327/s52966012/b4304149-2e11fb83-eacf286e-0278e5a7-8f98e193.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF and increasing o2 requirement // veal pleural effusion COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is noted. Bilateral pleural effusions with mild to moderate pulmonary edema. Subsequent areas of atelectasis at both the left and the right lung bases. The left border of the heart is unremarkable, the right border cannot be exactly determine given coexisting pleural effusion. A non characteristic scarring in the right upper lobe is unchanged. " 641d13c8-b3fe48e2-5504dafe-aad04557-7a8690bf.jpg,test/p13/p13269330/s53752266/641d13c8-b3fe48e2-5504dafe-aad04557-7a8690bf.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with metastatic lung cancer. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: New pleural tube has been placed in the left lung with tip ending at mid thoracic field. The moderate to severe bilateral pleural effusion is reduced, especially on the left. Cardiomediastinal silhouette is unchanged and normal. There is no pneumothorax IMPRESSION: Left chest tube has been placed with reduction of the bilateral pleural effusion, especially on the left " 3f16bf1e-710b02c9-82c66637-a63835b6-df8c5d42.jpg,test/p18/p18971362/s54834078/3f16bf1e-710b02c9-82c66637-a63835b6-df8c5d42.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p trauma L pneumothorax // infiltrate, pneumothorax infiltrate, pneumothorax IMPRESSION: Compared to prior chest radiographs ___. Lung volumes remain quite low. Mild pulmonary edema has improved, now predominantly dependent, where there is also mild to moderate atelectasis, left greater than right. Pleural effusion is presumed, but not substantial. No pneumothorax. Heart size top-normal. " 4274fb23-0c083ff4-7dc527b7-8cd06a76-99173000.jpg,test/p15/p15848257/s50941578/4274fb23-0c083ff4-7dc527b7-8cd06a76-99173000.jpg,test," FINAL REPORT HISTORY: Cough for 1 week. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The cardiac silhouette size is top normal. Mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " 35e7b368-58f8a5a8-500a60a3-e439b14a-1cefa0de.jpg,test/p13/p13275896/s56868136/35e7b368-58f8a5a8-500a60a3-e439b14a-1cefa0de.jpg,test," FINAL REPORT INDICATION: History of coronary artery disease with a GI bleed, status post transfusions. Evaluate for pulmonary edema or effusions. COMPARISONS: Chest radiograph from ___. TECHNIQUE: A semi-upright AP view of the chest was obtained with a total of two exposures. FINDINGS: The endotracheal tube is in satisfactory position 4.3 cm from the carina. An enteric tube courses below the diaphragm with the tip out of the field of view. Again, there is blunting of the left costophrenic angle, likely due to small effusion. There is no right effusion. There is no pneumothorax. There is mild vascular congestion without overt pulmonary edema, improved from the prior exam. There is minimal left basilar atelectasis. There is no focal airspace opacity to suggest a pneumonia. The mediastinal contours are normal. The heart size is at the upper limits of normal. IMPRESSION: 1. Small left pleural effusion. 2. Interval improvement in the mild vascular congestion. " 310cd3ee-24fdf839-2a29d390-8158d70e-74e7f790.jpg,test/p18/p18266518/s51199141/310cd3ee-24fdf839-2a29d390-8158d70e-74e7f790.jpg,test," FINAL REPORT INDICATION: ___F with speech difficulty, cough // eval infiltrate TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Torso CT from ___ and chest x-ray from ___. FINDINGS: The lungs are hyperinflated. Chronic changes including scarring identified at the left upper lung as well as increased interstitial markings throughout the lungs. There is no new consolidation no are effusion. Cardiomediastinal silhouette is mildly enlarged as on prior. No acute osseous abnormalities identified. IMPRESSION: Hyperinflation and scarring. No definite consolidation. " 39678102-855f761f-df13647b-207cda2b-c6658d0c.jpg,test/p16/p16877684/s52721355/39678102-855f761f-df13647b-207cda2b-c6658d0c.jpg,test," FINAL REPORT STUDY: PA and lateral ___. CLINICAL HISTORY: ___-year-old woman with asthma and cough. FINDINGS: Comparison is made to the previous study from ___. Heart size is within normal limits. There is no focal consolidation, pleural effusion, or signs for overt pulmonary edema. Bony structures are intact. IMPRESSION: Normal study of the chest. " 001388e8-273d1ec1-adaff70b-46128da1-67f5baee.jpg,test/p12/p12878814/s58503016/001388e8-273d1ec1-adaff70b-46128da1-67f5baee.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with fever, BMT // eval heart and lungs and PICC placement COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Right IJ dialysis catheter again noted with tip in the low SVC. Lung volumes are low. Lung volumes are low limiting assessment. There is mild bibasilar atelectasis. No focal consolidation is seen. No large effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures appear intact. IMPRESSION: Mild bibasilar atelectasis. No convincing evidence for pneumonia. " c73abc53-44dd933f-c04caa63-e56896bc-05609759.jpg,test/p18/p18812486/s51266038/c73abc53-44dd933f-c04caa63-e56896bc-05609759.jpg,test," FINAL REPORT HISTORY: Lower GI bleeding, HCC, HCV, neutropenia status post chemo with shortness of breath for one to ___ years. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top normal with tortuosity of the thoracic aorta. There is central pulmonary vascular congestion with increased perihilar predominance and peripheral increased reticulation suggestive of edema. No definite focal consolidation is seen. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Mild-to-moderate pulmonary edema. " 5ad8ba97-b5c1fe97-ff5c4885-2a39f2f6-59950502.jpg,test/p13/p13036647/s54930715/5ad8ba97-b5c1fe97-ff5c4885-2a39f2f6-59950502.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with L upper back pain, fever and productive cough green sputum COMPARISON: ___ and ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low though allowing for this the lungs appear clear aside from mild left basal atelectasis. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: Mild left basal atelectasis, otherwise unremarkable. " 1a8868b0-098ae13a-a0f0b1bb-319f1deb-37abca74.jpg,test/p12/p12820032/s57739886/1a8868b0-098ae13a-a0f0b1bb-319f1deb-37abca74.jpg,test," FINAL REPORT INDICATION: Chills, myalgias, question acute cardiopulmonary process. COMPARISONS: Chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is notable for LV predominance. There are no displaced fractures. The imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " b87100cb-baedbbfa-9961a8cf-e626889e-c5a058d2.jpg,test/p17/p17303677/s59620815/b87100cb-baedbbfa-9961a8cf-e626889e-c5a058d2.jpg,test," FINAL REPORT HISTORY: Cough, green sputum. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. There is no pleural effusion or pneumothorax. No acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 18201c39-713fe615-bbe4349f-a82d6e5b-2ef84729.jpg,test/p14/p14716808/s56759770/18201c39-713fe615-bbe4349f-a82d6e5b-2ef84729.jpg,test," FINAL REPORT HISTORY: Myeloma and cough, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is some ill-defined opacification at the base posteriorly on the lateral view. This could well represent atelectatic changes as seen on prior studies. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. Compression deformity of the lower thoracic vertebral body is again seen on lateral view. " 0ee65e94-4de59880-51b2b3ee-dfacba04-3cac8681.jpg,test/p17/p17402090/s53570728/0ee65e94-4de59880-51b2b3ee-dfacba04-3cac8681.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with severe COPD s/p coiling. // Increasing SOB Increasing SOB IMPRESSION: Heart size and mediastinum are stable. Multiple endobronchial valves are projecting over the right upper lung. No collapse of the right upper lobe weight a part of a right upper lobe is currently seen. Severe emphysema is re- demonstrated. There is no appreciable pleural effusion. There is no pneumothorax. " 2bed6650-86ce408d-ac26f944-5f490766-a7599b5b.jpg,test/p15/p15964158/s52255009/2bed6650-86ce408d-ac26f944-5f490766-a7599b5b.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISONS: Chest radiograph of earlier the same date. FINDINGS: The patient is status post placement of a left pigtail pleural catheter, with marked reduction in size of a left pleural effusion, with small residual effusion remaining and a new small left apical pneumothorax. On the right, a moderate-to-large layering effusion with adjacent atelectasis in the right mid and lower lung regions as well as a small right apical pneumothorax are unchanged. " 44aa97f1-0ef2d266-8c0f3c7d-c3d33c38-36619b2f.jpg,test/p10/p10441044/s50287757/44aa97f1-0ef2d266-8c0f3c7d-c3d33c38-36619b2f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Left-sided pneumothorax, ARDS, chest tube to waterseal, change in appearance of pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous image, the extension of the pneumothorax has markedly increased. This is particularly evident at the left lung base. Here, the dimension of the pneumothorax is approximately 3-4 cm. Otherwise, there are no relevant changes. The monitoring and support devices are in constant position. Atelectasis at the right lung base is constant. Retrocardiac atelectasis. Borderline size of the cardiac silhouette without pulmonary edema. " 016a2674-304a11ff-dac0ea17-3c3539f7-6bb7cf9c.jpg,test/p14/p14716808/s51455142/016a2674-304a11ff-dac0ea17-3c3539f7-6bb7cf9c.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with shortness of breath, cough TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ at 14:46 FINDINGS: Cardiac silhouette size is within normal limits. The aorta remains tortuous with similar aneurysmal dilatation. Mediastinal and hilar contours are otherwise unchanged. Pulmonary vasculature is not engorged. There has been interval improvement in aeration of the lung bases with decreased atelectasis demonstrated. No new focal consolidation, pleural effusion or pneumothorax is present. Multiple remote bilateral rib fractures and compression deformities are again seen within the imaged thoracolumbar spine. Partially imaged is a stent graft within the abdominal aorta. IMPRESSION: Improved aeration of the lung bases with residual atelectasis. Otherwise, no substantial interval change from the previous exam performed earlier the same day. " 960942dd-b974abb7-c7cec489-3f97a4c7-57d5b363.jpg,test/p10/p10464640/s57448809/960942dd-b974abb7-c7cec489-3f97a4c7-57d5b363.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old woman with cirrhosis, FTT, on tube feeds // placement of Dobhoff placement of Dobhoff IMPRESSION: Compared to chest radiographs since ___, most recently ___ Feeding tube has been advanced into the upper stomach. Mild cardiac enlargement unchanged. Lungs grossly clear. Pleural effusions small if any. No pneumothorax. " b99dc6cc-9ef9db53-04ba3a10-f55ac523-f5f04af9.jpg,test/p19/p19085941/s51551647/b99dc6cc-9ef9db53-04ba3a10-f55ac523-f5f04af9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute pancreatitis, transferred for pancreatic pseudocyst // PICC line placement, pleural effusions, pulm infiltrates TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable in appearance. Mild interstitial edema is noted and has progressed in the interim. A left basal atelectasis is unchanged. Left PICC line tip terminates at the level of lower SVC. Slightly more focused left upper lobe opacity is to be further followed to exclude the possibility of developing infection " a5144404-8885b726-6745aed0-75d534a6-0f59545a.jpg,test/p17/p17556194/s50878495/a5144404-8885b726-6745aed0-75d534a6-0f59545a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pachymeningitis, ?TB with ongoing seizures. Newly febrile // ? PNA, infiltrate, aspiration TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiac size is normal. The mediastinum is unchanged with tortuous aorta. ET tube is in standard position. Right IJ catheter tip is in the cavoatrial junction. The left lung is grossly clear. Right pleural calcification and right pleural thickening is stable. There is no pneumothorax. large region of chronic calcific consolidation in the right mid lung is a slightly denser could be increasing atelectasis, pneumonia cannot be excluded. NG tube tip is coiled in the stomach the tip is pointing to the EG junction " f5124c24-e698db73-60c87543-431e5faa-b31b96e0.jpg,test/p19/p19577168/s50218934/f5124c24-e698db73-60c87543-431e5faa-b31b96e0.jpg,test," FINAL REPORT HISTORY: ___-year-old female with right-sided chest pain. COMPARISON: None available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax. No subdiaphragmatic free air is evident. IMPRESSION: No acute cardiopulmonary process. " cbd5fde4-4e076388-90c11101-d10d0fbf-e3e4c33b.jpg,test/p17/p17556194/s51170010/cbd5fde4-4e076388-90c11101-d10d0fbf-e3e4c33b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with dl picc and fevers of unknown origin COMPARISON: Prior exam from ___. FINDINGS: AP portable semi upright view of the chest. Left upper extremity PICC line again noted with unchanged position in the distal left brachiocephalic vein. Tracheostomy projects over the superior mediastinum. Area of partially calcified consolidation in the right lower lobe is grossly unchanged better assessed on prior CT. Streaky left lower lobe opacity likely represents atelectasis. Blunting of the right CP angle may indicate a small right pleural effusion. No large pneumothorax. Cardiomediastinal silhouette is unchanged. No acute bony abnormalities. IMPRESSION: Findings as above. No convincing signs of pneumonia. " 6e80c47c-d0378514-dcb3a728-25436c79-85cbacb1.jpg,test/p18/p18735467/s56766483/6e80c47c-d0378514-dcb3a728-25436c79-85cbacb1.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is identified, and no acute osseous abnormalities are detected. IMPRESSION: Normal chest radiograph. " be975cc2-ccb5457f-afa1819c-52d90cf5-eb0330b8.jpg,test/p12/p12043836/s57921474/be975cc2-ccb5457f-afa1819c-52d90cf5-eb0330b8.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Evaluate for pneumothorax. FINDINGS: The heart is severely enlarged. There is volume loss/infiltrate in both lower lungs. There is a left pleural effusion. The patient is status post valve replacement. Left-sided PICC line with tip in the SVC is unchanged. There is mild pulmonary vascular redistribution. Mediastinal drains have been removed. There is a small left apical pneumothorax. " 4016b648-7e315f93-bb0e5b74-87f1f530-7dd96d62.jpg,test/p16/p16660031/s54450069/4016b648-7e315f93-bb0e5b74-87f1f530-7dd96d62.jpg,test," FINAL REPORT INDICATION: Cough for three days. COMPARISON: ___ and ___. FINDINGS: AP and lateral chest radiographs. The lung volumes are low with bibasilar atelectasis. This also exaggerates the size of the heart. There is no large pleural effusion or pneumothorax. IMPRESSION: Low lung volumes and bibasilar atelectasis. " 38483bfd-e65e3b0a-109cc698-aa3ee20d-b8649f12.jpg,test/p15/p15885818/s59366881/38483bfd-e65e3b0a-109cc698-aa3ee20d-b8649f12.jpg,test," FINAL REPORT HISTORY: New onset AFib. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is minimal biapical pleural thickening. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 5adb1d49-ec751ff8-ae2f6cda-f8ad53e4-e0c3c469.jpg,test/p16/p16833478/s59443748/5adb1d49-ec751ff8-ae2f6cda-f8ad53e4-e0c3c469.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hereditary hemorrhagic telangiectasias, here with fever, cough, LUQ pain // r/o infiltrate COMPARISON: No comparison IMPRESSION: The lung volumes are relatively low. Borderline size of the cardiac silhouette without pulmonary edema. There is no evidence of pneumonia but, better seen on the lateral than on the frontal radiograph, small bilateral pleural effusions are present. No pneumothorax. Normal hilar and mediastinal structures. " 9a2a8e9b-aef06496-bcd5a587-eed10c2d-7dd611e4.jpg,test/p15/p15793371/s54902146/9a2a8e9b-aef06496-bcd5a587-eed10c2d-7dd611e4.jpg,test," WET READ: ___ ___ ___:___ PM Low lying ETT, recommend withdrawing by 2-3 cm. ______________________________________________________________________________ FINAL REPORT INDICATION: History of IV drug use, presenting with fevers and altered mental status. Now intubated. Assess for acute intrathoracic process. COMPARISON: Chest radiograph from ___ from ___. FINDINGS: A single AP radiograph of the chest was acquired. The endotracheal tube is low lying, ending 1.2 cm above the level of the carina. An enteric catheter courses below the level of the diaphragm and out of the field of view inferiorly. Lung volumes are low, causing exaggeration of the heart size and accentuation of the pulmonary vasculature. There is mild-to-moderate left retrocardiac atelectasis and minimal right lower lung atelectasis. Aspiration pneumonitis at the left lung base is not excluded. The lungs are otherwise clear. There are no pleural effusions. No pneumothorax is seen. The heart size is normal. The mediastinal contours are normal allowing for supine technique. IMPRESSION: 1. Low lung volumes with mild-to-moderate left lower lung atelectasis and minimal right lower lung atelectasis. Left lower lung aspiration pneumonitis in the setting of recent intubation is not excluded. 2. Low-lying endotracheal tube terminating 1.3 cm above the level of the carina. Recommend retraction by 2-3 cm. " b789a5e5-5e804fde-6669c556-9942af69-71abf0ba.jpg,test/p12/p12358216/s57662601/b789a5e5-5e804fde-6669c556-9942af69-71abf0ba.jpg,test," WET READ: ___ ___ ___ 6:02 PM Left chest tube has been removed. No residual pneumothorax. Right pigtail catheter at the base is new. No pneumothorax on this side either. Decrease in the size of the large right-sided pleural effusion although still present. Opacities in the left mid lung are relatively stable, perhaps a focus of infection so continued follow up is recommended ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old with right pleural effusion after chest tube placement and removal of left pleural effusion and pneumothorax. Assess pleural abnormalities. COMPARISON: ___ through ___. FINDINGS: IMPRESSION: Moderate right pleural effusion is much smaller following insertion of a right basal small bore catheter. Left pleural effusion is small if any. There is no pneumothorax on either side. Mild edema is present in the left lung. Heart size is normal. ET tube, right PICC line, and upper enteric drainage tube are all in standard placements. " d19b0782-2f523566-a6c55449-390ef1d5-7e4951a1.jpg,test/p11/p11025320/s59926864/d19b0782-2f523566-a6c55449-390ef1d5-7e4951a1.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with SOB // Eval for infiltrate TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Again noted punctate small calcific nodules as also noted in the prior study. No focal consolidation, pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 628746b3-b55db05f-7875d89b-00a54c0a-7e70b53a.jpg,test/p12/p12512852/s59091272/628746b3-b55db05f-7875d89b-00a54c0a-7e70b53a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. The lateral CP angle of the right hemithorax is excluded on the frontal projection. The lungs appear clear bilaterally. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. Please note limitations due to partial exclusion of the right CP angle. " 1c485aab-f6738b07-07e221ca-d4413c93-b16c4b07.jpg,test/p12/p12723922/s51913965/1c485aab-f6738b07-07e221ca-d4413c93-b16c4b07.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with hypoxia. Evaluate for pneumonia. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lung volumes are low, exaggerating mild to moderate cardiomegaly and mild vascular engorgement. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Patient is status post total arthroplasty of the right shoulder with the humeral component projecting inferiorly in relation to the glenoid component. Left-sided ICD leads project over the right atrium and the left ventricle. IMPRESSION: No acute cardiopulmonary process. Status post total arthroplasty of the right shoulder with humeral component projecting inferiorly. Please correlate clinically. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 5:43 AM, 5 minutes after discovery of the findings. " 235bb6d8-7592d260-2fe3b9f6-69fd4d07-ebeb3339.jpg,test/p17/p17459404/s53938913/235bb6d8-7592d260-2fe3b9f6-69fd4d07-ebeb3339.jpg,test," FINAL REPORT INDICATION: ___ year old man with pleural effusion. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___. Chest CT from ___, ___. FINDINGS: Compared to prior, there is homogeneous opacity in the left hemithorax with a small area of air and significant volume loss, likely due to complete left upper and lower lobe collapse with large pleural effusion replacing the area. Discontinuation of air column is seen in the left main bronchus, proximal to the bronchial stent. Shift of mediastinum to the left is seen. Heart size is unable to be evaluated. The right lung and right hilum appear normal. No significant right pleural effusion is seen. Chest tube is seen in the left hemithorax. Left bronchial stent appears grossly unchanged in location. IMPRESSION: Complete collapse of left upper and lower lobe, replaced with pleural effusion. " fac1ca6c-af6d70b0-d018b65a-66b85496-2d942f36.jpg,test/p16/p16514111/s55359858/fac1ca6c-af6d70b0-d018b65a-66b85496-2d942f36.jpg,test," FINAL REPORT HISTORY: ___-year-old man with cirrhosis and confusion. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest are provided. The lungs are clear. The hilar and mediastinal contours normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Two surgical clips are noted in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary process. " 73f4da07-91065bcb-db4786da-ceb8c72e-ddc408b0.jpg,test/p10/p10537484/s59103871/73f4da07-91065bcb-db4786da-ceb8c72e-ddc408b0.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of earlier the same day. FINDINGS: Right pigtail pleural catheter has been placed within the lower right hemithorax with associated evacuation of the previously large right effusion. Moderate right lateral and basilar pneumothorax is new. Improving aeration in right middle and lower lobes with residual partial atelectasis remaining. On the left, there is worsening retrocardiac opacity which probably reflects a combination of atelectasis and effusion, although coexistent pulmonary infection is also possible. " 0847d410-1fc68a32-0caf6725-445fae77-23c33403.jpg,test/p13/p13865397/s55403084/0847d410-1fc68a32-0caf6725-445fae77-23c33403.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD. s/p R lung resection for lung cancer now with 10 days of prod cough. // eval for PNA eval for PNA IMPRESSION: In comparison with the study of ___, there is little change. No evidence of acute focal pneumonia or vascular congestion. Bibasilar opacification is consistent with small pleural effusions or pleural thickening with mild atelectatic changes. " 86d21afa-6c8ee8df-578244ae-06f58281-a8bd0535.jpg,test/p14/p14211073/s53990115/86d21afa-6c8ee8df-578244ae-06f58281-a8bd0535.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fevers x 1 week*** WARNING *** Multiple patients with same last name! // eval pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 629fb509-2da9c6e3-8dd79d12-caa50b20-aff2e1a9.jpg,test/p16/p16750854/s50330435/629fb509-2da9c6e3-8dd79d12-caa50b20-aff2e1a9.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain, assess for pneumonia or CHF. FINDINGS: PA and lateral views of the chest provided. There is a prosthetic cardiac valve, likely an aortic valve replacement. Midline sternotomy wires and mediastinal clips are noted. The heart is within normal limits of size. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. Aortic valve replacement surgery noted. " 039aebc2-77cd67a9-ca9fb163-54172760-316aeb9d.jpg,test/p18/p18066864/s56870058/039aebc2-77cd67a9-ca9fb163-54172760-316aeb9d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Cirrhosis and hemoptysis with concern for PNA // evaluation for pneumonia, mass, edema, atelectasis evaluation for pneumonia, mass, edema, atelectasis IMPRESSION: In comparison with the study of ___, there again are low lung volumes which accentuate the transverse diameter of the cardiac silhouette. There is mild indistinctness of pulmonary vessels, which could reflect some elevated pulmonary venous pressure. No definite vascular congestion or acute focal pneumonia. " b1ae15c5-be7e7aad-ca861ef9-6ccfce11-53a7f858.jpg,test/p17/p17804391/s50166435/b1ae15c5-be7e7aad-ca861ef9-6ccfce11-53a7f858.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumo on R, s/p CT placement // ? resolving pneumo COMPARISON: Chest radiograph ___, chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Right chest tube is unchanged in position. Small, right apical pneumothorax and right basilar pneumothorax are unchanged. Small, bilateral pleural effusions are mildly worsened. Mild pleural thickening at the left apex is unchanged. Hilar and cardiomediastinal contours are normal. Posterior, minimally displaced right rib fractures involving definitely the sixth and probably the seventh and eighth ribs are unchanged. IMPRESSION: 1. Small, right apical pneumothorax and small, right basilar pneumothorax are unchanged. 2. Minimally displaced rib fractures are unchanged. " 136cc747-b3ac3bac-f11ab71b-29b3e459-2f31fa48.jpg,test/p14/p14582872/s55045355/136cc747-b3ac3bac-f11ab71b-29b3e459-2f31fa48.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with fall and hip fracture, preoperative exam TECHNIQUE: Supine AP view of the chest COMPARISON: None. FINDINGS: The patient is status post median sternotomy. Heart size is mildly enlarged. The aorta is diffusely calcified and tortuous. There is mild cephalization of pulmonary vascular markings, likely due to supine positioning. No overt pulmonary edema is present. Minimal patchy opacities are seen in the lung bases, likely reflective of atelectasis. Pleural thickening is seen involving both apices. No large pneumothorax or pleural effusion is seen on this supine exam. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary abnormality. " 3698d0b0-c88e24db-7731077f-97be15ee-47e66c98.jpg,test/p15/p15633489/s57960655/3698d0b0-c88e24db-7731077f-97be15ee-47e66c98.jpg,test," WET READ: ___ ___ ___ 10:44 AM Mild pulmonary edema is relatively stable compared to the prior radiograph performed on ___. Contrast is noted within the colon. The heart and mediastinal contours are stable. Low lung volumes. ___ ___. WET READ VERSION #1 ___ ___ 7:59 PM Mild pulmonary edema is relatively stable compared to the prior radiograph performed on ___ Contrast is noted within the colon. The heart and mediastinal contours are stable. Low lung volumes. ___ ___. WET READ VERSION #2 ___ ___ ___ 10:34 AM Mild pulmonary edema is relatively stable compared to the prior radiograph performed on ___. Contrast is noted within the colon. The heart and mediastinal contours are stable. Low lung volumes. ___ ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pulmonary edema // interval improvement of pulmonary edema interval improvement of pulmonary edema COMPARISON: Comparison to prior study dated ___ at 16 49 FINDINGS: PA and lateral views of the chest ___ at 17 42 from___ ___ are submitted. IMPRESSION: Lung volumes remain somewhat low. The perihilar vasculature is prominent and South lies consistent with underlying pulmonary venous hypertension that. On the main pulmonary artery is enlarged consistent with known underlying pulmonary hypertension. There is a reticular nodular interstitial abnormality which may be related to the patient's underlying aortic stenosis and mitral regurgitation reflecting interstitial edema, although an atypical infectious process or underlying interstitial lung disease should also be considered. Clinical correlation is advised. No pneumothorax. Contrast is seen within the descending and transverse colon. Layering small left effusion and possible smaller right effusion. " 35e5a496-f51e7cc4-1ac5108b-a3b7b06a-a6048a0a.jpg,test/p13/p13060714/s57370420/35e5a496-f51e7cc4-1ac5108b-a3b7b06a-a6048a0a.jpg,test," FINAL REPORT HISTORY: ___-year-old man with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest demonstrate clear lungs. Cardiac apex is unremarkable. No pleural effusion or pneumothorax. Surgical clips in the left axilla are present. IMPRESSION: No evidence of acute cardiopulmonary process. " 85b1d1b4-30de9d4d-37cc6595-825ab76e-4c3127fa.jpg,test/p11/p11583321/s57053394/85b1d1b4-30de9d4d-37cc6595-825ab76e-4c3127fa.jpg,test," WET READ: ___ ___ ___ 8:11 PM Right basilar linear opacities likely reflect atelectasis although pneumonia is possible. Left lung base is clear. No pleural effusion. Progression of compression fracture of one mid thoracic vertebral body with redemonstration of additional compression fractures in the thoracic spine. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Chest pain and cough. PA and lateral upright chest radiographs were reviewed in comparison to prior study obtained on ___. The post-sternotomy wires are unremarkable. Cardiomediastinal silhouette is stable. Lungs are essentially clear except for bibasal atelectasis, overall unchanged. Multiple compression fractures demonstrated on the lateral view are noted, progressed with progression of one of the mid thoracic vertebral body compression fractures. The bibasal opacities most likely represents areas of atelectasis. " 4b6160eb-33db13bb-516c1791-3df7281c-5d5b1b80.jpg,test/p11/p11068569/s56922961/4b6160eb-33db13bb-516c1791-3df7281c-5d5b1b80.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with history of asthma with new O2 requirement TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is mild to moderately enlarged with a left ventricular predominance. The mediastinal contours are unchanged. There is mild pulmonary vascular congestion, accentuated by the presence of low lung volumes. There is no focal consolidation, pleural effusion or pneumothorax present. Streaky atelectasis is noted in the lung bases. No acute osseous abnormality is detected. IMPRESSION: Mild pulmonary vascular congestion and mild bibasilar atelectasis. " 1cca45e6-a1373589-e54a720a-3f885856-76b5a4af.jpg,test/p12/p12547577/s53332099/1cca45e6-a1373589-e54a720a-3f885856-76b5a4af.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear within normal limits. There is mild elevation of the left hemidiaphragm and patchy opacification at the left base, but decreased, whereas other portions of the lungs appear clear. However, the left diaphragm is somewhat elevated which may indicate some atelectasis or mild gastric distension, noting new gastric air-fluid levels. There is probably a small pleural effusion on the left, noting posterior costophrenic blunting. IMPRESSION: Improving left basilar opacification. New gastric air-fluid levels with mild distension. " 535372d5-c8e2e0c4-87c4de81-c50dd68c-2536641a.jpg,test/p11/p11549602/s59877736/535372d5-c8e2e0c4-87c4de81-c50dd68c-2536641a.jpg,test," WET READ: ___ ___ ___ 7:13 PM left chest tube has been reposistioned, its tip now projects just superior to left hemidiaphragm. ET, NG, right IJ and left PICC unchanged. Right lung base atelectasis. Cannot excluded small left pneumothorax. Subq gas in left hemithorax persists. ___ ___ ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with C-spine osteomyelitis or epidural abscess. Portable AP radiograph of the chest was reviewed in comparison to ___. NG tube tip is 6.5 cm above the carina. Mediastinal silhouette is unchanged. Left chest tube is in place. There is small apical pneumothorax on the left. Right basal atelectasis and pleural effusions are unchanged. For precise details, please review CT thoracic spine obtained the same day earlier. " 41291d95-45f270b1-6b1a188e-b8e274b8-2f9458e5.jpg,test/p10/p10755736/s55256787/41291d95-45f270b1-6b1a188e-b8e274b8-2f9458e5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w stage 4B rectal cancer on Folfox, DM1 c/b diabetic nephropathy s/p kidney/pancreas transplant ___ yrs ago on tacro who was initially admitted to HMED for sepsis, found to have MSSA bacteremia, transferred to FICU on ___ (for the ___ time) for acute hypoxemic respiratory failure, now being transferred to CCU for concern for acute mitral regurgitation and pulmonary edema. Intubated. // interval change? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: After diuresis extensive bilateral opacities improved. Still there are remain dense peribronchial bilateral consolidations larger in the right lung. Lines and tubes are in unchanged standard position. There is no pneumothorax or enlarging pleural effusions " 928a58f3-1880a385-d37a9b0e-08041afc-2e7a244e.jpg,test/p14/p14597978/s57388355/928a58f3-1880a385-d37a9b0e-08041afc-2e7a244e.jpg,test," WET READ: ___ ___ 10:37 PM Endotracheal tube is in appropriate position. The PICC unchanged in position with the tip projecting over the cavoatrial junction. Nasoenteric tube tip projects over the stomach with the side port likely at the GE junction. Lungs are grossly clear. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p left fem pop exploration // post op baserline- tubes, lines TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: A right-sided PICC terminates in the distal SVC. The patient is intubated, the endotracheal tube is positioned 4 cm above the level of the carina. A nasogastric tube is in-situ, the tip terminates below the diaphragm. Lung volumes are slightly low resulting crowding of the bronchovascular structures. Mild prominence of the interstitial markings and bilateral hila is likely related to this. No frank pulmonary edema. The cardiomediastinal contour is unchanged compared to the prior study. No consolidation or pneumothorax. IMPRESSION: Low lung volumes. No acute cardiopulmonary process seen. " 8a5469c7-2a8112cb-f22e147d-45c3c4e6-54be8ac6.jpg,test/p11/p11582633/s55937820/8a5469c7-2a8112cb-f22e147d-45c3c4e6-54be8ac6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB acute ___ chest pressure // aortic dissection? PNA? COMPARISON: ___ PA and lateral chest radiograph and ___ portable chest radiograph FINDINGS: Cardiomediastinal contours are stable in appearance compared to previous portable radiograph of ___ when consideration is made for differences in positioning. Pulmonary vascularity is normal, and lungs are clear. Lateral left costophrenic sulcus is not well demonstrated but has similar appearance to previous study. IMPRESSION: No portable radiographic findings to suggest pneumonia or complications of aortic dissection. However, a portable chest radiograph has a low sensitivityive for diagnosing aortic dissection, and dedicated chest CTA may be considered if there remains clinical suspicion for this entity. " 0909e20b-f91c2986-db5c0bcb-e03dfb05-a68c693a.jpg,test/p13/p13292409/s53021969/0909e20b-f91c2986-db5c0bcb-e03dfb05-a68c693a.jpg,test," FINAL REPORT HISTORY: Asthma flareup with coughing, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Mild apical pleural thickening is again seen on the right. " db56c72f-21109d23-6fe6dd7b-04e7d1b3-b2de46b8.jpg,test/p12/p12645334/s55453370/db56c72f-21109d23-6fe6dd7b-04e7d1b3-b2de46b8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with CHF, liver transplant with ascites, increasing shortness of breath, dyspnea on exertion TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: Moderate enlargement of the cardiac silhouette persists. The mediastinal contour is unchanged with atherosclerotic calcifications noted at the aortic knob. Mild pulmonary edema is slightly worse in the interval with moderate size bilateral pleural effusions, increased in size. Patchy opacities in the lung bases, more so on the right likely reflect areas of atelectasis. No pneumothorax is present. Degenerative changes are again noted within the thoracic spine. IMPRESSION: Mild pulmonary edema and moderate size bilateral pleural effusions, worse in the interval. Bibasilar atelectasis. " 5ace35ba-f1d287c1-dcac2484-e3e5c9b9-656419f7.jpg,test/p11/p11107985/s52709835/5ace35ba-f1d287c1-dcac2484-e3e5c9b9-656419f7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Positive PPD, evaluation for lung lesions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Minimal atelectasis at the right lung bases. No evidence of acute lung disease, in particular no signs for active or non-active TB. No pleural effusions. No lung nodules or masses. Normal hilar and mediastinal contours. " dfbda0c4-7e740e7b-94781918-f333c2ac-47899810.jpg,test/p13/p13930488/s53027734/dfbda0c4-7e740e7b-94781918-f333c2ac-47899810.jpg,test," FINAL REPORT HISTORY: ___-year-old male with 3-week history of cough and colon hinged. History of pulmonary nodules and smoking history. COMPARISON: Chest x-ray ___. Chest CT from ___. FINDINGS: PA and lateral views of the chest. The lungs are clear of consolidation, effusion, or pulmonary vascular congestion. Nodular opacity projecting over the anterior left 5th rib is thought to represent a nipple shadow. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 12c55ec7-8724f3ac-7e360867-e9075f1d-c0e3a4d9.jpg,test/p11/p11238238/s55340619/12c55ec7-8724f3ac-7e360867-e9075f1d-c0e3a4d9.jpg,test," FINAL REPORT AP CHEST, 5:58 A.M., ___ HISTORY: Strep pneumonia. IMPRESSION: AP chest compared to ___: Large scale consolidation in both lower lobes, left greater than right, is improving. Pleural effusion small on the left, also decreased. Heart size normal. Mild pulmonary edema on ___ has not recurred. No pneumothorax. " 4338f52d-74d9129e-1c539768-e982de1b-47b39e57.jpg,test/p18/p18752908/s56087560/4338f52d-74d9129e-1c539768-e982de1b-47b39e57.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: New seizure, prior smoking, evaluation. COMPARISON: ___. FINDINGS: The lung volumes are normal. No evidence of pneumonia. No pulmonary edema, no pleural effusion, no lung nodules or masses. Mild bilateral symmetrical apical thickening. Normal size of the cardiac silhouette. Endotracheal tube and nasogastric tube, seen in ___, are no longer present. " b39e9915-c3f6d9b2-8ab5a191-a042a815-6e8e8d87.jpg,test/p13/p13312152/s58746490/b39e9915-c3f6d9b2-8ab5a191-a042a815-6e8e8d87.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypercarbic respiratory failure // eval lung IMPRESSION: As compared to previous radiograph from earlier the same date, there has been substantial improvement in left lower lobe atelectasis. Remainder of the exam is not appreciably changed except for advancement of a nasogastric tube into the body of the stomach. " 8e554750-7cd71450-3d6ec355-7269bd99-fabef89c.jpg,test/p13/p13961236/s57121381/8e554750-7cd71450-3d6ec355-7269bd99-fabef89c.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pacemaker placement, to assess for the lead position. TECHNIQUE: PA and lateral chest views were reviewed and read in comparison with the prior radiograph from ___. FINDINGS: Patient has received a new left pectoral pacemaker with a single lead ending into the right ventricle. There is no pneumothorax. Mildly elevated left hemidiaphragm is mostly secondary to gas-distended bowel. Pleural effusion if any is small on the left side. Since ___, moderately severe pulmonary edema has completely resolved. There is no pleural effusion on the right side. No discrete lung opacities of concern. Mild to moderately enlarged heart is stable. The thoracic aorta is moderately calcified and tortuous. " 8baceb5b-b82d1586-6b5fee11-47d0efe5-9ab0f240.jpg,test/p10/p10336114/s58646090/8baceb5b-b82d1586-6b5fee11-47d0efe5-9ab0f240.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The patient is status post coronary artery bypass graft surgery. The heart appears mildly enlarged. The cardiac, mediastinal and hilar contours appear unchanged. There is a moderate left-sided pleural effusion, probably with some degree of loculation along the left lateral hemithorax, as well as patchy parenchymal opacity, most likely compatible with atelectasis. On the right, there is also a pleural effusion, probably free-flowing and small to moderate in size. There is also a small pneumothorax on the right. The distance between the apical visceral pleural edge and the outer chest wall measures about 2.2 cm. A mild interstitial abnormality suggests mild pulmonary edema. Fissures are thickened. The bones are probably demineralized. IMPRESSION: Pneumothorax on the right. Bilateral pleural effusions. Interstitial abnormality suggesting mild pulmonary edema. Although opacities at the lung bases, greater on the left than right, are probably compatible with atelectasis, underlying infectious process is not entiredly excluded by this examination. " 3fd1a756-e83f776e-e83f79e7-762ab4e0-abc998f9.jpg,test/p10/p10037432/s53928123/3fd1a756-e83f776e-e83f79e7-762ab4e0-abc998f9.jpg,test," FINAL REPORT HISTORY: Fall on left side of chest, complaining of pain. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is normal. Mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. No definite fracture is identified. There is no evidence of a pneumoperitoneum. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. No definite fracture. If there is focal area of concern, dedicated rib series may be helpful. " ce179372-14e9ec77-5c1cb492-9864d149-e9975bb5.jpg,test/p16/p16874100/s56428586/ce179372-14e9ec77-5c1cb492-9864d149-e9975bb5.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Weakness, questionable pneumonia. COMPARISON: No comparison available at the time of dictation. FINDINGS: The patient is rotated and has a moderately well calcified right-sided aortic arch. There is no evidence of pneumonia, no pleural effusion and no pneumothorax. The overall prominence of the pulmonary vessels, however, suggests mild fluid overload. Normal size of the cardiac silhouette. " 13c8fd5c-87cf607f-fe9f06d8-4eb85744-39c29eba.jpg,test/p12/p12299124/s58535120/13c8fd5c-87cf607f-fe9f06d8-4eb85744-39c29eba.jpg,test," FINAL REPORT INDICATION: ___ year old man with preop angio // preop Surg: ___ (angio) TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ and CT abdomen pelvis dated ___ FINDINGS: Normal highest size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. Calcified structures in the left upper quadrant are unchanged consistent with prior calcified splenic hematoma. Additional calcifications are seen in the mid abdomen and right upper quadrant compatible with chronic pancreatitis and nephrolithiasis. Upper lobe emphysema is most likely present IMPRESSION: No acute process. " 0e27fe48-726e1b05-c3a54bbe-6e1402d5-9c841a15.jpg,test/p12/p12784119/s51796692/0e27fe48-726e1b05-c3a54bbe-6e1402d5-9c841a15.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough, chills, myalgias, HIV // PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There has been interval improvement in right-sided parenchymal opacities which have essentially resolved. No new focal consolidation is seen. Blunting of the left costophrenic angle is re- demonstrated. No right pleural effusion is seen. There is no pneumothorax. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Interval improvement in previously seen right-sided parenchymal opacities which are now essentially resolved. Trace left pleural effusion. " 913fd1de-78ce25e1-4ceb33cf-a57015d5-308c7a29.jpg,test/p17/p17885927/s50201327/913fd1de-78ce25e1-4ceb33cf-a57015d5-308c7a29.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETT // ETT position, please do tomorrow am TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 19:36 IMPRESSION: There is substantial interval change in the right mediastinal contour that might reflect interval development of atelectasis or potential portion of the right middle lobe. The ET tube tip is in place, 6.5 cm above the carinal. Name ___ hematoma on the right is another possibility. Correlation with patient's symptoms and potentially chest CT is to be considered. NOTIFICATION: Discussed with Dr. ___ ___ the phone by Dr. ___ at 11:30 on ___ " 65394539-2b765035-6f05dc14-13d21c5b-cfbe9f45.jpg,test/p11/p11528387/s58263220/65394539-2b765035-6f05dc14-13d21c5b-cfbe9f45.jpg,test," FINAL REPORT HISTORY: CLL; cough. TECHNIQUE: PA and lateral chest radiograph 4 views. COMPARISON: ___. FINDINGS: Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph; specifically, no evidence of pneumonia. " d4260b83-f4fa5e3a-283bc4e7-eee94146-f7bdf45e.jpg,test/p16/p16068752/s59114039/d4260b83-f4fa5e3a-283bc4e7-eee94146-f7bdf45e.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPHS DATED ___ COMPARISON: ___. FINDINGS: Cardiomediastinal contours are within normal limits and without change when allowances are made for accentuation by lower lung volumes on today's study. Lungs are clear except for linear bibasilar atelectasis. There is no pleural effusion or pneumothorax. No acute, displaced rib fracture is evident on this chest radiograph examination. IMPRESSION: No evidence of pneumothorax or grossly displaced anterior rib fracture. Conventional chest radiographs are relatively insensitive for detecting anterior rib fractures, and dedicated coned-down rib radiograph at the site of point tenderness could be considered for more complete evaluation if warranted clinically. " 1f5eed68-0bbb0f45-115281fa-df71f029-33861607.jpg,test/p12/p12724735/s57141823/1f5eed68-0bbb0f45-115281fa-df71f029-33861607.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with sob, hypoxia // eval effusions TECHNIQUE: Portable chest radiograph COMPARISON: Chest radiograph ___ FINDINGS: There are parenchymal opacities, most pronounced at the lung bases bilaterally, which most likely represents pulmonary edema. However, pneumonia or aspiration cannot be excluded. There are likely small pleural effusions bilaterally. There is upper zone redistribution. No pneumothorax. Heart size is mildly enlarged. Right-sided hemodialysis dual-lumen catheter terminates in the right atrium. Note is made of surgical clips in the left paratracheal region, near the left lung apex. IMPRESSION: Parenchymal opacities predominantly at the lung bases along with probable pleural effusions most likely represents pulmonary edema. However, infection or aspiration cannot be excluded in the appropriate clinical setting. Small bilateral pleural effusions cannot be excluded. " 37551b51-f49e388b-96d92abb-fd7ab3e9-fb921378.jpg,test/p16/p16755216/s53015976/37551b51-f49e388b-96d92abb-fd7ab3e9-fb921378.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for ___ years // cough for ___ years cough for ___ years IMPRESSION: In comparison with study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural " 87a2d74c-aa75de5c-c7c309d9-923dfb11-c4eaed69.jpg,test/p10/p10532853/s50945569/87a2d74c-aa75de5c-c7c309d9-923dfb11-c4eaed69.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Tachycardia, chest pain and reduced right-sided breath sounds. TECHNIQUE: Chest, AP portable. COMPARISON: ___. FINDINGS: The heart is again moderately enlarged. The main pulmonary artery contour is also prominent. Indistinct pulmonary vascularity and hilar engorgement suggest mild pulmonary venous hypertension. A moderate pleural effusion on the right appears unchanged with likely atelectatic changes in the right middle and dependent lower lobes. There has been no definite change. IMPRESSION: Persistent right-sided pleural effusion with probable atelectasis. Findings suggest pulmonary venous hypertension. Moderate to severe cardiomegaly. " 7be40eaf-72fcfbd4-251c6b7b-8c38a7c0-2e1debc2.jpg,test/p14/p14839725/s52362352/7be40eaf-72fcfbd4-251c6b7b-8c38a7c0-2e1debc2.jpg,test," FINAL REPORT INDICATION: ___-year-old female with inflammatory arthropathy and dyspnea, here to evaluate for interstitial lung disease. COMPARISON: No prior studies available. FINDINGS: Frontal and lateral radiographs of the chest show appropriate inspiratory lung volumes. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. The pulmonary vasculature is not engorged. There is no interstitial prominence. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. IMPRESSION: No evidence of interstitial lung disease. " 6a6d25d4-0cd83aeb-fb8b3477-6800413c-b5af309f.jpg,test/p15/p15395979/s51928530/6a6d25d4-0cd83aeb-fb8b3477-6800413c-b5af309f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough shortness of breath // eval for pna COMPARISON: None available FINDINGS: There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 1e317011-de1cbac0-81f9cb8a-34db0d4b-0abafa13.jpg,test/p15/p15690303/s56575228/1e317011-de1cbac0-81f9cb8a-34db0d4b-0abafa13.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with left pneumothorax. Chest tube removal. COMPARISON: ___. FINDINGS: Left chest tube has been removed. There is no visible pneumothorax. Subcutaneous air has decreased. ET tube, left jugular line, NG tube are in adequate position. Bilateral widespread lung opacities are unchanged, pleural effusions are probably small. Mediastinal and cardiac contours, mild enlargement are stable. CONCLUSION: There is no pneumothorax after chest tube removal. Subcutaneous air has decreased. Unchanged bilateral widespread opacities. " e3d14589-e86561fb-ead3161b-5d835260-b1bec32c.jpg,test/p16/p16031267/s53522597/e3d14589-e86561fb-ead3161b-5d835260-b1bec32c.jpg,test," WET READ: ___ ___ 8:19 AM 1. Sequential frontal radiographs of the chest and upper abdomen demonstrate placement of an enteric tube, with final position of the distal tip overlying the gastric body. 2. Stable position of the left sided central venous catheter with distal tip projecting over the low SVC versus cavoatrial junction. 3. Interval removal of an ET tube. 4. There is a mildly enlarged cardiac silhouette, along with centrally-predominant fluffy airspace opacities, and suggestion of a interlobular septal thickening most apparent at the peripheral right lung, compatible pulmonary vascular congestion and mild volume overload. 5. More conspicuous airspace opacity in the right lower lung is again seen, possibly sequela of aspiration pneumonitis or pneumonia. C. Hostage p___WET READ VERSION #1 ___ ___ ___ 8:25 PM 1. Sequential frontal radiographs of the chest and upper abdomen demonstrate placement of an enteric tube, with final position of the distal tip overlying the gastric body. 2. Stable position of the left sided central venous catheter with distal tip projecting over the low SVC versus cavoatrial junction. 3. Interval removal of an ET tube. 4. There is a mildly enlarged cardiac silhouette, along with centrally-predominant fluffy airspace opacities, and suggestion of a interlobular septal thickening most apparent at the peripheral right lung, compatible pulmonary vascular congestion and mild volume overload. 5. More conspicuous airspace opacity in the right lower lung is again seen, possibly sequela of aspiration pneumonitis or pneumonia. C. Hostage p_________________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with seizures s/p fall and intraparenchymal contusions now s/p dobhoff placement // dobhoff placement Contact name: ___, ___: ___ IMPRESSION: As compared to previous radiograph of ___, serial radiographs document placement of a feeding tube into the body of the stomach. Exam is otherwise remarkable for worsening bilateral asymmetrically distributed alveolar opacities, which could be due to multifocal aspiration and or developing infection in the appropriate clinical setting. " 0aba79b9-1873c229-523c8da6-d46d1637-f2e38b95.jpg,test/p17/p17396346/s58046382/0aba79b9-1873c229-523c8da6-d46d1637-f2e38b95.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Upper abdominal pain, cough and fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are areas of linear atelectasis/scarring in the right middle and lower lobes. Subtle blunting of the posterior costophrenic angle on the lateral view may be artifactual, although trace pleural effusions are not excluded. The cardiac silhouette remains enlarged. Mild pulmonary edema is again seen, similar to prior. Surgical clips are again seen projecting over the left axilla. IMPRESSION: Persistent mild cardiomegaly and mild pulmonary edema. Areas of atelectasis/scarring. " c96bfc1f-d978c936-fe7c9e17-1383f84b-175e8733.jpg,test/p16/p16478119/s50487346/c96bfc1f-d978c936-fe7c9e17-1383f84b-175e8733.jpg,test," WET READ: ___ ___ ___ 8:04 PM Right lower lobe consolidation concerning for pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough and fever // r/o pna COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. Airspace consolidation is seen within the right lower lobe, concerning for pneumonia. Elsewhere, lungs are clear. No large effusion or pneumothorax. No signs of congestion or edema. The heart and mediastinal contours appear normal. The imaged bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Right lower lobe consolidation concerning for pneumonia. " 245a5834-0cbf48c4-e391f0a9-af993483-3aa9ddb8.jpg,test/p11/p11084812/s55142486/245a5834-0cbf48c4-e391f0a9-af993483-3aa9ddb8.jpg,test," FINAL REPORT INDICATION: ___-year-old female with CHF, presents with shortness of breath and weakness. COMPARISONS: Chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded, show mild interstitial opacities with more confluent left lower lobe opacities. The cardiac silhouette is mildly enlarged. The mediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present. Evaluation is limited due to poor photon penetration. IMPRESSION: Mild to moderate pulmonary edema. " 59f55770-3e97de73-2f7c599a-feb243c3-e4d9f733.jpg,test/p10/p10504635/s56153348/59f55770-3e97de73-2f7c599a-feb243c3-e4d9f733.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph from ___. CLINICAL HISTORY: Multifocal pneumonia, AML, question interval change. FINDINGS: AP upright portable chest radiograph is obtained. A left arm PICC line is again noted with its tip residing at the expected level of the superior vena cava. The previously detected pneumonia has completely resolved in the interval. The lungs appear well aerated bilaterally. Left CP angle partially excluded. Cardiomediastinal silhouette appears normal. No pneumothorax. Bony structures intact. IMPRESSION: Interval resolution of pulmonary opacities/pneumonia. PICC line is in appropriate position. " 4bf3faa9-5fb234d5-d85489b7-27218680-3d5cbdba.jpg,test/p19/p19819686/s52547154/4bf3faa9-5fb234d5-d85489b7-27218680-3d5cbdba.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Fever, assess pneumonia. FINDINGS: Supine portable AP view of the chest provided. Evaluation limited due to severe dextroscoliotic deformity and kyphotic angulation of the chest. Allowing for this, no definite signs of pneumonia or overt CHF. No large effusion or pneumothorax is seen. Overall, cardiomediastinal silhouette appears essentially stable. IMPRESSION: Limited, negative. " e9d149a6-4d05fb32-814713a1-fe15bffa-d2fe0341.jpg,test/p14/p14951470/s52989909/e9d149a6-4d05fb32-814713a1-fe15bffa-d2fe0341.jpg,test," FINAL REPORT INDICATION: Syncope. Evaluate for pneumonia. COMPARISON: Chest radiographs, ___, ___ and ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 7c884b74-c9ae82de-757242be-da702146-12a21445.jpg,test/p17/p17528875/s59596488/7c884b74-c9ae82de-757242be-da702146-12a21445.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 603947e2-d52a5cac-6e78bae8-b35fa097-ccddbce6.jpg,test/p13/p13922124/s51054954/603947e2-d52a5cac-6e78bae8-b35fa097-ccddbce6.jpg,test," FINAL REPORT INDICATION: ___M with cough, abd pain diffusely, and hypotensive, evaluate for infection. TECHNIQUE: Chest PA and lateral COMPARISON: 1. Chest x-ray ___ 2. CT chest ___. FINDINGS: There is a right chest tunneled line with tip projecting over the low SVC versus cavoatrial junction. An enteric tube courses inferiorly with distal tip projecting below the lower limit of the radiograph. The cardiomediastinal silhouette is stable. Hazy opacities at the right cardiophrenic angle are unchanged in comparison to prior exams and likely reflect superimposition of normal structures. Retrocardiac opacity better seen on subsequent CT. The hilar within normal limits. There is no pulmonary edema. There is no focal lung consolidation. There is no pneumothorax or sizable pleural effusion. IMPRESSION: Retrocardiac opacity better seen on subsequent CT which could represent infection and/or aspiration. " 31d485e1-2c4f2bdd-44b21e75-9837fc0f-98b5a050.jpg,test/p14/p14942408/s52654753/31d485e1-2c4f2bdd-44b21e75-9837fc0f-98b5a050.jpg,test," FINAL REPORT HISTORY: History of chest pain, headache. Please evaluate mediastinum. COMPARISON: Chest radiograph from ___ and CT abdomen and pelvis from ___. TECHNIQUE: Frontal and lateral radiographs of the chest FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. Note is made of mild right apical pleural thickening. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. There is a nodular opacity overlying the left posterior 9th rib, which may correlate to the nodule seen on the prior CT. The visualized osseous structures are unremarkable. IMPRESSION: Minimal tortuosity of the aorta, similar to prior. Otherwise, the hilar and mediastinal contours are unremarkable. No acute intrathoracic abnormalities identified. " ea3915ae-3db0725b-3ca2226c-66f7085c-007802c1.jpg,test/p19/p19071652/s54169822/ea3915ae-3db0725b-3ca2226c-66f7085c-007802c1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. Moderate-to-severe cardiomegaly persists. Also persisting are signs of mild-to-moderate fluid overload. No larger pleural effusions. No pneumonia. " df3d7205-18c96293-fe6d89ce-400fd65a-ada6b423.jpg,test/p14/p14948594/s56290966/df3d7205-18c96293-fe6d89ce-400fd65a-ada6b423.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // eval for ptx TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. Hypertrophic changes seen the spine, no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 33d3476b-41c040dc-011684d8-0a4779d5-38b765b1.jpg,test/p14/p14108973/s57317988/33d3476b-41c040dc-011684d8-0a4779d5-38b765b1.jpg,test," FINAL REPORT HISTORY: Pleural effusion. FINDINGS: In comparison with study of ___, there is some increase in the degree of left pleural effusion with the smaller right effusion stable. Compressive atelectatic changes are seen at the bases in this patient with previous CABG procedure. Disruption of the superior sternal wire is unchanged, as is the position of the dual-channel pacemaker. No definite vascular congestion. " d97d45e6-466ad6ea-6cb2dde1-748422e6-07cca631.jpg,test/p18/p18124415/s57643569/d97d45e6-466ad6ea-6cb2dde1-748422e6-07cca631.jpg,test," FINAL REPORT INDICATION: History of subclavian line placement. Question pneumothorax. COMPARISONS: Chest radiograph from ___. FINDINGS: Single portable chest radiograph was provided. A right subclavian central line terminates at the cavoatrial junction. Prominence of pulmonary vasculature may be due to low lung volumes and resultant bronchovascular crowding. There is no pneumothorax, pleural effusion or focal consolidation. Cardiomediastinal silhouette appears enlarged, likely due to technique. IMPRESSION: 1. Right subclavian central line terminates at the cavoatrial junction. 2. Low lung volumes and findings which may represent mild fulid overload but no overt edema. " b9b626d3-3fa4ce1c-a2c149d5-41fd1f7f-78995a11.jpg,test/p15/p15645388/s54062507/b9b626d3-3fa4ce1c-a2c149d5-41fd1f7f-78995a11.jpg,test," FINAL REPORT INDICATION: Chest pain. Assess for pneumonia. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. A 3 mm nodular opacity projects over the left mid lung zone. Partially imaged upper abdomen is unremarkable. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. A 3 mm nodular opacity projecting over left mid lung zone of indeterminate chronicity due to lack of prior exams. If prior exams cannot be obtained for comparison, a chest CT may be obtained for further assessment or alternatively, this lesion may be followed with conventional chest radiographs in six months. Findings emailed to QA nurse for communication at 4:10 pm ___ by phone. " 9cadcf41-6f921a49-f8f20595-f352c2a3-d1850721.jpg,test/p19/p19593443/s59210355/9cadcf41-6f921a49-f8f20595-f352c2a3-d1850721.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // ? lungs clear ? lungs clear IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. The basilar atelectatic changes persist, more prominent on the right. In the appropriate clinical setting, the asymmetric opacification at the right base would have to raise the possibility of developing consolidation. " d4fc23f7-a476c304-e8ba153e-15488563-8dc80c61.jpg,test/p10/p10374536/s55518667/d4fc23f7-a476c304-e8ba153e-15488563-8dc80c61.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dyspnea // r/o CHF r/o CHF IMPRESSION: In comparison with the study of ___, there is little interval change. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Single lead pacer again extends to the region of the apex of the right ventricle. " 106df8c1-e6911050-b5ef7b32-c04648f0-6888c5be.jpg,test/p18/p18071110/s58831216/106df8c1-e6911050-b5ef7b32-c04648f0-6888c5be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman presented with high degree AV block. Underwent PPM on ___ // Eval for any complications. TECHNIQUE: Chest PA and lateral COMPARISON: ___ IMPRESSION: There is a new dual lead pacemaker with tips projecting over the expected location. There is volume loss in both lower lungs. Lower lobe infiltrates cannot be excluded. There is no pneumothorax. " fc3b65a9-45374d5d-61c0e937-ce1eb755-62fcf4c7.jpg,test/p16/p16249146/s50327427/fc3b65a9-45374d5d-61c0e937-ce1eb755-62fcf4c7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, sweats for five days, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged evidence of a large hiatal hernia. The size of the cardiac silhouette is unchanged and at the upper range of normal. There is no pulmonary edema. No pleural effusion is seen. The lung parenchyma is normal. No hilar or mediastinal abnormalities. " 8ac2fe00-671bdd79-9357cbcc-096e5f3b-d18e9cc7.jpg,test/p12/p12823036/s56654311/8ac2fe00-671bdd79-9357cbcc-096e5f3b-d18e9cc7.jpg,test," WET READ: ___ ___ ___ 8:45 PM Patchy nodular opacities demonstrated within both lung bases, more so on the right. Findings are concerning for an infectious process or aspiration. ______________________________________________________________________________ FINAL REPORT HISTORY: Fever and wheezing. TECHNIQUE: Upright AP view of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Ill-defined patchy nodular opacities are noted within the lung bases, most pronounced in the right lung base. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Patchy nodular opacities demonstrated within both lung bases, more so on the right. Findings are concerning for an infectious process or aspiration. " 4d71837b-ecfacf04-9397a4f7-b39b8daa-2e1f693d.jpg,test/p15/p15154432/s59917547/4d71837b-ecfacf04-9397a4f7-b39b8daa-2e1f693d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p ___ procedure for perforated diverticulitis c/b septic shock, acute respiratory failure, and leukopenia. // please assess interval changes TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: NG tube tip isout of view, below the diaphragm. Tracheostomy tube is in standard position. Left IJ catheter tip is in the proximal right atrium, unchanged. There are persistent low lung volumes. Bibasilar opacities have markedly improved consistent improved atelectasis and resolved to collapsed left lower lobe. Bilateral effusions are less less conspicuous than before. Mild to moderate pulmonary edema is unchanged. Cardiomediastinal contours are stable with moderate cardiomegaly and tortuous aorta " 6c0e49ce-fccb63bf-4fa9b15d-6e6767de-0a28bc2b.jpg,test/p13/p13014961/s56333584/6c0e49ce-fccb63bf-4fa9b15d-6e6767de-0a28bc2b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman // eval dobhoff placement,low chest eval dobhoff placement,low chest IMPRESSION: Compared to chest radiographs ___ through ___. Moderate bilateral pleural effusions, substantial bibasilar atelectasis, particularly on the left, mild pulmonary edema, and widening of the vascular upper mediastinum have all worsened since ___, stable since ___. No pneumothorax. ET tube, left internal jugular line are in standard placements. Transesophageal feeding tube may end in the duodenum. " 800bb2e3-9d2a5eaf-3930cbef-66bc0846-514dfaa5.jpg,test/p16/p16852352/s57774212/800bb2e3-9d2a5eaf-3930cbef-66bc0846-514dfaa5.jpg,test," FINAL REPORT TECHNIQUE: Single supine portable radiograph of the chest was reviewed in comparison with prior chest x-ray from ___. FINDINGS: Both lung volumes are low. Minimal bibasilar atelectasis is unchanged. Top normal heart size. Mediastinal and hilar contours are stable. Pleural effusion. There are lung opacities concerning for pneumonia. " 9dde8c14-8eeb1f7e-ee6833b2-1e2e467b-a9c93998.jpg,test/p12/p12614215/s57660117/9dde8c14-8eeb1f7e-ee6833b2-1e2e467b-a9c93998.jpg,test," FINAL REPORT HISTORY: Decreased breath sounds on the right. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest demonstrate a small right hemithorax. There is volume loss within the right lower lobe that has the appearance of previous surgery. Additionally, there is a suggestion of a focus of calcification in the right lower lung zone. The left lung is clear. The cardiomediastinal silhouette is unremarkable. There is no pneumothorax. IMPRESSION: Small right hemithorax with lower lobe volume loss, could be postsurgical in nature or could represent calcified fibrothorax, a chest CT can be obtained for further evaluation. Findings were discussed with Dr. ___ by Dr. ___ ___ the telephone on ___ at 11:00, ___ min after findings were made. " 99aae2f7-5d9ec823-f9b570bd-57c5fd06-95a0085c.jpg,test/p13/p13126641/s54666778/99aae2f7-5d9ec823-f9b570bd-57c5fd06-95a0085c.jpg,test," FINAL REPORT INDICATION: ___-year-old male with weakness, possible pneumonia and upper gastrointestinal bleed. Please evaluate for pulmonary edema or intra-abdominal free air. TECHNIQUE: Portable frontal chest radiograph was obtained. COMPARISON: Chest radiograph from ___ and chest CT from ___. FINDINGS: The patient is status post median sternotomy, and multiple mediastinal surgical clips reflect prior thymoma resection. Streaky bilateral paramediastinal, predominately upper lobe, fibrotic changes are compatible with prior radiation treatment as seen on the prior CT, and there may be mild central vascular congestion. No pleural effusion is seen. No focal consolidation or overt pulmonary edema is noted. The heart is top-normal in size. No intra-abdominal free air is noted in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. No intra-abdominal free air seen. " a3dd7adb-91833728-408c88e1-7b90dfd4-a777b727.jpg,test/p15/p15005501/s56022932/a3dd7adb-91833728-408c88e1-7b90dfd4-a777b727.jpg,test," FINAL REPORT INDICATION: PICC line placement TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: PICC line in situ at the cavoatrial junction. The cardiomediastinal shadow is normal. No airspace consolidation. No pulmonary edema. No pleural effusion. No pneumothorax. IMPRESSION: Right-sided PICC line in situ with the tip at the cavoatrial junction. " 12814968-ca8315ef-a4d9d618-9ff8d42b-bd0f0b9f.jpg,test/p12/p12797228/s53065561/12814968-ca8315ef-a4d9d618-9ff8d42b-bd0f0b9f.jpg,test," FINAL REPORT AP CHEST, 3:09 P.M. ON ___ HISTORY: ___-year-old female with COPD, diabetes, unresponsive and now more hypoxic. IMPRESSION: AP chest compared to ___ through ___: Right apical pleural parenchymal opacity is probably scarring. Since early ___, severe bibasilar atelectasis and a transient pneumonia have resolved. There is no appreciable pleural effusion, and the heart size is normal. " e8e62cb8-a64b1e5a-03d82487-48174e68-a23bb5ed.jpg,test/p14/p14689761/s58600132/e8e62cb8-a64b1e5a-03d82487-48174e68-a23bb5ed.jpg,test," FINAL REPORT INDICATION: Cough. COMPARISONS: ___ to ___. FINDINGS: PA and lateral chest radiographs were obtained. Multiple bilateral pulmonary nodules are similar in size and number to ___, but have increased since ___. There is no consolidation, effusion or pneumothorax. Right hilar enlargement is unchanged. No new abnormal cardiac or mediastinal contours. IMPRESSION: Hilar enlargement and multiple pulmonary nodules compatible with history of sarcoidosis. Pulmonary nodules appear grossly stable since ___. However, they are increased since ___ and a non-urgent CT scan of the chest is still recommended for complete evaluation if this has not been done elsewhere. " 3e7432e5-dc1b5bb2-de77b443-7ee43c73-d7d6aa9e.jpg,test/p14/p14371035/s51434458/3e7432e5-dc1b5bb2-de77b443-7ee43c73-d7d6aa9e.jpg,test," FINAL REPORT HISTORY: Sepsis. TECHNIQUE: Portable upright AP view COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal contours are unchanged, with mild calcification of the aortic arch. Right PICC has been removed. Of the pulmonary vasculature is normal. Previously noted small bilateral pleural effusions appear resolved. There is minimal streaky atelectasis in the lung bases. No focal consolidation is present. The extreme left costophrenic angle is excluded from the field of view. There is no pneumothorax. Several old bilateral rib fractures are noted. Scoliosis of the thoracolumbar spine is re- demonstrated. IMPRESSION: Resolution of previously noted small bilateral pleural effusions and improved aeration of the lung bases with minimal residual atelectasis. " 9a852f4c-85266cb1-7e441f14-37819b17-4ea7e115.jpg,test/p11/p11091044/s51032811/9a852f4c-85266cb1-7e441f14-37819b17-4ea7e115.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left-sided PTX s/p chest tube // please evaluate for interval change, in particular ptx please perform at approximately 6AM please evaluate for interval change, in particular ptx please perform at approximately 6AM IMPRESSION: Compared to chest radiographs since ___, most recently ___. Bibasilar atelectasis, severe in the left lower lobe, mild to moderate on the right, is substantially greater today. Tiny left apical pneumothorax persists. Left pleural effusion small if any, also unchanged. Heart size normal. No right pneumothorax. Left thoracostomy tube has been repositioned slightly, now ending just above the level of the aortic arch. " 1865fdca-0b6cd4c7-46710753-30b3f48f-0a79bd69.jpg,test/p15/p15080551/s54995904/1865fdca-0b6cd4c7-46710753-30b3f48f-0a79bd69.jpg,test," FINAL REPORT HISTORY: Lung cancer with Tarceva therapy. FINDINGS: In comparison with the study of ___, the dense opacification in the right mid lung zone is more diffuse with suggestion of increased reticular markings. This would be consistent with some response to chemotherapy. Has this patient also had radiation therapy in the region? Remainder of the study is unchanged. " 8165d012-ddd79cf3-aaa8d8f5-ebc507c1-583a72ca.jpg,test/p15/p15126244/s56905780/8165d012-ddd79cf3-aaa8d8f5-ebc507c1-583a72ca.jpg,test," FINAL REPORT INDICATION: ___-year-old man with four days of cough and purulent sputum. COMPARISON: ___ and ___, CT chest ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion, or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. Marked interstitial prominence is unchanged from ___. Two lower lung nodules are prominent nipple shadows as seen on ___. IMPRESSION: No pneumonia, edema or effusion. " e7b62d74-ce79f848-a1a3b74f-f380b7c7-ed3ba1d5.jpg,test/p15/p15268535/s54768934/e7b62d74-ce79f848-a1a3b74f-f380b7c7-ed3ba1d5.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Stable marked enlargement of cardiac silhouette accompanied by pulmonary vascular congestion, mild pulmonary edema. A more confluent opacity in the right lower lobe has worsened and could reflect asymmetrical edema or secondary process such as infection. Small right pleural effusion has increased in size, but small left pleural effusion and adjacent left retrocardiac opacity are unchanged. " 8f7f3a69-95aba6ae-64170827-2e61703c-3eb38530.jpg,test/p15/p15144249/s56972951/8f7f3a69-95aba6ae-64170827-2e61703c-3eb38530.jpg,test," FINAL REPORT INDICATION: ___F with CHF, presenting with SOB // eval for pulmonary edema TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. Cardiomediastinal silhouette is stable. Atherosclerotic calcifications again noted at the aortic arch. Coronary artery stent is noted. No acute osseous abnormalities. Compression deformity in the lumbar spine is similar compared to prior. IMPRESSION: No acute cardiopulmonary process. " 961b7bac-b05f761c-6e426326-79fb0a88-a3677d81.jpg,test/p17/p17093630/s57034105/961b7bac-b05f761c-6e426326-79fb0a88-a3677d81.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p CABG, post pull // eval for ptx COMPARISON: Chest x-ray from ___ at 14:03 FINDINGS: Multiple lines and tubes have been removed including the intra-aortic balloon pump. A right IJ central line remains present, tip over upper right atrium. New compared with the prior study, there is increased retrocardiac density alteration of the left heart border consistent with left lower lobe collapse and there consolidation likely with associated small to moderate left-sided effusion. There is minimal blunting of right costophrenic angle, without gross effusion. There is minimal atelectasis at the right lung base medially. An overt CHF. No pneumothorax detected. IMPRESSION: Right IJ line remains present, tip over upper SVC. Clinical correlation regarding retraction by approximately 2.5 cm, to lie in the lower SVC, is requested. No pneumothorax detected. Interval development of increased opacity in the left lung base, extending up to the perihilar region, likely a combination of a left pleural effusion and underlying collapse and/or pneumonic consolidation. " f8edf4f4-6f9c4aa6-41a21c48-ef773a77-e4a77d15.jpg,test/p17/p17959674/s58526553/f8edf4f4-6f9c4aa6-41a21c48-ef773a77-e4a77d15.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with tachypnea. TECHNIQUE: Single AP radiograph view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded with a slightly prominent interstitial pattern throughout the lungs but slightly more prominent at both lung bases. The appearance is not significantly changed since ___ but when correlated with the CT from ___ may reflect residual bronchiolitis or an atypical infectious process. Clinical correlation is recommended. No pleural effusion or pneumothorax. The heart is normal in size. No acute osseous abnormality. IMPRESSION: Stable slightly prominent interstitial process more marked at the lung bases which when correlated with a chest CT of ___ could reflect residual bronchiolitis or an atypical infectious process. Clinical correlation is recommended. " 1016515c-0b1933d5-3796b613-a67aa7d4-9875aa02.jpg,test/p17/p17513014/s50337816/1016515c-0b1933d5-3796b613-a67aa7d4-9875aa02.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with dyspnea on exertion for ___ days. Evaluate for pleural effusion or pulmonary edema. COMPARISON: Chest radiograph from ___. FINDINGS: Chest, PA and lateral. Heart size is normal. The hila and mediastinum are unremarkable. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmoanry process. " 4ceb7346-842090fc-5fc500a2-dc1af853-63f21c00.jpg,test/p12/p12555865/s50352363/4ceb7346-842090fc-5fc500a2-dc1af853-63f21c00.jpg,test," FINAL REPORT EXAMINATION: Chest single view INDICATION: ___ year old woman with ? AVM // CVL, ETT, OGT confirmation Contact name: ___, ___: ___ TECHNIQUE: Portable AP COMPARISON: None. FINDINGS: The lungs are clear. The heart and great vessels are normal. No pleural effusion or pneumothorax. Right subclavian line. Is placed with its tip in the right atrium. ET tube is 2.7. NG tube in the stomach with side hole in the distal esophagus. Suggest to advance the tube a few cm. IMPRESSION: Right subclavian line is probably in right atrium. ET tube appropriate position. NG tube leg in stomach but the side hole is in distal esophagus " 8fa77112-1ed7193e-d3fc0ab6-56cbdb58-8878f2c1.jpg,test/p15/p15345462/s58798919/8fa77112-1ed7193e-d3fc0ab6-56cbdb58-8878f2c1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with substernal CP // PNA? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " f0ab0e18-f87bfa40-cb21ab5d-a49597ab-51ce3073.jpg,test/p11/p11251476/s56685999/f0ab0e18-f87bfa40-cb21ab5d-a49597ab-51ce3073.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, history of smoking and COPD, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Flattening of the hemidiaphragms visible on the lateral radiograph, indicative of mild-to-moderate overinflation. Borderline size of the cardiac silhouette with tortuosity of the thoracic aorta. Normal hilar and mediastinal structures. In the lung parenchyma, there is no evidence of a recent or newly appeared parenchymal opacity. However, the lateral radiograph shows areas of mild bronchiectasis in the posterior portions of the right lower lobe. These are unchanged in extent and severity as compared to the previous image. No evidence of pleural effusions. No pulmonary edema. " ef542f4b-baffb406-c09fd020-4cc3d240-d6d6d99a.jpg,test/p18/p18896047/s55865884/ef542f4b-baffb406-c09fd020-4cc3d240-d6d6d99a.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Status post fall down the stairs with audible wheezing. COMPARISONS: Remote prior study from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart appears mildly enlarged. The mediastinal and hilar contours are essentially unchanged allowing for differences in technique. One change is that the central pulmonary arteries appears somewhat larger and the lungs are hyperinflated suggesting there may be obstructive lung disease. There is suspected hiatal hernia, moderate in size and located somewhat to the left line, but similar to the remote prior study. Streaky left basilar opacities suggest associated atelectasis or scarring. There is no definite pleural effusion or pneumothorax. Bony structures are unremarkable. Mild rightward convex curvature is centered along the mid thoracic spine. IMPRESSION: Findings which may suggest obstructive pulmonary disease with streaky left basilar opacification, most suggestive of atelectasis, in association with a suspected hiatal hernia. " ff1c7f29-e0c7f822-45c3faa0-84042558-15ef642c.jpg,test/p17/p17824494/s57656779/ff1c7f29-e0c7f822-45c3faa0-84042558-15ef642c.jpg,test," FINAL ADDENDUM ADDENDUM: The left base retrocardiac opacity could represent combination of pleural effusion and atelectasis however consolidation due to infection may be present. ______________________________________________________________________________ FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough and altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette remains markedly enlarged, which could be due to cardiomyopathy and/or pericardial effusion. There is a moderate left pleural effusion with retrocardiac atelectasis. Mild interstitial edema is seen. There is prominence of the pulmonary arteries which may be due to component of pulmonary arterial hypertension. No pneumothorax is seen. Mediastinal contours are stable. Surgical clips are noted overlying the left axilla. " 2179c161-cd8386a1-04f6887d-47e339d5-81c730c9.jpg,test/p17/p17973921/s55916640/2179c161-cd8386a1-04f6887d-47e339d5-81c730c9.jpg,test," WET READ: ___ ___ ___ 2:04 PM No free intraperitoneal air. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: AP AND LATERAL CHEST X-RAY INDICATION: ___-year-old man with nausea, vomiting, epigastric pain, evaluate for free intraperitoneal air. TECHNIQUE: AP and lateral upright chest radiographs. COMPARISON: Chest x-ray ___. FINDINGS: There is no free air under the diaphragm. The cardiomediastinal silhouettes are stable and within normal limits. The bilateral hila are unremarkable. The lungs are clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No free air under the diaphragm. . No acute cardiopulmonary process. " 3a4ab766-f8d3de0f-18d2f8b4-f9891db5-95b7e0b8.jpg,test/p13/p13417577/s56079481/3a4ab766-f8d3de0f-18d2f8b4-f9891db5-95b7e0b8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever, recurrent PNA COMPARISON: Prior study from ___ and prior chest CT from ___. FINDINGS: PA and lateral views of the chest provided. Previously noted PICC line is been removed. Patient is known to have a large hiatal hernia accounting for retrocardiac opacity partially obscuring the right medial lung base. Right lower lobe consolidation is concerning for pneumonia/aspiration. There is persistent nodularity in the left mid lung peripherally with subtle spiculated margins. A prominent bleb is noted at the left lung apex. Small bilateral pleural effusions are noted, right greater than left. No pneumothorax. Overall cardiomediastinal silhouette appears similar to prior. Imaged bony structures are intact. IMPRESSION: 1. Right lower lobe consolidation is concerning for pneumonia/ aspiration. 2. Small pleural effusions, right greater than left. 3. Large hiatal hernia. 4. Spiculated nodularity in the left mid lung peripherally appears similar to multiple prior exams. Nonemergent CT may be considered as neoplasm difficult to exclude. " 5396f6f9-f113f8eb-06c118c5-42c7be7f-7662a8ad.jpg,test/p14/p14832532/s50105912/5396f6f9-f113f8eb-06c118c5-42c7be7f-7662a8ad.jpg,test," FINAL REPORT INDICATION: Recent diarrhea and vomiting. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. Distal resection of the right clavicle and multiple anterior chest clips are again seen. A healing right 3rd rib fracture is new since the ___ examination. IMPRESSION: No acute intrathoracic process. Healing right 3rd rib fracture is new since ___. " 9169b338-7ab1e782-b0b9c351-13a50226-023da42f.jpg,test/p13/p13979708/s56575708/9169b338-7ab1e782-b0b9c351-13a50226-023da42f.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Status post left pleural biopsy. Comparison is made with prior study, preop evaluation, ___. Cardiomediastinal contours are normal. Consolidation in the left lower lobe has almost completely resolved. The right lung is clear. There is no pneumothorax. A small left pleural effusion and/or thickening has improved. " 971005a5-442d08ce-6ffc3387-3ca1aa1a-be2b7d26.jpg,test/p13/p13341950/s50348372/971005a5-442d08ce-6ffc3387-3ca1aa1a-be2b7d26.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Worsening dyspnea on exertion. History of COPD. COMPARISONS: ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is a patchy linear opacity projecting along the lingula, as before, suggesting persistent minor atelectasis or scarring. Streaky right upper lobe opacities suggest scarring with post-operative suture material that is unchanged. There is no pleural effusion or pneumothorax. The patient is status post partly visualized posterior upper lumbar fusion. Volume loss and sclerosis along thoracolumbar vertebral bodies at the site of fusion and immediately above appear probably unchanged. The patient is also status post anterior neck fusion. IMPRESSION: Chronic opacities suggesting minor scarring without definite evidence for acute disease. " 6460512d-44c9c904-ec6cc145-fb4abc45-0c114b75.jpg,test/p19/p19818481/s59151801/6460512d-44c9c904-ec6cc145-fb4abc45-0c114b75.jpg,test," FINAL REPORT INDICATION: Shock, postop. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Portable frontal radiograph of the chest demonstrate ET tube, NG tube and left internal jugular central venous catheter in unchanged satisfactory position. Worsening multifocal opacities in the bilateral lungs could represent pneumonia or aspiration. Likely small left pleural effusion is unchanged. Stable heart size and mediastinal contours. IMPRESSION: Worsening bilateral multifocal opacities could reflect multifocal pneumonia or aspiration. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:05 AM, 10 minutes after discovery of the findings. " c8ffb676-da0cfc9f-914c116a-a726c98e-023c8ad1.jpg,test/p10/p10755736/s57698613/c8ffb676-da0cfc9f-914c116a-a726c98e-023c8ad1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pulm edema // pulm edema pulm edema IMPRESSION: Comparison to ___. Mild improvement of the pre-existing pulmonary edema. The widespread bilateral parenchymal opacities, however, still clearly visible. Mild cardiomegaly persists. No pleural effusions. " 27526e2b-d4544c9b-8d73f25e-758f3413-c70ffebe.jpg,test/p15/p15672432/s50496862/27526e2b-d4544c9b-8d73f25e-758f3413-c70ffebe.jpg,test," FINAL REPORT INDICATION: ___M with L sided chest pain // eval pneumonia, other acute process TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d9d84e27-d2a7f966-85e9c209-fba32673-37b6f903.jpg,test/p16/p16367769/s55447420/d9d84e27-d2a7f966-85e9c209-fba32673-37b6f903.jpg,test," FINAL REPORT REASON FOR EXAMINATION: New NG tube. Portable AP radiograph of the chest was reviewed in comparison to ___. NG tube tip is in the stomach. Right internal jugular line tip is at the cavoatrial junction. Cardiomediastinal silhouette is unchanged. Bibasilar areas of atelectasis are unchanged. No pleural effusion or pneumothorax. " f69db006-8e0ac494-260342fe-8799ceb0-a50c7137.jpg,test/p18/p18656167/s59335938/f69db006-8e0ac494-260342fe-8799ceb0-a50c7137.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: HIV, hepatitis C with cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 7a9d9bed-499b84ef-282587f0-7beb2404-f5f9f1d6.jpg,test/p10/p10021487/s52512958/7a9d9bed-499b84ef-282587f0-7beb2404-f5f9f1d6.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: assessment for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Total opacification of the right hemithorax, signs of fluid overload on the left. Moderate cardiomegaly. Unchanged monitoring and support devices. " a292aa0c-2bb81ce0-d0f70289-799eeb97-ed0fc835.jpg,test/p18/p18570637/s55381436/a292aa0c-2bb81ce0-d0f70289-799eeb97-ed0fc835.jpg,test," FINAL REPORT HISTORY: COPD, hypertension, diverticulosis, admitted with hematochezia. Being diuresed for CHF, now with orthostasis. Question pulmonary edema. CHEST, TWO VIEWS. COMPARISON: Chest x-ray dated ___. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is diffuse parenchymal scarring, also compatible with COPD, including some pleural parenchymal scarring at the right lung apex and some focal opacity in the right lung laterally. The hila are prominent, with a tapered appearance, suggesting pulmonary hypertension. There is patchy retrocardiac opacity consistent with some left lower lobe collapse and/or consolidation, improved compared with ___. There is a small right effusion, new compared with ___. There is also a small amount of pleural fluid or thickening in the left costophrenic angle. There is possible minimal upper zone redistribution. Allowing for background parenchymal scarring, doubt overt CHF. Osteopenia and degenerative changes of the thoracic spine are noted. IMPRESSION: 1) Advanced COPD with probable pulmonary hypertension. 2) LLL collapse/consolidation, improved compared with ___. 3) Small bilateral effusions, new on the right. 4) Possible minimal upper zone redistribution, doubt overt CHF. " 6b54e4a6-914630c6-b691dc4c-cab040bd-e90d62f6.jpg,test/p19/p19442084/s53902574/6b54e4a6-914630c6-b691dc4c-cab040bd-e90d62f6.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Apical pneumothorax after chest tube pulled, followup. Note is made that the original dictation of this study was lost and the study was brought for us for review today on ___. The current study demonstrates small-to-moderate apical pneumothorax, grossly unchanged since the prior study. Subcutaneous air collection is unchanged on the right. Heart size and mediastinum are unchanged. No interval increase in pleural effusion has been demonstrated. " 9e9e3d0e-d2d73e26-b0d68356-052af492-a756d8dd.jpg,test/p11/p11493670/s53469586/9e9e3d0e-d2d73e26-b0d68356-052af492-a756d8dd.jpg,test," WET READ: ___ ___ ___ 9:36 AM - tip of dobhoff tube is not entirely visualized though the tube extends subdiaphragmatically WET READ VERSION #1 ___ ___ 6:51 PM - tip of dobhoff tube is not entirely visualized though the tube extends subdiaphragmatically ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new Dobhoff tube. // Evaluate Dobhoff placement. Evaluate Dobhoff placement. IMPRESSION: In comparison with the study of ___, there has been placement of a Dobhoff tube that extends to the lower body of the stomach. Otherwise little change. " c605f4f2-e70cba04-db7a3287-fcdde94e-808391fb.jpg,test/p19/p19818481/s57061957/c605f4f2-e70cba04-db7a3287-fcdde94e-808391fb.jpg,test," FINAL REPORT INDICATION: Atrial fibrillation and dizziness. Evaluate for infiltrate. COMPARISONS: Chest radiograph, ___. FINDINGS: Dextroscoliosis of the upper thoracic spine is unchanged from prior exams. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. Cardiac silhouette is mildly enlarged, also unchanged from prior exams. Flowing anterior osteophytes are present in the thoracic spine, likely secondary to DISH. IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable mild cardiomegaly. " 52abb431-66942e69-bfa10d83-03052036-9d711c50.jpg,test/p13/p13723259/s51512718/52abb431-66942e69-bfa10d83-03052036-9d711c50.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY. INDICATION: Patient with critical aortic stenosis, multiple myeloma, acute kidney insufficiency with cough, dyspnea on exertion, edema ?, infiltrate?. COMPARISON: ___ to ___. FINDINGS: Moderate pulmonary edema has improved and is now minimal. The bibasilar atelectasis and pleural effusions have also improved. There is no new lung consolidation. No pneumothorax. Mediastinal and cardiac contours are normal. Left sixth rib fracture as shown on recent CT scan is starting to heal. CONCLUSION: 1. Improvement of pulmonary edema which is now mild. 2. Improvement of bibasilar atelectasis and pleural effusions. 3. There is no evidence of new consolidation. " 9b7bf679-38933f33-8392546f-bd9a5fa0-e019be15.jpg,test/p17/p17224335/s50838524/9b7bf679-38933f33-8392546f-bd9a5fa0-e019be15.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p CABG/AVR with acute desat // eval for effusion/ PTX eval for effusion/ PTX IMPRESSION: Comparison to ___, 01:44. No radiographic explanation for acute desaturation. The bilateral pleural effusions are of overall unchanged extent. Moderate cardiomegaly persists. Mild fluid overload. Platelike atelectasis at the level of the left hilus. In the well ventilated areas of the lung parenchyma there is no evidence of new parenchymal opacities. " 096a3ec2-704c6d9c-50eafa23-641ca47a-c6ea9b41.jpg,test/p10/p10449873/s52209920/096a3ec2-704c6d9c-50eafa23-641ca47a-c6ea9b41.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Syncope and altered mental status, status post two recent falls. FINDINGS: PA and lateral views of the chest were provided. A retrocardiac opacity is again seen, compatible with a hiatal hernia. There is no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears grossly stable. No definite bony injuries. " 06a569d5-844fc2cf-e7817875-b33383f0-a66da30c.jpg,test/p19/p19601036/s58786006/06a569d5-844fc2cf-e7817875-b33383f0-a66da30c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chylothorax, s/p repair, pls eval interval change // please eval interval change please eval interval change IMPRESSION: In comparison with the study of ___, there is little overall change. Bilateral chest tubes remain in place with stable bilateral effusions and underlying atelectatic changes. " a0aeacef-88fe61e2-67ec62ec-f5c6d12b-f202813d.jpg,test/p18/p18005830/s52965670/a0aeacef-88fe61e2-67ec62ec-f5c6d12b-f202813d.jpg,test," FINAL REPORT HISTORY: Epigastric abdominal pain. COMPARISON: ___. Lateral views of the chest. FINDINGS: The lungs are clear though focal solid renal pleural effusion pneumothorax seen. Cardiac and mediastinal silhouettes are unremarkable. No evidence of free air seen beneath the diaphragms. No displaced fracture seen. IMPRESSION: No acute cardiopulmonary process. " db541269-04e8a658-c5d6e73a-056b1c09-c6c2401d.jpg,test/p10/p10380149/s54913972/db541269-04e8a658-c5d6e73a-056b1c09-c6c2401d.jpg,test," FINAL REPORT HISTORY: Cough and dyspnea. Evaluation for pneumonia versus CHF. COMPARISON: Comparison is made to the same day radiographs from 3 hours prior. FINDINGS: Portable AP radiograph demonstrates persistent increased interstitial markings and indistinctness of the pulmonary vasculature, particularly on the right, along with blunting of the costophrenic angles, as before. Additionally, more distinct opacities are present within the right upper and right lower lobes, concerning for multifocal pneumonia. The cardiomediastinal silhouette is unchanged. Multilevel degenerative changes within the thoracic spine are again noted. IMPRESSION: 1. Opacities within the right upper and right lower lobes are concerning for multifocal pneumonia, in the correct clinical setting. 2. Pulmonary vascular congestion and small bilateral pleural effusions. " 20ffddc9-6deef68a-82c9c286-92309b4f-e1c31b86.jpg,test/p15/p15813164/s54536162/20ffddc9-6deef68a-82c9c286-92309b4f-e1c31b86.jpg,test," FINAL REPORT EXAM: Chest AP upright and lateral views. CLINICAL INFORMATION: Four days of shortness of breath and cough, 102 fever. COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest were obtained. The patient is rotated to the right. The patient is status post median sternotomy. There is slight blunting of the left posterior costophrenic angle which may be due to a trace pleural effusion. There is perihilar opacity, right greater than left which could be due to asymmetric edema or infection. No pneumothorax seen. The cardiac silhouette is top normal. The aorta is somewhat tortuous. IMPRESSION: Left greater than right perihilar opacities could be due to asymmetric edema or infection. " 020995c2-9e5ff640-3be0ce03-9af143fe-de489453.jpg,test/p15/p15721149/s50846150/020995c2-9e5ff640-3be0ce03-9af143fe-de489453.jpg,test," FINAL REPORT HISTORY: Persistent cough in a patient with history of lung cancer. FINDINGS: In comparison with study of ___, there is little change. Again there is evidence of prior lobectomy and radiation in the right upper zone, with retraction of the trachea to this side. Juxtaphrenic peak is stable in this patient with right lung volume loss. No evidence of pulmonary vascular congestion. There is no evidence of acute focal pneumonia. " ab4659f3-e2c2ca71-183a54d3-319c9e03-d6305e4a.jpg,test/p18/p18296202/s57997879/ab4659f3-e2c2ca71-183a54d3-319c9e03-d6305e4a.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with brain tumor, status post resection with anxiety attack, clinical question: Screening needed for placement in psychiatric facility. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. High-positioned diaphragms as identified on the frontal view are most likely result of poor inspirational effort in this non-cooperative patient. Crowded appearance of basal pulmonary vasculature is observed, and plate linear atelectasis is present bilaterally. Heart size is not clearly identifiable because of the high-positioned diaphragms but probably unchanged in comparison with the previous study three days ago. The pulmonary vasculature is not congested. No signs of acute parenchymal infiltrates are present. The lateral and posterior pleural sinuses are free. No evidence of pneumothorax in the apical area. Skeletal structures of the thorax grossly unremarkable. Impression: Plate atelectasis related to poor inspirational efforts. No evidence of cardiac enlargement, pulmonary congestion, or acute infiltrates. Stable conditions in comparison with the next previous similar study obtained three days earlier. " 0ab616fd-3f69c4c2-04a2e605-fe0b91ae-e51b770f.jpg,test/p18/p18406213/s54399142/0ab616fd-3f69c4c2-04a2e605-fe0b91ae-e51b770f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with likely tubo-ovarian abscess and sepsis with SOB // Please eval for pulm edema, PNA, effusions, other etiologies of SOB TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ IMPRESSION: Moderate to severe pulmonary edema has progressed. There is persistent low lung volumes. There is no pneumothorax. cardiac size cannot be evaluated. Bibasilar opacities larger on the right side are likely atelectasis, superimposed infection cannot be excluded. There is also increasing loss of volume in the right middle lobe. " aea5d40b-b2e7a1b0-84385dc2-bd6e5a24-44fe918b.jpg,test/p14/p14522445/s59475864/aea5d40b-b2e7a1b0-84385dc2-bd6e5a24-44fe918b.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ year old man with cough, hx of ESRD on HD, some chills // ? infiltrates ? edema TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made multiple prior studies, including most recent radiographs of the chest from ___, dating back to ___. FINDINGS: Bilateral hilar opacities, right greater than left, similar compared to the prior study from ___, compatible with moderate pulmonary edema. Moderate cardiomegaly is unchanged. Mild pectus deformity is again noted, likely accentuating the right lower lung opacity. There is no large pleural effusion pneumothorax. IMPRESSION: Bilateral hilar opacities likely reflect moderate pulmonary edema. Cardiomegaly is stable. " 60195474-8b005d9a-ba896639-dde6ba48-49b2d063.jpg,test/p16/p16508811/s56646773/60195474-8b005d9a-ba896639-dde6ba48-49b2d063.jpg,test," FINAL REPORT INDICATION: ___-year-old man with tachycardia and chest pain. COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE Portable view of the chest. FINDINGS: A right PICC ends in the low SVC. Heart size is mildly enlarged. There is no overt pulmonary edema. There is no focal lung consolidation. There is no pneumothorax or pleural effusion. IMPRESSION: No focal consolidation to suggest pneumonia. Stable mild cardiomegaly. " 8b640d44-5ae15f1e-5a714bc9-c8dc1dbd-cb64bdbb.jpg,test/p15/p15844438/s57817703/8b640d44-5ae15f1e-5a714bc9-c8dc1dbd-cb64bdbb.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Postoperative assessment. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant. Moderate cardiomegaly. Bilateral areas of atelectasis, left more than right, and minimal fluid overload. No newly appeared parenchymal opacities suggestive of an infectious process. " a29b6bb0-89b93b7a-7bafc079-c2f864e3-bcbb0327.jpg,test/p16/p16105001/s56996302/a29b6bb0-89b93b7a-7bafc079-c2f864e3-bcbb0327.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Decreased breath sounds and increasing shortness of breath. Rule out pneumonia. IMPRESSION: PA and lateral chest compared to ___: Small bilateral pleural effusions and infrahilar consolidation, most likely atelectasis, one day following laparotomy, reflected in the pneumoperitoneum collected beneath the right hemidiaphragm. Increased mild cardiomegaly and mediastinal vascular engorgement suggest volume resuscitation. There is no pneumothorax. " 714ea93a-a4de700b-fb08ab7f-0df8adc3-e53554bf.jpg,test/p11/p11585485/s55401668/714ea93a-a4de700b-fb08ab7f-0df8adc3-e53554bf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusions, chest tubes in place // ___ year old man with pleural effusions, chest tubes in place ___ year old man with pleural effusions, chest tubes in place COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Multiple substantial right pleural fluid loculations have developed since ___ when there was a larger volume of right pneumothorax following insertion of the indwelling right lower pleural drainage catheter. Much of the apparent cardiomegaly is due to adjacent paramediastinal pleural fluid loculation, but the heart probably is enlarged. There is no pulmonary edema or left pleural effusion. Left lung clear. Left subclavian line ends in the upper SVC. " 773ece84-a372a757-828c7719-283c8f48-afe2ff1e.jpg,test/p19/p19464772/s59621242/773ece84-a372a757-828c7719-283c8f48-afe2ff1e.jpg,test," FINAL REPORT HISTORY: Nausea vomiting abdominal pain status post NG tube placement. Evaluate NG tube placement. COMPARISON: Chest radiograph from ___ at 13:40 FINDINGS: Frontal radiograph of the chest demonstrate an NG tube with the tip and side hole below the diaphragm. Dilated loops of small bowel are again appreciated predominantly in the left upper quadrant. There is pneumobilia. Compared to the earlier chest radiographs, lung volumes are lower and there appears to be new mild pulmonary vascular congestion. " ef3e2183-6ba26bed-a5fbd845-bd8e5713-abb8a7fc.jpg,test/p13/p13994738/s51181817/ef3e2183-6ba26bed-a5fbd845-bd8e5713-abb8a7fc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with infiltrates in early ___. // Have infiltrates resolved? COMPARISON: ___. IMPRESSION: A platelike atelectasis and an opacity in the right lung, paralleling the minor fissure, has almost completely resolved. Still visualized, in almost unchanged extent, is a retrocardiac opacity that reflect peribronchial thickening, most likely related to chronic bronchitis. No new opacities are visualized. Normal size of the heart. No pleural effusions. No pulmonary edema. " 6ba97a3a-7660c30a-2fb81373-b22b0ebd-a01986fe.jpg,test/p14/p14819550/s57308718/6ba97a3a-7660c30a-2fb81373-b22b0ebd-a01986fe.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with fever and cough. Clinical concern for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Normal cardiomediastinal and hilar contours. Clear, fully expanded lungs. No evidence of pneumonia, pneumothorax, or pleural effusion. No definite osseous or soft tissue abnormalities. IMPRESSION: No evidence of pneumonia. " 11e5068d-4faa4ab6-ca20244e-47d983a2-3fdb7600.jpg,test/p15/p15294749/s52009312/11e5068d-4faa4ab6-ca20244e-47d983a2-3fdb7600.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with presyncope, dry cough, chills // r/o infection TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The aorta is tortuous an calcified. The mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " adf1ffe8-28ab951a-66ea2338-1b591c19-586621cc.jpg,test/p10/p10030487/s53249827/adf1ffe8-28ab951a-66ea2338-1b591c19-586621cc.jpg,test," FINAL REPORT INDICATION: ___-year-old female with a history of influenza and fevers, who presents for evaluation of new oxygen requirement. Rule out pneumonia. COMPARISONS: Chest radiographs from ___ at 11:33AM, ___, ___, and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart is mildly enlarged, stable compared to the prior PA scan from ___. There has been interval improvement of the bibasilar atelectasis with persistent linear scarring at the bases. No new focal consolidations are seen. There is no pneumothorax. There is a left-sided Port-A-Cath which terminates in the right atrium. Again seen is a large hiatal hernia. IMPRESSION: Interval improvement of the bibasilar atelectasis with residual scarring at the bases. No evidence of a new pneumonia. Large hiatal hernia. " 5b16f853-649a3cd2-ab39a38e-88cebdd4-0bed9210.jpg,test/p17/p17310183/s56552227/5b16f853-649a3cd2-ab39a38e-88cebdd4-0bed9210.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax. There is no free intraperitoneal air. IMPRESSION: No acute intrathoracic finding. " db5d7de4-161555ef-fa0e68b5-33086bd0-0d21868d.jpg,test/p15/p15709365/s59066735/db5d7de4-161555ef-fa0e68b5-33086bd0-0d21868d.jpg,test," WET READ: ___ ___ ___ 9:18 AM Small right apical pneumothorax. ______________________________________________________________________________ FINAL REPORT HISTORY: Right apical pneumothorax. Evaluate for pneumothorax. COMPARISON: Outside chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: There is a small right apical pneumothorax. The left lung is clear. There is mild bibasilar atelectasis. There is no focal consolidation or pleural effusion. The cardiomediastinal and hilar contours are within normal limits. Known right rib fractures seen on prior CT are better evaluated on cervical spine CT exam and not clearly visualized on this examination. IMPRESSION: Small right apical pneumothorax. " 2208235c-ad9a6b39-b5c0b72f-25b48774-e551dcec.jpg,test/p15/p15914421/s53473603/2208235c-ad9a6b39-b5c0b72f-25b48774-e551dcec.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with left Port-A-Cath and swelling of the arm. PA and lateral upright chest radiographs were reviewed in comparison to ___. The left-sided Port-A-Cath tip terminates at the level of the cavoatrial junction. Compared to the prior study, there is no change in the position of the Port-A-Cath catheter that follows the expected course of the left brachiocephalic vein, SVC and cavoatrial junction. Heart size and mediastinum are stable. Bibasilar opacities are present, involving lung bases, substantially more pronounced than on the prior study and might potentially reflect areas of infection in the proper clinical setup. Atelectasis or post-radiation changes would be another possibility. Surgical sutures projecting over the left mid lung might be related to prior left breast surgery. No appreciable pleural effusion is seen. No pneumothorax is demonstrated. " ef4013f0-75140e4b-b0699d6a-0707a5f5-0c4512c4.jpg,test/p13/p13756625/s57974285/ef4013f0-75140e4b-b0699d6a-0707a5f5-0c4512c4.jpg,test," FINAL REPORT HISTORY: ___-year-old man with cough, on chemotherapy for pancreatic cancer. Evaluation for infectious process. COMPARISON: Comparison is made to CT of the chest from ___, as well as radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. A left-sided Port-A-Cath is unchanged in position, with tip terminating in the mid SVC. There is no pleural effusion, pneumothorax, pulmonary edema, or focal airspace consolidation. IMPRESSION: No acute cardiopulmonary process. " 19358e5c-ce232aeb-26c6e733-e433c91a-f75d5986.jpg,test/p15/p15672432/s58006461/19358e5c-ce232aeb-26c6e733-e433c91a-f75d5986.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with cough, RLL rhonci, hyperglycemia, tachycardia // evaluate for acute process COMPARISON: ___. FINDINGS: AP portable upright view of the chest. No definite consolidation, large effusion or pneumothorax is seen. No overt signs of edema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process " 27726080-f9212c2b-281e3749-7f89e09d-484f0465.jpg,test/p16/p16776336/s53273548/27726080-f9212c2b-281e3749-7f89e09d-484f0465.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p CABG // f/u effusions, atx COMPARISON: ___ FINDINGS: Compared with 1 day earlier, the right IJ line has been removed. No pneumothorax is detected. The patient the cardiac silhouette is less pronounced than vascular plethora is slightly improved. The left pleural effusion and underlying collapse and/or consolidation are again seen. As before, there is atelectasis and a small effusion at the right base. Platelike atelectasis is again seen in the left upper and right mid zones. Sternotomy wires noted. IMPRESSION: Slight interval improvement in cardiac enlargement and CHF " 31424af5-9d78e511-e49f0b74-a7eff99c-7678a2b8.jpg,test/p15/p15505239/s54692496/31424af5-9d78e511-e49f0b74-a7eff99c-7678a2b8.jpg,test," FINAL REPORT HISTORY: ___-year-old male with sepsis. Assess for pneumonia. COMPARISONS: PA and lateral chest radiographs from ___. PORTABLE FRONTAL CHEST RADIOGRAPH: Previously described increased opacity within the bilateral lung bases appear similar to prior and may be related to resolving pneumonia. No new confluent opacity is identified. There is no vascular congestion or overt interstitial edema. Blunting of the right costophrenic angle is stable from prior, may reflect a small unchanged effusion. Mediastinal and hilar contours are within normal limits. Moderate-to-severe cardiomegaly appears unchanged. IMPRESSION: 1. Possible resolution of prior bibasilar pneumonia. No new confluent opacity to suggest acute infection. 2. Unchanged probable small right pleural effusion. 3. Unchanged moderate-to-severe cardiomegaly. " fcdf0c89-e0c2f13c-593f533b-1bf11043-f0ed364a.jpg,test/p12/p12110495/s56689400/fcdf0c89-e0c2f13c-593f533b-1bf11043-f0ed364a.jpg,test," FINAL REPORT INDICATION: Cough, evaluate for pneumonia or heart failure. COMPARISONS: ___. AP AND LATERAL VIEWS OF THE CHEST: The heart size is enlarged but unchanged from prior study. There are small bilateral pleural effusions. No pneumothorax or large consolidation is seen. There is mild pulmonary vascular congestion. A right-sided pacemaker is present with leads terminating in the right atrium and right ventricle. There are moderate degenerative changes of the thoracic spine with calcification in anterior longitudinal ligament. IMPRESSION: Cardiomegaly and pulmonary vascular congestion is consistent with mild pulmonary edema. " cd1d8c7e-9b3baf1c-a89efb87-b6cf673e-6a4f620d.jpg,test/p18/p18712109/s55174722/cd1d8c7e-9b3baf1c-a89efb87-b6cf673e-6a4f620d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p small bowel resection for jejunal perforation // pls eval interval change pls eval interval change IMPRESSION: ET tube tip is 4 cm above the carinal. Duct cough tube tip is in the stomach. Right internal jugular line tip is at the level of cavoatrial junction. Heart size and mediastinum appear to be slightly enlarged since the prior study with interval development of vascular congestion and mild interstitial pulmonary edema. There is no pneumothorax. There is no interval increase in pleural effusion. " 3edceb77-8678d5ab-82a7b96b-3839ac4a-c67c13bd.jpg,test/p12/p12537194/s58627988/3edceb77-8678d5ab-82a7b96b-3839ac4a-c67c13bd.jpg,test," FINAL REPORT INDICATION: ___ year old man with SOB/backpain found to have R pleural effusion and mets. // Trend R pleural effusion***PLEASE PERFORM ___ AT 4:00 AM*** TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Trapped right lung unchanged. Right-sided pleural effusion shows mild interval progression compared to the previous 2 radiographs. Chest drain projects over the medial aspect of the right hemithorax. Leftward mediastinal shift appears slightly increased compared to prior imaging. Increased vascular markings of the left lung of most likely physiological due to shunting. No left-sided airspace consolidation. IMPRESSION: Interval progression of the right-sided pleural effusion. " 0e1bc04a-ab898acd-6d0b8252-1c5c87d3-3b87094a.jpg,test/p13/p13356687/s54560449/0e1bc04a-ab898acd-6d0b8252-1c5c87d3-3b87094a.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old female with confusion. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications seen at the aortic arch. Hypertrophic changes seen in the spine. Right upper quadrant surgical clip is identified. Degenerative changes are seen at the right acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " e951ebc5-805068c0-62af1508-409a724a-26959041.jpg,test/p11/p11472206/s54732928/e951ebc5-805068c0-62af1508-409a724a-26959041.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Unusual air collection. IMPRESSION: PA and lateral chest compared to ___ at 8:24 p.m. and chest CT performed concurrently but reported separately: This is a very unusual midline gas collection, has no strict correlate on the chest CTA, which does however show gaseous distention of the esophagus, which is the explanation for the radiographic appearance, unchanged since earlier in the evening. Moderate-to-severe cardiomegaly and mediastinal venous engorgement are unchanged. Lungs are clear and there is no pleural effusion or pneumothorax. " 3987c9b7-d270cb80-1934a5c7-0f261b26-6e93dcca.jpg,test/p19/p19347794/s55670817/3987c9b7-d270cb80-1934a5c7-0f261b26-6e93dcca.jpg,test," FINAL REPORT AP CHEST 3:10 A.M., ___ HISTORY: ___-year-old woman with anuria and hypotension. Evaluate worsening pulmonary edema. IMPRESSION: AP chest compared to ___: The progressive diffuse basal predominant pulmonary abnormality which developed between ___, is almost certainly pulmonary edema and other findings of congestive heart failure. Today, there is considerably more heterogeneous opacity in the right upper and mid lung zones, raising possibility of concurrent pneumonia or pulmonary hemorrhage, although both basal consolidation and small-to-moderate bilateral pleural effusions have increased, which are signs of worsening cardiac decompensation. Left internal jugular line ends at the origin of the SVC. There is no pneumothorax. " e8783b1a-9b1b8cd3-3d478a6d-bc911546-646d97b8.jpg,test/p17/p17237809/s54945273/e8783b1a-9b1b8cd3-3d478a6d-bc911546-646d97b8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cardiac surgery- CTs d/c'd // evaluate for pneumothorax COMPARISON: ___ IMPRESSION: As compared to the previous image, all monitoring and support devices, with the exception of the right venous introduction sheet, have been removed. The lung volumes have slightly decreased. Minimal left pleural effusion with subsequent atelectasis. Borderline size of the cardiac silhouette without pulmonary edema. No pneumonia. No pneumothorax. " 783966dd-9be4f7ee-6aea9f7b-3f5cc2f7-7b75a672.jpg,test/p18/p18951987/s52316401/783966dd-9be4f7ee-6aea9f7b-3f5cc2f7-7b75a672.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cardiac arrest, cooling and re-warming, evaluation of support devices. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices, including the ECMO device in the vena cava and the Swan-Ganz catheter are in unchanged and correct position. Moderate centralized pulmonary edema persists. The lung volumes remain low. There are no larger pleural effusions. No pneumothorax. " f1bdb5c3-41809e0b-5519110b-cc0d4d34-8d803cc3.jpg,test/p17/p17963990/s50534993/f1bdb5c3-41809e0b-5519110b-cc0d4d34-8d803cc3.jpg,test," FINAL REPORT HISTORY: Fever, productive cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. Elevation of the right hemidiaphragm is chronic. Lungs are clear. No pleural effusion or pneumothorax is seen. Remote right-sided rib fractures are re- demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " a3ff7e1f-68a53712-2d6cfa54-eb65e959-86a0b315.jpg,test/p13/p13405151/s53575734/a3ff7e1f-68a53712-2d6cfa54-eb65e959-86a0b315.jpg,test," FINAL REPORT PA and LATERAL CHEST ___ COMPARISON: Radiograph ___. FINDINGS: Patient is status post median sternotomy and aortic valve replacement. Cardiomediastinal contours are stable in appearance. Slight improvement in pulmonary vascular congestion and decrease in extent of interstitial edema with mild residual edema remaining. Moderate right pleural effusion with loculated intrafissural component appears similar to the prior study, and a small left pleural effusion is also not appreciably changed. Bibasilar areas of atelectasis have slightly improved, however. Small left apical pneumothorax is unchanged, and there is also a questionable tiny right apical pneumothorax. IMPRESSION: 1. Improving interstitial edema and decreased bibasilar atelectasis. 2. Unchanged small left apical pneumothorax. Probable tiny right apical pneumothorax. 3. Moderate right and small left pleural effusion. " f5f407a5-ff287ac5-86a47d91-546fa45f-00923cf7.jpg,test/p10/p10146311/s59720163/f5f407a5-ff287ac5-86a47d91-546fa45f-00923cf7.jpg,test," FINAL REPORT HISTORY: Congestion and leukocytosis COMPARISON: ___. FINDINGS: Two views were obtained of the chest. The lungs are low in volume but clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. Incompletely assessed left shoulder again demonstrates multiple calcific densities which could reflect osteochondromatosis. IMPRESSION: No acute intrathoracic process. " 1d1cea4b-0eb4737a-6a9d5170-912a6a64-5ea161b0.jpg,test/p17/p17215355/s54632801/1d1cea4b-0eb4737a-6a9d5170-912a6a64-5ea161b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man post-op from 8 teeth extraction however only 7 teeth accounted for post-op // ? aspirated tooth TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs of___. FINDINGS: A metallic density projects over the left upper abdomen, compatible with a filling in the aspirated tooth, which lies in the stomach. No aspirated foreign bodies are seen in the lungs. The heart size is top normal, and there is persistent mild pulmonary edema. The left pleural effusion has decreased, now small. There is no pneumothorax. IMPRESSION: 1. Missing tooth is identified within the stomach. 2. Persistent mild pulmonary edema. 3. Decreased left pleural effusion, now small. " 694ad48f-43692409-a7a36a6c-863722bd-375f7070.jpg,test/p17/p17547554/s54361318/694ad48f-43692409-a7a36a6c-863722bd-375f7070.jpg,test," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with study of ___, there again are bilateral pleural effusions, slightly more prominent on the left, with compressive atelectasis at the bases. The somewhat ill-defined opacities in the apices are essentially unchanged. Mild indistinctness of pulmonary vessels is consistent with some elevation of pulmonary venous pressure. " 11e12d38-56302f89-0d163150-5d8848cd-be0b5ca1.jpg,test/p18/p18613386/s57789914/11e12d38-56302f89-0d163150-5d8848cd-be0b5ca1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Admitted for the rule out of acute chest processes. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. There is normal shape of the hemidiaphragms. No pleural effusions. Normal size of the cardiac silhouette without evidence of pulmonary edema. No pneumonia. No pneumothorax. " 4c664e62-63bb5663-703557c5-2ede95dc-f54d2bf3.jpg,test/p11/p11705661/s53972502/4c664e62-63bb5663-703557c5-2ede95dc-f54d2bf3.jpg,test," FINAL REPORT INDICATION: Patient with history of primary sclerosing cholangitis and Crohn's disease, now with fever and chills. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 416372de-faf3c592-a26a137f-0b53cbb7-94616663.jpg,test/p12/p12078658/s59941000/416372de-faf3c592-a26a137f-0b53cbb7-94616663.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with abd pain, ?ischemic esophagus on OSH endoscopy. // eval for free air TECHNIQUE: AP portable view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes are low leading to crowding of the bronchovascular structures. Streaky, bibasilar airspace opacities are noted, which likely represent atelectasis. The left costophrenic angle is somewhat blunted, which may reflect a small pleural effusion versus chronic scarring. The descending thoracic aorta is unfolded. The cardiomediastinal silhouette is otherwise grossly within normal limits and without evidence of pneumomediastinum. No pneumoperitoneum. IMPRESSION: Low lung volumes and streaky bibasilar opacities likely reflecting atelectasis, with aspiration felt to be less likely. No convincing evidence for pneumomediastinum. " 5f4369be-68cd55ef-852894d2-8681be20-7083bfe9.jpg,test/p14/p14698539/s57732208/5f4369be-68cd55ef-852894d2-8681be20-7083bfe9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulm edema // interval change? IMPRESSION: As compared to ___ radiograph, bilateral perihilar and basilar airspace opacity show slight interval improvement. No other relevant change. " 4fa96fab-2b1a8f5d-5480868a-b297d73c-3fb82c1e.jpg,test/p19/p19751455/s59234558/4fa96fab-2b1a8f5d-5480868a-b297d73c-3fb82c1e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with NSLC undergoing phototherapy c/b recurrent airway obstruction from necrotic tissue now s/p obstructing event. // consolidation, PNA, Mucuous plugging TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Left apical pleural cap and multiple chain sutures are noted, unchanged from the prior examination. Bibasilar airspace opacities are stable and likely represent scarring versus fibrotic changes. No new airspace opacities are identified. There is no pneumothorax or overt pulmonary edema. The cardiomediastinal silhouette is stable. IMPRESSION: No acute cardiopulmonary process. " 17787375-640e75cd-79f1b313-55b403b1-a4196163.jpg,test/p14/p14230891/s53951804/17787375-640e75cd-79f1b313-55b403b1-a4196163.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with intermittent chest pain, history of stents in the past. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. Cardiomediastinal silhouette is within limits. Atherosclerotic calcification is again noted at the aortic arch. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 5cacc463-45b02eba-c56152ef-e63c4851-b0e6c1ba.jpg,test/p18/p18264393/s57881422/5cacc463-45b02eba-c56152ef-e63c4851-b0e6c1ba.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Stroke, evaluation after intubation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged, with exception of the Dobbhoff catheter that has been slightly advanced. The tip of the catheter is not visible on the current image. The lung volumes have decreased. There is increasing evidence of atelectatic changes at both lung bases. Mild cardiomegaly persists. New blunting of the right and left costophrenic sinus could reflect small pleural effusions. No evidence of pneumothorax. No overt pulmonary edema. " 1ccafe1d-e18cadf0-dde6438a-5dc36ae4-16fdd94a.jpg,test/p10/p10154479/s55385219/1ccafe1d-e18cadf0-dde6438a-5dc36ae4-16fdd94a.jpg,test," FINAL REPORT INDICATION: ___F with sob and cp // eval pneumonia TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: Lungs are clear without focal consolidation, effusion, or edema. Moderate size hiatal hernia is noted. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications seen at the aortic arch. No acute osseous abnormalities. Compression deformities of lower thoracic/upper lumbar vertebral bodies are unchanged from prior. IMPRESSION: No acute cardiopulmonary process. " c2c5b0d8-5032fc43-0fb032c8-c1b524c8-0a001fa5.jpg,test/p19/p19814071/s58109166/c2c5b0d8-5032fc43-0fb032c8-c1b524c8-0a001fa5.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough and right pleuritic pain. COMPARISON: PA and lateral chest radiograph, ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well inflated and clear bilaterally with no masses or lesions identified. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable and within normal limits. The pleural surfaces are unremarkable. IMPRESSION: No evidence of pneumonia. " 4a18fb83-19bfc1a3-33ab45a2-2a12c73b-907627b4.jpg,test/p14/p14199690/s50442474/4a18fb83-19bfc1a3-33ab45a2-2a12c73b-907627b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SDH // Interval changes Interval changes IMPRESSION: In comparison with the study of ___, there again are bilateral areas of increased opacification, concerning for aspiration or infectious pneumonia. Otherwise, little change. " f24e6086-6d4a4768-9fe643b5-229f63ab-5760b139.jpg,test/p10/p10216097/s58218519/f24e6086-6d4a4768-9fe643b5-229f63ab-5760b139.jpg,test," WET READ: ___ ___ ___ 7:36 AM Significant increase in large right pleural effusion with leftwards shift of mediastinum. No left pleural effusion. No evidence of pulmonary edema. Limited evaluation of the heart due to overlying abnormality. ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery. WET READ VERSION #1 ___ ___ ___:55 AM Interval increase in large right pleural effusion with leftwards shift of mediastinum. No left pleural effusion. No evidence of pulmonary edema. Limited evaluation of the heart due to overlying abnormality. ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent chest tubes. // Is there an acute process in the lungs? TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: There is substantial interval increase in right pleural effusion with the leftward shift of the mediastinum. No substantial left pleural effusion demonstrated. No definitive pulmonary edema is seen. No pneumothorax is present. NOTIFICATION: ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery. " 87f36db9-fed660be-4bed5c44-34cdcb9b-3f827916.jpg,test/p13/p13119476/s57467669/87f36db9-fed660be-4bed5c44-34cdcb9b-3f827916.jpg,test," FINAL REPORT INDICATION: ___ year old man with CHF exacerbation // r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The severe enlargement of cardiac silhouette due to cardiomegaly and/or pericardial effusion is worse from prior. There is increased pulmonary venous congestion diffusely. No consolidation appreciated. The neo esophagus is again noted. The left pleural effusion has increased and there is a new moderate right pleural effusion. No pneumothorax. No fractures. The transvenous biventricular pacer leads continuous from the left pectoral generator terminate at right ventricle and left ventricle. IMPRESSION: 1. No pneumonia appreciated. 2. Worsening pulmonary venous congestion with new right pleural effusion and persistent left pleural effusion. 3. There is worse cardiomegaly and/ or pericardial effusion. " f4a78667-d8d13480-eb99988e-947ada31-f49f0023.jpg,test/p12/p12379467/s58962485/f4a78667-d8d13480-eb99988e-947ada31-f49f0023.jpg,test," FINAL REPORT HISTORY: History of non-Hodgkin's lymphoma now with shortness of breath, wheezing, and cough. Evaluate for pneumonia. COMPARISON: Multiple prior radiographs chest dated ___ and ___ and CT of the chest dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded clear lungs. The previously seen area of increased opacification in the left lower lobe was better evaluated on recent CT of the chest. There is no consolidation, pneumothorax, or pleural effusion. The cardiomediastinal and hilar contours are unchanged. Known hilar lymphadenopathy is better assessed on the recent CT of the chest as well. A right-sided Port-A-Cath is present with the tip terminating in the mid SVC. IMPRESSION: No acute cardiopulmonary process. " a4bd75b1-3a841a1f-a3412ed0-ce15a2e0-75ca305f.jpg,test/p14/p14318921/s50033858/a4bd75b1-3a841a1f-a3412ed0-ce15a2e0-75ca305f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pressure TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Marked rotary dextroscoliosis of the thoracic spine is present. Heart size appears mildly enlarged. The aorta is tortuous. The mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Lungs are grossly clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is clearly seen. IMPRESSION: Marked rotary dextroscoliosis. No acute cardiopulmonary abnormality. " 624d7143-68809ee0-e658c4b2-5adfe45c-36a3842a.jpg,test/p14/p14244279/s52874285/624d7143-68809ee0-e658c4b2-5adfe45c-36a3842a.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dizziness and dehydration. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal, and hilar contours appear stable. The heart is at the upper limits of normal size. There is no pleural effusion or pneumothorax. Vague opacity in the right lower lung is stable and suggests minor atelectasis or scarring. Fissures are minimally thickened. IMPRESSION: Minimal thickening of the fissures, which may be a consequence of very slight fluid overload but no definite evidence for pneumonia or parenchymal edema. " 4db82408-0b6f3195-d81ac286-64067c58-009d21c4.jpg,test/p14/p14065514/s51381835/4db82408-0b6f3195-d81ac286-64067c58-009d21c4.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient status post esophagectomy six days ago, evaluate for pneumothorax after CT removal. FINDINGS: PA and lateral chest views were obtained with the patient in upright position. Comparison is made with the next preceding single view chest examination obtained four hours earlier during the same day. On the present examination, the apical right-sided pneumothorax has increased in size and measures now 2 to 3 cm in width surrounding the apical area. No marked decrease in lung volume and no new pulmonary infiltrates are identified. The right-sided Port-A-Cath system remains in unchanged position. No new pulmonary abnormalities or pneumothorax in the left hemithorax. Lateral view discloses that the pneumothorax separation reaches also anteriorly as well as posteriorly terminating with a small loculated air-fluid level at the level of the eighth vertebral body of the thoracic spine as seen on the lateral view. No other new pulmonary or pleural abnormalities are identified. There exists moderate gas distension of the bowel pull-through in the right-sided mediastinal area. Increase in right-sided pneumothorax was observed and immediately submitted via page to ___ at 3:45 p.m. " 6cdc34ce-4820e58b-ca91ba90-ac063f7f-b89f0a63.jpg,test/p13/p13032040/s55682871/6cdc34ce-4820e58b-ca91ba90-ac063f7f-b89f0a63.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever, c/f DKA // Eval for PNA COMPARISON: None FINDINGS: AP and lateral views of the chest were obtained A hemodialysis catheter terminates in the low SVC. Median sternotomy wires and surgical clips compatible with prior CABG. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 25b1f581-32a8bccf-ddc5c8cd-f34d16a5-befd4bdc.jpg,test/p11/p11888614/s51240157/25b1f581-32a8bccf-ddc5c8cd-f34d16a5-befd4bdc.jpg,test," FINAL REPORT INDICATION: ___M with chest pain x 1 hour substernal in nature back pain // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. Chest CT ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion pneumothorax. The lungs are expanded and clear without focal consolidation concerning for pneumonia. Pulmonary vascularity is within normal limits. The upper abdomen is unremarkable. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " 3c7c942c-81d5372a-82dca8ad-0182dd8e-d7b4df29.jpg,test/p12/p12043836/s59116294/3c7c942c-81d5372a-82dca8ad-0182dd8e-d7b4df29.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis, ESRD, plueral effusions // ? PNA, ? consolidation, ? inc pleural effusion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the position of the 2 right-sided chest tubes is constant. Constant appearance of the postoperative right basal lateral parenchymal opacities. The sternal wires are in unchanged alignment. Moderate cardiomegaly persists. No pneumothorax. " 45a1b992-cd955a64-5467a538-14924e65-aae6da43.jpg,test/p15/p15326361/s53635588/45a1b992-cd955a64-5467a538-14924e65-aae6da43.jpg,test," WET READ: ___ ___ ___ 10:20 PM Multiple focal parencymal opacities, mostly in the right lung, which are generally stable since the prior exam. The intersitial opacities are improving, suggestive of an improving instersitial pneumonia. The residual opacities may either be residual pneumonia or metastatic disease. There is no new opacity. There are small bilateral pleural effuions, including a loculate portion tracking along the right costophrenic angle. Stable cardiomediastinal silhouette. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: History of metastatic pancreatic cancer, evaluation for pneumonia. Concern for aspiration. COMPARISON: ___. FINDINGS: Focal parenchymal opacities of multiple origin, most are located in the right lung, with judge annually, stable as compared to the previous examination. The pre-existing interstitial opacities are improving, suggesting improving interstitial pneumonia or mild interstitial fluid overload. The residual opacities might eight be healing pneumonia or metastatic disease. No opacities have newly occurred. Small bilateral pleural effusions, stable mild cardiomegaly. " 815251df-587aa0dd-876cd0e2-6f189e71-3fd252ae.jpg,test/p12/p12870544/s50521595/815251df-587aa0dd-876cd0e2-6f189e71-3fd252ae.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p MVC // eval for interval change IMPRESSION: Compared to recent radiograph of 1 day earlier, cardiomediastinal contours are stable. Moderate right pleural effusion and adjacent right lower lung opacification have slightly improved in the interval, and an area of opacification in the left retrocardiac region has apparently worsened. No other relevant changes. " b9524b92-525f2a4b-515c2440-9b472de6-dc51b48d.jpg,test/p14/p14834560/s54087919/b9524b92-525f2a4b-515c2440-9b472de6-dc51b48d.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with pancreatic cancer // portacath placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___ FINDINGS: The left Port-A-Cath terminates in the mid SVC. Lateral view demonstrates an opacity projecting over the lower thoracic spine, which was seen as atelectatic changes on recent CT ___. The lungs are otherwise free of focal consolidations, pleural effusions or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Port-A-Cath terminates in the mid-SVC. No acute cardiopulmonary process. " a67c498b-504d2c72-76e0fb39-83839448-da7fd06f.jpg,test/p18/p18202323/s50974739/a67c498b-504d2c72-76e0fb39-83839448-da7fd06f.jpg,test," FINAL REPORT HISTORY: Failure of blood return on Port-A-Cath. FINDINGS: No previous chest radiographs are available. There is extensive opacification in the right hilar and suprahilar regions. This presumably relates to the primary tumor or hilar lymphadenopathy, possibly with post-obstructive changes. Multiple nodular opacifications are seen as on the recent CT scan, consistent with metastases. Specifically, the Port-A-Cath extends to the lower portion of the SVC or possibly upper part of the right atrium. No evidence of significant kink or other abnormality in the catheter. " 511ae7ff-25ab204d-336b4e00-fc58564b-4fa7dbdc.jpg,test/p14/p14760908/s54583188/511ae7ff-25ab204d-336b4e00-fc58564b-4fa7dbdc.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___ radiograph. FINDINGS: Lung volumes are slightly increased compared to the prior study. Cardiomediastinal contours are stable in appearance. Left lung is grossly clear. Increasing patchy opacity at the right lung base medially may reflect patchy atelectasis or a developing focus of pneumonia. " cb25edad-f4fce088-01a53038-9e042d54-b5e9bcd2.jpg,test/p13/p13305035/s59003109/cb25edad-f4fce088-01a53038-9e042d54-b5e9bcd2.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ chest x-ray. FINDINGS: Cardiac silhouette rmains enlarged and is accompanied by worsening pulmonary vascular congestion and slight increase in size of right pleural effusion. Moderate left pleural effusion is unchanged. " 1ab1d053-e8130389-116d13f2-31dce5dc-ed7c9591.jpg,test/p14/p14832062/s55950126/1ab1d053-e8130389-116d13f2-31dce5dc-ed7c9591.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ COMPARISON: ___. FINDINGS: Mild cardiomegaly is accompanied by pulmonary vascular congestion and interstitial edema. As compared to previous radiographs of ___ and ___, the extent of pulmonary edema has improved, and pleural effusions have decreased in size, with residual small effusions remaining. Although most of the pre-existing alveolar opacities have cleared since the prior ___ radiograph, a mass-like area of consolidation measuring 3.4 x 2.6 cm in the right upper lobe has only partially improved, previously measuring 4.2 x 3.9 cm in diameter. As this is a new finding compared to ___, it is not concerning for malignancy, but it could potentially represent an area of infection in the appropriate clinical setting. IMPRESSION: 1. Improving pulmonary edema with residual predominantly interstitial edema remaining, and decreasing pleural effusions. 2. Focal mass-like opacity in right upper lobe has slightly decreased in size since ___. Differential diagnosis includes asymmetrical edema versus focal infectious pneumonia. " cc12e831-af9e3d52-7e9a629e-3649d371-2e9ef386.jpg,test/p13/p13031024/s50742387/cc12e831-af9e3d52-7e9a629e-3649d371-2e9ef386.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with CP and cough // eval cause for CP TECHNIQUE: Chest PA and Lateral COMPARISON: Numerous prior radiographs including ___, ___ and ___ FINDINGS: The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is mildly enlarged. IMPRESSION: No acute cardiopulmonary process. No definitive change from prior radiographs. " eaf8726b-c9338440-b69c5885-82e98f84-97dc9e38.jpg,test/p10/p10534438/s55727151/eaf8726b-c9338440-b69c5885-82e98f84-97dc9e38.jpg,test," FINAL REPORT INDICATION: History of hypertension. Please evaluate for cardiomegaly. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest radiographic examination. No cardiomegaly. " ba61c27a-1dea2167-56bc2ded-7b31507e-a935bc4c.jpg,test/p12/p12713218/s58632068/ba61c27a-1dea2167-56bc2ded-7b31507e-a935bc4c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: Report from chest CT ___ and chest radiograph ___. Images are not available for direct comparison at this time. FINDINGS: Lung volumes are low. This accentuates the size of the cardiac silhouette which appears mildly enlarged. The aorta is unfolded. Mediastinal contours are unremarkable. No pulmonary edema, focal consolidation, pleural effusion or pneumothorax is present. Elevation of the right hemidiaphragm is re- demonstrated. Mild patchy bibasilar opacities may reflect atelectasis and/or scarring. Multilevel degenerative changes are seen in the thoracic spine with mild loss of height of a low thoracic vertebral body. Patient is status post left mastectomy. IMPRESSION: Low lung volumes. No definite evidence for pneumonia. Bibasilar atelectasis or scarring. " 4adf35d4-6d5066ff-1cdadf7d-298d69ac-1ac22a8a.jpg,test/p18/p18897036/s54679449/4adf35d4-6d5066ff-1cdadf7d-298d69ac-1ac22a8a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain and SOB // eval pneumothorax, pneumonia, other acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 565d428f-7eb4994f-7d72f58b-99f0702c-ce45e84a.jpg,test/p19/p19550773/s50754783/565d428f-7eb4994f-7d72f58b-99f0702c-ce45e84a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with large right pleural effusion s/p chest tube // eval for interval change. COMPARISON: Chest x-ray from ___ at 10:37 FINDINGS: Compared with the prior study, the previously seen right lung base pigtail catheter is no longer visualized. A moderate to moderately large right pneumothorax is newly visible. Possible small amount of fluid in the right costophrenic sulcus, unchanged. Prominence of the right hilum is again noted. The cardiomediastinal silhouette remains grossly midline. Prominence of the superior mediastinum is also again noted. On the left, there is minimal upper zone redistribution, without overt CHF. No focal infiltrate or effusion is identified in the left chest. IMPRESSION: Previously seen right pigtail catheter no longer visualized. New moderately large right pneumothorax identified. Probable small right effusion. Prominence of superior mediastinum and right hilum is similar to prior. (Note is made that the patient underwent a chest CT on ___). Aside from minimal upper zone redistribution, left lung and pleural sulcus are grossly clear. No overt CHF. NOTIFICATION: Findings discussed by phone with covering intern Dr. ___ ___ by Dr ___, 5 minutes after discovery on ___ . By report, the right pigtail catheter has been removed. " 4519a616-14030d5a-a03faccf-f73fa2ad-4fd5612c.jpg,test/p16/p16445377/s52383015/4519a616-14030d5a-a03faccf-f73fa2ad-4fd5612c.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___ No prior studies for comparison. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs and pleural surfaces are clear. Minimal scoliosis is noted. IMPRESSION: No acute cardiopulmonary radiographic abnormality. " 808ebf00-a7b7bdcd-64b2239e-5f9b9ee6-073b538c.jpg,test/p13/p13620449/s51070392/808ebf00-a7b7bdcd-64b2239e-5f9b9ee6-073b538c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with VT, hypotensive episode, pulmonary edema // Interval change Interval change IMPRESSION: In comparison with the study of ___, the right Swan-Ganz catheter has been replaced with an IJ sheath. Continued substantial enlargement of the cardiac silhouette with some pulmonary vascular congestion. The opacification at the right base is less prominent than on the previous study. " d7dcb934-94d0ebaa-428a0ce4-edb8bcb2-17914f82.jpg,test/p12/p12763939/s54996188/d7dcb934-94d0ebaa-428a0ce4-edb8bcb2-17914f82.jpg,test," FINAL REPORT HISTORY: Evolving pneumonia after diaphragmatic repair. FINDINGS: In comparison with the study of ___, there is little overall change. Retrocardiac opacification and hazy opacification at the left base are again seen, consistent with lower lobe volume loss and pleural effusion. Right lung is essentially clear. Tracheostomy tube and enteric tube remain in place. " e92437ec-7a733bc9-b1242d90-60e868cd-33c45f26.jpg,test/p11/p11251476/s51942374/e92437ec-7a733bc9-b1242d90-60e868cd-33c45f26.jpg,test," FINAL REPORT HISTORY: Hypoxia. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___ and ___. FINDINGS: Re- demonstrated is mild enlargement of cardiac silhouette. The aortic knob is densely calcified. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. There is hyperinflation of lungs with flattening of the diaphragms is compatible with COPD. Linear opacities at the lung bases are compatible with scarring and bronchiectatic changes, similar compared to the previous exam. No pleural effusion or pneumothorax is present. IMPRESSION: No acute cardiopulmonary abnormality. Unchanged bronchiectasis within the lung bases. " 6c04718a-0b45d8e3-07d153d6-b0bc2c62-31ac4548.jpg,test/p14/p14885862/s50203097/6c04718a-0b45d8e3-07d153d6-b0bc2c62-31ac4548.jpg,test," FINAL REPORT HISTORY: Recent pneumonia, eval for resolution of infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Lungs are well expanded and clear. Cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. No bony abnormality is detected. IMPRESSION: No current radiographic evidence of pneumonia. " 9e26bf42-8c481471-e9b6646c-54a4e52c-98e2dc2c.jpg,test/p11/p11522912/s53931543/9e26bf42-8c481471-e9b6646c-54a4e52c-98e2dc2c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // interval cahnge interval cahnge COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Severe left lower lobe atelectasis, moderate left pleural effusion and milder right basal atelectasis are unchanged since ___ and showed to better advantage on views of the lower chest on the abdomen CT ___. Moderate to severe cardiomegaly is long-standing. ET tube and nasogastric tube are in standard placements and a left pic line ends in the low SVC. No pneumothorax. " 42cb0640-79210494-a05fef02-093654b7-d2a6f350.jpg,test/p19/p19960115/s53421528/42cb0640-79210494-a05fef02-093654b7-d2a6f350.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p whipple for pancreatic adenocarcinoma, now with acute onset abdominal pain, tachypnea, tachycardia and diaphoresis // r/o acute cardiorespiratory process r/o acute cardiorespiratory process IMPRESSION: In comparison with the study of ___, obliquity of the patient makes it somewhat difficult to evaluate the heart and lungs. Again there are relatively low lung volumes with mild indistinctness of pulmonary vessels consistent with some elevation of pulmonary venous pressure. No definite acute focal pneumonia is identified, though this would have to be considered in the appropriate clinical setting given the absence of a lateral view. " d508ea50-bfdf7ae4-2862bee2-07ca96c6-29ac66e9.jpg,test/p11/p11556982/s55244539/d508ea50-bfdf7ae4-2862bee2-07ca96c6-29ac66e9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chronic crohn's dz. // anergic. Quant gold interderminate. Need to make sure no evidence of TB to continue remicade. No known exposures and no symptoms c/w TB. anergic. Quant gold interderminate. Need to make sure no ev COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection, including tuberculosis. Tunneled dual channel catheter ends just above and just below the superior cavoatrial junction, as before. " 72e22aff-f0f63379-f0cc184e-5c4b56d9-92d0ee23.jpg,test/p11/p11218867/s54270040/72e22aff-f0f63379-f0cc184e-5c4b56d9-92d0ee23.jpg,test," WET READ: ___ ___ ___ 5:16 PM Left pneumothorax slightly increased from prior. findings sent to Dr. ___ at ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess left pneumothorax. Patient is status post mediastinal mass Bx. Comparison is made with prior study performed five hours earlier. Small left pneumothorax has slightly increased. Small left pleural effusion and bibasilar atelectasis, left greater than right are unchanged. Cardiac size is normal. Widened mediastinum is unchanged. Right Port-A-Cath tip is in the right atrium, unchanged " 30a80989-bb0277b5-7adc8a81-58c6225c-15326142.jpg,test/p17/p17983733/s52375756/30a80989-bb0277b5-7adc8a81-58c6225c-15326142.jpg,test," FINAL REPORT INDICATION: ___F with chest tightness, evaluate for infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 3071d620-939b12e9-a11724da-0e8428bf-a5c2c2d8.jpg,test/p15/p15420672/s56116729/3071d620-939b12e9-a11724da-0e8428bf-a5c2c2d8.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough. Evaluate for pneumonia. PA AND LATERAL CHEST RADIOGRAPHS: COMPARISONS: None available. FINDINGS: The lungs are clear. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal. IMPRESSION: Normal chest. " 849a3476-5a462027-6dc33477-5bba7c06-812b8c63.jpg,test/p15/p15259708/s57825102/849a3476-5a462027-6dc33477-5bba7c06-812b8c63.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with intermittent fever, T 100.8 last night. no cough, but has anterior rib pain. h/o breast cancer. non-smoker // r/o lung / pleural disease as cause of fever r/o lung / pleural disease as cause of fever IMPRESSION: No comparison. Moderate scoliosis with subsequent asymmetry of the ribcage. Normal lung volumes. Normal size of the cardiac silhouette. No pneumonia, no pulmonary edema, no pleural effusions. " 91e0e67a-9171570d-232987c4-62fe3c70-ccbb9954.jpg,test/p11/p11344751/s53188222/91e0e67a-9171570d-232987c4-62fe3c70-ccbb9954.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF // s/p NGT placement IMPRESSION: As compared to ___ radiograph, nasogastric tube is been placed, with tip coursing below the diaphragm. Cardiomediastinal contours are stable allowing for patient rotation. Apparent worsening opacification in the right perihilar and basilar regions could reflect asymmetrical edema or secondary process such as aspiration or infectious pneumonia. Short-term followup radiographs may be helpful in this regard " 45b34090-03e872fd-70983e8e-886bcff3-99dbb131.jpg,test/p13/p13274225/s59577009/45b34090-03e872fd-70983e8e-886bcff3-99dbb131.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic colon cancer now with anterior chest rt parasternal pain in chest wall - eval for pathologic fracture please of ribs/sternum // ___ year old man with metastatic colon cancer now with anterior chest rt parasternal pain in chest wall - eval for pathologic fracture please of ribs/sternum TECHNIQUE: Single frontal view of the chest COMPARISON: Chest CT ___ FINDINGS: Cardiac size is normal. Mediastinal lymph nodes, hilar lymph nodes and lung nodules are better seen on prior CT. There is no evidence of pneumonia or pulmonary edema. There is no pneumothorax or pleural effusion. No evidence of displaced rib fractures. Left port a cath tip is in the right atrium IMPRESSION: No acute cardiopulmonary abnormality " 9040d3d3-0554a61f-37b407fd-eef99bcd-415ba4ef.jpg,test/p17/p17277045/s50759217/9040d3d3-0554a61f-37b407fd-eef99bcd-415ba4ef.jpg,test," FINAL REPORT INDICATION: History: ___F with paroxysmal atrial fibrillation , CHF, CAD, CVA, anxiety with panic attacks who presents with dyspnea, palpitations for 1 day. TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Mild to moderate cardiomegaly is re- demonstrated. Mild atherosclerotic calcifications are seen involving the aortic arch. Mild pulmonary edema is worse compared to the prior exam with perhaps trace bilateral pleural effusions. No pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Mild pulmonary edema and possible trace bilateral pleural effusions. " e0d01c94-9d448b34-7cb7705c-0aac08cb-db928667.jpg,test/p10/p10847228/s56729212/e0d01c94-9d448b34-7cb7705c-0aac08cb-db928667.jpg,test," FINAL REPORT INDICATION: Cough, nausea, vomiting. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. The pulmonary vascularity is normal. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " ee7be22d-15ae6c1c-6556bdc3-3197da41-b68ccae2.jpg,test/p18/p18554235/s52951406/ee7be22d-15ae6c1c-6556bdc3-3197da41-b68ccae2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cardiac arrest, PE, cooling protocol // interval change interval change COMPARISON: Chest radiographs ___ and ___. Impression IMPRESSION: Pulmonary edema which cleared between ___ and ___ has recurred, accompanied by increase pulmonary and mediastinal vascular engorgement and new borderline cardiomegaly. Greater opacification in the left lower lobe has worsened again, presumably atelectasis, but raising concern for aspiration. There is no pneumothorax. ET tube and nasogastric tube are in standard placements. " 324e609b-6f4d48ae-6965da14-c0370c15-c5b340a8.jpg,test/p18/p18780736/s58576882/324e609b-6f4d48ae-6965da14-c0370c15-c5b340a8.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ 2:35 PM Largely unchanged bilateral pleural effusions. In the right clinical setting, superimposed pneumonia in the lung bases cannot be excluded. ______________________________________________________________________________ FINAL REPORT INDICATION: Worsening cough in a patient with CLL on immunosuppressants. Evaluate for interval change, pleural effusions, infection. COMPARISONS: Chest CT from ___. PA AND LATERAL VIEWS OF THE CHEST: Moderate to large bilateral pleural effusions are unchanged. The remainder of the lung fields are clear. There is no pneumothorax. The hilar and mediastinal contours are normal. A Port-A-Cath terminates in the mid SVC. IMPRESSION: Largely unchanged bilateral pleural effusions. In the right clinical setting, superimposed pneumonia in the lung bases cannot be excluded. " 6392d79d-73943ed2-02455449-4b33495b-94efec45.jpg,test/p18/p18726372/s50395831/6392d79d-73943ed2-02455449-4b33495b-94efec45.jpg,test," FINAL REPORT HISTORY: Seizure. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low. Heart size is mildly enlarged. Mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures and patchy bibasilar airspace opacities are re- demonstrated. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes limit assessment of the lung bases. Streaky bibasilar airspace opacities most likely reflect atelectasis. As before, infection or aspiration within the lung bases cannot be completely excluded. " 311daf8a-1e2dda61-3f445db9-08914d76-c75204bd.jpg,test/p14/p14998572/s55720826/311daf8a-1e2dda61-3f445db9-08914d76-c75204bd.jpg,test," FINAL REPORT CHEST RADIOGRAPH Comparison is made with a prior study from ___. CLINICAL HISTORY: Palpitations, assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Haziness along the right and left heart border is unchanged and most likely reflects the presence of epicardial fat pads. Tiny clips are noted in the superior mediastinum, likely related to prior thyroidectomy. IMPRESSION: No acute intrathoracic process. " e1783229-51590d74-17d8b367-fb9a7d66-c3f99e79.jpg,test/p10/p10860177/s55397322/e1783229-51590d74-17d8b367-fb9a7d66-c3f99e79.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Removal of mediastinal and pleural chest tubes, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, all monitoring and support devices, except the right venous introduction sheath has been removed. On the current image, there is no evidence of pneumothorax. No pleural effusions. No pulmonary edema. No pneumonia. Borderline size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. The sternal wires are in unchanged alignment. " f6b4da08-d34ed4ba-44080c0a-05de8d33-8a7c532d.jpg,test/p15/p15922911/s51433399/f6b4da08-d34ed4ba-44080c0a-05de8d33-8a7c532d.jpg,test," FINAL REPORT INDICATION: History of cough. Please evaluate for pneumonia. COMPARISONS: None. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No acute intrathoracic abnormalities identified. " 987b7aed-6b6de611-b338ac52-25eb77d7-9e83ada7.jpg,test/p15/p15383299/s51792927/987b7aed-6b6de611-b338ac52-25eb77d7-9e83ada7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of L sided CP w/radiation to the L arm // r/o pulm path r/o pulm path IMPRESSION: No previous images. Mild hyperexpansion of the lungs, but no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 1783f0ff-a6feb471-db2e856c-7acf55c7-4693aafc.jpg,test/p15/p15471443/s57174613/1783f0ff-a6feb471-db2e856c-7acf55c7-4693aafc.jpg,test," WET READ: ___ ___ ___ 6:25 AM Moderate pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with xfer from OSH for flash edema vs worsening cardiogenic shock, bibasilar edema on OSH CXR // eval ? worsening edema TECHNIQUE: Single AP view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Mild cardiomegaly is stable. Severe global pulmonary opacification has worsened considerably over 9 hr. Transvenous right atrial and right ventricular pacer leads follow their expected courses, unchanged, continuous from the left pectoral generator. Bilateral pleural effusions are trace. IMPRESSION: Moderate pulmonary edema in the setting of only mild cardiomegaly raises the possibility that this is noncardiogenic edema. " 084adf92-2be69eaf-4549e271-77b95b26-cc332815.jpg,test/p18/p18009005/s55501624/084adf92-2be69eaf-4549e271-77b95b26-cc332815.jpg,test," FINAL REPORT HISTORY: Cough and fever. Rule out pneumonia. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. No acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " d929924f-f97d7deb-53516a19-1f315371-7a0baffd.jpg,test/p18/p18266518/s51199141/d929924f-f97d7deb-53516a19-1f315371-7a0baffd.jpg,test," FINAL REPORT INDICATION: ___F with speech difficulty, cough // eval infiltrate TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Torso CT from ___ and chest x-ray from ___. FINDINGS: The lungs are hyperinflated. Chronic changes including scarring identified at the left upper lung as well as increased interstitial markings throughout the lungs. There is no new consolidation no are effusion. Cardiomediastinal silhouette is mildly enlarged as on prior. No acute osseous abnormalities identified. IMPRESSION: Hyperinflation and scarring. No definite consolidation. " 7b895f91-0a1985ad-2dcafccd-a78478ed-0c4a7d40.jpg,test/p14/p14313382/s59209434/7b895f91-0a1985ad-2dcafccd-a78478ed-0c4a7d40.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: New fever to 103. FINDINGS: There are small bilateral effusions that have increased in size compared to the prior exam. There is no focal infiltrate. The cardiac and mediastinal silhouettes are normal. " b1a166c4-71c60b7a-47718337-553805fa-6b93beaf.jpg,test/p16/p16770700/s57971693/b1a166c4-71c60b7a-47718337-553805fa-6b93beaf.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with stroke and new Dobbhoff placement, after positioning. As compared to the prior study obtained earlier at 4:40 p.m., The coiled NG tube is seen in the esophagus with its tip at the gastroesophageal junction and should be further advanced. The rest of the findings are unchanged. " 8f53551e-1a2ab329-690040a4-b01cf515-e0d03f3a.jpg,test/p13/p13340770/s53171681/8f53551e-1a2ab329-690040a4-b01cf515-e0d03f3a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD/asthma with CXR ___ showing some atelectasis vs. pneumonia, any change? // any infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are fully expanded and clear without any atelectasis. No pleural effusion or pneumothorax is seen the diaphragms appear flattened, which suggests hyperinflation. IMPRESSION: 1. Resolution of previous bibasilar atelectasis. 2. Diaphragmatic flattening suggesting hyperinflation. " d0d8322f-c9b8c121-6bde7844-dfb22216-38fe641f.jpg,test/p10/p10292574/s59141134/d0d8322f-c9b8c121-6bde7844-dfb22216-38fe641f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: AFib, RVR, pleuritic chest pain, recent fall, question fracture or pneumonia. FINDINGS: PA and lateral views of the chest were provided. The heart is mildly enlarged, though this is stable. Patient is slightly rotated to the left on the frontal radiograph, which limits evaluation. There is no focal opacity to suggest pneumonia. No signs of CHF, no effusion and no pneumothorax. A calcified nodular opacity in the left upper lung is stable and likely represents a calcified granuloma. There is no pneumothorax. No displaced rib fractures are seen. IMPRESSION: Mild cardiomegaly, unchanged. Otherwise, unremarkable. " d6db5b90-edfcbc57-8af8fb47-9e2e1e5c-1f912de8.jpg,test/p19/p19016035/s54736199/d6db5b90-edfcbc57-8af8fb47-9e2e1e5c-1f912de8.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with fevers, chills, and 3 days of productive cough. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and hyperinflated lungs. Retrocardiac bronchial wall thickening and air bronchograms are unchanged compared to ___, and likely represent chronic bronchitis. There is no focal consolidation, pleural effusion, or pneumothorax. Apical pleural thickening is noted bilaterally. The visualized upper abdomen is unremarkable. IMPRESSION: Retrocardiac opacity is likely chronic bronchitis, without evidence of acute pneumonia. " 6d6e976f-7652c78c-14a7b54b-6c33ea99-2dd42b2f.jpg,test/p13/p13689440/s51625268/6d6e976f-7652c78c-14a7b54b-6c33ea99-2dd42b2f.jpg,test," WET READ: ___ ___ ___ 7:43 AM Developing mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man withendocarditis and new AI // eval for interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient now a shows mild pulmonary edema. The lung volumes have decreased. There are no pleural effusions. No cardiomegaly. The right pectoral pacemaker and a right internal jugular vein catheter are in unchanged position. " d7042426-f4e2b57e-80194f88-e27d29ef-1000d8e9.jpg,test/p12/p12577091/s54773172/d7042426-f4e2b57e-80194f88-e27d29ef-1000d8e9.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. There is no displaced fracture identified. IMPRESSION: No acute cardiopulmonary process. " dece5393-fff56a25-b5f349be-82a7fdea-cdbda972.jpg,test/p15/p15723633/s51816620/dece5393-fff56a25-b5f349be-82a7fdea-cdbda972.jpg,test," FINAL REPORT CHEST, PA AND LATERAL. INDICATION: ___-year-old male with shortness of breath, here to evaluate for acute cardiopulmonary process. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Both lungs are symmetrically hyperinflated with flattening of the bilateral hemidiaphragms, compatible with COPD. Biapical opacities are likely related to scarring. No significant pleural effusion, focal consolidation, or pneumothorax is detected. No pulmonary edema is noted. The cardiac silhouette is normal in size. The mediastinal contours are within normal limits. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary abnormality. " bc65d823-21eeb72d-2f1c98fd-5cace04e-884280b3.jpg,test/p19/p19388814/s50735678/bc65d823-21eeb72d-2f1c98fd-5cace04e-884280b3.jpg,test," FINAL REPORT INDICATION: ___-year-old female with pain in the left shoulder, clavicles, left upper thorax after fall. Evaluate for acute intrathoracic process or fracture. COMPARISONS: None available. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no evidence of rib fracture. IMPRESSION: No evidence of acute intrathoracic process. " a2272d21-49ec6e16-a648c3d8-132d1bb4-15f54276.jpg,test/p17/p17105647/s59264511/a2272d21-49ec6e16-a648c3d8-132d1bb4-15f54276.jpg,test," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old male with chest tightness. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is normal. No acute osseous abnormality is identified. IMPRESSION: Normal chest x-ray. " 68b19f43-1772d242-0e7d1fb5-49926cdc-321e5b81.jpg,test/p11/p11689448/s51098976/68b19f43-1772d242-0e7d1fb5-49926cdc-321e5b81.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old man with cough and is a former smoker. FINDINGS: Comparison is made to previous study from ___. Median sternotomy wires are again seen and unchanged. The heart size is within normal limits. There are densities at the bases suggestive of subsegmental atelectasis at the lung bases. This may represent early consolidation, however. The upper lung fields are clear. There are no signs of pulmonary edema. Bony structures are grossly intact. " bd9e476f-202fb144-5306b3bb-2a721b32-d4ecb871.jpg,test/p17/p17025509/s53244434/bd9e476f-202fb144-5306b3bb-2a721b32-d4ecb871.jpg,test," WET READ: ___ ___ ___ 7:06 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with cp*** WARNING *** Multiple patients with same last name! // eval for cp TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary abnormality. " b01728f8-aa96e4bf-3dbce0eb-8f8b4cf4-58e24a1e.jpg,test/p18/p18236201/s54584190/b01728f8-aa96e4bf-3dbce0eb-8f8b4cf4-58e24a1e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ y/o with recent COP from amiodarone // f./u CXR after prednisone taper for interval change f./u CXR after prednisone taper for interval change IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with mild vascular congestion. No acute pneumonia or pleural effusion. Specifically, no evidence of interstitial changes to radiographically suggest amiodarone toxicity. " ea4296ac-bae73611-98c87b65-e4aa8e16-9021325b.jpg,test/p10/p10765644/s53099217/ea4296ac-bae73611-98c87b65-e4aa8e16-9021325b.jpg,test," FINAL REPORT INDICATION: ___-year-old with shortness of breath and orthopnea, assess for CHF. COMPARISONS: ___. FINDINGS: Increased interstitial opacity with septal lines compatible with mild pulmonary edema in the setting of moderate cardiomegaly and likely small bilateral pleural effusions. No focal consolidation is seen. A 6mm nodule is seen in the right upper lung between the first and second ribs overlying the scapula. The lungs are hyperexpanded compatible with chronic obstructive pulmonary disease. Dual-lead pacer is in unchanged position. Multiple vertebral compression deformities are unchanged in the thoracic spine. IMPRESSION: Mild congestive failure. Possible 6mm nodule in the right upper lung for which apical lordotic views are recommended. Findings discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. " 83e767b9-8471927c-0c16e052-ef268ddd-5740d930.jpg,test/p13/p13584591/s53899898/83e767b9-8471927c-0c16e052-ef268ddd-5740d930.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cirrhosis, liver transplant evaluation. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " f8a622ad-0fa61a60-525a6ce7-7d4b3f4a-734c5892.jpg,test/p12/p12763897/s56849193/f8a622ad-0fa61a60-525a6ce7-7d4b3f4a-734c5892.jpg,test," FINAL REPORT HISTORY: History of hemochromatosis with abnormal liver function tests. COMPARISON: Outside hospital chest CT from ___ FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. Prominent prevascular nodes noted on CT are not clearly delineated on this study. No acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " c1ec4429-0a60193c-21b934ce-5083359d-e94f8690.jpg,test/p13/p13877204/s57629475/c1ec4429-0a60193c-21b934ce-5083359d-e94f8690.jpg,test," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old male patient with newly diagnosed acute myelocytic leukemia, now with persistent cough and fever, evaluate for pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Poor inspirational effort results in relatively high-positioned diaphragms obscuring partially the heart shadow. There is, however, no significant difference in heart size when comparison is made with the previous study. The high-positioned diaphragms result in a crowded appearance of the pulmonary vasculature on the bases with possibly a linear density in retrocardiac position on the left base suggestive of a peripheral plate atelectasis. Acute parenchymal infiltrates, however, cannot be identified and the lateral and posterior pleural sinuses are free from any fluid accumulation. The pulmonary vascular pattern is not congested and no pneumothorax is identified in the apical area on the frontal view. No gross skeletal abnormalities on the standard views. When comparison is made with the chest examination of ___, findings are stable short of the poor inspirational effort on today's examination. Suggestion of trace plate linear atelectasis on the left base was already mentioned on the preceding study. " 30517c16-bcde1d7c-13795ee5-07976d3d-c056276e.jpg,test/p11/p11654007/s55045409/30517c16-bcde1d7c-13795ee5-07976d3d-c056276e.jpg,test," FINAL REPORT CLINICAL INFORMATION: ___-year-old male with syncope, evaluate for acute process. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate stable appearance of left basilar opacity, likely to represent scar. The heart is normal, the mediastinal contours are normal. Surgical clips are noted in the region of the stomach fundus. IMPRESSION: No acute chest pathology. " 700daad7-60834725-e998b88b-6f7e2383-60a64306.jpg,test/p10/p10888608/s50701465/700daad7-60834725-e998b88b-6f7e2383-60a64306.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with right lateral lower chest wall pain x2 days COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. No displaced rib fracture seen. Dedicated rib series may be performed if there is further concern. " 1bd2fd76-8b7184e7-e11450f6-db22419c-1bb2ac8e.jpg,test/p10/p10283452/s58168674/1bd2fd76-8b7184e7-e11450f6-db22419c-1bb2ac8e.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Continued altered mental status and decreased oxygen saturations. Portable AP radiograph of the chest was reviewed in comparison to ___. Right internal jugular line tip is at the level of superior SVC. Heart size and mediastinum are stable. Right basal and left retrocardiac opacities are more pronounced on the current study, concerning for infectious process. Although atelectasis and aspiration would be another possibility. No substantial pulmonary edema is seen, with improvement as compared to prior study. " 9b328d35-5c0aad6f-0af17791-8d562347-2c3a399b.jpg,test/p10/p10226344/s52566741/9b328d35-5c0aad6f-0af17791-8d562347-2c3a399b.jpg,test," FINAL REPORT INDICATION: ___ year old man with severe AS here with hip fracture, now concerns for volume overload, eval for pulm edema. TECHNIQUE: Portable frontal view of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: There are small bilateral layering pleural effusions. There is no focal consolidation, overt pulmonary edema or pneumothorax. The heart size is normal. Enlargement of the aortic knob is stable since ___. There is no free air beneath the right hemidiaphragm. IMPRESSION: Small bilateral layering pleural effusions. No overt pulmonary edema. " beebebf4-c3154f66-43f89cca-33442776-8118a185.jpg,test/p18/p18143490/s54988449/beebebf4-c3154f66-43f89cca-33442776-8118a185.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p line change and DHT placement // eval DHT/ line position COMPARISON: ___ FINDINGS: Interval insertion of a DH T with the tip in the body of the stomach. The nasogastric tip is also in the fundus with the first side port at the gastroesophageal junction. Interval removal of the Swan-Ganz catheter with a jugular sheath remaining on the right. Increasing veil like opacity in the right lower lobe likely layering effusion. Persistent mild to moderate left effusion and retrocardiac opacity. IMPRESSION: Interval insertion of a DH T with the tip in the body of the stomach. The nasogastric tip is also in the fundus with the first side port at the gastroesophageal junction. " 8cc58ff0-7a6c1d2c-945fc98c-f8627827-6176a8e0.jpg,test/p15/p15510911/s50824866/8cc58ff0-7a6c1d2c-945fc98c-f8627827-6176a8e0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with polytrauma // routine CXR TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes remain low. There is a new airspace opacity at the right lung base consistent with right middle lobe consolidation. In the setting of trauma this may reflect a pulmonary contusion but infection cannot be excluded. There is a small amount free air under both hemidiaphragms. A gastrostomy tube appears to have been placed recently which may account this finding but hollow visceral injury cannot be excluded. IMPRESSION: New right basal consolidation, in the setting of trauma this may reflect a contusion however infection cannot be excluded. Small amount free air under the diaphragm. NOTIFICATION: Findings discussed with Dr. ___ ___ trauma ICU) by telephone by Dr. ___ at 10:00 on ___, within 5 min of discovery. " ca45fa0b-1a4c825b-7a5d32aa-0cad375a-696713e2.jpg,test/p14/p14707155/s55926520/ca45fa0b-1a4c825b-7a5d32aa-0cad375a-696713e2.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 2 EXAMS INDICATION: ___ year old man with VT arrest with dobhoff placement. Place evaluate for dobhoff placement. // Evaluate for dobhoff placement. Evaluate for dobhoff placement. IMPRESSION: In comparison with the previous study, the Dobhoff tube has been redirected into the esophagus and extends to the upper stomach. " 3deb66eb-1bd42b9f-f8f4e49d-47d8735a-7c2fdaca.jpg,test/p12/p12111976/s58782481/3deb66eb-1bd42b9f-f8f4e49d-47d8735a-7c2fdaca.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with heart failure and VT // ?edema, effusion, PNA COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The patient carries a new right pectoral Port-A-Cath. The course of the pacemaker lead is unchanged. Moderate cardiomegaly. Atelectasis in the middle lobe region. No pleural effusions. No overt pulmonary edema. " 4440871d-2d89bec6-619cc06e-ef6038ca-520345d1.jpg,test/p12/p12841950/s59497154/4440871d-2d89bec6-619cc06e-ef6038ca-520345d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recurrent left anterior chest pain x 15 months, not exertion. Lungs clear. No rashes. No tenderness to chest wall. Never a smoker. // r/o pulmonary or pleural disease r/o pulmonary or pleural disease IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion. There is no pneumothorax. " 23debd56-1f37f825-374e56e3-e62b7ff2-8583f15c.jpg,test/p19/p19314531/s52359810/23debd56-1f37f825-374e56e3-e62b7ff2-8583f15c.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: COPD with worsening weakness, assess for pneumonia. FINDINGS: PA and lateral views of the chest are provided. The lungs are hyperinflated, but appear clear. Cardiomediastinal silhouette is normal. No effusion or pneumothorax. Bony structures are intact. IMPRESSION: COPD without superimposed pneumonia. " 22fc2f24-7582d6a8-41b904f9-0864ede1-139ce17c.jpg,test/p18/p18083755/s51365345/22fc2f24-7582d6a8-41b904f9-0864ede1-139ce17c.jpg,test," FINAL REPORT HISTORY: Female status post VATS resection x2, ___, for pulmonary nodules. Assess for interval change. COMPARISON: Chest radiograph ___; ___; CT chest ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Right upper lobe nodule is no longer visible. Band-like opacity seen in right middle lobe is more distinct with chain sutures. Fullness of right hilum is as seen on prior CT. Lungs are fully expanded and otherwise clear, without pleural effusion or pneumothorax. Heart size, mediastinal contour are normal. No bony abnormality. IMPRESSION: 1. Right upper lobe opacity is no longer visible. 2. Interval resolution of right pleural effusion. " 4c329481-002c1bee-b4cc5476-f6417021-856d5c83.jpg,test/p15/p15132671/s53918315/4c329481-002c1bee-b4cc5476-f6417021-856d5c83.jpg,test," WET READ: ___ ___ ___ 3:06 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness evaluate for pneumonia. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Cardiomegaly is mild. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " b0113446-2fefb180-121f8ad6-ee97a481-bb747ce8.jpg,test/p14/p14160937/s57419116/b0113446-2fefb180-121f8ad6-ee97a481-bb747ce8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with arthralgias // ? hilar ___ or infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: CT chest from ___ IMPRESSION: Heart size and mediastinum unremarkable. Lungs are patellar can be seen on prior chest CT. No is demonstrated. No pleural effusion or pneumothorax seen. " 2839d5e9-047b80ed-9f37f334-07f3292c-731543f2.jpg,test/p12/p12292383/s55895189/2839d5e9-047b80ed-9f37f334-07f3292c-731543f2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD exacerbation, recent right upper lobe ground-glass opacity. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Pacemaker in situ. No pneumonia. No pulmonary edema. No other parenchymal opacities. The ground-glass nodule described on the previous CT examination from ___ is not visible on the current image. " 9f95f2ac-690f74ea-dba737ce-7e065da2-e7ed8e54.jpg,test/p15/p15813164/s58873265/9f95f2ac-690f74ea-dba737ce-7e065da2-e7ed8e54.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with cough for one month, no fever, evaluate for infiltrates or other new processes. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding chest examination of ___. Status post sternotomy. Previous chest examination identifies it as status post aortic valve replacement. Heart size is now within normal limits. The thoracic aorta is moderately widened and elongated but no local contour abnormalities are identified. Pulmonary vasculature is not congested. No evidence of acute parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. A well-demarcated round less than ___-mm calcification is seen on the left lung base laterally. A granuloma which was already identified on preoperative chest examination of ___. Comparison with the next preceding PA and lateral chest examination of ___ at that time existing and remaining moderate cardiac enlargement has now normalized. Thus, postoperative cardiac enlargement has regressed. IMPRESSION: Status post aortic valve and bypass surgery without evidence of detectable aortic valve prosthesis components within the heart shadow. Heart size is now normalized, no pulmonary congestion or acute infiltrates are present, stable left-sided basal calcified granuloma. " 0d6db000-b7832a09-4e80e472-89242ef5-20701513.jpg,test/p18/p18929056/s58958987/0d6db000-b7832a09-4e80e472-89242ef5-20701513.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Dyspnea. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead left-sided pacemaker is again seen with leads extending to the expected positions of the right atrium and right ventricle. The lungs are hyperinflated, with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. No pleural effusion or pneumothorax is seen. Slight increased opacity at the right lung base, best seen on the frontal view may relate to atelectasis, although in the appropriate clinical setting, infectious process is not excluded. No overt pulmonary edema is seen. Chest radiography is inappropriate for evaluation of pulmonary embolism. The aorta is calcified and tortuous. The cardiac silhouette is top normal to mildly enlarge. IMPRESSION: 1. Hyperinflated lungs suggest chronic obstructive pulmonary disease. 2. Slight increase in opacity at the right lung base may relate to atelectasis, although in the appropriate clinical setting, infectious process is not excluded. " e5d24160-352b7820-c68358ab-28201d39-c5a00b1f.jpg,test/p11/p11602365/s52832509/e5d24160-352b7820-c68358ab-28201d39-c5a00b1f.jpg,test," FINAL REPORT INDICATION: Cough, fever, right lower lobe crackles, 6 days postop axillary tissue dissection; please evaluate for pneumonia. COMPARISON: No prior studies available for comparison. FINDINGS: 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. IMPRESSION: Asymmetrically increased right lower lobe opacification concerning for pneumonia. " 4c8a542f-1b468a50-e7264d2b-8e448a4e-72efd4e4.jpg,test/p13/p13680500/s50194674/4c8a542f-1b468a50-e7264d2b-8e448a4e-72efd4e4.jpg,test," FINAL REPORT HISTORY: Chest pain, shortness of breath, tachycardia on oral contraceptives. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are seen. IMPRESSION: Normal chest radiograph. " 15d691d9-f36d0b4d-9e73112b-ebbe33d3-28fba581.jpg,test/p13/p13295971/s53770859/15d691d9-f36d0b4d-9e73112b-ebbe33d3-28fba581.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with weakness. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate slightly low lung volumes resulting in exaggeration of the cardiac silhouette and bronchovascular crowding. Allowing for this, heart size is top-normal to mildly enlarged in size. There is mild vascular congestion and pulmonary edema. There is no appreciable pleural effusion or pneumothorax. No focal consolidation is identified. A mildly elevated left hemidiaphragm is similar appearance compared to multiple chest radiographs dating back to ___. IMPRESSION: Mild vascular congestion and pulmonary edema. No focal consolidation identified. " 82ff7ece-2370da9c-27a2d5c4-cb232abf-7f6868f4.jpg,test/p10/p10902272/s57613682/82ff7ece-2370da9c-27a2d5c4-cb232abf-7f6868f4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Permanent pacemaker, evaluation. COMPARISON: Chest radiograph from ___. FINDINGS: As compared to the previous radiograph, the temporary pacemaker has been replaced by a permanent pacemaker, with a generator positioned in the left pectoral region and the wire is projecting over the right ventricle. No evidence of pneumothorax or other complications. Unchanged appearance of the cardiac silhouette. No pleural effusions. " c2ba56ab-37920759-3c6e6fcc-1da08bca-d5306788.jpg,test/p19/p19170368/s53670891/c2ba56ab-37920759-3c6e6fcc-1da08bca-d5306788.jpg,test," WET READ: ___ ___ ___ 3:31 PM Large right pneumothorax without signs of tension. Chest tube placement advised. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with shortness of breath, history of pneumothorax COMPARISON: Abuts the this wet read N FINDINGS: AP portable upright view of the chest. There is a large right pneumothorax with complete collapse of the right lung. No shift of midline structures to the left to suggest a tension component. No pleural effusion. Suture material at the left lung apex suggests prior surgical resection. Left lung is otherwise unremarkable. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: Large right pneumothorax without signs of tension. Decompression with chest tube advised. " d68549ce-8762bcac-545ec84e-a15f9645-d63c87d7.jpg,test/p12/p12191113/s52603196/d68549ce-8762bcac-545ec84e-a15f9645-d63c87d7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with chest pain, neck pain and shoulder pain for the past 3 months // ?acute cp process TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " a2fe5380-cf2baeea-aa44471d-fd1fa3fe-97fcecce.jpg,test/p12/p12116463/s56223982/a2fe5380-cf2baeea-aa44471d-fd1fa3fe-97fcecce.jpg,test," FINAL REPORT HISTORY: Cough, chills for 1 week. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low. This accentuates the size of the cardiac silhouette which is likely top normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 354d3473-4ca72cfd-2f4630a5-41771248-29549b21.jpg,test/p12/p12457153/s50501409/354d3473-4ca72cfd-2f4630a5-41771248-29549b21.jpg,test," FINAL REPORT INDICATION: ___-year-old man with weakness. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: Upright AP and lateral radiographs of the chest. The lungs are clear. There is hyperinflation of the lungs evidenced by increased anterior clear space and flattening of the diaphragms, suggestive of chronic obstructive pulmonary disease. Increased prominence of interstitial markings likely represents chronic lung disease. The aorta is tortuous. There is bilateral lower lobe atelectasis. There is no pneumothorax or pleural effusion. There is no pulmonary edema. IMPRESSION: 1. No evidence of pneumonia. 2. Left lower lobe atelectasis. 3. Increased prominence of interstitial markings likely represents chronic lung disease. Hyperinflation suggests COPD. " 9f3318f9-b05bb1b8-bc259d9c-8ebf8bb1-8bd911c1.jpg,test/p17/p17865089/s59072515/9f3318f9-b05bb1b8-bc259d9c-8ebf8bb1-8bd911c1.jpg,test," FINAL REPORT AP CHEST, 4:40 A.M., ___ HISTORY: Check OG tube placement. IMPRESSION: AP chest compared to ___. Nasogastric tube is in standard position in the mid portion of the stomach. ET tube, right internal jugular, and left subclavian lines are also in standard placements respectively. Atelectasis at the base of the right lung is mild, more severe at the left base accompanied by a small-to-moderate left pleural effusion unchanged. Heart size is top normal, increased since ___, but there is no pulmonary edema. No pneumothorax. " 9859d33a-bc960077-f2242195-f3af11f1-15401946.jpg,test/p18/p18588429/s58437376/9859d33a-bc960077-f2242195-f3af11f1-15401946.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new BiVICD implant // evaluate for lead placement and pneumothorax evaluate for lead placement and pneumothorax IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. The triple -lead pacer device remains in place with leads in good position. No evidence of vascular congestion. Cardiac silhouette is at the upper limits of normal in size or slightly enlarged. " 6e041bf6-980f7e94-e98ad17f-a3836306-05613484.jpg,test/p14/p14018583/s57056995/6e041bf6-980f7e94-e98ad17f-a3836306-05613484.jpg,test," WET READ: ___ ___ ___ 5:34 PM Subtle cortical step-off at the posterior aspect of the sternum, could represent a sternal fracture. Alternatively, this may represent an artifact. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with question of rib fractures. Evaluate for pneumothorax. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Chest radiograph from ___ and and thoracolumbar spine radiographs from ___ FINDINGS: The lungs are underinflated but clear. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. No displaced rib fractures are identified. On the lateral view, there is suggestion of subtle cortical step-off at the posterior aspect of the sternum, which may represent a fracture. IMPRESSION: Subtle cortical step-off at the posterior aspect of the sternum, could represent a sternal fracture vs artifact. Correlate clinically with anterior chest pain and history. " 8295e173-6d31b9c4-8c6fa027-f5a5c225-7190d5c7.jpg,test/p17/p17051420/s55924810/8295e173-6d31b9c4-8c6fa027-f5a5c225-7190d5c7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with CP, // r/o cardiopulm abnormality COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Mild cardiomegaly is similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " de1de4a8-8e8ad1b4-80eec672-965d9a73-fca9554f.jpg,test/p14/p14908521/s53200190/de1de4a8-8e8ad1b4-80eec672-965d9a73-fca9554f.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with seizure // PNA, bleed COMPARISON: Prior chest CT dated ___. FINDINGS: Upright AP and lateral views of the chest provided. Known right upper lobe lesion is not clearly visualized. Overlying EKG leads are present. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Sclerotic appearance of several vertebral bodies on the lateral projection is compatible with known metastatic disease. A compression deformity involving the mid thoracic spine is better assessed on prior CT chest. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. Known upper lobe lesion poorly visualized. Sclerotic osseous metastases better assessed on prior CT. " aa166fd8-db230ad6-ddcd589d-4505e69c-7c2b0137.jpg,test/p19/p19277082/s54038844/aa166fd8-db230ad6-ddcd589d-4505e69c-7c2b0137.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " f4ae14b8-77399fde-37a9caeb-9749772f-cb71aedf.jpg,test/p14/p14185546/s52803612/f4ae14b8-77399fde-37a9caeb-9749772f-cb71aedf.jpg,test," FINAL REPORT INDICATION: Status post multiple fusions for unstable cervical and thoracic spine fractures. Evaluate for interval change. COMPARISON: CXR ___; CT ___ from ___ ___. FRONTAL SUPINE PORTABLE CHEST: Low lung volumes result in bronchovascular crowding. Since ___, pleural effusions are smaller with adjacent atelectasis, right more than left. Vascular congestion persists. A right subclavian line is unchanged in position. Spinal hardware is incompletely evaluated. No pneumothorax. Cardiac and mediastinal silhouettes are grossly stable allowing for differences in position and technique. A section of tubing projects over the right axilla. We cannot determine what it is or where it goes. If it is intended to be intra-thoracic or central, it is not, ending at the junction of the second posterolateral rib and scapula. " 38e75808-1abde7c0-cfa6f4e6-4cb2bbad-183b6aa3.jpg,test/p14/p14151932/s50775678/38e75808-1abde7c0-cfa6f4e6-4cb2bbad-183b6aa3.jpg,test," FINAL REPORT HISTORY: Pancreatic carcinoma after Whipple's, to assess for worsening pneumonia. FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. Opacification at the left costophrenic angle is consistent with some reaccumulation of pleural fluid with underlying compressive atelectasis. There may be mild residual elevation of pulmonary venous pressure, improved since the previous study. The course of the left subclavian vein and appearance of the tip suggests that the tube lies in the azygous vein. Lateral radiograph could confirm this diagnosis. " 38b9f425-24894188-09f5aaa9-5ea8b519-6761d5fb.jpg,test/p15/p15527518/s57381624/38b9f425-24894188-09f5aaa9-5ea8b519-6761d5fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p intubation. Evaluate endotracheal tube placement. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from earlier on the same date. FINDINGS: The new endotracheal tube tip projects 1.4 cm above the carina and should be withdrawn at least 2 cm for optimal placement. The large left infrahilar consolidation is worse, with increased opacification of the left lung. There is associated leftward mediastinal shift and a more superiorly displaced left lower lobe bronchus. Findings suggest possible left upper a lingual collapse with left basal atelectasis and left-sided effusion. IMPRESSION: 1. The new endotracheal tube tip projects 1.4 cm above the carina and should be withdrawn at least 2 cm for optimal placement. 2. Worsening left lung opacification, likely a combination of upper lobe collapse and effusion. NOTIFICATION: The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 11:30 on ___, ___ min after discovery. " 76659dc1-204cb48c-cdc9cc15-2f414d85-0d89c666.jpg,test/p13/p13917858/s50993960/76659dc1-204cb48c-cdc9cc15-2f414d85-0d89c666.jpg,test," FINAL REPORT INDICATION: ___F with hypotension // eval line placement, rule-out PTX TECHNIQUE: Single portable view of the chest. COMPARISON: Prior exam from earlier the same day at 07:25. FINDINGS: There has been interval placement of a left internal jugular central venous catheter with tip projecting over the mid SVC. There is no pneumothorax. Otherwise, there is been no change. Probable moderate right pleural effusion is again seen with vague right upper lung opacity less clearly delineated. Cardiomegaly with mitral annular calcifications. Retrocardiac opacity suspicious for hiatal hernia. Lumbar levoscoliosis is noted. IMPRESSION: Ventral placement of a left-sided central venous catheter with tip projecting over the mid SVC. No pneumothorax. " f8aa65ce-4f907c79-f01f09d7-572791a9-81717536.jpg,test/p13/p13275896/s58139906/f8aa65ce-4f907c79-f01f09d7-572791a9-81717536.jpg,test," WET READ: ___ ___ ___ 11:48 PM OG tube in area of stomach. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Gastrointestinal bleed, evaluation for orogastric tube placement. COMPARISON: No comparison available at the time of dictation. FINDINGS: The patient is intubated. The endotracheal tube is in correct position. The nasogastric tube shows a normal course, the tip is located in prepyloric position. The lung volumes are low. Atelectasis are seen at both the left and the right lung bases. There is mild fluid overload. No larger pleural effusions. No pneumothorax. " e4c9fdc6-a5b8aff4-dc2566b9-7250402a-09a2acfa.jpg,test/p11/p11822137/s50955735/e4c9fdc6-a5b8aff4-dc2566b9-7250402a-09a2acfa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea // r/o infiltrate COMPARISON: Chest radiograph ___ Chest CT without IV contrast ___ FINDINGS: PA and lateral views of the chest provided. Bilateral peripherally calcified breast implants are again visualized, creating increased density over the lung bases on the frontal view. There are superimposed multifocal parenchymal opacities in the right lower lobe and suspected parenchymal opacity in the left lower lobe which are new since ___ and ___. Stable appearance of right upper lobe opacity compared to ___. No effusion or pneumothorax. Scoliosis and posterior spinal fixation hardware are again visualized. IMPRESSION: Multifocal opacities in the right lower lobe and suspected opacity in the left lower lobe which are new since chest CT ___ concerning for an multifocal infectious process. " 1e05ca1d-9916266c-c58cb1a6-0acf8d1c-bf213534.jpg,test/p15/p15072866/s50137061/1e05ca1d-9916266c-c58cb1a6-0acf8d1c-bf213534.jpg,test," FINAL REPORT HISTORY: Chest pain COMPARISON: ___ FINDINGS: Frontal and lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours. Clear lungs. No pneumothorax or pleural effusion. IMPRESSION: Normal chest radiograph " bcba4a10-662aea15-f83ebc16-b99d3754-2a92cc3c.jpg,test/p13/p13229615/s58430415/bcba4a10-662aea15-f83ebc16-b99d3754-2a92cc3c.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old male with shortness of breath. COMPARISON: None. FINDINGS: Single portable view of the chest. The lungs are grossly clear. There is no evidence of confluent consolidation or pulmonary edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No definite acute cardiopulmonary process. " 8c8924c3-58d02815-d580d2c9-60ffc827-745b0416.jpg,test/p14/p14606539/s59380369/8c8924c3-58d02815-d580d2c9-60ffc827-745b0416.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: There are low lung volumes. The heart size is stably borderline enlarged. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Cholecystectomy clips are seen in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " be25fa4b-6c44ab41-0feeed32-76d0eeb8-c1c1fc32.jpg,test/p15/p15219741/s53511899/be25fa4b-6c44ab41-0feeed32-76d0eeb8-c1c1fc32.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain and shortness of breath // eval for pn COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There is again noted to be a right pleural effusion with associated lower lobe atelectasis, difficult to exclude a superimposed pneumonia. There is mild left basal atelectasis without large effusion. Clips are noted in the upper abdomen. Cardiomediastinal silhouette appears grossly unchanged. No pneumothorax. IMPRESSION: Persistent moderate right pleural effusion with associated compressive lower lobe atelectasis, difficult to exclude a superimposed pneumonia. Mild left basal atelectasis. " ed56e5c6-3dbed7ea-342cdb3f-660a6136-808eec57.jpg,test/p12/p12061930/s50723970/ed56e5c6-3dbed7ea-342cdb3f-660a6136-808eec57.jpg,test," FINAL REPORT INDICATION: ___-year-old male with dyspnea, cough, fever. COMPARISON: Chest radiograph from ___ and ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: There are bilateral airspace patchy opacities, more pronounced in both lower lung fields, more specifically in the right middle and right lower lobe as well as in the left lower lobe in the retrocardiac region. No pleural effusion or pneumothorax is identified. The heart is mildly enlarged. IMPRESSION: Multifocal pneumonia. Recommend repeat after treatment to document resolution. " 1294a8dd-93ae4974-f37d9a39-13131ef5-d7b1f2d0.jpg,test/p10/p10862640/s54141598/1294a8dd-93ae4974-f37d9a39-13131ef5-d7b1f2d0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with presents with paroxysmal atrial fibrillation. Diaphoresis, chest tightness, exertional dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " de004eb1-77ef3456-8f983a3d-eaf22492-322f3dda.jpg,test/p14/p14948967/s51253718/de004eb1-77ef3456-8f983a3d-eaf22492-322f3dda.jpg,test," FINAL REPORT INDICATION: ___ F s/p kidney transplant, recent re-intubation for fluid overload, extubated yesterday, now w cough // ? fluid overload, ? consolidation COMPARISON: Radiographs from ___ IMPRESSION: Endotracheal tube and feeding tube have been removed. There is a residual right IJ central line with the distal tip in the distal SVC. Heart size is prominent but stable. There has been improved aeration. There has been improvement of pulmonary edema. There is no focal consolidation or pneumothoraces. " cb2cbde0-0a98013f-ae5ff24e-29aba124-1178bcb1.jpg,test/p15/p15929503/s59627900/cb2cbde0-0a98013f-ae5ff24e-29aba124-1178bcb1.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with dizziness and new oxygen requirement. Evaluate for pneumonia TECHNIQUE: Chest AP and lateral COMPARISON: ___ FINDINGS: Compared to ___, there is unchanged cardiomegaly. As before, the patient is status post median sternotomy. There is a left chest defibrillator with leads in expected and unchanged positions. Unchanged moderate to severe enlargement of the cardiac silhouette. There is mild pulmonary vascular congestion without overt pulmonary edema, improved since prior. No pleural effusion or pneumothorax. Prominent extrapleural fat is noted bilaterally. No acute osseous abnormalities. IMPRESSION: Mild pulmonary vascular congestion without overt pulmonary edema. No focal consolidation to suggest pneumonia. " 5a11b068-34957a74-6d8edf18-fb721ab7-7ea092b1.jpg,test/p19/p19496992/s56430139/5a11b068-34957a74-6d8edf18-fb721ab7-7ea092b1.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old man with new BIVICD implant. Pneumothorax and lead placement. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs, from ___, ___, ___, and ___. FINDINGS: No change in the position of the BiV-ICD leads, which terminate in the right atrium, right ventricle, and epicardial vein of the left ventricle. Since the radiograph from the prior day, there has been no significant change. Unchanged bilateral pleural plaques, left clavicular old fracture, old left rib fractures, and bilateral apical caps are noted. No pneumothorax or new effusion. IMPRESSION: Bi-V ICD leads terminate in the right atrium, right ventricle, and left ventricle. No pneumothorax. " 458fdecb-704d167c-500bcb3e-283f9689-1cf16627.jpg,test/p17/p17913240/s54986141/458fdecb-704d167c-500bcb3e-283f9689-1cf16627.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of left-sided pleural effusion in ___. Evaluate for residual effusion. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Trace blunting of the left costophrenic angle indicates small amount of fluid, improved since the prior. Mild bibasilar atelectasis. No evidence of pneumonia. Heart size is normal. No pneumothorax. IMPRESSION: Trace left pleural effusion, improved since the prior. " 399504fd-f97b62cd-bb56fa65-7f07bb57-e3229bd8.jpg,test/p15/p15947328/s54690471/399504fd-f97b62cd-bb56fa65-7f07bb57-e3229bd8.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with ptx, rib fx // eval ptx change with end exp film TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Redemonstrated is a small, left apical pneumothorax, minimally increased in size from the prior examination and likely secondary to increased inspiration. The cardiomediastinal silhouette is unchanged in appearance. Calcifications are noted within the aortic arch. The right hemidiaphragm is elevated and demonstrates sub-diaphragmatic lucency likely secondary to colonic interposition, stable from the prior exam. Bibasilar atelectasis is noted. The upper lungs are grossly clear. IMPRESSION: Stable, small left apical pneumothorax, minimally changed from the prior examination. " d7db769b-4946d2af-26341dc8-6de7ab74-ceeaf528.jpg,test/p13/p13990571/s58979493/d7db769b-4946d2af-26341dc8-6de7ab74-ceeaf528.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___ as well as a CT of the chest from ___. CLINICAL HISTORY: Pleuritic chest pain, productive cough, evaluate for pneumonia. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. The heart is top normal in size. The mediastinal contour is normal aside from atherosclerotic calcification along the aortic knob. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 25a26755-f41cff34-aac999f8-0c7a98e4-c4e1f754.jpg,test/p10/p10449408/s52779068/25a26755-f41cff34-aac999f8-0c7a98e4-c4e1f754.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Evaluate for pulmonary edema, status post multiple units of blood products. Patient with VAT. Comparison is made with prior study ___. Cardiomediastinal contours are unchanged. Diffuse lung opacities in the right lung have minimally improved in the perihilar region. Left lower lobe opacities have improved. Bilateral effusions, larger on the right side are probably unchanged allowing the difference in positioning of the patient. There is no pneumothorax. Mild vascular congestion is stable. There is no overt pulmonary edema. Right supraclavicular catheter tip is in the cavoatrial junction. NG tube tip is out of view below the diaphragm. Loss of volume in the right middle lobe and right lower lobes is unchanged. " d0976aa4-accebabf-81aa00f4-d9f253fc-7778ae4b.jpg,test/p18/p18456328/s56108157/d0976aa4-accebabf-81aa00f4-d9f253fc-7778ae4b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with subacute onset of sternal chest pain. Evaluate for pneumothorax or pneumomediastinum. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is mildly enlarged, similar to ___. Bibasilar atelectasis is again seen. The lungs are otherwise clear. No pleural effusion, pneumothorax, or pneumomediastinum is seen. Median sternotomy wires are intact. Several metallic clips overlie the cardiac shadow. There are severe degenerative changes of the right shoulder including complete effacement of the right acromiohumeral interval suggesting rotator cuff pathology. IMPRESSION: Bibasilar atelectasis. No pneumothorax or pneumomediastinum. " 25ee1106-a1c8dd6d-f3b69896-10751463-43b1fb36.jpg,test/p16/p16568324/s52410992/25ee1106-a1c8dd6d-f3b69896-10751463-43b1fb36.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo M s/p cardiac arrest // OG tube placement OG tube placement COMPARISON: Large fifth, most recently 17:19. IMPRESSION: Two frontal views of the torso centered just above the diaphragm, excluding the extreme the lung apices, show a nasogastric drainage tube initially in the lower esophagus, eventually advanced to the upper stomach. Pulmonary vascular engorgement has worsened, although there is no definite pulmonary edema as yet. Heart size is normal. Right central venous line ends in the mid SVC, ET tube in standard placement. There is no appreciable pleural effusion or evidence of pneumothorax in the imaged field of view. " 7bde708b-27d79bd9-2ca0801f-76ed70c6-687dc305.jpg,test/p11/p11847776/s59347112/7bde708b-27d79bd9-2ca0801f-76ed70c6-687dc305.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fall onto face with significant trauma. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are hyperinflated with flattening of the diaphragms suggesting chronic obstructive pulmonary disease. There is blunting of the right costophrenic angle worrisome for small right pleural effusion. There may be a trace left pleural effusion. There is no pneumothorax. No definite focal consolidation. The cardiac silhouette is mildly enlarged. The aorta is calcified and tortuous. Patient is status post median sternotomy. A single-lead right-sided pacemaker is seen with lead extending to the expected position of the right ventricle. No displaced fracture is seen. IMPRESSION: Enlarged cardiac silhouette. Small right pleural effusion and possible trace left pleural effusion. " 251dcf1a-420b158f-da5021a2-3a13df05-a58806b3.jpg,test/p19/p19642544/s55177986/251dcf1a-420b158f-da5021a2-3a13df05-a58806b3.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior CT chest and chest radiograph from same day. CLINICAL HISTORY: New right pigtail chest tube, confirm position and assess for residual pneumothorax. FINDINGS: Supine portable AP view of the chest was provided. A pigtail chest tube has been placed with the tip residing in the medial right pleural space. The right lung appears well expanded without residual pneumothorax appreciated on this supine radiograph. There is left retrocardiac atelectasis. The known right mid clavicular shaft deformity is again seen. " 4cd06d02-d7d2fb94-f1ea8015-6d58236c-dbf5bfed.jpg,test/p18/p18772706/s58571733/4cd06d02-d7d2fb94-f1ea8015-6d58236c-dbf5bfed.jpg,test," WET READ: ___ ___ ___ 8:22 AM Right lung opacities appear minimally increased. There is new linear atelectasis at the left base. Heart size is unchanged. Right Port-A-Cath remains in the right atrium. WET READ VERSION #___ ___ ___ 9:10 PM Right lung opacities appear minimally increased. There is new linear atelectasis at the left base. Heart size is unchanged. Right Port-A-Cath remains in the right atrium. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with aspiration pneumpnitis/pna // new focal opacities? IMPRESSION: As compared to ___ radiograph, widespread airspace opacities in the right lung with relative sparing of the right apex have progressed, concerning for worsening pneumonia. Adjacent small to moderate right pleural effusion is also increased. Exam is otherwise remarkable for new patchy and linear opacities at the left lung base suggestive of a combination of atelectasis and infectious pneumonia based upon correlation with CTA of the chest of ___. " 3844e4f9-b5a71185-4c5d6e1c-c586831b-d35a4c22.jpg,test/p13/p13659269/s57708418/3844e4f9-b5a71185-4c5d6e1c-c586831b-d35a4c22.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with malaise, N/V, fever, R pleuritic CP // eval ? R sided infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Left pleural effusion is resolved in the interim. No pleural effusion currently. No focal consolidation to suggest pneumonia. No pneumothorax or edema. Heart size is mildly enlarged, unchanged. Descending aorta is slightly tortuous or ectatic, unchanged. Mild pulmonary vascular congestion but no edema. IMPRESSION: No focal pneumonia. " 26c9b77f-358d12ca-c2aa6c5b-b46bc57c-94385d14.jpg,test/p10/p10336114/s56658784/26c9b77f-358d12ca-c2aa6c5b-b46bc57c-94385d14.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sepsis secondary to pneumonia. Now with increased shortness of breath and course breath sounds. // Please eval for worsening change. COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the known right pneumothorax is improved. The pneumothorax now as a dimension of approximately 5 mm. The left than right pleural effusions are unchanged. An area of pleural thickening on the left has overall decreased in extent. More severe than on the previous image, however, are signs indicative of pulmonary edema. The size of the cardiac silhouette is constant. Gastric overdistension could be alleviated by her nasogastric tube. " 2a1bd50f-807c3cc6-d127d944-764b6ece-8eecd690.jpg,test/p18/p18058525/s56845798/2a1bd50f-807c3cc6-d127d944-764b6ece-8eecd690.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough and fever. No comparison studies available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: Normal chest radiograph. " 175ee8d9-30d23ca7-5dbf8030-7dfe37e4-d8b2c2b6.jpg,test/p11/p11564282/s58672091/175ee8d9-30d23ca7-5dbf8030-7dfe37e4-d8b2c2b6.jpg,test," FINAL REPORT INDICATION: Fever and new oxygen requirement, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Mild areas of atelectasis at both lung bases. Neither the frontal nor the lateral radiograph show evidence of pneumonia or other newly appeared parenchymal abnormality. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " 009805ac-63467867-ecdbdca7-7e5c3c92-d5a55936.jpg,test/p12/p12951485/s53577775/009805ac-63467867-ecdbdca7-7e5c3c92-d5a55936.jpg,test," FINAL REPORT INDICATION: Productive cough. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are normal. The lungs are clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " e82b6d0c-1a313229-88921891-44576cea-816e467c.jpg,test/p11/p11423154/s54900541/e82b6d0c-1a313229-88921891-44576cea-816e467c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with unprovoked seizure undergoing toxic/metabolic/ infectious workup, no clear precipitant // eval ? infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: Overall lung volumes are low, which may accentuate heart size and vasculature, which appear increased in size compared with prior, with mild prominence of the pulmonary vasculature. No pleural effusion or pneumothorax is seen. There is atelectasis at the lung base. IMPRESSION: Apparent increase in size of the heart and mild prominence of the pulmonary vasculature may be secondary to overall low lung volumes and technique. No pneumonia. " 633ecece-65c894f1-7f79517f-c14cdb7a-d5595f39.jpg,test/p15/p15571243/s58785133/633ecece-65c894f1-7f79517f-c14cdb7a-d5595f39.jpg,test," FINAL REPORT INDICATION: History: ___F with hypoxia hx b/l PE // eval for PE, PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. Outside CT of the chest ___ pre FINDINGS: Known right hilar mass is re- demonstrated. There are faintly visualized right bronchial stents. There is increasing thickening of the lateral pleura in the right mid lung, likely pleural fluid. There is worsening right pleural effusion and probable associated atelectasis. Atelectasis at the left base is mild. The heart is obscured along its right border limiting evaluation. There is no pneumothorax. Known nodules in the left lung are better seen on prior chest CT. IMPRESSION: 1. Re- demonstrated known right hilar mass. 2. Enlarging moderate right pleural effusion. No convincing evidence of pneumonia, however right pleural effusion could obscure a pneumonia if one is present. 3. Known pulmonary nodules are better appreciated on prior chest CT. " c533a644-205cc474-ff1f94e1-8dac2b43-e3540cfa.jpg,test/p11/p11020337/s51483695/c533a644-205cc474-ff1f94e1-8dac2b43-e3540cfa.jpg,test," FINAL REPORT HISTORY: Pneumonia after antibiotics, to assess for resolution. FINDINGS: In comparison with the study of ___, the patient has taken a much better inspiration. There are several residual streaks of atelectasis, though the basilar opacification is substantially cleared. Upper zones are normal, and there is no evidence of vascular congestion. " 8050ca3f-fb25c7dd-4655dc2b-a941ceb8-66a6ad61.jpg,test/p16/p16901713/s55692199/8050ca3f-fb25c7dd-4655dc2b-a941ceb8-66a6ad61.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ? CHF in ___, nl LV function on ECHO // Has evidence of CHF improved? Has evidence of CHF improved? IMPRESSION: In comparison with the study of ___, there is again mild enlargement of the cardiac silhouette. The degree of pulmonary vascular congestion suggested on the previous study has decreased, with the pulmonary vessels only minimally if at all engorged. No evidence of acute focal pneumonia. " 4e73132f-25ee108d-c7f5ce02-69c976ef-cf8a5525.jpg,test/p19/p19822093/s51893186/4e73132f-25ee108d-c7f5ce02-69c976ef-cf8a5525.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with IDDM, L foot ulcer presenting with vomiting. // eval for acute process, foot osteomyelitis TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There has been no significant interval change. Evidence of old lateral right-sided rib fractures is again seen. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Thin linear radiopaque structure projecting over the posterior inferior thorax at the level of the posterior diaphragms, best seen on the lateral view was also present on the prior study from ___ and CT from ___ and seen to be intimately associated with right-sided posterior ninth rib. IMPRESSION: No acute cardiopulmonary process. " eead3bd3-136ae699-efde5b54-70f5308f-9c4033ba.jpg,test/p10/p10965259/s53745451/eead3bd3-136ae699-efde5b54-70f5308f-9c4033ba.jpg,test," FINAL REPORT INDICATION: History: ___M with fever and cough // evaluate for pneumonia COMPARISON: None . IMPRESSION: The lungs are clear. There is no pneumothorax, effusion, consolidation or CHF. Degenerative changes are present in the spine. " f2192a75-66c8469a-f0ebfebf-93033674-bb13e071.jpg,test/p19/p19402811/s55883782/f2192a75-66c8469a-f0ebfebf-93033674-bb13e071.jpg,test," WET READ: ___ ___ ___ 6:00 AM No significant cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___M with lightheadedness, nausea // evaluate for masses, pulmonary congestion, ACS TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No significant cardiopulmonary abnormality. " 8cf8f8a6-c55f573c-42bef82b-b2864ac5-fb84db23.jpg,test/p18/p18785569/s55803757/8cf8f8a6-c55f573c-42bef82b-b2864ac5-fb84db23.jpg,test," FINAL REPORT HISTORY: New white count, pneumonia. CHEST, TWO VIEWS: The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is mild cardiomegaly, with left a ventricular configuration. The aorta is unfolded. Increased opacity projecting over the heart on the frontal view likely represents a hiatal hernia. The hernia itself was better delineated on a film dated ___. There is atelectasis and/or scarring in the lower lobe posteriorly. Mild eventration of the right hemidiaphragm is noted. No CHF. The mid and upper zones of both lungs remain grossly clear. No definite consolidation. Degenerative changes and ossification of the anterior longitudinal ligament of the spine incidentally noted. IMPRESSION: 1. Background COPD. 2. Cardiomegaly, with unfolded aorta. 3. Moderate-sized hiatal hernia. 4. Bibasilar atelectasis. No definite consolidation. Subtle infiltrate could be obscured by the hiatal hernia, but no air bronchograms are appreciated. 5. No CHF. " e65f57f8-1d89c987-5912c22a-d3c46555-aa3bfe46.jpg,test/p11/p11501394/s58179188/e65f57f8-1d89c987-5912c22a-d3c46555-aa3bfe46.jpg,test," FINAL REPORT INDICATION: 24 hours of chest pressure, evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. No acute osseous abnormality is identified. IMPRESSION: No evidence of acute cardiopulmonary process. " 2bbc8e8a-ecb540e6-3d56ca5e-7e169bfa-88f6cf88.jpg,test/p16/p16332866/s54083896/2bbc8e8a-ecb540e6-3d56ca5e-7e169bfa-88f6cf88.jpg,test," FINAL REPORT INDICATION: Change in seizures. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. The lungs are clear. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities. Resection of the right fifth rib is again noted. The partially imaged inferior vena cava filter is again seen in the upper abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " e534993a-156f2552-e8b699cf-46a3ca42-fcda0c51.jpg,test/p10/p10711229/s54255234/e534993a-156f2552-e8b699cf-46a3ca42-fcda0c51.jpg,test," WET READ: ___ ___ 8:06 PM Mild central pulmonary vascular congestion and a trace interstitial edema similar to prior study. No focal consolidations suggestive of pneumonia. ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:28 P.M., ___ HISTORY: An ___-year-old woman with sepsis and increasing oxygen requirement. IMPRESSION: AP chest compared to ___: Moderately severe pulmonary edema has improved in the left lung since ___. More pronounced consolidation at the base of the right lung could be residual edema and atelectasis but pneumonia, particularly aspiration needs to be considered. Mild-to-moderate cardiomegaly and mediastinal venous engorgement unchanged, pulmonary vascular cephalization more pronounced. Pleural effusion is presumed but not substantial. " 2e25b67d-2fe26860-9bd31e83-0ae5d783-44e5bc1e.jpg,test/p17/p17962324/s56599347/2e25b67d-2fe26860-9bd31e83-0ae5d783-44e5bc1e.jpg,test," WET READ: ___ ___ 8:15 PM Normal chest. CABG. No pneumoperitoneum. No signif healing of L 9th rib fx. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with history of splenic pseudoaneurysm, bradycardia, and shortness of breath. Portable AP chest radiograph was reviewed in comparison to ___. Heart size is top normal and stable as well as tortuous aorta. Lungs are clear. There is no pleural effusion or pneumothorax. Hyperinflation is noted on the right that might be consistent to substantial emphysema. IMPRESSION: No evidence of abnormality to explain the patient's symptoms. " 4a818085-9c53f1a6-ebad093e-fa894602-2c8403c7.jpg,test/p15/p15844438/s53161281/4a818085-9c53f1a6-ebad093e-fa894602-2c8403c7.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with sigmoidectomy, ___, acute desaturation. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: Mild pulmonary edema is new since previous exam. Right jugular line has been removed and right subclavian line is in adequate position in mid SVC. Left small pleural effusion and atelectasis have increased since the previous exam. Moderate cardiomegaly is unchanged. CONCLUSION: 1. Mild pulmonary edema is new. 2. Increase in small left pleural effusion and atelectasis. Please refer to subsequent chest CTA. " cfd61fc6-594d7058-d264a64d-43e9ba04-27f0260d.jpg,test/p11/p11304959/s58114900/cfd61fc6-594d7058-d264a64d-43e9ba04-27f0260d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF ___ severe MR intubated with balloon pump // evaluate for location of ET tube and balloon pump evaluate for location of ET tube and balloon pump COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Moderate bilateral pleural effusions, improved on the right, stable on the left. Severe bilateral lower lobe atelectasis unchanged. Heart size top-normal. ET tube, right internal jugular line, and intra-aortic balloon pump in standard placements. Nasogastric drainage tube ends in the upper portion of a nondistended stomach would need to be advanced at least 5 to move all the side ports below the diaphragm. " 7b49d1cf-6ee62c78-0e2ff235-61e7af06-b8fc92f6.jpg,test/p10/p10512988/s50825478/7b49d1cf-6ee62c78-0e2ff235-61e7af06-b8fc92f6.jpg,test," FINAL REPORT HISTORY: Cough, sputum, crackles at bases. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: AP and lateral images of the chest. The lungs are moderately well-expanded. There is a large hiatal hernia with adjacent atelectasis, unchanged from prior exam. The lungs otherwise clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unchanged from prior exam. IMPRESSION: 1. No acute cardiopulmonary process. 2. Large hiatal hernia, unchanged from prior exam. " 133fb36b-aba8a820-0493cc85-08c2aea1-f8719e92.jpg,test/p12/p12431768/s59350451/133fb36b-aba8a820-0493cc85-08c2aea1-f8719e92.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old female with history of COPD, presenting with abdominal pain and fever, assess pneumonia. FINDINGS: PA and lateral views of the chest are provided. Lung volumes are low. Bronchovascular crowding likely accounts for the lower lung opacity. No definite sign of pneumonia or overt CHF. Heart and mediastinal contours are stable. No pneumothorax. Bony structures are intact. IMPRESSION: Limited, negative. " 39478940-45a5a6b4-34dcae2c-4e326acd-326d920c.jpg,test/p11/p11551927/s55844868/39478940-45a5a6b4-34dcae2c-4e326acd-326d920c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute pancreatitis // interval progression TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Cardiac size is top normal. Collapsed right lower lobe is unchanged. Mild vascular congestion has markedly improved. Left apical opacity is persistent. There is no pneumothorax or pleural effusion. Monitoring devices are in unchanged position. IMPRESSION: Persistent collapsed right lower lobe and probably pneumonic consolidation in the left upper lobe " fd2013d5-8dbe2611-a8d3f3af-d3100890-04c66ad8.jpg,test/p19/p19912537/s53697349/fd2013d5-8dbe2611-a8d3f3af-d3100890-04c66ad8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent trach placement and CHF // Assess interval change in lung fields TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Tracheostomy is in place. Cardiomediastinal silhouette is unchanged but there is interval development of severe interstitial pulmonary edema. . There is asymmetry noted, right lung is more involved than the left as well as there is increased amount of right pleural effusion. " 4b0a285d-bb95d4a6-8940e5a4-acc8b9d8-1bc80268.jpg,test/p14/p14108116/s56058530/4b0a285d-bb95d4a6-8940e5a4-acc8b9d8-1bc80268.jpg,test," FINAL REPORT HISTORY: ___-year-old male with weakness and fatigue. History of metastatic prostate cancer. COMPARISON: Chest x-ray from ___. CT abdomen from ___. CT torso from ___. FINDINGS: Frontal and lateral views of the chest. When compared to prior, there has been no significant interval change. There is no evidence of consolidation, effusion, or pulmonary vascular congestion. Cardiac silhouette is enlarged but stable in configuration. Expansile left lower anterior rib lesion is seen in addition to old right rib fractures. Additional sclerotic metastatic lesions are better seen on prior CT. IMPRESSION: No definite acute cardiopulmonary process. " 64df31f6-412e3acc-41283abc-28278a50-49253a39.jpg,test/p17/p17062380/s51101498/64df31f6-412e3acc-41283abc-28278a50-49253a39.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Hyperglycemia. Assess for infection. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographdemonstrates well expanded lungs.No CHF, focal infiltrate, pleural effusion or pneumothorax. Minimal scarring of the left costophrenic angle noted. Heart size, mediastinal contour, and hila are within normal limits. Possible minimal anterior wedging of a mid thoracic vertebral body,? T7, which does not appear acute. IMPRESSION: No acute cardiopulmonary process. No focal infiltrate to suggest pneumonia. NOTIFICATION: No acute cardiopulmonary process. No pneumonia. " 957530ac-ec195353-a2aec247-f8a7854e-fb3d34c8.jpg,test/p16/p16914073/s54219592/957530ac-ec195353-a2aec247-f8a7854e-fb3d34c8.jpg,test," FINAL REPORT HISTORY: Aortic stenosis and pulmonary edema. Evaluate for change. COMPARISON: ___. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: Extensive bilateral interstitial opacities have progressed since yesterday's examination representative of progressive severe pulmonary edema. There is otherwise no change compared to prior examination. A right-sided PICC remains at the cavoatrial junction. Median sternotomy wires are in place. IMPRESSION: Progressive severe pulmonary edema. " 35a33eda-8b3971e0-7b94154f-51f9c8b7-a26e8de4.jpg,test/p14/p14688791/s56496112/35a33eda-8b3971e0-7b94154f-51f9c8b7-a26e8de4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ICD // Eval for lead placement Eval for lead placement IMPRESSION: In comparison with study of ___, there is little change in the appearance the heart and lungs. There has been interval placement of a dual-channel ICD with leads extending to the right atrium and apex of the right ventricle. No evidence of pneumothorax. Of incidental note is a left cervical rib. " 257e7f1a-17d50e6e-07767e55-fdc6bcd8-d26dc417.jpg,test/p15/p15352109/s53242316/257e7f1a-17d50e6e-07767e55-fdc6bcd8-d26dc417.jpg,test," FINAL REPORT INDICATION: ___-year-old male with a pneumonia noted on an outside hospital chest x-ray who presents for followup evaluation. COMPARISON: Chest radiograph from ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No focal consolidations suggestive of pneumonia identified. If the prior OSH imaging becomes available, an addendum can be issued. " 0b15bec5-520ff928-6679557d-7d41521b-5d6fac1e.jpg,test/p14/p14983953/s56571304/0b15bec5-520ff928-6679557d-7d41521b-5d6fac1e.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Dobbhoff placement. FINDINGS: Tracheostomy tube is seen. The feeding tube is now visualized below the diaphragm. It crosses midline and then curves upwards. This likely is still within the stomach rather than within the duodenum. The appearance of the lungs and pleural plaques are unchanged. " ae92c89b-38fa9be8-d9c2a266-a393d3eb-bc4e0222.jpg,test/p14/p14345906/s53496993/ae92c89b-38fa9be8-d9c2a266-a393d3eb-bc4e0222.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute hypoxia // eval for infiltrates, edema TECHNIQUE: Single frontal view of the chest COMPARISON: Chest x-ray ___ ___ CT chest ___ FINDINGS: Mild cardiomegaly is stable. Moderate pulmonary edema is new. Right middle lobe nodule described in prior studies is unchanged. There is no pneumothorax or large effusions. Right central catheter tip is in the cavoatrial junction. Sternal wires are aligned. Patient is status post CABG IMPRESSION: New moderate pulmonary edema. " c17c75f8-4eb10e16-7cf2f722-64ca2a6c-9fb11607.jpg,test/p16/p16425310/s58602502/c17c75f8-4eb10e16-7cf2f722-64ca2a6c-9fb11607.jpg,test," FINAL REPORT INDICATION: ___ year old woman with acute CRAO // eval pulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well expanded and clear. The hila and pulmonary vasculature are normal. No pleural abnormalities or pneumothorax. Heart size is normal. The aorta is tortuous. The mediastinum is normal. IMPRESSION: No acute cardiopulmonary process. " c3c2f320-f2391944-e3d4b065-6ad05a35-8b0b24b1.jpg,test/p11/p11119441/s53089278/c3c2f320-f2391944-e3d4b065-6ad05a35-8b0b24b1.jpg,test," FINAL REPORT HISTORY: Cough, elevated lactate. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal with a left ventricular predominance. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal and the lungs are clear. There is no focal consolidation, pleural effusion or pneumothorax is identified. Severe compression deformity of a mid thoracic vertebral body is unchanged. No acute osseous abnormalities are otherwise seen. IMPRESSION: No acute cardiopulmonary process. " 329c9c0b-26c5966e-a8ca6a62-0228e414-283a167e.jpg,test/p16/p16952784/s59095555/329c9c0b-26c5966e-a8ca6a62-0228e414-283a167e.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough and chills. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is slightly enlarged with left ventricular configuration. The mediastinal and hilar contours appear within normal limits. There is mild relative elevation of the right hemidiaphragm compared to the left. No pleural effusion or pneumothorax is demonstrated. The lungs appear clear. Moderate anterior osteophytes are noted along the mid thoracic spine. IMPRESSION: No evidence of acute disease. " 2b18ff15-ce2d34c7-65d3c2c6-bfab07df-1e89143a.jpg,test/p13/p13042186/s52011069/2b18ff15-ce2d34c7-65d3c2c6-bfab07df-1e89143a.jpg,test," FINAL REPORT INDICATION: ___F with chest pain, evaluate for pneumonia. COMPARISON: None Available. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no evidence of pneumonia. IMPRESSION: No evidence of pneumonia. " b53ece7a-4e3edb32-727f091d-35974703-995183ac.jpg,test/p14/p14216395/s53936455/b53ece7a-4e3edb32-727f091d-35974703-995183ac.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with worsening cough and congestion. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. Heart size is top normal, improved since ___. " 7763f67a-3cc5e145-65fec39b-ff162aea-a8584a74.jpg,test/p13/p13712284/s58982959/7763f67a-3cc5e145-65fec39b-ff162aea-a8584a74.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with increased sob // evaluate for pleural effusions COMPARISON: ___ IMPRESSION: The right thoracic drain is in unchanged position. The right pleural effusion has now completely been drained. There is no evidence of a right pneumothorax. The effusion on the left, with subsequent atelectasis, is not substantially changed in extent but distributed in a slightly different manner. Unchanged appearance of the cardiac silhouette. " 0fce33c8-4e254a85-6de6738a-6801d97a-acb74020.jpg,test/p11/p11434374/s58570033/0fce33c8-4e254a85-6de6738a-6801d97a-acb74020.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumothorax on water seal // change? change? IMPRESSION: Compared to chest radiographs ___ through ___ at 09:00. Small right pneumothorax has changed in distribution but not in overall size since earlier in the day, basal pigtail drainage catheter still in place. Small left pleural effusion and left basal consolidation are unchanged. Heart size normal. Minimal pulmonary edema is unchanged. Right jugular central venous line ends in the low SVC. " b308d35d-f36d6fcb-04699d0b-b96b8d67-62f73bfa.jpg,test/p14/p14074396/s53948810/b308d35d-f36d6fcb-04699d0b-b96b8d67-62f73bfa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with sob // eval pneumonia COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Extensive airspace consolidation is seen within the right lung involving right upper, middle and lower lobes compatible with multifocal pneumonia. The left lung appears clear. No large pleural effusion or pneumothorax. The heart size is mildly enlarged. The mediastinal contour is unremarkable. Bony structures appear intact. IMPRESSION: Multifocal pneumonia within the right lung. Mild cardiomegaly. " 53ad60f5-3643919d-1b618122-27dff066-33566ebb.jpg,test/p18/p18039147/s58784959/53ad60f5-3643919d-1b618122-27dff066-33566ebb.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with cough TECHNIQUE: Chest AP and lateral views. COMPARISON: Chest radiograph ___, chest CTA ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. Lungs are well-expanded without focal consolidation concerning for pneumonia. Postsurgical changes after right lower lobe wedge resection with right mid rib fracture is an blunting of the right costophrenic angle are noted. Degenerative changes are present throughout the thoracic spine. The upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " acb50ef2-159f34c3-485363e5-ca411aec-24ca916f.jpg,test/p17/p17871905/s55939618/acb50ef2-159f34c3-485363e5-ca411aec-24ca916f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with seizure ___, s/p fall, bruising COMPARISON: Chest radiographs from ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 5e58f443-501e91b7-d15d61b6-128f4cf8-af30a755.jpg,test/p19/p19662220/s52978847/5e58f443-501e91b7-d15d61b6-128f4cf8-af30a755.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with syncope TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Clips in the right upper quadrant of the abdomen indicate prior cholecystectomy. IMPRESSION: No acute cardiopulmonary abnormality. " 01386eaf-629674b2-c464cbe2-6653a44a-62402b0e.jpg,test/p19/p19034608/s57067351/01386eaf-629674b2-c464cbe2-6653a44a-62402b0e.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: Chest radiograph, ___, ___. FINDINGS: Cardiomediastinal and hilar contours remain stable. There is no pleural effusion or pneumothorax. Lungs are well expanded and clear. Pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 0d7a4201-0dc6b681-0e0e4abb-7406f5bb-f6d86752.jpg,test/p13/p13679831/s52397102/0d7a4201-0dc6b681-0e0e4abb-7406f5bb-f6d86752.jpg,test," FINAL REPORT INDICATION: ___-year-old male with left arm, shoulder, and scapular pain. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. Heart and mediastinal contours are within normal limits. Cervical spine hardware is incompletely imaged. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " ad49e937-60343560-44cd430c-ec6a2cce-562664b1.jpg,test/p16/p16590876/s57050854/ad49e937-60343560-44cd430c-ec6a2cce-562664b1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESRD on HD here with HCAP // ? pulmonary edema, interval change in infiltrates or effusion TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Cardiomegaly and mediastinal contours are stable. Interval substantial increase in right pleural effusion and unchanged appearance of moderate left pleural effusion, larger than right is demonstrated. Pulmonary edema has improved which potentially may explain increase in pleural effusion as a result of lung clearance. Multifocal calcifications projecting over the lungs are re- demonstrated. " 39aad534-404b378a-19fc6a9d-f3ed5e60-7edf5cd3.jpg,test/p19/p19891610/s54809073/39aad534-404b378a-19fc6a9d-f3ed5e60-7edf5cd3.jpg,test," FINAL REPORT INDICATION: ___ year old man with lymphoma s/p chemo and currently undergoing XRT. No with fever, SOB, cough, concern for pneumonia // ___ year old man with lymphoma s/p chemo and currently undergoing XRT. No with fever, SOB, cough, concern for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is a small area of consolidation in the left lower lobe concerning for pneumonia. Scoliosis of thoracic spine. Tortuous aorta. Top normal heart size without evidence of pulmonary edema or pleural effusions. No pneumothorax. Mediastinal borders and hilar structures are normal. IMPRESSION: Left lower lobe pneumonia. Scoliosis of thoracic spine. Tortuous aorta. " d8b4f432-f9b2ab7a-8362727d-579d538a-00b1edd5.jpg,test/p19/p19565388/s52284572/d8b4f432-f9b2ab7a-8362727d-579d538a-00b1edd5.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Bradycardia and hypotension. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 5 cm above the carina. The temporary pacemaker leads terminate in the expected location of the right ventricle. The patient continues to be rotated. Within the limitations, the appearance of the mediastinum is stable. Left retrocardiac opacity cannot be excluded, most likely representing atelectasis. Right upper lobe opacity is unchanged as well, with atelectasis or infectious process being a possibility. No interval development of pneumothorax or increase in pleural effusion has been demonstrated. " 77c6d0e9-1fb8f432-45bd5560-94fbd81c-137bb30e.jpg,test/p17/p17051420/s55910335/77c6d0e9-1fb8f432-45bd5560-94fbd81c-137bb30e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // iniltrate or pneumothorax iniltrate or pneumothorax IMPRESSION: Comparison to ___. On the current radiograph, mild pulmonary edema is present, with both vascular and an interstitial component. Moderate cardiomegaly. No larger pleural effusions. No pneumonia, no pneumothorax. " 63277a33-52b1b68f-3cc27969-c7338841-fb360dff.jpg,test/p11/p11107643/s55747256/63277a33-52b1b68f-3cc27969-c7338841-fb360dff.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with cough, fever TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph FINDINGS: Left-sided dual-chamber pacemaker device is re- demonstrated with leads terminating in the right atrium and right ventricle. Mild enlargement of the cardiac silhouette is unchanged. The aorta is diffusely calcified. Mediastinal and hilar contours are similar. There is no pulmonary edema. Minimal atelectasis is noted in the lung bases without focal consolidation. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is present. IMPRESSION: No focal consolidation to suggest pneumonia. " a3fd026d-3f550021-d2cb5409-900e296a-4b44059d.jpg,test/p10/p10361825/s50607705/a3fd026d-3f550021-d2cb5409-900e296a-4b44059d.jpg,test," FINAL REPORT PORTABLE CHEST FILM ___ AT 725 CLINICAL INDICATION: ___-year-old with cirrhosis, endocarditis, endotracheal tube in place, question resolving edema. Comparison is made to the patient's prior study of ___ at 456. A portable supine chest film ___ at 725 is submitted. IMPRESSION: 1. Right internal jugular central line, endotracheal tube and nasogastric tube are unchanged. Stable cardiac and mediastinal contours in this post-operative patient status post median sternotomy with aortic valve replacement. There is persistent but improving mild pulmonary edema. Retrocardiac consolidation persists, and there is likely an associated layering effusion. These findings most likely reflect partial lower lobe atelectasis, although aspiration or pneumonia cannot be entirely excluded. No large pneumothorax, although the sensitivity to detect a pneumothorax is diminished given supine technique. " 8a45f64c-9d3c2eed-ea1b6492-af73c196-d1d18620.jpg,test/p17/p17632100/s58452909/8a45f64c-9d3c2eed-ea1b6492-af73c196-d1d18620.jpg,test," FINAL REPORT PORTABLE CHEST RADIOGRAPH DATED ___ No comparisons. Heart is upper limits of normal in size, and the aorta is tortuous. Patchy and linear bibasilar opacities may represent atelectasis and/or aspiration in this patient with recent history of aspirated foreign body. Mild-to-moderate gastric distention is incompletely imaged in the upper part of the abdomen. " 10348f8a-27f96992-bf0b62d1-b69aa84f-766a1b3f.jpg,test/p17/p17445268/s50188920/10348f8a-27f96992-bf0b62d1-b69aa84f-766a1b3f.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Hemoptysis, NG tube replaced. FINDINGS: NG tube tip is off the film, at least in the stomach. Bilateral pleural effusions are slightly worse. There continues to be mild cardiomegaly. There is lower lobe volume loss/infiltrate slightly worse than before as well. " 6e563f2a-a21f4da8-13d95e38-bdbf441b-d622c734.jpg,test/p14/p14244279/s52468508/6e563f2a-a21f4da8-13d95e38-bdbf441b-d622c734.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PMH significant for HIV on HAART (reportedly with undetectable VL), HepC s/p Harvoni (reportedly with undetectable VL), CAD s/p multiple stents, CKD (baseline Cr 1.5), HTN, COPD and chronic diarrhea who presents with hematuria and abdominal pain. New onset of chest pressure and SOB. // Pneumonia, vascular congestion, new process TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate to severe cardiomegaly is a stable. Opacity in the right lower lobe are a combination of pleural effusion and adjacent consolidation, minimally increased. There is no pneumothorax. " 59549f28-14beccf3-6939a994-6a425dda-eab66a78.jpg,test/p11/p11913943/s56703870/59549f28-14beccf3-6939a994-6a425dda-eab66a78.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man who presented with STEMI // please assess for cardiomegaly, CHF COMPARISON: None. IMPRESSION: Cardiac silhouette is upper limits of normal in size for portable technique. Pulmonary vascular congestion is accompanied by diffuse interstitial edema. " 4c0cbfc8-9cd283f7-398f45b1-9332105f-4153a3a2.jpg,test/p17/p17415919/s53894398/4c0cbfc8-9cd283f7-398f45b1-9332105f-4153a3a2.jpg,test," FINAL REPORT HISTORY: Chest pain radiating to left arm, improvement when sitting forward. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 99c9fcba-9cd72abc-3586af02-cb69f317-bc86ce1f.jpg,test/p18/p18062541/s59988801/99c9fcba-9cd72abc-3586af02-cb69f317-bc86ce1f.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with hypertension, hyperlipidemia, diabetes mellitus and obesity with new onset of atrial fibrillation and mild dyspnea on exertion. Evaluate for CHF. FINDINGS: PA and lateral chest views were obtained with patient in upright position. There is significant cardiac enlargement. The configuration suggests prominence of the left ventricular contour to the left and posteriorly. There is also probably some mild left atrial enlargement. The thoracic aorta is generally widened and elongated but does not demonstrate local contour abnormalities. The pulmonary vasculature demonstrates an upper zone re-distribution pattern, but no evidence of significant interstitial or alveolar edema is present. The lateral and posterior pleural sinuses are free and there are no acute pulmonary infiltrates. No pneumothorax in the apical area. Skeletal structures demonstrate some degree of demineralization of the vertebral bodies of the thoracic spine as seen in the lateral view, but there is no evidence of any vertebral body compression fracture. Prominent soft tissue structures surrounding the thorax indicative of advanced obesity. Our records do not include a previous chest examination available for comparison. IMPRESSION: Cardiac enlargement, mild degree of pulmonary congestion, but no pleural effusion or acute infiltrates in this ___-year-old female patient who developed atrial fibrillation. " 4cbd4338-5bfad10f-c0d31239-3ba0ceb0-573a470a.jpg,test/p14/p14755254/s54085514/4cbd4338-5bfad10f-c0d31239-3ba0ceb0-573a470a.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Worsening fatigue and wheezing. There is mild cardiomegaly. Pacer leads are in standard position in the right atrium and right ventricle. There is mild interstitial edema. There is a tiny right effusion. There is no pneumothorax. Moderate degenerative changes are in the thoracic spine. " b2360951-7b6b5c05-8bd4bd15-628a9df1-6e048be7.jpg,test/p17/p17783978/s59055286/b2360951-7b6b5c05-8bd4bd15-628a9df1-6e048be7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dementia and increased somnolence. // Please evaluate for infection. Please evaluate for infection. IMPRESSION: Comparison to ___. No relevant change. The pathologic cardiac and aortic contours are stable. The lung volumes remain low. No pleural effusions. No pulmonary edema, no pneumonia. " e1623210-40a05b91-64fe71d3-bbcf558f-41e2574f.jpg,test/p18/p18669714/s52225271/e1623210-40a05b91-64fe71d3-bbcf558f-41e2574f.jpg,test," FINAL REPORT INDICATION: ___M with CP, SOB, and non-productive cough // r/o PNA, PTX TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pneumothorax or pleural effusion. The lungs are well-expanded and clear without focal consolidation concerning for pneumonia. Localized tram-tracking in the right upper lobe may represent focal bronchiectasis. The upper abdomen is unremarkable. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " a0b655de-fa120575-cf8327d6-25944742-06112825.jpg,test/p12/p12315713/s50125660/a0b655de-fa120575-cf8327d6-25944742-06112825.jpg,test," FINAL REPORT HISTORY: Shortness of breath and hypoxia. FINDINGS: In comparison with the study of ___, there is little overall change. Hyperexpansion of the lungs with coarse interstitial markings are consistent with chronic pulmonary disease. No evidence of acute focal pneumonia. Blunting of the costophrenic angle on the right is again seen, most likely related to scarring or chronic pleural thickening. Tortuosity of the aorta is again noted. IMPRESSION: No interval change and no evidence of acute pneumonia in this patient with findings consistent with chronic obstructive pulmonary disease. " 26a053c4-d5542019-07be9681-06d3187f-83317305.jpg,test/p10/p10337761/s51156352/26a053c4-d5542019-07be9681-06d3187f-83317305.jpg,test," FINAL REPORT INDICATION: Right pleural effusion after thoracentesis, please evaluate post thoracentesis. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Single chest portable radiograph demonstrates unremarkable mediastinal and hilar contours. Stable enlarged cardiac silhouette present. Interval reduction in right pleural effusion, now small in size, with stable adjacent right lower lung atelectasis. No pneumothorax evident. No focal opacification concerning for pneumonia identified. IMPRESSION: No pneumothorax. Interval reduction in right pleural effusion, now small in size. " ffe7b25d-26312cd5-0784767a-bc569418-2c6892d4.jpg,test/p15/p15159712/s56841783/ffe7b25d-26312cd5-0784767a-bc569418-2c6892d4.jpg,test," FINAL REPORT INDICATION: ___-year-old female with possible STEMI. Evaluate for infiltrate. COMPARISONS: None. FINDINGS: The heart size is moderately enlarged with a widening vascular pedicle. Pulmonary vascular markings are indistinct and prominent in the upper lobes, compatible with mild edema. Indistinct bilateral costophrenic angles are compatible with small effusions. Bibasilar atelectasis is present. No focal consolidation or pneumothorax. IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions. " a54aae12-675694e6-c0f3b736-6ba0bed4-5f8b05c1.jpg,test/p16/p16325018/s51879091/a54aae12-675694e6-c0f3b736-6ba0bed4-5f8b05c1.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough // r/o mass, infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. The cardiomediastinal silhouette is unchanged. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute radiographic intrathoracic pulmonary disease. " c0ff6c49-9b31e7a1-fe8a6c06-c78e76ad-de8ff00f.jpg,test/p18/p18135822/s59608350/c0ff6c49-9b31e7a1-fe8a6c06-c78e76ad-de8ff00f.jpg,test," FINAL REPORT INDICATION: Patient with history of vomiting and epigastric pain. Assess for pneumothorax or pneumomediastinum. COMPARISONS: Chest radiograph of ___. FINDINGS: PA and lateral views of the chest demonstrate low lung volumes. There is no pleural effusion, focal consolidation, pneumothorax. Hilar and mediastinal silhouettes are unremarkable. There is no evidence of pneumomediastinum. Heart size is normal. There is an irregular lucency projecting over left supraclavicular region, which may be external to the patient. Partially imaged upper abdomen is unremarkable. IMPRESSION: 1. Clear lungs. No evidence of pneumomediastinum or pneumothorax. 2. An irregular lucency projecting over left supraclavicular region, may be external to the patient, artifact, or reflect soft tissue abnormality, correlate clinically. " c0a6340c-1d9e98cc-59cfc828-a6f21571-5d0005d2.jpg,test/p18/p18513773/s56318824/c0a6340c-1d9e98cc-59cfc828-a6f21571-5d0005d2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with acute dyspnea, htn, likely CHF exacerbation vs hypertensive emergency // eval ? pulm edema eval ? pulm edema IMPRESSION: Comparison to ___. The size of the cardiac silhouette is increased. There is a increase in vascular diameters as well as markings of the interstitial structures, predominantly in the central regions of the lungs. The findings are reflecting centralized pulmonary edema of moderate severity. No pleural effusions. No pneumonia. No pneumothorax. " 58e9e5a5-e4649d9d-1d2ba990-a32cdfab-d157682e.jpg,test/p15/p15765578/s56498238/58e9e5a5-e4649d9d-1d2ba990-a32cdfab-d157682e.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Shortness of breath. History of CHF. Cardiac size is top normal. There is no evidence of pulmonary edema, pneumonia, pneumothorax, or pleural effusion. " 340585a0-b43acc1c-6fb5bc26-575f22f9-79e0c306.jpg,test/p19/p19247129/s57919758/340585a0-b43acc1c-6fb5bc26-575f22f9-79e0c306.jpg,test," FINAL REPORT INDICATION: Hemoptysis. COMPARISON: None. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well expanded. A 1cm trianguar opacity projects over the inferior margin of the right hilus and is not explained by normal structures. There is no consolidation, effusion or pneumothorax. Cardiac and mediastinal contours are normal. IMPRESSION: Apparent 1cm nodule projecting over the right hilus may be due to summation of shadows. Repeat radiographs with routine oblique views are recommended to confirm the authenticity of the finding. This recommendation was communicated to the ED QA nurse team via email at ___ ___ ___. " 41588536-a1cbc698-eb012e4c-e4eb52e2-4969b615.jpg,test/p17/p17885927/s56772388/41588536-a1cbc698-eb012e4c-e4eb52e2-4969b615.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RUL nodule s/p R VATS wedge, completion lobectomy // s/p CT removal TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: Same day early a IMPRESSION: There is interval decrease in the mediastinal with the most likely due to partial improvement of the atelectasis. There is no interval increase in pneumothorax after removal of the right chest tube. Left lung is essentially clear except for pleural calcifications. " 81fa8570-e8617745-04526280-e4ec5f26-76ccbfb0.jpg,test/p13/p13604162/s52153588/81fa8570-e8617745-04526280-e4ec5f26-76ccbfb0.jpg,test," FINAL REPORT HISTORY: Partial closure of open abdomen, to check tubes and lines. FINDINGS: In comparison with the study of ___, the right IJ catheter appears to extend into the upper portion of the right atrium. The endotracheal tube and nasogastric tube are unchanged. Apparent esophageal probe extends to the level of the esophagogastric junction. There is increased opacification in the retrocardiac region, consistent with substantial volume loss in the lower lobe. Some elevation of pulmonary venous pressure is seen with pleural effusion on the left. " d7c07c9a-5f56c010-c43d9175-0e008fb0-50208b0f.jpg,test/p13/p13577794/s51416525/d7c07c9a-5f56c010-c43d9175-0e008fb0-50208b0f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph dated ___. CLINICAL HISTORY: Leukocytosis and cough, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided. A rounded nodular opacity projects over the left upper lung on the first of four images, which measures ___ x 15 mm. There is poorly defined increased peribronchovascular opacity in the lower lungs bilaterally which could represent an early bronchopneumonia. No large pleural effusions are seen. There is convex bulge along the right mediastinal border concerning for lymphadenopathy. Mild hilar prominence is also noted which could be due to bronchovascular crowding. Bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: 1. Mediastinal prominence, concerning for lymphadenopathy. Left upper lobe pulmonary nodule measuring 16 mm. Findings are concerning for possible malignancy and therefore CT is recommended to further assess. 2. Subtle bronchovascular opacities in the lower lungs could represent pneumonia in the correct clinical setting. This can also be further assessed at the time of CT. Findings were discussed with Dr. ___ and Dr. ___ at the time of this dictation. " e96f5011-eeb3dd54-8d243ec1-981ac418-5073e4b7.jpg,test/p18/p18279197/s53842511/e96f5011-eeb3dd54-8d243ec1-981ac418-5073e4b7.jpg,test," FINAL REPORT INDICATION: Elevated blood pressure. No comparison studies available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart is mildly enlarged. The hilar and mediastinal contours are within normal limits. There is mild central pulmonary vascular congestion with trace interstitial edema. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: Mild cardiomegaly and central vascular congestion. " 6d6e8799-b83c838d-d4ffa7e9-f0215583-1fa3e12a.jpg,test/p11/p11551927/s58795376/6d6e8799-b83c838d-d4ffa7e9-f0215583-1fa3e12a.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with acute pancreatitis. Evaluate interval progression. FINDINGS: Comparison is made to previous study from ___. The tracheostomy, enteric tube, bilateral central venous lines appear unchanged in position. The heart size is stable in size. There are markedly low lung volumes. There is mild pulmonary interstitial edema. There are more confluent areas of opacity in the left upper lobe and right base. This may be due to atelectasis or developing infiltrate. They are stable since the prior study. There are no pneumothoraces. " a6303edb-4dd9cf0d-cd701669-41606e85-3f370a66.jpg,test/p16/p16497592/s59108834/a6303edb-4dd9cf0d-cd701669-41606e85-3f370a66.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 2 wks of coughing // pneumonia pneumonia IMPRESSION: Comparison ___. No relevant change. No evidence pneumonia or other pathologic condition of the lung parenchyma. Mild bilateral apical scarring. No pleural effusions. Normal size of the heart. " 68805674-b8397080-009d8291-27482b75-8913de7b.jpg,test/p14/p14154049/s59731186/68805674-b8397080-009d8291-27482b75-8913de7b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Fever and chills, chest pain, question pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " ef9c9753-6e0d3a14-2ca40a9a-d3bf8cff-10be156c.jpg,test/p16/p16386563/s58656575/ef9c9753-6e0d3a14-2ca40a9a-d3bf8cff-10be156c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p craniectomy for infection now with new onset chest pain x several hours. // Rule out chest pathology given new onset chest pain. TECHNIQUE: AP view of the chest. COMPARISON: Prior radiographs most recent on ___ FINDINGS: A right PICC terminates in the mid to low SVC. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: Right PICC in the mid SVC. Clear lungs. No pneumothorax. " c0a3f844-3a823976-0bf79672-3790842c-9348da7c.jpg,test/p18/p18615658/s55704296/c0a3f844-3a823976-0bf79672-3790842c-9348da7c.jpg,test," FINAL REPORT HISTORY: Found down. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. There is mild bibasilar atelectasis. No focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 92098f3c-42372446-09269bb7-88c20885-8d1ef93d.jpg,test/p19/p19252123/s54589038/92098f3c-42372446-09269bb7-88c20885-8d1ef93d.jpg,test," FINAL REPORT INDICATION: ___F with sharp, left chest pain since ___ AM TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are well inflated and clear. Heart size and mediastinal contours are normal. There is no pleural effusion or pneumothorax. Osseous structures are intact. Dystrophic calcifications over the right breast likely correspond to fibroadenomas, last imaged on a mammogram from ___. IMPRESSION: No acute cardiopulmonary abnormality. " 75b97e2c-6cec2383-44c42e82-b8158624-d440440c.jpg,test/p16/p16390325/s55784495/75b97e2c-6cec2383-44c42e82-b8158624-d440440c.jpg,test," FINAL REPORT HISTORY: Sepsis status post intubation and orogastric tube placement. COMPARISON: None available. FINDINGS: Semi-upright portable radiograph of the chest demonstrates an endotracheal tube which terminates in the right mainstem bronchus which needs to be retracted approximately 5 cm to terminate 4 cm above the level of the carina. There is left lower lobe atelectasis/collapse with volume loss on the left, and leftward shift of the mediastinal structures. An orogastric tube courses through the esophagus and below the diaphragm, terminating in the stomach. A catheter tube overlies the left lung base. The right lung is well-expanded with a linear area of atelectasis within the right lung base. There is no pneumothorax. No pleural effusion is present on the right and a small to moderate pleural effusion is present on the left. There is no evidence of overt pulmonary edema. IMPRESSION: 1. Endotracheal tube terminates in the right mainstem bronchus, resulting in left lower lobe atelectasis/collapse, and leftward shift of the mediastinum. The ET tube should be retracted 5 cm for in order to terminate 4 cm above the carina. 2. Small to moderate left pleural effusion. The above findings were communicated to Dr. ___ by Dr. ___ ___ telephone at 10:00, 1 minute after discovery. " 6704233b-e6f92471-aa5c32ed-f489dc5b-1f1ad3a0.jpg,test/p14/p14086847/s57498444/6704233b-e6f92471-aa5c32ed-f489dc5b-1f1ad3a0.jpg,test," FINAL REPORT AP CHEST, 4:56 A.M., ___ HISTORY: ___-year-old woman after an esophagogastrectomy. Right chest tube. Rule out pneumothorax. IMPRESSION: AP chest compared to ___: No pneumothorax or appreciable right pleural effusion, ___ drainage tube still in place. Right subclavian catheter ends low in the SVC. Upper mediastinal drain in the midline. Moderate left pleural effusion and left lower lobe atelectasis are stable. Left upper lung clear. Very small amount of barium is retained in the neoesophagus following upper GI swallow. The vacuum bulb seen on yesterday's 4:32 a.m. chest radiograph is now positioned over the right upper abdominal quadrant. " 2c30646d-78e04c28-8efacf13-6a92a1a2-7d203ed5.jpg,test/p12/p12503315/s53075043/2c30646d-78e04c28-8efacf13-6a92a1a2-7d203ed5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval IMPRESSION: In comparison with the study of ___, there is little change in the substantial right pleural effusion with underlying volume loss in the right lower lung. The left lung is essentially clear. No evidence of pulmonary vascular congestion. " 56bee079-ea5993fb-34625893-07a94e6e-1e0b7397.jpg,test/p15/p15497400/s55012878/56bee079-ea5993fb-34625893-07a94e6e-1e0b7397.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough. Evaluate for infiltrate. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 598c1942-435cdf63-0f35e156-bca6766b-f020947c.jpg,test/p15/p15938425/s58887278/598c1942-435cdf63-0f35e156-bca6766b-f020947c.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The patient is status post median sternotomy and CABG. Heart is mildly enlarged. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal and the lungs are clear. No pleural effusion or pneumothorax is identified. There are mild degenerative changes in the thoracic spine. Cholecystectomy clips are noted in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 31c1ff27-efe0b34c-f8b81088-73df6e0c-836198d5.jpg,test/p17/p17398573/s50918803/31c1ff27-efe0b34c-f8b81088-73df6e0c-836198d5.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with a positive PPD. IMPRESSION: PA and lateral chest compared to ___ and ___: Moderate cardiomegaly has improved. Combination of mediastinal fat and possible middle lobe atelectasis should not be mistaken for pneumonia. Lungs are otherwise clear. There may be a very small new right pleural effusion. Thoracic aorta is generally large and tortuous but not focally aneurysmal. No evidence of tuberculosis. " 4d66866e-b2f18763-5a9861e5-ede79f8a-33ff24bb.jpg,test/p16/p16223998/s52195841/4d66866e-b2f18763-5a9861e5-ede79f8a-33ff24bb.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with brain mets and recent pneumonia. Cardiomediastinal contours are normal. The lungs are clear. There is no pleural effusion. IMPRESSION: Resolved pneumonia. " fc244f77-db553e3f-c78b421c-b59017c6-da624298.jpg,test/p18/p18408877/s57020209/fc244f77-db553e3f-c78b421c-b59017c6-da624298.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with GOLD IV COPD, hypoxemia // any change in infiltrates any change in infiltrates IMPRESSION: AS COMPARED TO THE PREVIOUS IMAGE, THE SEVERE SIGNS OF OVERINFLATION AND OF PARENCHYMAL DESTRUCTION PERSIST IN UNCHANGED MANNER. THE PRE-EXISTING PARENCHYMAL OPACITIES HAVE MINIMALLY DECREASED IN EXTENT AND SEVERITY, BUT MILD PERIBRONCHIAL OPACITIES REMAIN VISIBLE, NOTABLY AT THE RIGHT LUNG BASIS AND IN THE RETROCARDIAC LUNG REGION. NO EVIDENCE OF PLEURAL EFFUSIONS. " 608aa9ee-62ab3834-30e5a713-3134ccf9-93156c19.jpg,test/p10/p10374990/s53769407/608aa9ee-62ab3834-30e5a713-3134ccf9-93156c19.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with history of effusions, thoracic hardware removal, // interval change interval change IMPRESSION: In comparison with the study ___, the cardiac silhouette appears less prominent and there is continued mild elevation of pulmonary venous pressure with layering pleural effusions and compressive atelectasis bilaterally, most prominent on the left. Multiple drains and catheters again project over the upper chest. " 44908c8c-1a8fa629-c4eb0a75-bda793e2-1ef547ae.jpg,test/p14/p14218694/s58704034/44908c8c-1a8fa629-c4eb0a75-bda793e2-1ef547ae.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH OF ___ COMPARISON: No prior radiographs for comparison. FINDINGS: Heart size, mediastinal and hilar contours are normal. Patchy opacities are present in both lower lobes, as well as small bilateral pleural effusions, right greater than left. IMPRESSION: 1. Patchy bibasilar opacities which could potentially represents an aspiration pneumonia in the appropriate clinical setting. 2. Small bilateral pleural effusions, right greater than left. " 8cff651a-192d023c-307a72df-bf402288-f8f2967b.jpg,test/p14/p14394962/s50336313/8cff651a-192d023c-307a72df-bf402288-f8f2967b.jpg,test," WET READ: ___ ___ ___ 7:14 PM No acute cardiopulmonary abnormality. No subdiaphragmatic free air identified, though assessment is limited on this supine study. Consider upright or left lateral decubitus AP views of the abdomen for further assessment. WET READ VERSION #1 ___ ___ 7:05 PM No acute cardiopulmonary abnormality. No free air under the diaphragm. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with epigastric pain TECHNIQUE: Supine AP view of the chest COMPARISON: ___ FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. The lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities identified. Clips are seen projecting over the left upper quadrant of the abdomen. No subdiaphragmatic free air is identified, though assessment is limited on this supine study. IMPRESSION: No acute cardiopulmonary abnormality. No subdiaphragmatic free air identified, though assessment is limited on this supine study. Consider upright or left lateral decubitus AP views of the abdomen for further assessment. " 059ca40b-f9839cf5-7dc36d64-a6a10d5c-67b4d559.jpg,test/p11/p11040157/s56619586/059ca40b-f9839cf5-7dc36d64-a6a10d5c-67b4d559.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old woman with cirrhosis and alcoholic hepatitis // NG placement NG placement IMPRESSION: The probe tube tip is right distal to the gastroesophageal junction and should be further advanced. Cardiomediastinal silhouette including severe cardiomegaly and widening mediastinum is unchanged. Vascular congestion is moderate to severe, unchanged " d6dc1214-ab9dd95d-c1a8433f-a3e9eb79-d8c9b75c.jpg,test/p10/p10771731/s58957089/d6dc1214-ab9dd95d-c1a8433f-a3e9eb79-d8c9b75c.jpg,test," FINAL REPORT INDICATION: ___F with seizure. Evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are low, which leads to bronchovascular crowding. No focal consolidation is seen. The cardiomediastinal silhouette and hilar contours are within normal limits. There is no pneumothorax or pleural effusion. There is no free air under the diaphragm. IMPRESSION: Low lung volumes without focal consolidation. " acd1cafb-900a2856-d5d8b7f6-9bf7f757-019ea214.jpg,test/p16/p16553329/s53481703/acd1cafb-900a2856-d5d8b7f6-9bf7f757-019ea214.jpg,test," WET READ: ___ ___ ___ 6:53 AM Probable small posterior sulcus pleural effusions. Otherwise, no acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with shortness of breath, evaluate for cardiopulmonary disease. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___ and ___. FINDINGS: There is no focal consolidation, PE pulmonary edema, or pneumothorax. The lateral view radiograph suggests small bilateral pleural effusions in the posterior costophrenic sulcus. The cardiomediastinal silhouette, including mild cardiomegaly, is unchanged. A vascular stent projects over the left axilla, new from prior studies. IMPRESSION: Probable small bilateral bold pleural effusions. Otherwise, no acute cardiopulmonary process. " e57ccd36-833a5988-b5903ac2-ddeff6ef-98e996f1.jpg,test/p19/p19277070/s56949195/e57ccd36-833a5988-b5903ac2-ddeff6ef-98e996f1.jpg,test," WET READ: ___ ___ 8:36 PM Focal opacity projecting over the left lung on the frontal view, not definitely seen on the lateral view. If more definitive characterization desired, consider shallow obliques see if it persists. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with hypotension and brady with previous history of IVDU and endocarditis. XRAY part of infectious work-up. // Any possible source of infection? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: There is a focal region of consolidation projecting over the anterior left sixth rib without localization on the lateral view. Elsewhere, the lungs are clear. Cardiomediastinal silhouette is stable noting prosthetic mitral valve. No acute osseous abnormalities. IMPRESSION: Focal opacity projecting over the left lung on the frontal view, not definitely seen on the lateral view. If more definitive characterization desired, consider shallow obliques see if it persists. " 9a4460d6-7265a312-724228f0-acf9b15a-ba8ac499.jpg,test/p13/p13752571/s51153407/9a4460d6-7265a312-724228f0-acf9b15a-ba8ac499.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with RA, right shoulder pain, ?rt. apical abnormality // ?abnormality in Rt. apex - per report of shoulder xray ___ COMPARISON: Shoulder radiograph from ___ and chest CT from ___. FINDINGS: PA, lateral, and apical views of the chest provided. The previously seen increased opacity on shoulder radiograph is likely reflecting a small apical consolidation, which was also previously characterized on chest CT from ___. This opacity is barely seen in this current chest radiograph. Otherwise, lungs are clear. Heart size is normal. There is no pleural effusion. IMPRESSION: Previously described right apical opacity, which was most likely reflecting a small apical consolidation, is barely seen in this current study. " 7eaa78d8-2c28a536-c29211f4-15512fc4-62ad1d15.jpg,test/p17/p17429491/s53787320/7eaa78d8-2c28a536-c29211f4-15512fc4-62ad1d15.jpg,test," FINAL REPORT INDICATION: History: ___F with lung cancer, worsening hypoxia // presence of pleural effusion, infiltrate, effusion COMPARISON: Multiple prior exams, most recently of the same day at 742 a.m. TECHNIQUE: Single frontal view of the chest. FINDINGS: Near complete opacification of the left hemothorax has developed since the radiograph 1.5 hr prior with increased leftward shift of the mediastinal structures, consistent with lung collapse. At least a small to moderate sized left pleural effusion is present. An intrabronchial mass is seen in the distal left mainstem bronchus with a fiducial marker. The right lung appears clear. No pneumothorax is identified in either lung. IMPRESSION: Interval development of left lung near-complete, likely related to distal left mainstem intrabronchial mass. Left pleural effusion, at least small to moderate in size. " 714dde96-b59a2bb6-33b90f7a-73612061-3c905a98.jpg,test/p17/p17472053/s55360762/714dde96-b59a2bb6-33b90f7a-73612061-3c905a98.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with mild sternal discomfort after MVC, with some seat belt-related ecchymosis // eval for sternal injury TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture or definite sternal injury is identified. IMPRESSION: No acute cardiopulmonary process. No definite findings of an acute sternal injury, however, please note that dedicated sternal radiographs or, better CT, is more sensitive for such. " 9936219e-69f6302b-1c8f3e43-ddd7d073-4f16ae35.jpg,test/p12/p12385889/s58803774/9936219e-69f6302b-1c8f3e43-ddd7d073-4f16ae35.jpg,test," FINAL REPORT HISTORY: ALL status post bone marrow transplant with fever and cough. COMPARISON: Chest radiographs ___ and ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: Normal chest radiographs. Findings paged to Dr. ___ at 4:20pm on ___. " ea76dc7b-0fd21a0e-f51068cd-8415aa43-0ce78859.jpg,test/p10/p10380616/s54799713/ea76dc7b-0fd21a0e-f51068cd-8415aa43-0ce78859.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with s/p trach increase redness at the site // eval for pna COMPARISON: Chest radiograph ___ Chest radiograph ___ FINDINGS: Frontal and lateral views of the chest are obtained. Tracheostomy stent is visualized. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The hilar contours are stable. Cardiac and mediastinal silhouettes are stable. The chronic compression fracture of 1 of the mid to lower thoracic vertebral bodies is again seen, grossly unchanged from most recent comparison study. IMPRESSION: No acute intrathoracic process. " c35a320c-ede47a69-49efc7a8-85c5cff6-af7b5abf.jpg,test/p14/p14521150/s51481925/c35a320c-ede47a69-49efc7a8-85c5cff6-af7b5abf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man on amiodarone r/o toxicity // r/o infiltrate r/o infiltrate IMPRESSION: In comparison with the study of ___, there is little change. Continued enlargement of the cardiac silhouette with tortuosity of the aorta, but no vascular congestion, pleural effusion, or acute focal pneumonia. Specifically, no evidence of interstitial changes to suggest amiodarone toxicity radiographically. " 9252d659-8ed61f48-64fb6137-0d7d14bf-2bdb23a3.jpg,test/p18/p18446519/s52520951/9252d659-8ed61f48-64fb6137-0d7d14bf-2bdb23a3.jpg,test," FINAL REPORT INDICATION: Left pleuritic chest pain. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. A ___ x 10 mm right lower lobe pulmonary nodule is redemonstrated. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Stable appearance of right lower lobe pulmonary nodule, which can be further assessed with CT. " 2b5b962e-15904140-d9383089-def354d1-679e8bce.jpg,test/p12/p12722180/s57433874/2b5b962e-15904140-d9383089-def354d1-679e8bce.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Shortness of breath. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is mildly enlarged. Mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. Mild cardiomegaly. " f09870f3-70f2ebd5-0f29986c-3517ee32-68efb7ba.jpg,test/p14/p14306457/s56445956/f09870f3-70f2ebd5-0f29986c-3517ee32-68efb7ba.jpg,test," FINAL REPORT INDICATION: Chest pain and cough. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a cardiac silhouette which is top-normal in size and well-aerated lungs which are clear. There is no focal consolidation, pleural effusion, or pneumothorax. Again seen is a large hiatal hernia, increased in size. Gaseous distention of the esophagus is noted. IMPRESSION: No acute cardiopulmonary process. " 59575acf-558f7786-57da7b46-ce2df355-f9c38ff0.jpg,test/p10/p10879946/s51647056/59575acf-558f7786-57da7b46-ce2df355-f9c38ff0.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever, tachycardia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 167eb1f4-45515968-ef73273f-afd4b6e4-36a367f2.jpg,test/p15/p15481018/s53936828/167eb1f4-45515968-ef73273f-afd4b6e4-36a367f2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis, fatigue COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Slightly improved aeration at the right lung base compared with prior. Mild residual left basal atelectasis noted. No convincing evidence for pneumonia, edema, large effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild left basal atelectasis, otherwise unremarkable exam. " 4bf5e44b-abc1c542-a2defe05-cd663329-b1c24e9d.jpg,test/p16/p16633648/s53767300/4bf5e44b-abc1c542-a2defe05-cd663329-b1c24e9d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Rt. brachial plexopathy and Hx smoking. // ? mass lesion Rt. apex, or thoracic rib to contribute to/cause Rt. brachial plexopathy. ? mass lesion Rt. apex, or thoracic rib to contribute to/cause Rt. brachial plexopathy., ? apical mass/thoracic rib IMPRESSION: No comparison. The right upper lobe shows a relatively extensive ill-defined parenchymal opacity with air bronchograms and multiple nodular components. The changes are limited by the minor fissure. The most likely differential diagnosis is pneumonia. However, of the antibiotic therapy, resolution needs to be radiologically documented to exclude a coexisting neoplasm. Otherwise unremarkable chest x-ray. In particular there is no evidence for the presence of a right apical Pancoast lesion. No pleural effusions. No pulmonary edema. Normal size of the heart. RECOMMENDATION(S): Radiographic followup until complete resolution of the right upper lobe pneumonia is documented. " fe4da171-205dca48-6874633f-805abe12-45755c06.jpg,test/p14/p14176612/s59666846/fe4da171-205dca48-6874633f-805abe12-45755c06.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumonia. COMPARISONS: None. FINDINGS: The lungs are clear without consolidation or edema. There is a tiny hyperdense lesion in the right lung base overlying a rib shadow, which may represent a small bone island within the rib, or alternatively, a calcified granuloma. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 1ecf048b-5d960f8c-e3cb6e09-6585d8c8-206f213e.jpg,test/p14/p14327362/s51275780/1ecf048b-5d960f8c-e3cb6e09-6585d8c8-206f213e.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Palpitations, presyncope. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Left apical pleural thickening is seen. There is evidence of left apical bronchiectasis/scarring, correlate with patient history. The right lung is clear. There is no pleural effusion or pneumothorax. The cardiac silhouette is top normal. IMPRESSION: Left apical pleural thickening with suggestion of areas of left upper lobe bronchiectasis and scarring. " d40031e9-3256ba93-eb912aef-ffafd68b-27b50b00.jpg,test/p10/p10918745/s50433412/d40031e9-3256ba93-eb912aef-ffafd68b-27b50b00.jpg,test," FINAL REPORT PORTABLE CHEST FILM ___ AT 10:06 CLINICAL INDICATION: ___-year-old with stroke, non-responsive, NG tube placement. Comparison is made to the patient's prior study of ___ at 20:13. Portable upright chest film ___ at 10:06 is submitted. IMPRESSION: 1. Interval removal of a right internal jugular central line. Interval placement of a nasogastric tube which has its tip within the stomach, although the side port is near but just below the gastroesophageal junction. It would be prudent to advance the tube somewhat to minimize the risk of aspiration. The right lung is grossly clear. There continues to be patchy opacity at the left base which does not appear to be significantly changed since ___ may reflect an area of atelectasis, aspiration, early pneumonia or possibly asymmetric edema given the fact that there is pulmonary venous hypertension and a suggestion of mild interstitial edema. Correlation is advised. Overall cardiac and mediastinal contours are stable. Calcifications in the aorta consistent with atherosclerosis. No pneumothorax. " 5f06cf8b-6bed649d-891ac8f8-7d66aae5-13a54264.jpg,test/p14/p14588212/s58935098/5f06cf8b-6bed649d-891ac8f8-7d66aae5-13a54264.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with history of renal cancer s/p resection ___, who presents with intermittent chest pain to left side x 4 days // Eval for acute process vs. bony lesion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Minimal left base atelectasis is seen without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. Please note that chest CT is more sensitive in detecting small pulmonary nodules. " 075f3c73-e879629d-d8090e47-e558c035-d5412f42.jpg,test/p15/p15605278/s59877678/075f3c73-e879629d-d8090e47-e558c035-d5412f42.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // eval for pneumonia, CHF TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " bf62010c-b3660958-c3c1917f-8e5a9aa5-c11e7ec3.jpg,test/p14/p14538144/s58414938/bf62010c-b3660958-c3c1917f-8e5a9aa5-c11e7ec3.jpg,test," FINAL REPORT INDICATION: Neutropenic fever, question pneumonia. New placement of central venous line. COMPARISON: ___. FINDINGS: Portable frontal radiograph of the chest demonstrates a new left internal jugular central venous line ending in the upper right atrium. Stable top-normal heart size. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: Left internal jugular central venous line ends in the upper right atrium and could be withdrawn by 3 cm to be in the low SVC. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:07 AM, 15 minutes after discovery of the findings. " 8da01e20-cfd3beb3-fc76d6be-2c847219-f042f18e.jpg,test/p19/p19890943/s55815194/8da01e20-cfd3beb3-fc76d6be-2c847219-f042f18e.jpg,test," FINAL REPORT HISTORY: Left-sided pleural effusion status post thoracentesis. TECHNIQUE: Portable frontal chest radiograph. COMPARISON: ___ 9:26. FINDINGS: There has been significant interval improvement in large left effusion with a small amount of remnant fluid and associated compressive atelectasis as well as a linear streak of atelectasis in the lingula. Remainder of the lungs is clear. There is no pneumothorax. Cardiomediastinal silhouette and hilar contours are normal. IMPRESSION: Small remnant left pleural effusion status post thoracentesis without evidence of pneumothorax. " dae6adb5-71520fab-0419be26-e5e29681-6db6559d.jpg,test/p11/p11244690/s52543532/dae6adb5-71520fab-0419be26-e5e29681-6db6559d.jpg,test," FINAL REPORT HISTORY: ___-year-old female with persistent cough. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are within normal limits. A couple of bronchi seen on end demonstrate mild bronchial cuffing. IMPRESSION: Very mild peribronchial cuffing. Because this finding is minimal in this patient, it may be within normal limits, but mild small airways disease cannot be excluded. " b8da6ce2-f49a1c11-c1256f54-13095fbf-8d556308.jpg,test/p15/p15009233/s51745487/b8da6ce2-f49a1c11-c1256f54-13095fbf-8d556308.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fatigue, recurrent AF, and signs of increasing chf. // ?chf TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Since ___, worsening cardiomegaly and worsening perihilar infiltrates consistent with pulmonary edema. Right moderate pleural effusion and small left pleural effusion are new since ___. Hilar structures are normal. IMPRESSION: New or decompensating cardiogenic pulmonary edema. " efa7ce32-9434194a-c88b2633-833bc1e5-4b39a4fc.jpg,test/p11/p11226572/s54348250/efa7ce32-9434194a-c88b2633-833bc1e5-4b39a4fc.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Fever, cough, and shortness of breath. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The chest appears somewhat hyperinflated. There is no pleural effusion or pneumothorax. There is no indication of lymphadenopathy or parenchymal interstitial disease that would be likely to reflect sarcoidosis. In the lingula, there is persistent minor opacification, but considerably reduced so possibly due to scarring from a prior process. IMPRESSION: Persistent lingular opacity, but markedly reduced, so possibly due to scarring; although perhaps unlikely recurrent pneumonia at the site is not entirely excluded, however. No radiographic findings particularly suggestive of active sarcoid. " 55890011-0d81cbee-73139ca8-b5d02b16-cd2f0aac.jpg,test/p16/p16897258/s51005214/55890011-0d81cbee-73139ca8-b5d02b16-cd2f0aac.jpg,test," FINAL REPORT HISTORY: ___-year-old male with pleural effusion. COMPARISON: Chest radiographs dated through ___. FINDINGS: Frontal and lateral chest radiograph demonstrates no significant change in the severity of the left pleural fluid. Several nodular opacities within the left upper lobe consistent with patient's known history of metastasis better demonstrated on CT dated ___. The right lung is grossly clear with no new focal consolidation. The cardiomediastinal and hilar contours are unchanged when compared to chest radiograph dated ___. No pneumothorax. IMPRESSION: No significant change in severity of left-sided pleural effusion. No pneumothorax. " 5ca19676-93b79e82-240e6a50-43e65b5e-7c2ecbe7.jpg,test/p18/p18194653/s56516980/5ca19676-93b79e82-240e6a50-43e65b5e-7c2ecbe7.jpg,test," FINAL REPORT INDICATION: Massive pulmonary embolism, now on ECMO. COMPARISON: CXR ___ through ___; CTA ___ FINDINGS: A frontal supine view of the chest was obtained portably. The endotracheal tube ends 4.6 cm above the carina. The upper enteric tube courses below the diaphragm with the tip out of view. A coiled structure in the upper esophagus has been previously described on multiple prior studies as a coiled temperature probe. The left internal jugular catheter ends in the upper SVC. A large bore right internal jugular ECMO catheter ends in the right atrium. Bilateral parenchymal opacities have increased compared to ___, due to worsening edema, now moderate-severe. Cardiac and mediastinal silhouettes are stable with right heart enlargement. IMPRESSION: 1. Temperature probe remains coiled in the upper esophagus. 2. Worsening moderate-severe pulmonary edema. " 84ffc895-ed3b460b-e7b50768-28e240ce-9d73f9ce.jpg,test/p10/p10693028/s56128035/84ffc895-ed3b460b-e7b50768-28e240ce-9d73f9ce.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with concern for TIA/stroke // evidence of infection TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. The posterior right costophrenic angle not fully included on the lateral view, however, no large pleural effusion is seen. There is no evidence of pneumothorax. Aortic calcification is noted. The cardiac silhouette is not enlarged. Multiple old appearing right-sided rib fractures are seen with evidence of some overlying lateral right pleural thickening. The posterior right eighth fracture appears somewhat displaced but likely old. IMPRESSION: No acute cardiopulmonary process. " e9ec432f-24dc4d27-96c78257-50b51ff3-b4a53766.jpg,test/p18/p18354499/s57779057/e9ec432f-24dc4d27-96c78257-50b51ff3-b4a53766.jpg,test," WET READ: ___ ___ ___ 11:36 PM Slightly hyperinflated lungs, with linear scarring or atelectasis in the left lower lobe. Normal heart size. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ileo-colonic Crohn's and Celiac // Interval change Interval change IMPRESSION: Heart size and mediastinum are normal in appearance. Right lung is clear. There is left mid and lower lung opacities, that in the absence of the previous studies unclear if represent chronic scar or new left lower lobe infection. No pleural effusion or pneumothorax is seen. When previous studies become available, addendum will be gladly added. " 4ed98c94-d560480c-8d5c2049-85634ff2-143d88ca.jpg,test/p10/p10781468/s57718478/4ed98c94-d560480c-8d5c2049-85634ff2-143d88ca.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with recent gastric embolization with right-sided abdominal pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Mildly indistinct pulmonary vascular markings are seen. More dense left retrocardiac opacity is identified. Small bilateral pleural effusions are seen. The cardiac silhouette is enlarged, but unchanged. Atherosclerotic calcifications seen in the thoracic aorta. No acute osseous abnormality is identified. IMPRESSION: Small bilateral effusions and mild interstitial edema. Retrocardiac opacity could be secondary to atelectasis, although superimposed infection is also possible. " dd54d7af-c28b486c-5949dbae-c2aefcdd-95cc505a.jpg,test/p16/p16702712/s50254587/dd54d7af-c28b486c-5949dbae-c2aefcdd-95cc505a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea and sepsis // interval change TECHNIQUE: Portable chest x-ray COMPARISON: Chest x-ray ___ 14:21 FINDINGS: Shallow inspiration. Bilateral perihilar, basilar opacities, new since prior exam, consider edema, pneumonitis/aspiration, or component of atelectasis. New mild interstitial edema. Small pleural effusions. IMPRESSION: Bilateral perihilar, basilar opacities, consider edema, pneumonitis/aspiration, or component of atelectasis. Mild interstitial edema Small pleural effusions. " fff1141d-f753099a-9010aa7d-223c5aae-1abf582f.jpg,test/p17/p17429491/s50996439/fff1141d-f753099a-9010aa7d-223c5aae-1abf582f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic lung Ca s/p endobronchial debulking // interval change TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 5 hours earlier IMPRESSION: There is continued improvement in aeration of the left lung. Moderate left pleural effusion, known left perihilar mass and more chronic opacities in the right lung are again noted. Cardiomediastinal contours are midline, note the patient is very rotated. ET tube is in standard position. " df685f00-7d4392a4-587d720d-09952c2e-6d4dd850.jpg,test/p10/p10924056/s57655423/df685f00-7d4392a4-587d720d-09952c2e-6d4dd850.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post embolization, evaluation. COMPARISON: No comparison available at the time of dictation. FINDINGS: The patient is intubated, with the tip of the endotracheal tube projecting approximately 4 cm above the carina. The patient also has a nasogastric tube which is in correct position. No pneumothorax. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. " 576e7966-ae5ae532-87668568-f5f73663-c7836d1e.jpg,test/p18/p18651563/s59122167/576e7966-ae5ae532-87668568-f5f73663-c7836d1e.jpg,test," FINAL REPORT INDICATION: ___F with cough and fever. COMPARISON: Multiple chest radiographs dating back to ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: Compared to the most recent prior radiograph on ___ there has been interval improvement in multifocal lung opacities. There remains increased opacification at the right lung base improved from the most recent prior, but more pronounced compared to the baseline radiograph from ___, possibly related to residual scarring in this region. There is no pleural effusion or pneumothorax. The heart is mildly enlarged. The mediastinal contours normal. IMPRESSION: Improved appearance of the chest compared to prior with residual opacity in the right lower lobe, possibly related to scarring or atelectasis in this region. " 0b1df812-b5904bbd-322243b2-09cf27f2-121f2dcc.jpg,test/p15/p15350640/s51654338/0b1df812-b5904bbd-322243b2-09cf27f2-121f2dcc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with a pleural effusion. COMPARISON: Chest radiograph dated ___. FINDINGS: Trace right pleural effusion, if any. The right-sided Port-A-Cath appears intact and unchanged in position. No focal consolidation to suggest pneumonia. No pulmonary edema or pneumothorax. The cardiomediastinal silhouette, hila, and pleura are stable. IMPRESSION: Small right pleural effusion. " 06bb2118-7a343c53-d43a4a6f-484ccfaf-3dbe555d.jpg,test/p19/p19975044/s59641711/06bb2118-7a343c53-d43a4a6f-484ccfaf-3dbe555d.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT ___ CLINICAL INDICATION: ___-year-old with status post CABG, evaluate effusion or pneumothorax. Comparison is made to the patient's previous study dated ___ at 11:21. PA and lateral views of the chest, ___ at ___ are submitted. IMPRESSION: Status post median sternotomy for CABG with stable postoperative cardiac and mediastinal contours. Persistent small layering left effusion with associated retrocardiac opacity likely reflecting compressive atelectasis, although pneumonia cannot be entirely excluded. Right internal jugular central line continues to have its tip in the proximal SVC. There is improved aeration with no evidence of pulmonary edema or pneumothorax. " b3572f74-81497e2f-93522ec1-73e7a584-ccb12a13.jpg,test/p16/p16388704/s58976060/b3572f74-81497e2f-93522ec1-73e7a584-ccb12a13.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Crohn's disease, cirrhosis ? sob vs increased breathiness // Please evaluate for etiology of shortness of breath. COMPARISON: CT chest ___ ; chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. A linear area of atelectasis is seen in the lingula. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Surgical clips in the right upper quadrant are seen. A chest port overlying the right chest wall terminates at the SVC. A 1 cm linear opacity overlying the right border of the trachea is likely external to the patient. IMPRESSION: 1. Diffuse, air-filled distention of the thoracic esophagus suggests esophageal dysmotility. 2. No new lung findings to account for shortness of breath. " 5d4428cf-5228537b-e2ab77a9-f0388136-fe9045e0.jpg,test/p19/p19017172/s57955978/5d4428cf-5228537b-e2ab77a9-f0388136-fe9045e0.jpg,test," FINAL REPORT HISTORY: ___-year-old man with increased cough for 3 months, pain in the right anterior ribs, and wheezing. Evaluate for pneumonia or lung cancer changes. COMPARISON: Prior radiographs the test chest dated ___ through ___, as well as is CT of the chest dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate persistent large right perihilar mass, which is slightly larger as compared to the prior study. This is in a region of prior fiducial seed placement, and may correspond to post-radiation changes; however, recurrence of malignancy cannot be excluded. Again seen are heterogeneous opacities at the right base, with a small right-sided pleural effusion. The left lung is essentially clear. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax or focal consolidation. IMPRESSION: 1. Persistent large right perihilar mass, which is slightly larger as compared to the prior study. This is in a region of prior fiducial seed placement, and may correspond to post-radiation changes; however, recurrence of malignancy cannot be excluded. Recommend dedicated CT of the chest for additional evaluation. 2. No pneumonia. " 960cc4b2-cbcb767e-eddb3ef3-9fccb44b-aeb0c78f.jpg,test/p18/p18834094/s57212374/960cc4b2-cbcb767e-eddb3ef3-9fccb44b-aeb0c78f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with stroke now with tachypnea // eval for pulmonary edema eval for pulmonary edema IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the heart and lungs. The enteric tube again extends to the distal stomach. " 6d8d9bbf-8de5639f-d2b8f458-dcee18d1-0a1825ad.jpg,test/p17/p17561108/s57922821/6d8d9bbf-8de5639f-d2b8f458-dcee18d1-0a1825ad.jpg,test," FINAL REPORT AP CHEST 5:32 A.M. ON ___ HISTORY: Chronic respiratory failure. IMPRESSION: AP chest compared to ___: Severe pulmonary edema continues to progress. Moderate-to-severe cardiomegaly is stable. Right internal jugular infusion port ends in the upper SVC. No pneumothorax. Pleural effusions are small, if any. " bcade611-fd31879b-c804e851-9a3934b9-a39af196.jpg,test/p14/p14239401/s54831148/bcade611-fd31879b-c804e851-9a3934b9-a39af196.jpg,test," FINAL REPORT INDICATION: Cough and dyspnea. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 2935b295-657330ae-b00d103d-e73d0c5c-93a7d2c0.jpg,test/p17/p17237809/s52103327/2935b295-657330ae-b00d103d-e73d0c5c-93a7d2c0.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with intubated // eval for ET placement TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: AP supine chest radiograph. Endotracheal tube terminates 3.7 cm above the carina. NG tube descends inferiorly along the thoracic midline, the tip is poorly visualized. Midline sternotomy wires and mediastinal clips are noted. Mild cardiomegaly with hilar congestion. Retrocardiac space poorly assessed, though difficult to exclude effusion and left basilar consolidation. No pneumothorax. Bony structures intact. IMPRESSION: 1. Cardiomegaly with hilar congestion. 2. Retrocardiac opacity - difficult to exclude effusion or consolidation. 3. ET tube positioned appropriately. 4. NG tube tip not visualized. " b54b5af9-0fe339f1-af97c192-91b6fb4b-47436b1c.jpg,test/p15/p15672432/s50496862/b54b5af9-0fe339f1-af97c192-91b6fb4b-47436b1c.jpg,test," FINAL REPORT INDICATION: ___M with L sided chest pain // eval pneumonia, other acute process TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 937d47bb-c52ddd94-72d8f02c-97cab547-f9db9bab.jpg,test/p11/p11842879/s54785209/937d47bb-c52ddd94-72d8f02c-97cab547-f9db9bab.jpg,test," FINAL REPORT INDICATION: Patient with rash, myalgias, and shortness of breath for one month. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPHS: The cardiac, mediastinal, and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " afe3f155-97de7b08-b41671cb-5040c3ee-4ccdfd6e.jpg,test/p15/p15066319/s56171170/afe3f155-97de7b08-b41671cb-5040c3ee-4ccdfd6e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ? Broken Rib - please get rib view TECHNIQUE: Chest PA and Lateral FINDINGS: Lungs are clear. Cardiac silhouette is normal. No rib fractures identified. No pneumothorax. No pleural effusion. Normal mediastinum. IMPRESSION: Normal chest x-ray. " 22150c9e-06dda92f-04b273f3-a6852eca-98be4d6d.jpg,test/p10/p10578743/s54380796/22150c9e-06dda92f-04b273f3-a6852eca-98be4d6d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yoM with DM, CKD, MGUS, Crohns (s/p iliocolectomy), CAD s/p stents, CVAx___ s/p R hip arthoplasty c/o hypoxia // Any evidence of effusion/atelectasis/PNA? Any evidence of effusion/atelectasis/PNA? IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette without definite vascular congestion. Retrocardiac opacification with blunting of the costophrenic angle is again seen, most likely consistent with some combination of pleural effusion and volume loss in the left lower lobe. In the appropriate clinical setting, superimposed pneumonia could also be considered " 892731f6-2d4bd6d1-f180d557-a91100a4-7f052032.jpg,test/p12/p12620306/s54863919/892731f6-2d4bd6d1-f180d557-a91100a4-7f052032.jpg,test," WET READ: ___ ___ ___ 6:12 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with tachycardia, evaluate for pneumonia or pneumothorax. TECHNIQUE: Single upright AP chest radiograph COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. IMPRESSION: No acute cardiopulmonary process. " 47da966e-378906cd-d2d0386e-411ceb4d-7414b955.jpg,test/p11/p11799619/s52388473/47da966e-378906cd-d2d0386e-411ceb4d-7414b955.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with a history of MIs, stents now with chest pain // ? acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Streaky linear opacities in the right lower lobe with slight elevation of the right hemidiaphragm is somewhat similar the prior exam and ___ and may reflect atelectasis and perhaps some degree of scarring. No focal consolidation, effusion, edema, or pneumothorax. The cardiomediastinal silhouette is unchanged. Hilar contours are also similar the prior exam. No acute osseous abnormality. IMPRESSION: Right lower lobe atelectasis, similar to the prior exam. " 3cabd9fe-9c7c0313-7ae67c5d-d0a46360-46e76d79.jpg,test/p17/p17304751/s59988840/3cabd9fe-9c7c0313-7ae67c5d-d0a46360-46e76d79.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___ year old woman with history of lymphoma, c/o two weeks of sweats, cough, DOE. Fever 100.___F. // Assess for pneumonia ASSESS FOR PNEUMONIA WET READ TO ___ NP. PAGER ___ TECHNIQUE: PA and lateral views of the chest. COMPARISON: Prior chest radiograph from ___. FINDINGS: The heart is top normal in size and unchanged. The hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___ on the telephone on ___ at 2:13 PM, 10 minutes after discovery of the findings. " 6d889681-27ba5bd5-91d9d063-7689f5da-8c89b313.jpg,test/p10/p10899387/s55552539/6d889681-27ba5bd5-91d9d063-7689f5da-8c89b313.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, hepatopulm syndrome and SOB // eval for effusion, pulm edema eval for effusion, pulm edema IMPRESSION: No comparison. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pulmonary edema, no pleural effusions. No pneumonia. " 31faabb3-222019a8-e671aa2c-283bb03b-5aa0a476.jpg,test/p14/p14957008/s55284582/31faabb3-222019a8-e671aa2c-283bb03b-5aa0a476.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with stroke. Question infection. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Lungs are clear without focal consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormality is identified. IVC filter noted in the upper abdomen on the lateral view. IMPRESSION: No acute cardiopulmonary process. " 9bef4a04-84d59964-8a9b7ea9-ed71707f-ec375c48.jpg,test/p10/p10967333/s55467188/9bef4a04-84d59964-8a9b7ea9-ed71707f-ec375c48.jpg,test," FINAL REPORT HISTORY: Male with worsening shortness of breath and suboptimal peak flow. History of asthma. Assess for pneumonia or asthma flare. COMPARISON: Chest radiograph ___; ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Stable calcified right lower lobe nodule and chronic pleural thickening and scarring of right costophrenic angle. No new focal opacity, pleural effusion, pneumothorax, or pulmonary edema. Heart size, mediastinal contour and hila are normal. No bony abnormality. IMPRESSION: 1. Chronic stable pleural thickening and scarring of right costophrenic angle. 2. Stable right lower lobe calcified nodule may represent calcified granuloma. 3. No pneumonia. Results were conveyed via telephone to Dr. ___ by Dr. ___ on ___ at 2:20 p.m. within 10 minutes of observation of findings. " f0f2e452-b749e0b3-377c912b-1ac10aef-9c4d6027.jpg,test/p12/p12643806/s58773566/f0f2e452-b749e0b3-377c912b-1ac10aef-9c4d6027.jpg,test," FINAL REPORT TECHNIQUE: Single portable upright chest view was reviewed in comparison with prior chest radiographs of ___ with the most recent from ___. FINDINGS: Mild pulmonary edema has improved since ___. There is no pleural effusion or pneumothorax. Mildly enlarged heart size, mediastinal and hilar contours are unchanged. Multiple rib fractures with deformities bilaterally are similar. Right PICC line ends at the lower SVC. IMPRESSION: Mild pulmonary edema, improved Since ___. " 4cbe46dc-5fc233d1-7e417b16-3b3a0a91-1e3214ca.jpg,test/p13/p13462065/s56043635/4cbe46dc-5fc233d1-7e417b16-3b3a0a91-1e3214ca.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Weight loss, cough. Comparison is made with prior study ___. Cardiomediastinal contours are normal. The lungs are hyperinflated, consistent with COPD. Bilateral effusions are small, associated with adjacent atelectasis. There is biapical asymmetric, left greater than right, mild scarring. IMPRESSION: COPD. Small effusions. " 58c974e7-cd93cc33-bd08fa0e-c219ac73-cb50fb49.jpg,test/p17/p17810083/s54051002/58c974e7-cd93cc33-bd08fa0e-c219ac73-cb50fb49.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath after drain cleaner exposure. Question pneumonitis. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. There is no effusion, consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " c0fa563e-0f4f1cb7-1b0177d1-746c5449-52991bdd.jpg,test/p16/p16645602/s51630121/c0fa563e-0f4f1cb7-1b0177d1-746c5449-52991bdd.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with altered mental status. Evaluate for pneumonia. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest were obtained. The study is somewhat limited by patient's lordotic position and low lung volumes. A vagal stimulator projects over the left hemithorax with a catheter extending to the neck. There is no focal consolidation, pleural effusion, or pneumothorax. Mild bibasilar atelectasis is noted. The cardiac silhouette is mildly enlarged, unchanged. Mediastinal silhouette and hilar contours are normal allowing for low volumes. IMPRESSION: Limited study. Mild bibasilar atelectasis. No acute cardiopulmonary process. " eafc738d-e0cc3e78-8a1895f7-88b9fb52-29118e70.jpg,test/p19/p19438380/s51909894/eafc738d-e0cc3e78-8a1895f7-88b9fb52-29118e70.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with right sided chest pain and productive cough // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Mild cardiomegaly is unchanged. No pulmonary vascular congestion or edema. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 2b3557bf-6c2b6eef-b6ce2804-f7a93e5e-bf06ef88.jpg,test/p16/p16233087/s51046843/2b3557bf-6c2b6eef-b6ce2804-f7a93e5e-bf06ef88.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p MVR s/p CT removal // eval for pneumo COMPARISON: Chest x-ray from ___ at 06:42 FINDINGS: Compared with the prior film, the ET tube and NG tube have been removed. The left chest tube has also been removed. Additional linear densities are seen over the upper abdomen, but the mediastinal drain and right chest tube may very well have been removed. No pneumothorax is detected. The right IJ Swan-Ganz catheter is again seen. The tip as been retracted and now overlies the proximal right main pulmonary artery. The patient is status post sternotomy, with cardiomegaly, which appears unchanged. The possibility of pericardial fluid cannot be excluded. There is persistent increased retrocardiac density with obscuration left hemidiaphragm, consistent with left lower lobe collapse and/or consolidation. There is also persistent hazy opacity in the right cardiophrenic region. No right side no significant right-sided pleural effusion. The possibility of a small left effusion cannot be excluded. Minimal upper zone redistribution, but no overt CHF. Note is again made of a normal variant azygos fissure . Much of the detail visible on the ___ chest CT is not apparent radiographically. IMPRESSION: 1. Cardiomediastinal silhouette is enlarged, but unchanged. 2. No pneumothorax detected. No gross effusion. A small left effusion would be difficult to exclude. 3. Persistent left lower lobe collapse and/or consolidation. Persistent patchy right cardiophrenic opacity. 4. No overt CHF. 5. No pneumothorax detected status post removal of chest tube. " f94c9e5b-3c22f6c0-20ea2234-ccd632f8-87840cc5.jpg,test/p16/p16477871/s59653720/f94c9e5b-3c22f6c0-20ea2234-ccd632f8-87840cc5.jpg,test," FINAL REPORT HISTORY: Intermittent chest pain. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: The lung volumes are low, leading to crowding of the bronchovascular structures. The bilateral costophrenic angles are blunted laterally, suggesting atelectasis as the posterior costophrenic angels are sharp. Redemonstrated is mild scarring at the right lung base. There is no evidence of focal consolidation, pneumothorax, or frank pulmonary edema. Again seen is a 1 cm left upper lung nodule, less conspicuous as compared to the prior exam. The previously identified 1 cm right lower lung pulmonary nodule is not well visualized on this exam. The patient is status post median sternotomy and CABG, with sternotomy wires seen intact and well aligned. The cardiomediastinal silhouette is stable. No acute bony abnormality is detected. IMPRESSION: 1. No radiographic evidence for acute cardiopulmonary process. 2. Redemonstrated 1 cm left upper lobe pulmonary nodule. Recommended dedicated chest CT for further evaluation as previously mentioned. " 914e91b3-e31f9317-27f2b30e-30457825-77b03a27.jpg,test/p13/p13868179/s52423026/914e91b3-e31f9317-27f2b30e-30457825-77b03a27.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with general weakness TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph and chest CT___ FINDINGS: Heart size is borderline enlarged, unchanged. Aortic knob calcifications are again noted. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 6b7a1101-90690062-e9317ded-3b0a4335-d8ea7be0.jpg,test/p12/p12523062/s53642314/6b7a1101-90690062-e9317ded-3b0a4335-d8ea7be0.jpg,test," WET READ: ___ ___ 11:50 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // ? effusions, consolidation TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes are normal. There is a left-sided AICD device with a single lead following the expected course to the right ventricle. Right Port-A-Cath is in place with tip terminating in the lower SVC. No focal consolidation, pleural effusion or pneumothorax is seen. There is no central vascular congestion or overt pulmonary edema. Mediastinal and hilar contours are normal. Heart size is normal. IMPRESSION: No acute intrathoracic process. " 830cecf0-f352e668-e40e2651-27571673-98e7403d.jpg,test/p10/p10621548/s54034038/830cecf0-f352e668-e40e2651-27571673-98e7403d.jpg,test," FINAL REPORT HISTORY: Productive cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made radiographs dated ___. FINDINGS: As compared to prior examination, there has been minimal interval change. Redemonstrated is elevation of the right hemidiaphragm. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. The heart size is normal. The aorta is noted to be mildly tortuous. Mediastinal contours are otherwise normal. IMPRESSION: No radiographic evidence for pneumonia. " 1bf225cc-53c23475-293980ca-3de874ee-347ff072.jpg,test/p15/p15099341/s58260262/1bf225cc-53c23475-293980ca-3de874ee-347ff072.jpg,test," FINAL REPORT INDICATION: History: ___F with CP s/p car ride // PNA? Mediastinal widening? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal silhouette is within normal limits. Pleuroparenchymal scarring is noted at the apices. Lungs are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic process. " d62cc70f-7681b9cb-9dfa4898-f5df32d6-868b8995.jpg,test/p15/p15138264/s59703337/d62cc70f-7681b9cb-9dfa4898-f5df32d6-868b8995.jpg,test," FINAL REPORT INDICATION: ___ year old man with follow up pneumonia // follow up pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Multifocal airspace opacities involving the right upper lobe, right lower lobe and lingula have improved in keeping with resolving multifocal pneumonia. The heart is not enlarged. No pleural effusions or pneumothorax. IMPRESSION: Improved bronchopneumonia with residual opacities in the right upper, right lower and lingula. RECOMMENDATION(S): Repeat radiographs in 4 weeks to ensure resolution, if opacities do not resolve, consider CT thorax " 36d1d206-18507991-91719de3-e492df6d-6b687937.jpg,test/p12/p12027445/s52271631/36d1d206-18507991-91719de3-e492df6d-6b687937.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ovarian cancer // screening TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated without focal consolidation or pleural effusion. Chronic interstitial prominence is unchanged with biapical pleural scarring is unchanged. The heart and mediastinum are within normal limits. Spinal degenerative changes are stable. IMPRESSION: No acute pulmonary disease. " 2d2404e2-d9991910-3e6cfe6d-eee12515-f7af5c5b.jpg,test/p17/p17740146/s58849330/2d2404e2-d9991910-3e6cfe6d-eee12515-f7af5c5b.jpg,test," FINAL REPORT HISTORY: Left anterior chest wall pain. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, four views. FINDINGS: Heart size is normal with mild tortuosity of the thoracic aorta. Hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 9ea98915-2093cb43-28ea4881-ba794215-7cea6059.jpg,test/p19/p19246656/s56735828/9ea98915-2093cb43-28ea4881-ba794215-7cea6059.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old woman with 2 weeks worsening cough, SOB, malaise // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: PA and lateral chest radiographs dated ___ FINDINGS: In comparison to the chest radiographs obtained ___, no significant changes are appreciated. Lungs are fully expanded and clear without consolidations or suspicious pulmonary nodules. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No radiographic evidence of pneumonia or other significant cardiopulmonary abnormalities. " c0737fe4-73312d2d-3fa2a789-fd39a3a0-00c79b78.jpg,test/p11/p11126593/s59943781/c0737fe4-73312d2d-3fa2a789-fd39a3a0-00c79b78.jpg,test," FINAL REPORT INDICATION: ___-year-old man with palpitations, assess for pneumonia or fluid overload. COMPARISONS: ___. FINDINGS: Lungs are low in volume. Metallic density projecting over the right hemithorax is unchanged. Cardiomediastinal silhouette is unchanged allowing for portable technique and low lung volumes. No evidence of edema or focal consolidation is seen. IMPRESSION: No acute intrathoracic process. " 3690a901-81d80440-4fdc3504-91df50b0-b549427c.jpg,test/p14/p14464018/s54237149/3690a901-81d80440-4fdc3504-91df50b0-b549427c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with shortness of breath and LV lead malfunction // assess lead integrity, assess for chf assess lead integrity, assess for chf COMPARISON: Prior chest radiographs since ___ most recently one ___. IMPRESSION: No change in course or any discontinuity of trans subclavian right atrial biventricular pacer defibrillator leads from the left pectoral generator. Moderate cardiomegaly probably increased since ___. Pulmonary vasculature unremarkable. No edema or pleural effusion. Lungs essentially clear. " 68eadcbd-a1599985-dbd18155-438cc651-19c4273d.jpg,test/p15/p15506939/s58521201/68eadcbd-a1599985-dbd18155-438cc651-19c4273d.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Sudden-onset headache as well as chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 088f8501-2439bdea-732e618e-872ef8dc-5283800a.jpg,test/p14/p14247006/s56753570/088f8501-2439bdea-732e618e-872ef8dc-5283800a.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Access pacer leads. There is mild-to-moderate cardiomegaly. Transvenous pacemaker leads terminate in standard position, in the right atrium, right ventricle, and through the coronary sinus. There is no pneumothorax or pleural effusion. There is mild vascular congestion. " 82053992-94297f95-8a6c1fa4-74599fbd-632cf12b.jpg,test/p15/p15228659/s53228774/82053992-94297f95-8a6c1fa4-74599fbd-632cf12b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with left sided chest pain // r/o CHF/Pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There is no pulmonary edema. Chronic changes at the distal right clavicle, right coracoclavicular interval are not well assessed on this study. IMPRESSION: No acute cardiopulmonary process. " f80706bd-cbac3aab-85a4b33e-8a2fa54e-0ae1adbe.jpg,test/p12/p12805811/s57887075/f80706bd-cbac3aab-85a4b33e-8a2fa54e-0ae1adbe.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post abdominal surgery, nasogastric tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, after abdominal surgery, abdominal air is still visible in subphrenic location. The patient has received a nasogastric tube. The course of the tube is unremarkable. The tip of the tube, however, only projects over the gastroesophageal junction. The tube should be advanced by at least 5 to 10 cm. The patient has also received a left-sided hemodialysis catheter. The course of the catheter is unremarkable, the tip projects over the right atrium. There is no evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged. " 08fab63e-bd236030-0343bce8-55387659-9cdcefb5.jpg,test/p10/p10336855/s53459292/08fab63e-bd236030-0343bce8-55387659-9cdcefb5.jpg,test," FINAL REPORT INDICATION: ___ year old woman with ___ F with PMH of right A1 aneurysm clipped in ___, a left MCA stroke in ___ and an episode concerning for a new stroke in ___ presented with AMS and large right MCA stroke. // interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: Low lung volumes. Resolution of right lower lobe opacity. Stable mild cardiomegaly. Left basilar atelectasis has nearly resolved with minimal residual. The ET tube is approximately 2.5 cm above the carina. The NG tube is visualized in the stomach. The right PICC line terminates in the cavoatrial junction. IMPRESSION: Resolution of right lower lobe opacities and near resolution of left basilar atelectasis. " 22ce8e6c-16ebd70a-4bb2be1a-7ab0e302-1fe4cc48.jpg,test/p10/p10835660/s55652710/22ce8e6c-16ebd70a-4bb2be1a-7ab0e302-1fe4cc48.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness and cough. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. There is new mild-to-moderate relative elevation of the right hemidiaphragm compared to the left side. The lungs appear clear. Slight degenerative changes are similar along the thoracic spine. IMPRESSION: 1. No evidence of pneumonia. 2. New mild relative elevation of the right hemidiaphragm since ___. " bcb7d104-eba2e30a-7d2917f9-69d5e66a-929ceff5.jpg,test/p18/p18249843/s59537287/bcb7d104-eba2e30a-7d2917f9-69d5e66a-929ceff5.jpg,test," FINAL REPORT INDICATION: ___ year old woman with CHF and possible PNA // interval change in pulmonary edema, evaluate for consolidation COMPARISON: Radiographs from ___ IMPRESSION: There is a left-sided central line with the distal lead tip at the cavoatrial junction. There are low lung volumes. There is cardiomegaly which is stable. There is a small right-sided pleural effusion. There is unchanged mild to moderate pulmonary edema. Atelectasis at the lung bases are again seen. Lateral view is suboptimal. However, there are degenerative changes of the lumbar spine. There are no pneumothoraces. " 2ebce8d9-b4a1ddb9-5ef6130b-424c0711-c38064bb.jpg,test/p11/p11123733/s55208039/2ebce8d9-b4a1ddb9-5ef6130b-424c0711-c38064bb.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lungs are hyperinflated with flattening of the diaphragms compatible with COPD. Heart size is mildly enlarged but unchanged. The mediastinal and hilar contours are stable. Previous pattern of mild pulmonary edema has resolved. Small bilateral pleural effusions are noted. No focal consolidation or pneumothorax is seen. Minimal atelectasis is noted in the lung bases. Degenerative changes are seen within the thoracic spine. IMPRESSION: Mild bibasilar atelectasis and small bilateral pleural effusions. COPD. " 47e59dbc-448cb751-b4342f5a-33143ede-8cf0cacc.jpg,test/p11/p11551927/s51826694/47e59dbc-448cb751-b4342f5a-33143ede-8cf0cacc.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with History of pancreatic pseudocyst p/w fever to 102.9 and pseudocyst ___ fell out // R/O pneumonia COMPARISON: ___. FINDINGS: AP semi upright and lateral views of the chest provided. PICC line is again noted with left arm access and tip in the low SVC. Lung volumes are low with atelectasis of the right lung base. No large consolidation, effusion or pneumothorax is seen. The heart and mediastinal contours appear stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild right basal atelectasis. PICC line in place. " 34a48da7-10b6122a-aeb28229-fb50f480-16633cb7.jpg,test/p12/p12238407/s56222693/34a48da7-10b6122a-aeb28229-fb50f480-16633cb7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute liver and kidney failure with increased ventilatory requirements and tachypnea // eval for pulmonary edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Minimal increase in transparency of the right lung, suggesting slightly improved ventilation. Unchanged appearance of the left lung. Borderline size of the cardiac silhouette. Mild fluid overload. No larger pleural effusions. No pneumonia. The monitoring and support devices are constant. " 9f703460-51f64523-07d0d166-70904345-5f81c3a8.jpg,test/p19/p19729398/s58157702/9f703460-51f64523-07d0d166-70904345-5f81c3a8.jpg,test," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old female patient status post bronchoscopy and endobronchial ultrasound-guided biopsy. Assess for interval change. FINDINGS: PA and lateral chest views were obtained with patient in upright position. There is status post sternotomy and the metallic component of a porcine valve prosthesis is identified in mitral valve position. Cardiac enlargement is very mild, but the left atrial contours are identified both in frontal and lateral view and suggests mild enlargement of the left atrium. Pulmonary vasculature, however, is not congested and no signs of acute infiltrates are present. Rather low positioned and somewhat flattened diaphragms are noted, coinciding with increased translucency of the lung bases suggestive of some degree of COPD. There is no evidence of any pleural effusion and no signs of pneumothorax in the apical area. IMPRESSION: Status post mitral valve replacement. No evidence of significant pulmonary congestion. No signs of pneumothorax but some general pulmonary findings suggestive of COPD. " 4ed156fe-42046bef-29d14842-2351c92c-370b2661.jpg,test/p10/p10459005/s54021560/4ed156fe-42046bef-29d14842-2351c92c-370b2661.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___M with increasing dyspnea ___ edema and cough // r/o infiltrate,chf TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: Mild prominence of the central pulmonary vasculature suggests a underlying mild pulmonary vascular congestion. No overt pulmonary edema is identified. There is no, pneumothorax, or consolidation. Trace right pleural effusion. Severe cardiomegaly is unchanged. The patient is status post median sternotomy and CABG. A left-sided pectoral pacemaker is unchanged in position. IMPRESSION: Stable, severe cardiomegaly and mild central pulmonary vascular congestion. Trace right pleural effusion. " d80edd61-1eda30ca-ca0376c8-63c316a7-dedc870f.jpg,test/p18/p18446519/s50854050/d80edd61-1eda30ca-ca0376c8-63c316a7-dedc870f.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Coughs and subjective fever with chills. History of HIV. COMPARISONS: Radiographs from ___; prior CT studies from ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. A lung nodule again projects over the right lower lobe, probably unchanged to the extent this can be judged from radiography. On the lateral view, the superior contours of the hemidiaphragms are obscured by a vague opacity that is not well seen on the frontal view, but otherwise lung fields appear clear. IMPRESSION: 1. Suspicion for pneumonia based on a vague anterior inferior opacity depicted only on the lateral view, probably in the lingula, although potentially right middle lobe; atelectasis is a possible alternative diagnosis. 2. Similar appearance of right basilar pulmonary nodule, although small changes would be difficult to detect with radiography. " c1a5c726-81899e87-119a4cad-2a69690f-2998df3b.jpg,test/p13/p13049990/s55625985/c1a5c726-81899e87-119a4cad-2a69690f-2998df3b.jpg,test," FINAL REPORT INDICATION: ___M with chest pain, dizziness, fatigue // eval heart and lungs TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. Coronary artery stents are noted. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " b18f46db-1a812b8f-8422240a-cd1d097d-17c7aa5a.jpg,test/p15/p15173403/s57770930/b18f46db-1a812b8f-8422240a-cd1d097d-17c7aa5a.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Possible right pneumothorax. IMPRESSION: AP chest compared to ___, 2:39 p.m.: There is a small right pneumothorax with components at the apex, and at the right base lateral to the pleural drainage tube, probably comparable in volume to 2:39 p.m. when the pleural air was more readily visible at the base of the right lung. Right rib fractures are substantially displaced. There is no appreciable right pleural effusion. Left lung is clear. Heart is mildly enlarged but unchanged and there is no pulmonary vascular abnormality. " 61097f8d-9b180fef-7f56033f-52538d25-d20cb915.jpg,test/p11/p11062577/s51708727/61097f8d-9b180fef-7f56033f-52538d25-d20cb915.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: Patient with hepatitis C cirrhosis, found down. Intubated. FINDINGS: Comparison is made to previous study from ___. Endotracheal tube, feeding tube, and right-sided central venous line are unchanged in position. Heart size is within normal limits. There is some coarsening of the bronchovascular markings without signs for overt pulmonary edema or focal consolidation. No pneumothoraces are seen. " 1e959c5a-6037d937-7289ca6a-61246ece-d25a8a00.jpg,test/p17/p17603668/s59194210/1e959c5a-6037d937-7289ca6a-61246ece-d25a8a00.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p liver transplant on HD, needs chest xray verification of no suspicious lesions consistent with TB to be admitted to outpatient HD unit. PPD not effective in transplant patients // Assess for concerning lesions c/w TB as screening for outpatient HD unit Assess for concerning lesions c/w TB as screening for outpatient HD unit IMPRESSION: Compared to prior chest radiographs ___. Previous pleural effusions any basal atelectasis have resolved. Lungs are well expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Dual channel right supraclavicular central venous dialysis catheters end in the low SVC and close to the superior cavoatrial junction, respectively. No pneumothorax. " 9b47cc75-fe521673-bcf56155-8787d012-4242c9a3.jpg,test/p13/p13473495/s54050506/9b47cc75-fe521673-bcf56155-8787d012-4242c9a3.jpg,test," FINAL REPORT INDICATION: Cough and positive blood cultures. Assess for pneumonia. COMPARISONS: Chest radiograph of ___ and CT chest of ___. FINDINGS: Frontal and lateral views of the chest were slightly limited due to patient's body habitus. Lung volumes are low, which accentuate bronchovascular markings. Mild pulmonary edema is unchanged. There is mild thickening of the minor fissure. Bibasilar opacities are noted. There is no pleural effusion. Moderate cardiomegaly is stable. Hilar and mediastinal silhouettes are unchanged. A dual-chamber dialysis catheter tip projects over proximal right atrium. IMPRESSION: Stable mild pulmonary edema and moderate cardiomegaly. Bibasilar opacities may represent atelectasis or infection in the appropriate clinical setting. " 562f41eb-a5205c56-94c8c690-ae56e2bf-37b3a9f9.jpg,test/p10/p10635271/s51005405/562f41eb-a5205c56-94c8c690-ae56e2bf-37b3a9f9.jpg,test," WET READ: ___ ___ ___ 6:13 PM pt with known type B dissection. cardiomediastinal silhuette is grossly unchanged, however conventional radiographs are not sensistive in detecting changes in dissection. consider CT of clinical concern for acute aortic syndrome. pacemaker leads unchanged in position. right pleural effusion, slightly improved since prior. large hiatal hernia with associated small pleural effusion. no pulmonary edema or pneumothorax. ___ ___ ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Aortic stenosis, chronic aortic dissection. COMPARISON: Outside hospital film from ___. FINDINGS: As compared to the previous radiograph, the pre-existing pleural effusions have bilaterally decreased in extent. There is persistent moderate cardiomegaly with retrocardiac atelectasis, but no evidence of overt pulmonary edema. The effusions are better appreciated on the lateral than on the frontal radiograph. Moderate valvular calcifications. No evidence of pneumonia. Left pectoral pacemaker, the leads show normal course and position. " 3da9e6cf-a669a44c-19e9dd70-2acdfcac-5d3e75fd.jpg,test/p14/p14163729/s56584952/3da9e6cf-a669a44c-19e9dd70-2acdfcac-5d3e75fd.jpg,test," FINAL REPORT INDICATION: ___-year-old female with generalized weakness. Question pneumonia. COMPARISON: Multiple chest radiographs, the latest from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. The cardiac silhouette is mildly enlarged. The mediastinal silhouette shows aortic calcifications. The hilar contours and pleural surfaces are normal. No pleural effusion or pneumothorax is present. Cholecystectomy clips are noted in the right upper quadrant, unchanged. A hyperdense focus is noted overlying the L1 vertebral body, which could represent a bone island, unchnaged from prior. A healed rib fractures is unchanged in the left hemithorax. IMPRESSION: No acute intra-thoracic process. " b1750e2a-301f85ee-46b1b394-f744b455-83cc45c9.jpg,test/p17/p17062695/s55437264/b1750e2a-301f85ee-46b1b394-f744b455-83cc45c9.jpg,test," FINAL REPORT HISTORY: Weakness. Evaluate for pneumonia. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: The mediastinal clips, sternotomy wires and an aortic valve prosthesis are constant. Again, there is an increase in interstitial markings which may reflect underlying mild pulmonary edema or chronic lung disease. The heart size is mildly enlarged but unchanged. The aorta is calcified and tortuous. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. IMPRESSION: Increase in interstitial markings which may reflect underlying mild pulmonary edema or chronic lung disease. " 6b38e9c6-b1f50fba-5f9ff23f-f6c28f4d-df67a05c.jpg,test/p11/p11551927/s58424422/6b38e9c6-b1f50fba-5f9ff23f-f6c28f4d-df67a05c.jpg,test," FINAL REPORT HISTORY: Dobbhoff removal. FINDINGS: In comparison with study of ___, the malpositioned Dobbhoff tube in the right mainstem bronchus has been removed. Continued low lung volumes without evidence of cardiomegaly or pulmonary vascular congestion or left pleural effusion. The outermost portion of the right lung has been excluded from the images. Mild atelectatic changes are seen. " b395d4e6-c604462b-8a6b4ffd-e5a0fe11-08176210.jpg,test/p16/p16517723/s52765818/b395d4e6-c604462b-8a6b4ffd-e5a0fe11-08176210.jpg,test," FINAL REPORT HISTORY: Patient with progressive lower extremity weakness, rule out intrathoracic process. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs were obtained. The lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " eaa862a2-6c57e3ea-bad4024a-564f7f14-d963c808.jpg,test/p11/p11607628/s50790949/eaa862a2-6c57e3ea-bad4024a-564f7f14-d963c808.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ 2:11 PM 1. Endotracheal tube appropriately retracted to 5 cm above the carina. 2. Resolution of pulmonary edema. 3. Stable moderate left greater than right bilateral pleural effusions. 4. Stable mild cardiomegaly. ______________________________________________________________________________ FINAL REPORT INDICATION: Evaluate position of endotracheal tube and patient with prolonged QT and cardiac arrest. COMPARISON: Multiple chest radiographs from ___ to ___ and baseline examination of ___. SEMI-UPRIGHT AP VIEW OF THE CHEST: The endotracheal tube has been retracted to appropriate position approximately 5 cm above the carina. The left IJ central venous line and nasogastric tube are in unchanged and appropriate position. The pulmonary edema has resolved. The moderate, left greater than right bilateral pleural effusions are unchanged. Minimal cardiomegaly also stable. There is no pneumothorax. IMPRESSION: 1. Endotracheal tube appropriately retracted to 5 cm above the carina. 2. Resolution of pulmonary edema. 3. Stable moderate left greater than right bilateral pleural effusions. 4. Stable mild cardiomegaly. " 8bddc9cc-534e4ff3-0ad85df0-d2fa2503-f84efa3a.jpg,test/p11/p11708854/s50618156/8bddc9cc-534e4ff3-0ad85df0-d2fa2503-f84efa3a.jpg,test," FINAL REPORT INDICATION: ___ year old woman with 4 days of SOB with activity, cough, wheezing. // ?infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: There is a focal dense consolidation obscuring the right diaphragmatic surface, posterior thoracic spine, and right cardiac border which is consistent with a right lower lobe and right middle lobe pneumonia. Left lung is grossly clear. There are no pleural effusions. Cardiomediastinal border is and hilar structures are normal. IMPRESSION: Right lower lobe and probable right middle lobe pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:04 PM, 5 minutes after discovery of the findings. " a45f263e-8f0e37d3-1de6ea48-6b4a2861-d1d43534.jpg,test/p19/p19398915/s59632408/a45f263e-8f0e37d3-1de6ea48-6b4a2861-d1d43534.jpg,test," FINAL REPORT EXAMINATION: Study of ___, INDICATION: ___ year old man with pna // eval for progressing disease eval for progressing disease IMPRESSION: In comparison with the there may be slight improvement in the diffuse multifocal pneumonia. Continued bilateral pleural effusions with enlargement of the cardiac silhouette and elevated pulmonary venous pressure. " b1b658ed-3991553f-9e1fa447-c88d2cf1-cfdc445c.jpg,test/p12/p12595468/s58901891/b1b658ed-3991553f-9e1fa447-c88d2cf1-cfdc445c.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: ___. FINDINGS: There is minimal left base atelectasis. No focal consolidation is seen. There is persistent blunting of the right costophrenic angle. No large left pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Stable blunting of the right costophrenic angle, may be due to underlying pleural thickening or trace pleural effusion. No focal consolidation. " 68315e71-a39229ed-7c593874-0906a16a-2b10301c.jpg,test/p14/p14277220/s55719848/68315e71-a39229ed-7c593874-0906a16a-2b10301c.jpg,test," FINAL REPORT HISTORY: Trauma. COMPARISON: None available. FINDINGS: Bilateral hazy opacities interstitial are visualized and likely representative of fibrotic changes. Otherwise the lungs are without a focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute fractures are identified. IMPRESSION: No evidence of acute injury. Bilateral hazy interstitial opacities are likely representative of fibrotic changes. " c7e0d474-458a7006-02d8553f-18ddcbde-31464011.jpg,test/p19/p19101665/s59027695/c7e0d474-458a7006-02d8553f-18ddcbde-31464011.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Right lower lobe pneumonia per outside hospital records, mild non-productive cough. FINDINGS: The right-sided PICC line has been removed. The right hemidiaphragm is elevated. On the lateral film, there is some increased opacity overlying the heart in the expected region of the right middle lobe that may represent the previously described right middle lobe infiltrate. It is difficult without the outside films to assess for change in appearance. There is volume loss seen in the right lower lung and mild elevation of the right hemidiaphragm. The left lung is clear. " a1915615-13ee0ec5-e7a55d4b-9585e4f1-57a28cbf.jpg,test/p10/p10500801/s58577720/a1915615-13ee0ec5-e7a55d4b-9585e4f1-57a28cbf.jpg,test," FINAL REPORT INDICATION: Shortness of breath on the right side. COMPARISON: Chest CTA ___ and chest radiograph ___. PA AND LATERAL VIEWS OF THE CHEST: Large right-sided pneumothorax is demonstrated with leftward shift of mediastinal structures compatible with tension. The left lung is hyperinflated with evidence of emphysema. No pleural effusion or pulmonary vascular congestion is seen. The heart size is normal. The mediastinal contours are unremarkable. Streaky linear opacities within the visualized left lung likely reflect bronchiectasis. There are multilevel degenerative changes in the thoracic spine. IMPRESSION: Large right-sided pneumothorax with mild leftward shift of mediastinal structures indicative of tension. Findings discussed with Dr. ___ by Dr. ___ ___ phone on ___ at 2:31 p.m. " 0031238b-59d3c74e-c91468b6-fbba47b9-7c10998c.jpg,test/p13/p13584591/s54629076/0031238b-59d3c74e-c91468b6-fbba47b9-7c10998c.jpg,test," FINAL REPORT INDICATION: ___-year-old male with altered mental status, question infiltrate. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation. The cardiomediastinal silhouette is stable. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 96f7733a-8c70479f-f947b8f6-c58af23b-85d7226d.jpg,test/p17/p17525695/s58072304/96f7733a-8c70479f-f947b8f6-c58af23b-85d7226d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent gastric sleeve. Fever to 100.4, dyspneic. // Please evaluate for infection COMPARISON: CTA torso ___ FINDINGS: There is no focal consolidation or pneumothorax. There is a small left pleural effusion and left basilar atelectasis. Mild cardiomegaly is similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Small left pleural effusion and left basilar atelectasis. " 70ffa2e6-2ce36327-44ae1ce1-ffba6e3b-b45e216f.jpg,test/p12/p12900408/s59218751/70ffa2e6-2ce36327-44ae1ce1-ffba6e3b-b45e216f.jpg,test," FINAL REPORT INDICATION: Two-week history of cough, sputum, fevers, or chills. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is visualized. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " d07575b7-64372d6a-203a5a87-bae28414-0ed0027d.jpg,test/p15/p15002678/s51324900/d07575b7-64372d6a-203a5a87-bae28414-0ed0027d.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Oxygen requirement status post RFA. Comparison is made with prior study ___. Mild cardiomegaly is stable. Moderate right and small left pleural effusions are grossly unchanged. There is mild fluid overload, unchanged from prior. " fa42b1de-8787e18d-3455452c-524459cb-e4d13f69.jpg,test/p18/p18553055/s57579867/fa42b1de-8787e18d-3455452c-524459cb-e4d13f69.jpg,test," FINAL REPORT HISTORY: Endotracheal tube, assess placement. COMPARISON: CT chest ___. FINDINGS: Portable supine chest radiograph was obtained. Endotracheal tube terminates in the midtrachea 4.2 cm above the carina. Nasogastric tube is seen with the sidehole along the distal esophagus and can be advanced approximately 10 cm for optimal positioning. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal mediastinal contours. Calcified lesion in the upper abdomen corresponds to known calcified renal mass. IMPRESSION: Satisfactory position of endotracheal tube. Nasogastric tube could be advanced approximately 10 cm for more optimal positioning. " b9cba38f-bbcc0b74-192f237c-f21ecf81-a25c4113.jpg,test/p19/p19500638/s53110507/b9cba38f-bbcc0b74-192f237c-f21ecf81-a25c4113.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough and shortness of breath // eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Patchy lingular opacity is most likely due to atelectasis although early infectious process is not excluded in the appropriate clinical setting. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable. IMPRESSION: Subtle patchy lingular opacity most likely due to atelectasis, less likely early consolidation. " ee4bee32-7175b16e-1a9bea24-9765b1ad-3a177643.jpg,test/p16/p16179342/s59428219/ee4bee32-7175b16e-1a9bea24-9765b1ad-3a177643.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: This is an ___/F with PMHx of dCHF, AF SSS on Coumadin s/p PPM, and DM who presents with weakness and tachycardia found to have aflutter. // please evaluate ?infiltrate noted on most recent cxr please evaluate ?infiltrate noted on most recent cxr IMPRESSION: Comparison to ___. No relevant change. Low lung volumes. A parenchymal opacity at the right lung basis is stable. Extensive left retrocardiac atelectasis. Signs of mild fluid overload persist. Moderate cardiomegaly is unchanged. " ef691cad-e759dc3c-679bc366-57a9cd82-769d3dcc.jpg,test/p15/p15243543/s51990398/ef691cad-e759dc3c-679bc366-57a9cd82-769d3dcc.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: Comparison is made with chest radiographs from ___ and CT chest from ___. FINDINGS: There are low lung volumes. Some streaky opacities suggestive of atelectasis are seen, but the lungs are otherwise clear. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. Visualized osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " f9eef844-8a5ed0a7-14b9e6f3-b332f6ee-3ec8b003.jpg,test/p10/p10440477/s57438283/f9eef844-8a5ed0a7-14b9e6f3-b332f6ee-3ec8b003.jpg,test," FINAL REPORT HISTORY: History of MVC status post chest tube placement. Please evaluate. COMPARISON: Chest radiograph performed at 12:17 on the same day as well as a CT chest performed at 06:00 on the same day. TECHNIQUE: Portable supine exam of the chest. FINDINGS: There has been interval placement of a left-sided chest tube. The tip of a chest tube terminates at the mid left lung on the ___ view. Again the lung volumes are low which limits assessment of the lung parenchyma however note is made of mild bibasilar atelectasis. There is mild pulmonary vascular congestion otherwise the cardiomediastinal contours are stable. There is no pneumothorax or definite pleural effusion. The previously noted rib fractures are not well visualized on this exam. IMPRESSION: Limited study given low lung volumes. Interval placement of a left chest tube which appears to terminate in the mid left lung. No ptx. " 64546f6a-27d543a9-a044b3dc-8e9ae4e0-03c96314.jpg,test/p11/p11583321/s57053394/64546f6a-27d543a9-a044b3dc-8e9ae4e0-03c96314.jpg,test," WET READ: ___ ___ ___ 8:11 PM Right basilar linear opacities likely reflect atelectasis although pneumonia is possible. Left lung base is clear. No pleural effusion. Progression of compression fracture of one mid thoracic vertebral body with redemonstration of additional compression fractures in the thoracic spine. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Chest pain and cough. PA and lateral upright chest radiographs were reviewed in comparison to prior study obtained on ___. The post-sternotomy wires are unremarkable. Cardiomediastinal silhouette is stable. Lungs are essentially clear except for bibasal atelectasis, overall unchanged. Multiple compression fractures demonstrated on the lateral view are noted, progressed with progression of one of the mid thoracic vertebral body compression fractures. The bibasal opacities most likely represents areas of atelectasis. " a125027e-e4df63c9-0228a233-8cad5c62-89e66208.jpg,test/p14/p14021217/s57989721/a125027e-e4df63c9-0228a233-8cad5c62-89e66208.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cirrhosis, cough // ?infection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There relatively low lung volumes and mild bibasilar atelectasis. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No focal consolidation to suggest pneumonia. " c67c4a94-08f421c9-da96f529-f2152029-e7ce040b.jpg,test/p15/p15928416/s56164613/c67c4a94-08f421c9-da96f529-f2152029-e7ce040b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with atraumatic spleen rupture concern for granuloma, TB, lymphadenopathy? // granuloma, TB, lymphadenopathy? COMPARISON: CT abdomen ___ IMPRESSION: Heart is upper limits of normal in size and accompanied by pulmonary vascular congestion without overt edema. Widening of the azygos contours likely due to azygos vein distension, but lymph node enlargement is not excluded. Attention to this region on follow-up radiograph may be helpful when the patient may cooperate with positioning for standard PA and lateral technique. Small bilateral pleural effusions are new and accompanied by bibasilar atelectasis and or consolidation. " dfd86e10-12f68bfa-62327fa4-f70559e8-046f5cf5.jpg,test/p14/p14851663/s50494673/dfd86e10-12f68bfa-62327fa4-f70559e8-046f5cf5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman POD___ s/p L groin cut down and L CFA and circumflex repair, with SOB, desats // ?acute process TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate cardiomegaly is stable. Pacer lead tip is in the right ventricle. There is no pneumothorax. Small left effusion and adjacent atelectasis have increased. There is mild vascular congestion. Right lower lobe atelectasis has increased. " 578bc2b9-43de6d3c-0689be86-103bc25f-6b3f6cbd.jpg,test/p12/p12471550/s53279742/578bc2b9-43de6d3c-0689be86-103bc25f-6b3f6cbd.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with large volume ascites and decreased breath sounds at the left base. FINDINGS: Frontal and lateral views of the chest were compared to previous exam from ___. Again low lung volumes are seen as well as elevation of the left hemidiaphragm. Linear opacity at the left lung base is suggestive of atelectasis. The lungs are otherwise clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 1dd31130-bb0a1ee6-b5c183ec-8a37ad1d-89a1b4f4.jpg,test/p12/p12670557/s51437073/1dd31130-bb0a1ee6-b5c183ec-8a37ad1d-89a1b4f4.jpg,test," FINAL REPORT HISTORY: Ventral hernia repair. FINDINGS: In comparison with the earlier study of this date, there has been placement of an endotracheal tube, with its tip approximately 5.6 cm above the carina. Nasogastric tube and left subclavian catheter are essentially unchanged. Otherwise, there is little overall change in the diffuse opacifications involving both lungs as on the previous study. " 5ea86132-442ebb61-59d2ca67-5aa0959a-50e42fc8.jpg,test/p14/p14341122/s50456395/5ea86132-442ebb61-59d2ca67-5aa0959a-50e42fc8.jpg,test," FINAL REPORT HISTORY: Cough, sputum production, rule out pneumonia. COMPARISON: Chest radiograph from ___ in conjunction with CT torso from ___. FINDINGS: Heterogeneous opacities in the right lower lobe are concerning for atypical pneumonia. Left lung is clear. Normal heart size and mediastinal contours. No pleural effusion or pneumothorax. IMPRESSION: Right lower lobe heterogeneous opacities concerning for atypical pneumonia, recommend followup chest radiograph in ___ weeks to document resolution, or sooner if symptoms do not respond. NOTIFICATION: Telephone notificationto Dr. ___ by Dr. ___ at 13:15 on ___. " 92ba6736-97a5dd31-8a9f07a2-55c81481-eb71b7a2.jpg,test/p14/p14931729/s52298224/92ba6736-97a5dd31-8a9f07a2-55c81481-eb71b7a2.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiomediastinal silhouette is stable given differences in inspiration. Evidence of large hiatal hernia is again noted. No new focal consolidation is seen. No pleural effusion or pneumothorax is seen. There is no pulmonary edema. IMPRESSION: No acute cardiopulmonary process. Hiatal hernia. " 251281da-165f7e73-14dc211b-487ef84a-9b0081e7.jpg,test/p18/p18026405/s54414443/251281da-165f7e73-14dc211b-487ef84a-9b0081e7.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with confusion // r/o pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There relatively low lung volumes. Streaky linear mid to lower lung opacities bilaterally most likely are due to atelectasis. There is also probably a mild component of pulmonary vascular congestion. No pleural effusion is seen. There is no evidence of pneumothorax. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are stable and unremarkable. Lucency under the right hemidiaphragm is felt to be within bowel. IMPRESSION: Top-normal to mildly enlarged cardiac silhouette with mild pulmonary congestion. Bilateral areas of mid to lower lung atelectasis. " 734b9e49-d49f8763-ed344d98-4a8e6504-29ab1896.jpg,test/p11/p11790326/s50356223/734b9e49-d49f8763-ed344d98-4a8e6504-29ab1896.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with ABD pain, diffuse tenderness, vomiting, chest pain, recent PNA // Eval for acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are relatively low lung volumes. Increased interstitial markings bilaterally suggests mild pulmonary vascular congestion. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged. No pleural effusion is seen. There is no focal consolidation. Hilar contours are stable. Patient is status post median sternotomy. Evidence of DISH is seen along the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion. Persistent cardiomegaly. " e7805594-0218aafa-98fd9d56-43b8b72b-a299f2d7.jpg,test/p18/p18947046/s58258092/e7805594-0218aafa-98fd9d56-43b8b72b-a299f2d7.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: None. FINDINGS: Single frontal view of the chest. Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " b992bf46-c3ff7adc-6b606c80-ff75e6d4-b02dbb54.jpg,test/p13/p13826980/s52334852/b992bf46-c3ff7adc-6b606c80-ff75e6d4-b02dbb54.jpg,test," FINAL REPORT INDICATION: ___-year-old female with leukocytosis, here to evaluate for pneumonia. COMPARISON: Chest radiograph, last performed on ___. FINDINGS: Frontal and lateral radiographs of the chest show persistent low inspiratory lung volumes. Previously seen mild pulmonary edema from ___ is resolved. The lungs are clear without focal consolidation, pleural effusions or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. A right internal jugular central venous catheter is unchanged in position with the tip terminating at the cavoatrial junction. Mild distention of loops of bowel is noted in the upper abdomen. IMPRESSION: 1. No focal consolidation. 2. Resolved mild pulmonary edema from ___. " bc586aba-9f4447ed-8e00ef35-c55fe367-6727ddb6.jpg,test/p10/p10611307/s54443212/bc586aba-9f4447ed-8e00ef35-c55fe367-6727ddb6.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with hypoxia and dizziness. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are hyperinflated. There is mild bibasilar atelectatic changes are visualized but the lungs are without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. A density projecting over the left lung base appears stable and likely representative of either a calcified granuloma or a sclerotic rib lesion. Degenerative changes are visualized throughout the thoracic spine. No acute fractures are noted. IMPRESSION: No acute cardiopulmonary process. " 0466824b-75f6e8b0-d2e79938-f1be245e-cf6bc02b.jpg,test/p14/p14482644/s56407191/0466824b-75f6e8b0-d2e79938-f1be245e-cf6bc02b.jpg,test," FINAL REPORT HISTORY: Hypoxemia with possible pneumonia. FINDINGS: In comparison with the study of ___, the right hemidiaphragm is more sharply seen. It is unclear whether this could reflect a more erect posture of the patient, or a decrease in the degree of pleural effusion. Minimal atelectasis is above the elevated right hemidiaphragm. The left lung is essentially clear. No definite vascular congestion. Cardiomediastinal silhouette is unchanged. " 1833c59e-9c485426-b5410bbd-f10d6a96-bdaf981a.jpg,test/p13/p13745545/s53908730/1833c59e-9c485426-b5410bbd-f10d6a96-bdaf981a.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with lung mass. Status post right lung biopsy. Evaluate for pneumothorax. FINDINGS: Comparison is made to prior study from ___. There is a dual-lead left-sided pacemaker with lead tips in the right atrium and right ventricle. Cardiac silhouette is enlarged but unchanged. There are again seen opacities within the lung bases as well as bilateral pleural effusions. No pneumothoraces are seen on either side. There is a focus of calcification adjacent to the right humeral head consistent calcific tendinitis. " 0d1ee020-f70753ea-e350b537-4b979845-554e5027.jpg,test/p18/p18799590/s53679185/0d1ee020-f70753ea-e350b537-4b979845-554e5027.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with left hand numbness. Question infection. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Biapical right greater than left pleural-based scarring is again noted. The lungs are otherwise clear without consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 3b970fc9-f8abfdfa-5d6030ae-dbbeb161-ee9a0dfe.jpg,test/p19/p19646078/s58718891/3b970fc9-f8abfdfa-5d6030ae-dbbeb161-ee9a0dfe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p // eval ETT eval ETT IMPRESSION: Heart size and mediastinum are stable. Mediastinal drains, bilateral chest tubes are in unremarkable position. Swan-Ganz catheter tip terminates at the level of right ventricle outflow tract. ET tube tip is not clearly seen on the current examination an oblique view might be suggested. The ET tube tip most likely terminates 3.2 cm above the carinal. " 00667922-a01e86de-8c7d85c1-a2fc2a15-e316ab58.jpg,test/p12/p12855476/s55768630/00667922-a01e86de-8c7d85c1-a2fc2a15-e316ab58.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p ped strike, intubated, diuresed // interval assessment interval assessment IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are unchanged. There is continued increased opacification at the left base with poor definition of the hemidiaphragm, consistent with volume loss in the left lower lobe and pleural effusion. The right hemidiaphragm is more sharply seen, consistent with improving effusion and atelectasis on this side. Again there is evidence of previous cervical fusion. " 05b2e26c-3dcadece-72c8c9f2-d941d4f4-21df64cf.jpg,test/p11/p11599704/s57422793/05b2e26c-3dcadece-72c8c9f2-d941d4f4-21df64cf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with persistent fevers, on broad spectrum antibiotics // infiltrate? infiltrate? IMPRESSION: Compared to chest radiographs on ___. Mild pulmonary edema has developed in the mid and lower lung zones. Heart size is normal. Pleural effusions small on the right. No good evidence for pneumonia. " 6ccf7ac8-542e227c-c3db606b-623a4315-9292120c.jpg,test/p12/p12645758/s58354913/6ccf7ac8-542e227c-c3db606b-623a4315-9292120c.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath. Evaluation for cardiopulmonary process. COMPARISON: None available. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no evidence of focal consolidation, pleural effusion, pulmonary edema or pneumothorax. IMPRESSION: Normal radiographs of the chest. " f565ccf1-4f2ec432-64727d56-55909b19-127d2bbd.jpg,test/p11/p11984732/s50458000/f565ccf1-4f2ec432-64727d56-55909b19-127d2bbd.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fatigue and pneumonia. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Minimal moderate cardiomegaly with signs of mild-to-moderate pulmonary edema. Bilateral areas of atelectasis. Small pleural effusions. No new parenchymal opacities suggesting pneumonia. " d5cba008-636044d8-15d817da-fb7b65dc-07890912.jpg,test/p15/p15233042/s54464701/d5cba008-636044d8-15d817da-fb7b65dc-07890912.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for fluid overload, chronic heart failure. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged evidence of sternal wires and partially ruptured and displaced wires. Status post right shoulder surgery. The current radiograph shows moderate-to-severe cardiomegaly with mild-to-moderate pulmonary edema. No pleural effusions. No evidence of pneumonia. At the time of dictation and observation, ___, 8:46 a.m., the referring physician, ___. ___ was paged for notification. " 583b02d3-5cd29061-6fc637ec-5cff3f19-0d90b688.jpg,test/p15/p15527518/s56664549/583b02d3-5cd29061-6fc637ec-5cff3f19-0d90b688.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough and shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy and CABG. Mild cardiomegaly is re- demonstrated along with tortuosity of the thoracic aorta. Minimal upper zone vascular redistribution is noted without overt pulmonary edema. Hilar contours are unchanged. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormality is detected. IMPRESSION: Mild cardiomegaly with mild pulmonary vascular congestion but no overt pulmonary edema. No focal consolidation to suggest pneumonia. " f30bbb0b-e2fc0d98-807a79b1-7976e0dd-4fbccb61.jpg,test/p19/p19028690/s56321718/f30bbb0b-e2fc0d98-807a79b1-7976e0dd-4fbccb61.jpg,test," FINAL REPORT INDICATION: Shortness of breath. Comparison radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is top normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " b0f24f28-6d614a05-323aa26e-65d273ee-4f39e1ce.jpg,test/p19/p19749517/s50830761/b0f24f28-6d614a05-323aa26e-65d273ee-4f39e1ce.jpg,test," FINAL REPORT HISTORY: Acute pancreatitis, question infiltrate, ARDS. Desaturations. CHEST, SINGLE AP PORTABLE VIEW. The heart is not enlarged. There is no CHF, focal infiltrate or effusion. No free air identified beneath the diaphragm. " 3fc69d75-1907ca62-3ff20fea-c6a91552-72bf1396.jpg,test/p17/p17784248/s57906714/3fc69d75-1907ca62-3ff20fea-c6a91552-72bf1396.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with dyspnea on exertion and a prior history of blood left upper extremity DVT. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. Chest radiograph dated ___. FINDINGS: Leftward curvature of the mid thoracic spine is moderate. Tubing external to the patient projecting over the right apex limits detailed evaluation of the parenchyma in this region. Stable appearance of opacity in the left apex with associated volume loss, reflecting radiation fibrosis. Mild right apical pleural thickening is unchanged. Subtle increased opacity in the left lower hemithorax with increasing indistinctness of the left half border compared to the prior 2 exams could indicate developing infection in the appropriate clinical situation or atelectasis. Increased interstitial markings is nonspecific and could indicate underlying interstitial lung disease. No frank pulmonary edema, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is also overall unchanged with persistent mild cardiomegaly. Dilation of the pulmonary arteries is better appreciated on the cross-sectional imaging previously. Calcification of the aortic knob is moderate to severe, unchanged. Surgical clips projecting over the left axilla and right upper quadrant are unchanged. The patient has had prior left mastectomy. There may be calcification of the anterior longitudinal ligament and mild degenerative changes in the visualized thoracic spine. IMPRESSION: 1. Increased left hemithorax opacity on the frontal view over the last 2 exams could be atelectasis or developing infection or consolidation appropriate clinical situation. If there is high concern CT could be helpful to further evaluate. 2. Mild cardiomegaly without frank pulmonary edema. " 8df91244-178764bf-c46dc2c3-29ebccd7-e16f58d6.jpg,test/p13/p13090933/s50176947/8df91244-178764bf-c46dc2c3-29ebccd7-e16f58d6.jpg,test," FINAL REPORT HISTORY: Spinal stenosis, pre-op. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There is minimal left base atelectasis. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " 678d0394-3f417678-dd75a2a1-afaaeac2-dec2cecb.jpg,test/p15/p15471650/s51538450/678d0394-3f417678-dd75a2a1-afaaeac2-dec2cecb.jpg,test," WET READ: ___ ___ ___ 2:19 PM Standard positioning of the endotracheal tube. Enteric tube tip is within the stomach, though side port is just above the gastroesophageal junction. For optimal positioning, recommend advancement of the enteric tube by approximately 7 cm. No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with intubated TECHNIQUE: Portable supine AP view of the chest COMPARISON: None. FINDINGS: Endotracheal tube tip terminates 6.9 cm from the carina. Enteric tube tip is within the stomach, but side port is above the gastroesophageal junction. Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality visualized. IMPRESSION: 1. Standard positioning of the endotracheal tube. 2. Enteric tube tip is within the stomach, though side port is just above the gastroesophageal junction. For optimal positioning, recommend advancement of the enteric tube by approximately 7 cm. 3. No acute cardiopulmonary abnormality. " e519787b-104e3e8f-f115ebd6-71f45046-b49ce7db.jpg,test/p14/p14558435/s58989259/e519787b-104e3e8f-f115ebd6-71f45046-b49ce7db.jpg,test," FINAL REPORT INDICATION: Fever, evaluate for pneumonia. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiograph demonstrates unremarkable cardiomediastinal and hilar contours. Platelike atelectasis is noted within the right mid lung. Otherwise, the lungs are clear without focal opacification concerning for pneumonia. Right-sided chest tube in place with a small residual pleural effusion, decreased compared to prior study. Incompletely visualized percutaneous abdominal drain is coiled anterolateral to hepatic dome. CBD stent is incompletely visualized. No pneumothorax. IMPRESSION: No focal opacification concerning for pneumonia. Interval decrease in right-sided pleural effusion, now small in size. Right-sided chest tube and a percutaneous abdominal drain noted. " 0b6c9e87-74d066a9-c9b96966-02c345f9-88c47417.jpg,test/p18/p18169012/s53564232/0b6c9e87-74d066a9-c9b96966-02c345f9-88c47417.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever // ?consolidation TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild cardiomegaly and tortuous aorta are stable. Pacer leads are in standard position. There is mild vascular congestion. There is no evident pneumothorax, pleural effusion or pneumonia. " 02827765-0dadc6a9-147bdaa0-062df4f6-22d5471a.jpg,test/p15/p15797232/s56075244/02827765-0dadc6a9-147bdaa0-062df4f6-22d5471a.jpg,test," FINAL REPORT HISTORY: Intubated on a ventilator. Evaluate for infiltrate. TECHNIQUE: Semi-erect portable frontal view of the test. COMPARISON: Chest radiographs ___ and ___. CT torso ___. FINDINGS: An endotracheal tube at the orifice of the right mainstem bronchus. A left subclavian catheter terminates in the distal SVC. There catheter is noted within the stomach. The lung volumes are low, which results in crowding of the bronchovascular structures. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are unchanged. Retained enteric contrast is seen within the descending colon. IMPRESSION: Endotracheal tube at the orifice of the right mainstem bronchus. Repositioning is recommended. These findings were discussed with ___, NP by Dr. ___ at 10:55 on ___ by telephone at the time of discovery. " f67ffc92-c2cbdffe-f5616d21-f5f13204-ee0fc1f6.jpg,test/p17/p17487379/s57230210/f67ffc92-c2cbdffe-f5616d21-f5f13204-ee0fc1f6.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient status post pericardial window placement, now status post removal of chest tube, evaluate for pneumothorax. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding portable chest examination of ___. Previously identified pleural drainage tube at right lower base has been removed. Mild degree of pleural blunting is noted. The right pulmonary parenchyma remains well aerated, but the entire right lung is surrounded by a small pleural separation with an apically seen up to 2 cm wide pneumothorax. The mid portion of the chest demonstrates an air-fluid level surrounds the aerated lung, indicating the presence of a hydropneumothorax. No new parenchymal abnormalities are present. In the left hemithorax, findings remain unremarkable with an unchanged appearance of a linear plate atelectasis in the mid lung field. Position of previously described left internal jugular approach central venous line remains unchanged. IMPRESSION: Small apical pneumothorax with hydropneumothorax level in mid chest surrounding rather well aerated lung. " 64b3cc54-034ddde7-08914efa-87b84c03-bfedf0aa.jpg,test/p11/p11710223/s53645199/64b3cc54-034ddde7-08914efa-87b84c03-bfedf0aa.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p R VATS wedge resection x 2, s/p chest tube pull // please perform at 12:30 pm; s/p chest tube pull TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ and ___, and CT of the chest dated ___. FINDINGS: There are low lung volumes, which results in bronchovascular crowding. Linear opacity at the right base is most consistent with atelectasis. Atelectasis is also seen at the left base. There are small bilateral pleural effusions. There has been interval removal of the right-sided chest tube. No pneumothorax. Suture material projects over the right mid lung, consistent with history of VATS wedge resection. IMPRESSION: 1. No pneumothorax. 2. Bibasilar atelectasis. " 7cda882e-2e6d51ad-60cd7f83-6940b748-9060e639.jpg,test/p14/p14530916/s50562798/7cda882e-2e6d51ad-60cd7f83-6940b748-9060e639.jpg,test," FINAL REPORT INDICATION: ___-year-old male with lightheadedness and fatigue, evaluate for pneumonia. COMPARISON: ___. CHEST, PA AND LATERAL: The lungs are clear. Heart size is top normal. The aorta is tortuous and unfolded. There are no pleural effusions or pneumothorax. Moderate S-shaped scoliosis, with large bridging anterior osteophytes. IMPRESSION: No acute cardiopulmonary process. " b9c0c489-ee7037ab-15931471-b936d6ca-5a35deee.jpg,test/p14/p14320851/s53681278/b9c0c489-ee7037ab-15931471-b936d6ca-5a35deee.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with worsening of R sided dysmetria and ? neg CTH // ? recurdescence of stroke sxs - evaluate for infection TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. There is small linear atelectasis at the left lung base. The lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 74333f52-3c4cb4ae-39f96a19-4ecc790d-4c9ea2ed.jpg,test/p12/p12784119/s51796692/74333f52-3c4cb4ae-39f96a19-4ecc790d-4c9ea2ed.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough, chills, myalgias, HIV // PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There has been interval improvement in right-sided parenchymal opacities which have essentially resolved. No new focal consolidation is seen. Blunting of the left costophrenic angle is re- demonstrated. No right pleural effusion is seen. There is no pneumothorax. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Interval improvement in previously seen right-sided parenchymal opacities which are now essentially resolved. Trace left pleural effusion. " 2fdfd0a9-b7fbb781-5b862897-2413b8f9-5b6fd4c6.jpg,test/p15/p15340094/s58000720/2fdfd0a9-b7fbb781-5b862897-2413b8f9-5b6fd4c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with left hip pain after fall from standing at home. Reports chronic cough // Please eval for any PNA/infection COMPARISON: Chest x-ray from ___. Targeted review of abdominal ct from ___. Chest CT from ___ is off line and not immediately available for comparison. FINDINGS: There is probable background hyperinflation, consistent with COPD. The heart size is at the upper limits of normal. The aorta is calcified minimally unfolded. There is upper zone redistribution, but no overt CHF. There is blunting of the right costophrenic angle, with minimal patchy density there, which appears to represent a long-standing finding and is seen on the radiograph from ___. There appears to be an adjacent skin fold on today's examination. There is minimal density overlying the apex of the heart --? confluence of shadows from the bone, heart and vessels. This was not seen on the ___ chest x-ray. There is minimal atelectasis at the left lung base, which is also slightly more pronounced . No focal consolidation or effusion is identified. Clips noted in the right upper quadrant of the abdomen. IMPRESSION: 1. Probable background COPD. 2. Doubt acute pulmonary process. 3. Blunting of the right costophrenic angle again noted. 4. Focal density at the left heart apex most likely represents confluence of vascular and osseous shadows. Recommend followup radiograph in ___ months to document clearing. " b376a016-7c98f400-7fce16be-964f08a5-2deba0eb.jpg,test/p15/p15058800/s57726034/b376a016-7c98f400-7fce16be-964f08a5-2deba0eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with multiple myeloma, now relpased., c/o new shortness of breath // volume overload, effusions TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Stable cardiomegaly and tortuosity of the thoracic aorta. The pulmonary vasculature is normal. Lungs are clear except for new linear bibasilar atelectasis. . No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Bones are demineralized and mild compression deformity in the mid thoracic spine is unchanged. IMPRESSION: Linear bibasilar atelectasis. " 8c06fa9e-00e5a318-0266eeb3-c9c3c2ae-89e4cd5f.jpg,test/p16/p16497592/s59108834/8c06fa9e-00e5a318-0266eeb3-c9c3c2ae-89e4cd5f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 2 wks of coughing // pneumonia pneumonia IMPRESSION: Comparison ___. No relevant change. No evidence pneumonia or other pathologic condition of the lung parenchyma. Mild bilateral apical scarring. No pleural effusions. Normal size of the heart. " fd463347-08e2a16d-031d3068-22548fd9-52a1ca78.jpg,test/p13/p13158876/s56801493/fd463347-08e2a16d-031d3068-22548fd9-52a1ca78.jpg,test," WET READ: ___ ___ 3:13 PM New right IJ central venous catheter terminating at the upper right atrium. No pneumothorax. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: New right IJ catheter. TECHNIQUE: Frontal chest radiograph. COMPARISON: Radiograph ___. CT Torso ___. FINDINGS: A new right IJ catheter terminates in the right atrium. The heart size is top normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, pleural effusion, or focal consolidation. The patient is post cholecystectomy. A left upper lobe pulmonary nodule is better seen on the CT from ___. IMPRESSION: New right IJ central venous catheter terminating at the right atrium. No pneumothorax. " 728971aa-b854370d-c810146e-133eedb3-ee9bb7f9.jpg,test/p19/p19231238/s56334671/728971aa-b854370d-c810146e-133eedb3-ee9bb7f9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with borderline CXR for PNA presents with agitation, now on abx with elevating leukocytosis. Would like to know certainty of pulmonary source of infection after pt has been hydrated // please re-evaluate for PNA TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: Cardiac enlargement. Pulmonary vascularity has mildly improved. Interstitial edema has improved. Mild left pleural effusion is more prominent. Very shallow inspiration on the lateral radiograph. Bibasilar opacities have improved. Metallic density projected over upper abdomen. IMPRESSION: Improved pulmonary edema and pulmonary vascularity. Left pleural effusion is more prominent. Bibasilar opacities are improved. " 030e12b8-a7979619-3d2fa9be-ddfdf9ad-3df16ecd.jpg,test/p10/p10774120/s58390648/030e12b8-a7979619-3d2fa9be-ddfdf9ad-3df16ecd.jpg,test," FINAL REPORT INDICATION: Cough and fever. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. Subtle opacities adjacent to the left heart border represent crossing of anterior and posterior ribs. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 45f46882-ef0eab9e-f5d3210e-f54f8c29-1f5aed72.jpg,test/p11/p11586698/s53379043/45f46882-ef0eab9e-f5d3210e-f54f8c29-1f5aed72.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of GPA, now with recurrent synovitis in B/L knees and hands // GPA manifested with DAH and ILD: please evaluate for changes c/w evolving lung vasculitis, compared to prior CXR GPA manifested with DAH and ILD: please evaluate for changes c/w evolving lung vasculitis, compared to prior CXR IMPRESSION: In comparison with the study of ___, there again are low lung volumes. The cardiac silhouette is within normal limits. There is again some prominence of interstitial markings, though less on than on the previous study, consistent with interstitial lung disease. The improvement may reflect some decrease in pulmonary vascular congestion. Blunting of both costophrenic angles process and there are some atelectatic changes at the bases. " eedcf4f0-6e9c325e-e3b65ed3-aecea573-b71291b7.jpg,test/p12/p12431768/s56491967/eedcf4f0-6e9c325e-e3b65ed3-aecea573-b71291b7.jpg,test," FINAL REPORT INDICATION: Dyspnea. Evaluate for interval change in pneumonia. The patient also has history of left shoulder trauma with tenderness. COMPARISON: ___, ___, ___. FRONTAL AND LATERAL CHEST: There is no focal consolidation, pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes and hilar contours are normal. The retrocarinal opacity described on ___ is less apparent on this study. Heart size is top normal. The patient had history of trauma two weeks ago with left shoulder pain. No definite fracture is seen. If there is clinical concern for shoulder pathology, dedicated shoulder radiographs could be performed. Dr. ___ ___ the findings with Dr. ___ by phone at 12:47 a.m. on ___. " 5be88028-64aad0cf-3d536a6f-d16a6dc5-5dbf749e.jpg,test/p18/p18651563/s52713163/5be88028-64aad0cf-3d536a6f-d16a6dc5-5dbf749e.jpg,test," FINAL REPORT HISTORY: ___-year-old female with cough and fever for three days. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs demonstrate subtle wispy opacity in the left upper lobe, not present on prior exam. Flattened hemidiaphragms suggest chronic obstructive disease. There is no pleural effusion or pneumothorax. Bilateral glenohumeral joint degenerative changes are noted. IMPRESSION: Subtle wispy opacity in the left upper lobe may represent early pneumonia; recommend follow-up to resolution to exclude underlying mass. " 91fea541-2ff9fb67-de3c9030-f50c3461-543cecac.jpg,test/p19/p19358609/s56123546/91fea541-2ff9fb67-de3c9030-f50c3461-543cecac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, dyspnea // pneumonia pneumonia COMPARISON: ___ IMPRESSION: There is no change in the deformity of the left chest. Heart size and mediastinum are stable in appearance. Scarring in the right apex is unchanged. No definitive new consolidation to suggest interval development of infectious process demonstrated. No pleural effusion is seen. No pneumothorax is seen. " dcf1723c-c804ad67-bb6a5b03-c3719aa0-adfabf9a.jpg,test/p16/p16939016/s58439212/dcf1723c-c804ad67-bb6a5b03-c3719aa0-adfabf9a.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man s/p cabg with unstable hct // eval for hemothorax TECHNIQUE: Portable chest radiograph COMPARISON: Portable chest radiograph dated ___ at 08:17 FINDINGS: In comparison to the chest radiograph obtained approximately 8 hours prior, a small, right pleural effusion is now evident. Small, left pleural effusion and adjacent atelectasis are unchanged. Moderate cardiomegaly is unchanged, but mediastinal widening and pulmonary vascular congestion are improved. Lungs are otherwise clear without focal consolidation. A right-sided IJ central venous catheter terminates in the right atrium via. A left-sided IJ central venous catheter terminates in mid SVC. An ET tube tip terminates 3 cm above the carina. An enteric tube passes subdiaphragmatically, but terminates outside the field of view. IMPRESSION: Newly appreciated small right pleural effusion and unchanged small left pleural effusion may be compatible with a hemothorax. Mediastinal widening and pulmonary edema otherwise improved. " 916b71c5-ee108c9c-bf13dfb5-85b560ae-de0179b4.jpg,test/p10/p10046679/s57374230/916b71c5-ee108c9c-bf13dfb5-85b560ae-de0179b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETT for respiratory failure // Eval for ETT placement TECHNIQUE: Single frontal view of the chest COMPARISON: Portable chest radiograph taken earlier on the same day on ___:___ FINDINGS: ET tube is 5 cm above the carina. Interval placement of NG tube as well with distal portion traversing B on the diaphragm and extending beyond the lower margins of the film. Right subclavian PICC with tip in the SVC, position unchanged. Low lung volumes bilaterally. There is a new left mid lung opacity consistent with pneumonia. There is increased opacity in the left lung base obscuring the left hemidiaphragm consistent with left lower lobe collapse and pleural effusion. There is inferior displacement of the minor fissures consistent with volume loss and increased collapse of the right middle lobe. Cardiac size appears enlarged in this portable view but unchanged from previous. There is no pneumothorax. IMPRESSION: Left mid lung pneumonia Left lower lobe collapse with pleural effusion Increased right middle lobe volume loss and collapse ET tube tip is 5 cm above carina NOTIFICATION: The findings were discussed with Dr. ___, ___D. by ___, ___D. on the telephone on ___ at ___:___ AM, ___ minutes after discovery of the findings. " 278973f2-3761f492-c6e77f55-baa196a0-df624841.jpg,test/p19/p19650702/s51814494/278973f2-3761f492-c6e77f55-baa196a0-df624841.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p tracheobronchoplasty p/w septic shock, leukocytosis resolving // perform at 8am on ___. r/o interval change TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Compared to ___, the right perihilar heterogeneous opacity has minimally improved and could represent residual edema or pneumonia. There is mild vascular congestion. Mild cardiomegaly is stable. No pleural effusion. No pneumothorax. Right PIC line terminates at the cavoatrial junction. IMPRESSION: Questionable right perihilar residual edema or small pneumonia, minimally improved from ___. Mild vascular congestion. Stable mild cardiomegaly. " a2b66c0b-6e43cc2e-bd46ba10-198b87be-dcc26c44.jpg,test/p12/p12349570/s59579057/a2b66c0b-6e43cc2e-bd46ba10-198b87be-dcc26c44.jpg,test," FINAL REPORT INDICATION: Right arm pain and dizziness for six weeks after stroke. COMPARISON: ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. There are mild degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 82f19ee6-5e3b618b-75cc3593-c0bc3c05-db304122.jpg,test/p17/p17070596/s55852470/82f19ee6-5e3b618b-75cc3593-c0bc3c05-db304122.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lung cancer and chest tube. // interval change interval change IMPRESSION: Compared to chest radiographs ___ through ___. Left pleural abnormality, including nodular thickening and small residual effusion, and substantial left basilar atelectasis, unchanged, pleural drainage tube still in place. Heart size top-normal. Mediastinum midline. Right lung and pleural space normal. " 085c96a0-b082ae78-19960a4d-42541090-c3dda630.jpg,test/p16/p16571206/s50183310/085c96a0-b082ae78-19960a4d-42541090-c3dda630.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with nephrotic syndrome likely MCD. Patient with anasarca who developed a cough overnight. Lungs clear. // Rule out pneumonia, pulmonary edema Rule out pneumonia, pulmonary edema IMPRESSION: Impression with the study of ___, there are again are bilateral pleural effusions. All mild areas of atelectasis are seen at the bases, especially on the left. " 24168ae8-d0a9aec8-7ddb28ef-844d097e-b7e3e76a.jpg,test/p11/p11440576/s52282166/24168ae8-d0a9aec8-7ddb28ef-844d097e-b7e3e76a.jpg,test," FINAL REPORT INDICATION: Chest pain and upper back pain. Evaluate for pneumonia or heart failure. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___ and coronary CTA ___. FINDINGS: The lungs are clear and the lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart is mildly enlarged and unchanged. There is no pulmonary edema. The mediastinal and hilar contours are unremarkable. A discontinuous wire in the anterior mediastinum is unchanged IMPRESSION: No acute cardiopulmonary process with stable mild cardiomegaly. " cc96a2de-34195bbd-99483ebd-6c45456d-62999c28.jpg,test/p17/p17159286/s56218871/cc96a2de-34195bbd-99483ebd-6c45456d-62999c28.jpg,test," WET READ: ___ ___ ___ 7:58 PM Interval placement of a ETT terminating 7.0 cm above the carina. A nasogastric tube courses into the stomach. Lungs appear relatively well expanded and clear. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESRD, seizure, intubated // ET Tube placement ET Tube placement COMPARISON: ___ IMPRESSION: ET tube tip is 7 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are stable. Lungs are well expanded. There is interval improvement of the left basal consolidation. No vascular congestion demonstrated. " abcbbdf0-5bb78c43-f5e343aa-36b066d7-4172bfeb.jpg,test/p11/p11494804/s56623444/abcbbdf0-5bb78c43-f5e343aa-36b066d7-4172bfeb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever, h/o cholangiocarcinoma // pna? COMPARISON: ___ and ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. CBD stent is partially imaged in the upper abdomen. IMPRESSION: No acute intrathoracic process. " 4f7b4453-6a54e8f5-8de3809d-cfa4a82a-608c61fc.jpg,test/p13/p13628037/s59257353/4f7b4453-6a54e8f5-8de3809d-cfa4a82a-608c61fc.jpg,test," FINAL REPORT HISTORY: AML, pre-bone marrow transplant. FINDINGS: The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Central catheter extends to the mid to lower portion of the SVC. " c431e57c-7544689d-23f30bbb-81fa0667-ef974abe.jpg,test/p17/p17396346/s54011073/c431e57c-7544689d-23f30bbb-81fa0667-ef974abe.jpg,test," FINAL REPORT INDICATION: ___ year old woman with severe COPD, OSA, hypoxemia // any edema? effusion? consolidation? TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: There is significantly worse bilateral pulmonary edema. There is bilateral pleural effusion. The heart is enlarged but unchanged. The mediastinum is normal. No pneumothorax. No fractures. IMPRESSION: Worsening pulmonary edema. " a7ae0c27-73fe32bb-6d9fd821-4b8a0d03-0ced0365.jpg,test/p14/p14319319/s52885023/a7ae0c27-73fe32bb-6d9fd821-4b8a0d03-0ced0365.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Lower chest pain bilaterally. Question infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral views chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 197dfe56-22c0cb9c-42d98d7e-fac31f29-1723d412.jpg,test/p13/p13204581/s55746711/197dfe56-22c0cb9c-42d98d7e-fac31f29-1723d412.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p esophagectomy // check interval change check interval change IMPRESSION: Comparison to ___. Improved ventilation of the retrocardiac lung regions. Stable appearance of the postoperative esophagus in right paramediastinal location. No pneumonia, no pneumothorax, no pleural effusions. " 4e6b2f27-374ba74c-fc5206ef-1ea12563-91d06285.jpg,test/p14/p14477164/s59500236/4e6b2f27-374ba74c-fc5206ef-1ea12563-91d06285.jpg,test," WET READ: ___ ___ ___ 12:47 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with epigastric pain, equivocal murphys, known gall stones, sob // ? infection, cardiac abnormality; ? gall stones, cholecystitis TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___, and CT of the torso dated ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unchanged. The aorta is tortuous. A nodular opacity projecting over the left upper lung appears unchanged from ___, and is without anatomical correlate on CT torso from ___ although may be related to fragmented ossification at the first rib costochondral junction. Degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary process seen. " c662e4ab-2514a734-9b60730f-8c355fa0-702c7eb5.jpg,test/p15/p15152711/s52127538/c662e4ab-2514a734-9b60730f-8c355fa0-702c7eb5.jpg,test," FINAL REPORT INDICATION: ___ year old woman with Alcohol cirrhosis // new liver transplant evaluation, assess for cardiopulmonary abnormalities TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, ___ outside chest CT FINDINGS: Lung volume is low. There is no consolidation, pneumothorax, or pleural effusion. Cardiomediastinal silhouette is normal size. Multiple old healed fractures are noted on the right. Multiple compressive deformities of the thoracic spine are unchanged. IMPRESSION: No acute cardiopulmonary process. " 86e72e2a-75141de8-a0ee9423-c9177a9b-392bd582.jpg,test/p10/p10046679/s52056662/86e72e2a-75141de8-a0ee9423-c9177a9b-392bd582.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hx CHF, rhoncorous breath sounds // Eval for fluid overload Eval for fluid overload IMPRESSION: Comparison to ___. The patient is extubated. The feeding tube is in stable position. Stable low lung volumes with bilateral areas of atelectasis and moderate cardiomegaly. Minimal left pleural effusion persists. No pulmonary edema. No new focal parenchymal opacities. " 801d021c-61fc9b9c-a4cef098-7c707af3-745f107b.jpg,test/p14/p14828338/s53877380/801d021c-61fc9b9c-a4cef098-7c707af3-745f107b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hairy cell leukemia with cough and fever // ? infiltrate ? infiltrate IMPRESSION: Compared to chest radiographs since ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. A 24 mm wide irregular metal fragment projecting over the left trapezius region is seen only on the frontal view and I cannot tell whether it is extrathoracic are not. " d639c514-1b57da74-68732c6e-f4da3d37-532d3884.jpg,test/p17/p17284612/s50414542/d639c514-1b57da74-68732c6e-f4da3d37-532d3884.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with a productive cough for two days. Question pneumonia. IMPRESSION: AP chest compared to ___: Due to limitations of imaging in patient of this size, I cannot be sure whether there is new consolidation in the right middle lobe, but that is suggested by both frontal and lateral views. I would treat the patient for pneumonia. Lungs are otherwise clear. The heart is mildly enlarged, and there is some vascular congestion but no pulmonary edema or pleural effusion. " d634c2ad-722be49e-e234683b-e7971f2f-6294e5ff.jpg,test/p19/p19659826/s51095833/d634c2ad-722be49e-e234683b-e7971f2f-6294e5ff.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with mvc rib pain thoracic pain // r/o rib fractures t spiner ractures r/o rib fractures t spiner ractures IMPRESSION: There no prior chest radiographs available for review. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referrable focal findings should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning. " 53e60b80-aede3a29-7aaec401-546585d9-bfac12e3.jpg,test/p19/p19973946/s54591438/53e60b80-aede3a29-7aaec401-546585d9-bfac12e3.jpg,test," FINAL REPORT HISTORY: Cough for ___ years. Worsening over the past 2 weeks. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Peribronchial cuffing in the periohilar region is identified. There is no focal opacity, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: Nonspecific peribronchial cuffing in the perihilar region could indicate acute or chronic bronchitis or asthma. " aa1dda68-a5cb5c3d-1e860a73-a9246c8b-0672380b.jpg,test/p13/p13654589/s57495053/aa1dda68-a5cb5c3d-1e860a73-a9246c8b-0672380b.jpg,test," FINAL REPORT INDICATION: ___M with cp // eval for pleural effusion/ptx TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Coronary artery stent is noted. Atherosclerotic calcifications are noted at the aortic arch. Median sternotomy wires are intact. Surgical clip projects over the right upper lung and in the right upper quadrant. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 3532e175-63b7f41d-c1471d4d-a5510d68-4d337e8c.jpg,test/p17/p17788664/s56243811/3532e175-63b7f41d-c1471d4d-a5510d68-4d337e8c.jpg,test," FINAL REPORT HISTORY: Sternal chest discomfort for two months. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top normal with mild unfolding of the thoracic aorta. Hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. There is no destructive rib fracture. IMPRESSION: No acute intrathoracic process. " 37a6d323-61c543ed-673d5e19-71327b01-82e9643b.jpg,test/p16/p16700191/s51451270/37a6d323-61c543ed-673d5e19-71327b01-82e9643b.jpg,test," FINAL REPORT INDICATION: ___ year old woman with daily cough on Humira. // ? cadiopulmonary disease TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral views the chest demonstrate well expanded clear lungs. The cardio mediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. Note is made of calcified atherosclerotic plaque in the aortic arch and right carotid artery. IMPRESSION: No acute cardiopulmonary process. " f3f0359a-2a84f407-fefaa975-e88acce4-812aec85.jpg,test/p10/p10436993/s56716945/f3f0359a-2a84f407-fefaa975-e88acce4-812aec85.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Fever. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " 2e7efdcc-614990bd-6d9078c8-a3ed2531-b1506109.jpg,test/p15/p15571472/s56799757/2e7efdcc-614990bd-6d9078c8-a3ed2531-b1506109.jpg,test," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest radiograph ___ and CT torso ___. FINDINGS: The patient is status post right pneumonectomy with evidence of volume loss in the right hemithorax, including rightward shift of mediastinal structures. Assessment of the cardiac and mediastinal contours is limited due to the post pneumonectomy changes. Left lung demonstrates mild atelectatic changes in the lung base. No focal consolidation or pleural effusion is seen. No pulmonary vascular engorgement is noted. There is no pneumothorax within the left hemithorax. Diffuse demineralization of the osseous structures is noted. IMPRESSION: Status post right pneumonectomy. Mild left basilar atelectasis, without evidence for pneumonia. " 6f778fc3-fa3adb24-5783ee88-a16b9653-4ac6828a.jpg,test/p17/p17957742/s58907536/6f778fc3-fa3adb24-5783ee88-a16b9653-4ac6828a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG // eval for infiltrate/ effusion IMPRESSION: As compared to prior radiograph of ___, asymmetrically distributed combined alveolar and interstitial opacities have worsened, particularly in the left mid lung. These findings may be due to asymmetrical edema with or without superimposed secondary process such as infectious pneumonia or aspiration. Bibasilar atelectasis has worsened on the right and improved on the left, and note is made of small bilateral pleural effusions but no visible pneumothorax. " 90aa9454-b3d9ccad-3fe9f717-23953351-ade10c45.jpg,test/p17/p17556194/s57701708/90aa9454-b3d9ccad-3fe9f717-23953351-ade10c45.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new PEG placement and Trach placement. Please perform xray to assess both trach and PEG. // assess trach/PEG placement IMPRESSION: Since a recent radiograph of ___, the patient has undergone placement of a tracheostomy tube, in standard position, with no evidence of pneumomediastinum or pneumothorax. There has also been interval placement of a PEG in the left mid abdomen, which likely accounts for development of marked pneumoperitoneum. Exam is otherwise similar to the recent study except for removal of a nasogastric tube and endotracheal to. " 72235eef-3f777783-2cca2fae-758a0721-dfae6ead.jpg,test/p11/p11621459/s59949908/72235eef-3f777783-2cca2fae-758a0721-dfae6ead.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Fever and tachycardia. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is minimal atelectasis in the right middle lobe, as before. Otherwise, the lungs appear clear. A central venous catheter has been removed. IMPRESSION: No evidence of acute cardiopulmonary disease. " f7b94d04-8deb1f30-384f6649-af040159-af10d5ff.jpg,test/p13/p13089395/s57015385/f7b94d04-8deb1f30-384f6649-af040159-af10d5ff.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left chest wall pain after motor vehicle collision TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph and chest CTA ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear and pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 09ed8ba4-73e4ab17-d95babbd-6555b283-11a09022.jpg,test/p11/p11874868/s54138117/09ed8ba4-73e4ab17-d95babbd-6555b283-11a09022.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain // eval for infiltrate TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: No acute intrathoracic process. " ff4e2f6d-d834a36a-56c406f4-3170978a-1a71a408.jpg,test/p15/p15904475/s51056794/ff4e2f6d-d834a36a-56c406f4-3170978a-1a71a408.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with shortness of breath. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___, ___, and ___. FINDINGS: Compared with the prior study, marked cardiomegaly, pulmonary vascular congestion, and edema have improved, but are persistent. Lungs demonstrate improved aeration. No new focal consolidation or pleural effusions. No pneumothorax identified. IMPRESSION: Interval improvement, but persistence of, marked cardiomegaly, pulmonary vascular congestion, and pulmonary edema. No new focal consolidation. " 106cd8e3-a7d91453-5ae84bdc-e797402f-16e0e876.jpg,test/p13/p13600861/s56574538/106cd8e3-a7d91453-5ae84bdc-e797402f-16e0e876.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with Gram-positive cocci pneumonia on chest x-ray, bilateral infiltrates. COMPARISON: ___. FINDINGS: Bilateral widespread opacities have significantly worsened since previous exam. There is no pneumothorax or pleural effusion. ET tube ends 2.8 cm above the carina. Right jugular line is in upper atrium. NG tube is in the stomach. Mediastinal and cardiac contours are top normal. CONCLUSION: Bilateral widespread opacities have significantly worsened. It could be due to real progression of the pneumonia or change in the ventilation parameters. This was discussed with the medical team at 9:37 a.m. " 31f7f528-72efb83c-da2bdb64-9d33dbb3-14fae5c2.jpg,test/p14/p14328615/s50835941/31f7f528-72efb83c-da2bdb64-9d33dbb3-14fae5c2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Weight loss, history of smoking, dullness at the right lung base. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is new appearance of a moderate to severe right pleural effusion. The effusion occupies almost half of the right hemithorax. Subsequently, areas of right basal atelectasis are present. The presence of additional pathology, marked by the large effusion, cannot be excluded. On the left, there is no evidence of abnormalities. No left pleural effusions. The left aspects of the cardiac silhouette are unchanged. No evidence of mediastinal or hilar disease. Moderate tortuosity of the thoracic aorta. At the time of dictation, the referring physician, ___. ___, was paged for notification at 1:23 p.m., ___. " 58b58758-1d172a6d-7e64386e-21f580d8-181ca33a.jpg,test/p14/p14085350/s50767046/58b58758-1d172a6d-7e64386e-21f580d8-181ca33a.jpg,test," WET READ: ___ ___ ___ 9:23 PM Slightly low lung volumes with no acute cardiopulmonary process. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Cough, to assess for pneumonia. FINDINGS: In comparison with the earlier study of this date, there is little change and no evidence of acute pneumonia, vascular congestion or pleural effusion. " 62e795e0-d6d5effd-ef24234d-16236a43-55ae010e.jpg,test/p18/p18658996/s59039616/62e795e0-d6d5effd-ef24234d-16236a43-55ae010e.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cryptogenic cirrhosis and chronic effusions due to MALT lymphoma. Question NG tube placement. COMPARISON: ___. FINDINGS: Single frontal view of the chest demonstrates a new enteric tube traversing below the diaphragm, out of view, in good location. The cardiac silhouette is prominent. The mediastinal and hilar contours are within normal limits. There is interval increased vascular congestion and development of mild pulmonary edema. There are bilateral pleural effusions, increased on the left, with new subsegmental atelectasis in the lingula. IMPRESSION: Appropriate NG tube placement. " de44cf41-47132fee-77645fc4-02c4dfea-a342ea5f.jpg,test/p12/p12822417/s53064922/de44cf41-47132fee-77645fc4-02c4dfea-a342ea5f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cardiogenic shock // Eval for line and ETT placement, pulmonary edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 5.6 cm above the carinal. NG tube tip terminates most likely at or right be for the gastroesophageal junction with the side hole being in the distal esophagus and should be further advanced. Cardiomediastinal silhouette is unchanged as well as the degree of cardiomegaly, mild interstitial pulmonary edema and most likely present bilateral pleural effusions. There is no pneumothorax. " 31d9173d-69a8eb34-e6709521-e50c77b3-016623b2.jpg,test/p14/p14562427/s56214042/31d9173d-69a8eb34-e6709521-e50c77b3-016623b2.jpg,test," FINAL REPORT HISTORY: History of anemia, hyperlipidemia and MRSA/strep bacteremia presents with fevers and chills. Evaluate for acute cardiopulmonary process. TECHNIQUE: PA and lateral chest radiographs were provided. COMPARISON: None. FINDINGS: The lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 30bb4bc7-69aee5c8-3a085d74-52ec34e1-590b06ab.jpg,test/p14/p14213883/s59127645/30bb4bc7-69aee5c8-3a085d74-52ec34e1-590b06ab.jpg,test," FINAL REPORT INDICATION: ___-year-old man with a history of end-stage renal disease, status post kidney transplant, presents to the clinic with increasing fatigue and dyspnea on exertion and chest congestion. Rule out pulmonary edema. COMPARISON: Preop chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal, and hilar contours are unchanged. Pleural thickening within both lung bases is unchanged from the prior examinations. Opacification in the right lower lung medial base is consistent with right lower lobe pneumonia. Findings were discussed with Dr. ___ at 16:31 on ___ via telephone. " 1ceeb528-a73ea27c-75d56d3d-aea09d9a-1f75c39a.jpg,test/p11/p11822564/s50697152/1ceeb528-a73ea27c-75d56d3d-aea09d9a-1f75c39a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, ___ CT chest FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " c75431b3-f7013723-16139f57-dbe5ebdb-012e77cc.jpg,test/p19/p19791816/s55634813/c75431b3-f7013723-16139f57-dbe5ebdb-012e77cc.jpg,test," WET READ: ___ ___ ___ 8:01 PM The endotracheal tube ends 4 cm above the carinal, in appropriate position. The lungs, heart, pleural and mediastinal surfaces are stable. ___ ___ ___. WET READ VERSION #1 ___ ___ ___ 8:00 PM The endotracheal tube ends 4 cm above the carinal, in appropriate position. The lungs, heart, pleural and mediastinal surfaces are stable. ___ ___ ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p intubation // ETT in right place? ETT in right place? IMPRESSION: In comparison with the earlier study of this day, the endotracheal tube tip lies approximately 4 cm above the carina. Nasogastric tube extends into the stomach. Little change in the appearance of the heart and lungs and extensive pleural calcification. " aa42453b-c77357a1-0304ae1c-2bbc3d3c-233a275e.jpg,test/p13/p13997228/s54497505/aa42453b-c77357a1-0304ae1c-2bbc3d3c-233a275e.jpg,test," FINAL REPORT INDICATION: ___-year-old female with ongoing cough for the last three weeks, reactive airway symptoms. Evaluate for evidence of infiltrative processes. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiographic examination. " 00cc85d6-f2a60700-529ee8b0-3fd6ebf0-bedd7c5c.jpg,test/p11/p11069386/s56372120/00cc85d6-f2a60700-529ee8b0-3fd6ebf0-bedd7c5c.jpg,test," FINAL REPORT INDICATION: Syncope. Question infection. COMPARISONS: Multiple prior chest radiographs, most recently from ___. FINDINGS: Single portable upright chest radiograph was provided. Again seen is prominence of the interstitial markings, similar to the prior studies, compatible with chronic lung disease. There is no superimposed pulmonary edema or focal consolidation. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unchanged. The bones are intact. IMPRESSION: No acute cardiopulmonary process. Chronic interstitial lung disease. " 91b67490-73bd8a41-339cc85f-64de9e55-fd1c416b.jpg,test/p17/p17490954/s51816377/91b67490-73bd8a41-339cc85f-64de9e55-fd1c416b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with dementia, acute mental status change and possible syncope with fall. COMPARISON: Chest radiograph ___, ___. TECHNIQUE: Fontal and lateral views of the chest were obtained. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well expanded. The previously seen focal area of increased density at the right lung base has improved; however, there is vague, more diffuse, subtle increased density at the right lung base, which may reflect an ongoing infectious process. The left lung is essentially clear. Multiple healed rib fractures of the left upper posterior ribs are again noted as well as chronic abnormalities of the right posterior rib 6. The upper abdomen is unremarkable. IMPRESSION: Persistent subtle vague increased density at the right lung base, which may indicate a residual consolidation. " 12592bef-cfe1d363-fd9ae251-726ed316-d9a22263.jpg,test/p17/p17982558/s51166477/12592bef-cfe1d363-fd9ae251-726ed316-d9a22263.jpg,test," FINAL REPORT INDICATION: Cough for three days. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal, and hilar contours are normal. Consolidative opacity in the anterior basal right lower lobe is compatible with pneumonia. The left lung is clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Right lower lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. " 2a45ce12-39d3088f-2d4bcfde-1baeb55b-1738268f.jpg,test/p12/p12772508/s52977522/2a45ce12-39d3088f-2d4bcfde-1baeb55b-1738268f.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest x-ray. INDICATION: A ___-year-old man with altered mental status and hypoglycemia, evaluate for pneumonia. TECHNIQUE: PA and lateral projections, upright positioning. COMPARISON: None. FINDINGS: Multiple median sternotomy wires and mediastinal surgical clips are noted. The cardiomediastinal silhouettes are within normal limits. Fullness of the right hilum may reflect bronchovascular crowding in the setting of low lung volumes and a suboptimal inspiratory effort, however, underlying abnormality is unable to be excluded. Recommend comparison with old chest x-rays or a followup non urgent upright PA and lateral chest x-ray to assess for resolution. Otherwise, a streaky opacity at the right lung base likely represents platelike atelectasis. There is no pneumothorax or pleural effusion. IMPRESSION: Right hilar fullness possibly reflective of bronchovascular crowding due to low lung volumes, however, underlying abnormality unable to be excluded. Recommend comparison with prior chest x-rays or 4- week followup upright PA and lateral chest x-ray to assess for resolution. Otherwise, no focal lung consolidation. " 1355afe7-2c8d460a-e2a20a81-966417c9-9640f7db.jpg,test/p10/p10835660/s55652710/1355afe7-2c8d460a-e2a20a81-966417c9-9640f7db.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness and cough. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. There is new mild-to-moderate relative elevation of the right hemidiaphragm compared to the left side. The lungs appear clear. Slight degenerative changes are similar along the thoracic spine. IMPRESSION: 1. No evidence of pneumonia. 2. New mild relative elevation of the right hemidiaphragm since ___. " b8b6e48b-12591633-e3223e75-cc3305ff-f2ef1b16.jpg,test/p14/p14263099/s53577033/b8b6e48b-12591633-e3223e75-cc3305ff-f2ef1b16.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cabg and ct removal // r/o ptx IMPRESSION: In comparison with the earlier study of this date, there is no evidence of pneumothorax. Remainder the study is unchanged. " 65324fd1-700b32b0-ccde4694-b459a490-c50d03e2.jpg,test/p14/p14534470/s57231852/65324fd1-700b32b0-ccde4694-b459a490-c50d03e2.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with chest pain, question pneumonia or pneumothorax. COMPARISON: CT ___ FINDINGS: The lungs are clear. No effusion, pneumothorax, or consolidation is present. Heart and mediastinal contours are normal. A 1-cm left apical lung nodule is stable compared with chest ___ ___. IMPRESSION: Stable left apical lung nodule. Otherwise, unremarkable. " 1f41e46d-288e7510-a911b29e-5d9f7ace-6697ffa9.jpg,test/p11/p11366266/s57197843/1f41e46d-288e7510-a911b29e-5d9f7ace-6697ffa9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with perforated diverticulitis s/p SBR and ___'s, hypotensive in OR. On phenylephrine upon admission to ___ with low UOP with acute SOB // interval worsening of pulm edema or effusion? IMPRESSION: In comparison to prior radiograph from earlier the same date, bilateral asymmetrically distributed alveolar opacities demonstrate a mixed response, with overall worsening in the left upper lobe and right lower lobe, and improvement in the right upper and left lower lobes. Such rapid fluctuations favor pulmonary edema as the most likely etiology although coexisting aspiration or pneumonia are possible in the appropriate clinical setting. Small to moderate right pleural effusion has increased in size in the interval. No other relevant change. " 9dd51694-eff764b9-720b425b-da82034f-0b5fdede.jpg,test/p11/p11255297/s53112890/9dd51694-eff764b9-720b425b-da82034f-0b5fdede.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain, shortness of breath, and abdominal pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Since prior, there has been interval development of right middle and lower lobe parenchymal opacities. Nodular opacity at the left lateral costophrenic angle is again noted, better characterized by a CT scan. Postoperative changes with clips in the posterior mediastinum are again noted. Hiatal hernia is also visualized. Cardiomediastinal silhouette is otherwise within normal limits. Osseous structures are unremarkable. IMPRESSION: Right middle and lower lobar regions of consolidation compatible with pneumonia in the proper clinical setting. Repeat after treatment is recommended to document resolution. " 65f842b0-cde02c66-4a159655-cf8db57e-0587be47.jpg,test/p10/p10476869/s53412032/65f842b0-cde02c66-4a159655-cf8db57e-0587be47.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Left upper lobe pneumonia or abscess, evaluate for interval change. IMPRESSION: AP chest compared to ___ through ___, read in conjunction with the chest CT on ___: Left upper lobe lesion does not look appreciably different than its appearance on the isolated frontal view on ___. This pair of images, however, should serve as a baseline for subsequent followup examinations with conventional radiographs rather than requiring CT scan followup. There is no pleural effusion. Lungs are otherwise clear. " 33daeaad-69f72c42-612fa3d5-2639d52a-d0353fba.jpg,test/p18/p18705722/s55909759/33daeaad-69f72c42-612fa3d5-2639d52a-d0353fba.jpg,test," FINAL REPORT HISTORY: Chest tightness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and CABG. Severe cardiomegaly is re- demonstrated, unchanged. Mediastinal and hilar contours are stable. There is mild pulmonary vascular congestion which appears to be chronic. No overt pulmonary edema is seen. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Severe cardiomegaly with mild chronic pulmonary vascular congestion. " 653b1ee3-05aa6a23-5839e910-1eb2dd7f-bb5d45b0.jpg,test/p11/p11639209/s55762449/653b1ee3-05aa6a23-5839e910-1eb2dd7f-bb5d45b0.jpg,test," FINAL REPORT AP CHEST, 11:53 A.M., ___ HISTORY: Laryngeal cancer after laryngectomy, an acute episode of respiratory distress. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Both apical pleural margins are severely thickened, right greater than left. Hila are elevated and therefore the likely explanation is scarring, perhaps due to prior radiation. Lower lungs are grossly clear. Heart size top normal. No pleural effusion or pneumothorax. " fc9a03c4-d6a87c3f-ca1a2466-d599811b-4c784f12.jpg,test/p15/p15754509/s53245740/fc9a03c4-d6a87c3f-ca1a2466-d599811b-4c784f12.jpg,test," FINAL REPORT HISTORY: Patient with increasing oxygen requirements, history of COPD, assess for atelectasis versus consolidation. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. A left subclavian central line terminates in the mid SVC. There are persistent small-to-moderate bilateral pleural effusions with compressive atelectasis. The cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax. Left humeral head fracture is again noted. IMPRESSION: Unchanged bilateral small-to-moderate pleural effusions with compressive atelectasis. " aca8138c-2159132b-cd929700-457734cd-48a170df.jpg,test/p15/p15623256/s56022138/aca8138c-2159132b-cd929700-457734cd-48a170df.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with prod cough, chest pain and SOB over past 3 weeks COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes somewhat low limiting assessment.There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Spurring in the lower T-spine noted. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 40c3e5c5-1c3b22b9-3f2dfc65-183c4016-5e9bb570.jpg,test/p11/p11366266/s50212675/40c3e5c5-1c3b22b9-3f2dfc65-183c4016-5e9bb570.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with worsening SOB // worsening SOB, eval PNA, effusion worsening SOB, eval PNA, effusion IMPRESSION: Right PICC line tip is at the level of lower SVC. Heart size and mediastinum are stable. There is interval progression of pulmonary edema. Small bilateral pleural effusions are unchanged. " d0bcafec-b3cc131a-6977fb18-cb2813dc-645001d0.jpg,test/p15/p15173584/s54294611/d0bcafec-b3cc131a-6977fb18-cb2813dc-645001d0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with neutropenic fever // consolidation, effusion, interval change consolidation, effusion, interval change IMPRESSION: In comparison with the study of ___, there are lower lung volumes with bibasilar opacification, especially on the left, consistent with pleural effusion and compressive atelectasis. Cardiac silhouette remains within normal limits and there is no evidence of pulmonary vascular congestion. Vague area of increased opacification at the left base medially could possibly represent a region of developing consolidation in the appropriate clinical setting. " 95383c20-022b71a5-ae3651d8-a0b5e8bf-dd6657b9.jpg,test/p15/p15505239/s51841838/95383c20-022b71a5-ae3651d8-a0b5e8bf-dd6657b9.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with fatigue, leukocytosis. Question pneumonia. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Best seen on the lateral exam is increased consolidation in the retrocardiac region, not definitively seen but potentially localizing to the right on the frontal. Given clinical setting, this would be suspicious for pneumonia. There is no large effusion. Cardiac silhouette is enlarged but stable in configuration. Degenerative changes seen at shoulders bilaterally as well as hypertrophic changes in the spine. IMPRESSION: Region of consolidation better seen on the lateral. In the proper clinical setting, this would be compatible with pneumonia. Recommend repeat after treatment to document resolution. " 40f3fb55-3b55a027-8dcdbf02-e47511c4-bddc0d78.jpg,test/p14/p14775533/s59631761/40f3fb55-3b55a027-8dcdbf02-e47511c4-bddc0d78.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with arotic dissection // low cxr for feeding tube placement IMPRESSION: In comparison with the earlier study of this date, there is little interval change. Extensive subcutaneous emphysema persists along the chest walls and into the neck bilaterally as well as in the pectoral muscles. Left chest tube is in place and there is no definite pneumothorax. Otherwise, little change in the appearance of the monitoring and support devices as well as the heart and lungs. " 9786a24a-62d74bba-3c75e17c-de6cc38e-cc035c12.jpg,test/p10/p10905552/s51682704/9786a24a-62d74bba-3c75e17c-de6cc38e-cc035c12.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Pleuritic chest pain and cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Mild degenerative changes are seen along the spine. IMPRESSION: No focal consolidation. " e82d5a74-34efa079-e486a692-c9926c0c-c69f730d.jpg,test/p11/p11167924/s55662180/e82d5a74-34efa079-e486a692-c9926c0c-c69f730d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia // interval change interval change COMPARISON: Prior chest radiographs ___ through ___:25. IMPRESSION: Patient has been extubated. Left lower lobe is still completely airless due to dense consolidation ; since there is mild accompanying leftward mediastinal shift, the change since ___ is due to worsening atelectasis, but the extent to which pneumonia is concurrent is radiographically indeterminate. . Heterogeneous opacification of the base of the right lung could be combination of atelectasis, mild edema and pleural effusion, but pneumonia needs to be considered in the right lower lobe as well. Feeding tube passes into the stomach and out of view. Left PIC line ends in the mid SVC. No pneumothorax. Calcified nodule projecting over the right middle lobe is actually in chest wall, shown on ___ chest radiograph. " 37a511ac-4f3c5abd-16cea674-4eaba556-b88017a0.jpg,test/p12/p12260873/s52004969/37a511ac-4f3c5abd-16cea674-4eaba556-b88017a0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man now intubated // Intubation Intubation IMPRESSION: Comparison to ___. The patient has been intubated. The tip of the endotracheal tube projects approximately 4 cm above the carina. No complications, notably no pneumothorax. Normal size of the cardiac silhouette. No pleural effusions. No pulmonary edema. " e48ed8d3-27f97788-dc065001-4c97a9c2-90ab47ba.jpg,test/p19/p19343087/s50622338/e48ed8d3-27f97788-dc065001-4c97a9c2-90ab47ba.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain and dyspnea on exertion COMPARISON: Prior exam from ___. FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is unchanged. There is increased retrocardiac opacity concerning for pneumonia. There is a small left pleural effusion. Right lung is clear. Mediastinal contour is grossly unremarkable. Bony structures are intact. IMPRESSION: Retrocardiac opacity concerning for pneumonia with small left pleural effusion, new from prior. Mild cardiomegaly unchanged. " 07d9cfc7-21e6114a-ef8bbf92-cf7afc36-d24b1b4d.jpg,test/p17/p17489307/s50318072/07d9cfc7-21e6114a-ef8bbf92-cf7afc36-d24b1b4d.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Indwelling support and monitoring devices are in standard position, and cardiomediastinal contours are stable. Resolution of previously reported interstitial edema. Left retrocardiac opacity has worsened and probably represents a combination of atelectasis and pleural effusion. " 3de4173b-8f42aff3-603f12c7-66304a25-6ea46321.jpg,test/p11/p11355690/s51655460/3de4173b-8f42aff3-603f12c7-66304a25-6ea46321.jpg,test," WET READ: ___ ___ ___ 6:14 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with PICC for IV antibiotics ___ lumbar wound, now due for abx dosing // confirm PICC placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Bilateral electronic devices project over the chest. The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. There is a left-sided PICC line with the tip best seen on the lateral projection. This is likely just at the cavoatrial junction. IMPRESSION: No acute cardiopulmonary abnormality. " b1325cf2-5698de41-77ce4f66-4cdf30d2-87bdc87b.jpg,test/p18/p18978615/s54442145/b1325cf2-5698de41-77ce4f66-4cdf30d2-87bdc87b.jpg,test," FINAL REPORT HISTORY: Tachypnea with elevated white count, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change in the cardiomediastinal silhouette. No vascular congestion or pleural effusion. There is mild increased of opacification at the left base medially, most likely reflecting some atelectatic change. However, in the appropriate clinical setting, supervening pneumonia could be considered. " 1aec31d5-0a6a849a-4124efb8-092e0ee8-2ae38cf9.jpg,test/p14/p14631209/s54690314/1aec31d5-0a6a849a-4124efb8-092e0ee8-2ae38cf9.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: ___-year-old woman with confusion after spinal surgery. IMPRESSION: PA and lateral chest compared to ___: Atelectasis at the right lung base is relatively mild, accompanied by tiny bilateral pleural effusion, but no other focal pulmonary abnormality. Heart is normal size. Mediastinal and hilar contours are unremarkable. " 1efa19cd-ea8ea1e4-23e0461b-30831c4c-bbaeea23.jpg,test/p18/p18594766/s52757059/1efa19cd-ea8ea1e4-23e0461b-30831c4c-bbaeea23.jpg,test," FINAL REPORT PORTABLE CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with pullback of right PICC, check position. Comparison is made to the patient's prior study of ___ at ___. A portable semi-erect chest film ___ at ___ is submitted. IMPRESSION: 1. The right PICC line now has its tip in the proximal SVC. There are streaky opacities in both lung bases likely reflecting subsegmental atelectasis. No pulmonary edema. Left hemidiaphragm is slightly elevated of uncertain significance. No pneumothorax. Overall cardiac and mediastinal contours are unchanged, although there is some stable fullness of the right paratracheal soft tissues which is felt to represent distended vascular structures and lymphadenopathy as evident on a CT dated ___. " 38b952ea-60919d6f-37d6c7dd-5c729c4f-6b8da0a7.jpg,test/p13/p13264243/s56142358/38b952ea-60919d6f-37d6c7dd-5c729c4f-6b8da0a7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with AF, on amiodarone long term // Amio toxicity Amio toxicity IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is enlargement of the cardiac silhouette without definite vascular congestion or acute focal pneumonia. Specifically, no evidence of interstitial prominence to radiographically suggest amiodarone toxicity. " ec9e4777-d3d5290e-09e775a5-f940cb7c-a48844ad.jpg,test/p13/p13548972/s51397127/ec9e4777-d3d5290e-09e775a5-f940cb7c-a48844ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with likely aspiration pneumonia // assess for pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There is a new relatively massive platelike atelectasis at the right lung bases, combined to an area of ill-defined subtle parenchymal opacity. Overall, the findings are consistent with aspiration. The appearance of the left lung is unchanged. Mild cardiomegaly persists. " c41a32a3-28cfa1d5-25a93388-96507da0-2b1694aa.jpg,test/p13/p13549706/s54657999/c41a32a3-28cfa1d5-25a93388-96507da0-2b1694aa.jpg,test," FINAL REPORT HISTORY: Cough. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: None. FINDINGS: There are low lung volumes. Heart size is normal with a left ventricular predominance. The mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures but no overt pulmonary edema is present. Patchy bibasilar airspace opacities may reflect atelectasis though infection or aspiration cannot be completely excluded. No pleural effusion or pneumothorax is seen. There are multilevel degenerative changes in the thoracic spine. IMPRESSION: Low lung volumes with patchy bibasilar opacities possibly reflecting atelectasis but infection or aspiration cannot be excluded. " fb768f73-ecff77d8-063bc01c-329cc557-e8642761.jpg,test/p14/p14885862/s57739906/fb768f73-ecff77d8-063bc01c-329cc557-e8642761.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain, syncope. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is within normal limits. The aorta is slightly tortuous. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 9f9c9043-0a921601-5123af22-c210d219-70c7d2a0.jpg,test/p12/p12981244/s52976713/9f9c9043-0a921601-5123af22-c210d219-70c7d2a0.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with sudden onset epigastric pain radiating to the chest, to evaluate for perforation. COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. There is no free air in the abdomen. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary abnormality. " f69dff53-500aebee-896cbdde-ae41c69f-7b23cfec.jpg,test/p18/p18175753/s54861186/f69dff53-500aebee-896cbdde-ae41c69f-7b23cfec.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Morbidly obese, desaturation, increased shortness of breath, rule out acute process. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Moderate cardiomegaly with increasing diameter of the pulmonary vasculature, suggesting mild fluid overload. No pleural effusions. Minimal tortuosity of the thoracic aorta. No pneumonia. Normal appearance of the hilar and mediastinal structures. " 9c3167b4-088f7fae-fa62338a-3cbf20c9-08091576.jpg,test/p18/p18082516/s59795768/9c3167b4-088f7fae-fa62338a-3cbf20c9-08091576.jpg,test," FINAL REPORT HISTORY: Fall. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The patient is status post median sternotomy and aortic valve replacement. Lung volumes are low. There is mild enlargement of cardiac silhouette. The aorta remains tortuous and diffusely calcified. Convex contour to the right superior mediastinum corresponds to tortuous great vessels, unchanged. No pulmonary vascular engorgement is demonstrated. Streaky left basilar opacity could reflect atelectasis, although infection cannot be excluded. No pleural effusion or pneumothorax is clearly demonstrated. No acute osseous abnormalities are visualized. Degenerative changes of both shoulders are noted with narrowed acromial humeral intervals suggestive of underlying rotator cuff disease. IMPRESSION: Low lung volumes. Patchy left basilar opacity likely reflects atelectasis though infection cannot be excluded. " 5aa5e558-f470c80e-96c984a4-6f022250-9fd9112c.jpg,test/p18/p18123897/s56832790/5aa5e558-f470c80e-96c984a4-6f022250-9fd9112c.jpg,test," FINAL REPORT INDICATION: ___ year old woman with ARDS septic shock, more hypoxic // interval change COMPARISON: Radiographs from ___ at 02:43 IMPRESSION: Support lines and tubes are unchanged in position. There is again seen diffuse airspace opacities throughout both lung fields which are confluent. There have worsened since the previous study and prominent air bronchograms are identified. No pneumothoraces are seen. " 958afabf-e86c62ec-a7ad84ef-4006bb89-266c930c.jpg,test/p12/p12724735/s58076029/958afabf-e86c62ec-a7ad84ef-4006bb89-266c930c.jpg,test," FINAL REPORT INDICATION: History: ___F with s/p line // eval for line TECHNIQUE: Portable semi-erect radiograph of the chest. COMPARISON: Radiograph from ___ FINDINGS: Multiple prior radiographs dated back to ___. Moderate cardiomegaly has been stable compared to prior exams dated back to ___. Diffuse opacities are seen throughout the left hemi thorax, predominantly overlying the mid left lung. A left-sided IJ is seen, with the tip likely in the ipsilateral brachiocephalic/internal jugular vein junction. A right-sided hemodialysis catheter is seen, terminating in the right atrium, unchanged in position compared to the prior exam. There is no large pleural effusion, or pneumothorax. IMPRESSION: Left-sided IJ line terminates likely in the left ipsilateral brachiocephalic vein/internal jugular vein junction. Diffuse opacities overlying the mid left lung, may be secondary to pneumonia. " ad7b272a-373807fb-4a9f3326-55512687-3ee7144a.jpg,test/p19/p19646078/s53165460/ad7b272a-373807fb-4a9f3326-55512687-3ee7144a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p redo, MVR, CTs d/c'd // evaluate for pneumothorax evaluate for pneumothorax IMPRESSION: Heart size and mediastinum are stable in appearance. Right internal jugular line has been removed. Right basal consolidation pleural effusion have slightly accumulated after removal of the chest tubes. There is no pneumothorax. There is no pulmonary edema. " 5484fab9-44277ae9-3cfe4a2d-a6140fa7-01c0313e.jpg,test/p18/p18583455/s57201055/5484fab9-44277ae9-3cfe4a2d-a6140fa7-01c0313e.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain and shortness of breath, status post fall. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette remains top normal to mildly enlarged. Mediastinal and hilar contours are stable. Spinal stimulator device is stable in position. There is no overt pulmonary edema. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture seen, however, dedicated rib series or CT are more sensitive. " 4ae5da57-a9e3282b-d9369eec-f7cdb0c1-8ee8b350.jpg,test/p16/p16666640/s55303527/4ae5da57-a9e3282b-d9369eec-f7cdb0c1-8ee8b350.jpg,test," FINAL REPORT AP CHEST HISTORY: Lung cancer following mediastinoscopy. IMPRESSION: AP chest compared to ___ and ___. There is no pneumomediastinum or pneumothorax. The margins of the large juxtahilar right lung mass are somewhat indistinct and there may be new consolidation inferior to it, which could be hemorrhage or atelectasis. Right pleural effusion is small if any. Left lung is clear. Heart size is normal. " c75c63ff-5099eac4-514044ea-c6878959-39ef4039.jpg,test/p18/p18179671/s50162876/c75c63ff-5099eac4-514044ea-c6878959-39ef4039.jpg,test," FINAL REPORT HISTORY: Shortness of breath x2 days. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is top-normal in size with a tortuous aortic contour. IMPRESSION: No acute intrathoracic process. " 34b86810-f035a8c6-a0d1e56b-0363c930-8de2b199.jpg,test/p17/p17547554/s53397107/34b86810-f035a8c6-a0d1e56b-0363c930-8de2b199.jpg,test," FINAL REPORT INDICATION: UTI. Evaluate for pneumonia. COMPARISONS: Chest radiograph ___. CT chest ___. FINDINGS: There is an ill-defined rounded opacity in the left upper lobe, which measures 19 mm. This mass was previously characterized on the CT of the chest. There is a second ill-defined rounded lesion in the right upper lobe, which measures 12 mm, and may be a second nodule or a fibrotic conglomerate. This is stable also stable. There is new mild pulmonary edema. There are small bilateral pleural effusions, larger on the left than the right, which are stable. The aorta is tortuous, and unchanged. The heart size is normal. The bones are diffusely dimineralized and difficult to evaluate. IMPRESSION: 1. New mild pulmonary edema. 2. Stable small bilateral pleural effusions, slightly greater on the left than the right. 3. Stable left upper lobe nodule and ill-defined right upper lobe opacity which may be a second nodule or a fibrotic conglomerate. " b9075e67-ba335cb9-48229e4a-bc6c0116-5fb86012.jpg,test/p18/p18856970/s55005734/b9075e67-ba335cb9-48229e4a-bc6c0116-5fb86012.jpg,test," WET READ: ___ ___ 4:10 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with seizure, altered mental status // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are well-expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " c8ead8fa-3199a76b-8437a5c0-d4ff5ca3-5aead48c.jpg,test/p12/p12094244/s54882263/c8ead8fa-3199a76b-8437a5c0-d4ff5ca3-5aead48c.jpg,test," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with recent esophageal tear. Evaluate for interval change. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. The heart size is normal. No configurational abnormality is present. Thoracic aorta and mediastinal structures are now unremarkable. Pulmonary vasculature is not congested. No evidence of pleural effusions in either lateral or posterior pleural sinuses and no pneumothorax in the apical area. Comparison is made with several preceding chest examinations as well as review of two CTs is performed. Apparently, the patient had a perforation of the lower esophagus with air in the mediastinal structures. All these abnormalities have now normalized and no remaining pulmonary, cardiovascular or pleural abnormality remains. " f91704b2-12bc8248-dee6b1df-9ab96ee5-57c309f5.jpg,test/p19/p19130309/s56004779/f91704b2-12bc8248-dee6b1df-9ab96ee5-57c309f5.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p dual chamber ICD // r/o pneumo TECHNIQUE: Single view chest radiograph COMPARISON: Prior chest radiographs from ___, ___, ___ FINDINGS: Since ___, a left pectoral pacemaker is seen with transvenous leads in the right atrium and right ventricle. Moderate cardiomegaly is unchanged. Bibasilar atelectasis is increased. No pneumothorax. Median sternotomy wires are intact and aligned. IMPRESSION: Left pectoral pacemaker with leads in the RA and RV. No pneumothorax. " 65c3046a-d1b2d6fe-0c314f8b-9d658e2a-465e1c72.jpg,test/p13/p13103745/s55166013/65c3046a-d1b2d6fe-0c314f8b-9d658e2a-465e1c72.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old man with lymphadenopathy and known lung nodules. Status-post bronch biopsies; evaluate for pneumothorax. COMPARISON: Chest radiograph dated ___. CT chest dated ___. FINDINGS: The lungs are well-expanded. The known right upper lobe lung mass is unchanged. The mediastinal contour is stable. Stable mild cardiomegaly. No pneumothorax or pneumomediastinum. No pleural effusion. No acute osseous abnormality. IMPRESSION: No pneumothorax or pneumomediastinum status-post bronchial biopsies. No acute cardiopulmonary process. " 3ffdf75e-61c22af7-5df6812d-9ca98042-3290deea.jpg,test/p19/p19792705/s53834988/3ffdf75e-61c22af7-5df6812d-9ca98042-3290deea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with confusion TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, and ___ chest CT FINDINGS: Cardiac, mediastinal and hilar contours are unchanged and the heart size is within normal limits. The pulmonary vasculature is normal. Small bilateral pleural effusions are re- demonstrated, not substantially changed in the interval. There is minimal bibasilar atelectasis. Remainder of the lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. Multilevel degenerative changes are seen in the imaged thoracic spine. IMPRESSION: Small bilateral pleural effusions, not substantially changed in the interval. " 58481bb2-849ea747-53eea5d7-4bb841fb-171cd82a.jpg,test/p10/p10538311/s58312045/58481bb2-849ea747-53eea5d7-4bb841fb-171cd82a.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with cough since mid ___, worse over the last two weeks ; evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: No prior dedicated chest imaging is available on PACS at the time of this dictation. FINDINGS: The lungs are clear. No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila and pleura are normal. Thoracic cage and soft tissues appear normal. IMPRESSION: No acute cardiopulmonary process. " a3970b99-830488ae-fba9abbd-451e4155-a9710af1.jpg,test/p11/p11900721/s54329915/a3970b99-830488ae-fba9abbd-451e4155-a9710af1.jpg,test," FINAL REPORT HISTORY: History of cirrhosis, now with crackles on examination. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None. FINDINGS: The lung volumes are low and there is minimal atelectasis. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The heart size is normal. Mediastinal contours are normal. No bony abnormality is detected. IMPRESSION: No evidence of acute cardiopulmonary process. " b1cad0fa-de18f0f2-c58a2aee-e4ae3888-5520fcec.jpg,test/p17/p17477764/s52150254/b1cad0fa-de18f0f2-c58a2aee-e4ae3888-5520fcec.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and dysphagia. COMPARISONS: Chest radiographs from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear unchanged. There is patchy left lower lung opacity obscuring the left hemidiaphragm, probably within the lingula, which is non-specific but most suggestive of minor atelectasis. There is no evidence for pneumomediastinum or pneumothorax. There is no pleural effusion. Bony structures are unremarkable. IMPRESSION: Patchy opacity in the lingula, most suggestive of minor atelectasis. Pneumonia is difficult to completely exclude, although doubted. Short-term follow-up radiographs could be considered if clinically indicated. No evidence for pneumomediastinum or mediastinal widening. " f59bb9eb-290a5f04-a906351a-d32ba90b-a3482d7b.jpg,test/p13/p13694166/s56866172/f59bb9eb-290a5f04-a906351a-d32ba90b-a3482d7b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with metastatic squamous cell carcinoma of the neck with right sided facial swelling; recent PET scan showing progression TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___ and PET-CT ___ FINDINGS: Cardiac silhouette size is normal. Mediastinal contour is unchanged. Right upper and lower lobe perihilar consolidative opacities are again demonstrated with continued increased interstitial markings in the right lower lobe, not substantially changed in the interval allowing for differences in modalities. Right lateral and basilar pleural thickening is also similar. The left lung is clear. No pulmonary edema, left-sided pleural effusion, or pneumothorax is present. Moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No definite interval change in right upper and lower lobe perihilar consolidative opacities which remain concerning for malignancy with continued right lateral and basilar pleural thickening. Increased interstitial markings in the right lower lobe remain concerning for lymphangitic spread of tumor. " 8d0bb29c-2feb31df-92967cc2-79e48b3a-c7909395.jpg,test/p15/p15340094/s54280569/8d0bb29c-2feb31df-92967cc2-79e48b3a-c7909395.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old female with recently diagnosed right lower lobe pneumonia, presenting with dyspnea. Evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The heart remains mildly enlarged. Since the prior exam there appears to be increased hilar engorgement and cephalization suggesting development of pulmonary vascular congestion. The previously noted opacity in the right lower lung is not clearly visualized and may have resolved in the interval. No large effusion or pneumothorax. Bony structures are intact. IMPRESSION: Pulmonary vascular congestion, mild cardiomegaly, right lower lung pneumonia appears resolved. " 251e9b09-94ff99fd-6348956b-23e02911-2618ea53.jpg,test/p14/p14073891/s51188364/251e9b09-94ff99fd-6348956b-23e02911-2618ea53.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Postop fever. COMPARISON: ___ FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " fa801543-e6e99ca1-f8408df3-bc5fb0d2-91b26e96.jpg,test/p16/p16117641/s51046145/fa801543-e6e99ca1-f8408df3-bc5fb0d2-91b26e96.jpg,test," FINAL REPORT HISTORY: Cough and bibasilar crackles. COMPARISON: Multiple priors from ___ to ___. FINDINGS: PA and lateral chest radiographs again demonstrate mild cardiomegaly, unchanged from multiple priors. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiac, hilar, and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 28731c8f-845c8d12-7ef634bd-1e481453-371c6b29.jpg,test/p12/p12200987/s54203219/28731c8f-845c8d12-7ef634bd-1e481453-371c6b29.jpg,test," WET READ: ___ ___ ___ 2:51 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with cp // r/o infectious process TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. Hypertrophic changes of the spine are noted. IMPRESSION: No acute cardiopulmonary process. " a3e6a83a-8269f03b-20c589e6-b8f750c3-8e85fff5.jpg,test/p16/p16609016/s59326099/a3e6a83a-8269f03b-20c589e6-b8f750c3-8e85fff5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cabg and ct removal // r/o ptx TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: There has been interval removal of multiple chest tubes. A right internal jugular catheter is unchanged in position compared to the prior study. Previous median sternotomy noted. No pneumothorax or pleural effusions seen. Patchy opacities of the bilateral lung bases consistent with mild pulmonary edema. IMPRESSION: No pneumothorax seen. " e1a79b70-903c0af3-143bc525-912dc413-125d4262.jpg,test/p10/p10191971/s59497040/e1a79b70-903c0af3-143bc525-912dc413-125d4262.jpg,test," FINAL REPORT HISTORY: Hypoxemia, cough, shortness of breath. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal contour is unchanged. Fullness of the hila bilaterally along with widespread perihilar ill-defined opacities and more focal opacification in the right lung base appear slightly progressed in the interval. No pneumothorax is demonstrated. Small right pleural effusion is noted. There is no acute osseous abnormality. IMPRESSION: Slight worsening of widespread perihilar and right basilar opacities reflective of lymphomatous infiltration with superimposed bronchitis. More focal opacity in the right lung base is concerning for pneumonia. Small right pleural effusion. " 09cff9e7-cc333a22-325f1f17-3bee8cdd-b77fd40e.jpg,test/p16/p16000871/s53106744/09cff9e7-cc333a22-325f1f17-3bee8cdd-b77fd40e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hyperkalemia, worsening scr // eval volume status TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: No focal consolidation is seen. There is slight blunting of the bilateral costophrenic angles which could be due to trace pleural effusions. Possible mild central point vascular engorgement without overt pulmonary edema. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Several chronic appearing mid to lower lateral right rib deformities are noted, possibly sequela of prior trauma. IMPRESSION: Slight blunting of the costophrenic angles could be due to trace pleural effusion. No focal consolidation. Mild central pulmonary vascular engorgement without overt pulmonary edema. " d38e7b3e-32ad74e0-0599677e-ad976046-e0001f76.jpg,test/p13/p13259332/s51688598/d38e7b3e-32ad74e0-0599677e-ad976046-e0001f76.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: New lower extremity weakness, sensory changes. Cardiac size is normal. The aorta is tortuous. Aside from atelectasis or scarring in the left lower lobe, the lungs are clear. There is no pneumothorax or pleural effusions. Osseous structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " 3451f96f-4bb88e6d-af55954f-5a123090-3de62af3.jpg,test/p13/p13984946/s51243341/3451f96f-4bb88e6d-af55954f-5a123090-3de62af3.jpg,test," WET READ: ___ ___ ___ 7:36 PM 1. No free air or pneumothorax. 2. Lungs are clear. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with chest pain and epigastric pain // r/o free air or pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The cardiomediastinal contours within normal limits. Stable elevation of the right hemidiaphragm again noted. There is no free air or pneumothorax. Mild right basal atelectasis, otherwise clear lungs. There is no free air below the right hemidiaphragm. There is no fracture or dislocation. IMPRESSION: Stable right hemidiaphragmatic elevation without evidence of pneumonia or free air. " 32271adc-63a4ab69-aa7c8569-29b7748a-74b669dd.jpg,test/p13/p13365915/s51920019/32271adc-63a4ab69-aa7c8569-29b7748a-74b669dd.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of ___. FINDINGS: Support and monitoring devices are unchanged in position except for slight advancement of Swan-Ganz catheter into left main pulmonary artery. New homogeneous opacity abutting the left upper and mid mediastinal contours probably represents acute left upper lobe collapse, particularly considering volume loss in the left hemithorax. There is also substantial left lower lobe atelectasis. Moderate left pleural effusion has increased in size and appears partially loculated. Small right pleural effusion has apparently decreased in size with associated improving aeration of the adjacent right lower lobe. At the time of this dictation, a subsequent chest radiograph has been performed demonstrating resolution of the left upper lobe collapse. It is dictated separately under clip ___. " d2dcb527-c5b859c3-4a65751a-b2e140f4-785067f2.jpg,test/p18/p18290366/s51850681/d2dcb527-c5b859c3-4a65751a-b2e140f4-785067f2.jpg,test," FINAL REPORT INDICATION: ___ year old woman with long standing hx of bx proven sarcoid, inactive on hydroyxycholoquine for years // assess for any change since ___ CXR in preparation for possible stopping of hydroxychloroquine EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral view COMPARISON: Chest radiograph ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. No radiographic evidence of intrathoracic sarcoidosis. IMPRESSION: No radiographic evidence of intrathoracic sarcoid. " ffca1b3e-b18fcad4-6847c501-c856f8c9-8d0dd03d.jpg,test/p12/p12070984/s57907191/ffca1b3e-b18fcad4-6847c501-c856f8c9-8d0dd03d.jpg,test," FINAL REPORT INDICATION: Shortness of breath with fall. Evaluate for pneumonia or rib fracture. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___ and ___. FINDINGS: Lungs are mildly hyperinflated. Heart is mildly enlarged but unchanged.The mediastinal and hilar contours are within normal limits for age. No CHF, pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. No displaced rib fracture is detected on these lung technique films. Possible subtle pleural thickening along the right chest wall in the mid some There is mildly accentuated thoracic spine kyphosis, with mild multilevel degenerative changes and with slight anterior wedging of several mid thoracic vertebral bodies, that does not appear acute. The sternum is not well visualized due to over penetration. IMPRESSION: No acute cardiopulmonary process. If concern for a rib fracture persists, dedicated rib series with markers would be recommended. " 170fe82b-95311bea-8f863030-dbf1a77e-c57de1fe.jpg,test/p11/p11805066/s50431140/170fe82b-95311bea-8f863030-dbf1a77e-c57de1fe.jpg,test," FINAL REPORT INDICATION: ___ year old woman without significant PMH who presents with a new RUL lung mass of undifferentiated large cell carcinoma, with airway compromise and SVC syndrome now s/p 5 cycles XRT, tracheostomy ___, RMSB and LMSB stenting, abx for PNA (never had full course for HACP given low clinical concern) and will pursue palliative chemotherapy as an outpatient. // Stent Migration TECHNIQUE: Portable chest radiograph COMPARISON: Chest radiograph dated ___. FINDINGS: The tracheostomy tubes, chest tube, gastrostomy tube, and the bilateral bronchial stents are unchanged. There is complete opacification of the right lung, which is a progression from previous chest radiograph. The new right lower lung opacification could represent increased pleural effusion and progression of the right lung mass with now more vertical orientation of the right mainstem bronchus. The left lung is clear with persistent lower lobe atelectasis and pleural effusion. No pneumothorax. No fractures. IMPRESSION: 1. No bronchial stent migration. 2. Complete opacification of the right hemithorax which may represent progression of the right lung mass and pleural effusion. " bcf3533a-8bf62b12-c9713f7c-d3a7ae33-4a3c666c.jpg,test/p18/p18397764/s58567852/bcf3533a-8bf62b12-c9713f7c-d3a7ae33-4a3c666c.jpg,test," FINAL REPORT HISTORY: ___-year-old female with hyperthyroidism and atrial fibrillation. Question CHF. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no effusion or pulmonary vascular congestion. Cardiac silhouette is top normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 6ef094f5-b6420806-a9b56157-e56aa76b-18ec53c6.jpg,test/p17/p17422041/s52383484/6ef094f5-b6420806-a9b56157-e56aa76b-18ec53c6.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough and sputum production. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are essentially clear. There is no pleural effusion or pneumothorax. Hyperinflation is demonstrated on the lateral view. " e57e4a38-93d1432a-6d72fb7a-92d3a7ba-9b0882d9.jpg,test/p15/p15949479/s59907975/e57e4a38-93d1432a-6d72fb7a-92d3a7ba-9b0882d9.jpg,test," FINAL REPORT INDICATION: ___ year old man with SBO, HCAP now emesis x2, increased O2 requirement. // interval change RUL, LLL, RLL consolidations? aspiration? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The lung volumes are hyperinflated. Consolidation of the right upper lobe and right lower lobe are either worsened or new than prior exam, which may represent recent aspiration if the latter. Left lower lobe atelectasis is present and appears unchanged. The enlarged cardiomediastinal and hilar contours are stable. Probable small pleural effusions bilaterally. Pacemaker is intact and leads are in the appropriate position. Stable degenerative changes of thoracic spine. IMPRESSION: Worsening multifocal pneumonia. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 2:41 PM, 10 minutes after discovery of the findings. " 543d2bb3-f23379e9-6c7d39f9-cb7167a3-7ba4c35a.jpg,test/p12/p12006413/s50179554/543d2bb3-f23379e9-6c7d39f9-cb7167a3-7ba4c35a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with IVDU, MSSA endocarditis on vanc/rifampin/nafcillin/fluconazole, w/ new fevers last night. // Eval for PNA vs septic emboli. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The PICC line tip has been pulled back an it is now in the proximal SVC. The pacer device appearance is unchanged. The broken sternal wires again visualized. There is no focal infiltrate. There is blunting of both CP angles which may represent tiny effusions. The heart is mildly enlarged. IMPRESSION: No focal infiltrate " 8905186c-672aaeb6-947ad725-5c8e2823-0f28c6e0.jpg,test/p11/p11514486/s51878922/8905186c-672aaeb6-947ad725-5c8e2823-0f28c6e0.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph dated ___ as well as a CT torso dated ___. CLINICAL HISTORY: Cough, malaise, assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained. There is stable irregular opacity in the lower lungs compatible with known areas of scarring as assessed on prior CT. No definite signs of pneumonia or CHF. Cardiomediastinal silhouette appears stable with top normal heart size redemonstrated. No pleural effusion or pneumothorax. Bony structures appear intact. IMPRESSION: No signs of pneumonia or CHF. Stable areas of scarring in the lower lungs. " db41cdac-12bee6ea-dbcb0bf4-4bd37468-d1023d36.jpg,test/p14/p14605239/s56488787/db41cdac-12bee6ea-dbcb0bf4-4bd37468-d1023d36.jpg,test," FINAL REPORT INDICATION: ___-year-old female with seizure. Evaluate for evidence of pneumonia. COMPARISON: Chest radiograph from ___, CT torso from ___, and PET-CT from ___. TECHNIQUE: AP and lateral chest radiograph. FINDINGS: A 6.0 x 5.6 cm left perihilar mass is identified and compatible with known malignancy. This mass has not significantly changed in size compared with prior chest radiograph. No other focal opacities are noted. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Minimal atelectasis is noted in the lung bases, but no focal consolidation. No rib fractures are identified. IMPRESSION: Unchanged rounded perihilar mass compatible with known malignancy. Mild bibasilar atelectasis. " c90a5be9-cd4cc974-a3a44122-fc902822-d47393b7.jpg,test/p17/p17133357/s58325150/c90a5be9-cd4cc974-a3a44122-fc902822-d47393b7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent history of fatigue, night sweats. Last CX ___ showed bilateral hazy opacities. Clinical exam worse today, fine crackles ___ way up left, base of R. // r/o pulmonary edema, PNA, pleural effusion COMPARISON: ___ IMPRESSION: As compared to ___, there are bilateral basal parenchymal opacities, mainly peribronchial in distribution, an showing air bronchograms, notably on the lateral image. As noted in the previous report, these findings are suggestive of pneumonia. The extent and severity of these changes is constant. Constant size of the cardiac silhouette. No pleural effusions. Minimal fluid markings of the fissures. NOTIFICATION: At the time of dictation and observation, 11:44, on the ___, the findings were added to ste to the radiology dashboard. " ae6443b2-35484da2-67f1c6c1-f8ebb08a-75d30d07.jpg,test/p14/p14415224/s54716454/ae6443b2-35484da2-67f1c6c1-f8ebb08a-75d30d07.jpg,test," FINAL REPORT INDICATION: Cough and vomiting. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: There are low lung volumes. The heart size is normal. The mediastinal and hilar contours are unremarkable. Left lower lobe consolidative opacity is concerning for pneumonia. The right lung is clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Left lower lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. " e80af066-34975609-5197442d-f3791f17-694ce6fe.jpg,test/p10/p10024982/s53158855/e80af066-34975609-5197442d-f3791f17-694ce6fe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p PEA, currently intubated // interval changes interval changes IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tubes have been removed. The other monitoring and support devices remain in place. Continued enlargement of the cardiac silhouette in a patient with a previous cardiac surgery procedure. Some indistinctness of pulmonary vessels are consistent with elevated pulmonary venous pressure. Hazy opacification at the right base is consistent with layering pleural effusion. " 8e347a71-8fde9cb0-1238f4de-f7b02bf5-27021a12.jpg,test/p12/p12255611/s58231406/8e347a71-8fde9cb0-1238f4de-f7b02bf5-27021a12.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with cough, fever, hypotension // presence of pleural effusion, infiltrate COMPARISON: None FINDINGS: AP portable upright view of the chest. Surgical clips are noted in the upper mid abdomen. Peribronchovascular opacities are noted in the lungs which could reflect atypical pneumonia. No lobar consolidation, effusion or pneumothorax. Upper lung lucency may reflect underlying emphysema. The heart size is normal. Mediastinal contours unremarkable. Imaged bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: Peribronchovascular opacity concerning for atypical infection. " 071348f8-6ef54f12-8829b286-85a6c7eb-166cfd66.jpg,test/p18/p18019515/s54832461/071348f8-6ef54f12-8829b286-85a6c7eb-166cfd66.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with chest pain // eval for pna eval for pna IMPRESSION: No comparison. Normal lung volumes. Moderate cardiomegaly with enlargement of the left atrium. Moderate elongation of the descending aorta. The presence of a small left pleural effusion cannot be excluded. No overt pulmonary edema. Minimal retrocardiac atelectasis. No pneumonia. Status post left axillary lymph node dissection. " b580e1d6-0187d75e-0f34cc22-86057b39-0b0bcb9f.jpg,test/p17/p17734689/s50013774/b580e1d6-0187d75e-0f34cc22-86057b39-0b0bcb9f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p flank hernia repair near diaphragm. // pls eval for ptx pls eval for ptx IMPRESSION: Compared to chest radiographs ___. Lung volumes are extremely low, particular the right. Abnormality at the base of the right lung looks nearly identical to its appearance in ___. Either it is persistent or recurrent. Diagnostic possibilities are atelectasis or pneumonia. Atelectasis at the left lung base medially is more severe today. Pleural effusion is small if any. Heart size top-normal. " 5a570617-37f6995d-7fa90aaa-390008f2-01804854.jpg,test/p19/p19904800/s52465486/5a570617-37f6995d-7fa90aaa-390008f2-01804854.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with diffuse B cell lymphoma and cough/fever // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal contour remains prominent, though less pronounced compared to the prior study, suggestive of improving lymphadenopathy. The hilar contours are again prominent compatible with underlying lymphadenopathy. No pulmonary edema, focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormality is visualized. Bilateral breast implants are again seen. IMPRESSION: No radiographic evidence for pneumonia. Mediastinal contour appears less pronounced suggestive of improving lymphadenopathy. Continued bilateral hilar lymphadenopathy. " ba1f955e-a18b92ce-422da5e6-fedc5a3b-356b7e67.jpg,test/p15/p15227454/s54106215/ba1f955e-a18b92ce-422da5e6-fedc5a3b-356b7e67.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with SOB, history of lymphoma. COMPARISON: PET-CT scan dated ___. FINDINGS: PA and lateral views of the chest provided. Multiple right-sided pulmonary nodules better assessed on prior CT. Surgical clips again noted in the left neck and mediastinum as well as the left chest wall. Cardiomediastinal silhouette is stable. There is hilar congestion and possible mild pulmonary edema. There is pleural based opacity at the right lower lung likely representing scarring as seen on prior CT exam. No large effusion or pneumothorax is seen. No convincing signs of pneumonia. Bony structures are intact. IMPRESSION: Findings as above with hilar congestion and possible mild edema. Nodules in the right lung better assessed on prior CT exam. " fcf044bc-4875ddfb-c424995e-befebb14-6121ec3f.jpg,test/p16/p16646670/s55946271/fcf044bc-4875ddfb-c424995e-befebb14-6121ec3f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and CT chest ___ FINDINGS: The heart size appears mildly enlarged, similar to that seen previously. Mediastinal contour is unchanged. Numerous masses in the lungs bilaterally compatible with metastases have increased in size and number. A large right pleural effusion has substantially increased in size from the previous study with associated right basilar atelectasis. Streaky atelectasis is noted in the left lung base. There is no pneumothorax. There are moderate degenerative changes in the imaged thoracic spine with partially imaged posterior fusion hardware spanning the lower thoracic and upper lumbar spine. IMPRESSION: Substantial interval increase in size of right pleural effusion, now large, with right basilar atelectasis. Increased size and number of multiple metastases within the lungs. " 7536639e-70fca8b3-b137ac03-a0bf3c30-c8e06b72.jpg,test/p16/p16086874/s56509501/7536639e-70fca8b3-b137ac03-a0bf3c30-c8e06b72.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hepatic cirrhosis, patient with elevated white blood cell count, evaluation. COMPARISON: ___. FINDINGS: The lung volumes remain low. There is increasing evidence of fluid overload but no overt pulmonary edema. No pleural effusions. No pneumonia. No pneumothorax. " cac5a505-53d7d41b-2b545907-abef7626-ee069f2f.jpg,test/p15/p15035317/s58342513/cac5a505-53d7d41b-2b545907-abef7626-ee069f2f.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: Patient with MDS. ___ transplant examination. FINDINGS: Comparison is made to previous study from ___. Heart size is upper limits of normal. Lungs are grossly clear without focal consolidation, pleural effusions or pulmonary edema. Bony structures are grossly intact. IMPRESSION: No signs for acute cardiopulmonary process. " 4fa6b4a2-cf5f036c-f9677834-ab77edeb-7957e658.jpg,test/p13/p13745545/s50318247/4fa6b4a2-cf5f036c-f9677834-ab77edeb-7957e658.jpg,test," FINAL REPORT INDICATION: ___-year-old man with exudative effusion, COPD and HCV, assess left effusion. COMPARISONS: ___. Two views of the chest were obtained. Left dependent small-to-moderate pleural effusion is increased with associated atelectasis. Right trace effusion is unchanged. Hyperexpanded lungs and prominent interstitial markings are compatible with provided history of emphysema. Mild cardiomegaly persists with satisfactory unchanged position of the dual-lead pacer/defibrillator. No pneumothorax is seen. IMPRESSION: Slight interval increase in the small-to-moderate left pleural effusion. " 99bda358-d135d999-305c5ad0-5026ccf2-3eb723ad.jpg,test/p15/p15388421/s59103692/99bda358-d135d999-305c5ad0-5026ccf2-3eb723ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Pleural effusion // f/u on Chest tube and lung expansion f/u on Chest tube and lung expansion IMPRESSION: In comparison with the study of ___, there is continued decrease in the degree of pleural fluid with less atelectatic changes at the right base. There may be a small residual basilar pneumothorax. Subcutaneous gas is again seen along the right lateral chest wall. Remainder of the study is essentially unchanged. " c9738291-a23b5183-e23283f2-6861d5fa-aead9533.jpg,test/p10/p10687096/s57597578/c9738291-a23b5183-e23283f2-6861d5fa-aead9533.jpg,test," FINAL REPORT INDICATION: ___-year-old male with arm laceration for preop evaluation. COMPARISONS: None. Two views were obtained of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. Nipple shadow is seen over the right lower lung. IMPRESSION: No acute intrathoracic process. " a3ede87d-6e244f69-f9e601e4-48080138-871e8465.jpg,test/p18/p18632133/s51703559/a3ede87d-6e244f69-f9e601e4-48080138-871e8465.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough x3wk, rhonchiin left lung base COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. Cardiomediastinal and hilar contours are normal. There are no pleural effusions. IMPRESSION: No pneumonia. " f5fd0a41-82aca5c7-7167475a-1ecd32f1-b1489ec7.jpg,test/p14/p14365867/s56969060/f5fd0a41-82aca5c7-7167475a-1ecd32f1-b1489ec7.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Shortness of breath. TECHNIQUE: Chest, PA upright and lateral. COMPARISON: None. FINDINGS: Although partly obscured by opacification in the left hemithorax, the heart is probably normal in size. Left hilum is obscured by a consolidation involving much of the central part of the left upper lobe with some accompanying volume loss and leftward shift. Right hilar and mediastinal contours are unremarkable. There is also a small pleural effusion on the left and, more generally, a diffuse interstitial abnormality including bilateral fissural which suggests coinciding pulmonary edema. Opacification of the left upper lobe is heterogeneous and somewhat nodular although likely infectious. IMPRESSION: 1. Central consolidation in the left upper lobe suggesting pneumonia. Particularly given the distribution and some possible nodularity, it is important to pursue follow-up radiographs to show resolution in ___ weeks if clinical circumstances also suggest pneumonia. Otherwise chest CT is suggested. 2. Findings consistent with moderate coinciding pulmonary edema. 3. Small pleural effusion on the left. " 8583425a-07cad26a-209244cb-6677ccf5-ac6e0f96.jpg,test/p13/p13688556/s57146592/8583425a-07cad26a-209244cb-6677ccf5-ac6e0f96.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___M with chest pain, R arm pain // pneumothorax, effusion? TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: As compared to the prior exam, there has been no relevant interval change. The lungs are hyperinflated. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. Hyperinflation. " e7234886-dd6677e7-d29c60b9-f88ef9b0-3d2147ec.jpg,test/p15/p15487342/s50139408/e7234886-dd6677e7-d29c60b9-f88ef9b0-3d2147ec.jpg,test," WET READ: ___ ___ ___ 9:37 PM Perhaps slight interval worsening in pulmonary edema with atelectasis in the left lower lobe. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Pneumonia, worsening hypoxia. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size is enlarged, unchanged. Mediastinal contours are stable. Widespread interstitial opacities appear to be progressed since the prior study and given the rapid change are most likely concerning for interval development of pulmonary edema. Atelectasis at the left lower lung appears to be more pronounced than on the prior study. Bilateral pleural effusions cannot be excluded. " 79fbb9a0-7bda771c-cd1aea39-dde69816-56a3982c.jpg,test/p15/p15403852/s59978809/79fbb9a0-7bda771c-cd1aea39-dde69816-56a3982c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p MVR/AVR and intubated // evaluate lung fields evaluate lung fields COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Mild to moderate pulmonary edema improved. Moderate enlargement of the postoperative cardiomediastinal silhouette also improved. Pleural effusions are presumed, but not large. No pneumothorax. Cardiopulmonary support devices in standard placements. " 4f353a71-e78715e6-431dc078-d26df990-13a52c68.jpg,test/p14/p14338126/s53181977/4f353a71-e78715e6-431dc078-d26df990-13a52c68.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p multiple abdominal surgeries, intubated // interval change interval change IMPRESSION: In comparison with the study of ___, there is worsening of the pulmonary edema with continued bilateral effusions and compressive basilar atelectasis. Cardiomegaly is again seen. Monitoring and support devices are unchanged. " 1fdb260a-9689c8ab-db13b213-c17d07da-25ac27d6.jpg,test/p10/p10558918/s55296963/1fdb260a-9689c8ab-db13b213-c17d07da-25ac27d6.jpg,test," FINAL REPORT HISTORY: ___-year-old female with fever, sweats and cough. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___ and ___. FINDINGS: Frontal and lateral chest radiograph demonstrate well-expanded lungs. There is mild interstitial edema. Mild cardiomegaly is noted. The aorta is tortuous and atherosclerotic calcifications are seen at the aortic knob. A two-lead cardiac pacer is seen with a presumed abandoned third lead. There are moderate degenerative changes seen of the thoracic spine. " 4cca295b-7dc3d769-40f45c2e-4690be02-f006a499.jpg,test/p14/p14591676/s50510409/4cca295b-7dc3d769-40f45c2e-4690be02-f006a499.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion,s/p thoracentesis // s/p thoracentesis s/p thoracentesis IMPRESSION: In comparison with study of earlier in this date, there has been a left thoracentesis with removal of a moderate amount of pleural fluid. Substantial remainder is again seen. No evidence of post procedure pneumothorax. The lung volumes are improved an the right lung is essentially clear. " 915fd1bc-cac846b7-dc557c68-fe480c1e-0c15ff59.jpg,test/p18/p18526154/s53707977/915fd1bc-cac846b7-dc557c68-fe480c1e-0c15ff59.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and fever - hx of lung cancer on treatment with good response so far // cough and fever cough and fever IMPRESSION: In comparison with study of ___, the patient has taken a much better inspiration. " 65d38ad6-b435c078-956cae5d-5ef774d3-07c80fee.jpg,test/p10/p10329555/s52850859/65d38ad6-b435c078-956cae5d-5ef774d3-07c80fee.jpg,test," FINAL REPORT HISTORY: Lung cancer with dyspnea on exertion and known left upper lobe collapse. FINDINGS: In comparison with study of ___, there is again evidence of a hilar mass with associated left upper lobe collapse. The area of the humeral head where there was a sclerotic focus previously is not definitely evaluated on this study. Shift of the mediastinum is seen towards the left. The right lung is essentially clear, and there is no evidence of vascular congestion. A nodular opacification at the left base represents prominent nipple shadow. " 569858b5-96ae8fbf-dd5d75c8-1b8718d4-8e18da8b.jpg,test/p19/p19130309/s56697475/569858b5-96ae8fbf-dd5d75c8-1b8718d4-8e18da8b.jpg,test," FINAL REPORT INDICATION: ___-year-old man with persistent cough, recent URI, known heart failure, assess for pneumonia, pulmonary edema. COMPARISONS: PA and lateral chest radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is unchanged. A left chest wall pacemaker is seen with lead in the right ventricle. Median sternotomy wires are intact. Surgical clips are present in the left chest wall. There are no acute skeletal findings. IMPRESSION: No acute cardiopulmonary process. " 4f3df502-ed93ed1e-f0653d17-d6b56a02-30204255.jpg,test/p10/p10706411/s59938913/4f3df502-ed93ed1e-f0653d17-d6b56a02-30204255.jpg,test," FINAL REPORT AP CHEST, 11:14 A.M., ___ HISTORY: Respiratory failure, diabetes, hypertension, hypothyroidism, depression. IMPRESSION: AP chest compared to ___: Pneumonia in the right lung was followed by pulmonary edema. Since ___, there has been substantial clearing, but there are still small areas of nodular consolidation and possible cavitation in both lungs. Heart size is mildly enlarged but unchanged. ET tube, right internal jugular and left internal jugular catheters in standard placements. Upper enteric drainage tube should be advanced 5 cm to move all the side ports into the stomach. No pneumothorax or pleural effusion. " 3cbd042b-d4c9406c-b956a579-a458d327-c68e337a.jpg,test/p13/p13424439/s53667003/3cbd042b-d4c9406c-b956a579-a458d327-c68e337a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with post bronch pneumothorax // status of ptx status of ptx IMPRESSION: In comparison with the study ___ ___, following the procedure there is evidence of mediastinal gas along the left side of the chest from the hilum to the transverse arch of the aorta with extension into the soft tissues of the lower neck. The otherwise, there again are disuse scattered areas of opacification bilaterally. No definite pneumothorax. " 8f501be1-cc4ddc5a-015045f8-09ad6dd7-47d7d147.jpg,test/p14/p14485086/s53932365/8f501be1-cc4ddc5a-015045f8-09ad6dd7-47d7d147.jpg,test," FINAL REPORT INDICATION: History of sepsis. Evaluate for interval change. COMPARISONS: Chest radiograph, ___. Chest radiograph, ___. FINDINGS: An endotracheal tube is approximately 5.7 cm from the carina. A right internal jugular catheter ends in the mid SVC. A feeding tube is seen with the tip in the stomach, although the side port overlies the esophagus. The cardiomediastinal silhouette is normal. A larger right and moderate left pleural effusion are unchanged in size from the prior radiograph. There is no new consolidation. There is no pneumothorax. IMPRESSION: 1. Stable large right and moderate left pleural effusions. 2. Side port of the feeding tube within the esophagus. " bb89e6b4-ff82a842-c00c47af-6d20fe24-19b3080d.jpg,test/p19/p19750978/s50945137/bb89e6b4-ff82a842-c00c47af-6d20fe24-19b3080d.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Cirrhosis, recent ex lap for free air, question new free air. FINDINGS: This is an AP portable upright film and therefore has less sensitivity for free air than standing upright film. No free air is identified. The lungs are clear. Right IJ line is unchanged. " fdf0c30c-66185aad-efc5c8b4-983620b8-ce7c6649.jpg,test/p14/p14044629/s53636515/fdf0c30c-66185aad-efc5c8b4-983620b8-ce7c6649.jpg,test," FINAL REPORT INDICATION: History of lupus and pericarditis. Presenting with chest pain. COMPARISONS: Chest radiograph from ___. Chest CT from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The mediastinal contours are normal. The heart size is at the upper limits of normal. Sternal wires are intact. There is stable non-___ of the manubrium and sternum, which was previously identified on the prior CT. IMPRESSION: No acute cardiopulmonary process. " 3a37de2d-4c279c82-cdf147c3-04ca33b1-da895027.jpg,test/p11/p11401718/s57940484/3a37de2d-4c279c82-cdf147c3-04ca33b1-da895027.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with tachypnea, UTI, hx of dCHF // evidence of edema evidence of edema IMPRESSION: Compared to chest radiographs since ___, most recently ___. Very low lung volumes exaggerate mild pulmonary edema and pulmonary vascular congestion. Heart size probably top-normal. No An unexplained in radio-opaque line projecting over the left supraclavicular region could be a small left apical pneumothorax or vascular calcification or, most likely, something external. Repeat examination should be performed when feasible. Pleural effusions are small if any. NOTIFICATION: The findings were discussed with ___ , M.D. by ___, M.D. on the telephone on ___ at 8:43 AM, 1 minutes after discovery of the findings. " 4a764dfa-de07c23a-9528401d-35a7f2af-37b15678.jpg,test/p15/p15117526/s58944535/4a764dfa-de07c23a-9528401d-35a7f2af-37b15678.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure, gastrointestinal bleed, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes with borderline size of the cardiac silhouette and mild tortuosity of the thoracic aorta. Left pectoral pacemaker in situ. Leads positioned in the right atrium and right ventricle. Bilateral hilar enlargement, likely caused by dilated pulmonary arteries. However, coexisting adenopathy cannot be excluded and could be confirmed with CT. No pneumothorax, no pleural effusions. No evidence of pneumonia. " 17b9accc-278e61aa-14151ab2-1a482e6f-b53410cb.jpg,test/p14/p14045504/s50801327/17b9accc-278e61aa-14151ab2-1a482e6f-b53410cb.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___ COMPARISON: ___ chest radiograph. FINDINGS: Left apicolateral hydropneumothorax is similar in appearance to the previous study. Although it appears small in size on the frontal view, it is more substantial on the lateral view in the retrosternal region and is best characterized as moderate in size. Postoperative alterations of the cardiomediastinal contours on the left are unchanged as well as left-sided volume loss consistent with prior left upper lobe resection. Improving atelectasis at the lung bases, and a decrease in small left pleural effusion, which is nearly resolved. Probable persistent small right pleural effusion. IMPRESSION: Persistent left hydropneumothorax. " f3223104-4cf456f4-17bd4446-764d366e-015bad57.jpg,test/p12/p12471831/s54892027/f3223104-4cf456f4-17bd4446-764d366e-015bad57.jpg,test," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___ chest radiograph. FINDINGS: Heart size is top normal, exaggerated by low lung volumes. Cardiomediastinal contours are stable. Increased retrocardiac opacity may represent atelectasis, but is compatible with infection in the appropriate clinical setting. No substantial pleural effusion or pneumothorax. Right PICC terminates in the upper SVC. Left humeral head screws are in stable position. IMPRESSION: New retrocardiac opacity may represent atelectasis but could represent infection in the appropriate clinical setting. " 56ca7fa4-acb1423b-c0ee2b70-3d431792-45032197.jpg,test/p17/p17763712/s56497923/56ca7fa4-acb1423b-c0ee2b70-3d431792-45032197.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion and pleurex cath in place // please re-evaluate please re-evaluate IMPRESSION: In comparison with the study of ___, the left apical pneumothorax has essentially cleared. Continued hyperexpansion of the lungs is consistent with chronic pulmonary disease. Bilateral pleural effusions with compressive basilar atelectasis again seen. No evidence of acute focal pneumonia or vascular congestion. " 2dfbb644-a3ed11ae-d79e8bca-3b10a953-1f1fa5ef.jpg,test/p19/p19722097/s56644373/2dfbb644-a3ed11ae-d79e8bca-3b10a953-1f1fa5ef.jpg,test," WET READ: ___ ___ ___ 10:13 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness/ dyspnea COMPARISON: Chest radiograph study from ___. FINDINGS: PA and lateral views of the chest provided. The lungs are hyperinflated but clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " ad08154b-84264188-e5042541-c4a59fce-5e9bd246.jpg,test/p14/p14546527/s58041802/ad08154b-84264188-e5042541-c4a59fce-5e9bd246.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with effusion // effusion f/u COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the left internal jugular vein catheter and the left pleural drain has been removed. The left pleural effusion has minimally degree accumulated but the effusion is restricted to the area of the left costophrenic sinus. Moderate cardiomegaly persists. Pre-existing parenchymal opacities at the level of the left hilus have almost completely resolved. Normal appearance of the right lung. The alignment of the sternal wires is constant and normal. " d564b8bd-1984a263-893e4340-ad464d65-5a365d87.jpg,test/p11/p11740539/s59959483/d564b8bd-1984a263-893e4340-ad464d65-5a365d87.jpg,test," FINAL REPORT HISTORY: Status post CABG. COMPARISON: ___. FINDINGS: One the right IJ line with tip in the right atrium is unchanged. The continues to be a small amount of volume loss in both lower lungs although aeration is slightly better than the film from 2 days prior. There is a small left apical pneumothorax similar in size compared to the prior study. " 480e095c-3ae72546-ddcf394d-e20f3c9e-72984e07.jpg,test/p15/p15588831/s54844817/480e095c-3ae72546-ddcf394d-e20f3c9e-72984e07.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p cabg and l vats // eval ptx and effusions COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Status post VATS and CABG. Small pleural effusions are visualized and better seen on the lateral than on the frontal radiograph. The small cavitary lesion in the left lung apex is constant. Moderate cardiomegaly and sternal wires persist. " b49e83d0-fd960418-4e70e02f-a1d20b09-343eb43b.jpg,test/p12/p12535940/s52526702/b49e83d0-fd960418-4e70e02f-a1d20b09-343eb43b.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough, crackles right lower base // ? pneumonia (PLEASE PAGE ___ IF POSITIVE) TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___ FINDINGS: The lung volumes are stable. A retrocardiac opacity does not the hemidiaphragm silhouettes. There is however a lower left lung opacity partially obscuring the left heart border. The cardiomediastinal hilar contours are normal. The pleural surfaces are normal. Stable degenerative changes of thoracic spine. IMPRESSION: Left lower lung opacity, less likely a retrocardiac opacity, could represent atelectatic changes or in the appropriate clinical setting may represent a consolidation suggestive of pneumonia. NOTIFICATION: Unsuccessful attempts were made to contact the referring physician. Therefore, the impression impression above was entered by Dr. ___ on ___ at 14:36 into the Department of Radiology critical communications system for direct communication to the referring provider. " 141529f3-4384c55c-0b1d30ae-5c794ca1-d5764528.jpg,test/p14/p14605980/s50041045/141529f3-4384c55c-0b1d30ae-5c794ca1-d5764528.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 3 days chest pressure // ?abnormalities ?abnormalities IMPRESSION: No comparison. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. No pneumothorax. The lateral radiograph shows a normal spine and ribcage. " 674f2fc0-7d829b31-9815de62-da44943a-68d98283.jpg,test/p13/p13210259/s51796339/674f2fc0-7d829b31-9815de62-da44943a-68d98283.jpg,test," FINAL REPORT HISTORY: Left-sided chest pain. COMPARISON: ___. FINDINGS: AP and lateral views of the chest demonstrate normal heart size. Mediastinal contours are normal. Again noted is a small left pleural effusion with a new right pleural effusion and adjacent atelectasis. Bibasilar opacities are potentially atelectasis. Correlate clinically for infection. There are mildly increased interstitial markings. A tortuous, calcified descending aorta is noted. Calcified apical scarring is seen. IMPRESSION: Unchanged left pleural effusion with new right pleural effusion and biasilar atelectasis. Correlate clinically for infection. " d88a038a-9e7a372a-26a7366e-2bc3f532-47899179.jpg,test/p13/p13647340/s57597872/d88a038a-9e7a372a-26a7366e-2bc3f532-47899179.jpg,test," WET READ: ___ ___ 2:55 AM 1. No acute cardiopulmonary process. 2. Multiple congenital rib anomalies. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with wheezing, SOB, evaluate for pneumonia or acute process. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. Multiple rib anomalies are noted including ___ paired ribs, left sixth and seventh rib fusion, and multiple irregularly spaced rib interspaces. IMPRESSION: 1. No acute cardiopulmonary process. 2. Multiple congenital rib anomalies. " 3183173f-1e26d95e-96487d81-d0862f16-d95a1f71.jpg,test/p12/p12032671/s52896684/3183173f-1e26d95e-96487d81-d0862f16-d95a1f71.jpg,test," FINAL REPORT INDICATION: ___ year old man with new NGT placement // please confirm 1 of 2 step process TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: Initial radiograph at 201:47 hrs demonstrates the a NG tube with its tip in the esophagus beyond the tracheal bifurcation. On the second image obtained at 21:53, the tip projecting over the stomach. The tip of the left PICC line projects over the superior cavoatrial junction. No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiac silhouette is unchanged. IMPRESSION: Interval placement of a gastric tube which extends into the body of the stomach. " 455955e1-9bff664f-9c430c3e-ddf511c1-0cdbb459.jpg,test/p11/p11975330/s50978721/455955e1-9bff664f-9c430c3e-ddf511c1-0cdbb459.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with hemoptysis and history of right upper lobectomy for cancer ___ years ago. Evaluate for cancer recurrence. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding available chest examination of ___. The heart is mildly enlarged. There is a prominence of the left ventricular contour to the left and posteriorly, but there is no evidence of marked left atrial enlargement. The thoracic aorta is mildly widened and shows calcium deposits in the wall at the level of the arch. There is no local contour abnormality of the thoracic aorta. Pulmonary vasculature is not congested. There is a moderately elevated right-sided diaphragm, a finding which coincides with a deformity of the third and fourth rib posteriorly suggesting an old right-sided thoracotomy. As this also coincides with a mild elevation of the right-sided hilar structures, these findings are compatible with a previously performed right upper lobectomy as indicated in the requisition. There is no evidence of new acute pulmonary infiltrates on either side nor is there evidence of pleural effusion in the lateral or posterior pleural sinuses. No other significant skeletal abnormalities within the thorax area as the previously described rib deformities. Mild cardiac enlargement mostly involving the left ventricle in this elderly female patient, but no signs of acute pulmonary vascular congestion. Described changes in right hemithorax compatible with right upper lobectomy. No evidence of reoccurrence of pulmonary malignancy or signs of metastases. " a0dc7073-f0efa8d3-df44ee78-0c51dc5d-e5098c89.jpg,test/p13/p13154240/s57941801/a0dc7073-f0efa8d3-df44ee78-0c51dc5d-e5098c89.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with black sputum and cough. // r/o pneumonia TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 351d6f74-def8551c-425c136c-a74db518-1e0e37f8.jpg,test/p18/p18649932/s59796101/351d6f74-def8551c-425c136c-a74db518-1e0e37f8.jpg,test," FINAL REPORT INDICATION: Altered mental status. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are within normal limits. The pulmonary vascularity is normal. The lungs are clear. No pleural effusion or pneumothorax is visualized. The patient is status post fixation of a right mid clavicular fracture with plate and multiple screws. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " dad29dda-b71c17e9-b195b39f-ecc853e0-eb447231.jpg,test/p17/p17767787/s57368804/dad29dda-b71c17e9-b195b39f-ecc853e0-eb447231.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with hypoglycemia TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Heart size remains moderately enlarged. The mediastinal contour is unchanged. There is mild pulmonary vascular congestion, as seen previously. No focal consolidation, pleural effusion or pneumothorax is present. Electronic devices are seen projecting over the chest bilaterally which obscures assessment of the underlying lung bases. No acute osseous abnormalities seen. IMPRESSION: Study is somewhat limited by the presence of overlying external devices. Mild pulmonary vascular congestion, similar to the previous study. " 161772bb-7610068f-7b113389-07df74c7-f3bcae90.jpg,test/p10/p10430393/s57905286/161772bb-7610068f-7b113389-07df74c7-f3bcae90.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with abd pain after a fall // acute process COMPARISON: Concurrent CT abdomen, CT chest 5 hr later FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation or pneumothorax. Markedly dilated and very tortuous aorta. Vertebral compression deformities are better seen on concurrent CT. No free air below the right hemidiaphragm is seen. IMPRESSION: Markedly dilated and very tortuous aorta is better evaluated on subsequent CT chest, dictated separately. " c6ba19a9-1bed3f6d-6c5a8c43-c91bed1d-ab9687a0.jpg,test/p15/p15798014/s51701509/c6ba19a9-1bed3f6d-6c5a8c43-c91bed1d-ab9687a0.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old female two days status post fall, presents with persistent malaise and nausea, assess for pneumonia. FINDINGS: AP and lateral views of the chest were provided. A large mass is redemonstrated in the right upper lobe without significant overall change in appearance. There is a persistent small right pleural effusion with right basilar atelectasis and elevation of the right hemidiaphragm. The left lung is unchanged. Overall, cardiomediastinal silhouette is stable with coronary stents partially imaged. Bony structures are intact. Clips in the right upper quadrant noted. IMPRESSION: Large right upper lobe mass again seen with small right pleural effusion and right basal atelectasis. No definite acute changes to account for the patient's symptoms. " fdf63d9b-88123d5d-3f0c4305-e6ed9f44-8765f6a1.jpg,test/p11/p11967908/s51206080/fdf63d9b-88123d5d-3f0c4305-e6ed9f44-8765f6a1.jpg,test," FINAL REPORT INDICATION: ___-year-old female with non-Hodgkin's lymphoma and CHF, presenting with generalized weakness. Rule out pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: AP and lateral chest radiographs were provided. There is prominence of the interstitial markings, slightly increased since the prior exam consistent with mild pulmonary edema. There is no focal consolidation or pneumothorax. Speckled calcifications in the right upper lung are stable from the prior CT chest. There are small bilateral pleural effusions, similar in appearance to the prior study. The cardiomediastinal silhouette is unchanged. Patient is status post right axial dissection with clips. The bones are intact. IMPRESSION: Slightly worsened pulmonary edema. Stable small bilateral pleural effusions. " 8c70ef90-f441a4b3-9b0f1426-6c9816ab-e68430d6.jpg,test/p14/p14729260/s50263601/8c70ef90-f441a4b3-9b0f1426-6c9816ab-e68430d6.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: A ___-year-old woman being worked up for a bone marrow transplant. IMPRESSION: PA and lateral chest compared to ___: Heart size top normal, unchanged. Upper lobe pulmonary vasculature mildly dilated, new since ___. Although this is often an indication of early cardiac decompensation, there is no pulmonary edema or pleural effusion. Shape of the cardiac silhouette indicates left atrial enlargement. Lungs are clear, pleural surfaces unremarkable. " 0df4f963-8b3d2007-c977cbd7-751db997-ada9c5a9.jpg,test/p16/p16526126/s54365719/0df4f963-8b3d2007-c977cbd7-751db997-ada9c5a9.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old female with fever for ___ days. HIV positive. Renal transplant. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. No evidence of intrathoracic infection or malignancy. " 6ac7fa63-a3677e51-55b6201e-0bedc5d1-33b7b3c6.jpg,test/p18/p18614648/s54705874/6ac7fa63-a3677e51-55b6201e-0bedc5d1-33b7b3c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with productive cough TECHNIQUE: Portable chest x-ray COMPARISON: Portable chest x-ray dated ___ at 4:59am. FINDINGS: Again seen is spinal hardware. There is a retrocardiac opacity consistent with volume loss in at the left lower lung. The lungs are otherwise clear. The cardiomediastinum is left shifted as compared to prior, but this could be due to obliquity. IMPRESSION: Retrocardiac opacity with associated volume loss at the left lower lung, but this may be due to the change in obliquity of the patient. " dbe69a5e-2d3a2509-dcabfb3b-330b0140-af0113c4.jpg,test/p17/p17729814/s51392282/dbe69a5e-2d3a2509-dcabfb3b-330b0140-af0113c4.jpg,test," FINAL REPORT INDICATION: ___ year old woman with sdh, edh // eval for interval change COMPARISON: Radiographs from ___ IMPRESSION: Support lines and tubes are unchanged in position. The side port of the nasogastric tube is again at the GE junction and could be advanced several cm for more optimal placement. Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. Atelectasis at the lung bases is again seen. There are no pneumothoraces. " 539ce39a-abe69d24-1e9065f1-39605064-cc9050b8.jpg,test/p15/p15687638/s57370125/539ce39a-abe69d24-1e9065f1-39605064-cc9050b8.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: ___-year-old female with history of asthma and complains of inability to stop shivering. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There may be minimal pulmonary vascular congestion. The cardiac silhouette is top normal. The aortic knob is calcified. IMPRESSION: No focal consolidation. Possible minimal pulmonary vascular congestion. Top normal cardiac silhouette. " beb05c22-d3ae4c7c-62ebbbfa-c3651dd7-a34b7f28.jpg,test/p11/p11312914/s56400917/beb05c22-d3ae4c7c-62ebbbfa-c3651dd7-a34b7f28.jpg,test," FINAL REPORT INDICATION: Two-three-week history of cough and inspiratory crackles at the left base, treated with antibiotics. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: There is no consolidation, pleural effusion, vascular congestion or pneumothorax. There is mild cardiomegaly and the aorta is tortuous, unchanged. IMPRESSION: No evidence pneumonia or volume overload. Findings were relayed by Dr. ___ to Dr. ___ by phone at 10:33 a.m.. " ada7a096-f4963d75-9db48387-d41f7f21-167f12f5.jpg,test/p16/p16254738/s51581110/ada7a096-f4963d75-9db48387-d41f7f21-167f12f5.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with lobar collapse, evaluation for interval change. COMPARISON: ___. FINDINGS: Mild cardiac congestion has slightly increased. There is no pneumothorax or pleural effusion. Mediastinal and cardiac contours are normal. Lung volumes are low. Tracheostomy is in adequate position. CONCLUSION: Worsening of mild pulmonary edema. " 33214875-c5a8ab32-56eff638-26a27272-667c5e55.jpg,test/p15/p15597371/s56799145/33214875-c5a8ab32-56eff638-26a27272-667c5e55.jpg,test," FINAL REPORT INDICATION: Hypoxia. COMPARISON: ___. FINDINGS: Portable AP chest radiograph is technically limited due to the patient's inability to remain still per technologist's note. Pulmonary vascular congestion, perihilar opacities, and bilateral pleural effusions are consistent with moderate pulmonary edema. The heart size is not significantly changed compared to ___. There is no pneumothorax. IMPRESSION: Moderate pulmonary edema. " 1eb64188-91a8891d-9abee782-9fa65477-5fe42818.jpg,test/p16/p16013292/s56772750/1eb64188-91a8891d-9abee782-9fa65477-5fe42818.jpg,test," FINAL REPORT INDICATION: Substernal and epigastric discomfort. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The patient is status post median sternotomy and CABG. The heart size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal and the lungs are clear. No pleural effusion or pneumothorax is visualized. There are mild degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " cae24ba4-cd9f60bc-b01fbb1c-a88fd155-2b452cbc.jpg,test/p17/p17747028/s50873873/cae24ba4-cd9f60bc-b01fbb1c-a88fd155-2b452cbc.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest tightness and shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Normal chest radiographs. " e48fe8a7-e195c5f1-f2d8af0a-804bf637-10e933d5.jpg,test/p17/p17222468/s55557615/e48fe8a7-e195c5f1-f2d8af0a-804bf637-10e933d5.jpg,test," FINAL REPORT INDICATION: ___-year-old woman status post right upper lobectomy for lung cancer, ? interval change. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs were obtained. Heart is normal size and cardiomediastinal contours are unchanged. Increased prominence of vascular markings likely suggests pulmonary vascular engorgement and fluid overload. Low volume lungs are clear bilaterally. No significant pleural effusions. Right apical pneumothorax is stable. Extensive subcutaneous emphysema is again noted within the right lateral chest wall and right neck. There is interval removal of the right-sided chest tube. IMPRESSION: Stable right apical pneumothorax. No significant changes compared to the prior radiograph. " 16f4e00d-7a4fa56d-fdb9cbec-619be1fa-89423bb1.jpg,test/p17/p17473608/s57614421/16f4e00d-7a4fa56d-fdb9cbec-619be1fa-89423bb1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with partial right MCA infarct. Evaluate for pneumonia. TECHNIQUE: Portable AP upright chest radiograph COMPARISON: ___ FINDINGS: There is moderate stable cardiomegaly compared to ___. Dual-chamber pacemaker leads are unchanged. The lungs demonstrate increased pulmonary vascular congestion and mild interstitial edema with no large pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: Pulmonary vascular congestion of mild interstitial edema, however no evidence of pneumonia. Moderate cardiomegaly. " b2f95101-57bf5f00-7571b0f3-988d362d-2bdad8e7.jpg,test/p18/p18456006/s58899313/b2f95101-57bf5f00-7571b0f3-988d362d-2bdad8e7.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Shortness of breath, diabetes, hypertension, viral pneumonia. Followup volume overload. Comparison is made with prior study, ___. Moderate cardiomegaly is accentuated by the projection and low lung volumes. The aorta is tortuous and there is no evidence of volume overload in the current study. There is no pneumothorax or pleural effusion. " e6cb026a-61ea8616-a2358343-08336ad6-7c90c3f2.jpg,test/p11/p11124675/s56596422/e6cb026a-61ea8616-a2358343-08336ad6-7c90c3f2.jpg,test," FINAL REPORT INDICATION: ___-year-old woman, intubated, question interval change. COMPARISONS: Multiple prior radiographs, most recently portable AP radiograph from ___. FINDINGS: ET tube is 5.6 cm from the carina. NG tube is seen coursing below the diaphragm; however, is not completely imaged. Since the most recent prior radiograph, lung volumes are slightly lower. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unchanged. A right PICC line has been removed. IMPRESSION: Slightly lower lung volumes. Otherwise, no significant change. " 90875937-91c71245-8a6981bd-e5190cbb-061dff7b.jpg,test/p14/p14915803/s50031377/90875937-91c71245-8a6981bd-e5190cbb-061dff7b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // r/o infiltrate FINDINGS: Cardiomediastinal contours are normal. Lungs are grossly clear. No pleural effusion or pneumothorax. IMPRESSION: No findings to account for cough. " 3b2c1e24-a8532898-e5334342-5d7d69b8-c24f569b.jpg,test/p17/p17446597/s55040804/3b2c1e24-a8532898-e5334342-5d7d69b8-c24f569b.jpg,test," FINAL REPORT HISTORY: ___-year-old male with diastolic congestive heart failure now with respiratory distress. Evaluate for pulmonary edema. COMPARISON: Multiple prior chest radiographs most recently ___. FINDINGS: Portable frontal chest radiograph demonstrates interval removal of endotracheal tube. Redistribution of right pleural effusion now with right basal predominance. Left vascular congestion with mild edema. Cardiomegaly with unchanged hilar contour. No focal consolidation. Inferior sternotomy wire fracture is noted. No pneumothorax. IMPRESSION: Redistributed right pleural effusion with mild edema. " ad33bba2-62d3ed6f-a5491ca6-2fa9946f-91a5c7bb.jpg,test/p17/p17957742/s57732607/ad33bba2-62d3ed6f-a5491ca6-2fa9946f-91a5c7bb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MODS // interval change interval change COMPARISON: Comparison to ___ at 11:12 FINDINGS: Portable supine chest radiograph ___ at 07:26 is submitted. IMPRESSION: Persistent more focal areas of consolidation in the left mid and lower lung are seen and could reflect pneumonia. However, there is increasing pulmonary opacities bilaterally suggesting that these findings could solely reflect worsening asymmetric moderate to severe pulmonary edema. Clinical correlation is recommended. No pneumothorax, although the sensitivity to detect pneumothorax is diminished given supine technique. Probable small layering effusions. Patient is status post median sternotomy with aortic valve replacement and stable postoperative cardiac and mediastinal contours. Right subclavian central line, left internal jugular dual-lumen catheter, endotracheal tube and nasogastric tube are unchanged in position. " 65b68238-c242b1b4-7ec2dbbf-21f3c435-97b76948.jpg,test/p12/p12032671/s55417629/65b68238-c242b1b4-7ec2dbbf-21f3c435-97b76948.jpg,test," FINAL REPORT INDICATION: ___ year old man with fevers // Please evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low with accentuates normal heart size. Normal mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " a7bb10e5-d6f78cab-78efc828-8c0f65eb-482e48e5.jpg,test/p16/p16990823/s55756107/a7bb10e5-d6f78cab-78efc828-8c0f65eb-482e48e5.jpg,test," FINAL REPORT HISTORY: Chest pain and shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities detected. IMPRESSION: Normal chest radiograph. " b2e87053-e2e6f3e8-022a57a3-eb022a77-da5e833e.jpg,test/p15/p15211166/s54227419/b2e87053-e2e6f3e8-022a57a3-eb022a77-da5e833e.jpg,test," FINAL REPORT INDICATION: ___-year-old female with hypoxia. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: Two frontal images of the chest were obtained. There are low lung volumes likely secondary to poor inspiration. The lungs are clear. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. IMPRESSION: Essentially unchanged chest radiograph with no evidence of acute cardiac or pulmonary pathologies. " 36dc5446-925e0e98-f81e37e8-8f3d3df0-57447d64.jpg,test/p15/p15057394/s54471175/36dc5446-925e0e98-f81e37e8-8f3d3df0-57447d64.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. The patient is apparently status post coronary artery bypass graft surgery. There is no pleural effusion or pneumothorax. There is a mild increase in patchy opacity in the left lower lobe which suggests minor atelectasis. Elsewhere the lungs appear clear. Deformity of the left anterior lateral left fifth rib appears unchanged. IMPRESSION: Mild increase in opacity at the left lung base suggesting mild increase in pre-existing atelectasis; no definite evidence of disease. " 86075489-1dafd76a-5ab65e27-a19fbe6c-5b4a61b1.jpg,test/p13/p13135946/s52546073/86075489-1dafd76a-5ab65e27-a19fbe6c-5b4a61b1.jpg,test," FINAL REPORT INDICATION: Rule out aspiration. COMPARISON: Chest radiographs on ___ and ___. FINDINGS: PA and lateral views of the chest. A PICC line ends in the mid-to-low SVC. Small bilateral pleural effusions seen only on the lateral view have decreased since ___. Aside from minimal atelectasis at the posterior left lung base, the lungs are clear. The aorta is tortuous but not dilated. Heart size is normal. IMPRESSION: 1. Minimal left basal atelectasis. 2. Small bilateral pleural effusions, decreased in size compared to ___. 3. No evidence of aspiration. " c36d4f4e-ad4be4b5-7ced1999-edb1ff3f-2d4d24ff.jpg,test/p19/p19166734/s59121700/c36d4f4e-ad4be4b5-7ced1999-edb1ff3f-2d4d24ff.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M s/p MVC // Please assess for traumatic injury TECHNIQUE: Portable chest x-ray. COMPARISON: None. FINDINGS: Portable semi-upright radiograph of the chest demonstrates a normal cardiomediastinal silhouette. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 735b9ec0-24fffc84-34f92eff-23d87d2f-a9e9b06e.jpg,test/p19/p19151721/s51433832/735b9ec0-24fffc84-34f92eff-23d87d2f-a9e9b06e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is little overall change. Moderate cardiomegaly, nasogastric tube in situ. Both left and right internal jugular vein catheter are in unchanged position. No pleural effusions. No pneumothorax. Minimal fluid overload. " 552aba15-c52909b9-55a61285-246f45b6-ccc58095.jpg,test/p17/p17175679/s50019398/552aba15-c52909b9-55a61285-246f45b6-ccc58095.jpg,test," FINAL REPORT INDICATION: ___M with nausea x 3 days, back pain. crackles at the bases cough // r/o pna vs pulmonary edema vs pneumothorax TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear of consolidation, large effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " f83c0952-2fd6f851-61792f3f-af0548eb-b86f9b98.jpg,test/p18/p18123897/s52606675/f83c0952-2fd6f851-61792f3f-af0548eb-b86f9b98.jpg,test," FINAL REPORT INDICATION: ___F with vomiting, h/o chf // r/o chf, obstruction TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral chest radiograph demonstrate clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no evidence of pulmonary edema, pleural effusion, or pneumothorax. Imaged upper abdomen is unremarkable. No air is seen under the right hemidiaphragm. IMPRESSION: No acute intrathoracic abnormality. " b0e4257b-edf30bbb-8cc37886-748feb76-38671820.jpg,test/p18/p18264198/s53162768/b0e4257b-edf30bbb-8cc37886-748feb76-38671820.jpg,test," FINAL REPORT AP CHEST, 1:24 P.M., ___ HISTORY: ___-year-old man after tracheostomy. Question interval change. IMPRESSION: AP chest compared to ___: Tracheostomy tube is in standard placement. There is no mediastinal air or widening. Previous moderately severe pulmonary edema has improved, with the most pronounced residual around the left hilus and in the right infrahilar lung. Substantial atelectasis persists at the left lung base. There is no pneumothorax or more than minimal pleural effusion. Heart size normal. Right jugular line ends in the mid-to-low SVC and a nasogastric tube passes below the diaphragm and out of view. " b91355ac-f8749425-776a0e1e-db354f6b-6aef4517.jpg,test/p17/p17396346/s57367485/b91355ac-f8749425-776a0e1e-db354f6b-6aef4517.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with dyspnea and hypoxia // r/o acute process COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Clips in the left axilla again noted with asymmetric breast size. Cardiomegaly is re- demonstrated with mild pulmonary edema. No convincing signs of pneumonia. Mild bibasilar atelectasis noted. No large effusion or pneumothorax. Bony structures are intact. IMPRESSION: Cardiomegaly with mild pulmonary edema. Mild bibasilar atelectasis. " a9148349-706bc4b5-d98236ca-1d744fe5-5184719d.jpg,test/p12/p12711775/s51105873/a9148349-706bc4b5-d98236ca-1d744fe5-5184719d.jpg,test," WET READ: ___ ___ 8:06 PM Mildly rotated position. Within this limitation, nodefinite acute cardiopulmonary process. Minimal blunting of the costophrenic and posterior recesses likely pleural thickening vs trace pleural effusion. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Possible syncope or seizure. IMPRESSION: 1. PA and lateral chest reviewed in the absence of prior chest radiographs: 2. PA ___ and lateral views of the chest reviewed in the absence of prior chest imaging: Eversion of the diaphragm contours suggests hyperinflation due to small airways obstruction and/or emphysema. No focal pulmonary abnormality is seen. Heart is normal size and there is no pleural effusion or evidence of central adenopathy. The esophagus is filled with air, but not particularly distended, a common finding in elderly patients. " 53f8efa9-4eab3bd0-53183a41-b74c0467-4e74672a.jpg,test/p18/p18001762/s57190506/53f8efa9-4eab3bd0-53183a41-b74c0467-4e74672a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with DOE, wheezing since yesterday, hx asthma, no fevers, chills, or chest pain // eval ? infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The cardiac silhouette size remains mildly enlarged. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. Minimal atelectasis is noted in the right lower lobe. There are no acute osseous abnormalities. IMPRESSION: Minimal atelectasis in the right lower lobe. Otherwise, no acute cardiopulmonary process. " e32d07fa-b4673720-0f1eb52d-cd979411-4caa1abb.jpg,test/p11/p11415795/s54498926/e32d07fa-b4673720-0f1eb52d-cd979411-4caa1abb.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with chronic appendicitis status post CABG, preop chest x-ray. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Previously seen pulmonary edema has resolved. The lungs are clear. There is no effusion or consolidation. Cardiomediastinal silhouette is top normal. Median sternotomy wires and mediastinal clips are again noted. Chronic right lateral rib fractures are identified. IMPRESSION: No acute cardiopulmonary process. " c35ecdb8-90e6a321-283a3405-773624d9-7352924f.jpg,test/p17/p17561108/s55868957/c35ecdb8-90e6a321-283a3405-773624d9-7352924f.jpg,test," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: Shortness of breath. COMPARISON: ___. FINDINGS: Single frontal view of the chest was obtained. Right-sided Port-A-Cath is again seen, terminating in the very upper SVC. Right lung volume remains low and there is a similar configuration to the entrapped/loculated fluid in the right lung. The left lung is clear. The cardiac and mediastinal silhouettes are stable. There is subtle possible increased opacity at the left lung base, which may relate to overlying soft tissue, although an early/developing consolidation is not excluded. IMPRESSION: Stable appearance to the right hemithorax. Equivocal subtle patchy opacity at the left lower lung, which could be due to atelectasis; however, developing consolidation is not excluded in the appropriate clinical setting. " 3fc53a2b-34b2b806-c40e6ddd-6cbcf624-ad6a53a5.jpg,test/p16/p16155910/s53521336/3fc53a2b-34b2b806-c40e6ddd-6cbcf624-ad6a53a5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Etoh CIRRHOSIS, ASCITES, HEMOCHROMATOSIS, CAD, AND PEPTIC ULCER DISEASE // New liver transplant evaluation. please assess for any cardiopulmonary abnormalities New liver transplant evaluation. please assess for any cardiopulmonary abnormalities IMPRESSION: Compared to prior chest radiographs since ___, most recently G ___. Lungs grossly clear. Heart size normal. No pleural abnormality or evidence of central lymph node enlargement. " 4032d914-dce9611c-0cbe678e-9ab64757-a766156c.jpg,test/p11/p11938332/s51657043/4032d914-dce9611c-0cbe678e-9ab64757-a766156c.jpg,test," FINAL REPORT INDICATION: History: ___F with cough and sputum // ?PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral chest radiograph demonstrate clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax or pleural effusion. No evidence of pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " 257c35cb-1429d652-1d6ae30c-0c1678d5-c1c0875b.jpg,test/p17/p17135687/s50318214/257c35cb-1429d652-1d6ae30c-0c1678d5-c1c0875b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with R CTs to H2O seal at ___. Need CXR at ___-___, please. // PTX increased? Need CXR at ___. TECHNIQUE: Portable chest COMPARISON: ___ at ___ 29 FINDINGS: There has been interval increase in the right-sided pneumothorax. 2 right-sided chest tubes are again seen. There has been interval increase in the left pleural effusion with complete opacification of the left lung and mediastinal shift to the left compatible with a volume loss and associated effusion/bleeding. Left chest tube is again visualized. Tracheostomy tube is seen. Bullet simple fragments are again visualized. The feeding tube tip is in the stomach. " ce37baf9-4600bdfc-7a8fa749-8318568e-0513fa52.jpg,test/p16/p16960145/s51500685/ce37baf9-4600bdfc-7a8fa749-8318568e-0513fa52.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with rib fx and fever, ? pneumonia v atelectasis // pna v atalectasis TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild cardiomegaly and tortuous aorta are again noted. Aside from atelectasis in the left base the lungs are clear. Patient has known multiple left rib fractures. There is no evident pneumothorax or increasing pleural effusions. " 6f89325c-7cba4e32-9db551d4-ec5cc64d-1dec914e.jpg,test/p10/p10078115/s56712964/6f89325c-7cba4e32-9db551d4-ec5cc64d-1dec914e.jpg,test," FINAL REPORT INDICATION: Left basal ganglia hemorrhage. Intubated. Assess for interval change. COMPARISON: Chest radiograph from ___. FINDINGS: The endotracheal tube is appropriately positioned, ending 6 cm above the level of the carina. A right subclavian central venous catheter ends in the low SVC. An enteric catheter courses below the level of the diaphragm and out of the field of view inferiorly. There is central pulmonary vascular congestion without frank interstitial pulmonary edema. Subsegmental left retrocardiac atelectasis is not significantly changed. Mild elevation of the right hemidiaphragm is not significantly changed. Mild cardiomegaly is similar in appearance. The mediastinal contours are unchanged. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: 1. Appropriately positioned lines and tubes. 2. Unchanged subsegmental left retrocardiac atelectasis and mild cardiomegaly. " 30a88ba5-00927d91-bde298dd-5ea9d5f7-d5dcae88.jpg,test/p10/p10151713/s53475872/30a88ba5-00927d91-bde298dd-5ea9d5f7-d5dcae88.jpg,test," WET READ: ___ ___ ___ 1:37 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F w/cough, please eval for white sputum, please eval for PNA // ___F w/cough, please eval for white sputum, please eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___ FINDINGS: The lungs are fully expanded and clear. There is no evidence of focal consolidation, pulmonary edema, or pneumothorax. There is mild blunting of the right costophrenic angle, possibly due to pleural thickening or a small pleural effusion. The cardiomediastinal silhouette and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 106aa395-112faee2-5d3f5dd7-b2c66a36-0c49a9d6.jpg,test/p12/p12256957/s51639337/106aa395-112faee2-5d3f5dd7-b2c66a36-0c49a9d6.jpg,test," FINAL REPORT HISTORY: Trip and fall on this side, right rib pain today. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. No acute fracture is seen. IMPRESSION: No acute fracture, although please note that rib series or CT are more sensitive. No acute cardiopulmonary process. " 6a6c7cfa-d8d84201-1729a440-3e418abe-05ae51ed.jpg,test/p18/p18704423/s57815203/6a6c7cfa-d8d84201-1729a440-3e418abe-05ae51ed.jpg,test," WET READ: ___ ___ 11:43 PM Large volume free intraperitoneal air which has increased compared to prior chest radiographs. Dr. ___ paged *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with confusion evaluate for pneumonia. TECHNIQUE: AP and lateral COMPARISON: Chest radiograph from ___ and abdominal radiograph ___. FINDINGS: There is a free intraperitoneal air seen below the diaphragm which appears increased from prior chest radiograph from ___. Cardiomediastinal silhouette is unchanged. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: Pneumoperitoneum which appears increased compared to prior chest radiographs. Unclear whether truly increased or due to differences in patient position. CT scan pending. " 4b660fbe-a3c8ece1-ed841440-11894da0-4ed7539e.jpg,test/p18/p18779306/s56015525/4b660fbe-a3c8ece1-ed841440-11894da0-4ed7539e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with melanoma s/p left axillary lymphadenectomy, complaining of chest tightness and sputum producing cough. // Pneumonia? COMPARISON: None available IMPRESSION: Cardiomediastinal contours are normal. Lungs are well expanded and grossly clear. " 725aec5b-ea0202b8-70a68bef-37e5ca2a-8853050e.jpg,test/p16/p16901713/s56376061/725aec5b-ea0202b8-70a68bef-37e5ca2a-8853050e.jpg,test," FINAL REPORT INDICATION: ___-year-old female patient with lupus and emphysema, presenting with wheezing. Study requested to rule out pleural effusion or pneumonia. COMPARISON: Prior chest radiograph from ___ and ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is atelectasis at the left lung base. Otherwise, no focal consolidations concerning for pneumonia are identified. There are no pleural effusions, pneumothorax or pulmonary edema. Visualized osseous structures are grossly unremarkable. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process. " 448d8382-9e727ad6-48643ae5-b9f0223e-f4f12b65.jpg,test/p18/p18133739/s58067523/448d8382-9e727ad6-48643ae5-b9f0223e-f4f12b65.jpg,test," FINAL REPORT INDICATION: History: ___F with exertional dyspnea // ? acute cardiopulm process COMPARISON: None. IMPRESSION: Cardiomediastinal silhouette is within normal limits. There is streaky atelectasis at the lung bases without definite consolidation. There is no pulmonary edema or pleural effusions. There are no pneumothoraces. " 98220657-19c13b54-5ac3c896-d64dc877-ef1d20b5.jpg,test/p16/p16233087/s56387319/98220657-19c13b54-5ac3c896-d64dc877-ef1d20b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Back pain and shortness breath. COMPARISON: Chest radiograph from ___. CT from ___. FINDINGS: The right lower lobe nodule is indistinct on today's study. The lungs are otherwise clear. An azygos lobe and fissure are incidentally noted. Mild cardiomegaly is stable. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " 5ace239b-61b2f2f3-103b0d93-d3803c39-ef06ca44.jpg,test/p17/p17962324/s50545797/5ace239b-61b2f2f3-103b0d93-d3803c39-ef06ca44.jpg,test," FINAL REPORT INDICATION: ___M with h/o cad w/ dyspnea and hypoxia // chf? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated but clear of focal consolidation. There is relative increased lucency in the right upper lung which is similar compared to prior. Elsewhere, interstitial markings are somewhat more prominent when compared to prior suggesting pulmonary vascular congestion. There is no focal consolidation suspicious for pneumonia nor pleural effusion. Cardiac silhouette is moderately enlarged. Median sternotomy wires and mediastinal clips are noted. No acute osseous abnormalities. IMPRESSION: Pulmonary vascular congestion without overt edema or focal consolidation. " e7bf10b7-477d551a-0d9b8209-3b0652b7-04229722.jpg,test/p15/p15395644/s58083141/e7bf10b7-477d551a-0d9b8209-3b0652b7-04229722.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p AVR, CABG, MVr, TVr // follow up effusions TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Mild pulmonary edema is unchanged. Cardiomegaly is unchanged. Sternotomy wires are stable. Left pleural effusion is large, unchanged. No appreciable pneumothorax is seen and overall no substantial change as compared to the prior study has been demonstrated except for minimal progression of interstitial edema " cbab0c07-ef99d976-54ff5ab2-5afa114f-4c1fbe58.jpg,test/p10/p10517359/s52254925/cbab0c07-ef99d976-54ff5ab2-5afa114f-4c1fbe58.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient suspected for chronic thromboembolism. Chest examination prior to V/Q scan of examination. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding chest examination of ___. Moderate cardiac enlargement is present with prominence of left ventricular contour and that of the left atrium. This suggests the possibility of moderate mitral valve incompetence. No other significant abnormalities are present and the lungs are not congested. The previously identified bilateral pleural effusions have disappeared. A new finding consists of a hazy density occupying the lateral and superior aspect of the right-sided hemithorax and coinciding with a clearly prominent soft tissue mass in the right axilla. There is no evidence of remaining pleural effusions laterally or posteriorly. In comparison with the previous examination, this new right-sided axillary density is new. Referring physician, ___. ___ ___ was contacted by telephone to report the questionable findings. The time was 4:15 p.m. " 30ffa5d3-1e2dce93-81b61338-0770fc91-a64f7972.jpg,test/p14/p14558435/s58964897/30ffa5d3-1e2dce93-81b61338-0770fc91-a64f7972.jpg,test," FINAL REPORT HISTORY: ___-year-old female with pleuritic chest pain. STUDY: Portable AP upright chest radiograph. COMPARISON: ___. FINDINGS: The heart size is within normal limits as are the mediastinal contours. The lung volumes are low but show no lobar consolidation. Again, a small amount of pleural fluid is seen tracking along the right lateral pleural space. Clips in the gallbladder fossa represent prior cholecystectomy with couple of dropped clips sitting just at the dome of the liver. A plastic CBD stent is also present. There is no pneumothorax. IMPRESSION: Low lung volumes and small right pleural effusion. " a1002ccb-9cb657c1-84261903-3ce3a676-1a74c445.jpg,test/p15/p15232493/s57410391/a1002ccb-9cb657c1-84261903-3ce3a676-1a74c445.jpg,test," FINAL REPORT INDICATION: ___-year-old lady with bilateral crackles, assess for edema. COMPARISON: Chest x-ray dated ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: Heart appears to be mildly enlarged. The calcification within the aortic arch is unchanged from the prior exam. Cardiomediastinal contours are otherwise unremarkable. There is a degree of haziness within the costophrenic angles as well as redistribution of pulmonary vasculature to suggest pulmonary vascular congestion; however, the degree of congestion does not appear to be significantly different from the prior study ___ ___. Lungs are otherwise clear with no focal infiltrates, pleural effusions or evidence of pneumothorax. Bony structures are intact. IMPRESSION: Mild pulmonary venous congestion. " c967b2c7-65868e38-7a06ea5d-589b8b81-0fa98a01.jpg,test/p16/p16669225/s58711504/c967b2c7-65868e38-7a06ea5d-589b8b81-0fa98a01.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old woman with CAP but persistent O2 requirement and now increasing leukocytosis. Parapneumonic effusion, abscess? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and CT chest from ___. FINDINGS: Since the prior radiograph, there has been interval worsening in the consolidation of the lower portion of the right upper lobe, of which the minor fissure is the lower border. This is consistent with pneumonia. The right heart border is obscured. There is blunting of the bilateral costophrenic angles with right greater than left pleural effusions. There is no pneumothorax. Osseous structures are unremarkable. IMPRESSION: 1. Interval worsening of the radiographic appearance of the right upper lobe pneumonia, without evidence of abscess. 2. Significant right greater than left pleural effusions. " c8a91f1e-e839833d-dd3bd000-a64a6f4c-57ee0f2f.jpg,test/p15/p15219741/s56728440/c8a91f1e-e839833d-dd3bd000-a64a6f4c-57ee0f2f.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cirrhosis, HCC with hepatic hydropneumothorax s/p pleural drainage catheter // evaluated for R pleural effusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. Go IMPRESSION: A large right pleural effusion with fissural component is increased from ___. The right pleural drainage catheter has been repositioned laterally. No pneumothorax. Mediastinal contours and cardiomegaly are stable. The left lung is well expanded and clear without pleural effusion or pulmonary edema. " 392ced8a-d043b6b6-ceeb7af7-2fa5e59a-2b7a30c9.jpg,test/p14/p14895079/s59031208/392ced8a-d043b6b6-ceeb7af7-2fa5e59a-2b7a30c9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval IMPRESSION: As compared to ___ chest radiograph, a right pleural catheter remains in place. A large, multiloculated right pleural effusion has increased in size and is associated with a worsening right mid and lower lung atelectasis and or consolidation. Cardiomediastinal contours are stable in appearance with persistent widening of the right peritracheal and right hilar contours corresponding to lymphadenopathy in this region. Left lung and pleural surfaces are clear. " 8fc056b5-2e1e6196-bb9ed617-3f131b0c-8907daea.jpg,test/p15/p15914421/s53798624/8fc056b5-2e1e6196-bb9ed617-3f131b0c-8907daea.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___F with sob // eval for pulm edema TECHNIQUE: Frontal portable chest radiograph COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are low, which accentuates bronchovascular markings. Subtle bibasilar opacities are not significantly changed, and compatible with known NSIP. There is no new focal consolidation, pleural effusion or pneumothorax. No overt pulmonary edema. Accounting for portal technique, cardiomediastinal silhouette is unremarkable. No acute osseous abnormalities are identified. The Port-A-Cath is unchanged in position with distal tip in the right atrium. Surgical clips are seen within the right axilla. IMPRESSION: Low lung volumes, without evidence of overt pulmonary edema. " b0a84653-e501ecee-243c210d-b58af648-1f5b2cc2.jpg,test/p16/p16034229/s54157854/b0a84653-e501ecee-243c210d-b58af648-1f5b2cc2.jpg,test," FINAL REPORT INDICATION: ___F with hx of Crohn's s/p recent I+D of perirectal abscess presenting w/ fevers and pain // Please evaluate for evidence of pneumonia TECHNIQUE: PA and lateral views the chest COMPARISON: ___. FINDINGS: Right PICC tip terminates over the lower SVC. The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. No free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process. " ca6da964-57f4416f-0cd66173-fa6d3683-f984c954.jpg,test/p12/p12799100/s56197158/ca6da964-57f4416f-0cd66173-fa6d3683-f984c954.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with altered mental status, fatigue // evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Obscuration of the anterior aspect of the right hemidiaphragm on the lateral view is suggestive of right basilar consolidation in the anterior segment and likely corresponds to obscuration of the lateral right hemidiaphragm on the frontal radiograph. The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. IMPRESSION: Focal right basilar consolidation concerning for early pneumonia. Follow-up radiographs are recommended 4 weeks after completion of antibiotic therapy to ensure resolution. " 8512bc5f-a32f8d55-0b1dc005-d6c0f444-78d971b1.jpg,test/p14/p14972258/s52832756/8512bc5f-a32f8d55-0b1dc005-d6c0f444-78d971b1.jpg,test," FINAL REPORT HISTORY: Struck by a car. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are identified. IMPRESSION: No acute cardiopulmonary process. " 245fa340-c9db87f3-1f8580bc-1622e021-a5145441.jpg,test/p14/p14400773/s59007933/245fa340-c9db87f3-1f8580bc-1622e021-a5145441.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and pain lungs when coughinbg // evaluate evaluate IMPRESSION: No previous images. The heart is normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 301e9c2e-945e4a0f-d0f215cd-1825c941-ada01752.jpg,test/p11/p11102931/s57541675/301e9c2e-945e4a0f-d0f215cd-1825c941-ada01752.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain. Rule out cardiopulmonary process. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is top normal in size. The hilar and mediastinal contours are within normal limits. There is tortuosity of the aorta. Lungs are clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process. " cd6cd2d4-a8587ed7-ea938051-fe9d633d-cc368625.jpg,test/p10/p10957877/s59787819/cd6cd2d4-a8587ed7-ea938051-fe9d633d-cc368625.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: MCA stroke and CHF, intubated. Comparison is made with prior study ___. Moderate-to-severe cardiomegaly is stable. Pacer leads are in standard position. ET tube tip is in standard position. NG tube tip high, the tip is at the level of the hemidiaphragms and the side port is in the mid esophagus, should be advanced for more standard position. Small left pleural effusion has increased. Mild-to-moderate pulmonary edema is stable. Right lower lobe opacities are combination of atelectasis and small effusion. Findings discussed with Dr ___ by phone on ___ at 1.45pm. " afcfd284-63418822-69e12ab3-c5009757-54d24967.jpg,test/p13/p13377780/s58696680/afcfd284-63418822-69e12ab3-c5009757-54d24967.jpg,test," FINAL REPORT INDICATION: ___F with cough, congestion, syncope // acute cardiopulm disaese TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Mildly increased interstitial markings are again seen throughout the lungs. Linear left basilar opacity most suggestive of atelectasis. The cardiomediastinal silhouette is within normal limits. Chronic deformities of the right lateral ribs are again seen. No acute osseous abnormalities identified. IMPRESSION: Prominent interstitial markings may be due to mild interstitial edema, similar to prior. " 32e2e92d-26f1c0fd-77aafab2-77ee2ece-8b441616.jpg,test/p19/p19903197/s54121953/32e2e92d-26f1c0fd-77aafab2-77ee2ece-8b441616.jpg,test," FINAL REPORT EXAMINATION: Portable upright chest x-ray INDICATION: ___ year old woman with PMH of COPD, IVDU, HCV, Cirrhosis (MELD 9) complicated HCC s/p liver resection, mild shortness of breath and desaturation on ambulation. // Please evaluate lungs for consolidation or pleural effusion. Additionally, please evaluate cardiac silhouette for enlargement. TECHNIQUE: Portable upright chest x-ray COMPARISON: Comparison is made to chest x-rays dated from ___ through ___. FINDINGS: The cardiomediastinal silhouette is increased in size from ___ study which is likely exaggerated by low lung volumes. The hilar silhouettes are normal. There are no pleural effusions or pneumothorax. There is opacification of the right lower lung which could represent pulmonary vascular congestion, though given unilateral appearance and absence of pleural effusion raises the concern of developing pneumonia. . IMPRESSION: Right lower lung opacification concerning for developing pneumonia. " 7d174432-0eaf5a9a-145c6dbb-9c39caab-026648f9.jpg,test/p12/p12016108/s58647950/7d174432-0eaf5a9a-145c6dbb-9c39caab-026648f9.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 403 CLINICAL INDICATION: ___-year-old with small cell lung cancer, here with pneumonia, sepsis, evaluate for interval change. Comparison is made to the patient's previous study dated ___ at 613. Single portable semi-erect chest film ___ at 5 a.m. is submitted. IMPRESSION: Right internal jugular central line with its tip in the proximal SVC. More confluent airspace consolidation in the right lower lobe which is concerning for pneumonia. Pulmonary venous hypertension without evidence of overt pulmonary edema. No large left effusion. No pneumothorax. Overall, cardiac and mediastinal contours are stable. " fa0c7833-98d86bb3-9dce50c9-404a5fc3-a92a8622.jpg,test/p14/p14001478/s51778381/fa0c7833-98d86bb3-9dce50c9-404a5fc3-a92a8622.jpg,test," FINAL REPORT AP CHEST, 3:22 A.M. ON ___ HISTORY: ___-year-old woman with overdose of a calcium channel blocker. IMPRESSION: AP chest compared to ___: Multifocal nearly nodular consolidation in both lungs, most likely pneumonia or septic emboli, alternatively pulmonary hemorrhage, is new or dramatically worsened since 9 a.m. on ___. Heart is top normal size, unchanged. Pulmonary and mediastinal vasculature mildly engorged, but not accompanied by pulmonary edema. Pleural effusions are present and minimal. Dr. ___ was paged at 9:37 a.m. to discuss these findings. ET tube is in standard placement, an upper enteric tube passes into the stomach and out of view. Right internal jugular line ends between 6 and 7 cm below the level of the carina, would need to be withdrawn 3 cm to place it with confidence in the low SVC. " 97dd20f4-dfc19e94-c9e24cca-154878d2-7e737e66.jpg,test/p19/p19777911/s58633026/97dd20f4-dfc19e94-c9e24cca-154878d2-7e737e66.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Neutropenic fever. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. Large calcified thyroid nodule is again projecting over the left paratracheal space. The left internal jugular line tip terminates at the level of cavoatrial junction. IMPRESSION: No evidence of acute cardiopulmonary process. " cd79ebe6-52d46991-9a41d935-65aef48f-51264321.jpg,test/p11/p11303371/s55199144/cd79ebe6-52d46991-9a41d935-65aef48f-51264321.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Tachycardia, shortness of breath and malaise. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. " 66d70639-e7619eda-e418b302-846aa313-4a32c5f8.jpg,test/p10/p10159435/s50568690/66d70639-e7619eda-e418b302-846aa313-4a32c5f8.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. Noting atherosclerotic calcifications at the arch. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 015ec99a-6bcb8c4b-640b4b02-5ed6824e-1f062437.jpg,test/p18/p18646760/s55645181/015ec99a-6bcb8c4b-640b4b02-5ed6824e-1f062437.jpg,test," FINAL REPORT HISTORY: Patient with elevated prolactin and cervical lymphadenopathy, identify hilar lymphadenopathy. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs were obtained. The lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No central lymphadenopathy or other radiographic finding to suggest sarcoidosis. " f7ed011f-c4cd27c2-4c875644-d10f0652-373efbe7.jpg,test/p12/p12498222/s59869128/f7ed011f-c4cd27c2-4c875644-d10f0652-373efbe7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p RUL wedge resection, postpullfilm // eval for interval change, CT out, eval for ptx, please confirm CT out prior to calling for patient TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs most recent on ___ FINDINGS: There has been interval removal of a right-sided chest tube. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Surgical chain sutures are seen at the right apex status post right upper lobe wedge resection procedure. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No evidence of pneumothorax or other acute cardiopulmonary process. " 4a8646a9-4c3b868d-50b8b6b7-035c7e65-332b548a.jpg,test/p15/p15355458/s57154020/4a8646a9-4c3b868d-50b8b6b7-035c7e65-332b548a.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Stroke and respiratory failure, likely ovarian malignancy. Comparison is made with prior study ___. Widened mediastinum, mild-to-moderate cardiomegaly, and bibasilar atelectasis larger on the right side are unchanged. There is mild increase in mild pulmonary edema. If any there is a small left effusion. Lines and tubes are in standard position. " 39741740-c9218b6f-bf0c8b99-44bd0a0a-c6c13433.jpg,test/p10/p10892549/s56619535/39741740-c9218b6f-bf0c8b99-44bd0a0a-c6c13433.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval IMPRESSION: In comparison with the study of ___, there is again blunting of the left costophrenic angle which could well represent pleural thickening as well as a small effusion. There is no evidence of acute pneumonia or vascular congestion. Mild hyperexpansion of the lungs is seen as well as mild apical pleural " 146e8390-fd657795-492c6a0b-7aaa1bef-06c08c00.jpg,test/p11/p11052935/s59503672/146e8390-fd657795-492c6a0b-7aaa1bef-06c08c00.jpg,test," FINAL REPORT PORTABLE CHEST, ___ HISTORY: ___-year-old woman with shortness of breath. Question pneumonia. FINDINGS: Single portable view of the chest is compared to previous exam from ___. As on prior, the lungs are hyperinflated with parenchymal changes suggestive of emphysema, particularly at the left lung apex. Increased interstitial markings are identified at the left lung base. Elsewhere, the lungs are grossly clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. Linear patchy at the right lung base is compatible with atelectasis versus scarring. IMPRESSION: Increased interstitial markings at the left lung base, potentially due to chronic changes; however, in the proper clinical setting, component of infection is also possible. Two views of the chest may help further characterize. " 30ef7a52-649ebef7-b4327926-9538c67e-a467e838.jpg,test/p14/p14888745/s59926187/30ef7a52-649ebef7-b4327926-9538c67e-a467e838.jpg,test," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old female with fever and shortness of breath. COMPARISON: None. FINDINGS: Single AP upright portable view of the chest was obtained. Overlying soft tissue partially obscures the left lung base and there are slightly low lung volumes. Given the above, no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top normal to mildly enlarged, but may be accentuated by AP technique. The mediastinum and hilar contours are unremarkable. IMPRESSION: Top normal to mildly enlarged cardiac silhouette, may be accentuated by AP technique. No focal consolidation. " 8159799c-7615c0ba-9676dd65-8b0cd6ed-96872c8f.jpg,test/p10/p10004322/s57662923/8159799c-7615c0ba-9676dd65-8b0cd6ed-96872c8f.jpg,test," WET READ: ___ ___ 2:03 PM Streaky posteroinferior left lobe opacity may reflect atelectasis, though infection cannot be entirely excluded. Recommend correlation with physical exam and laboratory data. WET READ VERSION #1 ___ ___ ___ 1:02 PM Probable posteroinferior left lower lobe pneumonia. Recommend follow-up radiograph in ___ weeks following antibiotic administration to assess resolution. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with 2 weeks productive cough, shortness of breath, weakness TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Subtle streaky opacity in the left lower lobe may reflect atelectasis, though infection cannot be entirely excluded. There is no pleural effusion or pneumothorax. There is no central vascular congestion or overt pulmonary edema. Mediastinal and hilar contours are normal. Heart size is normal. IMPRESSION: Streaky left lobe opacity may reflect atelectasis, though infection cannot be entirely excluded. Recommend correlation with physical exam and laboratory data. NOTIFICATION: Updated wet read findings were discussed with ___, Medical Student by ___, M.D. on the telephone on ___ at 1:58 PM, 2 minutes after discovery of the findings. " 86b05031-1d3b89d5-e0df14ec-91725abd-d7efe570.jpg,test/p19/p19001598/s56307251/86b05031-1d3b89d5-e0df14ec-91725abd-d7efe570.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with posop w/ fever // eval PNA vs atelectasis COMPARISON: Chest x-ray from ___ FINDINGS: Rotated positioning. A left-sided pacemaker present, with lead tips over right atrium right ventricle. An NG tube is present, tip extending beneath diaphragm, off film. Surgical ___ are noted over the upper abdomen in the midline. Linear density overlying the left lung could represent an epidural catheter, best correlated clinically. The patient is status post sternotomy. Note is made that the lower most sternotomy wire is fractured. There is probable mild cardiomegaly. There is increased retrocardiac density with a probable small left effusion and partial obscuration the left hemidiaphragm. There is minimal atelectasis in the right cardiophrenic region. No pneumothorax is detected. There is pleural parenchymal thickening/scarring at the left lung apex. The right first rib may be truncated, but is unchanged. Aside from right base atelectasis, the right lung is grossly clear. No gross right effusion, though minimal pleural fluid could be present on the right. Suspect background hyperinflation/COPD. Note made of old rib fractures seen in lower right chest, similar to ___. Compared to ___ the heart size is larger. Left effusion and left lower lobe collapse and/or consolidation is new and right cardiophrenic atelectasis is more pronounced. IMPRESSION: 1. Small to moderate left effusion with underlying collapse and/or consolidation of the left base. 2. Atelectasis in the right cardiophrenic region. 3. Cardiac silhouette larger compared with ___. 4. Clinical correlation is required for full assessment. 5. Fractured inferior sternotomy wire, unchanged compared with ___. " 01ea0788-2ae4acec-bea7313b-bb16f1aa-34101705.jpg,test/p14/p14998572/s50254580/01ea0788-2ae4acec-bea7313b-bb16f1aa-34101705.jpg,test," FINAL REPORT HISTORY: Multiple myeloma status post ASCT and on Revlimid, now with persistent diaphoresis and cough. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate mild cardiomegaly and well-aerated lungs which are clear. A linear opacity in the right upper lung likely represents scarring or postsurgical changes. Also noted are surgical clips which would be consistent with prior thyroid surgery. There is no focal consolidation or pulmonary edema. No pleural effusion or pneumothorax is seen. IMPRESSION: Clear lungs without focal consolidation concerning for pneumonia. " 04207593-2556c21e-91ec15f2-4ac6ff71-5793f9ce.jpg,test/p16/p16177830/s54633142/04207593-2556c21e-91ec15f2-4ac6ff71-5793f9ce.jpg,test," FINAL REPORT INDICATION: ___-year-old man presenting with shortness of breath. The patient has a history of metastatic non-small cell lung cancer. Evaluate for pneumonia. COMPARISON: CT of the torso from ___. FINDINGS: Chest, portable. There is a spiculated right hilar mass, with slightly denser adjacent hazy opacity. Another opacity in the left lower lung is actually a calcified pleural plaque based on the prior CT. The lungs are otherwise clear. The mediastinal and cardiac contours are normal. There are atherosclerotic calcifications in the aortic arch. There is no pneumothorax or pleural effusion. Pulmonary vascularity is noted. Increased lucency in the right upper lung is secondary to bullous emphysema as seen on the prior CT. IMPRESSION: 1. No evidence of pneumonia. 2. Right hilar mass with slight increase in the surrounding vague opacity, likely representative of local lymphangitic congestion. 3. Biapical bullous emphysema. " a9d97225-0bbced86-8a75e837-3c32f1a6-3d52a68d.jpg,test/p16/p16444272/s59567902/a9d97225-0bbced86-8a75e837-3c32f1a6-3d52a68d.jpg,test," FINAL REPORT HISTORY: Chronic chylothorax, status post pleurodesis. Evaluation for interval change. COMPARISON: ___-on/___. FINDINGS: Portable AP chest radiograph demonstrates no significant interval change from ___. Again seen is severe cardiomegaly and bilateral retrocardiac atelectasis. Mild to moderate pulmonary edema is not significantly changed. There is no pneumothorax. The two right-sided chest tubes are in stable position. The left PICC remains in the right atrium. " 5184ac98-b8eed2ef-fad80f15-88cfe333-2ecee713.jpg,test/p18/p18393676/s54486088/5184ac98-b8eed2ef-fad80f15-88cfe333-2ecee713.jpg,test," FINAL REPORT HISTORY: Recent Cordis catheter placement. COMPARISON: Chest radiograph ___. FINDINGS: A single portable frontal view of the chest was performed. A right internal jugular catheter is present with its tip terminating in the upper SVC. There is no pneumothorax or pleural effusion. The lungs are clear. The mediastinal contours are normal. The cardiac silhouette is mild to moderately enlarged but improved from ___. The pleural surfaces are unremarkable. IMPRESSION: Satisfactorily positioned right internal jugular vein catheter without complications. " 6db6460f-ea256df5-41d317c7-8380a351-0aa477ca.jpg,test/p11/p11055110/s50720511/6db6460f-ea256df5-41d317c7-8380a351-0aa477ca.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with s/p C4-T2 posterior fusion, ? luceny found on prior imaging on right clavicular head // evaluate ? lucent area on right clavicular head COMPARISON: Chest radiograph ___ IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. If there is serious clinical concern for possible clavicular abnormality than bone detail views of that organ should be obtained " f6aeb8fc-1d08fa02-42a4b37b-564deaa7-df8578de.jpg,test/p17/p17361736/s55951742/f6aeb8fc-1d08fa02-42a4b37b-564deaa7-df8578de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent stroke, now desatting // assess for pulm pathology assess for pulm pathology IMPRESSION: In comparison with the study of ___, there is again cardiomegaly in a patient with intact midline sternal wires after CABG procedure. Pulmonary vascular congestion is seen as well as probable small pleural effusion and atelectatic changes at the left base. " 5676c8be-8ee5b996-2054a953-d69197bb-fc0d978e.jpg,test/p14/p14473173/s52304658/5676c8be-8ee5b996-2054a953-d69197bb-fc0d978e.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: The patient is status post trauma with previously seen pneumothoraces on prior CT, ___. Pneumothoraces are not visualized in this examination, are below the resolution of chest x-ray. Cardiomediastinal contours are normal. Bilateral perihilar right upper lobe opacities have worsened consistent with worsening aspiration and/or contusions. There is no pleural effusion. Right central catheter tip is at the cavoatrial junction. " a271de51-7ef82cba-7035fd29-08a310b4-2c3fbaa5.jpg,test/p16/p16335435/s51517475/a271de51-7ef82cba-7035fd29-08a310b4-2c3fbaa5.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with nasal congestion, cough, shortness of breath, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 7f1070a9-8a7f9566-ea515e90-e91e85fd-3e478c9d.jpg,test/p11/p11595140/s55338892/7f1070a9-8a7f9566-ea515e90-e91e85fd-3e478c9d.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with epigastric pain. Question pneumonia. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Lungs are clear of focal consolidation or effusion. Biapical scarring, right greater than left is as on prior exam. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unchanged. IMPRESSION: No acute cardiopulmonary process. " 93e134ab-acfc028a-d55d1bd2-e9b9afbc-c8449437.jpg,test/p19/p19512875/s59455199/93e134ab-acfc028a-d55d1bd2-e9b9afbc-c8449437.jpg,test," FINAL REPORT INDICATION: ___M with 7d prod cough // r/o pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray and abdominal CT from ___. . FINDINGS: The lungs are hyperinflated. Mild biapical scarring is noted. There is a focal opacity projecting on the lateral view overlying the spine likely localizing to the right base on the frontal view, unchanged from prior. This correlates with an area of scarring seen on prior CT. There is no focal consolidation worrisome for infection. Cardiac silhouette is within normal limits tortuosity of the abdominal aorta is again noted. IMPRESSION: Hyperinflation without superimposed acute cardiopulmonary process. " c2ff3578-4eccf40a-b6fcf8ab-a3f2cd27-519988b5.jpg,test/p17/p17500951/s56981708/c2ff3578-4eccf40a-b6fcf8ab-a3f2cd27-519988b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG // eval for pleural effusions COMPARISON: Chest radiographs ___. IMPRESSION: Vascular congestion on ___ has resolved. There is no pulmonary edema. Substantial bibasilar atelectasis however has. Heart size is normal. No pneumothorax. " 13f9bcd9-8b1f23cb-ead5d79a-b9018f58-1108f155.jpg,test/p13/p13204634/s53950806/13f9bcd9-8b1f23cb-ead5d79a-b9018f58-1108f155.jpg,test," FINAL REPORT INDICATION: Throat burning and reported abdominal pain after accidental ingestion of bleach. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are clear. Again seen is apical scarring, unchanged. There is no evidence of pneumomediastinum or intraperitoneal free air. No pleural effusion or pneumothorax is identified. The previously seen nodular opacity is not as well appreciated on today's exam. IMPRESSION: No evidence of pneumomediastinum or intraperitoneal free air. " 91dd3a39-25378558-11da71b6-abd43fcb-b45b4f4e.jpg,test/p13/p13139059/s58456977/91dd3a39-25378558-11da71b6-abd43fcb-b45b4f4e.jpg,test," FINAL REPORT INDICATION: Cough. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " dc4bb9b1-808b7356-b8e91216-b8b09dd2-f8a4a23e.jpg,test/p10/p10191971/s56265061/dc4bb9b1-808b7356-b8e91216-b8b09dd2-f8a4a23e.jpg,test," FINAL REPORT HISTORY: T-cell lymphoma, now with dyspnea, cough, and hoarseness. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: Interval removal of a previous left PICC line. A zone of minimally increased density is seen in the ight lower lobe, concerning for a possible consolidation. Bilateral, perihilar lymphadenopathy is noted, unchanged in appearance from prior examination. There is no pleural effusion, pneumothorax, or pulmonary edema. The heart size is normal. Mediastinal contours are stable. IMPRESSION: Right lower lobe consolidation, concerning for early pneumonia. Findings were entered into the radiology dashboard by Dr. ___ at 1:22pm on ___, 5 minutes after discovery. " 5d9dafb3-bab839a9-3827a10e-6b807561-49e4595b.jpg,test/p11/p11336664/s52856970/5d9dafb3-bab839a9-3827a10e-6b807561-49e4595b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman post op // infiltrates, volume status infiltrates, volume status COMPARISON: Comparison to ___ at 05:30 IMPRESSION: Interval replacement of the nasogastric tube with a feeding tube which has the distal end projecting over the stomach. Right internal jugular central line unchanged in position. Overall cardiac and mediastinal contours are likely unchanged given patient rotation. Slightly increased opacity at both bases, right greater than left, suggestive of worsening atelectasis, although pneumonia cannot be excluded. No evidence of pulmonary edema. No pneumothorax. Probable small layering pleural effusions. " 6c14351d-b46b2b6b-4b076117-e083ee0a-81044182.jpg,test/p14/p14760908/s55419510/6c14351d-b46b2b6b-4b076117-e083ee0a-81044182.jpg,test," FINAL REPORT HISTORY: Fever question consolidation. COMPARISON: ___. FINDINGS: There are patchy areas of increased opacity in both lower lobes. Unclear if this is due to volume loss or early infiltrate. The left subclavian line is unchanged. There is lucency under the right hemidiaphragm on this semi erect film and free air cannot be excluded. IMPRESSION: 1. Bilateral lower lobe infiltrates 2. ? Free air under right hemidiaphragm. Findings discussed with ___ at the time of dicating this report on ___ at 3:55 Pm by Dr. ___ " de7b0a75-0b505b57-09bf82b4-e441ea3d-c6f19990.jpg,test/p14/p14185111/s59203006/de7b0a75-0b505b57-09bf82b4-e441ea3d-c6f19990.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old man with desaturation and obstructive airway disease. Getting diuresed. Evaluate for pulmonary edema or focal infiltrates. FINDINGS: Comparison is made to previous study from ___. The heart is enlarged but stable. There is improvement of the small pleural effusion since the previous study. There are no signs for overt pulmonary edema or definite consolidation. No pneumothoraces are seen. Median sternotomy wires are present. " 4fd0a566-3e22d898-c45a337d-628e800d-070961af.jpg,test/p12/p12535940/s55982934/4fd0a566-3e22d898-c45a337d-628e800d-070961af.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Lymphoma, fever, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No newly appeared focal parenchymal opacity. No opacities suggestive of pneumonia. No pleural effusions. Normal lung volumes. No hilar and/or mediastinal changes. Normal size of the cardiac silhouette. " 3f587837-78cf0080-942de941-667c5f48-5dec70e2.jpg,test/p19/p19928728/s57376049/3f587837-78cf0080-942de941-667c5f48-5dec70e2.jpg,test," FINAL REPORT AP CHEST 5:21 A.M. ___ HISTORY: Traumatic hemorrhage and spinal fractures. IMPRESSION: AP chest compared to ___: Moderate cardiomegaly and somewhat asymmetric moderately severe pulmonary edema worsened minimally since ___. Small pleural effusions are presumed. No pneumothorax. ET tube and nasogastric tube and a left PIC line are in standard placements respectively. " a076980f-7ea4be06-9edb09b0-0168388d-999b88af.jpg,test/p19/p19657612/s52912984/a076980f-7ea4be06-9edb09b0-0168388d-999b88af.jpg,test," WET READ: ___ ___ 9:31 PM Low lung volumes and atelectasis. No definite PTX. Consider left lateral decubitus radiographs if there is continued suspicion. Normal cardiomediastinal silhouette. W/r ___. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Trauma patient with probable pneumothorax. Please reassess. FINDINGS: Lung volumes are low. There is no definite pneumothorax. This would be better assessed with the lateral decubitus radiograph if there is continued concern. " 205f99b5-079e0579-a702e1f1-bde661e8-1ad48d16.jpg,test/p15/p15794450/s55951652/205f99b5-079e0579-a702e1f1-bde661e8-1ad48d16.jpg,test," FINAL REPORT AP CHEST, 4:50 A.M. ON ___ HISTORY: ___-year-old man with large brain hemorrhage or ischemic stroke. IMPRESSION: AP chest compared to ___: Previous right middle lobe atelectasis has cleared. Mild residual edema in the left lower lung unchanged. Heart size difficult to assess, obscured by the high diaphragm, but grossly unchanged. Pleural effusion small, if any. No pneumothorax. ET tube in standard placement. Upper enteric tube passes to the upper portion of a non-distended stomach. " a865912b-f38810ed-ae9abf31-245684cf-2a45e8e6.jpg,test/p15/p15805011/s56802822/a865912b-f38810ed-ae9abf31-245684cf-2a45e8e6.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with pleuritic chest pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs remain clear of focal consolidation or effusion. Prominent extrapleural fat is seen at the bases bilaterally. Cardiomediastinal silhouette is stable in appearance as are the osseous and soft tissue structures. IMPRESSION: No acute cardiopulmonary process. " d514cd23-89e55e62-c4506160-899f673f-315cd839.jpg,test/p15/p15374924/s59993741/d514cd23-89e55e62-c4506160-899f673f-315cd839.jpg,test," FINAL REPORT HISTORY: Dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. The pulmonary vascularity is normal. No pleural effusion or pneumothorax is demonstrated. Small focus of calcification adjacent to the left humeral head may reflect calcific tendinopathy. IMPRESSION: No acute cardiopulmonary abnormality. " 5b8bf366-128770a8-d2150c84-f764ad82-a93e9486.jpg,test/p18/p18564227/s54102224/5b8bf366-128770a8-d2150c84-f764ad82-a93e9486.jpg,test," WET READ: ___ ___ ___ 9:52 PM Interval development of mild pulmonary interstitial edema as evidenced by increased peribronchial cuffing and perihilar vascular engorgement. No focal consolidation or pleural effusion. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with urosepsis and large volume resuscitation // pulmonary edema COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient is currently rotated to the left, causing an apparent increase in diameter of the aortic knob. The lung volumes are unchanged. There is mild fluid overload but no overt pulmonary edema. No pleural effusions. No visible rib fractures. No pneumothorax. The alignment of the sternal wires is unchanged. " 24cd2eab-00747786-7e0df9ce-3603777b-346216f5.jpg,test/p14/p14120635/s50700468/24cd2eab-00747786-7e0df9ce-3603777b-346216f5.jpg,test," WET READ: ___ ___ ___ 8:25 AM Dobhoff tube terminates in the stomach. Right-sided PICC line terminates at the superior cavoatrial junction. WET READ VERSION #1 ___ ___ 5:39 PM Dobhoff tube terminates in the stomach. Right-sided PICC line terminates at the superior cavoatrial junction. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff advanced // dobhoff placement? dobhoff placement? COMPARISON: Comparison to ___ at 17:19 FINDINGS: Portable chest radiograph ___ at 17:23 is submitted. IMPRESSION: A feeding tube is seen coursing below the diaphragm with the tip projecting over the stomach. The right subclavian PICC line is unchanged position with the tip in the distal SVC. Tracheostomy tube remains in satisfactory position with the tip approximately 4 cm above the carina. Heart remains stably enlarged. The perihilar edema has improved. However, there is persistent consolidation in the retrocardiac region likely representing lower lobe collapse in the setting of a small layering left effusion. " c2843959-0bda3247-fffca4b2-fd089b5d-54c536f8.jpg,test/p10/p10364180/s59914498/c2843959-0bda3247-fffca4b2-fd089b5d-54c536f8.jpg,test," FINAL REPORT HISTORY: ___-year-old female with congestive heart failure, COPD and possible pneumonia with ongoing dyspnea. Evaluate for pulmonary edema and size of pleural effusions. COMPARISON: Radiographs of the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate interval decrease in the degree of interstitial edema and partial clearing of the right lower lobe opacity. Again seen are small bilateral pleural effusions, right greater than left, which are stable. The heart is enlarged. There is no pneumothorax. IMPRESSION: Interval improvement in interstitial edema and partial clearing of right lower lobe opacification. Stable bilateral pleural effusions, right greater than left. " 73b7dc15-ccef6e58-bd3098b6-de27cc17-706a81a5.jpg,test/p19/p19601036/s53398977/73b7dc15-ccef6e58-bd3098b6-de27cc17-706a81a5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p cabg and mv repair with chylothorax // eval effusion COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the right pleural catheter has been removed. On the left, the pigtail catheter in the pleural space is in unchanged position. No pneumothorax. Unchanged extent of the bilateral pleural effusions. Moderate cardiomegaly. No pulmonary edema. No pneumonia. " 13e2af68-b3c346cd-05705610-aa50d5b3-3f4496e4.jpg,test/p11/p11126801/s53407460/13e2af68-b3c346cd-05705610-aa50d5b3-3f4496e4.jpg,test," FINAL REPORT PATIENT HISTORY: ___ years old man with hospital-acquired pneumonia, intubated, sepsis and anasarca, evaluate for interval changes. TECHNIQUE: Portable AP single-view chest x-ray in the semi-erect position. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: All the monitoring devices are unchanged in standard position. Since prior chest x-ray, there is some improvement of the right upper lobe for reduced pleural effusion, but persists bibasilar pleural effusion and atelectasis with right mid field opacities. Heart size is still mildly enlarged. There is no pneumothorax. IMPRESSION: Improved ventilation of the right upper lobe mainly for reduced pleural effusion. Persistent bibasilar atelectasis with pleural effusion and right mid lung opacities. " 32687383-fcf6e3a8-df9fb5b0-13d0f24d-d276e55b.jpg,test/p16/p16614879/s55083071/32687383-fcf6e3a8-df9fb5b0-13d0f24d-d276e55b.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 3fc3f02c-f23262b8-89534385-3c00c592-38fbd825.jpg,test/p11/p11828845/s59949503/3fc3f02c-f23262b8-89534385-3c00c592-38fbd825.jpg,test," FINAL REPORT INDICATION: ___-year-old male with 4 days of chest pain. Please evaluate for pneumonia or cardiomegaly. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " b500e761-bf63e3f9-c18345f3-7425b705-0ab72580.jpg,test/p11/p11598484/s59421335/b500e761-bf63e3f9-c18345f3-7425b705-0ab72580.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with GIB and fevers. // Please evaluate for etiology of GIB. Please evaluate for etiology of GIB. COMPARISON: There are no prior chest radiographs. IMPRESSION: The heart is mildly enlarged, but pulmonary vasculature is normal and there is no edema or pleural effusion. Lungs are clear. " 0eeb1b58-85c92314-eb15def5-f73aab98-df6b67b0.jpg,test/p18/p18802292/s51789467/0eeb1b58-85c92314-eb15def5-f73aab98-df6b67b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with leukocytosis, ?PNA on CTA abdomen // eval for acute process TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: CT of the abdomen and pelvis dated ___. FINDINGS: There are faint bibasilar opacities, consistent with multifocal pneumonia. The above fields clear. The cardiomediastinal silhouette is normal. There is no pulmonary vascular congestion, pleural effusion, or pneumothorax. IMPRESSION: Multifocal pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:28 AM, 5 minutes after the discovery of the findings. " 87dee9e0-0aabf21f-81c449d2-3afd14f8-827f7589.jpg,test/p15/p15672432/s59312722/87dee9e0-0aabf21f-81c449d2-3afd14f8-827f7589.jpg,test," FINAL REPORT INDICATION: Cough, evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph performed earlier on the same day at 20:14 FINDINGS: Lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Visualized upper abdomen is unremarkable. Osseous structures are grossly intact. IMPRESSION: No evidence of acute cardiopulmonary process. " 6f75ab1d-a8b7efdd-c8827699-90bfb207-2bb076e1.jpg,test/p18/p18780736/s50485224/6f75ab1d-a8b7efdd-c8827699-90bfb207-2bb076e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left pleural effusion // s/p Left pleural effusion thoracentesis r/o left PTX s/p Left pleural effusion thoracentesis r/o left PTX IMPRESSION: In comparison with the study of ___, there is a pigtail catheter in place with removal of most of the pleural effusion. No evidence pneumothorax following thoracentesis. Remainder the study is unchanged. " a00df42c-5bd85edb-4fb74b4e-c5fb1ad3-b7c536b7.jpg,test/p14/p14748701/s54691848/a00df42c-5bd85edb-4fb74b4e-c5fb1ad3-b7c536b7.jpg,test," FINAL REPORT INDICATION: ___-year-old man with shortness of breath. Question pneumothorax. COMPARISON: None. SINGLE AP PORTABLE CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. The patient is slightly rotated to the right. No acute osseous abnormality seen. IMPRESSION: No acute cardiopulmonary pathology, in particularly no evidence of pneumothorax. " d2aa7e32-526466fc-7b252479-9f9b7728-0b5fadd8.jpg,test/p13/p13021959/s51064057/d2aa7e32-526466fc-7b252479-9f9b7728-0b5fadd8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with stroke // eval for PNA TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There is a large amount of free air under the hemidiaphragms. Remainder the appearance of the chest is unchanged. NOTIFICATION: This examination was immediately called to the on-call neurology service resident by Dr. ___. Additional history was given that the patient had recently had a PEG tube placed " 695fac95-92ba1637-aa299c67-891f695c-01d2cfde.jpg,test/p10/p10779064/s55290960/695fac95-92ba1637-aa299c67-891f695c-01d2cfde.jpg,test," WET READ: ___ ___ ___ 8:41 PM ETT ends approximately 5.2cm above the carina. Otherwise unchanged position of monitoring and support devices. Cardiomediastinal contour is stable. There is no large pleural effusion or pneumothorax. Jsteinkeler p___WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p mvr/tvr/cabg post-op bleeding // assess for hemothorax COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the tip of the endotracheal tube now projects approximately 5 cm above the carinal. No other change is noted. The other monitoring and support devices are in constant position. No pneumothorax, no larger pleural effusions. Unchanged size of the cardiac silhouette. " 5033688f-776a216e-0f94e4e4-99c8c072-f0424da3.jpg,test/p10/p10913302/s57824613/5033688f-776a216e-0f94e4e4-99c8c072-f0424da3.jpg,test," WET READ: ___ ___ 5:17 PM Low lung volumes, limiting evaluation. Within the limitations, no evidence of a consolidation, edema, pleural effusion, or pneumothorax. Normal cardiomediastinal silhouette. Right port-a-cath with the tip in the low SVC. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with leukocytosis. FINDINGS: Single AP view of the chest demonstrates a Port-A-Cath with distal lead tip at the cavoatrial junction. There are somewhat low lung volumes. There is no focal consolidation, pleural effusion, or pulmonary edema. Bony structures are intact. " 63b6efc6-ba31dbda-a8bf2f09-d3d761d8-850cafb5.jpg,test/p16/p16949700/s53549548/63b6efc6-ba31dbda-a8bf2f09-d3d761d8-850cafb5.jpg,test," FINAL REPORT HISTORY: Known CAD, ischemic cardiomyopathy, now status post PEA arrest. Rule out worsening pulmonary edema. CHEST, SINGLE AP PORTABLE SUPINE VIEW. None of the available views include the lung bases. Allowing for this, an ET tube is present, tip approximately 7.1 cm above the carina. An NG tube is present, tip extending along the length of the visible mediastinum. A right IJ central line is present, tip over distal SVC. A left-sided dual-lead pacemaker is present, lead tips over right atrium and right ventricle. Scattered mediastinal clips are present. There is cardiomegaly, similar, possibly slightly improved compared with ___ at 18:56 p.m. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. There is upper zone redistribution and mild diffuse vascular blurring, with crowding of vessels in the right cardiophrenic region, quite similar to the prior film. Assessment for small effusions is limited, but no gross effusion is detected. IMPRESSION: 1. Limited assessment of lung bases. 2. Upper zone redistribution and evidence for interstitial edema. 3. Left lower lobe collapse and/or consolidation and probable element of consolidation at the right base medially. 4. Cardiomegaly, possibly slightly improved. 5. Otherwise, appearance is similar to one day earlier. Possibility of early alveolar edema cannot be excluded. " 70efc5a1-2c4ca095-bfef8011-2547976f-5d93461e.jpg,test/p15/p15193875/s54249616/70efc5a1-2c4ca095-bfef8011-2547976f-5d93461e.jpg,test," FINAL REPORT INDICATION: ___-year-old man with GBM and Port-A-Cath blocked. COMPARISONS: Port-A-Cath placement ___. FINDINGS: The catheter from a right chest Port-A-Cath courses in the subcutaneous soft tissues over the clavicle, then makes a 270-degree counterclockwise loop before extending inferiorly from the right IJ to the mid SVC. It is difficult to tell whether this loop is in the subcutaneous tissues or the right internal jugular vein. Immediately after placement in ___, the catheter followed the normally expected smooth arc from the subcutaneous tissues into the internal jugular vein. No intervening imaging is available The lungs are clear. There is no consolidation, effusion, or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: Right chest Port-A-Cath catheter makes an abnormal loop in the region of the internal jugular vein insertion. The tip is now in the mid SVC. Findings were discussed with ___, RN, via telephone at 1:00 p.m., ___. " f79f3b3e-795b8015-e22cc26e-8175619e-e3b9e559.jpg,test/p16/p16254450/s54285373/f79f3b3e-795b8015-e22cc26e-8175619e-e3b9e559.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man s/p Ascending Aorta replacment // eval effusions COMPARISON: Chest radiographs ___ through ___ IMPRESSION: Normal postoperative appearance cardiomediastinal silhouette. Left lower lobe atelectasis has worsened since ___. Small bilateral pleural effusions slightly larger. No pulmonary edema. Tiny left apical pneumothorax, new or newly apparent. Right jugular line ends in the mid SVC, sharply folded as it enters the scan. " ec95bfa2-f1be4294-523cc830-c9513894-bf87f492.jpg,test/p12/p12820032/s52264886/ec95bfa2-f1be4294-523cc830-c9513894-bf87f492.jpg,test," FINAL REPORT HISTORY: 3 week cough which is not improving, rule out pneumonia. TECHNIQUE: PA and lateral views of the chest: COMPARISON: Chest radiographs ___ and ___. CTA chest ___. FINDINGS: The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The hilar structures and pleural surfaces are normal. The imaged upper abdomen is unremarkable. A mild dextroconvex scoliosis of the thoracic spine is unchanged. IMPRESSION: Normal chest radiograph. " aa6f7425-ceebc6a0-d9a02fa9-163fe317-c1ccea6a.jpg,test/p12/p12479159/s56496076/aa6f7425-ceebc6a0-d9a02fa9-163fe317-c1ccea6a.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Multiple new strokes, CHF. Comparison is made with prior study ___. There are low lung volumes, unchanged. Bibasilar opacities consistent with atelectasis have increased on the right. There is no pulmonary edema, pneumothorax or large pleural effusion. Cardiac size is top normal. " 6e1fe066-9dd2dc09-88508f27-29a75edf-53144aca.jpg,test/p16/p16454913/s59472177/6e1fe066-9dd2dc09-88508f27-29a75edf-53144aca.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___. FINDINGS: Tracheostomy tube remains in place. Diffuse cardiomediastinal widening appears similar to the prior study, and appears to be predominantly due mediastinal lipomatosis as well as distended vascular structures based on prior CT of ___. Pulmonary vascular congestion is accompanied by mild-to-moderate pulmonary edema. Bilateral lower lobe retrocardiac opacities have worsened, and may reflect atelectasis with or without coexisting infection. Moderate bilateral pleural effusions are present, similar on the left, but worse on the right. Right PICC continues to terminate in the right axilla. " 605bcd22-55630110-ddaa85ac-164f9b6d-1e819a3a.jpg,test/p18/p18525476/s52808315/605bcd22-55630110-ddaa85ac-164f9b6d-1e819a3a.jpg,test," FINAL REPORT HISTORY: Fever, evaluate for pneumonia. TECHNIQUE: Frontal and lateral radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. The heart size is normal. Mediastinal contours are normal. Lower cervical spinal fusion hardware is seen. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 00610438-1acf01b1-ae6036d9-89bd85f7-67822758.jpg,test/p18/p18635756/s58441430/00610438-1acf01b1-ae6036d9-89bd85f7-67822758.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, history of ovarian cancer TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities seen. A subcutaneous port is noted projecting over the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 29065277-e53eecbc-5c4b0918-ff2a72d0-442a9c9d.jpg,test/p17/p17069014/s53364668/29065277-e53eecbc-5c4b0918-ff2a72d0-442a9c9d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and fever. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Mild to moderate cardiomegaly is re- demonstrated. Mediastinal contour is unchanged, and enlargement of the hila bilaterally is re- demonstrated, not substantially changed in the interval. There is new mild pulmonary edema. Left basilar opacity may reflect atelectasis. No pleural effusion or pneumothorax is identified. Increased sclerosis throughout the thoracic spine is compatible with renal osteodystrophy. IMPRESSION: Mild pulmonary edema. Left basilar opacity may reflect atelectasis though infection is not excluded in the correct clinical setting. " f9b7d2cf-e7491c06-91db66b4-c8ee893e-9e6f8758.jpg,test/p19/p19209206/s57684663/f9b7d2cf-e7491c06-91db66b4-c8ee893e-9e6f8758.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever, weakness. COMPARISON: None. FINDINGS: There is minimal left base atelectasis. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 6a6ffe01-1015eb05-236ee6b6-32f7b590-5e1a8b2b.jpg,test/p17/p17071972/s59163031/6a6ffe01-1015eb05-236ee6b6-32f7b590-5e1a8b2b.jpg,test," FINAL REPORT HISTORY: Shortness of breath, to evaluate for fluid infiltrate or mass. FINDINGS: In comparison with the study of ___, there are slightly lower lung volumes. Minimal atelectatic changes at the bases, though no acute focal pneumonia, vascular congestion, or pleural effusion. " 198f771e-90ade7ed-815d8256-0c11ad5f-81742a4f.jpg,test/p16/p16998152/s53068251/198f771e-90ade7ed-815d8256-0c11ad5f-81742a4f.jpg,test," FINAL REPORT HISTORY: ___-year-old male with alcoholic liver disease, persistent white count and PICC in right upper extremity, was moved during dressing change. Assess PICC placement. COMPARISON: Chest radiograph, ___, ___: TECHNIQUE: Single portable frontal chest radiograph. FINDINGS: Right PICC tip is in mid SVC. Interval increase in mild pulmonary edema with mildly enlarged heart size, mediastinal vein dilatation and perihilar haze. No pleural effusions are noted. Interval increase in left upper lobe and left lower lobe ill-defined opacities suggestive of pneumonia. IMPRESSION: 1. Interval worsening of left upper lobe and left lower lobe pneumonia. 2. Mild increase in pulmonary edema. 3. Right PICC tip is in mid SVC. " a5ff1b54-505a132b-261c94e9-49c050e7-3ae95f02.jpg,test/p16/p16590876/s58637863/a5ff1b54-505a132b-261c94e9-49c050e7-3ae95f02.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with cough // r/o PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___. FINDINGS: Compared with chest radiograph on ___, there is improved aeration at the bilateral lung bases, with no other significant change.The lungs are clear without focal consolidation. There are calcified granulomas bilaterally, unchanged. No pleural effusion or pneumothorax is seen. Cardiomegaly and aortic calcifications are similar to prior.. Old right-sided rib fractures are stable in appearance. IMPRESSION: No pneumonia. " bdda4d72-31379425-9c9254ab-4af04dd5-0c8a80ae.jpg,test/p16/p16046758/s58698545/bdda4d72-31379425-9c9254ab-4af04dd5-0c8a80ae.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with non-small cell lung cancer and dyspnea, status post left-sided thoracocentesis, evaluate for pneumothorax and post-procedure improvement of effusion. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study obtained 11 hours earlier during the same day. The right-sided post-operative findings with the density in the apical area and sizable effusions obliterating the right-sided diaphragmatic contour and extending along the right lateral wall remain rather unchanged. Also, the left-sided pleural effusion is still seen although much less comparison with the right-sided effusion. Observe that the patient is slightly rotated towards the left in comparison with the preceding study but otherwise the findings are stable. No pneumothorax has developed. " 143567cf-57b21a40-89835a1c-4207b22b-efe42d59.jpg,test/p18/p18605337/s55780786/143567cf-57b21a40-89835a1c-4207b22b-efe42d59.jpg,test," WET READ: ___ ___ ___ 6:13 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with cough*** WARNING *** Multiple patients with same last name! // cough TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___ and ___. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiac size is normal. The aorta is ectatic. There is no free air beneath the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 6b170986-452bcaa3-7bce25c2-4416ff37-a6e00db1.jpg,test/p15/p15078112/s56824160/6b170986-452bcaa3-7bce25c2-4416ff37-a6e00db1.jpg,test," FINAL REPORT INDICATION: ___ year old woman with AML recently started chemo, now w/ recurent neutropenic fevers // eval for infiltrates EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral view COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Right subclavian venous catheter terminates in mid SVC. Small lingular opacity is similar to ___. Small Left pleural effusion is new since ___. There is faint right upper lung perihilar opacity, which was better visualized the CT from same day. There is no pneumothorax. Cardiac silhouette is mildly enlarged. IMPRESSION: Small left pleural effusion is new since ___. Multifocal infection was better evaluated on the CT from same day. Some findings seen on CT are not obvious on the radiograph. Initial followup imaging should start with a conventional radiograph, however if there is discordance between the clinical and radiological findings, CT should be considered for better evaluation. " 4705e957-902ffb00-c6688333-fe27773a-ef55017f.jpg,test/p17/p17349580/s57256441/4705e957-902ffb00-c6688333-fe27773a-ef55017f.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Multiple surgical clips project over mid right inferior neck. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 87e07914-4959cb50-0b787be9-bae797b0-a4d16af3.jpg,test/p13/p13349392/s52221340/87e07914-4959cb50-0b787be9-bae797b0-a4d16af3.jpg,test," WET READ: ___ ___ ___ 3:15 AM Moderate bronchial wall thickening suggesting small airways disease or bronchitis. No focal consolidation. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with cough, and shortness of breath, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: Moderate bronchial wall thickening suggests small airways disease or bronchitis. Linear opacities bilaterally, particularly within the lingula, probably represent subsegmental atelectasis. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Bronchial wall thickening suggesting bronchitis. No focal consolidation. " ff5d7cd2-7bb6423d-41144633-646876ef-48e873f7.jpg,test/p16/p16268439/s51734953/ff5d7cd2-7bb6423d-41144633-646876ef-48e873f7.jpg,test," WET READ: ___ ___ ___ 7:00 PM No evidence of acute process. Nodular focus projecting over the left mid lung, suggesting a nipple shadow; suggest a PA view with nipple markers to confirm when clinically appropriate. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with chest pain. TECHNIQUE: Single frontal radiograph of the chest was obtained. COMPARISON: There are no comparison studies available. FINDINGS: There is a nodular density projecting over the left mid lung which suggests a nipple shadow. Lung fields appear otherwise clear, the cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: No acute cardiothoracic process. Probably nipple shadow projecting over the left mid lung; when clinically appropriate, confirmation with an additional PA view using nipple markers is recommended. " 9a560c25-77e5ba81-9e7fe14d-92a7aa3f-0edc6a4f.jpg,test/p10/p10574391/s52837633/9a560c25-77e5ba81-9e7fe14d-92a7aa3f-0edc6a4f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Chest pain, left side; question pneumonia or effusion. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 647f8ddf-e6e0e871-ae32a46c-4ee13b8f-4d9a7c57.jpg,test/p14/p14597978/s59517054/647f8ddf-e6e0e871-ae32a46c-4ee13b8f-4d9a7c57.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with graft infection // r/o inf, eff TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: The patient remains intubated, the ETT terminates approximately 5 cm above the carina. A nasogastric tube is incompletely visualized however the tip lies below the diaphragm. A right-sided PICC terminates in the distal SVC. The trachea is central, lung volumes remain slightly low. The cardiomediastinal contour is unchanged compared to the prior study. There has been progression of the atelectasis at the left lung base with a more linear appearance on the current study. Mild prominence of the pulmonary vascular likely reflects a degree of fluid overload. No pleural effusion seen. No pneumothorax seen. IMPRESSION: Progression of the left basilar atelectasis. Otherwise no significant interval change. " 5b170573-b4d5ded1-02e40ad5-92a877a2-1e473e37.jpg,test/p17/p17319434/s57135651/5b170573-b4d5ded1-02e40ad5-92a877a2-1e473e37.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of increasing agitation. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. Dual-lead left-sided pacemaker is again seen, unchanged in position. The patient is status post median sternotomy and CABG. There are slightly low lung volumes. Slight prominence of the central pulmonary vasculature may be due to mild pulmonary vascular engorgement unchanged. The cardiac silhouette is top normal to mildly enlarged. Aorta is tortuous. No pleural effusion or pneumothorax is seen. IMPRESSION: Low lung volumes, but otherwise no significant interval change. " d39b2eb7-ab2ddf54-687245b9-015936aa-3e692812.jpg,test/p13/p13383915/s54757947/d39b2eb7-ab2ddf54-687245b9-015936aa-3e692812.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with shortness of breath // eval for pneumonia COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low, though allowing for this, there is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " af89840d-4ed836cf-8164650f-ea647562-4f6bc070.jpg,test/p12/p12406522/s59086336/af89840d-4ed836cf-8164650f-ea647562-4f6bc070.jpg,test," FINAL REPORT INDICATION: ___-year-old female status post intubation for ILI. COMPARISON: Chest radiographs from ___, ___, ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: There is a right-sided PICC line which terminates in the low SVC. The tracheostomy tube terminates 2.4 cm above the carina. The left apical consolidation and right mid lung consolidation appear stable. There are small bilateral pleural effusions. There is no pneumothorax. The heart size is stable. The hilar and mediastinal contours are unremarkable. IMPRESSION: ET tube terminates 2.4 cm above the carina. Stable left apical and right mid lung consolidation. " c9154486-63939b3d-6a1e7fc4-f2d6e85d-10395b3d.jpg,test/p18/p18207676/s52502708/c9154486-63939b3d-6a1e7fc4-f2d6e85d-10395b3d.jpg,test," FINAL REPORT HISTORY: ___-year-old man with fever. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " f7dcb6d7-f4aeae9e-e3137654-a3ae2497-0c1baa99.jpg,test/p18/p18567332/s52093626/f7dcb6d7-f4aeae9e-e3137654-a3ae2497-0c1baa99.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and EKG changes. COMPARISONS: None. TECHNIQUE: Chest, AP and lateral. FINDINGS: The patient is status post sternotomy. The heart is at the upper limits of normal size. There is moderate unfolding of the thoracic aorta. The lungs appear clear. There are no pleural effusions or pneumothorax. Mild degenerative changes involve the lower thoracic spine. IMPRESSION: No evidence of acute disease. " 70748c0a-67df3a67-e98f347c-4f48a864-4471c79c.jpg,test/p15/p15219741/s57809495/70748c0a-67df3a67-e98f347c-4f48a864-4471c79c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old female with weakness TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Minimal left basal linear opacity likely represents atelectasis. No other focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal contours are normal. No subdiaphragmatic free air. Right-sided pleural drain is noted. IMPRESSION: No acute cardiopulmonary process. " 94958657-0374d308-da6cbc03-c88a6916-f72d23e8.jpg,test/p17/p17491585/s55145326/94958657-0374d308-da6cbc03-c88a6916-f72d23e8.jpg,test," WET READ: ___ ___ 7:13 PM Very low lung volumes, bibasilar atelectasis. No pneumothorax. Improved pulmonary vascular engorgement, otherwise no relevant change from ___. ______________________________________________________________________________ FINAL REPORT HISTORY: Short of breath. CHEST, SINGLE AP VIEW. Allowing for slight technical differences, I doubt significant change compared with ___. Again seen are low inspiratory volumes, vascular engorgement, and mild CHF. Probable small bilateral effusions. " d044fc50-209220cf-a74b0671-1424127e-e83032f6.jpg,test/p12/p12729806/s51655856/d044fc50-209220cf-a74b0671-1424127e-e83032f6.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with cough. Clinical concern for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Median sternotomy wires intact and aligned. Left pectoral pacemaker with leads terminating in the right atrium, right ventricle, and left coronary sinus. Stable cardiomegaly with pulmonary vascular congestion. No evidence of acute, focal pneumonia. IMPRESSION: No evidence of pneumonia. NOTIFICATION: Findings communicated to Dr. ___ at 12:35. " 29477ae1-980a7cdf-e0905007-bf1fc833-1b35eb2a.jpg,test/p11/p11966397/s58616087/29477ae1-980a7cdf-e0905007-bf1fc833-1b35eb2a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after right upper lobectomy to assess for pneumothorax after chest tube removal. PA and lateral upright chest radiographs were reviewed in comparison to ___. After right chest tube has been discontinued, there is unchanged amount of subcutaneous air, large, also involving the left neck. There is no definitive increase in the small right apical pneumothorax seen. No basal component of pneumothorax is demonstrated. " 52229e66-cb6fbb0a-01bbebb3-fcee1e87-c4db86e8.jpg,test/p15/p15664988/s51250197/52229e66-cb6fbb0a-01bbebb3-fcee1e87-c4db86e8.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Cough, fever, question pneumonia. FINDINGS: Portable AP upright chest radiograph obtained. There is airspace consolidation within the left lower lobe, involving the left lower lobe superior segment and basal posterior segments. Right lung is clear. No large effusion is seen. No pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: Findings compatible with pneumonia in the left lower lobe, involving superior and basal segments. " 700fe786-116bacda-8219a0bc-42d1bba7-bb638738.jpg,test/p15/p15934572/s53772183/700fe786-116bacda-8219a0bc-42d1bba7-bb638738.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Radiographs of ___. FINDINGS: Cardiomediastinal contours are stable in appearance allowing for leftward patient rotation. Low lung volumes result in crowding of bronchovascular structures. Patchy right lower lobe and combined patchy and linear left lower lobe opacities are present, and most likely represent atelectasis. Aspiration or developing infectious pneumonia are also possible in the appropriate clinical setting, a short-term followup radiographs may be helpful in this regard if warranted clinically. " 5b777102-deab9acb-5fc502f0-d463e6e7-d89532e5.jpg,test/p13/p13280760/s54669145/5b777102-deab9acb-5fc502f0-d463e6e7-d89532e5.jpg,test," FINAL REPORT HISTORY: ___-year-old female with pancreatitis and pleural effusions. TECHNIQUE: Frontal chest radiograph was obtained portably with the patient in an upright position. COMPARISON: ___. FINDINGS: Lung volumes are low. Small-to-moderate bilateral pleural effusions and severe bibasilar atelectasis persist. Upper lobe vascular congestion could be physiologic given severe atelectasis and small pleural effusions. Heart and mediastinal contours are unchanged. Enteric catheter courses below the diaphragm with tip projecting over the left upper quadrant, likely in the distal duodenum. Right PICC appears similarly positioned. No pneumothorax is detected. IMPRESSION: Low lung volumes with persistent small to moderate bilateral pleural effusions and severe bibasilar atelectasis. " 460564da-f530de8e-fabb35c1-53d562ae-404235d0.jpg,test/p19/p19016834/s56761306/460564da-f530de8e-fabb35c1-53d562ae-404235d0.jpg,test," FINAL REPORT INDICATION: Status post dilation of esophageal stricture. COMPARISONS: Chest radiograph ___. Chest radiograph ___. Chest radiograph ___. FINDINGS: There is no pneumothorax or pneumomediastinum. The cardiomediastinal silhouette is normal. A small right pleural effusion is unchanged. Since the prior radiograph, there has been increased nodular peribronchial opacification, most readily explained by chronic aspiration. Mild hazy opacification at the left base is unchanged and likely represents chronic atelectasis. IMPRESSION: 1. No pneumothorax or pneumomediastinum. 2. Increasing peribronchial opacification at the right base likely represents aspiration, possibly pneumonia. " d5609128-b37482f7-aed4838a-f7fed1bc-cede2bfb.jpg,test/p10/p10203235/s57516281/d5609128-b37482f7-aed4838a-f7fed1bc-cede2bfb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with T2DM, CAD s/p CABG and multiple stents p/w productive cough x 2 weeks + increased rhonchi at right lung base // eval pna eval pna IMPRESSION: In comparison with the study of ___, there is little interval change in this patient with cardiac enlargement, CABG, and intact midline sternal wires. No vascular congestion, pleural effusion, or acute focal pneumonia. " aefbda54-d5d54726-0f384953-bf14f2b5-b464f575.jpg,test/p18/p18761473/s52415437/aefbda54-d5d54726-0f384953-bf14f2b5-b464f575.jpg,test," FINAL REPORT AP CHEST, 12:47 P.M., ___ HISTORY: ___-year-old man with new right central venous line. Confirm placement. Assess complications. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs, in conjunction with torso CT ___: New right subclavian line ends low in the SVC. No pneumothorax, mediastinal widening or pleural effusion. Small nodules most readily visible in the left lung conform to the CT appearance generally, but there appears to be less peribronchial infiltration in the apical posterior segment of the left upper lobe. Heart size is normal. Progression in pulmonary abnormality between ___ and ___ torso CTs and subsequent improvement could be due to remission in an usual manifestation of metastases, but is more typical in terms of morphology for an inflammatory condition, either atypical infection, or if the patient has received steroids, sarcoidosis. " f050ab09-dc55058a-9401d8bd-27dac99d-1efab2f2.jpg,test/p16/p16397983/s56597524/f050ab09-dc55058a-9401d8bd-27dac99d-1efab2f2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are normal. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 34e08a00-39fa1879-4a1c64f3-dc972c9e-f4f15c1e.jpg,test/p12/p12466486/s58247455/34e08a00-39fa1879-4a1c64f3-dc972c9e-f4f15c1e.jpg,test," FINAL REPORT INDICATION: Shortness of breath and cough with wheezing. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: Cardiac, mediastinal, and hilar contours are normal. The pulmonary vascularity is normal, and the lungs are clear. No pleural effusion or pneumothorax is present. There are mild degenerative changes of the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " f751cda6-fa23282c-33229754-135f516e-99eeebad.jpg,test/p11/p11868916/s53181293/f751cda6-fa23282c-33229754-135f516e-99eeebad.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with persistent coughing // pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. FINDINGS: The lungs are well expanded and clear. Hila and cardiomediastinal contours and pleural surfaces are normal. IMPRESSION: Normal. No evidence of pneumonia. " bf9e3a55-66e9fec7-9f3ee1b1-bf5b28f5-cb13fff5.jpg,test/p16/p16620451/s55240825/bf9e3a55-66e9fec7-9f3ee1b1-bf5b28f5-cb13fff5.jpg,test," FINAL REPORT INDICATION: ___ year old woman with s/p CABG, evaluate for cough or increasing effusion. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Multiple prior studies, the most recent of ___. FINDINGS: The previously seen right internal jugular line has been removed. Compared to the prior radiograph ___ ___, a small to moderate left and trace right pleural effusions have decreased in size. The lungs expansion has improved and left lower lobe atelectasis has decreased. There is no pneumothorax or focal consolidation. Mediastinal clips and sternotomy wires are again noted. The cardiac and mediastinal contours are stable. IMPRESSION: Improved lung expansion and interval decrease in a small to moderate left and trace right pleural effusions since ___. " b58c1f6f-63f7d48f-97cacb17-1e260f81-25dd001d.jpg,test/p19/p19794590/s50345020/b58c1f6f-63f7d48f-97cacb17-1e260f81-25dd001d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hepatitis B, cirrhosis, evaluation of endotracheal tube position. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a previously placed right pectoral Port-A-Cath has been removed in the interval. The patient has been intubated. The tip of the endotracheal tube projects 4.7 cm above the carina. The tube could be advanced by 1 to 2 cm. Moderate cardiomegaly without pulmonary edema. Clips projecting over the liver, with radiodense material at this location, suggesting status post chemoembolization. No other pulmonary findings. No pleural effusions, no pulmonary edema. No pneumonia. " 2b4aef0b-7c00190c-e7349602-02ae96eb-49fe44e6.jpg,test/p15/p15355483/s54078298/2b4aef0b-7c00190c-e7349602-02ae96eb-49fe44e6.jpg,test," WET READ: ___ ___ ___ 12:15 AM No pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with fever. TECHNIQUE: Frontal radiograph of the chest was obtained. COMPARISON: None. FINDINGS: Pectus excavatum. The lungs are clear, cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: No pneumonia. " ec5bbef9-d20b8493-94b8abf2-85623733-764c34c1.jpg,test/p19/p19901661/s52648671/ec5bbef9-d20b8493-94b8abf2-85623733-764c34c1.jpg,test," WET READ: ___ ___ ___ 5:44 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with UC, plan for colectomy in AM // Please do pre-op CXR Please do pre-op CXR COMPARISON: There are no prior chest radiographs. IMPRESSION: Single frontal view shows lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " a6f27cb1-e8afd4fc-b13267ed-10ccc134-520a7743.jpg,test/p15/p15831124/s50838747/a6f27cb1-e8afd4fc-b13267ed-10ccc134-520a7743.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated; leukocytosis. // eval infiltrate eval infiltrate COMPARISON: Comparison to ___ at 05:40. IMPRESSION: Left internal jugular central line and endotracheal tube are unchanged. A nasogastric tube is seen coursing to the level of the distal esophagus but the tip is not identified on the current examination. There is worsening moderate pulmonary edema. Bilateral layering effusions, left greater than right. Retrocardiac consolidation likely reflects partial lower lobe compressive atelectasis, although pneumonia cannot be excluded. No pneumothorax. " 04940fa2-e63ae3f1-12d0753b-d1401075-d92382d0.jpg,test/p11/p11276090/s54800773/04940fa2-e63ae3f1-12d0753b-d1401075-d92382d0.jpg,test," WET READ: ___ ___ ___ 11:47 PM No acute intrathoracic abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cirrhosis s/p fall // eval for ICH NHCT eval for pna xray TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. Again noted are reticular opacities in the bilateral apices, consistent with underlying chronic interstitial lung disease. No overlying consolidation is identified. The cardiomediastinal silhouette and pulmonary vasculature are similar the prior examination. IMPRESSION: No acute intrathoracic abnormality. " be6bed0b-18908a76-88c47ad7-2a83fdca-6819c8fe.jpg,test/p15/p15805011/s56802822/be6bed0b-18908a76-88c47ad7-2a83fdca-6819c8fe.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with pleuritic chest pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs remain clear of focal consolidation or effusion. Prominent extrapleural fat is seen at the bases bilaterally. Cardiomediastinal silhouette is stable in appearance as are the osseous and soft tissue structures. IMPRESSION: No acute cardiopulmonary process. " 16ee5b32-19e3aef8-2289e31c-e3ba6ca8-f6c21d5c.jpg,test/p10/p10455192/s56281143/16ee5b32-19e3aef8-2289e31c-e3ba6ca8-f6c21d5c.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph from earlier the same date. FINDINGS: Tip of endotracheal tube terminates about 1 cm above the carina and should be withdrawn several centimeters for standard positioning, as communicated by phone to Dr. ___ on ___ at 1:30 p.m. at the time of discovery. There are otherwise no relevant short interval changes since the previous study performed about two hours earlier. " 310b75ae-92386510-974dc3da-19ccd81d-151531a9.jpg,test/p11/p11051429/s57031458/310b75ae-92386510-974dc3da-19ccd81d-151531a9.jpg,test," FINAL REPORT INDICATION: Headache and chest pain. Evaluate for pneumonia. COMPARISON: Chest radiograph ___ and ___. FINDINGS: Frontal and lateral views of the chest. A pacemaker has been placed in the interval, with leads terminating in the right atrium and right ventricle. Clips are seen within the neck. No pleural effusion or pneumothorax. No focal airspace consolidation worrisome for pneumonia. Cardiac silhouette remains mildly enlarged. Mediastinal and hilar structures are unchanged. IMPRESSION: No acute cardiopulmonary process. " 20e77eb4-8591ccb7-3472757b-43d479ef-4b8aa644.jpg,test/p19/p19163194/s55583947/20e77eb4-8591ccb7-3472757b-43d479ef-4b8aa644.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Dyspnea and fatigue, assess for pneumonia. FINDINGS: The upright and lateral views of the chest were obtained. Stable elevation of the right hemidiaphragm is noted. There is no focal consolidation, effusion, or pneumothorax. Overall heart and mediastinal configuration is unchanged. Bony structures are intact. IMPRESSION: No acute intrathoracic process. Stable right hemidiaphragmatic elevation. " 5ebe2325-f0335741-ad149d95-4d831762-27b9d620.jpg,test/p17/p17018536/s51671333/5ebe2325-f0335741-ad149d95-4d831762-27b9d620.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___. IMPRESSION: Bilateral lung volumes are low. Mild-to-moderately enlarged heart size may be exaggerated by low lung volumes. Central pulmonary vasculature is mildly prominent suggestive of mild pulmonary vascular congestion, but no over edema. Increased retrocardiac opacity suggestes lower lung atelectasis and given low lung volumes, any element of concurrent pneumonia cannot be ruled out. Upper lungs are clear. There is no pleural abnormality. " cbc45f04-383a73d4-d1c5f6f1-39de1d30-f74c7bc1.jpg,test/p12/p12468629/s56653403/cbc45f04-383a73d4-d1c5f6f1-39de1d30-f74c7bc1.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with erythema nodosum and bilateral red rash, for assessment of lymphadenopathy. COMPARISON: ___. The patient is after median sternotomy and CABG. Heart size and mediastinum are stable in appearance with no interval development of mediastinal lymphadenopathy. Pleural thickening in the right lower lung is noted and might be consistent with prior post-surgical changes. Sternotomy wires are broken at the level of the first wire, unchanged. Left lower lobe linear opacity is seen and might potentially represent atelectasis, not clearly seen on the prior study, thus infectious process is a possibility (less likely). No appreciable pleural effusion or pneumothorax is seen. " 990e55c0-27fbbd8a-8b9ec799-d54134a8-55f79ecc.jpg,test/p17/p17569640/s50933234/990e55c0-27fbbd8a-8b9ec799-d54134a8-55f79ecc.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with altered mental status and worsening dementia. Question pneumonia. FINDINGS: Frontal and lateral views of the chest. No prior. The lungs are hyperinflated but clear of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Hypertrophic changes noted in the spine with lateral bridging osteophytes, one of which produces increased opacity projecting just lateral to the distal trachea on the frontal view. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " 39304d78-f80b1ac1-b845f6f9-07a5f403-1ce54b0b.jpg,test/p16/p16578228/s58102876/39304d78-f80b1ac1-b845f6f9-07a5f403-1ce54b0b.jpg,test," FINAL REPORT HISTORY: Right chest pain with tender to palpation lateral 10th rib. TECHNIQUE: Frontal and lateral views of the chest and 3 additional views of the right-sided ribs. COMPARISON: Chest radiograph from ___ no prior rib radiographs. FINDINGS: Chest: Minimal basilar atelectasis is seen. There is no focal consolidation. No large pleural effusion is seen. The lungs are relatively hyperinflated, with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. The aorta is calcified and unfolded. The cardiac silhouette is top-normal to mildly enlarged. No overt pulmonary edema is seen. The bones are diffusely osteopenic. Right-sided ribs. No displaced fracture is seen; however, please note that the lower most ribs are not well assessed on this study due to overlying soft tissue. If high clinical concern for rib fracture, consider CT. No large pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. No definite rib fracture is seen, however, please note that the lower right-sided ribs are not optimally evaluated due to overlying soft tissue and if there is high clinical concern for rib fracture, consider CT. " b8ba93d0-b12d9433-f4d2d554-f954442e-76944b6a.jpg,test/p13/p13520909/s51578820/b8ba93d0-b12d9433-f4d2d554-f954442e-76944b6a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with aspiration and PEA arrest // lines/tubes IMPRESSION: AS COMPARED TO PRIOR RADIOGRAPH OF 1 DAY EARLIER, PULMONARY VASCULAR CONGESTION IS ACCOMPANIED BY SLIGHT WORSENING OF PULMONARY EDEMA AND INCREASING PLEURAL EFFUSIONS, RIGHT GREATER THAN LEFT. " 8cdfc5e8-6cbdee7e-eb68e735-dda2bae2-f95084de.jpg,test/p16/p16706702/s54737000/8cdfc5e8-6cbdee7e-eb68e735-dda2bae2-f95084de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fall, found down. On coumadin // Eval for acute process Eval for acute process IMPRESSION: No comparison. Massive cardiomegaly. No pulmonary edema. No pleural effusions. No pneumonia. Moderate scoliosis with subsequent asymmetry of the ribcage. " 82c7340a-30458f0c-554c50a9-ed2dd612-b49f41c8.jpg,test/p17/p17249901/s56123196/82c7340a-30458f0c-554c50a9-ed2dd612-b49f41c8.jpg,test," FINAL REPORT INDICATION: Asymptomatic bradycardia. TECHNIQUE: Two views of the chest. COMPARISON: None available. FINDINGS AND IMPRESSION: Lung volumes are low causing some bronchovascular crowding. No pleural effusion, pulmonary edema or pneumothorax is present. No focal opacity to suggest pneumonia. The heart is mildly enlarged. " f681aa12-bf351026-d13374e5-4eb4370f-afa72632.jpg,test/p14/p14977523/s51187772/f681aa12-bf351026-d13374e5-4eb4370f-afa72632.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever // please evaluate for acute abnormality TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " a69455a7-93fceca8-957f32ac-f1c5bbce-2fdf26bc.jpg,test/p11/p11828845/s59949503/a69455a7-93fceca8-957f32ac-f1c5bbce-2fdf26bc.jpg,test," FINAL REPORT INDICATION: ___-year-old male with 4 days of chest pain. Please evaluate for pneumonia or cardiomegaly. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 01946afb-03454b6c-72672dfc-5d46af4f-60a07205.jpg,test/p18/p18573535/s53170506/01946afb-03454b6c-72672dfc-5d46af4f-60a07205.jpg,test," FINAL REPORT INDICATION: Chest tube removal, assess for pneumothorax. COMPARISON: None available. FINDINGS: One AP portable upright view of the chest. No pneumothorax. No pleural effusions. The cardiac, mediastinal, and hilar contours are normal. Low lung volumes and mild bibasilar atelectasis. Spinal hardware is in appropriate position. No evidence of pneumonia. IMPRESSION: 1. No pneumothorax. 2. Low lung volumes and mild bibasilar atelectasis. " 56755803-a1b56124-58715ba8-a7c00521-0938fa08.jpg,test/p13/p13637928/s50901240/56755803-a1b56124-58715ba8-a7c00521-0938fa08.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: An ___-year-old woman with fever. IMPRESSION: PA and lateral chest compared to ___: New relatively discrete small opacities in the right lung, some containing ring shadows, could be areas of pneumonia or septic emboli. Left lung is grossly clear. There is no appreciable pleural effusion. Heart is mildly enlarged, unchanged since ___. Thoracic aorta is generally large and tortuous, but not focally dilated. Dr. ___ was paged at 9 a.m. as soon as the findings were recognized. " 36e2293e-ba15aec3-d2bb96c0-9f564656-ddd4925f.jpg,test/p16/p16312465/s56471663/36e2293e-ba15aec3-d2bb96c0-9f564656-ddd4925f.jpg,test," FINAL REPORT HISTORY: Multiple myeloma; postop day pattern status post left humeral fracture repair with persistent low-grade temperature. TECHNIQUE: Portable upright chest radiograph. COMPARISON: Multiple chest radiographs dating back to ___. FINDINGS: Heart size is normal with unremarkable cardiomediastinal silhouette and hilar contour. A right subclavian infusion port is unchanged in position with the catheter tip projecting over the right atrium. Again appreciated are linear opacities in the right lower lung and left mid lung likely representative of atelectasis along with an elliptical consolidation in the left mid lung likely representing change in configuration of atelectasis otherwise without effusion or pneumothorax. Left humeral head fixation hardware is incompletely imaged. IMPRESSION: Persistent atelectasis without evidence of pneumonia. " 7377c600-b5a82b96-a9289684-675c7af2-ef12db9f.jpg,test/p19/p19928728/s54779532/7377c600-b5a82b96-a9289684-675c7af2-ef12db9f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure and pneumonia, assessment for interval change. COMPARISON: ___, 4:19 a.m. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices, the post-surgical devices and the aspect of the cardiac silhouette and the pulmonary parenchyma are constant. " c25fcc9d-d0485cf2-bcc48484-c6156e54-1a2365a8.jpg,test/p11/p11126593/s52963740/c25fcc9d-d0485cf2-bcc48484-c6156e54-1a2365a8.jpg,test," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old man with atrial fibrillation status post fall with delirium. Lung nodule seen on the AP view. FINDINGS: The nodular area of density seen on the prior radiograph is faintly visualized on today's study. This may represent developing infiltrate versus a lung nodule. CT scan for baseline assessment would be helpful. The rest of the lung fields are grossly clear. The cardiac silhouette and mediastinum is within normal limits. IMPRESSION: Faint density in the left mid lung zone, corresponding to the nodular density seen on the prior study. This may represent developing infiltrate or a pulmonary nodule. If there is high concern, a CT scan could be performed for further assessment. " c18ddd83-d4b4841b-2a6b88db-6a58797f-242d503e.jpg,test/p13/p13372717/s53209468/c18ddd83-d4b4841b-2a6b88db-6a58797f-242d503e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with malaise. cough. right gait deviation COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 2504429c-23e3f23f-2468e77c-ebbcc30a-a129d1bf.jpg,test/p10/p10613392/s56770979/2504429c-23e3f23f-2468e77c-ebbcc30a-a129d1bf.jpg,test," FINAL REPORT HISTORY: Hypoxia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. Lungs are hyperinflated. No focal consolidation, pleural effusion or pneumothorax is seen. Minimal scarring is noted within the lung apices. No acute osseous abnormalities are detected. Anterior cervical fusion hardware is not well assessed on these views. IMPRESSION: No acute cardiopulmonary process. Hyperinflated lungs may suggest underlying COPD. " 971b4bd8-09f04bc5-e43b86b5-dde445a3-5cbfca46.jpg,test/p11/p11888614/s58264635/971b4bd8-09f04bc5-e43b86b5-dde445a3-5cbfca46.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Prominence of interstitial markings is similar to prior radiograph particularly that on ___. The cardiac, mediastinal, hilar contours are stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. IMPRESSION: No significant interval change. " 15369b8f-762bb024-6238a3ea-ba9cc7dc-8fbe2feb.jpg,test/p15/p15672432/s56249196/15369b8f-762bb024-6238a3ea-ba9cc7dc-8fbe2feb.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with chest pain // ? infectious process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ through ___ FINDINGS: Median sternotomy wires are demonstrated. Moderate cardiomegaly is stable. Prominence of the pulmonary vasculature is overall similar to the prior examination. No evidence of focal consolidation, pulmonary edema or pneumothorax. Minimal linear atelectasis at the left lung base. IMPRESSION: No radiographic evidence of pneumonia. " 5c10b132-14310eb7-d1ea4da2-95390738-67f0f259.jpg,test/p12/p12602065/s58655926/5c10b132-14310eb7-d1ea4da2-95390738-67f0f259.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___F with cough and sob // eval pna eval pna COMPARISON: ___ FINDINGS: The lungs are clear. The heart and mediastinal structures are unremarkable. The bony thorax is grossly intact IMPRESSION: No active disease. " d54ef0a0-83bbecbd-8f411a3e-992acef9-9bf53927.jpg,test/p18/p18594766/s53150140/d54ef0a0-83bbecbd-8f411a3e-992acef9-9bf53927.jpg,test," FINAL REPORT PORTABLE CHEST FILM, ___ AT 21:26 CLINICAL INDICATION: ___-year-old with chest tube to waterseal, question pneumothorax. Comparison is made to the patient's prior study dated ___ at 15:58. Portable AP semi-upright chest film ___ at 21:26 is submitted. IMPRESSION: 1. Right subclavian PICC line with its tip in the proximal SVC. Spinal hardware is seen overlying the upper and mid thoracic spine. A left chest tube is in place. No pneumothorax is seen. However, there is airspace opacity at the left lung base with an associated elevated left hemidiaphragm. These findings together would favor lower lobe atelectasis rather than aspiration or acute infectious process. Clinical correlation is advised. The right lung is grossly clear. Overall cardiac and mediastinal contours are difficult to assess due to heart border being obscured and overlying spinal hardware. " fa5c6c55-23da4cb6-f54ec1b1-96f46186-1d6ae158.jpg,test/p13/p13224377/s56665830/fa5c6c55-23da4cb6-f54ec1b1-96f46186-1d6ae158.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pnuemonia // assess for interval change COMPARISON: Chest CT from ___. Chest radiograph from ___. FINDINGS: AP portable upright view of the chest. A transesophageal catheter extends into the stomach, and beyond the scope of this examination. A right-sided tunneled line is present. Again seen are widespread bilateral pulmonary opacities, worse along the right base, better visualized on the chest CT from ___. The overall radiographic appearance is minimally changed since ___. IMPRESSION: Multi focal pneumonia, with radiographic appearance minimally changed since ___. " 26a5b1ef-d28ca62a-1de00d71-e206c839-2eb59fa6.jpg,test/p10/p10668217/s50013011/26a5b1ef-d28ca62a-1de00d71-e206c839-2eb59fa6.jpg,test," FINAL REPORT INDICATION: ___-year-old with fever. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: There is a minor right basilar atelectasis. The cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: No acute cardiothoracic process. " 8a26987f-db5cc16e-97b24868-6b0cd5ee-1e543853.jpg,test/p19/p19736957/s59665991/8a26987f-db5cc16e-97b24868-6b0cd5ee-1e543853.jpg,test," WET READ: ___ ___ ___ 10:05 PM No acute cardiopulmonary pathology. Multiple bilateral healed rib fractures. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Altered mental status. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size is mildly enlarged, unchanged. Mediastinum is stable. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. Multiple rib fractures on the left and several fractures on the right are noted. Slightly elevated left hemidiaphragm is unchanged. " 5317ec37-9e0577b8-16991588-124d625e-d82536d4.jpg,test/p14/p14353305/s52127873/5317ec37-9e0577b8-16991588-124d625e-d82536d4.jpg,test," FINAL REPORT INDICATION: ___-year-old man with pneumothorax, now on waterseal. Evaluate for pneumothorax. COMPARISONS: PA and lateral chest radiographs from ___ and portable AP radiograph from ___. FINDINGS: A right chest tube is in place. There is a small apical pneumothorax, unchanged the prior study. There is no evidence of tension. There is no focal consolidation or pleural effusion. The cardiomediastinal silhouette is normal. IMPRESSION: Small right apical pneumothorax unchanged from prior study. " b98fb27c-26e1a9fc-89bcc0f9-18c6452a-399afd83.jpg,test/p11/p11967908/s54036654/b98fb27c-26e1a9fc-89bcc0f9-18c6452a-399afd83.jpg,test," FINAL REPORT HISTORY: Patient with history of right breast cancer and radiation with new oxygen requirements. COMPARISON: ___. FINDINGS: In normal cardiac silhouette. Right apical pleural thickening similar to priors and likely due to radiation therapy. No focal consolidation, pleural effusion or pneumothorax. Surgical clips in the right axillary region compatible with prior lymph node dissection. Mild pulmonary venous congestion. IMPRESSION: No radiographic explanation for increased oxygen requirements. CT of the chest may be considered to determine pulmonary embolism as cause of increased oxygen requirements if clinically warranted. " 156d85a6-37f83982-814c40b7-0c904fd0-64211957.jpg,test/p18/p18906387/s55884445/156d85a6-37f83982-814c40b7-0c904fd0-64211957.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Tectal glioma, cardiac pacer // check placement of pacer leads TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: In comparison with chest radiograph from ___, there is no relevant change. Left-sided cardiac pacing device with dual leads following their expected courses to the right atrium and ventricle. There is no focal consolidation, effusion, or pneumothorax. Mediastinal and hilar contours are stable. Heart size is normal. IMPRESSION: Left-sided cardiac pacing device with dual leads following their expected courses to the right atrium and ventricle, unchanged since ___. " 110a468b-5fee590c-18b5c882-5d19b5b3-1f795aca.jpg,test/p18/p18043846/s51668778/110a468b-5fee590c-18b5c882-5d19b5b3-1f795aca.jpg,test," FINAL REPORT INDICATION: Chest and back pain. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. Lower lung volumes explain mild generalized increase in lung volumes. IMPRESSION: No acute intrathoracic process. " 2f89f0d4-82c9ce33-067be2c2-1d384368-1c46d107.jpg,test/p17/p17824494/s50999489/2f89f0d4-82c9ce33-067be2c2-1d384368-1c46d107.jpg,test," FINAL REPORT HISTORY: Dizziness in a patient with a history of congestive heart failure, cardiomyopathy, and atrial fibrillation. COMPARISON: Chest radiograph from ___. FINDINGS: Semi-upright AP and lateral radiographs of the chest are provided. The heart is enlarged. There is a left layering pleural effusion. Kerley B lines and pulmonary vascular redistribution is present. There is no pneumothorax. There is no large airspace consolidation. IMPRESSION: Moderate left pleural effusion and pulmonary edema consistent with congestive heart failure. Underlying pneumonia in LLL cannot be excluded. " d6985100-672dd3df-4e9f9884-8df7f669-acc00ae0.jpg,test/p15/p15756536/s59900692/d6985100-672dd3df-4e9f9884-8df7f669-acc00ae0.jpg,test," FINAL REPORT PA AND LATERAL CHEST FROM ___ AT 23:58 CLINICAL INDICATION: ___-year-old with no pneumothorax, assess for interval change. Comparison is made to the patient's prior portable study of ___ at 23:03. PA and lateral views of the chest dated ___ at 23:58 are submitted. IMPRESSION: 1. Increasing moderate right apical and lateral pneumothorax with a fluid component consistent with a basilar hydropneumothorax. There continues to be pneumoperitoneum, which is likely not significantly changed given differences in positioning. Overall cardiac and mediastinal contours are stable. Small bilateral layering pleural effusions. Lungs are better inflated with improvement in aeration at both bases and no evidence of pulmonary edema. Results were communicated by phone to Dr. ___ at 8:36am at the time of discovery. " aea3e7c4-93b61b83-8f42e010-ef1faf7d-48660918.jpg,test/p18/p18656167/s58638156/aea3e7c4-93b61b83-8f42e010-ef1faf7d-48660918.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath. TECHNIQUE: Single portable AP radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: Single AP portable chest radiograph demonstrates no focal consolidation. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion pneumothorax or pulmonary edema. Visualized osseous structures demonstrates no acute abnormality. There are minimal right lower lobe atelectasis. IMPRESSION: No acute intrathoracic abnormality. " 46ec7c3b-29912d96-69c9ea2c-fb84e6f3-c117e4f6.jpg,test/p11/p11985705/s50932164/46ec7c3b-29912d96-69c9ea2c-fb84e6f3-c117e4f6.jpg,test," FINAL REPORT INDICATION: ___-year-old female with shortness breath and fever. Question pneumonia. COMPARISON: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " eed17edc-a35f03d0-2977e2a6-9e2d0333-9dc57886.jpg,test/p16/p16070047/s51219842/eed17edc-a35f03d0-2977e2a6-9e2d0333-9dc57886.jpg,test," FINAL REPORT HISTORY: Chronic TPN requirements, admitted with PICC line. Evaluate placement. COMPARISON: Chest radiograph from ___. FINDINGS: A portable frontal chest radiograph demonstrates a left PICC with the tip in the mid to low SVC and a nasoenteric tube that likely enters the small bowel. The cardiomediastinal silhouette is normal and the lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Left PICC with the tip in the mid to low SVC. " 496ca4eb-96600429-f794c4d3-8b1b7172-f615041e.jpg,test/p13/p13975291/s58907220/496ca4eb-96600429-f794c4d3-8b1b7172-f615041e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with wet gangrene R ___ toe // Please assess for acute pathology Surg: ___ (Toe amp) Please assess for acute pathology IMPRESSION: Compared to chest radiographs since ___, most recently ___. Heart size top- normal, improved. Lungs clear. No pleural abnormality. Mediastinal contours explained by benign fat deposition. " 5c203f6a-299eab68-d8f1cc85-7e157760-2b6f2096.jpg,test/p11/p11658675/s53244011/5c203f6a-299eab68-d8f1cc85-7e157760-2b6f2096.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with eosinophilic pneumonia, recent hospitalization infiltrate. COMPARISON: ___. FINDINGS: There is worsening of the lingular consolidation. Right lung base opacities are unchanged. The lung volumes are low. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. Patient had previous kyphoplasty. CONCLUSION: Worsening of left lower lung consolidation. " f5804629-5c1663c0-d5fdc16b-dab059cd-49897c43.jpg,test/p17/p17892707/s56655679/f5804629-5c1663c0-d5fdc16b-dab059cd-49897c43.jpg,test," FINAL REPORT HISTORY: Thoracentesis. FINDINGS: In comparison with the study of ___, there has been a thoracentesis on the left with removal of a substantial amount of pleural fluid. No definite pneumothorax. There are two curvilinear opacifications symmetrically bilaterally that mimic pneumothoraces. These could represent merely an unusual appearance to the anterior portion of the first ribs, possibly reflecting calcification of costal cartilage. Persistent opacification at the right base, though less prominent than on the previous study. " a778f294-fc0aae5c-6869ac8f-bd5df4b0-86616b0d.jpg,test/p15/p15854395/s55835521/a778f294-fc0aae5c-6869ac8f-bd5df4b0-86616b0d.jpg,test," FINAL REPORT HISTORY: Hypoglycemia. Evaluate for infectious process. COMPARISON: None available. FINDINGS: PA and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. There is no free air under the diaphragm. The bony structures are unremarkable. IMPRESSION: Normal chest radiograph. " 1ce9b49e-4037ac35-2f81a9bf-f57b8df9-3675f9d7.jpg,test/p13/p13225622/s59216895/1ce9b49e-4037ac35-2f81a9bf-f57b8df9-3675f9d7.jpg,test," FINAL REPORT INDICATION: ___F with pancreatic ca on folfurinox now with fever, feeling unwell // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT with contrast ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are expanded clear without focal consolidation concerning for pneumonia. The upper abdomen is unremarkable. Note is made of a right chest port with tip terminating in the low SVC. IMPRESSION: No acute cardiopulmonary process. " 7309d080-569cb608-8b7a74e1-d364b546-7fb1576a.jpg,test/p12/p12278337/s51735328/7309d080-569cb608-8b7a74e1-d364b546-7fb1576a.jpg,test," FINAL REPORT INDICATION: Shortness of breath and recent pneumonia. Rule out acute process. COMPARISON: Chest radiographs ___ and ___. CT thoracic and lumbar spine ___. FINDINGS and IMPRESSION: Frontal and lateral view of the chest. The lungs are hyperinflated with expansion in the AP dimension, consistent with chronic obstructive pulmonary disease. Atelectasis and pleural thickening is again seen at the left lung base, and the abnormal upward bulging contour of the left diaphragmatic pleural surface is longstanding. There are no definite pleural effusions. There is no pneumothorax or focal consolidation worrisome for pneumonia. An elliptical 10mm wide nodule projecting over the left fourth rib anteriorly could be rib calcification, but a CT scan would be needed to exclude a lung nodule. The heart size is normal and the mediastinal contours are unchanged. Calcifications are again seen in the aortic arch. ED QA nurses were notified by email of alteration from initial reading. " 9a7c8ccc-b61c8c72-ad94bc26-89127226-c3dc78d8.jpg,test/p13/p13035993/s58037819/9a7c8ccc-b61c8c72-ad94bc26-89127226-c3dc78d8.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___ CT and chest radiograph. CLINICAL HISTORY: Chest pain and shortness of breath, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is minimal atelectasis in the left lung base, likely in the region of the inferior lingula as seen on prior study. There is no new consolidation, effusion, or pneumothorax. No signs of CHF. Cardiomediastinal silhouette appears normal. Bony structures appear intact. Mild degenerative changes of the shoulders are noted. No free air below the right hemidiaphragm. IMPRESSION: Mild left lung base atelectasis. Otherwise unremarkable study. " 28c43202-2c3e4c78-91147880-4bf7571c-fc5d987b.jpg,test/p19/p19657904/s56788489/28c43202-2c3e4c78-91147880-4bf7571c-fc5d987b.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 4:21 CLINICAL INDICATION: ___-year-old with asthma and CHF status post extubation. Assess for interval change. Comparison is made to the patient's prior study of ___ at 21:56. Single portable upright chest film, ___ at 4:21 is submitted. IMPRESSION: 1. Right internal jugular central line has its tip in the distal SVC. Interval extubation and removal of the nasogastric tube. 2. Low lung volumes with bibasilar airspace opacities and likely layering effusions suggestive of compressive atelectasis, less likely pneumonia. No evidence of pulmonary edema. No pneumothorax. Heart remains enlarged. Overall mediastinal contours are likely unchanged, given differences in positioning and technique between studies. Degenerative changes of the acromioclavicular joint. Cystic changes within an incompletely visualized right humeral head, possibly related to degenerative change or remote trauma. " 55a1e2cd-465a408a-fabcf3a4-56d6d67b-ffe4f626.jpg,test/p12/p12829950/s50376986/55a1e2cd-465a408a-fabcf3a4-56d6d67b-ffe4f626.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with L sided PNA and PE // please assess for interval change in L lung field s/p chest PT please assess for interval change in L lung field s/p chest PT IMPRESSION: Port-A-Cath catheter tip is at the level of lower SVC. Heart size and mediastinum are stable. Left pleural effusion is moderate to large. No pulmonary edema demonstrated. No pneumothorax is seen. " 72d79b4f-8d0f537f-b4702915-41cb6adf-e46d63a1.jpg,test/p16/p16893353/s52621660/72d79b4f-8d0f537f-b4702915-41cb6adf-e46d63a1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with asthma, CHF, CAD with worsening PFTs and shortness of breath // any infiltrate or edema any infiltrate or edema IMPRESSION: Comparison to ___. No relevant change is noted. Low lung volumes. Left pectoral pacemaker. Mild cardiomegaly without pulmonary edema. No pleural effusions. No pneumothorax. " 59a80c0e-4753bec5-80d43cc4-5d02a06d-f1397367.jpg,test/p18/p18747007/s53216096/59a80c0e-4753bec5-80d43cc4-5d02a06d-f1397367.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. No pneumothorax. " 7b3a40cf-a269baa7-71c53369-525fa7eb-ba705ecd.jpg,test/p17/p17739770/s52809092/7b3a40cf-a269baa7-71c53369-525fa7eb-ba705ecd.jpg,test," FINAL REPORT INDICATION: Polytrauma, query pneumonia or pneumothorax. TECHNIQUE: Semi-erect portable chest view was read in comparison with prior chest radiographs, the most recent from ___. FINDINGS: Endotracheal tube tip is 4.6 cm above the carina, orogastric tube ends into the stomach and the right subclavian line tip is at lower SVC, and all are appropriately positioned. Both lungs are well expanded without any opacities concerning for pneumonia or aspiration or atelectasis. There is no pleural abnormality. Heart size is normal. Mediastinal and hilar contours are unremarkable. IMPRESSION: No pneumonia or pneumothorax. " b3cc46bb-8a1f8400-77a90db9-10784b74-b3849e23.jpg,test/p15/p15680450/s51004284/b3cc46bb-8a1f8400-77a90db9-10784b74-b3849e23.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with h/o 2nd degree Mobitz 1 a/v block with Ling ILR placement, dislodged. // Check position of Ling implant TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. LINQ device seen in a somewhat horizontal orientation projecting over the medial left lower chest, approximately at the level of the anterior left fourth and fifth ribs. On the lateral view, the device is seen to be very superficial in the anterior skin of the chest, and possibly protruding from it. IMPRESSION: LINQ device seen in a somewhat horizontal orientation projecting over the medial left lower chest, approximately at the level of the anterior left fourth and fifth ribs. On the lateral view, the device is seen to be very superficial in the anterior skin of the chest, and possibly protruding from it. " a1a23bef-c952b110-3269dd0d-62148287-d7e352c0.jpg,test/p15/p15835176/s54281165/a1a23bef-c952b110-3269dd0d-62148287-d7e352c0.jpg,test," FINAL REPORT INDICATION: Hypoxemia, requiring intubation. Evaluation of right IJ catheter placement. COMPARISON: ___ at 10:54 and 10:33 a.m. FINDINGS: Portable AP chest radiograph demonstrates the ET tube in stable position. The NG tube tip is within the stomach. A right IJ catheter tip is in the lower SVC without evidence of pneumothorax. Severe pulmonary edema is unchanged along with a mild pleural effusion on the right. There likely is also a small effusion on the left with possible left basilar atelectasis. Severe cardiomegaly is also unchanged. " acd85a91-54961b4a-7c60bcd7-15003f0b-4f8bda57.jpg,test/p16/p16142166/s51629915/acd85a91-54961b4a-7c60bcd7-15003f0b-4f8bda57.jpg,test," FINAL REPORT HISTORY: Pleural effusion, to assess for pneumothorax. FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions, more prominent on the left, with some compressive atelectasis at the base in this patient with continued enlargement of the cardiac silhouette. No evidence of pneumothorax. " 9f68f784-5188d495-c5803627-37126944-42f904c6.jpg,test/p11/p11778596/s58510004/9f68f784-5188d495-c5803627-37126944-42f904c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of progressive breathlessness. History of pericardial effusion; echo last week showed improvement. // evaluate for source of shortness of breath evaluate for source of shortness of breath IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 45e6c7eb-c69136a9-c43ad0a3-944de0dd-e8b4537e.jpg,test/p13/p13549706/s50448522/45e6c7eb-c69136a9-c43ad0a3-944de0dd-e8b4537e.jpg,test," FINAL REPORT INDICATION: History: ___M with Purulent drainage from sacral ulcer, fevers and altered mental status TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Lung volumes are low. Cardiac and mediastinal contours are unchanged with tortuosity of the thoracic aorta again noted. Pulmonary vasculature is not engorged. Patchy opacities are re- demonstrated in the lung bases, not significantly changed in the interval, most likely reflective of atelectasis. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with patchy bibasilar opacities, likely atelectasis. Infection or aspiration is not completely excluded. " c3e2ce46-3cb89883-e096b31c-534f5997-e2887c6e.jpg,test/p15/p15573773/s51172881/c3e2ce46-3cb89883-e096b31c-534f5997-e2887c6e.jpg,test," FINAL REPORT INDICATION: Hypotension and crackles at the left lung base. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Right-sided central venous catheter tip terminates at the cavoatrial junction, unchanged. Previously noted nasogastric tube has been removed. There is severe cardiomegaly, which is unchanged. Mild perihilar haziness and vascular indistinctness is compatible with mild pulmonary vascular congestion, slightly improved from the prior study. Streaky ill-defined opacities at the lung bases may reflect atelectasis. No pleural effusion or pneumothorax is definitively noted. Multiple bilateral old rib fractures are present. Additionally, the patient is status post ORIF of a left proximal humeral fracture. IMPRESSION: Mild pulmonary vascular congestion, improved from the prior study. Patchy opacities at the lung bases likely reflect atelectasis, though infection cannot be completely excluded. " dafaff05-7bfa13be-7f9071f3-f9448f63-293a0e64.jpg,test/p15/p15058800/s50084895/dafaff05-7bfa13be-7f9071f3-f9448f63-293a0e64.jpg,test," WET READ: ___ ___ 8:05 AM 1. Moderate cardiomegaly with cephalization of vasculature, and small bilateral pleural effusions is consistent with pulmonary edema. 2. Persistent right lower lobe opacity is unchanged from ___ and most consistent with atelectasis. Clinical correlation is recommended to assess for superimposed infection. WET READ VERSION #1 ___ ___ 11:52 PM 1. Moderate cardiomegaly with cephalization of vasculature, and small bilateral pleural effusions is consistent with pulmonary edema. 2. Persistent right lower lobe opacity is unchanged from ___ and most consistent with atelectasis. Clinical correlation is recommended to assess for superimposed infection. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multiple myeloma, ___% O2 on RA, history of dyspnea // pulm edema vs infection vs effusion pulm edema vs infection vs effusion IMPRESSION: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Bibasilar opacifications, more prominent on the right, are consistent with a combination of pleural effusion and compressive atelectasis at the bases. In the appropriate clinical setting, superimposed pneumonia would have to be considered. " 7005dad4-ee85668c-03163833-ec66009b-108905b5.jpg,test/p10/p10498753/s54457001/7005dad4-ee85668c-03163833-ec66009b-108905b5.jpg,test," FINAL REPORT INDICATION: ___F with fever and cough x 9 days, temp ___.___ yesterday and RLL wheezing and crackles // assess for infiltrate. TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. Reportedly, interval normal chest x-ray had been performed at an outside institution. FINDINGS: Although less conspicuous when compared to prior exam, there is opacity projecting over the right lower lobe best demonstrated on the lateral view. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Right lower lobe consolidation compatible with pneumonia, less extensive when compared to prior. Followup will be necessary to document resolution after treatment. NOTIFICATION: Findings were discussed with Dr. ___ at 19:20 on ___. " 2b807fa2-54da6f68-8c3177b7-2573a755-9b916396.jpg,test/p10/p10767527/s53467980/2b807fa2-54da6f68-8c3177b7-2573a755-9b916396.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough ,rales at the L base // r/o pna COMPARISON: ___ FINDINGS: New basal consolidation overlies the spine on the lateral view. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Left lower lobe pneumonia. RECOMMENDATION(S): Followup no sooner than 4 weeks, in ___ weeks. NOTIFICATION: The findings and recommendations were communicated to ___ ___ by ___ via telephone at 11:57 AM on ___. " d6fa5b96-ffdd66ab-28a2a694-cd5cd65a-b9647155.jpg,test/p11/p11340648/s58210294/d6fa5b96-ffdd66ab-28a2a694-cd5cd65a-b9647155.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with CP // eval for consolidation COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " b6d85dac-6319ef9d-6360e856-46193b33-4f2e02b6.jpg,test/p12/p12455543/s55840711/b6d85dac-6319ef9d-6360e856-46193b33-4f2e02b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recurrent pneumothorax s/p mechanical pleurodesis now with chest tube removed; please schedule for 3:30 pm // interval change with chest tube removed; please schedule for 3:30pm TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiomegaly is a stable. The there is no evident pneumothorax. Thickening of the right pleural and a small right effusion are stable. Patient has known emphysema and interstitial reticular are opacities in the lower lobes better seen in prior CT. New opacity in the periphery of the right upper lobe could represent atelectasis or aspiration attention on followup is recommended. Biapical scarring with calcifications right greater than left is better evaluated in prior CT IMPRESSION: No evident pneumothorax. New opacities in the periphery of the right upper lobe could represent atelectasis or aspiration attention in followup is recommended " b0a878d1-ea3b8aaa-b15a49b9-2883ea20-a9f9b82a.jpg,test/p16/p16974695/s50206199/b0a878d1-ea3b8aaa-b15a49b9-2883ea20-a9f9b82a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alcoholic cirrhosis, p/w hypoxia // hypoxia IMPRESSION: As compared to ___ radiograph, lung volumes are low, accentuating the cardiac silhouette and bronchovascular structures. Interval worsening of bibasilar opacities which may reflect atelectasis with or without a component of consolidation. Small pleural effusions are also demonstrated, and there is no visible pneumothorax. " d39296d4-8d61fdda-95920427-c261d541-bf5371ce.jpg,test/p12/p12650779/s59154662/d39296d4-8d61fdda-95920427-c261d541-bf5371ce.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with altered mental status // ? acute process, pneumonia TECHNIQUE: Portable AP view of the chest. COMPARISON: Chest radiographs dated ___. FINDINGS: Lung volumes are slightly decreased. Left retrocardiac atelectasis is noted. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Allowing for AP projection, the cardiac silhouette is top-normal in size. IMPRESSION: No evidence of acute cardiopulmonary process. " ecef3e58-dcaacb8d-ff8a0df3-4e5f556c-b4c376f1.jpg,test/p17/p17013671/s57002637/ecef3e58-dcaacb8d-ff8a0df3-4e5f556c-b4c376f1.jpg,test," WET READ: ___ ___ 5:40 PM No radiopaque foreign body. Nodular opacity projecting over the right lung base most likely a nipple shadow however nonurgent repeat with nipple markers suggested. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with 3 days of inability to swallow solids // Evaluate for foreign body in esophagus TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is a nodular opacity projecting over the right lung base which is felt most likely to be a nipple shadow. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. There is no radiopaque foreign body nor may pneumomediastinum. Exuberant anterior osteophytes seen at the mid to lower thoracic spine. IMPRESSION: No radiopaque foreign body. Nodular opacity projecting over the right lung base most likely a nipple shadow. RECOMMEDATIONS: Nonurgent repeat with nipple markers suggested. " d53d8bc5-0197f87e-7e6c6765-2fbdd1f4-52bfbdfc.jpg,test/p13/p13473495/s59702344/d53d8bc5-0197f87e-7e6c6765-2fbdd1f4-52bfbdfc.jpg,test," FINAL REPORT HISTORY: ___-year-old male with positive blood culture. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: The lateral radiograph is essentially nondiagnostic due to underpenetration likely due to patient body habitus. On frontal radiograph, lung volumes are low with bibasilar atelectasis. Evaluation is somewhat limited due to patient body habitus. The cardiac silhouette is enlarged. Double-lumen central venous catheter appears similarly positioned. Mild interstitial edema persists. No pneumothorax is seen. IMPRESSION: Limited study with persistent mild interstitial edema and cardiomegaly. Bibasilar opacities, atelectasis, can not exclude infection. " eab0060a-84dbd83d-3cb4acee-7e7eeb2d-eac09a0e.jpg,test/p19/p19473527/s51364495/eab0060a-84dbd83d-3cb4acee-7e7eeb2d-eac09a0e.jpg,test," FINAL REPORT HISTORY: ___-year-old male with question of progressing left upper lobe opacity. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is confluent, left greater than right, pulmonary fibrosis which is most prominent in the left upper lobe. Findings have progressed since ___ with increased left upper lobe heterogeneous pulmonary markings. There is new tenting of the left hemidiaphragm, suggesting left lung volume loss. Bilateral loculated pleural effusions have increased, now moderate in size with increased left upper lung subpleural opacity. Heart size is stable. Left PICC has been removed. IMPRESSION: Confluent, left greater than right, pulmonary fibrosis, progressed since ___ with increased left upper lobe heterogeneous pulmonary markings. Findings are consistent with worsening fibrotic disease with probable superimposed infection or, less likely, pulmonary edema. Increased loculated pleural effusion, now moderate in size, especially on the left. " 67d0b858-24d11795-e00d138a-265ea2ec-93a00765.jpg,test/p17/p17763712/s56478253/67d0b858-24d11795-e00d138a-265ea2ec-93a00765.jpg,test," WET READ: ___ ___ ___ 1:34 PM 1. Left greater than right pleural effusions, increased from ___. 2. Bibasilar airspace opacities, may represent atelectasis or infection in the appropriate clinical setting. 3. Interval improvement in left upper lobe opacity, which may represent resolving infection. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with met breast cancer // increasing SOB--___ evaluate pleura, lungs and pericardium compare to recent chest imaging available in our system TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Right-sided Port-A-Cath is unchanged in position, and terminates near the superior cavoatrial junction. Previously noted left upper lobe opacity has improved, and suggests resolving infection. There are bilateral pleural effusions, left greater than right, which have increased from ___. Adjacent bibasilar opacities most likely represent compressive atelectasis, although infection should be considered in the appropriate clinical setting. No pneumothorax. Cardiomediastinal contours are unchanged. No acute osseous abnormalities identified. IMPRESSION: 1. Left greater than right pleural effusions, increased from ___. 2. Bibasilar airspace opacities, may represent atelectasis or infection in the appropriate clinical setting. 3. Interval improvement in left upper lobe opacity, which may represent resolving infection. " bb77e2c2-293677f3-e67a2167-afd3af05-c37afbfd.jpg,test/p18/p18509816/s57837588/bb77e2c2-293677f3-e67a2167-afd3af05-c37afbfd.jpg,test," FINAL REPORT INDICATION: Pleuritic chest pain, left side, worse with inspiration. COMPARISON: None available. FINDINGS: A small to moderate left pleural effusion is present with adjacent left lower lobe opacity. Mild streaky opacity in the righ lung base is also noted. No right pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: Small to moderate size left pleural effusion with adjacent left lower lobe opacity, possibly compressive atelectasis but pneumonia is not excluded. Mild right basilar atelectasis. " 67d315d1-70f8b2ea-9c32a5b2-84cd09a9-d816f23e.jpg,test/p18/p18094860/s58339127/67d315d1-70f8b2ea-9c32a5b2-84cd09a9-d816f23e.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with previously noted lingular abnormality on chest radiograph from ___. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Previously identified lingular abnormality cannot be substantiated on today's examination. There is no evidence of an acute abnormality. There is overlying fat along the left cardiac border. Lungs are otherwise clear. There are no new focal consolidations. There are no pleural effusions or pneumothorax. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process. " 7021c5b5-779a3f33-2707f6bc-e1595921-3dc44eae.jpg,test/p10/p10500801/s54632870/7021c5b5-779a3f33-2707f6bc-e1595921-3dc44eae.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: COPD , stem cell transplant and recent pneumothorax. Cardiomediastinal contours are normal. There is a questionable tiny left apical pneumothorax. The lungs are hyperinflated, but clear. There is no pleural effusion. There are mild degenerative changes in the thoracic spine. " 67bddfaf-e4f12f5e-70356fa3-d6ee51b7-afe7f0b0.jpg,test/p16/p16454295/s59490500/67bddfaf-e4f12f5e-70356fa3-d6ee51b7-afe7f0b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with type 1 diabetes and ESRD on HD s/p failed kidney transplant now s/p kidney/pancreas transplant w/ PV anastamosis, c/b postop bleeding, now s/p exlap, evacuation of hematoma // position of NGT tip TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: NG tube tip is in the stomach. Right internal jugular line tip is at the level of cavoatrial junction. Heart size and mediastinum are stable. There is interval the a progression of interstitial opacities consistent with slight interval worsening of interstitial pulmonary edema. Small pleural effusions cannot be excluded. There is no definitive evidence of pneumothorax. " 6492da2a-1a4132cc-b9a55c24-f0eed472-9f41e278.jpg,test/p14/p14345849/s54354842/6492da2a-1a4132cc-b9a55c24-f0eed472-9f41e278.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with spontaneous pneumothorax, left pigtail catheter. Comparison is made with prior study performed two hours earlier. There are low lung volumes. Left apical pneumothorax is barely visible. Pulmonary edema has markedly improved. Bibasilar atelectases have improved, larger on the left side. Cardiomediastinal contours are unchanged. Low lung volumes are stable. Left pigtail catheter is in place. Sternal wires are aligned. " 08d4c771-6bb87d07-743373f2-6f92e74d-b27d2a98.jpg,test/p19/p19553650/s58330380/08d4c771-6bb87d07-743373f2-6f92e74d-b27d2a98.jpg,test," FINAL REPORT HISTORY: Patient with right middle lobectomy status post chest tube removal, rule out pneumothorax. COMPARISON: PA and lateral views of the chest performed earlier on the same day on ___. FINDINGS: Frontal and lateral chest radiographs were obtained. The rigth chest tube has been removed. There is now a small right apical pneumothorax. There is no evidence of tension. There is a persistent moderate hydropneumothorax adjacent to anterior right lung base. The left lung is fully expanded and clear. Cardiomediastinal silhouette and hilar contours are stable. There is also increased subcutaneous gas at right lateral chest wall. IMPRESSION: Interval removal of right chest tube with small right apical pneumothorax as well as persistent moderate hydropneumothorax at the anterior right lung base. There is also increased right lateral subcutaneous gas. Findings were communicated with Dr.___ by Dr.___ ___ telephone at 6:30pm ___ ___. " 39eca17e-194b4f60-e9a84900-30b96636-79ebc083.jpg,test/p16/p16007125/s56112413/39eca17e-194b4f60-e9a84900-30b96636-79ebc083.jpg,test," FINAL REPORT INDICATION: Unresponsive with hypoglycemia. Evaluation for infectious process. COMPARISONS: ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The heart size is top normal, unchanged. The cardiac, hilar, and mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 3843b70d-323e44ac-58516d30-4532a2cd-52ca2d96.jpg,test/p18/p18103848/s51504625/3843b70d-323e44ac-58516d30-4532a2cd-52ca2d96.jpg,test," FINAL REPORT EXAMINATION: Portable chest x-ray INDICATION: Post intubation. TECHNIQUE: Portable frontal chest radiograph. COMPARISON: Prior plain radiograph dated ___ FINDINGS: Patient is status post median sternotomy with multiple sternal wires identified. Interval intubation with the ETT tube at the level of the carina. A feeding tube is noted with its distal tip overlying the proximal stomach. A Swan-Ganz catheter is noted with its tip at the level of the main pulmonary artery. There is mild bilateral pulmonary edema with minimal blunting of the costophrenic angles bilaterally suggestive of small pleural effusions. This preliminary report was reviewed with Dr. ___, ___ radiologist. NOTIFICATION: The findings were discussed with ___ (PA) by ___, M.D. on the telephone on ___ at 11:00 PM, 20 minutes after discovery of the findings. " 124ef59a-0b18e654-20032f34-12787e74-0ca201aa.jpg,test/p17/p17869062/s57918521/124ef59a-0b18e654-20032f34-12787e74-0ca201aa.jpg,test," FINAL REPORT INDICATION: Painless jaundice, confirm NG tube placement. COMPARISON: ___. TECHNIQUE: Single AP portable upright chest. FINDINGS: A nasogastric tube courses below the diaphragm, with tip below the borders of the radiograph, but likely located within the distal stomach. A right-sided PICC has been repositioned and now terminates in lower SVC. Mild left basilar atelectasis is persistent but slightly improved. Otherwise, no significant interval change. IMPRESSION: Nasogastric tube below the diaphragm, with tip likely located in distal stomach. Right-sided PICC with tip in lower SVC after repositioning. Left basilar atelectasis. " 9fa4bf8a-f0b64c13-94284826-c098b20e-72ec9b98.jpg,test/p12/p12337553/s50994408/9fa4bf8a-f0b64c13-94284826-c098b20e-72ec9b98.jpg,test," FINAL REPORT INDICATION: ___-year-old male with productive cough. Evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 63550527-b5eb9cc6-6af13c30-10adaf14-3d1b436c.jpg,test/p19/p19301386/s55168354/63550527-b5eb9cc6-6af13c30-10adaf14-3d1b436c.jpg,test," FINAL ADDENDUM ADDENDUM The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 3:31 PM, 3 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and wheezing r/o infiltrate // cough and wheezing cough and wheezing IMPRESSION: Comparison to ___. In the interval, the patient has developed at rather peripheral parenchymal opacity in the apical and lateral aspect of the right upper lobe. In the appropriate clinical setting, these opacities could represent pneumonia. No other parenchymal opacities are noted. No pulmonary edema. No pleural effusions. Normal size of the heart. " 65879c7e-d234e328-1bb87f3c-597cfd63-3cb59bd4.jpg,test/p15/p15426827/s53167415/65879c7e-d234e328-1bb87f3c-597cfd63-3cb59bd4.jpg,test," WET READ: ___ ___ ___ 6:41 PM Multiple images in placement of a Dobbhoff feeding tube with the distal tube coiled on itself and the tip terminating in the distal esophagus. Recommend repositioning or replacing. Increased size of moderate to large right pleural effusion and increased small to moderate left pleural effusion from ___. Cardiomegaly. ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:49 P.M., ___ HISTORY: Cirrhosis. Needs Dobbhoff for feeding tube. IMPRESSION: A series of chest radiographs, comprising at least five serial exposures after attempts at placement of a feeding tube, all with wire stylet in place. What is purportedly the last in the series shows the weighted tip of the feeding tube folded up against the cardia but perhaps with the tip in the gastroesophageal junction. Subsequent chest radiograph two hours later showed that the feeding tube had withdrawn to the upper esophagus or had been reinserted in either the upper esophagus or the trachea. House staff had been notified. All the examinations show persistence of a large right pleural effusion, severe cardiomegaly, and marked left lower lobe atelectasis, but no pneumothorax. " a9e92f48-db481345-556a7527-e3ee0d69-3ce2a470.jpg,test/p11/p11096044/s52910674/a9e92f48-db481345-556a7527-e3ee0d69-3ce2a470.jpg,test," FINAL REPORT INDICATION: ___ year old woman with sensation as though she can't quite get a satisfactory breath. Peak flows only slightly diminished. No wheezing. Past social smoker. QUite one year ago. // r/o infection, pulmonary abnormality TECHNIQUE: Chest PA and lateral COMPARISON: No prior FINDINGS: The lungs are clear of airspace or interstitial opacity. The cardiomediastinal silhouette is unremarkable. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute radiographic intrathoracic pulmonary disease. " 11d2e27e-81b176c2-a8b3900d-b8d22421-3d7f3e54.jpg,test/p15/p15100941/s59623706/11d2e27e-81b176c2-a8b3900d-b8d22421-3d7f3e54.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with 3V disease awaiting revascularization // source of hypoxia, volume overload TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Cardiomegaly is a stable. The patient is rotated, this accentuates the widened mediastinum and tortuous aorta. Improving left lower lobe atelectasis, otherwise the lungs are clear. There is no pneumothorax or pleural effusion. Right IJ catheter tip is in the lower SVC IMPRESSION: No acute cardiopulmonary abnormality " 85ef3b1d-2f103c29-74a6f843-333c54d6-ecc98646.jpg,test/p12/p12459657/s55385370/85ef3b1d-2f103c29-74a6f843-333c54d6-ecc98646.jpg,test," FINAL REPORT INDICATION: Unusual fatigue and chills. History of smoking. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Multiple priors, most recently on ___. FINDINGS: There is persistent eventration of the right hemidiaphragm, best seen on ___. Median sternotomy wires are noted. There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is top normal. Mitral valve replacement is also noted. IMPRESSION: No acute cardiopulmonary abnormality. " 5ef3f242-96f1815d-04154fa6-fb00a886-ee56732a.jpg,test/p14/p14955873/s50166779/5ef3f242-96f1815d-04154fa6-fb00a886-ee56732a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fevers, chills, HA. // ? pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 274c7285-321e8219-ebea1070-70ee7f0c-5c97559e.jpg,test/p17/p17037392/s53565318/274c7285-321e8219-ebea1070-70ee7f0c-5c97559e.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough, hyperglycemia // eval for infection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " b4d01da6-910cba4d-dd0accfb-14635f79-0baf3cf1.jpg,test/p14/p14536823/s59593543/b4d01da6-910cba4d-dd0accfb-14635f79-0baf3cf1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with right -sided flank pain over the past ___ days with faint basilar crackles // Please evaluate for basilar pneumonia Please evaluate for basilar pneumonia IMPRESSION: Comparison to ___. No relevant change is seen. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " ac48e1ae-b32742a7-9b42bdfa-8001b29f-3b0a5325.jpg,test/p13/p13852390/s50587175/ac48e1ae-b32742a7-9b42bdfa-8001b29f-3b0a5325.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest tightness w hx of asthma COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lungs are clear bilaterally. No focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. Visualized bones and soft tissue are normal. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 890b0e32-375329b5-84111138-fc411b5e-6442efca.jpg,test/p14/p14702995/s56778086/890b0e32-375329b5-84111138-fc411b5e-6442efca.jpg,test," FINAL REPORT INDICATION: History: ___F with L flank pain // rib fx or infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volume is low. Mild bibasilar opacities likely reflect atelectasis, although pneumonia is not fully excluded at the left base. Small left pleural effusion is noted. Cardiac silhouette is difficult to assess due to low lung volumes. No displaced rib fracture is identified. Compression deformities of the spine appear similar to before. IMPRESSION: Evaluation of lung bases is limited due to low lung volumes. The repeat radiograph with improved inspiratory level may be helpful to more fully evaluate left lower lobe opacities to help distinguish atelectasis from infectious pneumonia. " fa5bb005-8fee7058-f4ff6ad2-40c6e413-98610729.jpg,test/p17/p17270077/s52474633/fa5bb005-8fee7058-f4ff6ad2-40c6e413-98610729.jpg,test," FINAL REPORT HISTORY: New O2 requirement, status post diuresis for volume overload. CHEST (PORTABLE AP) COMPARISON: ___ 1:05 PM The lungs are hyperinflated, consistent with COPD. There is moderate to moderately severe cardiomegaly. There is mild residual pulmonary vascular plethora. There is patchy retrocardiac opacity, unchanged. Small left effusion, which is slightly smaller. Again seen is a left subclavian central line with tip over proximal/mid SVC. Incidental note is made of a chronic right shoulder rotator cuff tear. " 20423c8d-46159df2-87d2b6be-b38efc53-722e975b.jpg,test/p17/p17925184/s52932178/20423c8d-46159df2-87d2b6be-b38efc53-722e975b.jpg,test," FINAL REPORT INDICATION: Altered mental status and delirium, here to evaluate for pneumonia. COMPARISON: Chest radiographs dated ___. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: There is increased opacification at the right lung base and a new air-space opacity in the right lung apex concerning for worsening infection. A small right pleural effusion is also likely present and unchanged. There is no pulmonary edema or pulmonary vascular congestion. Hyperinflation of the lungs with emphysematous changes at the lung apices are again seen. A left PICC tip is unchanged with the tip terminating in the upper SVC. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. IMPRESSION: Worsening right basilar opacity and possible new right apical opacity concerning for worsening infection. Aspiration is not excluded. Small right pleural effusion is unchanged from ___. " 2091f316-f28675d9-0b905e45-e2532bb6-5d0f9aca.jpg,test/p15/p15951127/s57223803/2091f316-f28675d9-0b905e45-e2532bb6-5d0f9aca.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Interval placement of endotracheal tube in standard position. Nasogastric tube courses below the diaphragm but tip is not included on the radiograph. Lung volumes are increased compared to the prior radiograph. Heart size is normal. Interval development of bilateral juxtahilar and basilar airspace opacities, which could be due to multifocal aspiration, likely coexisting with pulmonary edema, particularly given the presence of peripheral septal lines in the lower lobes. Small-to-moderate bilateral pleural effusions are also present, but there is no visible pneumothorax. " ac14991b-22bef021-c43eda0c-37419394-1b5e5e0c.jpg,test/p15/p15159712/s56434326/ac14991b-22bef021-c43eda0c-37419394-1b5e5e0c.jpg,test," FINAL REPORT HISTORY: Cough, diabetic ketoacidosis. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes remain low. The heart size remains moderately enlarged but unchanged. The mediastinal contours remain similar, with a markedly tortuous aorta again demonstrated. There is crowding of the bronchovascular structures, but without overt pulmonary edema demonstrated. Mild atelectatic changes are also noted at the lung bases. No pleural effusion, focal consolidation or pneumothorax is seen. There are moderate multilevel degenerative changes in the thoracic spine. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " 97562119-96aad3da-f3d2c51d-b565a7f2-0e966fc4.jpg,test/p18/p18567227/s51936179/97562119-96aad3da-f3d2c51d-b565a7f2-0e966fc4.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Lingular linear atelectasis is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. The pulmonary arteries are slightly prominent which could be due to a component of pulmonary artery hypertension. There is mild pulmonary vascular congestion. No displaced fracture seen. IMPRESSION: Mildly prominent pulmonary arteries could relate to a component of pulmonary arterial hypertension. Mild pulmonary vascular congestion. " d67d7140-6e1a6811-53030513-32974340-0d70884e.jpg,test/p17/p17530252/s57674920/d67d7140-6e1a6811-53030513-32974340-0d70884e.jpg,test," FINAL REPORT INDICATION: Right shoulder and left breast pain. Evaluate for bony abnormality or mass under shoulder. COMPARISON: No prior studies available for comparison. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. The lungs are clear. No pleural effusion or pneumothorax present. No bony abnormality present. The right glenohumeral joint is barely included within this examination. IMPRESSION: Normal study with limited evaluation of right shoulder. If continued concern for right shoulder bony abnormality, recommend dedicated right shoulder radiographs. If continued concern for soft tissue abnormality, recommend ultrasound or MRI. " 40cb37d4-266a3d98-690a8043-2075f531-49408461.jpg,test/p12/p12502220/s59476798/40cb37d4-266a3d98-690a8043-2075f531-49408461.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with septic shock TECHNIQUE: Upright AP view of the chest COMPARISON: ___ at 11:31 FINDINGS: Left-sided AICD/pacemaker device is noted with leads terminating in the right atrium, right ventricle, and coronary sinus. Right internal jugular central venous catheter tip terminates in the low SVC, unchanged. Moderate to severe cardiomegaly is re- demonstrated. The aorta is tortuous and diffusely calcified. There is mild pulmonary edema, slightly worse in the interval. Streaky retrocardiac opacity could reflect atelectasis, but infection is not excluded. No pleural effusion or pneumothorax is clearly identified though assessment of both lung apices is slightly limited due to overlying soft tissues from the neck and chin obscuring these regions. IMPRESSION: Mild pulmonary edema, slightly worse in the interval with retrocardiac opacity, likely atelectasis but infection is not excluded. " 3746bdaa-b5ec9b36-0824047a-74af43e8-6d1e9b1c.jpg,test/p10/p10074282/s56730462/3746bdaa-b5ec9b36-0824047a-74af43e8-6d1e9b1c.jpg,test," FINAL REPORT INDICATION: History: ___F with x2 days vomiting, alt MS // r/o infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. There is stable prominence of the bilateral hila. There is a right lower lobe opacity which is new from prior. Streaky left lower lobe opacity likely reflects atelectasis. Small right pleural effusion. No pneumothorax seen. IMPRESSION: New right lower lobe opacity concerning for pneumonia or aspiration. Small right pleural effusion. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:05 AM, 5 minutes after discovery of the findings. " 6a80d3ab-86289c7b-84c7858a-7778b7f5-45301f00.jpg,test/p12/p12929008/s50923159/6a80d3ab-86289c7b-84c7858a-7778b7f5-45301f00.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with cough, evaluate for pneumonia. COMPARISON: None Available. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: The lungs are fully expanded and clear. The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " d9632377-eacfed1b-f80bb969-3599e4f6-b7826b3a.jpg,test/p17/p17564064/s54128909/d9632377-eacfed1b-f80bb969-3599e4f6-b7826b3a.jpg,test," FINAL REPORT INDICATION: ___F with recent EUS/FNA of GB mass, now w severe abd pain // presence of free air TECHNIQUE: Portable frontal view of the chest. COMPARISON: None. FINDINGS: There is no free air beneath the right hemidiaphragm. There is a subtle opacity projecting over the right upper lung, partially overlapping with the right clavicle, measuring approximately 3cm. Bibasilar opacities most likely represent atelectasis. There is no pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: 1. Nodular opacity projecting in the right upper lung, correlation with CT chest is recommended. 2. No free air beneath the right hemidiaphragm. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:52 PM, 10 minutes after discovery of the findings. " 42688666-805bdec5-f905b200-68541795-3d7bb61a.jpg,test/p18/p18568518/s55474024/42688666-805bdec5-f905b200-68541795-3d7bb61a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old female with small cell lung cancer presenting with dyspnea. Evaluate for mass, pulmonary edema or pneumonia. TECHNIQUE: Portable AP radiograph of the chest from ___. COMPARISON: ___. Correlation made to chest CT dated ___. FINDINGS: The tip of an accessed right pectoral MediPort projects over the low SVC. There is no pneumothorax. Prominent bilateral interstitial lung markings likely correspond in part to the patient's known severe emphysema. However, increased prominence of the interstitial markings bilaterally may be due to superimposed edema or infection. IMPRESSION: Chronic interstitial changes of emphysema with increased interstitial opacities, which may be due to superimposed infection or edema. " cb429c76-4f2c0808-ee7fa145-df35a041-24af5f22.jpg,test/p19/p19803391/s50082533/cb429c76-4f2c0808-ee7fa145-df35a041-24af5f22.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HIV and metastatic anal cancer. Now with cough // Evaluate for PNA Evaluate for PNA IMPRESSION: In comparison with the study of ___, the Port-A-Cath again extends to the mid to lower portion of the SVC. No evidence of acute cardiopulmonary disease. Specifically, no pulmonary or skeletal metastases seen. " 2d8a9e04-764df426-cd1a2af9-72d4ffbd-54326750.jpg,test/p15/p15502354/s58697534/2d8a9e04-764df426-cd1a2af9-72d4ffbd-54326750.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart remains moderate to severely enlarged. The aorta is tortuous. While there are continued increased intersitital markings suggestive of mild chronic pulmonary vascular congestion, no overt pulmonary edema is demonstrated. No focal consolidation, pleural effusion or pneumothorax is seen. Extensive anterior flowing osteophytes are noted within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " af8f5c71-d290518e-00876e29-33dc7645-a7d6ad00.jpg,test/p16/p16826765/s53176607/af8f5c71-d290518e-00876e29-33dc7645-a7d6ad00.jpg,test," WET READ: ___ ___ ___ 3:52 PM No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with prior CVA, syncope. Assess for pneumonia, head bleed TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The lungs are well inflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: No pneumonia. " e3398bfe-ad607d2b-5549766b-60a678a4-3ac7c62b.jpg,test/p16/p16841866/s57328115/e3398bfe-ad607d2b-5549766b-60a678a4-3ac7c62b.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Low-grade fever and productive cough. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. Streaky opacities in the left lower lobe appear probably unchanged and suggest minor atelectasis although a small component of suspected lingular atelectasis appears new. However, there is no evidence for congestive heart failure convincing evidence for pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. " 3ecfebb2-99301bc7-2f25367f-9f7872f1-b61866f6.jpg,test/p17/p17396841/s54728835/3ecfebb2-99301bc7-2f25367f-9f7872f1-b61866f6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o HTN, HL, CHF here with hypoxia, DOE with concern for CHF exacerbation, worsening leukocytosis concerning for additional pulmonary process // eval for acute pulm process, PNA eval for acute pulm process, PNA IMPRESSION: In comparison with the study of ___, there is little overall change. Again there are low lung volumes with enlargement of the cardiac silhouette and moderate pulmonary vascular congestion. Left basilar opacification raises the possibility of pleural effusion and superimposed pneumonia. " 802c77ed-2d258ec7-7da73b9e-5f8b2e52-c9a7518e.jpg,test/p16/p16454913/s55496889/802c77ed-2d258ec7-7da73b9e-5f8b2e52-c9a7518e.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with tracheobronchoplasty, evaluation for pneumonia and other reasons for desaturation. COMPARISON: ___. Since the prior study, there is no substantial change in the cardiomediastinal silhouette, but there is interval improvement in bibasal aeration with bilateral pleural effusions noted to be substantially smaller. There is no pneumothorax. " 3e3d3063-e2a678d3-4602fb93-1abde40d-be0d2be4.jpg,test/p15/p15882528/s53103933/3e3d3063-e2a678d3-4602fb93-1abde40d-be0d2be4.jpg,test," FINAL REPORT INDICATION: ___ year old woman with breast cancer ongoing neoadjuvant chemo-febrile with non-productive cough. Evaluate for pneumonia. COMPARISON: None Available. TECHNIQUE PA and lateral view of the chest. FINDINGS: The lungs are fully expanded and clear. The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. NOTIFICATION: Findings were discussed over the telephone with Dr. ___ by Dr. ___ ___ at 09:15, 5 minutes after they were made. " 855baf51-17148540-81b5ba9f-95971757-6a1645fa.jpg,test/p16/p16159024/s51074540/855baf51-17148540-81b5ba9f-95971757-6a1645fa.jpg,test," FINAL REPORT INDICATION: ___M with URI sxs, recent travel from ___, asymmetric wheezing // eval ? infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lungs are hyperinflated. There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. IMPRESSION: No acute cardiopulmonary process. " 652486bf-2871978d-16739a02-db9eaf9f-52f0ac15.jpg,test/p19/p19231238/s59310249/652486bf-2871978d-16739a02-db9eaf9f-52f0ac15.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with worsening constipation // ?obstruction, ?infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: No significant interval change. Mild pulmonary vascular congestion is overall and top- normal heart size are unchanged. No pleural effusion or pneumothorax. Extensive degenerative changes of the thoracic spine are overall unchanged. Surgical clips are noted on the lateral view projecting over the upper abdomen. IMPRESSION: Stable mild cardiomegaly. " 489e1ac2-3fde7d80-5cf5b1df-0b25e7b0-c8e89e3d.jpg,test/p17/p17181115/s57935453/489e1ac2-3fde7d80-5cf5b1df-0b25e7b0-c8e89e3d.jpg,test," FINAL REPORT PORTABLE CHEST FILM ___ AT 7:44 CLINICAL INDICATION: ___-year-old with confusion, question infection. Comparison to prior study of ___. A portable AP upright chest film ___ at 7:44 is submitted. IMPRESSION: 1. Interval decrease in lung volumes with crowding of the pulmonary vasculature but no evidence of focal airspace consolidation to suggest pneumonia, pleural effusions, pneumothorax or pulmonary edema. There is fullness in the paratracheal region which may be vascular in etiology, although lymphadenopathy could also have this appearance. Followup imaging with improved inspiratory effort may be helpful to discern whether the right paratracheal fullness is related to vascular structures or represents a pathologic finding. A few linear streaky opacities in the left costophrenic angle likely reflects scarring or subsegmental atelectasis. No pneumothorax. Heart is upper limits of normal size given portable technique. " 24c63b4c-9630818e-bdea4d46-059b2112-7dd3b0d8.jpg,test/p12/p12870544/s57802952/24c63b4c-9630818e-bdea4d46-059b2112-7dd3b0d8.jpg,test," FINAL REPORT INDICATION: ___M with a h/o sickle cell anemia c/b ___ s/p b/l pial synangiosis admitted as unrestrained driver in high speed MVC with GCS 5, intubated at the scene, suffering a large subdural hematoma, LUL collapse, and R ___-11th rib fractures // interval change, ETT position FINDINGS: As compared to ___, endotracheal tube is 5.5 cm from the carina. Given for differences in technique and patient rotation, new small to moderate right-sided pleural effusion is layering posteriorly. Retrocardiac opacity has improved. Mild pulmonary vascular congestion has progressed. No pneumothorax. Mild cardiomegaly. IMPRESSION: ETT is 5.5 cm from the carina Mild pulmonary vascular congestion has worsened and note is made of a new small to moderate right pleural effusion. " ca4f0e35-a2b35596-46ff395e-f8b1d162-2d199a8f.jpg,test/p14/p14083729/s58210381/ca4f0e35-a2b35596-46ff395e-f8b1d162-2d199a8f.jpg,test," FINAL REPORT HISTORY: ___-year-old male with jerking movements. Question infection. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 290487ad-4ba9d4ba-ec40bae1-244fd43f-1887ce31.jpg,test/p18/p18026603/s56755580/290487ad-4ba9d4ba-ec40bae1-244fd43f-1887ce31.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis, moderate AS, ___ with hypoxemia // eval for pulmonary edema eval for pulmonary edema IMPRESSION: Comparison to ___. Lung volumes have further decreased but the severity of the pre-existing pulmonary edema has also decreased. Moderate cardiomegaly persists. No larger pleural effusions. Stable left central venous access line. " b08bd14a-50971c77-e39bc7c3-9c32b5b2-902e63b3.jpg,test/p19/p19206717/s50236666/b08bd14a-50971c77-e39bc7c3-9c32b5b2-902e63b3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with a history of bronchiectasis (prior resistant pseudomonas), asthma, DM2, HTN, HLD, presents with chest pain, shortness of breath and productive cough, found to be hypoxic with leukocytosis, treated empirically for PNA in ED, now tachypneic on Bipap. // Any interval change? Any interval change? IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain unchanged. There is increasing opacification at the left base, which could reflect some worsening pleural effusion and atelectatic changes. Less prominent changes are seen on the right. In the appropriate clinical setting, it would be difficult to exclude the possibility of superimposed consolidation. " d5af279a-2968430c-b296b87a-89e3d0ba-63adfbe7.jpg,test/p14/p14554669/s59184943/d5af279a-2968430c-b296b87a-89e3d0ba-63adfbe7.jpg,test," FINAL REPORT PA AND LATERAL RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old female status post assault. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: None. FINDINGS: The lungs and pleural surfaces are clear without evidence of pneumothorax or pleural effusions. No focal consolidations are seen. Heart size is normal. No acute rib fractures are seen. IMPRESSION: No acute intrathoracic process. " 6d29f8f9-c15281ec-2104a696-50246204-67138698.jpg,test/p10/p10963981/s53585158/6d29f8f9-c15281ec-2104a696-50246204-67138698.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with spinal cord injury/paraplegia, presented with hemoperitoneum now with hemolysis, acidosis, s/p femoral line placement and intubation // line in place Contact name: ___, ___: ___ IMPRESSION: Compared to chest radiographs most recently ___ and ___:13. Previous borderline interstitial edema has resolved. Heart size top-normal unchanged. The featureless contour of the mediastinum is attributable to fat deposition, but would obscure adenopathy. The ET tube in standard placement. Esophageal drainage tube passes into the stomach and out of view. " 2a91afbb-012fc670-4a9a3cdc-c57116f9-2dbb68e1.jpg,test/p13/p13480812/s56678610/2a91afbb-012fc670-4a9a3cdc-c57116f9-2dbb68e1.jpg,test," FINAL REPORT Either EXAMINATION: The Ed used the INDICATION: ___ year old man with h/o HIV and asthma with diffuse wheezing and hypoxemia // r/o infiltrate TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Hyperinflated lungs are consistent with obstructive disease. There is no focal consolidation, effusion, or pneumothorax. Mediastinal and hilar contours are normal. Heart size is normal. IMPRESSION: 1. No evidence of pneumonia. 2. Hyperinflated lungs are in keeping with history of asthma. " 17b308e5-7ddc8e2d-ad46d6a3-8588ba7c-83c044b5.jpg,test/p15/p15342918/s53167372/17b308e5-7ddc8e2d-ad46d6a3-8588ba7c-83c044b5.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with pain with deep breath and shortness of breath. FINDINGS: Frontal and lateral views of the chest. No prior. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 564b7102-213289ed-ce5e7923-aeb5de9f-9a5141fa.jpg,test/p15/p15002678/s54481740/564b7102-213289ed-ce5e7923-aeb5de9f-9a5141fa.jpg,test," FINAL REPORT PA AND LATERAL RIGHT DECUBITUS CHEST, ___ HISTORY: ___-year-old woman with right pleural effusion. Decubitus view to assess volume. IMPRESSION: PA, lateral and decubitus view of the chest compared to ___: There is minimal residual of previous moderate-sized right pleural effusion. A cluster of small nodules and peribronchial infiltration in the right lung apex laterally, projecting over the first anterior interspace, developed between ___ and ___. They have not resolved. Most likely explanation is non-tuberculous mycobacterial infection, but tuberculosis is possible and should be considered from the clinical standpoint. Heart size is normal. Aside from granulomatous calcifications in the right hilus there is no suggestion of central lymph node enlargement. Heart size is normal. " 3f3e703a-914b00ec-a9086854-279baab7-a4694469.jpg,test/p11/p11315005/s56802963/3f3e703a-914b00ec-a9086854-279baab7-a4694469.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: Patient with cognitive delay, hypertension and with recent fall. New oxygen requirement. FINDINGS: Comparison is made to prior study from ___. There is cardiomegaly. There are numerous calcified mediastinal and hilar lymph nodes as well as calcified granulomas. There is a left retrocardiac opacity and left-sided pleural effusion. No pneumothoraces are seen. " 76921c99-0e577132-daca405f-bea896c6-a2f062f4.jpg,test/p14/p14894591/s50372606/76921c99-0e577132-daca405f-bea896c6-a2f062f4.jpg,test," WET READ: ___ ___ ___ 8:09 PM Small right greater than left subpulmonic pleural effusion with increased density at both lung bases likely representing atelectasis although infection is not excluded given the appropriate clinical circumstance. NG tube terminates within the gastric body. ______________________________________________________________________________ FINAL REPORT AP CHEST, 7:59 P.M., ___ HISTORY: Recurrent SBO, new episode. Evaluate for pulmonary process. IMPRESSION: AP chest compared to ___. Upper enteric drainage tube has been advanced and probably ends in the mid portion of a non-distended stomach. There is new consolidation at the base of the left lung, either atelectasis or pneumonia and new small-to-moderate right pleural effusion, partially fissural, partially subpulmonic. The heart is normal size, pulmonary vasculature is top normal caliber and there is no pulmonary edema or pneumothorax. Intestinal distention in the upper abdomen is comparable to the appearance on ___, but incompletely imaged and cannot be analyzed. " f2c6766f-91006c30-b6228087-73572563-c8689254.jpg,test/p10/p10426710/s50483677/f2c6766f-91006c30-b6228087-73572563-c8689254.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with edema ? ARDS // infiltrate infiltrate IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are stable. Continued enlargement of the cardiac silhouette with asymmetric pulmonary edema and layering effusions with compressive atelectasis at the bases, more prominent on the left. " 6b11ab73-0285644c-d8aa20d0-be5b1bce-8df4f455.jpg,test/p13/p13586954/s57224977/6b11ab73-0285644c-d8aa20d0-be5b1bce-8df4f455.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with dyspnea // ? CHF vs. PNA TECHNIQUE: Portable, upright radiograph view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Lungs are clear. No focal consolidation, effusion, pneumothorax, or edema. The heart is normal in size. The mediastinum is not widened. Aortic knob calcifications are unchanged. IMPRESSION: No edema or focal pneumonia. " abc12804-95703bf2-adc1cce3-98067900-5de9199e.jpg,test/p13/p13119719/s59394801/abc12804-95703bf2-adc1cce3-98067900-5de9199e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma, worsening shortness of breath and cough. // evaluate for infiltrates evaluate for infiltrates IMPRESSION: In comparison with the study of ___, there is again tortuosity of the descending aorta and hyperexpansion of the lungs raising the possibility of chronic pulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 9e74c30b-83943b9f-90f6464e-82d34449-e9ddbe0a.jpg,test/p18/p18951987/s53573988/9e74c30b-83943b9f-90f6464e-82d34449-e9ddbe0a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Assessment for endotracheal tube. FINDINGS: The endotracheal tube is in unchanged position as compared to the previous examination from ___, 5:24 p.m. ECMO device has been inserted over the inferior vena cava. The tip of the device now projects over the superior vena cava, at the level of the azygos vein. Extensive bilateral alveolar opacities with subtle air bronchograms. Left lower lobe atelectasis. Moderate cardiomegaly. " 69c5bdf9-132eef13-207a7f11-42caf8d2-5d0749ff.jpg,test/p17/p17169964/s56580665/69c5bdf9-132eef13-207a7f11-42caf8d2-5d0749ff.jpg,test," FINAL REPORT HISTORY: ___-year-old man with recurrent aspiration pneumonias, now with decreased breath sounds on the left. Question pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Left lower lobe opacities are definitely present; however, in comparison to the most recent prior film, they are probably improving. Right lower lobe opacities are certainly improving with a much clearer visualization of the diaphragm today than on the prior film. Heart size is normal. Aorta is slightly tortuous. No pleural effusion or pneumothorax. IMPRESSION: Near-complete resolution of the right-sided opacities. Continued left- sided opacities which are improving compared to the most recent prior radiograph. " cda0a204-9b21fe51-07f92143-f3492141-35a382a5.jpg,test/p14/p14865329/s57930174/cda0a204-9b21fe51-07f92143-f3492141-35a382a5.jpg,test," FINAL REPORT HISTORY: Mechanical fall, worsening pulmonary status. Question interval change. CHEST, SINGLE AP VIEW. COMPARISON: Chest x-ray from ___ at 6:01 a.m. Rotated positioning. Allowing for this, an ET tube is present, tip approximately 6.3 cm above the carina. An NG tube is present, tip extending beneath the diaphragm, off the film. A right subclavian PICC line is present, tip over mid SVC. At the periphery of these films, the patient's cervical spine fixation hardware is noted. The cardiomediastinal silhouette is enlarged, with prominent hila, but grossly unchanged. There is hazy opacity at the left lung base, with left lower lobe collapse and/or consolidation, and more patchy opacity at the right lung base. These findings are similar to the prior film. Possible minimal blunting of the right costophrenic angle, but no other evidence of effusion. Although there is suggestion of vascular plethora, there is no upper zone redistribution or other findings to confirm CHF. IMPRESSION: No definite change compared with one day earlier. Bibasilar collapse and/or consolidation again noted. " 5ad72a7f-b449dd5b-d903be02-71091004-59447432.jpg,test/p19/p19262736/s53169520/5ad72a7f-b449dd5b-d903be02-71091004-59447432.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with c. diff colitis and sepsis and also troponin leak with possible pulmonary edema, currently diuresing // change in pulmonary edema change in pulmonary edema IMPRESSION: Compared to prior chest radiographs since ___ most recently descent ___ through ___. Opacification in both lower lungs continues to progress. It is impossible to exclude a component of dependent edema, but the asymmetry and the especially severe consolidation in the right lower lobe suggests that a substantial portion of the abnormality is pneumonia. The sudden onset of right lower and middle lobe collapse on ___ suggests aspiration or retained secretions was at work Moderate right pleural effusion is larger. Heart is normal size. No pneumothorax or appreciable left pleural effusion. Right PIC line ends in the upper SVC. All all " 76c80c69-23f4d8e4-9cc9078e-97d31838-dc5de81f.jpg,test/p18/p18965447/s56362568/76c80c69-23f4d8e4-9cc9078e-97d31838-dc5de81f.jpg,test," FINAL REPORT AP CHEST, 10:11 A.M., ___ HISTORY: History of lymphoma. Receiving methotrexate. IMPRESSION: AP chest compared to ___: Lungs are hyperinflated but clear. No pleural abnormality or evidence of central adenopathy. Normal pulmonary mediastinal vasculature. Heart size normal. Right subclavian line ends in the SVC. " 7720640e-31ba1865-843d1ba8-4dcc65e5-305dcb59.jpg,test/p13/p13224377/s57479493/7720640e-31ba1865-843d1ba8-4dcc65e5-305dcb59.jpg,test," FINAL REPORT INDICATION: ___ year old woman with AML post ERCP now with increased cough, assess for pneumonia. And TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Since prior, with there has been development of opacities in the left mid lung as well as the right base, findings could represent aspiration. The heart and mediastinal contours are unchanged. There is no pleural effusion or pneumothorax. A right PICC ends in the distal SVC. IMPRESSION: Developing opacities in the left mid lung and right base could represent aspiration in the correct clinical setting. NOTIFICATION: Findings were discussed with Dr. ___ with Dr. ___ ___ the telephone on ___ at 16:20, ___ min. " b790dc9a-a5921fec-752c66a7-9d4d5f4a-3cd2acbd.jpg,test/p12/p12043836/s55968259/b790dc9a-a5921fec-752c66a7-9d4d5f4a-3cd2acbd.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Sepsis, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous image, the monitoring and support devices are constant. Constant moderate-to-severe cardiomegaly with mild fluid overload and a relatively important right pleural effusion. The effusion is associated with right areas of parenchymal atelectasis. No pneumothorax. No new changes. " e76bfe93-256e3e5d-4ccd101d-f33c5948-1f1ffa15.jpg,test/p14/p14504631/s51422141/e76bfe93-256e3e5d-4ccd101d-f33c5948-1f1ffa15.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval IMPRESSION: Compared to chest radiographs ___ through ___. Moderate right pleural effusion is slightly smaller, with a fissural component. Moderate cardiomegaly stable. Left lung clear. No left pleural abnormality. " fbd17d18-58dbd713-eba31aed-db107e18-00bcdb9e.jpg,test/p12/p12429047/s51372919/fbd17d18-58dbd713-eba31aed-db107e18-00bcdb9e.jpg,test," FINAL REPORT INDICATION: ___-year-old man with left basilar crackles and cough. Assessment for pneumonia. COMPARISON: Comparison is made to radiograph of the chest from ___. FINDINGS: PA and lateral views of the chest are obtained. The left lung base is elevated, unchanged since ___. Mild left basilar atelectasis is noted, otherwise the lungs are clear. The heart size is normal. CONCLUSION: Left lung base elevation unchanged. Mild left basilar atelectasis. No acute cardiopulmonary abnormality. The above findings were communicated to Dr. ___ by Dr. ___ ___ page at 14:10, 5 minutes after discovery was made and were subsequently discussed via telephone. " a2e911b9-ff8e25c5-cfb3a915-da6bdace-ba44789e.jpg,test/p16/p16449190/s58635503/a2e911b9-ff8e25c5-cfb3a915-da6bdace-ba44789e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with R VATS decortication for empyema, s/p pull of chest tube // please evaluate for PTX s/p pull of chest tube PLEASE EVALUATE FOR PTX S/P PULL OF CHEST TUBE, PAIN. IMPRESSION: In comparison with the earlier study of this date, the right chest tube has been removed. No evidence of pneumothorax. Little change in the appearance of the heart and lungs except for a better inspiration. " eda196f9-b755e51a-dfe92fe5-cca3a403-ace2060f.jpg,test/p12/p12370706/s50626006/eda196f9-b755e51a-dfe92fe5-cca3a403-ace2060f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with stage IA uterine carcinosarcoma // Staging Staging IMPRESSION: No previous images. The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Specifically, no evidence of pulmonary or skeletal metastases. " bd8d9b6f-319c694e-2bce7f2c-9dbec9ef-56734dc7.jpg,test/p14/p14977442/s57781841/bd8d9b6f-319c694e-2bce7f2c-9dbec9ef-56734dc7.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough. PA and lateral upright chest radiographs were reviewed in comparison to ___ and CT abdomen from ___. The lung volumes are low most likely due to suboptimal inspiratory effort. Heart size is enlarged but again it might reflect suboptimal inspiratory effort. The lung bases demonstrate increased crowdedness of the vessels thus repeated radiograph in full inspiration is required. There is small hiatal hernia noted on lateral view. There is no pleural effusion or pneumothorax. " 89814f10-199e96aa-c3030c6f-b263ca00-05c6af71.jpg,test/p19/p19969991/s58755758/89814f10-199e96aa-c3030c6f-b263ca00-05c6af71.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Ms. ___ is a ___-year old woman with atrial fibrillation on apixaban, hypothyroidism who presents with shortness of breath x 2 months and found to be in afib RVR and new right pleural effusion. // eval for interval decrease in right effusion eval for interval decrease in right effusion COMPARISON: Chest radiographs and CT scanning ___. IMPRESSION: Previous moderate to large right pleural effusion is smaller but still substantial. There is no pneumothorax. Atelectasis in the medial aspect of the right middle and right lower lobe has improved, but not cleared. Left lung is clear. Heart is large. There is no pulmonary edema. " 5dfe03cb-abc000b5-f7eb928d-f7f3ca94-1cfffc86.jpg,test/p14/p14199690/s52007787/5dfe03cb-abc000b5-f7eb928d-f7f3ca94-1cfffc86.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SDH // Evolution of pneumomediastinum IMPRESSION: In comparison to ___ chest radiograph, there is no current evidence pneumomediastinum or pneumothorax. Bibasilar atelectasis has slightly worsened on the right and has decreased in severity on the left. No other relevant change. " f3d91a94-49c805ce-9ba3663b-173ae839-ac357e9a.jpg,test/p17/p17283683/s53009684/f3d91a94-49c805ce-9ba3663b-173ae839-ac357e9a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // Eval pneumothorax/pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are grossly stable with the aorta slightly more tortuous as compared to the prior study. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " fe0ef42f-6c3dc777-66669d56-ce4389ff-37ba6117.jpg,test/p16/p16897258/s54464033/fe0ef42f-6c3dc777-66669d56-ce4389ff-37ba6117.jpg,test," FINAL REPORT HISTORY: Status post pleurodesis and left VATS. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. IMPRESSION: Persistent, moderate to large partially loculated left pleural effusion with components of loculated lateral and basilar hydropneumothorax. A left chest tube is again noted to be in place. As compared to the most recent examination, there has been a slight improvement in the aeration of both the right and left lungs. Residual atelectasis is seen within the lingula and left lower lobe. The right lung is essentially clear, other than the multiple tiny nodules which are better characterized on the recent chest CT, and which are somewhat less prominent today as compared to the prior chest radiographs. The patient previously extensive subcutaneous emphysema has now almost entirely resolved. " e60138b5-4f97a6b8-176234a5-321ede07-f6576d02.jpg,test/p14/p14219343/s53811074/e60138b5-4f97a6b8-176234a5-321ede07-f6576d02.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with CHF // Eval for CHF TECHNIQUE: Portable AP upright view of the chest. COMPARISON: Multiple prior chest radiographs, most recently dated ___. FINDINGS: A left-sided chest wall pacer is noted with leads overlying the right atrium and ventricle, unchanged in their position. The cardiac size is difficult to approximate, but appears persistently enlarged. Interval increase in the degree of now moderate to severe pulmonary edema. Streaky bibasilar opacities likely reflect atelectasis, although superimposed infection is difficult to exclude. Bilateral moderate pleural effusions are noted, increased bilaterally from the prior examination. IMPRESSION: Persistent cardiomegaly with worsening of now moderate to severe pulmonary edema and moderate bilateral pleural effusions. " cb7f1b0a-63c716c4-4b22e75b-a019a764-90dcde4f.jpg,test/p10/p10692417/s56004476/cb7f1b0a-63c716c4-4b22e75b-a019a764-90dcde4f.jpg,test," FINAL REPORT HISTORY: History of breast cancer with brain metastases status post resection. Evaluate for pneumonia. COMPARISON: Prior chest radiographs from ___ and ___. TECHNIQUE: PA and lateral chest radiogrpahs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is mild calcification of the aortic knob. Lungs are well expanded. There is mild atelectasis at the left lung base. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " b918ce85-a47ab401-73c840d9-2090fe0b-4f2fb418.jpg,test/p19/p19898586/s59682353/b918ce85-a47ab401-73c840d9-2090fe0b-4f2fb418.jpg,test," FINAL REPORT HISTORY: Intracerebral hemorrhage. Evaluate for pneumonia. COMPARISON: Chest radiograph 11:38 today. FRONTAL AND LATERAL VIEWS OF THE CHEST: There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart size is top-normal and unchanged. The aorta is tortuous. Advanced degenerative changes involve the left glenohumeral joint. IMPRESSION: No change from 5 hours prior. " fe48e3ed-a5cf46fe-ac0b8f22-30fea9d7-02680a65.jpg,test/p16/p16055278/s53282511/fe48e3ed-a5cf46fe-ac0b8f22-30fea9d7-02680a65.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP and cough. // pna? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is mild fullness of the central pulmonary vasculature suggesting vascular engorgement without overt pulmonary edema. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No focal consolidation to suggest pneumonia. Central pulmonary vascular engorgement. " 13e74403-fb5ec524-1c5d0384-744cdb87-66121ad5.jpg,test/p10/p10319873/s59547133/13e74403-fb5ec524-1c5d0384-744cdb87-66121ad5.jpg,test," FINAL REPORT INDICATION: Dyspnea, right-sided chest pain, cough. COMPARISON: Chest radiograph from ___. PA AND LATERAL VIEWS OF THE CHEST: The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No evidence of pneumonia. " 91579805-6a6c1cc2-cb762ef6-2b4bb3d4-baae0fef.jpg,test/p19/p19601036/s55293143/91579805-6a6c1cc2-cb762ef6-2b4bb3d4-baae0fef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with chylothorax sp right vats and replacement of left CT // ptx COMPARISON: Chest radiographs ___ IMPRESSION: Moderate atelectasis and small left pleural effusion have increased since ___ following repositioning of the left basal thoracostomy tube. Small right pleural effusion may remain, but most of the opacification in the right lower lung is due to dependent edema. The upper lungs are clear. Mild to moderate cardiomegaly is stable. Right PIC line ends in the. No pneumothorax. Mid SVC " 2f4e3aed-619f1714-c77247c8-4855b07e-abf328aa.jpg,test/p16/p16218486/s52236028/2f4e3aed-619f1714-c77247c8-4855b07e-abf328aa.jpg,test," FINAL REPORT HISTORY: Septic shock with crackles on examination. FINDINGS: In comparison with the study of ___, there again are low lung volumes with elevation of the right hemidiaphragmatic contour. PICC line has been removed. Otherwise, little interval change. No evidence of discrete pneumonia. Mild basilar atelectatic changes. " d999f2e2-127ab27b-39198b1c-6ead4f64-6cc385be.jpg,test/p19/p19287958/s55465933/d999f2e2-127ab27b-39198b1c-6ead4f64-6cc385be.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with cough TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Right-sided PICC tip terminates in the proximal right atrium. Moderate enlargement of the cardiac silhouette is re- demonstrated. The mediastinal contour appears unchanged. Bilateral hilar enlargement with perihilar haziness and vascular indistinctness is compatible with mild pulmonary edema, slightly worse in the interval. A large right pleural effusion is substantially increased in the interval. A small left pleural effusion is also likely present. Bibasilar opacities likely reflect areas of atelectasis. No pneumothorax is identified. IMPRESSION: Mild pulmonary edema, worse in the interval. Substantial increase in size of large right pleural effusion with bibasilar airspace opacities, potentially atelectasis, but infection is not excluded. Small left pleural effusion is without substantial interval change. " 900e2b2e-bdd02d91-4f2396e2-6338b14c-51f9a0c3.jpg,test/p16/p16794551/s59491566/900e2b2e-bdd02d91-4f2396e2-6338b14c-51f9a0c3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF and GIB // Assess for pulm edema Assess for pulm edema COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Moderate cardiomegaly is chronic. Pulmonary vasculature is mildly engorged but there is no pulmonary edema. Left pleural effusion is small if any. No pneumothorax. " 6a789e9a-6195948c-3aa59b9a-d79cc848-f52530fe.jpg,test/p11/p11255297/s59342860/6a789e9a-6195948c-3aa59b9a-d79cc848-f52530fe.jpg,test," FINAL REPORT HISTORY: Wedge resection with vomiting, to assess for aspiration. FINDINGS: In comparison with study ___, there is no definite change. Post-surgical changes are again noted. The area behind the heart is somewhat difficult to evaluate and the possibility of an aspiration event in the retrocardiac region is difficult to unequivocally exclude. " 162bccc8-aac2d464-24c19b6e-d4713387-a7c795dd.jpg,test/p11/p11976982/s53295383/162bccc8-aac2d464-24c19b6e-d4713387-a7c795dd.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Metastatic RCC with worsening cough and hemoptysis. Comparison is made with prior study, ___. Cardiac size is normal. Mediastinal lymphadenopathy, bilateral hilar lymphadenopathy, loculated right pleural effusion, and multiple bilateral lung nodules are again noted and unchanged, better evaluated in prior CT from ___. No new consolidations are evident. Multiple osseous metastases are also better evaluated in prior CT. " cfa6f879-767cb5fe-cfb7acdf-144814b9-7e4fb170.jpg,test/p11/p11888614/s52249249/cfa6f879-767cb5fe-cfb7acdf-144814b9-7e4fb170.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with substance abuse p/w chest pain // eval edema, pna TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. A rounded, nodular opacity overlies the right lower lung, and cannot be discreetly separated from the ninth posterior rib. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Nodular opacity overlying the right lower lung and anterior right fifth rib. TO DETERMINE WHETHER THIS IS A LUNG NODULE OR THE RIGHT NIPPLE OR SCLEROSIS IN THE ANTERIOR RIGHT FIFTH RIB, SHALLOW OBLIQUE VIEWS WITH NIPPLE MARKER SHOULD BE OBTAINED. NOTIFICATION: Dr. ___ reported the findings to ___ QA nurses by receipted email on ___ at 8:47 AM, 5 minutes after discovery of the findings. " cf6bb5f4-6aa0535c-faf4ab60-791bd2d3-daa096ca.jpg,test/p17/p17008145/s59540887/cf6bb5f4-6aa0535c-faf4ab60-791bd2d3-daa096ca.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with history of lymphoma, pretransplantation assessment. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size and mediastinum are stable in appearance, including tortuous aorta. Lungs are clear. No pleural effusion or pneumothorax is seen. " 55dd4fc8-bae3339c-416e5748-6896e34a-57e2cdb8.jpg,test/p10/p10027957/s52771355/55dd4fc8-bae3339c-416e5748-6896e34a-57e2cdb8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with leukocytosis // pneumonia? pneumonia? COMPARISON: Previous chest radiographs ___. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection, including tuberculosis. Mild scoliosis is probably chronic. " 77db010e-7cbc6f7a-24fb3d5e-0c80875e-989ddec1.jpg,test/p19/p19438380/s51909894/77db010e-7cbc6f7a-24fb3d5e-0c80875e-989ddec1.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with right sided chest pain and productive cough // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Mild cardiomegaly is unchanged. No pulmonary vascular congestion or edema. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " af14e1ae-2ad97463-74fe0e77-c745e7ef-ab7a398c.jpg,test/p16/p16620451/s59248466/af14e1ae-2ad97463-74fe0e77-c745e7ef-ab7a398c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cabg // r/o inf, eff TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: A right internal jugular line tip terminates at the level of mid SVC. Cardiomegaly and mediastinal contours are stable. Left pleural effusion is unchanged. Lungs are essentially clear except foal left atelectasis most likely relaxation. The absence of the right mediastinal shift suggest the presence of substantial volume loss on the left. " 2e1c7e7e-71eb1d9a-1522af98-2532b8f6-028ffae1.jpg,test/p11/p11055521/s58393571/2e1c7e7e-71eb1d9a-1522af98-2532b8f6-028ffae1.jpg,test," WET READ: ___ ___ 11:12 AM The left chest tube appears to be located anterior to the heart in within the chest wall and may extend beyond the left pleural lining. The tip of the chest tube still projects over the right thoracic spinal border. There appears to be a new small right apical pneumothorax. Left apex is not included in the image and inhibits the evaluation of the left apical pneumothorax. Spoke with ___, on call resident at 11:20 pm WET READ VERSION #1 ___ ___ 11:23 PM The left chest tube appears to be located anterior to the heart in within the chest wall and may extend beyond the left pleural lining. The tip of the chest tube still projects over the right thoracic spinal border. There appears to be a new small right apical pneumothorax. Left apex is not included in the image and inhibits the evaluation of the left apical pneumothorax. Spoke with ___, on call resident at 11:20 pm ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with multiple rib fractures s/p fall, L chest tube placed at OSH. Please obtain a frontal and a lateral chest xray to evaluate location of the L chest tube. Concern that chest tube is not actually positioned inside the chest (crosses midline on previous film). Lateral view needed to clarify location. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from earlier on the same day FINDINGS: The left chest tube is in unchanged position, crossing the midline on the frontal view and located retrosternally on the lateral view. Epicardial pacer wires in dual-chamber pacemaker leads are in satisfactory position. Previously seen left apical pneumothorax is not well appreciated secondary to exclusion from the field-of-view. Right apical pneumothorax is small. Moderate left basilar atelectasis persists. IMPRESSION: Left chest tube within the thorax, in the retrosternal space, crossing the midline, impinging on the anterior mediastinum. " fdcf16a0-33b60d61-55fea145-581bf1f9-8cfafb64.jpg,test/p19/p19950400/s50875615/fdcf16a0-33b60d61-55fea145-581bf1f9-8cfafb64.jpg,test," FINAL REPORT INDICATION: Chest pain and shortness of breath. COMPARISON: Chest fluroscopy ___. FINDINGS: PA and lateral images of the chest were obtained. The patient is status post median sternotomy with multiple fractured wires, unchanged. Clips are located in the left thorax. Stable enlarged cardiac silhouette. The lung fields are clear without focal consolidation or pulmonary edema. Pleural thickening located in the left lateral pleura, especially inferiorly. There are no adjacent changes in the ribs. There are no bony abdnormalities. There is no free air below the right hemidiaphragm. IMPRESSION: Pleural thickening of the left lateral pleura could represent a loculated effusion or prominent extrapleural fat. Stable enlarged cardiac silhouette. " e1179de7-271799b3-0b7c09b0-788ffbbf-37d8a6b4.jpg,test/p18/p18135208/s51432046/e1179de7-271799b3-0b7c09b0-788ffbbf-37d8a6b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiac silhouette size is normal. The aorta is mildly tortuous. Mediastinal and hilar contours are within normal limits. Lungs are hyperinflated but clear without focal consolidation. Minimal scarring is noted at the lung apices. No pleural effusion or pneumothorax is present. Pulmonary vasculature is normal. There are minimal degenerative changes in the lower thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " f6aec743-4823a23e-9db85140-71e382eb-86a61092.jpg,test/p19/p19794869/s57691968/f6aec743-4823a23e-9db85140-71e382eb-86a61092.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with left sided chest pain // rule out mass rule out mass IMPRESSION: No previous images. Low lung volumes accentuate the prominence of the transverse diameter of the heart. No pneumonia, vascular congestion, pleural effusion, or pneumothorax. " d5e50442-39325816-a6fa0986-a89a4c14-e6e9be8d.jpg,test/p10/p10429729/s50888188/d5e50442-39325816-a6fa0986-a89a4c14-e6e9be8d.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with stage IV cancer with inability to tolerate p.o. Question esophageal stricture. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Left chest wall port is seen with catheter tip in the upper right atrium. Surgical chain sutures project over the right lung apex. There is increased soft tissue density in the right hilar and suprahilar regions. The lungs are otherwise clear without focal consolidation, effusion or pulmonary vascular congestion. Cardiomediastinal silhouette is otherwise unremarkable. No acute osseous abnormality is identified. IMPRESSION: Increased soft tissue density in the right suprahilar and right paramediastinal region for which clinical correlation is suggested (post-treatment changes such as radiation?) noting that underlying parenchymal changes or adjacent adenopathy in the setting of malignancy is possible. " ec9554ea-1fcb34fa-35ed22ca-20b6932c-fa9c690f.jpg,test/p17/p17469778/s52641052/ec9554ea-1fcb34fa-35ed22ca-20b6932c-fa9c690f.jpg,test," FINAL REPORT HISTORY: Cardiac arrest, aspiration. COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 88fc99ad-409e6b5f-a5525c49-f6a830a0-9800d19c.jpg,test/p11/p11648387/s57225591/88fc99ad-409e6b5f-a5525c49-f6a830a0-9800d19c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with history of CF and bronchiectasis here with chest pain// ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CTA chest ___ FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unchanged. Lungs are hyperinflated without focal consolidation. Bronchiectasis within the lung bases and previously seen scattered inflammatory pulmonary nodules are better appreciated on the prior CT. Patchy atelectasis or scarring is noted in both lung bases without focal consolidation. No pleural effusion or pneumothorax is present. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 0b9d394d-9f423e3d-f36db9b6-8db97085-fbc1b167.jpg,test/p19/p19181583/s59068552/0b9d394d-9f423e3d-f36db9b6-8db97085-fbc1b167.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with fever and cough for three days. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs were obtained. FINDINGS: A right upper lobe opacity is consistent with pneumonia. THere is a faint suggestion of a ""finger in glove"" appearence. Indistinctness of the right heart border suggests an additional right middle lobe consolidation. No effusion, nodule, or pneumothorax is present. Cardiac and mediastinal contours are normal. A 2.8 x 4.8cm calcified structure projects over the liver. IMPRESSION: 1. Right upper lobe, and possibly right middle lobe pneumonia. Given upper lobe involvement, risk factors for TB should be evaluated. The appearence may also fit with allergic bronchopulmonary aspergillosis. 2. 5cm calcified liver lesion is, in retrospect, unchanged since ___ when it appears incidentally in the outer field of view of a lumbar spine radiograph. Suggest correlation with prior imaging or consideration of a liver ultrasound. The finding of right upper lobe pnuemonia was communicated with phone with Dr ___ at ___ on ___. Additional differentials and finding 2 were communicated with Dr ___ ___ email at ___. " 188ac803-b77777f1-214be1d3-eba5f469-7698b7b0.jpg,test/p17/p17413422/s52372526/188ac803-b77777f1-214be1d3-eba5f469-7698b7b0.jpg,test," FINAL REPORT HISTORY: Dyspnea, rule out infiltrate. COMPARISON: Chest radiographs from ___ ___ ___. FINDINGS: Frontal and lateral views of the chest were performed. The lungs are clear and the lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The pleura is unremarkable. The imaged upper abdomen is normal. There are no osseous abnormalities appreciated. IMPRESSION: No acute cardiopulmonary process. " c479d794-b3401956-0ac6e599-805caac4-2c44f05a.jpg,test/p15/p15831124/s55045547/c479d794-b3401956-0ac6e599-805caac4-2c44f05a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sepsis, inc'ing pressors requirement. // eval for interval change COMPARISON: ___ IMPRESSION: Complete opacification of left hemi thorax with ipsilateral shift of mediastinum is consistent with complete left lung collapse, likely accompanied by pleural effusion. Within the right hemi thorax, a layering right pleural effusion is present2. NOTIFICATION: Dr. ___ was notified of this finding by telephone on ___ at 11:30 at time of discovery " 887e5c54-1baf5ae3-2ecd3374-e943c196-212a20d9.jpg,test/p16/p16617891/s55238781/887e5c54-1baf5ae3-2ecd3374-e943c196-212a20d9.jpg,test," FINAL REPORT In comparison with the study of earlier in this day, there is little change. Continued prominence of the cardiac silhouette with tortuosity of the aorta but no vascular congestion or pleural effusion. Specifically, no evidence of acute focal pneumonia or substantial atelectatic change. Cardiac silhouette is at the upper limits of normal in size or slightly enlarged and there is mild tortuosity of the aorta. No vascular congestion or pleural effusion. No convincing evidence of acute pneumonia. " 62275a1c-6e21f05f-1638dd72-85a3cd10-1daab806.jpg,test/p10/p10578743/s54380796/62275a1c-6e21f05f-1638dd72-85a3cd10-1daab806.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yoM with DM, CKD, MGUS, Crohns (s/p iliocolectomy), CAD s/p stents, CVAx___ s/p R hip arthoplasty c/o hypoxia // Any evidence of effusion/atelectasis/PNA? Any evidence of effusion/atelectasis/PNA? IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette without definite vascular congestion. Retrocardiac opacification with blunting of the costophrenic angle is again seen, most likely consistent with some combination of pleural effusion and volume loss in the left lower lobe. In the appropriate clinical setting, superimposed pneumonia could also be considered " 8f49c8a5-7f173d30-c8be6766-ae79a895-9a00a305.jpg,test/p12/p12437533/s55852032/8f49c8a5-7f173d30-c8be6766-ae79a895-9a00a305.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___F with right flank pain with hematuria, hx of breast and endometrial ca // right flank pain with hematuria, hx of breast and endometrial ca right flank pain with hematuria, hx of breast and endometrial ca COMPARISON: ___ FINDINGS: There is streaky density bilaterally consistent with parenchymal scarring as before. The lungs are otherwise clear. The heart is at the upper limit of normal in size. The aorta is calcified. Mediastinal structures are otherwise unremarkable. The bony thorax is grossly intact. IMPRESSION: No active disease. " 41945344-39b17dd3-9397dc9d-d9ec907d-ba9ad72d.jpg,test/p13/p13152426/s58082418/41945344-39b17dd3-9397dc9d-d9ec907d-ba9ad72d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with fever // acute process COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are markedly low which limits evaluation. Allowing for this, the lungs are clear. No signs of pneumonia or edema. Heart size cannot be assessed. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: As above. " 3a80c74d-56fd864c-9588accb-55e3b783-58d8adf4.jpg,test/p17/p17419105/s55797065/3a80c74d-56fd864c-9588accb-55e3b783-58d8adf4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with aspiration, lung collapse // eval int change COMPARISON: Chest x-ray from ___ FINDINGS: Compared with the prior study, right upper zone opacity has increased, with more confluent opacification and air bronchograms. This could be somewhat accentuated by differences in technique, but nonetheless, appears increased. Consolidation at the right base and in the retrocardiac regions persists. There is minimal upper zone redistribution and likely some vascular plethora. There is a small left effusion. The possibility small right effusion cannot be excluded. NG tube present, tip extending beneath diaphragm, off film. IMPRESSION: Worsening consolidation right upper zone. Persistent consolidation right an left base. Suspect mild CHF. Small left and question small right effusion. " 9916d8a1-0839be45-07c9d6c7-152e3448-65f90c26.jpg,test/p12/p12230961/s56780514/9916d8a1-0839be45-07c9d6c7-152e3448-65f90c26.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Pre-operative for wash-out of abscess. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute disease. " 9747cea7-e81061ba-fc9e8421-5b8329f8-4116d5db.jpg,test/p16/p16193188/s58662698/9747cea7-e81061ba-fc9e8421-5b8329f8-4116d5db.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent pneumonia, questionable resolution. COMPARISON: ___. FINDINGS: As compared to the previous examination, the preexisting right lower lung pneumonia has completely resolved. There is no evidence of remnant parenchymal opacities suggestive of an infectious process in the chest. Unchanged bilateral calcified hilar lymph nodes and bilateral calcified apical thickening and small calcified granulomas. No acute changes. Borderline size of the cardiac silhouette, tortuosity of the thoracic aorta. No pleural effusion. " e23d0529-1d706804-fc8f1bac-996ccf60-4e4e473c.jpg,test/p10/p10206502/s51209765/e23d0529-1d706804-fc8f1bac-996ccf60-4e4e473c.jpg,test," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: CT chest ___, AP chest radiograph ___. INDICATION: ___-year-old male with dyspnea on exertion and mild hypoxemia. FINDINGS: PA and later chest x-ray were obtained and compared to the immediate preceding chest radiograph. There is presence of median sternotomy wires. There is a biventricular pacing system with leads terminating in the right atrium, right ventricle, and left anterior oblique marginal vein. There are also wires from a previously placed and removed right pacer. The cardiomediastinal and hilar contours are stable. There are stable increased interstitial markings at the bilateral bases, but no new lung parenchymal opacity. There is mild blunting of the costophrenic sulci consistent with small pleural effusions; however, there is no evidence of interstitial edema. IMPRESSION: Small bilateral pleural effusions, otherwise no acute cardiopulmonary abnormality. " da1ca7e7-4e892d5b-a1a98283-8b044166-58c088f3.jpg,test/p16/p16902797/s53869409/da1ca7e7-4e892d5b-a1a98283-8b044166-58c088f3.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs remain clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is normal. No acute osseous abnormality detected. Linear opacities seen in the neck on the left, potentially surgical clips, unchanged. IMPRESSION: No acute cardiopulmonary process. " 97763ad1-81cb2cf4-ef947d57-757cede4-2879ce51.jpg,test/p13/p13764741/s56860695/97763ad1-81cb2cf4-ef947d57-757cede4-2879ce51.jpg,test," FINAL REPORT HISTORY: Fevers and chills. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___ and chest CTA ___. FINDINGS: Heart size is mildly enlarged, unchanged. Mediastinal and hilar contours are stable, with a small hiatal hernia again seen. The pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Multiple clips are seen within the neck compatible with prior thyroidectomy. Partially imaged is lumbar spinal fusion hardware. IMPRESSION: No radiographic evidence for pneumonia. " 46aecfdf-2804cbf9-9020d54e-16c79db0-bc095917.jpg,test/p14/p14819550/s58441992/46aecfdf-2804cbf9-9020d54e-16c79db0-bc095917.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fevers of unknown origin and Afib COMPARISON: ___ and chest CT from ___. FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low. Chronic pleural thickening and probable tiny left pleural effusion are again noted, similar to that seen on recent CT of the chest. Cardiomediastinal silhouette is stable. No new consolidation or convincing signs of pneumonia or edema. Bony structures are intact. IMPRESSION: No significant interval change. " 0d60bb89-41429b9f-0c431123-7a7f419c-7f03c502.jpg,test/p16/p16742247/s57585291/0d60bb89-41429b9f-0c431123-7a7f419c-7f03c502.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HLH, bronchiectasis. // Interval change? Interval change? COMPARISON: Comparison to ___ at ___ FINDINGS: PA and lateral views of the chest ___ at ___:___ are submitted. IMPRESSION: Residual opacity best appreciated in the right middle lobe/lingula are slightly more prominent than in ___ and likely corresponds to the bronchiectasis seen on the recent chest CT dated ___. An ongoing infection cannot be entirely excluded. No pneumothorax. No pulmonary edema. Stable cardiac and mediastinal contours. ___, MD, MPH " 4951f028-f1392ac4-f07436df-e001c4a2-b1c0a41e.jpg,test/p11/p11272182/s51287881/4951f028-f1392ac4-f07436df-e001c4a2-b1c0a41e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with adjusted subclavian line. TECHNIQUE: Portable upright AP view chest COMPARISON: ___ at 21:40 FINDINGS: Right subclavian central venous catheter tip has been repositioned, now terminating at the junction of the SVC and right atrium. No pneumothorax is demonstrated. Mild pulmonary vascular engorgement appears slightly worse in the interval. Continued patchy opacities in the lung bases are re- demonstrated. Cardiac and mediastinal contours are unchanged. Endotracheal tube and enteric tubes are in standard positions. IMPRESSION: Right subclavian central venous catheter tip at the SVC/right atrial junction. " 739e10f5-34af475b-30c532aa-9f776a70-ca4d001d.jpg,test/p11/p11528413/s51450305/739e10f5-34af475b-30c532aa-9f776a70-ca4d001d.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough and fever. Question acute process. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate slightly low lung volumes. The lungs are, however, clear. There is no pneumothorax, vascular congestion, or pleural effusion. Cardiomediastinal silhouette is within normal limits. Mild unfolding of the thoracic aorta is noted, with arch calcifications. Moderate multilevel thoracic spondylosis is present. IMPRESSION: No evidence of pneumonia. " 6c717478-e6eb5ebe-93c4d8fa-39842f0c-026c9da2.jpg,test/p14/p14505540/s52739677/6c717478-e6eb5ebe-93c4d8fa-39842f0c-026c9da2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with delirium // ?PNA COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes remain low. Moderate cardiomegaly with tortuosity of the thoracic aorta. No overt pulmonary edema. No pneumonia. No pleural effusions. " a5eb3a2f-1255693a-a3413a4d-48c8684a-7e2ebada.jpg,test/p18/p18418794/s54088422/a5eb3a2f-1255693a-a3413a4d-48c8684a-7e2ebada.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Drainage of epidural abscess, hypoxia, and atrial fibrillation. Portable AP radiograph of the chest was reviewed in comparison to ___ obtained at 08:32 a.m. NG tube tip is in the stomach. The overall appearance of the lungs is unchanged since the prior study. The patient is rotated diminishing the sensitivity of the abnormality. Left lower lobe opacity appears to be unchanged. " f03016ed-9ffc3c55-d8ea88a2-40bd23de-29a1efbc.jpg,test/p18/p18153746/s57513245/f03016ed-9ffc3c55-d8ea88a2-40bd23de-29a1efbc.jpg,test," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old male with brain tumor, on chemotherapy and has thrombocytopenia, now with cough and chest congestion. FINDINGS: Comparison is made to prior study from ___. Cardiac silhouette and mediastinum is normal. Lungs are clear. There is no focal consolidation, pleural effusions, or signs for overt pulmonary edema. Bony structures are intact. IMPRESSION: No acute cardiopulmonary process. " d3864964-498ecfc4-6edf4755-8c81cbe7-2859c81e.jpg,test/p14/p14193109/s50700984/d3864964-498ecfc4-6edf4755-8c81cbe7-2859c81e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dizziness, weakness // eval for PNA COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Subtle linear densities in the left lower lung likely reflect scarring or atelectasis and appear unchanged from prior exam. No focal consolidation concerning for pneumonia. No edema. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Imaged osseous structures appear grossly intact. IMPRESSION: No signs of pneumonia. " b524f671-4fb1c4a9-905f3043-b89b9e48-3de08d3c.jpg,test/p16/p16454913/s57992524/b524f671-4fb1c4a9-905f3043-b89b9e48-3de08d3c.jpg,test," FINAL REPORT HISTORY: ___-year-old man status post EGD and bronchoscopy with therapeutic aspiration of secretions. Question atelectasis. COMPARISON: Multiple prior studies, most recently from ___ and ___. FINDINGS: Single semi-erect AP portable view is provided. Again there are bibasilar consolidations and pleural effusions with mild pulmonary edema, but improved opacities particularly in the right lower lobe. The opacities in the left midlung are new. These findings are consistent with with redistribution of edema, although the new opacity in the left midlung could represent a focal infectious process versus fluid in the fissure. Cardiomediastinal silhouette and hilar contours are stable. A left-sided internal jugular line terminates in the right atrium unchanged from prior studies. Above the tracheotomy, there is narrowing of the airway which could be due to diffuse edema of larynx. " 8896fdb1-8b025379-38130763-c6f7e983-2b460c28.jpg,test/p18/p18186173/s55020828/8896fdb1-8b025379-38130763-c6f7e983-2b460c28.jpg,test," FINAL REPORT HISTORY: Status post VATS for left upper lobe wedge resection. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: There are minimal left lower lobe postsurgical changes identified. Otherwise, the lungs are grossly clear without evidence of focal consolidation or pleural effusion, pneumothorax, or pulmonary edema. The heart size is normal. Mediastinal contours are normal. IMPRESSION: Stable, left lower lobe postsurgical changes. No radiographic evidence for acute cardiopulmonary process. " ad61e762-bbfc1893-d9f91a10-41e5899f-1709062d.jpg,test/p10/p10979480/s57404536/ad61e762-bbfc1893-d9f91a10-41e5899f-1709062d.jpg,test," WET READ: ___ ___ ___ 9:07 PM bilateral opacifications, l >r, concerning for aspiration vs pna. right subclavian line in mid-distal svc. Bilateral low lung vol with crowding of bronchovascular markings. hrt size accentuated by low lung vol. fusion device similar to prior. d/w dr. ___ at 9pm on ___ via tel. ______________________________________________________________________________ FINAL REPORT COMPARISONS: Chest radiograph, ___. FINDINGS: A right port ends at the superior atriocaval junction. Bibasilar opacifications, greater on the left than the right, are likely new pneumonias. Lung volumes are low causing accentuation of the heart size and pulmonary vasculature, which are likely normal. There is no pulmonary edema, pleural effusion, or pneumothorax. Thoracic spine hardware is unchanged. IMPRESSION: Bibasilar pneumonia. Findings were telephoned to Dr. ___ at 9pm on ___ by Dr. ___. " 59cbdab2-d54f6a61-3e72070a-532387e5-54e80ef4.jpg,test/p12/p12488897/s56105566/59cbdab2-d54f6a61-3e72070a-532387e5-54e80ef4.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with dyspnea. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are low but the lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: Low lung volumes with no focal consolidations. " 1236033e-48f26b9e-6904461b-fed4360d-f88a9eb2.jpg,test/p15/p15434659/s55292625/1236033e-48f26b9e-6904461b-fed4360d-f88a9eb2.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Rounded density on AP radiograph, reassessment. AP radiograph of the chest was compared to ___. The right central venous line tip is at the level of cavoatrial junction. The NG tube passes below the diaphragm terminating in the stomach. There is interval development of perihilar opacities, with mainly perihilar and lower lobe predisposition consistent with mild interstitial pulmonary edema. Left lower lobe partial atelectasis can be assessed on a chest CT, partially imaged and further attention to this area on subsequent radiographs as well as potentially assessment with chest CT might be considered. " 557079ab-fbf071b8-2fd7b38b-a35b99c5-94f1594f.jpg,test/p14/p14659758/s53344956/557079ab-fbf071b8-2fd7b38b-a35b99c5-94f1594f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cirrhosis, ?UGI, dehydration // ?cpd or fluid overload TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes. Bibasilar opacities could be due to atelectasis and/ or pneumonia.No large pleural effusion is seen although a trace pleural effusion is difficult to exclude. There is no pneumothorax. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. IMPRESSION: Low lung volumes. Bibasilar opacities may be due to atelectasis and/or pneumonia. No overt pulmonary edema. " 8ab5838a-6e7cae05-11607059-a0582f09-3b31b58f.jpg,test/p11/p11439189/s51252318/8ab5838a-6e7cae05-11607059-a0582f09-3b31b58f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stroke and fevers // fevers concern for PNA fevers concern for PNA IMPRESSION: In comparison with the study of ___, the patient has taken a somewhat better inspiration. Again there is increased opacification of the left base consistent with atelectasis and pleural effusion. In the appropriate clinical setting, a superimposed aspiration or pneumonia would have to be considered. Subparagraph on the right, the hemidiaphragm is now a sharply seen with mild basilar atelectatic changes. Tracheostomy tube remains in place. " 4f6b7e74-1cb3f732-09061350-7d3e5ef2-b4ddcb6c.jpg,test/p11/p11958913/s50016959/4f6b7e74-1cb3f732-09061350-7d3e5ef2-b4ddcb6c.jpg,test," FINAL REPORT HISTORY: History cough fever and asthma. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Multiple chest radiographs, most recent on ___. FINDINGS: Again seen is mild enlargement of the cardiac silhouette with tortuosity of the aorta, unchanged in appearance. The lungs are clear. The pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. These findings were communicated to Dr. ___ by telephone at 3:10 PM, at the time of discovery, by Dr. ___. " 70d2f6f6-687d58dc-33fa06e8-75431672-ae5cb004.jpg,test/p13/p13328928/s56487528/70d2f6f6-687d58dc-33fa06e8-75431672-ae5cb004.jpg,test," FINAL REPORT INDICATION: Dyspnea on exertion, here to evaluate for pneumonia. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs are symmetrically well expanded and well aerated without focal consolidation concerning for pneumonia, pleural effusion or pneumothorax. There is no pulmonary vascular congestion or overt pulmonary edema. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits with mild tortuosity of the thoracic aorta. Partial calcification at the aortic knob is noted. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 6e797ea9-f54348b2-960208dc-9fcbbfaa-b854596b.jpg,test/p18/p18704055/s54821905/6e797ea9-f54348b2-960208dc-9fcbbfaa-b854596b.jpg,test," WET READ: ___ ___ ___ 10:03 PM Hyperlucent paracardiac line on the right is similar to the prior exam. There may be a tiny right apical pneumothorax. Small bilateral pleural effusions. Interval improvement in pulmonary edema. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with s/p CABG // eval postop changes COMPARISON: Chest radiographs ___. IMPRESSION: Previous interstitial edema has resolved. Top-normal heart size, slightly larger than preoperatively, the common postoperative phenomenon. Small bilateral pleural effusions are inconsequential. Lungs are clear. No pneumothorax. " 59fbde3b-33927def-cb5e540d-b916a3b1-861498e7.jpg,test/p15/p15287471/s50997924/59fbde3b-33927def-cb5e540d-b916a3b1-861498e7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypertension, recent hospitalization, recently discharged from floor, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the extent of the bilateral pleural effusions has slightly increased. The signs of moderate pulmonary edema are constant. Unchanged bilateral areas of atelectasis, but no pneumonia is visible in the ventilated parts of the lung. The monitoring and support devices are constant. No pneumothorax. " 24a52c75-e232a870-4b735497-15c55c63-eabcfe16.jpg,test/p17/p17276069/s51760610/24a52c75-e232a870-4b735497-15c55c63-eabcfe16.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Morbid obesity, elevated white blood cell count. Evaluation for acute changes. COMPARISON: Outside hospital chest x-ray from ___. FINDINGS: The patient is in slightly rotated position. This explains an overall apparent deviation of the trachea to the left. However, there is no focal narrowing of the tracheal lumen or focal tracheal displacement. Low lung volumes, bilateral basal areas of atelectasis but no evidence of pleural effusion or focal opacity typical for pneumonia. A right internal jugular vein catheter is in situ. The tip of this catheter projects over the right atrium, the device could be pulled back by 3-4 cm. Borderline size of the cardiac silhouette. No pleural effusions. " 17af45f2-291ef080-8ec39d44-7110c40f-a5e0928e.jpg,test/p10/p10688397/s53195050/17af45f2-291ef080-8ec39d44-7110c40f-a5e0928e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETT 9 cm above carina // ?advance ETT TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: The endotracheal tube is now positioned 5.5 cm above the level the carina. Lung volumes are unchanged. Persistent left lower lobe atelectasis. Probable small left pleural effusion. No pneumothorax seen. IMPRESSION: The endotracheal tube is now positioned 5.5 cm above the trachea. " ce84af31-c7a0205e-803a9e64-18b7dc8c-ab6c3221.jpg,test/p13/p13604031/s58665797/ce84af31-c7a0205e-803a9e64-18b7dc8c-ab6c3221.jpg,test," WET READ: ___ ___ ___ 4:32 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: AP and lateral chest x-ray. INDICATION: A ___-year-old man with altered mental status, evaluate for infection. TECHNIQUE: AP and lateral projections, upright positioning. COMPARISON: None. FINDINGS: There is a sub-optimal inspiratory effort and low lung volumes. The cardiomediastinal silhouettes are within normal limits. The bilateral hila are unremarkable. Right cardiophrenic angle and diffuse interstitial prominence likely reflects bronchovascular crowding in the setting of low lung volumes. Linear opacities at the left lung base are consistent with subsegmental atelectasis. There is no focal lung consolidation. There is no evidence of pulmonary vascular congestion. There is no pleural effusion or pneumothorax. Degenerative changes of the right glenohumeral joint are noted. IMPRESSION: No acute cardiopulmonary process. " 8ade5232-713ffd61-d46b400b-8672f789-b0130f78.jpg,test/p13/p13463427/s56964754/8ade5232-713ffd61-d46b400b-8672f789-b0130f78.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: EtOH cirrhosis, variceal bleed with cough. Cardiac size is top normal. There are low lung volumes. The aorta is tortuous. The lungs are clear. There is no pneumothorax or pleural effusion. " 2abd9eb5-18f85c8b-a612d9a1-650376f8-696d2aaa.jpg,test/p12/p12272471/s57694780/2abd9eb5-18f85c8b-a612d9a1-650376f8-696d2aaa.jpg,test," FINAL REPORT INDICATION: ___-year-old man with pleural effusions, evaluate. COMPARISONS: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: There is interval removal of right-sided chest tube. Lungs are better expanded compared to the previous study and with normal volumes. Small right pleural effusion again noted. Right basal atelectasis is improved. Left lung is clear. Heart is normal size and mediastinal contours are unremarkable. No pneumothorax. IMPRESSION: 1. Persistent small right-sided pleural effusion. 2. Increased lung volumes and improvement in bibasilar atelectasis. " 71b74038-a1614ffe-be771557-85f880dc-d0941f01.jpg,test/p13/p13398905/s50053977/71b74038-a1614ffe-be771557-85f880dc-d0941f01.jpg,test," FINAL REPORT HISTORY: Shortness of breath for one week, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. There may be minimal left basilar atelectatic streaks, though no evidence of acute focal pneumonia or vascular congestion. " da4f8d3f-7b8b37a7-062603dc-05ef74ee-65cf544d.jpg,test/p15/p15465911/s58556267/da4f8d3f-7b8b37a7-062603dc-05ef74ee-65cf544d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sickle cell crisis // eval for pulmonary process TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Port-A-Cath catheter tip is at the cavoatrial junction. Cardiac silhouette appears to be enlarged as compared to the prior study might potentially be related to the sickle cell crisis. New opacities are noted in the lower lobes as well as vascular enlargement. No clear pneumonia is seen but right lower lobe pneumonia cannot be excluded or potentially pulmonary infarct. No large pleural effusion is seen but small pleural effusion is most likely present " ce155fd8-8c896895-3ca81d29-8be9e1a7-a7167290.jpg,test/p12/p12679065/s54209221/ce155fd8-8c896895-3ca81d29-8be9e1a7-a7167290.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with palpitations and chest pain // PNA COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " eb5114b5-90d0a4d9-52fdfd98-f1fc92c9-40e3839d.jpg,test/p11/p11810275/s53259470/eb5114b5-90d0a4d9-52fdfd98-f1fc92c9-40e3839d.jpg,test," FINAL REPORT INDICATION: Evaluation for percutaneous pacemaker lead position. COMPARISON: Chest radiograph performed ___. FINDINGS: Upright PA and lateral views of the chest were reviewed and compared to the prior study. A left anterior axillary bielectrode pacemaker has intracavitary electrodes, the first in position compatible with the right atrial appendage and the second lead in position compatible with the apical portion of the right ventricle. Mild cardiomegaly is unchanged and the mediastinal contours are within normal limits. There is no vascular congestion, pulmonary edema, pleural effusion or pneumothorax. There are no concerning osseous or soft tissue lesions. IMPRESSION: New left axillary bielectrode pacemaker with the first lead in position compatible with the right atrial appendage and the second lead in position compatible with the apical portion of the right ventricle. Unchanged mild cardiomegaly. No pneumothorax. " 5616a97e-ac776d58-ebba646b-a8647ad5-0c0fc3f5.jpg,test/p11/p11848597/s51420676/5616a97e-ac776d58-ebba646b-a8647ad5-0c0fc3f5.jpg,test," FINAL REPORT HISTORY: Preoperative for angiogram. FINDINGS: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. Somewhat better inspiration with continued enlargement of the cardiac silhouette without appreciable vascular congestion or pleural effusion. Pacer device remains in good position. No evidence of acute focal pneumonia. " 9c2749e5-4d8a9052-c5d6225d-56284136-075d9343.jpg,test/p16/p16359994/s58098061/9c2749e5-4d8a9052-c5d6225d-56284136-075d9343.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dyspnea on exertion please eval for pulm edema, PNA // eval for pulm edema, PNA eval for pulm edema, PNA IMPRESSION: Heart size and mediastinum are stable. Lungs are overall clear. There is no appreciable pleural effusion. There is no pneumothorax. There is no evidence of pulmonary edema or new consolidation. " aa9091f2-0e79c0fb-9975f44e-b8b0f384-297095f0.jpg,test/p15/p15558620/s58082617/aa9091f2-0e79c0fb-9975f44e-b8b0f384-297095f0.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with MG p/w dysarthria // ?cpd TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest CT from ___ ___. FINDINGS: There is a large hiatal hernia, causing lower lobe atelectasis . Otherwise, the lungs are grossly clear. There is no pleural abnormality. The hilar and mediastinal contours are improved from prior. Bone-on-bone degenerative changes of the right glenohumeral joint is seen. There is compression fracture of a lower thoracic vertebra, unchanged from ___. Heavy calcification in the mitral annulus and thoracic aorta are seen. IMPRESSION: Basal atelectasis. No pulmonary edema, pleural effusion or consolidation. " 2ac8f4d1-6c1345f4-5d68f3c3-5e16691b-23b31346.jpg,test/p12/p12555865/s51203046/2ac8f4d1-6c1345f4-5d68f3c3-5e16691b-23b31346.jpg,test," FINAL REPORT INDICATION: ___ year old woman with ___ yo F with hx of depression on paxil presents with HA, Seizure found to have SAH with IVE found to have ___ ___ aneurysm s/p coiling on ___ // PNA with fever spike TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right-sided subclavian central line in situ with the lead tip in the distal SVC. Persistent opacification involving the left lower lobe. Mild elevation of the left hemidiaphragm. There is interval improvement of airspace opacification involving the left midlung zone. The right lung is clear. No significant effusion. No sinister bony lesions. IMPRESSION: Persistent opacification involving the retrocardiac left lower lobe. Mild interval improvement in the opacification projecting over the left mid lung zone. This preliminary report was reviewed with Dr. ___, ___ radiologist. " 9417a5cc-4ab4ad3c-0c03a399-01484c96-8fe453b4.jpg,test/p12/p12573761/s50961036/9417a5cc-4ab4ad3c-0c03a399-01484c96-8fe453b4.jpg,test," FINAL REPORT HISTORY: Status post palliative right hemicolectomy, new onset fever, tachycardia. CHEST, TWO VIEWS. Compared with ___, there is new minimal atelectasis at the right base and new slight blunting of the right posterior costophrenic angle. Otherwise, no interval changes are identified. No frank consolidation is seen. The right hemidiaphragm is elevated, unchanged. Cardiomediastinal silhouette is stable, without cardiac enlargement. No CHF or frank consolidation. No left-sided atelectasis or effusion. No ptx. IMPRESSION: Minimal right base atelectasis and small right pleural effusion, new compared with ___. Otherwise, no significant interval change. No CHF or frank consolidation. " 8a94b451-410af04f-6f97e89c-36bfcc82-ea3f358a.jpg,test/p12/p12538134/s57398604/8a94b451-410af04f-6f97e89c-36bfcc82-ea3f358a.jpg,test," FINAL REPORT HISTORY: ___-year-old female with COPD. Evaluate for pneumonia. TECHNIQUE: Single portable AP chest radiograph was provided. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The right lung is clear. Patient is status post left lower lobectomy. There is elevation of the left hemidiaphragm, unchanged. Retrocardiac and lateral left basilar opacity laterally is not definitely changed and may be due to scarring. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is unchanged. There are calcifications of the aortic knob. The bones are again notbale for thoracotomy chages, left 6th rib not seen posteriorly. IMPRESSION: No defintie acute cardiopulmonary process. " 1888e449-3203d9c2-5d87905a-71c2a2c7-4d6e6cc0.jpg,test/p16/p16949700/s59657922/1888e449-3203d9c2-5d87905a-71c2a2c7-4d6e6cc0.jpg,test," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: Dyspnea, evaluate for fluid overload. COMPARISON: ___. FINDINGS: Single frontal view of the chest was obtained. Dual-lead left-sided ICD is again seen with leads extending to the expected positions of the right atrium and right ventricle. The cardiac silhouette remains enlarged, possibly slightly increased as compared to the prior study. There has been interval decrease in moderate pulmonary edema which is now minimal. Subtle right base opacity is seen, which may be due to overlying soft tissue and technique versus asymmetric pulmonary edema. No large pleural effusion is seen. There is no evidence of pneumothorax. " fa20802a-0efc408f-846e00d0-b12ce46a-b6d2d32d.jpg,test/p12/p12953693/s51444413/fa20802a-0efc408f-846e00d0-b12ce46a-b6d2d32d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // Eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size remains mildly enlarged. The aorta is tortuous. The mediastinal and hilar contours are otherwise similar. Pulmonary vasculature is not engorged. Streaky atelectasis is noted in the lung bases without focal consolidation. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities detected. IMPRESSION: Minimal streaky bibasilar atelectasis without focal consolidation. " 1e712769-4df92cb4-0c6d3f95-23b553bc-9e2fa4a5.jpg,test/p15/p15154432/s50361695/1e712769-4df92cb4-0c6d3f95-23b553bc-9e2fa4a5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with perforated diverticulitis, complicated hospital course s/p trach // please eval for acute change please eval for acute change IMPRESSION: Compared to prior chest radiographs ___ through ___. Tip of the tracheostomy tube is no more than one cm above the carina. On ___ it reached the carina. Clinical assessment is indicated. Severe cardiomegaly unchanged. Pulmonary vascular engorgement stable. Left lower lobe is probably severely atelectatic. Pleural effusions are presumed, but not large. No pneumothorax. Left PIC line ends close to the superior cavoatrial junction. " bffeab57-cbdf4e5d-6aa1a93f-1ceb2ca1-dc247505.jpg,test/p10/p10088966/s56032947/bffeab57-cbdf4e5d-6aa1a93f-1ceb2ca1-dc247505.jpg,test," FINAL REPORT HISTORY: Productive cough. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a left Port-A-Cath with the tip in the low SVC. There is mild cardiomegaly with mild pulmonary edema, as well as small bilateral pleural effusions. No focal opacity concerning for pneumonia is identified. There is no pneumothorax. IMPRESSION: 1. No focal opacity concerning for pneumonia. 2. Mild cardiomegaly with mild pulmonary edema and small bilateral pleural effusions. A preliminary read was provided via telephone by Dr. ___ to Dr. ___ at ___ on ___. " c205f847-bf3c8484-d74a51be-cd4da176-36c0414e.jpg,test/p18/p18131667/s52447384/c205f847-bf3c8484-d74a51be-cd4da176-36c0414e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with leukocytosis, cough // PNA? IMPRESSION: As compared to ___ radiograph, cardiomediastinal contours are stable. Lungs are clear with no areas of consolidation to suggest pneumonia. " fe77f026-5896df96-9dc9ea5c-60569c04-b7d8c090.jpg,test/p12/p12079605/s55236238/fe77f026-5896df96-9dc9ea5c-60569c04-b7d8c090.jpg,test," WET READ: ___ ___ ___ 7:26 PM There is bibasilar atelectasis, and no focal consolidation, pleural effusion or overt pulmonary edema is seen. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with neutropenic fever, continues to spike on cefepime // eval for changes from previous cxr- please perform ___ @ 5 PM eval for changes from previous cxr- please perform ___ @ COMPARISON: Chest radiographs if ___. IMPRESSION: Lung volumes are slightly lower exaggerating the region of peribronchial opacification at the right lung base. I cannot differentiate dependent atelectasis from early edema on conventional radiographs. Chest CT scanning would be necessary. Mild cardiomegaly and pulmonary vascular congestion are unchanged. There is no appreciable pleural effusion. " af94be11-8f2ecb0f-98ea324c-90150ec3-d1c6ab6e.jpg,test/p14/p14827673/s53554369/af94be11-8f2ecb0f-98ea324c-90150ec3-d1c6ab6e.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain and shortness of breath. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. There is pulmonary vascular congestion without overt edema. Heart size is mildly enlarged. Aorta is tortuous. IMPRESSION: Pulmonary vascular congestion and mild cardiomegaly. " 08eee6a6-e917f882-f87d4b0e-b6be6584-3a5cd6da.jpg,test/p18/p18001424/s59490275/08eee6a6-e917f882-f87d4b0e-b6be6584-3a5cd6da.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with productive cough, dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Left-sided dual-chamber pacemaker device is re- demonstrated with leads terminating in the right atrium and right ventricle. Heart size is mildly enlarged. The aortic knob is calcified. Mediastinal and hilar contours are unchanged. Focal aneurysm of the descending thoracic aorta is again noted, and better assessed on the previous CT. Previously noted left pleural effusion has substantially decreased in size while the right pleural effusion also appears minimal. Pulmonary vasculature is normal. No focal consolidation or pneumothorax is present. The lungs are hyperinflated. Patient is status post bilateral mastectomies with clips demonstrated overlying the chest wall bilaterally. Multiple clips are also noted in the right upper quadrant of the abdomen. Known diffuse osseous metastatic lesions are better appreciated on the previous CT. IMPRESSION: Decreased size of left pleural effusion, now minimal, and continued small right pleural effusion. Re- demonstration of diffuse osseous metastases. " cc52683a-0cfc492c-ba08130e-26390204-9d150767.jpg,test/p16/p16394447/s59556333/cc52683a-0cfc492c-ba08130e-26390204-9d150767.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest INDICATION: ___ year old woman with cough, renal transplant // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size within normal. No pleural effusions. No focal consolidation or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 3d5e7e38-b6905189-1e6f7b24-87bafc24-76f908ed.jpg,test/p11/p11967908/s53744651/3d5e7e38-b6905189-1e6f7b24-87bafc24-76f908ed.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with sudden onset dyspnea // evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs the most recent on ___ FINDINGS: The cardiomediastinal and hilar contours are stable and within normal limits. The heart is normal in size. The lungs are hyper expanded consistent with emphysema, similar to the prior exam. Calcifications project over the right upper lobe as before. Again seen is asymmetric right apical pleural thickening, with crowding of vessels in scarring in the right upper zone retraction of the right hilum. Clips are seen over the right axilla, unchanged in appearance from the prior study. Bilateral perihilar and bibasilar opacities raise the question of mild CHF, minimally increased from the prior examination. No focal consolidation is identified. No pneumothorax is seen. There is mild blunting of the posterior costophrenic angles bilaterally. IMPRESSION: COPD, with extensive background parenchymal scarring, right apical pleural thickening, right apical scarring and calcification, and right hilar retraction, again seen. Please note that small pulmonary nodules can be radiographically occult. Perihilar and bibasilar reticular opacities, minimally more pronounced than on the prior study from ___ raise the question of mild superimposed CHF. Atypical infection could also be considered in the appropriate clinical setting. " e9a44312-0a8ff1fc-c94c14d0-3177aa50-c14542e9.jpg,test/p19/p19686705/s55925713/e9a44312-0a8ff1fc-c94c14d0-3177aa50-c14542e9.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with progressive 1 month Hx SOB and 1 day right foot/ankle pain/swelling after fall yesterday. COMPARISON: None. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low. Bronchovascular crowding likely accounts for subtle opacity in the lower lungs. There is no large effusion or pneumothorax. No convincing signs of pneumonia or CHF. The heart size appears within normal limits. The aorta is slightly unfolded. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Somewhat limited exam without overt signs of pneumonia or edema. " 38d5eacf-bc522360-4e24539a-79a3ef78-f3cbd034.jpg,test/p19/p19017919/s51025673/38d5eacf-bc522360-4e24539a-79a3ef78-f3cbd034.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF and severe aortic stenosis // ?worsening pulmonary edema? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes remain low. The patient is in moderate to severe pulmonary edema. The severity of the edema has not substantially changed since the previous examination. No larger pleural effusions. Mild cardiomegaly. No new focal parenchymal opacities. " 78bbdac3-a74687f9-2333dd93-95c6cf0c-a617e402.jpg,test/p10/p10760672/s50174695/78bbdac3-a74687f9-2333dd93-95c6cf0c-a617e402.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH, agitated cannot swallow, s/p NGT insertion. // evaluate NGT placement evaluate NGT placement IMPRESSION: In comparison with the study of ___, the nasogastric tube extends to the distal antrum of the stomach. Again there are low lung volumes, with little change in the pre-existing bilateral parenchymal opacities. In view of the clinical situation, aspiration would have to be considered. " 3ad8a27f-beffab6d-126f648b-404e33e2-06f01eea.jpg,test/p10/p10473247/s54350944/3ad8a27f-beffab6d-126f648b-404e33e2-06f01eea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with syncope, weakness. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: Mild cardiomegaly is unchanged. Calcified aortic arch is unchanged. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Mild cardiomegaly is unchanged since ___. " 924bb110-d8748e56-ffd907f0-b83d751e-19d54eef.jpg,test/p13/p13292409/s50081713/924bb110-d8748e56-ffd907f0-b83d751e-19d54eef.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with severe asthma and persistent shortness of breath, not improving on prednisone. COMPARISONS: ___ to ___. FINDINGS: The lungs are well expanded and clear. No focal consolidation, effusion, or pneumothorax is present. Cardiac and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. Findings were discussed with Dr. ___ ___ telephone at ___ on ___. " fb550ba7-5adb5455-752b1894-2ca434a2-fe68f2b1.jpg,test/p18/p18458646/s55554736/fb550ba7-5adb5455-752b1894-2ca434a2-fe68f2b1.jpg,test," WET READ: ___ ___ ___ 3:01 PM Right lower lobe consolidation and small right pleural effusion appear slightly improved as compared to the most recent prior study. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with fever, cough, recent admission for pneumonia // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___, and CT of the chest dated ___. FINDINGS: Right lower lobe consolidation and small right pleural effusion appear slightly improved as compared to the most recent prior study. Again seen is a small calcified granuloma in the right upper lung. Note is made of pectus excavatum. Cardiomediastinal and hilar contours are unchanged. No pneumothorax. IMPRESSION: Right lower lobe consolidation and small right pleural effusion appear slightly improved as compared to the most recent prior study. " 931dfcab-35d2d703-15587674-3c862a85-2f7683b9.jpg,test/p12/p12122401/s52550738/931dfcab-35d2d703-15587674-3c862a85-2f7683b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p PPM // PTX, leads COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. 1 lead projects over the right atrium and 1 over the right ventricle. . No pneumothorax or other complications. Unchanged appearance of the lung parenchyma. No edema. No pleural effusions. Normal size of the cardiac silhouette. " a14ecd4a-c733ae8c-8ae0aa04-cdc008f5-47f1a4cf.jpg,test/p13/p13091862/s52650473/a14ecd4a-c733ae8c-8ae0aa04-cdc008f5-47f1a4cf.jpg,test," FINAL REPORT INDICATION: ___M with c/o CP // r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion, pneumothorax, or evidence of pulmonary edema. Surgical clips project over the neck just above the level of the thoracic inlet consistent with thyroidectomy. There is no air under the right hemidiaphragm. IMPRESSION: No acute intrathoracic abnormality. " f9d2f98c-2c7af425-df6e6ba9-c897b099-10c81148.jpg,test/p11/p11943583/s59697785/f9d2f98c-2c7af425-df6e6ba9-c897b099-10c81148.jpg,test," WET READ: ___ ___ 10:54 AM Bibasilar opacities are concerning for developing infection, given the clinical history. *** ED URGENT ATTENTION *** WET READ VERSION #1 ___ ___ 12:16 AM Right basilar opacity, superior to the presumed chronic right pleural effusion, is concerning for developing infection, given the clinical history. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with shortness of breath. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___ and ___. FINDINGS: Opacification of the right lung base, corresponding with the previously described chronic right pleural effusion, is again seen. There are new bibasilar consolidations, which could be due to developing infection, given the clinical history. No left-sided pleural effusion. Heart is stably enlarged. No pneumothorax. IMPRESSION: Bibasilar opacities are concerning for developing infection, given the clinical history. " 1e8731fc-4f4bc8c7-b45b04ee-cddec95d-e8c53deb.jpg,test/p19/p19951574/s56766111/1e8731fc-4f4bc8c7-b45b04ee-cddec95d-e8c53deb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with left clavicular pain status post motor vehicle collision TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " a6642789-abe3f6bd-4746fc0a-2cb8b72b-e930cc2d.jpg,test/p18/p18111516/s53276326/a6642789-abe3f6bd-4746fc0a-2cb8b72b-e930cc2d.jpg,test," WET READ: ___ ___ ___ 10:03 PM Mild interstitial edema and persistent bilateral effusions. Rounded opacity projecting over the right lung apex, potentially summation of shadows however nonurgent repeat PA suggested when patient is amenable to exclude underlying parenchymal lesion. ______________________________________________________________________________ FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with residual aphasia and right hemiparesis status post chocking event. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of confluent consolidation. There is however a rounded opacity projecting over the right 2nd rib anteriorly, not seen on prior. There are small bilateral pleural effusions. Increased pulmonary vascular markings suggest mild interstitial edema, however, this is improved since prior. The cardiac silhouette is moderately enlarged, similar to prior. Atherosclerotic calcifications again noted at the aortic arch. No acute osseous abnormality is identified. IMPRESSION: Mild interstitial edema and persistent bilateral effusions. Rounded opacity projecting over the right lung apex, potentially summation of shadows however nonurgent repeat PA suggested when patient is amenable to exclude underlying parenchymal lesion. " 12f8d0c6-ea390f7a-6a39f921-247e4a85-4f55690d.jpg,test/p12/p12938515/s58001541/12f8d0c6-ea390f7a-6a39f921-247e4a85-4f55690d.jpg,test," FINAL REPORT AP CHEST, 9:57 P.M., ___ HISTORY: A ___-year-old man with cirrhosis and labored breathing, altered mental status changes and possible pneumonia or volume overload. IMPRESSION: AP chest compared to ___ through ___ at 8:04 a.m. Relatively widespread distribution of pulmonary opacification, most likely due to moderately severe pulmonary edema, moderate right pleural effusion, all little changed over the past week. Heart size is borderline enlarged. Right jugular line ends in the upper SVC. No pneumothorax. " 24fe16b6-544fc9f2-3e086078-f003054d-1a46ee3f.jpg,test/p11/p11390883/s54466017/24fe16b6-544fc9f2-3e086078-f003054d-1a46ee3f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis, intubated for acute hypoxic resp failure (?ARDS vs pna) // ?pulm edema vs. consolidation TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: The patient is markedly rotated which limits assessment. The endotracheal tube is positioned with its tip approximately 2 cm above the carina, this is improved compared to the prior study. Bilateral diffuse airspace opacities are slightly improved when compared to the prior study. Again this may reflect pulmonary edema versus infection. The cardiomediastinal contour is unchanged. No pleural effusion or pneumothorax seen. A right internal jugular catheter terminates in the distal SVC. IMPRESSION: Improved positioning of the endotracheal tube. Slight interval improvement in the bilateral airspace opacities. " 9123a1d0-90cb589f-da0bdefd-4847f983-49071881.jpg,test/p17/p17522005/s54043978/9123a1d0-90cb589f-da0bdefd-4847f983-49071881.jpg,test," FINAL REPORT CLINICAL INFORMATION: ___-year-old female with dizziness and right-sided chest pain, question infection. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate mild indistinctness of the pulmonary vasculature. There is no significant effusion, and no pneumothorax. The heart size remains moderately enlarged. A biventricular AICD is in place with leads in appropriate position. The mediastinal contours are stable. IMPRESSION: Moderate cardiomegaly, with mild cardiac decompensation. " 55306b7e-9243ee80-eb266c80-ccb8a99d-afb946de.jpg,test/p12/p12584492/s59131896/55306b7e-9243ee80-eb266c80-ccb8a99d-afb946de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cabg // s/p ct removal ? ptx TECHNIQUE: Chest single view COMPARISON: ___ 13:44 FINDINGS: Interval removal of chest tubes. No pneumothorax. Left basilar opacity, likely atelectasis. Previously suggested pneumomediastinum is less apparent. Right lung is clear. Epicardial pacer wires. Shallow inspiration. Sternotomy. IMPRESSION: No pneumothorax. Left basilar opacity, stable, likely atelectasis " f5fd61c2-c5b6125e-636afd2e-73dce435-fd4fdb57.jpg,test/p13/p13859753/s51254585/f5fd61c2-c5b6125e-636afd2e-73dce435-fd4fdb57.jpg,test," FINAL REPORT INDICATION: ___ year old woman with COPD, CHF, s/p AVR, who now has increased SOB of unclear cause // assess for any tell tale evidence of CHF TECHNIQUE: Chest PA and lateral FINDINGS: The lungs are clear. There is no pneumothorax or pleural effusion. Mild to moderate cardiomegaly has increased in this patient with prior sternotomy for CABG and AVR. The aortic valve prosthesis is difficult to see on this chest x-ray. Mild pulmonary artery dilatation is also stable. IMPRESSION: No acute cardiopulmonary findings. Mild to moderate cardiomegaly has increased since ___ " 4145f943-73227c33-108f07b4-2a31fff8-76bd3c48.jpg,test/p18/p18297041/s53196467/4145f943-73227c33-108f07b4-2a31fff8-76bd3c48.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of 2 prior lifetime seizures p/w seizure. Prior CXR with nipple shadow. Please obtain PA and lateral (with nipple guard if needed) // ? acute cardiopulmonary process (seizure ? underlying infection; prior CXR with nipple shadow) ? acute cardiopulmonary process (seizure ? underlying infection; prior CXR with nipple shadow) IMPRESSION: Comparison to ___. No relevant change. Known sclerotic vertebral lesion. The markers identifiable at the rounded structure seen on the previous images. Correspond to the nipples. No pneumonia, no pulmonary edema, no pleural effusions. " eab9801e-b5dfab33-3cb22362-8a3ee7f4-41642ffb.jpg,test/p12/p12822417/s51904858/eab9801e-b5dfab33-3cb22362-8a3ee7f4-41642ffb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with cardiogenic shock, has right-sided pulmonary artery catheter. // Evaluate PA catheter placement. COMPARISON: Chest radiographs since ___ through ___ IMPRESSION: Swan-Ganz catheter ends in the proximal right pulmonary artery. ET tube in standard placement. Nasogastric tube ends in the upper stomach and would need to be advanced 6 cm to move all the side ports into the stomach. Previous opacification in the right lower chest, either pleural or parenchymal, is improving. Similar left-sided abnormality, probably pleural, and has improved since ___. Upper lungs are entirely clear. Conventional PA and lateral chest x-rays would be helpful in distinguishing the nature endings. Heart size is normal. No pulmonary vascular congestion or edema. No pneumothorax. " 6effefaf-d7b80c81-98629012-29e7f1fb-fb54c022.jpg,test/p11/p11660627/s59343144/6effefaf-d7b80c81-98629012-29e7f1fb-fb54c022.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of weight gain, renal failure, hypertension. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Status post median sternotomy. Moderate cardiomegaly persists. There is mild interstitial pulmonary edema. No pleural effusion or pneumothorax is seen. The aorta is calcified and tortuous. IMPRESSION: Moderate enlargement of the cardiac silhouette and mild interstitial edema. " 42993a81-61db7c46-6330ec1d-8f7fe1d9-a72e5f5e.jpg,test/p11/p11655748/s53271964/42993a81-61db7c46-6330ec1d-8f7fe1d9-a72e5f5e.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Fever. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size, mediastinum are unremarkable. Lungs are essentially clear except for suspected left retrocardiac opacity with potentially represents developing/resolving infectious process. Attention to this area on the subsequent studies is recommended. " 0c61d9ae-3697d4f3-7223e884-d7bdf383-73dfaf49.jpg,test/p17/p17779045/s59948141/0c61d9ae-3697d4f3-7223e884-d7bdf383-73dfaf49.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Syncope, left-sided headache and right-sided visual change. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged with a left ventricular configuration, as before. The mediastinal and hilar contours appear unchanged. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. There has been no significant change. IMPRESSION: No evidence of acute disease. " bfe4e1c0-3548002f-2f856321-5ae4f07f-d91ba070.jpg,test/p10/p10524770/s59421334/bfe4e1c0-3548002f-2f856321-5ae4f07f-d91ba070.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with confusion // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs remain hyperinflated and clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Patient is status post median sternotomy and CABG. IMPRESSION: No acute cardiopulmonary process. " 05f2d559-34b2a918-09f27fe6-ca11cedd-7b242472.jpg,test/p14/p14644600/s56727154/05f2d559-34b2a918-09f27fe6-ca11cedd-7b242472.jpg,test," FINAL REPORT HISTORY: ___-year-old man with fatigue and malaise and dry cough. Evaluation for chronic lung disease. COMPARISON: Comparison is made to radiographs of the chest from ___ as well as CT of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. No pleural effusion, pulmonary edema, pneumothorax or focal consolidation concerning for pneumonia. IMPRESSION: Normal chest radiographs. No evidence of chronic lung disease. " 6fbd5107-4abf9d84-6ff62564-081b6e09-0f0ab895.jpg,test/p17/p17755879/s58342894/6fbd5107-4abf9d84-6ff62564-081b6e09-0f0ab895.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Assault with sternal pain and pain along the left second through fourth ribs. FINDINGS: PA and lateral views of the chest were obtained demonstrating no acute fracture. Lungs appear clear. No pneumothorax or pleural effusion. Cardiomediastinal silhouette is normal. IMPRESSION: Unremarkable chest radiograph. If there is strong clinical concern for rib fracture, a dedicated rib series may be helpful to further reassess. " f7b27159-f826668a-f22b4fb3-82bd7125-423662ec.jpg,test/p17/p17801051/s53205298/f7b27159-f826668a-f22b4fb3-82bd7125-423662ec.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o multiple myeloma s/p auto-BMT, recent cough, shortness of breath, asthma/COPD // any evidence of pneumonia any evidence of pneumonia IMPRESSION: Compared to chest radiographs ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . " 73b4d0d9-0383e525-c8c57d30-f893abbf-c91e157a.jpg,test/p14/p14546527/s59452187/73b4d0d9-0383e525-c8c57d30-f893abbf-c91e157a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG, follow up for pneumothorax. PA and lateral upright chest radiographs were reviewed in comparison to ___. The right internal jugular line tip is at the level of low SVC. Left pleural effusion is moderate, unchanged. Left apical pneumothorax is present, unchanged. Subcutaneous air appears to be improved as compared to prior study. Mediastinal air is noted. No clear evidence of apical pneumothorax is seen. " fa9ffea8-5f539ef1-e05490d6-aa29104b-96d7311d.jpg,test/p10/p10921049/s51175273/fa9ffea8-5f539ef1-e05490d6-aa29104b-96d7311d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cardiac arrest w/hypoxemic respiratory failure s/p intubation. // ?interval change ?interval change IMPRESSION: Comparison to ___. Decrease in extent and severity of the pre-existing bilateral parenchymal opacities. The opacities, however, remain clearly visible. Moderate retrocardiac atelectasis. No larger pleural effusions. " 5ec6c8a7-5c2d6b08-4f7c87d6-9059ad7d-2b0de7b3.jpg,test/p19/p19038040/s55046411/5ec6c8a7-5c2d6b08-4f7c87d6-9059ad7d-2b0de7b3.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ AT ___ HOURS. HISTORY: Elevated white blood cell count with PICC line. COMPARISON: Multiple priors, the most recent dated ___. FINDINGS: The previously noted right upper extremity PICC line has apparently been removed and replaced with a left upper extremity approach PICC line. The distal tip of the line is projecting well within the right atrium. Retraction by at least 6 to 7 cm is advised for placement at the superior cavoatrial junction. Lung volumes are profoundly diminished with hazy opacity at the lung bases, likely reflecting atelectasis. In addition, there is likely fluid tracking within the right major fissure. There are bilateral pleural effusions. A subpulmonic component, particularly on the right cannot be excluded, resulting in the appearance of an elevated right hemidiaphragm. No pneumothorax is seen. There is no consolidation or edema. Mild aortic tortuosity is accentuated by low lung volumes. The cardiac silhouette is within normal limits for size. The osseous structures are grossly unremarkable. IMPRESSION: PICC line as above. Consider retracting 6 to 7 cm for optimal placement. Bilateral pleural effusions with bibasilar atelectasis. " fd0d630c-5e5363db-5ce2f7f0-a5f25bb3-44a7a2bf.jpg,test/p19/p19103579/s53134306/fd0d630c-5e5363db-5ce2f7f0-a5f25bb3-44a7a2bf.jpg,test," FINAL REPORT HISTORY: Rib fractures. FINDINGS: In comparison with study of ___, the patient has taken a much better inspiration. There is no evidence of pneumonia, vascular congestion, pleural effusion, or pneumothorax. The rib fractures are not optimally seen on this study. If clinically warranted, special oblique views for the ribs could be obtained. " 8479d7b9-abce116b-452c3604-5ec20b0d-d896fc2b.jpg,test/p19/p19956960/s53956813/8479d7b9-abce116b-452c3604-5ec20b0d-d896fc2b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Recent seizure, assess for pneumonia or aspiration. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear, well-expanded lungs without focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 0967a954-90ce7c97-d92db200-04cb76b7-57471f4b.jpg,test/p15/p15353701/s53302142/0967a954-90ce7c97-d92db200-04cb76b7-57471f4b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with mitral regurg/pulmonary edema, new leukocytosis // evidence of infiltrate evidence of infiltrate IMPRESSION: In comparison with the studies of ___, there again is moderate to severe pulmonary edema with substantial layering pleural effusions, more prominent on the right, and underlying compressive basilar atelectasis. In view of the extensive pulmonary changes, it would be extremely difficult to unequivocally exclude superimposed pneumonia, especially in the absence of a lateral view. " 1f5227b3-337017cc-fc7b643e-3930746e-3d97ff13.jpg,test/p17/p17337707/s51143687/1f5227b3-337017cc-fc7b643e-3930746e-3d97ff13.jpg,test," FINAL REPORT INDICATION: ___-year-old male with new profound pulmonary hypertension, who presents for evaluation. COMPARISONS: ___, ___, and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Again seen is the dual-chamber intracardiac device with the leads in the expected locations of the right atrium and right ventricle respectively. There is no focal consolidation, pleural effusion, or pneumothorax. The patient is status post sternotomy and valve replacement. The heart size is normal. The hilar and mediastinal contours are unremarkable. Again seen are mild bibasilar opacities, similar to the prior study and may represent mild chronic lung disease. There is no pleural effusion or pneumothorax. IMPRESSION: No acute abnormalities identified to explain patient's pulmonary hypertension. " b6a1d78e-7785ec3a-4d00e02d-e772af7b-8f551dbf.jpg,test/p14/p14232172/s54734584/b6a1d78e-7785ec3a-4d00e02d-e772af7b-8f551dbf.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath. Evaluate for pneumonia. EXAMINATION: Single frontal PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: Since the prior examination there has been resolution of right perihilar opacification but interval development of right basilar opacification. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are otherwise stable demonstrating borderline cardiomegaly. Pulmonary vascularity is not increased. IMPRESSION: New right basilar opacification could either relate to aspiration or early pneumonia. Recommend followup to resolution with repeat radiographs in six weeks. Findings were discussed with Dr. ___ via telephone by Dr. ___ at 11:50 a.m. on ___. " fbb61e4d-27e927a5-abbcaf0f-4295d4a4-740c0b9e.jpg,test/p18/p18663902/s59990286/fbb61e4d-27e927a5-abbcaf0f-4295d4a4-740c0b9e.jpg,test," FINAL REPORT HISTORY: ___-year-old female with leukocytosis. Evaluation for fluid status and possible pneumonia. COMPARISON: Comparison is made to radiograph of the chest from yesterday. FINDINGS: No airspace opacity concerning for pneumonia is identified. Single semi-upright portable radiograph of the chest demonstrates the lungs are well expanded, with no evidence of pneumothorax or large pleural effusion. Cephalization of the pulmonary vasculature is unchanged compared to multiple prior studies. The heart size is mild to moderately enlarged. Calcifications are noted in the aortic arch. A prominent right pulmonary artery is also unchanged. A right approach PICC terminates in the mid SVC, and a jejunostomy tube, right upper quadrant embolization coils, and a plastic common bile duct stent are noted in the abdomen. IMPRESSION: No evidence of pneumonia. Stable mild-to-moderate cardiomegaly. " 0ea50d95-d52b68b9-e48588d0-00651038-0a761ebc.jpg,test/p18/p18022983/s57381264/0ea50d95-d52b68b9-e48588d0-00651038-0a761ebc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p traumatic fall with multiple rib fx and small ptx // pls eval for any interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Low lung volumes. There are bibasilar linear opacities, unchanged in comparison to the prior chest radiograph, which likely represent atelectasis. Heart size is top normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. The sternal fracture is visualized and appears unchanged in orientation in comparison to the prior radiograph. The rib fractures are not visualized on these images. There is lumbar fixation hardware, which is incompletely imaged. IMPRESSION: 1. Bibasilar linear opacities representing atelectasis, which is unchanged. 2. Sternal fracture again visualized, which is unchanged. " c661b80b-05a037a8-db2f49da-6501c685-cb3c2b33.jpg,test/p12/p12475406/s56748545/c661b80b-05a037a8-db2f49da-6501c685-cb3c2b33.jpg,test," FINAL REPORT INDICATION: Right parasternal chest pain. Assess for pneumonia. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidations, or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. Cervical hardware is partially imaged. IMPRESSION: No acute cardiopulmonary process. " c018a3f8-52153987-c9cf6d22-32b20f4b-52dfb88a.jpg,test/p17/p17945025/s58209632/c018a3f8-52153987-c9cf6d22-32b20f4b-52dfb88a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RLL mass s/p biopsy // ptx ptx IMPRESSION: Status post right sided biopsy. There is no evidence for the presence of a right pneumothorax. Left apical emphysema is visualized. Moderate cardiomegaly. The consolidation at the right lung bases persists. " ea32f2ad-87900f2e-18887afb-c1d7b35b-a70f2368.jpg,test/p14/p14875942/s57463257/ea32f2ad-87900f2e-18887afb-c1d7b35b-a70f2368.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dyspnea. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A single-lead pacemaker device appears unchanged with leads again terminating in the right ventricle in addition to epicardial leads. The heart is again enlarged. The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. Mild loss in height of two mid thoracic vertebral bodies appears unchanged. The bones appear demineralized. IMPRESSION: No evidence of acute cardiopulmonary disease. " 310ed1a6-ee306bc9-07d8d696-d5e3caa3-37749a62.jpg,test/p17/p17051517/s58376214/310ed1a6-ee306bc9-07d8d696-d5e3caa3-37749a62.jpg,test," WET READ: ___ ___ ___ 4:08 PM Moderate pulmonary edema. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with shortness of breath. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: CTA of the chest from ___ and chest radiograph from ___. FINDINGS: There is a moderate cardiomegaly and moderate pulmonary edema. Mild blunting of the right cardiophrenic angle, likely due to overlying soft tissue. There is no pneumothorax. The mediastinum and hila are normal. IMPRESSION: Moderate cardiomegaly and moderate pulmonary edema. " f5e9093b-ea2adf27-ec601f82-b77caaf0-a406eabe.jpg,test/p13/p13083956/s50057246/f5e9093b-ea2adf27-ec601f82-b77caaf0-a406eabe.jpg,test," FINAL REPORT HISTORY: Palpitations. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 0fe9bbd6-463973c8-2e8af187-1ffbc2ce-7856a241.jpg,test/p11/p11632236/s56069374/0fe9bbd6-463973c8-2e8af187-1ffbc2ce-7856a241.jpg,test," FINAL REPORT INDICATION: History of liver transplant, failure to thrive. Please assess for NG tube placement. COMPARISONS: Chest radiograph from ___. TECHNIQUE: Frontal AP portable radiograph of the chest. FINDINGS: Extensive bilateral, however, predominantly left-sided interstitial lung opacities are overall slightly worse compared to the prior exam. There is also increased opacification at the right lung base. Small bilateral pleural effusions are persistent. There is no evidence of a pneumothorax. There is a right-sided central venous dialysis line which terminates at the cavoatrial junction. An NG tube extends below the diaphragm with the tip in the body of the stomach. IMPRESSION: 1. Interval increase in moderate bilateral pulmonary edema. 2. Increase in opacification at the right lung base may be concerning for superimposed infection. 3. Nasogastric tube extends below the diaphragm with the tip in the body of the stomach. ___ were d/w Dr. ___ by Dr. ___ by phone at 4p on the day of the exam. " 978ce2ad-0171169f-76c4dc70-483c84fb-c019c0e0.jpg,test/p18/p18768053/s57526099/978ce2ad-0171169f-76c4dc70-483c84fb-c019c0e0.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " e1b6dce6-d9ec64d1-7b3a9ff7-5ae9f729-f65c7fa4.jpg,test/p11/p11775739/s51657638/e1b6dce6-d9ec64d1-7b3a9ff7-5ae9f729-f65c7fa4.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old man s/p RUL,RML wedge on ___ // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___ FINDINGS: The small right apical pneumothorax was noted on yesterday's CXR has expanded from 22 mm to 27 mm today. No evidence of tension. Postoperative right upper lobe hematoma has largely resolved. However, there is a new parenchymal opacity in the right mid-lung zone, of unclear significance. There is left lower lobe atelectasis. The right-sided port and right chest tube are unchanged in position. Stable cardiomediastinal silhouette. No acute osseous abnormalities. IMPRESSION: 1. Interval worsening of small right apical pneumothorax. 2. New right mid-lung opacity. Differential is broad, including partial collapse vs. infection vs. new hematoma. Recommend close attention on follow-up imaging. NOTIFICATION: Findings telephoned to ___, by Dr. ___ on ___ at 3:28PM, time of discovery. " 96c6f7df-b66ebef0-dcd79cfc-0a7f4b3e-938e7e9d.jpg,test/p13/p13050559/s56277386/96c6f7df-b66ebef0-dcd79cfc-0a7f4b3e-938e7e9d.jpg,test," WET READ: ___ ___ 9:37 PM No pneumothorax or other significant change since the prior CXR from yesterday. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old man with large mediastinal mass and right upper lobe collapse. Status post mediastinoscopy. FINDINGS: Comparison is made to previous study from ___. Findings are relatively stable. There is again seen right upper lobe collapse and increased consolidation within the right upper lobe. Heart size is within normal limits. The rest of the lung fields are grossly clear. " ea463320-3ae1c6f5-3bdd1155-9e90396d-409e554c.jpg,test/p16/p16843799/s52617001/ea463320-3ae1c6f5-3bdd1155-9e90396d-409e554c.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man after CABG. Evaluation for discharge. IMPRESSION: AP chest compared to ___: Considerable increase in the postoperative caliber of the mediastinum between ___ and ___ persists. It raises serious questions about mediastinal bleeding or even aortic dissection. Dr. ___ was paged at 1:25 p.m. as soon as the findings were recognized. Lungs are low in volume and there is only mild left basal atelectasis, stable since ___. There is no pneumothorax or appreciable pleural effusion. A right jugular line ends in the right atrium as before. " bbc211eb-b59face3-e81d2ed2-b93947b6-87692a15.jpg,test/p11/p11302785/s56012207/bbc211eb-b59face3-e81d2ed2-b93947b6-87692a15.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with hyperglycemia COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. There is a moderate right pleural effusion with associated compressive atelectasis in the right lower lung. Difficult to exclude an underlying pneumonia. The heart is mildly enlarged. The left lung appears grossly clear. No overt signs of edema. No pneumothorax. Mediastinal contour is normal. Bony structures are intact. Clips in the right upper quadrant noted. IMPRESSION: As above. " 6faef31c-7296f668-db593b2b-e6afab54-c552105c.jpg,test/p13/p13292409/s54748505/6faef31c-7296f668-db593b2b-e6afab54-c552105c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with asthma s/p thermoplasty // ? ptx ? ptx IMPRESSION: In comparison with the study of ___, the cardiac silhouette is within normal limits and there is no evidence of pulmonary vascular congestion. No pleural effusion or acute focal pneumonia identified. " 5c512d42-ed80ecbf-e84f4488-ca188a0c-189cc7c3.jpg,test/p15/p15035317/s58342513/5c512d42-ed80ecbf-e84f4488-ca188a0c-189cc7c3.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: Patient with MDS. ___ transplant examination. FINDINGS: Comparison is made to previous study from ___. Heart size is upper limits of normal. Lungs are grossly clear without focal consolidation, pleural effusions or pulmonary edema. Bony structures are grossly intact. IMPRESSION: No signs for acute cardiopulmonary process. " 10baf808-67222a6b-c692e577-23661cc1-7463d41f.jpg,test/p16/p16884585/s54814385/10baf808-67222a6b-c692e577-23661cc1-7463d41f.jpg,test," FINAL REPORT HISTORY: ___-year-old female with right upper quadrant pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. No free air seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 32580b13-4bec3b12-28ee981f-42677ab0-c6dae585.jpg,test/p18/p18079519/s55946711/32580b13-4bec3b12-28ee981f-42677ab0-c6dae585.jpg,test," FINAL REPORT HISTORY: Post-operative cardiac surgery. FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. Again there is enlargement of the cardiac silhouette with a prosthetic mitral valve in place and dense calcification of the annulus. No evidence of vascular congestion or acute pneumonia. Bilateral pleural effusions persist. " a0e5adb7-8bca6da4-1db37f32-bbd0b9d0-8fe5cd65.jpg,test/p16/p16617005/s59472246/a0e5adb7-8bca6da4-1db37f32-bbd0b9d0-8fe5cd65.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with 71 + ETOH level 215 + AMS tx from___ ___, s/p fall events are unknown. NCHCT + left IPH/SDH/SAH. taken emergently to OR now s/p left crani for evac // interval change ___ TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: Mild-to-moderate pulmonary edema has increased. Large right pleural effusion and probably small left effusions are grossly unchanged. Opacities in the right upper and right lower lobes have minimally increased. . Lines and tubes are in standard position. There is no evident pneumothorax. Callus formation, deformity secondary to a spiral fracture in the left humeral mid diaphysis is unchanged Cardiomediastinal contours are unchanged Bilateral calcified pleural plaques are again noted " 324b0bf7-e29c2613-32c9cf56-ffa5762b-d3274f1e.jpg,test/p17/p17898988/s50951191/324b0bf7-e29c2613-32c9cf56-ffa5762b-d3274f1e.jpg,test," FINAL REPORT INDICATION: Dyspnea, fatigue, and chills. COMPARISONS: Chest radiograph ___. Chest radiograph ___. FINDINGS: Again, the lungs are hyperinflated, with attenuated vascular markings particularly towards the apices, compatible with moderate to severe emphysema. There is no consolidation, pulmonary edema, pleural effusion, or pneumothorax. Mild bibasilar atelectasis is present. The cardiomediastinal silhouette is normal. A large hiatal hernia with an air-fluid level is unchanged. IMPRESSION: 1. No acute cardiopulmonary process. 2. Emphysema. Large hiatal hernia. 3. Stable large hiatal hernia. " 1c0db258-0b13ff4b-1fdc256c-4e30c91a-84435152.jpg,test/p14/p14729260/s53838051/1c0db258-0b13ff4b-1fdc256c-4e30c91a-84435152.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Hx of NHL, s/p ALLO transplant. Recent left pneumonia. Please reassess and compare to prior study. // Hx of NHL, s/p ALLO transplant. Recent left pneumonia. Please reassess and compare to prior study. Hx of NHL, s/p ALLO transplant. Recent left pneumonia. Pleas IMPRESSION: In comparison with the study of ___, there has been substantial clearing of the lingular pneumonia. A small residual process. Repeat follow-up in ___ weeks could be obtained. " 0d11dfd6-e3bac579-5d2ddf3c-404ca5cc-ae08921c.jpg,test/p14/p14306457/s50255864/0d11dfd6-e3bac579-5d2ddf3c-404ca5cc-ae08921c.jpg,test," FINAL REPORT INDICATION: Syncope, evaluate for acute process. COMPARISONS: Chest x-ray on ___. FINDINGS: PA and lateral views of the chest demonstrate the left side Port-A-catheter removed. The cardiomediastinal silhouette is normal. A large hiatal hernia is redemonstrated. There is no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: 1. No acute cardiopulmonary process. 2. Large hiatal hernia. " 1a936b32-55cd7d25-9ad38a78-95bb7da3-fdd37632.jpg,test/p14/p14965566/s52757052/1a936b32-55cd7d25-9ad38a78-95bb7da3-fdd37632.jpg,test," FINAL REPORT REASON FOR EXAMINATION: New bibasal crackles. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is top normal. Mediastinum is unremarkable. Lungs are essentially clear. There is no pleural effusion or pneumothorax. Degenerative changes are noted along the spine. " eba79f63-1832dd3c-f680c9b0-547be88e-4cdb98c8.jpg,test/p11/p11393554/s57815924/eba79f63-1832dd3c-f680c9b0-547be88e-4cdb98c8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with pancreatic ca here w/ ___ edema, DOE, and ___ // pulmonary edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Right-sided Port-A-Cath terminates in the upper SVC without evidence of pneumothorax.There is slight blunting of the left costophrenic angle which may be due to a trace pleural effusion with overlying atelectasis. Subtle opacity at the left mid lung is nonspecific, underlying infection not excluded. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Trace left pleural effusion. Left mid to lower lung opacity is nonspecific but in the appropriate clinical setting, could relate to pneumonia or small airways disease. " 4ac88699-e9b3f6c0-a2899fea-0670c485-c5e326ed.jpg,test/p11/p11472206/s54698879/4ac88699-e9b3f6c0-a2899fea-0670c485-c5e326ed.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Shortness of breath. Patient with history of CHF. There is moderate cardiomegaly. The lungs are clear. There is no pneumothorax or pleural effusion. Sternal wires are aligned. IMPRESSION: No evidence of pulmonary edema. " 421db009-ef9b6ab7-73f7054b-dc244952-00f665e0.jpg,test/p17/p17648875/s55541110/421db009-ef9b6ab7-73f7054b-dc244952-00f665e0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever, cough, right upper quadrant pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 11daaf22-4a479d4f-531a5217-c9779ac9-9ea36037.jpg,test/p10/p10558630/s53648732/11daaf22-4a479d4f-531a5217-c9779ac9-9ea36037.jpg,test," FINAL REPORT HISTORY: ___-year-old with syncope. COMPARISON: CT chest from ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Note is made of pectus excavatum. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " 671a62f5-aa7ca952-52310ad3-89d1f6a7-7f983e8b.jpg,test/p19/p19722050/s54161684/671a62f5-aa7ca952-52310ad3-89d1f6a7-7f983e8b.jpg,test," FINAL REPORT INDICATION: ___ year old M with PMHx MS, Vitiligo, Latent TB, ___ transferred from ___ to ED with cough, hypotension, and concern for aspiration PNA. // please eval for interval development of aspiration pneumonitis or PNA, no evidence on yesterday's CXR, trying to determine if there is any component of an aspiration event in lungs TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are unchanged. Moderate pulmonary edema and bibasilar linear opacities are new since ___. Mediastinal contours, hila, and cardiac silhouette are normal. No pleural effusion or pneumothorax. Lateral view is highly limited by motion. IMPRESSION: 1. Moderate pulmonary edema new from ___. 2. Bibasilar opacities are likely due to pulmonary edema and atelectasis, given distribution, less likely aspiration. " fbdc8b7d-4de4bcf6-1519b029-ed1dbfef-5874c71b.jpg,test/p19/p19736957/s50430072/fbdc8b7d-4de4bcf6-1519b029-ed1dbfef-5874c71b.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 3 EXAMS INDICATION: ___ year old man with failure to thrive awaiting dobhoff // awaiting dobhoff placement, to be done at same time as CXR TECHNIQUE: 3 PORTABLE AP VIEWS OF THE CHEST. COMPARISON: Chest radiograph ___ FINDINGS: The initial image shows a Dobhoff tube positioned in the mid esophagus. Subsequent images show the tip is below the left hemidiaphragm, likely in the stomach or duodenum. Multiple rib fractures with varying degrees of healing seen. No con solid a shin or pneumothorax seen. IMPRESSION: Slab off tube is positioned in the stomach or duodenum on the last available image. " 5b00c71d-2adce216-56bce58b-fe43b158-23500f65.jpg,test/p11/p11830275/s55299795/5b00c71d-2adce216-56bce58b-fe43b158-23500f65.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, AP portable single view. INDICATION: ___-year-old male patient with CHF and wheezing, evaluate for pulmonary edema/congestion. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of ___. The heart size is unchanged. No conclusive evidence of significant cardiac enlargement. The pulmonary vasculature is now quite normal, thus no evidence of pulmonary congestion or edema. The lateral pleural sinuses remain free. Tissue densities overshadow the apical area in marked lordotic position, but there is no evidence of pneumothorax. When comparison is made with the next preceding study, the earlier existing pulmonary vascular distended pattern has now regressed and is normal. No pneumothorax seen. " e2e86aab-973b505f-cfdecfd7-35a83916-16d8d84f.jpg,test/p12/p12764579/s56300125/e2e86aab-973b505f-cfdecfd7-35a83916-16d8d84f.jpg,test," FINAL REPORT HISTORY: Low oxygen saturations. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Increased opacification at the right base is essentially unchanged. Indistinctness of pulmonary vessels is consistent with elevated pulmonary venous pressure. " 4b5c3574-4b072141-728f6b01-5a2fc347-388f928e.jpg,test/p11/p11551927/s52362271/4b5c3574-4b072141-728f6b01-5a2fc347-388f928e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute pancreatitis // interval progression COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pre-existing parenchymal opacities have minimally decreased in extent and severity. They nevertheless remain clearly visible. Moderate cardiomegaly and very low lung volumes persist. Monitoring and support devices are in unchanged position. " 757658fe-e2c14bf9-c96aa27d-41d22ac4-26e1abe4.jpg,test/p10/p10532853/s57532026/757658fe-e2c14bf9-c96aa27d-41d22ac4-26e1abe4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath and edema TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. Heart size remains moderately enlarged. Mediastinal and hilar contours are unchanged, and no pulmonary edema is present. A moderate size right pleural effusion is increased in the interval, and a trace left pleural effusion appears new. Right basilar opacity likely reflects compressive atelectasis. No pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Increased size of bilateral pleural effusions, moderate on the right and small on the left, with right basilar compressive atelectasis. No pulmonary edema. " 8474151e-72a52507-26c9f280-d3765f2b-eba24346.jpg,test/p14/p14513439/s50398301/8474151e-72a52507-26c9f280-d3765f2b-eba24346.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Anxiety. Chest pain. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. There has been no significant change. IMPRESSION: No evidence of acute cardiopulmonary disease. " 696c6972-6e9d0d93-9dc6e254-eb587608-32bd24d2.jpg,test/p15/p15853461/s58249079/696c6972-6e9d0d93-9dc6e254-eb587608-32bd24d2.jpg,test," FINAL REPORT INDICATION: Confusion. COMPARISONS: ___, ___. FINDINGS: Frontal and lateral views of the chest demonstrate hyperextended lungs. There is no pleural effusion, focal consolidation or pneumothorax. Moderate cardiomegaly is unchanged. Prominent pulmonary outflow tract is stable. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. Moderate cardiomegaly. " 96d21f8f-9121bfd3-89bf3d89-5dfa8d2d-ec3cc181.jpg,test/p13/p13899130/s58508522/96d21f8f-9121bfd3-89bf3d89-5dfa8d2d-ec3cc181.jpg,test," FINAL REPORT INDICATION: Acute onset shortness of breath. COMPARISONS: CT chest done today, on ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion or pneumothorax. The mildly enlarged hilar lymph nodes seen on the chest CT done today are less well seen on this radiograph. IMPRESSION: No acute cardiopulmonary process. The mildly enlarged hilar lymph nodes seen on the chest CT done today are less well seen on this radiograph. " 7a6297f0-5c49e9cd-402c89b2-58b7ee17-7bcb8173.jpg,test/p17/p17261065/s55172379/7a6297f0-5c49e9cd-402c89b2-58b7ee17-7bcb8173.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF, transplant evaluatino underway // eval for interval change in swan eval for interval change in swan COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Severe cardiomegaly may be slightly smaller today than on ___. No pulmonary edema or pleural effusion. Lungs fully expanded and clear. Previous pulmonary vascular congestion has improved since ___. Transvenous right atrial biventricular pacer defibrillator leads unchanged in their respective positions continuous from the left pectoral generator. Swan-Ganz catheter is been withdrawn to the proximal right pulmonary artery. " cb23766c-7d6c5a0f-e4e1ee83-9dc36b20-32aa4fed.jpg,test/p17/p17193583/s55556496/cb23766c-7d6c5a0f-e4e1ee83-9dc36b20-32aa4fed.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with mvc now with pain and tenderness to neck and face // ? fracture TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture identified. IMPRESSION: No acute cardiopulmonary process. " 8a0acec6-ac7e21d8-fae05833-5ef73f7b-976af872.jpg,test/p14/p14687773/s59273159/8a0acec6-ac7e21d8-fae05833-5ef73f7b-976af872.jpg,test," WET READ: ___ ___ 8:16 PM As compared to the previous radiograph, the right pleural effusion has decreased with increased aeration of the right mid-lower lung lobes. Minimal fluid overload. Moderate cardiomegaly, status post valvular replacement, unchanged left pectoral single lead pacemaker. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Critical aortic stenosis. Systolic CHF. Following thoracentesis. IMPRESSION: PA and lateral chest compared to ___: Small-to-moderate right pleural effusion is smaller than on ___, and there is no pneumothorax. Severe cardiomegaly, pulmonary vascular engorgement, and borderline edema are unchanged. Poor aeration of the right lower lung could be due to residual atelectasis but needs to be followed to evaluate possible pneumonia. Transvenous left subclavian pacer lead ends in the right ventricle. " 733da064-3f4a99e7-19e799b6-95e1414b-c2d6c875.jpg,test/p10/p10410935/s52100683/733da064-3f4a99e7-19e799b6-95e1414b-c2d6c875.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Multifocal HCC, questionable pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has developed mild fluid overload. This is reflected by basoapical blood flow re-distribution. No evidence of pneumonia. No pleural effusions. No substantial atelectasis. At the time of dictation and observation, 11:46 a.m., on ___, the referring physician ___. ___ was paged for notification. " e5979a41-90efa0bb-286bdf94-f0068451-89b540d8.jpg,test/p15/p15890599/s52406838/e5979a41-90efa0bb-286bdf94-f0068451-89b540d8.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with cough, question pneumonia. COMPARISONS: PA and lateral chest radiographs from ___. FINDINGS: PA and lateral chest radiograph is provided. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unremarkable. There is no evidence of CHF. Visualized osseous structures are unremarkable. There is no free air under the right hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " 6620f7e1-f815ac27-a214c2bc-0713a80d-4cde9189.jpg,test/p16/p16154666/s58644194/6620f7e1-f815ac27-a214c2bc-0713a80d-4cde9189.jpg,test," FINAL REPORT HISTORY: ___-year-old female with presyncope. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. When compared to prior, there has been no significant interval change. Mildly diffuse increased interstitial markings are seen throughout the lungs likely representing mild interstitial edema. There is no overt pulmonary edema. There is no large effusion. Cardiomegaly is stable in configuration. No acute osseous abnormality detected. IMPRESSION: Mild pulmonary vascular congestion without overt pulmonary edema. " 739087c1-f629f289-a7c7cc6c-4fb06b9b-93c11a88.jpg,test/p17/p17620982/s55837204/739087c1-f629f289-a7c7cc6c-4fb06b9b-93c11a88.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Cirrhosis, back pain, new ascites, decreased breath sounds in the right lung. There are no prior studies available for comparison. There is a moderate-to-large pleural effusion associated with adjacent atelectasis. There is no pneumothorax. Cardiac size cannot be evaluated. There is mild interstitial edema, better seen in the base of the left hemithorax. There are moderate degenerative changes in the thoracic spine. " b82dacb8-41b547cb-4672a20f-568fa0ea-e6e62b80.jpg,test/p19/p19988137/s55748300/b82dacb8-41b547cb-4672a20f-568fa0ea-e6e62b80.jpg,test," FINAL REPORT INDICATION: ___-year-old female with sickle cell disease now with persisting cough. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates no focal opacity convincing for pneumonia. Cardiomediastinal and hilar contours appear unchanged since ___, the heart is top-normal in size. There is no pleural effusion or pneumothorax.The vessels appear engorged which given history may reflect high output cardiac dysfunction. IMPRESSION: No focal opacity concerning for pneumonia. Stably enlarged heart and engorged vessels may reflect high output cardiac dysfunction in this patient with Sickle Cell Disease. NOTIFICATION: These findings communicated to Dr. ___ by Dr. ___ ___ telephone at 14:53 on ___ at the time study was reviewed. " 98e0c9cb-2b482548-5ca47cf3-8aaafe49-39ffea47.jpg,test/p13/p13387125/s54684228/98e0c9cb-2b482548-5ca47cf3-8aaafe49-39ffea47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with left lower chest pain // etiology LT MID-LEVEL/POSTERIOR CHEST PAIN W/INSPIRATION AND MOVEMENT NO INJURY NO COUGH PER PT HX LUPUS,SEIZURES,DDD TECHNIQUE: PA and lateral chest films COMPARISON: ___ FINDINGS: The cardiomediastinal silhouette is unchanged. The lungs are clear bilaterally. No pleural effusion or pneumothorax is seen. IMPRESSION: Normal radiographic examination of the chest. " 0fa60830-7f276ded-253508bd-80c95884-2572789f.jpg,test/p13/p13620449/s58662533/0fa60830-7f276ded-253508bd-80c95884-2572789f.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with a history of decompensated CHF status post ICD placement. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Left pectoral ICD with a single lead terminating in the right ventricle. Stable cardiomegaly. Pulmonary vessels appear less engorged, although this may simply reflect the differences between an upright PA film and a supine AP film instead of a true improvement in pulmonary vascular congestion. No evidence of pneumonia, pneumothorax, or pleural effusions. IMPRESSION: Stable versus slightly decreased pulmonary vascular congestion. " 44a17832-3ad631a0-0a3a4c14-4bbc459c-ca2429ea.jpg,test/p17/p17639459/s56196145/44a17832-3ad631a0-0a3a4c14-4bbc459c-ca2429ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with SOB, fever // eval for pleural effusion, PNA TECHNIQUE: Portable AP view of the chest was obtained. COMPARISON: The cardiac silhouette is minimally enlarged. The aorta is tortuous. The pulmonary vasculature is mildly indistinct. Vague opacity is seen at the left lung base, which may represent pneumonia in the appropriate clinical setting. Increased interstitial markings in the bilateral lung bases are noted. No definite pleural effusion is identified. There is no pneumothorax. There is multifocal osseous blastic disease limits evaluation of the lungs. FINDINGS: 1. Vague left basilar opacity, in the appropriate clinical context, may represent pneumonia. 2. Increased, bibasilar interstitial markings, of unclear etiology, possibly related to mild edema versus chronic interstitial lung disease. 2. Widespread, multifocal osteoblastic disease. IMPRESSION: If tolerable for the patient, PA and lateral views of the chest can be obtained for further evaluation. " 4f5774d0-7b50b168-7928e113-f3fabe67-88013ce4.jpg,test/p15/p15625104/s53671357/4f5774d0-7b50b168-7928e113-f3fabe67-88013ce4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with shortness of breath TECHNIQUE: Upright AP view of the chest COMPARISON: None. FINDINGS: There is complete opacification of the left hemithorax. No contralateral shift of the mediastinal structures is demonstrated indicating that this is compatible with left lung collapse. A few air bronchograms are noted in the left lung. Within the right lung, there appears to be mild pulmonary vascular congestion without focal consolidation. The right lung is hyperinflated with probable emphysematous changes. No pleural effusion or pneumothorax is seen on the right. There is diffuse demineralization of the osseous structures with multiple compression deformities noted in the imaged thoracic spine of indeterminate age. IMPRESSION: Complete opacification of the left hemithorax compatilble with collapse. Coexisting infection is not excluded. Mild pulmonary vascular congestion in the right lung. Multiple thoracic compression fractures. " 6e0bd950-91acfee5-16960c94-b7075d1f-c6f95a23.jpg,test/p14/p14586198/s58347949/6e0bd950-91acfee5-16960c94-b7075d1f-c6f95a23.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chf, new O2 req; edema? Effusion? TECHNIQUE: Portable AP radiograph of the chest from ___. COMPARISON: ___. FINDINGS: Mild pulmonary edema has improved. Small bilateral pleural effusions are unchanged. Cardiomegaly is stable. There is no pneumothorax. . IMPRESSION: Improved mild pulmonary edema. Stable small bilateral pleural effusions. " 41a46d67-28577e12-6fe386db-03833394-d64dc4ff.jpg,test/p17/p17004268/s53709003/41a46d67-28577e12-6fe386db-03833394-d64dc4ff.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with L chest wall and back pain s/p fall // eval for fx TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen radiographically. IMPRESSION: No acute cardiopulmonary process. " c3fc4435-c95489d1-45684cc3-064d3353-6a49034e.jpg,test/p11/p11401718/s50773693/c3fc4435-c95489d1-45684cc3-064d3353-6a49034e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with leg swelling and confusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The aorta remains tortuous. The mediastinal and hilar contours are otherwise similar. Pulmonary vasculature is not engorged. Lungs remain hyperinflated. No focal consolidation, pleural effusion or pneumothorax is demonstrated. Mild degenerative changes are again seen within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 25e3b6cb-608089cf-856d2cc1-96d85a4d-596fbc33.jpg,test/p13/p13312184/s58745357/25e3b6cb-608089cf-856d2cc1-96d85a4d-596fbc33.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with MS flare // ? intrathoracic process COMPARISON: ___. IMPRESSION: As compared to the previous image, the patient has undergone valvular repair. The size of the cardiac silhouette is normal. Normal hilar and mediastinal structures. No pleural effusions. No pneumonia, no pulmonary edema. " 658ab623-3284b1c0-27b5464a-399a95a1-e5c544b8.jpg,test/p19/p19330158/s56170751/658ab623-3284b1c0-27b5464a-399a95a1-e5c544b8.jpg,test," WET READ: ___ ___ ___ 11:56 PM Free air under the diaphragm in the right upper quadrant, consistent with recent surgery. ______________________________________________________________________________ FINAL REPORT HISTORY: Vomiting. Rule out free air. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Note is made of free air in the right upper quadrant, below the diaphragm. There is minimal left midlung opacity in the region of prior consolidation, likely related to scarring. No new focal consolidation or large pleural effusion is seen. Note is made of a coronary stent. IMPRESSION: Free air under the diaphragm in the right upper quadrant, consistent with recent surgery two days prior. " 80f4e543-49b5ae7e-694d92a2-8474bc9f-aa7df703.jpg,test/p14/p14477164/s54369205/80f4e543-49b5ae7e-694d92a2-8474bc9f-aa7df703.jpg,test," FINAL REPORT INDICATION: ___F with dizziness, CP SOB, evaluate for infiltrate. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal silhouette is stable, consistent with a tortuous thoracic aorta. The heart appears normal in size. The hila are unremarkable. The lungs are clear without focal consolidation. There is no pulmonary vascular congestion or pulmonary edema. There is no pneumothorax or sizable pleural effusion. Surgical clips noted in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 1340edaa-a3ec9554-638caa8f-c18de5d9-ef4437fb.jpg,test/p10/p10821855/s56513395/1340edaa-a3ec9554-638caa8f-c18de5d9-ef4437fb.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with ?positive BCx from an outside hospital, complaining of vomiting and myalgias. ?pneumonia/consolidation // ___F with ?positive BCx from an outside hospital, complaining of vomiting and myalgias. ?pneumonia/consolidation TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " b1e89d61-3a9db0e9-193a6bed-6e372984-c8e06bdd.jpg,test/p10/p10078115/s51073410/b1e89d61-3a9db0e9-193a6bed-6e372984-c8e06bdd.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with left basal ganglia hemorrhage. Portable AP radiograph of the chest was compared to ___. Tracheostomy is in place. The NG tube is not seen, potentially withdrawn. Heart size and mediastinum are unchanged in appearance. Lung volumes are slightly lower with overall no interval development of new consolidations in addition to pre-existing left retrocardiac atelectasis is seen. There is no pneumothorax. " 1ad6caf3-c1679736-8f61776c-7cb83a0d-ae6047a9.jpg,test/p19/p19165656/s53658580/1ad6caf3-c1679736-8f61776c-7cb83a0d-ae6047a9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with a pacemaker who is going to have an MRI // assess pacemaker lead placement assess pacemaker lead placement IMPRESSION: The view is lordotic. Left pectoral pacemaker, 1 lead projects over the right atrium and 1 over the right ventricle. Mild degenerative changes. At the first costo sternal junction, reflecting as rounded increase in radiodensity. No acute changes, no pulmonary edema. No pneumonia, no pleural effusions. " 0c46b05e-2043b5bb-ca546d34-939640ab-32ec590e.jpg,test/p14/p14327362/s51275780/0c46b05e-2043b5bb-ca546d34-939640ab-32ec590e.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Palpitations, presyncope. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Left apical pleural thickening is seen. There is evidence of left apical bronchiectasis/scarring, correlate with patient history. The right lung is clear. There is no pleural effusion or pneumothorax. The cardiac silhouette is top normal. IMPRESSION: Left apical pleural thickening with suggestion of areas of left upper lobe bronchiectasis and scarring. " 5fdf8715-ca937500-706f0331-f7134eff-1728168f.jpg,test/p19/p19524729/s59773488/5fdf8715-ca937500-706f0331-f7134eff-1728168f.jpg,test," WET READ: ___ ___ ___ 8:19 AM 1. Mild pulmonary edema with small left pleural effusion. 2. Low lung volumes with crowding of vasculature. 3. Stable moderate cardiomegaly. ___ d/w Dr. ___ on ___ at 10:08PM, ___ mins after observation. WET READ VERSION #1 ___ ___ ___ 10:11 PM 1. Mild pulmonary edema with small left pleural effusion. 2. Low lung volumes with crowding of vasculature. 3. Stable moderate cardiomegaly. ___ d/w Dr. ___ on ___ at 10:08PM, ___ mins after observation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with diastolic heart failure, presenting w/ volume overload // ?pulm edema ?pulm edema IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE AGAIN ARE LOW LUNG VOLUMES THAT ACCENTUATE THE ENLARGEMENT OF THE CARDIAC SILHOUETTE. THERE MAY BE MILD ELEVATION OF PULMONARY VENOUS PRESSURE WITHOUT EVIDENCE OF ACUTE FOCAL PNEUMONIA. " 8a7ee739-3ee9e605-fa32b6f7-257cc4e8-2e607263.jpg,test/p18/p18387698/s58424597/8a7ee739-3ee9e605-fa32b6f7-257cc4e8-2e607263.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old man with chest tube. Evaluate placement. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The right pigtail catheter is in place with no significant change in the right pleural effusion, as compared with the most recent radiograph from ___. Right basilar atelectasis, left heart border, and left lung base appearance are unchanged. No pneumothorax is identified. IMPRESSION: No significant change since the prior radiograph from ___. Right chest tube is unchanged in position. " 7c074e90-9757a806-36f09192-82331273-534b1d21.jpg,test/p16/p16514153/s58250166/7c074e90-9757a806-36f09192-82331273-534b1d21.jpg,test," WET READ: ___ ___ ___ 8:56 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with chest pain, dyspnea, evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: Patient is status post aortic core valve and mitral valve replacement with unchanged median sternotomy wires. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is stable. IMPRESSION: No acute cardiopulmonary process. " 2a545aa1-d79351b3-1fbc6404-36f216ba-66faf5e9.jpg,test/p10/p10374990/s50393469/2a545aa1-d79351b3-1fbc6404-36f216ba-66faf5e9.jpg,test," FINAL REPORT INDICATION: History: ___F with pleural effusions and increased sob // ? infection TECHNIQUE: Frontal view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Metallic device overlying the chest obscures underlying heart and lungs. Given the limitations, small bilateral pleural effusions appear similar to ___. Prosthetic aortic valve is in unchanged position. IMPRESSION: Small bilateral pleural effusions appear similar to ___ " 80bdfde8-57835ce3-4747f6d0-26841bc8-49655ec1.jpg,test/p19/p19685014/s52653770/80bdfde8-57835ce3-4747f6d0-26841bc8-49655ec1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Mild cardiomegaly is again seen. Calcified mediastinal and hilar lymph nodes again noted. The lungs are clear without focal consolidation, effusion or pneumothorax. Asymmetric breast tissue again noted with outline of a right breast implant noted. Mediastinal contour stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Stable cardiomegaly. No pneumonia or CHF. " add46527-df788627-5e7db26e-09b0fd71-16a29aa1.jpg,test/p15/p15793456/s52887977/add46527-df788627-5e7db26e-09b0fd71-16a29aa1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are hyperexpanded. There are bullous emphysematous changes in the lower lobes increased since ___. There is no focal consolidation, pleural effusion or pneumothorax. The ascending aorta is dilated and tortuous but unchanged since ___. The imaged upper abdomen is unremarkable. IMPRESSION: 1. Bullous emphysematous changes in the lower lobes increased since ___. Consideration to alpha-1- antitrypsin deficiency should be given. " bbc6cf8a-4d85f9e9-2cb4f745-927dbd31-74d78bdc.jpg,test/p10/p10572581/s59873389/bbc6cf8a-4d85f9e9-2cb4f745-927dbd31-74d78bdc.jpg,test," FINAL REPORT INDICATION: ___-year-old male with previous chest x-ray concerning for TRALI, now clinically stable. Evaluate for interval progression. COMPARISON: Chest radiographs from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are poorly inflated. There has been significant interval improvement of interstitial markings and hilar prominence compared with prior exam. A left-sided pleural effusion, better seen in the lateral view, appears significantly improved compared with prior exam. There is no pneumothorax. The cardiomediastinal and hilar contours are unremarkable with the exception of mild aortic tortuosity as well as stable moderate cardiomegaly. Sternotomy wires are intact. Post CABG ring markers and pacer leads are noted. IMPRESSION: Substantial interval improvement of post CABG pulmonary vascular congestion and left-sided pleural effusion. " 20b8314a-c140e3f6-89687027-1ade7230-53b9bdfa.jpg,test/p14/p14707863/s54249323/20b8314a-c140e3f6-89687027-1ade7230-53b9bdfa.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Previous pneumothorax. Chest tube removed. IMPRESSION: PA and lateral chest compared to ___ and ___. Very small right apical pneumothorax is unchanged in overall size, now contains a small amount of fluid compared to ___ when an apical pleural tube was in place. There has been minimal if any change in the small volume of layering right pleural effusion, while a small left pleural effusion has decreased in the interim. The heart is normal size. Aside from mild right-sided atelectasis, the lungs, though low in volume, are clear. ___ was paged. " 6ae62c69-fc76232c-3285cb7a-f26b800b-76ff5113.jpg,test/p15/p15403852/s54155993/6ae62c69-fc76232c-3285cb7a-f26b800b-76ff5113.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fevers, recent PNA // eval for infiltrate eval for infiltrate COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lung volumes are persistently quite low. Mild pulmonary edema in the right lung has not changed appreciably since the end of ___. Severe consolidation in the left lower lobe is similarly stable. The extent of consolidation in the left upper lobe and accompanying left pleural effusion have increased since ___, stable since ___. Heart is moderately enlarged, unchanged. No pneumothorax. Cardiopulmonary support devices unchanged in standard placements. " b792217f-a3f09e6c-836e7dcf-8669b62f-d2d39014.jpg,test/p14/p14960967/s58168938/b792217f-a3f09e6c-836e7dcf-8669b62f-d2d39014.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with left rib fx with small associated PTX // Eval for resolution/evolution of left PTX -- please perform UPRIGHT and on EXPIRATION (*** ___ - 6am ***) TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. Left rib fracture is better seen in prior CT IMPRESSION: Previously described tiny left pneumothorax is not clearly visualized in this examination " 7b72100f-eb2903f0-8dcb474c-7ab4a38f-34520b75.jpg,test/p19/p19658434/s51888628/7b72100f-eb2903f0-8dcb474c-7ab4a38f-34520b75.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of coronary artery disease status post remote CABG, now with chest pain. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are stable with top normal heart size. The fourth median sternotomy wire from is fractured, similar compared to ___. IMPRESSION: Stable chest radiographs with top normal heart size and no radiographic evidence for acute cardiopulmonary process. " e222110b-32d4d990-c10f62ea-f2f4707e-4737e664.jpg,test/p19/p19560890/s59845472/e222110b-32d4d990-c10f62ea-f2f4707e-4737e664.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Vague sclerosis along the anterior lateral course of the left second rib may indicate a prior non-displaced fracture. Bony structures are otherwise unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " 9256c523-b77d6327-747b7fc5-eb510367-90732ccc.jpg,test/p10/p10404367/s50127641/9256c523-b77d6327-747b7fc5-eb510367-90732ccc.jpg,test," FINAL REPORT HISTORY: Lymphoma with methotrexate, now with fever. FINDINGS: In comparison with the study of ___, there is a vague area of increased opacification at the left base that could represent a developing consolidation. The remainder of the study is essentially unchanged except for poor definition of the left heart border, which also could indicate a lower lung consolidation. " 9ae42433-ffa510f7-516ba549-6aad0cd4-f23fcf96.jpg,test/p12/p12150026/s59220831/9ae42433-ffa510f7-516ba549-6aad0cd4-f23fcf96.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever and weakness. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 783ec674-9868052d-e0ef11e7-0bbfeabb-a68d4742.jpg,test/p17/p17658659/s51743474/783ec674-9868052d-e0ef11e7-0bbfeabb-a68d4742.jpg,test," FINAL REPORT INDICATION: Low-grade fever and pancytopenia. COMPARISONS: None. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The splenic shadow is enlarged. IMPRESSION: 1. No acute cardiopulmonary process. 2. Splenomegaly. " 360acac9-4731025d-328ae3d1-0e6fe247-5541b4d9.jpg,test/p15/p15656501/s51554466/360acac9-4731025d-328ae3d1-0e6fe247-5541b4d9.jpg,test," FINAL REPORT HISTORY: Symptomatic PVCs and chest pains with lightheadedness. Evaluation for cardiopulmonary process. COMPARISON: Comparison is made to radiographs of the chest from ___ as well as radiographs of the thoracolumbar spine from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no evidence of pleural effusion, pneumothorax or pulmonary edema. A spinal stimulator is seen within the spinal canal at the level of the thoracic spine, unchanged since ___. IMPRESSION: No acute cardiopulmonary process. " 32e56a1e-bcabc63a-fbb4d291-641d4ba3-4023a8bf.jpg,test/p13/p13141248/s59977839/32e56a1e-bcabc63a-fbb4d291-641d4ba3-4023a8bf.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with chest pain for three weeks, evaluate for possible pleurisy. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar chest examination of ___. The heart size is normal. No configurational abnormality is present. Thoracic aorta unremarkable. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present at the lateral and posterior pleural sinuses are free. No evidence of pneumothorax in the apical area on the frontal view. Skeletal structures of the thorax grossly within normal limits. In comparison with the next previous study the chest findings are completely unchanged and stable. IMPRESSION: No evidence of pleurisy, cardiac enlargement or pulmonary congestion in this ___-year-old male patient with chest pain for three weeks. " 7358ae06-792a79d3-0cb6ca6e-caa402f0-99daecd9.jpg,test/p10/p10940071/s57763043/7358ae06-792a79d3-0cb6ca6e-caa402f0-99daecd9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with pacer, syncope // Eval for pacer TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Pacer leads terminate in the right atrium and right ventricle. Lungs are hyperinflated. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Compression deformities involving several thoracic vertebral bodies are again noted. IMPRESSION: 1. No acute cardiopulmonary process. 2. Compression deformities involving several thoracic vertebral bodies. " 996587b6-04e8b149-d56f62f2-98930ba6-a7ca8e13.jpg,test/p16/p16902313/s51241259/996587b6-04e8b149-d56f62f2-98930ba6-a7ca8e13.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with confusion and bradycardia // mediastinal widening? TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Heart size is mildly enlarged. The aorta is tortuous with atherosclerotic calcifications noted at the knob. The mediastinal contours are otherwise within normal limits. Lungs are hyperinflated without focal consolidation. Prominence of the hila could reflect enlargement of the pulmonary arteries, without evidence for pulmonary vascular congestion or pulmonary edema. No pleural effusion or pneumothorax is identified. There are mild degenerative changes detected in the thoracic spine. IMPRESSION: No evidence for mediastinal widening. Tortuous aorta with atherosclerotic calcifications at the arch. No acute cardiopulmonary process. " 5e04f1c7-b63fa6c4-4172256e-00cff163-baa6f345.jpg,test/p12/p12260674/s52033559/5e04f1c7-b63fa6c4-4172256e-00cff163-baa6f345.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with weakness. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Linear left basilar opacities are seen, presumably atelectasis versus scarring. The lungs are otherwise clear without consolidation, effusion, or pulmonary vascular congestion. Cardiomediastinal silhouette is unchanged, noting cardiomegaly. Median sternotomy wires and mediastinal clips again seen. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 53840ddd-831cabc4-23c1d6a4-518492dd-2ba6361d.jpg,test/p13/p13499010/s53754498/53840ddd-831cabc4-23c1d6a4-518492dd-2ba6361d.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate clear lungs without effusion or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are normal. The pulmonary vasculature is normal. IMPRESSION: No acute chest abnormality. " e0d631cb-9f3fee91-2d91b116-65cbc6d7-51d9dece.jpg,test/p15/p15068871/s58036287/e0d631cb-9f3fee91-2d91b116-65cbc6d7-51d9dece.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with recently diagnosed systemic lupus erythematosus, presenting with pleuritic pain, evaluate for effusion. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is normal. No configurational abnormality is identified. The thoracic aorta and mediastinal structures are unremarkable. The pulmonary vasculature is normal. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No pneumothorax in the apical area on frontal view. The skeletal structures of the thorax are grossly within normal limits. There exists no prior chest examination or records available for comparison. IMPRESSION: Normal chest findings in female patient with new established diagnosis of SLE. " 771a04b6-d0c3c1dc-4bc4d2d5-a5e655d8-2f5070db.jpg,test/p13/p13477622/s58782224/771a04b6-d0c3c1dc-4bc4d2d5-a5e655d8-2f5070db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new tachypnea, tachycardia, increased O2 requirement POD 5 from esophageal resection c/b AFib w/ RVR // ? cardiopulmonary changes s/p new tachypnea, tachycardia, increased O2 requirement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 23:37 IMPRESSION: Heart size and mediastinum are unchanged. NG tube tip appears to be at the gastroesophageal junction and should be potentially advanced. Correlated with the desired position. Bibasal atelectasis are demonstrated but overall similar to previous examination. No pulmonary edema is seen. No pneumothorax demonstrated. " cbb5c90e-e6e87b23-59b674fa-81a8a3ff-70c60c54.jpg,test/p18/p18351278/s54833181/cbb5c90e-e6e87b23-59b674fa-81a8a3ff-70c60c54.jpg,test," FINAL REPORT INDICATION: History: ___M with dizziness // Eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. The bones are intact. IMPRESSION: No acute cardiopulmonary process. " 4fa0c74a-778cf44b-724884f9-2496f7a9-00afd63f.jpg,test/p18/p18062541/s58981973/4fa0c74a-778cf44b-724884f9-2496f7a9-00afd63f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p left sided pacemaker implant // r/o pneumothorax, check RV/RA leads TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: The patient after is after placement of the left-sided pacemaker with the leads terminating in the right ventricle and right atrium expected locations. There is no evidence of pneumothorax. Heart size and mediastinum are unchanged in appearance. Lungs are essentially clear. Minimal left mid lung atelectasis/scarring is unchanged. " b6bbcc92-99dee17e-f8815c15-6212d0c7-3a4e58dc.jpg,test/p11/p11390883/s52232210/b6bbcc92-99dee17e-f8815c15-6212d0c7-3a4e58dc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis, resp failure, recent hypertensive urgency and worsening o2 requirement // eval for pulmonary edema, interval changes IMPRESSION: As compared to previous radiograph from earlier today, widespread alveolar opacities attributed to pulmonary edema have slightly improved, and bilateral pleural effusions have also apparently decreased in size, particularly on the right. Tip of endotracheal tube remains low, within 1.5 cm of the carina. Other support and monitoring devices are in standard position. " f133dd4c-34484da8-4c093830-7a33f102-41df4305.jpg,test/p14/p14064075/s59007882/f133dd4c-34484da8-4c093830-7a33f102-41df4305.jpg,test," FINAL REPORT HISTORY: Cough COMPARISON: None FINDINGS: PA and lateral views of chest demonstrate clear lungs. Heart size is normal. Aorta is slightly tortuous. There is no pulmonary edema, pneumothorax or pleural effusion. Anterior flowing osteophytes are noted along the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary process. " eb0afeee-8c439963-6b747d60-121fa4a7-3350590e.jpg,test/p13/p13041326/s55503410/eb0afeee-8c439963-6b747d60-121fa4a7-3350590e.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with weakness. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral there COMPARISON: None. FINDINGS: The lung volumes are low and there is bibasilar atelectasis. Otherwise, the lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. The heart size is top normal. The mediastinal contours are normal. IMPRESSION: No pneumonia. " 388301ea-2bfb6c60-b55cfc7b-d0bd81ae-695042f3.jpg,test/p18/p18628103/s55489021/388301ea-2bfb6c60-b55cfc7b-d0bd81ae-695042f3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HTN, prior PMH R thalamic infarct, now w/ L thalamic infarct, unable to swallow, s/p NG placement // Verify NGT placement Verify NGT placement COMPARISON: None. Please note that comparison to old studies can be helpful to detect subtle interval change FINDINGS: Portable semi-erect chest radiograph ___ at 15:30 is submitted. The right lateral chest wall and costophrenic angle are not included. IMPRESSION: A nasogastric tube is seen coursing below the diaphragm with the tip projecting over the stomach. The patient is markedly rotated limiting evaluation of the cardiac and mediastinal contours. The aorta does appear prominent and unfolded. Patchy opacities at both lung bases may reflect atelectasis, although aspiration or pneumonia should also be considered. No evidence of pulmonary edema or pneumothorax. Suture material overlying the left humeral head. " a08f5359-9bdff808-166fcc5f-f7578a17-f385bf77.jpg,test/p17/p17982586/s56748930/a08f5359-9bdff808-166fcc5f-f7578a17-f385bf77.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with parkinsons who failed swallow study today // aspiration pneumonia TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ and CT chest ___ FINDINGS: Left-sided pacer device is noted with leads in unchanged positions terminating in the regions of the right atrium, right ventricle, and coronary sinus. Cardiac silhouette size appears moderately enlarged but similar. Bilateral hilar enlargement is compatible with pulmonary arterial enlargement, as seen previously. Pulmonary vasculature is not engorged. Bilateral calcified pleural plaques are re- demonstrated. Focal opacity within the left apex is re- demonstrated, and remains concerning for pneumonia. No pneumothorax or pleural effusion is present. No acute osseous abnormality is detected. Marked degenerative changes of both acromioclavicular and glenohumeral joints are re- demonstrated. Additionally, moderate degenerative changes are again noted in the thoracic spine with bridging anterior osteophytes compatible with DISH. IMPRESSION: 1. No substantial interval change from the previous CT examination with persistent pneumonia in the left upper lobe. 2. Bilateral calcified pleural plaques indicative of prior asbestos exposure. 3. Pulmonary arterial hypertension. " b993a029-aac9a521-c92a8397-e74ff4d6-b0da3e3b.jpg,test/p18/p18103989/s52921237/b993a029-aac9a521-c92a8397-e74ff4d6-b0da3e3b.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with chest pain X 2days // ? rib fracture ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 4e1fd272-77c7afbd-f5e9e704-f72f0ba5-466567bd.jpg,test/p15/p15648077/s54462306/4e1fd272-77c7afbd-f5e9e704-f72f0ba5-466567bd.jpg,test," FINAL REPORT HISTORY: ___ year old man with altered mental status. COMPARISON: Outside hospital chest radiograph ___. FINDINGS: Frontal lateral views of the chest. The lungs are clear and well expanded. There is no pleural effusion or pneumothorax. There is a granuloma in the right lung. The cardiac and mediastinal contours are normal. IMPRESSION: Clear lungs. " 098401ce-da5690a5-968ce24d-af7ec2b2-0f5ba83e.jpg,test/p11/p11828962/s53125132/098401ce-da5690a5-968ce24d-af7ec2b2-0f5ba83e.jpg,test," FINAL REPORT HISTORY: Pleural effusion status post decortication. Evaluate for interval changes. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiographs of ___, ___ and ___. FINDINGS: A right upper extremity PICC has been removed in the interim. There is been improvement in the small left pleural effusion. Linear atelectasis seen in the left midlung. The right lung is essentially clear. There is no focal airspace consolidation or pneumothorax. IMPRESSION: Slight decrease in small left pleural effusion. " c0297b7b-c6de52c6-beed4873-c5c86801-515bd8bd.jpg,test/p10/p10277901/s55312440/c0297b7b-c6de52c6-beed4873-c5c86801-515bd8bd.jpg,test," FINAL REPORT INDICATION: ___-year-old male with hypoxic respiratory failure secondary to CHF exacerbation requiring assessment of Dobbhoff tube placement. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: Two frontal images of the chest demonstrate a Dobbhoff tube with the tip located within the proximal stomach. The tube should be advanced several centimeters more to put the tip more fully with the stomach. There is mild improvement in the pulmonary perivascular haze noted on previous exam. Otherwise, the chest radiograph remains essentially unchanged from previous imaging. There are no pleural effusions. There is no pneumothorax or other complications seen. Cardiomediastinal silhouette is unchanged. IMPRESSION: Left Dobbhoff tube in place with tip in the proximal stomach, recommend advancing the tube several centimeters to put the tip more fully within the stomach. Otherwise, essentially unchanged chest radiograph. " e4cdfbc5-43a59359-5d57f81b-fc10a8e9-6e4fa352.jpg,test/p15/p15451291/s53134160/e4cdfbc5-43a59359-5d57f81b-fc10a8e9-6e4fa352.jpg,test," FINAL REPORT INDICATION: Mechanical fall. COMPARISON: ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: There are low lung volumes. This accentuates the size of the cardiac silhouette which is likely within normal limits. The mediastinal contours are unremarkable. There is crowding of the bronchovascular structures. Minimal patchy opacity in lung bases likely reflects atelectasis. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. No overt pulmonary edema is seen. IMPRESSION: Low lung volumes limit assessment of the lung bases. Streaky opacities in the lung bases likely reflect atelectasis, though infection cannot be excluded. No evidence of acute traumatic injury. " e583f97d-91ebdb29-0687e3d5-174d1d34-56f4be29.jpg,test/p10/p10488031/s56740136/e583f97d-91ebdb29-0687e3d5-174d1d34-56f4be29.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory distress // Please eval for infiltrates Please eval for infiltrates IMPRESSION: No relevant change as compared to the previous image. Moderate cardiomegaly. Left pectoral pacemaker with unchanged position of the leads. Mild to moderate pulmonary edema. Right PICC line in unchanged position. Retrocardiac atelectasis. No new focal parenchymal opacities. The hyperlucency in the left upper lobe, mimicking a pneumothorax, is explained by a large polar that has previously been documented on the CT examination from ___. " db24a7e6-dc5738da-c684cab2-289a23ae-7a78d207.jpg,test/p16/p16454295/s59739818/db24a7e6-dc5738da-c684cab2-289a23ae-7a78d207.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with renal/pancreas txp, p/w periumbilical abd pain, diarrhea COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Clips in the right upper quadrant noted. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " a3e6e89a-752c3421-e4e43fbd-6199d377-0f2664f2.jpg,test/p18/p18039866/s50926815/a3e6e89a-752c3421-e4e43fbd-6199d377-0f2664f2.jpg,test," FINAL REPORT INDICATION: ___-year-old female patient with cough for a month. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is normal in size. The hilar and mediastinal contours are normal. The lungs are well expanded and clear. There are no pleural effusions or pneumothorax. The osseous structures are unremarkable. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process. " 41284376-0d4c40bd-7096fb01-d5f51267-bb1be129.jpg,test/p17/p17989167/s54305983/41284376-0d4c40bd-7096fb01-d5f51267-bb1be129.jpg,test," FINAL REPORT INDICATION: ___M with weakness/cough // weakness/cough TECHNIQUE: Frontal and lateral views of the chest COMPARISON: Chest CT from ___. FINDINGS: Blunting of the lateral and posterior costophrenic angles suggest small persistent bilateral effusions as seen on recent CT. The lungs are clear without focal consolidation edema or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified IMPRESSION: Small persistent bilateral effusions without acute cardiopulmonary process. " cd99602b-e6e40bfd-38ae9cdd-9bf87f86-099929cd.jpg,test/p13/p13085886/s50744710/cd99602b-e6e40bfd-38ae9cdd-9bf87f86-099929cd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new hemoptysis wheezing // PNA vs fluid overload PNA vs fluid overload IMPRESSION: Left subclavian line tip is at the level of mid SVC. Heart size and mediastinum are stable. There is interval development of bibasal opacities in particular in the right lower lobe concerning for new infection. No pleural effusion or pneumothorax. " 1a4899ba-bb489e78-bc173ed4-eeeb6993-138a8361.jpg,test/p11/p11891567/s52160567/1a4899ba-bb489e78-bc173ed4-eeeb6993-138a8361.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ No prior studies for comparison. FINDINGS: Heart size, mediastinal and hilar contours are within normal limits. Lungs are clear except for patchy and linear opacities at the right lung base, which favor atelectasis. Aspiration and early pneumonia are additional considerations, and followup radiographs may be helpful in this regard. " a59dc1b9-faa79d7e-32573248-c8dfce97-f4d64f18.jpg,test/p14/p14979984/s56410682/a59dc1b9-faa79d7e-32573248-c8dfce97-f4d64f18.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with ankle injury, syncope TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 7e8d0a75-83e867d8-2f9ac0bd-6ff78de5-0fcc329b.jpg,test/p15/p15497616/s53624545/7e8d0a75-83e867d8-2f9ac0bd-6ff78de5-0fcc329b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough and dizziness // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " b9074a5c-7eef626c-4b251438-c744a7ea-163aade8.jpg,test/p10/p10062617/s50247193/b9074a5c-7eef626c-4b251438-c744a7ea-163aade8.jpg,test," FINAL REPORT INDICATION: ___ year old male with shortness of breath, new oxygen requirement TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___, ___ and ___. FINDINGS: The lungs are clear of focal consolidation or pneumothorax. There is a small left pleural effusion or pleural thickening. The heart continues to be enlarged, and there is a left cardiac pacer device is with leads terminating in appropriate position. The mediastinal contours are normal. Outpouching of the left hemidiaphragm may reflect a hiatal hernia or eventration which can be better assessed with a conventional PA radiograph. IMPRESSION: No pneumonia or pulmonary edema. Small left pleural effusion or pleural thickening. " 870b2181-a11d30b8-8343b923-821cbaa2-01b53c27.jpg,test/p17/p17679569/s53126107/870b2181-a11d30b8-8343b923-821cbaa2-01b53c27.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p tracheoplasty // check interval change check interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Aside from mild subsegmental atelectasis, improved since ___, lungs are essentially clear. Small right pleural effusion may be present. Normal postoperative cardiomediastinal silhouette. No pneumothorax. Right PIC line ends close to the superior cavoatrial junction. " 2f35319e-a0782ce3-a7bdea95-62d01468-3ac07a46.jpg,test/p10/p10476869/s57858155/2f35319e-a0782ce3-a7bdea95-62d01468-3ac07a46.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post left thoracotomy, left upper lobectomy, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a complete resolution of the pre-existing soft tissue air collection in the lateral soft tissues on the left. The elevation of the hemidiaphragm on the left is constant. There is no evidence of post-operative air collections. Borderline size of the cardiac silhouette. Clips in unchanged position. Unremarkable right lung. " 5b92bd62-8014f720-f66a4d86-adcbd331-8c17251b.jpg,test/p10/p10767527/s50507057/5b92bd62-8014f720-f66a4d86-adcbd331-8c17251b.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough and wheezes recent pneumonia // left mid lung rhonchi and wheezes TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. IMPRESSION: The mediastinal contours, hila and cardiac silhouette are normal. No pleural effusion. The left lower lobe consolidative opacity has improved but not resolved since ___, consistent with pneumonia responding to treatment. If clinically improving, repeat chest radiograph in 4 weeks is recommended to ensure resolution. If clinically worsening, repeat imaging may be required sooner. RECOMMENDATION(S): If clinically improving, repeat chest radiograph in 4 weeks is recommended to ensure resolution. NOTIFICATION: The findings were discussed with ___, R.N. by ___ ___, M.D. on the telephone on ___ at 10:13 AM, 2 minutes after discovery of the findings. " 0f682852-a2e8438e-67437ada-cc2b5e88-aea3b62d.jpg,test/p12/p12799209/s59307264/0f682852-a2e8438e-67437ada-cc2b5e88-aea3b62d.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of positive PPD, on treatment with one episode of night sweats. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are slightly low lung volumes. Given this, the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 452bf1a8-ea12c465-acf47c4a-d6792e38-bd82d013.jpg,test/p15/p15497573/s52353772/452bf1a8-ea12c465-acf47c4a-d6792e38-bd82d013.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man s/p cardiac arrest, now intubated // PTX? tube placement? COMPARISON: Most recent prior chest radiograph ___. IMPRESSION: Previous moderate right pleural effusion has resolved. Mediastinum has returned to a midline position. There is an unusual nearly vertical contour in the left mid and lower chest dividing greater radiopacity medially from hyperlucency laterally. An upright chest radiograph is recommended to determine if this is pneumothorax. Greater opacification in the left lower lobe generally, now obscuring the diaphragmatic surface, is most readily explained by new atelectasis. Given the clinical history, aspiration may be contributory. Left pleural effusion is small if any. Moderate enlargement of the cardiac silhouette is chronic. Right lung is clear. ET tube is in standard placement. The tube cough is sharply defined by secretions retained above it. Findings were discussed at length with the clinical care team in conference this morning. " 2c74f4ac-55c85a93-9b601a89-b3e97dbe-38ad60d9.jpg,test/p10/p10476869/s51514216/2c74f4ac-55c85a93-9b601a89-b3e97dbe-38ad60d9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with rel follicular lymphoma presented with pericardial and pleural effusions // eval for interval change eval for interval change IMPRESSION: In comparison with the study ___ ___, there is little overall change in the opacification in the left lower zone consistent with postoperative changes following left upper lobectomy, with pleural fluid and probable atelectatic changes. The right lung is essentially clear. " aa016058-5b1d4f76-2b664519-2f83aa84-ab81376b.jpg,test/p17/p17471102/s58555236/aa016058-5b1d4f76-2b664519-2f83aa84-ab81376b.jpg,test," WET READ: ___ ___ ___ 3:12 PM ET in lower trachea, could consider slight retraction; balloon may be overinflated; NGT in stomach but could be advanced somewhat for better purchase. Non-specific retrocardiac opacity; attention in follow-up suggested. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post intubation. Patient with intracranial hemorrhage. COMPARISONS: None. TECHNIQUE: Chest, semi-upright AP portable. FINDINGS: The patient is status post endotracheal intubation. The tube is somewhat low lying, with the tip terminating only about 1-1.5 cm above the carina. In addition, the balloon appears somewhat over-inflated. A nasogastric tube terminates in the stomach although with relatively little purchase. Its sidehole lies only slightly below the gastroesophageal junction. There is a dual-lead pacemaker/ICD device in place. The heart is at upper limits of normal size. The aorta shows mild-to-moderate unfolding and patchy calcification. Otherwise, the mediastinal and hilar contours appear unchanged. There is a retrocardiac opacity obscuring the left hemidiaphragm which could be seen with substantial atelectasis, perhaps with a pleural effusion; however, infectious causes are difficult to exclude. IMPRESSION: 1. Somewhat low lying endotracheal tube and generously inflated cuff. Slight retraction of the tube and if feasible decreased distention of the balloon may be appropriate if clinically indicated. 2. Nasogastric tube terminating in the stomach, although if better purchase in the stomach is desired clinically then the tube could be advanced. 3. Left lower lung opacity, which is nonspecific but could be seen with atelectasis and perhaps pleural effusion although pneumonia or aspiration are difficult to completely exclude. Short-term followup radiographs may be appropriate to reassess. " 2e02aa87-3b98c054-2b3d8077-71a699bb-fe28f1ab.jpg,test/p16/p16891303/s57738845/2e02aa87-3b98c054-2b3d8077-71a699bb-fe28f1ab.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Cough, fever, assess pneumonia. FINDINGS: PA and lateral views of the chest are obtained. Lung volumes are markedly low which limits evaluation. An AICD is unchanged with proximal lead in the expected location of the right atrium and distal lead in the expected location of the right ventricle, unchanged. Given the low lung volumes, evaluation is limited, though the imaged portion of the lungs appears clear. No large effusion or pneumothorax is seen. Heart size appears enlarged, though this may be technique-related. Bony structures are intact. IMPRESSION: Markedly limited exam without definite signs of pneumonia. " e9f30812-e6ee7930-9afc2509-20da3724-bfe8e110.jpg,test/p17/p17967970/s54021165/e9f30812-e6ee7930-9afc2509-20da3724-bfe8e110.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with right pl effusion post RUL wedge // check interval change post pigtail catheter placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a further decrease in extent. Of the pre-existing pleural effusion that, by now, has almost completely resolved. No change in appearance of the heart and of the postoperative left lung. " 0add1c1f-f4114255-4d5598cd-b8bf00f6-29d7958f.jpg,test/p13/p13021836/s53024083/0add1c1f-f4114255-4d5598cd-b8bf00f6-29d7958f.jpg,test," FINAL REPORT INDICATION: ___-year-old female patient with ___'s and CHF, now with one day of shortness of breath. Study requested for evaluation of signs of CHF and/or infiltrates. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiograph from ___, there is no pulmonary edema. There is stable mild cardiomegaly. There is a small left pleural effusion. There are no focal consolidations or pneumothorax. IMPRESSION: Small left pleural effusion with no pulmonary edema. These findings were discussed with Dr. ___ by Dr. ___ ___ telephone on ___ at 3:24 p.m., at time of discovery. " 6b15ef90-67328c61-fba76b02-1bf97464-f70ed715.jpg,test/p16/p16514153/s51218896/6b15ef90-67328c61-fba76b02-1bf97464-f70ed715.jpg,test," FINAL REPORT EXAMINATION: Portable chest x-ray INDICATION: ___ year old woman with recent TEE, cough. R/o PNA. // pneumonia? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Interval decrease in the lung volumes causing crowding of the bronchovascular markings and subsegmental atelectasis. No acute focal consolidation, pneumothorax or pleural effusions. Mild pulmonary vascular congestion. No overt pulmonary interstitial edema. Prior CABG, median sternotomy and mitral valve placement. IMPRESSION: Mild pulmonary vascular congestion. " 037f84e5-65df8100-f42131e5-6aac2027-b9016db3.jpg,test/p12/p12815514/s55390640/037f84e5-65df8100-f42131e5-6aac2027-b9016db3.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: None. TECHNIQUE: Two PA and one lateral chest radiograph were obtained. FINDINGS: The lungs are well expanded and clear. There are no focal consolidations, effusions, or pneumothoraces. A 5 mm hyperdensity projecting over the right hemidiaphragm is likely a vessel on end or small calcified granuloma. Mediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 34d23bc3-2fc08ad2-36eb96f0-2fa778fb-138343b1.jpg,test/p18/p18429449/s58984392/34d23bc3-2fc08ad2-36eb96f0-2fa778fb-138343b1.jpg,test," FINAL REPORT HISTORY: ___-year-old male with new evaluation for possible lymphadenopathy. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs demonstrate an ill-defined opacity projecting over the ___ lateral posterior left rib, not seen on lateral views. For this, additional imaging with chest CT is recommended. The lungs are otherwise well expanded and clear without focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are unremarkable. IMPRESSION: 1. Ill defined opacity projecting over the ___ lateral posterior left rib not seen on lateral views for which additional imaging with CT is recommended. 2. No findings to suggest lymphadenopathy. These findings were communicated to the ordering physician via ___ critical findings website at the time findings were reviewed. " 3258a5e0-0ab2a783-7dd7f12b-4461fabc-49b9579e.jpg,test/p11/p11823175/s51837231/3258a5e0-0ab2a783-7dd7f12b-4461fabc-49b9579e.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Shortness of breath, asthma, and bronchiectasis. There are no prior studies available for comparison. Cardiac size is top normal. There are low lung volumes. There is no evidence of pneumonia or CHF. There are mild bibasilar atelectases. There is no pneumothorax or pleural effusion. Mild degenerative changes are in the thoracic spine. " 8cd74876-5900b6ee-671fdde4-0fed7f06-2ce2812f.jpg,test/p12/p12126715/s54965874/8cd74876-5900b6ee-671fdde4-0fed7f06-2ce2812f.jpg,test," FINAL REPORT INDICATION: Psychosis and worsening mental status, elevated white blood cell count, history of pneumonia. Evaluate for aspiration or infection. COMPARISON: Chest radiograph on ___. FINDINGS: One portable AP supine view of the chest. Slight mediastinal widening is due to fat deposition as was seen on prior radiographs and chest CT ___. The previously seen left lower lobe lingular consolidation has resolved. The right lung is clear. There are no new areas of consolidation. There is no pleural effusion or pneumothorax. Heart size is normal. Mediastinal and hilar contours are normal. No pulmonary vascular congestion. IMPRESSION: Left lower lobe consolidation has resolved. No new areas of consolidation. " 65b18fc0-c3fdfd1d-66613229-3f1dfaa2-dd32501a.jpg,test/p14/p14353305/s52663876/65b18fc0-c3fdfd1d-66613229-3f1dfaa2-dd32501a.jpg,test," FINAL REPORT HISTORY: Spontaneous pneumothorax. COMPARISON: ___. PA and lateral views of the chest. The lungs are clear. Cardiac silhouette is normal in size. Hilar and mediastinal contours are normal. There is no evidence of pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary process. " 1b4b3ba2-c81cb6af-3b82e213-c098586b-58326fe6.jpg,test/p11/p11866965/s56343178/1b4b3ba2-c81cb6af-3b82e213-c098586b-58326fe6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is mildly enlarged. The aorta is tortuous and demonstrates diffuse atherosclerotic calcifications. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Previously demonstrated multifocal bilateral parenchymal opacities have largely resolved with only minimal residual opacity seen in the right lower lobe. No focal consolidation, pleural effusion or pneumothorax is identified. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: Previously noted multifocal bilateral parenchymal opacities have largely resolved. No concerning focal consolidation to suggest pneumonia, and no evidence of pulmonary edema. " f76760fd-4651eb4f-ee620c7a-1131af1a-a091b81a.jpg,test/p14/p14141188/s57587299/f76760fd-4651eb4f-ee620c7a-1131af1a-a091b81a.jpg,test," FINAL REPORT HISTORY: ___-year-old female patient with trauma status post rib fractures. COMPARISON: Prior chest radiograph and neck CT from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is normal in size. The hilar and mediastinal contours are normal. Two stable calcifications likely representing granulomatous disease are noted on the right. Lungs are otherwise well expanded and clear. There are no pleural effusions or pneumothorax. Previously described rib fractures are not visualized on today's examination. IMPRESSION: No evidence of an acute cardiopulmonary process. " 5ac094c4-15ff9c67-e0496282-87a9e0e0-68c822aa.jpg,test/p19/p19175407/s55368333/5ac094c4-15ff9c67-e0496282-87a9e0e0-68c822aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ___ year old man with Refractory angina, CXR required prior to EECP // evaluate for infiltrations IMPRESSION: In comparison to ___, and ___ chest radiographs, the cardiac silhouette appears slightly larger and is accompanied by mild pulmonary vascular congestion without overt pulmonary edema. There are no pleural effusions. Note is made of previous median sternotomy and coronary bypass surgery as well as indwelling permanent pacemaker leads. " 0c213a31-4d3bbc4b-90480a94-e058c71f-eff51f75.jpg,test/p18/p18729018/s51185072/0c213a31-4d3bbc4b-90480a94-e058c71f-eff51f75.jpg,test," FINAL REPORT HISTORY: Cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is stable. No by bony abnormality is detected. IMPRESSION: No acute cardiopulmonary process. Findings were conveyed by Dr. ___ to Dr. ___ ___ telephone at 14:24 on ___, ___ min after interpretation. " 0c4a227a-5f316a92-b923ea62-28fe3886-b900e59f.jpg,test/p14/p14398566/s55664919/0c4a227a-5f316a92-b923ea62-28fe3886-b900e59f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia vs. ARDS vs. pulmonary edema s/p intubation // Please evaluate for interval change Please evaluate for interval change IMPRESSION: ET tube tip is 4.3 cm above the carinal. Right PICC line tip is in the right atrium and should be pulled back 3 cm. NG tube tip passes below the diaphragm terminating in the stomach. Widespread parenchymal opacities consistent with provided history of ARDS in combination with pulmonary edema are unchanged. " 7346b4ed-87ed06aa-4bdfb4af-40f947e8-bb600314.jpg,test/p10/p10200479/s52870630/7346b4ed-87ed06aa-4bdfb4af-40f947e8-bb600314.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Shortness of breath and new onset atrial fibrillation. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal in the lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. Moderate degenerative changes with osteophytes are seen in the thoracic spine. Deformity of the left superolateral rib cage appears chronic. IMPRESSION: No acute cardiopulmonary abnormality. " 4bbe3abc-8e6789a9-2cbafb93-3d61a99d-5c5c9d11.jpg,test/p17/p17147147/s56598185/4bbe3abc-8e6789a9-2cbafb93-3d61a99d-5c5c9d11.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Lung Ca; Rt sided effusion, s/p ___ // s/p Rt thoracentesis- assess for PTX and residual fluid COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is no evidence of pneumothorax of the thoracocentesis. A right chest drain is in situ. There is considerable better ventilation of the right apical lung portions. The patient is extubated. No change in appearance of the left lung. " 9ffbf0c6-03526b26-0fbfbe94-062903ed-1f16c8e3.jpg,test/p10/p10646211/s54913801/9ffbf0c6-03526b26-0fbfbe94-062903ed-1f16c8e3.jpg,test," FINAL REPORT INDICATION: History of chronic kidney disease, on transplant list, presents with dyspnea, productive cough, myalgias, pleuritic chest pain. Evaluate for infiltrate. COMPARISON: Chest radiograph ___, ___, ___ and ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are normally expanded and clear. There is no focal airspace opacity. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 29ca20d2-59b8edc8-f6035992-fa5e236d-2c44cc2b.jpg,test/p12/p12457907/s51269952/29ca20d2-59b8edc8-f6035992-fa5e236d-2c44cc2b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: ___-year-old woman with status post VATS, right upper lobectomy, rule out pneumothorax post chest tube removal. TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior radiographs with the most recent from ___. FINDINGS: Following removal of the right chest tube, mild-to-moderate right apical pneumothorax is unchanged since yesterday. The upper lobectomy changes with ipsilateral right hemithorax volume loss and mediastinal shift is similar in appearance. Left lung is clear. Diffuse subcutaneous emphysema along the right lateral chest wall, unchanged since prior study. " 5812a133-ba64a5d9-531869f6-13f8e7f8-b6b857fe.jpg,test/p18/p18049473/s55071679/5812a133-ba64a5d9-531869f6-13f8e7f8-b6b857fe.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS. INDICATION: Cough, fever, PNA last month. There is history of HIV, end-stage renal disease on hemodialysis. Question pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There has been no change since ___ including interstitial abnormality, seen best at the right lung base is stable and hazy opacification surrounding the left hilus. The stability these findings indicates that neither is due to interstitial edema or acute pneumonia. Given the abnormal appearance of a chest CT scan in these regions in ___, I would strongly recommend a repeat chest CT to see if diagnostic intervention is necessary. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. IMPRESSION: Bilateral pulmonary abnormalities, probably chronic or subacute, rather than acute, warranting chest CT evaluation. NOTIFICATION: Dr. ___ ___ the findings with ___ by telephone on ___ at 10:00, 2 hr after discovery of the findings. " 4ec36cd4-89635c89-ebedfff5-5d672828-bc3fc94e.jpg,test/p19/p19189423/s55370369/4ec36cd4-89635c89-ebedfff5-5d672828-bc3fc94e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Evaluate endotracheal tube position following intubation. COMPARISON: Chest radiograph from ___ at 08:49. FINDINGS: The endotracheal tube terminates 6.5 cm above the carina. The orogastric tube is within stomach. Appearance of the heart and lungs otherwise unchanged. No pneumothorax or pleural effusion. IMPRESSION: Satisfactory position of endotracheal and orogastric tubes. Otherwise no interval change. " 7447f341-b95ad6b2-e8cc8ece-1e5e07f3-e911f9a9.jpg,test/p16/p16675371/s50081532/7447f341-b95ad6b2-e8cc8ece-1e5e07f3-e911f9a9.jpg,test," WET READ: ___ ___ ___ 6:20 AM The previously seen opacity at the right lung base is no longer visualized and is likely within the superficial soft tissues and does not represent a pulmonary opacity. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with chest pain and shortness of breath // repeat cxr for olbique rulse TECHNIQUE: Chest AP and lateral COMPARISON: ___ chest radiograph. FINDINGS: In comparison to the previous examination, the right lung base opacity is no longer visualized. The cardiomediastinal silhouette is unremarkable. The lungs are otherwise clear. IMPRESSION: The previously seen opacity at the right lung base is no longer visualized and is likely within the superficial soft tissues and does not represent a pulmonary opacity. The lung fields are otherwise clear. " 05ba55b2-53497d5a-d10aadaf-df60fbba-bbd1631d.jpg,test/p11/p11255297/s55626392/05ba55b2-53497d5a-d10aadaf-df60fbba-bbd1631d.jpg,test," FINAL REPORT INDICATION: ___F with aspiration // pna? TECHNIQUE: PA and lateral views the chest. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Chain sutures project over the left lung base. Retrocardiac opacity with undulating contour is compatible with patulous esophagus and fat Bochdalek's hernia seen on prior CT scan. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 42a21ce5-44724a78-d05c687a-5021ff9f-608d466b.jpg,test/p12/p12112753/s57363519/42a21ce5-44724a78-d05c687a-5021ff9f-608d466b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Chest pain and hypoxia. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are clear except for left upper lobe questionable opacity, potentially might represent summation of shadows. The rest of the lungs are unremarkable. No pleural effusion or pneumothorax is seen. IMPRESSION: Questionable opacity in the left apex. Correlation with lordotic view is recommended for precise characterization. " bcabc788-81daa53e-a834db06-320fb71e-e14cfd71.jpg,test/p16/p16907183/s56080834/bcabc788-81daa53e-a834db06-320fb71e-e14cfd71.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status and auditory hallucinations. COMPARISONS: None. TECHNIQUE: Chest, three views. FINDINGS: There is a dual lead pacemaker/ICD device whose leads terminate in the right atrium and ventricle, respectively. The heart is mildly enlarged. There is mild unfolding of the thoracic aorta. There is no pleural effusion or pneumothorax. Slight fullness of each hilum suggests minimal vascular congestion. Otherwise, the lungs appear clear. IMPRESSION: Findings suggestive of slight vascular congestion or fluid overload; otherwise unremarkable. " a59b2067-3bba41c9-9f95de5d-c70ca18f-685f0c07.jpg,test/p11/p11192888/s55903578/a59b2067-3bba41c9-9f95de5d-c70ca18f-685f0c07.jpg,test," WET READ: ___ ___ 7:55 AM Interval repositioning of nasoenteric tube, now terminating in the fundus of the stomach. The left PICC remains in the left subclavian vein, in the midclavicular line, and the remainder of the chest is unchanged in appearance compared to the prior study. WET READ VERSION #1 ___ ___ ___ 11:22 PM Interval repositioning of nasoenteric tube, now terminating in the fundus of the stomach. The left PICC remains in the left subclavian vein, in the midclavicular line, and the remainder of the chest is unchanged in appearance compared to the prior study. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with BiV pcer in place s/p L PICC line and Dobhoff tube placement (Dobhoff advanced since prior film). // eval Dobhoff tube and L PICC line placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the Dobbhoff catheter has been advanced. The catheter is now securely positioned in the stomach. No other changes. " bf5a061a-fb8b0aac-1677eb0f-40fc3bae-a4f58e94.jpg,test/p10/p10380296/s51729701/bf5a061a-fb8b0aac-1677eb0f-40fc3bae-a4f58e94.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Chest pain. TECHNIQUE: Chest, portable AP upright. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours appears that unchanged. There is a stent along the course of the ascending aorta and arch. Abnormal aneurysmal dilatation along the distal arch appears radiographically stable. The lungs appear clear. There are no pleural effusions or pneumothorax. There has been no significant change. IMPRESSION: No significant change in abnormal aortic contour reflecting known aneurysm and the prior stent placement. No evidence of acute cardiopulmonary disease. " 186f9c80-ffa853db-f5e98edb-4d4a3e54-642dd486.jpg,test/p15/p15853461/s58249079/186f9c80-ffa853db-f5e98edb-4d4a3e54-642dd486.jpg,test," FINAL REPORT INDICATION: Confusion. COMPARISONS: ___, ___. FINDINGS: Frontal and lateral views of the chest demonstrate hyperextended lungs. There is no pleural effusion, focal consolidation or pneumothorax. Moderate cardiomegaly is unchanged. Prominent pulmonary outflow tract is stable. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. Moderate cardiomegaly. " d40f36aa-a8cb7dbf-f5e14d45-87efe405-6f9b4cdb.jpg,test/p19/p19770195/s55117555/d40f36aa-a8cb7dbf-f5e14d45-87efe405-6f9b4cdb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sob. started on IVF overnight. ? pulmonary edema // SOB TECHNIQUE: Single portable AP supine view of the chest was obtained COMPARISON: ___, ___ FINDINGS: The cardiomediastinal silhouette is unremarkable. Since the most recent examination, there appears to been interval development of vascular congestion. Possible septal lines are noted. These findings are likely exaggerated due to supine technique. No definite consolidation is identified.Evaluation for pleural effusion no pneumothorax is limited on supine evaluation. Again seen is what appears to be transverse colon and well left chest. IMPRESSION: 1. Interval development of pulmonary vascular congestion, consistent with edema. 2. H iatal hernia containing large bowel. " cfa7539c-6474d7e4-08aee65d-07133868-7ef07dd8.jpg,test/p10/p10758807/s54411198/cfa7539c-6474d7e4-08aee65d-07133868-7ef07dd8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever // ? Pna TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 10ed7c6f-f7b40c80-6f84be5a-45aeee05-dd94d3d8.jpg,test/p16/p16776887/s59880487/10ed7c6f-f7b40c80-6f84be5a-45aeee05-dd94d3d8.jpg,test," FINAL REPORT INDICATION: History of altered mental status. Question presence of infiltrate. COMPARISONS: None. FINDINGS: Portable semi-erect chest radiograph provided. There are prominent interstitial markings bilaterally with increased vasculature consistent with pulmonary congestion. There are bilateral pleural effusions, right greater than left. There is no pneumothorax. The cardiomediastinal silhouette is enlarged. IMPRESSION: Pulmonary vascular congestion with bilateral pleural effusions, right greater than left. " 9d70aa7c-3c791216-745e034c-2d902a40-80d8cc0e.jpg,test/p11/p11845452/s58796764/9d70aa7c-3c791216-745e034c-2d902a40-80d8cc0e.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Normal heart, lungs, pleura and mediastinal surfaces. IMPRESSION: No pneumothorax. " c9c5a148-1783a52e-8afe0c2a-ca81ccd2-99f8b8e7.jpg,test/p18/p18859129/s58243699/c9c5a148-1783a52e-8afe0c2a-ca81ccd2-99f8b8e7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sah // line placement line placement IMPRESSION: In study of earlier in this date, this and placement of a left subclavian catheter that extends to the mid portion of the SVC. No evidence of post procedure pneumothorax or other change in the appearance the heart and lungs. " 1a5bcfe2-1a9cd809-f39f6186-2cb278dd-f1bf0615.jpg,test/p18/p18899080/s53323425/1a5bcfe2-1a9cd809-f39f6186-2cb278dd-f1bf0615.jpg,test," FINAL REPORT INDICATION: ___ year old man with newly diagnosed lung cancer // Pt with left sided lung cancer and worsening hypoxia COMPARISON: Radiographs from ___ at 09:03. IMPRESSION: Left-sided pleural base catheter is unchanged. Heart size is enlarged. There is again seen a large left-sided pleural effusion and atelectasis. Right lung is relatively clear aside for basilar atelectasis. There are no pneumothoraces. " b05820e8-d56d5497-9c88cb4a-6573fdca-dad0c9bd.jpg,test/p17/p17939203/s59642982/b05820e8-d56d5497-9c88cb4a-6573fdca-dad0c9bd.jpg,test," FINAL REPORT AP CHEST, 10:30 A.M., ___. HISTORY: ___-year-old man with hypotension and tachycardia intraoperatively. History of renal transplant. IMPRESSION: AP chest compared to ___: Supine positioning accounts in large part for distention of mediastinal veins. Given this artifact, heart is probably normal size, and lungs though low in volume are clear. No pneumothorax or pleural effusion. Tip of the endotracheal tube is just above the thoracic inlet, approximately 7.5 cm from the carina and could be advanced 3 cm for more secure seating. " f9336bd3-8e089807-caf8c607-6ddb6fe8-c123c916.jpg,test/p11/p11389640/s55762149/f9336bd3-8e089807-caf8c607-6ddb6fe8-c123c916.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Frequent emesis COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is minimal basilar atelectasis. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No pneumomediastinum is seen. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 80ba2888-9323c401-6f8bed61-f34c5af1-2a707a5a.jpg,test/p11/p11551927/s55487107/80ba2888-9323c401-6f8bed61-f34c5af1-2a707a5a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new dobhoff // eval dobhoff placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the Dobbhoff catheter was inserted. While the first image shows the Dobbhoff catheter malpositioned in the right bronchial system, the second image documents the tip of the Dobbhoff catheter projecting over the stomach. The catheter, however, could be advanced by approximately 5 cm to be securely positioned in the middle parts of the stomach. No complications, notably no pneumothorax. The right subclavian catheter and the tracheostomy tube are unchanged. No pneumothorax. " a18c805a-5f92cab5-e71fab33-67dcd23f-a2b11ce2.jpg,test/p18/p18134008/s56986243/a18c805a-5f92cab5-e71fab33-67dcd23f-a2b11ce2.jpg,test," WET READ: ___ ___ ___ 7:51 PM lucency under left hemidiaphragm, free air not excluded. can further evaluate with lateral decubitus or CT. low lung volumes, which accentuate vascular markings. bibasilar opacities, could relate to aspiration and/or infection. central vascular engorgement. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAM: Chest, AP upright portable view. CLINICAL INFORMATION: Dyspnea. COMPARISON: ___. FINDINGS: There are low lung volumes, which accentuate the bronchovascular markings. Bibasilar opacities are seen, which could be due to atelectasis and aspiration, although infectious process is not excluded. No large pleural effusions are seen, although a trace pleural effusion is difficult to exclude. There is lucency under the left hemidiaphragm, difficult to discern whether intraluminal or extraluminal/free air. There may have been a similar lucency under the left hemidiaphragm on chest radiograph from ___, although this is difficult to accurately compare. Findings can be further evaluated on lateral decubitus view or CT to further evaluate concern for pneumoperitoneum. IMPRESSION: 1. Low lung volumes which accentuate the bronchovascular markings. Bibasilar opacities, could be due to aspiration and/or infection along with atelectasis. Central pulmonary vascular engorgement. 2. Lucency under the left hemidiaphragm, difficult to discern whether intraluminal or extraluminal/free air, but there is concern for pneumoperitoneum. Findings can be further evaluated with lateral decubitus view or CT. " c231d537-2af348f1-2eb57204-e87cb4e3-34ec1838.jpg,test/p12/p12797041/s51245007/c231d537-2af348f1-2eb57204-e87cb4e3-34ec1838.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ ___ No prior studies for comparison. FINDINGS: Lung volumes are increased, likely due to clinically suspected COPD. Heart size, mediastinal and hilar contours are normal. Possible mild bronchial wall thickening is seen in the perihilar regions, best visualized on the lateral view. No pleural effusion. Bones are demineralized, and note is made of scoliosis and degenerative changes in the spine. IMPRESSION: 1. Overinflated lungs and bronchial wall thickening, findings which could be due to chronic bronchitis in the setting of a history of smoking and chronic cough. 2. No acute pulmonary abnormality. " 3e48c2e7-d64bf83a-727afff3-33e0394e-014613be.jpg,test/p12/p12135283/s54846880/3e48c2e7-d64bf83a-727afff3-33e0394e-014613be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RA and hx of Bronchitis. Crackles hears at both bases with report of chest heaviness going over stairs // Please R/O pneumonia or other pathology COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes are not substantially changed. Mild increase in diameter of the aortic arch. This increase in diameter is seen on both the frontal and the lateral view. In addition, ___ the vessels at the upper aspect of the right hilus appears slightly increased in caliber. Unchanged size of the cardiac silhouette. Unchanged elongation of the descending aorta. No pleural effusions. No evidence of pulmonary edema. For evaluation of potential changes at the level of the aorta, CT should be performed. The recommendation and observation was entered into the radiology dashboard system at the time of dictation and observation. " 26304208-ff5afff8-657cf4a6-c64d8d2c-aebdad8b.jpg,test/p13/p13763479/s53990760/26304208-ff5afff8-657cf4a6-c64d8d2c-aebdad8b.jpg,test," WET READ: ___ ___ ___ 3:09 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with palpitations and bradycardia // ? pneumonia, widened mediastinum, cardiomegaly TECHNIQUE: Portable semi-upright chest radiograph. COMPARISON: Chest x-ray dated ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 5a1f8566-c8537869-19bd7ccd-a22367fa-4980e564.jpg,test/p17/p17864200/s50132773/5a1f8566-c8537869-19bd7ccd-a22367fa-4980e564.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain and dyspnea. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 115181c5-3acd1351-c3038798-86f16cfb-2c1a1b13.jpg,test/p14/p14637100/s53802402/115181c5-3acd1351-c3038798-86f16cfb-2c1a1b13.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with HD catheter that got accidentally pulled out // ?pneumothorax TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Interval removal of a left-sided dialysis catheter. No evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged and likely prominence of the main pulmonary artery. There is mild pulmonary vascular congestion. Left mid lung linear atelectasis/scarring is seen. No pleural effusion is seen. Right subclavian stent re- demonstrated. IMPRESSION: No pneumothorax. Pulmonary vascular congestion. " 070af669-a3400e55-df41e253-4b3be8f5-894aa186.jpg,test/p17/p17598360/s51397153/070af669-a3400e55-df41e253-4b3be8f5-894aa186.jpg,test," WET READ: ___ ___ 6:53 PM INterval placement of PA catheter, which ends in the right pulmonary artery. Other supportive devices are in stable position. UNchanged appearance of the thorax. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:26 P.M. ON ___ HISTORY: ___-year-old man with pulmonary hypertension and CHF after a right heart cath. Evaluate placement of pulmonary artery catheter. IMPRESSION: AP chest compared to ___: A new Swan-Ganz catheter ends in the right pulmonary artery, roughly at the level of origin of the descending pulmonary artery. Mild pulmonary edema persists, may have improved slightly since ___. Small left pleural effusion persists. Heart size normal. Pulmonary artery is dilated as before. ET tube is in standard placement, upper enteric drainage tube passes into the stomach and out of view. A left internal jugular line ends at the thoracic inlet. No pneumothorax. " d4178642-4eec5b8a-b9194ff0-944315d5-15aac198.jpg,test/p15/p15196754/s51396592/d4178642-4eec5b8a-b9194ff0-944315d5-15aac198.jpg,test," FINAL REPORT INDICATION: New onset chest pain. COMPARISON: None. TECHNIQUE: PA and lateral views of chest. FINDINGS: The cardiac, mediastinal and hilar contours are within normal limits. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is seen. IMPRESSION: Normal chest radiograph. " c86a3a22-ef08ba06-7d547b90-b5c502c9-d1066b24.jpg,test/p19/p19165656/s57487824/c86a3a22-ef08ba06-7d547b90-b5c502c9-d1066b24.jpg,test," FINAL REPORT INDICATION: ___ year old man with respiratory distress // Interval changes TECHNIQUE: Portable COMPARISON: ___ FINDINGS: Lungs are clear. No pleural effusion or pneumothorax. Heart size is normal. Dual lead defibrillator with the tips in the RA and RV is new. IMPRESSION: No acute cardiopulmonary process. " 7942b8cd-3860f40d-048c4e6b-d278d7f8-3be8bf82.jpg,test/p12/p12287217/s59079299/7942b8cd-3860f40d-048c4e6b-d278d7f8-3be8bf82.jpg,test," FINAL REPORT INDICATION: ___F with preop // eval for preop TECHNIQUE: AP and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 2b905a50-09f068cf-20450506-89db76a8-3b52a20e.jpg,test/p18/p18963838/s51239280/2b905a50-09f068cf-20450506-89db76a8-3b52a20e.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea, etoh cirrhosis // please eval for acute cp process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Scattered right mid to lower lung linear atelectasis/scarring is seen. There is a small left pleural effusion. No definite focal consolidation is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Small left pleural effusion. Scattered right mid to lower lung linear atelectasis/ scarring. " 636d1a0c-ef695104-4f2cd812-fc4ad832-09afb2f9.jpg,test/p11/p11540763/s58907226/636d1a0c-ef695104-4f2cd812-fc4ad832-09afb2f9.jpg,test," FINAL REPORT HISTORY: Chest heaviness. TECHNIQUE: 2 views of the chest. COMPARISON: CT torso ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours and unchanged aortic tortuosity. IMPRESSION: No acute intrathoracic process. " 19b335e8-d0338009-90dd8b7b-c8fc7cb2-c13a0ebd.jpg,test/p19/p19773753/s53043678/19b335e8-d0338009-90dd8b7b-c8fc7cb2-c13a0ebd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with positive PPD. // TB evaluation. TB evaluation. COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lungs are grossly clear. Moderate cardiomegaly stable. There is no evidence of central adenopathy or any pleural abnormality. Conventional radiographs should be obtained, if feasible, for detection of more subtle abnormalities than visible on bedside AP chest radiographs. RECOMMENDATION(S): Conventional chest radiographs when feasible. " 0077d0d6-a137f1e7-cc948f64-752d575f-34debba4.jpg,test/p18/p18785569/s51556643/0077d0d6-a137f1e7-cc948f64-752d575f-34debba4.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: Chest radiograph of ___ and CT chest of ___. FINDINGS: Frontal, moderate right pleural effusion seen on ___ exam is now small. There is no left pleural effusion. There is no focal consolidation. No pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is top normal. Moderate hiatal hernia is apparent. There is mild perihilar vascular congestion. Partially imaged upper abdomen is unremarkable. IMPRESSION: 1. Small right pleural effusion has significantly decreased in size since ___ exam. No focal consolidation or pulmonary edema. 2. Moderate hiatal hernia. " dc8ed61b-0002acf6-b6ab7b2d-6df94635-ee2c980b.jpg,test/p16/p16514153/s57681840/dc8ed61b-0002acf6-b6ab7b2d-6df94635-ee2c980b.jpg,test," FINAL REPORT INDICATION: ___ year old woman with severe COPD c/o dyspnea // evaluate for volume overload COMPARISON: Comparison is made with prior studies including ___ IMPRESSION: There is linear atelectasis or scarring in both lung bases. There is no pneumothorax, effusion, consolidation or CHF. Postoperative changes are stable. " 32da1114-e1c5624d-c5d5aebe-0ba48a6b-640744c0.jpg,test/p17/p17006872/s51610754/32da1114-e1c5624d-c5d5aebe-0ba48a6b-640744c0.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post VATS pleurodesis, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the size of the known right pneumothorax has increased, the apical diameter of the pneumothorax is now approximating 3 cm. The right chest tube is in unchanged position. There is currently no evidence of tension. The left lung is unremarkable. " 3a7b1baa-c28ca4ad-6b96ae96-3613b528-c6359a71.jpg,test/p12/p12388314/s53115054/3a7b1baa-c28ca4ad-6b96ae96-3613b528-c6359a71.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new O2 requirement s/p lumbar laminectomy // ___ year old woman with new O2 requirement IMPRESSION: In comparison to ___ chest radiograph, lung volumes are low it, accentuating the cardiac silhouette and bronchovascular structures. Even allowing for this factor, there is been development of pulmonary vascular congestion with minimal interstitial edema. Exam is otherwise remarkable for patchy bibasilar atelectasis and probable trace pleural effusions. " 4e4ee64d-3ce3898a-33848556-be1f59ca-033b5e6b.jpg,test/p16/p16546662/s56805706/4e4ee64d-3ce3898a-33848556-be1f59ca-033b5e6b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with diastolic dysfunction with worsened Dyspnea; bed bound // r/o chf ; if can't do PA and lateral can do AP TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiographs dated ___. FINDINGS: Compared to chest radiographs from ___, small left pleural effusion has resolved. Slight prominence of interstitial markings, as well as hyperinflated lungs with flattening of the bilateral hemidiaphragms, suggest COPD. No pneumothorax. No central vascular congestion or overt pulmonary edema. Rounded opacity in the right perihilar region and 18 mm nodule opacity in the left upper lobe are new. Mediastinal and hilar contours are stable. Heart size is normal. IMPRESSION: 1. No pulmonary edema. 2. Resolved small left pleural effusion. 3. New rounded opacity in the right perihilar region and new 18 mm nodular opacity in the left upper lobe are new. Recommend follow-up chest CT for further evaluation. RECOMMENDATION(S): Follow-up chest CT for further evaluation of new rounded opacity in the right perihilar region and new 18 mm nodular opacity in the left upper lobe. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 17:03 into the Department of Radiology critical communications system for direct communication to the referring provider. " 6bd5a883-9c41706c-df481beb-f17c1ddf-5ba7367c.jpg,test/p16/p16458160/s56843258/6bd5a883-9c41706c-df481beb-f17c1ddf-5ba7367c.jpg,test," FINAL REPORT INDICATION: ___ year old man POD 5 sp r thoracotomy and decortication, CT removed today. Please perform at approx ___ // Interval change? Increase PTX? TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Right-sided chest tube is been removed. The appearance of the lungs is unchanged compared to prior again seen is a hiatal hernia smaller right than left chest cavity with pleural thickening/effusion right-sided subcutaneous emphysema right-sided skin ___ and a pacemaker IMPRESSION: Right chest tube removed otherwise no substantive change " 6a2ebc86-d8c85cb4-f695d22e-1c176486-5b2433de.jpg,test/p10/p10717732/s51118147/6a2ebc86-d8c85cb4-f695d22e-1c176486-5b2433de.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with end-stage renal disease on peritoneal dialysis presenting with cough. Evaluate for pulmonary edema versus pneumonia. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Multiple prior chest radiographs, most recent on ___. FINDINGS: Compared with prior chest radiograph there is mildly increased prominence of the vascular markings in the upper lobes. Otherwise no focal opacities are identified. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Pulmonary vascular congestion. No evidence of pneumonia. " 3ab29f5f-d3af4f74-b2887892-fdd8f536-bf191bc3.jpg,test/p18/p18001424/s58511496/3ab29f5f-d3af4f74-b2887892-fdd8f536-bf191bc3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with worsening SOB post ppm // PLEASE EVAL FOR ptx COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. 1 lead projects over the right atrium and 1 over the right ventricle. The extent and severity of the pre-existing left pleural effusion has slightly improved. Mild fluid overload but no overt pulmonary edema. No evidence of pneumothorax. " f316f0a2-c8f25819-b1679530-9a90b120-ad3d3c15.jpg,test/p12/p12799209/s57369198/f316f0a2-c8f25819-b1679530-9a90b120-ad3d3c15.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Left upper quadrant pain, assess for pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 195e3d3b-9142e340-52b14df3-4253e625-0aec8801.jpg,test/p13/p13733398/s55953860/195e3d3b-9142e340-52b14df3-4253e625-0aec8801.jpg,test," FINAL REPORT HISTORY: ___-year-old male with HIV and non-productive cough, rule out pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral chest radiograph demonstrates minimal streaky opacity projecting over the lower thoracic spine, likely corresponding to opacity seen in a retrocardiac distribution. The lungs are otherwise clear without pleural effusion or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are normal. IMPRESSION: Possible left lower lobe pneumonia. " e0a1318f-c13fe358-8038088a-ef91bc8c-577dde4e.jpg,test/p18/p18121111/s52115798/e0a1318f-c13fe358-8038088a-ef91bc8c-577dde4e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with new OG tube placement // OG tube placement TECHNIQUE: Single, AP, portable view of the chest. COMPARISON: ___. FINDINGS: Interval placement of an orogastric tube terminating within the stomach. A right internal jugular central venous line terminates at the cavoatrial junction, and an endotracheal tube terminates approximately 2.0 cm above the level of carina. Bilateral airspace opacities and a right upper lobe cavity are essentially unchanged from prior examination. The cardiomediastinal silhouette is stable. Calcifications are noted at the aortic arch. IMPRESSION: New orogastric tube terminating within the stomach. Otherwise, no relevant interval change. " 6fcd93cd-f7fa23d8-7388514a-a318b4ab-7e564b8e.jpg,test/p12/p12829950/s59725824/6fcd93cd-f7fa23d8-7388514a-a318b4ab-7e564b8e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with desat to ___ ? CHF vs PNA // ?CHF vs desat TECHNIQUE: Chest single COMPARISON: ___ FINDINGS: Interval new volume loss in the left chest, shift of mediastinal structures to the left, left basilar consolidation, predominantly from atelectasis. There may be small component of left pleural effusion. Left perihilar opacity, atelectasis versus infiltrate. There is abrupt cut off of distal left mainstem bronchus, decreased arborization of the left bronchial tree, possibly for mucous plugging. Right Port-A-Cath in place. Surgical instrumentation in the thoracic spine. Right lung is clear. Degenerative arthritis right shoulder. No pneumothorax. IMPRESSION: Left lung volume loss, predominantly from atelectasis. Component of left perihilar infiltrate cannot be excluded. There may be small left pleural effusion. Suggestion of mucous plugging left lung. " 13730480-ce0d2dd3-540bc36c-0550b15d-072dca67.jpg,test/p15/p15241931/s51362104/13730480-ce0d2dd3-540bc36c-0550b15d-072dca67.jpg,test," FINAL REPORT HISTORY: Uveitis, to assess for sarcoidosis. FINDINGS: No previous images. The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Specifically, no evidence of hilar or mediastinal adenopathy. " 7a17b7a2-74b76e26-e8df3864-e1cb58f3-c4d5b49a.jpg,test/p17/p17652927/s56522960/7a17b7a2-74b76e26-e8df3864-e1cb58f3-c4d5b49a.jpg,test," FINAL REPORT CHEST TWO VIEWS: ___ HISTORY: ___-year-old male with history of cardiomyopathy, chest pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. New right PICC line is identified. The exact tip is not clearly delineated and is seen to the level of the upper SVC where it crosses over the single lead from left chest wall pacing device. Previously identified Swan-Ganz catheter via right IJ is no longer seen. The lungs are clear. There is no pleural effusion. Cardiac silhouette is enlarged but stable. Osseous and soft tissue structures are unremarkable. IMPRESSION: Stable cardiomegaly but no acute cardiopulmonary process. Right PICC tip is not clearly delineated on this exam. " c350877a-689e30ec-03bdc187-412210b2-8b34c303.jpg,test/p19/p19826673/s52962056/c350877a-689e30ec-03bdc187-412210b2-8b34c303.jpg,test," WET READ: ___ ___ ___ 11:27 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___F with chest pain and mild SOB // ?acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9c407b1c-62467d1d-8ce24d1b-9ad6ff84-e33080cf.jpg,test/p12/p12936816/s50490166/9c407b1c-62467d1d-8ce24d1b-9ad6ff84-e33080cf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with shortness of breath, hypoxic TECHNIQUE: Portable semi-upright AP view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is mildly enlarged but unchanged. The aorta remains tortuous. The mediastinal contour is similar. There is mild pulmonary vascular congestion. Lung volumes are low with patchy atelectasis noted at the lung bases. No pleural effusion or pneumothorax is identified. Chronic fracture deformity of the right proximal humerus is demonstrated along with old left-sided rib fractures. IMPRESSION: Low lung volumes with patchy atelectasis in the lung bases and mild pulmonary vascular congestion. " 5435e9ba-ad10289a-1891e565-938a027b-c99652a0.jpg,test/p19/p19797689/s51614740/5435e9ba-ad10289a-1891e565-938a027b-c99652a0.jpg,test," FINAL REPORT HISTORY: Shortness of breath. Evaluation for edema or pneumonia. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: Frontal and lateral views chest demonstrate decreased lung volumes. There is dense left retrocardiac opacity which may represent atelectasis, infection or aspiration. There is blunting of the left costophrenic angle which may represent a small pleural effusion. No pneumothorax is identified. The right hilum is prominent but stable compared to multiple prior radiographs. The aorta is ectatic and tortuous and the heart is mildly enlarged. There are degenerative changes in the thoracic spine. IMPRESSION: 1. Left retrocardiac opacity could represent atelectasis, infection or aspiration. 2. The left costophrenic angle is blunted. A small left pleural effusion is not excluded. " 50727020-d9d51ece-88be94b2-baf1bf31-769b4a53.jpg,test/p10/p10987724/s54248321/50727020-d9d51ece-88be94b2-baf1bf31-769b4a53.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung mass and biopsy // pneumothorax pneumothorax IMPRESSION: 2 large mass S in the right middle and right lower lobe are unchanged in appearance. There is no pneumothorax. " 31b884fd-0e671248-0e6048a6-9b00dda4-f82a714c.jpg,test/p17/p17445268/s56480936/31b884fd-0e671248-0e6048a6-9b00dda4-f82a714c.jpg,test," WET READ: ___ ___ ___ 8:31 PM New moderate right hydropneuthorax. Positive signs of tension pneumothorax including splaying of ipsilateral ribs and mild leftward mediastinal shift as compared to recent prior. ___ d/w Dr. ___ at 8:28 pm on ___ by telephone, 5 minutes after discovery. ___ p_________________________________________________________________________________ FINAL REPORT INDICATION: History of bronchiectasis, status post bronchoscopy ___, has diminished breath sounds on right. Evaluate for pneumothorax or pneumonia. COMPARISONS: Multiple prior radiographs of the chest, most recent ___. CT chest ___. FINDINGS: A moderate right hydropneumothorax with a small amount of layering fluid component is new since ___, and causes widening of the ipsilaterrib spaces and mild left mediastinal shift. A combination of multifocal nodules and peribronchial infiltration, predominantly in the right lower lung is unchanged and is better evaluated on recent chest CT. Heart size is normal. The mediastinal and hilar contours appear normal. IMPRESSION: Interval development of moderate right hydropneumothorax, should be evaluated for any clinical evidence of tension physiology. A preliminary report was given via telephone by Dr. ___ to Dr. ___ ___ at 8:28 p.m. on ___ five minutes after discovery of the findings and read: ""New moderate right hydropneumothorax. Positive signs of tension pneumothorax, including splaying of ipsilateral ribs and mild leftward mediastinal shift as compared to recent prior."" " a9e47844-1266fbb1-65edaeb3-8c2b4d87-11ce55a0.jpg,test/p10/p10881033/s51952176/a9e47844-1266fbb1-65edaeb3-8c2b4d87-11ce55a0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 77a977cc-ff64a6bd-f1497d54-baa00fc8-e34b9488.jpg,test/p16/p16044504/s56321921/77a977cc-ff64a6bd-f1497d54-baa00fc8-e34b9488.jpg,test," FINAL REPORT HISTORY: Gallbladder carcinoma. Question NG tube placement. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Once again demonstrated is right basilar atelectasis, not significantly changed from ___ study. The left lung is essentially clear. There is continued elevation of the right hemidiaphragm. An NG tube is seen coursing into the stomach on the lateral view primarily. Cardiac size is normal. Hilar contours are unremarkable. IMPRESSION: 1. NG tube in the stomach. 2. Right lower middle lobe opacities compatible with atelectasis. " ba9fa9ef-4b3fa9cb-b5b77aa2-e61c4f48-00d44f2d.jpg,test/p10/p10705459/s59860588/ba9fa9ef-4b3fa9cb-b5b77aa2-e61c4f48-00d44f2d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with food impaction // perforation? anatomical distortion? COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Lungs are hyperinflated. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Old right rib deformities are again seen. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 700c87be-85bca01d-c9e22d37-d7cd98fd-a4247057.jpg,test/p19/p19085277/s57475387/700c87be-85bca01d-c9e22d37-d7cd98fd-a4247057.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain, left sided. COMPARISON: NONE FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low with streaky lower lobe opacities which could represent an atelectasis versus early pneumonia. No convincing signs of edema, effusion or pneumothorax. The heart size is top-normal. The mediastinal contours unremarkable. No free air below the right hemidiaphragm. Bony structures are intact. IMPRESSION: Top normal heart size with streaky opacities in the lower lungs likely atelectasis less likely pneumonia. " ab7e5ad7-f1f3a36b-645fa7dd-db90abd0-eec2d709.jpg,test/p19/p19600190/s51171905/ab7e5ad7-f1f3a36b-645fa7dd-db90abd0-eec2d709.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with fever and recent surgery. Question pneumonia. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. On the current exam, the lungs are clear. Cardiomediastinal silhouette is mildly enlarged, similar to prior. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " dc428017-8d3a611c-7c3667a0-39b8960b-12027068.jpg,test/p14/p14350419/s55700579/dc428017-8d3a611c-7c3667a0-39b8960b-12027068.jpg,test," FINAL REPORT INDICATION: Headache, on Coumadin. COMPARISON: ___. FRONTAL AND LATERAL CHEST: Lung volumes are lower than on the prior study. There is no focal consolidation, pleural effusion or pneumothorax. Mild cardiomegaly is accentuated by lower lung volumes. Mediastinal silhouette and hilar contours are stable. Degenerative change in the thoracic spine is again noted. IMPRESSION: No pneumonia, edema or effusion. " b129de8c-c8097cf6-beb7f5ec-0520d076-8df0b2bc.jpg,test/p19/p19633644/s58971826/b129de8c-c8097cf6-beb7f5ec-0520d076-8df0b2bc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stent placement // assess for airway collapse r/o ptx IMPRESSION: In comparison with the study of ___, following stent placement there has been complete re-expansion of the right hemithorax. There is some soft tissue prominence in the lower right paratracheal region. This may well be related to the perihilar and mediastinal mass seen on the CT examination of ___. No evidence of acute focal pneumonia. " c33dea94-8e9fbbda-3bca12be-7ad2265c-b82a4749.jpg,test/p11/p11415043/s55628326/c33dea94-8e9fbbda-3bca12be-7ad2265c-b82a4749.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Hemoptysis. Cardiac size is top normal. The lungs are clear. There is no pneumothorax or pleural effusion. Osseous structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " e2ba9c20-58d95c86-cb388bb6-fe7d33ed-097a3d93.jpg,test/p19/p19275466/s51558219/e2ba9c20-58d95c86-cb388bb6-fe7d33ed-097a3d93.jpg,test," WET READ: ___ ___ 11:51 PM No acute cardiopulmonary pathology. No subdiaphragmatic free air ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___F with epigastric pain and epigastric/RUQ TTP. +___'s // R/O cholecystitis, perforation, pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None similar. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or focal airspace consolidation. No subdiaphragmatic free air is noted. Gas-filled loops of transverse and descending colon are noted in the left upper quadrant. IMPRESSION: No acute cardiopulmonary pathology. No subdiaphragmatic free air. " 9b8e6874-3da5ed73-6a1fb910-9264586b-95305888.jpg,test/p15/p15130765/s54349163/9b8e6874-3da5ed73-6a1fb910-9264586b-95305888.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with meningioma and pacemaker // evaulate pacemaker COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The course and position of the pacemaker leads are constant. The pre-existing small bilateral pleural effusions have completely resolved. Other than on the previous radiograph, the current image shows no evidence of pulmonary edema. Moderate cardiomegaly and elongation of the descending aorta persist. No pneumonia. " cd14b6ec-a7eb8609-62a5d081-ff08a9b6-67abbeea.jpg,test/p14/p14626328/s58846888/cd14b6ec-a7eb8609-62a5d081-ff08a9b6-67abbeea.jpg,test," FINAL REPORT HISTORY: New onset of chest pain. FINDINGS: In comparison with the study of ___, there are lower lung volumes. Cardiac silhouette remains within normal limits, and there is no definite vascular congestion or pleural effusion. Increased opacification is seen adjacent to the left heart border with an associated dense streak of atelectasis. Although all of this could be a manifestation of volume loss, in view of the clinical history, developing infrahilar consolidation would have to be considered. If the condition of the patient would permit, a lateral view would be most helpful. " 35ebd012-9e6e3b2d-86373133-230aa8a5-aeefabcb.jpg,test/p18/p18232511/s54893528/35ebd012-9e6e3b2d-86373133-230aa8a5-aeefabcb.jpg,test," FINAL REPORT HISTORY: ___-year-old male with bibasilar opacities on prior AP chest radiograph. PA and lateral examination for further characterization. COMPARISON: Frontal chest radiograph from ___ at 8:34 a.m. AP AND LATERAL CHEST RADIOGRAPHS: Lateral examination is extremely limited due to the arm down positioning. Persistent basilar opacities may be seen with atelectasis although the etiology is not specific. A new mild interstitial abnormality suggests mild pulmonary vascular congestion. The upper lungs remain clear. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Persistent basilar opacities which are not specific; these could be seen with atelectasis, although other etiologies such as pneumonia and aspiration are not entirely excluded. 2. Findings suggesting mild new vascular congestion. 3. Convex right mid mediastinal contour; evaluation with chest CT is recommended when clinically appropriate. Final report discussed with Dr. ___ at 9:15 pm by telephone. " c8b19311-e35d7ff3-19cd9214-e023c8f4-d732a4fb.jpg,test/p18/p18124077/s57001317/c8b19311-e35d7ff3-19cd9214-e023c8f4-d732a4fb.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. INDICATION: ___ year-old woman with obesity and chest pain, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette appears normal. The bony structures are intact. A soft tissue calcification in the right shoulder adjacent to the humeral head is noted, which may indicate tendinopathy. IMPRESSION: No acute intrathoracic process. Calcific tendinopathy at the right shoulder. " b28b8d62-93dcc9a9-c6d96f01-c06c3217-20b72895.jpg,test/p11/p11167924/s58533862/b28b8d62-93dcc9a9-c6d96f01-c06c3217-20b72895.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with hx AFib on___ transferred from OSH s/p fall, found to have intracranial hemorrhage (SAH/SDH), L acetabular/pelvic fracture, and temporal bone fracture. Now with unclear source of fever. // ? PNA. unclear source of fever TECHNIQUE: Single frontal view of the chest COMPARISON: CT abdomen pelvis ___. Portable chest x-ray ___. FINDINGS: A new consolidation in the left lower lobe obscuring the left hemidiaphragm is consistent with a pneumonia. There is a small left pleural effusion which is better seen on prior CT chest. Again seen is right basal atelectasis. There is mild pulmonary vascular congestion. Severe cardiomegaly is stable. There is no pneumothorax. IMPRESSION: Left lower lobe pneumonia. " 73939ddf-33b6e0b5-329c5a5a-bdbe4178-c851e1cf.jpg,test/p15/p15262883/s58746632/73939ddf-33b6e0b5-329c5a5a-bdbe4178-c851e1cf.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest CT from ___. CLINICAL HISTORY: Right chest pain, status post fall during skiing. Assess rib fracture. FINDINGS: PA and lateral views of the chest were provided. There is an acute fracture involving the posterolateral ___ of the right sixth rib. There is no consolidation or pneumothorax seen. No effusion. Cardiomediastinal silhouette is normal. IMPRESSION: Acute fracture involving the right sixth posterolateral ___. No pneumothorax or pulmonary consolidation. " dac6f30f-a33487ff-87a32dc1-7aa5231f-0f81f7b4.jpg,test/p11/p11900721/s56159432/dac6f30f-a33487ff-87a32dc1-7aa5231f-0f81f7b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (upright AP AND LAT) INDICATION: ___F with right sided pain s/p fall // ?pna, rib fractures COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided.There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with top-normal heart size. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 17a12a25-6bf3aa0f-afed4538-1dae4014-69e610b7.jpg,test/p11/p11401718/s55673471/17a12a25-6bf3aa0f-afed4538-1dae4014-69e610b7.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with unwittness fall with head trauma, neck pain, and confusion COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided.There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 256ccc58-7b5ba6a3-41584608-90292f7b-5e1d73d3.jpg,test/p11/p11104877/s57702030/256ccc58-7b5ba6a3-41584608-90292f7b-5e1d73d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff // Dobhoff Dobhoff IMPRESSION: In comparison with the earlier study of this date, the opaque portion of the Dobbhoff tube lies just distal to the esophagogastric junction. Otherwise, little overall change. " 7adda98c-1498ce05-3c08ac2d-f5f17af1-2a4f0180.jpg,test/p15/p15160486/s58254298/7adda98c-1498ce05-3c08ac2d-f5f17af1-2a4f0180.jpg,test," FINAL REPORT HISTORY: Status post Pleurx catheter placement. COMPARISON: Chest radiograph 10:11 today and ___. FINDINGS: A right Pleurx catheter is present with its tip directed inferomedially. The right subpulmonic pneumothorax and pleural effsuion are unchanged allowing for differences in inspiration. A small pleural effusion remains. Extensive subcutaneous air along the right chest and airspace opacities within the right lung are postoperative. The known right lung mass is unchanged. The left lung is clear. The cardiomediastinal contours are unremarkable. A calcified tortuous aorta is again noted. IMPRESSION: Right pleural effusion and pneumothorax likely without significant interval change given differences in inspiration and patient position. " 16f58537-d847b5c0-ac725b5f-cdbce804-a17791cb.jpg,test/p19/p19296519/s50559017/16f58537-d847b5c0-ac725b5f-cdbce804-a17791cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with NICM s/p ICD placement. Eval lead position and post procedure complications. // ___ year old man with NICM s/p ICD placement. Eval lead position and post procedure complications. Please book in 7:___:15 time slot TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None provided. FINDINGS: Left-sided AICD with single lead following its expected course to the right ventricle. There is no pneumothorax or mediastinal widening. No focal consolidation. No pleural effusion. There is no central vascular congestion or overt pulmonary edema. Moderate cardiomegaly has increased since prior exam. IMPRESSION: 1. Left-sided AICD with single lead following expected course to the right ventricle. No pneumothorax or mediastinal widening. No pleural effusion. 2. Moderate cardiomegaly, increased since prior exam. " 3797db97-9d956d35-7023f57c-a8defcfd-b77cede7.jpg,test/p11/p11619572/s59279131/3797db97-9d956d35-7023f57c-a8defcfd-b77cede7.jpg,test," FINAL REPORT INDICATION: ___-year-old male with follicular lymphoma. Evaluate for PICC placement. TECHNIQUE: Portable upright AP chest radiograph. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: There has been interval placement of new left-sided PICC with its tip terminating in mid SVC. There is no pneumothorax. There has been interval resolution of bilateral pleural effusion and no new effusion is seen. The heart is mildly enlarged. The hilar and mediastinal contour appear normal. IMPRESSION: New left-sided PICC terminating in the mid SVC. No complications. " 3c3af2dd-22955f82-716b65ea-898cdee2-0187a3ea.jpg,test/p10/p10058910/s59412780/3c3af2dd-22955f82-716b65ea-898cdee2-0187a3ea.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ON ___ HISTORY: Chest pain. FINDINGS: The lungs are clear without infiltrate or effusion. The cardiac and mediastinal silhouettes are normal. The bony thorax is normal. IMPRESSION: Normal chest. " 7ccb32ce-f786cfe4-fa21f9c9-ab649e02-69fcfa46.jpg,test/p12/p12341904/s57235729/7ccb32ce-f786cfe4-fa21f9c9-ab649e02-69fcfa46.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 5ac21e39-6c0d04b8-4fdf4c03-b8c1cd1f-a72d444d.jpg,test/p17/p17206954/s55012439/5ac21e39-6c0d04b8-4fdf4c03-b8c1cd1f-a72d444d.jpg,test," FINAL REPORT CLINICAL INFORMATION: Constipation. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are hyperinflated. No focal consolidation, pleural effusion or evidence of pneumothorax is seen. The cardiac silhouette is not enlarged. " 4a5c8543-207d7698-31b50747-6159c10d-6a44f7aa.jpg,test/p13/p13364910/s50152158/4a5c8543-207d7698-31b50747-6159c10d-6a44f7aa.jpg,test," FINAL REPORT INDICATION: ___ year old woman with multifocal pneumonia (no growth on sputum and BAL cx) with ICU stay and intubation now extubated and recovering with continued hypoxemia. // Status of pulmonary effusion and pneumonia, evidence of mucus plugging? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Dense airspace opacities involving both lungs with relative sparing of the left apex are overall unchanged in appearance. Cardiomediastinal silhouette including mild cardiomegaly is stable. There is no pleural effusion or pneumothorax. The left PICC is unchanged in position. IMPRESSION: No substantial change from prior " 1c67b91f-b49ffc98-19264bd0-97b5a1f5-a00ef9f5.jpg,test/p15/p15355458/s51116708/1c67b91f-b49ffc98-19264bd0-97b5a1f5-a00ef9f5.jpg,test," FINAL REPORT HISTORY: ___-year-old female with bacteremia and pelvic mass. COMPARISON: ___, ___, ___. FINDINGS: Portable semi-upright frontal chest radiograph demonstrates an endotracheal tube tip located at least 2.3 cm from the level of the carina. A left subclavian central venous catheter tip is at the confluence of the SVC and brachiocephalic vein, with its tip projecting laterally against the wall of the SVC. An NG tube is in place, superimposed on the stomach, though the tip is not seen off the inferior margin of the film. Low lung volumes are slightly decreased with bibasilar opacities and bilateral pleural effusions, right greater than left. Mild edema is unchanged. Calcified mitral valve annulus is again noted. IMPRESSION: 1. Unchanged mild edema, bibasilar atelectasis and bilateral pleural effusion. 2. Left subclavian central venous catheter tip projects against the wall of the SVC, and repositioning is suggested to prevent erosion of the catheter tip through the wall. " 4272eb09-45c663d2-5ce1717b-aa01eb49-32e3e00b.jpg,test/p10/p10850692/s57192969/4272eb09-45c663d2-5ce1717b-aa01eb49-32e3e00b.jpg,test," FINAL REPORT HISTORY: Chest pain and syncope. COMPARISON: None. FINDINGS: A single portable AP chest radiograph was obtained. The lungs are well expanded and clear. There is no effusion, pneumothorax or consolidation. An extra linear contour at the AP window is attributable to mediastinal fat. Cardiac and mediastinal contours are otherwise normal. IMPRESSION: No acute cardiopulmonary process. " bfce3dbd-3444b870-b5d0a2bb-08b50828-c7d068bb.jpg,test/p11/p11740863/s59281009/bfce3dbd-3444b870-b5d0a2bb-08b50828-c7d068bb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with stroke. Screening CXR. // please evaluate for any evidence of infection please evaluate for any evidence of infection IMPRESSION: In comparison with the study of ___, there is little change. Again there is some hyperexpansion of the lungs suggesting underlying chronic pulmonary disease with the cardiac silhouette at or above upper limits of normal. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. " bf686848-3e094fb7-a45fb1e9-a3edb2cb-bdb61a4f.jpg,test/p18/p18697563/s55056117/bf686848-3e094fb7-a45fb1e9-a3edb2cb-bdb61a4f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Altered mental status, assess infectious process in the chest. FINDINGS: AP upright and lateral views of the chest are provided. Lung volumes are markedly low, which limits the evaluation. Allowing for this; however, there is no overt consolidation, effusion, or pneumothorax. No signs of CHF. The heart size appears top normal, though this is likely due to projection and technique. Mediastinal contour likewise is prominent though this also likely reflects technique. The bony structures appear intact. Degenerative spurring in the mid-to-lower thoracic spine noted. No free air below the right hemidiaphragm. IMPRESSION: Limited negative. " 3fa92c2b-7f836009-0f4af14a-feb7755d-b79a5835.jpg,test/p15/p15086031/s50428627/3fa92c2b-7f836009-0f4af14a-feb7755d-b79a5835.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded and clear. No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The thoracic aorta is tortuous, similar to the prior exam and CT from ___. Bony structures appear intact. Rib deformities are unchanged. IMPRESSION: No acute intrathoracic process. " 5fb48c02-6828dd93-f91a8015-6ca9a92a-b43aaf9b.jpg,test/p14/p14065514/s52958670/5fb48c02-6828dd93-f91a8015-6ca9a92a-b43aaf9b.jpg,test," FINAL REPORT HISTORY: Esophagectomy, vomiting feculent material, aborted endoscopy procedure. Rule out chronic aspiration. COMPARISON: ___. FINDINGS: There are low lung volumes. Surgical changes are noted along the right perihilar region. Cardiomediastinal silhouette is unchanged. No focal consolidation, pleural effusion or pneumothorax is present. IMPRESSION: No evidence of chronic aspiration. " 04965b39-121ab9a5-c28c669d-43ad92c5-47602350.jpg,test/p19/p19582228/s56455402/04965b39-121ab9a5-c28c669d-43ad92c5-47602350.jpg,test," FINAL REPORT INDICATION: ___F with elevated lactate presenting with dizziness and lightheadedness // evidence of infiltrate TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 362ecad0-d4668a2b-b3484df7-4ddd508f-cc748e97.jpg,test/p13/p13285177/s58397984/362ecad0-d4668a2b-b3484df7-4ddd508f-cc748e97.jpg,test," FINAL REPORT INDICATION: History of shortness of breath, on CPAP. Question pulmonary edema. COMPARISONS: Chest radiograph from ___. TECHNIQUE: Portable chest radiograph is provided. FINDINGS: There is prominence of the central pulmonary vasculature consistent with mild pulmonary edema. Bibasilar opacities likely represent atelectasis. The heart appears mildly enlarged. There is no focal consolidation pleural effusion or pneumothorax. IMPRESSION: Findings consistent with mild pulmonary edema. Bibasilar opacities likely represent atelectasis. " ea3f9cea-230cb9a4-f7551f19-cdf2484e-64b39530.jpg,test/p15/p15619921/s56599839/ea3f9cea-230cb9a4-f7551f19-cdf2484e-64b39530.jpg,test," FINAL REPORT AP CHEST, 5:01 A.M., ___ HISTORY: A ___-year-old woman with pancreatitis and new hypoxia. IMPRESSION: AP chest compared to ___ and ___: Worsening opacification at the base of the left hemithorax is due in part to increasing moderate pleural effusion, probably also atelectasis. Moderate right pleural effusion is larger and pulmonary vascular engorgement more pronounced. Heart size is only top normal. No pneumothorax. " 67b33efc-9298c079-f8797b37-75dd6a17-407c36bb.jpg,test/p11/p11745865/s52874036/67b33efc-9298c079-f8797b37-75dd6a17-407c36bb.jpg,test," FINAL REPORT INDICATION: Recent pneumonia, now with persistent cough and decreased breath sounds in the right lung base. COMPARISONS: Multiple chest radiographs from ___ to ___. PA AND LATERAL VIEWS OF THE CHEST: The lungs are hyperinflated, the thoracic AP diameter has increased and the diaphragm is flattened, consistent with chronic COPD. The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No evidence of pneumonia. Stable chronic radiographic evidence of COPD. " 37025069-29c58701-ae5079b2-84c69d07-ec07adcf.jpg,test/p13/p13880211/s55564449/37025069-29c58701-ae5079b2-84c69d07-ec07adcf.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with chest pain and shortness of breath. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is identified. IMPRESSION: Normal chest x-ray. " 30b2bcb6-5f952889-79aa9558-63a05eab-b91416ed.jpg,test/p16/p16421179/s51830679/30b2bcb6-5f952889-79aa9558-63a05eab-b91416ed.jpg,test," FINAL REPORT AP CHEST, 4:42 A.M., ___ HISTORY: ___-year-old woman with respiratory distress. IMPRESSION: AP chest compared to ___ at 9:02 p.m.: Previous moderate right pleural effusion and right basal atelectasis have both improved. There is mild vascular engorgement in the upper lungs but no edema. Moderate cardiomegaly also looks to have had improved. Thoracic aorta is generally large and heavily calcified but not focally aneurysmal. Dr. ___ was paged. " 35080a96-f84cd44c-ae5b9bf5-67f18e04-0a21cd9c.jpg,test/p17/p17748848/s55256296/35080a96-f84cd44c-ae5b9bf5-67f18e04-0a21cd9c.jpg,test," FINAL REPORT HISTORY: Cough and syncope. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Normal chest radiographs. " 9fcc5266-d32f267c-2a6f6e42-e2d6be4a-880d9bd3.jpg,test/p12/p12405140/s58516376/9fcc5266-d32f267c-2a6f6e42-e2d6be4a-880d9bd3.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old woman with respiratory failure, status post drowning with resuscitation. FINDINGS: Comparison is made to prior radiographs from ___. The endotracheal tube and feeding tube are unchanged. There are again seen diffuse airspace opacities throughout both lungs which appear relatively stable. There in mild improvement in the left perihilar region. There are no pneumothoraces. " e3685a42-2e14ee55-98653b25-fb26c99c-4bd931f9.jpg,test/p19/p19491686/s58589276/e3685a42-2e14ee55-98653b25-fb26c99c-4bd931f9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M s/p CVL placement // Confirm L CVL placement TECHNIQUE: Single frontal view of the chest COMPARISON: Earlier today, ___ at 08:01 FINDINGS: There has been interval placement of a left internal jugular central venous catheter which terminates in the mid SVC without evidence of pneumothorax. The lungs are hyperinflated, consistent with chronic obstructive pulmonary disease. Relative lucency over the upper chest consistent with pulmonary emphysema. Re- demonstrated are bibasilar, right greater than left, consolidations worrisome for multifocal pneumonia and/ or aspiration. The right base consolidation appears slightly more consolidated as compared to 3 hr prior. No large pleural effusion is seen. There is no evidence of pneumothorax. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Left internal jugular central venous catheter terminates in the mid SVC without evidence of pneumothorax. Right greater than left bibasilar consolidations, slightly more consolidative on the right, worrisome for multifocal pneumonia and/ or aspiration. Re- demonstrated pulmonary emphysema. . " 2b230acb-21e079ca-34743275-6e0e6d49-380e84e7.jpg,test/p13/p13990571/s56873433/2b230acb-21e079ca-34743275-6e0e6d49-380e84e7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with asthma, shortness of breath and chest tightness x 1 week TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Low lung volumes are present. Heart size remains moderately enlarged. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Increased interstitial opacities within the lung bases and periphery of both lungs are not substantially changed in the interval, previously thought reflect UIP. No new focal consolidation, pleural effusion or pneumothorax is definitively noted. Multiple clips are seen in the left upper quadrant of the abdomen. No acute osseous abnormalities detected. IMPRESSION: Low lung volumes with chronic interstitial lung disease, not substantially changed since the previous radiograph, and thought to reflect UIP on prior chest CT. No new focal consolidation. " 41ca7a82-5a668d24-c2a5837b-3d06f96b-c1331720.jpg,test/p18/p18371833/s58366146/41ca7a82-5a668d24-c2a5837b-3d06f96b-c1331720.jpg,test," FINAL REPORT INDICATION: Fever. COMPARISONS: Chest radiographs of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Port-A-Cath tip projects over upper SVC. G-tube is in place. Expansile, mixed lytic and sclerotic lesion of the right distal clavicle is noted. IMPRESSION: No evidence of acute cardiopulmonary process. " 3943d7d8-957c5b23-f83e0a9b-c994e9d3-20a6c6d7.jpg,test/p18/p18742296/s56225531/3943d7d8-957c5b23-f83e0a9b-c994e9d3-20a6c6d7.jpg,test," FINAL REPORT HISTORY: Bronchitis and smoking history. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Again there are relatively low lung volumes, but no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 91a534ab-e8aca836-fd7edd67-c930d0fc-e57ad09b.jpg,test/p16/p16818299/s50990134/91a534ab-e8aca836-fd7edd67-c930d0fc-e57ad09b.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: AVR. Pre-discharge. IMPRESSION: PA and lateral chest compared to ___ and ___. Small bilateral pleural effusions are new or increased since ___, but tiny residual apical pneumothoraces are unchanged. Moderate left basal atelectasis probably unchanged as well. Heart size top normal. No pulmonary edema or mediastinal abnormality. " 18ba5001-91bdb921-402a7bca-0e9b1867-cabad770.jpg,test/p18/p18143678/s54078384/18ba5001-91bdb921-402a7bca-0e9b1867-cabad770.jpg,test," FINAL REPORT INDICATION: ___ year old man with C diff on vanc, LLE cellulitis s/p clindamycin x 10 days, with leukocytosis // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___. FINDINGS: Compared to prior, there is improvement of pulmonary edema. Otherwise there is no significant change. Lung volumes continue to be low. Upper lobes are clear. Again seen are enlarged heart and substantial left lower lobe collapse with bilateral pleural effusion. Right-sided central line is unchanged from prior. Left-sided pacer is not changed in position. No pneumothorax. IMPRESSION: Improvement of pulmonary edema. Left lower lobe atelectasis, not significantly changed from prior. " 8cdc23bf-32906593-e49a71af-10f2ef2a-bb9c304d.jpg,test/p12/p12246599/s51625053/8cdc23bf-32906593-e49a71af-10f2ef2a-bb9c304d.jpg,test," FINAL REPORT HISTORY: ___-year-old man with dysphagia and coughing after p.o. intake. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Right chest wall port catheter terminates in the mid SVC. Left chest wall pacer lead terminates in the right ventricle. Heart size and cardiomediastinal contours are normal. Mild interstitial opacities appear chronic, most noted along the periphery. Minimal left base atelectasis is probably present. IMPRESSION: 1. Possible minimal left base atelectasis. Underlying aspiration is not excluded. 2. Chronic interstitial lung disease. " 454d9f1a-a1a06236-cb3e6878-aca28ace-4af8dd2f.jpg,test/p10/p10619883/s56444989/454d9f1a-a1a06236-cb3e6878-aca28ace-4af8dd2f.jpg,test," FINAL REPORT HISTORY: Chest pain, evaluate for acute process. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 810f7b10-7200ce5f-791c09b4-978d50d8-d75d6a89.jpg,test/p11/p11005665/s54880421/810f7b10-7200ce5f-791c09b4-978d50d8-d75d6a89.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M h/o asc aorta/aortic arch (inominate/L CCA) replacement Type A cb distal graft aneurysm s/p desc ao tube graft, reimplant subclav a with hybrid graft L Chest recon w mesh. // comparison to previous CXR IMPRESSION: As compared to ___, worsening volume loss is present in the left hemi thorax, with near complete collapse of the left lower lobe. Moderate to large, partially loculated left pleural effusion persists. Cardiomediastinal contours are stable in this patient status post recent thoracic aorta procedure. Right lung and pleural surfaces are clear. " 68e76280-ea6c7e17-97913e1b-46fc3eb9-ef92115a.jpg,test/p11/p11016966/s57594039/68e76280-ea6c7e17-97913e1b-46fc3eb9-ef92115a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, chest pain, ?pneumonia // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart is persistently mildly enlarged, with left ventricular configuration, and the aorta is tortuous. Lungs are clear. . No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No radiographic evidence of pneumonia. " cdc41b82-b4f60245-ba1622d0-016a61dc-e4e7a4ea.jpg,test/p10/p10717732/s55527040/cdc41b82-b4f60245-ba1622d0-016a61dc-e4e7a4ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p AVR/ao root enlargement/cabg // eval for pleural effusions eval for pleural effusions IMPRESSION: In comparison with the study ___ ___, there is some improved aeration in the left hemithorax, the residual opacification persists. The left IJ catheter is been removed. The right lung remains essentially clear. " e9d4edef-c8dd24e2-07efcdda-a87a076f-2e4f78ee.jpg,test/p17/p17527219/s56801085/e9d4edef-c8dd24e2-07efcdda-a87a076f-2e4f78ee.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LVAD // r/o inf, eff IMPRESSION: Allowing for differences in technique, there has been little change in the appearance of the chest since recent study of 1 day earlier except for slight decrease in size of right pleural effusion and associated improvement in adjacent atelectasis in the right mid and lower lung. " 3987b6dd-64ed1edf-a7bfb509-b6a4d90a-c2772046.jpg,test/p16/p16917219/s55966655/3987b6dd-64ed1edf-a7bfb509-b6a4d90a-c2772046.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Subclavian bypass, postoperative evaluation. COMPARISON: Preoperative chest x-ray from ___. FINDINGS: As compared to the previous radiograph, clips are now projecting over the soft tissues in the right neck and mild gas inclusions are seen in the soft tissues. No pneumothorax. No pulmonary edema. No larger pleural effusions. Mild tortuosity of the thoracic aorta. No pneumonia. " 71579d86-5fd8f793-4c890681-14a2da03-e6779737.jpg,test/p19/p19928728/s51695469/71579d86-5fd8f793-4c890681-14a2da03-e6779737.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Fall. Comparison is made with prior study, ___. Tracheostomy tube is in a standard position. NG tube tip is out of view, below the diaphragm. Left PICC tip is in the mid SVC. There is no pneumothorax. If any, there is a small left pleural effusion. Mild cardiomegaly is stable. Right lower lobe opacities have increased, worrisome for aspiration. There is mild vascular congestion. Spinal hardware is again noted. " bb2ec5e1-ada1247e-33e3a640-9b80d1f5-9c7f15b6.jpg,test/p11/p11888614/s52249249/bb2ec5e1-ada1247e-33e3a640-9b80d1f5-9c7f15b6.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with substance abuse p/w chest pain // eval edema, pna TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. A rounded, nodular opacity overlies the right lower lung, and cannot be discreetly separated from the ninth posterior rib. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Nodular opacity overlying the right lower lung and anterior right fifth rib. TO DETERMINE WHETHER THIS IS A LUNG NODULE OR THE RIGHT NIPPLE OR SCLEROSIS IN THE ANTERIOR RIGHT FIFTH RIB, SHALLOW OBLIQUE VIEWS WITH NIPPLE MARKER SHOULD BE OBTAINED. NOTIFICATION: Dr. ___ reported the findings to ___ QA nurses by receipted email on ___ at 8:47 AM, 5 minutes after discovery of the findings. " 3925c488-a33f0e7f-3832af9d-e01a70c5-bb24fb07.jpg,test/p15/p15904606/s52784457/3925c488-a33f0e7f-3832af9d-e01a70c5-bb24fb07.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with flu, worsening resp status // Eval for pulm edema, worsening infection Eval for pulm edema, worsening infection COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lungs are clear. Mild cardiomegaly and mild pulmonary vascular cephalization are long-standing. No pneumonia or pulmonary edema. No pneumothorax or pleural effusion. " ed2fb24d-9b0bb43c-b2d866a6-0db35adf-c120aaf9.jpg,test/p15/p15184004/s53332317/ed2fb24d-9b0bb43c-b2d866a6-0db35adf-c120aaf9.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ ___ COMPARISON: Chest radiographs ___ ___ and ___ as well as prior chest CT ___ ___. FINDINGS: Stable enlarged cardiac silhouette, which corresponds to both cardiomegaly and small pericardial effusion on recent chest CT. Bilateral chronic interstitial lung disease appears similar to recent studies, with distribution favoring UIP. No superimposed acute areas of consolidation or atelectasis are evident, and there is no evidence of either pleural effusion or pneumothorax. Proximal right humeral fracture is incompletely evaluated on this CXR. IMPRESSION: 1. Chronic interstitial lung disease with distribution favoring UIP. No superimposed acute process to explain the patient's symptoms. If pulmonary embolism is suspected clinically, a dedicated CT angiography study would be suggested. 2. Incompletely imaged proximal right humeral fracture, which has been more fully evaluated by a dedicated right shoulder radiograph ___ ___. " 4f313509-c627b8d1-37de81ad-43ed9799-f3f7c602.jpg,test/p13/p13809836/s59613536/4f313509-c627b8d1-37de81ad-43ed9799-f3f7c602.jpg,test," FINAL REPORT HISTORY: Status post PICC removal, now with 5 cm of PICC missing. Assess for foreign body. COMPARISON: Chest radiograph ___. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: The cardiomediastinal silhouette and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. Osseous structures are grossly unremarkable. There is no radiopaque foreign body noted. IMPRESSION: No acute intrathoracic process. No evidence of radiopaque foreign body. " e01f51d2-8c7e8676-ffe59519-f8856494-3fba7311.jpg,test/p14/p14591676/s52749063/e01f51d2-8c7e8676-ffe59519-f8856494-3fba7311.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with increasing SOB and oxygen requirements with known pleural effusion // Evaluate for interval change in pleural effusion. TECHNIQUE: Chest single view COMPARISON: ___ 11:06 FINDINGS: Large left pleural effusion, similar. Left perihilar, basilar opacification, stable, likely atelectasis. Right lung clear. Sternotomy. Benign bone island right humeral head. Suggestion of osseous loose body right shoulder joint. Surgical clips right upper quadrant. IMPRESSION: Stable exam " 7193d3f9-e07872e0-08f06850-e3bbf098-ed3a1c67.jpg,test/p15/p15690303/s52829854/7193d3f9-e07872e0-08f06850-e3bbf098-ed3a1c67.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with hypertension, multiple injuries, mechanical fall downstairs, left humeral fracture. COMPARISON: Yesterday chest x-ray. FINDINGS: ET tube is in adequate position and NG tube is below the diaphragm. There is no visible residual pneumothorax. Subcutaneous air has slightly decreased in size. Moderate pulmonary edema has slightly improved and is now mild. Bibasilar consolidation with pleural effusions are stable. Left-sided chest tube still has a side port outside of the patient. CONCLUSION: 1. There is no visible pneumothorax. However, the left-sided chest tube still has a side port outside of the patient. 2. Improving moderate pulmonary edema is now mild. 3. Unchanged bibasilar consolidation with pleural effusions. This have been discussed with the medical team. " 25657e8a-992a60f4-80d742d2-dca213ef-0600bf4d.jpg,test/p11/p11123733/s52855807/25657e8a-992a60f4-80d742d2-dca213ef-0600bf4d.jpg,test," FINAL REPORT INDICATION: ___M with shortness of breath, history of CAD // evaluate for pulmonary edema TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. ___. FINDINGS: Since prior, there has been no significant interval change. Moderate left and small right pleural effusions are again seen with adjacent atelectasis. There is mild pulmonary edema, also similar. Moderate cardiac enlargement and atherosclerotic calcifications are noted. Median sternotomy wires are intact. Compression deformity in the lower thoracic spine is unchanged since ___. IMPRESSION: No significant interval change since yesterday's exam with moderate left and small right pleural effusions and mild pulmonary edema. " e7e8422c-1cb7d654-4b8b5e3a-cf568310-6679e492.jpg,test/p18/p18139875/s55138184/e7e8422c-1cb7d654-4b8b5e3a-cf568310-6679e492.jpg,test," FINAL REPORT HISTORY: HCM, heart block, status post dual-chamber PPM, check lead position and rule out pneumothorax. CHEST, TWO VIEWS. COMPARISON: Portable chest x-ray from ___. Compared with the prior study, left-sided dual-lead pacemaker has been placed, with lead tips over the right atrium and right ventricle. No pneumothorax is detected. Again seen is moderately severe cardiomegaly with mildly tortuous unfolded aorta. The hila are both prominent with a tapered appearance, raising the question of pulmonary hypertension. There is minimal upper zone redistribution, without other evidence of CHF. There is minimal atelectasis at the left lung base. No focal infiltrate or effusion is identified. Probable osteopenia and mild degenerative changes of the thoracic spine are noted. " 8712d8d6-c216bc4e-59196f0a-fed6eff8-1b631b0c.jpg,test/p10/p10665320/s51943526/8712d8d6-c216bc4e-59196f0a-fed6eff8-1b631b0c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with smoking for many years // r/o any abnormality COMPARISON: ___. FINDINGS: Cardiomediastinal contours are normal. Lungs and pleural surfaces are clear. IMPRESSION: Stable radiographic appearance of the chest with no acute cardiopulmonary abnormalities. " 1572b49c-4b3a17ad-64d3b940-16e4d683-ef225bb9.jpg,test/p16/p16081819/s50004606/1572b49c-4b3a17ad-64d3b940-16e4d683-ef225bb9.jpg,test," FINAL REPORT HISTORY: Tongue cancer with increased shortness of breath. FINDINGS: No previous films are available. The heart is normal in size and there is no vascular congestion or pleural effusion. No acute focal pneumonia. " daf2e22e-313c7fd6-81d93835-48ff2c1f-3978a930.jpg,test/p11/p11410945/s57459563/daf2e22e-313c7fd6-81d93835-48ff2c1f-3978a930.jpg,test," FINAL REPORT HISTORY: Rheumatoid arthritis on treatment, now with fever and possible pericarditis. FINDINGS: In comparison with the study of ___, there is little change. Cardiac silhouette remains within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Hyperexpansion of the lungs with flattening of the hemidiaphragms is again consistent with some chronic pulmonary disease. " 8b4e5a33-927fe6d8-a154a849-3a8fc30c-b251aa10.jpg,test/p11/p11585485/s56450218/8b4e5a33-927fe6d8-a154a849-3a8fc30c-b251aa10.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with nhl // pre bmt COMPARISON: ___ IMPRESSION: As compared to the previous image, the left pleural effusion and left basal atelectasis has completely resolved. A new effusion, however, has occurred on the right, causing mild right basilar atelectasis as well as extension into the minor fissure. The well ventilated lung parenchyma is free of pneumonia or other pathologically changes. The lung volumes are high. No pulmonary edema. Borderline size of the cardiac silhouette. Left pectoral Port-A-Cath in situ. " 4e54cce7-a93342c7-d7d4a31e-d198e04b-2bcdf90d.jpg,test/p16/p16514153/s58250166/4e54cce7-a93342c7-d7d4a31e-d198e04b-2bcdf90d.jpg,test," WET READ: ___ ___ ___ 8:56 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with chest pain, dyspnea, evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: Patient is status post aortic core valve and mitral valve replacement with unchanged median sternotomy wires. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is stable. IMPRESSION: No acute cardiopulmonary process. " fd924b50-07115f8f-a7e137fc-70d0106d-3c5d9bc6.jpg,test/p16/p16386563/s51108710/fd924b50-07115f8f-a7e137fc-70d0106d-3c5d9bc6.jpg,test," WET READ: ___ ___ ___ 9:26 AM No focal consolidation concerning for pneumonia. Mild cardiomegaly without pulmonary edema. No large pleural effusion or pneumothorax. WET READ VERSION #1 ___ ___ ___ 7:30 PM No focal consolidation concerning for pneumonia. Mild cardiomegaly without pulmonary edema. No large pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with intracranial epilepsy monitoring now with fevers // eval pneumonia COMPARISON: Chest radiographs ___ IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. Distention of the azygos vein is unchanged, probably a normal variant. " d072ca65-d9d035cd-5ffb9645-92ab6518-4dc50b93.jpg,test/p15/p15086031/s56517275/d072ca65-d9d035cd-5ffb9645-92ab6518-4dc50b93.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with chest pain. IMPRESSION: PA and lateral chest compared to ___: Lungs fully expanded and clear. Heart size normal. Thoracic aorta very tortuous but not clearly aneurysmal. Mediastinum otherwise unremarkable. Hila not enlarged. Ribbon-like deformities of three right middle ribs posteriorly include indentations on the upper margins of the ribs, rather than the undersides generally seen with multiple neuromas. I suspect this is dysplasia, but if the patient has skin nodules or other stigmata, the diagnosis of neurofibromatosis should be considered. One skin nodule is seen in the right supraclavicular region and another laterally at the level of the eighth rib. Clinical correlation advised. " 2ee693d6-a5a0a2ea-d516d2ba-3c2fd331-d1e6509c.jpg,test/p12/p12909079/s50489518/2ee693d6-a5a0a2ea-d516d2ba-3c2fd331-d1e6509c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxemic respiraotry failure and heart failure // Interval change? COMPARISON: ___. IMPRESSION: Low lung volumes. The pre-existing bilateral perihilar opacities are increased in extent and severity. In addition, the diameter of the pulmonary vessels has increased, likely reflecting mild pulmonary edema. The extent of the bilateral pleural effusions is constant. Constant retrocardiac atelectasis. " 8ce4a75c-e977aa12-7dbd8f70-8d764593-bf7f421d.jpg,test/p15/p15227454/s58017623/8ce4a75c-e977aa12-7dbd8f70-8d764593-bf7f421d.jpg,test," FINAL REPORT INDICATION: ___-year-old male with syncope. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiographs from ___, ___ and ___. FINDINGS: There are multiple left upper lobe and left mediastinal surgical clips, and the patient is status post left rib resection. There is a small right pleural effusion and thickening, and there is no focal consolidation or pulmonary edema. The heart size is normal, and a calcified aortic valve is noted. IMPRESSION: Small right pleural effusion. Calcified aortic valve may cause aortic stenosis contribute to syncope. " c11c7aa6-2ae5c9d0-89c9cf36-07d78f7d-e1b6516b.jpg,test/p17/p17077719/s51837251/c11c7aa6-2ae5c9d0-89c9cf36-07d78f7d-e1b6516b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Chronic cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are unremarkable. Tortuous aorta is noted. Lungs are essentially clear. There is no pleural effusion or pneumothorax. " 05675b81-3349d2a1-4305b31f-7896d138-5300aa04.jpg,test/p16/p16454913/s54012607/05675b81-3349d2a1-4305b31f-7896d138-5300aa04.jpg,test," FINAL REPORT INDICATION: ___-year-old man with tracheobronchomalacia status post tracheoplasty. COMPARISON: ___ to ___. FINDINGS: A single portable semi-erect chest radiograph is obtained. The endotracheal tube tip remains 4 cm above the carina. An enteric catheter passes out of the field of view. A right pleural catheter is in unchanged position. Central pulmonary vasculature congestion has worsened since the prior exam 24 hours ago, contributing to apparent mediastinal widening. Retrocardiac opacity is unchanged. A moderate left and small right pleural effusion is similar. IMPRESSION: Interval worsening of central pulmonary vascular congestion. " 1f7ba140-b003ee99-5b0b5d7d-af4aa6b4-a212ee2d.jpg,test/p17/p17709047/s58802826/1f7ba140-b003ee99-5b0b5d7d-af4aa6b4-a212ee2d.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. The lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is seen. Surgical sutures are demonstrated within the left upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 446cb614-24d17a1f-e02cbd5c-02141998-0b1f7cad.jpg,test/p15/p15474097/s59508129/446cb614-24d17a1f-e02cbd5c-02141998-0b1f7cad.jpg,test," FINAL REPORT INDICATION: ___-year-old female with EKG changes, shortness of breath on exertion. Evaluate for evidence of CHF or pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are hypoinflated. The right lung is clear, while the left lung demonstrates an ill-defined opacity that is obscuring a portion of the margin of the left hemidiaphragm, which is confirmed in the lateral view where the left hemidiaphragm is not clearly identified. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Ill-defined opacity in the left lower lung base might represent atelectasis, although an infectious/inflammatory process cannot be excluded. " 87c4ff58-a834217e-b9865b25-66a5ae8b-1e10e17a.jpg,test/p10/p10705688/s54409933/87c4ff58-a834217e-b9865b25-66a5ae8b-1e10e17a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough chills // eval for pna COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute intrathoracic process. " d8dd9015-fcdbc179-bb6dacd9-a5c237e5-abfabe88.jpg,test/p18/p18658996/s58121690/d8dd9015-fcdbc179-bb6dacd9-a5c237e5-abfabe88.jpg,test," FINAL REPORT INDICATION: Cirrhosis and pleural MALT lymphoma, status post thoracentesis yesterday. Evaluate for interval change. COMPARISON: Chest radiograph on ___. FINDINGS: AP and lateral views of the chest. Enteric tube has been removed. Moderate bilateral pleural effusions are unchanged. Bilateral dependent edema and atelectasis, and normal cardiomediastinal and hilar contours are stable. No pneumothorax. The pigtail catheter in the overlying left lower hemithorax is again seen. IMPRESSION: Moderate bilateral pleural effusions are unchanged. Bilateral dependent pulmonary edema and atelectasis. Suggest follow up to rule out pneumonia in the lower lobes. " fd4a255b-fcabcbd5-5b869aef-e75b5a98-a343ba3a.jpg,test/p18/p18654206/s57817784/fd4a255b-fcabcbd5-5b869aef-e75b5a98-a343ba3a.jpg,test," WET READ: ___ ___ ___ 4:54 PM Left lower lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. ______________________________________________________________________________ FINAL REPORT HISTORY: Cough, yellow sputum, fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The pulmonary vasculature is normal. A focus of consolidation within the left lower lobe is concerning for pneumonia. Right lung is clear. No pleural effusion or pneumothorax is clearly seen. There are no acute osseous abnormalities. IMPRESSION: Left lower lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. " 17c09e95-99fac791-88ce4a30-90b7e159-166aa4e2.jpg,test/p18/p18692222/s55320438/17c09e95-99fac791-88ce4a30-90b7e159-166aa4e2.jpg,test," FINAL REPORT HISTORY: MDS, neutropenic with wet cough, low-grade fevers, crackles in left lower lung, question pneumonia. CHEST, TWO VIEWS. COMPARISON: Chest x-ray from ___ at 18:30 p.m. Left-sided pacemaker-type device (apparently an ICD) is present, with lead tips over right atrium and right ventricle. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is mild-to-moderate cardiomegaly. The aorta is calcified and minimally unfolded. There are some patchy opacities at both lung bases, which have progressed compared with ___, and which could represent pneumonic infiltrates. Minimal stranding in the lingula is likely also present. Right upper zones remain clear. No CHF. Minimal blunting of the posterior costophrenic angle, but no gross effusion. A small density in the right upper zone overlying the right clavicle measures approximately 3.8 mm and could correspond to the nodular density seen on the ___ CT scan. IMPRESSION: 1. COPD and cardiomegaly. 2. Patchy opacities in both lower lobes posteriorly, that could represent pneumonic infiltrates and that have progressed compared with the CXR from ___ at 18:30 p.m. Lingular stranding likely also present. 3. Small nodular density (3.8 mm) right upper zone, likely corresponds to finding on the ___ CT scan. " 6da288ac-7d2628ef-c110328e-b4737ff1-bc823ac9.jpg,test/p10/p10686756/s52769164/6da288ac-7d2628ef-c110328e-b4737ff1-bc823ac9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with CP // r/o acute process COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 27ba8059-a695c7b1-bb199f94-c8f4390e-73b8f2bb.jpg,test/p13/p13035993/s51818838/27ba8059-a695c7b1-bb199f94-c8f4390e-73b8f2bb.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumonia. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs. The cardiac silhouette is mildly enlarged. Mildly increased focal opacity in the central right lower lung without correlate on the lateral view likely represents atelectasis, but an early pneumonia cannot be excluded. The visualized upper abdomen is unremarkable. IMPRESSION: Mildly increased focal opacity in the central right lower lung likely represents atelectasis, but early pneumonia cannot be excluded. " ad5dbcae-e391d578-f01e2f54-b2d7c96c-0c121ec6.jpg,test/p10/p10575714/s59777295/ad5dbcae-e391d578-f01e2f54-b2d7c96c-0c121ec6.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with cp/sob COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low. Allowing for this, the lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 82f4ca72-aecf0110-542e915e-0cea0fad-c313288e.jpg,test/p17/p17094830/s58232027/82f4ca72-aecf0110-542e915e-0cea0fad-c313288e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chest x-ray for nodular opacity // ?pneumonia, atelectasis ?pneumonia, atelectasis IMPRESSION: On the current study, no definite nodular opacification is seen in the lower left hemithorax. The overall appearance is similar to the studies of ___ to on ___. " be53a477-bf7d63f6-b5023130-27c8cec7-a3f7e142.jpg,test/p12/p12343035/s51695816/be53a477-bf7d63f6-b5023130-27c8cec7-a3f7e142.jpg,test," WET READ: ___ ___ ___ 2:01 AM Area of opacity in the right upper lung may represent pneumonia in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with elevated WBC // r.o pna TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Frontal and lateral radiographs of the chest demonstrate an area of opacity in the right upper lung seen on the frontal view, which may represent pneumonia in the appropriate clinical setting. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion. IMPRESSION: Area of opacity in the right upper lung may represent pneumonia in the appropriate clinical setting. Recommend followup chest radiograph in ___ weeks to evaluate for resolution. RECOMMENDATIONS: Followup chest radiograph in ___ weeks to evaluate for resolution. NOTIFICATION: Updated recommendations were discussed with Dr. ___ by Dr. ___ ___ telephone at 11:02amon ___, approximately 2 hours after discovery. " 186f4780-419f494f-78d54aa3-7a6a90e4-0fbd25ff.jpg,test/p16/p16335622/s53197298/186f4780-419f494f-78d54aa3-7a6a90e4-0fbd25ff.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NGT placement // ?location ?location IMPRESSION: In comparison with a study of ___, there has been placement of a nasogastric tube that extends only to the lower esophagus. Otherwise little change. " 442bd76f-0a6c39d1-de896552-54372ce5-868e5cd5.jpg,test/p16/p16972269/s56095852/442bd76f-0a6c39d1-de896552-54372ce5-868e5cd5.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough and decreased breath sounds on the left. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral chest radiograph demonstrates clear lungs. Flattening of the hemidiaphrams suggests hyperinflation. There is no focal consolidation concerning for pneumonia. There is no pleural effusion. There is a tortuous or dilated aorta, allowing for changes in patient positioning, which appears stable since ___. Heart size is top normal. No pneumothorax. IMPRESSION: No pneumonia. " c5348298-3676af27-d5d0b636-7c62490e-5875cd16.jpg,test/p10/p10871684/s59894670/c5348298-3676af27-d5d0b636-7c62490e-5875cd16.jpg,test," FINAL REPORT HISTORY: ___ year old female with cough and fever. Evaluate for pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Multifocal opacities in the left lung, some quite nodular, is most likely multifocal pneumonia, but needs followup radiographs to exclude other concurrent diagnoses. Vague heterogeneous opacity overlying the right lower lung may also represent small consolidation. No substantial pleural effusion or pneumothorax. The heart size and cardiomediastinal contours are normal. IMPRESSION: Multifocal pneumonia involving the left lung and possibly the right lower lobe. Follow up CXR needed in 4 weeks to document substantial clearing in order to exclude other conditions. " 68a59091-bf97055d-54e9aae9-51a75fea-05edc5ea.jpg,test/p15/p15527518/s59309884/68a59091-bf97055d-54e9aae9-51a75fea-05edc5ea.jpg,test," FINAL REPORT HISTORY: ___ year old F with CP COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral views of the chest were obtained. These demonstrate clear lungs bilaterally with no focal opacity identified. Patient is status post median sternotomy with wires in unchanged position. Heart size is borderline enlarged, stable since prior examination dated ___. The mediastinal contour appears unchanged, the mediastinal convexity compatible with ascending and descending tortuous or dilated aorta. Osseous structures are without acute abnormality. IMPRESSION: No acute intrathoracic abnormality. " ed67bce1-437eead6-884a462f-9d013647-097b86fe.jpg,test/p14/p14809300/s56496537/ed67bce1-437eead6-884a462f-9d013647-097b86fe.jpg,test," WET READ: ___ ___ ___ 8:00 AM Similar appearance of moderate right and trace left effusions and bibasilar atelectasis, allowing for differences in patient positioning. Underlying right base or retrocardiac consolidation cannot be excluded. WET READ VERSION #1 ___ ___ ___ 7:45 PM Similar appearance of moderate right and trace left effusions and bibasilar atelectasis, allowing for differences in patient positioning. Underlying right base or retrocardiac consolidation cannot be excluded. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman w/COPD s/p right hip fracture with fever and hypoxemia // ?Pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Moderate right pleural effusion, fiducial marker in the right lung apex. Mild elevation of the left hemidiaphragm, caused by slightly distended bowel loops. Borderline size of the cardiac silhouette without overt pulmonary edema. Moderate areas of atelectasis at the right and the left lung base. " 14863047-111435f8-09770940-36e39875-04150978.jpg,test/p15/p15736763/s51076401/14863047-111435f8-09770940-36e39875-04150978.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old male with chest pain. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. A large bulla in the right upper lobe is unchanged. There is no focal consolidation, pleural effusion, or pneumothorax. Mild interstitial pulmonary edema and cardiomegaly are similar to ___. No displaced rib fracture is identified. IMPRESSION: 1. Mild congestive heart failure, similar to ___. 2. Large right upper lobe bulla. " 11be6b45-641fde10-6e149a88-b7929489-1e0fa870.jpg,test/p18/p18977683/s58179273/11be6b45-641fde10-6e149a88-b7929489-1e0fa870.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: 2 views of the chest. COMPARISON: ___. FINDINGS: The lungs are well expanded with increased interstitial markings which likely reflect chronic changes due to a nonspecific fibrotic lung disease as on the prior CT. Increased bibasilar opacities may reflect superimposed atelectasis; however aspiration would be difficult to exclude. There is no pleural effusion or pneumothorax. The heart is normal in size with normal mediastinal and hilar contours aside from enlarged pulmonary arteries consistent with provided history of pulmonary hypertension. Proximal left clavicular fracture is redemonstrated. IMPRESSION: Chronic fibrotic changes with superimposed increased basilar opacities which could reflect atelectasis or aspiration. " 25c1aa75-224e1db8-cc009d26-2db01fa5-693a8f80.jpg,test/p19/p19557250/s50001977/25c1aa75-224e1db8-cc009d26-2db01fa5-693a8f80.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new hypotension s/p trach // r/o PTX r/o PTX COMPARISON: Comparison to ___ at 13:02 FINDINGS: Portable AP semi-erect chest radiograph ___ at 21:25 IMPRESSION: Tracheostomy tube is in satisfactory position with the tip 4.5 cm above the carina. The right internal jugular central line and nasogastric tube are unchanged in position. The heart remains stably enlarged. Lung volumes are markedly reduced and there is a small layering left effusion with persistent retrocardiac consolidation likely reflecting partial lower lobe atelectasis. No pulmonary edema. No obvious pneumothorax. " 7ced5f50-e3b6da7d-771e1ac7-cb0f6c06-b5cc2321.jpg,test/p10/p10667727/s59300854/7ced5f50-e3b6da7d-771e1ac7-cb0f6c06-b5cc2321.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman who is intubated // ?interval change in exam ?interval change in exam COMPARISON: Comparison to ___ at 16:52 FINDINGS: Portable semi-erect chest film ___ at 09:13 is submitted. IMPRESSION: Endotracheal tube, nasogastric tube, and right internal jugular central line are unchanged in position. There are stable bibasilar opacities with layering effusions, right greater than left ,suggestive of partial lower lobe atelectasis. No pulmonary edema. No pneumothorax. Stable cardiac and mediastinal contours. " fb7be1c5-3056c41c-2b348c94-b9b4d3f1-860b4beb.jpg,test/p12/p12458842/s58474022/fb7be1c5-3056c41c-2b348c94-b9b4d3f1-860b4beb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ct pull. Eval for ptx. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: Compared with the most recent radiograph, there has been interval removal of although monitoring and support devices in this post CABG patient, including the mediastinal drains, and anterior chest tube, endotracheal tube, NG tube, and Swan-Ganz catheter. The right IJ introducer sheath is still present. As expected, lung volumes have decreased, causing apparent increase in the size of the cardiac silhouette and bibasilar atelectasis. There is no new large pleural effusion or pneumothorax. Patient is status post valve replacement and median sternotomy with intact wires. IMPRESSION: 1. No evidence of pneumothorax. No new large pleural effusion. 2. Expected post extubation changes as above. " 530f4750-8fddb6e9-b12f1b43-6fce9ba7-43012e49.jpg,test/p13/p13593286/s57735408/530f4750-8fddb6e9-b12f1b43-6fce9ba7-43012e49.jpg,test," FINAL REPORT INDICATION: Evaluation of pneumothorax. COMPARISON: ___ at 11:28 a.m. (earlier today). TECHNIQUE: PA upright chest radiograph. FINDINGS: Left pneumothorax is no longer clearly seen. The cardiomediastinal contours are unremarkable. Lungs remain clear. No pleural effusions. IMPRESSION: Left apical chest tube is unchanged. No pneumothorax is identified. " d11f868a-0e783eb0-05a529d8-bc799872-95aacbbd.jpg,test/p18/p18169012/s55475502/d11f868a-0e783eb0-05a529d8-bc799872-95aacbbd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NGT, advanced after initial placement. // Confirm NGT placement TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 2 hours earlier. IMPRESSION: NG tube tip is in the stomach. No other interval change from prior study. " f5574a6a-17837757-f3bcb3e2-5e63dbf5-a05bb7d5.jpg,test/p18/p18232511/s54893528/f5574a6a-17837757-f3bcb3e2-5e63dbf5-a05bb7d5.jpg,test," FINAL REPORT HISTORY: ___-year-old male with bibasilar opacities on prior AP chest radiograph. PA and lateral examination for further characterization. COMPARISON: Frontal chest radiograph from ___ at 8:34 a.m. AP AND LATERAL CHEST RADIOGRAPHS: Lateral examination is extremely limited due to the arm down positioning. Persistent basilar opacities may be seen with atelectasis although the etiology is not specific. A new mild interstitial abnormality suggests mild pulmonary vascular congestion. The upper lungs remain clear. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Persistent basilar opacities which are not specific; these could be seen with atelectasis, although other etiologies such as pneumonia and aspiration are not entirely excluded. 2. Findings suggesting mild new vascular congestion. 3. Convex right mid mediastinal contour; evaluation with chest CT is recommended when clinically appropriate. Final report discussed with Dr. ___ at 9:15 pm by telephone. " e2b5d535-14aca299-52a90951-a124d5b0-2ea5568f.jpg,test/p15/p15024999/s56672451/e2b5d535-14aca299-52a90951-a124d5b0-2ea5568f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M s/p open subtotal chole ___ now w/ perforated appendicitis and ___.8x3.4 intraabdominal fluid collection. New fever // Pls eval any intrathoracic process Pls eval any intrathoracic process IMPRESSION: Comparison to ___. Low lung volumes persist. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly. Small bilateral pleural effusions are better seen on the lateral than the frontal image. No pneumonia. " 44bdf958-64f7e05d-9e8aebe6-92856cc7-4962dfc7.jpg,test/p16/p16476559/s51446813/44bdf958-64f7e05d-9e8aebe6-92856cc7-4962dfc7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF, DM, HTN, h/o CVA, Afib, CKD who presented with increased dyspnea and ___ edema now with continued dyspnea and frothy red sputum. // eval for pulmonary edema, pulm hemorrhage, pna COMPARISON: ___. IMPRESSION: As compared to the previous image, the lung volumes have decreased. No other changes noted. Moderate to severe cardiomegaly. Elongation of the descending aorta. The sternal wires and the pacemaker leads are in constant position. There is no evidence of larger pleural effusions, no signs of pulmonary edema and no pneumonia. " a90f8098-ad7df3a8-4b43476d-409ca861-8019d187.jpg,test/p14/p14645491/s57079756/a90f8098-ad7df3a8-4b43476d-409ca861-8019d187.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recurrent bronchitis // r/o infiltrate r/o infiltrate IMPRESSION: THERE IS AGAIN EVIDENCE OF PREVIOUS LEFT LOWER LOBECTOMY WITH VOLUME LOSS OF THE HEMITHORAX AND ELEVATION OF THE DIAPHRAGM. NO EVIDENCE OF ACUTE PNEUMONIA, VASCULAR CONGESTION, OR PLEURAL EFFUSION. SIGNIFICANT FLOWING OSTEOPHYTES ARE AGAIN SEEN IN THE THORACIC SPINE ON THE LATERAL VIEW. " 37e839b0-7662d5de-30f9dd7e-71743f2a-9c18a4e6.jpg,test/p10/p10390732/s51882599/37e839b0-7662d5de-30f9dd7e-71743f2a-9c18a4e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // ? PNA ? PNA COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Min scarring at the left patient has had median sternotomy for aortic and mitral valve replacements. A right subclavian vascular stent is unchanged in position since ___. Moderate cardiomegaly has improved. There is no pulmonary edema. Lateral view shows posterior elevation of left lung base probably due to chronic pleural scarring. There are no findings to suggest pneumonia. " fa0a62ff-91d77499-7c240f5a-d3b3c395-f518a87b.jpg,test/p10/p10148417/s57323547/fa0a62ff-91d77499-7c240f5a-d3b3c395-f518a87b.jpg,test," FINAL REPORT HISTORY: Interstitial lung disease. FINDINGS: In comparison with the study of ___, there is little change in the appearance of the monitoring and support devices or the widespread heterogeneous lung opacities consistent with extensive pulmonary fibrosis. The possibility of supervening pneumonia or pulmonary edema would be very difficult to exclude radiographically. " dc6965b6-14722e9e-8e7b12d4-61abc549-1a8b2a67.jpg,test/p10/p10654063/s55653668/dc6965b6-14722e9e-8e7b12d4-61abc549-1a8b2a67.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with cough occasionally and night sweats, // r/o abn TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Compared to the examination obtained ___, pulmonary edema has resolved. A focal nodular opacity projecting over the anterior left fifth rib is likely a nipple shadow. Hyperinflation of the lungs suggests chronic obstructive pulmonary disease. Moderate biapical scarring is again noted. A focal opacity within the right apex was new in ___, but is unchanged since and does therefore not reflect active infection. No pleural effusion or pneumothorax.. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. A vertebral body compression deformity in the mid to upper thoracic spine is unchanged since at least ___. IMPRESSION: No radiographic evidence of intrathoracic malignancy or active infection. Compared to ___, pulmonary edema has resolved. Severe emphysema. " 03453083-8d0abd7d-56da57da-ebb62ce0-70cfa1c4.jpg,test/p19/p19765159/s58969411/03453083-8d0abd7d-56da57da-ebb62ce0-70cfa1c4.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: COPD, presenting with one week of shortness of breath. COMPARISONS: Radiographs from ___ are not currently available for review and likewise for radiographs from ___. However, a chest CT from ___ is available and comparison can be made to the scout view. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size to mildly enlarged. The aorta is partly calcified. The mediastinal and hilar contours appear unchanged. On the prior CT, there was a substantial hiatal hernia which is not well visualized on this examination. Small bilateral pleural effusions are present and better seen on the lateral view. The lungs are hyperinflated. Fissures are minimally thickened, which may suggest slight fluid overload. However, the lungs appear clear. Small anterior osteophytes are noted throughout the visualized thoracolumbar spine. Leftward convex curvature along the upper lumbar spine is probably similar and associated with compression deformity of an upper lumbar vertebral body that may be similar, although not optimally characterized. IMPRESSION: Slightly thickened fissures and small pleural effusions, which may suggest mild congestion or fluid overload; otherwise unremarkable. " 60211009-db5c32f2-e5523dec-f127c0ee-4b481022.jpg,test/p19/p19033748/s54990681/60211009-db5c32f2-e5523dec-f127c0ee-4b481022.jpg,test," FINAL REPORT HISTORY: Confusion and fever. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: None. FINDINGS: The heart size is top normal. The aorta is tortuous and aortic knob calcifications are demonstrated. Assessment of the mediastinal contour is somewhat limited due to the presence of bilateral ___ rods extending from the cervical spine to the lumbar spine. There is no pulmonary vascular congestion. Apart from minimal atelectasis at the lung bases, the lungs are clear. No large pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 447ff7e9-84136d3f-33accca8-fb2ce96a-e4373ada.jpg,test/p16/p16061694/s57543081/447ff7e9-84136d3f-33accca8-fb2ce96a-e4373ada.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with multiple rib fractures and small left pneumothorax. Comparison is made with prior study CTA ___. Small left pneumothorax is better seen in prior CT. Cardiomediastinal contours are midline. Cardiac size is normal. Multiple left rib fractures are again noted. Small left effusion has increased. Left basal opacities have increased, could be due to atelectasis or aspiration. Opacities in the right lower lobe are grossly unchanged. " 2ec14779-254876aa-328921a4-eefa7d4a-904079a5.jpg,test/p17/p17702558/s56561183/2ec14779-254876aa-328921a4-eefa7d4a-904079a5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with L pleural effusion s/p pleurX // r/o pneumothorax, s/p chest tube r/o pneumothorax, s/p chest tube IMPRESSION: In comparison with the study ___ ___, there is a left PleurX catheter in place. There has been a small amount of aeration of lung in the left upper zone. The extensive opacification of all multiple the left hemithorax is again seen. No evidence of appreciable pneumothorax. The right lung is essentially clear. " 803d2ab2-e205aecf-3e8fa2bc-528db964-5c55505b.jpg,test/p12/p12950787/s59058326/803d2ab2-e205aecf-3e8fa2bc-528db964-5c55505b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with episode of desaturation, improving // GNR's growing on culture; evaluate for infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Right pleural effusion has not substantially changed since the prior study but may be minimally decreased. Bibasal atelectasis is noted. " 7c130b1e-3a60d0fb-452452b1-643e6e95-02486057.jpg,test/p13/p13050559/s57878047/7c130b1e-3a60d0fb-452452b1-643e6e95-02486057.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RUL collapse // follow up procedure follow up procedure IMPRESSION: In comparison with the study ___ ___, there has been some aeration of the right upper lobe after the procedure. Nevertheless, some residual opacification persists. Extensive mediastinal adenopathy is again seen on the right. The left lung remains clear. " ab76e065-f7eb94e3-8976bf27-193a421f-351b3ea8.jpg,test/p19/p19800005/s56620664/ab76e065-f7eb94e3-8976bf27-193a421f-351b3ea8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman POD#1 pericardial cyst excision, sanguineous CT output, crit ___ from ___ // ?hemothorax COMPARISON: Chest x-ray from ___ FINDINGS: There is a new small right 8 apical pneumothorax, new compared with ___. The right-sided again seen is a right-sided chest tube. Hazy opacity at the right lung base laterally is new and could represent atelectasis or, alternatively, layering pleural fluid. An additional atelectasis is present in the right cardiophrenic region/medial lung base. At the left lung base left hemidiaphragm is slightly elevated, with subsegmental atelectasis. No definite consolidation. No gross effusion. No focal infiltrate or pneumothorax. Small tubular density projecting between the medial clavicular heads over the lower trachea, compatible with a stent graft, as again noted. IMPRESSION: New small right apical pneumothorax, compared with ___. Right-sided chest tube in place. Hazy opacity at the right base could reflect a small to moderate amount of atelectasis and/or pleural fluid. NOTIFICATION: The presence of the new right apical pneumothorax was discussed with covering physician ___, ___.D. by ___, M.D. on the telephone on ___ at 17:06 PM, ___ min minutes after discovery of the findings. " 07149dcc-4758ca39-f048a725-8cb8e56a-43b3aa98.jpg,test/p17/p17735448/s54874424/07149dcc-4758ca39-f048a725-8cb8e56a-43b3aa98.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with cough, asthma. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes remain low. Other than bibasilar atelectasis, the lungs are clear. No focal consolidation, effusion, edema, or pneumothorax. The heart is top-normal in size, unchanged. The descending thoracic aorta is slightly tortuous or ectatic. IMPRESSION: No acute cardiopulmonary process. " f04b1b48-3c410459-eae41053-2b4704f2-b0c7cd28.jpg,test/p14/p14258645/s58027858/f04b1b48-3c410459-eae41053-2b4704f2-b0c7cd28.jpg,test," FINAL REPORT AP CHEST, 12:50 P.M. ON ___. CLINICAL HISTORY: ___-year-old man with pleural effusion after thoracentesis. Rule out pneumothorax. IMPRESSION: AP chest compared to ___, 3:15 p.m.: Previous small left pleural effusion is no longer present. Because of the extensive asbestos-related pleural calcification, I cannot exclude small pneumothorax, but there does not appear to be any change in the orientation of pleural calcifications to the perimeter of the left hemithorax. Heart size is top normal. Lungs are generally obscured by pleural calcification. " 708638af-646b3c9f-fdb2469a-b99daabc-c5601e2e.jpg,test/p12/p12401831/s58827275/708638af-646b3c9f-fdb2469a-b99daabc-c5601e2e.jpg,test," FINAL REPORT AP CHEST, 5:18 P.M. ON ___ HISTORY: ___-year-old quadriplegic woman with increased difficulty breathing and recent abnormal chest radiograph. IMPRESSION: AP chest compared to ___ through ___: Greater opacification of the left lower lobe is now accompanied by more marked increase in the height of the left hemidiaphragm. Findings are best explained by worsening atelectasis, perhaps in the presence of diminished left hemidiaphragm excursion, either muscular or neural in origin. Right lung is clear. Heart size is normal. The function of the left hemidiaphragm can be determined by fluoroscopic or ultrasound observation. If the hemidiaphragm moves appropriately, then investigation should be turned to the patency of the bronchial tree. Dr. ___ was telephoned to report these findings, at 2 p.m. " 07b8b202-ba1ae0d7-c99e64a8-cf33feff-fccb2378.jpg,test/p15/p15321935/s55742864/07b8b202-ba1ae0d7-c99e64a8-cf33feff-fccb2378.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M 2wk fevers, N/V, abd pain, found to have w/multiple liver lesions likely abscesses and septic shock now s/p IR drainage // interval eval COMPARISON: ___. IMPRESSION: As compared to the previous image, the position of the 3 right-sided drains is unchanged. Unchanged appearance of the cardiac silhouette but decrease in extent of the pleural fluid collection on the left. The retrocardiac atelectasis is constant. No pneumothorax. No new opacities in the lung parenchyma. " 96444393-7d6808f7-3785e4e7-3dfdd56b-0ee056c9.jpg,test/p10/p10761013/s58879788/96444393-7d6808f7-3785e4e7-3dfdd56b-0ee056c9.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for acute process. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are low. No pleural effusions. Normal appearance of the lung parenchyma. No pneumonia, no pulmonary edema. No other acute changes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. " ba744772-7b6d90b8-6656e744-3d68a432-2c01b9e0.jpg,test/p17/p17649973/s58732917/ba744772-7b6d90b8-6656e744-3d68a432-2c01b9e0.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with lupus, on azathioprine and prednisone with fever to 104. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 59e580ed-fcad9348-cea3e6db-d1f87b72-59ab3c4c.jpg,test/p16/p16006141/s54118637/59e580ed-fcad9348-cea3e6db-d1f87b72-59ab3c4c.jpg,test," FINAL REPORT SINGLE AP PORTABLE VIEW OF THE CHEST REASON FOR EXAM: GI bleed. Intubated. Comparison is made with prior study performed a day before. There are lower lung volumes. Bibasilar atelectases present on the left have increased. Bilateral pleural effusions have increased. Cardiac size cannot be evaluated, is obscured by pleural parenchymal abnormalities. ET tube tip is 4.7 cm above the carina. Right IJ catheter tip is in the lower SVC. Mild vascular congestion is new. " 45d34f58-4fc0ebe7-f41098d3-b01576e3-fa154f39.jpg,test/p15/p15972718/s50007550/45d34f58-4fc0ebe7-f41098d3-b01576e3-fa154f39.jpg,test," FINAL REPORT INDICATION: Fever. COMPARISON: None available. TECHNIQUE: AP and lateral chest radiograph, two views. FINDINGS: Heart size is normal with a mildly tortuous aorta. Hilar contours are normal. Lungs are clear. There is no pleural effusion or pneumothorax. Severe degenerative changes are noted in bilateral shoulders. A slight indentation of the trachea on the right at the level of the thoracic inlet is suggestive of enlarged thyroid. IMPRESSION: 1. No evidence of pneumonia. 2. Slight indentation of the right aspect of the trachea at the level of thoracic inlet, suggestive of enlarged thyroid. " 9c0bedab-77800dd2-919e37e2-7352d90f-2f2b5e03.jpg,test/p16/p16267047/s54044685/9c0bedab-77800dd2-919e37e2-7352d90f-2f2b5e03.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: None. FINDINGS: PA and lateral chest radiographs. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. 4-mm nodular opacity overlying the anterior left 4th rib may be a bone island or a prominent vessel. IMPRESSION: No acute cardiopulmonary process. " 19f04e80-9834ffe9-27ca9255-f552c791-73434b88.jpg,test/p15/p15481018/s54299570/19f04e80-9834ffe9-27ca9255-f552c791-73434b88.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with hepatic encephalopathy, no clear infectious source // R/o PNA or other infectious process TECHNIQUE: Chest: Upright PA and Lateral COMPARISON: Chest radiographs ___ FINDINGS: There are low lung volumes bilaterally. Linear atelectasis of the right lung base is seen. No focal consolidation. No pleural effusion or pneumothorax. The cardiac size is top normal. IMPRESSION: No evidence of pneumonia. Bilateral low lung volumes with linear atelectasis of the right lung base. " 106df383-a289d8a1-fa56bac1-b9d31ee8-e2995311.jpg,test/p18/p18175023/s59154916/106df383-a289d8a1-fa56bac1-b9d31ee8-e2995311.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough since this weekend, O2 sat ___% // evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are remarkable for stable tortuosity of the thoracic aorta and a calcified right paratracheal lymph node. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " c95bac3a-a1c4d63b-72565338-e0073171-f6d20ce1.jpg,test/p15/p15534382/s56546474/c95bac3a-a1c4d63b-72565338-e0073171-f6d20ce1.jpg,test," FINAL REPORT INDICATION: ___F with fall, head strike, c/o C and T spine ttp.*** WARNING *** Multiple patients with same last name! // eval for fx TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 6c7ce6a0-0c3b5714-09c05052-01aca6fc-0aed00ea.jpg,test/p13/p13899130/s59513931/6c7ce6a0-0c3b5714-09c05052-01aca6fc-0aed00ea.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Subtle basilar opacity seen posteriorly over the spine on the lateral view inferiorly may be due to atelectasis, although an early infectious process is not excluded in the appropriate clinical setting. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. " 93791055-314fda8d-b24294b4-4b7f2e11-800a0ec5.jpg,test/p13/p13181161/s51544854/93791055-314fda8d-b24294b4-4b7f2e11-800a0ec5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea, hypoxia // ?PNA, edema ?PNA, edema IMPRESSION: In comparison with the study of ___, the endotracheal tube and enteric tube have been removed. The cardiac silhouette is at the upper limits of normal in size or slightly enlarged. There is some elevation of pulmonary venous pressure with this hazy opacification at the bases consistent with layering effusions and atelectatic change, is slightly more prominent on the left. In the appropriate clinical setting, superimposed pneumonia would be difficult to exclude. " aab4761a-241be56d-6e8813ac-05c3981d-94304a5c.jpg,test/p16/p16490354/s50975437/aab4761a-241be56d-6e8813ac-05c3981d-94304a5c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with myasthenia ___ flare // concern for pulmonary congestion concern for pulmonary congestion IMPRESSION: Heart size is normal. Mediastinum is normal. Right PICC line tip is at the level of lower SVC. Left basal consolidation is substantial but overall improved since the prior study as well as there is substantial improvement in pulmonary edema. No focal consolidations is seen. No pneumothorax is seen. " 10571566-6d4ca58f-1aee4441-dd86fd26-bb967469.jpg,test/p17/p17421663/s56648612/10571566-6d4ca58f-1aee4441-dd86fd26-bb967469.jpg,test," FINAL REPORT PORTABLE CHEST ___ ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable in appearance. Pulmonary vascular congestion is accompanied by mild interstitial edema. A more confluent opacity in the right lower lobe has slightly improved, and shows more marked improvement when compared to and earlier chest x-___ ___ ___. This could potentially represent a resolving area of asymmetrical edema, but other processes such as pneumonia should also be considered in the appropriate clinical setting. Small right pleural effusion is also noted and has improved since earlier radiographs as well. Large lung volumes suggest underlying COPD in the appropriate clinical setting. " ac2bc5fb-c181f807-907ef393-692441ee-057ffb40.jpg,test/p13/p13473495/s50319774/ac2bc5fb-c181f807-907ef393-692441ee-057ffb40.jpg,test," FINAL REPORT HISTORY: Body pain and feeling hot. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Severe cardiomegaly persists. A left subclavian vascular stent is re- demonstrated. Mediastinal contours are unchanged. There is pulmonary vascular congestion,slightly worse in the interval. A small amount of fluid is noted within the minor fissure. No focal consolidation, pleural effusion or pneumothorax is demonstrated. IMPRESSION: Pulmonary vascular congestion, slightly worse in the interval. " 826f6e06-bdc0fac1-3572cf71-a5195e84-d1e36c9e.jpg,test/p11/p11062577/s58880973/826f6e06-bdc0fac1-3572cf71-a5195e84-d1e36c9e.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with COPD, now with tachypnea. // Eval for pleural effusions vs PNA. COMPARISON: Portable chest radiograph of ___ FINDINGS: The Dobbhoff tube terminates in the stomach. The left-sided PICC terminates in the superior-SVC. Unchanged appearance of surgical clips along the left lateral chest wall. Compared to the prior chest x-ray on ___, there are new bibasilar opacities, right greater than the left. There is no pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: New bibasilar opacities, right greater than left. This is likely due to atelectasis and a small pleural effusion, but pneumonia should be considered in the appropriate clinical context. " ef619970-341f5ca0-5205abce-a83cf8de-daf9da36.jpg,test/p19/p19928034/s54815285/ef619970-341f5ca0-5205abce-a83cf8de-daf9da36.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with febrile neutropenia. // Evaluate for pneumonia/infectious process. Evaluate for pneumonia/infectious process. IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear within the limitations of chest radiograph technique. There is no pleural effusion. There is no pneumothorax. If clinically warranted, correlation with chest CT to exclude the possibility of radiographically occult neutropenic pneumonia is to be considered. " 281e4d1a-3017e7fd-33fa1a63-18ed3b40-5672f7db.jpg,test/p12/p12773009/s54524235/281e4d1a-3017e7fd-33fa1a63-18ed3b40-5672f7db.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: ___-year-old man with CLL status post chemotherapy eight days ago with fever to 101.8, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is mild blunting of the right CP angle, which could represent a small effusion or pleural thickening. There is no focal consolidation to suggest the presence of pneumonia. No pneumothorax or signs of CHF. Heart size is top normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No findings to suggest pneumonia. Stable blunting of the right CP angle. Top normal heart size. " 2409f16a-16495cc4-bb5dc356-8b2c4992-90778688.jpg,test/p17/p17198746/s58900467/2409f16a-16495cc4-bb5dc356-8b2c4992-90778688.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // pna COMPARISON: No comparison available at the time of dictation. IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions, no pneumonia, no pulmonary edema. " 7289fbd0-d8ec63d6-39109c39-00c29d5f-7b773a58.jpg,test/p13/p13021440/s52595921/7289fbd0-d8ec63d6-39109c39-00c29d5f-7b773a58.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Sepsis, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is improved transparency of the lung parenchyma, likely translating improved ventilation. No new parenchymal opacities. Unchanged retrocardiac atelectasis. Moderate cardiomegaly. Unchanged monitoring and support devices. " 9968c760-389a85cc-97c4ed93-1f7cbb4a-c19521ed.jpg,test/p13/p13723259/s58885564/9968c760-389a85cc-97c4ed93-1f7cbb4a-c19521ed.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, chest congestion, SOB // ? PNA ? PNA IMPRESSION: Comparison to ___. Bilateral healed rib fractures. Status post sternotomy. The alignment of the sternal wires is stable. Unchanged normal lung volumes. Mild scarring at the right lower lobe basis. No pneumonia, no pulmonary edema, no pleural effusions. " 479f06ca-8d79407b-6f3b86b6-cdef8038-91027136.jpg,test/p11/p11812774/s52126479/479f06ca-8d79407b-6f3b86b6-cdef8038-91027136.jpg,test," FINAL REPORT INDICATION: ___ year old female with cough, vomiting. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiographs from ___, ___, ___ and ___. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 52707faa-14685b99-abd3ca6e-9bf3ef35-91e1c282.jpg,test/p12/p12953887/s50743581/52707faa-14685b99-abd3ca6e-9bf3ef35-91e1c282.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest discomfort. COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral chest radiograph demonstrates well expanded and clear lungs. The cardiomediastinal contour is unremarkable. There is no pleural effusion or pneumothorax. No evidence to suggest COPD. IMPRESSION: Normal chest radiograph. " 862374c1-6ea6c5fc-7f487a0c-77f9bf1d-fbf546d5.jpg,test/p11/p11276090/s59496894/862374c1-6ea6c5fc-7f487a0c-77f9bf1d-fbf546d5.jpg,test," FINAL REPORT INDICATION: ___ year old man with decompensated cirrhosis, had para today that drained 4L. Now with worsening abdominal pain. Evidence of free air under diaphragm. TECHNIQUE: Portable AP view of the chest. COMPARISON: Chest radiograph from ___ FINDINGS: No focal consolidation is identified. Subtle opacity projecting over the left fourth rib laterally likely represents pleural thickening as seen on CT chest from ___ and stable over at least ___ years. The cardiomediastinal silhouette, hila contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Visualized upper abdomen is unremarkable without evidence of pneumoperitoneum. IMPRESSION: No evidence of pneumoperitoneum. " 216d6e5e-a3b28ae7-632d68f7-2ac8d5b4-428ed11b.jpg,test/p12/p12590117/s55245526/216d6e5e-a3b28ae7-632d68f7-2ac8d5b4-428ed11b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Polytrauma, cardiomyopathy, evaluation for interval change. COMPARISON: ___, 4:47 a.m. FINDINGS: As compared to the previous radiograph, the extent of the pre-existing right pneumothorax has minimally increased. The right chest tube is in unchanged position. There is no evidence of tension. The other monitoring and support devices, including the left chest tube and the endotracheal tube are also unchanged. Unchanged moderate cardiomegaly and left pleural effusion, with atelectatic changes at both lung bases. The mildly displaced rib fractures are constant in appearance. No other relevant changes. " e292aeb6-e34e1027-567ef069-21e9927e-5ee9a1f9.jpg,test/p13/p13462065/s54699336/e292aeb6-e34e1027-567ef069-21e9927e-5ee9a1f9.jpg,test," WET READ: ___ ___ 7:57 AM No pneumothorax. No significant change. WET READ VERSION #___ ___ ___ 11:13 PM No pneumothorax. No significant change. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M h/o ETOH abuse, PUD, CBD stricture w/ CBD stent p/w acute onset abdominal pain and duodenal perforation s/p ex lap ___ patch of duodenal ulcer s/p left pigtail removal // interval change, pneumothorax? Please do at 5 pm. INTERVAL CHANGE, PNEUMOTHORAX? PLEASE DO BETWEEN 7PM AND 8 PM. IMPRESSION: In comparison with the earlier study of this date, there is little change and no evidence of pneumothorax several hr after removal of the chest tube. " 96f6b655-cb517472-567ebf62-3c6395e0-01936fb3.jpg,test/p11/p11413236/s51943964/96f6b655-cb517472-567ebf62-3c6395e0-01936fb3.jpg,test," FINAL REPORT INDICATION: ___F with CHF, h./o mast cell degranulation, sudden onset dyspnea, // please eval pna, pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Right chest wall Port-A-Cath terminates in the upper SVC. Postoperative mediastinum, including calcified left suprahilar lymph node, and cardiomegaly are unchanged from ___. Bibasilar atelectasis is mild. IMPRESSION: No evidence of pneumonia or pulmonary edema. " 864c32b8-9a203655-831c5b9a-f9adadcb-767da6bb.jpg,test/p10/p10785610/s51475084/864c32b8-9a203655-831c5b9a-f9adadcb-767da6bb.jpg,test," FINAL REPORT INDICATION: ___M with chest pain and SOB // R/o Infiltrate TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " e71ddf49-53bbf45c-9af60d84-2b66d781-d2c27992.jpg,test/p14/p14954759/s59052466/e71ddf49-53bbf45c-9af60d84-2b66d781-d2c27992.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman after tamponade from pericardial effusion following pericardiocentesis at outside hospital. IMPRESSION: PA and lateral chest compared to recent prior available chest radiograph, ___. Size of the cardiac silhouette is normal, minimally larger than before. Small left pleural effusion is new. The hila, particularly the right is slightly larger with a configuration that could be due to vascular engorgement. Aside from linear atelectasis in both lungs, lungs are clear, specifically no collapse, pneumonia, or edema. There is no pneumothorax. " f45ffb1a-071cda1b-3bdf7510-f6c856f1-3606887d.jpg,test/p17/p17860352/s58729628/f45ffb1a-071cda1b-3bdf7510-f6c856f1-3606887d.jpg,test," FINAL REPORT INDICATION: ___ year old woman with ___'s, recent aspiration pna, diastolic dysfunction // r/o fluid overload TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: Interval advancement of the Dobhoff feeding tube, now extending into the body of the stomach. Decreased opacities at both lung bases however there is some persistent mildly increased reticular markings in both lungs. No pneumothorax identified. The appearance of the cardiomediastinal silhouette is unchanged. IMPRESSION: Interval decrease in the bibasilar opacities. No focal consolidation identified. The Dobhoff feeding tube has been advanced into the body of the stomach. " 421434da-1549025d-f3a67d72-a9b0ed36-1a7da020.jpg,test/p10/p10038828/s57631331/421434da-1549025d-f3a67d72-a9b0ed36-1a7da020.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with 2 days intermittent left-sided chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged with mild tortuosity of the thoracic aorta again noted. There is minimal streaky atelectasis in the left lower lobe. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormality is detected. Cholecystectomy clips are again noted in the right upper quadrant of the abdomen. IMPRESSION: Streaky atelectasis in the left lower lobe. " a857b795-4d6cd759-c99fcdb7-3b9e8477-ba8bf358.jpg,test/p10/p10681072/s51267558/a857b795-4d6cd759-c99fcdb7-3b9e8477-ba8bf358.jpg,test," FINAL REPORT INDICATION: Fever and cough. COMPARISON: Chest radiograph ___. FINDINGS: A left port is present with tip in the mid SVC. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. Surgical clips are seen projecting over the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " b3ee2835-8ac518af-34dab470-91df026d-d92b6f40.jpg,test/p10/p10850692/s59915203/b3ee2835-8ac518af-34dab470-91df026d-d92b6f40.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with PPM 1 wk ago. // assess lead position for ppm TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___ FINDINGS: There is mild hyperinflation of the lungs, which is usually due to emphysema or small airways obstruction. Otherwise, the lungs are clear. The left pectoral pacemaker is seen with transvenous leads in the right atrium and right ventricle. No pneumothorax. No focal consolidations are seen. IMPRESSION: 1. Left pectoral pacemaker seen with transvenous leads in the right atrium and right ventricle. No pneumothorax. 2. Mild hyperinflation of the lungs. " e83f3b3f-3ac529cf-3617d856-28a41d66-4c2a6252.jpg,test/p17/p17109815/s53581061/e83f3b3f-3ac529cf-3617d856-28a41d66-4c2a6252.jpg,test," FINAL REPORT INDICATION: ___-year-old man with well-controlled HIV, frequent travel to ___, new positive QuantiFERON Gold, no symptoms; rule out evidence of active TB. COMPARISONS: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Dense small rounded opacity in the left lower lobe could be a lung nodule or a bone island. The cardiomediastinal silhouette is normal. There is no evidence of recent or non-recent TB. Osseous structures demonstrate no acute skeletal abnormality. IMPRESSION: 1. No evidence of recent or non-recent TB. 2. Dense rounded opacity in the left lower lobe. Recommend shallow oblique views for further evaluation. These findings were entered into the critical results dashboard by Dr. ___ at 12:15pm. " e11e8a5b-6049d2ad-4130168f-0f4e5137-069e1d6e.jpg,test/p15/p15239201/s59339515/e11e8a5b-6049d2ad-4130168f-0f4e5137-069e1d6e.jpg,test," FINAL REPORT INDICATION: ___ year old man with hepatic hydrothroax, pleural effusion, cough, fever, rule out pneumonia superimposed on pleural effusion. Question superimposed infection. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray dated ___. FINDINGS: Lung volumes are improved. Moderate left pleural effusion is unchanged given differences in technique. There is mild pulmonary vascular congestion. There is interval right basilar patchy atelectasis. The heart is normal in size. IMPRESSION: 1. Unchanged left pleural effusion 2. Mild pulmonary vascular congestion. " 3d34ea51-867eaac0-c47071d8-ed410348-0f767639.jpg,test/p17/p17725745/s59870650/3d34ea51-867eaac0-c47071d8-ed410348-0f767639.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pressure, history of CHF, non-ST elevation MI. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy. The cardiac silhouette is mildly enlarged. The aortic knob is calcified. There may be minimal central pulmonary vascular congestion without overt pulmonary edema. Mild degenerative changes are again seen along the spine. IMPRESSION: Possible minimal pulmonary vascular congestion without overt pulmonary edema. Please note that the multiple pulmonary nodules noted on chest CT from ___ are better appreciated and evaluated on that study/CT and recommendation for followup per that study remains. " 1eabb0d4-704204e8-87b65fb9-39bda569-f2f1afcf.jpg,test/p16/p16033427/s50619450/1eabb0d4-704204e8-87b65fb9-39bda569-f2f1afcf.jpg,test," FINAL REPORT INDICATION: ___ year old man R PTX and pneumostat in place // check interval change EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, AP and lateral views COMPARISON: Chest radiograph ___ FINDINGS: Right pigtail pleural catheter is in unchanged position. Small to moderate right pneumothorax is unchanged in size. There is persistent collapse of right lower lobe. Emphysematous changes are seen throughout bilateral lungs. Left mid to low lung linear atelectasis is noted. Borderline enlarged cardiac silhouette is stable. IMPRESSION: No notable change compared to ___. Small to moderate right pneumothorax is stable. Persistent right lower lobe collapse. " b49b8cec-64eafcc2-c6ec26f3-d9ed6a9f-085ca4f7.jpg,test/p12/p12539779/s57219024/b49b8cec-64eafcc2-c6ec26f3-d9ed6a9f-085ca4f7.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough and right-sided crackles. COMPARISON: Semi-upright portable AP chest radiograph ___. TECHNIQUE: Upright AP portable chest radiograph with technically inadequate lateral view ( patient is in dissability chair). FINDINGS: There is slightly improved low lung volume with no areas of focal consolidation, pleural effusion, or pneumothorax identified. There is stable cardiomegaly with calcification of the aorta with no evidence of pulmonary edema or vascular congestion. The pleural surfaces are unremarkable. IMPRESSION: No evidence of heart failure or infection. " 4713c2c5-43053ebf-e325e951-5a8bcbeb-af9dcf8d.jpg,test/p10/p10194204/s56335375/4713c2c5-43053ebf-e325e951-5a8bcbeb-af9dcf8d.jpg,test," FINAL REPORT INDICATION: Chest tightness and dyspnea. Evaluate for acute cardiopulmonary process. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Streaky bibasilar atelectasis is present. No pleural effusion or pneumothorax. Heart is normal size. There is no pulmonary edema. Mediastinal and hilar contours are unremarkable. IMPRESSION: Bibasilar atelectasis. " 5b6a278f-d0473cd5-f2f9ba9d-72f16198-208087b1.jpg,test/p11/p11849511/s51451888/5b6a278f-d0473cd5-f2f9ba9d-72f16198-208087b1.jpg,test," FINAL REPORT PORTABLE CHEST FILM ___ AT 5:55 CLINICAL INDICATION: ___-year-old with respiratory failure, assess for pulmonary process. Comparison is made to the patient's prior study of ___ at 541. Portable AP semi-erect chest film ___ at 5:55 is submitted. IMPRESSION: 1. Left internal jugular central line has its tip in the proximal SVC. The endotracheal tube has its tip approximately 4.5 cm above the carina. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. The pigtail catheter and basilar chest tube are also unchanged in position. There is a layering left effusion with associated airspace opacity most likely representing partial lower lobe atelectasis, although a superimposed infection cannot be entirely excluded. No pneumothorax is appreciated. No evidence of pulmonary edema. Heart remains stably enlarged. Mediastinal contours appear less widened, likely due to differences in positioning and inspiration. " a73b2f08-e404ddaa-3f7fde8b-78e79077-6d0401aa.jpg,test/p11/p11218867/s51387330/a73b2f08-e404ddaa-3f7fde8b-78e79077-6d0401aa.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Followup left pneumothorax. Comparison is made with prior study performed five hours earlier. Cardiac size is normal. Widened mediastinum is unchanged. Small left pneumothorax is stable. Small left pleural effusion is unchanged. Bibasilar opacities, left greater than right, are unchanged. They are likely atelectases, but superimposed infection cannot be excluded . " ec44eb24-7857df2d-14630f34-109245bf-32013033.jpg,test/p16/p16935275/s55007850/ec44eb24-7857df2d-14630f34-109245bf-32013033.jpg,test," FINAL REPORT HISTORY: Intubation. Evaluation for endotracheal tube position. COMPARISON: Comparison is made to radiograph of the chest from ___ and ___. FINDINGS: Single portable supine view of the chest demonstrates relatively low lung volumes. Theendotracheal tube terminates approximately 2.0 cm above the level of the carina, and could be retracted aproximately 1 cm. A nasogastric tube is also seen coursing below the level of diaphragm and out of view. No focal consolidations, pleural effusion or pneumothorax is identified. The cardiomediastinal silhouette is not significantly changed since the prior study. IMPRESSION: 1. Endotracheal tube terminates 2 cm above the level of the carina and could be retracted by 1 cm. 2. No acute cardiopulmonary process. " d3a16201-64872db1-4ca47988-7b513f26-312e7599.jpg,test/p13/p13516301/s58509329/d3a16201-64872db1-4ca47988-7b513f26-312e7599.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman s/p dual chamber pacemaker via L axillary vein // confirm lead placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___ FINDINGS: There is no significant interval change compared to the prior radiograph performed yesterday evening. The dual-chamber pacemaker is redemonstrated with leads terminating in the right atrium and right ventricle. There is mild pulmonary vascular congestion. Bilateral pleural effusions are noted, likely also present on the prior study. There is no evidence of pneumonia or pneumothorax. The cardiomediastinal silhouette is within normal limits. Surgical clips are noted in the right upper quadrant. IMPRESSION: Unchanged position of dual chamber pacemaker with leads terminating in the right atrium and right ventricle. " 1cc0320e-4b6e4412-2aa7e0d9-48ded132-ee3ad732.jpg,test/p12/p12509843/s55487194/1cc0320e-4b6e4412-2aa7e0d9-48ded132-ee3ad732.jpg,test," FINAL REPORT HISTORY: Patient with chronic lower extremity edema, elevated BNP and crackles, question pulmonary edema. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs were obtained. Lung volumes are extremely low with resulting bronchovascular crowding. The heart is mildly enlarged without pulmonary edema. There is no pleural effusion or pneumothorax. IMPRESSION: Low lung volumes. Mild cardiomegaly without pulmonary edema. " fdba0667-faa73efd-da3746a5-2a72a1fa-f5b292b7.jpg,test/p16/p16741986/s56541794/fdba0667-faa73efd-da3746a5-2a72a1fa-f5b292b7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with painEGDatus post egd // evaluate for free air TECHNIQUE: Semi-upright AP view of the chest COMPARISON: ___ chest radiograph, ___ CT chest FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Lungs are clear. No pleural effusion or pneumothorax is identified. No subdiaphragmatic free air is seen. Cholecystectomy clips are noted in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. No subdiaphragmatic free air. " 4aadf34d-73717b8d-cc19c376-dd5c1f59-c0258df9.jpg,test/p16/p16552738/s52402508/4aadf34d-73717b8d-cc19c376-dd5c1f59-c0258df9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fevers, cough, CLL, recent xray with ? infiltrate COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. As seen on yesterday's radiograph, there is increased prominence of the right hilar contours. Findings may indicate adenopathy and further evaluation with nonemergent chest CT is advised. No signs of pneumonia or edema. No large effusion or pneumothorax. Heart size is normal. Mediastinal contour is unremarkable. IMPRESSION: Right hilar prominence which requires further evaluation with nonemergent chest CT scan. No pneumonia. " 719d0dd3-c5e9f8cf-c8c2bf04-97162434-2a302dea.jpg,test/p17/p17692815/s53702313/719d0dd3-c5e9f8cf-c8c2bf04-97162434-2a302dea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent agitation and pulling at ET tube // confirm ETT placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the nasogastric tube and the endotracheal tube are in constant position. The bilateral basal parenchymal opacities, right more than left, are also constant. Moderate cardiomegaly persists. Mild fluid overload but no overt pulmonary edema. No pneumothorax. Clips projecting over the right cervical region. " d034790a-b42a48ae-d09f3219-3c7a906e-7c283635.jpg,test/p15/p15236847/s56503029/d034790a-b42a48ae-d09f3219-3c7a906e-7c283635.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with generalized weakness and fatigue // Evidence of pneumonia or volume overload TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 999ac8c8-36f00193-8a0952bd-90a7d184-4a3ca3c5.jpg,test/p16/p16384483/s55946148/999ac8c8-36f00193-8a0952bd-90a7d184-4a3ca3c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F DMI w/ DKA Afib RVR w/ L groin necrotizing soft tissue infection // intubated, interval change intubated, interval change IMPRESSION: Compared to prior chest radiographs, ___. Right upper lobe collapse has probably improved. Left lower lobe atelectasis has worsened. Fullness in the mediastinum and left hilus could be due to adenopathy overload appears to have worsened since ___. Heart is moderately enlarged. Small left pleural effusion is new. Chest CT scanning would give more information, but whether is appropriate depends upon clinical clinical findings with respect to cardiorespiratory status. ET tube is in standard placement. Esophageal drainage tube passes into the stomach and out of view. Right jugular line ends in the low SVC. No pneumothorax. " f17e5811-aa24d5d9-bfbd77e7-a22362be-fdecf21f.jpg,test/p16/p16479007/s56839078/f17e5811-aa24d5d9-bfbd77e7-a22362be-fdecf21f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with R rib pain after fall // rr/o R rib fx TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture seen. However, if clinical concern for rib fracture is high, dedicated rib series or CT is more sensitive. " 77614865-7441cbc7-eb477e26-fe383be3-bc7f5a88.jpg,test/p15/p15227491/s54921742/77614865-7441cbc7-eb477e26-fe383be3-bc7f5a88.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p ex lap, R hemicolectomy s/p ex-lap and washout with b/l pleural effusions and pulmonary edema, s/p lasix, with increasing shortness of breath // please evaluate for pneumonia or worsening pleural effusions or pulmonary edema please evaluate for pneumonia or worsening pleural effusions TECHNIQUE: AP and lateral chest radiograph COMPARISON: ___. FINDINGS: There has been interval improvement of pulmonary edema, now moderate in severity. Otherwise, pleural effusions are unchanged. Right PICC line is unchanged in position. Left axillary clips are unchanged in position. Allowing for changes in positioning, cardiomediastinal silhouette appears unchanged. IMPRESSION: Moderate pulmonary edema, mildly improved. Pleural effusions are unchanged. " 35c80656-e610fdf6-1e57e3f3-093cff59-b4c3a2c1.jpg,test/p18/p18179234/s51898564/35c80656-e610fdf6-1e57e3f3-093cff59-b4c3a2c1.jpg,test," FINAL REPORT INDICATION: History: ___M with pna // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ and ___ FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. Calcification of the aortic knob is unchanged. A 1.5 cm round density in the right neck is unchanged, possibly reflecting a calcified thyroid nodule. Surgical anchor screws in the right humeral head are stable. IMPRESSION: No evidence of pneumonia. " f29184b3-651333e4-ecd90dc4-426cec6a-7318247f.jpg,test/p14/p14832062/s53592907/f29184b3-651333e4-ecd90dc4-426cec6a-7318247f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recurrent pneumonia, shortness of breath, evaluation for changes. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing collapse of the middle lobe, described in detail on the CT examination from ___, is unchanged. There currently is no evidence for new parenchymal opacities. No pleural effusions. The size of the cardiac silhouette continues to be mildly enlarged, there are no pleural effusions. No evidence of pulmonary edema. " f6ab4a75-c0a6ba83-a44efef8-f982e2c6-e2f12eab.jpg,test/p14/p14014948/s53520057/f6ab4a75-c0a6ba83-a44efef8-f982e2c6-e2f12eab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // infiltrate? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiomediastinal contours are unchanged. Lines and tubes are in unchanged standard position. Right lower lobe atelectasis has improved otherwise lungs are clear. There is no pneumothorax or pleural effusion " 031383ef-c349b7d5-4e6aa797-bc84faf3-c335bc16.jpg,test/p17/p17444265/s56487285/031383ef-c349b7d5-4e6aa797-bc84faf3-c335bc16.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // ?ptx, rib fx TECHNIQUE: PA and lateral views the chest. COMPARISON: The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No displaced fractures identified. FINDINGS: No acute cardiopulmonary process. " f33cf26b-abb7e96d-c04694fb-9a51a2a2-927a1e70.jpg,test/p19/p19596467/s58553372/f33cf26b-abb7e96d-c04694fb-9a51a2a2-927a1e70.jpg,test," FINAL REPORT HISTORY: ___-year-old female with recent upper respiratory infection and fever, now with worsening cough. Evaluate for pneumonia. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well-expanded clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, consolidation, or pleural effusion. Incidental note is made of mild cervical scoliosis. IMPRESSION: No pneumonia. " 085b43f4-c4135735-a5211a9f-153e2117-b9509ae0.jpg,test/p12/p12590117/s58869150/085b43f4-c4135735-a5211a9f-153e2117-b9509ae0.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___. FINDINGS: Newly placed tracheostomy tube terminates 7.5 cm above the carina at the thoracic inlet level. The tip apparently abutting the right lateral wall of the trachea, but this may be accentuated by leftward patient rotation. Attention to this finding on a repeat non-rotated radiograph would be helpful in this regard. Bilateral chest tubes remain in place, with no evidence of left pneumothorax, and a resolving tiny right lateral pneumothorax. Cardiac silhouette remains enlarged, and accompanied by pulmonary vascular congestion and improving perihilar edema. Slight worsening of basilar lung opacities is noted, particularly in the right lower lobe, and could reflect asymmetrical dependent edema, but differential diagnosis includes atelectasis, aspiration and developing infectious pneumonia. Small pleural effusions are again demonstrated. " 6e5d3718-21db3ce1-edbb5fa0-0e72f502-5e7b49f8.jpg,test/p11/p11812613/s58717833/6e5d3718-21db3ce1-edbb5fa0-0e72f502-5e7b49f8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with h/o cardiomyopathy, CAD, w/ cough, white phlegm. Says it feels like pneumonia // ?pneumonia TECHNIQUE: Chest: PA Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Moderate cardiomegaly and tortuous aorta stable. Left pectoral pacemaker with single lead position in the right ventricle. IMPRESSION: No acute cardiopulmonary process or evidence of pneumonia. NOTIFICATION: The findings were discussed with Dr. ___, ___D. by ___, ___D. on the telephone on ___ at ___:___ AM, 5 minutes after discovery of the findings. " 2fa999a5-fc3e09ed-b4d811cc-c885600d-8ca24080.jpg,test/p18/p18148913/s59129536/2fa999a5-fc3e09ed-b4d811cc-c885600d-8ca24080.jpg,test," FINAL REPORT INDICATION: ___-year-old with urosepsis and line re-positioning. COMPARISONS: ___. PORTABLE SEMI-UPRIGHT CHEST RADIOGRAPH: Right IJ catheter has been withdrawn such that it resides within the mid SVC. Examination is otherwised unchanged. " 6b438127-8f6a68fd-5990e39b-4b83dd10-aeedfe93.jpg,test/p14/p14558830/s54143768/6b438127-8f6a68fd-5990e39b-4b83dd10-aeedfe93.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Pleural effusion. Comparisons made with prior CT of ___. There is a large right pleural effusion that has increased. There is a change in the right perihilar opacity due to postradiation changes. I cannot exclude the presence of a mass and CT should be performed for further evaluation. There is no evident pneumothorax. Left lower lobe lung nodule is better seen in prior CT. Left PICC tip is in the mid to lower SVC. The sternal wires are aligned. Cardiomediastinal contours are midline. Cardiac size cannot be evaluated, is partially obscured by pleural parenchymal abnormality. Patient is status post CABG and coronary stent. " 915764f7-52a456ca-605b6773-1a58758a-65e52f54.jpg,test/p10/p10684181/s55801391/915764f7-52a456ca-605b6773-1a58758a-65e52f54.jpg,test," FINAL REPORT HISTORY: ___-year-old female with recurrent seizure. Question pneumonia. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Midthoracic dextroscoliosis again noted. IMPRESSION: No acute cardiopulmonary process. " 3a176049-e982cebb-4ee85118-bae41cd2-0d4b4c39.jpg,test/p12/p12911421/s55568792/3a176049-e982cebb-4ee85118-bae41cd2-0d4b4c39.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with h/o COPD and recent CABG p/w cough and shortness of breath. Assess for infiltrate, effusion TECHNIQUE: Chest PA and lateral COMPARISON: Multiple postoperative chest radiographs, dating back to ___ most recent on ___ FINDINGS: There is mild diffuse increased density of the left lung compared with the right lung, which has been an usual radiographic finding since the CABG, with different degrees of severity on subsequent exams, suggestive of asymmetric recurrent pulmonary edema of the left lung. A vague opacity in the right upper lung as well as foci of more conspicuous opacities along the inferior left cardiac margin and above the left hemidiaphragm, which margins are obscures, may represent overlapping infection/inflammation. There may be a small right-sided pleural effusion. No left-sided pleural effusion is identified. Significant biapical scarring is present. There is no pneumothorax. Cardiac size is top-normal. Sternotomy wires are intact. IMPRESSION: 1. Asymmetric diffuse interstitial opacities in the left lung is slightly improved from the previous exams but a repeated finding since CABG procedure. Differential diagnosis includes asymmetric pulmonary edema from ipsilateral venous or lymphatic obstruction. If symptoms presist a pulmonary venogram could be performed. Aspiration should also be considered although this appearance is rather atypical for this diagnosis. 2. Vague bilateral opacities may represent superimposed infectious or inflammatory process. Correlate with clinical signs of pneumonia. " 2a3722e0-34be34fb-85ec40b7-a3cd0d6a-54e28c97.jpg,test/p10/p10688397/s57259184/2a3722e0-34be34fb-85ec40b7-a3cd0d6a-54e28c97.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with polytrauma s/p ETT adjustment // ETT position s/p adjustment TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: The endotracheal tube is positioned approximately 8 cm above the carina. Per discussion with the ICU nurse, the endotracheal tube was subsequently Re ingested in position more distally. The patient is currently asymptomatic. There is an unusual rounded air density projecting over the mediastinum, just distal to the endotracheal tube. No clear cause for this is identified and it was not present on the earlier study. The lungs are grossly unchanged compared to the prior study. . IMPRESSION: The endotracheal tube is now positioned approximately 8 cm above the carina however per report, the tube has subsequently been ingested. A 2 cm locule of air projecting over the mediastinum is of unclear etiology. Recommend repeat chest radiographs to evaluate for any interval change. " 49a7063b-66278527-5c8d368a-ccf23d99-b77dd011.jpg,test/p18/p18179428/s59425555/49a7063b-66278527-5c8d368a-ccf23d99-b77dd011.jpg,test," FINAL REPORT HISTORY: Hemothorax status post chest tube placement. COMPARISON: Chest radiograph ___. FINDINGS: AP view of the chest is reviewed. There is a right-sided chest tube with tip terminating in the lung apex. There is subcutaneous edema near the entry site of the chest tube. There is elevation of the right hemidiaphragm, which appears worsened compared to the prior study. There is a small right effusion with bibasilar opacities, more pronounced on the right. The cardiomediastinal and hilar contours are unremarkable. No pneumothorax grossly detected. No displaced fractures noted. IMPRESSION: Small right pleural effusion with bibasilar opacities, possibly atelectasis, though aspiration or contusion is not excluded. No pneumothorax grossly detected. " 54713eb8-45d3144c-45f3a6f1-2f7ac080-75be86f0.jpg,test/p11/p11549602/s51113834/54713eb8-45d3144c-45f3a6f1-2f7ac080-75be86f0.jpg,test," FINAL ADDENDUM This is an addendum. Left PICC tip is not clearly visualized, but in concurrent CT the tip ends in the cavoatrial junction. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph dated ___. CLINICAL HISTORY: Dyspnea and hypoxia with exertion. FINDINGS: PA and lateral views of the chest were obtained. Hardware is again seen spanning the thoracic spine. Right basal opacity is likely atelectasis and possible effusion. Overall, since the prior exam, there has been no significant change. Rib fractures are noted in the left and right lower ribs as seen previously. No new consolidation or signs of CHF. " e6fcf04b-a2b07d67-bd148c7f-c7a57241-deabfaea.jpg,test/p17/p17436646/s55366192/e6fcf04b-a2b07d67-bd148c7f-c7a57241-deabfaea.jpg,test," FINAL REPORT HISTORY: Chills and back pain. Evaluate for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: ___-___ mass with fiducial marker is in right hemithorax and unchanged. There are no new opacities concerning for infection. There is no edema. There is no pleural effusion. There is no pneumothorax. Heart size is top normal. Aorta is mildly tortuous. There is calcification of the aortic knob. IMPRESSION: No evidence of acute cardiopulmonary process. " e1993fe3-47916ba4-8cc7840c-beac0faf-b11867ef.jpg,test/p11/p11104877/s54677462/e1993fe3-47916ba4-8cc7840c-beac0faf-b11867ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with variceal bleeding, ___ in place. // Comparison to previous. TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right central venous line is in place. The ET tube tip is most likely terminating 2.5 cm above the carinal. What appears to be ___ ___ tube is demonstrated, unchanged. Bibasal consolidations are unchanged. " 129997e4-0cc3cd30-066eeed6-e5dc680c-f84e52c4.jpg,test/p15/p15289580/s58311792/129997e4-0cc3cd30-066eeed6-e5dc680c-f84e52c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxemic resp failure // edema, pna, interval change? edema, pna, interval change? COMPARISON: Chest radiographs ___ through ___, read in conjunction with chest CT on ___. IMPRESSION: The severe widespread varied infiltrative pulmonary process improved somewhat between ___ and ___, is subsequently unchanged. The moderate cardiomegaly persists. There is no pneumothorax. Pleural effusions are presumed, but not large. Right jugular line ends in the low SVC. " 542b6962-d08ca24f-06fa335a-ea28f7d9-5b896c85.jpg,test/p12/p12154616/s53306241/542b6962-d08ca24f-06fa335a-ea28f7d9-5b896c85.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior CT torso dated ___. CLINICAL HISTORY: ___-year-old man with chest pain, assess for acute intrathoracic process. FINDINGS: AP upright and lateral views of the chest were provided. The heart is moderately enlarged. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The mediastinal contour is stable with an unfolded thoracic aorta again noted. The bony structures appear intact. IMPRESSION: Moderate cardiomegaly. No signs of pneumonia or CHF. " a84ac020-01335229-a355b426-b96a4856-07ad635e.jpg,test/p12/p12343684/s53922399/a84ac020-01335229-a355b426-b96a4856-07ad635e.jpg,test," FINAL REPORT INDICATION: History: ___M with tachycardia // eval for consolidation TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Lung volumes are low, but there is no focal consolidation concerning for pneumonia. New right middle lobe opacities located medially and giving the decrease in the position of the minor fissure might represent atelectasis potentially of right middle lobe or of right lower lobe. No other focal consolidations demonstrated. Pulmonary vasculature is within normal limits. The upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. New atelectasis of most likely right middle lobe (less likely right lower lobe). No definitive consolidation to suggest infection demonstrated. " a03f22a1-623f2c97-e44520fa-bae4ee11-b086b70a.jpg,test/p19/p19771635/s57190991/a03f22a1-623f2c97-e44520fa-bae4ee11-b086b70a.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: A ___-year-old woman with cough and pleuritic right basal chest pain. Hemoptysis. Is there pulmonary pathology? IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. " d183fade-8c55823a-c81833ce-93642237-fecad1a9.jpg,test/p15/p15964158/s53212792/d183fade-8c55823a-c81833ce-93642237-fecad1a9.jpg,test," WET READ: ___ ___ ___ 5:23 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with sob // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Lungs are hyperinflated and clear. The cardiomediastinal and hilar contours are unchanged. . No pneumothorax, pleural effusion, or consolidation. Multiple healed bilateral rib fractures and right clavicular head fractures are seen. IMPRESSION: No pneumonia. COPD " c1b6f0b0-c201e15c-84aa8630-f1c9dba3-2c2a1773.jpg,test/p18/p18517718/s52573831/c1b6f0b0-c201e15c-84aa8630-f1c9dba3-2c2a1773.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are within normal limits and without change. Minimal bibasilar atelectasis is present, but there are no new areas of consolidation to suggest the presence of a new site of pneumonia. Nasogastric tube continues to terminate in the stomach, but side port is in close proximity to the gastroesophageal junction. " e31297d5-cfcadc6d-8dde164e-641e25e7-8885328d.jpg,test/p14/p14437129/s53577421/e31297d5-cfcadc6d-8dde164e-641e25e7-8885328d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: UNEXPLAINED RALES RT BASE COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Aorta is slightly tortuous at its descending portion. Lungs are clear. Trachea is deviated at its superior and mid portion to the left with no substantial narrowing. The opacity in the right upper mediastinum also seen posteriorly to the trachea on the lateral view most likely represents thyroid enlargement and appears to be substantially more pronounced as compared to ___. Its retro tracheal diameter is currently are approximately 4 x 3.4 cm as compared to 3 x 2.2 cm on the previous examination. Also the tracheal deviation to the left is more pronounced than on ___, overall consistent with increase in size of the right thyroid lesion. Lungs are clear with no pleural effusion or pneumothorax seen. " c7d00f86-2727ff70-42f7da46-93aab818-fe453fd1.jpg,test/p14/p14610896/s51137509/c7d00f86-2727ff70-42f7da46-93aab818-fe453fd1.jpg,test," WET READ: ___ ___ ___ 8:25 PM Tracheal contours appear normal currently. No acute cardiopulmonary process. Catheter coursing along the left mid-clavicular line likely represents something overlying the patient. ___ d/w ___ @8:24 pm on ___ by telephone. ___ p_________________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: Evaluate paratracheal lucency seen on previous chest radiograph. IMPRESSION: PA and lateral chest compared to ___, 1:46 a.m. The lucent region projecting to the left of the trachea on yesterday's radiograph is smaller today, probably air in the esophagus. Heart size is top normal. Lungs are clear and there is no pleural abnormality. " 0c5e8ddb-092d2687-2281565a-ffcd95d0-d00afbfb.jpg,test/p11/p11451979/s55143357/0c5e8ddb-092d2687-2281565a-ffcd95d0-d00afbfb.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Hypoxemia. AP radiograph of the chest was compared to ___. The patient is not intubated. The Swan-Ganz catheter tip is at the level of the right ventricle outflow tract. Widespread consolidations are unchanged. There is no change in cardiomediastinal silhouette. As compared to ___ examination obtained in 09:03 a.m. The appearance of the lungs demonstrate more extent of the opacification. " 6a8d909f-9e80d2d1-088129f2-a168171f-0ed97a96.jpg,test/p13/p13990946/s52092934/6a8d909f-9e80d2d1-088129f2-a168171f-0ed97a96.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, chest tightness, crackles. no fever // r/o pna COUGH 5 DAYS,CHEST TIGHTNESS,CRACKLES NO FEVER R/O PNEUMONIA,ABNORMALITY IMPRESSION: Compared to chest radiographs ___. Peribronchial opacification at the lower pole the left hilus is probably atelectasis. Lungs are otherwise fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " ffd65d87-b5e1e39f-0d359d9c-76c8f1f1-7dfc5752.jpg,test/p10/p10145553/s59304812/ffd65d87-b5e1e39f-0d359d9c-76c8f1f1-7dfc5752.jpg,test," FINAL REPORT HISTORY: Wheezing, slightly more prominent on the right, and cough x ___ weeks. COMPARISON: Chest radiograph from ___ and CT chest from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and unchanged hyperinflated lungs which are clear. Right greater than left apical scarring is unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. Unchanged hyperinflated lungs with right greater than left apical scarring. " 1481b133-f43c6212-c14b86f7-1c1cea58-5464ac93.jpg,test/p16/p16447390/s52048759/1481b133-f43c6212-c14b86f7-1c1cea58-5464ac93.jpg,test," FINAL REPORT HISTORY: Prostate cancer with weakness and hypoxemia, right for a cardiopulmonary process or infiltrate. COMPARISON: Chest radiograph ___ and chest CT ___. FINDINGS: AP and lateral views of the chest: There are tiny bilateral pleural effusions. There is no pneumothorax or focal airspace consolidation to suggest pneumonia. The heart size is enlarged but unchanged. There is mild pulmonary vascular congestion consistent with mild volume overload. The mediastinal contours are unremarkable. IMPRESSION: Mild volume overload. " a2172c3d-a577e970-90901b25-2363e6ad-38f59cc4.jpg,test/p16/p16376060/s51601144/a2172c3d-a577e970-90901b25-2363e6ad-38f59cc4.jpg,test," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old male with question pneumothorax on portable images. COMPARISON: Portable films from earlier the same day. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no evidence of pneumothorax. There is no focal consolidation or definite effusion noting that the right posterior costophrenic angle is excluded from the view on the lateral exam. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified noting hypertrophic changes in the thoracic spine. IMPRESSION: No pneumothorax. No acute cardiopulmonary process. " 37181d97-67a1f50f-0765c8cb-df88712e-a9d8f78e.jpg,test/p18/p18036188/s52318528/37181d97-67a1f50f-0765c8cb-df88712e-a9d8f78e.jpg,test," FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with the study of ___, the Dobbhoff tube extends to the distal stomach, where it coils upon itself so that the opaque tip lies close to the esophagogastric junction. There is a large left and moderate right pleural effusion with compressive atelectasis at the bases. Hemodialysis catheter remains in place. " 3450ba25-815a737f-ec3390c4-928ec9d2-6a0eaf82.jpg,test/p15/p15816738/s52918978/3450ba25-815a737f-ec3390c4-928ec9d2-6a0eaf82.jpg,test," FINAL REPORT PORTABLE CHEST, ___. COMPARISON: Radiograph of two days earlier. FINDINGS: Marked cardiomegaly is again demonstrated with particular prominence of the right cardiac chambers. Main pulmonary artery is enlarged, suggestive of pulmonary arterial hypertension. Interval worsening of pulmonary vascular congestion accompanied by interstitial pulmonary edema. Moderate right pleural effusion and small left pleural effusion have also slightly increased in the interval. Dense opacity in the right retrocardiac region could be due to a combination of pleural effusion and atelectasis, but infectious consolidation in this region is also possible. " 3700e900-cbeaaf77-7570be92-2c18461f-a6404866.jpg,test/p14/p14147261/s56934815/3700e900-cbeaaf77-7570be92-2c18461f-a6404866.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ng tube. TECHNIQUE: Portable AP radiograph of the chest from ___. COMPARISON: ___. FINDINGS: The ET tube has been advanced, and now terminates just distal to the clavicular heads. There has also been interval placement of a nasogastric tube which terminates in the stomach. A new retrocardiac left lower lobe opacities may be due to atelectasis or aspiration. Cardiomegaly is stable. IMPRESSION: New left lower lobe retrocardiac airspace opacity which may be due to aspiration or atelectasis. Stable cardiomegaly. Lines and tubes in satisfactory position. NOTIFICATION: The impression above was entered by Dr. ___ on ___ at 15:54 into the Department of Radiology critical communications system for direct communication to the referring provider. " fb394c96-5cb88eb1-b9aee213-90a2f0f1-b7f3b35a.jpg,test/p11/p11719118/s58337930/fb394c96-5cb88eb1-b9aee213-90a2f0f1-b7f3b35a.jpg,test," WET READ: ___ ___ ___ 3:25 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with syncope, prolonged QT // pulm edema? cardiomegaly? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lung volumes are low, resulting in bronchovascular crowding. The lungs appear clear. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. Clips are seen within the left axilla. IMPRESSION: No acute cardiopulmonary process. " b308b9b8-00a9a1f5-c6e64956-12a387b0-8e510e71.jpg,test/p18/p18131667/s50472559/b308b9b8-00a9a1f5-c6e64956-12a387b0-8e510e71.jpg,test," FINAL REPORT INDICATION: ___F with AMS, sepsis // evidence of infection TECHNIQUE: Single portable view of the chest COMPARISON: ___ FINDINGS: The heart is of normal size. There is no pleural effusion or pneumothorax. There is no evidence of pneumonia. Right PICC and IJ central line are no longer seen. A PEG tube is seen in the left upper quadrant. IMPRESSION: No evidence of acute process on this single portable view. " c54c9367-9c9f228e-278f5888-62bdb57c-a480861b.jpg,test/p15/p15968244/s52947027/c54c9367-9c9f228e-278f5888-62bdb57c-a480861b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p CABG bleeding // eval effusion/mediastinum COMPARISON: ___ ___, 13:18 IMPRESSION: As compared to the previous radiograph, the lung volumes have minimally decreased. The monitoring and support devices all in unchanged position. No evidence of mediastinal widening. No larger pleural effusions. Unchanged mild moderate cardiomegaly. " a8429148-00efa9e5-36779673-6c0a5950-ccc49a09.jpg,test/p19/p19779220/s58536944/a8429148-00efa9e5-36779673-6c0a5950-ccc49a09.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with 2 days of n/v, now with substernal chest pressure and difficulty breathing // eval for cardiomegaly, free air TECHNIQUE: AP upright and lateral radiographs COMPARISON: None FINDINGS: Linear retrocardiac opacity likely represents atelectasis. The lungs are otherwise clear and the cardiomediastinal contours are normal. Heart size is top normal. No pleural effusion or pneumothorax. No subdiaphragmatic free air is seen. IMPRESSION: Left lung base opacity likely represents atelectasis. No evidence of pneumonia. Heart size is top normal. " 2cfc3c84-e5dd557a-62473e78-1c7ca0ed-6b234f96.jpg,test/p15/p15945590/s51132881/2cfc3c84-e5dd557a-62473e78-1c7ca0ed-6b234f96.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF // eval for interval improvement COMPARISON: Chest radiographs ___ through ___. IMPRESSION: There has been no appreciable change over the past several days including moderate right pleural effusion, collapsed left lower lobe, an indeterminate extent of right basal atelectasis or other consolidation, moderate cardiomegaly and engorged pulmonary vasculature. ET tube is in standard placement. Right PIC line ends in the mid SVC, nasogastric tube passes into the stomach and out of view. No pneumothorax. " fc87f431-11acc172-e4a77b7b-f2626c85-15680b81.jpg,test/p12/p12993146/s56316967/fc87f431-11acc172-e4a77b7b-f2626c85-15680b81.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with shortness of breath. // Please assess for thoracic pathology. Please assess for thoracic pathology. IMPRESSION: In comparison with the study of ___, there again is enlargement of the cardiac silhouette and with tortuosity of the aorta and brachiocephalic vessels and some prominence of the central pulmonary vessels which could reflect some pulmonary arterial hypertension. However, there is no convincing evidence of pulmonary vascular congestion or pleural effusion. " 84407cdd-faafefc8-4faf0fd5-77e30751-acc477b6.jpg,test/p19/p19084403/s51862875/84407cdd-faafefc8-4faf0fd5-77e30751-acc477b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F w/fever, please eval for occult pna COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Slightly rotated positioning somewhat limits assessment. Focal tenting of the right hemidiaphragm is unchanged which may reflect the presence of an accessory fissure. Lungs are clear without focal consolidation, large effusion or pneumothorax. No signs of edema or congestion. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. " 67429834-edffefb1-a2ab3507-38d3ed96-960a8f3e.jpg,test/p18/p18963919/s57875990/67429834-edffefb1-a2ab3507-38d3ed96-960a8f3e.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 0b697e9a-61a539d6-8e13e2bb-7814cc22-d7301b5a.jpg,test/p19/p19206181/s59264795/0b697e9a-61a539d6-8e13e2bb-7814cc22-d7301b5a.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: No comparison studies available. FINDINGS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 37856291-e9a602e7-335dff27-2a06786c-86584527.jpg,test/p12/p12514721/s58325850/37856291-e9a602e7-335dff27-2a06786c-86584527.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___ and PET-CT from ___. CLINICAL HISTORY: Short of breath, wheezing, assess for pneumonia or CHF. Patient has a history of non-small cell lung cancer. FINDINGS: AP upright chest radiograph obtained. A metallic clip at the right medial lower lung resides within a known pulmonary nodule. There is a retrocardiac opacity, compatible with large hiatal hernia. Compared with the prior chest radiograph, there is interval development of micronodular opacity within the right lower lung which could reflect treatment-related change or possibly aspiration. Otherwise, the lungs are clear. Cardiomediastinal silhouette is stable. Bony structures appear intact. IMPRESSION: Retrocardiac opacity compatible with hiatal hernia. Micronodule opacity in the right lower lung could represent post-treatment change or aspiration. Known lung nodule marked with fiducial marker, better assessed on prior CT PET. " 1c0a7b04-ca17b79c-cb4e2064-2ae86565-0d362c95.jpg,test/p12/p12105725/s57199981/1c0a7b04-ca17b79c-cb4e2064-2ae86565-0d362c95.jpg,test," FINAL REPORT HISTORY: Persistent cough for three weeks. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate hyperexpanded lungs with flattened diaphragm consistent with emphysema. Otherwise, there is no focal opacity concerning for pneumonia. The cardiac and mediastinal contours are normal. No pleural abnormality is detected. IMPRESSION: No acute pneumonia. " 383e3538-e911b155-956c4dd5-de511679-be2f3390.jpg,test/p17/p17332967/s55329669/383e3538-e911b155-956c4dd5-de511679-be2f3390.jpg,test," FINAL REPORT INDICATION: Substernal chest pain. COMPARISON: None. FINDINGS: PA and lateral chest radiographs demonstrate low lung volumes and bibasilar atelectasis. However, there is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 8906583c-d1e83b76-6cab38d4-34e2adbc-d3577777.jpg,test/p14/p14983031/s57407935/8906583c-d1e83b76-6cab38d4-34e2adbc-d3577777.jpg,test," FINAL REPORT HISTORY: ___-year-old female with indigestion and right arm intermittent tingling. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Mid thoracic dextroscoliosis is seen with posterior fixation hardware traversing the thoracic and upper lumbar spine. The lungs appear clear of consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits within limitation of the significant scoliosis. Surgical clips project over the neck on the right. Soft tissues are otherwise unremarkable. There is no free air seen below the diaphragm. IMPRESSION: No definite acute cardiopulmonary process. " 978f5eb4-c60f4ab2-dc368ddc-f35f05fa-84c74491.jpg,test/p17/p17156194/s56831304/978f5eb4-c60f4ab2-dc368ddc-f35f05fa-84c74491.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with 24 hrs substernal chest pain, risk factors for coronary artery disease, no respiratory symptoms TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is top normal. The aorta is unfolded. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Clips are seen in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 46c59f58-455f0fc7-b5dd0c41-2937d04b-ba41662a.jpg,test/p16/p16500918/s57875259/46c59f58-455f0fc7-b5dd0c41-2937d04b-ba41662a.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with dyspnea and AFib with rapid ventricular rate. COMPARISON: ___. FINDINGS: There is a moderate-to-large right-sided pleural effusion. Increased interstitial markings are seen throughout the lungs. There is no left-sided effusion. Cardiac silhouette is slightly enlarged but difficult to assess given silhouetting on the right. Right chest wall dual-lead pacing device is seen with lead tips in the right atrium and right ventricular apex. No acute osseous abnormality is identified. IMPRESSION: Moderate-to-large right effusion and pulmonary vascular congestion. " 8090b078-efef3280-2f4caf28-57e54277-647af42b.jpg,test/p17/p17276069/s53976623/8090b078-efef3280-2f4caf28-57e54277-647af42b.jpg,test," WET READ: ___ ___ ___ 6:15 PM Aside from interval removal of the right internal jugular central venous catheter, there has been little change in comparison to the prior study from ___. Lung volumes remain low with no focal consolidations. ___ at 18:15 on ___. ______________________________________________________________________________ FINAL REPORT HISTORY: Rising white blood count, to assess for pneumonia. FINDINGS: In comparison with the study of ___, the right IJ catheter has been removed. Low lung volumes again most likely account for the prominence of the transverse diameter of the heart. Extensive scattered radiation obscures the image, though no definite vascular congestion or acute focal pneumonia is identified. " 4e1abdb3-8f5f1639-9507c04d-2d389791-ae89e67f.jpg,test/p14/p14353305/s53488668/4e1abdb3-8f5f1639-9507c04d-2d389791-ae89e67f.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain, dyspnea TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___ FINDINGS: Sutures are noted in the left lung apex. Otherwise, the lungs are clear without focal opacity, pulmonary edema, or pneumothorax. Blunting of the left costophrenic angle on the lateral view suggests a trace pleural effusion. No right-sided pleural effusion is demonstrated. The cardiac and mediastinal contours are normal. No acute osseous abnormalities seen. IMPRESSION: Trace left pleural effusion. Otherwise no acute cardiopulmonary abnormality. " 370f8439-8c59ea7c-25c77b9b-91bca240-911c30cf.jpg,test/p12/p12948890/s50182661/370f8439-8c59ea7c-25c77b9b-91bca240-911c30cf.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with history of seizures, p/w new seizure today. TECHNIQUE: AP and lateral COMPARISON: Chest radiograph ___. FINDINGS: Cardiomediastinal silhouette is unchanged. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. Changes of DISH are seen in the thoracic spine. IMPRESSION: No evidence of pneumonia. No acute cardiopulmonary process. " 366b1d2f-3829e63d-6e286b93-a0d2a879-6acf932b.jpg,test/p10/p10911508/s51820583/366b1d2f-3829e63d-6e286b93-a0d2a879-6acf932b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Epigastric and chest pain. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. No free air below the right hemidiaphragm. Degenerative changes of the right acromioclavicular joint noted. " 6ef9d2ce-c8f1c20f-ba9649a1-046cda12-9264aa72.jpg,test/p18/p18554342/s54669989/6ef9d2ce-c8f1c20f-ba9649a1-046cda12-9264aa72.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever, s/p aspiration on video swallow // pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Again noted is the spinal fixation hardware and midline ___. The cardiac and mediastinal silhouettes are normal. There is no focal infiltrate. There is blunting of the CP angles and a may be tiny bilateral pleural effusions IMPRESSION: No focal infiltrate. " c49826c9-236227b4-e45f859e-a804e86b-541963dc.jpg,test/p11/p11842879/s54713955/c49826c9-236227b4-e45f859e-a804e86b-541963dc.jpg,test," FINAL REPORT AP CHEST, 5:38 A.M., ___ HISTORY: ___-year-old woman with dermatomyositis, multi-region lung collapse, intubated. IMPRESSION: AP chest compared to ___: Multifocal pulmonary consolidation strongly suggesting pneumonia in the lower lobes medially has not changed appreciably since ___. Right upper lobe is newly collapsed. Pneumomediastinum and subcutaneous emphysema in the right neck are stable, new in the left neck. Pneumomediastinum developed on ___, and has increased slowly ever since. There may be a tiny right apical pneumothorax or alternatively extrapleural emphysema simulating pneumothorax. Moderate cardiomegaly is stable. ET tube, right internal jugular line, and nasogastric drainage tube are in standard placements respectively. There is no evidence of pneumoperitoneum or pneumoretroperitoneum. Possibility of perforation of the esophagus, less likely the trachea, was discussed with the clinical house staff in conference. " 0828d204-a15f2a70-0b460b6b-949dca33-1cfa7b31.jpg,test/p11/p11549602/s52840990/0828d204-a15f2a70-0b460b6b-949dca33-1cfa7b31.jpg,test," FINAL REPORT PORTABLE CHEST RADIOGRAPH COMPARISON: ___. FINDINGS: No visible pneumothorax following thoracentesis procedure. Small-to-moderate right and small left pleural effusions are present with adjacent lower lobe opacities, which likely reflect atelectasis. " 98ae6eeb-c623df1d-23a19f0d-557469ea-34f9a5e8.jpg,test/p11/p11812613/s55472998/98ae6eeb-c623df1d-23a19f0d-557469ea-34f9a5e8.jpg,test," WET READ: ___ ___ ___ 9:47 PM left base opacity, potentially pneumonia- repeat films after treatment for resolution WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST, TWO VIEWS. HISTORY: ___-year-old male with recent fevers and scant hemoptysis. Question pneumonia. FINDINGS: Frontal and lateral views of the chest were compared to previous exam from ___ and ___. There is patchy opacity at the left lung base projecting over the spine on the lateral view. Elsewhere, the lungs are clear. Cardiac silhouette is enlarged but stable. Osseous and soft tissue structures are unremarkable. IMPRESSION: Patchy left base opacity compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. " 9bd640b2-360e8714-6e193f2d-ee9ff52b-58f5857e.jpg,test/p16/p16237334/s50879108/9bd640b2-360e8714-6e193f2d-ee9ff52b-58f5857e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ett, ?aspiration? // Interval change? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is slight interval progression of right basal opacity concerning for developing aspiration pneumonia giving the provided history. The patient has been extubated as well as the NG tube has been removed. There is no pneumothorax or appreciable pleural effusion. " 241f714a-2e591dc3-74f8a3d7-e7c110fe-33fc5c35.jpg,test/p11/p11668433/s55998217/241f714a-2e591dc3-74f8a3d7-e7c110fe-33fc5c35.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Multiple strokes, evaluation for pneumonia, atelectasis. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes, normal size of the cardiac silhouette. No parenchymal opacities. The monitoring and support devices are in constant position. " e81ae8b6-48078d58-90de1dd2-9cafa64a-6e48aafe.jpg,test/p13/p13167274/s54778561/e81ae8b6-48078d58-90de1dd2-9cafa64a-6e48aafe.jpg,test," FINAL REPORT Myeloma, on chemotherapy, TB exposure recently. CHEST COMPARISON FILM: ___. Cardiac size is within normal limits. Lung fields are clear. The costophrenic angles are sharp. No evidence of active TB. There has been no change in the appearance of the lung fields since ___. IMPRESSION: No evidence of TB. " 3374b2e9-a44e21f6-41179a06-8f88a81c-c9d93556.jpg,test/p19/p19543748/s56593534/3374b2e9-a44e21f6-41179a06-8f88a81c-c9d93556.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with history of RCC. Comparison is made with prior study ___ and chest CT ___. Multiple bilateral lung nodules are better seen in prior CT from ___. Mediastinal and hilar adenopathy also is better evaluated in prior CT. There is no evidence of consolidation with complete resolution of opacities seen in prior chest x-ray of ___. There is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine. " 90e2fc3c-024d2870-1895da05-26ad4494-e703ef7f.jpg,test/p13/p13903940/s58121918/90e2fc3c-024d2870-1895da05-26ad4494-e703ef7f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with resp insufficiency s/p surgery // Pulmonary process progression Pulmonary process progression IMPRESSION: Comparison to ___. The patient has been extubated. No other relevant changes noted. Borderline size of the cardiac silhouette. Mild fluid overload but no overt pulmonary edema. Left retrocardiac atelectasis. No larger pleural effusions. " 27d07cd3-41f3c015-be7a9196-abcc53bf-ed5327fa.jpg,test/p13/p13538279/s55550694/27d07cd3-41f3c015-be7a9196-abcc53bf-ed5327fa.jpg,test," FINAL REPORT HISTORY: ___-year-old male with low-grade temperature status post surgery. COMPARISON: ___. FINDINGS: Single portable view of the chest. The right chest wall port is again seen noting that the catheter tip is not as clearly delineated on today's exam. The lungs are clear without focal consolidation or large effusion. The cardiomediastinal silhouette is unchanged given differences in positioning and low lung volumes. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 8f6cee59-1fa2d44d-1ac2529b-be7b7425-37234b53.jpg,test/p13/p13848298/s58518861/8f6cee59-1fa2d44d-1ac2529b-be7b7425-37234b53.jpg,test," FINAL REPORT INDICATION: History: ___F with dyspnea // r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dated ___ and ___ comment CT of the chest dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate a stable appearing right upper lobe opacity and right axillary calcifications. Heart size normal. Tortuous aorta. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 179a6f1b-53f04b73-0cd8095e-8cfeea81-10e0fb9b.jpg,test/p13/p13888167/s57043469/179a6f1b-53f04b73-0cd8095e-8cfeea81-10e0fb9b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Pneumothorax. Portable AP radiograph of the chest was reviewed in comparison to ___. The right pigtail catheter is in place. There is no definitive pneumothorax noted on the current study. Left basal opacities have minimally progressed in the interim. No pleural effusion increase is seen in the interim. " c94acc65-89df902e-95ee6900-5596c3de-cf301322.jpg,test/p13/p13364910/s56321391/c94acc65-89df902e-95ee6900-5596c3de-cf301322.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent intubation, multifocal pneumonia // interval change of multifocal opacities and evidence of volume overload interval change of multifocal opacities and evidence of volu IMPRESSION: In comparison with the study ___ ___, there is little changed. Monitoring and support devices. Are again seen. Areas of increased opacification persist in the right upper zone as well as both bases, concerning for multifocal pneumonia. " 3bb79e4e-13ce6207-842b84d7-32826c14-b51843a1.jpg,test/p17/p17914820/s50969726/3bb79e4e-13ce6207-842b84d7-32826c14-b51843a1.jpg,test," FINAL REPORT HISTORY: AFib, tachy-brady, history of pulmonary fibrosis, pulmonary hypertension, rhonchi on exam with decreased breath sounds bilaterally. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: Dual lead left-sided pacemaker is stable in position. There are diffuse bilateral opacities again seen, which appear stable to minimally improved since the prior study which may be due to pulmonary edema superimposed on chronic lung disease trace pleural effusions are difficult to exclude. Linear calcification is again seen along the right hemidiaphragm. The cardiac silhouette remains enlarged. Mediastinal contours are stable. " efbf5d1e-0cddaeb4-b4b023ea-ca7f6560-dc50121f.jpg,test/p18/p18439312/s59081356/efbf5d1e-0cddaeb4-b4b023ea-ca7f6560-dc50121f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post acute mitral insufficiency, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes remain low. There are signs of moderate pulmonary edema. Unchanged monitoring and support devices. Unchanged areas of atelectasis at the lung bases. No evidence of pleural effusions. " cfe47370-25dbb40c-7e51617f-6713fb66-28f33f76.jpg,test/p11/p11277318/s59812848/cfe47370-25dbb40c-7e51617f-6713fb66-28f33f76.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever and cough // r/o infltrate COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " a1d967ce-65b78fda-7d2af0d3-29c07756-84de6dfe.jpg,test/p13/p13715870/s53714876/a1d967ce-65b78fda-7d2af0d3-29c07756-84de6dfe.jpg,test," WET READ: ___ ___ ___ 7:20 PM Right PICC with tip terminating in the mid SVC. Decreased lung volumes compared to ___. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: PICC line placement, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the tip of the PICC line now projects over the mid SVC. As compared to the previous image, the lung volumes are decreased and there are areas of mild atelectasis. Sternal wires are in unchanged position. No acute changes. " 3cf01810-ba0b1249-459efac3-7274c452-a9f4f6c2.jpg,test/p17/p17287974/s59278816/3cf01810-ba0b1249-459efac3-7274c452-a9f4f6c2.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Desaturation, coughing and crackles on auscultation. Comparison is made with prior study ___. There are low lung volumes. Mild cardiomegaly is unchanged. Unchanged loss of volume and fibrotic parenchyma adjacent to the right upper mediastinum is likely a combination of lobectomy and probably radiation changes. There is elevation of the right hemidiaphragm. Evidence of thoracotomy on the right. The sternal wires are aligned. Patient is status post aortic valvular replacement. There is no pneumothorax or large effusion. IMPRESSION: No acute cardiopulmonary abnormalities. " 2f2cfbe4-aa0328bd-1f576adc-2a61eb16-7d45a443.jpg,test/p17/p17118056/s50704552/2f2cfbe4-aa0328bd-1f576adc-2a61eb16-7d45a443.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with chest pain // ? pulmonary edema ?pneumonia TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Assessment is somewhat limited by kyphotic positioning. Heart size remains mildly enlarged. The aorta is diffusely calcified and tortuous, as seen previously. Mediastinal and hilar contours are otherwise unchanged. Pulmonary vasculature is not engorged. Lungs are hyperinflated with emphysematous changes again noted. Lungs are otherwise clear. No pleural effusion or pneumothorax is present. Multilevel moderate degenerative changes are again noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 5f0e80cd-e49d1ecd-fb1c1c07-32abb840-09cdde8e.jpg,test/p14/p14538785/s58775347/5f0e80cd-e49d1ecd-fb1c1c07-32abb840-09cdde8e.jpg,test," FINAL REPORT INDICATION: ___ year old man with chest tube placed // eval for pneumothorax TECHNIQUE: Portable AP upright view of the chest COMPARISON: ___ FINDINGS: There is interval placement of a pigtail pleural catheter in the mid left chest. The large left pleural effusion however has minimally changed. The right lung is clear. The is no right pleural effusion. The cardiac silhouette is partially obscured and difficult to evaluate. The visualized mediastinal contours are otherwise stable. IMPRESSION: Interval placement of a left pleural catheter with minimal improvement in large left pleural effusion. " 54278155-1896f94a-974d8f3d-bfd44db2-5ac8171b.jpg,test/p11/p11909985/s58759745/54278155-1896f94a-974d8f3d-bfd44db2-5ac8171b.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // PTX? TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: Lungs are clear. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Normal chest x-ray. " a7208f25-1e4217a2-c4ed1963-9c23e5b8-c765e245.jpg,test/p10/p10753211/s54371718/a7208f25-1e4217a2-c4ed1963-9c23e5b8-c765e245.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough and malaise with chills, sweats and urinary incontinence this morning. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes, which accentuate the bronchovascular markings. Given this, there is minor left basilar atelectasis without definite focal consolidation. No large pleural effusion or pneumothorax is seen. The cardiac silhouette is top normal. Mediastinal contours are unremarkable. IMPRESSION: Likely mild left basilar atelectasis without definite focal consolidation. " 021eab9d-c8e69be8-eda24d44-1f29c5d5-aae4d1a4.jpg,test/p10/p10286475/s55309892/021eab9d-c8e69be8-eda24d44-1f29c5d5-aae4d1a4.jpg,test," WET READ: ___ ___ 1:08 AM 1. Worsening heterogeneous right lower lobe opacity worrisome for pneumonia or aspiration pneumonia. 2. Left lower lobe retrocardiac opacity with elevation of left hemidiaphragm is most consistent with atelectasis. 3. Stable small left pleural effusion. ___ d/w Dr. ___ on ___ at 1:06 PM, ___ min after observation ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo male, with h/o CML on hydroxyurea, recent admitted for AMS thought to be ___ medication overdose, presenting with AMS, leukocytosis and hypoxia concerning for HCAP, now s/p chest tube placement on right side ___ and with episode of hypoxemia. // r/o PTX, expansion pulmonary edema r/o PTX, expansion pulmonary edema COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: No appreciable right pleural effusion or pneumothorax, small bore pleural drain still in place at the base of the right chest. Increasing heterogeneous opacification or right lower lobe medially could be pneumonia or atelectasis. Small left pleural effusion stable. Mild cardiac enlargement stable. No pulmonary or mediastinal venous engorgement or pulmonary edema. " 87f0e7d0-d39966bf-a94b4cf3-2b549e16-6f334401.jpg,test/p14/p14338126/s57458655/87f0e7d0-d39966bf-a94b4cf3-2b549e16-6f334401.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, cardiomyopathy TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Minimal atelectasis is noted in the bases, as seen previously. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 798fd862-f5f1eacd-61e503bc-f4c7dc34-bc81c54f.jpg,test/p11/p11578803/s54944297/798fd862-f5f1eacd-61e503bc-f4c7dc34-bc81c54f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypotension s/p afib ablation and AICD // eval for pneumothorax vs ? pericardial effusion eval for pneumothorax vs ? pericardial effusion TECHNIQUE: Portable AP supine chest radiograph was obtained COMPARISON: Frontal chest radiograph ___ at 15:23 FINDINGS: Left pneumothorax is unchanged. There is no mediastinal shift. Dense material in the left hemi thorax on has a more dependent position suggestive of intrathoracic contrast. Cardiomediastinal silhouette and pulmonary vasculature are within normal limits. There is no consolidation. Cardiac device generator overlying the left chest is unchanged with leads in the right atrium, right ventricle, and coronary sinus. IMPRESSION: Unchanged left pneumothorax without evidence of mediastinal shift. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:27 PM, 5 minutes after discovery of the findings. " dbdeabe7-7b4fca49-ad2283b0-c5e5babe-4ccace94.jpg,test/p11/p11728419/s59530732/dbdeabe7-7b4fca49-ad2283b0-c5e5babe-4ccace94.jpg,test," WET READ: ___ ___ ___ 12:53 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT INDICATION: Hypotension. Concern for pneumonia. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: None. IMPRESSION: The patient is rotated rightward. The heart size is normal. Sternal closure devices appear intact. There is no pneumothorax, focal consolidation, or pleural effusion. " b908af8a-a7f2bb78-d8aa1a29-91a65bb7-547b116d.jpg,test/p17/p17070596/s53585078/b908af8a-a7f2bb78-d8aa1a29-91a65bb7-547b116d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain // eval infiltrate, cardiomegaly TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs on ___ FINDINGS: Bronchiectasis seen at the lung bases is re- demonstrated. The cardiomediastinal and hilar contours are within normal limits. The heart is normal in size. There is mild pulmonary vascular engorgement without frank pulmonary edema. A left lower lobe heterogeneous opacity is concerning for pneumonia. No focal consolidation is identified. There is no pneumothorax. Bibasilar reticular opacities are suggestive of small airways inflammation. Focal scarring in periphery of left IMPRESSION: Left lower lobe opacity concerning for pneumonia. Bibasilar reticular opacities are consistent with small airways inflammation in the setting of known bronchiectasis. NOTIFICATION: Findings discussed with Dr. ___ ___ telephone at 12:33 on ___ by Dr. ___. " c8b0cc10-e15a61e9-d5829c87-46a8db9a-fe052265.jpg,test/p13/p13011896/s55560671/c8b0cc10-e15a61e9-d5829c87-46a8db9a-fe052265.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Heart block. Dual-chamber pacemaker. IMPRESSION: PA and lateral chest compared to ___: Cannot be sure whether there is a small left apical pneumothorax. I would recommend a repeat frontal chest radiograph, carefully positioned, with no overlying garments. Small bilateral pleural effusions are probably residual of previous episodes of congestive failure. Heart size is now normal and there is no pulmonary edema. Mild left basal atelectasis is still present. Transvenous right atrial and right ventricular pacer leads follow their expected courses from the left axillary pacemaker. Dr. ___ was paged. " 18e5e1b4-13e4c6ba-99e2b037-2c25e802-9087284d.jpg,test/p14/p14889848/s59792494/18e5e1b4-13e4c6ba-99e2b037-2c25e802-9087284d.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:07 AM Normal chest radiograph. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest x-ray on ___. FINDINGS: PA and lateral radiographs of the chest demonstrate a normal cardiomediastinal silhouette. The lungs are clear without pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: Normal chest radiograph. " f8f2d63e-8d53d217-094843ca-6394bb92-c9f671a8.jpg,test/p10/p10391104/s50031555/f8f2d63e-8d53d217-094843ca-6394bb92-c9f671a8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent VT and PNA s/p extubation // interval changes s/p extubation TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs most recently from ___. FINDINGS: Patient has been extubated. Left midlung consolidation has not changed significantly since the prior study. Mild pulmonary edema may be slightly improved. There is no pleural effusions or pneumothorax. No new focal consolidations are identified. The cardiomediastinal silhouette is unchanged. IMPRESSION: Persistent left midlung consolidation. Improvement of mild pulmonary edema. " 7c4a966d-284a72ac-e00c8478-5a02e27c-731e23d0.jpg,test/p14/p14659758/s52893769/7c4a966d-284a72ac-e00c8478-5a02e27c-731e23d0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with decompensated ETOH Cirrhosis, Cdiff and UTI not improving on appropriate Abx // Evaluation for pneumonia, effusion, edema Evaluation for pneumonia, effusion, edema IMPRESSION: Compared to chest radiographs since ___, most recently ___. Moderately severe bibasilar atelectasis and very low lung volumes unchanged. Upper lungs clear. Heart size top normal exaggerated by the elevated diaphragm. " 17cbece1-ca5947bf-80fcfab6-45d1ff4f-3358c7bf.jpg,test/p12/p12610389/s52416957/17cbece1-ca5947bf-80fcfab6-45d1ff4f-3358c7bf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with asthma, hypoxia // ?pneumothorax COMPARISON: ___. FINDINGS: AP portable upright view of the chest. Evaluation somewhat limited due to slight patient rotation and overlying EKG leads. Allowing for this, the lungs appear clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process. " 20700fe1-e262987c-043351f9-c98c5dd7-3afe9a26.jpg,test/p14/p14583219/s58790598/20700fe1-e262987c-043351f9-c98c5dd7-3afe9a26.jpg,test," FINAL REPORT INDICATION: Right flank pain. Right lower chest pain. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest. Normal lungs, heart, pleura and mediastinal surfaces. IMPRESSION: Normal chest radiograph. " 3f836781-f603b420-3a5f520d-9d4936a3-6733ffb4.jpg,test/p15/p15069337/s50219828/3f836781-f603b420-3a5f520d-9d4936a3-6733ffb4.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with axtaxia // eval for pnaNCHCT eval for ICH TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Minimal basilar atelectasis/scarring is seen without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. Slight prominence of the hila likely relates to pulmonary vascular engorgement. Some degenerative changes are seen along the spine. IMPRESSION: Mild cardiomegaly and mild central pulmonary vascular engorgement. No focal consolidation to suggest pneumonia. " 01cd75ef-f229b4fe-46847cbe-5c3d2037-7eb6aba0.jpg,test/p15/p15868868/s58212673/01cd75ef-f229b4fe-46847cbe-5c3d2037-7eb6aba0.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fever. Evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: There is a new right upper lobe opacity concerning for pneumonia. The heart continues to be enlarged. There is no overt pulmonary edema, pneumothorax or pleural effusion. IMPRESSION: Right upper lobe opacity concerning for pneumonia. " 42cc3f2e-b21b2276-98fb401f-911ee301-64af7341.jpg,test/p17/p17477199/s50199764/42cc3f2e-b21b2276-98fb401f-911ee301-64af7341.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Lungs appear hyperinflated. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 5e3a68e0-184cf7e9-4df8a4f8-6029a97d-1dde3268.jpg,test/p10/p10855190/s51043653/5e3a68e0-184cf7e9-4df8a4f8-6029a97d-1dde3268.jpg,test," WET READ: ___ ___ ___ 2:14 PM Left basilar consolidation, largely due to compressive atelectasis in the setting of left hemidiaphragm elevation. However, superimposed pneumonia would be difficult to exclude in the appropriate clinical setting. Otherwise no relevant change compared to ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with productive cough // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is persistent left hemidiaphragm elevation, with resulting left basilar atelectasis. However, superimposed infection would be difficult to exclude in the appropriate clinical setting. Prominent interstitial markings are unchanged across multiple prior examinations, and suggests underlying chronic lung disease. Right lung is otherwise essentially clear. No effusion or pneumothorax. Heart is normal in size. Right shoulder arthroplasty is noted. Significant wedge compression of the lower thoracic spine with resulting kyphosis is unchanged. IMPRESSION: Left basilar consolidation, largely due to compressive atelectasis in the setting of left hemidiaphragm elevation. However, superimposed pneumonia would be difficult to exclude in the appropriate clinical setting. Otherwise no relevant change compared to ___. " 8ed4fa72-dff34f66-2bd11296-e0ec7ff2-4b0e202f.jpg,test/p16/p16448755/s50792338/8ed4fa72-dff34f66-2bd11296-e0ec7ff2-4b0e202f.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Hypoxia and fever. REFERENCE EXAM: ___. FINDINGS: Compared to the study from the prior afternoon, there is no significant interval change. " f209acd9-5920711b-4ab0ec8e-2a9389cc-af7ec849.jpg,test/p12/p12095092/s58726538/f209acd9-5920711b-4ab0ec8e-2a9389cc-af7ec849.jpg,test," WET READ: ___ ___ ___ 1:52 AM Mild cardiomegaly and upper zone redistribution, but no interstitial edema or pleural effusions. No evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with respiratory distress // PNA? TECHNIQUE: Portable upright chest radiograph COMPARISON: None FINDINGS: Heart size is mildly enlarged. Mild central vascular congestion and upper zone redistribution, but no interstitial edema. There is bronchial wall thickening and reticulonodular opacities of the lung bases bilaterally. Right peribronchovascular opacity is also demonstrated with associated mild volume loss. No pleural effusion or pneumothorax. IMPRESSION: Bronchial wall thickening and reticulonodular opacities at the lung bases bilaterally and peribronchovascular right upper lobe opacity concerning for a of bronchiolar infection or aspiration. Correlate with concurrent CT findings for more complete characterization " 961a3351-81fe49e9-40687884-8f2c8e49-0980bbb1.jpg,test/p17/p17925184/s51060337/961a3351-81fe49e9-40687884-8f2c8e49-0980bbb1.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Left PICC has been advanced to the lower superior vena cava. Feeding tube continues to be directed cephalad within the fundus of the stomach. Cardiac silhouette is normal in size. Bilateral moderate partially layering pleural effusions are again demonstrated, with apparent interval increase in size on the right. Adjacent areas of basilar atelectasis are present. Remainder of lungs are clear, and note is made of upper lobe predominant emphysema. " 82217537-35b348d6-ec901701-bdf752b6-39134440.jpg,test/p13/p13299285/s58949070/82217537-35b348d6-ec901701-bdf752b6-39134440.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pancreatic CA with right pleural effusion // cardiopulmonary process COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a minimal increase in extent of the right pleural effusion. The right chest tube is in unchanged position. The other monitoring and support devices are also constant. Unchanged appearance of the cardiac silhouette and of the left lung. " 6d061cbc-b8d7fb80-ccc0f16c-2b4ef7de-15725b5b.jpg,test/p16/p16722322/s59666209/6d061cbc-b8d7fb80-ccc0f16c-2b4ef7de-15725b5b.jpg,test," FINAL REPORT HISTORY: Altered mental status. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top normal. Cardiomediastinal silhouette and hilar contours are unremarkable. There are mild increased perihilar and basal opacities compatible with mild pulmonary edema. There is no focal consolidation. There is no pleural effusion or pneumothorax. IMPRESSION: Mild pulmonary edema. " 09f626d9-21c64b20-5f02fa88-213c4712-81dd3788.jpg,test/p13/p13620449/s56632904/09f626d9-21c64b20-5f02fa88-213c4712-81dd3788.jpg,test," FINAL REPORT HISTORY: Lead position. FINDINGS: In comparison with study of ___, there is no change in the appearance of the position of the ICD lead, with its tip in the region of the apex of the right ventricle. Continued enlargement of the cardiac silhouette without vascular congestion or acute focal pneumonia. " 00abab70-6faf3606-7a0d35b6-0310b436-db18b1af.jpg,test/p17/p17201840/s56505713/00abab70-6faf3606-7a0d35b6-0310b436-db18b1af.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with neutropenia and cough pls eval for PNA // PNA vs pulm edema COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Previous moderate cardiomegaly has improved, and there is no evidence of cardiac decompensation currently aside from a small right pleural effusion. Lungs are clear. Previous left pleural effusion is resolved. Central lymph node calcifications are chronic, most likely due to prior granulomatous infection, but there is no indication of active infection today. " 275cd2f4-4d98b4ca-1fffe684-298f8a12-a8fd9cf5.jpg,test/p12/p12706984/s52466701/275cd2f4-4d98b4ca-1fffe684-298f8a12-a8fd9cf5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with worsening hypoxemia. // Is there interval change? TECHNIQUE: Chest AP and lateral COMPARISON: Plain films of the chest from 2 hours and 10 hours prior FINDINGS: Lung volumes are low. there is no pleural effusion or pneumothorax. The cardiomediastinal silhouette and pulmonary vasculature is unremarkable. Minimal right infrahilar opacity is seen, not definitively identified on prior examinations, which may represent vascular crowding or atelectasis, though focal consolidation is not entirely excluded. Vague new retrocardiac opacity is also seen, which may be related to atelectasis, though aspiration is not excluded. IMPRESSION: 1. More prominent right infrahilar and retrocardiac opacities than seen on most recent comparison may represent aspiration or atelectasis. " 3081c55c-086ccea1-0ddb96ef-a7fbc377-efb68bf9.jpg,test/p14/p14419091/s59297527/3081c55c-086ccea1-0ddb96ef-a7fbc377-efb68bf9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man , loculated pleural effusion // s/p unsuccessful Chest tube r/o R sided PTX COMPARISON: Chest x-ray from ___ at 13 22. FINDINGS: There is curvilinear density over the left upper lobe laterally, new compared with ___, which raises the question of a small pneumothorax. However, the appearance is somewhat atypical and no correlative finding is identified on the ___ chest CT. The differential could include artifact due to a skin fold. No obvious right apical pneumothorax is identified. Possible mild interval increase in upper zone redistribution. Otherwise, allowing for differences in positioning, the cardiomediastinal and pleural slight parenchymal findings are overall similar. Incidental note is made of marked narrowing of the right rotator cuff interval, consists with chronic rotator cuff tear and severe glenohumeral osteoarthritis bilaterally . IMPRESSION: 1. Curvilinear density at the left upper lobe, equivocal for a small pneumothorax. The differential could include a skin fold. Clinical correlation and attention to this area on followup films is requested. 2. No right-sided pneumothorax identified. 3. Possible slight increase in the degree of upper zone redistribution. Otherwise, I doubt significant interval change. " ee0bb4a2-a7c5dbf5-dc4f2f3f-1c1fae8d-67a29fd9.jpg,test/p14/p14584470/s52567205/ee0bb4a2-a7c5dbf5-dc4f2f3f-1c1fae8d-67a29fd9.jpg,test," FINAL REPORT INDICATION: Evaluation of pleural effusions. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Multiple priors most recent ___. FINDINGS: There is a moderate loculated right pleural effusion, slightly different in distribution from ___. Moderate cardiomegaly and pulmonary vascular congestion is unchanged from ___. Again noted are median sternotomy wires, mitral valve replacement, and tricuspid valve repair. The right PICC terminates in the mid SVC. IMPRESSION: 1. Moderate loculated right pleural effusion. 2. Mild vascular congestion, unchanged from ___. " 649db699-5691f306-961fc630-3d6184cd-29281904.jpg,test/p16/p16830759/s56592101/649db699-5691f306-961fc630-3d6184cd-29281904.jpg,test," FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with study of ___, the Dobbhoff tube now lies in the upper body of the stomach. Lower lung volumes, but no definite vascular congestion or acute pneumonia. " 1fef4528-2cdb6418-9c61c25d-92b724bd-754cd569.jpg,test/p12/p12273785/s58102267/1fef4528-2cdb6418-9c61c25d-92b724bd-754cd569.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o uterine CA with lung mets. // assess for source of dyspnea TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs of___. FINDINGS: The left upper lobe is collapsed, with hyperexpansion of the superior segment of the left lower lobe. Numerous pulmonary metastases have increased in size compared with prior radiographs, but ___ metastases in the left lower lobe appear unchanged or slightly smaller.However, differences in lung volumes limit COMPARISON in of the lower lobes. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. A large staghorn calculus is present in the right kidney. IMPRESSION: Complete left upper lobe collapse, likely due to obstructing left hilar lesion or juxta hilar metastasis. Contrast-enhanced chest CT is recommended for further characterization. Bilateral pulmonary metastases. Right staghorn calcified renal calculus NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:46 AM, 5 minutes after the discovery of the findings. " 991c622e-0c3c8bc7-51e9972f-951b65c6-66e7c09d.jpg,test/p16/p16003391/s56817035/991c622e-0c3c8bc7-51e9972f-951b65c6-66e7c09d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea on exertion and leg swelling. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are underinflated with increased interstitial opacities, likely representing chronic interstitial changes and atelectasis. Mild cardiomegaly is noted, and the descending thoracic aorta is slightly tortuous. No focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax. IMPRESSION: As above. " 02008f84-6f76cad0-550e9056-73afe6b6-0883afa5.jpg,test/p12/p12105725/s59781767/02008f84-6f76cad0-550e9056-73afe6b6-0883afa5.jpg,test," FINAL REPORT HISTORY: Shortness of breath and palpitations. TECHNIQUE: PA and lateral chest radiograph. 2 views. COMPARISON: ___. FINDINGS: Heart size is top-normal. The cardiomediastinal silhouette is unremarkable with the exception of mild tortuosity of the thoracic aorta. Hilar contours are normal. There is no evidence of interstitial edema. The lungs are mildly hyperinflated suggestive of COPD but are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process specifically no evidence of interstitial edema. Mild hyperinflation suggestive of COPD. " fca5f800-6cc05312-add429f8-e226963c-8ea015bd.jpg,test/p18/p18303550/s50640833/fca5f800-6cc05312-add429f8-e226963c-8ea015bd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx met RCC with ongoing cough and worsening dyspnea // evaluate for change in left lung effusion/metastatic disease evaluate for change in left lung effusion/metastatic disease IMPRESSION: In comparison with the study of ___, there is now complete opacification of the left hemithorax with the pigtail catheter removed. This is consistent with a massive left pleural effusion with collapse of most of the left lung. There is abrupt cut off of the air column E an the left bronchial tree, worrisome for severe narrowing of the airway. Mild blunting of the right costophrenic angle is seen. " c3956f34-44268c16-402b2ecc-263ad3a0-8f511344.jpg,test/p10/p10496352/s51003883/c3956f34-44268c16-402b2ecc-263ad3a0-8f511344.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with silicone stent // ? ptx ? ptx IMPRESSION: No prior chest radiographs are available for review. Silicone tracheobronchial Y stent is difficult to see, but probably in standard position. The bronchial components may be smaller than the bronchi could accept. Clinical correlation advised. Lungs are clear. Cardiomediastinal and hilar silhouettes are unremarkable. " 21ec2204-483aaa9a-fa6fef2a-2579394a-ac4c6e4c.jpg,test/p12/p12773009/s52086616/21ec2204-483aaa9a-fa6fef2a-2579394a-ac4c6e4c.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT 846 INDICATION: ___-year-old with history of recent pneumonia, assess for change. Comparison is made to the patient's previous study dated ___ at ___. PA and lateral views of the chest ___ at 846 is submitted. IMPRESSION: 1. There has been interval resolution of the left apical consolidation, but there is now a left hilar and suprahilar area of consolidation, which most likely represents an infectious process given that it is less mass like on the lateral projection than on the frontal view. Consideration should also include post-obstructive pneumonia in this patient with known CLL and extensive lymphadenopathy on a chest, abdomen, pelvis CT performed on ___. Clinical correlation is advised. Bilateral layering pleural effusions, right greater than left, are seen. No pneumothorax. No evidence of pulmonary edema. Heart remains stably enlarged. Several small nodular opacities in the periphery of the left mid and lower lung measuring up to 4-5 mm in size likely correspond to two of the CT identified multiple calcified and non-calcified pulmonary nodules for which followup imaging was advised on the CT report dated ___. " 6e2961cc-d47622d1-cfce3a6c-8894457a-277d9918.jpg,test/p19/p19751455/s56303395/6e2961cc-d47622d1-cfce3a6c-8894457a-277d9918.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NSCLC s/p photodynamic therapy now intubated with respiratory failure post procedure. // evaluate for interval changes TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Total collapse of the right lung is demonstrated most likely reflecting atelectasis. Left basal opacity is unchanged but substantial. ET tube tip is 5 cm above the Carina. Left apical thickening is re- demonstrated. " 618dd964-2e359eba-5072ae13-afb83cf8-5127b9c3.jpg,test/p17/p17564669/s50831524/618dd964-2e359eba-5072ae13-afb83cf8-5127b9c3.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Right lobe crackles and no cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Tortuous aorta is redemonstrated, unchanged. There is most likely present calcified left hilar lymph node. Lungs are essentially clear, although slightly hyperinflated. There is no pleural effusion or pneumothorax. There is no evidence of pulmonary edema. " b1260ec2-6d938ad4-3db82602-1c230efa-e324ffed.jpg,test/p15/p15193648/s53201432/b1260ec2-6d938ad4-3db82602-1c230efa-e324ffed.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with CVA/Afib RVR rates in 170s with SSCP. Evaluate for pneumonia. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Right shoulder radiograph ___, left shoulder radiograph from ___, and CT abdomen pelvis from ___. FINDINGS: Heart size is top normal. Lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 2d36af5e-de33b440-469311b9-e968dffd-b34b60f8.jpg,test/p16/p16822208/s50487779/2d36af5e-de33b440-469311b9-e968dffd-b34b60f8.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___, from ___ and from ___. FINDINGS: There is mild cardiomegaly without pulmonary edema. The lung volumes are low, but there is no focal consolidation. There is no pleural effusion and no pneumothorax. IMPRESSION: Cardiomegaly but no pulmonary edema. No acute process. " 9452840e-ef28c993-c25ee410-88e4334c-d866dcaa.jpg,test/p13/p13875890/s50367749/9452840e-ef28c993-c25ee410-88e4334c-d866dcaa.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Right subclavian catheter has been withdrawn slightly, now terminating at the junction of the superior vena cava and right atrium. Cardiomediastinal contours are within normal limits allowing for rotation. Improving left lower lobe opacity but new patchy opacity has developed at the right base. The latter may reflect patchy atelectasis, aspiration, and less likely pneumonia. Small left pleural effusion is present, but there is no evidence of pneumothorax. " 56fc8d58-bff685db-de90e423-71febd9c-d7f515b4.jpg,test/p16/p16820602/s55801153/56fc8d58-bff685db-de90e423-71febd9c-d7f515b4.jpg,test," FINAL REPORT HISTORY: Left apical abnormality on left shoulder radiographs. Dedicated chest radiographs are being performed for further evaluation. COMPARISON: Shoulder radiograph ___, chest radiograph ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. The nodular opacity seen on the prior shoulder radiograph is likely due to hypertrophy and sclerosis at the left 1st rib costochondral junction. Gynecomastia is again noted. IMPRESSION: No concerning opacity in the left apex. " ddf3911d-e713f0cd-cb499c18-782c59a1-50985353.jpg,test/p16/p16183583/s57981114/ddf3911d-e713f0cd-cb499c18-782c59a1-50985353.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxia // eval for evolving infiltrates/effusion IMPRESSION: As compared to ___ radiograph, diffuse reticular and nodular opacities have slightly worsened, and more confluent opacities at the bases are slightly improved. In conjunction with recent CT chest findings, this is likely due to widespread aspiration pneumonia although differential diagnosis includes hypersensitivity pneumonitis in the appropriate clinical setting. " fb0aea85-1925bd7c-454bdb3a-3c84527e-9068b1a2.jpg,test/p18/p18039782/s55391699/fb0aea85-1925bd7c-454bdb3a-3c84527e-9068b1a2.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p dual chamber ICD. // assess lead placement and r/o PTx. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Insertion of a dual lead defibrillator with the tip in the right atrium and right ventricle. No new. Lungs are clear. The heart is not enlarged. No pleural effusions. IMPRESSION: Uncomplicated insertion dual lead defibrillator in good position. " 8ed35a60-fb766a28-cba4d999-d32d602d-7d1ad9af.jpg,test/p18/p18418794/s57827334/8ed35a60-fb766a28-cba4d999-d32d602d-7d1ad9af.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluate for acute process. TECHNIQUE: AP upright and lateral chest views were reviewed in comparison with multiple prior chest radiographs FINDINGS: The patient has received a new right-sided PICC line which ends at mid/lower SVC. Both lungs are clear. There are no lung opacities concerning for pneumonia or pulmonary edema. There is no pleural effusion or pneumothorax. Mildly enlarged heart size has been stable since at least ___. IMPRESSION: No pneumonia or pulmonary edema. New right-sided PICC line tip is at mid-to-lower SVC. " 0cf679fe-ecd95166-cdb5cfe9-e23419fe-d4317701.jpg,test/p16/p16921972/s52458930/0cf679fe-ecd95166-cdb5cfe9-e23419fe-d4317701.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with new optic neuritis. Evaluate for sarcoid. COMPARISONS: None. FINDINGS: The lungs are clear. There is no focal consolidation, pneumothorax, or pleural effusion. The hila are unremarkable bilaterally. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9251662c-2af4ab8f-b56b3c80-c23f3c07-d0f0e755.jpg,test/p15/p15566270/s58340663/9251662c-2af4ab8f-b56b3c80-c23f3c07-d0f0e755.jpg,test," WET READ: ___ ___ ___ 5:07 AM No significant cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___F with car accident, strike L knee to dash, prior L-spine surgery. TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No significant cardiopulmonary abnormality. " aeecb56b-6a7c6781-eee7fe46-ae018f67-22fc249c.jpg,test/p10/p10250358/s56010602/aeecb56b-6a7c6781-eee7fe46-ae018f67-22fc249c.jpg,test," FINAL REPORT HISTORY: Metastatic cancer with new oxygen requirement. COMPARISON: CT from ___. outside exam. FINDINGS: the right hemidiaphragm is mildly elevated. There is volume loss at both bases. Heart size is normal. The aorta is slightly calcified. There is mild pulmonary vascular redistribution. Old rib fractures are noted on the right. There is hazy increased opacity in the right lung which could be due to volume loss or infiltrate. Is increased opacity at the left CP angle could represent metastatic disease or small infiltrate or effusion. The known metastatic disease with multiple lung nodules are better visualized on the prior CT. IMPRESSION: ? infiltrate vs. atelectasis right mid lung. " 8255e732-8bde1e5f-5ec3c1d7-7c389a81-4726bc84.jpg,test/p17/p17110944/s56836764/8255e732-8bde1e5f-5ec3c1d7-7c389a81-4726bc84.jpg,test," FINAL REPORT HISTORY: Lymphadenopathy, worrisome for sarcoidosis. FINDINGS: No previous images. The heart is normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Specifically, no evidence of hilar or mediastinal adenopathy or interstitial prominence to radiographically suggest sarcoidosis. " 5441c892-375d8580-43f10b49-95cf1e57-f35a4982.jpg,test/p13/p13537571/s53721017/5441c892-375d8580-43f10b49-95cf1e57-f35a4982.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NGT placement // confirm NGT placement confirm NGT placement COMPARISON: Chest radiographs ___ second. IMPRESSION: The patient has been extubated and lung volumes are accordingly considerably lower. Mediastinal veins and pulmonary vasculature is more engorged, moderate cardiomegaly has increased and moderate to large left pleural effusion is also larger. Severe left lower lobe consolidation is probably atelectasis. Transesophageal drainage tube ends in the upper portion of the nondistended stomach. There is no pneumothorax. " c49fd1d5-d63c6f53-516cd8d4-c3d8ecc4-2417c766.jpg,test/p14/p14784477/s57227569/c49fd1d5-d63c6f53-516cd8d4-c3d8ecc4-2417c766.jpg,test," FINAL REPORT INDICATION: ___-year-old man status post sternoclavicular joint debridement. COMPARISON: Chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are stable, with the heart in the upper limits of normal. The lung volumes are low, with linear left basal atelectasis. No consolidation, pulmonary edema, pleural effusion or pneumothorax is seen. IMPRESSION: Left basilar atelectasis. " 47c9533f-7059734a-d0e3e88e-0a24c4fe-1e29f03e.jpg,test/p15/p15690303/s58805578/47c9533f-7059734a-d0e3e88e-0a24c4fe-1e29f03e.jpg,test," FINAL REPORT HISTORY: Left humeral fracture with displaced third rib fracture and pneumothorax. FINDINGS: In comparison with the study of ___, there is increased diffuse bilateral opacifications. Much of this could reflect pulmonary edema, though supervening pneumonia would certainly have to be considered. The subcutaneous gas has cleared. Rib fracture is again seen and the loculated fluid collection laterally in the mid zone on the left is unchanged or slightly more prominent. Central catheter remains in place, though the endotracheal tube has been removed. " 1a24cf65-3496b96d-64cbb633-c34cd507-b415113d.jpg,test/p15/p15180409/s58633614/1a24cf65-3496b96d-64cbb633-c34cd507-b415113d.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Increased seizure activity. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is probably at the upper limits of normal size, considering the technique used. The lung volumes are low. The mediastinal and hilar contours appear unchanged. There is perihilar fullness with a mild interstitial abnormality suggesting pulmonary vascular congestion. There is no pleural effusion or pneumothorax. The bones are probably demineralized. IMPRESSION: Findings compatible with mild vascular congestion. " dd352e73-c8ebcbc9-df4ddf6d-228a7213-84d7e308.jpg,test/p10/p10737302/s57139374/dd352e73-c8ebcbc9-df4ddf6d-228a7213-84d7e308.jpg,test," FINAL REPORT CLINICAL INDICATION: Right-sided injury with right neck and shoulder pain. Evaluation for fracture and pneumothorax. COMPARISON: None. Frontal And Lateral Views Of The Chest: The lungs are clear without focal opacity, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. There is no acute osseous abnormality. There is no free air beneath the hemidiaphragms. The soft tissues appear normal. IMPRESSION: Normal chest radiograph. " 74708e77-2a6a2c1d-bae6f24e-8eb0ce3d-e3b1b9a6.jpg,test/p13/p13809932/s55907821/74708e77-2a6a2c1d-bae6f24e-8eb0ce3d-e3b1b9a6.jpg,test," FINAL REPORT INDICATION: History: ___M with flank pain // PICC line placement, Flank pain? COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or new thorax. The visualized upper abdomen is unremarkable. No PICC is visualized. IMPRESSION: No PICC visualized. Normal chest radiograph. NOTIFICATION: Findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___, approximately 10 minutes after discovery. " 8d97d278-88e7366c-c4c4fd8b-ad0b0de4-e43e7708.jpg,test/p16/p16466609/s54256122/8d97d278-88e7366c-c4c4fd8b-ad0b0de4-e43e7708.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of COPD prsents with cough and lethargy unclear if has PNA vs. CoPD exacerbation // ? infiltrate TECHNIQUE: AP upright lateral chest radiograph COMPARISON: ___ FINDINGS: Mild cardiomegaly stable. No pulmonary vascular congestion or pulmonary edema. No pleural effusion.Patchy bibasilar opacities likely reflect atelectasis, which appears chronic. No focal consolidation to suggest pneumonia. IMPRESSION: Similar appearance of the lungs ___, with patchy bibasilar opacities reflecting atelectasis rather than pneumonia. Given the chronic nature of the atelectasis, consider evaluation for chronic causes of atelectasis including endobronchial lesions or diaphragmatic pathology. " eb428878-cd19511a-df09c523-4a2e4dbd-6a820006.jpg,test/p16/p16006682/s57159285/eb428878-cd19511a-df09c523-4a2e4dbd-6a820006.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with progressive multiple myeloma. Sternal chest pain. ? Lytic lesion. // Sternal chest pain. ? lytic lesion for etiology of pain Sternal chest pain. ? lytic lesion for etiology of pain TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs of___. FINDINGS: A new, minimally displaced, pathologic right posterior seventh rib fracture is noted, as well as a new minimally displaced sternal fracture. Several compression deformities of lower thoracic vertebral bodies are noted, likely chronic. There is a small to moderate left pleural effusion. Numerous ill-defined opacities likely represent metastatic disease, the extent of which would be better evaluated by chest CT. There is no pulmonary edema, focal consolidation, or pneumothorax. The heart is top normal in size. IMPRESSION: 1. New fractures of the right seventh rib and sternum. 2. Small to moderate left pleural effusion. 3. Numerous ill-defined opacities are likely metastases, and would be better evaluated by chest CT if clinically indicated. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___, NP on the telephone on ___ at 10:52 AM, 3 minutes after the discovery of the findings. " fdbb59b0-7a18acc3-6a723923-f30f57c0-ed01999c.jpg,test/p18/p18455691/s54341234/fdbb59b0-7a18acc3-6a723923-f30f57c0-ed01999c.jpg,test," FINAL REPORT INDICATION: ___-year-old male with dyspnea and new rapid AFib. Evaluate for acute cardiopulmonary process. COMPARISON: ___. TECHNIQUE: AP upright chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest radiographic examination. " 66b1a8b6-e2eda89e-1e036be8-486ce4e0-130d16b4.jpg,test/p13/p13092089/s50786592/66b1a8b6-e2eda89e-1e036be8-486ce4e0-130d16b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with SOB // Assess for consolidation or effusion. Assess for consolidation or effusion. IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal in size or minimally enlarged. Mild tortuosity of the aorta is again seen. No evidence of acute pneumonia or vascular congestion or pleural effusion. " 76cc2b57-cd9636c9-dcc033cb-c7de17ca-058a39c0.jpg,test/p17/p17894121/s59738811/76cc2b57-cd9636c9-dcc033cb-c7de17ca-058a39c0.jpg,test," FINAL REPORT HISTORY: TBM status post stent removal with hypoxemia. FINDINGS: In comparison with study of ___, there are lower lung volumes. Mild engorgement of pulmonary vessels could merely reflect the low lung volumes or slight elevation of pulmonary venous pressure in a patient with some enlargement of the cardiac silhouette. Midline sternal wires are again seen, with a break again noted in the third from the top. No evidence of acute focal pneumonia. " 38215845-1761a73c-d1574b8d-f771f90b-bf86cdc2.jpg,test/p13/p13419758/s55305323/38215845-1761a73c-d1574b8d-f771f90b-bf86cdc2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hematuria/flank pain, CT concerning for renal cell carcinoma, also w/ shortness of breath due to anemia vs lung mets // ?renal mets to lung TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: None available. FINDINGS: There are asymmetric nodular opacities at the right lung base. The left lung is clear. There is no pneumothorax. Cardiomegaly is mild. The mediastinal contours are normal. Metallic right upper quadrant surgical clips indicate prior cholecystectomy. IMPRESSION: Nodular opacities at the right lung base may be due to a combination of atelectasis and overlying rib shadows, but metastasis or even pneumonia are also possible. A dedicated chest CT is recommended for further evaluation. Mild cardiomegaly. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 16:08 into the Department of Radiology critical communications system for direct communication to the referring provider. " 1f524cec-9f6409fe-16e6ee6d-840e0b02-7ece2991.jpg,test/p15/p15973689/s53375496/1f524cec-9f6409fe-16e6ee6d-840e0b02-7ece2991.jpg,test," FINAL REPORT INDICATION: ___ year old man with s/p fall // multiple rib fx, chest tube, ptx TECHNIQUE: Portable AP semi-upright view of the chest COMPARISON: ___ FINDINGS: Endotracheal tube terminates approximately 8.7 cm above the carina with the patient's head up, previously 7.5 cm, and should be advanced by 3-4 cm for optimal placement. Enteric tube is in the stomach. Left chest tube directed towards the apex is unchanged. Cardiomediastinal silhouette is stable. The left lung is better aerated; however, diffuse heterogeneous opacities in the left lung are relatively unchanged. The right lung is clear. There is no pleural effusion or pneumothorax. Multiple fractures are better demonstrated on a subsequent CT from the same day. IMPRESSION: 1. Improved aeration of the left lung with persistent heterogeneous opacities, possibly representing contusion in the setting of trauma. 2. Endotracheal tube is too high and should be advanced by no more than 4 cm. " 2260b908-c4cb6f70-c14af53b-fc439c01-0be7d2b9.jpg,test/p12/p12927030/s51706852/2260b908-c4cb6f70-c14af53b-fc439c01-0be7d2b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with left sided chest pain, SOB. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " ae6a9c3e-1994f6fc-566936f5-9b51a110-2fb8ea7e.jpg,test/p11/p11888614/s55517450/ae6a9c3e-1994f6fc-566936f5-9b51a110-2fb8ea7e.jpg,test," FINAL REPORT INDICATION: ___-year-old man who a partially pulled out PICC line, evaluate position. COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE A portable view of the chest. FINDINGS: Since prior, a left PICC has been retracted and now ends at the confluence of the left brachiocephalic vein and superior vena cava. An endotracheal tube has been removed. There is no pneumothorax or pleural effusion. Cardiac enlargement is unchanged. Since prior, there has been increased right greater than left basilar opacity, compatible with worsening pulmonary edema. IMPRESSION: 1. Retraction of the left PICC now ending in the left brachiocephalic vein. 2. Worsening pulmonary edema. NOTIFICATION: Findings were discussed with the IV nurse by Dr. ___ ___ telephone on ___ at 13:30, ___ min after they were made. " c7604129-8de13217-d8851779-8e9208a2-f51fd7cd.jpg,test/p15/p15566276/s56093640/c7604129-8de13217-d8851779-8e9208a2-f51fd7cd.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess for pneumothorax status post CABG. COMPARISON: ___. Large cardiomegaly and widened mediastinum are stable. ET tube is in standard position. NG tube tip is out of view below the diaphragm. There are low lung volumes. There is no evident pneumothorax. Left pleural effusion is small. Vascular congestion has improved. Basal atelectases have improved on the right, increased on the left. Sternal wires are aligned. " 120d5ec4-21b322ca-f6674ea0-dfd97e5c-b4f5abc5.jpg,test/p13/p13501962/s57276593/120d5ec4-21b322ca-f6674ea0-dfd97e5c-b4f5abc5.jpg,test," FINAL REPORT HISTORY: Hypotension and abdominal distention. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unchanged with tortuosity of the thoracic aorta again noted. There is no pulmonary vascular congestion. Streaky linear opacities in the bases are compatible with subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Interposition of the colon between the diaphragm and liver is noted on the right. Distended bowel loops are partially imaged within the upper abdomen. IMPRESSION: Mild bibasilar atelectasis. " 2b303ce7-73e45551-969776d6-855d5e21-d94cf588.jpg,test/p19/p19531222/s50337696/2b303ce7-73e45551-969776d6-855d5e21-d94cf588.jpg,test," FINAL REPORT INDICATION: History of fever status post chemotherapy. Please evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. IMPRESSION: No focal consolidations concerning for pneumonia identified. " cbbfee47-f5f04a84-d95f3dd1-7b668641-77a751d1.jpg,test/p18/p18947568/s50713276/cbbfee47-f5f04a84-d95f3dd1-7b668641-77a751d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with over a week of productive cough, hx of DM // r/o pneumonia COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. No pneumonia, no pulmonary edema. Moderate elongation of the descending aorta. " a08b8e81-c9baab9a-e480b924-c172fea7-6166c109.jpg,test/p15/p15584013/s54171529/a08b8e81-c9baab9a-e480b924-c172fea7-6166c109.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with relapsed AML after transplant // evaluate for cause of fever COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: PA and lateral views of the chest provided. There is peripheral pleural and parenchymal scarring in the right upper lobe, better demonstrated on prior CT. Otherwise lungs are clear bilaterally except for minimal left apical scar. There is no focal consolidation, effusion, or pneumothorax. The tip of the left PICC terminates 8 cm below the level of the carina, unchanged from ___. IMPRESSION: No new source of infection is identified. " d3906b17-067cae9c-cbbbc4a2-026a7d8c-cf80d4b4.jpg,test/p16/p16249146/s56488435/d3906b17-067cae9c-cbbbc4a2-026a7d8c-cf80d4b4.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Untreated hypertension with presyncopal episode and longstanding decrease in appetite, assess for acute intrathoracic process. FINDINGS: AP upright and lateral views of the chest were provided. There is a large retrocardiac density noted containing compatible with a large hiatal hernia which has been previously imaged in part on a CT abdomen and pelvis from ___. The lungs are clear. No signs of pneumonia, pleural effusion, or pneumothorax. Mediastinal contour is normal. The heart size appears grossly within normal limits though partially obscured due to large hiatal hernia. Bony structures are intact. IMPRESSION: Large hiatal hernia, chronic. No acute intrathoracic process. " f67824df-c3e25239-bc4cfaa6-a5faff8b-4d2b08c4.jpg,test/p11/p11861017/s54439275/f67824df-c3e25239-bc4cfaa6-a5faff8b-4d2b08c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M intubated in the ICU, eval for cardiopulm change // ___M intubated in the ICU, eval for cardiopulm change ___M intubated in the ICU, eval for cardiopulm change IMPRESSION: There to chest radiographs ___ through ___. Previous severe pulmonary edema has almost cleared. Moderate right pleural effusion remains. Opacification in the left lower lobe which developed between ___ and ___ is probably atelectasis and there is a small accompanying left pleural effusion. Heart size is normal. No pneumothorax. Cardiopulmonary support devices are in standard placements. " 3d98d55c-ba9841b7-ebf407cb-875839d8-aa126d8b.jpg,test/p14/p14754762/s51823020/3d98d55c-ba9841b7-ebf407cb-875839d8-aa126d8b.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with pneumonia, surgery, now intubated. Monitor pneumonia. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: Since previous exam, the patient has been intubated and ET tube ends 2.7 cm above carina. Bibasilar opacities, more prominent in the right side, are unchanged since previous exam. There is no pneumothorax. Mediastinal and cardiac contours are normal. CONCLUSION: 1. New ET tube is in adequate position. 2. Bibasilar opacities are unchanged since ___. " 8bafeb4a-d5a4d10e-9672cfc9-772bcede-22b584d9.jpg,test/p11/p11658675/s51736943/8bafeb4a-d5a4d10e-9672cfc9-772bcede-22b584d9.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough, chest pain, and shortness of breath for three days. Rule out acute intrathoracic process. COMPARISON: ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: Portions of the left hemithorax are excluded from the field of view. Low lung volumes are noted with crowding of bronchovascular markings. The cardiac silhouette appears unchanged from ___. Bibasilar opacities are again noted which may represent atelectasis and scarring given patient's history of chronic aspiration; however, acute infectious process such as pneumonia cannot be completely excluded in the correct clinical setting. There is no evidence of pneumothorax or pleural effusion. " b6df4002-4df06c8a-c2b91157-4b210385-a241fe19.jpg,test/p12/p12240787/s53463626/b6df4002-4df06c8a-c2b91157-4b210385-a241fe19.jpg,test," WET READ: ___ ___ 7:52 AM 1. Unchanged appearance of left PleurX drainage catheter. 2. Stable small bilateral pleural effusions with adjacent atelectasis. 3. Interval decrease in focal peripheral opacity within the right upper lobe adjacent to the minor fissure. WET READ VERSION #1 ___ ___ 1:17 AM 1. Unchanged appearance of left PleurX drainage catheter. 2. Stable small bilateral pleural effusions with adjacent atelectasis. 3. Interval decrease in focal peripheral opacity within the right upper lobe adjacent to the minor fissure. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with left pleurx catheter that isn't draining // Please evaluate for kinks, malposition COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the left chest tube is in unchanged position. Left basal linear opacity is caused by a skin fold. The tracheostomy tube is also unchanged. Unchanged course and position of the left PICC line. The pre-existing opacity in the right upper lobe has substantially decreased in extent and severity. The heart continues to be slightly enlarged, with retrocardiac atelectasis and a small atelectasis at the right lung bases. No new focal parenchymal opacities. " 4d1cffa9-5010dde6-77262b34-7da9da78-58531e52.jpg,test/p19/p19473527/s58447936/4d1cffa9-5010dde6-77262b34-7da9da78-58531e52.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough, wheezing, and rhonchi. COMPARISONS: Radiographs from ___, ___, and ___; chest CT from ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The cardiac, mediastinal, and hilar contours appear unchanged. There is probably a small persistent pleural effusion on the left, but with increased superimposed opacification projecting along the posterior costophrenic angle. Fissures are thickened and there is a generalized mild prominence of the interstitium, suggesting interstitial changes, although mild vascular congestion is possible. Irregular pulmonary architecture, particularly in the upper lungs, is suggestive of emphysema. Multifocal left-sided rib deformities appear unchanged as well as scarring at the left lung apex. IMPRESSION: 1. Increased left posterior basilar opacification including persistent small pleural effusion. 2. Mild interstitial abnormality, which may reflect emphysema and mild chronic interstitial disease, although mild superimposed vascular congestion could be considered in the appropriate setting. " 315bffff-402cb82f-73c5b78a-a2093517-59b1273d.jpg,test/p18/p18973855/s59054389/315bffff-402cb82f-73c5b78a-a2093517-59b1273d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with multiple myeloma // Evaluation for entrance on clinical trial Evaluation for entrance on clinical trial IMPRESSION: Lung volumes are low. Heart size and mediastinum unremarkable. Lungs are overall clear with bibasal atelectasis most likely related to low lung volumes. There is no pleural effusion. There is no pneumothorax. " c7b6e4b2-50323312-95eb0dfd-b422cd89-4542892b.jpg,test/p17/p17676327/s51799267/c7b6e4b2-50323312-95eb0dfd-b422cd89-4542892b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated with lots of secretions // infiltrate? COMPARISON: Chest radiograph ___ FINDINGS: Single AP view of the chest provided. An endotracheal tube ends 2.0 cm above the Carina. A transesophageal tube courses below the level of the diaphragm, however the tip cannot be visualized. Lung volumes are low, however grossly clear. Bibasilar atelectasis is moderately increased. No pleural effusion or pneumothorax. Severe widening of the mediastinum is unchanged from ___. IMPRESSION: 1. Bibasilar and retrocardiac opacification is significantly increased from ___. This likely represents worsening atelectasis, however in the appropriate clinical setting pneumonia cannot be excluded. 2. Severe widening of the mediastinum is unchanged from ___. CT is recommended for further evaluation. " 7a12ddd1-5b2764dd-0379989e-4882d05d-6d604394.jpg,test/p12/p12493668/s59689007/7a12ddd1-5b2764dd-0379989e-4882d05d-6d604394.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old female presents for evaluation of bilateral leg pain, evaluate line placement. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ at 22:36 FINDINGS: There has been no significant interval change compared to the prior radiograph performed 1 hr earlier. A right internal jugular catheter terminates at the lower SVC. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No evidence of pneumoperitoneum. No acute osseous abnormalities identified. IMPRESSION: Right IJ catheter terminates at the lower SVC. " 46adb63a-ccbc4a4e-472c23ff-661ae0cd-9faca2ff.jpg,test/p14/p14521652/s59594944/46adb63a-ccbc4a4e-472c23ff-661ae0cd-9faca2ff.jpg,test," FINAL REPORT HISTORY: Fever, rash. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. Previously demonstrated minimally displaced fracture of the right 5th rib laterally is again noted. IMPRESSION: No acute cardiopulmonary process. " df98fed0-3a1b3da6-76b1becf-aa4d3b6b-1f80e225.jpg,test/p18/p18869899/s58296546/df98fed0-3a1b3da6-76b1becf-aa4d3b6b-1f80e225.jpg,test," FINAL REPORT HISTORY: ___-year-old female, status post CABG, evaluate for effusion. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate similar appearance to sternal reconstruction. There is elevation of the left hemidiaphragm, with a small left pleural effusion. There is no pneumothorax. The pulmonary vasculature is normal. The lungs are notable for retrocardiac atelectasis. The pulmonary vasculature is normal. A lap band is partially visualized. IMPRESSION: Left basilar atelectasis and a small left pleural effusion. " 546e9075-37ed704a-c838f419-b8b6ed65-6f20db95.jpg,test/p14/p14239401/s54495721/546e9075-37ed704a-c838f419-b8b6ed65-6f20db95.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: TIA-like symptoms, assess for pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate clear, well-expanded lungs without focal consolidation, effusion, or pneumothorax. No signs of CHF. Cardiomediastinal silhouette is unchanged with an unfolded thoracic aorta again noted. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 261bbb6d-9e3bdd9c-33c963dd-9a622d9f-c8bdc9a3.jpg,test/p14/p14761445/s56611359/261bbb6d-9e3bdd9c-33c963dd-9a622d9f-c8bdc9a3.jpg,test," FINAL REPORT INDICATION: Evaluate for foreign body in a patient with a food bolus in the esophagus. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are without focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body is seen. The visualized upper abdomen is unremarkable. IMPRESSION: No radiopaque foreign body present. " 73162f4e-510f5160-46a94d3c-448c4a59-2fab1dcb.jpg,test/p12/p12954954/s59493664/73162f4e-510f5160-46a94d3c-448c4a59-2fab1dcb.jpg,test," FINAL REPORT HISTORY: ___-year-old with productive cough. COMPARISON: No prior chest imaging. FINDINGS: IMPRESSION: Normal heart lungs hila mediastinum and pleural surfaces. No evidence of pneumonia. " 9462cf69-02633be2-98d003da-a213c740-893f8eb0.jpg,test/p15/p15692257/s50716852/9462cf69-02633be2-98d003da-a213c740-893f8eb0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with malignant melanoma // r/o PNA underyling infection COMPARISON: Chest CT from ___. FINDINGS: PA and lateral views of the chest provided. Lung volumes are low. Allowing for this, no convincing signs of pneumonia or CHF. No large effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Low lung volumes without definite signs of pneumonia or CHF. " e65d198e-86161ed4-4719ad15-64efc744-e3eb7787.jpg,test/p12/p12307852/s56230056/e65d198e-86161ed4-4719ad15-64efc744-e3eb7787.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status and confusion. COMPARISONS: Radiographs from ___ and more recent chest CT dated ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The chest is hyperinflated. Projecting over the right costophrenic angle is a nodular focus consistent with a nipple shadow. A mild compression deformity of a lower thoracic vertebral body appears stable and probably chronic. A L1 compression body fracture is also stable. A partly visualized prior healed impacted fracture of the proximal right humerus is also noted. IMPRESSION: No evidence of acute disease. " b9dd34db-c8e82de1-9c79d31c-a6e894c3-8b2be02e.jpg,test/p16/p16517220/s53051490/b9dd34db-c8e82de1-9c79d31c-a6e894c3-8b2be02e.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with shortness of breath, dyspnea on exertion chronically. COMPARISON: Chest x-ray of ___. FINDINGS: The lungs are clear. Cardiac contour is top normal and unchanged. There is no pleural effusion or pneumothorax. Deviation of the trachea towards the right has increased since ___ and is explained by thyroid nodules already investigated by sonogram. CONCLUSION: There is no acute cardiopulmonary process. " b5571563-f79427e2-ea9897eb-e5228111-28a5cdc4.jpg,test/p14/p14714280/s50044161/b5571563-f79427e2-ea9897eb-e5228111-28a5cdc4.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs were obtained. A faint nodule projects over the left 6th rib. Otherwise, the lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal. IMPRESSION: Faint nodule over the left 6th rib may be due to summation of shadows. A repeat radiograph with shallow obliques is recommend. " 866d85cf-382a3c30-71c273e5-32f0d1d8-416b9001.jpg,test/p13/p13826513/s51833590/866d85cf-382a3c30-71c273e5-32f0d1d8-416b9001.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with cirrhosis and shortness of breath // evaluate for pneumonia COMPARISON: Chest radiographs ___. IMPRESSION: Mild edema name developed in the lower lungs. The upper lungs are clear and there is no appreciable pleural effusion. Heart size is normal, but slightly increased since the prior study. There are no findings to suggest pneumonia. " 2318933c-7aa57df5-3221de89-9774ea92-a3702844.jpg,test/p19/p19601036/s52655255/2318933c-7aa57df5-3221de89-9774ea92-a3702844.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old woman with pericardial effusion s/p drainage c/o dyspnea // interval changes COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Left lower lobe atelectasis and moderate left pleural effusion are improving. Focal collection in the left lateral lung is decreasing. Small right pleural effusion is stable. Heart size top-normal. No pulmonary edema or vascular redistribution. Feeding tube passes into the stomach and out of view. No pneumothorax. " f412d37b-af15c02a-cbd7fd0e-6dcdcb62-76b16b1a.jpg,test/p11/p11200755/s50594379/f412d37b-af15c02a-cbd7fd0e-6dcdcb62-76b16b1a.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISONS: Chest radiograph from ___. Chest radiograph from ___. TECHNIQUE: A single upright AP view of the chest was obtained. FINDINGS: There is minimal hyperinflation. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Minimal hyperinflation. No evidence of pneumonia. " ddfa7f50-6f843f89-286809e0-e54060e0-04749884.jpg,test/p17/p17409654/s57523669/ddfa7f50-6f843f89-286809e0-e54060e0-04749884.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with cough, on hemodialysis TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Assessment slightly limited by patient positioning and rotation. Patient is status post median sternotomy and aortic valve replacement. Right-sided lumen central venous catheter tip terminates in the proximal right atrium. Lung volumes are low. Mild cardiomegaly with left ventricular configuration is again seen, not substantially changed in the interval. Tortuosity of the thoracic aorta is present. There is mild pulmonary edema, worse in the interval, with small bilateral pleural effusions. Patchy atelectasis is noted in the lung bases without focal consolidation. No pneumothorax is present. The osseous structures are diffusely demineralized. IMPRESSION: Mild pulmonary edema and small bilateral pleural effusions with bibasilar atelectasis. " fe40e052-25ccc389-7c2fb4bb-fbd464c1-0a9cb048.jpg,test/p11/p11899569/s54807165/fe40e052-25ccc389-7c2fb4bb-fbd464c1-0a9cb048.jpg,test," FINAL REPORT INDICATION: ___M COPD s/p fall and rib fx/PTX, CT placed ___ ___/ ? interval change. Please do study ___ ___ TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable chest radiograph FINDINGS: In comparison to ___ portable chest radiograph, there is interval mild improvement of pneumomediastinum, deep cervical emphysema, and subcutaneous emphysema. The right medial pneumothorax is again seen and unchanged from most recent study. No pneumothorax seen in the left lung. Hazy ill-defined linear right lower lobe opacity is consistent with right lower lung contusion status post right posterior tenth rib fracture. The cardiac and mediastinal contours are unchanged. There is no pleural effusion. The right apical chest tube is in stable position. IMPRESSION: 1. Interval mild improvement of pneumomediastinum, deep cervical emphysema, and bilateral subcutaneous emphysema. 2. Persistent small right medial pneumothorax unchanged from ___ chest radiograph. 3. Right lower lobe contusion is unchanged from prior study. " c6fe3497-84bd28ee-54730614-c82b935d-47321e11.jpg,test/p10/p10996799/s56335683/c6fe3497-84bd28ee-54730614-c82b935d-47321e11.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with asthma exacerbation // ? process TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Chronic right basilar opacity is similar in appearance as compared to the prior study as well as compared to ___. No definite new focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Chronic right basilar opacity is grossly similar in appearance as compared to the prior study. No definite new focal consolidation. " 001a2fdd-f89a982e-a51dd0d8-970dd8ae-b0187fa8.jpg,test/p17/p17479853/s50933881/001a2fdd-f89a982e-a51dd0d8-970dd8ae-b0187fa8.jpg,test," WET READ: ___ ___ ___ 5:24 AM No free air beneath the right hemidiaphragm. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with abdominal pain // evaluate for free air under diaphragm TECHNIQUE: Portable semi-upright chest radiograph. COMPARISON: CT of the abdomen pelvis dated ___. FINDINGS: Lung volumes are low, resulting in bronchovascular crowding. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No free air seen beneath the diaphragm. IMPRESSION: No free air beneath the diaphragm. " 5138ff09-e40173f6-74191212-7d3026dd-8eebdeb5.jpg,test/p16/p16388630/s50819693/5138ff09-e40173f6-74191212-7d3026dd-8eebdeb5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF, COPD, and PNA // Interval change? IMPRESSION: Stable cardiomegaly and enlargement of central pulmonary vasculature accompanied by pulmonary vascular congestion and worsening perihilar edema as well as a new right pleural effusion. Persistent small left pleural effusion and bilateral lower lobe atelectasis. Coexisting pneumonia is possible given clinical history of this diagnosis. " 1f9e76a6-f8b7bbd4-4acf666c-855e59f5-79b11f77.jpg,test/p15/p15998296/s55346885/1f9e76a6-f8b7bbd4-4acf666c-855e59f5-79b11f77.jpg,test," FINAL REPORT HISTORY: Necrotizing pneumonia and COPD. FINDINGS: In comparison with the study of ___, there is little overall change in the diffuse bilateral pulmonary opacifications consistent with necrotizing pneumonia. Some element of elevated pulmonary venous pressure is again present. " 371c4b19-55e88366-c467138f-8cf2ce6f-839cec5e.jpg,test/p15/p15019807/s57373283/371c4b19-55e88366-c467138f-8cf2ce6f-839cec5e.jpg,test," FINAL REPORT AP AND LATERAL CHEST ___, ___. COMPARISONS: Chest radiograph of ___. FINDINGS: Permanent pacemaker is present with leads in the right atrium, right ventricle, and a third lead for biventricular pacing. There is no evidence of pneumothorax. Cardiac silhouette is mildly enlarged but stable in size. Pulmonary vascularity is within normal limits. Longstanding loculated left pleural effusion appears similar to prior studies as well as smoothly marginated pleural opacity extending from the left apex along the lateral pleural surface, corresponding to increased extrapleural fat on prior CT torso of ___. Right lung and pleural surfaces are clear. IMPRESSION: 1. Biventricular pacer in standard position with no pneumothorax. 2. Chronic loculated left pleural effusion and extrapleural fat. " 2f2cc23a-41cc5484-247a8968-21ef6a74-e779ff0a.jpg,test/p13/p13648633/s58573317/2f2cc23a-41cc5484-247a8968-21ef6a74-e779ff0a.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man with portal pulmonary hypertension and increasing lower extremity edema with bibasilar lung crackles. IMPRESSION: PA and lateral chest compared to ___ through ___: Previous severe infiltrative abnormality in both lungs improved, but still has substantial residual in both lower lungs. Heart size is normal and there is no vascular congestion or pleural effusion to suggest cardiac decompensation. A tunneled catheter ends low in the SVC. Heart size is normal. Large calcified left hilar lymph nodes precede the widespread pneumonia in ___. " ef94b70e-03defac0-61bf9719-5f0bdad1-3f1c0bb1.jpg,test/p11/p11177105/s53612188/ef94b70e-03defac0-61bf9719-5f0bdad1-3f1c0bb1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: ___, assessment for nasogastric tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the tube is again positioned in the right bronchial system. The tube needs to be immediately removed. No evidence of complications such as pneumothorax. At the time of dictation and observation, 4:23 p.m., on the ___, the referring physician ___. ___ was paged for notification and the findings were discussed over the telephone 1 minute later. " e7b0bce2-914e6110-d1863ef9-e38dbc0e-0ac2df47.jpg,test/p12/p12327925/s57252874/e7b0bce2-914e6110-d1863ef9-e38dbc0e-0ac2df47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with weakness TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Low lung volumes are present. Are not size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Subsegmental atelectasis is present in the lung bases without focal consolidation. No pleural effusion or pneumothorax is detected. Previously demonstrated right upper lobe lesion is better seen on the prior chest CT. Thoracolumbar posterior fusion hardware is re- demonstrated. IMPRESSION: Low lung volumes with bibasilar subsegmental atelectasis. Known right upper lobe pulmonary lesion demonstrated on recent CT is not as well seen on the current exam. " 6a887b0d-d725a2b2-9077ab07-cca0ea1b-60e0564c.jpg,test/p12/p12489885/s51326689/6a887b0d-d725a2b2-9077ab07-cca0ea1b-60e0564c.jpg,test," WET READ: ___ ___ ___ 1:16 AM Normal radiographs of the chest. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with shortness of breath. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiographs of the chest. " e2a72698-56c36799-e3812289-7e985729-a65c2ecf.jpg,test/p12/p12724735/s54463152/e2a72698-56c36799-e3812289-7e985729-a65c2ecf.jpg,test," FINAL REPORT HISTORY: ___-year-old female with syncope and altered mental status. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: Heart size is moderately enlarged, as seen previously. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Mediastinal contours are stable. IMPRESSION: Stable moderate cardiomegaly. " 9214a208-23d17651-8c8f01bb-fc6dbe36-f9a0ca36.jpg,test/p13/p13621809/s50972500/9214a208-23d17651-8c8f01bb-fc6dbe36-f9a0ca36.jpg,test," FINAL REPORT HISTORY: Altered mental status and cough. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There is mild blunting of the left costophrenic angle seen on the frontal view which may be due to pleural thickening versus a trace pleural effusion. The right lung is clear. The lungs are hyperinflated suggesting underlying COPD. No focal consolidation is seen. There is no pneumothorax. The cardiac silhouette is top-normal. The aortic knob is calcified. IMPRESSION: Mild blunting of the left costophrenic angle on the frontal view may be due to pleural thickening, but a trace pleural effusion is not excluded. " eb5e568a-bea8c431-fe5db915-4a380b0e-d8cd30d5.jpg,test/p16/p16817189/s52914952/eb5e568a-bea8c431-fe5db915-4a380b0e-d8cd30d5.jpg,test," FINAL REPORT CHEST RADIOGRAPH: INDICATION: History of asthma, frequent cough, hemoptysis. Assessment. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Normal hilar and mediastinal structures. No pleural effusions. Normal size of the cardiac silhouette. No pneumothorax. No lung nodules or masses. " da5f9476-6784ddda-91f9098c-1464f381-02947986.jpg,test/p17/p17699605/s57457812/da5f9476-6784ddda-91f9098c-1464f381-02947986.jpg,test," FINAL REPORT INDICATION: ___ year old woman with alcoholic hepatitis and volume overload with aggressive diuresis // interval changes COMPARISON: Radiographs from ___ at 04:11 IMPRESSION: Right-sided central line is unchanged with the distal lead tip in the mid SVC. There are markedly low lung volumes with crowding of the pulmonary vascular markings and atelectasis at the lung bases, unchanged from prior. There are no pneumothoraces. " f80035ef-b7084fe9-3941aa5f-bf9f3d85-28b255ed.jpg,test/p14/p14947107/s59235897/f80035ef-b7084fe9-3941aa5f-bf9f3d85-28b255ed.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p dual chamber ppm. Eval for lead position and post PPM complications. // ___ year old man s/p dual chamber ppm. Eval for lead position and post PPM complications. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: A pacemaker is visualized on the left chest wall. Pacer wires terminates in the right atrium and right ventricle. There are no complications nor pneumothorax seen. Heart size is top normal. There are no pleural effusions nor pulmonary edema. Median sternotomy wires are intact and aligned. Mediastinal surgical clips are seen. IMPRESSION: 1. Pacer wire leads terminate in the right atrium and right ventricle. There are no complications nor pneumothorax seen. " a135a35a-c9d9e1f3-5546c06e-426246b7-d52e54af.jpg,test/p15/p15767906/s55678016/a135a35a-c9d9e1f3-5546c06e-426246b7-d52e54af.jpg,test," FINAL REPORT HISTORY: Confusion and low grade temperature. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are hyperexpanded but clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal mediastinal and hilar contours. Lumbar fusion hardware is incompletely assessed. IMPRESSION: No acute intrathoracic process. " bb96ed0d-785e003d-cbfef79c-9daf52bd-3d209933.jpg,test/p11/p11564282/s58672091/bb96ed0d-785e003d-cbfef79c-9daf52bd-3d209933.jpg,test," FINAL REPORT INDICATION: Fever and new oxygen requirement, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Mild areas of atelectasis at both lung bases. Neither the frontal nor the lateral radiograph show evidence of pneumonia or other newly appeared parenchymal abnormality. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " a2b7439f-82a68b87-a96bae8d-47448113-c4dac178.jpg,test/p18/p18874830/s53848670/a2b7439f-82a68b87-a96bae8d-47448113-c4dac178.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with shortness of breath // interval change in CXR from OSH? COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process " 3ba4cddb-0edc16b4-a7b9a06d-841f79e1-aac01f27.jpg,test/p17/p17261065/s59155845/3ba4cddb-0edc16b4-a7b9a06d-841f79e1-aac01f27.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with heart failure // interval change? interval change? IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are unchanged except for the right IJ Swan-Ganz catheter being pulled back to a more proximal portion of the right pulmonary artery. Substantial enlargement of the cardiac silhouette process without appreciable vascular congestion or acute focal pneumonia. " 975b04a5-3ec66dc8-d74b5e00-3ccf360d-3875a3e9.jpg,test/p16/p16139978/s59279149/975b04a5-3ec66dc8-d74b5e00-3ccf360d-3875a3e9.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: To rule out pneumonia. TECHNIQUE: PA and lateral chest views were reviewed. There is no prior chest radiographs available for comparison. FINDINGS: Both lungs are well expanded and clear. There are no opacities concerning for pneumonia. Heart size, mediastinal and hilar contours are normal. There is no pleural abnormality. IMPRESSION: No pneumonia. " b0135689-c5b0672d-d78733ea-349224d3-1a65b68e.jpg,test/p18/p18521703/s53096917/b0135689-c5b0672d-d78733ea-349224d3-1a65b68e.jpg,test," FINAL REPORT INDICATION: Chest tenderness after trauma. Rule out fracture. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate well-expanded lungs. The cardiomediastinal contours are within normal limits. The lungs are clear. There is no pleural effusion and no pneumothorax. Bony structures are grossly intact. IMPRESSION: 1. No acute intrathoracic abnormality. 2. No definte acute displaced rib fractures. " fe9b7fdf-20a74238-66ee54f5-3d04ef1b-ca366707.jpg,test/p10/p10078072/s59824734/fe9b7fdf-20a74238-66ee54f5-3d04ef1b-ca366707.jpg,test," FINAL REPORT HISTORY: Evaluate for the pneumothorax, pigtail catheter connected to Pleurovac now with leak. COMPARISON: ___ at 7:14. FINDINGS: The left pigtail catheter, right chest port and AICD leads are in unchanged position. A lucency along the left mediastinum could represent medial pneumothorax, not significantly changed from earlier exam. Otherwise, no significant change in bilateral pleural effusions. No focal consolidation is present. No evidence of pulmonary vascular congestion. IMPRESSION: Lucency along the left mediastinum could represent medial pneumothorax, not significantly changed from earlier radiograph. Otherwise, no significant change from prior radiographs. NOTIFICATION: Findings discussed with Dr. ___ by Dr. ___ at 14:30 on ___. " b8cffd62-256529f2-ba85304e-d9893418-47751813.jpg,test/p12/p12069536/s55074378/b8cffd62-256529f2-ba85304e-d9893418-47751813.jpg,test," WET READ: ___ ___ ___ 4:35 AM No acute cardiopulmonary process. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with left shoulder pain. Assess for PE, pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are well inflated with stable left lower lobe atelectasis and elevation of left hemidiaphragm. No new focal opacity. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of osseous structures are notable for old left-sided rib fractures. IMPRESSION: No acute cardiopulmonary process. No pneumonia. " cb838420-65caba87-0f536e1f-e3e6cc30-b6a7de03.jpg,test/p10/p10496352/s53847666/cb838420-65caba87-0f536e1f-e3e6cc30-b6a7de03.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with left PICC Tiff // Left 46cm PICC Tiff Left 46cm PICC Tiff IMPRESSION: In comparison with study ___ ___, there has been placement of a left subclavian PICC line. The tip of the catheter extends to the lower SVC. The patient has taken a much better inspiration and there is no evidence of acute cardiopulmonary disease. " 1031bc8b-00c63bd4-46345a83-62afc23b-7f51401f.jpg,test/p13/p13753871/s50615480/1031bc8b-00c63bd4-46345a83-62afc23b-7f51401f.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with c/o left thoracic pain and left arm pain after fall // ? Fx TECHNIQUE: Chest PA and lateral COMPARISON: The study is read in conjunction with concurrently obtained left shoulder and humerus radiographs. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pneumothorax, pulmonary edema, or focal consolidation. There is a slightly displaced fracture of the left lateral seventh rib. IMPRESSION: Slightly displaced left lateral seventh rib fracture. No pneumothorax or other acute cardiopulmonary process. " 9906b146-7f3dee30-935334b8-e5045688-b2067596.jpg,test/p10/p10150746/s56940896/9906b146-7f3dee30-935334b8-e5045688-b2067596.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old man with seizure, question pneumonia. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The lungs appear clear. The cardiomediastinal silhouette is unremarkable. There is no evidence of pneumothoraces or pleural effusions. Bones are intact. IMPRESSION: No acute cardiopulmonary process. " 3e0bfabf-fe08be35-d4847c2c-5139af28-a49754ac.jpg,test/p16/p16960956/s57495916/3e0bfabf-fe08be35-d4847c2c-5139af28-a49754ac.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old man with metastatic melanoma. On recent CT scan patient had small pneumothorax that was unexplained. He has no symptoms that correlate. // Please assess for change in pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: CXR ___ and CT ___ FINDINGS: The loculated right pneumothorax the was seen on the recent CT chest ___ is not appreciated on today's CXR. Right pleural thickening and RML/RLL scars are noted but better characterized on recent CT. Left lung base scarring is also unchanged. There are small bilateral pleural effusions. Cardiomediastinal silhouette is within normal limits. There are healed fractures of the left clavicle and left lateral fourth rib. No acute osseous abnormalities. IMPRESSION: No evidence of pneumothorax on today's CXR. " 8cd96831-886dadff-1c8ce576-24937b71-4fd9dd0a.jpg,test/p19/p19600190/s50750819/8cd96831-886dadff-1c8ce576-24937b71-4fd9dd0a.jpg,test," FINAL REPORT INDICATION: ___M with facial swelling // eval for pna TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low. There is superimposed mild pulmonary edema. There bibasilar opacities which are most likely atelectasis, left greater than right. Infection cannot be entirely excluded. Cardiomediastinal silhouette is grossly unchanged. IMPRESSION: Mild pulmonary edema. Left basilar opacity. This could be due to a combination of atelectasis and/or infection. " 98997622-803b36ba-a4b52e8d-46b60889-036f0d48.jpg,test/p18/p18697601/s54026046/98997622-803b36ba-a4b52e8d-46b60889-036f0d48.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with new hypoxia, eval for pulmonary edema // ___ year old man with new hypoxia, eval for pulmonary edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Portable chest x-ray ___. FINDINGS: Mild cardiomegaly is stable. There has been interval development of small bilateral pleural effusions worse on the left. A pneumothorax is not appreciated. The mediastinal silhouette is unremarkable. There is no pulmonary edema. IMPRESSION: Small bilateral pleural effusions. No pulmonary edema. " a62c4a2a-01d308c4-412bb08d-32f268fc-70c74f4d.jpg,test/p17/p17974607/s53459774/a62c4a2a-01d308c4-412bb08d-32f268fc-70c74f4d.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exams, most recent of which dates ___. CLINICAL HISTORY: Cough and hypoxia, evaluate for pneumonia. FINDINGS: PA and lateral views of the chest were provided. Low lung volumes limit the evaluation, though allowing for this, there is no definite evidence for focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette appears stable with borderline cardiomegaly noted. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Limited, negative. " 249ac994-4acf313f-c6cc9ea7-04b19446-6886359f.jpg,test/p14/p14108973/s53767230/249ac994-4acf313f-c6cc9ea7-04b19446-6886359f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CAD, presenting with acute MI and CHF requiring intraaortic balloon pump placement. // ?balloon pump placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received an intra-aortic balloon pump. The tip of the pump projects approximately 12 mm be low the upper parts of the aortic arch. Bilateral mild upper lobe predominant pulmonary edema has developed. Normal size of the cardiac silhouette. No pleural effusions. Normal alignment of the sternal wires. " 53d52dc6-fc4ccee2-8a921511-b66ad5c5-f8a67ee9.jpg,test/p14/p14398566/s51617326/53d52dc6-fc4ccee2-8a921511-b66ad5c5-f8a67ee9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ?aspiration PNA // please eval for interval change. COMPARISON: ___ at 04:25 FINDINGS: ET tube tip lies 4.8 cm above the carina. NG tube tip extends beneath the diaphragm off the film. No pneumothorax is detected. Allowing for technical differences, the cardiomediastinal silhouette is unchanged. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF. This is more pronounced than on the prior study. Allowing for technical differences, the retrocardiac opacity itself is unchanged, but there is some more patchy opacity at the left lung base likely related to this CHF. Right cardiophrenic opacity appears slightly improved. Partially imaged cervical thoracic spine fixation hardware is noted, not fully evaluated. IMPRESSION: Worsening CHF. Patchy opacity at the left lung base laterally is more pronounced, but could relate to CHF. Retrocardiac opacity itself is unchanged. Slight interval improvement in patchy opacity in right cardiophrenic region. " 116baddf-be623355-a0c8324f-7cb3709a-d454a3dc.jpg,test/p10/p10900906/s51875937/116baddf-be623355-a0c8324f-7cb3709a-d454a3dc.jpg,test," FINAL REPORT INDICATION: Dyspnea. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiac, mediastinal and hilar contours are normal. Slightly low lung volumes. IMPRESSION: Low lung volumes. No acute cardiopulmonary process is seen. " 03760a00-bec9d8f0-da3e4f45-504a3ebb-b369132f.jpg,test/p17/p17523577/s58441552/03760a00-bec9d8f0-da3e4f45-504a3ebb-b369132f.jpg,test," FINAL REPORT HISTORY: Chest pain, dyspnea. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is a subtle 9 mm nodular opacity projecting over the left lung base, at the level the anterior left 6th rib, which while may represent overlap of vascular structures, underlying pulmonary nodule is not excluded. The cardiac and mediastinal silhouettes are unremarkable. Evidence of DISH is seen along the thoracic spine. IMPRESSION: 1. No acute cardiopulmonary process. 2. 9 mm nodular opacity projecting over the left lower lung which, while may represent overlap of vascular structures, pulmonary nodule is not excluded. Recommend oblique radiographs for further evaluation and if finding persists, nonurgent chest CT for further evaluation. " 4aa58955-d41b1b22-3bc444d3-b0b4d64e-22dd7677.jpg,test/p12/p12402933/s58018273/4aa58955-d41b1b22-3bc444d3-b0b4d64e-22dd7677.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fever. Question congestive heart failure or pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate interval placement of a dual-channel dialysis catheter with tip visualized to the level of lower SVC. The lungs are slightly low in volume accentuating prominent cardiac silhouette, unchanged. Mild interstitial edema persists though has improved since ___. There is likely left basilar atelectasis as well as prominent pericardial fat producing overlapping opacity in the left base. Several clips are seen projecting over the gallbladder fossa. Spondylosis is present at the thoracolumbar junction. IMPRESSION: 1. Interval placement of a right-sided dialysis catheter. 2. Mild persistent interstitial edema. " c551cd21-bbdf048f-2b05bca3-96be2540-c3d0a72e.jpg,test/p17/p17986376/s53246197/c551cd21-bbdf048f-2b05bca3-96be2540-c3d0a72e.jpg,test," FINAL REPORT INDICATION: History: ___M with fever // eval for infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral chest radiographs demonstrate low lung volumes. Cardiomediastinal and hilar contours are within normal limits. Streaky opacity at the left lung base likely reflects atelectasis. No focal opacity convincing for pneumonia is present. There is no evidence of pleural effusion, pulmonary edema, or pneumothorax. Spinal hardware is noted involving the lower thoracic and lumbar spine. IMPRESSION: Streaky opacity at the left lung base appears atelectatic in etiology though superimposed infectious process cannot be excluded. " 1041d9e5-1e1c4b84-c0aaa681-730caef3-d10c0688.jpg,test/p13/p13585638/s51550751/1041d9e5-1e1c4b84-c0aaa681-730caef3-d10c0688.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with shortness of breath // evaluate for any pathology TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are remarkable for stable mild tortuosity of the thoracic aorta. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " ef4ef978-ffd5406d-95185c25-7b5d9f8b-27ad6a5e.jpg,test/p11/p11287191/s59696122/ef4ef978-ffd5406d-95185c25-7b5d9f8b-27ad6a5e.jpg,test," WET READ: ___ ___ ___ 9:22 PM Compared with CT chest dated ___ Overall similar appearance with right middle lobe bronchiectasis and right mid lung and lingular opacities. No definite new consolidation is identified, though not entirely excluded. There is no large pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo ___ speaking female with history of PVD s/p recent bypass grafting admitted with fevers, hypoxia, leukocytosis and hyponatremia now complicated by difficult foley and urinary retention now with rising WBC count and mild tachypnea // Evaluation for new consolidation Evaluation for new consolidation IMPRESSION: Heart size and mediastinum are unchanged. Surgical clips projecting over the right chest, unchanged. There is interval progression of left mid lung opacity, concerning for infectious process. The rest of the opacities in the right lung are overall similar. No interval development of pleural effusion or pneumothorax demonstrated. " dd93263c-dc00a15e-a335a34a-9eae0a67-0da88f22.jpg,test/p17/p17175688/s55574712/dd93263c-dc00a15e-a335a34a-9eae0a67-0da88f22.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with orthopnea // CHF exacerbation? COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Mild cardiomegaly again noted. The hila appear somewhat congested. There is no frank edema or definite signs of pneumonia. No effusion or pneumothorax. Mediastinal contour is unchanged. Bony structures are intact. IMPRESSION: Mild cardiomegaly with hilar congestion. " 0077590b-ade6f70f-65531ef1-73cf6f27-8a7eaa74.jpg,test/p15/p15874317/s51840765/0077590b-ade6f70f-65531ef1-73cf6f27-8a7eaa74.jpg,test," FINAL REPORT HISTORY: Weakness and palpitations. COMPARISON: ___. FINDINGS: PA and lateral radiographs of the chest demonstrate a left chest wall pacemaker generator with appropriately positioned right atrial and ventricular leads. Cardiac size is normal. Hilar and mediastinal contours are within normal limits, and a calcified aortic knob is seen. The lungs are clear and mildly hyperinflated. No pleural effusion or pneumothorax. Mild biapical scarring is noted. IMPRESSION: No acute cardiopulmonary process. " 98406829-86b6bdb6-062b40e7-16bbf975-68fe3a6d.jpg,test/p13/p13770933/s57349333/98406829-86b6bdb6-062b40e7-16bbf975-68fe3a6d.jpg,test," FINAL REPORT HISTORY: Hypoxia. TECHNIQUE: Single frontal view of the chest. COMPARISON: None. FINDINGS: The patient is kyphotic in position and rotated to the right. Basilar atelectasis is seen without definite focal consolidation. There are multiple left-sided old-appearing rib fractures with some associated opacity along the left pleura which may be due to pleural thickening from prior trauma. No evidence of pneumothorax is seen. The cardiac silhouette is top-normal to mildly enlarged. Aorta is unfolded. No overt pulmonary edema is seen. " 7f44a80c-56ef07b1-c0ee656b-524eebb9-95bf0e56.jpg,test/p18/p18969321/s56103720/7f44a80c-56ef07b1-c0ee656b-524eebb9-95bf0e56.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with diabetes, COPD and new onset shortness of breath for 1 week. Rule out pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: Portable AP chest radiograph was provided. The study is slightly limited due to patient's body habitus. Opacity at the left base may be due to overlying soft tissue or atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Left shoulder arthroplasty is noted. There are no displaced fractures. IMPRESSION: Limited due to patient body habitus. No acute cardiopulmonary process. " efa176d6-381c7cb9-dfbff0cf-18490a36-6ba91ed6.jpg,test/p16/p16773288/s54184139/efa176d6-381c7cb9-dfbff0cf-18490a36-6ba91ed6.jpg,test," FINAL REPORT HISTORY: Thoracentesis, to assess for pneumothorax. FINDINGS: In comparison with study of ___, there has been a thoracentesis with removal of fluid from the left chest. No definite pneumothorax. Continued enlargement of the cardiac silhouette with tortuosity of the aorta, though no evidence of vascular congestion. Residual atelectasis is seen at the left base. " a8bbd8f3-500ea73c-5718a187-bdedfc8b-18a8c6bf.jpg,test/p15/p15707291/s57789647/a8bbd8f3-500ea73c-5718a187-bdedfc8b-18a8c6bf.jpg,test," WET READ: ___ ___ 8:21 PM left basilar opacity has increased since ___ with new left pleural effusion. right basilar opacity is similar or slightly improved. upper lung zones are clear. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Followup pneumonia. Comparison is made with prior study performed a day earlier. Mild cardiomegaly is stable. Left lower lobe consolidation has minimally increased associated with new small left effusion. Right lower lobe consolidation is stable. The upper lungs are clear. There is no pneumothorax. " d12d9bf5-55b2b8d6-adb586e0-3e8c6b8e-24ce198d.jpg,test/p11/p11799619/s59359138/d12d9bf5-55b2b8d6-adb586e0-3e8c6b8e-24ce198d.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath. STUDY: Portable AP upright chest radiograph. COMPARISON: ___. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs demonstrate increasing opacity at the right base which is new compared to prior study. There is no large pleural effusion or pneumothorax. IMPRESSION: Findings compatible with right lower lobe pneumonia in the appropriate clinical setting. " b027fc42-cbf36bad-1a6bd50b-9a316a9a-05e366c6.jpg,test/p18/p18656167/s53700576/b027fc42-cbf36bad-1a6bd50b-9a316a9a-05e366c6.jpg,test," FINAL REPORT INDICATION: Leg cellulitis and rhonchi on exam. COMPARISON: ___ chest radiograph and ___ chest CT. PA AND LATERAL VIEWS OF THE CHEST: Cardiac, mediastinal and hilar contours are unchanged, with heart size within normal limits. Linear opacities in both lung bases likely reflect subsegmental atelectasis and/or scarring. No focal consolidation, pleural effusion, or pneumothorax is present. Old right-sided rib fractures are present. There are mild degenerative changes of the thoracic spine. IMPRESSION: Bibasilar atelectasis and/or scarring. Otherwise, no radiographic evidence for pneumonia. " a238199b-93d2aa00-f4451329-26e4438c-e170ad89.jpg,test/p11/p11569093/s54670469/a238199b-93d2aa00-f4451329-26e4438c-e170ad89.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post antrectomy, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated. The nasogastric tube has been removed. There are moderate bilateral pleural effusions with relatively substantial areas of atelectasis. Size of the cardiac silhouette cannot be determined. No evidence of new parenchymal opacities suggesting pneumonia. A left internal jugular vein catheter remains in situ. " 17c8f45f-266f4d11-f5cdfc7f-b7f26599-48135db1.jpg,test/p19/p19972786/s55628763/17c8f45f-266f4d11-f5cdfc7f-b7f26599-48135db1.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with headache, nausea, vomiting // r/o pneumonia, free air TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no subdiaphragmatic free air. Moderate cardiomegaly is unchanged. Eventration of the right hemidiaphragm is again noted. Bilateral pleural thickening, right greater than left is unchanged. There is no pneumothorax, overt pulmonary edema, or focal consolidation worrisome for pneumonia. Scarring in the right lower lobe may be from chronic aspiration. IMPRESSION: No acute cardiopulmonary process. Moderate cardiomegaly and pleural thickening is unchanged.Scarring in the right lower lobe may be from chronic aspiration. " 46e47b45-4baca286-f749c696-030945fe-ff6e0eeb.jpg,test/p13/p13834513/s59371260/46e47b45-4baca286-f749c696-030945fe-ff6e0eeb.jpg,test," FINAL REPORT HISTORY: Motor vehicle accident and small laceration. Question foreign body in laceration. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiac silhouette is normal. There is no pleural effusion or pneumothorax. No radiopaque foreign bodies are identified. IMPRESSION: No evidence of acute cardiopulmonary process. " efd63ce6-beb343e0-2595aa50-d580d0de-0f30a8ac.jpg,test/p11/p11682313/s53645611/efd63ce6-beb343e0-2595aa50-d580d0de-0f30a8ac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p rib resection on right. Pls eval for pneumothorax // Please eval for pneumothorax Surg: ___ () Please eval for pneumothorax IMPRESSION: No comparison. Status post right-sided rib resection. No evidence of pneumothorax. Mild fluid overload but no overt pulmonary edema. Borderline size of the cardiac silhouette. " 3289aa25-70b11fa4-15552031-949b8959-c8d7fc0f.jpg,test/p14/p14672794/s52971708/3289aa25-70b11fa4-15552031-949b8959-c8d7fc0f.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with one year of cough. IMPRESSION: A crescentic opacity projecting inferiorly from the right hilus is partially obscured by the right heart, but does not taper likely a normal vessel. It is either an abnormally large vessel (seen in the congenital disorder of hypogenetic lung syndrome) or a region of atelectasis. In either case, given the protracted symptoms, I would advise chest CT. Lungs are otherwise well inflated and clear. Heart size is top normal, but the pulmonary and hilar vasculature are otherwise normal. There is no pleural abnormality. " b2cb0cc9-b4eaa736-9b6368c2-8924ef7b-baf88b38.jpg,test/p13/p13446510/s54463875/b2cb0cc9-b4eaa736-9b6368c2-8924ef7b-baf88b38.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent port placement c/b small apical pneumothorax // progression of apical pneumothorax, chest tube on clamp trial progression of apical pneumothorax, chest tube on clamp tria IMPRESSION: IN COMPARISON WITH THE EARLIER STUDY OF THIS DATE, THERE IS AGAIN A SMALL APICAL PNEUMOTHORAX WHICH DOES NOT APPEAR TO HAVE INCREASED. OTHERWISE NO CHANGE. " 72d19558-c074635f-8857dd1c-74a52b8c-25e32c67.jpg,test/p16/p16384483/s58963233/72d19558-c074635f-8857dd1c-74a52b8c-25e32c67.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___F DMI in DKA with soft tissue infection of left thigh s/p multiple debridements, VAC placement now s/p feeding tube placement // location of feeding tube location of feeding tube IMPRESSION: Comparison to ___. The patient has received a nasogastric tube. The course of the tube is unremarkable, the tip projects over the middle parts of the stomach. No complications, notably no pneumothorax. Otherwise unchanged radiograph. " 38cab255-ed765688-12d4956f-6acc9792-52802f4c.jpg,test/p17/p17137598/s59648266/38cab255-ed765688-12d4956f-6acc9792-52802f4c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Shortness of breath for 2 months. TECHNIQUE: Chest PA and lateral, total three views. COMPARISON: ___ to ___. FINDINGS: Elevation of the right hemidiaphragm is unchanged since ___. Heart size is normal with the demonstration of tortuous thoracic aorta. Hilar contours are normal. Mild right base atelectasis is improved. Lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. Elevation of the right hemidiaphragm, unchanged since ___. NOTIFICATION: A message was left at the office of Dr. ___ by Dr. ___ ___ telephone at 11:42 ___, 5 minutes post interpretation. " f5940c37-6b6c619c-a85e493e-da583771-d6f7cece.jpg,test/p13/p13299285/s54360188/f5940c37-6b6c619c-a85e493e-da583771-d6f7cece.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory distress, likely aspiration // ?ETT placement ?ETT placement IMPRESSION: As compared to ___, the lung volumes have decreased. The tip of the endotracheal tube projects approximately 4.5 cm above the carina. Areas of atelectasis at both the left and the right lung bases. Mild pulmonary edema persists. Moderate cardiomegaly. No pleural effusions. The position of the bilateral pleural drains is constant. " 28e8e56e-e8f0667a-de187e93-8a065bee-bcbeccc5.jpg,test/p14/p14605976/s58045519/28e8e56e-e8f0667a-de187e93-8a065bee-bcbeccc5.jpg,test," FINAL REPORT HISTORY: Hemoptysis COMPARISON: ___. FINDINGS: PA and lateral views of chest demonstrate clear lungs. There is no evidence of pleural effusion or pneumothorax. Cardiac size is unremarkable. IMPRESSION: Unremarkable chest radiograph. " dd60ab32-cda8cb7f-3e317ae8-bbc3587f-04292dcc.jpg,test/p19/p19875621/s55102074/dd60ab32-cda8cb7f-3e317ae8-bbc3587f-04292dcc.jpg,test," FINAL REPORT HISTORY: Chest pain. Rule out acute process. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no pleural effusion, focal consolidation or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " f7d35a95-0749dca5-2c36ca78-2df48783-1eae9b24.jpg,test/p10/p10320599/s57770341/f7d35a95-0749dca5-2c36ca78-2df48783-1eae9b24.jpg,test," WET READ: ___ ___ ___ 7:52 AM 1. Interval placement of right-sided chest tube in grossly appropriate location. Hazy opacity in the right mid lung and new surgical chain sutures likely relates to recent right upper lobe wedge resection. 2. Prominence of the mediastinum likely relates to rightward patient rotation and AP technique, not appreciably changed since earlier same day chest radiograph. 3. Low lung volumes. More apparent left basilar and retrocardiac opacity may relate to atelectasis. 4. Right chest wall mild subcutaneous emphysema. C. Hostage WET READ VERSION #1 ___ ___ ___ 11:52 PM 1. Interval placement of right-sided chest tube in grossly appropriate location. Hazy opacity in the right mid lung and new surgical chain sutures likely relates to recent right upper lobe wedge resection. 2. Prominence of the mediastinum likely relates to rightward patient rotation and AP technique, not appreciably changed since earlier same day chest radiograph. 3. Low lung volumes. More apparent left basilar and retrocardiac opacity may relate to atelectasis. 4. Right chest wall mild subcutaneous emphysema. C. Hostage ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p open RUL wedge // eval for PTX, chest tube placement eval for PTX, chest tube placement IMPRESSION: In comparison with the earlier study of this date, there has been placement of a right chest tube without definite pneumothorax. Subcutaneous gas is seen along the right lateral chest wall with extension into the neck. Postsurgical changes are seen in the right hemithorax, especially in the mid zone. Opacification at the left base is consistent with volume loss in the lower lobe and probable small effusion. There is again enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. " 9fefd247-f3a372a6-310500b5-0b50e9ac-3bf26121.jpg,test/p11/p11011024/s52650408/9fefd247-f3a372a6-310500b5-0b50e9ac-3bf26121.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with metastatic breast cancer with leptomeningeal mets now with recurrent fevers // Any evidence of pneumonia? Any evidence of pneumonia? IMPRESSION: Comparison to ___. Stable elevation of the right hemidiaphragm with the presence of a small right pleural effusion, more obvious on the lateral than on the frontal view. No evidence of pneumonia. No pulmonary edema. Normal size of the heart. " 21d9c043-79c72104-f5fff513-90e94698-f54fa510.jpg,test/p15/p15249511/s59016335/21d9c043-79c72104-f5fff513-90e94698-f54fa510.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: PA and lateral radiograph of chest was reviewed in comparison to prior study from ___. FINDINGS: Both lungs are well expanded without any focal abnormalities. There is no pleural effusion. Heart size, mediastinal and hilar contours are normal. IMPRESSION: Normal chest radiograph. " 41c3cdc4-8374f040-3f1df9a1-d23f1dfd-a04ccf47.jpg,test/p18/p18025486/s56273312/41c3cdc4-8374f040-3f1df9a1-d23f1dfd-a04ccf47.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with severe cough. COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary pathology. " 07e8dcf8-a26d9d2c-be5b4537-2fe00f54-f961f852.jpg,test/p13/p13040755/s56862374/07e8dcf8-a26d9d2c-be5b4537-2fe00f54-f961f852.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Pneumothorax status post chest tube placement. Evaluate for interval change. TECHNIQUE: Single portable frontal view of the chest. COMPARISON: ___ 23:14 FINDINGS: Note that the lateral left lung base is not completely included on imaging. Compared to the examination from 7 hr prior, there has been essentially no change with a left basal pigtail chest tube remaining in place with no increasing pneumothorax. Trace residual pneumothorax is seen along the left heart border. IMPRESSION: See above. " dd574780-58cb02ce-e84a75e4-c7928f96-c6ed0cb9.jpg,test/p16/p16771607/s52230181/dd574780-58cb02ce-e84a75e4-c7928f96-c6ed0cb9.jpg,test," FINAL REPORT INDICATION: Septic shock. TECHNIQUE: Frontal chest radiograph COMPARISON: ___ FINDINGS: The small bore tube with multiple fenestrations has been removed. The remaining lines and tubes are unchanged. There is no pneumothorax. The examination is not significantly changed. There are bilateral layering pleural effusions with an enlarged heart and vascular congestion. " fe250252-55bd211c-2c5b832f-bf0dd3d9-d4a8cac1.jpg,test/p11/p11218867/s51830539/fe250252-55bd211c-2c5b832f-bf0dd3d9-d4a8cac1.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with Hodgkin disease. IMPRESSION: PA and lateral chest compared to ___: Widened contour of the left upper mediastinum, seen on the frontal view, is minimally narrowed than it was on ___. Previous left pleural effusion and pneumothorax have both resolved. Lungs are well expanded and clear. Heart size is normal. Right central venous infusion port ends at the level of the superior cavoatrial junction. " 326f82e2-793a37a2-9c4aefd4-e2ad94b4-7ce19fe1.jpg,test/p16/p16962213/s55733450/326f82e2-793a37a2-9c4aefd4-e2ad94b4-7ce19fe1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with left cavernoma // pre-op Surg: ___ (crani) CEREBELLAR ICH IMPRESSION: In comparison with study of ___, there is little change except for lower lung volumes. No pneumonia, vascular congestion, or pleural effusion. " 6537d272-1c5f85f4-a588438a-a4097b8f-7fa8b06a.jpg,test/p19/p19635953/s51367745/6537d272-1c5f85f4-a588438a-a4097b8f-7fa8b06a.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Alcoholic hepatitis. Aspiration event. IMPRESSION: AP chest compared to ___: Consolidation in the perihilar left lung and in the right upper lung extending to the apex is readily explained by massive aspiration. A smaller region of consolidation may be present in the right lung projecting behind the lower pole of the right hilus. Mild cardiomegaly and mediastinal vascular engorgement have increased suggesting cardiac decompensation. Dr. ___ was paged. " 77a9ced8-48675c13-4c82837f-92694ee2-5a430c13.jpg,test/p14/p14995394/s56435106/77a9ced8-48675c13-4c82837f-92694ee2-5a430c13.jpg,test," FINAL REPORT CHEST HISTORY: Left lower lobe pneumonia, followup. REFERENCE EXAM: ___. FINDINGS: The previously described infiltrate is now more dense and retracted, likely due to volume loss rather than due to resolution. There is new bilateral pleural effusions. Remainder of the exam is unchanged. " 481a3e73-6b43813e-f16d30d6-5a685829-7c5691af.jpg,test/p18/p18055066/s55486286/481a3e73-6b43813e-f16d30d6-5a685829-7c5691af.jpg,test," FINAL REPORT INDICATION: ___ year old woman with MVC, sternal and bilateral rib ttp // ?sternal or rib fractures TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Lower lung volumes seen on the current exam. The lungs however remain clear. There is no pneumothorax or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. If concern for rib fracture, consider dedicated rib series. " ec4e0482-c550f94a-85508a65-22c40185-d7964460.jpg,test/p12/p12226373/s54286146/ec4e0482-c550f94a-85508a65-22c40185-d7964460.jpg,test," FINAL REPORT HISTORY: Eosinophilic pneumonia and asthma, on steroids, still with cough. FINDINGS: In comparison with the study of ___, there are lower lung volumes. Continued prominence of the cardiac silhouette without vascular congestion or pleural effusion. Specifically, no definite focal consolidation. " 58536d53-48ead72d-685c64ce-80f9f265-862ba6a2.jpg,test/p13/p13282286/s58701312/58536d53-48ead72d-685c64ce-80f9f265-862ba6a2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CKD undergoing kidney transplant evaluation // pre kidney transplant work up pre kidney transplant work up IMPRESSION: Comparison to ___. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pleural effusions. No pneumonia, no pulmonary edema. " 033beb99-ffe5984c-d59e5597-6fb9e58a-b98cd8b8.jpg,test/p11/p11825167/s53759732/033beb99-ffe5984c-d59e5597-6fb9e58a-b98cd8b8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain + cough. // infection? TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are within normal limits. The trachea is central. The cardiomediastinal contour is normal. The heart is not enlarged. No blunting of the costophrenic angles to suggest a pleural effusion. No focal consolidation seen. No pneumothorax seen. There are mild multilevel degenerative changes throughout the thoracic spine surgical hardware in the cervical spine is incompletely visualized. IMPRESSION: No acute cardiopulmonary process seen. " 023f869d-be743bd5-9847528b-d9405d04-bddf5fa3.jpg,test/p19/p19167068/s57444062/023f869d-be743bd5-9847528b-d9405d04-bddf5fa3.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath and fever. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures appear within normal limits. IMPRESSION: No evidence of acute cardiopulmonary disease. " 20f0097b-97b4622d-c744845c-aae8a401-6bd5a30d.jpg,test/p11/p11984732/s52257069/20f0097b-97b4622d-c744845c-aae8a401-6bd5a30d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of CABG, chronic heart failure. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is an increasing amount of right pleural effusion, the extent of the effusion is now moderate. There is unchanged evidence of mild-to-moderate pulmonary edema and moderate cardiomegaly with retrocardiac atelectasis and blunting of the left costophrenic sinus, likely caused by the left pleural effusion. Sternal wires and clips after CABG are in unchanged position. Unchanged position of the pacemaker leads. " ef11cf8a-522a504a-5d8a4ba1-b70be0b0-914e208a.jpg,test/p18/p18605511/s52231671/ef11cf8a-522a504a-5d8a4ba1-b70be0b0-914e208a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain, cough // PNA? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes, which accentuate the bronchovascular markings. Additionally, the patient's arm overlies the lateral images, obscuring the view. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac mediastinal silhouettes are stable. The prior fracture/ injury of the proximal left humerus is again noted. IMPRESSION: Low lung volumes. No definite focal consolidation. Limited lateral views due to the patient's overlying arm. " a9bb0028-c97cfbd1-b72629d7-e6119c40-2b882b95.jpg,test/p11/p11275268/s56660169/a9bb0028-c97cfbd1-b72629d7-e6119c40-2b882b95.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Sinus infection with concern for pneumonia. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear and well expanded. No focal consolidation, effusion, or pneumothorax is seen. The heart and mediastinal contours are normal. Bony structures are intact. IMPRESSION: No signs of pneumonia. " 6f597984-5bc70f07-cb9e2899-e3028150-45049c27.jpg,test/p17/p17400046/s50175154/6f597984-5bc70f07-cb9e2899-e3028150-45049c27.jpg,test," FINAL REPORT INDICATION: interval change ___ year old woman s/p MCC. polytrauma, intubated // interval change EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable chest radiograph, frontal view. COMPARISON: Chest radiograph ___ FINDINGS: ET tube has been removed. Left PICC terminates in right atrium. A left midline catheter projects over the left axilla. Lung volume is low. Mild right base atelectasis is stable. Otherwise lungs are clear without pulmonary edema. There is no pneumothorax or large pleural effusion. Cardiomediastinal silhouette is normal size. IMPRESSION: 1. Stable mild right base atelectasis. No pulmonary edema. 2. Left PICC terminates in right atrium. It can be pulled by 2 cm to reposition at the cavoatrial junction. " 9dba38dd-e6a47cee-e5f5198d-db625d1a-ac89982c.jpg,test/p16/p16474416/s57207420/9dba38dd-e6a47cee-e5f5198d-db625d1a-ac89982c.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of left upper lobe pneumonia. COMPARISON: PA and lateral chest radiograph ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear bilaterally with no areas of focal consolidation. Previously seen pneumonia has completely resolved. There is no pleural effusion, pneumoperitoneum or pneumothorax. Cardiomediastinal silhouette is within normal limits. The pleural surfaces are unremarkable. There are stable mild degenerative changes seen along the thoracic spine. IMPRESSION: Complete resolution of previously seen pneumonia. " 6ebc9a06-0564c3c9-87ebb980-4417cd6b-4a4a11c3.jpg,test/p11/p11934652/s54878230/6ebc9a06-0564c3c9-87ebb980-4417cd6b-4a4a11c3.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: COPD, weakness and uncoordination. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is mild bibasilar atelectasis without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable, as are the hilar contours. IMPRESSION: No acute cardiopulmonary process. " 6d9c06f7-330de41c-ebfde0a8-59c53921-477aa94b.jpg,test/p13/p13815268/s53232887/6d9c06f7-330de41c-ebfde0a8-59c53921-477aa94b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fevers. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: Intact median sternal wires are noted. Numerous mediastinal surgical clips are indicative of prior surgery. Heart size is stable and the lungs are essentially clear. There is no pleural effusion or pneumothorax. The osseous structures are osteopenic and there is multilevel osteophyte formation in the visualized thoracic spine. IMPRESSION: Clear lungs with no focal consolidation. " 38207891-b348f4e2-c6ef6623-7c49c121-43ce9c09.jpg,test/p12/p12573761/s50961036/38207891-b348f4e2-c6ef6623-7c49c121-43ce9c09.jpg,test," FINAL REPORT HISTORY: Status post palliative right hemicolectomy, new onset fever, tachycardia. CHEST, TWO VIEWS. Compared with ___, there is new minimal atelectasis at the right base and new slight blunting of the right posterior costophrenic angle. Otherwise, no interval changes are identified. No frank consolidation is seen. The right hemidiaphragm is elevated, unchanged. Cardiomediastinal silhouette is stable, without cardiac enlargement. No CHF or frank consolidation. No left-sided atelectasis or effusion. No ptx. IMPRESSION: Minimal right base atelectasis and small right pleural effusion, new compared with ___. Otherwise, no significant interval change. No CHF or frank consolidation. " 130b3a8d-2c175103-b26a2678-f868aa99-8df97085.jpg,test/p15/p15378092/s55933666/130b3a8d-2c175103-b26a2678-f868aa99-8df97085.jpg,test," FINAL REPORT HISTORY: Cough, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change in the appearance of the heart and lungs. The patient has taken a better inspiration and there is no pneumonia, vascular congestion, or pleural effusion. Central catheter tip extends to the mid portion of the SVC. " 4120c3e0-a15ca36a-c380eb8e-21d67261-ef5b80aa.jpg,test/p12/p12784119/s55331417/4120c3e0-a15ca36a-c380eb8e-21d67261-ef5b80aa.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: HIV positive, cough, assess for pneumonia. FINDINGS: AP upright portable chest radiograph is obtained. The lungs are clear and well expanded. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. Old left rib deformity again noted. IMPRESSION: No signs of pneumonia. " 4b2407f3-cabda3e1-56db4d7d-cbb9e68a-26753dec.jpg,test/p12/p12435705/s56278079/4b2407f3-cabda3e1-56db4d7d-cbb9e68a-26753dec.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new oxygen requirement s/p craniectomy with abscess debridement // Please evaluate for new areas of consolidation or pulmonary edema that could explain oxygen requirement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lateral radiograph shows new small bilateral pleural effusions. In addition, there is a zone of increased radiodensity in the retrocardiac lung regions, likely reflecting retrocardiac atelectasis. However, given the clinical presentation of the patient, developing pneumonia cannot be excluded. A short term repeat frontal and lateral radiograph should be performed. Mild cardiomegaly without pulmonary edema. The left central venous access line is unchanged. " 5ad2e9f0-2e4ae7f2-0d6cbcb3-ae978122-0abd2385.jpg,test/p15/p15195289/s52317337/5ad2e9f0-2e4ae7f2-0d6cbcb3-ae978122-0abd2385.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Heart size is normal and without change. Mediastinal and hilar contours are also normal. Lungs and pleural surfaces are clear. No acute skeletal findings. IMPRESSION: Stable radiographic appearance of the chest with no acute cardiopulmonary radiographic abnormalities. " d625089f-805e3a29-db6f920f-86073c26-283deb1a.jpg,test/p14/p14074396/s52136202/d625089f-805e3a29-db6f920f-86073c26-283deb1a.jpg,test," WET READ: ___ ___ 2:28 PM Persistent large right pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with history of non-small-cell lung cancer stage IV, dyspnea, cough // pt with ___, clogged, effusion. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray dated ___. FINDINGS: There is persistent near complete opacification of the right hemi-thorax. A right chest tube is again noted projecting over the right lower lung. There is no shift of mediastinal structures. There is no pneumothorax. Left lung remains clear. IMPRESSION: Near complete opacification of the right hemi thorax despite presence of a right chest tube. " d68b1976-11ae6585-42363e89-67de1791-66c0f827.jpg,test/p16/p16426056/s56479298/d68b1976-11ae6585-42363e89-67de1791-66c0f827.jpg,test," FINAL REPORT INDICATION: Seizure, sleep deprivation, evaluation for acute process. COMPARISON: No comparison available at the time of dictation. FINDINGS: The patient is intubated, the tip of the endotracheal tube projects 4.4 cm above the carina. There is minimal atelectasis at the left lung base, in the retrocardiac lung areas. Otherwise, the lung parenchyma is normal. The patient shows cortical irregularities of two ribs on the left, likely caused by old and healed rib fractures. Borderline size of the cardiac silhouette, no pulmonary edema. No pneumonia. No pneumothorax. No pleural effusions. " 31dcea5c-b3a79732-e5c0b225-bc642c4d-3aa938b3.jpg,test/p10/p10602633/s55706286/31dcea5c-b3a79732-e5c0b225-bc642c4d-3aa938b3.jpg,test," FINAL REPORT HISTORY: Hypertension, CHF with recurrent lower extremity cellulitis, presenting with asymmetric leg swelling and shortness of breath. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: The heart size is top normal with mild tortuosity of the thoracic aortic arch. The mediastinal silhouette and hilar contours are otherwise unremarkable. Low lung volumes accentuate the cardiopulmonary vasculature. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " b68109ca-7e49006c-b992005b-5063abfe-1fab0e46.jpg,test/p10/p10550621/s59880459/b68109ca-7e49006c-b992005b-5063abfe-1fab0e46.jpg,test," FINAL REPORT CHEST RADIOGRAPH: INDICATION: Cough, questionable chronic heart failure, exacerbation. COMPARISON: No comparison available at the time of dictation. FINDINGS: Massive cardiomegaly. Partial left lower lobe atelectasis. Mild atelectatic changes at the bases of the right lung, right middle lobe collapse. No evidence of pulmonary edema. Partial height reduction of a thoracic vertebral body. No abnormalities in the normally ventilated parts of the lungs. " 0079c1c0-4c5362a6-8b8219a0-25c8a515-72230216.jpg,test/p16/p16751898/s54391654/0079c1c0-4c5362a6-8b8219a0-25c8a515-72230216.jpg,test," FINAL REPORT INDICATION: Fevers, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are clear. No pleural effusion, pneumothorax or focal airspace consolidation. Heart is top normal in size. The mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " ee7cc43c-c838c849-93f2aa16-753f1bc4-b05b4f73.jpg,test/p17/p17137598/s50757588/ee7cc43c-c838c849-93f2aa16-753f1bc4-b05b4f73.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG // eval postop changes TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: Sternotomy. Right IJ central line tip low SVC. Elevated right hemidiaphragm, similar. Improved bibasilar opacities. Trace fluid versus atelectasis right lower lung. Tortuous thoracic aorta. Small bilateral pleural effusions. Mild compression fracture lower thoracic spine. IMPRESSION: Improvement since prior exam " 0714496c-09c6d6db-d2a08df4-f197a781-5b42e037.jpg,test/p15/p15641930/s51707003/0714496c-09c6d6db-d2a08df4-f197a781-5b42e037.jpg,test," FINAL REPORT AP CHEST, 7:46 A.M., ___ HISTORY: ___-year-old woman after VFIB arrest. IMPRESSION: AP chest compared to ___: Moderate cardiomegaly and pulmonary vascular engorgement are unchanged. Heterogeneity in the background density of the lungs suggests considerable emphysema. Pulmonary edema is mild, if any. A chest CT scan would help clarify the radiographic appearance. " 65122cf8-e8154169-108ecf82-ddf8584a-c6e2a177.jpg,test/p11/p11742241/s58173343/65122cf8-e8154169-108ecf82-ddf8584a-c6e2a177.jpg,test," WET READ: ___ ___ ___ 8:55 PM ___ image obtained demonstrated low position of ETT 1.4 cm above carina - retract by 1-2 cm for more optimal position.lungs clear and well inflated on second CXR. NGT should be advanced as its tip[ resides just beyobnd GE junction. WET READ VERSION #1 WET READ VERSION #2 ___ ___ ___ 8:46 PM RIGHT MAINSTEM INTUBATION WITH LEFT LUNG WHITE OUT. REPOSITION IMMEDIATELY. PAGE SENT TO DR. ___. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Unresponsive, intubated, assess for acute process and position of tubes. FINDINGS: 2 supine portable AP chest radiographs were obtained during placement of the endotracheal tube approximately 16 minutes apart. The first film demonstrates right mainstem intubation with complete whiteout of the left lung. The second film was obtained 16 minutes later shows retraction of the endotracheal tube with its tip now positioned approximately 1.4 cm above the carina. There is interval expansion of the left lung. The NG tube resides in the left upper abdomen with its tip positioned only approximately 5 cm beyond the GE junction. Advancement of the NG tube may result in more optimal positioning. The cardiomediastinal silhouette appears grossly unremarkable. No bony abnormalities are seen. IMPRESSION: 1. Low position of ET tube positioned 1.4 cm above the carina. Please retract by at least 1 cm for more optimal positioning. 2. NG tube tip just beyond the GE junction and can be advanced for more optimal positioning. 3. Aerated lungs post retraction of ET tube. " 960ee496-474254a4-4d33be97-e3cd1c4d-a4ee2d73.jpg,test/p15/p15079493/s52544801/960ee496-474254a4-4d33be97-e3cd1c4d-a4ee2d73.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypotension // assess decrease in gastric bubble size assess decrease in gastric bubble size IMPRESSION: Comparison to ___, 06:17. As compared to the previous radiograph, the signs of CV a centralized pulmonary edema have decreased in severity. However, the overall severity of the edema is still moderate. Normal size of the heart. No new focal parenchymal opacities. Despite the presence of a feeding tube the gastric bubble is still over distended. All monitoring and support devices are in correct position. " bc337584-79f16638-46ff58b9-ab4030cd-1e3217f8.jpg,test/p14/p14280192/s52241547/bc337584-79f16638-46ff58b9-ab4030cd-1e3217f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with post-op hypoxia, hypotension // eval for pulmonary edema, effusion TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: The appearance of the lines and tubes are unchanged. There continues to be pulmonary edema with pulmonary vascular redistribution and hazy alveolar infiltrates right greater than left and small bilateral effusions. . However, the overall appearance has improved compared to the study from the prior day. IMPRESSION: Slight improvement in pulmonary edema. " e277fac9-68d4768c-7a2fb618-af209e5a-f8909440.jpg,test/p18/p18663902/s54167704/e277fac9-68d4768c-7a2fb618-af209e5a-f8909440.jpg,test," FINAL REPORT CLINICAL HISTORY: Patient has pancreatic pseudocyst, now with tachypnea and tachycardia. CHEST There is mild cardiomegaly and atelectasis at the left lower lobe. Mild failure is likely present, but there has been little change since the prior x-rays of ___ and ___. " 0649ddc1-7171d273-466171d0-34e6b76f-51429569.jpg,test/p16/p16444272/s59744455/0649ddc1-7171d273-466171d0-34e6b76f-51429569.jpg,test," FINAL REPORT HISTORY: Chronic chylothorax. COMPARISON: ___ FINDINGS: There is near complete right lower lobe collapse which is increased compared to the prior study. There is a moderate right pneumothorax that is more apparent than on the prior exam. ___ are seen in the right upper lung . The PICC line with tip in the right atrium is again visualized. The tip of this has been pulled back slightly but is still slightly low. There continues to be dense retrocardiac opacity consistent with volume loss/infiltrate/effusion. IMPRESSION: Increased right pneumothorax with increased right lower lobe collapse. " 735c9b14-13c32bc4-b115b7a0-96d9e59d-db48027b.jpg,test/p16/p16033728/s55325592/735c9b14-13c32bc4-b115b7a0-96d9e59d-db48027b.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: None. FINDINGS: PA and lateral chest radiographs. The left hemidiaphragm is elevated and there is bibasilar atelectasis. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. " 8a651d0c-b7d54fe1-c95cba7b-642ed986-633d46bb.jpg,test/p11/p11838364/s59303771/8a651d0c-b7d54fe1-c95cba7b-642ed986-633d46bb.jpg,test," FINAL REPORT HISTORY: Bilateral pneumonia diagnosed at another institution. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs were obtained. Moderate left greater than right pleural effusions are new since ___. There is some overlying atelectasis at the left base. The presence of additional pneumonia cannot be excluded. Severe cardiomegaly has progressed since ___. Aortic arch calcifications are noted. There is no pneumothorax. IMPRESSION: Moderate left greater than right pleural effusions and associated atelectasis. There is no definite evidence of pneumonia but presence of infection cannot be excluded. " abea55f3-8ead5c2e-102611b2-3c372e20-699732ad.jpg,test/p13/p13635436/s52450333/abea55f3-8ead5c2e-102611b2-3c372e20-699732ad.jpg,test," FINAL REPORT HISTORY: ___-year-old female with shortness breath. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: There are low lung volumes, but the lungs are clear. Slightly enlarged-appearing heart likely due to magnification from AP projection. Cardiomediastinal silhouette is otherwise unremarkable. There is no pneumothorax or pleural effusion. Visualized osseous structures are unremarkable. IMPRESSION: Normal chest radiographs. " 07a00319-fb200718-fa40364d-ba919c5f-19043e28.jpg,test/p14/p14045504/s51092500/07a00319-fb200718-fa40364d-ba919c5f-19043e28.jpg,test," CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST COMPARISON: ___ chest x-ray. FINDINGS: Central left juxtahilar mass and left upper lobe collapse are again demonstrated, consistent with known history of lung cancer. New patchy right lower lobe opacity has developed, and could reflect atelectasis or aspiration. Marked gastric distention is new, and is accompanied by air-filled distention of the lower thoracic esophagus. " a4c66984-f8b0e90a-539bada4-12e8d771-50b3fd41.jpg,test/p10/p10088966/s59763427/a4c66984-f8b0e90a-539bada4-12e8d771-50b3fd41.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p MVrepair, CABG // predischarge eval predischarge eval IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. There is again enlargement of the cardiac silhouette, though minimal vascular congestion. Mild atelectatic changes without evidence of acute pneumonia. Central catheter remains in good position. " ac094616-aaac14c2-90f2683f-a9ccd4af-c7768dc8.jpg,test/p17/p17767787/s53808536/ac094616-aaac14c2-90f2683f-a9ccd4af-c7768dc8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pressure and dyspnea COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Mild interstitial edema is noted with small bilateral pleural effusions. The heart is normal in size. The hila appear minimally in cord shin. No pneumothorax. Bony structures intact. IMPRESSION: Mild interstitial pulmonary edema, small bilateral effusions. " 93b33507-4a73a97f-14de4e72-18127e59-426118fb.jpg,test/p17/p17574863/s52378589/93b33507-4a73a97f-14de4e72-18127e59-426118fb.jpg,test," WET READ: ___ ___ ___ 9:52 PM RIght costophrenic angle not included in field of view. Left IJ line tip in unchanged position. Feeding tube tip in expected region of the stomach. Bilateral low lung vol and left basilar opacities likely atelectasis. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Liver transplant, confirm Dobbhoff placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a newly placed Dobbhoff catheter. The tip is in the expected region of the stomach, but the tube is coiled in the stomach. No evidence of complications. Unchanged low lung volumes with signs of mild fluid overload. Moderate cardiomegaly and retrocardiac atelectasis. " 5672a8f6-9ab07a14-cb1fa659-bb5862ef-8a365fd2.jpg,test/p13/p13253051/s55234911/5672a8f6-9ab07a14-cb1fa659-bb5862ef-8a365fd2.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 7465591d-fddaebbf-6e328ba7-80977995-fd5bc115.jpg,test/p19/p19939526/s51271143/7465591d-fddaebbf-6e328ba7-80977995-fd5bc115.jpg,test," FINAL REPORT HISTORY: ___-year-old female with left shoulder pain status post fall. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are hyperinflated but clear of focal consolidation, effusion or pneumothorax. Cardiac silhouette is mildly enlarged. The thoracic aorta is tortuous. Moderate-sized hiatal hernia is identified. No definite displaced fracture is identified. IMPRESSION: Hyperinflation without acute cardiopulmonary process. Mild cardiomegaly. Moderate hiatal hernia. No displaced fractures identified on this nondedicated examination. " 8b31db62-b687c867-5edfba2d-e950efc8-7a2760cf.jpg,test/p17/p17210427/s52987335/8b31db62-b687c867-5edfba2d-e950efc8-7a2760cf.jpg,test," FINAL REPORT HISTORY: Asthma, worsening shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are well expanded. Heart size is top normal. Mediastinal and hilar contours are unremarkable. Pulmonary vascularity is normal. There is no focal consolidation, pleural effusion or pneumothorax. Scarring within the lung apices is unchanged. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. Hyperinflated lungs which can be seen with asthma/COPD. " 0f412d4e-0245b2eb-6839caa5-ab64a54a-275f2c7e.jpg,test/p18/p18950565/s58058997/0f412d4e-0245b2eb-6839caa5-ab64a54a-275f2c7e.jpg,test," FINAL REPORT INDICATION: ___ year old man with new dual chamber ppm // assess lead position COMPARISON: Radiographs from ___ IMPRESSION: There is a new left-sided pacemaker with the distal lead tips in right atrium and ventricle. Heart size is within normal limits. There is mild tortuosity of the thoracic aorta. Lungs are clear. There are no pneumothoraces. " 93d548e0-6970a35d-c60da9b1-f4e8a756-a561e087.jpg,test/p18/p18230852/s55457152/93d548e0-6970a35d-c60da9b1-f4e8a756-a561e087.jpg,test," FINAL REPORT INDICATION: ___ year old man with multifocal PNA, intubated in setting of recent episaxis // interval change in PNA? COMPARISON: Radiographs from ___ IMPRESSION: Support lines and tubes are unchanged in position. The side port of the nasogastric tube is again above the GE junction and this could be advanced 10 cm for more optimal placement. Cardiomediastinal silhouette is within normal limits. Atelectasis at the lung bases are again seen. Fluid within the right minor fissure is stable. There are no pneumothoraces. " 976f9fca-a95c4577-51813695-df116edf-a4914afc.jpg,test/p13/p13299285/s53775206/976f9fca-a95c4577-51813695-df116edf-a4914afc.jpg,test," WET READ: ___ ___ ___ 8:56 AM Interval placement of a right-sided pigtail catheter without evidence for appreciable pneumothorax or residual effusion. WET READ VERSION #1 ___ ___ 8:03 PM Interval placement of a right-sided pigtail catheter without evidence for appreciable pneumothorax or residual effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with panc ca and effusion // s/p Rt pigtail into pleural effusion- asses residual fluid, CT placement and PTX? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There has been interval placement of a right basal pigtail catheter. There is a tiny right apical pneumothorax. Right pleural effusion has almost completely resolved. Marked Improved aeration the right lower lobe. Cardiomediastinal contours are unchanged. Other lines and tubes are in unchanged standard position " 19f7ace2-12bd8219-bf6d70cd-32fb7ba6-b4d0573d.jpg,test/p18/p18699523/s56279887/19f7ace2-12bd8219-bf6d70cd-32fb7ba6-b4d0573d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with hematemesis // evidence of pneumomediastinum or air under diaphram COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Right upper extremity PICC line is again seen with its tip extending into the right atrium. Lung volumes are low. No focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette appears normal. No signs of pneumomediastinum or pneumoperitoneum. Clips in the right upper quadrant noted. Bony structures are intact. IMPRESSION: PICC line descends into the right heart. Correlate for positional adequacy. Otherwise unremarkable. " 417bfde1-3bef1eb9-177e1ec1-dd62c046-3cea286c.jpg,test/p14/p14268088/s55937363/417bfde1-3bef1eb9-177e1ec1-dd62c046-3cea286c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with difficulty breathing // ?interval change ?interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Moderate to large bilateral pleural effusions have increased. At least the left lower lobe is collapsed. Pulmonary edema is developing in the upper lobes. Heart is severely enlarged and heavy calcifications are present probably in both the mitral anulus and aortic valve. " a22c0a74-3ba2c789-9800aa62-12385b68-ef39feb1.jpg,test/p15/p15403852/s57626930/a22c0a74-3ba2c789-9800aa62-12385b68-ef39feb1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p avr/mvr and ct removal // r/o ptx r/o ptx IMPRESSION: Comparison to ___. The right chest tube was removed. No pneumothorax. The other monitoring and support devices, including the left chest tube, the Swan-Ganz catheter and the endotracheal tube are in unchanged position. Improved transparent see of the lung parenchyma, likely reflecting improved ventilation. " e5a182c8-483dbed5-fada7cce-4f80ac62-00cf91f4.jpg,test/p16/p16312465/s58475143/e5a182c8-483dbed5-fada7cce-4f80ac62-00cf91f4.jpg,test," WET READ: ___ ___ ___ 12:02 PM The lung volumes are decreased, accentuating the bronchovascular structures. Increased density at the right lower lobe adjacent to the heart is felt to reflect atelectasis versus superimposed bronchovascular structures. However if clinical concern, PA and lateral views are recommended to exclude an infectious process. Blunting of the left costophrenic angle, could relate to a small pleural effusion. There is mild pulmonary vascular congestion. Discussed with Dr. ___ by ___ via phone on ___ at 12:10 AM. WET READ VERSION #1 ___ ___ ___ 12:10 AM The lung volumes are decreased, accentuating the bronchovascular structures. Increased density at the right lower lobe adjacent to the heart is felt to reflect atelectasis versus superimposed bronchovascular structures. However if clinical concern, PA and lateral views are recommended to exclude an infectious process. Blunting of the left costophrenic angle, could relate to a small pleural effusion. There is mild pulmonary vascular congestion. Discussed with Dr. ___ by NSR via phone on ___ at 12:10 AM. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with multiple myeloma, new O2 requirement, ? etiology // ___ year old woman with multiple myeloma, new O2 requirement, ? etiology IMPRESSION: There is a right subclavian central line with the distal lead tip at the cavoatrial junction, stable. The lung volumes are decreased, accentuating the bronchovascular structures. Increased density at the right lower lobe adjacent to the heart is felt to reflect atelectasis versus superimposed bronchovascular structures. However if clinical concern, PA and lateral views are recommended to exclude an infectious process. Blunting of the left costophrenic angle, could relate to a small pleural effusion. There is mild pulmonary vascular congestion. " c4f37165-e8e219ca-a2bb5324-9ab788c0-db775f42.jpg,test/p15/p15677235/s55392752/c4f37165-e8e219ca-a2bb5324-9ab788c0-db775f42.jpg,test," FINAL REPORT INDICATION: Sudden onset dizziness and weakness. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Low lung volumes. There is chronic opacity in the right middle lobe, unchanged. The right hemidiaphragm apex is more lateral. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: 1. Low lung volumes. No acute cardiopulmonary process. 2. Unchanged chronic opacity in right middle lobe. 3. Slight lateralization of right hemidiaphragm apex, may be sign of subdiaphgragmatic process, correlate clinically. " 47425a3d-9cc31557-8967bb68-31fe2b6f-841fd5d6.jpg,test/p11/p11112875/s57724273/47425a3d-9cc31557-8967bb68-31fe2b6f-841fd5d6.jpg,test," FINAL REPORT INDICATION: ___ year old man with NGT placement // Is NGT in place? COMPARISON: Radiographs from ___. IMPRESSION: There is a nasogastric tube whose side port is above the GE junction. The catheter could be advanced 10 cm for more optimal placement. Lungs are clear. Heart size is grossly within normal limits. " 534381c9-8d3e04e0-857deeec-6596f27e-c885b755.jpg,test/p16/p16590891/s58102453/534381c9-8d3e04e0-857deeec-6596f27e-c885b755.jpg,test," FINAL REPORT CLINICAL HISTORY: Malaise, low sodium. Evaluate for cause. CHEST, PA AND LATERAL COMPARISON: ___. The heart and mediastinum are normal. The lung fields are clear. Costophrenic angles are sharp. There has been no change since the prior chest x-ray. IMPRESSION: Normal chest. " b445f67d-9a05b85a-23374e55-c23bd111-9accdff3.jpg,test/p18/p18068560/s57718998/b445f67d-9a05b85a-23374e55-c23bd111-9accdff3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with squamous cell lung cancer s/p LLL bronchus stent, presenting with massive hemoptysis and respiratory failure s/p intubation and bronchoscopy for hemorrhage control ___. Initial CXR with complete opacification of left hemithorax // please assess for interval change and patency of left sided airways please assess for interval change and patency of left sided IMPRESSION: As compared to ___, there is improved ventilation of the left lung. However, extensive re-expansion edema and remnant areas of atelectasis in the mid and lower lung zones persist. Unchanged appearance of the right lung. The cardiac silhouette is again visualized and overall at the upper range of normal. No change in position of the endotracheal tube. The nasogastric tube has been removed. The patient has received a left central venous access line, the tip projects over the upper SVC. " 3b3571bc-c6826128-b2388461-6bbccbb4-2284c51a.jpg,test/p17/p17983733/s52866894/3b3571bc-c6826128-b2388461-6bbccbb4-2284c51a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain // eval for pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 49faa7a3-6735943e-330a622f-50305fcc-e4a96bb7.jpg,test/p16/p16589824/s57060988/49faa7a3-6735943e-330a622f-50305fcc-e4a96bb7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph from ___ and CT chest from ___. CLINICAL HISTORY: Intermittent shortness of breath, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. The imaged bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 54bd5212-956ac09b-e9720e81-c17c17c8-ab193210.jpg,test/p12/p12973912/s59249508/54bd5212-956ac09b-e9720e81-c17c17c8-ab193210.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Cough, fever, shaking chills, infection, pneumonia. TECHNIQUE: Two views of the chest were obtained. COMPARISON: ___. REPORT: The examination is technically limited. There is blunting of the left costophrenic sulcus, suggesting a small effusion, new from prior study. There is also evidence of increased lung markings projected behind the heart, with focal silhouetting of the left hemidiaphragm. These could reflect atelectasis or pneumonia, but given the symptoms, should be treated as infection. Lateral view is somewhat degraded due to motion artifact. There are increased lung markings as previously noted in the lung bases. There is also evidence of an unchanged dorsal kyphotic fracture with an acute wedge. CONCLUSION: Increased markings behind the heart may reflect some atelectasis or perhaps pneumonia. There is increasing effusion and probably background minor interstitial edema. Unchanged thoracic compression wedge fracture with acute (approximately ___ degrees) angulation. " c8fd9b99-b888d94e-87f7a3e5-668d5d6b-58053622.jpg,test/p15/p15294749/s51915457/c8fd9b99-b888d94e-87f7a3e5-668d5d6b-58053622.jpg,test," FINAL REPORT HISTORY: ___-year-old female with diarrhea and vertigo. COMPARISON: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is top normal size and cardiomediastinal contours are stable. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Calcification of the aortic knob is similar to prior. Bilateral acromioclavicular and glenohumeral joint degenerative changes are mild. IMPRESSION: No acute cardiopulmonary process. " 30361da0-96ece3eb-c4f98652-da6e288d-b7cef244.jpg,test/p17/p17109815/s53581061/30361da0-96ece3eb-c4f98652-da6e288d-b7cef244.jpg,test," FINAL REPORT INDICATION: ___-year-old man with well-controlled HIV, frequent travel to ___, new positive QuantiFERON Gold, no symptoms; rule out evidence of active TB. COMPARISONS: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Dense small rounded opacity in the left lower lobe could be a lung nodule or a bone island. The cardiomediastinal silhouette is normal. There is no evidence of recent or non-recent TB. Osseous structures demonstrate no acute skeletal abnormality. IMPRESSION: 1. No evidence of recent or non-recent TB. 2. Dense rounded opacity in the left lower lobe. Recommend shallow oblique views for further evaluation. These findings were entered into the critical results dashboard by Dr. ___ at 12:15pm. " 58fdfd6d-afe559f9-a9740508-5e3cdbe4-53aab497.jpg,test/p17/p17239555/s58852458/58fdfd6d-afe559f9-a9740508-5e3cdbe4-53aab497.jpg,test," WET READ: ___ ___ ___ 12:58 PM No acute cardiopulmonary process. No evidence of retained tooth fragments on this exam. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with Tooth fracture // Eval for retained teeth TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. No evidence of retained tooth fragments is seen. IMPRESSION: No acute cardiopulmonary process. No evidence of retained tooth fragments on this exam. " 016f955f-894df245-0200e2d4-787e16f9-49b16b0d.jpg,test/p18/p18108260/s56703932/016f955f-894df245-0200e2d4-787e16f9-49b16b0d.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: CAD, CHF, status post VF arrest with single-chamber ICD implant, assess lead position. FINDINGS: PA and lateral views of the chest were provided. There has been interval placement of a left chest wall ICD with lead tip positioned in the region of the right ventricle. Lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears grossly within normal limits. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. Appropriately positioned ICD with lead tip positioned in the expected position of the right ventricle. " d14ff2d1-f634c19d-3dd80016-bdb84656-cd1c68b1.jpg,test/p16/p16190725/s56567313/d14ff2d1-f634c19d-3dd80016-bdb84656-cd1c68b1.jpg,test," FINAL REPORT INDICATION: ___ year old woman with asc aorta aneurysm eval for effusions // effusion TECHNIQUE: Single portable AP view of the chest COMPARISON: ___ FINDINGS: The lungs are well inflated and clear. There is interval resolution of previously noted left pleural effusion. Persistent cardiomegaly with enlargement of the left atrium. Sternal sutures noted in situ. No interval change in the bony thorax. Surgical clips project over the right lung apex. IMPRESSION: Well inflated clear lungs. Interval resolution of left pleural effusion. Cardiomegaly with left atrial enlargement persist. " 981e3309-eaf91685-c988ccec-c1e1c1f6-e68c13e0.jpg,test/p10/p10083754/s54841118/981e3309-eaf91685-c988ccec-c1e1c1f6-e68c13e0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cough neutropenic // r/o infection TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph from ___, ___. FINDINGS: Right subclavian catheter tip terminates in the lower SVC. Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of pneumonia. " fe187b62-6df6835e-55f02cfd-761bc4e8-3faf86c8.jpg,test/p16/p16535066/s59631762/fe187b62-6df6835e-55f02cfd-761bc4e8-3faf86c8.jpg,test," FINAL REPORT HISTORY: ___-year-old male with right subclavian line placement. COMPARISON: Chest radiograph from ___. PA AND LATERAL CHEST RADIOGRAPH: A right-sided central subclavian line terminates in the mid SVC. There is no pneumothorax. The lungs are grossly clear. There is no vascular congestion or pleural effusions. Cardiomediastinal and hilar contours are within normal limits. Surgical clips are identified within the left upper quadrant. IMPRESSION: 1. Interval placement of a right-sided subclavian central line, terminating in the mid SVC. No pneumothorax. 2. No acute cardiopulmonary process. " a47c10f3-54c2a65b-9c41168e-c44c4a6e-2ccdce92.jpg,test/p11/p11830275/s59953145/a47c10f3-54c2a65b-9c41168e-c44c4a6e-2ccdce92.jpg,test," FINAL REPORT INDICATION: ___ year old man with hx L hip fracture, needs preop CXR // preop Surg: ___ (hip fx repair w/ ortho) TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: Low bilateral lung volumes with left basal atelectasis and probable trace left pleural effusion. The right lung is clear. Mild central vascular congestion. The size of the cardiac silhouette is unchanged. IMPRESSION: Left basal atelectasis and a trace effusion. Mild central pulmonary vascular congestion. " 47530f14-687aae9b-103c93d7-9a0b65da-10b28712.jpg,test/p17/p17884118/s51707688/47530f14-687aae9b-103c93d7-9a0b65da-10b28712.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with falls, weakness // eval for pna COMPARISON: ___. C-spine CT from today. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low which limits assessment. An area of scarring on CT C-spine in the left upper lung is not clearly visualized. Pulmonary hilar prominence may reflect mild hilar congestion. There is no overt pulmonary edema or large consolidation, effusion or pneumothorax. The heart size appears grossly stable. Mediastinal contour is unchanged. Bony structures appear intact. No acute displaced rib fractures seen. IMPRESSION: Mild hilar congestion. No fracture or signs of traumatic injury. " c0e741ab-1ad2467d-162e173c-86b07a42-4561f8f7.jpg,test/p13/p13455047/s57310520/c0e741ab-1ad2467d-162e173c-86b07a42-4561f8f7.jpg,test," FINAL REPORT INDICATION: ___-year-old man with shortness of breath and lactic acidosis. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well inflated and clear. No effusion or pneumothorax is present. Cardiac and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " d9e6a4c7-a2f507a0-b64ffd05-218006f2-896155a8.jpg,test/p10/p10550621/s53618152/d9e6a4c7-a2f507a0-b64ffd05-218006f2-896155a8.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Atrial fibrillation. Question congestive heart failure. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: There is substantial elevation of the right hemidiaphragm with associated opacification that may be due to pleural effusions and atelectasis. This study indicates that the pleural effusion component is similar to perhaps slightly smaller. The left lung remains clear. There is no evidence for pleural effusion on the left. The cardiac, mediastinal and hilar contours appear unchanged. IMPRESSION: Elevation of the right hemidiaphragm with suspected pleural effusion, not incompletely characterized, although apparently similar to decreased. A decubitus view or CT could be helpful to evaluate how much of the appearance is truly due to pleural effusion if needed clinically. " 751de7f3-12ff7bf0-52c36492-42f7a777-2df04f38.jpg,test/p12/p12960546/s53612811/751de7f3-12ff7bf0-52c36492-42f7a777-2df04f38.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with volume overload, now with decreased breath sounds on the right side. FINDINGS: Comparison is made to the previous study from ___. There is a dual-lead left-sided pacemaker with lead tips in right atrium and right ventricle. There has been increase in the right-sided pleural effusion which is now moderate in size. A small left-sided pleural effusion and left retrocardiac opacity are also seen. There is mild pulmonary edema. There are no pneumothoraces identified. " 74ce6189-5461eb94-27004f0f-29d4927f-191ae5b5.jpg,test/p11/p11185907/s50532228/74ce6189-5461eb94-27004f0f-29d4927f-191ae5b5.jpg,test," FINAL REPORT INDICATION: ___ year old woman with rib fx and with left chest tube, recently put to waterseal // pls r/o PTX TECHNIQUE: Portable upright AP chest radiograph. COMPARISON: Chest radiographs since ___. CT torso from ___. FINDINGS: The right lung is hyper expanded and clear. Increased opacification in the left lung base is slightly improved. Small left apical pneumothorax is stable. There is no significant pleural effusion. Left chest tube, displaced left rib fractures, and subcutaneous emphysema in the left chest wall are unchanged. IMPRESSION: 1. Stable small left apical pneumothorax. 2. Left lung opacification may represent resolving resolving pulmonary hemorrhage, soft tissue contusion, or early pneumonia. " 3bd00322-32563b7e-7e3962db-bd3b09e4-9e4c4c0f.jpg,test/p13/p13384632/s58713028/3bd00322-32563b7e-7e3962db-bd3b09e4-9e4c4c0f.jpg,test," FINAL REPORT INDICATION: Asymptomatic hypoxia after AV fistula thrombectomy. Evaluate for pleural effusion. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lung volumes are low. Heart is mildly enlarged. There is mild pulmonary edema. There are small to moderate bilateral pleural effusions, left greater than right. Superimposed consolidation is seen in the left lung base and could reflect atelectasis or pneumonia. A more nodular focal opacity overlying the left eighth rib may relate to the same process. Sternotomy wires and mediastinal clips are noted. IMPRESSION: 1. Mild pulmonary edema with small to moderate bilateral pleural effusions. 2. Opacity at the left lung base may represent atelectasis or infection. Followup after diuresis is recommended. " 925fcbbf-d148e51f-baa702b8-8d3e4c9a-3579e336.jpg,test/p11/p11551927/s52641377/925fcbbf-d148e51f-baa702b8-8d3e4c9a-3579e336.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with fever. Evaluate for pneumonia. FINDINGS: Comparison is made to previous study from ___. Tracheostomy and right-sided central line are unchanged in position. There is crowding of the pulmonary vascular markings due to low lung volumes. There is some atelectasis at the right mid lung and left base. No definite consolidation is seen. There are no pneumothoraces. " ceb3f158-33453d95-91f1424a-150afbc6-13b9c4b9.jpg,test/p14/p14827673/s58867136/ceb3f158-33453d95-91f1424a-150afbc6-13b9c4b9.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest CTA and chest radiograph. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " e1a1f2fb-bc41fe84-2ae24e1c-bbf6a186-899bfb8f.jpg,test/p17/p17451002/s54151058/e1a1f2fb-bc41fe84-2ae24e1c-bbf6a186-899bfb8f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with worsening shortness of breath, cough TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac, mediastinal and hilar contours are unchanged, with the heart size within normal limits. Pulmonary vasculature is not engorged. Minimal streaky opacity in the right lower lobe may reflect an area of atelectasis though infection is not completely excluded. No pneumothorax or pleural effusion is present. There are no acute osseous abnormalities. IMPRESSION: Streaky opacity in the right lower lobe may reflect an area of atelectasis though infection is not completely excluded. " db368d36-8c00c286-fd73c287-46b788dc-3238c890.jpg,test/p14/p14213287/s56237499/db368d36-8c00c286-fd73c287-46b788dc-3238c890.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph from ___ as well as a CT torso from ___. CLINICAL HISTORY: Altered mental status, assess for acute intrathoracic process. FINDINGS: Lateral views of the chest were obtained. The lungs appear clear bilaterally. The previously detected opacity in the left lower lung appears to have resolved, though evaluation on a chest radiograph is suboptimal to assess complete resolution. Would recommend non-emergent CT of the chest to ensure resolution of the previously detected lingular opacity as well as multiple additional lung nodules described in detail on prior CT chest. Cardiomediastinal sillouhette appears normal. Bony structures are intact. IMPRESSION: No acute findings. Given findings on CT dated ___, a nonemergent 3 month f/u chest CT is appropriate to ensure complete resolution and/or stability of nodules per ___ guidelines. " f34e280a-4a81ca72-19ece66a-5f4380c2-e21f54f9.jpg,test/p14/p14889848/s59792494/f34e280a-4a81ca72-19ece66a-5f4380c2-e21f54f9.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:07 AM Normal chest radiograph. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest x-ray on ___. FINDINGS: PA and lateral radiographs of the chest demonstrate a normal cardiomediastinal silhouette. The lungs are clear without pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: Normal chest radiograph. " 79fdd67a-8c84085c-85606c4e-2eeaca4e-cd8ccf4c.jpg,test/p13/p13163471/s55474366/79fdd67a-8c84085c-85606c4e-2eeaca4e-cd8ccf4c.jpg,test," FINAL REPORT HISTORY: Sepsis with fluids, to assess for overhydration. FINDINGS: In comparison with the study of ___, there again are low lung volumes which accentuate the prominence of the transverse diameter of the heart. Bilateral atelectatic changes have increased. There may be mild elevation of pulmonary venous pressure. Central catheter again extends to the upper to mid portion of the SVC. " ea8261b2-7b61231c-bba7b095-eff93148-444ff9f1.jpg,test/p12/p12817683/s50324505/ea8261b2-7b61231c-bba7b095-eff93148-444ff9f1.jpg,test," FINAL REPORT HISTORY: ___-year-old male status post renal transplant, now with shortness breath. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: There has been interval removal of the right PICC line. The heart size is at the upper limits of normal although likely exaggerated by low lung volumes. The mediastinal and hilar contours are unremarkable. Minimal bibasilar atelectasis is seen. There is no pneumothorax or pleural effusion. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " 8e243016-3dae5099-a5020c6a-7692a875-3228baf1.jpg,test/p12/p12758750/s52745464/8e243016-3dae5099-a5020c6a-7692a875-3228baf1.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain. COMPARISON: Chest radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The lungs are clear. There is no focal consolidation or pneumothorax. There is no vascular congestion or pleural effusions. Cardiomediastinal and hilar contours are within normal limits and unchanged from prior. A right coronary stent appears unchanged from prior. IMPRESSION: No acute cardiopulmonary process. " 5add15c0-d5dbdec9-b3dae5ee-6a83d7ae-32fcd99d.jpg,test/p18/p18436690/s57907819/5add15c0-d5dbdec9-b3dae5ee-6a83d7ae-32fcd99d.jpg,test," FINAL REPORT HISTORY: Right rib pain and abrasion after fall. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The aorta is mildly unfolded with mild atherosclerotic calcifications. Mediastinal and hilar contours otherwise are within normal limits. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acutely displaced rib fractures are seen. Remote left ___ lateral rib fracture is present. IMPRESSION: No acute cardiopulmonary abnormality. No acutely displaced rib fractures seen. If there is continued concern for rib fracture, a dedicated rib series is recommended. " 2254a4fb-c6d00934-333ce261-aac2d5ba-da2be24e.jpg,test/p13/p13542676/s50751906/2254a4fb-c6d00934-333ce261-aac2d5ba-da2be24e.jpg,test," FINAL REPORT HISTORY: ___-year-old female with cough. COMPARISON: Chest radiograph from ___. PA AND LATERAL CHEST RADIOGRAPHS: The lungs are clear. There is no focal consolidation or pneumothorax. There is no vascular congestion or pleural effusions. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " 3f7d7b4e-7aa15ec2-694f0602-b7b55257-88037f89.jpg,test/p10/p10380296/s51158741/3f7d7b4e-7aa15ec2-694f0602-b7b55257-88037f89.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with known effusions // Interval change Interval change COMPARISON: Prior chest radiographs ___ through ___ at 17:08. IMPRESSION: Left lower lobe collapse and moderate left pleural effusion are unchanged since ___. Mediastinal widening Stable also since ___ has progressed since ___, raising concern for mediastinal bleeding or enlarging pseudoaneurysm, and possible left hemo thorax. Heterogeneous opacification at the base of the right lower chest is nonspecific, includes atelectasis and aspiration. NOTIFICATION: Dr. ___ paged vascular intern on-call to discuss the findings on ___ 09:45 1minutes after discovery of the findings, ultimately reported by telephone to Dr ___ on ___ at 10:05. " 0830c934-2824b95a-a720bde8-c1ad33de-2480d326.jpg,test/p18/p18148913/s55301420/0830c934-2824b95a-a720bde8-c1ad33de-2480d326.jpg,test," FINAL REPORT INDICATION: ___-year-old female with altered mental status and fevers. Evaluate for cardiopulmonary process. COMPARISON: None. low lung volumes, but otherwise clear FINDINGS: Single view of the chest was obtained with patient in rotated position. Low volumes are low, exaggerating heart size. Cardiomediastinal contours are normal. The lungs are clear without focal consolidation or diffuse abnormality. No pneumothorax or pleural effusion. Pulmonary vasculature is unremarkable. Osseous structures are unremarkable. No radiopaque foreign bodies. IMPRESSION: No acute cardiopulmonary process. " 699435e4-261a2df8-69c0831b-c9345d18-49935a24.jpg,test/p18/p18194315/s58847631/699435e4-261a2df8-69c0831b-c9345d18-49935a24.jpg,test," FINAL REPORT INDICATION: ___-year-old female with progressive left-sided rib pain, here to evaluate for rib fracture or mass. COMPARISON: Chest radiographs, last performed on ___ and ___. FINDINGS: Frontal and lateral radiographs of the chest show appropriate inspiratory lung volumes. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. No pulmonary nodules are appreciated. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits and unchanged from ___. The aortic knob is partially calcified and deviate the trachea slightly to the right. There is mild-to-moderate kyphosis of the thoracic spine and biconcave wedging of the lower T-spine, unchanged from ___. No osseous rib lesion is identified. IMPRESSION: 1. No osseous rib abnormality. 2. No pulmonary nodule appreciable by radiography. " 35b4258e-2d89e951-4a845614-3e986a92-003be46e.jpg,test/p12/p12773009/s55009120/35b4258e-2d89e951-4a845614-3e986a92-003be46e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: CLL, new left upper lobe evaluation. COMPARISON: Chest CT from ___, and CT torso from ___. FINDINGS: The large left upper lobe rounded opacity with a diameter of approximately 5 cm that was documented on the CT examination from ___, measures 7 cm in diameter on the current radiograph. The lesion, thus, has increased in size. The appearance of the lesion on CT is strongly suggestive of a fungal inflammatory process. Unchanged bilateral pleural effusions, right more than left. Unchanged moderate cardiomegaly. No other or newly occurred parenchymal opacities. No pulmonary edema. " 0b2b4caa-3fa0fe08-ca3d11d4-a2fd44d5-7956dd67.jpg,test/p11/p11098660/s53551215/0b2b4caa-3fa0fe08-ca3d11d4-a2fd44d5-7956dd67.jpg,test," FINAL REPORT HISTORY: Aortic valve replacement with shortness of breath likely secondary to CHF. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are well expanded and clear with mild vascular congestion without overt pulmonary edema. The heart remains moderately enlarged with sternotomy wires and aortic valvular prosthesis is noted. There is no pleural effusion or pneumothorax. IMPRESSION: Mild vascular congestion without overt pulmonary edema. " bfd260e1-53010c82-d74fec00-2ded7b69-35d9a301.jpg,test/p11/p11648387/s57315445/bfd260e1-53010c82-d74fec00-2ded7b69-35d9a301.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with history of cystic fibrosis, cough. Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest ___; chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. There is bibasilar atelectasis. Lungs are otherwise clear. Known bronchiectasis and previously identified inflammatory pulmonary nodules would be better evaluated with CT. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Multilevel degenerative changes of the visualized thoracolumbar spine. IMPRESSION: No acute cardiopulmonary abnormality. " e5cd773f-b22011f0-ecdc62e7-eb99e6a0-4e8fc079.jpg,test/p19/p19041117/s51651929/e5cd773f-b22011f0-ecdc62e7-eb99e6a0-4e8fc079.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___M with cough/thoracic back pain // r/o acute process r/o acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: None available. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " e77db350-504afdeb-5216cf17-e937b656-b01ea91c.jpg,test/p18/p18525476/s52808315/e77db350-504afdeb-5216cf17-e937b656-b01ea91c.jpg,test," FINAL REPORT HISTORY: Fever, evaluate for pneumonia. TECHNIQUE: Frontal and lateral radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. The heart size is normal. Mediastinal contours are normal. Lower cervical spinal fusion hardware is seen. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " fe1c8b70-4741bde8-d8eac8f0-00e5daea-0135a01f.jpg,test/p11/p11790339/s52689981/fe1c8b70-4741bde8-d8eac8f0-00e5daea-0135a01f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ICH, intermittent desaturations // interval change TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: The ET tube is in the right mainstem bronchus. At the time and dictated this report the severity been repositioned. IMPRESSION: Right mainstem bronchus intubation. " 69ffc11b-a24c8f28-96faab13-fb761198-f34f3942.jpg,test/p17/p17004967/s59143621/69ffc11b-a24c8f28-96faab13-fb761198-f34f3942.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with HCV, ___+ pack year smoking history who presents with RUQ pain over his liver/ribs // Eval for right rib pathology vs. intrapulmonary acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac silhouette size is top-normal. Mediastinal contours are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 119b3d88-c1b877b0-7f7cf67f-bd748cf6-059d895a.jpg,test/p11/p11581156/s58986438/119b3d88-c1b877b0-7f7cf67f-bd748cf6-059d895a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left sided pleural effusion // ?interval change IMPRESSION: As compared to the previous radiograph of 1 day earlier, right-sided chest tube and left pigtail pleural catheter remain in place. Loculated left basilar pneumothorax it is apparently slightly larger than on the prior study, and there is also suggestion of worsening left lower lobe collapse. However, patient rotation limits COMPARISON. Allowing for this factor, there is probably no substantial change in the appearance of a moderate to large loculated right pleural effusion or any presence of a tiny right apical pneumothorax. " 5f4221fa-5f528de5-78401294-c751a1b2-4496b23b.jpg,test/p10/p10398981/s55727793/5f4221fa-5f528de5-78401294-c751a1b2-4496b23b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with h/o cirrhosis and UGIB s/p intubation now with worsening hypoxia. // Eval for pneumonia (?aspiration) vs. pulmonary edema vs. other process IMPRESSION: SINCE THE RECENT STUDY OF EARLIER TODAY, SUPPORT AND MONITORING DEVICES REMAIN IN STANDARD POSITION AND CARDIOMEDIASTINAL CONTOURS ARE STABLE. IN ADDITION TO WORSENING BILATERAL RETROCARDIAC OPACIFICATION, NEW MULTIFOCAL REGIONS OF AIRSPACE OPACIFICATION ARE PRESENT BILATERALLY, WITH RIGHT LUNG INVOLVEMENT MORE THAN LEFT. ALTHOUGH ALTHOUGH A COMPONENT MAY REFLECT PULMONARY EDEMA IN THE SETTING OF BILATERAL SEPTAL LINES, SUPERIMPOSED SECONDARY PROCESS SUCH AS MULTIFOCAL ASPIRATION IS LIKELY. " c1c405c1-cfc25cac-07a1d1bd-63c9b82a-4582b8f6.jpg,test/p16/p16914073/s52464829/c1c405c1-cfc25cac-07a1d1bd-63c9b82a-4582b8f6.jpg,test," FINAL REPORT HISTORY: Hypotension, chest pain. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: Reference chest radiograph ___. FINDINGS: The patient is status post median sternotomy and CABG. The heart size is borderline enlarged. The aorta is unfolded. There is mild pulmonary edema. Lung volumes are low. Streaky bibasilar airspace opacities likely reflect atelectasis. Small bilateral pleural effusions are noted. There is no pneumothorax. No acute osseous abnormalities are detected. Clips are seen within the right upper quadrant of the abdomen. IMPRESSION: Mild pulmonary edema and small bilateral pleural effusions. Patchy bibasilar airspace opacities likely reflect atelectasis. " 696f0d6b-0efc935f-4854b02c-dec119f8-a4f54915.jpg,test/p18/p18577525/s51024263/696f0d6b-0efc935f-4854b02c-dec119f8-a4f54915.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of right lower lung mass, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is minimal improvement of the extensive parenchymal opacity on the right, notably the level of the right lower lobe. Otherwise, no relevant change is seen. A slight increase in lung density on the left is caused by positional factors. Endotracheal tube, left PICC line and nasogastric tube are in unchanged position. Unchanged appearance of the cardiac silhouette. " 9698de96-85228861-0ba1ce51-acd6734d-6baed63e.jpg,test/p15/p15952632/s50985845/9698de96-85228861-0ba1ce51-acd6734d-6baed63e.jpg,test," FINAL REPORT INDICATION: ___ year old woman with L sided chest pain, hx PE (on right) // any lesion to explain CP? any lesion to explain CP? IMPRESSION: In comparison with the study of ___, the patient has taken a slightly better inspiration. Again there is mild enlargement of the cardiac silhouette without vascular congestion, pleural effusion, or acute focal pneumonia. Clips in the region of the thoracic inlet most likely reflect previous cardiac surgery. " 5a7b9591-8f195625-f999d954-bfe1f3ac-1cd2e55c.jpg,test/p16/p16050648/s58912963/5a7b9591-8f195625-f999d954-bfe1f3ac-1cd2e55c.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam dated ___. CLINICAL HISTORY: Hypoxia, question pneumothorax. FINDINGS: AP portable upright chest radiograph was provided. Overlying EKG leads limit the evaluation. Also noted, low lung volumes limit evaluation. Bronchovascular crowding is noted without convincing sign of pneumonia or CHF. Mitral annular calcification again noted. The heart is within normal limits of size. Mediastinal contour is unremarkable. Bony structures are intact. IMPRESSION: Limited, negative for acute intrathoracic process. " 9fb74ca1-7b985548-bba2331d-a53ab634-a908e168.jpg,test/p16/p16581134/s54930442/9fb74ca1-7b985548-bba2331d-a53ab634-a908e168.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pancreatits/cholecystitis, re-intubated with RLL infiltrate, now improving s/p bronch // ? ET tube placement, interval improvement in RLL COMPARISON: Chest x-ray from ___ at 05:35 FINDINGS: Slight interval improvement in patchy opacity at medial right lung base otherwise, no significant interval change. Again seen is patchy retrocardiac opacity with lateralization of the left hemidiaphragm, compatible with left lower lobe collapse and/or consolidation and small left effusion. Hazy opacity at the right lung base laterally could reflect a small right effusion. There is upper zone redistribution and vascular plethora compatible with CHF. No new infiltrate identified. The ET tube tip lies 3.5 cm above the carina. NG tube tip extends beneath the diaphragm, off film. Again seen is a right IJ line, tip over distal SVC. No pneumothorax detected. IMPRESSION: Slight interval improvement in patchy opacity at medial right lung base otherwise, no significant interval change. " d684e995-70a03dac-e6a055a5-0e59fd8c-ef003a0d.jpg,test/p14/p14534470/s57231852/d684e995-70a03dac-e6a055a5-0e59fd8c-ef003a0d.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with chest pain, question pneumonia or pneumothorax. COMPARISON: CT ___ FINDINGS: The lungs are clear. No effusion, pneumothorax, or consolidation is present. Heart and mediastinal contours are normal. A 1-cm left apical lung nodule is stable compared with chest ___ ___. IMPRESSION: Stable left apical lung nodule. Otherwise, unremarkable. " 9f3881ce-9e9027ff-bcae1e4b-73ca24e0-e8d527b7.jpg,test/p16/p16154462/s53110809/9f3881ce-9e9027ff-bcae1e4b-73ca24e0-e8d527b7.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with PPD positive TB, to rule out TB COMPARISON: None. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: There is no evidence of active or latent TB. " 1581169b-3a321c7e-26e6a810-59f0de7d-07d87f4c.jpg,test/p18/p18651563/s50615462/1581169b-3a321c7e-26e6a810-59f0de7d-07d87f4c.jpg,test," WET READ: ___ ___ 7:11 PM Low lung volumes without definite evidence of pneumonia. There is mild interstitial edema. WET READ VERSION #1 ___ ___ 6:16 PM Low lung volumes without definite evidence of pneumonia or pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F w/nausea, vomiting, rigors, please eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. FINDINGS: Lung volumes are low with crowding of bronchovascular structures. There are increased pulmonary interstitial markings with fullness of the bilateral hila, likely reflecting some mild pulmonary edema. No focal consolidation is identified. Bibasilar atelectasis is again seen. There is no pneumothorax. Small bilateral pleural effusions are possible. Heart size remains enlarged. IMPRESSION: Cardiomegaly with hilar congestion and mild interstitial pulmonary edema. " f23f94a0-734ae81b-79002fdd-53a8eb87-f161433e.jpg,test/p12/p12800722/s52983306/f23f94a0-734ae81b-79002fdd-53a8eb87-f161433e.jpg,test," FINAL REPORT INDICATION: Left breast pain and bilateral lower extremity edema. COMPARISONS: Chest radiograph, ___. FINDINGS: In comparison to the prior radiograph, the lung volumes are low, causing accentuation of the pulmonary vasculature. Despite the low lung volumes, the increased interstitial prominence is consistent with mild pulmonary edema. There is no consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is at the upper limits of normal, and unchanged from prior exams. Prominent pretracheal soft tissue is also stable since ___ and may be due to prominent vasculature, or less likely, an enlarged thyroid. The trachea is midline. IMPRESSION: Mild pulmonary edema which is accentuated by low lung volumes. " 8cb61254-73c9034e-8d716f58-a2133686-d70be3a6.jpg,test/p19/p19193156/s51961900/8cb61254-73c9034e-8d716f58-a2133686-d70be3a6.jpg,test," FINAL REPORT INDICATION: REMOVAL OF CHEST TUBES TECHNIQUE: FRONTAL CHEST RADIOGRAPH. COMPARISON: ___ FINDINGS: There is a Swan-Ganz catheter appropriately positioned. The endotracheal tube and nasogastric tube have been removed. Bibasilar chest tubes have also been removed. No pneumothorax is appreciated. There is mild vascular congestion as well as small bilateral pleural effusions greater on the left. IMPRESSION: No pneumothorax appreciated following chest tube removal. " 82490663-17633f4a-8438de6a-ce13fcaa-e165aced.jpg,test/p11/p11505655/s55641045/82490663-17633f4a-8438de6a-ce13fcaa-e165aced.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. There is asymmetric left basilar opacity. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Left basilar opacity, potentially atelectasis, noting that infection is also possible in the appropriate clinical setting. " 43703c4f-635fb77a-16a22670-e4268129-96f114cb.jpg,test/p17/p17396841/s52069863/43703c4f-635fb77a-16a22670-e4268129-96f114cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with significant pulmonary edema // ? interval change ? interval change IMPRESSION: Comparisons ___. Increase in severity of the pulmonary edema, with increasing opacities at the right lung basis and increasing atelectasis on the left. Stable monitoring and support devices. Stable low lung volumes with mild cardiomegaly. " 22c64f37-dcace42a-0fb3f504-151524bc-d46d5ba5.jpg,test/p15/p15558137/s58682762/22c64f37-dcace42a-0fb3f504-151524bc-d46d5ba5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p AVR, CTs d/c'd // evaluate for pneumothorax evaluate for pneumothorax IMPRESSION: In comparison with the study of ___, there is no evidence of pneumothorax after chest tube removal. The pneumomediastinum or pneumopericardium has substantially decreased. The area of possible opacification in the left perihilar region is no longer seen. No vascular congestion or acute focal pneumonia. " ab86bade-c05bf733-4723c6e1-2bf15769-ce828d45.jpg,test/p15/p15852685/s52875391/ab86bade-c05bf733-4723c6e1-2bf15769-ce828d45.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are within normal limits. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 5bf87c6f-ccd9bee7-124212bb-019a6a42-99a04f1d.jpg,test/p10/p10326773/s58602032/5bf87c6f-ccd9bee7-124212bb-019a6a42-99a04f1d.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pneumonia // pneumonia TECHNIQUE: APsingle view COMPARISON: ___, ___ FINDINGS: Left-sided central venous catheter terminates at the cavoatrial junction. Endotracheal tube terminates 5.3 cm above the Carina. Enteric tube is visualized only in the upper mediastinum and not seen clearly, likely due to underpenetration. There is interval worsening of bilateral perihilar and lower lobe opacities with cardiomegaly compatible with worsening pulmonary edema. Likely bilateral small pleural effusions. No pneumothorax. Bony thorax is unchanged. IMPRESSION: Left-sided central venous catheter tip projects over the mid SVC, unchanged compared to the prior radiograph. Worsening pulmonary edema and/ or bibasilar atelectasis. Enteric tube is not clearly visualized on this radiograph and a repeat chest radiograph with better penetration may be obtained to evaluate for the same. RECOMMENDATION(S): Enteric tube is not clearly visualized on this radiograph, may be retracted and a repeat chest radiograph with better penetration may be obtained to evaluate for the same. NOTIFICATION: The findings were discussed by Dr. ___, MD with ___, NP on the telephone on ___ at 1:31 PM, few minutes after discovery of the findings. " cc241919-23450292-e1fcad9b-d6f6d202-eafdbb63.jpg,test/p13/p13501962/s59134560/cc241919-23450292-e1fcad9b-d6f6d202-eafdbb63.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with colonic distention, assess NG tube. Comparison is made with prior study performed two hours earlier. NG tube tip is in the stomach. There are no other interval changes. " d7a38818-c24ac63b-c8e6dede-5bbe8689-be6ac392.jpg,test/p12/p12331281/s59297517/d7a38818-c24ac63b-c8e6dede-5bbe8689-be6ac392.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fever // eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Aortic calcification is seen. IMPRESSION: No acute cardiopulmonary process. " ace94f54-8d84f84e-c466defb-9fb516a6-53286754.jpg,test/p18/p18510105/s57174190/ace94f54-8d84f84e-c466defb-9fb516a6-53286754.jpg,test," FINAL REPORT INDICATION: ___-year-old man status post subxiphoid pericardial window. Evaluation for pneumothorax. COMPARISON: Comparison is made to radiographs of the chest from ___ and ___. FINDINGS: Frontal radiograph of the chest demonstrates interval removal of a left pleural tube. There is no pneumothorax. There is continued left lower lobe atelectasis with associated volume loss. The right lung is grossly clear. There is no significant pulmonary edema. The cardiomediastinal silhouette is unchanged since the prior study. CONCLUSION: Interval removal of left pleural tube with no evidence of pneumothorax. Otherwise, unchanged since the prior study. " 8204f07c-b90bef82-42407fab-7adba1a0-4e6cece4.jpg,test/p17/p17337707/s56272672/8204f07c-b90bef82-42407fab-7adba1a0-4e6cece4.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Palpitations. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A dual-lead pacemaker/ICD device appears unchanged. The patient is status post sternotomy and aortic valve replacement. The lungs are hyperinflated. The cardiac, mediastinal and hilar contours appear unchanged. Basilar reticulation suggesting mild interstitial lung disease appears unchanged. Otherwise, lungs appear clear. There are no pleural effusions or pneumothorax. Mild degenerative changes are similar along the lower thoracic spine, including small-to-moderate anterior osteophytes. IMPRESSION: Findings suggesting pulmonary fibrosis at the lung bases. No evidence of acute superimposed disease. " b504df2d-df9309c9-e3b32f0a-e07ad124-5dc844fe.jpg,test/p10/p10429638/s59166088/b504df2d-df9309c9-e3b32f0a-e07ad124-5dc844fe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulm edema // interval change COMPARISON: ___, 19:34. IMPRESSION: As compared to the previous radiograph, there is on going slow decrease of the interstitial lung edema, with a known small to moderate right pleural effusion. No new focal parenchymal opacities. Unchanged appearance of the cardiac silhouette. " 6d8deb43-9aedde63-fe07e9e2-f8568a12-9fb95dac.jpg,test/p13/p13031769/s53621016/6d8deb43-9aedde63-fe07e9e2-f8568a12-9fb95dac.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough, shortness of breath and bilateral crackles. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Prominence of the main pulmonary artery is expected given patient age and within normal limits. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No definitive abnormality demonstrated within the limitations of this study technique. Questionable prominence of interstitial pattern in the lower lobes is present and if clinically warranted, correlation with chest CT might be considered. Alternatively, reassessment of the patient four weeks after antibiotic treatment might be considered if infectious etiology is suspected. " 7cb9af37-f9e94a5a-11edbc3d-0ef1e443-00a97a2d.jpg,test/p11/p11494804/s53379010/7cb9af37-f9e94a5a-11edbc3d-0ef1e443-00a97a2d.jpg,test," WET READ: ___ ___ ___ 5:41 AM Right PICC terminates at the ___. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Cholangiocarcinoma and fevers. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: PA and lateral images of the chest. The right PICC terminates in the superior cavoatrial junction. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: 1. Right PICC terminates in the superior cavoatrial junction. 2. No acute cardiopulmonary process. " 088b35f1-e3e927f4-faf3226d-cac73074-52c788af.jpg,test/p11/p11507904/s53524827/088b35f1-e3e927f4-faf3226d-cac73074-52c788af.jpg,test," FINAL REPORT INDICATION: ___-year-old female with question of pulmonary embolism. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate unchanged ___ rod posterior to the spine and left PICC in place. The cardiomediastinal silhouette is within normal limits. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. Trace atelectasis may be present in the left base. IMPRESSION: No evidence of acute cardiopulmonary process. " b66e0026-184076b2-00d9c665-bec12ba5-6cdc796b.jpg,test/p16/p16725503/s59190069/b66e0026-184076b2-00d9c665-bec12ba5-6cdc796b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with chest pain // ? infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 473fea50-68792275-cd67b086-080c482d-5015c1fb.jpg,test/p19/p19262736/s54246865/473fea50-68792275-cd67b086-080c482d-5015c1fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia and NSTEMI // NGT placement NGT placement IMPRESSION: Right PICC line tip is at the level of mid to lower SVC. Right internal jugular line tip is at the level of mid SVC. NG tube tip is in the stomach. There is substantial interval improvement in pulmonary edema. No substantial pleural effusion or pneumothorax is seen. Liver calcifications are projecting over the right upper abdomen. " a86db3b4-b0d9e006-d3aa8dbc-25d99174-d1cadbb7.jpg,test/p18/p18001762/s54689402/a86db3b4-b0d9e006-d3aa8dbc-25d99174-d1cadbb7.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumothorax. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiac silhouette and lungs which are clear without focal consolidation, pleural effusion, or pneumothorax. A widened mediastinum is likely due to mediastinal lipomatosis and appear similar to prior studies. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. No pneumothorax identified. " a71bb5c0-dce20b0a-23d4a7e5-c3f87219-2dbada59.jpg,test/p12/p12081080/s51428380/a71bb5c0-dce20b0a-23d4a7e5-c3f87219-2dbada59.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with confusion, hepatorenal syndrome // evaluate for pneumonia COMPARISON: ___. ___ CT. FINDINGS: PA and lateral views of the chest provided. There is mild prominence of the bronchovascular markings which is unchanged over multiple prior radiographs. There is no focal consolidation, large effusion or pneumothorax. No signs of congestion or edema. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " f29f1105-e7888fda-7d6d3054-61454bb8-d05cdc4f.jpg,test/p19/p19517789/s59789499/f29f1105-e7888fda-7d6d3054-61454bb8-d05cdc4f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new ETT with multiple stab wounds to neck, w/ ? arterial bleeding at scene likely suicide attempt, now s/p L neck exploration w/ L EJ ligation R thumb lac repair // eval ngt position TECHNIQUE: Portable AP radiographs of the chest from ___ at ___ and 20:58. COMPARISON: ___. FINDINGS: The patient is status post intubation with ET tube terminating at the level of the clavicles. However, a newly placed nasogastric tube is malpositioned, coiling in the lower esophagus. There are new left cervical skin and a stable small amount of right supraclavicular soft tissue subcutaneous emphysema. There is no pneumothorax. The lungs are clear. The heart and mediastinum are within normal limits. The followup radiograph of 20:58 shows removal of the nasogastric tube. The ET tube is unchanged in position. There is no other significant interval change. IMPRESSION: Initially malpositioned nasogastric tube coiled in the lower esophagus was removed on the subsequent radiograph of 20:58 hrs. ET tube in satisfactory position. Clear lungs. Small right supraclavicular subcutaneous emphysema. " c6a5f51f-d76a9201-eed715df-c5839483-2f0c77e4.jpg,test/p19/p19758701/s51080132/c6a5f51f-d76a9201-eed715df-c5839483-2f0c77e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever, cough, mild sob // r/o pna r/o pna IMPRESSION: In comparison with the study of ___, there is again some hyperexpansion of the lungs suggesting chronic pulmonary disease. However, no acute pneumonia, vascular congestion, or pleural effusion. " 3ecde911-179f216a-622f7643-e2e2b0d4-d7f6d3c7.jpg,test/p17/p17071231/s56006927/3ecde911-179f216a-622f7643-e2e2b0d4-d7f6d3c7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mechanical fall who fell forward on the front of her chest and thorax; bruise over clavicle at midline of the body // evaluate for any fracture evaluate for any fracture TECHNIQUE: ___ a one need is either Send IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lateral view shows two angulated fractures in the mid body of the sternum, with no substantial associated hematoma, and no pleural effusion or pneumothorax. 4 contiguous anterolateral fractures of right middle ribs may also be new. Lungs are clear. Left chest cage is intact. Cardiomediastinal silhouette shows no evidence of acute trauma. Mild cardiomegaly including left atrial dilatation, and a small hiatus hernia are chronic. There is no pulmonary vascular congestion or edema. NOTIFICATION: I paged the referring physician, starting at 08:15 on ___. There was no response. I have notified him by email, read receipt requested. " 5aaa0389-3a19fba6-3ee6384b-2027e42d-070402f1.jpg,test/p11/p11863164/s59920030/5aaa0389-3a19fba6-3ee6384b-2027e42d-070402f1.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old woman with hand swelling. Evaluate for upper lobe lesion. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The heart size, mediastinal, and hilar contours are normal. The lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No acute cardiopulmonary process or specific evidence of an upper lobe lung lesion. " 539395bb-39d5afc4-4371bfdc-0e4e6835-e25ce2ef.jpg,test/p13/p13480812/s59636599/539395bb-39d5afc4-4371bfdc-0e4e6835-e25ce2ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with Sepsis, RUQ abdominal pain // r/o PNA COMPARISON: Sever previous chest x-rays from ___ through ___. Targeted review of chest ct from ___. FINDINGS: There is a large, somewhat rounded, area of focal opacity in the lateral portion of the right upper lobe, abutting the minor fissure, with equivocal associated air bronchograms. Possible minimal atelectasis at the right base. Otherwise, no focal infiltrates or consolidations are identified. No CHF or effusion. No pneumothorax detected. There is mild cardiomegaly. Within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy is detected. The current radiograph suggests mild right convex curvature of the thoracic spine centered at T4/5 --___ thoracic spine curvature was probably subtly present on ___. IMPRESSION: 1. Focal opacity in the right upper lobe, abutting the minor fissure, new compared with the chest x-ray dated ___. The appearance is most suggestive of a pneumonic consolidation. If clinically indicated, a lateral view could help to more completely delineate the size and area of involvement. Followup imaging to confirm complete resolution and to exclude underlying abnormality would be strongly recommended. 2. Mild cardiomegaly. The cardiac silhouette is slightly more pronounced than on the ___ chest x-ray. " 6c22576f-b31d907b-4290b290-9fbb1f76-7e9ef61c.jpg,test/p15/p15470171/s58506691/6c22576f-b31d907b-4290b290-9fbb1f76-7e9ef61c.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from earlier today. CLINICAL HISTORY: NG tube, assess positioning. FINDINGS: AP supine portable view of the chest provided. There has been interval placement of an NG tube with its tip well positioned in the left upper abdomen. Otherwise, no change. " 3235220f-36a8c379-06fe9e8b-ef701227-560531cf.jpg,test/p13/p13206251/s52898114/3235220f-36a8c379-06fe9e8b-ef701227-560531cf.jpg,test," FINAL REPORT HISTORY: Fever, dyspnea. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. There is posterior fusion hardware in the mid to lower thoracic spine at the getting history level with mild anterior wedging of the thoracic vertebral body in the middle of this. IMPRESSION: No acute cardiopulmonary process. Mild anterior wedging of a lower thoracic vertebral body of indeterminate age, however, the history is fever, dyspnea. Correlated clinically for acuity. " 6f3b8ee4-dd287f68-dcf978ae-fe66d40a-a7b36a77.jpg,test/p10/p10326925/s59231023/6f3b8ee4-dd287f68-dcf978ae-fe66d40a-a7b36a77.jpg,test," FINAL REPORT CLINICAL INDICATION: Playing hockey, slid into the boards, now with right hip pain and lower rib pain. COMPARISON: None. FINDINGS: PA and lateral veiws of the chest. The cardiomediastinal contour is within normal limits. No focal consolidation, pleural effusion, or pneumothorax identified. No rib fracture is identified on these lung-technique films. IMPRESSION: Chest xray examination within normal limits. Please note that chest radiographs are not sensitive for detection of subtle chest wall trauma. If there are focal areas of pain, dedicated views of those areas are recommended. " 6c987334-face1732-1e528166-6394a8a3-29d22728.jpg,test/p13/p13337217/s54240090/6c987334-face1732-1e528166-6394a8a3-29d22728.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with polysubstance overdose, found with foam in his mouth // aspiration pna? aspiration pna? IMPRESSION: No comparison. Moderate platelike atelectasis at the left lung basis. No other parenchymal abnormalities. Borderline size of the cardiac silhouette. No pleural effusions. Healed right clavicular fracture. " e8dc2354-dc6509ed-191cf2aa-f8a69e29-eab9ad90.jpg,test/p19/p19531222/s50337696/e8dc2354-dc6509ed-191cf2aa-f8a69e29-eab9ad90.jpg,test," FINAL REPORT INDICATION: History of fever status post chemotherapy. Please evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. IMPRESSION: No focal consolidations concerning for pneumonia identified. " 6f58b90c-095967a1-12f62c81-70614815-9208a903.jpg,test/p19/p19358609/s59926281/6f58b90c-095967a1-12f62c81-70614815-9208a903.jpg,test," WET READ: ___ ___ ___ 10:06 PM No significant change from ___. no definite pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Lung cancer with worsening cough. FINDINGS: In comparison with the study of ___, there is little overall change in the post-surgical appearance of the left upper chest. Chronic changes are seen bilaterally, but no evidence of acute focal pneumonia. " 785234cc-77f372d2-c0f58d12-ebeea0ca-08b6fa94.jpg,test/p14/p14684855/s59267820/785234cc-77f372d2-c0f58d12-ebeea0ca-08b6fa94.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with altered mental status, status post TIPS TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Heart size is mildly enlarged. The aorta remains tortuous. Mediastinal and hilar contours are otherwise unremarkable. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is visualized. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary abnormality. " 5e44a118-0dd40c5c-171567d4-9880f0a8-403e3bcb.jpg,test/p12/p12219154/s56028372/5e44a118-0dd40c5c-171567d4-9880f0a8-403e3bcb.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Mild cough and fever. Cardiomediastinal contours are normal. Ill-defined opacity projecting posteriorly in one of the lower lobes seen in the lateral ribs could represent a focus of infection. Given the clinical symptoms, I cannot exclude that this is also partially due to superimposition of structures and followup is recommended. Otherwise the lungs are clear. There is no pneumothorax or pleural effusion. " e9a7b16f-a2cbb1f8-5ba2fc13-a83319b0-6268fdff.jpg,test/p14/p14280310/s56920231/e9a7b16f-a2cbb1f8-5ba2fc13-a83319b0-6268fdff.jpg,test," FINAL REPORT INDICATION: Chest pain and dyspnea. Evaluate for infiltrate or cardiomegaly. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lung volumes are slightly diminished. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart size is normal. The mediastinum and hilar structures are unremarkable. The aorta is mildly tortuous but unchanged. Cholecystectomy clips are incidentally noted. IMPRESSION: No acute cardiopulmonary process. " 9f26edbc-bc13584b-159c10f9-7a44dae0-f92d8eae.jpg,test/p10/p10699336/s51278281/9f26edbc-bc13584b-159c10f9-7a44dae0-f92d8eae.jpg,test," WET READ: ___ ___ ___ 6:29 PM Unchanged right lower lobe and retrocardiac opacities. Increased opacities along the left heart border, which could reflect progression of infection. Discussed via telephone by Dr. ___ with Dr. ___ at ___ on ___, upon initial review. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man w/ polytrauma s/p trach with likely pulmonary nocardia and new fever // worsening infection? TECHNIQUE: CHEST (PORTABLE AP) IMPRESSION: Unchanged right lower lobe and retrocardiac opacities. Increased opacities along the left heart border, which could reflect progression of infection. Discussed via telephone by Dr. ___ with Dr. ___ at ___ on ___, upon initial review " 60a9c93f-c190b3ef-d8ebd627-007686a9-a9e97d42.jpg,test/p13/p13673190/s56213070/60a9c93f-c190b3ef-d8ebd627-007686a9-a9e97d42.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with abdominal pain s/p colonoscopy yesterday // please evaluate for subdiaphragmatic free air TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. There are low lung volumes. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No evidence of pneumoperitoneum. IMPRESSION: Normal chest radiograph. No evidence of pneumoperitoneum. " 9ab84bc1-bd22ebbe-57d338e8-40767c77-a83571e9.jpg,test/p14/p14987339/s55523340/9ab84bc1-bd22ebbe-57d338e8-40767c77-a83571e9.jpg,test," FINAL REPORT INDICATION: Cough. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " 4556d0c5-095f3ddb-a75531b4-43ab0a5f-066f4758.jpg,test/p17/p17535980/s54057014/4556d0c5-095f3ddb-a75531b4-43ab0a5f-066f4758.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fever and cough. COMPARISON: Chest x-ray from ___ and ___. CT of the cervical spine from ___. FINDINGS: AP and lateral views of the chest. Low lung volumes are again noted. The lungs are clear of focal consolidation. Cardiomediastinal silhouette is within normal limits. Deviation of the trachea to the right at the thoracic inlet is compatible with left-sided thyroid nodule. No displaced fracture is identified. Degenerative changes seen at the shoulders and hypertrophic changes are seen in the spine. IMPRESSION: No acute cardiopulmonary process. " 0b4c8c20-27ce7ca9-8a82829d-8274714c-0ff89908.jpg,test/p10/p10373824/s54855167/0b4c8c20-27ce7ca9-8a82829d-8274714c-0ff89908.jpg,test," FINAL REPORT HISTORY: To evaluate for stability of right apical density. FINDINGS: In comparison with the study of ___, there appears to be little change in the biapical opacifications, more prominent on the right, most likely consistent with old scarring. Hyperexpansion of the lungs persists, consistent with chronic pulmonary disease, though there is no evidence of acute pneumonia. No evidence of pulmonary edema or pleural effusion. Old healed rib fractures are again seen at the left base. IMPRESSION: Little change. " b69b2ffd-2bbc7fbb-7d658c3e-6811c05f-8beaf434.jpg,test/p19/p19127072/s57668835/b69b2ffd-2bbc7fbb-7d658c3e-6811c05f-8beaf434.jpg,test," FINAL REPORT HISTORY: Left lower lobe pneumonia with tracheostomy. FINDINGS: In comparison with the study of ___, there is now a tracheostomy tube in place that appears to be well situated without evidence of associated complication. The opacification in the retrocardiac region and left lower lung is decreasing, consistent with improved atelectasis and/or pneumonia. The right lung is essentially clear and there is no pulmonary vascular congestion. " 9e25990d-4a86a0eb-0959570d-407d2e0b-eb5ffb2e.jpg,test/p19/p19736108/s52531846/9e25990d-4a86a0eb-0959570d-407d2e0b-eb5ffb2e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough, productive, assess pneumonia. FINDINGS: PA and lateral views of the chest were obtained. There is no focal consolidation, effusion, pneumothorax. Cardiomediastinal silhouette normal. Bony structures intact. No free air below the right hemidiaphragm. IMPRESSION: No signs of pneumonia. " 5218c013-49acaadc-8a396213-8de848ea-f26770f0.jpg,test/p10/p10892549/s54449485/5218c013-49acaadc-8a396213-8de848ea-f26770f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with left lower lobe pneumonia diagnosed at an outside hospital ___, with persistent dullness at left base // assess for persistent consolidation, effusion at left lower lobe assess for persistent consolidation, effusion at left lower TECHNIQUE: PA and lateral views COMPARISON: ___. FINDINGS: There is a loculated pleural effusion at the lateral left lung. There is a hay opacity that overlies the lower and mid left lung. Otherwise, the lungs are clear, the cardiomediastinum is without abnormality and there is no pneumothorax. IMPRESSION: There is a loculated pleural effusion at the left lateral lung. A left lateral decubitus film could elucidate whether there is a free component as well. NOTIFICATION: The above impression was entered into the critical results dashboard at 5:10pm on the day of the exam. " 3c27113a-f211b556-cc6b4da7-f4640c4a-55eab5c8.jpg,test/p18/p18628529/s51855877/3c27113a-f211b556-cc6b4da7-f4640c4a-55eab5c8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with sickle cell disease and fever // evaluate for consolidation evaluate for consolidation COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lungs are clear. Heart is normal size. Normal mediastinal and hilar contours and pleural surfaces. Left subclavian infusion port ends in the low SVC. " 5544fd9c-fe69a9f7-234e7767-1b63798a-5bc5d98c.jpg,test/p18/p18049473/s56487806/5544fd9c-fe69a9f7-234e7767-1b63798a-5bc5d98c.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with cough and fever. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs again demonstrate bilateral perihilar and left lower lobe opacities, similar in distribution compared to ___ but increased compared to the most recent chest radiograph on ___. Mild blunting of the left costophrenic angle with obscuration of the left hemidiaphragm is suggestive of a trace pleural effusion. IMPRESSION: 1. Bilateral perihilar and left lower lobe opacities, similar in distribution compared to ___ but increased compared to the most recent chest radiograph from ___. In this setting of the patient's history of HIV, there is a wide differential which includes infection such as PJP, progressive interstitial disease, and pulmonary edema. If warranted clinically, CT can be obtained for further evaluation. 2. Likely small left pleural effusion. NOTIFICATION: Updated findings and recommendations were communicated via telephone by Dr. ___ to Dr. ___ at 08:20 on ___, upon attending review. " 5992b97e-62a27a0c-b39a1712-8a18d633-6e81f393.jpg,test/p17/p17006872/s52641616/5992b97e-62a27a0c-b39a1712-8a18d633-6e81f393.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Recurrent severe pleuritic pain. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are clear. The patient is after surgery in the right upper lung, related to prior episodes of pneumothorax. Current examination demonstrates no appreciable pneumothorax on the right. Note is made that the study was done at end-inspiration. If patient's symptoms persist, recurrent view at end-expiration is recommended. There is no pleural effusion or pneumothorax. " f9a6c69f-622d9de1-9cee2f8e-3509bda8-a11f52a1.jpg,test/p16/p16903085/s57254949/f9a6c69f-622d9de1-9cee2f8e-3509bda8-a11f52a1.jpg,test," FINAL REPORT HISTORY: Shortness of breath. Left-sided chest pressure. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Right sided Port-A-Cath tip terminates in the lower SVC. The heart size is normal. Mediastinal and hilar contours are normal. Lungs are clear. No pleural effusion, pneumothorax or pulmonary edema is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 15708ab0-a9b9ded6-fa0d6b06-96ccff4b-cf8c12ea.jpg,test/p18/p18460817/s51192955/15708ab0-a9b9ded6-fa0d6b06-96ccff4b-cf8c12ea.jpg,test," WET READ: ___ ___ ___:___ AM Overall, there is been interval increase in diffuse patchy opacities involving the lung fields bilaterally, right greater than left, compared to the prior exam from ___. Although this is likely secondary to an infectious process, given their chronicity compared to the prior exam, a CT is recommended for further evaluation. ___ were d/w Dr. ___ by Dr. ___ ___ by phone at ___:___A on ___. WET READ VERSION #1 ___ ___ ___:___ AM Overall, there is been interval increase in diffuse patchy opacities involving the lung fields bilaterally, right greater than left. This could be secondary to an infectious process, however given their chronicity compared to the prior exam, a CT is recommended for further evaluation. ___ were d/w Dr. ___ by Dr. ___ by phone at ___:___A on ___. WET READ VERSION #2 ___ ___ ___:___ AM Overall, there is been interval increase in diffuse patchy opacities involving the lung fields bilaterally, right greater than left, compared to the prior exam from ___. Although this is likely secondary to an infectious process, given their chronicity compared to the prior exam, a CT is recommended for further evaluation. ___ were d/w Dr. ___ by Dr. ___ ___ by phone at ___:___A on ___. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with afib, here with fevers to ___ // eval for PNA vs. CHF exacerbation COMPARISON: Chest CT ___ and chest radiograph ___ third FINDINGS: Permanent pacemaker remains in place, with leads in the right atrium and right ventricle. Cardiac silhouette is mildly enlarged and accompanied by pulmonary vascular congestion. Combined alveolar and interstitial pattern involving the right lung to a much greater degree than the left is present. Additionally comment a more confluent opacity is present in the right juxta hilar region There is no definite pleural effusion or pneumothorax. IMPRESSION: Asymmetrically distributed diffuse alveolar and interstitial opacities could potentially be due to pneumonia coexisting with pulmonary edema. Short-term followup radiographs after diuresis may be helpful in this regard. " 898cc867-a2fb0321-fd909d3b-32348962-1f21032c.jpg,test/p18/p18456328/s57407162/898cc867-a2fb0321-fd909d3b-32348962-1f21032c.jpg,test," FINAL REPORT EXAM: Chest, single supine AP portable views. CLINICAL INFORMATION: Abdominal distention. Question of a left-sided PICC. COMPARISON: ___. FINDINGS: Patent left-sided PICC is seen terminating projecting over the soft tissue of the medial mid-to-proximal forearm, in inappropriate position. Recommend removal and replacement. Patient is status post median sternotomy and CABG. The cardiac silhouette is enlarged. There is prominence and indistinctness of the hila and prominence of the vessels suggesting pulmonary edema. Patchy left base retrocardiac opacity may be due to atelectasis, but consolidation due to aspiration or infection is not excluded. No pneumothorax seen. No definite pleural effusion is seen. IMPRESSION: Left PICC terminates in the mid-to-proximal forearm, not in appropriate position. Pulmonary edema/congestion. Cardiomegaly. Patchy left base retrocardiac opacity may be due to atelectasis, but consolidation due to aspiration or infection is not excluded. Findings regarding left-sided PICC in inappropriate position discussed with Dr. ___ at 3:28 p.m. on ___ via telephone. " c47ad088-e4cc5cf8-36620cb6-456d969a-6b84d788.jpg,test/p13/p13158753/s54955377/c47ad088-e4cc5cf8-36620cb6-456d969a-6b84d788.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Persistent cough. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " b7d62368-530a2254-0d50766f-fc7cc010-6fa4cee4.jpg,test/p19/p19904800/s50283821/b7d62368-530a2254-0d50766f-fc7cc010-6fa4cee4.jpg,test," FINAL REPORT INDICATION: History of diffuse B-cell lymphoma on chemotherapy, now with fever. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: The lungs are well inflated and clear. There is persistent prominence of the right paratracheal station, compatible with known lymphadenopathy. The cardiac silhouette is normal. There is no pleural effusion or pneumothorax. A right chest Port-A-Cath is noted terminating at the mid SVC. Bilateral breast implants are identified. IMPRESSION: Persistent fullness at the right paratracheal station compatible with known lymphoma. No focal consolidation. " 2599faca-03150b81-3235b9c4-5f34ccf8-ce05c74c.jpg,test/p13/p13417577/s51510616/2599faca-03150b81-3235b9c4-5f34ccf8-ce05c74c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, lung cancer, pleural effusion, left apical pneumothorax, with persistent oxygen requirement and leukocytosis // evaluate infiltrate vs fluid COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a minimal decrease in extent of the pre-existing pleural effusions. The right basal opacities minimally improved. The left apical cavitary opacity with an air-fluid level is constant in size and extent. No evidence of pneumothorax. Unchanged appearance of the cardiac silhouette. " 0cd0e2b0-4fe331c4-1facb833-ce5b7872-474434b5.jpg,test/p17/p17261183/s55393623/0cd0e2b0-4fe331c4-1facb833-ce5b7872-474434b5.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are normal. Lungs are clear except for minimal linear atelectasis at the left lung base with questionable adjacent small left pleural effusion. " dd0b46a3-7769f096-81985d74-80255506-94460241.jpg,test/p19/p19130309/s54309326/dd0b46a3-7769f096-81985d74-80255506-94460241.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p dual chamber ICD // lead placement TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs ___, ___, ___ FINDINGS: Little interval change since ___. The left pacemaker seen with transvenous leads in the right atrium and right ventricle. Moderate cardiomegaly is stable. Bibasilar atelectasis is mildly improved, particularly in the retrocardiac region. The lungs are essentially clear. Median sternotomy wires are intact and aligned. No complications related to the procedure, including pneumothorax, mediastinal bleed, or pleural bleed. IMPRESSION: Left pacemaker seen with transvenous leads in the RA and RV. No post-procedural complications. " a3a4b012-e6af71b0-12c96a54-e44440a5-9547b408.jpg,test/p19/p19262736/s55903084/a3a4b012-e6af71b0-12c96a54-e44440a5-9547b408.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with persistent hypoxia ___ pulmonary edema, mucus plugging // Please evaluate for interval change Please evaluate for interval change IMPRESSION: Right PICC line tip is at the level of mid SVC. Right lower lung atelectasis is unchanged. Pulmonary edema is moderate to severe combination of interstitial and alveolar pattern is are present, overall similar to previous study. No definitive pneumothorax. " a1942fc5-451d22fe-bfd77c8a-1fba1b6e-369d39c6.jpg,test/p11/p11129757/s51475430/a1942fc5-451d22fe-bfd77c8a-1fba1b6e-369d39c6.jpg,test," FINAL REPORT INDICATION: Fever, postoperative, evaluation for pathology. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are low. The size of the cardiac silhouette is unremarkable. No pleural effusions, no pneumothorax, no pulmonary edema, no pneumonia. Minimal atelectasis at both lung bases. " c24b42ff-e6abe0c0-c7363dc3-068e95f7-4ab0c021.jpg,test/p15/p15115062/s58594641/c24b42ff-e6abe0c0-c7363dc3-068e95f7-4ab0c021.jpg,test," FINAL REPORT INDICATION: ___-year-old male with altered mental status. Question pneumonia. COMPARISON: Radiograph of ___. CT of same day. FINDINGS: Frontal and lateral views of the chest demonstrate top normal cardiac size. The mediastinal and hilar contours are within normal limits. There is mildly increased interstitial markings raising question of mild edema, which is excluded on subsequent CT. Subtle aspiration cannot be excluded. There is no confluent consolidation to suggest definite pneumonia. No pneumothorax or pleural effusion. IMPRESSION: No definite acute cardiopulmonary process. " 173eca55-11d063e7-126edf59-3111466a-e1274908.jpg,test/p14/p14630468/s56569170/173eca55-11d063e7-126edf59-3111466a-e1274908.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with dyspnea, increased mucus production - eval for PNA COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. A tracheostomy tube is in place with with an overlying oxygen mask. The lung volumes are quite low. Bibasilar opacities are seen most suggestive of atelectasis versus scarring at the right lung base and atelectasis and probable small effusion on the left. The possibility of a superimposed pneumonia is difficult to exclude. The mid to upper lungs appear well aerated. Heart size appears grossly stable. The mediastinal contour is unchanged. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Bibasilar atelectasis with probable small left effusion. Tracheostomy tube noted. " b93794cf-8cf25eff-2b2db64d-8a3b20fa-8dbd140e.jpg,test/p19/p19476698/s58733828/b93794cf-8cf25eff-2b2db64d-8a3b20fa-8dbd140e.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Flank pain. TECHNIQUE: PA and lateral chest radiographs were obtained. REPORT: Cardiomediastinal silhouette is unremarkable. The lungs are clear. The visualized osseous structures are normal. No acute cardiopulmonary finding is evident. Please also refer to the same day CT. Despite the findings on CT, no definitive chest findings are noted on plain radiographs. CONCLUSION.Normal CXR.See CT report also " c81b70dd-6e74dfbc-dad34592-ddacfe2d-3c3a5d4c.jpg,test/p10/p10013502/s54857277/c81b70dd-6e74dfbc-dad34592-ddacfe2d-3c3a5d4c.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Leukocytosis. PA and lateral upright chest radiographs were reviewed in comparison to ___. The left PICC line tip is at the level of mid SVC. Heart size and mediastinum are stable. Bibasal atelectasis, right more than left is unchanged with no new consolidations demonstrated. No appreciable pleural effusion is seen. Lung volumes remain low. " 97fdb9b5-ad9a3065-6b1b7f65-13e4e54f-f1e2da60.jpg,test/p13/p13345709/s53086688/97fdb9b5-ad9a3065-6b1b7f65-13e4e54f-f1e2da60.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with STEMI // eval for cardiomegalyh COMPARISON: None FINDINGS: AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process " c369ae4d-c2842b17-d8dc2960-951698af-3b7b50cc.jpg,test/p16/p16205555/s55663131/c369ae4d-c2842b17-d8dc2960-951698af-3b7b50cc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p hip repair with hypotension, new O2sat // pls eval for PNA, edema pls eval for PNA, edema COMPARISON: Comparison to ___ at 11:00 FINDINGS: Portable AP upright chest film ___ at 07:33 is submitted. IMPRESSION: The dual lead left-sided pacer remains in place. Overall cardiac and mediastinal contours are stable. Interval reduction in lung volumes but no focal airspace consolidation is seen to suggest pneumonia. No evidence of pulmonary edema or pleural effusions. No pneumothorax. Incidental note is made of a coronary stent. " d4985654-3083ad86-39be1227-3c02c841-58601bd0.jpg,test/p10/p10364180/s52621679/d4985654-3083ad86-39be1227-3c02c841-58601bd0.jpg,test," FINAL REPORT HISTORY: Recent diagnosis of pneumonia with worsening shortness of breath and cough. Evaluate for pulmonary edema or interval change. COMPARISON: ___ FINDINGS: Frontal and lateral radiographs of the chest demonstrate top normal heart size. The cardiomediastinal silhouette and hilar contours are normal. Calcification of the aortic knob is unchanged. There is persistent patchy opacities in the right lower lobe and periphery of the left lung. There is new prominence of the interstitial markings consistent with mild pulmonary edema. There are new small bilateral pleural effusions greater on the right than the left. No pneumothorax. No displaced rib fracture identified. IMPRESSION: Persistent opacities in the right lower lobe and left upper lobe with mild pulmonary edema and new bilateral small pleural effusions. " d97f7c32-df584a48-2528a197-8b9d7f2d-89977644.jpg,test/p17/p17725745/s51940374/d97f7c32-df584a48-2528a197-8b9d7f2d-89977644.jpg,test," FINAL REPORT INDICATION: Hemoptysis, evaluate for pneumonia or mass. COMPARISON: Chest radiographs from ___. FINDINGS: PA and lateral views of the chest. Sternotomy wires and mediastinal clips are seen. Aortic knob calcifications are stable. There is mild left lower lobe atelectasis and minimal scarring adjacent to the left hilum. No evidence of pneumonia or mass. No pleural effusions or pneumothorax. Mild cardiomegaly is unchanged. Mediastinal and hilar contours are normal. IMPRESSION: No evidence of pneumonia or mass or any other findings to explain patient's hemoptysis. These findings were discussed with Dr. ___ at 2:30 p.m. on ___ by telephone. " bd90bd74-6526503d-f8c1af2a-3534a418-ca817d6a.jpg,test/p11/p11387449/s52124482/bd90bd74-6526503d-f8c1af2a-3534a418-ca817d6a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a prior chest radiograph from ___. CLINICAL HISTORY: Metastatic melanoma, tachycardia, and tachypnea, question pneumonia or fluid overload. FINDINGS: Two frontal chest radiographs were obtained with patient positioned upright. In comparison to two days ago, there is slight improvement in lower lung aeration. There is elevation of the right hemidiaphragm. No definite signs of pneumonia or CHF. There may be a tiny residual right pleural effusion. Cardiomediastinal silhouette is stable. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: Possible tiny right pleural effusion. Low lung volumes. No definite signs of pneumonia or CHF. " 32e45035-bbc6d4a6-49dd4de4-dbe564d2-69d4c784.jpg,test/p15/p15398472/s51196861/32e45035-bbc6d4a6-49dd4de4-dbe564d2-69d4c784.jpg,test," FINAL REPORT INDICATION: Chest and right upper quadrant pain. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 45844985-455bce44-f417c858-ac43f56f-07a7e63a.jpg,test/p10/p10900387/s51815179/45844985-455bce44-f417c858-ac43f56f-07a7e63a.jpg,test," FINAL REPORT HISTORY: History of ESRD on HD, HIV, IVDU, recent pneumonia. Now with suspected fevers and a noisy lung exam bilaterally. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: There is an asymmetry with increased opacity noted within the right lower lobe that does not silhouette out the right heart border or the right hemidiaphragm. This finding may be due to overlying breast tissue, but considering the clinical symptoms, it may represent an early pneumonia. No additional focal consolidations are noted. There is no pleural effusion, pneumothorax, or pulmonary edema is identified. Stable, mild to moderate cardiomegaly is seen. Mediastinal contours are normal. IMPRESSION: Asymmetrical opacification of the right lower lobe, which may represent an early, developing pneumonia in the proper clinical setting. Findings were conveyed by Dr. ___ to Dr. ___ ___ telephone at 16:36 on ___, ___ min after discovery. " 1ae6c07e-290bc675-2a4f2a10-95944c85-9c93642b.jpg,test/p18/p18995100/s57897996/1ae6c07e-290bc675-2a4f2a10-95944c85-9c93642b.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with bypass surgery, follow up atelectasis versus fluid overload. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with three postoperative portable chest examinations of ___, ___, and ___ as well as the preoperative chest examination of ___. On next previous portable examination identified mild and moderate-to-severe atelectasis on the lung bases have improved; however, the lateral view identifies a persistent left lower lobe infiltrate - atelectasis in the posterior segment. Pleural effusion is minimal, as the posterior pleural sinus is only mildly blunted. No other new infiltrates are seen. All previously identified postoperative chest tubes have been removed. When comparison is made with the preoperative PA and lateral chest examination, there is moderate postoperative enlargement of the heart contours consistent with the recent cardiac bypass surgery. The pulmonary vascular pattern has not changed significantly, so that the question for fluid overload can be negated. Basal atelectasis - infiltrates, more marked on the left base, are in regression and should not be related to fluid overload. No pneumothorax is identified on either side. " 5fa11420-4a9f6ba2-19a6fa39-404bee82-99489d2f.jpg,test/p15/p15620990/s57851938/5fa11420-4a9f6ba2-19a6fa39-404bee82-99489d2f.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Strep viridans endocarditis. Low-grade fever. Suspect pneumonia. IMPRESSION: PA and lateral chest compared to ___ through ___: A handful of small, round, and elongated opacities at the periphery of the right lung, presumed septic emboli, are grossly unchanged since ___, but similar lesions on the left are larger and more numerous than they were on ___, raising concern for continued septic embolization. Heart size is normal. Pulmonary vasculature is minimally engorged, and there is no edema or pleural effusion. Care should be taken to follow up this examination with routine (PA and lateral) chest radiographs rather than bedside frontal views alone, in hopes of being accurate about the profusion of new presumed septic emboli. If that will not be possible, I would recommend low-dose non-contrast CT scanning of the chest for surveillance. Right PIC line ends in the mid SVC. " 9aa2d2ef-75757f20-1b280572-ecf550bd-20a6e9a6.jpg,test/p10/p10980069/s59529095/9aa2d2ef-75757f20-1b280572-ecf550bd-20a6e9a6.jpg,test," WET READ: ___ ___ 4:51 AM No acute cardiopulmonary process. Mild cardiomegaly. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with hx CAD s/p stents x 5 p/w 8h history of chest pain // R/O CHF TECHNIQUE: PA and lateral images of the chest. COMPARISON: ___ is made with chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. There is mild cardiomegaly. IMPRESSION: No acute cardiopulmonary process. Mild cardiomegaly. " 4271a75e-3c09f965-e44daa80-3365aa08-c654e702.jpg,test/p10/p10979480/s58599027/4271a75e-3c09f965-e44daa80-3365aa08-c654e702.jpg,test," FINAL REPORT HISTORY: Fevers COMPARISON: ___ through ___ FINDINGS: Single portable chest radiograph. Low lung volumes accentuate the interstitial markings. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are unremarkable. There are mild aortic arch calcifications. The tip of a right chest Port-A-Cath tip terminates in the cavoatrial junction. Thoracolumbar fusion rods are intact. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal. IMPRESSION: Low lung volumes. No acute cardiopulmonary process. " 528871d5-6baf82c5-5fd7b922-bbc60517-26d6dc84.jpg,test/p11/p11888614/s51017937/528871d5-6baf82c5-5fd7b922-bbc60517-26d6dc84.jpg,test," FINAL REPORT INDICATION: ___M with chest pain, ETOH, evaluate for cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs with direct comparison made to the study from ___. FINDINGS: The lungs are well inflated and clear. No focal consolidations identified. The cardiomediastinal silhouette hilar contours are stable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " c90c68e0-04d5ac9d-9f47fbbd-7913a400-dbeca20b.jpg,test/p13/p13791874/s50345511/c90c68e0-04d5ac9d-9f47fbbd-7913a400-dbeca20b.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY. INDICATION: Patient with AFib, tachycardia, complex ablation on ___, shortness of breath, hemoptysis. COMPARISON: ___. FINDINGS: There is mild cardiac congestion superimposed to emphysema. There is no pneumothorax or pleural effusion. Moderate cardiomegaly is unchanged. There is no focal consolidation. Pleural effusions are small. CONCLUSION: Mild pulmonary edema. " f2439f49-77b52092-9aa01253-a0b2b86d-113b22dd.jpg,test/p14/p14887253/s56489799/f2439f49-77b52092-9aa01253-a0b2b86d-113b22dd.jpg,test," FINAL REPORT INDICATION: History of hypoxia, COPD. Please evaluate for pneumonia. COMPARISONS: None. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidation concerning for infection. No pleural effusion or pneumothorax is identified. Increased area of lucency below the right hemidiaphragm is likely secondary to interposed colon as normal haustral markings can be identified. IMPRESSION: No focal consolidations concerning for pneumonia identified. " bf17884d-55344ef8-6c25f16b-f8ed2ba4-e904c6f8.jpg,test/p14/p14755254/s51229679/bf17884d-55344ef8-6c25f16b-f8ed2ba4-e904c6f8.jpg,test," FINAL REPORT INDICATION: ___M with dyspnea and lethrrgy // r/o acute process TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without consolidation, effusion, or edema. Moderate cardiomegaly is again noted. Left chest wall dual lead pacing device is unchanged. No acute osseous abnormalities. IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process. " 17565799-5680c34b-3f6d804b-a54125d0-b5a63622.jpg,test/p18/p18704423/s52370819/17565799-5680c34b-3f6d804b-a54125d0-b5a63622.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SDH, intubated // eval ET tube position eval ET tube position COMPARISON: Chest radiographs ___. IMPRESSION: ET tube in standard placement. Small right pleural effusion and mild peribronchial opacification of the right lower lobe unchanged. Left lung clear. Borderline cardiomegaly is stable. " b267a4c6-2ddedd9d-e665a5a3-2b18ca45-3307161e.jpg,test/p16/p16497039/s51409558/b267a4c6-2ddedd9d-e665a5a3-2b18ca45-3307161e.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with shortness of breath, hypoxia. FINDINGS: AP single view of the chest has been obtained with patient in supine position. Comparison is made with the next preceding similar study obtained ___ hours earlier during the same day. Previously described left subclavian approach central venous line remains in unchanged position. No other indwelling lines are identified. Moderate cardiac enlargement with left ventricular prominence as before. There is now a diffuse haze overlying both lung fields coinciding with obliterated diaphragmatic contours. When comparison is made with the next preceding examination, these findings are new as previously the diaphragms were well identified and the diffuse haze did not exist. A possible explanation is that the patient had pleural effusions obscured in the posterior pleural sinuses that now in supine position distribute evenly in the dependent posterior departments of the pleural space. New discrete pulmonary parenchymal infiltrates cannot be identified, nor is there evidence of any pneumothorax. Requesting physician ___. ___ was paged, but answer was not received at 5:30 p.m. Page number was ___. As patient's gross chest findings are unaltered and no new infiltrate was seen; report was issued as normally. " 6c09f75a-9c195fc9-0d224a34-5d69ad8c-c0d79a60.jpg,test/p14/p14538785/s57461767/6c09f75a-9c195fc9-0d224a34-5d69ad8c-c0d79a60.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with empyema with chest tube placed. Please complete before ___ // empyema getting smaller? chest tube in place? IMPRESSION: As compared to ___ radiograph, left pigtail pleural catheter remains in place with slight decrease in size of partially loculated moderate left pleural effusion with adjacent left basilar atelectasis and or consolidation. Additionally, a very small right pleural effusion is accompanied by adjacent minor right basilar atelectasis. " 5f793a15-34421597-38a84b2a-f21e7b03-3cae2e24.jpg,test/p18/p18194653/s53807725/5f793a15-34421597-38a84b2a-f21e7b03-3cae2e24.jpg,test," FINAL REPORT HISTORY: Massive PE, right TandemHeart, worsening oxygenation, edema. CHEST, TWO VIEWS. Compared with ___ at ___, there is new patchy opacity in both lungs, scattered throughout the lung on the right and centered about the left hilum on the left. The ET tube is in satisfactory position, approximately 3.4 cm above the carina. Tubes over the right heart from both superior and inferior approach are unchanged. Tubes coiled over the superior mediastinum noted. No pneumothorax detected. No effusion. IMPRESSION: 1) Developing bibasilar patchy opacities, ? edema or other alveolar process, such as ARDS, infection, or possibly hemorrhage. Clinical correlation requested. 2) Tubing coiled over superior mediastinum. Findings discussed with the covering house officer, Dr. ___, at the time of discovery at approximately 12:55 p.m. on the day of the exam (___, phone). Based on that, the tubing coiled in the upper mediastinum is thought to represent a temperature probe, rather than an NG tube. " cf8c2c07-e8feaa77-21e3358e-8685736e-d14db062.jpg,test/p10/p10161112/s54891035/cf8c2c07-e8feaa77-21e3358e-8685736e-d14db062.jpg,test," FINAL REPORT HISTORY: Left upper lobe NSCLC endobronchial tumor, now status post sleeve resection. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___ at 7:28 a.m. Rotated positioning. Two left-sided chest tubes are in place. The left hemidiaphragm is elevated, consistent with volume loss. Lucency at the lung base outlining the left hemidiaphragm raises the question of a possible subtle pneumothorax. There is shift of the mediastinum to left, more pronounced than on the film from one day earlier. There is some patchy opacity at the left base, unchanged. There is prominent subcutaneous emphysema along the left chest wall, similar to prior. The right lung is grossly clear, without CHF, frank consolidation, or gross effusion. There is atelectasis at the right base, which appears slightly improved. IMPRESSION: 1) Volume loss on the left side, with suggestion of increased leftward mediastinal shift. Clinical correlation requested. 2) No definite pneumothorax, but lucency at the left lung base raises the possibility of an occult left-sided pneumothorax. 3) Overall, the left lung is otherwise relatively well expanded, except for minimal atelectasis at the left base. " df05ceec-c85f1ec1-2a6b9ee9-42308085-03dec9db.jpg,test/p18/p18116982/s52544291/df05ceec-c85f1ec1-2a6b9ee9-42308085-03dec9db.jpg,test," FINAL REPORT PORTABLE UPRIGHT CHEST RADIOGRAPH CLINICAL HISTORY: Neutropenic fever. Evaluate for pneumonia. Single frontal upright view of the chest was obtained with comparison to the examination which was performed seven days previously. FINDINGS: There is a new opacity involving the right lower lung zones, when compared to the prior examination, suspicious for infection. No evidence of pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes remain unchanged. A left-sided subclavian central venous catheter is again seen, with the tip in the lower SVC. IMPRESSION: Increased opacity in the right lower lung zones, suspicious for infection. " e9c31d85-4f1e9af4-041bb910-6f336003-5d930073.jpg,test/p11/p11900721/s53014573/e9c31d85-4f1e9af4-041bb910-6f336003-5d930073.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hepatic encephalopathy s/p unsuccessful NGT attempt with bleeding (appears to ___ ___/pharyngeal, please rule out PTX, new infiltrate, other acute process) // R/o PTX, infiltrate, other acute process TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " a3570d79-e9d09bb5-9cd5d0c0-d58e61a6-439faf3c.jpg,test/p13/p13259676/s58210843/a3570d79-e9d09bb5-9cd5d0c0-d58e61a6-439faf3c.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Seizures, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged moderate cardiomegaly, signs of pulmonary edema and relatively extensive retrocardiac atelectasis. No parenchymal opacities have newly appeared. Minimal pleural effusions are present both on the left and on the right. No pneumothorax. " 052e7fad-87b2b10a-734f81b5-904b06dd-13d80c87.jpg,test/p18/p18896198/s52747993/052e7fad-87b2b10a-734f81b5-904b06dd-13d80c87.jpg,test," FINAL REPORT INDICATION: ___ year old man with fever // eval for PNA TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: The right IJ central venous catheter has been removed. The enteric tube terminates in the stomach. No pneumonia. There is a right apical opacification that is difficult to see due to the overlying ribs and does not has typical appearance of pneumonia. The lungs are clear. The hila and pulmonary vasculature are normal. No pleural abnormalities or pneumothorax. The cardiomediastinal silhouette is normal and unchanged. No fractures. IMPRESSION: No pneumonia. " e76522d8-e59235bc-396fa179-3af5f581-9273ec97.jpg,test/p17/p17502683/s51844846/e76522d8-e59235bc-396fa179-3af5f581-9273ec97.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Substernal chest pain. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 0b200c2f-8590f883-4f175969-01be0c3c-ec3ddd4d.jpg,test/p15/p15003878/s58677239/0b200c2f-8590f883-4f175969-01be0c3c-ec3ddd4d.jpg,test," FINAL REPORT CLINICAL INFORMATION: ___-year-old male with multiple rib fractures and new subcutaneous gas in the right chest wall, question pneumothorax. COMPARISON: ___. FINDINGS: Semi-erect portable chest radiograph demonstrates extensive soft tissue gas outlining the pectoral muscles bilaterally, and in the subcutaneous tissues on the right. There is a moderate right-sided pneumothorax. Lung markings are not well appreciated due to overlying subcutaneous gas, there is a left base opacity. There is a discrepancy between the size of the lungs, with the right lung appearing larger. The trachea is midline, there is no shift of the cardiomediastinal silhouette to suggest tension. An endotracheal tube is in place, with its tip approximately 5 cm from the level of the carina. An orogastric tube is noted, the tip is not seen though it is below the level of the diaphragm. There is a left subclavian catheter, with its tip in the lower SVC. IMPRESSION: Right-sided pneumothorax with extensive subcutaneous gas. Findings were discussed with Dr. ___ at 10:20 p.m. in person. " 6060c75b-4a8b0f02-6007b0eb-4d09be73-251e588a.jpg,test/p19/p19651885/s51791356/6060c75b-4a8b0f02-6007b0eb-4d09be73-251e588a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with VT s/p sympathectomy and ablation // eval interval change in L hemothorax COMPARISON: Chest x-ray from ___ at 06:35 FINDINGS: Again seen is a pacemaker type device, overlying the left upper chest, with 3 leads noted. It the inferior approach catheter seen on the prior film, presumably a Swan-Ganz catheter, has been removed. If again seen is a left-sided chest tube. No well-defined pneumothorax is identified, though subtle pneumothorax might not be apparent on this exam. On today's exam, a thin linear lucency projects over the cardiac silhouette, of uncertain etiology or significance. There has been some interval clearing of the left lower lobe collapse and/or consolidation, with partial visualization of the left hemidiaphragm on today's exam. Vascular engorgement left upper zone is again noted, similar to the prior study. Possibility of a small left effusion would be difficult to exclude. Subcutaneous emphysema along the lower left chest wall again noted. The right lung is unchanged, with atelectasis in the infrahilar region. No CHF or right pleural effusion identified. Note is made that the right cardiac border is well defined. Small calcified granuloma in the right upper lung is again noted. IMPRESSION: Interval removal of presumed Swan-Ganz catheter. Slight interval improvement in left base opacity. Otherwise, I doubt significant interval change. Please note that although no obvious pneumothorax is detected, a subtle pneumothorax might not be apparent on this examination. " e99fb49b-a1e84657-f75c3b6a-fdb7838a-8c2bfb2b.jpg,test/p14/p14255450/s52612877/e99fb49b-a1e84657-f75c3b6a-fdb7838a-8c2bfb2b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post nephrectomy, evaluation for fevers. Questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous examination, there is no relevant change. Minimal basal areas of atelectasis. Normal size of the cardiac silhouette without pulmonary edema. No interval appearance of new parenchymal opacities suggestive of pneumonia. The contours of the hilar and mediastinal structures are unchanged and normal. " 3e741a20-f7ac241c-ac9e0fa6-2f4294c8-cd8acbc3.jpg,test/p17/p17293739/s53169016/3e741a20-f7ac241c-ac9e0fa6-2f4294c8-cd8acbc3.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Recent diagnosis of pneumonia, cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " ca7028f6-e913d265-49075f32-4c3ecc8b-0420a522.jpg,test/p18/p18216201/s51472439/ca7028f6-e913d265-49075f32-4c3ecc8b-0420a522.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after left thoracocentesis. AP radiograph of the chest was reviewed in comparison to prior study obtained the same day before thoracocentesis. There is interval decrease in left pleural effusion that has dropped from large-to-moderate. The effusion is at least in part appears to be loculated given the centrilobular contour along the chest wall. The left mediastinal shift is present and that shift might reflect underlying atelectasis. Right lung is clear. There is no pneumothorax. " 9e71706b-bbdfc8fd-f0d4f1bd-731d8662-6e1ff4aa.jpg,test/p15/p15326361/s53112385/9e71706b-bbdfc8fd-f0d4f1bd-731d8662-6e1ff4aa.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is mild bibasilar atelectasis. No focal consolidation is seen. There is no large pleural effusion. The aorta remains tortuous. The cardiac silhouette is top normal. Some degenerative changes are again seen along the spine. IMPRESSION: Mild bibasilar atelectasis. Otherwise, no acute cardiopulmonary process. " d9d981d3-8570b19e-34fbbc30-227611b6-b0361b2e.jpg,test/p19/p19071346/s59813503/d9d981d3-8570b19e-34fbbc30-227611b6-b0361b2e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p trauma, intubated/sedated // eval for changes IMPRESSION: In comparison to previous radiograph of 1 day earlier, bibasilar patchy opacities are new, raising the possibility for aspiration or developing infectious pneumonia. These findings are superimposed upon pre existing interstitial abnormality. No other relevant change. " 4b1268aa-1b5abbb9-b7bfe09b-4295c837-01e9157e.jpg,test/p18/p18226770/s56902808/4b1268aa-1b5abbb9-b7bfe09b-4295c837-01e9157e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with tobacco abuse, COPD, presenting with acutely worsening cough // ___ pack year history, persistent cough, acutely worsening COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Lungs are grossly clear. No pleural effusion or pneumothorax. Hilar contours are normal. The ascending aorta is tortuous. IMPRESSION: No acute cardiopulmonary process. " f79f9dd9-f65e43a2-492aec2c-5859d568-299fa79d.jpg,test/p18/p18855147/s52178503/f79f9dd9-f65e43a2-492aec2c-5859d568-299fa79d.jpg,test," WET READ: ___ ___ 8:44 PM NGT coiled in oropharynx, does not reach esophagus or stomach. Stomach markedly distended w/ gas. L carotid stent. Decreased volume overload with residual mild cardiomegaly/venous congestion. Minimal LLL atelectasis. WET READ VERSION #___ ___ ___ ___ 8:43 PM NGT coiled in oropharynx, does not reach esophagus or stomach. L carotid stent. Decreased volume overload with residual mild venous congestion. Minimal LLL atelectasis. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. COMPARISON: ___. FINDINGS: The patient has received a new nasogastric tube. The tube is coiled in the oropharynx and does not reach the esophagus. The stomach is moderately distended and filled with gas. Known left carotid stent. The pre-existing signs indicative of interstitial lung edema have decreased. No evidence of complications, notably no pneumothorax. " f3d1fd87-ae67071d-cec2b390-a8f01866-420b42f3.jpg,test/p14/p14834560/s51692301/f3d1fd87-ae67071d-cec2b390-a8f01866-420b42f3.jpg,test," WET READ: ___ ___ 3:36 PM Small left apical pneumothorax. Unchanged small right pleural effusion and right basilar atelectasis. No subdiaphragmatic free air. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: Epigastric pain. TECHNIQUE: Chest AP and lateral COMPARISON: ___ at 16:13 FINDINGS: Left-sided Port-A-Cath tip terminates in the mid SVC. Heart size remains moderately enlarged. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. A small right pleural effusion is similar in size with adjacent atelectasis in the right lung base. Lungs remain hyperinflated. A small apical left pneumothorax appears to be present not clearly noted on the prior exam. Mild multilevel degenerative changes are seen in the thoracic spine. No subdiaphragmatic free air is seen. IMPRESSION: Small left apical pneumothorax. Unchanged small right pleural effusion and right basilar atelectasis. No subdiaphragmatic free air. NOTIFICATION: The findings were discussed with medical student ___ ___ by Dr. ___ on the telephone on ___ at 10:56 AM. " d11d846d-a8712fc6-6255f03b-3151579a-daa9ce87.jpg,test/p11/p11858154/s59526576/d11d846d-a8712fc6-6255f03b-3151579a-daa9ce87.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with persistent cough. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are clear. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 458bc385-0406501a-c622ff2c-4ffe215a-7a93f694.jpg,test/p11/p11632236/s58903713/458bc385-0406501a-c622ff2c-4ffe215a-7a93f694.jpg,test," WET READ: ___ ___ 5:14 PM Dobhoff tube extends below the diaphragm with the tip in the body of the stomach. Interval improvement in the diffuse bilateral interstitial opacities compared to the prior exam from ___. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST, ___. COMPARISON: Radiograph ___. The feeding tube has been advanced slightly within the stomach. Other devices remain unchanged in position, and cardiomediastinal contours are stable. Diffuse bilateral ground-glass and reticular opacities have slightly improved within the left mid and lower lung region. The right lung is difficult to compare to the prior study due to incomplete imaging of the right lung. Healing lower left lateral rib fractures are noted with no visible pneumothorax. " 312a5345-2d7c0cc5-79b160b5-ef24bb2b-44dbba90.jpg,test/p14/p14913896/s50963960/312a5345-2d7c0cc5-79b160b5-ef24bb2b-44dbba90.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dry cough, left chest wall discomfort COMPARISON: Prior study from ___ FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is again noted, mild. No signs of congestion or edema. There is no focal consolidation concerning for pneumonia. Mild blunting of the left CP angle likely reflects the presence of a tiny effusion. No right-sided effusion. Mediastinal contour is unchanged with mildly unfolded thoracic aorta. Bony structures are intact. No displaced rib fracture is identified. IMPRESSION: Mild cardiomegaly, tiny left pleural effusion. " 625aa08d-eaba86e1-964add3b-4fab0a42-7fc0c783.jpg,test/p16/p16571027/s53701080/625aa08d-eaba86e1-964add3b-4fab0a42-7fc0c783.jpg,test," WET READ: ___ ___ ___ 8:52 PM Right PICC ends in the upper SVC. Lung volumes are low. There are bilateral lower lung heterogeneous opacities, possibly atelectasis, aspiration pneumonitis, and/or pneumonia. Probable small left pleural effusion. No pneumothorax. Increased elevation of the left hemidiaphragm compared to the most recent radiograph from ___. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old female with a history of aspiration pneumonia status post extubation who presents for evaluation of interval change. COMPARISON: Chest radiographs from ___ and ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The right-sided PIC line terminates in the upper SVC. There has been interval improvement of the mediastinal vascular engorgement and of the right lower lobe atelectasis with overall improved aeration of the lungs bilaterally. There has been an interval increase in the left lower lobe atelectasis. There is a small left pleural effusion. No focal consolidation concerning for infection is identified. There is no pneumothorax. IMPRESSION: 1. Overall improved aeration of the lungs bilaterally. 2. Interval increase in the mild left lower lobe atelectasis. " 96c5556a-b2dba395-d6c13771-9406ea22-a8faaedd.jpg,test/p19/p19478022/s55531817/96c5556a-b2dba395-d6c13771-9406ea22-a8faaedd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left rib pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal and the lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. No displaced rib fracture is visualized. IMPRESSION: No acute cardiopulmonary abnormality. No displaced rib fracture identified. If there is continued concern for a rib fracture, consider a dedicated rib series. " 7f2be6df-f8ab436d-9acbccec-df318d06-d0d23ec6.jpg,test/p13/p13859181/s59805248/7f2be6df-f8ab436d-9acbccec-df318d06-d0d23ec6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PE s/p tPA, intubated, requiring intra-aortic balloon pump. // Compare to prior COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices, including the intra-aortic balloon pump and Swan-Ganz catheter are in unchanged position. The lung volumes have minimally increased, potentially as a result of increased ventilatory pressure. Moderate pulmonary edema persists. The left lower lobe atelectasis is also unchanged. " d66447d2-53e303b1-dae75b01-f845c831-828f22eb.jpg,test/p17/p17473327/s50516006/d66447d2-53e303b1-dae75b01-f845c831-828f22eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, fatigue TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Minimal patchy opacity in the left lung base likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. There is mild compression deformity of a mid thoracic vertebral body as well as a vertebral body at the thoracolumbar junction, findings which appear unchanged from ___. Remote fractures of the left second, third, and fourth ribs are noted. IMPRESSION: Patchy left basilar opacity, likely atelectasis. " 0a5572e6-6855d7a5-746d007d-e18b3885-e21ca5c9.jpg,test/p10/p10735843/s53963340/0a5572e6-6855d7a5-746d007d-e18b3885-e21ca5c9.jpg,test," FINAL REPORT INDICATION: Evaluation for amiodarone toxicity in patient with long-term use. COMPARISON: Multiple chest radiographs, the most recent of ___. FINDINGS: PA and lateral views of the chest were reviewed. Compared to the prior study, the normal heart, lungs, mediastinum, and pleural surfaces are unchanged. IMPRESSION: No chest radiographic evidence of amiodarone lung toxicity. " c4613683-e56b8b8a-19ef9abf-66254348-72acd0bc.jpg,test/p17/p17653729/s50106356/c4613683-e56b8b8a-19ef9abf-66254348-72acd0bc.jpg,test," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Heart size remains moderately enlarged. The aorta is mildly tortuous and diffusely calcified. Mediastinal and hilar contours are unchanged. There is mild pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is identified. Mild multilevel degenerative changes are visualized in the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion. " e7823ea3-2a18fea9-0615ac46-91568ffb-8c40324e.jpg,test/p17/p17165725/s55505783/e7823ea3-2a18fea9-0615ac46-91568ffb-8c40324e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation of interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Two central venous access lines on the right and right pleural drain. Minimal increase in extent of remnant right pleural effusion with subsequent areas of atelectasis, but no new parenchymal opacities. Signs of mild pulmonary edema continues to be present. Moderate cardiomegaly. No pneumothorax. " de242e16-29090f65-2bc44074-cd96bc71-c0e09d17.jpg,test/p12/p12948450/s57886779/de242e16-29090f65-2bc44074-cd96bc71-c0e09d17.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new intubation. // Please eval for tube placement. Please eval for tube placement. IMPRESSION: No previous images. The endotracheal tube tip lies approximately 5.5 cm above the carina. Nasogastric tube extends to the stomach, though the side port is in the distal esophagus. Diffuse bilateral pulmonary opacifications are seen in a patient with enlargement of the cardiac silhouette. The appearance could reflect severe pulmonary edema or multifocal pneumonia, alveolar hemorrhage, or even ARDS. " cde7a37e-dd54c200-e8384e1d-e7550990-7d29f4ac.jpg,test/p17/p17328272/s50176508/cde7a37e-dd54c200-e8384e1d-e7550990-7d29f4ac.jpg,test," FINAL REPORT INDICATION: History of cough and dyspnea, please evaluate for pneumonia. COMPARISONS: Multiple chest radiographs dated back to ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: There is a right-sided PICC which terminates in the mid SVC. The heart size is normal. The hilar and mediastinal contours are normal. Note is made of subtle increase in consolidation at the left retrocardiac lung base. No large pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: Slight increase in consolidation at the left lung base, which could be secondary to an atelectasis; however, an acute infectious process cannot be excluded. " 153f34f8-a0656ec2-be7dfdb4-39ead012-e25581de.jpg,test/p12/p12006266/s53894773/153f34f8-a0656ec2-be7dfdb4-39ead012-e25581de.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: New central line placement, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, patient has received a right internal jugular vein catheter. Catheter is in normal position and course, the tip projects over the mid SVC. In unchanged manner, there is moderate cardiomegaly with a relatively extensive left pleural effusion and a left atelectasis. A newly appeared minimal right pleural effusion cannot be excluded. No evidence of pneumonia. " 47e1542a-dbd9c553-83e69e81-6d9c46f7-aa5324aa.jpg,test/p10/p10464640/s54018353/47e1542a-dbd9c553-83e69e81-6d9c46f7-aa5324aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with PSC presenting with elevated TBili. Concern for cholangitis. // PVT? changes? COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Feeding tube descends through the thoracic midline into the left upper abdomen. The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " f5300264-a35d5463-542f0c29-abf23c7d-82ecf33b.jpg,test/p12/p12698907/s53251780/f5300264-a35d5463-542f0c29-abf23c7d-82ecf33b.jpg,test," FINAL REPORT INDICATION: Fever and crackles in the right lower lobe. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 6aae3d78-09ce609d-125898ca-1b2c384f-31aa1f31.jpg,test/p19/p19155840/s56528523/6aae3d78-09ce609d-125898ca-1b2c384f-31aa1f31.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Behcet's exacerbation // ?intestinal perforation. Please get upright to look for free air TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. Overall normal chest radiograph. " c44da9bf-f5c3c259-1b6bc2bc-d5d2a67d-43e98607.jpg,test/p16/p16066381/s50747348/c44da9bf-f5c3c259-1b6bc2bc-d5d2a67d-43e98607.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with amnesia. Evaluate for ICH, vessel occlusion, TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. There are degenerative changes of the visualized spine. IMPRESSION: No acute cardiopulmonary abnormality. " 3810c9fd-459eb711-3c88095b-718cf51c-7cb14c3b.jpg,test/p10/p10459005/s57083109/3810c9fd-459eb711-3c88095b-718cf51c-7cb14c3b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recurrent ventricular tachycardia s/p ICD // interval changes interval changes IMPRESSION: In comparison with the study of ___, there are improved lung volumes. Again there is huge enlargement of the cardiac silhouette in a patient with intact midline sternal wires. There is minimal vascular congestion, producing a discordance that raises the possibility of cardiomyopathy or possibly even pericardial effusion. Blunting of the right costophrenic angle suggests small pleural effusion. Dual-channel pacer remains in place. The tip of the right atrial lead has been slightly change since the previous study. " 0f7e99d2-ca0c8147-820f2788-cfb9a97b-19a10410.jpg,test/p13/p13593747/s55304951/0f7e99d2-ca0c8147-820f2788-cfb9a97b-19a10410.jpg,test," FINAL REPORT INDICATION: Prolonged fatigue, r/o lymphadenopathy. COMPARISON: Comparison made to chest radiograph performed ___. FINDINGS: Chest, PA and lateral radiographs demonstrate unchanged moderate cardiomegaly. The mediastinal and hilar contours are unremarkable. The lungs are clear. No pleural effusion or pneumothorax evident. A vagal stimulator is identified. There is mild narrowing of the subglottic region at the level of the thoracic inlet unchanged compared to ___. There is a stable S-shaped scoliosis of the thoracolumbar spine with associated degenerative change. No pneumothorax or pleural effusion evident. IMPRESSION: No acute cardiopulmonary process. " 327f5cd8-a3309610-7ecf3b61-10d8997a-79c51b7a.jpg,test/p13/p13888167/s52941464/327f5cd8-a3309610-7ecf3b61-10d8997a-79c51b7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with increasing agitation. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, ___ CT chest FINDINGS: Heart size is no. Mediastinal and hilar contours are unchanged with atherosclerotic calcifications noted at the aortic knob. Pulmonary vasculature is not engorged. Lungs remain hyperinflated with emphysematous changes again visualized. Interstitial and streaky opacities are most pronounced at the lung bases with bronchial wall thickening, more pronounced in the left lung base, suggestive of chronic airway inflammation and potentially infection or aspiration. No pleural effusion, focal consolidation or pneumothorax is present. Hazy ovoid opacity within the right mid lung field seen likely corresponds to the previously radiofrequency ablated lesion in the right lower lobe. IMPRESSION: Emphysema with persistent bibasilar opacities, more pronounced in the left lung base, suggestive of chronic airway inflammation and potentially infection or aspiration, not substantially changed from the previous radiograph. " 39f01690-468ac9d2-40cfb54e-333fda8d-c198de2f.jpg,test/p19/p19643415/s51276997/39f01690-468ac9d2-40cfb54e-333fda8d-c198de2f.jpg,test," FINAL REPORT INDICATION: ___-year-old man with CLL, currently on chemotherapy. Unable to draw blood from the Port-A-Cath. COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: The left chest wall internal jugular approach central venous catheter is unchanged in position, terminating in the mid SVC. The cardiomediastinal and hilar contours are normal. An ill-defined opacity in the left corresponds to a region of scarring seen in the prior CT of ___. No new consolidation is seen. There is mild pulmonary vascular congestion, without overt edema. No pleural effusion or pneumothorax is seen. Old healed bilateral rib fractures are seen. IMPRESSION: Unchanged position of the left chest wall Port-A-Cath terminating in the mid SVC. " 43244dff-ee9a7618-87ec60e7-cb966e13-1f068e74.jpg,test/p17/p17845979/s57437949/43244dff-ee9a7618-87ec60e7-cb966e13-1f068e74.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Radiograph ___. FINDINGS: Lung volumes are low, accentuating the cardiac silhouette and bronchovascular structures. With this limitation in mind, heart size and pulmonary vascularity are within normal limits. Bronchial wall thickening is present in both lower lobes, best visualized on the lateral view in the infrahilar region. No confluent areas of consolidation are observed, and there are no pleural effusions. Gunshot fragments project over the lateral left hemithorax without change. IMPRESSION: 1. No focal consolidation to suggest the presence of pneumonia. 2. Lower lobe bronchial wall thickening, possibly due to chronic airways disease considering the presence of thick-walled bronchi in these regions on previous PET-CT of ___. " 42c72aa0-c207b55e-a16359a4-88fd2f0d-f2239670.jpg,test/p12/p12750648/s59312807/42c72aa0-c207b55e-a16359a4-88fd2f0d-f2239670.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with prev pneumonia // varify clearing varify clearing IMPRESSION: In comparison with study of ___, there has been essentially complete clearing of the left lower lobe pneumonia. At this time there is no evidence of vascular congestion, pleural effusion, or acute consolidation. " 0edafa68-eda69424-4b127bfe-b8e6d102-7b5c4a19.jpg,test/p14/p14409926/s57317379/0edafa68-eda69424-4b127bfe-b8e6d102-7b5c4a19.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with acute cholecystitis, pre-op for lap ccy. // Pre-op Surg: ___ (Lap cholecystectomy) COMPARISON: ___. IMPRESSION: LUNGS ARE NOW FULLY EXPANDED AND CLEAR. NORMAL CARDIOMEDIASTINAL AND HILAR SILHOUETTES AND PLEURAL SURFACES " f3613f9f-5c613e93-8adbbe3b-7f425bea-c492f580.jpg,test/p12/p12457907/s56090685/f3613f9f-5c613e93-8adbbe3b-7f425bea-c492f580.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of recent VATS upper lobectomy, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal postoperative appearance of the right hemithorax. No newly appeared parenchymal opacities. No larger pleural effusions. Normal size of the cardiac silhouette. " e3440b25-addc4e27-52d95c40-1401a4df-5c49577a.jpg,test/p11/p11725800/s58212350/e3440b25-addc4e27-52d95c40-1401a4df-5c49577a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with intubation TECHNIQUE: Portable AP view of the chest COMPARISON: Chest radiographs ___ and ___ at 15:29 FINDINGS: The tip of the endotracheal tube is difficult to exactly discern, but appears to be appropriately situated at the level of the thoracic inlet, approximately 5 cm from the carina. Enteric tube tip is within the stomach. As seen previously, there is continued extensive subcutaneous emphysema, pneumomediastinum, and a left basal lateral hydropneumothorax, all similar compared to the most recent previous study. Cardiac and mediastinal contours are unchanged. Scarring within the right hilar region is similar. Patchy opacities in the lung bases appear more pronounced in the interval, and likely reflect aspiration or infection. IMPRESSION: Endotracheal and enteric tubes in standard positions. Increased patchy opacities in lung bases concerning for aspiration or infection. " 80a169f2-222ccfec-59fe69ce-9882aaf8-b6ce602c.jpg,test/p16/p16454913/s56499764/80a169f2-222ccfec-59fe69ce-9882aaf8-b6ce602c.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with tracheobronchomalacia status post tracheoplasty. FINDINGS: Comparison is made to prior study from ___. Endotracheal tube, feeding tube, right-sided chest tube are all stable positioned. There is again seen cardiomegaly, bilateral pleural effusions, left retrocardiac opacity and moderate pulmonary edema. These findings are stable since the previous study. " e2ce0370-b910867d-6a1c4842-5f0b1c6a-d957bd4b.jpg,test/p13/p13247581/s54544721/e2ce0370-b910867d-6a1c4842-5f0b1c6a-d957bd4b.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Aortic arch replacement, check effusions. REFERENCE EXAM: ___. The right IJ line has been removed. Sternal wires are again visualized. There continues to be moderate cardiomegaly. There continues to be bilateral lower lobe volume loss with no definite infiltrate. " 23e67c22-0541cb74-42e7655c-e3c55a4c-6ccd8899.jpg,test/p17/p17463554/s59570045/23e67c22-0541cb74-42e7655c-e3c55a4c-6ccd8899.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pna // eval for interval change IMPRESSION: Allowing for differences in technique, there has not been a relevant change in the appearance of the chest since recent study of 1 day earlier. " c4cbf7f7-404e474a-b5d181d5-9ac24868-6eab32f5.jpg,test/p18/p18325765/s58927079/c4cbf7f7-404e474a-b5d181d5-9ac24868-6eab32f5.jpg,test," FINAL REPORT HISTORY: CHF. FINDINGS: In comparison with the study of ___, there is stable substantial enlargement of the cardiac silhouette without definite vascular congestion. This discordance raises the possibility of cardiomyopathy or pericardial effusion. No acute focal pneumonia identified. " 500b0787-9a4a3fb2-6a1d7764-ba5731d7-c6f8844a.jpg,test/p13/p13107111/s59575821/500b0787-9a4a3fb2-6a1d7764-ba5731d7-c6f8844a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with O2 req // acute change acute change FINDINGS: Is and for IMPRESSION: Compared to chest radiographs since ___, most recently ___. Long-term enlargement of the left pulmonary artery and outflow tract has increased substantially and distention of the azygos vein is new, reflecting an increase in pulmonary artery and right heart pressures. There is no pulmonary edema or appreciable atelectasis and no pleural effusion or pneumothorax. Moderate cardiomegaly is stable since at least ___ of this year. Nasogastric drainage tube passes into the stomach and out of view NOTIFICATION: The findings were discussed with ___ , M.D. by ___, M.D. on the telephone on ___ at 11:10 AM, 1 minutes after discovery of the findings. " d3d20c24-96755003-5f129fba-1ce8715e-653a7842.jpg,test/p17/p17725745/s51065722/d3d20c24-96755003-5f129fba-1ce8715e-653a7842.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with weakness // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiac silhouette is top-normal in size. Midline sternal wires are well aligned and intact. The mediastinal contours are unchanged since the prior examination. There is mild central vascular prominence without interstitial edema. No definite focal consolidation is identified. There is no pleural effusion or pneumothorax. IMPRESSION: No definite acute intrathoracic abnormality. " 0ca52dc1-f6cdfa05-2a720e88-02b17484-711560e9.jpg,test/p12/p12135031/s52944129/0ca52dc1-f6cdfa05-2a720e88-02b17484-711560e9.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old female, status post open right colectomy, now with new O2-requirement and diminished breath sounds at the right lung base; evaluate for fluid overload or pneumonia. FINDINGS: Two views are compared with the radiographs of ___, as well as appropriate portions of the NECT torso, dated ___. There is now significant pneumoperitoneum, related to the interval laparotomy. There are low lung volumes with bibasilar subsegmental atelectasis, likely postoperative, as well. Allowing for this, there is some pulmonary vascular congestion with bilateral pleural effusions, likely related to volume overload. There is no overt alveolar edema and no definite focal consolidation. Again demonstrated are: Atherosclerosis involving the thoracic aorta, diffuse osteopenia, and A/C arthrosis. IMPRESSION: 1. Post-operative pneumoperitoneum and low lung volumes and bibasilar subsegmental atelectasis. 2. Pulmonary vascular congestion which may reflect volume overload, but should be correlated clinically. " f065302d-932783db-9bed9bfd-ce82d991-7126dd84.jpg,test/p10/p10019003/s53986244/f065302d-932783db-9bed9bfd-ce82d991-7126dd84.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure // Interval change? Interval change? IMPRESSION: In comparison with the study of ___, the patient has taken a much better inspiration. Cardiac silhouette is now within normal limits, though there appears to be some increased elevation of pulmonary venous pressure. Right IJ catheter again extends to the mid portion of the SVC. " b1f88f71-4aea36df-673b280b-785f0abc-4a8fc391.jpg,test/p16/p16947035/s53901727/b1f88f71-4aea36df-673b280b-785f0abc-4a8fc391.jpg,test," WET READ: ___ ___ ___ 9:03 PM There are small bilateral pleural effusions, left greater than right. No pneumothorax. Bibasilar and retrocardiac atelectasis. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG. PA and lateral upright chest radiographs were reviewed in comparison to ___. The right internal jugular line has been removed. Heart size and mediastinum are stable. No appreciable pneumothorax seen. Bibasal areas of atelectasis associated with small pleural effusion are noted with substantial area of atelectasis in the retrocardiac location of left lower lobe, potentially forming rounded atelectasis. There is no evidence of pulmonary edema. There are no new consolidations to suggest infectious process. " 8c06f32b-9f545310-b44ccf66-fe2605e2-826ad6e4.jpg,test/p15/p15693812/s50013399/8c06f32b-9f545310-b44ccf66-fe2605e2-826ad6e4.jpg,test," WET READ: ___ ___ ___ 7:55 PM New OG tube is coiled within the esophagus or trachea and repositioning is recommended. Endotracheal tube well positioned. Bilateral interstitial opacities consistent with moderate pulmonary edema are unchanged. No pneumothorax. These findings were discussed with Dr. ___ by Dr. ___ at 19:53 on ___ via telephone at the time of discovery. ______________________________________________________________________________ FINAL REPORT AP CHEST, 7:40 P.M. ON 2 HISTORY: ___-year-old man with new OG tube. Confirm placement. IMPRESSION: As reported to the clinical house staff by Dr. ___ at 7:53 p.m. on ___, the new OG tube, previously in the stomach, is looped either in the upper esophagus or less likely in the trachea returning to the neck and passing out of view. By 8:29 p.m., there is radiographic evidence of appropriate repositioning. ET tube is in standard placement. Mild pulmonary edema is stable. Cardiomediastinal silhouette unremarkable. Pulmonary arteries large, suggesting pulmonary arterial hypertension. No pneumothorax or appreciable pleural effusion. " 169af51e-7f858632-7b4e1962-312cda87-70dd3748.jpg,test/p14/p14472543/s56948536/169af51e-7f858632-7b4e1962-312cda87-70dd3748.jpg,test," FINAL REPORT HISTORY: ___-year-old female with is Zoster and fevers. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation. Biapical scarring is again noted. Cardiomediastinal silhouette is unchanged. Mid to lower thoracic dextroscoliosis is again noted. IMPRESSION: No acute cardiopulmonary process. " 11ee8146-c274db32-641c1dc2-4a4b5293-3fa3036e.jpg,test/p10/p10577647/s57534555/11ee8146-c274db32-641c1dc2-4a4b5293-3fa3036e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with line placement TECHNIQUE: Semi-upright AP view of the chest COMPARISON: ___ at 10:51 FINDINGS: Left internal jugular central venous catheter tip terminates near the confluence of the brachiocephalic veins. No pneumothorax is identified. Remainder the chest is unchanged without acute cardiopulmonary abnormality. IMPRESSION: Left internal jugular central venous catheter tip terminates near the confluence of the brachiocephalic veins. No pneumothorax. " a8f58a0b-1b6b20b3-ee75330f-cb4ba89e-d4868cc4.jpg,test/p16/p16377954/s59898605/a8f58a0b-1b6b20b3-ee75330f-cb4ba89e-d4868cc4.jpg,test," FINAL REPORT INDICATION: ___ year old man with AML, now in new Afib with worsening hypoxemia. // Please evaluate for worsening pulmonary edema. TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates worsening bilateral heterogeneous airspace opacities concerning for moderate pulmonary edema with superimposed multi-focal pneumonia. There is a small left-sided pleural effusion. The cardiomediastinal and hilar contours are unchanged. Left-sided PICC ends in the mid SVC. No pneumothorax. IMPRESSION: Worsening bilateral heterogeneous airspace opacities concerning for moderate pulmonary edema with widespread superimposed infection. " 69519a0a-686f8e00-b7276336-eadc75da-34d2010d.jpg,test/p11/p11799619/s54411860/69519a0a-686f8e00-b7276336-eadc75da-34d2010d.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with chest pain. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. The lungs are clear of consolidation or effusion. Streaky right basilar opacity is most suggestive of atelectasis. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are notable for hypertrophic changes in the spine. IMPRESSION: No acute cardiopulmonary process. " ef39b6e8-cbd25a80-e08369ad-e8a01528-37ce078f.jpg,test/p11/p11894482/s53739319/ef39b6e8-cbd25a80-e08369ad-e8a01528-37ce078f.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with a smoking history and a presyncopal episode. Dehydration and productive cough. Suspect pneumonia. IMPRESSION: PA and lateral chest compared to ___: Borderline cardiac enlargement is stable. Lungs are essentially clear. There is no pleural effusion or evidence of mediastinal or hilar lymph node enlargement. As before, trachea is deviated to the right by a large goiter in the left lobe of the thyroid gland which has been present, by CT scanning, since at least ___. Trachea is not appreciably narrowed. " 9ca39c60-0cb20157-37c8e438-019fdeff-ca18e84b.jpg,test/p19/p19522934/s56447601/9ca39c60-0cb20157-37c8e438-019fdeff-ca18e84b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with trauma to left chest in ___ still with reproducible chest tenderness on left sternal border // eval for abnormality TECHNIQUE: CHEST (PA AND LAT) COMPARISON: None IMPRESSION: Heart size is normal. No abnormality within the mediastinum demonstrated on the PA view. On the lateral view there is a opacity projecting over the superior anterior mediastinum that might potentially reflect hematoma. Other abnormalities cannot be excluded. Lungs are clear and there is no pleural effusion or pneumothorax. Linear opacities projecting of the cardiac silhouette and might represent area of atelectasis in the lingula or right middle lobe. Giving the above described abnormalities, further assessment with chest CT is recommended " bbe22054-8a48ae84-8bf41a17-0b0fb320-283e5efb.jpg,test/p17/p17377288/s53026888/bbe22054-8a48ae84-8bf41a17-0b0fb320-283e5efb.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior study from ___. CLINICAL HISTORY: Chest pain status post prior MI, question acute intrathoracic process. FINDINGS: PA and lateral views of the chest were provided. A device projecting over the left chest wall is again noted of unclear significance. The lungs are clear, though volumes are low. Minimal linear density in left lower lung likely represents scarring. The cardiomediastinal silhouette appears grossly normal. Bony structures are intact. IMPRESSION: No acute findings in the chest. " 20a60dc6-d00cba03-96a62119-2a611338-36a3acab.jpg,test/p13/p13818030/s51196556/20a60dc6-d00cba03-96a62119-2a611338-36a3acab.jpg,test," FINAL REPORT HISTORY: Neck and chest pain. TECHNIQUE: PA and lateral views of chest. COMPARISON: None. FINDINGS: Lungs are clear. Cardiac silhouette is normal in size. No pleural effusion or pneumothorax. IMPRESSION: Normal chest x-ray. " b5facf38-5b396a94-aead764a-85b00723-d2d01246.jpg,test/p16/p16637272/s51351012/b5facf38-5b396a94-aead764a-85b00723-d2d01246.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and left sided wheezing // r/o pneumonia COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal appearance of the lung parenchyma. There is no pneumonia, pulmonary edema or pleural effusion. As an anatomical variant, the patient has a right-sided aortic arch. " 2535a45f-b9b42bfd-d1ec488d-e3e67429-28e27d6c.jpg,test/p12/p12568708/s57113937/2535a45f-b9b42bfd-d1ec488d-e3e67429-28e27d6c.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with altered mental status // eval for pneumonia COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. A fiducial is again seen in the right upper lobe at the site of a known mass. No focal consolidation concerning for pneumonia. Hilar congestion is noted without frank edema. No convincing signs of pneumonia. Left mid lung linear density likely platelike atelectasis. No large effusion or pneumothorax. The heart is top-normal in size. Mediastinal contour appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Top normal heart size, hilar congestion. Right upper lobe mass with fiducial marker again noted. No convincing evidence for pneumonia. " 0c8c4fb1-2e1936ef-b9d9cef5-e29d590f-92fa9267.jpg,test/p10/p10882916/s53964879/0c8c4fb1-2e1936ef-b9d9cef5-e29d590f-92fa9267.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a right central venous stent. The lung volumes are low. The alignment of the sternal wires is unchanged. Both lungs show relatively extensive perihilar areas of atelectasis. These changes, however, do not fulfill the typical morphological criteria for pneumonia. Standing frontal and lateral chest radiographs would be helpful to further assess the lung parenchyma. Intestinal overdistention is visible. " 2094ddf3-2348835f-2f468a2c-493f4e64-1b4ef954.jpg,test/p16/p16553329/s53060980/2094ddf3-2348835f-2f468a2c-493f4e64-1b4ef954.jpg,test," FINAL REPORT HISTORY: Slurred speech and altered mental status. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is within normal limits. Scattered calcifications within the upper lung fields bilaterally likely reflect the sequela of prior granulomatous disease. No focal consolidation, pleural effusion or pneumothorax is seen. There is likely minimal retrocardiac atelectasis. No acute osseous abnormalities are demonstrated. There are mild degenerative changes of the thoracic spine as well as within the imaged left AC joint. IMPRESSION: No acute cardiopulmonary abnormality. " 79f9780c-31b78923-4c81bfb4-e926b25e-fd1b99ab.jpg,test/p15/p15554295/s52405479/79f9780c-31b78923-4c81bfb4-e926b25e-fd1b99ab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p GSW to abdomen s/p ex-lap, cardiac arrest intraoperatively, SBR w/anastamosis, colonic primary repair, sigmoid and colon resection s/p delayed anastamosis, left EIV stent c/b stent migration to right pulm artery s/p endovascular removal, left CIA primary repair, who remains with open abdomen. // interval eval interval eval IMPRESSION: Right subclavian line tip is at the level of lower SVC. NG tube tip is in the stomach. Heart size and mediastinum are similar in appearance including cardiomegaly. Bibasal consolidations are unchanged but there is slight interval improvement in vascular congestion. " 7e78faad-9db65c56-3dfde8a8-c0fa81b7-af9f0e26.jpg,test/p14/p14047315/s56382002/7e78faad-9db65c56-3dfde8a8-c0fa81b7-af9f0e26.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with diffuse SAH with ventricular extension(___ 4), e/o L ACA and AComm aneurysms on CTA, s/p coiling a comm aneurysm with intraop rupture and rebleed(___) with post-op stay c/b episodes of persistently elevated ICPs; possible meningitis ; brief episode of asystoly requiring CPR; respiratory insufficiency likely sec to VAP now s/p teach PEG and GI bleed. // ?worsening atelectasis ?worsening atelectasis COMPARISON: Comparison to ___ at 04:43 FINDINGS: Portable semi-erect chest radiograph ___ at 04:20 is submitted. IMPRESSION: There is increasing opacity at the left base which although could reflect atelectasis, is concerning for aspiration or pneumonia. No pulmonary edema. Overall cardiac and mediastinal contours are stable given differences in patient positioning. Right subclavian PICC line continues to have its tip at the cavoatrial junction. A right-sided VP shunt is again visualized. No pneumothorax. " d20a94a1-3476871d-5e89df5b-3aa2462c-a720bdf7.jpg,test/p16/p16997599/s55061831/d20a94a1-3476871d-5e89df5b-3aa2462c-a720bdf7.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. There has been no significant change. IMPRESSION: No evidence of acute cardiopulmonary disease. " a249e71d-b1855b1b-d80c9388-e55e41da-859e7f8a.jpg,test/p11/p11566151/s51943427/a249e71d-b1855b1b-d80c9388-e55e41da-859e7f8a.jpg,test," FINAL REPORT EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old man with cough, recently treated for pneumonia. Evaluate for persistent consolidation. TECHNIQUE: Chest PA and lateral. COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Normal mediastinal and hilar contours. Normal heart size. Rounded, soft tissue density in the right cardiophrenic sulcus is stable over multiple examinations and likely reflects a pericardial cyst. Multiple, healed, left rib fractures are again seen. No evidence of acute fracture. Lungs are clear. No pneumothorax. There are stable, severe degenerative changes involving the left glenohumeral joint. Interval resolution of small, left pleural effusion. IMPRESSION: No evidence of pneumonia. " 53061d74-1d991606-3056cd54-f04c68ec-4d6dfc05.jpg,test/p10/p10374990/s57116986/53061d74-1d991606-3056cd54-f04c68ec-4d6dfc05.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R chylothorax, on octreotide and diet restriction. Liberalized diet on ___. // Please evaluate for interval change in R pleural effusion IMPRESSION: In comparison to prior radiograph of 1 day earlier, a moderate sized right pleural effusion and a small left pleural effusion have apparently slightly increased in size, although positional differences between the exams limit comparison. No other relevant change. " 922b8947-c19b4dff-4a0e4ddb-8ff1b1d5-4f906e25.jpg,test/p15/p15712408/s58139684/922b8947-c19b4dff-4a0e4ddb-8ff1b1d5-4f906e25.jpg,test," FINAL REPORT HISTORY: Vomiting and chest pain assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are well expanded without pleural effusion or pneumothorax. No focal consolidation is seen with near-complete resolution of the previously described bibasilar opacities with minimal residual in the posterior lower lobes. The heart is normal in size and normal mediastinal contours. IMPRESSION: No acute intrathoracic process with near complete resolution of bibasilar opacities previously described. " 4b1c5811-7390090b-f484d142-deef6306-dd288ec8.jpg,test/p19/p19912537/s51099652/4b1c5811-7390090b-f484d142-deef6306-dd288ec8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CAD, CHF now with acute pleuritic L sided chest pain // ?opacity, edema ?opacity, edema COMPARISON: Comparison to ___ at 18:18 FINDINGS: Portable AP upright chest ___ at 14:31 is submitted. IMPRESSION: Stable cardiac enlargement. There has been interval development of mild interstitial edema. Subtle patchy opacities at both bases likely reflect patchy atelectasis rather than aspiration or pneumonia. Clinical correlation is recommended. No pneumothorax. Previously reported 6 mm nodular opacity in the right mid lung is not well appreciated on the current study. " 7f7dcab5-490c4640-2d4c212b-588bf4a2-b27340a7.jpg,test/p12/p12815514/s55390640/7f7dcab5-490c4640-2d4c212b-588bf4a2-b27340a7.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: None. TECHNIQUE: Two PA and one lateral chest radiograph were obtained. FINDINGS: The lungs are well expanded and clear. There are no focal consolidations, effusions, or pneumothoraces. A 5 mm hyperdensity projecting over the right hemidiaphragm is likely a vessel on end or small calcified granuloma. Mediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " e6793fa8-1fbcde36-22b20a05-10cdfbc5-dc081aa1.jpg,test/p17/p17251067/s59466378/e6793fa8-1fbcde36-22b20a05-10cdfbc5-dc081aa1.jpg,test," WET READ: ___ ___ ___ 8:05 PM Low lung volumes with mild vascular engorgement without frank interstitial edema. Mild bibasilar atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD, HTN, and respiratory failure // acute change acute change COMPARISON: Chest radiograph ___:11 IMPRESSION: Moderate cardiomegaly, pulmonary vascular congestion, mediastinal venous dilatation all increased since ___:11. No pulmonary edema or pleural effusion as yet. Most likely explanation volume overload or biventricular heart failure. Lungs grossly clear " f3970299-28d7cda2-63547693-ea0226e2-b519acf0.jpg,test/p12/p12432773/s50064741/f3970299-28d7cda2-63547693-ea0226e2-b519acf0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent oxygen requirement despite diuresis // ?Volume overload, infiltrate COMPARISON: ___. FINDINGS: Cardiomegaly is accompanied by improved pulmonary vascular congestion and resolving interstitial edema. Right superior mediastinal widening with left for deviation of the trachea is consistent with thyroid enlargement. Lingular consolidation is again demonstrated as well as a dense nodular opacity in the right mid lung. Small right pleural effusion is noted. High-grade compression deformity at thoracolumbar junction is ofindeterminate age. IMPRESSION: 1. Improved congestive heart failure 2. Lingular consolidation, concerning for pneumonia in the appropriate clinical setting 3. Enlarged right lobe of thyroid gland with associated tracheal deviation. 4. Incompletely characterized nodular opacity in right mid lung, for which CT chest is previously been recommended in the absence of more remote films for comparison. " 1e7f8a61-47cbbabe-3a02632f-44bbf60a-e11ed185.jpg,test/p17/p17145985/s58692042/1e7f8a61-47cbbabe-3a02632f-44bbf60a-e11ed185.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Fever and productive cough. PA and lateral upright chest radiographs were reviewed. COMPARISON: No prior studies available for comparison. Heart size is normal. Mediastinum is normal. Fullness in the left hilus is demonstrated, mild but should be further assessed with anterior shallow oblique views. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. Splenomegaly is suspected on the radiograph and might be potentially correlated with ultrasound. " 6a6e582c-2bce81c0-3f9ec26b-c00515f3-49e2dd09.jpg,test/p17/p17078350/s50504889/6a6e582c-2bce81c0-3f9ec26b-c00515f3-49e2dd09.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion. TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: Plain chest radiograph dated ___. Correlation also made to CT abdomen/ pelvis dated ___. FINDINGS: There is a stable moderate right pleural effusion, which limits evaluation of the right lung base. The left lung is clear. There is no pneumothorax. The heart and mediastinum are within normal limits. IMPRESSION: Stable moderate right pleural effusion. Airspace disease at the right lung base cannot be excluded. " 05d37ca0-2c31372d-d9264333-1eeb5b62-795f9c1b.jpg,test/p19/p19005323/s53784218/05d37ca0-2c31372d-d9264333-1eeb5b62-795f9c1b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old male with hepatic cellular carcinoma presenting with shortness of breath. TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: No prior chest x-ray available for comparison. Correlation made to chest CT dated ___. FINDINGS: Lung volumes are low. There is mild elevation of the right hemidiaphragm with new right lower lobe subsegmental atelectasis. The left lung is clear. IMPRESSION: New right lower lobe subsegmental atelectasis. " 57dba416-ca76ee51-1a94399e-e25d4f0a-5a47e904.jpg,test/p17/p17974279/s54673835/57dba416-ca76ee51-1a94399e-e25d4f0a-5a47e904.jpg,test," WET READ: ___ ___ ___ 3:47 PM Findings concerning for right lower lung pneumonia on this limited film. A PA and lateral radiographs may be helpful to further elucidate the process in if the patient is able WET READ VERSION #1 ___ ___ ___ 3:46 PM Findings concerning for right lower lungpneumonia on this limited film. A PA and lateral radiographs may be helpful to further elucidate the process in if the patient is able ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with AMS // Evidence of infection TECHNIQUE: Single semi-erect portable view of the chest. COMPARISON: ___ and ___. FINDINGS: The right heart border is ill-defined and there are multiple patchy opacities extending throughout the right lower lung concerning for pneumonia. Cardiac size is normal although the patient is markedly rotated. There is no pneumothorax or pleural effusion. No evidence of pulmonary edema. IMPRESSION: Findings concerning for right lower lung pneumonia on this limited film. A PA and lateral radiographs may be helpful to further elucidate the process in if the patient is able " c87c7c06-4d0a740d-c4c78513-1e63bfe1-7b9e08f8.jpg,test/p13/p13473495/s59693688/c87c7c06-4d0a740d-c4c78513-1e63bfe1-7b9e08f8.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of pneumonia, evaluation for attempted line placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the hemodialysis catheter has been removed. Severe cardiomegaly with moderate pulmonary fluid overload persists, larger pleural effusions are not present. There currently is no indication for pneumonia. No pneumothorax. " cf8fb5cd-a1988de7-26e0452a-5f0684a7-c53bd162.jpg,test/p12/p12479159/s57789644/cf8fb5cd-a1988de7-26e0452a-5f0684a7-c53bd162.jpg,test," FINAL REPORT HISTORY: Stroke, to assess for pneumonia. FINDINGS: No previous images. The heart is normal in size, and there is no vascular congestion or pleural effusion. Low volumes make it somewhat difficult to evaluate the lungs. There are atelectatic changes at the bases, without definite acute focal pneumonia. " 93ec804c-bc707e1e-cb105ac7-9a7eca5d-15bb1a4e.jpg,test/p18/p18230852/s59950702/93ec804c-bc707e1e-cb105ac7-9a7eca5d-15bb1a4e.jpg,test," FINAL REPORT INDICATION: ___ year old man with aspiration, hyposixa, tacypnea // ? infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Suboptimal form. Endotracheal tube is seen to with the tip 96 mm proximal to the carina. No pneumothorax. Medial basal opacification on the left most likely representing aspiration. The cardiomediastinal shadow is unchanged. The lateral right lung and chest wall were not imaged. IMPRESSION: Endotracheal tube in a high position as detailed above. Focal left lower lobe airspace opacification in keeping with history of aspiration. " 488c2acb-4c031a4d-adf8c15f-3ca66812-32c70576.jpg,test/p13/p13561687/s55421223/488c2acb-4c031a4d-adf8c15f-3ca66812-32c70576.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cholangiocarcinoma, new fever, RUQ pain, perc chole drains in place // any PNA, cholangitis, other signs of infection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Areas of linear bibasilar atelectasis/ scarring are seen without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Right upper lobe calcified granuloma is re- demonstrated.. Pulmonary nodules 4 mm and smaller seen on prior chest CT from ___ or better appreciated on CT. IMPRESSION: No acute cardiopulmonary process. " 13de372f-308f9f37-17194667-4ac191bd-1dee9cff.jpg,test/p12/p12552999/s52614050/13de372f-308f9f37-17194667-4ac191bd-1dee9cff.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with history of chronic idiopathic pancreatitis presents with epigastric pain and hematemesis TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No subdiaphragmatic free air is identified. IMPRESSION: No acute cardiopulmonary abnormality. " 73f07e65-f4b710ba-e143aedc-1a6749cd-6d514cc1.jpg,test/p13/p13194374/s56465226/73f07e65-f4b710ba-e143aedc-1a6749cd-6d514cc1.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with rheumatoid arthritis, on immunosuppressants with cough for a week and rhonchi right greater than left. IMPRESSION: PA and lateral chest compared to ___: Lungs are fully expanded and clear. There is a slight increase in lobulation of the upper pole of the left hilus since ___, clearly new since ___. This ___ be benign reactive lymph node enlargement. If symptoms persist and the clinical situation warrants a chest CT (with intravenous contrast agent indicated for hilar evaluation) would be useful to assess possible central lymph node enlargement. Y-shaped calcification in the aortopulmonic window could be in the ligamentum arteriosum. The heart size is normal, pulmonary vasculature is unremarkable and there is no pleural abnormality. " 1f29dbbb-e1c3770e-3691b07d-ef3c9e40-0d1b248b.jpg,test/p12/p12010209/s55218821/1f29dbbb-e1c3770e-3691b07d-ef3c9e40-0d1b248b.jpg,test," FINAL REPORT HISTORY: ___-year-old man with multiple myeloma, being worked up for autologous bone marrow transplant. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in upright position. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: No focal consolidation, pleural effusion or pulmonary edema is seen, and the cardiac and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary disease to preclude bone marrow transplant. " ba76d0ef-b0a966f2-fca7c749-384a2218-7442e841.jpg,test/p17/p17199671/s55215290/ba76d0ef-b0a966f2-fca7c749-384a2218-7442e841.jpg,test," FINAL REPORT INDICATION: ___M with syncope, fall // r/o fracture TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The patient is status post CABG with median sternotomy wires. The heart size is top normal. Heavy calcification of the aortic knob is noted with tortuosity of the descending aorta. There is no pneumothorax or pleural effusion. Lung volumes are low, and increased interstitial markings indicate mild interstitial edema. There is no focal consolidation concerning for pneumonia. IMPRESSION: Low lung volumes with mild interstitial edema. No focal consolidation concerning for pneumonia. " 601b9d14-634efbe7-90e73339-9ef8ea6f-fb9440da.jpg,test/p15/p15762654/s53494133/601b9d14-634efbe7-90e73339-9ef8ea6f-fb9440da.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Baseline chest x-ray. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Moderate-to-severe cardiomegaly with enlargement of both the left and the right parts of the heart. No evidence of pneumonia, pleural effusion or pulmonary edema. Normal appearance of the hilar and mediastinal contours. " 827ae55f-90f68ff8-dca3a10c-03828c55-8452bdbd.jpg,test/p14/p14104022/s55754316/827ae55f-90f68ff8-dca3a10c-03828c55-8452bdbd.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Status post fall. Question pneumonia. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size with a left ventricular configuration. There is mild unfolding of the descending thoracic aorta with calcification along the arch. The mediastinal and hilar contours appear stable. There are no pleural effusions or pneumothorax. Patchy opacities are streaky in association with mild-to-moderate relative elevation of the right hemidiaphragm, suggesting minor associated atelectasis or perhaps scarring. Otherwise, the lungs appear clear. Mild degenerative changes are noted along the mid thoracic spine. IMPRESSION: No evidence of acute disease. " 4f37fffa-5a7f5620-bfda3957-5f18951f-2d06399f.jpg,test/p16/p16609016/s51193990/4f37fffa-5a7f5620-bfda3957-5f18951f-2d06399f.jpg,test," FINAL REPORT HISTORY: Weakness, fever, shortness of breath. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Patchy right basilar opacity is seen an infection is not excluded in the appropriate clinical setting. Alternatively it could relate to atelectasis. They may also be a subtle focal area of reticular nodular opacity in the lateral right upper lung which could also relate to infectious or inflammatory process. The left lung is clear. There is no pleural effusion or pneumothorax. The aorta is calcified and tortuous. The cardiac silhouette is top-normal. No overt pulmonary edema is seen. IMPRESSION: Patchy right basilar opacity could resent infection versus atelectasis. Subtle focal area of reticular nodular opacity in the lateral right upper lung which could also relate to infectious or inflammatory process. " caede2a0-7c8cdd95-e4785074-7af6bc7d-f784bd22.jpg,test/p13/p13623501/s51227602/caede2a0-7c8cdd95-e4785074-7af6bc7d-f784bd22.jpg,test," FINAL REPORT INDICATION: ___-year-old male with a history of one month of rib pain. Rule out left lower rib fracture. COMPARISON: Radiographs from ___, ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is mildly enlarged. The hilar and mediastinal contours are normal. The lungs are well expanded and clear. There is no pneumothorax or pleural effusion. No definite fracture is identified in the ribs bilaterally. Again seen is the expansile right lateral 7th rib lesion. Although this appears slightly more prominent, this could be secondary to technique. IMPRESSION: No definite evidence of a rib fracture. Again seen is the expansile right lateral 7th rib lesion. " 84f2e2d5-d7c0a036-d8e3bd7f-0d923e4a-0b347e0b.jpg,test/p17/p17106151/s53150549/84f2e2d5-d7c0a036-d8e3bd7f-0d923e4a-0b347e0b.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal or hilar contours are unchanged and within normal limits. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion, focal consolidation or pneumothorax is visualized. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 3e5b93f9-1d62b006-78c577cf-74b7639a-707edd6c.jpg,test/p15/p15481731/s54286255/3e5b93f9-1d62b006-78c577cf-74b7639a-707edd6c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with aspiration pneumonia, post extubation // eval for interval change TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 5 hours earlier IMPRESSION: No interval change from prior study. Multifocal lung consolidations larger in the upper lobes, appearance of the cardiomediastinal silhouette, small bilateral effusions and left PICC are unchanged. There is no pneumothorax " 5fdc5781-e088791a-7c71a99d-6556e726-bc6d332f.jpg,test/p16/p16476559/s56001799/5fdc5781-e088791a-7c71a99d-6556e726-bc6d332f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF // Eval for change in pulmonary edema TECHNIQUE: Portable AP film was obtained COMPARISON: ___ FINDINGS: Patient status post sternotomy. There is right-sided IJ line is in good position. Patchy parenchymal opacification is most pronounced in the right lower lobe and concern for evolving infection here is made. Elsewhere, there is mild pulmonary edema. IMPRESSION: No significant interval change from prior study attention on followup to the right " b6f7c3ae-9f328b30-9fda586e-34c89d97-73c2a548.jpg,test/p19/p19237377/s55891177/b6f7c3ae-9f328b30-9fda586e-34c89d97-73c2a548.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures appear within normal limits. IMPRESSION: No evidence of acute disease. " e2d38c8b-159b7318-983d4a13-17c3c4af-d6bc3bca.jpg,test/p17/p17968573/s59299011/e2d38c8b-159b7318-983d4a13-17c3c4af-d6bc3bca.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left great toe ulcer // Pre-op CXR Surg: ___ (Toe amputation) Pre-op CXR IMPRESSION: Moderately severe, basal predominant, interstitial pulmonary abnormality, chronicity indeterminate. This could be chronic infiltrative lung disease, acute pulmonary edema, or drug reaction, among other possibilities. Heart is top- normal size. There is a suggestion that there may be a small pericardial effusion. There is no pleural abnormality. " 37f7e3ca-93ef1bc3-81e615c8-a061addd-3a3b6dbf.jpg,test/p15/p15338518/s50581506/37f7e3ca-93ef1bc3-81e615c8-a061addd-3a3b6dbf.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent Dobbhoff tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the Dobbhoff tube shows now normal course. The tip projects over the middle parts of the stomach. No complications, notably no pneumothorax. Otherwise, the image is unchanged. " 1f14b09e-56238037-91886515-af36b82b-72c04d92.jpg,test/p14/p14548055/s55212901/1f14b09e-56238037-91886515-af36b82b-72c04d92.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Patient with worsening cough/pain in flanks for the last 2 days. // rule out acute cardiopulmonary process FINDINGS: Since the ___ chest radiograph, the heart has slightly increased in size and is accompanied by pulmonary vascular congestion and diffuse interstitial edema. There is no definite pneumonia, but followup PA and lateral chest radiographs after diuresis may be helpful to a more fully exclude this possibility, particularly at the right lung base. Lung volumes are increased, suggestive of COPD. Small bilateral pleural effusions are also demonstrated. IMPRESSION: 1. CHF with interstitial edema and small bilateral pleural effusions. 2. Followup PA and lateral radiographs after diuresis may be helpful to exclude the possibility of coexisting pneumonia in the right lung base. " 018a644b-b08edb22-5ef8f2b9-31ebd837-eb987702.jpg,test/p17/p17001135/s58050298/018a644b-b08edb22-5ef8f2b9-31ebd837-eb987702.jpg,test," WET READ: ___ ___ ___ 10:16 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with CP COMPARISON: Chest radiograph study from ___. FINDINGS: PA and lateral views of the chest provided. The lungs are hyperinflated but clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. S-shaped thoracic spine is again seen. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 66cd4c25-9504e065-4044dfe5-ccd89fc3-ffb50c10.jpg,test/p19/p19143018/s55575917/66cd4c25-9504e065-4044dfe5-ccd89fc3-ffb50c10.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p hernia repair now with fever 101 // ? infection ? atelectasis COMPARISON: ___ IMPRESSION: Cardiomediastinal contours are normal. Lung volumes are low and note is made of patchy and linear bibasilar opacities with appearance suggestive of atelectasis. Possible small left pleural effusion. " 5c6ac046-984de541-102e0217-3cb75dae-1a191c6c.jpg,test/p17/p17592232/s57105102/5c6ac046-984de541-102e0217-3cb75dae-1a191c6c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PNA, reintubated for low sats on nonrebreather. // pulmonary process? pulmonary process? IMPRESSION: Comparison to ___. Monitoring and support devices are stable. Stable mild to moderate left pleural effusion with subsequent retrocardiac atelectasis. The ventilation at the right lung bases has improved, with a decrease of the pre-existing parenchymal opacity. " 90ec3f53-26f267b1-dac439d4-213a4ca6-fafd85ec.jpg,test/p19/p19809073/s55719894/90ec3f53-26f267b1-dac439d4-213a4ca6-fafd85ec.jpg,test," FINAL REPORT HISTORY: Cough, congestion, fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated with flattening of the diaphragms suggestive of COPD. Heart size is normal. The aorta remains aneurysmally dilated and tortuous, unchanged. Pulmonary vascularity is not engorged. Ill-defined patchy opacity within the right lower lobe is concerning for pneumonia, and is new compared to the prior exam. Left lung is clear. No pleural effusion or pneumothorax is identified. Posttraumatic changes of the right acromioclavicular joint are re- demonstrated. There are no acute osseous abnormalities. IMPRESSION: Right lower lobe pneumonia. Follow up radiographs after treatment are recommended to ensure resolution of this finding. " 1655f268-d8529802-4df4f67e-b1363131-9d086815.jpg,test/p11/p11304959/s54588008/1655f268-d8529802-4df4f67e-b1363131-9d086815.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with heart failure and urosepsis now w/dyspnea. // Is there an acute pulmonary process (PNA vs. pulm edema?) Is there an acute pulmonary process (PNA vs. pulm edema?) IMPRESSION: In comparison with the study of ___, there is continued enlargement of cardiac silhouette with increasing bilateral pulmonary opacifications consistent with worsening pulmonary edema. Poor definition of the left hemidiaphragm is consistent with volume loss in the left lower lobe. Probable small pleural effusions with compressive basilar atelectasis. In view of the extensive changes in the lungs, it would be difficult radiographically to exclude superimposed pneumonia, especially in the absence of a lateral view. " bddae7e1-93707606-4868f528-7435aafc-db8577e4.jpg,test/p13/p13273041/s52392146/bddae7e1-93707606-4868f528-7435aafc-db8577e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dyspnea off HD // PNA? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a minimal increase in extent of the right pleural effusion. Moderate pulmonary edema persists. Moderate cardiomegaly with areas of atelectasis in the retrocardiac lung regions. No pneumothorax. " 31e7edca-0e5070e0-87fe867d-236a9f67-98cd13ec.jpg,test/p16/p16742247/s53747478/31e7edca-0e5070e0-87fe867d-236a9f67-98cd13ec.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Again seen is consolidation in the lingula which on the lateral view appears minimally improved. There is however more conspicuous opacity in the right mid to lower lung, likely localizing to the lower lobe on the lateral exam. Cardiomediastinal silhouette is within normal limits noting calcified mediastinal nodes. No acute osseous abnormality detected. IMPRESSION: Persistent lingular pneumonia with perhaps developing right lower lobe infection on the current exam as well. Recommend repeat after treatment to document resolution. " 8052008b-8893777c-a20fdc7a-6d43d20c-a036de36.jpg,test/p18/p18040018/s55458522/8052008b-8893777c-a20fdc7a-6d43d20c-a036de36.jpg,test," WET READ: ___ ___ ___ 7:43 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with cough, malaise // Eval for PNA TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. Decorative piercings are new from the prior study. IMPRESSION: No acute cardiopulmonary process. " b4f4ebed-777762c7-f022baeb-27a22182-7e262556.jpg,test/p11/p11372885/s52083297/b4f4ebed-777762c7-f022baeb-27a22182-7e262556.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma who presents w/ flare, was diagnosed w/ presumed pneumonia at outside urgent care center but didn't improve w/ doxycycline // eval for pneumonia. TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: ___. FINDINGS: The lungs are clear. There is no pneumothorax. The heart and mediastinum are within normal limits. IMPRESSION: Clear lungs with no evidence of pneumonia. " bedc6bd8-4a864815-c1be923f-efa7f080-7c03d3c0.jpg,test/p15/p15084854/s55517838/bedc6bd8-4a864815-c1be923f-efa7f080-7c03d3c0.jpg,test," FINAL REPORT INDICATION: Pain and shortness of breath. Evaluate for pulmonary embolism. TECHNIQUE: Chest PA and lateral. COMPARISON: None. FINDINGS: The cardiac and mediastinal silhouettes appear within normal limits. There no focal pulmonary opacities, pleural effusions, or evidence of pneumothorax. Osseous structures appear unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. Note that chest radiographs have limited utility in assessing for pulmonary embolism. " 6968fd6f-33b15d3d-54674814-9fa040c8-ef4fbbea.jpg,test/p17/p17190208/s59443887/6968fd6f-33b15d3d-54674814-9fa040c8-ef4fbbea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new OGT // OGT placement TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: A left-sided PICC terminates in the mid to distal SVC. A left-sided internal jugular catheter terminates in the proximal SVC. Endotracheal tube terminates 5.5 cm above the carina. A nasoenteric tube terminates in the left upper quadrant in the expected location of the stomach. Unchanged elevation of the right hemidiaphragm. No pneumothorax seen. Moderate cardiomegaly. IMPRESSION: An nasoenteric tube terminates in the stomach. " 1d49446f-3019d86d-bb08164f-b0555ff6-59c871c5.jpg,test/p10/p10146602/s58060815/1d49446f-3019d86d-bb08164f-b0555ff6-59c871c5.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT 858 CLINICAL INDICATION: ___-year-old with wedge resection, status post chest tube removal, assess for interval change. Comparison is made to the patient's previous study dated ___ at ___. IMPRESSION: 1. Overall, there continues to be extensive subcutaneous emphysema involving the right lateral chest wall soft tissues and extending into the soft tissues of the neck. The left neck soft tissues are now involved, and there is additional dissection laterally towards the soft tissues overlying the distal right clavicle. On the lateral projection, the amount of air does not appear to be significantly changed. There is suggestion of a tiny right apical pneumothorax. Post-operative changes in the right upper lung and paratracheal region are stable. Overall, cardiac and mediastinal contours are unchanged. No pulmonary edema or focal airspace consolidation to suggest pneumonia. No pleural effusions. " d3b3b9a5-fb553e9d-a88e99d7-72a9f3ad-e4dbd41c.jpg,test/p15/p15011336/s55542056/d3b3b9a5-fb553e9d-a88e99d7-72a9f3ad-e4dbd41c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo F on Aggrenox fall down 3 stairs L SDH, IPH // please rule out acute processess please rule out acute processess IMPRESSION: Compared to the only prior chest radiograph, ___. Lungs are well expanded and clear. Heart is mildly enlarged but there is no other indication of cardiac decompensation. Patient has had median sternotomy and cardiac valve replacement. Epicardial lead fragments are noted. There is no pneumothorax or pleural effusion. Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referrable focal findings should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning. . " 2e63f17e-35207f63-f5a47338-4a58b611-2b3310ad.jpg,test/p11/p11778209/s54998883/2e63f17e-35207f63-f5a47338-4a58b611-2b3310ad.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumothorax or pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Lungs are clear. No pleural effusion, pneumothorax or focal airspace consolidation. Heart is top normal. Mediastinal and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary abnormality. " ec043137-12c31f13-a1694ecf-bd9be09f-e92406d1.jpg,test/p13/p13339319/s51873083/ec043137-12c31f13-a1694ecf-bd9be09f-e92406d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with gallstone pancreatitis, remains hypoxic, requiring 4 L o2. // ? extent of effusion, pulm edema, atelectasis COMPARISON: ___ IMPRESSION: The lung volumes have further decreased. The presence of bilateral pleural effusions is likely. Relatively extensive retrocardiac and small right basal atelectasis. No overt pulmonary edema. No pneumonia. " 2f359258-011c05df-2c3becf0-7c7465b2-79918262.jpg,test/p15/p15554295/s56799705/2f359258-011c05df-2c3becf0-7c7465b2-79918262.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p GSW to abdomen s/p ex-lap, cardiac arrest intraoperatively, SBR w/anastamosis, colonic primary repair, sigmoid and colon resection s/p delayed anastamosis, left EIV stent c/b stent migration to right pulm artery s/p endovascular removal. Now with increasing tachycardia. CXR already taken for this order. // eval for PNA eval for PNA IMPRESSION: Right central venous line tip is at the level of mid SVC. NG tube tip is in the stomach. Heart size and mediastinum are unchanged. There is slight progression of the right lower lobe consolidation and both perihilar opacities that might represent a combination of volume overload and right lower lobe aspiration/ pneumonia or potentially atelectasis. " 2ab3e8df-5ac8ae5f-70507d62-07ff69fd-f8926559.jpg,test/p18/p18780188/s51426244/2ab3e8df-5ac8ae5f-70507d62-07ff69fd-f8926559.jpg,test," FINAL REPORT INDICATION: ___M with cough, r sided rib pain // R rib fractures? pna? TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no effusion, consolidation, or edema. Mild cardiomegaly is noted. Atherosclerotic calcifications are seen at the aortic arch. There is no visualized acute displaced fracture. Deformity of the left anterior ribs appears chronic. No definite acute displaced fracture identified. IMPRESSION: No acute cardiopulmonary process. No acute displaced rib fractures identified, consider dedicated rib series for increased sensitivity if desired. " dba58d1d-e4bbf710-df4d0fa1-393f5618-67b0b1b7.jpg,test/p11/p11773978/s58768494/dba58d1d-e4bbf710-df4d0fa1-393f5618-67b0b1b7.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ No prior studies for comparison. FINDINGS: Heart size, mediastinal and hilar contours are normal. An asymmetrical focal opacity is identified at the level of the right first costochondral junction, and is probably related to asymmetrical degenerative changes at this level. Lungs are otherwise clear, and there are no pleural effusions or acute skeletal findings. IMPRESSION: Focal opacity at level of right costochondral junction, likely due to asymmetrical degenerative changes at this level, but an apical lordotic chest radiograph is recommended to exclude the possibility of a lung nodule, as communicated by phone to Dr. ___ at 7:55 a.m. on ___ at the time of discovery. " 737a91d2-99f17405-69f24e3e-b0b61ec2-66821240.jpg,test/p15/p15246600/s56944817/737a91d2-99f17405-69f24e3e-b0b61ec2-66821240.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new diminished breath sounds R posterior base // please assess for pneumonia/pleural effusion/hemidiaphragm elevation COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral views of the chest provided. New elevation of the right hemidiaphragm probably facilitates migration of a loop of large bowel above the liver, Chilaiditi's sign. Atelectasis in the right middle lobe reflects elevated right hemidiaphragm. Lungs are otherwise clear. IMPRESSION: 1. New elevation of right hemidiaphragm suggests diaphragmatic dysfunction, including phrenic nerve paralysis. Further evaluation by fluoroscopic sniff test or targeted ultrasound can be considered. 2. No evidence of pneumonia. No pleural effusion. Recommendations: Assess diaphragmatic function with fluoroscopy or ultrasound. " 970a6bbe-9e711720-6e5363be-d78b7a3d-b1be0742.jpg,test/p15/p15418726/s59085651/970a6bbe-9e711720-6e5363be-d78b7a3d-b1be0742.jpg,test," FINAL REPORT INDICATION: Dyspnea. No comparison studies available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 30b2a7e4-7ab2fbea-13885bbf-682da18f-d648dbfe.jpg,test/p10/p10591267/s50662376/30b2a7e4-7ab2fbea-13885bbf-682da18f-d648dbfe.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with altered mental status. Evaluate for pneumonia, infiltrate, mass. TECHNIQUE: Chest AP and lateral COMPARISON: Outside CT torso ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " dee15381-e644df5d-3989a7d3-79de6de2-dbe8c2f2.jpg,test/p15/p15114289/s55626719/dee15381-e644df5d-3989a7d3-79de6de2-dbe8c2f2.jpg,test," FINAL REPORT INDICATION: Possible aspiration of pill. Now dyspneic. TECHNIQUE: Single frontal radiograph of the chest. COMPARISON: Radiograph dated ___. FINDINGS AND IMPRESSION: The lungs are clear. No pneumothorax or pulmonary edema is seen. No significant pleural effusion is identified, though the left costophrenic angle is excluded from the field of view. No evident radiopaque foreign body is seen within the airways. The cardiomediastinal silhouette is normal. Incidental note is made of remote left posterolateral seventh rib fracture. " 99898c3c-954c42a5-b2570206-10f38bc5-3b6a5021.jpg,test/p16/p16980011/s52507867/99898c3c-954c42a5-b2570206-10f38bc5-3b6a5021.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with seizure, question of infection TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Moderate to severe enlargement of the cardiac silhouette is unchanged. The mediastinal and hilar contours are similar. Lung volumes remain low. No focal consolidation, pleural effusion or pneumothorax is visualized. Pulmonary vasculature is normal. No acute osseous abnormalities demonstrated. Clip is seen projecting within the upper abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " e23ac2d9-c4faec88-65484c90-0351df9e-a4d676d2.jpg,test/p13/p13562596/s57856887/e23ac2d9-c4faec88-65484c90-0351df9e-a4d676d2.jpg,test," FINAL REPORT HISTORY: Fever and dyspnea. COMPARISON: ___, 8:57 a.m. TECHNIQUE: AP and lateral chest radiograph, two views. FINDINGS: Compared to same day examination from ___ hours earlier, there appears to be subtle increased opacities seen in the lower posterior lung fields clearly on the lateral view only without a clear frontal correlate. This may correspond to some retrocardiac densities. This is likely atelectatic in nature; however, underlying infection cannot be excluded. There is no pleural effusion or pneumothorax. IMPRESSION: Subtle heterogeneous opacities in the lower posterior lung field seen only on the lateral view. This is likely atelectatic, however, pneumonia remains a consideration. " 38b978f7-b3ad220a-e643e3f2-ebee6301-d6d1e28d.jpg,test/p18/p18509816/s51935399/38b978f7-b3ad220a-e643e3f2-ebee6301-d6d1e28d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is complete resolution of all pre-existing parenchymal and pleural abnormalities. The only notable finding is a relatively dense retrosternal space, seen on the lateral radiograph only, without evidence on the frontal image of any mediastinal abnormality. Finding should be followed on the lateral radiograph in two to three months from now. No pleural effusions. No pneumonia. No pulmonary edema. " 3993b94d-d6d03a5b-b83d3293-22bf35d8-189770eb.jpg,test/p17/p17945025/s50017179/3993b94d-d6d03a5b-b83d3293-22bf35d8-189770eb.jpg,test," FINAL REPORT INDICATION: ___ year old man with new fevers // rule out pulm infection TECHNIQUE: Portable COMPARISON: ___ FINDINGS: The previously described masslike opacity since ___ has significantly improved, with residual heterogeneous opacity, suggesting focal infection or atelectasis over malignancy. There is new mild opacity in the right middle lobe. The lungs are otherwise clear. Heart size is stable with mild cardiomegaly. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. IMPRESSION: The previously described masslike opacity since ___ has significantly improved, with residual heterogeneous opacity, suggesting focal infection or atelectasis over malignancy. There is new mild opacity in the right middle lobe, which could also represent worsening pneumonia in the appropriate clinical setting. " 4038352f-2d3def34-68eb25a7-7bc3f426-63286519.jpg,test/p10/p10986674/s59259025/4038352f-2d3def34-68eb25a7-7bc3f426-63286519.jpg,test," WET READ: ___ ___ ___ 8:55 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with chest pain // eval for ptx, widened mediastinum TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Surgical clips the lower neck are again noted. Heart size is within normal limits. Coronary artery stents are noted. Platelike atelectasis is noted the left midlung. Lung fields are otherwise clear. No focal consolidation. IMPRESSION: No acute cardiopulmonary abnormality. " 8f240fde-60139a4f-872dfa55-935f61b1-86787dbd.jpg,test/p16/p16611822/s53316982/8f240fde-60139a4f-872dfa55-935f61b1-86787dbd.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Interstitial lung disease, night sweats. PA and lateral upright chest radiographs were reviewed in comparison to ___ and chest CT from ___. Heart size is top normal, minimally enlarged since the prior study. Aorta is tortuous but unchanged. There is no evidence of lymphadenopathy within the limitations of this study technique. As compared to the prior study, there is slight interval progression of interstitial lung disease as noted along the periphery of the lungs with mild apical basal gradient. No focal consolidations demonstrated. No pleural effusion is seen. IMPRESSION: Findings concerning for interval progression of interstitial lung disease that if clinically warranted can be further assessed with high-resolution chest CT. " ac5b151f-18f7c419-2acb8bc1-341fd4d3-1d1082c3.jpg,test/p12/p12878814/s57995850/ac5b151f-18f7c419-2acb8bc1-341fd4d3-1d1082c3.jpg,test," FINAL REPORT PATIENT HISTORY: ___ years old man with relapsed lymphoma, assess for infiltrate, right base crackles. COMPARISON: There is no prior chest x-ray for comparison at the time of dictation. FINDINGS: PA and lateral views of the chest show normal lung volume without consolidation or nodules. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: No sign of acute cardiopulmonary processes. Findings were reported to ___ at 1 p.m. by Dr. ___. " a655fa3f-5a074dd4-2e4d3808-45c42970-e9dab588.jpg,test/p17/p17561108/s57592488/a655fa3f-5a074dd4-2e4d3808-45c42970-e9dab588.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Evaluate lung opacities. Comparison is made with prior study ___. Mild-to-moderate cardiomegaly is unchanged. There has been markedly increase in alveolar and ground-glass diffuse opacities seen in both lungs. Small right pleural effusion is stable. Right Port-A-Cath tip is in the upper SVC. There is no evident pneumothorax. Sternal wires are aligned. IMPRESSION: Extensive diffuse lung opacities. Differential diagnosis includes worsening infectious process, a component of edema can be present. Followup after diuresis is recommended. Findings were discussed with Dr. ___ by phone, ___ at 4:10 p.m., 2 minutes after the discovery of the finding. " e7e0c999-bf8e62d9-05e4feac-db036f69-3ce1f825.jpg,test/p13/p13050559/s54821354/e7e0c999-bf8e62d9-05e4feac-db036f69-3ce1f825.jpg,test," WET READ: ___ ___ ___ 8:27 PM Right IJ terminates in the right atrium. Could pull back 3-4 cm to be at cavoatrial junction, if desired. Otherwise, stable exam from prior. Findings communicated to Dr. ___ at 7:20 p.m. on ___ by phone. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with mediastinal lymphoma, prior SVC compression, on chemo, with arm swelling, facial plethora, vision changes // ?mediastinal expansion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received a right internal jugular vein catheter. The tip of the catheter projects over the mid to lower SVC. There is no evidence of complications, notably no pneumothorax. The known right upper lobe and the right paramediastinal opacity and mass. No new parenchymal opacities. No pleural effusions. Unchanged normal size of the cardiac silhouette. " dd674d09-001649c9-b532bb65-2d8dc70f-fdf26b2c.jpg,test/p11/p11694913/s59750147/dd674d09-001649c9-b532bb65-2d8dc70f-fdf26b2c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman presenting with chest pain. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Slightly low lung volumes, perhaps related to degree of respiratory effort. The lungs are otherwise clear. No focal consolidation, edema, effusion, or pneumothorax. Scoliosis of the thoracolumbar spine is overall unchanged. The cardiomediastinal silhouette is normal. IMPRESSION: Slightly low lung volumes but no evidence of acute intrathoracic process. " c63bb0ef-435553a4-c5483b9f-b78b0d97-c5da10b3.jpg,test/p14/p14532649/s51213332/c63bb0ef-435553a4-c5483b9f-b78b0d97-c5da10b3.jpg,test," FINAL REPORT AP CHEST, 5:09 A.M. ON ___. HISTORY: ___-year-old man with pneumonia and pulmonary edema. Hypoxic. IMPRESSION: AP chest compared to ___: Global pulmonary consolidation, which improved radiographically between ___, has worsened. The heterogeneous quality, nondependent distribution suggests this is not cardiogenic edema, or at least substantially something other than cardiogenic edema, such as multifocal pneumonia. Heart is normal size and mediastinal vasculature is not engorged. Small right pleural effusion has been present for several days. Left pleural effusion is minimal if any. No pneumothorax. Left PIC line ends in the mid to low SVC. " e6eadc00-843f5f52-55a5b222-192d1f83-9d6885b8.jpg,test/p11/p11119286/s59593142/e6eadc00-843f5f52-55a5b222-192d1f83-9d6885b8.jpg,test," FINAL REPORT INDICATION: Focal reproducible right-sided chest pain and repeated emesis. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion, pneumomediastinum, or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. Specifically, no evidence of pneumomediastinum or pneumothorax. " c3109fb8-fae16c1a-8e3a6614-26f7f9c5-b0b90449.jpg,test/p16/p16881403/s51404196/c3109fb8-fae16c1a-8e3a6614-26f7f9c5-b0b90449.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with cough, fever. // Please evaluate for pneumonia COMPARISON: No prior imaging is available. IMPRESSION: More than a score of a discrete opacities are present in the lungs, many of these are nodular, some are cavitated and some of those contain fluid, see for example an 18 mm wide lesion projecting posterior to the IVC on the lateral view. Interestingly the lower lobes are relatively spared, although I do not understand the significance of that distribution. Hilar adenopathy may be present. There is no large scale mediastinal adenopathy although conventional chest radiographs can overlook enlarged central lymph nodes. There is no pleural abnormality. Differential diagnosis includes septic emboli, with or without endocarditis, and disseminated mycobacterial or fungal infection. It is also possible that these lesions may have preceded recent infectious symptoms, and therefore the differential diagnosis includes cavitated metastases; in a female patient of this age choriocarcinoma should be investigated. CT scanning might provide useful information, at the very least documenting the extent of cavitation. NOTIFICATION: Dr. ___ reported the findings to Dr. ___ by telephone on ___ at 9:03 AM, 2 minutes after discovery of the findings. " 631fd8b8-3d5ba35e-f81cef7c-63cae19f-a7822538.jpg,test/p19/p19516231/s59024995/631fd8b8-3d5ba35e-f81cef7c-63cae19f-a7822538.jpg,test," FINAL REPORT HISTORY: Pleural biopsy, rule out pneumothorax. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: A left chest tube is directed toward the apex. There is a small, left pneumothorax, unchanged from prior. An increase in interstitial and perihilar opacities with central vascular engorgement is consistent with mild pulmonary edema. Significant thickening of the right apical pleura with encasement along the right mediastinum is unchanged. Slight increase in prominence of the mediastinum is likely related to technique. Small amount of pleural fluid is seen in the right lung apex and left costophrenic sulcus. Heart size is normal. Findings discussed with Dr. ___ by Dr. ___ at ___ on ___ by telephone at the time of discovery. " d1cd470b-709eb217-69977228-14bf4f2f-c0457196.jpg,test/p18/p18322589/s50924449/d1cd470b-709eb217-69977228-14bf4f2f-c0457196.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a new nasogastric tube. The tube shows a normal course, the tip is not included on the image. Otherwise, there is no relevant change, with the exception of mild decrease of the pre-existing parenchymal opacities caused by pleural effusions and subsequent areas of atelectasis at both lung bases. " e8662fd8-02c035ae-ca2e8fff-dc494b51-852628ce.jpg,test/p17/p17967970/s53343078/e8662fd8-02c035ae-ca2e8fff-dc494b51-852628ce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p thoracotomy, intubated, continued ventilator dependence // ?improvement in volume status IMPRESSION: Moderate right apical pneumothorax with apical and basilar components is similar to recent radiograph of ___. Subcutaneous emphysema in the adjacent chest wall has minimally decreased. Allowing for differences in technique, there has otherwise been it no relevant change in the appearance of the chest since the recent study of ___. " 5fb796d6-6bc4888e-b5d39bdd-b0721d3d-e75c7f54.jpg,test/p15/p15036649/s58898214/5fb796d6-6bc4888e-b5d39bdd-b0721d3d-e75c7f54.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Chest tube removal. Comparison is made prior to ___. There is a questionable tiny right pneumothorax. Moderate cardiomegaly is unchanged. Bibasilar atelectasis larger on the left side have increased. If any there are small bilateral pleural effusions. Radiolucent seen in the medial aspect of the upper and mid left hemithorax likely represents air in the pericardium and pneumomediastinum. Sternal wires are aligned. Of note, there is still present two pacer leads but they appear to end both in the right atrium. Prior ICD located the right ventricle is not longer visualized. " 106db2f6-40e21185-ac00c563-d95785a7-04333c92.jpg,test/p16/p16914073/s56170593/106db2f6-40e21185-ac00c563-d95785a7-04333c92.jpg,test," FINAL REPORT HISTORY: Cardiogenic shock.Evaluate for pulmonary edema. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___ at 9:05 a.m. Lordotic positioning. Compared with the prior film, the overall appearance is quite similar. Possible slight increase in the confluence of opacity in the left mid zone. Again seen are patchy alveolar opacities in both lungs in a perihilar distribution, most suggestive of CHF. There is a small right effusion. There is some patchy increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation which is unchanged. Sternal wires, mediastinal clips, and additional clips in the upper abdomen are again noted. Cardiomediastinal silhouette is unchanged.no pneumothorax is detected. IMPRESSION: Bilateral alveolar opacities consistent with pulmonary edema and small right effusion are essentially unchanged. Possible slight increase in the confluence of opacity in the left mid zone. " f93eb342-0cdb1e17-8fdd8d9e-a6e07688-1d99284a.jpg,test/p10/p10148145/s54466841/f93eb342-0cdb1e17-8fdd8d9e-a6e07688-1d99284a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man possible PE // pre- V/Q scan TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: Lungs are clear. Normal heart. No pleural effusions. No change since prior exam. IMPRESSION: Normal chest " 8a260b82-d9ca1bd8-a82e32d9-b0848354-9249fe28.jpg,test/p16/p16000871/s56018087/8a260b82-d9ca1bd8-a82e32d9-b0848354-9249fe28.jpg,test," WET READ: ___ ___ ___ 9:29 PM Pneumoperitoneum, possibly due to peritoneal dialysis catheter though clinical correlation is advised. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with tunneled line placed for HD 4 days ago presenting with persistent bleeding at the site. Patient had peritoneal catheter placed 4 days ago. COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Right IJ access dialysis catheter noted with tip in the region of the right atrium/cavoatrial junction. The heart remains mildly enlarged. Mild hilar congestion noted without frank pulmonary edema. No large effusion or pneumothorax. Bony structures are intact. There is moderate volume free intra peritoneal air noted in the upper abdomen which may be related to recently placed peritoneal dialysis catheter, though clinical correlation is advised. IMPRESSION: 1. Mild cardiomegaly with hilar congestion. 2. Pneumoperitoneum, possibly due to peritoneal dialysis catheter though clinical correlation is advised. NOTIFICATION: Findings were discussed with Dr. ___ at 21:20 on ___. " 5de0d150-e331dc32-717f2cef-77113ff0-6493eb51.jpg,test/p19/p19773700/s56121762/5de0d150-e331dc32-717f2cef-77113ff0-6493eb51.jpg,test," FINAL REPORT INDICATION: Patient with chest pain and cough. Evaluate for pneumonia. COMPARISON: Chest radiograph on ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are poorly expanded, but there are no focal opacities. Cardiomediastinal and hilar contours are unchanged, with a left ventricular predominance again seen. The aorta is tortuous. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 92f8e8cc-a7a5db41-c2152228-defd86a8-c8fd7049.jpg,test/p10/p10781468/s58768707/92f8e8cc-a7a5db41-c2152228-defd86a8-c8fd7049.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Dyspnea, question pneumonia or edema. FINDINGS: AP upright and lateral views of the chest were provided. There is interval progression in pulmonary edema with increasing bilateral pleural effusions with lower lobe consolidations, concerning for atelectasis versus pneumonia. Effusion is greater on the left than right. There is no pneumothorax. There is atherosclerotic calcification involving the thoracic aorta. The heart size is difficult to assess. Imaged bony structures are intact. IMPRESSION: Increasing pulmonary edema, increasing pleural effusions with increasing consolidations in the lower lungs concerning for atelectasis versus pneumonia. " ff40dee7-a902b467-b559aa2d-a07855a4-ecb0d7e5.jpg,test/p12/p12936816/s57459567/ff40dee7-a902b467-b559aa2d-a07855a4-ecb0d7e5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with unexplained tachypnea. // eval for PNA vs volume overload eval for PNA vs volume overload IMPRESSION: In comparison with the study of ___, the cardiomediastinal silhouette is stable. The lungs remain essentially clear except for some atelectatic changes at the bases. No evidence of appreciable vascular congestion or acute focal pneumonia, though this cannot be definitively excluded in the absence of a lateral view. " 2f248b27-c94556c4-e588e296-8920119e-152a08f1.jpg,test/p14/p14296716/s59320261/2f248b27-c94556c4-e588e296-8920119e-152a08f1.jpg,test," FINAL REPORT PA AND LATERAL CHEST HISTORY: Shortness of breath, chills, rule out pneumonia. IMPRESSION: PA and lateral chest reviewed in the absence of prior chest radiographs: There is no consolidation to suggest pneumonia. Bronchial wall thickening in the lower lobes seen on the lateral view could be due to bronchitis. There is no pleural effusion or evidence of central adenopathy. Heart size is normal. " 25569f48-bdc50cd8-fc01511b-69d6f780-9b7ab576.jpg,test/p15/p15193875/s52750209/25569f48-bdc50cd8-fc01511b-69d6f780-9b7ab576.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with glioblastoma Port-A-Cath. COMPARISON: Chest x-rays of ___ and ___. FINDINGS: Right-sided Port-A-Cath has been repositioned since previous exam and is now in adequate position ending in lower SVC. There is no kink. The lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: Right-sided Port-A-Cath has been repositioned and is now in adequate position without any kink. " 250bc646-395dc40b-e150c585-4e25c4b5-b3c779bc.jpg,test/p11/p11057136/s56452678/250bc646-395dc40b-e150c585-4e25c4b5-b3c779bc.jpg,test," FINAL REPORT HISTORY: COPD and shortness of breath. FINDINGS: In comparison with the study of ___, there is again hyperexpansion of the lungs with flattening of the hemidiaphragms consistent with chronic pulmonary disease. No convincing evidence of acute focal pneumonia. Evidence of previous CABG procedure, carotid stent, and cervical fusion. " c8cbce15-47b70a5b-1873cc81-89cdac3c-c3ffc857.jpg,test/p19/p19625496/s59951555/c8cbce15-47b70a5b-1873cc81-89cdac3c-c3ffc857.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with focal wheezing at the right base and mid lung zone with a history of asthma and recent upper respiratory infection. One week ago the patient developed sharp pleuritic chest pain in this region // please evaluate for pneumonia please evaluate for pneumonia IMPRESSION: Comparison to ___. No relevant change is noted. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pleural effusions, no pulmonary edema. No pneumothorax. " f113c40c-552a967d-2b24ead7-4cc469f7-1dee5319.jpg,test/p13/p13124419/s51041418/f113c40c-552a967d-2b24ead7-4cc469f7-1dee5319.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest and back pain // Cardiac workup TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Dual lead left-sided pacemaker is seen with lead extending the expected positions of the right atrium and right ventricle. The cardiac silhouette remains mildly enlarged. The aorta is tortuous. Mild prominence of the hila may be due to central pulmonary vascular engorgement. There is mild pulmonary vascular congestion. No focal consolidation is seen. There is no pleural effusion or pneumothorax. IMPRESSION: Mild cardiomegaly and mild pulmonary vascular congestion. " d0fa2a6c-a33ce1d8-f7ba7803-8a6312ba-2d134536.jpg,test/p11/p11816734/s57695113/d0fa2a6c-a33ce1d8-f7ba7803-8a6312ba-2d134536.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, wheezing // ? CHF, PNA COMPARISON: ___ IMPRESSION: No change as compared to the previous examination. Moderate cardiomegaly. Tortuosity of the thoracic aorta. No pleural effusions. No pneumonia, no pulmonary edema. " ae96fd82-dd19660f-4327fba5-eae15d39-466cf9c7.jpg,test/p11/p11874868/s59586689/ae96fd82-dd19660f-4327fba5-eae15d39-466cf9c7.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: The heart size is normal. Coronary artery stents are re- demonstrated. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear. Known pulmonary nodules seen on prior CT are not well seen on the current exam. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f7b96fb6-370b17fc-54eeee5c-4165d532-433b34cb.jpg,test/p17/p17147147/s52567055/f7b96fb6-370b17fc-54eeee5c-4165d532-433b34cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with known right pleural effusion, hemoptysis // eval pleural effusion, known Right Upper lobe parencyhmal changes eval pleural effusion, known Right Upper lobe parencyhmal ch IMPRESSION: In comparison with the study of ___ from an outside facility, there is little change. Areas of opacification are again seen in the right upper zone consistent with some combination of parenchymal and fibrotic changes. Blunting of the right costophrenic angle is again noted in consistent with pleural effusion. The left lung is hyperexpanded and clear. Right Port-A-Cath extends to the lower portion of the SVC. " 50178cbb-e7260a42-32e29ec5-3e566f6d-66c95a6b.jpg,test/p15/p15649892/s58299848/50178cbb-e7260a42-32e29ec5-3e566f6d-66c95a6b.jpg,test," WET READ: ___ ___ 12:01 AM Findings concerning for a right middle lobe pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ ___ ___'s disease with difficulty ambulating and pain on inspiration. Evaluate for acute intrathoracic process. COMPARISON: None. FINDINGS: Patchy opacities silhouette the right heart border on the frontal projection and overlie the region of the right middle lobe on the lateral projection, concerning for an infectious process. Minimal left lower lung atelectasis is noted. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: Findings concerning for a right middle lobe pneumonia. " 879f40c5-115bde45-4bdca263-5958f3db-c1359e70.jpg,test/p17/p17268630/s55038931/879f40c5-115bde45-4bdca263-5958f3db-c1359e70.jpg,test," FINAL REPORT HISTORY: Cough, shortness of breath. Evaluate for infiltrate. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Chest radiographs from ___. FINDINGS: The lungs are clear of focal opacities, pleural effusion, pulmonary edema or pneumothorax. A right lower lobe calcified granuloma is again seen. The heart and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 763b900a-0e0fdac5-dad56302-61e053bc-372c4e73.jpg,test/p15/p15103276/s52752441/763b900a-0e0fdac5-dad56302-61e053bc-372c4e73.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain and shortness of breath. COMPARISON: ___. Helical ___ ___. FINDINGS: AP and lateral views of the chest. There is relatively poor inspiratory effort on the current exam. There is secondary crowding of the bronchovascular markings. Cardiac silhouette appears enlarged compared to prior and likely accentuated by poor inspiratory effort and AP technique. Cardiomediastinal silhouette appears similar when compared to prior portable x-ray from ___. No acute osseous abnormality detected. IMPRESSION: No definite acute cardiopulmonary process noting poor inspiratory effort. " 9548b334-e45c8c7c-67261142-36a0b0de-30ea5e47.jpg,test/p16/p16575248/s56205165/9548b334-e45c8c7c-67261142-36a0b0de-30ea5e47.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain, to evaluate for acute process. COMPARISON: None available. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are clear, without consolidation, pulmonary edema, pleural effusion or pneumothorax. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary pathology. " a0dffc97-2ad169d7-899621f3-5c670c02-fdc24c7a.jpg,test/p13/p13372847/s51357743/a0dffc97-2ad169d7-899621f3-5c670c02-fdc24c7a.jpg,test," FINAL REPORT STUDY: AP CHEST, ___. CLINICAL HISTORY: ___-year-old woman with fever and sputum. Evaluate for pneumonia. FINDINGS: No prior study is available for direct comparison. There is an endotracheal tube whose distal tip is 3.8 cm above the carina, appropriately sited. There is a nasogastric tube whose distal tip and side port are below the GE junction and within the body of the stomach. Heart size is within normal limits. There is some prominence of the pulmonary interstitial markings suggestive of mild pulmonary edema. There is some patchy opacity at the left base which may represent atelectasis or developing infiltrate. Followup to resolution is recommended. There are no pneumothoraces. " 62293417-c3edd9fd-c05a2646-8a63d21e-b182d247.jpg,test/p16/p16553329/s53481703/62293417-c3edd9fd-c05a2646-8a63d21e-b182d247.jpg,test," WET READ: ___ ___ ___ 6:53 AM Probable small posterior sulcus pleural effusions. Otherwise, no acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with shortness of breath, evaluate for cardiopulmonary disease. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___ and ___. FINDINGS: There is no focal consolidation, PE pulmonary edema, or pneumothorax. The lateral view radiograph suggests small bilateral pleural effusions in the posterior costophrenic sulcus. The cardiomediastinal silhouette, including mild cardiomegaly, is unchanged. A vascular stent projects over the left axilla, new from prior studies. IMPRESSION: Probable small bilateral bold pleural effusions. Otherwise, no acute cardiopulmonary process. " 52f9eb9c-4e37db3a-b5f6773e-57ec2e46-f6689c02.jpg,test/p13/p13028893/s56273771/52f9eb9c-4e37db3a-b5f6773e-57ec2e46-f6689c02.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // rule out infiltrate TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: There is no focal consolidation, effusion, or pneumothorax. Heart size is top-normal. Mediastinal and hilar contours are normal. There is no pulmonary vascular congestion or edema. IMPRESSION: No evidence of pneumonia. " cee11739-4e4e2301-fd81fcaf-77ccea72-c42e4ba7.jpg,test/p13/p13859181/s54774720/cee11739-4e4e2301-fd81fcaf-77ccea72-c42e4ba7.jpg,test," WET READ: ___ ___ ___ 8:23 AM A new endotracheal tube ends 6 cm above the carina. Bilateral marked alveolar opacities likely represent severe pulmonary edema. ___ ___. WET READ VERSION #1 ___ ___ ___ 10:31 PM A new endotracheal tube ends 6 cm above the carina. Bilateral marked alveolar opacities likely represent severe pulmonary edema. ___ ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF with respiratory failure and intubation // Please eval for pulm edema Please eval for pulm edema IMPRESSION: In comparison with the study ___, there has been the development of multiple diffuse pulmonary opacification bilaterally, slightly more prominent on the right, consistent with pulmonary edema. There has been interval placement of an endotracheal tube, with its tip approximately 6 cm above the carina. " 91ff1d44-19d750b3-7753b1e6-f8d141c6-3db7d4a5.jpg,test/p17/p17194805/s51956521/91ff1d44-19d750b3-7753b1e6-f8d141c6-3db7d4a5.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with fatigue, cough, hyponatremia // pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded. A 15 mm well-circumscribed nodular density is noted in the left lower lobe. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pneumothorax, focal consolidation, or pulmonary edema. Mild aortic arch calcifications are present. Multilevel degenerative changes are present throughout the thoracic spine, with disc space narrowing and anterior flowing osteophytes contiguous over multiple levels, compatible with diffuse idiopathic skeletal hyperostosis (DISH). IMPRESSION: 1. No evidence of pneumonia. 2. Well-circumscribed nodular density in the left lower lobe may represent a granuloma. Correlation with prior imaging is recommended to ensure stability. If no prior imaging is available for comparison, low kilovoltage oblique radiographs could be obtained to document uniform calcification, diagnostic of a benign nodule. NOTIFICATION: The findings were discussed via telephone by Dr. ___ with Dr. ___ on ___ at 9:31 AM, after attending review. " f8bb1345-7de7b465-4f3d67ad-c3eadc06-f7cb4c24.jpg,test/p15/p15722937/s59158657/f8bb1345-7de7b465-4f3d67ad-c3eadc06-f7cb4c24.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // int change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiac size is normal. Extensive bilateral opacities are a stable. There is no pneumothorax or pleural effusion. Lines and tubes are in unchanged standard position. " e0057454-573c96f8-4c7bda68-67982241-d9237265.jpg,test/p16/p16160008/s51354005/e0057454-573c96f8-4c7bda68-67982241-d9237265.jpg,test," FINAL REPORT INDICATION: ___ year old man with metastatic renal cell carcinoma, presenting with fever. Assess for PNA. // ?PNA TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates well expanded clear lungs. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax, pleural effusion, or consolidation. The upper most apices are obscured by the patient's head. IMPRESSION: No acute cardiopulmonary process. " 7818d5bc-b7051c34-c5adaf53-6a90feed-48d34c42.jpg,test/p19/p19438264/s55528171/7818d5bc-b7051c34-c5adaf53-6a90feed-48d34c42.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dizziness, SOB, chills, nausea // evaluate for evidence of CHF and/or pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Focal area of lateral pleural thickening at the level of the left chest wall. Borderline size of the cardiac silhouette without evidence of pulmonary edema. Neither the frontal nor the lateral radiograph show evidence of pneumonia or pleural effusions. " 55147aac-4a85574a-e730b7df-d9dd1972-c3f5f489.jpg,test/p12/p12935888/s56407934/55147aac-4a85574a-e730b7df-d9dd1972-c3f5f489.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is minimal bibasilar atelectasis without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette remains mildly enlarged. The mediastinal and hilar contours are stable. No pulmonary edema is seen. Some degenerative changes are again seen along the spine. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 8e8bfdf6-bc75ce63-9a55270b-31809934-76746637.jpg,test/p15/p15751809/s54988589/8e8bfdf6-bc75ce63-9a55270b-31809934-76746637.jpg,test," FINAL REPORT EXAMINATION: AP and lateral chest radiographs INDICATION: ___ year old man s/p L chest tube after T11-T12 corpectomy and multi-level fusion. // Chest tube pulled at ___. Please perform x-ray to assess for pneumothorax around ___ today. TECHNIQUE: Chest AP and lateral COMPARISON: Portable chest radiograph dated ___ at 10:02 FINDINGS: In comparison to the chest radiograph obtained 6 hours prior, there has been interval removal of the left-sided chest tube with no change in the small left apical pneumothorax. A small amount of subcutaneous emphysema is unchanged. Heart size, mediastinal silhouette, and right basilar atelectasis are unchanged. IMPRESSION: Interval removal of a left-sided chest tube with no change in the small left apical pneumothorax. " d7b19480-883ba7a8-933e8975-87517672-dd967b49.jpg,test/p18/p18732974/s55921998/d7b19480-883ba7a8-933e8975-87517672-dd967b49.jpg,test," FINAL REPORT INDICATION: ___ year old man with bilateral acute cerebral infarcts with worsening WBC and fever overnight. // Evaluate for PNA TECHNIQUE: Portable AP chest radiograph COMPARISON: Chest radiograph from ___. CT of the chest from ___. IMPRESSION: Bibasilar opacities are more prominent than on ___ with extensive opacification overlying spine, concerning for aspiration. The heart is mildly enlarged, with mild vascular congestion and small bilateral pleural effusions with which may suggest an element of congestive heart failure or neurogenic pulmonary edema. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 5:00 PM, 10 minutes after discovery of the findings. " 7a0fc11a-d90b5bfe-0c8d5b63-6d42b5c2-fc0aa75d.jpg,test/p16/p16014068/s51100137/7a0fc11a-d90b5bfe-0c8d5b63-6d42b5c2-fc0aa75d.jpg,test," WET READ: ___ ___ 12:06 PM 1. Multiple bilateral rounded pulmonary nodular densities are compatible with known advanced metastatic disease. 2. No discrete focal consolidation concerning for pneumonia. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with fall and cerebellar hemorrhage. History of malignant sarcoma of the right proximal femur. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___ and CT chest of ___. FINDINGS: Lung volumes are low, causing bronchovascular crowding and accentuation of the heart size. Multiple scattered, rounded opacities in the left perihilar region and right lower lobe are consistent with known pulmonary nodules representing advanced metastatic disease. The right-sided Port-A-Cath tip projects at the region of the cavoatrial junction. No pleural effusion or pneumothorax detected. IMPRESSION: 1. Multiple bilateral rounded pulmonary nodular densities are compatible with known advanced metastatic disease. 2. No discrete focal consolidation concerning for pneumonia. No pneumothorax. " 9c050842-8c64949e-9905731f-b816948e-f4a7bd1e.jpg,test/p12/p12657764/s57134234/9c050842-8c64949e-9905731f-b816948e-f4a7bd1e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with azotemia, Cr 4.0, recurrent vomiting, cough, stable DOE // eval for acute process, widened mediastum eval for acute process, widened mediastum IMPRESSION: There no prior chest radiographs available for review. Heart size top normal. Mediastinal veins mildly dilated. Pulmonary circulation unremarkable. Lungs reasonably well expanded and clear. No pleural abnormality. " 143bebbd-2b237b73-7fcadc02-9f40d441-e223a0ba.jpg,test/p19/p19775210/s51542643/143bebbd-2b237b73-7fcadc02-9f40d441-e223a0ba.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cough, chest pain // Eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " a97bf789-e7c79d7f-55545f86-f99d9935-d42f309c.jpg,test/p12/p12722192/s56235939/a97bf789-e7c79d7f-55545f86-f99d9935-d42f309c.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ COMPARISON: ___ chest radiograph. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs are clear except for a small linear focus of atelectasis or scarring at the left base. No pleural effusion or pneumothorax is evident, and there is no chest radiographic evidence of an acute, displaced rib fracture. IMPRESSION: No chest radiographic evidence of acute, displaced rib fracture or pneumothorax. If pain is localized to a specific rib, dedicated rib views with markers may be helpful for more complete assessment if warranted clinically. " 295ddd4b-67b05a94-7f307e11-185b9057-931d9489.jpg,test/p19/p19169852/s55739531/295ddd4b-67b05a94-7f307e11-185b9057-931d9489.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with recent ICD replacement, p/w V-tach COMPARISON: CT chest ___ and chest radiograph ___ FINDINGS: Single AP upright portable view of the chest provided. The intervally new right chest wall AICD is seen with 2 leads seen extending into the right atrium and right ventricle. Left-sided leads are also seen extending into the right heart. Cardiomegaly is again noted with stable mediastinal contour. Mild hilar congestion is likely present without frank pulmonary edema. No pleural effusion or pneumothorax. No free air below the right hemidiaphragm is seen. Osseus structures appear intact. IMPRESSION: Stable cardiomegaly. Interval exchange of right chest wall pacer device with leads coursing into the region of the right atrium and right ventricle. " d901349d-8a917b75-571b4d8f-abae5824-18a6388b.jpg,test/p14/p14021217/s58896287/d901349d-8a917b75-571b4d8f-abae5824-18a6388b.jpg,test," FINAL REPORT INDICATION: ___M with AMS on lovenox // eval for ICH for head ct EVAL fo pna for cxrRUQ u/s eval for doppler and worsening portal vein thromobosis TECHNIQUE: Frontal lateral views the chest. COMPARISON: ___. FINDINGS: Extremely low lung volumes are seen which limits assessment. The lungs are grossly clear. Cardiac silhouette cannot be assessed. No acute osseous abnormalities. IMPRESSION: Limited exam due to low lung volumes without definite acute cardiopulmonary process. " 7890bd0a-740a07d5-1cb66244-97e1e8d5-d73dc360.jpg,test/p19/p19161635/s55041423/7890bd0a-740a07d5-1cb66244-97e1e8d5-d73dc360.jpg,test," FINAL REPORT INDICATION: ___-year-old male with right-sided head pain, evaluate for acute process. COMPARISON: Chest radiograph from ___. PA AND LATERAL CHEST RADIOGRAPHS: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. The osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " fd9a2f34-7f5850d9-7bbf5193-d5c0c11d-7eaa9ff1.jpg,test/p16/p16261645/s54933729/fd9a2f34-7f5850d9-7bbf5193-d5c0c11d-7eaa9ff1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxemia // Infiltrates, volume status, interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Minimal increase in extent of the retrocardiac atelectasis. Moderate cardiomegaly and low lung volumes persist. No new focal parenchymal opacities. " 5bab1114-4057a483-5f75f7f5-2aa1b3b8-2c87e093.jpg,test/p12/p12010209/s55240136/5bab1114-4057a483-5f75f7f5-2aa1b3b8-2c87e093.jpg,test," FINAL REPORT INDICATION: ___ year old man with hx of multiple myeloma with cough and green sputum, assess for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Frontal and lateral views of the chest demonstrate fully expanded and clear lungs. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Pectus excavatum deformity is noted. IMPRESSION: Normal chest radiograph. Specifically, no evidence of pneumonia. " 720b1d2f-64339a74-16ad8091-b29e7993-66bb109e.jpg,test/p10/p10058974/s54456726/720b1d2f-64339a74-16ad8091-b29e7993-66bb109e.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with altered mental status. Question infiltrate. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs remain clear of consolidation. Note is made of bilateral nipple shadows at the lung bases. There is no effusion or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unchanged, noting degenerative changes at the left glenohumeral joint. IMPRESSION: No acute cardiopulmonary process. " baeda180-d5f750be-d32ebc14-e145cab4-a6af000c.jpg,test/p16/p16702545/s58046418/baeda180-d5f750be-d32ebc14-e145cab4-a6af000c.jpg,test," FINAL REPORT He comparison chest radiographs ___ through ___ at 9:22 p.m. EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with HTN, CAD p/w an acute onset headache, nausea, and emesis with subsequent right visual field deficit and sensory aphasia found to have right parietal lobar intraparenchymal hemorrhage // interval change interval change IMPRESSION: Previous mild pulmonary edema has cleared and vascular congestion in the lungs and mediastinal venous engorgement have slightly improved. Heart size is top-normal. No pneumothorax or appreciable pleural effusion. Left subclavian catheter ends at the origin of the SVC. " c4a293b5-0058097a-3fbc54f2-3b56c6b4-b393ed4d.jpg,test/p14/p14105959/s54078994/c4a293b5-0058097a-3fbc54f2-3b56c6b4-b393ed4d.jpg,test," FINAL REPORT INDICATION: Chest pressure. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unchanged. Mild-to-moderate cardiomegaly is again noted. There is no pulmonary edema. Multiple surgical clips project over hilar and mediastinal silhouette. Sternotomy wires are in place. Remote right-sided rib fractures are visualized. IMPRESSION: No evidence of acute cardiopulmonary process. " d328143b-805a14a5-96d16c27-ee1e6d37-d197df8e.jpg,test/p12/p12070984/s54968359/d328143b-805a14a5-96d16c27-ee1e6d37-d197df8e.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Weakness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There has been no significant interval change since the prior study. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There is no overt pulmonary edema. IMPRESSION: No significant interval change. No acute cardiopulmonary process. " 18439838-d406b533-8f6a576b-7e6ad05c-48ff395f.jpg,test/p14/p14546527/s54961194/18439838-d406b533-8f6a576b-7e6ad05c-48ff395f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M ESRD/DM2 (HD since ___)s/p DD renal txp p/w oliguria and cr 6.8 found to have hydroneprhosis of tx kidney on U/S // eval for fluid overload COMPARISON: Chest x-ray dated ___ at 12:18 FINDINGS: The patient is status post sternotomy, with mild cardiomegaly, without significant change. There is mild upper zone redistribution and very slight vascular plethora, not significantly changed compared with ___. As before, the right hemidiaphragm is elevated left hemidiaphragm is lateralized, with patchy atelectasis in the right cardiophrenic region (slightly increased) and minimal blunting of left costophrenic angle. No new or increased pleural effusion is detected. Again seen is a right-sided PICC line with tip overlying SVC/RA junction. IMPRESSION: Mild upper zone redistribution and very slight vascular plethora, without overt CHF, probably unchanged. New patchy atelectasis in the right cardiophrenic region. No gross effusion. Minimal blunting of left costophrenic angle is unchanged and could represent chronic pleural thickening/scarring. " d678f53b-f8a06180-7476a9ff-27a7aa74-fbb434e3.jpg,test/p10/p10229323/s55318596/d678f53b-f8a06180-7476a9ff-27a7aa74-fbb434e3.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Motor vehicle accident, rib fractures. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is noted. The severe multifocal bilateral widespread areas of parenchymal opacities and consolidations are unchanged in severity. Unchanged appearance of the cardiac silhouette. Unchanged vertebral stabilization devices. Unchanged monitoring and support devices, including endotracheal tube and the right central venous access line. " 657a899f-bfcca303-cd0931cb-cc3cddec-535a54e1.jpg,test/p17/p17007226/s51189569/657a899f-bfcca303-cd0931cb-cc3cddec-535a54e1.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with new opacity and hypoxia // PNA, volume overload TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Increased opacity at the right lung base concerning for a right lower lobe pneumonia.Small right pleural effusion. The heart is mildly enlarged, unchanged compared to prior study. IMPRESSION: Right lower lobe pneumonia and small right pleural effusion. RECOMMENDATION(S): Follow-up chest x-ray is recommended in ___ weeks to confirm resolution of pneumonia. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 5:18 PM, 5 minutes after discovery of the findings. " 762abac0-83d91e45-9b5b4af4-3c25df66-93e20399.jpg,test/p18/p18471486/s55821948/762abac0-83d91e45-9b5b4af4-3c25df66-93e20399.jpg,test," FINAL REPORT INDICATION: ___-year-old male with alcohol intoxication and hypoxia. Evaluate for acute cardiopulmonary process. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded. A 2.7 x 2.6 cm rounded structure is noted in the right mid paramediastinal region which appears slightly increased in size compared with prior exam. Although, this may represent the main right pulmonary artery a hilar lesion cannot be excluded. Otherwise, the cardiomediastinal contour is unremarkable. There is no cardiomegaly. There is no pleural effusion or pneumothorax. No rib fractures are identified. IMPRESSION: Apparent right paramediastinal nodule may represent a prominent vessel versus a hilar mass. Further assessment with chest CT is recommended. " 66879731-202d8815-8e7a62c7-c69adea5-641d7dd7.jpg,test/p13/p13969264/s57293405/66879731-202d8815-8e7a62c7-c69adea5-641d7dd7.jpg,test," FINAL REPORT INDICATION: ___-year-old female with generalized weakness and low-grade temperature. Rule out pneumonia. COMPARISON: No relevant comparisons available. TWO VIEWS OF THE CHEST: The lungs are well expanded and show plate like atelectasis at the left lower lobe. The cardiac silhouette is top normal. The mediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " 184cd67e-faf518d3-482d304a-3677da7f-d2e29596.jpg,test/p14/p14852007/s57308954/184cd67e-faf518d3-482d304a-3677da7f-d2e29596.jpg,test," FINAL REPORT INDICATION: History: ___F with post intubation // post intubation TECHNIQUE: Frontal view of the chest COMPARISON: None FINDINGS: ET tube terminates 1.7 cm above the carina and is directed towards the right mainstem bronchus. There is no consolidation, pneumothorax, or pleural effusion. Cardiomediastinal silhouette is normal size. IMPRESSION: ET tube terminates 1.7 cm above the carina and is directed towards the right mainstem bronchus. Consider pulling back by 2 cm for optimal positioning. " 36907880-4fa950cd-71eba1b0-63eb7c00-b6f6ce65.jpg,test/p12/p12610375/s57271128/36907880-4fa950cd-71eba1b0-63eb7c00-b6f6ce65.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with unknown hx // please evaluate for infectious process COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Aside from mild lower lung atelectasis, the lungs appear clear. The heart and mediastinal contours are unchanged. No large effusion or pneumothorax is seen. No overt edema. Bony structures are intact. IMPRESSION: No definite signs of pneumonia. Mild basilar atelectasis. " 30d42eef-43805855-f7d3f6f5-6ff48ec4-1227afb3.jpg,test/p17/p17936680/s55477101/30d42eef-43805855-f7d3f6f5-6ff48ec4-1227afb3.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette is mild to moderately enlarged. There may be mild central pulmonary vascular engorgement and very minimal interstitial edema. No focal consolidation is seen. There is no pleural effusion or pneumothorax. " ba31d391-adc8973b-9d4cd27b-db033a0f-dffd5619.jpg,test/p15/p15834701/s59117856/ba31d391-adc8973b-9d4cd27b-db033a0f-dffd5619.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with local and distant cognitive impairment that's been present for two weeks now TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and ___ CT chest FINDINGS: Lung volumes are low. Heart size is borderline enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Patchy opacities are demonstrated in the lung bases. Elevation of the right hemidiaphragm is chronic. No pleural effusion, focal consolidation or pneumothorax is present. Mild degenerative changes are seen throughout the thoracic spine. IMPRESSION: Patchy bibasilar airspace opacities likely reflective of atelectasis in the setting of low lung volumes. " a57ff688-06059c6d-a959d7d6-eb0d1db4-b36fb4bc.jpg,test/p10/p10261509/s56896434/a57ff688-06059c6d-a959d7d6-eb0d1db4-b36fb4bc.jpg,test," FINAL REPORT INDICATION: ___-year-old man with increasing weakness, evaluate for acute cardiopulmonary process. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion or pneumothorax. " 6a7442eb-ba06c544-308e0718-8dc7f058-8f2b4f60.jpg,test/p19/p19231238/s58402348/6a7442eb-ba06c544-308e0718-8dc7f058-8f2b4f60.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Pulled at dialysis line. TECHNIQUE: Chest, AP and lateral. COMPARISON: ___. FINDINGS: Dialysis catheter terminates in the right atrium but has been perhaps retracted slightly. The cardiac, mediastinal and hilar contours appear stable including moderate cardiomegaly. There is no trace pleural effusions are suspected. Streaky retrocardiac opacity suggests atelectasis. The lungs appear otherwise clear. IMPRESSION: Perhaps slight retraction of dialysis catheter. No evidence of acute cardiopulmonary disease. Stable cardiomegaly. " 45ba8b9b-f9e34083-5cdd698d-934d94e9-bd679f4e.jpg,test/p15/p15287471/s53564047/45ba8b9b-f9e34083-5cdd698d-934d94e9-bd679f4e.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with acute renal failure, effusion? COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: Severe pulmonary edema and bilateral pleural effusions have increased since previous exam. Right hemodialysis catheter has been removed. New left hemodialysis catheter is in adequate position. The ET tube has been removed. There is new tracheostomy. There is no pneumothorax. Left-sided PICC line distal end is hard to assess. CONCLUSION: Severe pulmonary edema and pleural effusion have worsened since the previous exam. " 82a5332c-31229d55-2a0227e0-1e1422bc-eadf7115.jpg,test/p15/p15590394/s56232823/82a5332c-31229d55-2a0227e0-1e1422bc-eadf7115.jpg,test," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old female with palpitations and chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Low lung volumes seen on the current exam, particularly on the frontal view with secondary crowding of the bronchovascular markings. There is no definite consolidation or effusion. There is no pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No definite acute cardiopulmonary process and lower lung volumes on the current exam. " 49afb869-b802cbe2-2b79c7f7-ba3c1578-d2213559.jpg,test/p13/p13262317/s57992232/49afb869-b802cbe2-2b79c7f7-ba3c1578-d2213559.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with brain lesion plan for tumor resection on ___. // ___ year old woman with brain lesion plan for tumor resection on ___. Surg: ___ (Tumor resection ) TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: The heart is moderately enlarged and is slightly larger than on the prior exam. There is mild pulmonary vascular redistribution with increased interstitial markings likely representing an element of fluid overload. There is no focal infiltrate. IMPRESSION: Slight fluid overload, increased compared to prior " b1478a88-a68cedcd-c4895d66-1d5df23b-02618611.jpg,test/p19/p19919570/s59870726/b1478a88-a68cedcd-c4895d66-1d5df23b-02618611.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Crackles left side // Crackles left side Crackles left side COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lung volumes have improved, cardiomediastinal silhouette is substantially smaller and both pulmonary vascular engorgement and interstitial edema have resolved. There is no appreciable pleural effusion. No pneumothorax Right supraclavicular central venous catheter ends in the upper right atrium. " 794571d1-fed621c6-36936e73-1cb4d7aa-0b1ef3f1.jpg,test/p17/p17573892/s53630667/794571d1-fed621c6-36936e73-1cb4d7aa-0b1ef3f1.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ ___ COMPARISON: ___. FINDINGS: Heart size is normal. Decreased width of mediastinal and hilar contours is noted as compared to the prior examination suggesting that there may have lymphadenopathy present previously. Additionally, widespread pulmonary opacities present on the earlier chest x-ray have resolved as well. No new pulmonary or pleural abnormalities have developed. Skeletal structures are unremarkable. IMPRESSION: No evidence of acute pneumonia. " 0a4a209f-aa920311-8ae4e478-53d99003-93312a27.jpg,test/p17/p17556194/s50749775/0a4a209f-aa920311-8ae4e478-53d99003-93312a27.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with meningitis and intubated // ?interval change ?interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: The slight increase in pulmonary vascularity since ___, and no definite edema or pleural effusion. Heart size normal. Enlarge calcified abnormality in the right midlung is chronic. ET tube in standard placement. Right jugular line ends in the upper right atrium. Nasogastric drainage tube coils in the upper stomach with the tip pointing back to the gastroesophageal junction. " 510a11e1-b7517b9b-3ffd70d2-593cda74-9a6c76de.jpg,test/p18/p18677225/s52069546/510a11e1-b7517b9b-3ffd70d2-593cda74-9a6c76de.jpg,test," FINAL REPORT HISTORY: Melanoma, to assess for disease status. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Specifically, no evidence of parenchymal or skeletal metastasis. " 9d613b57-1e9cb7dc-4254ae60-0e087897-e0569aaa.jpg,test/p17/p17454111/s51929260/9d613b57-1e9cb7dc-4254ae60-0e087897-e0569aaa.jpg,test," FINAL REPORT INDICATION: History: ___M with weakness // ? Weakness TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Mild cardiomegaly has been stable compared to exams dated back to ___. There is mild bibasilar atelectasis. The hilar and mediastinal contours are normal. There is no pleural effusion, or pneumothorax. No definite focal consolidations concerning for pneumonia are identified. The visualized osseous structures are unremarkable. IMPRESSION: Mild bibasilar atelectasis. No focal consolidations concerning for pneumonia identified. " 94f008a7-ebf7b2de-9744e7a2-da2118fe-8e67b15d.jpg,test/p10/p10071620/s50877078/94f008a7-ebf7b2de-9744e7a2-da2118fe-8e67b15d.jpg,test," FINAL REPORT INDICATION: ___-year-old man with neck abscess and coarse lung sounds and cough. Rule out aspiration versus pneumonia. COMPARISONS: None. FINDINGS: PA and lateral views of the chest were provided. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Prior old rib fractures of the left fifth and sixth ribs are seen. IMPRESSION: No acute cardio-pulmonary process. " 75a14854-a365c196-8301d639-5e23c849-d43f1dce.jpg,test/p18/p18279264/s51199246/75a14854-a365c196-8301d639-5e23c849-d43f1dce.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 4:28 A.M. CLINICAL INDICATION: ___-year-old with sickle cell crisis, now improving. Assess for interval change. Comparison is made to the patient's prior study dated ___ at 735. A portable upright chest film ___ at 4:28 a.m. is submitted. IMPRESSION: Right internal jugular large-bore catheter continues to have its tip in the right atrium. The heart remains enlarged and somewhat globular in appearance which may reflect cardiomegaly, although a pericardial effusion should also be considered. There has been interval improvement in aeration in both lungs with residual multifocal patchy opacities which likely reflect a combination of pulmonary edema and infarcts. The pleural effusions have overall decreased in size. No pneumothorax. " 71028630-4c5466c0-bfbbbcd3-59a37bc9-135c12b3.jpg,test/p13/p13717902/s57323525/71028630-4c5466c0-bfbbbcd3-59a37bc9-135c12b3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory distress // interval changes TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: Cardiomegaly cannot be assessed. The small right and small to moderate left pleural effusions and adjacent atelectasis are grossly unchanged allowing the difference in positioning of the patient. ET tube is in standard position. NG tube tip is out of view below the diaphragm. . There is no evident pneumothorax. Mild Vascular congestion is stable. " ac3e0e21-b838cbcc-a7d7f9d7-60aa4258-080fa122.jpg,test/p14/p14513439/s50739375/ac3e0e21-b838cbcc-a7d7f9d7-60aa4258-080fa122.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___ CLINICAL HISTORY: Chest pain status post ECT. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " a0578edb-12a640ca-1ddab351-089c4d4c-00bb6f19.jpg,test/p18/p18615099/s54265960/a0578edb-12a640ca-1ddab351-089c4d4c-00bb6f19.jpg,test," FINAL REPORT INDICATION: Lethargy and hypotension. COMPARISON: ___ chest radiograph. PA AND LATERAL VIEWS OF THE CHEST: Patient is status post median sternotomy and CABG. Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. The heart remains mildly enlarged but stable. The aorta is unfolded. There is mild pulmonary vascular congestion, which is improved when compared to the prior exam. No new focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes in the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion, improved when compared to the prior exam. " 18504e85-e53a865c-dcf67b53-edf1a04f-d952847a.jpg,test/p16/p16356013/s58352595/18504e85-e53a865c-dcf67b53-edf1a04f-d952847a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___M s/p excision of infected aortobifem 5 days ago, now w fevers // ?PNA COMPARISON: Chest radiographs ___. IMPRESSION: Increasing consolidation in the left lower lobe could be worsening pneumonia. New consolidative abnormality the base of the right lung is either atelectasis or second focus of edema. Normal cardiomediastinal and hilar silhouettes. No pneumothorax. Pleural effusion minimal if any. Epidural infusion catheter projects over the midline, but the tip is not localized. " 81d892db-fd0d9e04-661f239a-df25f0f4-ca7930fd.jpg,test/p16/p16755216/s54819923/81d892db-fd0d9e04-661f239a-df25f0f4-ca7930fd.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with chest pain, evaluate possible underlying pathology. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is within normal limits. No typical configurational abnormality is seen. Thoracic aorta and mediastinal structures are unremarkable. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No pneumothorax in apical area. Skeletal structures demonstrate mild-to-moderate degenerative changes mostly in the mid portion of the thoracic spine, but no evidence of intervertebral body compression is seen. There exists no prior chest examination or records available for comparison. IMPRESSION: Chest findings within normal limits. " 8ed87f19-376e91fa-d4e25873-828fa43b-92107d74.jpg,test/p15/p15140083/s59845434/8ed87f19-376e91fa-d4e25873-828fa43b-92107d74.jpg,test," FINAL REPORT HISTORY: ___-year-old female with fever cough and wheezing. Evaluate for infiltrate. COMPARISON: Chest radiograph dated ___. FINDINGS: When compared to chest radiograph dated ___, this frontal and lateral radiograph is unchanged. The lungs are well expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: No findings to explain patient's symptoms. These finings were communicated to the ordering physician per request at the time films were reviewed. " 8fefcfc1-9ab5c752-9ae085e6-dccc27e1-4ea4d78e.jpg,test/p10/p10279030/s57130476/8fefcfc1-9ab5c752-9ae085e6-dccc27e1-4ea4d78e.jpg,test," FINAL REPORT HISTORY: Abdominal pain after colonoscopy. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities are detected. No free air is seen in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. No free intraperitoneal air identified. " 16c8dbab-54ede50d-da86b8ec-1d076dda-72d9806d.jpg,test/p16/p16948316/s53597842/16c8dbab-54ede50d-da86b8ec-1d076dda-72d9806d.jpg,test," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old male patient status post left VATS for left chest wall fluid collection. Evaluate. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study dated ___. The heart size is normal and unchanged. As before, mild mediastinal shift towards the left side is present but appears stable. Mild volume reduction of the left hemithorax related to previously performed left upper lobectomy. New surgical clips in hilar region can be seen. The postoperative changes of the vasculature with reduction of hilar contours are unchanged. Mild elevation of left diaphragm as before. No evidence of pneumothorax or new parenchymal abnormalities. No pulmonary vascular congestion. IMPRESSION: Satisfactory findings on postoperative followup examination. " 2696bce9-36f9043e-ce1f314c-83306a1c-31aed950.jpg,test/p19/p19938337/s58604501/2696bce9-36f9043e-ce1f314c-83306a1c-31aed950.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with PBC cirrhosis c/b multiple upper GI bleeds presenting from OSH with hemetemesis found to have high risk varices and bleeding ___ ulcer s/p glue. S/p TIPS today c/b rising direct tbili with new fever // PNA? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient was extubated. The lungs are better ventilated than on the previous image. Normal size of the cardiac silhouette. No pleural effusions. Calcifications at the level of the first costosternal junction on the right. " 09864669-ae62677a-32608b28-4a716cbb-1e70348c.jpg,test/p10/p10305105/s52298865/09864669-ae62677a-32608b28-4a716cbb-1e70348c.jpg,test," FINAL REPORT HISTORY: Bronchiectasis with cough with little improvement on antibiotics. FINDINGS: In comparison with study of ___, there is little change. No evidence of acute focal pneumonia, vascular congestion, or pleural effusion. Some hyperexpansion of the lungs with upper lobe lucency raises the possibility of chronic pulmonary disease. " db99aa4c-7a3d00cf-2b3098a9-e8eceac0-558f0c9f.jpg,test/p19/p19572730/s52161680/db99aa4c-7a3d00cf-2b3098a9-e8eceac0-558f0c9f.jpg,test," WET READ: ___ ___ ___ 5:53 AM No evidence of acute cardiopulmonary process. No evidence of pneumoperitoneum. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with epigastric pain, anemia and concern for perforated ulcer, evaluate for free air or bowel perforation. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. There is no subdiaphragmatic free air. IMPRESSION: No evidence of acute cardiopulmonary process. No evidence of pneumoperitoneum. " cef64b4c-819e02be-8f91a655-64c38896-9d1b6f25.jpg,test/p15/p15200162/s59444803/cef64b4c-819e02be-8f91a655-64c38896-9d1b6f25.jpg,test," FINAL REPORT EXAMINATION: Sign reports INDICATION: History: ___M with eval dissection/graft issue // hx of type a dissection s/p repair, p/w sharp r sided chest pain radiation to back TECHNIQUE: AP view of the chest. COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded with mild bibasilar atelectasis. There is no focal consolidation concerning for pneumonia. Surgical clips projecting over the right axilla and median sternotomy wires are noted. IMPRESSION: No specific findings concerning for acute process. " 08b0fd81-ba932917-03189ad2-7198ee99-d37f8954.jpg,test/p17/p17735461/s53480482/08b0fd81-ba932917-03189ad2-7198ee99-d37f8954.jpg,test," FINAL REPORT INDICATION: ___-year-old female with dyspnea and fevers. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: AP and lateral chest radiographs demonstrate clear lungs with no focal opacity convincing for pneumonia. There is no pleural effusion. When compared to prior radiograph dated ___, normal cardiomediastinal and hilar contours are unchanged. There is no evidence of pneumonia or cardiac decompensation. Cement infusion of a lower thoracic vertebral body, below the level of thoracic scoliosis, has taken place in the interim. IMPRESSION: No pneumonia. Cementoplasty, lower thoracic vertebral body. " 0765cbcd-37f5ba32-64883a0c-6d775bde-a40450ae.jpg,test/p14/p14814421/s56451402/0765cbcd-37f5ba32-64883a0c-6d775bde-a40450ae.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with cough and HIV. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " a54e59fa-f9d834a4-162d2e8a-86a8663e-3a631194.jpg,test/p14/p14065397/s57992391/a54e59fa-f9d834a4-162d2e8a-86a8663e-3a631194.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with weakness TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Heart size is normal. The patient is status post median sternotomy and aortic valve replacement. The aorta is tortuous. Pulmonary vasculature is not engorged. Scarring is noted within both lung apices. No pleural effusion, focal consolidation or pneumothorax is identified. The osseous structures are diffusely demineralized with moderate to severe multilevel degenerative changes noted in the imaged thoracic spine. Remote fracture of the distal left clavicle is noted. IMPRESSION: No acute cardiopulmonary abnormality. " e7f22d8e-1bbb24c6-30f3d38f-d47b3fbb-2d4a0734.jpg,test/p13/p13628037/s50382627/e7f22d8e-1bbb24c6-30f3d38f-d47b3fbb-2d4a0734.jpg,test," FINAL REPORT CHEST TWO VIEWS ON ___ HISTORY: Febrile neutropenia and cough. REFERENCE EXAM: ___. FINDINGS: There is some volume loss at the right base with a small amount of increased opacity in the lower lobes seen on the lateral film. This could represent early infiltrate. Followup is recommended. " 664790f3-7cf747df-0503f6d3-635fe373-705ef1fb.jpg,test/p15/p15561897/s51231685/664790f3-7cf747df-0503f6d3-635fe373-705ef1fb.jpg,test," FINAL REPORT INDICATION: ___F with RUQ abd pain // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable, there is no free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process. " c43d8b0a-3ad3ebec-da9f2a5b-c3686ab1-cfa1faaa.jpg,test/p12/p12907170/s57338776/c43d8b0a-3ad3ebec-da9f2a5b-c3686ab1-cfa1faaa.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for line placement and evaluation for mediastinal structures. COMPARISON: ___, 3:19 a.m. FINDINGS: As compared to the previous radiograph, all monitoring and support devices have been removed. The lateral radiograph shows a tubular device overlying the thorax from outside. The mediastinum is less wide and more transparent than on the previous examination. Moderate cardiomegaly persists. There is unchanged evidence of mild-to-moderate pulmonary edema. Fluid markings of the pleural space and small bilateral dorsal pleural effusions. No pneumothorax. " fbac9e17-ed6aac1a-95109de0-9b541aeb-9102cc42.jpg,test/p11/p11461163/s57991169/fbac9e17-ed6aac1a-95109de0-9b541aeb-9102cc42.jpg,test," FINAL REPORT HISTORY: Generalized weakness and shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Normal chest radiographs. " 755c1e47-aed06862-ba82294d-b01f1217-90522e74.jpg,test/p17/p17336850/s59090190/755c1e47-aed06862-ba82294d-b01f1217-90522e74.jpg,test," FINAL REPORT INDICATION: Frequent aspiration from leukocytosis. Concern for pneumonia. COMPARISON: Multiple priors from ___. FINDINGS: AP and lateral chest radiographs demonstrate persistent low lung volumes and opacification at the left lung base that may represent pneumonia in the proper clinical setting. The cardiomediastinal silhouette is stable. The right lung is clear. There is no pneumothorax. The right PICC terminates in a standard position. IMPRESSION: Probable left basilar pneumonia. " 3ce8f6a7-1d0d11f8-734fc80d-d04b1bb1-43a29e7f.jpg,test/p19/p19778971/s54277245/3ce8f6a7-1d0d11f8-734fc80d-d04b1bb1-43a29e7f.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST: REASON FOR EXAM: Intubated patient. Comparison is made with prior study performed a day earlier. The lower hemithoraces were not included on the film. Within this limitation, left retrocardiac opacity has worsened consistent with worsening atelectasis. Right lower lobe pneumonia is unchanged. Bilateral pleural effusions are probably stable. ET tube is in standard position. The tip is 5.7 cm above the carina. NG tube tip is out of view below the diaphragm. " 4ce7cad3-bcf7e9d5-3203ce0e-e9d5276f-e130f1ec.jpg,test/p14/p14237047/s50021610/4ce7cad3-bcf7e9d5-3203ce0e-e9d5276f-e130f1ec.jpg,test," FINAL REPORT INDICATION: ___ year old man with cholangiocarcinoma c/b post-procedural perforation // please assess improvement in free air COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: There is this a stable or slightly decreased amount of free air visualized in the subdiaphragmatic region. There has atelectasis in both lung bases. There is no pneumothorax or CHF. " a4960917-00748b4e-7e81541c-4f60fbf8-cb4ee757.jpg,test/p10/p10986674/s59287783/a4960917-00748b4e-7e81541c-4f60fbf8-cb4ee757.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough // pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable.. IMPRESSION: No focal consolidation worrisome for pneumonia. " 40c44356-b4356de4-6668f696-a99e9372-ce3d800c.jpg,test/p13/p13767558/s51145842/40c44356-b4356de4-6668f696-a99e9372-ce3d800c.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with chest discomfort. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Linear opacity identified at the left lung base is most likely atelectasis versus scarring. The lungs are otherwise clear. The cardiomediastinal silhouette is stable. Post-operative changes with median sternotomy and mediastinal clips are again noted. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " d0057f9b-6d318fb4-9c0db8de-2e19f5c9-e2403531.jpg,test/p17/p17450913/s52281635/d0057f9b-6d318fb4-9c0db8de-2e19f5c9-e2403531.jpg,test," FINAL REPORT HISTORY: Chest pain with prior history of pulmonary embolism. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Low lung volumes are present, which limits assessment of the lung bases. As noted previously, bibasilar streaky airspace opacities are noted left more so than on the right. These findings may reflect atelectasis but infection, aspiration, or even infarction cannot be completely excluded. The pulmonary vascularity is normal. The mediastinal and hilar contours are unremarkable, and the cardiac silhouette size is within normal limits. No large pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Bibasilar streaky airspace opacities, left more so than right. Findings are nonspecific but could reflect infection, atelectasis, aspiration, or possibly infarction. " 12ffbc45-230bf92a-3912b0f3-0f0393f3-bc8d178e.jpg,test/p19/p19463877/s50465110/12ffbc45-230bf92a-3912b0f3-0f0393f3-bc8d178e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with ?CHF and new onset SOB // r/o pulm etiology COMPARISON: No comparison IMPRESSION: The lung volumes are low. There is mild fluid overload but no overt pulmonary edema. The size of the cardiac silhouette is at the upper range of normal. Bilateral areas of atelectasis are present at the left and right lung bases. No pneumonia. No larger pleural effusions. No pneumothorax. " 3c2ca835-c5f29266-d3b208ae-4bb0cb5a-5c3ea32d.jpg,test/p11/p11065430/s50049473/3c2ca835-c5f29266-d3b208ae-4bb0cb5a-5c3ea32d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with sob, ?chf // eval for pna COMPARISON: No priors FINDINGS: AP portable upright view of the chest. Overlying EKG leads are present somewhat limiting the evaluation. There is left basal opacity which is concerning for effusion and adjacent consolidation. No signs of edema or congestion. The right lung is clear. The heart is mildly enlarged. The aorta is densely calcified. Bony structures are intact. IMPRESSION: Mild cardiomegaly with left basal opacity concerning for effusion and adjacent consolidation. " bfad6c3f-ae4a863a-fdc47b91-17192b3e-67c3e649.jpg,test/p19/p19775210/s51542643/bfad6c3f-ae4a863a-fdc47b91-17192b3e-67c3e649.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cough, chest pain // Eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 7ef0401c-c1cdbd56-bea0bbcc-23174ad2-5ae4fee2.jpg,test/p11/p11534871/s59853308/7ef0401c-c1cdbd56-bea0bbcc-23174ad2-5ae4fee2.jpg,test," FINAL REPORT HISTORY: Chest pain today, history of pericarditis. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The cardiac silhouette is not enlarged. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 2b844983-a7113f0e-f9896e03-c8dc9d43-6cb0d2b6.jpg,test/p19/p19424609/s52384536/2b844983-a7113f0e-f9896e03-c8dc9d43-6cb0d2b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HCV cirrhosis. S/p extubation. Unexplained pressor requirement - recently pan cultured. // Interval change, pleural effusion, volume status, infiltrates COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The ventilation of both the left and the right lung base are improved as compared to the previous image. However, an opacity at the right lung base persists. Normal size of the cardiac silhouette. No new focal parenchymal opacities. No pulmonary edema. " c1a78046-feca1cc6-1bfcf21b-374f88c9-65427014.jpg,test/p12/p12967358/s53042075/c1a78046-feca1cc6-1bfcf21b-374f88c9-65427014.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ year old man with fever to 101.8, slight sob // Please assess for acute processes TECHNIQUE: Chest PA and lateral COMPARISON: CARDIAC MRI FROM ___. FINDINGS: The heart is mildly enlarged, specifically due to left atrial enlargement. Lungs are well inflated and clear. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation worrisome for pneumonia. IMPRESSION: No acute cardiopulmonary process. " d8a9a2c7-5aeff961-d8796e29-a08cbfb9-34ce6207.jpg,test/p19/p19620779/s59769697/d8a9a2c7-5aeff961-d8796e29-a08cbfb9-34ce6207.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with elevated WBC s/p cervical lami with fusion // Evaluate for consolidation, infectious process TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: New retrocardiac opacities could be atelectasis or pneumonia in the appropriate clinical setting. Right lower lobe opacities are likely atelectasis. There is no evident pneumothorax. There are low lung volumes. Cardiomegaly cannot be assessed. Pacer leads are in standard position. There is S-shaped scoliosis. Cervical spinal hardware is partially imaged . " 51934572-bde0a33d-c184871e-fb4a344a-f9d648a2.jpg,test/p18/p18145476/s59679912/51934572-bde0a33d-c184871e-fb4a344a-f9d648a2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with SOB psl eval for pna or edema COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " b9728f79-67ce6ebe-6ab2d501-d2a65a4a-5c3a290e.jpg,test/p19/p19103751/s59410980/b9728f79-67ce6ebe-6ab2d501-d2a65a4a-5c3a290e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with multiple myeloma. With ongoing cough and URI symptoms please eval. // ___ year old woman with multiple myeloma. With ongoing cough and URI symptoms please eval. ___ year old woman with multiple myeloma. With ongoing cough and URI symptoms please eval. IMPRESSION: Comparison to ___. No relevant change. Normal size of the cardiac silhouette. Normal appearance of the cardiac silhouette. No pleural effusions. No pneumonia, no pulmonary edema. " 319d3b03-42e5b6c3-b17ee56f-59a21bf6-147d1a49.jpg,test/p12/p12285052/s54650718/319d3b03-42e5b6c3-b17ee56f-59a21bf6-147d1a49.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with sob and fever COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process " 242e8ba1-00a2dc9b-c30a1085-47aa3e7b-c8e1580f.jpg,test/p12/p12043836/s56015010/242e8ba1-00a2dc9b-c30a1085-47aa3e7b-c8e1580f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESRD, mechanical heart valve and right sided pleural effusion // chest tube eval TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Cardiomegaly is substantial. Replaced valves are in unchanged position. Right pigtail catheter is in place. No appreciable change in the right basal consolidation and loculated air in the right apex demonstrated. " 17f293e1-e280795e-b4163b54-da5a5573-b2ba9686.jpg,test/p10/p10705688/s54409933/17f293e1-e280795e-b4163b54-da5a5573-b2ba9686.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough chills // eval for pna COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute intrathoracic process. " 2c6bbfd7-63ccd1d9-c5bd346e-66136b21-9f7c4d55.jpg,test/p13/p13563091/s50799928/2c6bbfd7-63ccd1d9-c5bd346e-66136b21-9f7c4d55.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with heart prominence // eval prominence of right heart border seen on portable COMPARISON: AP lordotic portable chest x-ray from ___ FINDINGS: On the current examination, there is no definite enlargement of the right heart border. The cardiac morphology is probably within normal limits. The aorta is within normal limits for edge. The vascular pattern is within normal limits. No focal infiltrate, effusion or pneumothorax is detected. Again seen is the left-sided PICC line with tip over distal SVC. IMPRESSION: Cardiomediastinal silhouette within normal limits. Doubt abnormal prominence of the right heart border. " 4e7f7a09-2203ee9f-ae3c3f07-040ba833-92baef47.jpg,test/p10/p10532853/s53292365/4e7f7a09-2203ee9f-ae3c3f07-040ba833-92baef47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right empyema and chest tube in place. // Interval change? Interval change? COMPARISON: Comparisons to ___ at 07:19 FINDINGS: Portable semi-erect chest radiograph ___ at 938 is submitted. IMPRESSION: A right pleural catheter remains in place and there is a slightly smaller but persistent apical lateral pneumothorax. Overall, there is improving aeration at the right base with decrease in size of the pleural collection. The heart remains markedly enlarged which may reflect cardiomegaly, although a pericardial effusion cannot be excluded. Opacity at the left base most likely reflects partial lower lobe atelectasis, although pneumonia cannot be excluded. No evidence of pulmonary edema. " 2dce72ed-cbc8a5e4-817d25e1-587a8a14-1b21684f.jpg,test/p18/p18092465/s55607773/2dce72ed-cbc8a5e4-817d25e1-587a8a14-1b21684f.jpg,test," FINAL REPORT INDICATION: ___-year-old female with ARDS, right internal jugular central venous line placement TECHNIQUE: Frontal chest radiographs were obtained with the patient in the supine position. COMPARISON: Chest radiograph from ___ in CT from ___. . FINDINGS: There has been interval placement of a right central venous line which terminates in appropriate position, and there is no pneumothorax following placement.. The endotracheal tube and nasogastric tube are in stable position. There continues to be low lung volumes and bilateral severe diffuse pulmonary opacities. IMPRESSION: Interval placement of a right central venous line in appropriate position. No pneumothorax. " a62d1b18-c873c9ce-df6ae957-f7472ce1-4f512e9a.jpg,test/p17/p17717614/s59506059/a62d1b18-c873c9ce-df6ae957-f7472ce1-4f512e9a.jpg,test," WET READ: ___ ___ 12:10 PM No acute cardiopulmonary process. Interval decrease in mediastinum width, consistent with decreasing postsurgical mediastinal hematoma. WET READ VERSION #___ ___ ___ 11:32 AM Opacity in the medial right lung base, which may reflect atelectasis but cannot exclude aspiration or pneumonia in the right clinical setting. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___F with chest pain // acute process TECHNIQUE: AP and lateral. COMPARISON: No comparison is made chest radiographs from ___ and ___ FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The mediastinum is less wide than on prior radiographs of the time of discharge, consistent with decreasing postsurgical mediastinal hematoma. Median sternotomy wires are noted. IMPRESSION: No acute cardiopulmonary process. Interval decrease in mediastinum width, consistent with decreasing postsurgical mediastinal hematoma. NOTIFICATION: Updated findings from original wet read were communicated to Dr. ___ at 12:21 p.m. on ___ by phone. " a3524fd3-2f2abe28-e08b954a-c4708fa2-83dc7480.jpg,test/p12/p12911421/s53034253/a3524fd3-2f2abe28-e08b954a-c4708fa2-83dc7480.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Uncontrolled diabetes. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There has been prior sternotomy and probably coronary artery bypass graft surgery. There is no pleural effusion or pneumothorax. Mild subpleural thickening is unchanged at each lung apex. Pulmonary edema has resolved. IMPRESSION: No evidence of acute cardiopulmonary disease. " 52130235-fa27d759-389a4309-75e320bc-80d2bf12.jpg,test/p14/p14764965/s54381242/52130235-fa27d759-389a4309-75e320bc-80d2bf12.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with psychosis, question of being pushed. Evaluate for pneumonia or traumatic injury. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. There is suggestion of a 7-mm nodule in the right upper lung. Heart size is normal. Mediastinal silhouette and hilar contours are normal. No upper abdominal and osseous abnormality is identified. No displaced rib fracture is seen. IMPRESSION: 1. No pneumonia, edema or effusion. 2. Possible 7mm right upper lung nodule. Shallow oblique views are recommended for further evaluation. Discussed with Dr. ___ (psychiatry) by phone at 7:57am ___. " 5a32e51c-a514ec58-e1b7a4b8-2f68b033-aa066c89.jpg,test/p17/p17729814/s53339123/5a32e51c-a514ec58-e1b7a4b8-2f68b033-aa066c89.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with OGT // OGT placement OGT placement IMPRESSION: Feeding tube placement. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. No complications, notably no pneumothorax. " 4a6c0ef4-27c2580f-b268426e-7f3f571c-95ed9f34.jpg,test/p17/p17175688/s53245228/4a6c0ef4-27c2580f-b268426e-7f3f571c-95ed9f34.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with dyspnea TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size appears mild to moderately enlarged as seen previously. The aorta is unfolded with atherosclerotic calcifications noted in the descending thoracic aorta. Lung volumes are lower compared to the previous study. Enlarged on the hila is again noted bilaterally. Mild interstitial pulmonary edema is worse in the interval, with increased patchy bibasilar opacities likely reflective of atelectasis. No pleural effusion or pneumothorax is clearly identified. No acute osseous abnormality seen. A rounded radiopaque dense structure measuring 2 cm projects over the epigastric region. IMPRESSION: Mild interstitial pulmonary edema, worse in the interval, with patchy bibasilar opacities, likely atelectasis. " 77a56d4b-3d604d91-2e94f3cf-34b3fe74-03f998d2.jpg,test/p10/p10760122/s50607323/77a56d4b-3d604d91-2e94f3cf-34b3fe74-03f998d2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with HCC // Pneumonia or Cardiomegaly? COMPARISON: Prior exam from ___ and ___ FINDINGS: AP portable upright view of the chest. Partially imaged aortic stent noted projecting over the mid descending thoracic aorta extending inferiorly. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process " 20b3a383-f6a375b0-b4f46aff-c925cadf-49c4b3ad.jpg,test/p13/p13774492/s54211462/20b3a383-f6a375b0-b4f46aff-c925cadf-49c4b3ad.jpg,test," FINAL REPORT HISTORY: Evaluate for resolution of possible infiltrate versus atelectasis seen on recent chest radiograph. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. Opacity overlying the right middle lobe appears more discrete and is concerning for right middle lobe pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: Increased opacity overlying the right middle lobe concerning for pneumonia with an element of atelectasis. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___. " de97d86d-294f47ef-10931318-ac8a6e77-baac427c.jpg,test/p13/p13187640/s51300575/de97d86d-294f47ef-10931318-ac8a6e77-baac427c.jpg,test," WET READ: ___ ___ ___ 5:35 PM Prominent left hilum is nonspecific, underlying lymphadenopathy, consolidation, or pulmonary lesion not excluded. Left base retrocardiac opacity could be due to pneumonia, underlying other pulmonary lesion not excluded. Bibasilar subtle reticulonodular opacities may be due to small airways disease. Consider dedicated PA and lateral views of the chest or CT for better evaluation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with sternal, back, and axillary abscess, concern for intrapulm. abscess. // c/f lung abscess vs other intra pulm process vs bony mets/abscess into the bone. TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: Patient is rotated somewhat to the right. There are relatively low lung volumes. Left hilar prominence may be due to vascular congestion although underlying lymphadenopathy, pulmonary consolidation, or other pulmonary lesion is not excluded. Reticular nodular opacities at the lung bases are nonspecific but could be due to small airways disease. There is also additional more focal left base retrocardiac opacity ; differential diagnosis includes pneumonia although underlying pulmonary mass is not excluded. No large pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Mediastinal contours are grossly unremarkable. Chronic deformity at the partially imaged right glenohumeral joint. IMPRESSION: Prominent left hilum is nonspecific, underlying lymphadenopathy, consolidation, or pulmonary lesion not excluded. Left base retrocardiac opacity could be due to pneumonia, underlying other pulmonary lesion not excluded. Bibasilar subtle reticulonodular opacities may be due to small airways disease. Consider dedicated PA and lateral views of the chest or CT for better evaluation. " daf0ff1c-7e663e22-bf8d0a05-6a5dd1e2-9e6853ee.jpg,test/p16/p16589824/s57060988/daf0ff1c-7e663e22-bf8d0a05-6a5dd1e2-9e6853ee.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph from ___ and CT chest from ___. CLINICAL HISTORY: Intermittent shortness of breath, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. The imaged bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " fa25fbf8-5c1a7732-631a64de-196ba3d9-4d4e48d0.jpg,test/p10/p10740350/s59753466/fa25fbf8-5c1a7732-631a64de-196ba3d9-4d4e48d0.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Dysrhythmia and weakness. FINDINGS: PA and lateral views of the chest are provided. No focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal and stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 14c9365a-417ed560-8f628923-392c226b-4344317d.jpg,test/p13/p13795532/s53239987/14c9365a-417ed560-8f628923-392c226b-4344317d.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Headache, question pneumonia. FINDINGS: PA and lateral views of the chest are provided. Lung volumes are low. There is no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Limited, negative. " 75bd839e-a4c09a30-aff31cc6-134eefee-e856e906.jpg,test/p18/p18398420/s50103363/75bd839e-a4c09a30-aff31cc6-134eefee-e856e906.jpg,test," FINAL REPORT HISTORY: NG tube repositioning. TECHNIQUE: Single, AP, portable view of the chest with the patient in a semi-erect position. COMPARISON: Comparison is made to radiographs dated ___ at 9:53am. FINDINGS: As compared to the prior examination performed several hours earlier, there has been interval advancement of the nasogastric tube. The NGT side port is now noted to be just below the gastroesophageal junction, and the tip is seen within the stomach. The remainder of the examination is largely unchanged. IMPRESSION: Interval advancement of the NGT, now seen terminating within the stomach. Findings were conveyed by Dr. ___ to Dr. ___ ___ telephone at 11:20 on ___, 5 minutes after discovery. " 8b64433e-f04e7190-594e9eb4-eb781f53-cbe168ad.jpg,test/p18/p18658996/s55568378/8b64433e-f04e7190-594e9eb4-eb781f53-cbe168ad.jpg,test," FINAL REPORT AP CHEST, 12:14 AM, ___ HISTORY: ___-year-old man with diastolic CHF, chronic renal insufficiency, MALT lymphoma. IMPRESSION: AP chest compared to ___: Moderate bilateral pleural effusion, left greater than right, not appreciably changed since ___. Heart size top normal. Upper lungs clear. Lower lungs obscured by pleural effusion and somewhat atelectatic, but not grossly changed. No pneumothorax. " 4c85701b-221ec4f2-5a70d176-74de6064-4a5bd8c8.jpg,test/p13/p13621755/s51980165/4c85701b-221ec4f2-5a70d176-74de6064-4a5bd8c8.jpg,test," FINAL REPORT CHEST HISTORY: Bicycle accident. Rib fracture. The lungs remain clear. Mediastinal structures are unchanged. Fractures of the right clavicle and right fifth rib are redemonstrated. The patient has been extubated. A nasogastric tube has been replaced by a Dobbhoff feeding tube which terminates below the diaphragm in the region of the body of the stomach. IMPRESSION: Tube placement as described. " fbf6cd57-a15f2d21-493f19f3-c39d98df-e6a85394.jpg,test/p19/p19802326/s52503144/fbf6cd57-a15f2d21-493f19f3-c39d98df-e6a85394.jpg,test," FINAL REPORT HISTORY: ___-year-old male with new NG tube. Question placement. COMPARISON: ___. FINDINGS: Single frontal view of the chest demonstrates interval placement of an NG tube with tip in the stomach and a side port likely above the GE junction. This could be advanced by 5 or 6 cm to achieve standard positioning. Prominent cardiac silhouette is somewhat increased as compared to prior exam but likely exaggerated by AP technique. There is stable perihilar vascular congestion and bibasilar opacities. There is no apical pneumothorax or large pleural effusion. The extreme right costophrenic angle is not and compressed. IMPRESSION: NG tube with tip in the stomach and side port slightly above the GE junction. Recommend advancement by 5 cm to achieve standard positioning. Findings reported to Dr.___ ___ phone at approximately 11:00 on ___. " d2d5aa6f-1e1b9da2-f1b64440-9e892493-4397e234.jpg,test/p12/p12056448/s58752901/d2d5aa6f-1e1b9da2-f1b64440-9e892493-4397e234.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with TIA, history of interstitial pulmonary fibrosis and CHF. Comparison is made with prior study, ___. Moderate-to-severe cardiomegaly is stable. Pacer leads are in the standard position, in the right atrium, right ventricle and through the coronary sinus. There is no pneumothorax or pleural effusion. There are low lung volumes. Diffuse interstitial reticular abnormality with subpleural and right lung predominance is grossly unchanged from prior study in keeping with patient's known pulmonary fibrosis. " cf00c606-94f50bea-14a5dc6a-a04ca0e0-9783ace1.jpg,test/p15/p15470171/s53856544/cf00c606-94f50bea-14a5dc6a-a04ca0e0-9783ace1.jpg,test," FINAL REPORT INDICATION: ___-year-old female with dyspnea on exertion and cough. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Lungs are hyperinflated with flattening of the diaphragm with hyperlucency within the upper lobes bilaterally consistent with emphysematous changes. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality identified. " 0ff62837-d3565e0e-44870703-3525f428-e8b82c00.jpg,test/p12/p12868210/s59139187/0ff62837-d3565e0e-44870703-3525f428-e8b82c00.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left-sided chest pain. Evaluate for evidence of pneumothorax. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiographic examination. " 868a8bb1-16023501-a89409ea-a80d9e1a-1739457f.jpg,test/p10/p10711797/s53925392/868a8bb1-16023501-a89409ea-a80d9e1a-1739457f.jpg,test," FINAL REPORT This was's. EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with c/o persistent fatigue x few weeks; has crackles in right base. // R/O pneumonitis. R/O pneumonitis. COMPARISON: chest radiographs since ___ most recently ___. IMPRESSION: Bilateral hilar adenopathy is chronic, but improved since ___ and now contains calcifications. Pattern and sequence is consistent with sarcoidosis. Mild cardiomegaly is larger today than in ___ and there is borderline fecalization of blood flow but no pulmonary edema or pleural effusion. Lungs are otherwise clear. " 7e2a0efa-e1eb26ed-b22b0b70-7be30650-d58a6039.jpg,test/p16/p16155910/s56863590/7e2a0efa-e1eb26ed-b22b0b70-7be30650-d58a6039.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Rhonchi on exam, question pneumonia. FINDINGS: PA and lateral views of the chest provided. The lungs are clear without focal consolidation, effusion or pneumothorax. There is slight coarsening of interstitial markings, which could indicate underlying fibrosis/emphysema. The cardiomediastinal silhouette appears normal. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. Probable emphysema. " 2134c2ee-d0accf09-60867899-ebfd91cb-740492f2.jpg,test/p10/p10004749/s56644724/2134c2ee-d0accf09-60867899-ebfd91cb-740492f2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Severe watery diarrhea, evaluation for pleural effusion. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. No pleural effusions. No parenchymal abnormalities. Normal size of the cardiac silhouette. " 4a9eabdb-e93a7361-8c01ec28-d85ab78c-60c5d496.jpg,test/p14/p14809300/s56496537/4a9eabdb-e93a7361-8c01ec28-d85ab78c-60c5d496.jpg,test," WET READ: ___ ___ ___ 8:00 AM Similar appearance of moderate right and trace left effusions and bibasilar atelectasis, allowing for differences in patient positioning. Underlying right base or retrocardiac consolidation cannot be excluded. WET READ VERSION #1 ___ ___ ___ 7:45 PM Similar appearance of moderate right and trace left effusions and bibasilar atelectasis, allowing for differences in patient positioning. Underlying right base or retrocardiac consolidation cannot be excluded. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman w/COPD s/p right hip fracture with fever and hypoxemia // ?Pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Moderate right pleural effusion, fiducial marker in the right lung apex. Mild elevation of the left hemidiaphragm, caused by slightly distended bowel loops. Borderline size of the cardiac silhouette without overt pulmonary edema. Moderate areas of atelectasis at the right and the left lung base. " 4c9cf117-5da351ae-2ebcc7d8-b1649c5c-5b3c5aab.jpg,test/p19/p19074466/s56610164/4c9cf117-5da351ae-2ebcc7d8-b1649c5c-5b3c5aab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with one week wheezing and cough // ?cpd COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Incidental note is made of right AC joint arthropathy with bony hypertrophy and loss of joint space. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 493bc6ea-6fa6d913-0be1e874-a9238c44-5557362c.jpg,test/p11/p11607177/s58191507/493bc6ea-6fa6d913-0be1e874-a9238c44-5557362c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PA line // PA line positioning PA line positioning IMPRESSION: In comparison with the study of ___, the Swan-Ganz catheter projects further outside of the mediastinum on the right. It would have to be pulled back approximately 4-5 cm to be within the mediastinal contours. Otherwise, little change in the appearance of the heart and lungs. " 52c7f1c7-c0f57028-18b10997-92264a8d-7648054c.jpg,test/p17/p17239737/s55907645/52c7f1c7-c0f57028-18b10997-92264a8d-7648054c.jpg,test," FINAL REPORT INDICATION: Intermittent chest pain and dyspnea for five days. COMPARISON: Chest radiograph ___ and ___, ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion or pneumothorax. Mild enlargement of the cardiac silhouette is increased since ___, with right heart enlargement. Mild aortic tortuosity is unchanged. Hilar contours are normal. IMPRESSION: No pneumonia, edema, or effusion. " 17c09b64-6c9502ba-004cf161-75adb7fe-159b317f.jpg,test/p10/p10976602/s58725892/17c09b64-6c9502ba-004cf161-75adb7fe-159b317f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with dizziness // infiltrate? TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Dual lead left-sided pacer is stable in position. There is persistent severe enlargement of the cardiac silhouette. The mediastinal contours are stable. Aortic knob calcification is again seen. There is blunting of the bilateral posterior costophrenic angles raising concern for trace bilateral pleural effusions. Left basilar opacity is seen which may in part be due to overlying soft tissue and elevated left hemidiaphragm. No pneumothorax seen. IMPRESSION: Trace bilateral pleural effusions. Marked enlargement of the cardiac silhouette persists. No definite pulmonary edema. " a3b2cc72-86138d4c-a129d3c6-eb3a9bd7-45e4e52d.jpg,test/p14/p14120635/s59010320/a3b2cc72-86138d4c-a129d3c6-eb3a9bd7-45e4e52d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with AMS // Eval fir acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Again seen is metallic density overlying the left hilum as seen on multiple priors. No pulmonary edema is seen. Left axillary vascular stent is re- demonstrated. Moderate compression of a vertebral body at the thoracolumbar junction is noted, of indeterminate age, this level was not well seen on the prior lateral study from ___. IMPRESSION: No acute cardiopulmonary process. Moderate compression of a vertebral body at thoracolumbar junction of indeterminate age, this level was not well seen on prior studies. " 12bdab8a-f76e59e2-ff98627b-8cb8d14c-b8e45cba.jpg,test/p15/p15118488/s50697004/12bdab8a-f76e59e2-ff98627b-8cb8d14c-b8e45cba.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: dyspnea, lightheadedness, history of PE, kidney transplant. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Chronic scarring at the right lung base is again, best seen on multiple priors ___ ___. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable as compared to ___. The cardiac silhouette is less prominent as compared to the prior study from ___. IMPRESSION: No acute cardiopulmonary process. " 1d366210-957cd77f-4eda43ba-8519b231-fb8bd38a.jpg,test/p13/p13531354/s59228963/1d366210-957cd77f-4eda43ba-8519b231-fb8bd38a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // eval for structural process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is mild basilar atelectasis. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable. Some degenerative changes are seen along the spine which overall appear grossly mild. IMPRESSION: No acute cardiopulmonary process. " 4d16f689-42698ab0-c4961952-760d7a20-c0b6029c.jpg,test/p10/p10855616/s57539378/4d16f689-42698ab0-c4961952-760d7a20-c0b6029c.jpg,test," FINAL REPORT INDICATION: ___-year-old male presents with fever, nausea and vomiting. Question acute process. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate a mildly prominent cardiac silhouette likely accentuated by slightly low lung volumes. The descending aorta is unfolded. The lungs are clear with the exception of plate-like left basilar atelectasis versus pericardial fat pad. A small effusion cannot be excluded in the left base. There is no pneumothorax or vascular congestion. Thoracolumbar spondylosis is present. IMPRESSION: Likely left basilar atelectasis. No definite acute cardiopulmonary process. " 68dd4ea5-1dfbfc1b-f00e2748-c5e29221-461f6658.jpg,test/p18/p18796562/s58731545/68dd4ea5-1dfbfc1b-f00e2748-c5e29221-461f6658.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Chest pain. AP radiograph of the chest was reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are clear. No pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " 0a676359-9271323b-43f1611b-ae32faab-6c6f102d.jpg,test/p19/p19212152/s51123447/0a676359-9271323b-43f1611b-ae32faab-6c6f102d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dizziness and sob // ? any abnormality SOB AND DIZZINESS R/O ABNORMALITY COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Right lung is chronically mildly hyperinflated and the left hemidiaphragm is chronically elevated. Moderate cardiomegaly, partially obscured, has increased relative to ___. Pulmonary edema is mild, in the lower lungs and very small left pleural effusion is new or recurrent. Lateral view also shows some calcification in the aortic valve and moderately heavy calcification in the aortic annulus, throughout the thoracic aorta, and in at least one of the major head and neck vessels, rising anterior to the trachea. No pneumothorax. No findings suggesting pneumonia. " a5ffed1d-55d409a1-87240b49-53618c34-96378ff1.jpg,test/p10/p10464640/s54550268/a5ffed1d-55d409a1-87240b49-53618c34-96378ff1.jpg,test," FINAL REPORT INDICATION: ___F with worsening weakness // Eval for infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Lungs are well-expanded without focal consolidation concerning for pneumonia. An enteric tube is present with tip terminating in the region of the proximal jejunum. IMPRESSION: No acute cardiopulmonary process. " f3808cdd-4510c72a-23fbca4d-60a510dd-7cbd8a90.jpg,test/p14/p14502109/s58365465/f3808cdd-4510c72a-23fbca4d-60a510dd-7cbd8a90.jpg,test," FINAL REPORT HISTORY: Fever, assess for pneumonia. COMPARISON: Chest radiograph ___ and chest CT ___. FINDINGS: 2 views were obtained of the chest. Aside from unchanged linear scarring in the right mid lung, the lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " b00757cf-40f0e69a-4b35bc24-a96e4968-4755d159.jpg,test/p17/p17532588/s59548783/b00757cf-40f0e69a-4b35bc24-a96e4968-4755d159.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with history of gastroesophageal reflux disease, epigastric pain, vomiting TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 11b60df7-d0b7940e-a073abcd-562fa46c-e015cb36.jpg,test/p12/p12698907/s54238804/11b60df7-d0b7940e-a073abcd-562fa46c-e015cb36.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Spiking fevers, atelectasis. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated. The appearance of the lung parenchyma is unchanged. A zone of slightly increased radiodensity is seen in the right upper lobe and likely to be caused by patient position. Unchanged borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. " c81403f7-6e8568a7-a2bcbe7e-8c19dbff-7d6e3fad.jpg,test/p19/p19810919/s59090068/c81403f7-6e8568a7-a2bcbe7e-8c19dbff-7d6e3fad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with 3 weeks cough, blood tinged sputum, smoker (___ ppd). also smokes marijuana. Lung exam shows localized wheezing on right side. No known h/o asthma or COPD. // r/o pneumonia or lung abnormality r/o pneumonia or lung abnormality COMPARISON: There are no prior chest radiographs available for review. Impression. IMPRESSION: Lungs are well expanded and there is no pneumonia. Lateral view suggests a 6 x 11 mm elliptical nodule projecting over the heart. There are no other focal pulmonary abnormalities. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. RECOMMENDATION(S): Repeat conventional chest radiographs in ___ weeks, shown to the radiologist before the patient leaves the department to see if additional views are needed. " 7a177952-25e99826-3aced1b0-cedc55be-d3c8e1c1.jpg,test/p14/p14355329/s57605548/7a177952-25e99826-3aced1b0-cedc55be-d3c8e1c1.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient status post right-sided iliac aneurysm and fem-fem bypass performed on ___. Now with fever. Assess for pulmonary infiltrate. FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Cardiac enlargement as before. Unchanged position of previously described permanent right-sided pacer with dual intracavitary electrode system, unchanged. Moderate pulmonary vascular congestion as before. Diffuse haze over the lung bases, slightly less marked as before but probably related to changes in patient's position. No conclusive evidence of new discrete pulmonary parenchymal infiltrates on this portable chest examination. Status post sternotomy as before. Extensive calcifications seen in the wall of the aorta at the level of the arch. No pneumothorax is identified. IMPRESSION: Change of appearance of bilateral pleural effusions related to minor changes in patient's position. No conclusive evidence of new acute pulmonary infiltrates. If such diagnosis is essential, recommend additional lateral view as basal lung spaces are obscured by pleural effusions. " 27d8041f-e8f9ea04-73d531da-69422eda-bf57b047.jpg,test/p18/p18131843/s58349733/27d8041f-e8f9ea04-73d531da-69422eda-bf57b047.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with altered mental status. COMPARISONS: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs appear clear without focal consolidation, effusion or pneumothorax. Heart size and mediastinal contours are stable with an unfolded thoracic aorta containing moderate atherosclerotic calcifications. IMPRESSION: No evidence of pneumonia. " d54d0b9e-3787222e-fd34e1be-4ec6c252-0b6a189f.jpg,test/p10/p10528059/s57934389/d54d0b9e-3787222e-fd34e1be-4ec6c252-0b6a189f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with hx asthma, with CP, SOB. // pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Linear opacities at the lung bases are most consistent with atelectasis. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " b7989f62-40a1cbb0-802ea2ef-aea49c5b-7f536565.jpg,test/p15/p15472819/s54953459/b7989f62-40a1cbb0-802ea2ef-aea49c5b-7f536565.jpg,test," FINAL REPORT INDICATION: ___M with left-sided sharp chest pain and DOE // Any evidence of pneumonia or other cardiopulmonary pathology? TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 983cfeff-1aa95548-35cfd7ba-f082faa1-fe449e62.jpg,test/p18/p18628529/s57388530/983cfeff-1aa95548-35cfd7ba-f082faa1-fe449e62.jpg,test," FINAL REPORT HISTORY: History of chest pain, sickle cell disease. Please evaluate. COMPARISON: Multiple chest radiographs dating back to ___. Technique: Frontal and lateral radiographs of the chest. FINDINGS: There is a catheter in the left chest wall with the port terminating in the lower IVC. An apparent kink along the proximal course of the catheter is overall unchanged compared to the prior exam. Heart size and cardiomediastinal contours are normal. The lungs are clear without evidence of focal consolidations, pleural effusions or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Apparent kink along the proximal course of the port catheter is unchanged compared to the prior exam. " 096b0008-dffd6c76-8a5acd76-1fa10a78-ab623340.jpg,test/p18/p18462894/s53026188/096b0008-dffd6c76-8a5acd76-1fa10a78-ab623340.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough, suggested fevers and shortness of breath. COMPARISON: ___ chest CT. No prior chest radiograph available for comparison. FINDINGS: Frontal and lateral views of the chest were obtained. There is subtle patchy right mid lung opacity which could be due to pneumonia in the appropriate clinical setting versus atelectasis. No pleural effusion is seen. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. IMPRESSION: Patchy right mid lung opacity could be due to pneumonia in the appropriate clinical setting versus atelectasis. " 3dc16f8b-ee1b8713-a3a0bdbf-8ce66b08-3838cb2f.jpg,test/p16/p16096684/s52746008/3dc16f8b-ee1b8713-a3a0bdbf-8ce66b08-3838cb2f.jpg,test," FINAL REPORT INDICATION: Patient with shortness of breath and cough. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate marked overinflation due to emphysema or bronchospasm. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Imaged upper abdomen is unremarkable. IMPRESSION: Emphysema or bronchospasm. " 5924eeff-97f8ab81-a8ff2776-7251725c-3669362e.jpg,test/p11/p11310511/s55357708/5924eeff-97f8ab81-a8ff2776-7251725c-3669362e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Cough, fever, headache for three weeks. FINDINGS: AP upright and lateral views of the chest provided. Lungs are clear. Cardiomediastinal silhouette is normal. Bony structures intact. IMPRESSION: No acute findings in the chest. " a40c1f75-532c7dc8-21c45b61-3073fe37-e22e934a.jpg,test/p17/p17936680/s59613939/a40c1f75-532c7dc8-21c45b61-3073fe37-e22e934a.jpg,test," WET READ: ___ ___ ___ 3:53 AM No evidence of acute cardiopulmonary process. Unchanged mild to moderate cardiomegaly. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with sob, evaluate for acute abnormality TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette, including mild to moderate cardiomegaly, is unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. Unchanged mild to moderate cardiomegaly. " c3b5f527-8cf4ed1b-40aef1d4-a76e0b4e-50c62ebc.jpg,test/p18/p18189327/s51161694/c3b5f527-8cf4ed1b-40aef1d4-a76e0b4e-50c62ebc.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: ___-year-old female with right MCA stroke, question acute intrathoracic process. FINDINGS: AP semi-upright portable chest radiograph provided. The heart appears mildly enlarged. There is hyperinflation of the lungs, likely related to underlying COPD. No focal consolidation, effusion, or pneumothorax is seen. There is no overt edema. Bony structures are intact. IMPRESSION: Mild cardiomegaly, COPD, otherwise unremarkable. " 2642d9f8-af855422-c14c0653-70d6d8a8-63c7e514.jpg,test/p19/p19518697/s54142250/2642d9f8-af855422-c14c0653-70d6d8a8-63c7e514.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with weakness and ataxia. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded. Increased opacities in the left lower lobe could reflect aspiration or early pneumonia in the appropriate clinical situation. The right lung is clear. The heart is normal in size. Mediastinal contours are unchanged with probably a tortuous descending thoracic aorta. No pneumothorax, edema, or pleural effusion. Multilevel degenerative changes in the thoracic spine are mild. Right old clavicular fracture. IMPRESSION: Left lower lobe opacities may reflect aspiration and/or early pneumonia in the appropriate clinical situation. " 318492e3-22d0e4d7-304a7217-8a659211-19275b1f.jpg,test/p10/p10526322/s50760020/318492e3-22d0e4d7-304a7217-8a659211-19275b1f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with sob, cough COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Pacemaker projects over the right chest wall with leads extending to the region the right atrium and right ventricle. Midline sternotomy wires and prosthetic cardiac valve again noted. There is mild hilar engorgement without frank pulmonary edema. No focal consolidation, large effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild hilar engorgement, otherwise unremarkable. " a9520b0b-4777353a-40156c7f-33002bd8-96342067.jpg,test/p12/p12272771/s54231935/a9520b0b-4777353a-40156c7f-33002bd8-96342067.jpg,test," FINAL REPORT PORTABLE CHEST ON ___ AT ___ CLINICAL INDICATION: ___-year-old with pancreatic cancer, possible PE with hypotension, tachycardia, hypoxia, assess for edema or effusion. Comparison is made to the patient's prior study of ___ at ___. A portable AP upright chest film ___ at ___ is submitted. IMPRESSION: 1. Right subclavian PICC line has its tip in the distal SVC. There is an increasing left-sided layering pleural effusion with associated airspace opacity at the left base likely representing partial lower lobe collapse. Right lung is low in volume with patchy opacity at the base likely reflecting patchy atelectasis, although pneumonia or aspiration cannot be excluded. There is no evidence of pulmonary edema. No pneumothorax. Overall, cardiac and mediastinal contours are difficult to assess as the left heart border is obscured by the near-complete opacification of the left hemithorax. " 01fded44-661deaae-4e6972da-3c93e5cc-a1f29036.jpg,test/p17/p17989167/s50343799/01fded44-661deaae-4e6972da-3c93e5cc-a1f29036.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with AF + RVR // eval for interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There is an increase in extent of a small left pleural effusion with subsequent retrocardiac atelectasis. Also increased is the right basilar atelectasis. Mild to moderate pulmonary edema is present. The right venous access line is in unchanged position. " a96733d3-ce2f22ee-396d17a0-b6bec9e4-34231252.jpg,test/p13/p13337368/s56281245/a96733d3-ce2f22ee-396d17a0-b6bec9e4-34231252.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R radical hemipulvectomy, pelvic osteomyelitis, R PICC line, now readmitted with worsening osteo. // evaluate picc line placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right PICC line tip is at the level of mid SVC. Heart size and mediastinum are stable. Lungs are well aerated. There is no pleural effusion or pneumothorax. " 8e07f4b2-17706889-ec6fdb62-8b85d919-d0ded6b1.jpg,test/p14/p14186859/s58601407/8e07f4b2-17706889-ec6fdb62-8b85d919-d0ded6b1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain on right TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is demonstrated. Mild degenerative changes are seen in the thoracic spine. No displaced rib fractures are noted. IMPRESSION: No acute cardiopulmonary abnormality. " f27eca80-7cf2593f-b0c1787b-399ada86-159e6a70.jpg,test/p18/p18413647/s57435977/f27eca80-7cf2593f-b0c1787b-399ada86-159e6a70.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with palpitations and left arm numbness // any evidence of acute intrathoracic process? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 9523c53d-057fc34f-5dc5eb6c-abdd2e19-74f7dcbc.jpg,test/p16/p16771607/s58730369/9523c53d-057fc34f-5dc5eb6c-abdd2e19-74f7dcbc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe sepsis and spontaneous abortion, ARDS, s/p intubation with NGT placement // eval ETT, NG placement eval ETT, NG placement COMPARISON: In the chest radiograph ___ 6:53 a.m. IMPRESSION: Severe pulmonary edema and moderate pleural effusions have increased substantially since 3:00, worsened since 7:00. ET tube in standard placement. Nasogastric tube passes into the stomach and out of view. Heart size is normal and unchanged. The presence of pleural effusions suggests a component of hemodynamic edema. " d8f1d978-8a362db3-2e66a85a-87ffbded-d9443116.jpg,test/p11/p11677206/s54994768/d8f1d978-8a362db3-2e66a85a-87ffbded-d9443116.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p RUL w/ rib resection // check interval change with CT clamped for 3 hrs. Please do around noon TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Right mid and upper lung consolidations are unchanged as well as loculated hydro pneumothorax at the apex. Subcutaneous air in the right chest wall is unchanged as well as linear opacities at the a left lower lung associated with pleural effusion and left retrocardiac atelectasis " 57430897-a2d7cda5-cd50b918-3b1a8ed8-ac533569.jpg,test/p13/p13176838/s57921864/57430897-a2d7cda5-cd50b918-3b1a8ed8-ac533569.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with breast cancer post right mastectomy with chest pain, concern for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: A left chest wall Port-A-Cath tip ends at the cavoatrial junction. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No evidence of pneumonia. " 6c17f057-d27b3157-ba3feee5-e7031750-e2271804.jpg,test/p17/p17595883/s56490482/6c17f057-d27b3157-ba3feee5-e7031750-e2271804.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for three weeks // r/o infiltrate r/o infiltrate IMPRESSION: No previous images. There is hyperexpansion of the lungs suggesting underlying chronic pulmonary disease. However, no acute pneumonia, vascular congestion, or pleural effusion. " 91531cfd-d2ed72fe-1f42b8e9-c4c2916a-82cdca5e.jpg,test/p10/p10621303/s53910440/91531cfd-d2ed72fe-1f42b8e9-c4c2916a-82cdca5e.jpg,test," FINAL REPORT INDICATION: ___-year-old female with new onset shortness of breath, orthopnea and cough. Evaluate for cause. COMPARISON: None. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well-expanded clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 58836d83-5f53db1c-111570b3-e1fd02ca-e1318869.jpg,test/p17/p17471102/s53446372/58836d83-5f53db1c-111570b3-e1fd02ca-e1318869.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with lung opacity on prior chest examination, evaluate for pneumonia. FINDINGS: Patient's condition required examination in sitting upright position using AP frontal and left lateral views. Comparison can be made with the next preceding portable single view chest examination of ___. During the interval, the patient has been extubated. The previously described right-sided permanent pacer connected to dual intracavitary electrode system remains in unchanged position. There is cardiac enlargement with a configuration suggesting left ventricular prominence, a finding which in aorta shows calcium deposits in the wall, both at the conjunction with the generally widened and elongated thoracic aorta suggests systemic hypertension. The level of the arch as well as in the descending area. Local contour abnormalities are not identified. The pulmonary vasculature is not congested and the lateral and posterior pleural sinuses remain free from any fluid accumulation. No acute parenchymal infiltrates are seen, and the on previous portable examination suspected left lower lobe atelectasis has resolved. IMPRESSION: Extubated, significant cardiac enlargement but no evidence of pleural effusion, acute pulmonary congestion or acute infiltrates. " 88c1d93e-7da7d1e1-1921bfff-ffd872c0-29db9773.jpg,test/p15/p15752873/s55649798/88c1d93e-7da7d1e1-1921bfff-ffd872c0-29db9773.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with MVA on ___ p/w continue chest discomfort. // Please evaluate for e/o fracture vs. widened mediastinum. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The mediastinum is not widened. No displaced rib fracture is seen. IMPRESSION: No acute cardiopulmonary process. Clear lungs. If high clinical concern for subtle fracture, CT is more sensitive. " 0def63f2-4510a816-e78812c2-c614720f-194df804.jpg,test/p14/p14921632/s58936237/0def63f2-4510a816-e78812c2-c614720f-194df804.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with SOB // ?CHF vs. PE? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Left chest wall pacer device is noted with leads extending into the region of the right atrium and right ventricle. Midline sternotomy wires are noted. Increased interstitial opacities most compatible with interstitial pulmonary edema. No large effusion or pneumothorax. Heart size is normal. Mediastinal contours unremarkable. Bony structures are intact. IMPRESSION: Mild interstitial edema. " dcffdd40-62a59746-755dcd5a-513caf34-f55851bc.jpg,test/p14/p14017108/s50518156/dcffdd40-62a59746-755dcd5a-513caf34-f55851bc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent influenza // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Multiple priors most recent on ___ FINDINGS: Heart size is top normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 2fc803bd-61ee3bec-e2248220-4085299a-61a424f6.jpg,test/p12/p12957124/s58815495/2fc803bd-61ee3bec-e2248220-4085299a-61a424f6.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Dysphasia and esophageal cancer. Unable the handle secretions. COMPARISON: Scout view from PET-CT performed on ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The aorta is mildly tortuous and calcified. Otherwise, mediastinal and hilar contours are unremarkable. There is no definite pneumothorax or pleural effusion. Lungs appear clear. The chest is hyperinflated. IMPRESSION: No evidence of acute disease. Hyperinflation. " 25fd4eb9-1fce6e66-9c01ba49-29a7fe05-f1fa3cd1.jpg,test/p15/p15210727/s51973449/25fd4eb9-1fce6e66-9c01ba49-29a7fe05-f1fa3cd1.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with dyspnea. Question pneumonia. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear without consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 72427602-d700024b-6d75cce8-6f52bdb7-305632bb.jpg,test/p13/p13620341/s53198145/72427602-d700024b-6d75cce8-6f52bdb7-305632bb.jpg,test," FINAL REPORT INDICATION: ___-year-old male with a history of APML and lymphoma, who presents for evaluation of a few-day history of chest congestion. COMPARISONS: Chest radiographs from ___ and ___ and CT chest from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. There is a new vague opacification at the left lung base posteriorly, which may be from an infectious etiology in the correct clinical setting. There is no pneumothorax or pleural effusion. No other focal consolidations are identified. The visualized osseous structures are normal. IMPRESSION: Probable left lower lung pneumonia in the appropriate clinical setting. These findings were discussed with Dr. ___ by Dr. ___, by telephone, on the day of the exam at 5:15 pm. " 56aa7f2f-8baad3f3-305a08e2-4a09d641-c4cb4069.jpg,test/p11/p11303447/s53884863/56aa7f2f-8baad3f3-305a08e2-4a09d641-c4cb4069.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain for 10 days. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and a lateral chest radiograph demonstrates well expanded and clear lungs bilaterally. No focal opacities identified. Mediastinal and hilar contours are within normal limits. Osseous structures are without acute abnormality. No evidence of pneumothorax or pleural effusion. IMPRESSION: No acute intrathoracic abnormality. " bd0d09fe-95ca4623-a5a54f80-29c301c8-a9c3df46.jpg,test/p16/p16033427/s51258188/bd0d09fe-95ca4623-a5a54f80-29c301c8-a9c3df46.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right spontaneous pneumothorax s/p pigtail placement // please evaluate pneumothorax *** TO BE DONE AT 11AM *** TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 12 hr earlier IMPRESSION: Small right pneumothorax has decreased in size. No other interval change from prior study. " 8eb4365f-b5c3ad97-aa1e9647-0d3aae92-b81db7a2.jpg,test/p11/p11898077/s57384000/8eb4365f-b5c3ad97-aa1e9647-0d3aae92-b81db7a2.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CT chest from ___ and chest radiograph from ___. CLINICAL HISTORY: CAD, status post CABG, COPD, AFib, presents with cough, question pneumonia. FINDINGS: PA and lateral views of the chest were obtained. Midline sternotomy wires and the mediastinal clips are compatible with prior CABG. A right chest wall pacer device is present with dual leads extending into the expected location of the right atrium and right ventricle. The heart is within normal limits of size. No focal consolidation or signs of CHF. No pleural effusion or pneumothorax is seen. The mediastinal contour is normal, though calcification along the aortic knob is noted. The bony structures appear intact. Right AC joint arthropathy is again noted. IMPRESSION: No acute intrathoracic process. " 6f99bf69-bd94593c-3b270206-6f2f4c66-3c8c40a8.jpg,test/p11/p11865423/s58591860/6f99bf69-bd94593c-3b270206-6f2f4c66-3c8c40a8.jpg,test," FINAL REPORT INDICATION: ___-year-old female with abdominal pain and chest pain. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___, ___, ___ and ___. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart is top normal in size, and the mediastinal silhouette is normal. There is no intraperitoneal free air noted. IMPRESSION: No acute cardiopulmonary process. " f05c4bc4-30eb456f-05b13721-98f99c40-e38e8868.jpg,test/p14/p14088566/s51744141/f05c4bc4-30eb456f-05b13721-98f99c40-e38e8868.jpg,test," FINAL REPORT INDICATION: Hypotension and fevers. COMPARISONS: None. FINDINGS: The vascular structures are engorged, although there is no overt pulmonary edema. There is no consolidation, pleural effusion or pneumothorax. The mediastinal contours are normal. The cardiac silhouette is mildly enlarged. IMPRESSION: 1. Mild enlargement of the cardiac silhouette. With the history of ongoing hypotension, consider cardiomyopathy or pericardial effusion as an etiology. 2. No evidence of pneumonia. " 29b34857-36aa49b2-9a954b1c-cd56dd6e-05e80b4b.jpg,test/p17/p17645472/s50313472/29b34857-36aa49b2-9a954b1c-cd56dd6e-05e80b4b.jpg,test," WET READ: ___ ___ ___ 11:10 AM Known innumerable bilateral small pulmonary nodules better seen on prior chest CT. No superimposed acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with SOB, cough, CP // r/o acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: Known innumerable bilateral pulmonary nodules on prior chest CT are faintly visualized as an increase nodular opacities throughout the lungs. There is no confluent consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Known innumerable bilateral small pulmonary nodules better seen on prior chest CT. No superimposed acute cardiopulmonary process. " 41fb9788-4bcf6056-7601c249-d4681237-22f77e21.jpg,test/p17/p17735461/s53480482/41fb9788-4bcf6056-7601c249-d4681237-22f77e21.jpg,test," FINAL REPORT INDICATION: ___-year-old female with dyspnea and fevers. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: AP and lateral chest radiographs demonstrate clear lungs with no focal opacity convincing for pneumonia. There is no pleural effusion. When compared to prior radiograph dated ___, normal cardiomediastinal and hilar contours are unchanged. There is no evidence of pneumonia or cardiac decompensation. Cement infusion of a lower thoracic vertebral body, below the level of thoracic scoliosis, has taken place in the interim. IMPRESSION: No pneumonia. Cementoplasty, lower thoracic vertebral body. " 4fdeace6-ce6c761a-dbee3f98-3650d5d6-8642d519.jpg,test/p14/p14130631/s58686670/4fdeace6-ce6c761a-dbee3f98-3650d5d6-8642d519.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with R MCA stroke, intubated w/ pna // eval ett placement, interval change in consolidation TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there is no substantial change in widespread parenchymal consolidations. The patient has been extubated. NG tube tip is in the stomach. " b9294d3b-ad3853d6-e815e296-6343eb32-fcf5cab3.jpg,test/p15/p15219741/s55752329/b9294d3b-ad3853d6-e815e296-6343eb32-fcf5cab3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion now s/p ___ in ___ procedure center // ptx? ptx? IMPRESSION: Compared to chest radiographs ___ through ___ at 09:26. Right pleural effusion has decreased substantially. There is no pneumothorax. Right lower lobe collapse has improved slightly. Left lung low in volume but clear. " 260b538c-7d74d0aa-5bdae90a-9a1b3ea6-9b3ab10d.jpg,test/p12/p12393061/s53294552/260b538c-7d74d0aa-5bdae90a-9a1b3ea6-9b3ab10d.jpg,test," FINAL REPORT HISTORY: Small-bowel obstruction, for NG tube placement. FINDINGS: In comparison with prior study, there has been placement of a nasogastric tube that coils within the fundus of the stomach with the tip close to the esophagogastric junction. Right subclavian catheter again extends to the lower SVC. There are several streaks of atelectasis at both bases without acute focal pneumonia or vascular congestion. " fa906a88-1300f5e4-bb1df328-a983e58e-cd01d62d.jpg,test/p15/p15297759/s52630759/fa906a88-1300f5e4-bb1df328-a983e58e-cd01d62d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with antiphospholipid syndrome with hematomas and clot to renal vein, now w worsening leukocytosis and fevers. r/o infxn // evidence of PNA? evidence of PNA? COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Lung leads remain very low in volume but there is no focal consolidation to suggest pneumonia in the interstitial abnormality and most pronounced at the lung bases continues to improve. Heart size is normal. Small left pleural effusion is unchanged. " 7929d723-2f0b3c25-e0e7078b-999a1f36-4d32029c.jpg,test/p13/p13058213/s59579999/7929d723-2f0b3c25-e0e7078b-999a1f36-4d32029c.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough, sob, wheezing after GERD // f/u aspiration pneumonitis TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Interval improvement in the opacification involving the right mid and lower lung zones. No new areas of airspace consolidation. No pleural effusions. Evidence of previous cervicothoracic spine stabilization. IMPRESSION: Interval improvement in the opacification of the right mid to lower lungs. " 394a60ac-206f1704-9f6e8216-aa5c47a0-c1c5b9ea.jpg,test/p19/p19016834/s59584894/394a60ac-206f1704-9f6e8216-aa5c47a0-c1c5b9ea.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Esophageal stent is again seen, appears more inferior in position as compared to the prior study. Right perihilar chronic changes are seen. There is slight increase in the right mid lung opacity which could be due to underlying infection, possibly in the superior right lower lobes. No pneumothorax is seen. IMPRESSION: 1. Inferior migration of patient's esophageal stent as compared to the prior study. 2. Slight increase in right mid lung patchy opacity may due to consolidation in the superior right lower lobe which could be due to an infection. The above findings were discussed with Dr. ___ on ___ via telephone. " 042184b3-378ad877-4a09fce4-8ddfd857-f5e88b6b.jpg,test/p12/p12945480/s59634613/042184b3-378ad877-4a09fce4-8ddfd857-f5e88b6b.jpg,test," FINAL REPORT PORTABLE CHEST ___, ___ COMPARISON: ___ radiograph. FINDINGS: Heart size and pulmonary vascularity are normal. New moderate bilateral pleural effusions are partially layering on this semi-upright study. Dense left retrocardiac opacity may reflect atelectasis and/or infectious consolidation. " a8b28759-5ea188fd-39b40687-b2858d4d-35382dde.jpg,test/p14/p14679533/s59851669/a8b28759-5ea188fd-39b40687-b2858d4d-35382dde.jpg,test," WET READ: ___ ___ ___ 12:34 AM No evidence of pneumothorax. Discussed with Dr. ___ by Dr. ___ ___ telephone at 00:20, ___ min after discovery. ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:41 P.M., ___ HISTORY: Multiple subclavian vein access attempts. Vein occluded. Biventricular pacer upgrade. IMPRESSION: AP chest compared to ___: There has been no change in the course of either right atrial or right ventricular pacer leads. There is no pneumothorax, pleural effusion or mediastinal widening. Moderate cardiomegaly and pulmonary vascular engorgement stable. No edema. " d91cdfc5-8e25fcb1-91561bc2-d15802c5-b3294297.jpg,test/p13/p13753662/s57534791/d91cdfc5-8e25fcb1-91561bc2-d15802c5-b3294297.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chets pain // acute process acute process IMPRESSION: Comparison to ___. New 1 cm soft tissue density nodule, better appreciated on the frontal than on the lateral view, projecting over the left lung basis. CT should be performed to exclude the presence of a neoplasm. Mild elongation of the descending aorta. No pneumonia, no pulmonary edema, no pleural effusions. RECOMMENDATION(S): CT recommended for assessment of potential left basal lung nodule. NOTIFICATION: The recommendation was entered into the radiology dashboard system. " 2dac574f-85119161-76e08046-c48b9030-fc0f7757.jpg,test/p14/p14921655/s52815577/2dac574f-85119161-76e08046-c48b9030-fc0f7757.jpg,test," FINAL REPORT INDICATION: History: ___F with fever // eval for pna COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Normal chest radiographs. " bb55b990-74ac86f6-9da98a37-9de825d0-0b28b3ce.jpg,test/p18/p18692317/s50803780/bb55b990-74ac86f6-9da98a37-9de825d0-0b28b3ce.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with respiratory failure on BiPAP with pneumonia and edema? COMPARISON: ___. FINDINGS: The patient had prior sternotomy, probably for CABG. There is minimal cardiac congestion and there is no evidence of pneumonia. Small bilateral pleural effusions or pleural thickening is unchanged. There is no pneumothorax. Probable scarring at the right lung base is unchanged. CONCLUSION: There is no evidence of pneumonia. Mild congestion is stable. " 90794f85-4d2b5ccb-4e580551-64a7cfa6-13087c93.jpg,test/p19/p19372257/s51519827/90794f85-4d2b5ccb-4e580551-64a7cfa6-13087c93.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HTLV T cell leukemia/lymphoma with tachypnea // Please evaluate for edema, infiltrate, effusion IMPRESSION: As compared to previous radiograph of 2 days earlier, lung bases are better aerated and bilateral small pleural effusions have slightly decreased in size. No other relevant changes since recent study. " 180fac7b-2ec246b0-19dbea1b-c0f1f149-017e9b05.jpg,test/p11/p11798125/s51932602/180fac7b-2ec246b0-19dbea1b-c0f1f149-017e9b05.jpg,test," FINAL REPORT INDICATION: Palpitation, fatigue. Please evaluate for pneumonia or mediastinal or cardiac disease. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: PA and lateral radiograph demonstrates stable dextroscoliosis with apex at the thoracolumbar junction. The aorta is tortuous. Otherwise, mediastinal, hilar and cardiac contours are unremarkable. Bibasilar increased lung markings likely reflect early pulmonary edema. Deformity of right upper ribs and the right glenohumeral joint is unchanged compared to ___. There is a cardiac monitoring device projecting over the left heart, possibly a Reveal monitor. IMPRESSION: Stable heart size. Interstitial edema may indicate early heart failure. " d7c52f76-7994d3ed-005da562-6f1069b0-cd1710c0.jpg,test/p12/p12259138/s52491499/d7c52f76-7994d3ed-005da562-6f1069b0-cd1710c0.jpg,test," FINAL REPORT HISTORY: Dyspnea x6 months. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. The heart size is normal. Mediastinal and hilar contours are normal. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 92ff0a80-b1a00f26-437faeb3-249673fc-0c2c3f9d.jpg,test/p17/p17451002/s54668168/92ff0a80-b1a00f26-437faeb3-249673fc-0c2c3f9d.jpg,test," FINAL REPORT INDICATION: ___-year-old male with pain in the mid lung field and mid thorax. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: PA and lateral images of the chest demonstrate well-expanded lungs with some hyperinflation that would be consistent with COPD. These changes are similar to those seen on previous exam. The patient has also had intermittent small pulmonary opacities over the last several years, consistent with COPD. Previously seen right basilar infiltrate has resolved. There is no evidence of acute parenchymal process or infection on this exam. There is no pneumothorax. There is no pleural effusion. Cardiomediastinal silhouette is unremarkable. Visualized osseous structures are unremarkable. IMPRESSION: Chronic pulmonary changes consistent with chronic obstructive pulmonary disease. No evidence of acute pulmonary process. These findings were communicated to Dr. ___ ___ by phone at 3:30 p.m. " bab87312-23f7c0fc-28ef2c8d-b3785972-a89774fb.jpg,test/p12/p12479159/s52879130/bab87312-23f7c0fc-28ef2c8d-b3785972-a89774fb.jpg,test," FINAL REPORT INDICATION: ___M with AMS in setting of thrombocytopenia, neutropenia, possible fall // eval spontaneous vs traumatic hemorrhage TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Low lung volumes are noted with crowding of the bronchovascular markings. There is no confluent consolidation or overt pulmonary edema. There is no pneumothorax or effusion. Right PICC is seen with tip projecting over the upper SVC. No displaced fractures identified. IMPRESSION: No acute cardiopulmonary process. " 77782e9b-8b540d68-b5bf4399-fc0b9080-e4d6173f.jpg,test/p19/p19519081/s51485047/77782e9b-8b540d68-b5bf4399-fc0b9080-e4d6173f.jpg,test," WET READ: ___ ___ ___ 7:25 PM Mildly elevated right hemidiaphragm of unknown chronicity, could be due to the presence of a subpulmonic effusion or subdiaphragmatic/hepatic process. Clinical correlation is recommended and consider CT for further assessment. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with persistent cough for 6 months TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. No focal consolidation or pneumothorax is seen. Mild elevation of the right hemidiaphragm, of unknown chronicity, could be due to the presence of a subpulmonic effusion or subdiaphragmatic/hepatic process. No left-sided pleural effusion is identified. No acute osseous abnormalities seen. IMPRESSION: Mildly elevated right hemidiaphragm of unknown chronicity, could be due to the presence of a subpulmonic effusion or subdiaphragmatic/hepatic process. Clinical correlation is recommended and consider CT for further assessment. " 3e1988d7-37f281bc-d778b6b0-6b87fc1c-ae8b6ca8.jpg,test/p18/p18963838/s55518976/3e1988d7-37f281bc-d778b6b0-6b87fc1c-ae8b6ca8.jpg,test," FINAL REPORT INDICATION: Cirrhosis and cough. TECHNIQUE: Frontal chest radiograph. COMPARISON: Radiograph from ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 7e174686-9b8c101b-65b518a2-9f232013-2e1aeb29.jpg,test/p18/p18656167/s53961840/7e174686-9b8c101b-65b518a2-9f232013-2e1aeb29.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Difficulty swallowing. COMPARISONS: ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. An opacity in the medial right lower lung has essentially resolved, using the earlier radiographs as a baseline reference. The lateral view best depicts minimal residual opacification in the right middle lobe but nearly resolved. Mild hyperinflation is present. There is no pleural effusion or pneumothorax. Mild degenerative changes are similar along the thoracic spine. IMPRESSION: Nearly resolved right middle lobe opacity. No evidence for superimposed acute process. " 7fb9db08-a3429b97-95041321-db15aae2-60292107.jpg,test/p17/p17738146/s56882036/7fb9db08-a3429b97-95041321-db15aae2-60292107.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " cd642159-9623a05a-8354be0c-c8370d01-555be327.jpg,test/p19/p19398915/s56099610/cd642159-9623a05a-8354be0c-c8370d01-555be327.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Gastroesophageal bleeding, assessment for interval change. AP radiograph of the chest was compared to the prior study obtained from ___. The ET tube tip is 6 cm above the carina. The ___ tube passes below the diaphragm. There is most likely no inflated balloon present. Bilateral pleural effusions are substantial, unchanged as well as there is no change in left retrocardiac consolidation. Mild interstitial pulmonary edema is noted. " 7fe85dad-73b5f5e8-67fe56ee-68f07d4b-f5862211.jpg,test/p17/p17805168/s58964091/7fe85dad-73b5f5e8-67fe56ee-68f07d4b-f5862211.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain, palpatations and SOB, r/o cardiopulmonary process. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Subtle opacity projecting over the left lung base is concerning for an early pneumonia. Otherwise the lungs are clear. No effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: Subtle opacity at the left lung base is concerning for early pneumonia. " d0ec3fd8-9e745bcc-bb600aa0-302b81d8-633b3680.jpg,test/p11/p11438336/s54937437/d0ec3fd8-9e745bcc-bb600aa0-302b81d8-633b3680.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Confusion and fever, assess for pneumonia. FINDINGS: AP upright and lateral views of the chest were obtained. There is no focal consolidation, effusion, or pneumothorax. There is mild interstitial pulmonary edema with Kerley B lines and cephalization. Cardiomediastinal silhouette is stable with atherosclerotic calcification along the aortic knob. Bony structures appear intact with screws again noted in the left humeral head. IMPRESSION: Findings compatible with mild interstitial pulmonary edema. " 0ae609f1-6721c501-7d89f194-66251999-356803a1.jpg,test/p15/p15201551/s53336472/0ae609f1-6721c501-7d89f194-66251999-356803a1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx of CABG // preop Surg: ___ (removal of total knee) preop IMPRESSION: In comparison with the study ___ ___, patient has taken a better inspiration. There is globular enlargement of the cardiac silhouette without vascular congestion, pleural effusion, or acute focal pneumonia. Atelectatic changes are seen at the left base and there is blunting of the costophrenic angle. Of incidental note is possible calcification in the region of the carotid bifurcation on the low left. " 16f8f971-32b1392b-9139a671-945cd84b-64cfc2a9.jpg,test/p16/p16086874/s54021948/16f8f971-32b1392b-9139a671-945cd84b-64cfc2a9.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old male with weeping umbilical hernia, pre-op. FINDINGS: Frontal and lateral views of the chest are compared to CT abdomen from ___ and chest x-ray from ___. There has been interval resolution of subcutaneous gas overlying the right chest wall. There is persistent elevation of the right hemidiaphragm, which could be due to combination of ascitic fluid below the diaphragm and possible component of subpulmonic effusion as well. The lungs themselves are clear. Cardiomediastinal silhouette is within normal limits. Post-traumatic changes are seen involving multiple anterior right ribs and the lateral right clavicle. No acute osseous abnormality detected. No free air is seen below the diaphragm. IMPRESSION: Elevated right hemidiaphragm thought to represent some combination of subdiaphragmatic ascitic fluid and possible pleural effusion, similar to prior. No other superimposed acute cardiopulmonary process. " 4cd38811-82c2325b-b8d7665a-16f3bf0d-e12ffff0.jpg,test/p13/p13042664/s53221606/4cd38811-82c2325b-b8d7665a-16f3bf0d-e12ffff0.jpg,test," FINAL REPORT INDICATION: ___M with progressive dyspnea and increased pedal edema + DOE // r/o chf TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: There is mild to moderate cardiomegaly. The mediastinal and hilar contours are unremarkable. There are small bilateral pleural effusions. Pulmonary vasculature is again noted to be slightly engorged, especially at the lung bases. The left axillary pacer is present with tip terminating in the right atrium right ventricle as expected. IMPRESSION: Small bilateral pleural effusions with vascular engorgement. No obvious pneumonia. " d9c5f83f-d8f4d44a-e8bccfaa-7aef0c64-110d03e1.jpg,test/p18/p18083755/s54711318/d9c5f83f-d8f4d44a-e8bccfaa-7aef0c64-110d03e1.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT ___ CLINICAL INDICATION: ___-year-old status post VATS, chest tube pulled, evaluate pneumothorax. Comparison is made to the patient's previous study dated ___ at 3:34. PA and lateral views of the chest, ___ at ___ are submitted. IMPRESSION: Interval removal of the right chest tube. There is a stable tiny right apical pneumothorax. Postoperative changes are seen in the right mid lung where there are chain sutures. Residual air seen within the right lateral chest wall consistent with subcutaneous emphysema. There is improved overall aeration at the lung bases suggestive of resolving atelectasis. No pulmonary edema. There is slight blunting of the left costophrenic angle which may represent a small effusion or chronic pleural thickening. Overall, cardiac and mediastinal contours are unchanged. 2-3 mm nodular opacity in the lateral left mid lung, but this does not appear to have a CT correlate on the study performed on ___ and therefore is of uncertain clinical significance. Faint patchy rounded opacity in the right upper lobe likely corresponds to one of the nodules seen on the recent CT of ___. " c85ba30f-cd9c0037-82461307-6093db37-22155f06.jpg,test/p12/p12823036/s50788960/c85ba30f-cd9c0037-82461307-6093db37-22155f06.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with sob // eval pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are hyperinflated, but clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Hyperinflated, but clear lungs. " 60d10b6b-32a017d0-bbb07b87-5cde6ce7-4677dc4c.jpg,test/p13/p13743445/s59128119/60d10b6b-32a017d0-bbb07b87-5cde6ce7-4677dc4c.jpg,test," FINAL REPORT INDICATION: ___ year old man with productive cough x 1 month // rule out pneumonia COMPARISON: Multiple prior chest radiographs, most recently ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: The lungs are slightly hyperinflated, but no focal consolidation, pleural effusion, or pneumothorax. Heart size and cardiomediastinal contours are normal. Calcified presumed right axillary nodes are stable. IMPRESSION: No acute process. " fecc9e6f-c528a266-c4f5fdcb-b78284b4-2e0a81b9.jpg,test/p13/p13103745/s56741001/fecc9e6f-c528a266-c4f5fdcb-b78284b4-2e0a81b9.jpg,test," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Previously noted right basilar opacification has markedly improved, with near complete resolution of the right pleural effusion. Bibasilar streaky opacities could reflect atelectasis with mild pulmonary vascular engorgement noted. There is no pneumothorax. No acute osseous abnormalities are seen. IMPRESSION: 1. Near-complete resolution of the previously noted right basilar opacity and pleural effusion. 2. Streaky and patchy bibasilar airspace opacities could reflect atelectasis. 3. Mild pulmonary vascular congestion. " 621caa6b-8483b920-145986db-952f403d-f29445eb.jpg,test/p14/p14990135/s51532725/621caa6b-8483b920-145986db-952f403d-f29445eb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with ches tpain // chest pain COMPARISON: ___. IMPRESSION: No change as compared to the previous radiograph. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. No pneumothorax, no chest wall lesions. Unchanged mild bilateral apical thickening. " be484dd6-4750c842-191b75c5-00594619-31d16ec2.jpg,test/p19/p19277082/s54038844/be484dd6-4750c842-191b75c5-00594619-31d16ec2.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " ab1b6211-b9a22182-5bd8fa02-3fe3aaec-26331816.jpg,test/p19/p19092904/s52135239/ab1b6211-b9a22182-5bd8fa02-3fe3aaec-26331816.jpg,test," FINAL REPORT HISTORY: Scant hemoptysis, former smoker. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: As compared to the prior examination dated ___, there has been minimal interval change. The lungs are essentially clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The heart size is normal. Mediastinal and hilar contours are stable. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. Findings were conveyed by Dr. ___ to Dr. ___ ___ telephone at 3:10pm on ___. ___ min after discovery. " 4628f7dc-ab0cdb35-ff710db1-6d3af832-361c8e40.jpg,test/p15/p15914421/s59642896/4628f7dc-ab0cdb35-ff710db1-6d3af832-361c8e40.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph as well as older radiograph of ___. FINDINGS: Lung volumes are low. Cardiomediastinal contours are accentuated by low lung volumes, but appears stable. Coarse reticular opacities are present at both lung bases, and have been present since at least ___ and are not definitively seen on more remote radiograph of ___. Additionally, a slightly more confluent opacity is present peripherally in the left lower lobe and has worsened since the prior chest radiograph of ___. There are no pleural effusions. Nonspecific scarring in the right apex is unchanged. Left-sided Port-A-Cath is unchanged in position. Postoperative changes are seen within the breast. IMPRESSION: Chronic bibasilar reticular opacities, concerning for a fibrotic interstitial process from drug toxicity or a chronic progressive idiopathic interstitial pneumonia. A more focal, peripheral left lower lobe opacity is also worse compared to ___. Consider high-resolution CT for more complete characterization of these findings. " 5890b43a-d89f3c2a-fa15bf80-c1ca23b1-f14e5674.jpg,test/p11/p11613444/s59973168/5890b43a-d89f3c2a-fa15bf80-c1ca23b1-f14e5674.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with stroke // assess infiltrate assess infiltrate IMPRESSION: The heart is normal in size and there is no evidence of vascular congestion or pleural effusion. Bibasilar opacifications, more prominent on the left, suggest atelectasis. However, in the appropriate clinical setting, superimposed pneumonia would " 5a0fbb50-16fcbb3c-b43ab7db-64bdd2fa-0d3ba8ae.jpg,test/p19/p19358609/s53320690/5a0fbb50-16fcbb3c-b43ab7db-64bdd2fa-0d3ba8ae.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___ year old man with history of lung cancer status post left upper lobectomy and recent multifocal pneumonia. Evaluate for resolution of pneumonia. COMPARISON: Chest radiograph dated ___ and ___. CT chest dated ___. FINDINGS: The multifocal bilateral opacities have essentially completely resolved since ___. Left pleural effusion has also completely resolved. Residual background emphysematous changes most prominent in the right upper lung with scarring and pleural thickening as well as background post-left upper lobectomy changes with elevation of the left hemidiaphragm are unchanged compared to ___. Blunting of the left costophrenic angle reflects thickening/scarring. A calcified perihilar node is unchanged. The heart is normal in size. The descending thoracic aorta is slightly tortuous, unchanged. Dextroconvex scoliosis of thoracic spine is overall similar with similar distortion of thoracic cage. Prominent degenerative changes in the thoracic spine are also overall unchanged. IMPRESSION: Interval resolution of pneumonia. " 9d343413-b2ed06cc-50800bdc-dd001b36-d758ed69.jpg,test/p19/p19265807/s53047726/9d343413-b2ed06cc-50800bdc-dd001b36-d758ed69.jpg,test," FINAL REPORT AP CHEST, 6:22 A.M., ___. HISTORY: ___-year-old man with end-stage renal disease after ET tube placement. IMPRESSION: AP chest compared to ___: ET tube tip at the thoracic inlet, approximately 6 cm above the carina with the chin in neutral position or elevation should not be withdrawn any further, but is probably acceptable. Moderate bilateral pleural effusions and mild pulmonary edema have worsened, although heart size is approximately the same. No pneumothorax. " 87ab8784-89bb34a7-0cd83f89-8208e8d6-8ceaaf76.jpg,test/p13/p13849733/s59249240/87ab8784-89bb34a7-0cd83f89-8208e8d6-8ceaaf76.jpg,test," FINAL REPORT HISTORY: Right effusion, to assess for change. FINDINGS: In comparison with the study of ___, there appears to be further increase in the substantial right pleural effusion. There is evidence of compressive atelectasis at the base. Some opacification just above the level of the effusion on the frontal view could possibly be a manifestation of consolidation in the appropriate clinical setting. Remainder of this study is unchanged. " 3ae8a680-b8b03dbf-80777cdd-adc1564b-c0d0f1a4.jpg,test/p15/p15649400/s52175097/3ae8a680-b8b03dbf-80777cdd-adc1564b-c0d0f1a4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: interval change TECHNIQUE: AP chest x-ray COMPARISON: ___ FINDINGS: The patient is rotated to the right as before. The lungs are clear. There is no pneumothorax. The heart and mediastinal structures are stable. There is evidence of multiple kyphoplasties. There is no significant change. IMPRESSION: No active pulmonary disease. No significant change. " 2453a839-9042156b-f6cb80b1-b90b478c-837731e8.jpg,test/p19/p19961925/s56801712/2453a839-9042156b-f6cb80b1-b90b478c-837731e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with hx of cp, hx pericarditis // eval for effusion COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Low lung volumes limits the evaluation. The patient's chin also obscures the superior mediastinum and portions of the lung apices. There are bibasilar opacities which may reflect atelectasis and small effusions. There is hilar engorgement and mild congestion noted. Heart size appears mildly enlarged. The mediastinal contour is stable. The imaged bony structures appear intact. IMPRESSION: As above. " 22127511-4455559e-f2256d14-906b9632-7bb11727.jpg,test/p18/p18354402/s57481138/22127511-4455559e-f2256d14-906b9632-7bb11727.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with c/o sharp pain in the left para-sternal area, just below the clavicle, x few months. Improving but still nagging. No known trauma. // R/O bone lesion, fracture, arthritis COMPARISON: Chest radiograph ___. IMPRESSION: Ascending thoracic aorta is mildly dilated or tortuous. Heart size is normal. Lungs are clear. The other mediastinal and the hilar contours are normal and there is no pleural abnormality. Although no bone lesion is seen, conventional chest radiographs are not sensitive for detection of chest cage abnormalities. Regions where there are focal findings should be clearly marked and imaged with either bone detail views or CT scanning. " 09dec8bd-c56ffcf0-fbc81bf0-70b8a138-c08e2bb5.jpg,test/p11/p11573149/s54744317/09dec8bd-c56ffcf0-fbc81bf0-70b8a138-c08e2bb5.jpg,test," FINAL REPORT HISTORY: New line placement. Rule out pneumothorax. TECHNIQUE: Single, AP, portable view of the chest with the patient in a semi-erect position. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: Interval placement of a left-sided internal jugular venous line, seen extending into a presumed persistent left IVC. Lung volumes are decreased. Redemonstrated are persistent, diffuse air space opacities, unchanged in appearance from the prior exam. There is no pneumothorax or significant pleural effusion. Stable, mild to moderate cardiomegaly is noted. The mediastinum is widened, although unchanged from prior. IMPRESSION: Left IJ line, seen terminating in a presumed persistent left SVC. " 19282b47-85dd561e-fc805010-2bda3ec4-4f4c8109.jpg,test/p10/p10553685/s58978992/19282b47-85dd561e-fc805010-2bda3ec4-4f4c8109.jpg,test," FINAL REPORT INDICATION: ___F with dyspnea // ? acute cardiopulm process TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: Normal chest x-ray. " 4a11965d-1718326d-99d5934d-ec41e427-1d728159.jpg,test/p14/p14520474/s58408029/4a11965d-1718326d-99d5934d-ec41e427-1d728159.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p CABG // eval for pleural effusions TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs since ___, ___, most recently ___. FINDINGS: Lung volumes are increased and atelectasis has improved. Trace right and small left pleural effusions are improved. Linear segmental right lower lobe opacity represents atelectasis. Normal postoperative mediastinum and heart borders. Right internal jugular central venous catheter is unchanged terminating in the right atrium. No pneumothorax. Multiple old rib fractures. IMPRESSION: 1. Improved lung volumes and atelectasis. 2. Trace right and small left pleural effusions are improved since ___. " b9d12475-ad2ce88a-ff146976-344442e8-dfe1a5c4.jpg,test/p18/p18847797/s56971200/b9d12475-ad2ce88a-ff146976-344442e8-dfe1a5c4.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with chest pain and syncope. Question cardiomegaly. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Compared to prior, there are significantly lower lung volumes seen. Bibasilar opacities, particularly on the lateral may be therefore secondary to atelectasis; however, clinical correlation is recommended to exclude infection. Cardiac silhouette also appears more prominent in size, however, also potentially in part due to low lung volumes. Osseous and soft tissue structures are unremarkable. IMPRESSION: Lower lung volumes on the current exam. Bibasilar opacities, potentially due to atelectasis however, clinical correlation suggested regarding possibility of infection. Apparent increased size of the cardiomediastinal silhouette potentially also due to poor inspiratory effort. " bcf9e529-566ad268-3221e8c7-cbaf47d3-a19b9ca9.jpg,test/p15/p15878432/s57675175/bcf9e529-566ad268-3221e8c7-cbaf47d3-a19b9ca9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe AS presents with dyspnea. // pulm edema? pulm edema? IMPRESSION: In comparison with the study of ___, the monitoring and support devices have been removed. Continued low lung volumes with elevation of the right hemidiaphragmatic contour. Cardiac silhouette is unchanged and there is little if any vascular congestion. The left hemidiaphragm is now sharply seen, consistent with improved aeration in the left lower lobe. " 208b708b-c2b95e42-e5a3b6b7-9ee6f808-33c7af72.jpg,test/p12/p12299124/s51427291/208b708b-c2b95e42-e5a3b6b7-9ee6f808-33c7af72.jpg,test," FINAL REPORT INDICATION: History of seizure disorder, heavy smoker, and peripheral vascular disease with episodic weakness and aphasia. COMPARISON: ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs are clear and hyperexpanded, with increased AP diameter. No consolidation is appreciated. The pleural surfaces are normal with no pleural effusions or pneumothoraces. Cardiomediastinal contours and heart size are normal. IMPRESSION: Hyperinflated lungs with no evidence of acute consolidation or pleural effusions. " d98acfba-51a23b84-647e97f9-ee9cc7b5-ba09f817.jpg,test/p12/p12724628/s59156463/d98acfba-51a23b84-647e97f9-ee9cc7b5-ba09f817.jpg,test," FINAL REPORT INDICATION: Patient with subtotal gastrectomy, now with hypoxia. Please assess for interval change. COMPARISON: Comparison is made to CT torso performed ___ and chest radiograph performed ___. FINDINGS: Portable chest radiograph demonstrates unremarkable mediastinal and hilar contours. Rounded opacity projecting over the right heart border likely represents combination of rounded atelectasis and prominent pericardial fat pad evident on the ___ CT. Bibasilar atelectasis is evident. Minimal blunting of the bilateral costophrenic angles likely due to small pleural effusions. The sideport of the NGT is at the GE junction. IMPRESSION: 1. Small bilateral pleural effusions. No overt pulmonary edema or evidence of pneumonia. 2. NGT with sideport at GE junction. Recommend advancing 3-4 cm. " 60a8750c-a2a5110a-962584b8-1a33219f-0aa01d4a.jpg,test/p16/p16348494/s55769821/60a8750c-a2a5110a-962584b8-1a33219f-0aa01d4a.jpg,test," FINAL REPORT HISTORY: Severe lumbar spine stenosis. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Lateral view is nondiagnostic due to the patient's inability to raise his arms. The lung volumes are low. Cardiac, mediastinal and hilar contours are normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. IMPRESSION: Limited lateral view. No acute cardiopulmonary abnormality. " 8d6a4d57-b2fabe67-be64aa63-86424962-8c4fc526.jpg,test/p15/p15346117/s53325162/8d6a4d57-b2fabe67-be64aa63-86424962-8c4fc526.jpg,test," WET READ: ___ ___ ___ 8:05 AM 1. Right PICC now terminates in the low SVC. 2. Moderate pulmonary edema, similar to prior exam. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with PICC respositioning // PICC location TECHNIQUE: Upright AP and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from earlier the same day, ___, and ___. FINDINGS: The right PICC has been pulled back in interval and now terminates in the low SVC. The lungs are well expanded. Prominent pulmonary vasculature and interstitial markings are consistent with moderate pulmonary edema. The lungs are well expanded and clear. Small pleural effusions are present. No pneumothorax is seen. The cardiomediastinal silhouette is stably enlarged. IMPRESSION: 1. Right PICC now terminates in the low SVC. 2. Moderate pulmonary edema, similar to prior exam. " 6a45406b-2e2e7f74-a8ce91a4-2d4ad9ec-de9018f8.jpg,test/p12/p12740948/s54630904/6a45406b-2e2e7f74-a8ce91a4-2d4ad9ec-de9018f8.jpg,test," FINAL REPORT EXAMINATION: ___ INDICATION: History of end-stage renal disease on hemodialysis with multiple prior intubations for CHF exacerbations intubated on arrival to the ED. TECHNIQUE: Single frontal view of the chest. COMPARISON: None FINDINGS: Endotracheal tube tip terminates approximately 6 cm cranial to the carinal. NG tube tip terminates out of field of view, probably in the stomach. Heart size is moderately enlarged with mild unfolding of the thoracic aorta. Aortic knob calcifications are moderate. Prominent central pulmonary vascular congestion with bilateral perihilar predominant opacities, greater on the right compatible with severe pulmonary edema. Probable trace bilateral effusions. No pneumothorax. IMPRESSION: 1. Severe pulmonary vascular congestion and interstitial pulmonary edema with probable trace effusions. 2. Pneumonia cannot be excluded in the appropriate clinical context. 3. Endotracheal tube tip terminates 6 cm cranial to the carina. No pneumothorax. " 6ed1d613-d65d7ee1-3a0fb3c8-bd4eadf8-51e4efbb.jpg,test/p11/p11967908/s52526644/6ed1d613-d65d7ee1-3a0fb3c8-bd4eadf8-51e4efbb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old female with a history of lymphoma, CAD (s/p PCI), CHF (LVEF ___%), ESRD (on HD ___), and hypogammaglobulinemia with recent admissions for chest pain and PNA (___, ___) who presents to the ED with 1 day history of dyspnea, cough, fevers, and hypotension. // please evaluate CT placement, interval changes please evaluate CT placement, interval changes IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Cardiac silhouette remains at the upper limits of normal. Indistinctness of engorged pulmonary vessels is consistent with continued pulmonary edema. Left chest tube is in place and there is only minimal pleural effusion. No definite pneumothorax. Opacification at the left base silhouetting the hemidiaphragm is consistent with pleural fluid and underlying compressive atelectasis. " 54e70fa6-9e59a28b-061c903b-432b216e-211709ea.jpg,test/p13/p13826513/s51379972/54e70fa6-9e59a28b-061c903b-432b216e-211709ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with alcoholic cirrhosis // preop workup preop workup IMPRESSION: No previous images. There are low lung volumes but no evidence of cardiomegaly, vascular congestion, or definite pleural effusion. There is mild asymmetry of opacification at the bases, with increase on the left. This most likely represents atelectasis, though in the appropriate clinical setting superimposed pneumonia could be considered. This could be a manifestation of splenomegaly. " b09ebe3b-53ed0e6b-011acf48-8099bad4-0fed4abc.jpg,test/p17/p17995051/s53587641/b09ebe3b-53ed0e6b-011acf48-8099bad4-0fed4abc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MCA stroke, intubated, s/p bronch // interval change interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous mild pulmonary edema has resolved, pulmonary vasculature is normal and mediastinal venous distension is minimal. Heart size normal. ET tube and left subclavian line in standard placements. Esophageal drainage tube passes into the stomach but the tip is not distinct. Pleural effusion small if any. No pneumothorax. " bb6e5d1e-22d37a9c-dae0f228-528dfe8f-035b1313.jpg,test/p10/p10986205/s56021320/bb6e5d1e-22d37a9c-dae0f228-528dfe8f-035b1313.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F status post fall 5 days ago, ongoing lower back pain; also with pain in the left shoulder TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest CT ___ FINDINGS: Heart size remains moderately enlarged. The aorta is diffusely and densely calcified. Interstitial opacities are more pronounced in the right lung compared to the left, and again may reflect asymmetric pulmonary edema, but lymphangitic carcinomatosis is not excluded. Mediastinal and hilar contours are otherwise unchanged. Marked emphysematous changes are again noted. Right lower lobe lung mass is not substantially changed in the interval. Previously demonstrated pulmonary and pleural metastases are better assessed on the previous CT. Small left pleural effusion is again noted. There is no pneumothorax. Remote bilateral rib fractures are again seen. Mild compression deformity of a mid thoracic vertebral body remains unchanged. Clips are noted in the right upper quadrant of the abdomen. IMPRESSION: 1. Unchanged right lower lobe lung mass. Known pulmonary and pleural metastases are better demonstrated on the prior CT. 2. Small left pleural effusion. 3. Interstitial opacities are more pronounced on the right, possibly reflective of asymmetric pulmonary edema but lymphangitic carcinomatosis is not excluded. " d8572b3f-f8325029-6e705b21-850e2e74-72f09c8d.jpg,test/p14/p14141188/s55890966/d8572b3f-f8325029-6e705b21-850e2e74-72f09c8d.jpg,test," FINAL REPORT AP CHEST, 4:17 A.M. ON ___ HISTORY: MI. TIA. IMPRESSION: AP chest compared to ___. Lung volumes have improved. Minimal interstitial edema and small right pleural effusion persists. Heart size top normal. Large benign calcification in the right lung could be hamartoma or granuloma. " d1fd9894-e080e878-c526baf1-cbed0882-25b644ef.jpg,test/p11/p11780544/s55569645/d1fd9894-e080e878-c526baf1-cbed0882-25b644ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with SOB on exertion. // Infiltrates? IMPRESSION: Large lung volumes suggest hyperinflation due to obstructive airways disease although no bullae are seen and there has been no change since ___ or ___. Lungs are clear of any focal abnormality. Heart size is top- normal. There is no pleural abnormality or evidence of central lymph node enlargement. Moderate rightward deviation of the trachea in the neck is not accompanied by appreciable narrowing, and is unchanged since ___. This is most commonly due to an enlarged thyroid. " 129ec233-45d77d5b-7bdd431b-019753e1-d9afe8e3.jpg,test/p15/p15563103/s56767584/129ec233-45d77d5b-7bdd431b-019753e1-d9afe8e3.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Newly placed Dobbhoff tube. Portable AP radiograph of the chest demonstrates the Dobbhoff tube passing through the stomach, terminating at least in second portion of the duodenum. Heart size is normal. Aorta is slightly tortuous. The imaged portion of the lungs is unremarkable except for minimal left basal opacity most likely representing substantial fat pad or potentially newly developed atelectasis. " a1dc5931-69474e45-5361e18e-e6d18f4d-117c653d.jpg,test/p17/p17672672/s59676940/a1dc5931-69474e45-5361e18e-e6d18f4d-117c653d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CHF, recent sepsis and hypoxia on RA // Please eval for infiltrate vs. edema TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Multiple prior chest radiographs dating back to ___, most recently ___. FINDINGS: Compared to chest radiographs from ___, the degree of pulmonary edema has mildly improved. Moderate cardiomegaly has increased. Lung volumes remain low. Small effusion on the right, better assessed on prior chest CTA from ___, has also likely decreased. No effusion on the left. There is no new focal consolidation. No pneumothorax. Right central venous catheter terminates in the right atrium. IMPRESSION: 1. Mildly improved pulmonary edema with increased cardiomegaly, now moderate. 2. Small right pleural effusion, better assessed on prior chest CTA, likely unchanged. No effusion on the left. 3. No evidence of pneumonia. " 62145869-ed27872f-c77f4c67-36475c16-9da44eba.jpg,test/p17/p17879369/s57070117/62145869-ed27872f-c77f4c67-36475c16-9da44eba.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with metastatic melanoma with one residual ___-___ RLL nodule of uncertain significance // Assess status of right lung nodule and other possible metastases Assess status of right lung nodule and other possible metastases IMPRESSION: There no prior chest radiographs available for review. Granulomatous calcifications in the left upper lobe and centrally in at least the left hilus and lower paratracheal mediastinal lymph nodes, indicate prior infection. There is no evidence of active infection. Small region of peribronchial infiltration in the right upper lobe anterior segment may indicate an isolated region of bronchiectasis or scarring. Lower lungs are clear. Heart is normal size, however the ascending thoracic Aorta is either tortuous or dilated. There is no pleural abnormality. There is no evidence of intrathoracic malignancy. " e03d027a-0c9fc280-85777e1b-8c5ff83f-27947d7a.jpg,test/p18/p18328384/s52281715/e03d027a-0c9fc280-85777e1b-8c5ff83f-27947d7a.jpg,test," FINAL REPORT HISTORY: Shortness of breath. Evaluate for effusion. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: None. FINDINGS and IMPRESSION: There is a massive right pleural effusion with associated leftward shift of the mediastinum. A small portion of the right upper lung remains aerated. A small locule of air is seen within the right mid-lung which could reflect a cavitation. A 2.5 cm nodule is seen in the left lower lung, best appreciated on the frontal view. Comparison should be made to prior imaging if available, otherwise, a dedicated chest CT would be recommended. There is no left pleural effusion. There is no pneumothorax. " 041952df-ebad107e-c967f135-7a3addb3-f72a53bf.jpg,test/p18/p18014061/s55063826/041952df-ebad107e-c967f135-7a3addb3-f72a53bf.jpg,test," FINAL REPORT HISTORY: Patient with history of renal transplant, now with fevers, assess for pneumonia versus edema. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Lung volumes are low but clear. The cardiac silhouette is mildly enlarged. Mediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. IMPRESSION: Mild cardiomegaly with no pulmonary edema. No pneumonia. " 4df67309-3dacfdd4-23d656bb-bb895d6e-e29cda4c.jpg,test/p18/p18065780/s54053137/4df67309-3dacfdd4-23d656bb-bb895d6e-e29cda4c.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain, epigastric pain, cough, fevers. Please evaluate for a widened mediastinum or pneumonia. COMPARISON: Multiple prior radiographs, most recently ___. FINDINGS: A single portable frontal upright view of the chest was obtained. Apparent enlargement of the cardiac silhouette and widening of the mediastinum is likely related to the portable technique and the patient's rotated position. Redemonstrated are linear areas of scarring, most prominent at the base of the right lung. There is no focal consolidation. The lungs are symmetrically expanded bilaterally. Blunting of the right costophrenic angle is relatively unchanged and may reflect a small chronic right pleural effusion or pleural thickening in this region. There is no pneumothorax. IMPRESSION: Allowing for differences in technique and position, there is no significant change compared to the prior study. " 806a3233-eb0c60e4-9d1cbbf9-a84b51f1-5009cd64.jpg,test/p14/p14186178/s56885299/806a3233-eb0c60e4-9d1cbbf9-a84b51f1-5009cd64.jpg,test," FINAL REPORT CLINICAL INDICATION: Nausea and elevated lactate. Evaluate for pneumonia. COMPARISON: Chest radiograph, ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Limited examination. The lung volumes are markedly decreased and the apices are obscured by the patient's chin. The small visualized portion of the upper to mid lungs is clear. No large pneumothorax. " 784e7378-895a50ec-6432eb64-d8f75168-5430ec2f.jpg,test/p12/p12183689/s50447941/784e7378-895a50ec-6432eb64-d8f75168-5430ec2f.jpg,test," FINAL REPORT CHEST RADIOGRAPH. INDICATION: questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient remains intubated and carries a nasogastric tube and a left central venous access line in unchanged manner. A minimal atelectasis at the right lung bases persists, but there is no evidence of pneumonia. No pleural effusions. No pneumothorax. Normal size of the cardiac silhouette. " ab182807-83e4f151-69d855e8-64c58e63-8aa41960.jpg,test/p14/p14746824/s53958136/ab182807-83e4f151-69d855e8-64c58e63-8aa41960.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-___ ___ ___ COMPARISON: Chest x-___ ___ and chest CT of ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are stable compared to the prior study. Lungs are well expanded and clear, and there are no pleural effusions. Subcentimeter lung nodules on prior chest CT are likely below the resolution of conventional chest radiographs. Right internal jugular central venous catheter remains in place, terminating in the proximal superior vena cava. No acute skeletal abnormalities. IMPRESSION: No radiographic evidence of acute pulmonary disease. " 5f63983b-71c3c3ac-dd030083-caf9d353-4d010c22.jpg,test/p12/p12226373/s58861944/5f63983b-71c3c3ac-dd030083-caf9d353-4d010c22.jpg,test," FINAL REPORT INDICATION: ___-year-old female with recent pneumonia. Evaluate for pulmonary abnormalities. COMPARISON: PA and lateral chest radiograph on ___ and ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded. New multiple perdominantly peripheral upper zone consolidations are noted bilaterally, more conspicuous in the right. Otherwise, the cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Differential diagnosis for multiple perdominantly peripheral upper zone consolidations includes tuberculosis, eosinophilic pneumonia and cryptogenic organizing pneumonia. A chest CT, preferably with contrast if the patient's renal function allows it, is recommended for further assessment. These findings were discussed with Dr. ___ on ___ at 4:30 p.m. by Dr. ___ ___ telephone. " 4833c2cf-85ba6aa5-8c08f82a-2765bb5f-32dcd1c6.jpg,test/p13/p13567471/s58326886/4833c2cf-85ba6aa5-8c08f82a-2765bb5f-32dcd1c6.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, intubation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects approximately 6 cm above the carina. In the interval, the patient has developed bilateral pleural effusions of mild-to-moderate extent, with subsequent areas of atelectasis at both the left and the right lung bases. No pneumothorax. Minimal blunting of left mediastinal structures, likely caused by patient's rotation. " 7a968a7b-9311efa2-bbc09e08-98e73bb1-6996664b.jpg,test/p17/p17190208/s54467731/7a968a7b-9311efa2-bbc09e08-98e73bb1-6996664b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with volume overload and tachypnea // eval for worsening pulm edema eval for worsening pulm edema IMPRESSION: In comparison with the study of ___, there are slightly lower lung volumes. Continued enlargement of the cardiac silhouette with similar degree of pulmonary vascular congestion. Otherwise little change. " 99e2a68f-a22c4915-79543ffa-af57e300-29fea168.jpg,test/p18/p18332970/s52914397/99e2a68f-a22c4915-79543ffa-af57e300-29fea168.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with anorexia, admitted for malnutrition // per ED protocol TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are well expanded and clear. The heart size is normal. The hilar and mediastinal contours are normal. Since the last radiograph, right PICC has been removed. There is no pneumothorax or pleural effusion. IMPRESSION: Normal chest radiograph. " 21c0db8f-6ca767fc-37c717cb-193aada6-64d3a1b7.jpg,test/p10/p10188275/s59218332/21c0db8f-6ca767fc-37c717cb-193aada6-64d3a1b7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, chronic heart failure. Evaluation for pleural effusions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the extent of the pre-existing right pleural effusion has improved. The effusion is barely visible on today's image. There is a small amount of pleural scarring and thickening at the right lateral aspects of the chest. Minimal atelectasis at the lung bases. Otherwise, unchanged radiograph. " efe34a2b-32691b4f-c21ee631-9d2d77dd-5162055b.jpg,test/p18/p18658996/s53063634/efe34a2b-32691b4f-c21ee631-9d2d77dd-5162055b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. COMPARISON: ___, 8:23. FINDINGS: As compared to the previous radiograph, the patient has again a nasogastric tube visualized. The tip of the tube has been minimally advanced and is now projecting over the middle parts of the stomach. The other monitoring and support devices are constant. Constant appearance of the pleura, the lung parenchyma and the heart. No evidence of complications, notably no pneumothorax. " 1bd72d5f-b93382d3-d3317454-5079c4fa-074cbb05.jpg,test/p11/p11581260/s51650674/1bd72d5f-b93382d3-d3317454-5079c4fa-074cbb05.jpg,test," WET READ: ___ ___ ___ 7:24 PM IMPRESSION: No definite change in metastatic masses in the right hemithorax. Tracheal narrowing by a dominant mass, although present before and not necessarily changed, in the setting of known recent growth of metastases. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness and dyspnea. History of metastatic disease. COMPARISONS: Radiographs from ___ and CT from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged including right perihilar masses. The contours of the mid to lower trachea are indistinct on the right corresponding to known tracheal narrowing associated with a dominant mass involving the upper mediastinum. There is a more distinct round mass than before visualized in the right lower lung, possibly reflecting an increase in metastatic disease versus loculated pleural effusion since the prior radiographs, although necessarily changed when differences in technique are considered. There is persistent mild elevation of the right hemidiaphragm. Patchy right basilar opacity suggests atelectasis in addition to extensive pleural-based metastatic disease in the right lower hemithorax. The left lung remains clear. IMPRESSION: No definite change in metastatic masses in the right hemithorax. Tracheal narrowing by a dominant mass, although present before and not necessarily changed, in the setting of known recent growth of metastases. " a4a9161b-2f2e1696-b31b5c12-b708710e-dbbbe125.jpg,test/p11/p11988567/s57130517/a4a9161b-2f2e1696-b31b5c12-b708710e-dbbbe125.jpg,test," FINAL REPORT HISTORY: Chronic smoking, weakness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph. ___ chest CT. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unchanged, with mild tortuosity of the thoracic aorta. Diffuse thoracic aortic calcifications are also noted. The pulmonary vascularity is not engorged. Hyperinflation of the lungs is again noted. Lungs are otherwise clear without focal consolidation. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities are detected. Cholecystectomy clips are demonstrated within the right upper quadrant. Remote right-sided rib fracture is present. IMPRESSION: No acute cardiopulmonary abnormality. Hyperinflated lungs suggestive of underlying COPD. " edc24ef4-3fde94e3-3a6e2425-9dcaf170-73c75d8a.jpg,test/p19/p19849311/s50691102/edc24ef4-3fde94e3-3a6e2425-9dcaf170-73c75d8a.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with two weeks of cough, travel to ___ (___) six months ago. Evaluate for possible infiltrates. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. A marked right-sided convex scoliosis in the mid portion of the thoracic spine accounts for asymmetric presentation of the chest on the frontal view. The degree of scoliosis is unchanged since ___. The heart size remains normal as well as the thoracic aorta which follows the scoliotic curvature in its descending portion remains within normal limits. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are found and the lateral and posterior pleural sinuses are free. No evidence of pneumothorax in the apical area. With the exception of the described scoliosis which includes mild degenerative changes mostly in the mid portion of the thoracic spine, no other gross skeletal abnormalities can be identified. IMPRESSION: Stable chest findings, no evidence of cardiac enlargement, pulmonary congestion or acute infiltrates in this female patient with history of two weeks of cough. " cbdfa854-982ef1b1-ebf26f9e-dcf47957-064f9982.jpg,test/p12/p12645334/s53324418/cbdfa854-982ef1b1-ebf26f9e-dcf47957-064f9982.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Patient with altered mental status, likely hepatic encephalopathy. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes, which accentuate the bronchovascular markings. There is minimal interstitial edema. Basilar opacities are seen on the frontal view, not substantiated on the lateral view and may relate to bibasilar atelectasis with prominent vascular structures, although underlying infection or aspiration is not excluded, although felt less likely. The cardiac silhouette is top normal to mildly enlarged. The aorta is tortuous and calcified. Evidence of DISH is seen along the thoracic spine. IMPRESSION: Low lung volumes accentuate the bronchovascular markings. Mild prominence of the interstitial markings raises concern for mild interstitial edema. Bibasilar, right greater than left opacities seen on the frontal view may be due to combination of overlying vascular structures; however, underlying consolidation from infection or aspiration is not excluded. " 1af905ab-c14fdcc9-6a0822a7-7c0cfaa2-248bb608.jpg,test/p13/p13390013/s50853377/1af905ab-c14fdcc9-6a0822a7-7c0cfaa2-248bb608.jpg,test," FINAL REPORT INDICATION: Leg swelling, history of diastolic dysfunction. COMPARISON: ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size is normal. The aorta remains tortuous, but the mediastinal and hilar contours are stable. Lungs are clear and the pulmonary vascularity is normal. No focal consolidation, pleural effusion, or pneumothorax is present. There are mild degenerative changes of the thoracic spine. Degenerative changes of the glenohumeral joints are also noted, as well as involving the right acromioclavicular joint. A tiny ossific well-corticated density is noted superior to the right AC joint, likely the sequela of prior trauma. IMPRESSION: No acute cardiopulmonary abnormality. " 56c9fd1f-cc298cc1-c22ca876-efbe3b2e-29f4ffd7.jpg,test/p14/p14152892/s54346707/56c9fd1f-cc298cc1-c22ca876-efbe3b2e-29f4ffd7.jpg,test," FINAL REPORT INDICATION: Nocturnal dyspnea, here to evaluate for acute cardiopulmonary process. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation concerning for pneumonia, pleural effusion or pneumothorax. The pulmonary vasculature is within normal limits. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. Multiple surgical clips are noted in the left upper quadrant of the abdomen compatible with prior bowel surgery. IMPRESSION: No evidence of acute cardiopulmonary process. " f4611dad-89d6c1fb-64fef2fb-c27af878-c7d7cc1b.jpg,test/p12/p12698967/s55190604/f4611dad-89d6c1fb-64fef2fb-c27af878-c7d7cc1b.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with mechanical fall vs syncope and new onset of weakness TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: CTA head and neck ___ at 10:38, CT chest ___, chest radiograph ___ and ___ FINDINGS: Heart size is within normal limits. The aorta is tortuous and diffusely calcified. Mediastinal and hilar contours are grossly unchanged. No pulmonary vascular congestion is demonstrated. Triangular opacity within the right upper lobe measuring approximately 12 mm is more apparent than on the prior chest radiograph from ___, but was seen in ___. Tree-in-___ nodular opacities seen in the right upper lobe on the recent CTA head and neck likely reflect small airways disease, but is not well assessed on the current radiograph. No new focal consolidation or pneumothorax is detected. Mild blunting of the right costophrenic sulcus may be due to chronic pleural thickening versus a trace pleural effusion. The osseous structures are diffusely demineralized. Multiple compression fractures within the mid and lower thoracic spine as well as the upper lumbar spine appear grossly unchanged. Remote left-sided rib fractures are also re- demonstrated. IMPRESSION: No substantial interval change from the most recent chest radiograph. Small airways disease seen in the right upper lobe on recent CTA head and neck is not well assessed on the current radiograph. Right upper lobe 12 mm triangular opacity is grossly unchanged from ___, but should be further assessed with dedicated chest CT. " 43cb6516-23a6bc76-587ca80a-78547593-efbb52a5.jpg,test/p14/p14951470/s53943776/43cb6516-23a6bc76-587ca80a-78547593-efbb52a5.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with chest pain with diaphoresis. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are unremarkable. Lungs are essentially clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of abnormality to explain patient's symptom is demonstrated. " c99afbec-6669f59a-c1fce1ee-95d28dc9-99f2a6b5.jpg,test/p17/p17288913/s56359048/c99afbec-6669f59a-c1fce1ee-95d28dc9-99f2a6b5.jpg,test," FINAL REPORT INDICATION: Chest pressure. COMPARISONS: Chest radiograph, ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardimediastinal silouhette is normal. Cerivcal spinal fusion hardware is present, but not well evaluated on this exam. There is no significant change from prior the radiographs. IMPRESSION: No acute cardiopulmonary process. " 64ef4670-65647e4a-c2bfbf8f-3148c37e-d4c9435a.jpg,test/p16/p16059088/s59094037/64ef4670-65647e4a-c2bfbf8f-3148c37e-d4c9435a.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY DATED ___ COMPARISON: Chest x-ray of one day earlier. FINDINGS: Indwelling support and monitoring devices are in standard position. Lower lung volumes compared to the prior study accentuate the cardiomediastinal contours and bronchovascular structures. Allowing for this difference, there has been no substantial change in the appearance of the chest compared to the recent study of one day earlier. " e3e69d1b-7af0b39e-119cf227-4bc59eb7-36f7318f.jpg,test/p13/p13123063/s53254691/e3e69d1b-7af0b39e-119cf227-4bc59eb7-36f7318f.jpg,test," WET READ: ___ ___ ___ 4:54 AM Improved right basilar opacities from ___ most likely reflect atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with lethargy // Eval for cardiopulmonary process TECHNIQUE: Upright AP and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The inspiratory lung volumes are decreased. Streaky opacities in the right lung base with a linear configuration are improved from ___ and most likely reflect atelectasis. There is no pleural effusion or pneumothorax. The cardiac silhouette remains top normal in size. The mediastinal and hilar contours are unchanged. No acute osseous abnormality detected. IMPRESSION: Improved right basilar opacities from ___ most likely reflect atelectasis. " f168f063-a5a971fc-680a45b3-fbb9dd80-70bff34c.jpg,test/p18/p18124225/s56550622/f168f063-a5a971fc-680a45b3-fbb9dd80-70bff34c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___M w/ rib fx, small L pneumothorax with chest tube // eval for resolution of Pneumothorax COMPARISON: Chest radiographs ___ through ___ at 06:23. IMPRESSION: Left pleural drainage catheter unchanged in position, left upper chest. No appreciable pneumothorax or pleural effusion. Moderate relative elevation right hemidiaphragm and basal atelectasis unchanged since the earliest chest radiographs in this admission. Heart size normal. " 3b28cbc1-0a42eaf1-b48d4724-4d7db3f9-22b992fb.jpg,test/p17/p17606572/s50985084/3b28cbc1-0a42eaf1-b48d4724-4d7db3f9-22b992fb.jpg,test," WET READ: ___ ___ ___ 7:06 PM Increased bilateral lower lobe heterogeneous opacities with small left pleural effusion. Findings are consistent with edema but infection cannot be excluded. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with increased hypoxia, history of CHF // evaluate for consolidation, effusion or edema evaluate for consolidation, effusion or edema COMPARISON: Prior chest radiograph ___. IMPRESSION: Moderate cardiomegaly is slightly larger and upper lobe pulmonary vascular caliber minimally increased, and the mediastinal venous engorgement is stable, so the substantial increase in heterogeneous bibasilar opacification cannot be easily ascribed to dependent edema a above that may be the case. Pneumonia particularly severe aspiration should be considered. Small left pleural effusion is new. No pneumothorax. Transvenous right atrial and right ventricular pacer leads are unchanged in their respective positions continuous from the left pectoral generator. No pneumothorax. " 6aa9bad9-ece339a7-23db7e26-18338f04-8614e21d.jpg,test/p16/p16404707/s57664531/6aa9bad9-ece339a7-23db7e26-18338f04-8614e21d.jpg,test," FINAL REPORT HISTORY: Chest pain and shortness of breath. FINDINGS: In comparison with the study of ___, the patient has taken a slightly better inspiration. Cardiac silhouette is prominent, but there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 58168d95-f620d771-4b4ff689-973447ec-bcbc7433.jpg,test/p16/p16594585/s56165757/58168d95-f620d771-4b4ff689-973447ec-bcbc7433.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Dry cough for two weeks. PA and lateral upright chest radiographs were reviewed in comparison to ___ chest radiograph and CT chest obtained on ___. Heart size and mediastinum are stable in appearance. Bilateral perihilar bronchiectasis associated with linear opacities are stable. No new focal consolidation to suggest interval development of infectious process seen. No pleural effusion or pneumothorax is demonstrated. " 4a9fa920-21b90345-e06dd18f-9110ead6-abfc65f8.jpg,test/p19/p19598034/s50665908/4a9fa920-21b90345-e06dd18f-9110ead6-abfc65f8.jpg,test," FINAL REPORT INDICATION: ___M with EKG changes // assess for cardiac abnormalities TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Lung volumes are slightly low. Streaky bibasilar opacities are most likely atelectasis. The lungs are otherwise clear without consolidation, effusion, or edema. Cardiac silhouette is top-normal. There is slight tortuosity of the descending thoracic aorta. No acute osseous abnormalities, hypertrophic changes are noted in the spine. IMPRESSION: No acute cardiopulmonary process. " 2442a814-6fa7a3da-97317bc3-95eb0705-17f418b4.jpg,test/p17/p17794482/s57446371/2442a814-6fa7a3da-97317bc3-95eb0705-17f418b4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with lethargy // eval for pna COMPARISON: Prior exam from ___. FINDINGS: PA and lateral views of the chest provided. Right chest wall Port-A-Cath again seen with catheter tip in the region of the low SVC. There is subtle retrocardiac opacity seen on the lateral projection which could represent mild atelectasis. There is no convincing evidence for pneumonia, effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: As above. " 290c20e9-da776f1b-eea983b2-1e6639e0-4e6f51f9.jpg,test/p19/p19657612/s51226475/290c20e9-da776f1b-eea983b2-1e6639e0-4e6f51f9.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Splenic laceration and rib fractures, question pneumothorax. FINDINGS: There is no pneumothorax. There is bibasilar volume loss/consolidation which is increased compared to prior studies. The thoracic bony fracture at T8 is better visualized on the CT scan. The upper lungs are clear. There is no pneumothorax. " 15da8280-c72c297a-ab9416be-6eb22eb4-4873026a.jpg,test/p10/p10165672/s52806049/15da8280-c72c297a-ab9416be-6eb22eb4-4873026a.jpg,test," FINAL REPORT INDICATION: ___M with with CKD here with increased ___ swelling and dyspnea // evaluate for interstitial fluid TECHNIQUE: Frontal and lateral views of the chest COMPARISON: ___ and ___. FINDINGS: Compared to most recent prior, there has been interval progression of disease. There now bilateral upper lobe regions of consolidation in addition to the previously seen right basilar opacity which persists. There are new small bilateral effusions as well. Cardiac silhouette there is mild to moderately enlarged as on prior. IMPRESSION: Multi focal central regions of consolidation, progressed since prior and new bilateral effusions. Findings may be related to asymmetric pulmonary edema, infection is also possible. " cd8bb908-0d237106-828b37e2-cdf82c3e-b352b62d.jpg,test/p16/p16233087/s56695676/cd8bb908-0d237106-828b37e2-cdf82c3e-b352b62d.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___M with chest pressure since waking this morning, hx STEMI ___, s/p mitral valve replacement.Patient with hx cauda equina, s/p laminectomy ___ // Eval for acute process.Eval for cauda equina or acute lumbar spine process. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: A moderate left pleural effusion with adjacent atelectasis appears modestly improved from the prior examination. The right lung and left upper lung are clear without lobar consolidation or pneumothorax. Azygos fissure is incidentally noted. There is no frank pulmonary edema. The cardiomediastinal silhouette is unchanged. Median sternotomy wires are intact and well aligned. IMPRESSION: Perhaps minimally improved moderate left pleural effusion. Otherwise, no significant change from ___. " 22bf0b41-d76186ab-f9cd6d3e-fc619a23-76775d9c.jpg,test/p11/p11658675/s57123854/22bf0b41-d76186ab-f9cd6d3e-fc619a23-76775d9c.jpg,test," FINAL REPORT INDICATION: ___-year-old male with hypoxia. Evaluate for evidence of pneumonia. COMPARISON: Multiple prior chest radiographs, most recent on ___. TECHNIQUE: Frontal AP chest radiograph. FINDINGS: Bibasal consolidations appear worse compared with prior exam. There is also a new focus of a band-like consolidation extending from the left heart margin superiorly into the left mid lung. There is obscuration of the bilateral cardiac margins as well as the left hemidiaphragms. There might be a small left-sided pleural effusion. There is no evidence of pneumothorax. Aortic knob calcifications are present. Evidence of prior vertebroplasties is noted in the thoracic spine. IMPRESSION: Significant interval worsening of bibasal consolidations, with new opacity extending across the left lower lung and associated small left-sided pleural effusion. Finding could reflect pneumonia superimposed on a chronic lung disease. " 90456141-62ebfb99-96edf169-34d0e7cf-36edd090.jpg,test/p10/p10993512/s52568164/90456141-62ebfb99-96edf169-34d0e7cf-36edd090.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever, aspiration // ? aspiration ? aspiration IMPRESSION: Comparison to ___. In the interval, the patient has developed bilateral pleural effusions, left more than right. In addition, there is a retrocardiac atelectasis as well as a parenchymal opacity at the right lung base, combined to air bronchograms and thickening of the peribronchial connective tissue in the appropriate clinical setting this change could reflect pneumonia. No pulmonary edema. Unchanged borderline size of the heart. " 823b2472-2ce8e672-eee283b1-698ef2d5-1a9bfc70.jpg,test/p14/p14670565/s54825434/823b2472-2ce8e672-eee283b1-698ef2d5-1a9bfc70.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain. Evaluate for cardiomegaly or effusion. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " fa0c3eb5-e126479d-b818c361-29517480-3aaea159.jpg,test/p17/p17125981/s50956803/fa0c3eb5-e126479d-b818c361-29517480-3aaea159.jpg,test," FINAL REPORT INDICATION: ___-year-old female with worsening shortness of breath; evaluate for pneumonia. COMPARISON: Multiple chest radiographs, the latest from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show progression of bilateral lower lobe opacities with increase in small bilateral effusions. There is Upper zone redistribution and vascular plethora. Heart size is bordelrine. No pneumothorax is present. IMPRESSION: Bilateral lower lobe opacities have progressed with increase in effusion consistent with pneumonia. Probable component of CHF. " 543da826-2aa513c2-2d69495b-90ca2cc5-9a687626.jpg,test/p19/p19996786/s52281280/543da826-2aa513c2-2d69495b-90ca2cc5-9a687626.jpg,test," FINAL REPORT HISTORY: Asthmatic bronchitis, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 8f439377-9e5ff224-991aa3fc-144b6b51-8a0ea00b.jpg,test/p14/p14445477/s58542884/8f439377-9e5ff224-991aa3fc-144b6b51-8a0ea00b.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with recent pneumonia, status post antibiotic treatment ending on ___. Assess for resolution of infiltrate. FINDINGS: PA and lateral chest views have been obtained with patient in upright position. Comparison is made with the next preceding chest examination of ___. The on previous examination identified patchy infiltrates in the right lower lobe posterior segment have cleared up and the lungs are now unremarkable without evidence of remaining parenchymal infiltrates, pleural effusions or vascular congestion. The chest findings are now very similar to that obtained on ___ in which they also were deemed to be within normal limits. IMPRESSION: Resolution of right lower lobe infiltrates encountered on chest examination two weeks earlier. " 1a2a4476-a1f57145-3f3a27dd-c2f1aa53-b18139db.jpg,test/p14/p14784477/s58071037/1a2a4476-a1f57145-3f3a27dd-c2f1aa53-b18139db.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with s/p splenectomy, has had productive cough, has taken Zpack, now still with left sided rhonchi at base // please evaluate for signs of pneumonia, particularly L base TECHNIQUE: Chest PA and lateral COMPARISON: Portable AP chest radiograph dated ___ FINDINGS: Since the chest radiograph obtained ___, the lungs are better aerated. There is a band of atelectasis within the lower left lung. Lungs are otherwise fully expanded and clear without consolidations or effusions. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal. Incidental note is made of an accessory azygos lobe. IMPRESSION: No radiographic evidence of pneumonia or other significant cardiopulmonary abnormalities. Incidental note is made of an accessory azygos lobe. " df4f6096-bde1fc03-ed10b463-30b460cc-e514e7d8.jpg,test/p19/p19302735/s56724270/df4f6096-bde1fc03-ed10b463-30b460cc-e514e7d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with neutropenic fever // Pneumonia? Pneumonia? IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Low lung volumes. Moderate cardiomegaly. The alignment of the sternal wires and the position of the left pectoral Port-A-Cath is unchanged. No pneumonia, no pulmonary edema, no pleural effusions. " 16c93802-4105f7b7-ccac7e08-e85da98c-43fe8f96.jpg,test/p10/p10791554/s51520857/16c93802-4105f7b7-ccac7e08-e85da98c-43fe8f96.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. COMPARISON: Probably AP chest ___, ___. CT torso ___. INDICATION: ___-year-old with lung cancer and cough, considering pneumonia. FINDINGS: There is moderate cardiomegaly, stable compared to prior exams. Cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear. There is no focal consolidation, pulmonary edema, pleural effusion or pneumothorax. There is a wedge shaped compression deformity in mid thoracic vertebral body. IMPRESSION: 1. No pneumonia. " 13261adc-8de058bb-74ac0a15-22326947-be7b677a.jpg,test/p14/p14023590/s56033006/13261adc-8de058bb-74ac0a15-22326947-be7b677a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman right 1st rib resection // pneumothorax IMPRESSION: Small to moderate right apical lateral pneumothorax is present in this patient status post recent partial right first rib resection. Exam is otherwise remarkable for patchy bibasilar atelectasis, right greater than left. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:07 AM, 5 minutes after discovery of the findings. " e17d47b2-79e1be87-9be29af4-59dc7e42-fd5ba68d.jpg,test/p13/p13712747/s53271796/e17d47b2-79e1be87-9be29af4-59dc7e42-fd5ba68d.jpg,test," WET READ: ___ ___ ___ 3:19 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest x-ray. INDICATION: ___-year-old woman with altered mental status, rales at the lung bases, evaluate for pneumonia or edema. TECHNIQUE: PA and lateral upright chest radiographs. COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal silhouettes are stable and within normal limits. The bilateral hila are unremarkable. The lungs are clear. Subtle opacity at the right cardiophrenic angle is most compatible with crowding of bronchovascular structures and/or mild atelectasis in the setting of a suboptimal inspiratory effort. Otherwise, the lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 961ed444-ab9b3c6f-cacc56ba-3384677c-d65db64d.jpg,test/p16/p16500918/s53418440/961ed444-ab9b3c6f-cacc56ba-3384677c-d65db64d.jpg,test," FINAL REPORT HISTORY: Palpitations. Assess for acute process. COMPARISON: Comparison is made with chest radiograph performed ___. FINDINGS: The frontal and lateral chest radiograph demonstrates stable cardiomediastinal silhouette with mild prominence of the left atrium. Pacemaker leads are well positioned. The lungs are clear. No pleural effusion or pneumothorax identified. Multilevel degenerative changes are present. Sternotomy sutures are midline and intact. IMPRESSION: No acute intrathoracic process. " 4e6bcc5e-08e008a9-2b7afe7b-c083be2d-63516c16.jpg,test/p19/p19816477/s52893034/4e6bcc5e-08e008a9-2b7afe7b-c083be2d-63516c16.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old female with chills. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 44a702b2-ca50e1e6-1319f1cb-efbc906d-b92ae713.jpg,test/p17/p17910433/s54396784/44a702b2-ca50e1e6-1319f1cb-efbc906d-b92ae713.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with h/o afib on warfarin, CAD, HTN, and COPD with recent history of fall who presented to OSH after episode of diaphoresis and was found to have small SDH. NSTEMI on ___ and found to have 3V disease on cath, being evaluated for CABG. Patient developed worsening hypoxemia and hypotension with concern for impending cardiogenic shock so was transferred to the CCU for further management // eval for interval change IMPRESSION: In comparison to ___ radiograph, an intra-aortic balloon pump now terminates 3.6 cm below the expected level of the superior aortic knob. Cardiomediastinal contours are unchanged. Interval improved right basilar atelectasis. No other relevant change. " 4ff74870-4f5fd352-7f5b35b3-2ddc4b10-c4c6ed54.jpg,test/p15/p15341255/s52992721/4ff74870-4f5fd352-7f5b35b3-2ddc4b10-c4c6ed54.jpg,test," FINAL REPORT INDICATION: ___ year old man with pleural effusion // eval TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The right-sided pleural effusions shows interval increase in size, and appears mildly loculated. No mediastinal shift, suggesting slow development and atelectasis. There is no pulmonary edema. The left lung is clear. Pulmonary hyperinflation suggesting COPD. Evidence of previous CABG. Cardiomegaly is again noted. Degenerative changes of the thoracic spine. IMPRESSION: The right-sided pleural effusions shows interval increase in size, and appears mildly loculated " c694130b-0e9b4986-6846d93b-a0e36887-1f5e2580.jpg,test/p17/p17421663/s59639979/c694130b-0e9b4986-6846d93b-a0e36887-1f5e2580.jpg,test," FINAL REPORT EXAM: Chest, single supine AP portable view. CLINICAL INFORMATION: Altered mental status. COMPARISON: ___ at 05:38. FINDINGS: Left-sided PICC is in stable position. Endotracheal tube terminates approximately 7 cm above the level of the carina. A weighted enteric tube is again seen similar in position, inferior aspect not included on the image, but the weighted portion projecting in the left upper quadrant in the expected location of the proximal stomach. Left retrocardiac opacity persists, likely representing combination of left lower lobe atelectasis and pleural effusion. There may be minimal central pulmonary vascular engorgement. No focal consolidation is seen on the right. There is no right pleural effusion. Cardiac and mediastinal silhouettes are stable. " 91b91722-b65ac42a-d6c7120c-43880a8b-07ced11e.jpg,test/p11/p11551927/s57356881/91b91722-b65ac42a-d6c7120c-43880a8b-07ced11e.jpg,test," FINAL REPORT INDICATION: ___ year old man with severe pancreatitis, fluid overload, failure to extubate x 2 // interval assessment of fluid status, ? PNA TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes of results in bronchovascular crowding. Bibasilar atelectasis has worsened over the interval. There is moderate pulmonary edema. Cardiomediastinal and hilar contours are unchanged. The endotracheal tube ends 5.1 cm on the carina. Enteric feeding tubes course into the stomach and out of the field of view. Right internal jugular central venous line ends in the upper right atrium. No pneumothorax. IMPRESSION: 1. Moderate pulmonary edema. 2. Bibasilar atelectasis has worsened over the interval. " 27000454-f41b54df-64c201c0-b4cfe81d-59f75090.jpg,test/p18/p18137182/s53835399/27000454-f41b54df-64c201c0-b4cfe81d-59f75090.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with Pt with SOB and cough, history of connective tissue disease and interstitial lung disease. COMPARISON: ___, ___, ___, CT of the chest from ___. FINDINGS: PA and lateral views of the chest provided. When compared with the most recent prior chest radiograph, the pattern of pulmonary opacity appears grossly unchanged which suggests chronic lung disease. No acute interval change. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Lung volumes are low. Bony structures are intact. IMPRESSION: Similar pattern of pulmonary opacity likely related to chronic lung disease. " a6d94db7-c780c419-93ec53c1-c8679d4f-0593db31.jpg,test/p19/p19148894/s54741564/a6d94db7-c780c419-93ec53c1-c8679d4f-0593db31.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pressure, shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. Mild to moderate multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 7f05e280-72619762-87d0c2f1-cb956568-3cab18da.jpg,test/p12/p12481299/s51438526/7f05e280-72619762-87d0c2f1-cb956568-3cab18da.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Increasing shortness of breath. History of asthma. COMPARISONS: Radiographs and CT from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: There is mild interstitial prominence with peribronchial cuffing, which could be seen with airway inflammation, among other etiologies. Although interstitial opacities are more confluent in the right lower lung and elsewhere, this appearance is unchanged since the earlier examination and is, accordingly, of uncertain significance. Small osteophytes are noted along the mid thoracic spine. " 17d1821a-1136c5cf-23f8a0f3-11608965-2c30379d.jpg,test/p11/p11557721/s54787163/17d1821a-1136c5cf-23f8a0f3-11608965-2c30379d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough persisting since ___ // ? pneumonia, other acute pathology ? pneumonia, other acute pathology IMPRESSION: No previous images. The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 9f28675c-60ce366f-10159388-164d9e7e-45ff47eb.jpg,test/p17/p17615451/s59289345/9f28675c-60ce366f-10159388-164d9e7e-45ff47eb.jpg,test," WET READ: ___ ___ ___ 5:55 PM Low lung volumes and bibasilar opacities worsened from ___ represent increased atelectasis but superimposed infection cannot be excluded given the patient's clinical history. Wetread placed in CCC by ___. ______________________________________________________________________________ FINAL REPORT HISTORY: AML, neutropenic, new fever. CHEST, SINGLE AP PORTABLE VIEW. Report from ___ chest CT refers to a left lower ___ pneumonia that had improved since the prior exam, new ground-glass opacities in the right lower ___, ___ micronodules, and scattered sclerotic bone lesions. Please see full report from that study. Compared with the radiograph from ___, the bibasilar opacities are somewhat denser and more confluent. The differential diagnosis includes both atelectasis and infectious infiltrate. No gross effusion, though a small amount of pleural fluid could be present on either side. There is upper zone redistribution, but no overt CHF. The upper and mid zones of both lungs are grossly clear. A right-sided PICC line is again noted with tip near SVC/RA junction. No pneumothorax is detected. A small sclerotic density is again noted in the left humeral head, nonspecific in appearance. Mild degenerative changes of both AC joints are noted. IMPRESSION: Bibasilar patchy, slightly more pronounced than on ___, but seeen in the setting of slightly lower lung volumes, ? atelectasis versus pneumonia. " a0e27cb2-a0880121-35d9fd36-5e033cf0-4351c7e7.jpg,test/p15/p15981736/s59258169/a0e27cb2-a0880121-35d9fd36-5e033cf0-4351c7e7.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with history of asthma and hypertension with Aspergillus exposure in ___, presenting with worsening symptoms, assess for acute process. COMPARISONS: None. TECHNIQUE: Two views of the chest were obtained. FINDINGS: Lungs are well expanded and appear clear. No pleural effusion or pneumothorax is identified. Cardiomediastinal contours are unremarkable. " f3f2d54a-8042a92d-9c907f12-c989ce50-ca57061c.jpg,test/p17/p17268630/s55038931/f3f2d54a-8042a92d-9c907f12-c989ce50-ca57061c.jpg,test," FINAL REPORT HISTORY: Cough, shortness of breath. Evaluate for infiltrate. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Chest radiographs from ___. FINDINGS: The lungs are clear of focal opacities, pleural effusion, pulmonary edema or pneumothorax. A right lower lobe calcified granuloma is again seen. The heart and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " d7f34e02-364d15d6-1a184799-91292bfd-8de347be.jpg,test/p13/p13745545/s54019059/d7f34e02-364d15d6-1a184799-91292bfd-8de347be.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Chest tightness after left thoracocentesis. Portable AP radiograph of the chest was reviewed in comparison to ___. There is interval decrease in the left pleural effusion related to recent thoracocentesis. On the other hand, there is progression of bibasal opacities as compared to the prior study highly concerning for interval aspiration or infectious process. Small amount of right pleural effusion is noted. No pneumothorax is seen. Pacemaker leads terminate in the expected location of right atrium and right ventricle. " ad884c8e-d1f79573-0972a4e5-8fb932c6-7cec7609.jpg,test/p14/p14832062/s52771071/ad884c8e-d1f79573-0972a4e5-8fb932c6-7cec7609.jpg,test," FINAL REPORT HISTORY: Pneumonia. FINDINGS: In comparison with the study of ___, there are slightly better lung volumes. Continued enlargement of the cardiac silhouette with minimal, if any, vascular congestion. Retrocardiac opacification is consistent with some volume loss in the lower lobe. There may be small pleural effusions bilaterally. " becf8ed6-c5f60c71-89040c32-9d94b7c6-eb956bc1.jpg,test/p10/p10104732/s59794138/becf8ed6-c5f60c71-89040c32-9d94b7c6-eb956bc1.jpg,test," WET READ: ___ ___ ___ 8:27 PM No change from less than 8 hr prior. Stomach remains distended. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST FILM ___ AT 20:14 CLINICAL INDICATION: ___-year-old with AMS, HIV, now with fever. Any evidence of pneumonia. Comparison to ___ at ___. Portable AP upright chest film ___ at 20:14 is submitted. IMPRESSION: 1. Overall cardiac and mediastinal contours are stable. Lungs remain well inflated without evidence of focal airspace consolidation to suggest pneumonia. No pleural effusions, pneumothorax or pulmonary edema. Overall cardiac and mediastinal contours are unchanged. Gaseous distention of the stomach. " e611030b-6911c7d2-f8a96d5e-adf2f6a6-b93d1fe0.jpg,test/p15/p15619921/s56239567/e611030b-6911c7d2-f8a96d5e-adf2f6a6-b93d1fe0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old female w/ pmh of recurrent pancreatitis (initialy diagnosed this past year), MDS, hodgkins lymphoma s/p chemo/rads and splenectomy, CAD s/p CABG (___), afib on apixaban, multiple embolic strokes, who was admitted ___ with c/o abdominal pain found to have pancreatitis and has been c/b BRBPR, oliguric renal failure and on HD, RUE cellulitis/abcess 2/t PICC s/p I D on ___, who was transferred to ICU for hypotension c/f sepsis, now stable on the medical floor with continued dyspnea and anarsarca. // Assessment of dobhoff placementAssessment of dobhoff placement IMPRESSION: In comparison with the study of ___, the Dobbhoff tube is been pulled back so that the tip lies in the middle to lower portion of the body of the stomach. The right pigtail catheter has been removed and there is no evidence of pneumothorax. Otherwise little change. " ac717c58-b82ba502-70bec52e-5093da2b-f06d2623.jpg,test/p14/p14982705/s50540347/ac717c58-b82ba502-70bec52e-5093da2b-f06d2623.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CTA performed earlier the same day. FINDINGS: The patient is status post median sternotomy and CABG. Left-sided AICD/pacemaker device is noted with leads terminating in the region of the right atrium, right ventricle, and coronary sinus. Right-sided dual lumen central venous catheter tip terminates within the right atrium. The heart remains moderately enlarged. The mediastinal and hilar contours are unremarkable. There is no pulmonary vascular engorgement. Left lower lobe patchy opacity is concerning for infection or aspiration. A small left pleural effusion is re- demonstrated. There is no pneumothorax. IMPRESSION: Left lower lobe opacity concerning for pneumonia or aspiration. Small left pleural effusion. " a94d859d-0738e4da-7b876bd8-4ff1f234-9031aabc.jpg,test/p11/p11936312/s50880556/a94d859d-0738e4da-7b876bd8-4ff1f234-9031aabc.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man s/p cardiac arrest now intubated // Evaluate ET tube TECHNIQUE: Portable AP chest COMPARISON: None FINDINGS: An endotracheal tube terminates 6 cm above the carina. Lung volumes are low with bibasilar atelectasis. Linear density projecting over the lateral left heart border may reflect a dense focus of linear atelectasis or pleural plaque. There is an apparent 1.5 cm cavitary lesion with a relatively thick rim in the lateral mid left lung. Mild cardiomegaly with pulmonary vascular congestion. The 2 most superior median sternotomy wires are fractured in multiple places. Pleural effusions are small, if any. IMPRESSION: 1. ETT terminates 6 cm above the carina. 2. Fractured median sternotomy wires. 3. Mild cardiomegaly with pulmonary vascular congestion, but no overt edema. 4. Apparent 1.5 cm cavitary lesion in the lateral mid left lung. Recommend dedicated PA and lateral radiographs for further evaluation,when feasible. RECOMMENDATION(S): Apparent 1.5 cm cavitary lesion in the lateral mid left lung. Recommend dedicated PA and lateral radiographs for further evaluation,when feasible. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 2:03 PM, approximately 15 minutes after discovery of the findings. " d0d50ab7-4fe215bb-ce239378-383ec283-04e1e4cf.jpg,test/p10/p10519618/s56743847/d0d50ab7-4fe215bb-ce239378-383ec283-04e1e4cf.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with dysphagia, cough with likely pneumonia but portable film not definitely showing infiltrate. Possible aspiration. FINDINGS: Patient's condition required examination in sitting position using AP frontal and left lateral views. Available for comparison is a preceding AP single view chest examination of ___. There is marked cardiac enlargement. No typical configurational abnormality can be identified. The thoracic aorta is generally widened and elongated without evidence of local contour abnormalities. Diaphragms are relatively high positioned and resulting in crowded appearance of the pulmonary basal vasculature with evidence of a few linear densities compatible with atelectases. The pulmonary vasculature demonstrates perivascular haze throughout, but there is no evidence of discrete peripheral parenchymal infiltrates indicating pneumonia. No pneumothorax seen in the apical area. The lateral view discloses significant pleural effusion accumulating in the posterior pleural sinuses. When comparison is made with a preceding examination of ___, findings indicative of left-sided CHF with pleural effusion have progressed. Previous examination could not establish a pleural effusion in detail as no lateral view has been obtained. " 55f4602b-d3458739-8c8702df-ba4192c7-71c1dbb6.jpg,test/p15/p15929503/s55913229/55f4602b-d3458739-8c8702df-ba4192c7-71c1dbb6.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with Tetrology of Fallot and multiple Cardiac history with intermittent chest pain and SOB over the last day. Defibrilator in place // Evaluate for change in heart size and pulmonary edema, pleural effusions or infiltrate TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The left costophrenic angle is not fully included on the frontal view. The cardiac and mediastinal silhouettes are grossly stable. Left-sided AICD is stable the right rib cage deformity with underlying pleural thickening is stable and chronic. No focal consolidation, pleural effusion or pneumothorax is seen. IMPRESSION: Left costophrenic angle not fully included on the frontal image. Otherwise, no acute cardiopulmonary process. " cae0a0a9-e0a4a4ba-93aefd87-31bfbb7e-c689031d.jpg,test/p13/p13982131/s58455313/cae0a0a9-e0a4a4ba-93aefd87-31bfbb7e-c689031d.jpg,test," FINAL REPORT AP PORTABLE CHEST ___ AT ___ HOURS. HISTORY: Intubation. COMPARISON: None. FINDINGS: Consistent with the given history, an endotracheal tube is present approximately 5.6 cm from the carina. A presumed nasogastric tube has also been placed with its usual course through the mediastinum, coiling in the gastric fundus with the distal tip not visualized. Post-pyloric placement cannot be excluded. The lungs are clear without consolidation or edema. Lung volumes are slightly diminished with elevation of the hemidiaphragms. No consolidation or edema is noted. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted on the supine radiograph. No displaced fractures are evident. IMPRESSION: Endotracheal tube in satisfactory position. Please note details of presumed nasogastric tube placement. No acute pulmonary process. " 8564e506-7e0f713c-fbd76700-39cebbcd-e5fe4c4b.jpg,test/p11/p11296936/s58699649/8564e506-7e0f713c-fbd76700-39cebbcd-e5fe4c4b.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with orthopnea and chest pain, history of end-stage renal disease, on dialysis. Question CHF, question pneumonia. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Indistinct pulmonary vascular markings are again seen as well as more confluent infrahilar opacity on the right suggesting pulmonary edema. There is a small right-sided pleural effusion. Cardiac silhouette is enlarged but unchanged from prior. IMPRESSION: Mild to moderate pulmonary edema worse when compared to previous exam from ___ taking into account differences in technique. " ce34ad5e-b4ef3960-6300991e-c7888e54-95326676.jpg,test/p13/p13594538/s52825857/ce34ad5e-b4ef3960-6300991e-c7888e54-95326676.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with stent placement // ? stent placement ? stent placement IMPRESSION: In comparison with the study of ___, there is an placement of a tracheal stent that extends from approximately the top of T1 to the bottom of T2 at the mid clavicular level. The remainder the study is unchanged with no evidence of acute cardiopulmonary disease. Of incidental note is widening of the AC joint. A view of the shoulder could provide additional information about this area. " 8a6b0e8b-38134ec7-3b180c9d-76824f46-f51c37fd.jpg,test/p11/p11920813/s51113581/8a6b0e8b-38134ec7-3b180c9d-76824f46-f51c37fd.jpg,test," FINAL REPORT HISTORY: AML with cough, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change and no evidence of acute focal pneumonia. Relatively low lung volumes with atelectatic streak at the left base. The suggested nodular opacification on the prior study is not appreciated on the views presented. Central catheter remains in position. " ada2c554-85a63874-03f76328-78299bba-add2e215.jpg,test/p16/p16074663/s53332843/ada2c554-85a63874-03f76328-78299bba-add2e215.jpg,test," FINAL REPORT HISTORY: Dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is mildly enlarged. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal without congestion. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 6acae503-ae168c3d-8f8595dd-89753240-db7a6d7f.jpg,test/p18/p18526154/s52469615/6acae503-ae168c3d-8f8595dd-89753240-db7a6d7f.jpg,test," FINAL REPORT INDICATION: ___M with hypotension, cancer // Eval for cardiopulmonary process TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: When compared to recent chest x-ray there has been no significant interval change. Opacity in the left hilar/infrahilar region is compatible with patient's known malignancy. There is no new focal consolidation. No large effusion. The cardiomediastinal silhouette is stable. IMPRESSION: Known left perihilar malignancy without superimposed acute cardiopulmonary process. " 4a2effa6-9afab4d1-3e6139a0-260b89ae-5353b5ae.jpg,test/p19/p19071790/s58477532/4a2effa6-9afab4d1-3e6139a0-260b89ae-5353b5ae.jpg,test," FINAL REPORT INDICATION: ___M with presyncope // ?cpd TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are essentially clear. There is no effusion or edema. The cardiomediastinal silhouette is within normal limits. Prominent extrapleural fat seen laterally on both sides. No acute osseous abnormalities. Old anterior right sixth and seventh rib fractures are noted. IMPRESSION: No acute cardiopulmonary process. " 02cfa3a6-956cca69-f85842de-91e0349c-a7a0b93d.jpg,test/p19/p19826583/s58691784/02cfa3a6-956cca69-f85842de-91e0349c-a7a0b93d.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Weakness, tremors. COMPARISON: ___. FINDINGS: Skinfold overlies the left mid-to-lower hemithorax. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable, with the aorta tortuous and the cardiac silhouette top normal. No overt pulmonary edema is seen. There is anterior wedge compression of a vertebral body at the thoracolumbar junction, similar compared to CT torso from ___. IMPRESSION: No acute cardiopulmonary process. " d366fae4-ef5c6ae3-d787e922-7caf60bd-debb3d92.jpg,test/p13/p13721087/s58737060/d366fae4-ef5c6ae3-d787e922-7caf60bd-debb3d92.jpg,test," FINAL REPORT HISTORY: Volume overload or pneumonia. FINDINGS: In comparison with study of ___ from an outside facility, there is again huge enlargement of the cardiac silhouette with marked tortuosity of the aorta. Relatively normal pulmonary vessels are seen, with the discordancy raising the possibility of cardiomyopathy or pericardial effusion. The possibility of a supervening pneumonia is impossible to assess in the absence of a lateral view. " 93b354a1-87f92448-6d52b566-e3f3d3b6-908874bf.jpg,test/p19/p19865505/s51541024/93b354a1-87f92448-6d52b566-e3f3d3b6-908874bf.jpg,test," FINAL REPORT HISTORY: Fever, cough, chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 23a300e0-358ed85d-fadfd4db-4a2be200-6365365b.jpg,test/p12/p12244016/s52294035/23a300e0-358ed85d-fadfd4db-4a2be200-6365365b.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Recent aspiration. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The chest is hyperinflated. There is no pleural effusion or pneumothorax. No focal opacity is visualized. The bones are probably demineralized. IMPRESSION: No evidence of acute disease. Hyperinflation. " cb6c5d28-b29e8daa-4155197d-a5c62845-df5c0e39.jpg,test/p12/p12287756/s58537006/cb6c5d28-b29e8daa-4155197d-a5c62845-df5c0e39.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SAH and bibasilar consilidation with acute hypoxic resp failure, now intubated // ET tube placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 4 cm above the carina. The course of the newly inserted nasogastric tube is unremarkable. The tip projects over the proximal parts of the stomach. Minimal increase in lung volumes. The pre-existing signs of pulmonary edema are seen in unchanged manner. Atelectasis at the lung bases are also unchanged. " 2c0e499f-0348aae8-a559e1d6-01c187dd-3c3f519e.jpg,test/p19/p19280440/s51002280/2c0e499f-0348aae8-a559e1d6-01c187dd-3c3f519e.jpg,test," FINAL REPORT INDICATION: ___-year-old man with equivocal findings on previous chest radiograph and leukocytosis, rule out pneumonia. COMPARISON: ___. FINDINGS: PA and lateral views of the chest were obtained. Heart is normal size, and cardiomediastinal silhouette is unchanged. Lung volumes have increased, however, right infrahilar opacities persist. There is no pleural effusion or pneumothorax. IMPRESSION: Right infrahilar opacification has not improved and could represent persistent pneumonia. " 6a9179ea-0f916f3e-6f35b303-e7cba7cc-dfcd48f4.jpg,test/p14/p14590460/s55281468/6a9179ea-0f916f3e-6f35b303-e7cba7cc-dfcd48f4.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with right upper quadrant and left upper quadrant pain with cough. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. No free air identified below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " aba64a22-a844d3a5-80c0be3a-2a29372d-d772ed34.jpg,test/p18/p18016258/s54155631/aba64a22-a844d3a5-80c0be3a-2a29372d-d772ed34.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cardiogenic shock s/p STEMI requiring Impella. Now removed. // Interval change; ETT placement Interval change; ETT placement IMPRESSION: In comparison with the study of ___, the tip of the endotracheal tube measures approximately 4.3 cm above the carina. The Swan-Ganz catheter has been rim moved and replaced with a right IJ sheath. The right PICC line extends to the cavoatrial junction or possibly the upper portion of the right atrium. Again there are bilateral layering effusions, more prominent on the right, with underlying compressive atelectasis. No evidence of pneumothorax. " 62f5913f-e2c2d4f9-0097fb15-491c1bb6-da26e928.jpg,test/p18/p18747069/s52132988/62f5913f-e2c2d4f9-0097fb15-491c1bb6-da26e928.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with hypoxia, recent intubation for surgery, concern for pneumonia. COMPARISON: Multiple chest x-rays from ___ to ___ and chest CT of ___. FINDINGS: Moderate interstitial edema is unchanged since yesterday, but improved since ___. There are increased bilateral small pleural effusions with left lower lobe consolidation, which could represent atelectasis, pneumonia, or aspiration. Mediastinal and cardiac contours are top normal. There is no pneumothorax. CONCLUSION: 1. Residual moderate interstitial pulmonary edema is unchanged since yesterday, but improved since ___. 2. Small bilateral pleural effusions have worsened. 3. Increase in left lower lung consolidation could reflect atelectasis, aspiration, or pneumonia. " 62499ed7-b07d0ac1-0756bf57-691fda21-c639fe22.jpg,test/p10/p10573350/s51495523/62499ed7-b07d0ac1-0756bf57-691fda21-c639fe22.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with ___ edema // eval cardiomegaly TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs the most recent on ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: Normal heart size. No acute cardiopulmonary abnormality. " afceebed-2e2a8530-3d507577-942343da-23bd7d47.jpg,test/p15/p15007710/s57053735/afceebed-2e2a8530-3d507577-942343da-23bd7d47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with decreased bs right base, cough // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest CT FINDINGS: Cardiomediastinal contours are stable with moderate cardiomegaly, elongated tortuous aorta upper normal size and pulmonary arteries also upper normal size. Opacity in the right lower lobe in the periphery is more conspicuous than before likely a rounded atelectasis are seen in the prior CT. Opacity adjacent to the descending aorta could be atelectasis but attention in followup studies is recommended. There is no pneumothorax. There is probably small left effusion. The left hemidiaphragm is elevated. S-shaped scoliosis is again noted. IMPRESSION: Peripheral opacity in the right lower lobe is a rounded atelectasis Opacities adjacent to the descending thoracic aorta are more conspicuous than before, attention in followup studies is recommended differential diagnosis include worsening atelectasis or infection " feec8a3e-2a3ddcde-56693da7-4b9b4ef1-e7a69ab5.jpg,test/p12/p12542274/s54329610/feec8a3e-2a3ddcde-56693da7-4b9b4ef1-e7a69ab5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with abnml CT chest // f/u Right upper lobe pneumonia with areas of peripheral air-fluid levels, in location of prior bullae, right-sided pleural effusion. Radiology recommendation for chest radiograph 6 weeks after to ensure resolution. As ___, MD, ___ ___, MD; ___ f/u Right upper lobe pneumonia with areas of peripheral air-fluid levels, in location of prior bullae, right-sided pleural effusion. Radiology recommendation for chest radiograph 6 weeks after to ensure resolution. As ___ ___, MD, ___, MD; ___ IMPRESSION: Compared to chest radiographs and chest CT ___. Patient has severe emphysema with very large paraseptal bullae, particularly in the upper lobes. When imaged on ___ he had extensive pneumonia in the right upper lobe, with super infection of bullae, containing fluid. The pneumonia has substantially cleared and only a small amount of fluid remains in several bullae ; the largest fluid collection has resolved. There are no other foci of infection in the chest and no layering pleural effusion. Heart size is normal. A patient with emphysema this severe may have persistent consolidative abnormalities several months following the Clinical resolution of pneumonia. RECOMMENDATION(S): If the patient is not symptomatic of continuing or for recurrent pneumonia, a repeat chest radiograph can be performed in another 6 weeks. " 4ba9f33c-b4a154a9-cab489be-b05017c7-c6559410.jpg,test/p15/p15835816/s52389112/4ba9f33c-b4a154a9-cab489be-b05017c7-c6559410.jpg,test," FINAL REPORT HISTORY: Generalized weakness, concerning for pneumonia. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: No focal consolidation or pulmonary edema is seen. Cardiac silhouette is top normal. Aortic knob is calcified. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 5f22d5ac-094687fa-e301c89b-46429784-9292b1e3.jpg,test/p15/p15079493/s59332457/5f22d5ac-094687fa-e301c89b-46429784-9292b1e3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with persistent AMS s/p fall (possible seizure), prolonged intubation s/p likely aspiration // ? interval change ? interval change IMPRESSION: Comparison to ___. No relevant change is noted. Stable moderate pulmonary edema. The additional perihilar opacities on the left and the left retrocardiac atelectasis are also unchanged. No larger pleural effusions. No pneumothorax. Normal size of the heart. The monitoring and support devices are in stable correct position. " 1267f4d4-1b3e903e-ac9c08ed-58103ec5-3a8f9f40.jpg,test/p17/p17071231/s54009027/1267f4d4-1b3e903e-ac9c08ed-58103ec5-3a8f9f40.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis, now with leukocytosis and soft BP, concerning for infection // rule out PNA rule out PNA COMPARISON: Prior chest radiographs since ___, most recently ___. IMPRESSION: Lung volumes are appreciably lower today than after optimal inspiration on previous radiographs, but not appreciably changed since ___. Nevertheless there greater opacification in the left lower lobe today which although it could be atelectasis could also be pneumonia. Conventional chest radiographs would be helpful in trying to make that distinction. There is no appreciable pleural effusion. Heart size is normal. Left PIC line ends in the low SVC. " 0cc85123-856fe107-58ba5332-f1f123eb-06921b31.jpg,test/p18/p18896198/s56042012/0cc85123-856fe107-58ba5332-f1f123eb-06921b31.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___ year old man with fevers s/p craniotomy // eval for infection TECHNIQUE: Portable AP chest COMPARISON: ___ FINDINGS: There is increased opacity in the left lower lobe which may represent infiltrate or atelectasis. No pneumothorax. An enteric tube is unchanged in position. The remainder the exam is stable. IMPRESSION: New left lower lobe opacity which may represent an infiltrate or atelectasis. Reviewed with Dr. ___. " 18d12e56-9b941546-700c90ff-71ca8b47-ec1e93fe.jpg,test/p19/p19270543/s54737239/18d12e56-9b941546-700c90ff-71ca8b47-ec1e93fe.jpg,test," FINAL REPORT INDICATION: History: ___F with R sided neck pain, Lward nystagmus, L sided hearing loss // eval for dissection TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiac silhouette remains mildly enlarged. There is mild pulmonary edema. No pleural effusion or pneumothorax. Median sternotomy wires appear intact. IMPRESSION: Mild pulmonary edema. If there is ongoing clinical concern for dissection, then CT angiographic imaging would be recommended for further assessment. " 221399b1-30c38093-4ecf1a1e-a9b79fc9-582c2d6d.jpg,test/p17/p17576736/s59849625/221399b1-30c38093-4ecf1a1e-a9b79fc9-582c2d6d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with left pleural effusion s/p ___ // Reaccumulation? TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: There is mild left pleural effusion, it has increased since ___. Left basilar opacity, likely atelectasis. There is tiny left pneumothorax, not seen previously. Right lung is clear. Shallow inspiration accentuates heart size. IMPRESSION: Tiny left pneumothorax, not seen previously. Left pleural effusion has increased. Left basilar atelectasis, similar. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 6:13 PM, 15 minutes after discovery of the findings. " a5f95903-7e3349e0-75818b7b-4a30877d-c5abe867.jpg,test/p16/p16983225/s58971781/a5f95903-7e3349e0-75818b7b-4a30877d-c5abe867.jpg,test," FINAL REPORT HISTORY: Systolic CHF with cirrhosis and rare bibasilar rales. Evaluate for pulmonary edema. COMPARISON: ___. FINDINGS: Frontal radiograph of the chest demonstrates clear lungs with a small right pleural effusion. The left ventricular contour is mildly prominent but otherwise, the cardiac and mediastinal contours are normal. The lung volumes are slightly low, accentuating the cardiac contour and pulmonary vasculature. No pneumothorax is seen. No evidence of pulmonary edema. IMPRESSION: Minimal right pleural effusion with no evidence of pulmonary edema. " 3ad31e23-20909813-7b8faee0-30956136-df865b19.jpg,test/p10/p10768526/s57898221/3ad31e23-20909813-7b8faee0-30956136-df865b19.jpg,test," FINAL REPORT HISTORY: Chest wall pain with history of left chest nodule. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Small left lung nodule reported on prior CT is too small for resolution at radiography. " 94b95c11-aa8f5bee-704b2939-6a64b727-09697fcd.jpg,test/p12/p12475612/s54307584/94b95c11-aa8f5bee-704b2939-6a64b727-09697fcd.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Relatively low lung volumes are noted with linear bibasilar opacities, most likely atelectasis. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Bibasilar opacities likely due to atelectasis in the setting of low lung volumes, noting that infection cannot be entirely excluded. If desired, repeat exam with improved inspiratory effort can be performed. " f184b1ad-e8a5a7af-adc7f694-a9fa32a3-fa95b02c.jpg,test/p11/p11592669/s57930982/f184b1ad-e8a5a7af-adc7f694-a9fa32a3-fa95b02c.jpg,test," FINAL REPORT PORTABLE CHEST X-___ ___ ___ COMPARISON: ___ radiograph. FINDINGS: Indwelling support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable. Apparent leftward deviation of the trachea above the thoracic inlet appears to be due to leftward rotation of the neck. Lungs are clear. Within the imaged portion of the upper abdomen, a metallic foreign body reflecting a bullet is seen overlying the right upper quadrant, with adjacent right upper quadrant lucency, which may represent postoperative free intraperitoneal air in this patient who has undergone recent abdominal surgery. " ea0b3b14-95b0184b-e96316d8-7b2666f2-bd12ec3d.jpg,test/p18/p18486197/s57691620/ea0b3b14-95b0184b-e96316d8-7b2666f2-bd12ec3d.jpg,test," FINAL REPORT INDICATION: Cough, fever. Evaluate for infiltrate. COMPARISON: Chest radiograph ___, ___ and ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette is borderline enlarged. Mild central pulmonary vascular prominence is unchanged. Mild peribronchial infiltration in the left lower lobe is new compared to one month prior. There is no pleural effusion or pneumothorax. Pectus excavatum deformity is redemonstrated. IMPRESSION: 1. Borderline enlarged heart 2. Mild left lower lobe infiltrate may reflect non-specific inflammation and should be followed clinically and by radiography. " a10bf0cc-459a3178-cf771cf8-0060c6c3-9e0f2d9c.jpg,test/p18/p18514680/s50709323/a10bf0cc-459a3178-cf771cf8-0060c6c3-9e0f2d9c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with congested cough x 2 days. Hx COPD, TB, asbestosis, RUL resection. Rhonchi throughout all lung fields. Hx PNA one year ago. // Evaluate for consolidation Evaluate for consolidation COMPARISON: Comparisons ___ at 16:26 FINDINGS: PA and lateral views of the chest ___ at 10:04 are submitted. IMPRESSION: Lungs remain hyperinflated consistent with underlying emphysema. There are stable postoperative changes in the right hemithorax. The patient's mandible obscures the right apex. Calcified pleural and diaphragmatic plaques consistent with prior asbestos exposure. Residual blunting of the right costophrenic angle which may reveal a tiny effusion or chronic pleural thickening. No developing airspace consolidation to suggest the presence of pneumonia. No pneumothorax. Overall cardiac and mediastinal contours are stable given differences in patient positioning. " 892a4da8-e50b49d1-b331571f-0ed1ddb4-de4f6cb1.jpg,test/p10/p10074434/s57980377/892a4da8-e50b49d1-b331571f-0ed1ddb4-de4f6cb1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent cough x weeks. Never smoker // Evaluate for abnormalities Evaluate for abnormalities IMPRESSION: Compared to chest radiographs since ___, most recently ___. Hyperinflation reflects substantial emphysema, a chronic finding. . No focal pulmonary abnormality. Moderate cardiomegaly is chronic but there is no pulmonary vascular congestion or other evidence of acute cardiac decompensation. No central adenopathy or pleural effusion. " b4f84ccd-91753b14-655b6200-32dc429b-5c7d89e8.jpg,test/p16/p16839550/s55126083/b4f84ccd-91753b14-655b6200-32dc429b-5c7d89e8.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Progressive right-sided chest and abdominal pain, trouble breathing, status post recent fall on Coumadin. COMPARISONS: ___ and ___. TECHNIQUE: Chest, AP portable upright. FINDINGS: The patient is status post coronary artery bypass graft surgery. A dual-lead pacemaker/ICD device appears unchanged, again with leads terminating in the right atrium and ventricle, respectively. The heart is moderately enlarged. The mediastinal and hilar contours appear unchanged. There is similar blunting of each costophrenic sulcus suggesting scarring or trace pleural effusions. Right lateral pleural thickening appears unchanged. Otherwise, there is marked improvement in a right basilar opacity since the prior examination. There is no pneumothorax. IMPRESSION: No evidence of acute disease. " f11c845a-a75c1ba0-fa1ab7fb-62f65c34-94801753.jpg,test/p13/p13300324/s50462501/f11c845a-a75c1ba0-fa1ab7fb-62f65c34-94801753.jpg,test," FINAL REPORT HISTORY: Altered mental status. COMPARISON: None. TECHNIQUE: Single AP portable view of the chest. FINDINGS: Bibasilar and right mid lung opacities are seen. There is minimal biapical scarring as well. Given the patient's rotation, the mediastinum appears to be within normal limits. There is no overt pulmonary edema. 2.1 mm rounded structure in the right hilus may be a partially calcified lymph node. There is no large pleural effusion and there is no pneumothorax. A lucency under the left hemidiaphragm is most likely colon or the gastric bubble. Free air cannot be ruled out. If there is concern for the patient's abdominal exam, a lateral decubitus film would be helpful. IMPRESSION: 1. Basilar and right midlung opacities, potentially atelectasis but clinical correlation suggested. No obvious evidence of cardiopulmonary process. 2. Lucency under the left hemidiaphragm, most likely gastric bubble or colon, however, if there is concern for abdominal process, free air cannot be ruled out. A left lateral decubitus film would be helpful in evaluating. ___ at pager ___ was paged at 9:46 a.m. to discuss the findings. " c1875fd7-6081b292-2a5d0ced-7c3b3bf5-fbc6c906.jpg,test/p17/p17561108/s57961610/c1875fd7-6081b292-2a5d0ced-7c3b3bf5-fbc6c906.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man with lymphoma and right pleural thickening. Recent viral pneumonia. Assess changes to right pleural effusion. IMPRESSION: A PA and lateral chest compared to ___: A previous mild pulmonary edema on ___ has almost cleared, extensive right pleural thickening or loculated fluid at the periphery of the right lung is unchanged. Previous left lower lobe pneumonia has also cleared. Right supraclavicular jugular infusion port ends high in the SVC. No pneumothorax. Moderate cardiomegaly is chronic. " b68e27f6-e19efc0a-86f6a073-99e17a26-9725d6df.jpg,test/p11/p11745865/s51226785/b68e27f6-e19efc0a-86f6a073-99e17a26-9725d6df.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with c/o productive cough, diarrhea, fatigue x one week. ?crackles in Right base on examination. // R/O Pneumonia COMPARISON: Chest radiographs ___ Through ___ IMPRESSION: lungs are severely hyperinflated but unchanged since ___. No focal pulmonary abnormality is seen. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 853f5c1c-8a553840-fb128759-e13e7ebb-f9a6ba4f.jpg,test/p12/p12773009/s50325024/853f5c1c-8a553840-fb128759-e13e7ebb-f9a6ba4f.jpg,test," FINAL REPORT HISTORY: Increasing shortness of breath and sputum production. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: Previously noted consolidation in the anterior segment of the left upper lobe has improved when compared to the prior study, with residual opacity noted, compatible with improving pneumonia. Heart size is difficult to assess given the presence of a moderate left and small right bilateral pleural effusions. The effusion on the left has increased in size while the effusion on the right appears relatively unchanged. There is associated bibasilar atelectasis. The mediastinal contours are stable. New ill-defined opacification within the left apex may reflect a new area of infection. The pulmonary vascularity is not engorged. No acute osseous abnormality is seen and there is no pneumothorax. IMPRESSION: 1. Residual opacity in the left anterior segment of the left upper lobe is compatible with improving pneumonia. 2. New ill -defined opacification within the left lung apex may reflect a new site of infection. 3. Slight increase in size of the moderate sized left pleural effusion, and slight interval decrease in size of small right pleural effusion compared to the prior radiograph. There is associated bibasilar atelectasis. " 873c9ab7-07af15d4-a71ca81a-7196b1de-a1751a5e.jpg,test/p16/p16734287/s58707175/873c9ab7-07af15d4-a71ca81a-7196b1de-a1751a5e.jpg,test," WET READ: ___ ___ ___ 4:45 PM Patchy right infrahilar opacity, atelectasis or potentially pneumonia; a component of this appears nodular and may reflect a true nodule - short-term follow-up radiographs are suggested to reassess versus evaluation with chest CT. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Dyspnea. Question effusion. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged. The aortic arch is calcified. The mediastinal and hilar contours appear unchanged. There is a patchy right infrahilar opacity including a nodular focus of about 15 mm in diameter, although perhaps part of a developing consolidation. Posterior and lateral costophrenic sulci are blunted, so there may be potentially tiny bilateral pleural effusions. There is no pneumothorax. Mild rightward convex curvature and moderate degenerative changes are noted along the mid-to-lower thoracic spine. Vascular calcifications are widespread. IMPRESSION: Patchy right infrahilar opacity worrisome for pneumonia, but including a nodular component. The possibility of a true lung nodule should be considered. Either evaluation with dedicated chest CT, preferably with intravenous contrast, if possible, or short-term followup radiographs are recommended to assess further. " 948b62a4-26ae78a2-0bb9303b-c7f10b52-efcd88cb.jpg,test/p18/p18271325/s54774566/948b62a4-26ae78a2-0bb9303b-c7f10b52-efcd88cb.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph dated ___ as well as a CT chest from ___. CLINICAL HISTORY: Abdominal pain, assess pneumonia. FINDINGS: AP and lateral views of the chest were provided. Midline sternotomy wires and mediastinal clips are again seen. There is a small left pleural effusion again noted. Focal eventration of the right hemidiaphragm is seen. There is no definite sign of pneumonia or overt CHF. The heart and mediastinal contours appear stable. No acute bony abnormalities are seen. " 3423355a-a4ac847e-b96f9a21-46f37f13-8ed5f4f6.jpg,test/p13/p13163471/s50082744/3423355a-a4ac847e-b96f9a21-46f37f13-8ed5f4f6.jpg,test," FINAL REPORT HISTORY: ___-year-old male with psoriatic arthritis and multiorgan sepsis. Status post attempted subclavian line. Assess line placement. COMPARISON: Chest radiograph, ___, ___, ___. TECHNIQUE: Single portable supine frontal chest radiograph. FINDINGS: Left subclavian line tip is in the distal left brachiocephalic vein and is unchanged in position. NG tube enters into proximal stomach and is out of view. Mild improvement in low lung volumes with unchanged bilateral plate-like atelectasis in the lower lobes. Interval decrease in vascular congestion with normal heart size and no mediastinal vein dilatation, pleural effusion, or pulmonary edema. No pneumothorax. IMPRESSION: 1. Interval improvement in vascular congestion and lung volumes. 2. Stable bilateral lower lobe atelectasis. 3. No pneumothorax. " 3d428c48-cdd1da60-10fe278b-c81bb41c-850cb002.jpg,test/p11/p11296190/s52808604/3d428c48-cdd1da60-10fe278b-c81bb41c-850cb002.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with bladder ca // please evaluate for any abnormalities please evaluate for any abnormalities IMPRESSION: Comparison to ___. No relevant change is noted. No pneumonia, no pulmonary edema, no pleural effusions. Normal size of the heart. Normal hilar and mediastinal contours. " dd7d3bd8-6c4af50d-f214010f-061f23cd-879c0d3a.jpg,test/p12/p12268481/s56345944/dd7d3bd8-6c4af50d-f214010f-061f23cd-879c0d3a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Chills in a patient with alcoholic cirrhosis and shortness of breath. PA and lateral upright chest radiographs were reviewed in comparison to ___. Lung volumes are low with minimal bibasilar areas of atelectasis, mostly seen in the right lower lobe but no definitive evidence of pneumonia. Upper lungs are clear. Heart size and mediastinum are unremarkable. Minimal amount of pleural effusion cannot be excluded, but there is no substantial amount of pleural fluid seen. Lateral view demonstrates also right middle lobe opacity also most likely reflecting atelectasis, but again infectious process coexisting with atelectasis cannot be excluded. " e7144d99-b029ff7b-806eb3a9-5281285a-82baf5d7.jpg,test/p15/p15244289/s50617420/e7144d99-b029ff7b-806eb3a9-5281285a-82baf5d7.jpg,test," FINAL REPORT HISTORY: Worsening shortness of breath for 2 weeks. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: There has been interval increase in right-sided pleural effusion, which may be partially loculated, with overlying atelectasis, underlying consolidation cannot be excluded. Overall there are low lung volumes. Perihilar opacities may relate to pulmonary edema. Patchy left base opacity may be related to atelectasis versus developing consolidation. No left pleural effusion is seen. There is no evidence of pneumothorax. The right aspect of the cardiac silhouette cannot be adequately assessed due to adjacent opacity. IMPRESSION: Significant increase in right-sided pleural effusion, which may be partially loculated, with overlying atelectasis, underlying consolidation not excluded. Perihilar opacities may also relate to underlying pulmonary edema. Patchy left base opacity may be due to atelectasis or developing consolidation. " 0bc0757f-fa312b11-7c0ee18d-552a91fc-dd7efd17.jpg,test/p13/p13000759/s59358936/0bc0757f-fa312b11-7c0ee18d-552a91fc-dd7efd17.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with subacute CVA seen on MRI TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Heart size is normal. The aorta is tortuous. The pulmonary vasculature and hilar contours are normal. Lungs are hyperinflated but clear. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary abnormality. " e0d78850-ba66a40e-aeed0080-29bc2025-37633c1b.jpg,test/p14/p14483422/s59836512/e0d78850-ba66a40e-aeed0080-29bc2025-37633c1b.jpg,test," FINAL REPORT INDICATION: Left-sided chest pain, lung cancer. COMPARISON: Chest CT, ___ and chest radiograph ___. PA AND LATERAL VIEWS OF THE CHEST: Cardiac, mediastinal and hilar contours are unchanged, with the heart size within normal limits. Pulmonary vascularity is not engorged. Left upper lobe mass is redemonstrated, and right upper lobe ill-defined opacity appears relatively unchanged compared to prior chest CT, but is more pronounced when compared to the prior chest radiograph. Emphysematous changes are again noted. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Unchanged left upper lobe mass compatible with known cancer, with ill-defined opacity in the right upper lobe likely corresponding to the subpleural opacities seen on prior chest CT. This finding, however, appears more pronounced when compared to the prior chest radiograph. No new abnormality otherwise identified. " 7241c9fd-b202ae17-cd48bdd1-b2b9a127-69a42850.jpg,test/p11/p11281855/s52340014/7241c9fd-b202ae17-cd48bdd1-b2b9a127-69a42850.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with massive PE, status post intubation. ET tube is in standard position 2 cm above the carina, lies against the right tracheal wall. Swan-Ganz catheter tip is in the right main pulmonary artery. In one of the films, there appears be an NG tube in the left main bronchus; in the repeat radiograph, there is no NG tube. Cardiac size is top normal. Patient has a large hiatal hernia. Left lower lobe opacities have increased from prior study performed a day earlier; this could be due to atelectasis, but a complication of a massive PE such as infarct is in the differential. Right lower lobe opacities have also increased. There are lower lung volumes. If any, there are small bilateral pleural effusions. " e4181cfa-7e6ec67d-da47aada-a6730052-8e233999.jpg,test/p11/p11389640/s52508693/e4181cfa-7e6ec67d-da47aada-a6730052-8e233999.jpg,test," FINAL REPORT HISTORY: ___-year-old female with shortness of breath COMPARISON: Chest radiograph from ___ FRONTAL AND LATERAL CHEST RADIOGRAPH: The lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax. IMPRESSION: No acute cardiopulmonary process " 14ae9a97-7f00e1de-99f37a48-f5d472db-11df4113.jpg,test/p14/p14041164/s58031585/14ae9a97-7f00e1de-99f37a48-f5d472db-11df4113.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman s/p TAVR // eval for repositioned ETT placement COMPARISON: ___ and ___ 12:24 p.m.. IMPRESSION: Moderate right pleural effusion is increasing. Mild to moderate interstitial pulmonary edema has changed in distribution but not in overall severity. With the chin down, tip of the endotracheal tube 15 mm above the carina is only 15 mm lower than appropriate. Probable small left apical pneumothorax and subcutaneous emphysema in the left lower chest wall improving, pleural drain sharply folded could be partially occluded. NOTIFICATION: Dr. ___ paged Dr. ___ to discuss the findings on ___ 17:19 minutes after discovery of the findings, ultimately reported by telephone to on ___ 5:21 PM " fe46b30c-641c8576-2f95e3da-1c833d84-248ff2fe.jpg,test/p12/p12336678/s58860771/fe46b30c-641c8576-2f95e3da-1c833d84-248ff2fe.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with elev wbc ___ and cough, pls eval for pna // History: ___F with elev wbc ___ and cough, pls eval for pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 31d88d2c-649a5220-7bb5ed44-b1059fd0-d79f5ec0.jpg,test/p14/p14184291/s54809006/31d88d2c-649a5220-7bb5ed44-b1059fd0-d79f5ec0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormalities are seen. Pectus excavatum deformity is noted. IMPRESSION: No acute cardiopulmonary abnormality. " 2674305d-c1487835-0933579f-f24654df-009cf974.jpg,test/p14/p14166879/s57323156/2674305d-c1487835-0933579f-f24654df-009cf974.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough // ?pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Lungs are relatively hyperinflated. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " c8332f2c-772a2f74-fba4f080-5023df7d-6ffc9732.jpg,test/p15/p15798014/s51701509/c8332f2c-772a2f74-fba4f080-5023df7d-6ffc9732.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old female two days status post fall, presents with persistent malaise and nausea, assess for pneumonia. FINDINGS: AP and lateral views of the chest were provided. A large mass is redemonstrated in the right upper lobe without significant overall change in appearance. There is a persistent small right pleural effusion with right basilar atelectasis and elevation of the right hemidiaphragm. The left lung is unchanged. Overall, cardiomediastinal silhouette is stable with coronary stents partially imaged. Bony structures are intact. Clips in the right upper quadrant noted. IMPRESSION: Large right upper lobe mass again seen with small right pleural effusion and right basal atelectasis. No definite acute changes to account for the patient's symptoms. " fc9d2c68-d45633f2-0880e5f2-34f3b499-ed7e4bb8.jpg,test/p16/p16167724/s55817853/fc9d2c68-d45633f2-0880e5f2-34f3b499-ed7e4bb8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with SCC of buccal mucosa, has pneumonia, but new fever. // Evalaute for effusion, new consolidations COMPARISON: Chest radiographs since ___, through ___. IMPRESSION: Since remission of left lower lobe and entire left lung collapse on ___ and ___, the chest radiograph has returned to very much the same appearance as on ___ and ___, when there was bibasilar consolidation, left greater than right and small bilateral pleural effusion. Lateral view would be helpful to monitor the volume of pleural fluid. Upper lungs are clear. Cardiomediastinal silhouette is unremarkable. ET tube and left PIC line are in standard positions. " 88d66565-a29baa9c-2db373b0-154eb90d-a81fe4c9.jpg,test/p14/p14584470/s51477149/88d66565-a29baa9c-2db373b0-154eb90d-a81fe4c9.jpg,test," FINAL REPORT INDICATION: ___ year old woman with PMH ESRD from HTN s/p R sided LURT in ___, dCHF, afib, mechanical MVR on warfarin, PVD s/p left superficial femoral artery stent in ___ for nonhealing ulceration who presents for ___ and fluid overload // evaluate for CHF exacerbation TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dating back to ___ and chest CT dated ___. FINDINGS: Compared with the most recent prior study ___, moderate to severe cardiomegaly, hilar enlargement bilaterally, and moderate pulmonary vascular are unchanged, consistent with history of pulmonary hypertension. The previously multifocal nodular opacities in confluent right lower lobe consolidation have resolved. There is no pleural effusion, pneumothorax, or frank pulmonary edema. ___ intact median sternotomy wires and a mitral valve prosthesis are unchanged. A right IJ central venous catheter has been removed. IMPRESSION: 1. Moderate to severe cardiomegaly with associated pulmonary vascular congestion and bihilar enlargement consistent with pulmonary arterial hypertension without frank edema. 2. No focal consolidation. NOTIFICATION: The findings were discussed with ___, Medical Student by ___, M.D. on the telephone on ___ at 8:32 AM, 2 minutes after discovery of the findings. " 9af86980-be433290-8404cd64-c99c498c-b6ee4085.jpg,test/p17/p17135687/s59578592/9af86980-be433290-8404cd64-c99c498c-b6ee4085.jpg,test," FINAL REPORT INDICATION: ___ year old man with chest tube // chest tube EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal views COMPARISON: Chest radiograph ___ 12:20 FINDINGS: Two frontal views were provided. Initial radiograph shows persistent large right pneumothorax with contralateral mediastinal shift. Second subsequent radiograph shows new right chest tube and resolution of tension and mediastinal shift. Small right apical pneumothorax remains. There is trace pneumothorax on the left. Tracheostomy tube is in appropriate position. Transesophageal tube travels below diaphragm and out of view. Left chest tube is in unchanged position. Right subclavian venous line terminates in mid SVC. Multiple bullet fragments are again noted. IMPRESSION: Interval placement of right chest tube and resolution of mediastinal shift. Small right pneumothorax and trace left pneumothorax remains. " 215eeecc-63d6edbd-e04f1786-650977b1-8dd68e9a.jpg,test/p17/p17645472/s50313472/215eeecc-63d6edbd-e04f1786-650977b1-8dd68e9a.jpg,test," WET READ: ___ ___ ___ 11:10 AM Known innumerable bilateral small pulmonary nodules better seen on prior chest CT. No superimposed acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with SOB, cough, CP // r/o acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: Known innumerable bilateral pulmonary nodules on prior chest CT are faintly visualized as an increase nodular opacities throughout the lungs. There is no confluent consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Known innumerable bilateral small pulmonary nodules better seen on prior chest CT. No superimposed acute cardiopulmonary process. " e5c7d198-f0d2cb5b-1ad03a2c-33b67f48-db2dd55d.jpg,test/p14/p14147380/s55599778/e5c7d198-f0d2cb5b-1ad03a2c-33b67f48-db2dd55d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Chest and back pain 1 week after motor vehicle collision. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. No acute fracture identified. If there is continued clinical concern for a rib fracture, a dedicated rib series is suggested. " e561dd1c-d9eefb8b-d7775053-f3c1a360-e740b39b.jpg,test/p19/p19870619/s52364614/e561dd1c-d9eefb8b-d7775053-f3c1a360-e740b39b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with ICD firing TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Left-sided AICD is noted with leads terminating in the region of right atrium and right ventricle, unchanged. Heart size is mildly enlarged. Mediastinal hilar contours are unremarkable. Pulmonary vasculature is. Lungs are clear except for subsegmental atelectasis in the right lung base. No focal consolidation, pleural effusion is. Acute osseous abnormalities are seen IMPRESSION: No acute cardiopulmonary abnormality. AICD leads in unchanged positions. " dcadbac5-5df05835-45634b6c-25ab8fdb-94106c4f.jpg,test/p17/p17169886/s50901746/dcadbac5-5df05835-45634b6c-25ab8fdb-94106c4f.jpg,test," FINAL REPORT HISTORY: Fever and cough. COMPARISON: None. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 44f2519e-31c0bf83-1280035a-5b923e39-1bbc01ce.jpg,test/p18/p18977683/s54406792/44f2519e-31c0bf83-1280035a-5b923e39-1bbc01ce.jpg,test," FINAL REPORT HISTORY: Chest pain for a few seconds with shortness of breath. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___ chest CT and ___ chest radiograph. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vascularity is not engorged. There is no focal consolidation. Chronic interstitial abnormality is noted predominantly in both lung bases and along the periphery. No pleural effusion or pneumothorax is identified. Old displaced fracture involving the left proximal clavicle is again noted. ___ fiducial markers are seen within the liver dome. IMPRESSION: Chronic interstitial abnormality within the lung bases. Otherwise no acute cardiopulmonary abnormality. " 15cc3136-1e49c693-2e875b6a-0f9d78b3-4b9e893f.jpg,test/p12/p12878461/s57560316/15cc3136-1e49c693-2e875b6a-0f9d78b3-4b9e893f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with w progressive SOB, also new-onset afib // is there effusion or pna? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There are relatively low lung volumes. Given this, The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 8e15bb17-2d12769a-7550b830-cfc1e793-95ee3a1b.jpg,test/p17/p17293739/s52124899/8e15bb17-2d12769a-7550b830-cfc1e793-95ee3a1b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of HIV/AIDS, 2 weeks of worsening cough and sputum // Please evaluate for a PNA. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs on ___ and ___ FINDINGS: Heart size is minimally enlarged. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " ac63fbe7-1fa1f8fe-3b1b940f-83b62a92-569cca5f.jpg,test/p18/p18387698/s55949523/ac63fbe7-1fa1f8fe-3b1b940f-83b62a92-569cca5f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest tube in setting of parapneumonic effusion // evaluate chest tube placement, please perform in morning if possible COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous examination. Unchanged extent of the large right pleural effusion with subsequent atelectasis at the right lung bases. The position of the right chest tube is constant. No pneumothorax. Unchanged size of the cardiac silhouette. The left hemi thorax is unremarkable. " 0b88eed0-490f6de8-271d68b9-086c3f67-8660ff7f.jpg,test/p14/p14214098/s59144365/0b88eed0-490f6de8-271d68b9-086c3f67-8660ff7f.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Recently placed nasogastric tube terminates within the body of the stomach. Cardiomediastinal contours are stable in appearance. New patchy and linear atelectasis at the lung bases, left greater than right, as well as an apparent small left pleural effusion. No visible pneumothorax. Postoperative changes are observed in the abdomen. " c47efa2c-5264e141-564964fc-e5db51b9-37f974ba.jpg,test/p16/p16454913/s52945468/c47efa2c-5264e141-564964fc-e5db51b9-37f974ba.jpg,test," FINAL REPORT HISTORY: Tracheostomy. FINDINGS: In comparison with the study of ___, there is little overall change. Continued vascular congestion with probable small effusions bilaterally with compressive atelectasis. Hemodialysis catheter remains in place. " 9731a373-14098d7e-0d147216-11a7b8e1-d2b17601.jpg,test/p18/p18879361/s59654700/9731a373-14098d7e-0d147216-11a7b8e1-d2b17601.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CAD, CHF, presenting with left facial/mandibular abscess s/p I and D ___, with nasotracheal intubation // please assess location of nasotracheal tube please assess location of nasotracheal tube IMPRESSION: Compared to prior chest radiographs are ___. Lung volumes are substantially lower, exaggerating already moderate cardiomegaly, and reflected in bilateral lower lobe atelectasis. Upper lungs grossly clear. Pleural effusion could be present, particularly on the left. There is no pneumothorax. Fracture and displacement of the uppermost sternal wire was present in ___. New ET tube in standard placement. Esophageal drainage tube ends in the upper stomach. " aa65f25f-6504cc8b-041a7e27-7ae2ae9b-e9ac9c54.jpg,test/p15/p15003878/s51651577/aa65f25f-6504cc8b-041a7e27-7ae2ae9b-e9ac9c54.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH ___ COMPARISON: Chest radiographs dating between ___ and ___. FINDINGS: The ribs are ideally assessed on this conventional chest radiograph examination. With this limitation in mind, known right-sided rib fractures are healing, and several remain mildly displaced. No pneumothorax is identified, but there are persistent bilateral small pleural effusions present. Cardiomediastinal contours are within normal limits for technique. Right hemidiaphragm is elevated anteriorly without change. Lucency through the manubrium on the lateral chest radiograph corresponds to a fracture on the prior outside chest CT of ___. IMPRESSION: 1. Healing right rib fractures. Note that the ribs are not ideally assessed by chest radiography. If there is a clinical concern regarding new or displaced fractures, dedicated rib films may be considered. 2. Healing manubrial fracture. 3. Small bilateral pleural effusions. 4. Persistent eventration right hemidiaphragm. " 9ab4a320-4310a415-e80189a2-3785f64f-ad43cf3e.jpg,test/p18/p18427812/s57107994/9ab4a320-4310a415-e80189a2-3785f64f-ad43cf3e.jpg,test," FINAL REPORT HISTORY: Bilateral lower extremity weakness, Evaluate for pneumonia. COMPARISON: ___ FINDINGS: AP upright and lateral chest radiographs demonstrate low lung volumes. Heart is mildly enlarged and atherosclerotic calcifications are again seen along the aortic arch. Lungs demonstrate normal vascularity without focal consolidation. No pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " 57e9f852-af4bb7a7-619dac06-c7a4bacb-2856727c.jpg,test/p19/p19497735/s54616843/57e9f852-af4bb7a7-619dac06-c7a4bacb-2856727c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation and metastatic cancer // ? interval change ? interval change IMPRESSION: Comparison to ___. Minimal decrease of the pre-existing right pleural effusion. A small left pleural effusion is constant. Unchanged bilateral areas of atelectasis. The monitoring and support devices are stable. Moderate cardiomegaly persists. No new focal parenchymal opacities. " 94054150-37bec41a-2d3d7445-539f3af6-92b4e305.jpg,test/p17/p17328272/s56859521/94054150-37bec41a-2d3d7445-539f3af6-92b4e305.jpg,test," FINAL REPORT HISTORY: ___-year-old female with presyncope. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear of consolidation. The cardiomediastinal silhouette is within normal limits. Descending thoracic aorta is tortuous. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 11614856-f53a4451-dee64d36-35af68d7-09a10ca9.jpg,test/p14/p14151932/s55044726/11614856-f53a4451-dee64d36-35af68d7-09a10ca9.jpg,test," FINAL REPORT AP CHEST, 7:30 A.M., ___ HISTORY: ___-year-old man with gastric perforation after resuscitation. History of volume overload. IMPRESSION: AP chest compared to ___ through ___. Chronic right lower lobe collapse has worsened. Left lower lobe collapse has appeared since ___. The right middle and upper lobes are clear with no pulmonary edema, vascular congestion and the cardiomediastinal silhouette is normal with no venous engorgement. Overall, no findings of volume overload, but evidence of recurrent and persistent airway occlusion. Left subclavian line ends in the upper SVC. No pneumothorax. Pleural effusion, if any, is minimal and secondary to the collapse, not causative. Nasogastric tube ends in the lower esophagus and would need to be advanced 15 cm to move all the side ports into the stomach. Findings discussed by telephone with Dr. ___ at 1 p.m. " 4d060c80-7ae83060-c5c54abe-d46646b6-28558bf4.jpg,test/p16/p16622171/s52672154/4d060c80-7ae83060-c5c54abe-d46646b6-28558bf4.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough x 10 days, evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Ill-defined airspace opacities throughout the right lung may represent early pneumonia, potentially an atypical organism. There is no pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits with mild cardiomegaly and a tortuous descending aorta. The surgical clip in the left neck suggests prior hemithyroidectomy. IMPRESSION: Ill-defined right lung airspace opacity suggestive of pneumonia. Follow-up chest radiographs after treatment are recommended to confirm radiographic resolution. RECOMMENDATION(S): Follow-up chest radiographs following treatment are recommended to confirm radiographic resolution. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 1:15 PM, 2 minutes after discovery of the findings. " effb626d-40c3524e-ded2fe8b-6adbf209-c52c0d3c.jpg,test/p11/p11129702/s51608307/effb626d-40c3524e-ded2fe8b-6adbf209-c52c0d3c.jpg,test," FINAL REPORT HISTORY: Fever. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs and normal hilar and cardiomediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiographs of the chest. " 42456058-f50555f0-bbf439ea-b8fdb913-13f82f7b.jpg,test/p13/p13025152/s55223142/42456058-f50555f0-bbf439ea-b8fdb913-13f82f7b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, crackles RLL // Eval for infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes and bibasilar atelectasis. Bibasilar opacities most likely represent atelectasis although subtle consolidation is not excluded in the appropriate clinical setting. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There is gaseous distention of the stomach. IMPRESSION: Low lung volumes and bibasilar atelectasis. Bibasilar opacities most likely represent atelectasis although subtle consolidation is not excluded in the appropriate clinical setting. Gaseous distention of the stomach. " 72c228cc-3484414a-e9c49c47-336177d3-9e0debc9.jpg,test/p11/p11366266/s54886813/72c228cc-3484414a-e9c49c47-336177d3-9e0debc9.jpg,test," FINAL REPORT INDICATION: ___ year old woman with s/p OGT // OGT placement COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: Endotracheal tube tip is 2 cm above the carina. Central line tip is in the SVC. There is stable pulmonary edema. There is no dense consolidation or pneumothorax. " a200c4d9-39de37d9-f20906a3-87b342f8-59b476da.jpg,test/p17/p17847770/s56451780/a200c4d9-39de37d9-f20906a3-87b342f8-59b476da.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with weakness // ? infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " 5aa8d5f5-3e958380-e63d02bc-c9dceaf7-6c1ba53f.jpg,test/p17/p17862986/s51821156/5aa8d5f5-3e958380-e63d02bc-c9dceaf7-6c1ba53f.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Chest pain and cough. COMPARISON: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " c8cfc658-ae28bf0c-0caa2c27-3cdf418d-602948de.jpg,test/p19/p19791816/s56457202/c8cfc658-ae28bf0c-0caa2c27-3cdf418d-602948de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with altered mental status. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. A Port-A-Cath resides over the right chest wall with catheter tip extending to the mid SVC region unchanged. Extensive bilateral calcified pleural plaque is again noted right greater than left. A calcified granuloma projects over the left lower lung. No convincing evidence for pneumonia though evaluation of the right lung is limited. Heart remains mildly enlarged. The patient's kyphotic positioning somewhat limits assessment of the mediastinum. Bony structures appear intact though demineralized. IMPRESSION: Extensive calcified pleural plaque limits assessment. No definite sign of pneumonia. " 8e631ec6-01279044-3529d758-78ab4462-686f9134.jpg,test/p15/p15662315/s52401694/8e631ec6-01279044-3529d758-78ab4462-686f9134.jpg,test," FINAL REPORT HISTORY: Patient with history of cirrhosis presenting with hypertension. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. FINDINGS: AP upright and lateral radiographs of the chest were obtained. The heart size and mediastinal contours are stable. No focal consolidation, pleural effusion or pneumothorax. Similar appearance of bibasilar atelectasis. No pulmonary edema IMPRESSION: Bibasilar atelectasis. No evidence of pneumonia " 4d74e662-51e18756-9d1d35d5-6ef3313a-611c6b30.jpg,test/p17/p17085388/s54117267/4d74e662-51e18756-9d1d35d5-6ef3313a-611c6b30.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Cough, for evaluation. TECHNIQUE: Two views were obtained. COMPARISON: ___. REPORT: Heart size normal. Minor unfolding of the thoracic aorta, which has some calcifications in the descending portion. There is a little bit of biapical pleural thickening, nonspecific, there is minor prominence of the right hilum, which is vascular. There is no good evidence of congestive change. No evidence of pneumonia or acute cardiopulmonary process. Degenerative changes are identified in the thoracic spine. CONCLUSION: No acute findings. No real change from prior study. " bc43f993-e960f270-8a1510d4-f820e4e9-c2dea36e.jpg,test/p11/p11144826/s59948109/bc43f993-e960f270-8a1510d4-f820e4e9-c2dea36e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA and Lateral) INDICATION: ___-year-old woman presenting with productive cough, weakness, and fatigue; evaluate for pneumonia. TECHNIQUE: PA and lateral radiograph views of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: No significant interval change. The lungs are clear. No focal consolidation, pneumothorax, pleural effusion, or pulmonary edema. Stable appearance of the cardiomediastinal silhouette, hila, and pleura. Stable top-normal heart size. IMPRESSION: No evidence of acute intrathoracic abnormality. " 7f21929a-ec40bb9a-68479abc-7da6cb4d-0f5bcc2f.jpg,test/p19/p19871388/s55176355/7f21929a-ec40bb9a-68479abc-7da6cb4d-0f5bcc2f.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F s/p pedestrian struck with R neck and shoulder pain, difficulty with range of motion // ?impingement, clavicular or humeral fx, C-spine injury TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The cardiac silhouette is markedly enlarged, possibly slightly increased as compared to the prior study. No overt pulmonary edema is seen. No pleural effusion or focal consolidation, or evidence of pneumothorax is seen. Mediastinal contours are stable. IMPRESSION: Marked enlargement of the cardiac silhouette, possibly slightly increased as compared to the prior study given differences in technique. " abe5e2bf-f73d9f0d-7183b913-d4875b79-bea129c8.jpg,test/p18/p18003025/s56557036/abe5e2bf-f73d9f0d-7183b913-d4875b79-bea129c8.jpg,test," FINAL REPORT HISTORY: Seizures, question pneumonia. CHEST, TWO VIEWS. COMPARISON: No previous ___ chest radiographs on PACS record for comparison. The lungs are hyperinflated. The heart is not enlarged. The aorta is minimally unfolded. There is slight upper zone redistribution, without other evidence of CHF. There is minimal atelectasis at the lung bases. No focal infiltrate or effusion is identified. Within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy is detected. Mild-to-moderate degenerative changes of the thoracic spine are noted. IMPRESSION: Minimal atelectasis at both lung bases. No definite focal pneumonic infiltrate. " a8451def-b48bd8f4-21236016-245d184c-0b42223c.jpg,test/p15/p15128994/s50061051/a8451def-b48bd8f4-21236016-245d184c-0b42223c.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with dyspnea. Evaluate for pneumonia or CHF. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. Lung volumes are slightly low, resulting in bronchovascular crowding. There is a small amount of left basilar atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. The cardiac and mediastinal silhouettes and hilar contours are normal allowing for lung volumes. No acute osseous abnormality is identified. IMPRESSION: Minimal left basilar atelectasis. Otherwise, no acute intrathoracic process. " 7290c531-64b42016-46f7c803-be2b74e7-549d56a8.jpg,test/p12/p12522208/s58031530/7290c531-64b42016-46f7c803-be2b74e7-549d56a8.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with history of diabetes with progressive shortness of breath. COMPARISON: ___ chest x-ray and CT chest from ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications again seen of the aortic knob. Hypertrophic changes seen in the spine. IMPRESSION: No acute cardiopulmonary process. Pulmonary nodules seen on prior CT not clearly seen. Followup per prior ct recommendations. " 6c697038-d799068f-ff3044bb-aa0be373-c9caaa27.jpg,test/p19/p19747459/s52089463/6c697038-d799068f-ff3044bb-aa0be373-c9caaa27.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___ M with BPH urinary retention, clotted foley, preop CXR for prostatectomy. TECHNIQUE: PA and lateral chest radigraphs COMPARISON: None available FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " d95120d7-8e4abcb9-23d7832c-efcc9b04-46a22885.jpg,test/p12/p12285052/s54231235/d95120d7-8e4abcb9-23d7832c-efcc9b04-46a22885.jpg,test," WET READ: ___ ___ ___ 2:35 AM New left sided pneumothorax with rightward displacement of the mediastinum. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old female with new left-sided IJ placement. COMPARISON: Chest radiograph performed three hours prior to this study. TECHNIQUE: Portable supine chest radiograph. FINDINGS: There is a new large left-sided pneumothorax with a deep sulcus sign with rightward displacement of the mediastinum raising concern for tension pneumothorax. Otherwise, there is a new left-sided central line that is seen crossing the midline and ending likely at the confluence of the brachiocephalic veins. An esophageal tube is noted with the tip beyond the gastroesophageal junction. The endotracheal tube has its tip 3 cm above the carina, unchanged compared with prior exam. Again seen is right lower lung opacities that now appear slightly more conspicuous than in prior likely secondary to underlying basal atelectases. There is also blunting of the right costophrenic angle, which may be secondary to atelectatic lung. IMPRESSION: 1. Large left-sided pneumothorax with rightward displacement of the mediastinum raising concern for tension pneumothorax. 2. Supporting devices as described above. 3. More conspicuous opacities in the right lung base are compatible with worsening atelectasis in the setting of right lower lobe pneumonia/aspiration. " 194f670f-1cf85acc-243b0b67-a93bc743-5dde0676.jpg,test/p14/p14596797/s52717201/194f670f-1cf85acc-243b0b67-a93bc743-5dde0676.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___ year old woman with Burkitt's lymphoma, getting R-IVAC. Temperature to 100.___ yesterday. // Looking for evidence of infiltrate or infection COMPARISON: Chest radiograph dated ___. FINDINGS: The right PICC has since been removed. A right-sided Port-A-Cath is now with in place ending in the region of the cavoatrial junction. The lungs are clear. No focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. No significant change in the appearance of the mediastinal contours and hila. The heart size is normal. ___ projecting over the midline have been removed. IMPRESSION: No acute intrathoracic abnormality. No pneumonia. " 32cd1758-4c9ccfc8-435262e9-f9cd25df-ace6d580.jpg,test/p16/p16892041/s51871255/32cd1758-4c9ccfc8-435262e9-f9cd25df-ace6d580.jpg,test," FINAL REPORT INDICATION: ___-year-old male with abdominal pain and elevated lactate. Evaluate for abdominal free air. COMPARISON: ___. TECHNIQUE: Frontal upright chest radiograph. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no evidence of subdiaphragmatic free air. IMPRESSION: Unremarkable chest radiographic examination. No subdiaphragmatic free air. " 895797a6-80a7f3a1-7f04fe37-c9120853-c4b70e66.jpg,test/p10/p10532853/s51602494/895797a6-80a7f3a1-7f04fe37-c9120853-c4b70e66.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain, to rule out cardiomegaly. COMPARISON: CT chest with contrast ___ and a chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The lung volumes are low. Moderate-severe enlargement of the cardiac silhouette, is new since the earlier study of ___, with a globular cardiac configuration raising concern for pericardial effusion. Mild hazy opacities in both lung fields, may be secondary to pulmonary edema. No pleural effusion or pneumothorax is seen. IMPRESSION: Globular cardiomegaly, new since the prior study, concerning for pericardial effusion. Probable mild pulmonary edema. " 62ad6583-bb2250af-8958e964-9be68403-e7c7931f.jpg,test/p15/p15355458/s56261240/62ad6583-bb2250af-8958e964-9be68403-e7c7931f.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with hypoxemic respiratory failure, interval change. COMPARISON: ___ to ___. FINDINGS: ET tube ends 2.3 cm above the carina. Right jugular line ends in upper SVC and left subclavian line is at the junction of brachiocephalic vein and upper SVC. There is an NG tube in the stomach. Moderate pulmonary edema, small-to-moderate bilateral pleural effusion with compressive atelectasis and moderate cardiomegaly is stable. There is no pneumothorax. Mitral annulus is calcified. CONCLUSION: 1. Tube and lines are in adequate position. 2. Moderate pulmonary edema is stable. " e1ca5222-49a1585c-49b916ff-2305e34c-10b620a2.jpg,test/p18/p18652332/s56424703/e1ca5222-49a1585c-49b916ff-2305e34c-10b620a2.jpg,test," FINAL REPORT INDICATION: Chest pain. Patient with history of myocarditis. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. No pleural effusion, focal consolidation, or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " ddb53e58-3451419f-c78a3ab6-566c1fd8-7d7bf722.jpg,test/p18/p18539425/s57152651/ddb53e58-3451419f-c78a3ab6-566c1fd8-7d7bf722.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient after allogenic SCT with wheezing and shortness of breath, assess for infiltrates. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. The heart size remains unchanged and is within normal limits. Mild degree of aortic widening and elongation is present but no local contour abnormalities are seen. The pulmonary vasculature is not congested. No evidence of new acute parenchymal infiltrates can be identified. The pleural spaces are free laterally and posteriorly. No pneumothorax is present in the apical area on the frontal view. Review of multiple previous studies indicates that the patient had a left lower lobe atelectasis in retrocardiac position of ___. Chest CT examination two days later demonstrated findings of bronchiectasis in this area compatible with chronic infection. There existed also multiple bilateral patchy confluent infiltrates which most likely represented GVHD in this patient who is undergoing stem cell transplant. As there is presently no evidence on the plain chest examination that the latter type of infiltrates persist in the area of the left lower lobe, a crowded vascular pattern with some interstitial prominent structures remain and most likely represent scar formations after the left lower lobe posterior segment pneumonia. IMPRESSION: No evidence of new acute infectious pneumonic infiltrates. " 777f4e44-1a9924b9-1a753f46-d5f01d62-225dbc23.jpg,test/p11/p11388607/s54586614/777f4e44-1a9924b9-1a753f46-d5f01d62-225dbc23.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with reflux symptoms, diaphoresis // any cpd TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are well expanded and clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " dca3df46-b6245b1b-3856248d-76ee8e77-eac82ea8.jpg,test/p13/p13555521/s54262418/dca3df46-b6245b1b-3856248d-76ee8e77-eac82ea8.jpg,test," WET READ: ___ ___ ___ 1:24 AM Possible proximal ascending aortic aneurysm. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Strong family history of GI cancer with dysphasia, gastritis and reflux symptoms x___ years with 20 pound weight loss in 2 months. Assess for mediastinal mass. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographdemonstrates well expanded and clear lungs.No pleural effusion or pneumothorax. Slightly prominent bulge superior to the right heart border is nonspecific and can be seen in the setting of a proximal ascending aortic aneurysm. A tortuous aorta is noted. Heart size and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. IMPRESSION: Possible proximal ascending aortic aneurysm. " c1210175-467af68e-89629138-7fb240ce-0857bb1e.jpg,test/p15/p15866068/s50270030/c1210175-467af68e-89629138-7fb240ce-0857bb1e.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ year old woman CHF s/p PPM placement with continued pain and WBC ___ // ?Infiltrate TECHNIQUE: Single upright AP view of the chest. COMPARISON: Comparison is made to chest radiograph from ___. FINDINGS: The lungs are well-expanded and clear. A left chest wall pulse generator is unchanged in position, with leads terminating in the right atrial appendage, right ventricle, and left ventricle. There is no pneumothorax, pleural effusion, or focal consolidation concerning for pneumonia. The heart is mildly enlarged, but stable compared to the prior study. IMPRESSION: Stable mild cardiomegaly. No evidence of pneumonia. " 5ac37320-79291eb8-4b6a7536-a68287dc-2f500d75.jpg,test/p16/p16171124/s54888440/5ac37320-79291eb8-4b6a7536-a68287dc-2f500d75.jpg,test," WET READ: ___ ___ ___ 7:14 AM Heterogeneous right basilar opacity may represent atelectasis, however pneumonia could be considered in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with DKA. // pneumonia? TECHNIQUE: Portable semi-upright chest radiograph. COMPARISON: None per. FINDINGS: The patient is rotated. Low lung volumes exaggerate the mediastinal contours and result in bronchovascular crowding. An area of heterogeneous opacity in the right lung base is seen. No pneumothorax or pleural effusion IMPRESSION: Heterogeneous right basilar opacity may represent atelectasis, atelectasis or aspiration. Followup PA and lateral chest radiographs are recommended for more complete assessment when the patient's condition permits. " 013475c7-33248773-6e4b8223-de902450-3f1d6c8d.jpg,test/p16/p16202057/s57992322/013475c7-33248773-6e4b8223-de902450-3f1d6c8d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated with tachypnea // collapse IMPRESSION: As compared to the recent radiograph from earlier the same date, overall appearance of the chest is similar except for slight improved aeration at the left lung base and slight worsening linear atelectasis at the right lung base. Previously present gastric distension has apparently resolved. " 9ac069c1-0efa4044-14a56066-0ac81c73-24d8ef50.jpg,test/p16/p16606885/s59574567/9ac069c1-0efa4044-14a56066-0ac81c73-24d8ef50.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with frontal meningioma here for b/l craniotomy for mass resection // pt with tachypnea. pt with tachypnea. IMPRESSION: In comparison with the study of ___, there is little overall change. Monitoring and's support devices are stable. Continued low lung volumes without vascular congestion, pleural effusion, or acute focal pneumonia. " ee316aaf-4836b322-7a19300e-e45cd9fd-b0399146.jpg,test/p16/p16508811/s58890549/ee316aaf-4836b322-7a19300e-e45cd9fd-b0399146.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with ESRD ___ T1DM and HTN now s/p DDRT (most recently in ___), COPD, DM, PVD, atrial fibrillation on coumadin, congestive heart failure (LVEF = ___%), C diff, and recent NSTEMI (on ___) who presents with one week of URI symptoms and increasing shortness of breath with CXR concerning for PNA. // Eval for volume overload, change in PNA Eval for volume overload, change in PNA IMPRESSION: In comparison with the study of ___, there is diffuse increase in opacifications bilaterally. Although some of this could represent volume overload, much of the opacification, especially on the left, is consistent with superimposed pneumonia. " 1b1ef9e8-bd894991-960e0d42-f685ae31-cc147456.jpg,test/p15/p15073068/s53822245/1b1ef9e8-bd894991-960e0d42-f685ae31-cc147456.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Hilar contours are stable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 5cf36449-49ad7094-4b7b8977-1e0de9e4-fdb50440.jpg,test/p19/p19992202/s51697791/5cf36449-49ad7094-4b7b8977-1e0de9e4-fdb50440.jpg,test," WET READ: ___ ___ ___ 8:25 AM Patient significantly rotated, limiting assessment. Mild cardiomegaly is unchanged. No airspace consolidation or pulmonary edema. WET READ VERSION #1 ___ ___ ___ 7:21 PM Patient significantly rotated, limiting assessment. Mild cardiomegaly is unchanged. No airspace consolidation or pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Ms. ___ is a ___/F w/ hx of CAD, stroke w/ residual cognitive deficits, bipolar disorder w/ psychotic features, HTN, asthma, hypothyroidism, multiple falls and other issues who presents from ___ Rehab with altered mental status, fever, leukocytosis, and an unwitnessed fall, with positive UA and GNR bacteremia. // Please assess for pulmonary edema/acute process COMPARISON: ___ IMPRESSION: The patient is substantially rotated. No evidence of larger pleural effusions. No pneumonia, no pulmonary edema. Moderate cardiomegaly. " 39696f18-c871e1e3-a22fc77b-1a1d2bd4-1c3eb542.jpg,test/p12/p12210749/s56909069/39696f18-c871e1e3-a22fc77b-1a1d2bd4-1c3eb542.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ESRD admitted to initiate HD for hyperkalemia with progressive shortness of breath and rales at left lung base on exam // pneumonia? pulmonary edema? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has developed mild pulmonary edema, as reflected by increased vascular diameters as well as mild peribronchial cuffing. And atelectasis in the retrocardiac lung regions has slightly increased in extent. The known pleural and parenchymal changes on the right are constant, including a small loculated intrafissural pleural effusion. Moderate cardiomegaly persists. No pneumothorax. " bd05eccc-ba8057fb-9b099897-dc066a8c-7d83bd9f.jpg,test/p13/p13384632/s57958749/bd05eccc-ba8057fb-9b099897-dc066a8c-7d83bd9f.jpg,test," FINAL REPORT INDICATION: End-stage renal disease with dyspnea. Evaluate for fluid overload. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: CTA chest ___ and chest radiograph ___. FINDINGS: The lung volumes are low. There is mild pulmonary edema with small bilateral pleural effusions. Heart is mildly enlarged but unchanged. There is no focal consolidation worrisome for pneumonia though a nodular opacity projecting over the left lower lung is again noted which is thought to represent a focus of rounded atelectasis as stated on prior CT chest. No pneumothorax. Sternotomy wires and mediastinal clips are again noted. IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions. " e24f5fb2-8bb209a3-3c511077-ed487a63-ffaf40c7.jpg,test/p18/p18432672/s57229475/e24f5fb2-8bb209a3-3c511077-ed487a63-ffaf40c7.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with ?pna // cough TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are well-expanded. In the right upper lobe, there is a subtle hazy opacity, worrisome for developing atypical or viral pneumonia. The heart is mildly enlarged. There is no pleural effusion, pulmonary edema, or pneumothorax. IMPRESSION: Findings suggestive of developing atypical or viral pneumonia in the right upper lobe. Mild cardiomegaly. NOTIFICATION: The above findings were communicated by Dr. ___ to the ___ ___ nurses via email for notification to the patient, after attending review. " 7d0f9d8e-cd79d67f-46d360f9-a3222691-cf9d484d.jpg,test/p11/p11291823/s55264028/7d0f9d8e-cd79d67f-46d360f9-a3222691-cf9d484d.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: SEPSIS, ESRD, CAD. Comparison is made with prior study ___. Cardiomegaly and widened mediastinum are stable. Left IJ catheter is in unchanged position. The tip is in the left brachiocephalic vein. Right central catheter, double lumen, is in unchanged standard position. Moderate pulmonary edema is stable. Right greater than left atelectases are minimally improved. Small-to-moderate right pleural effusion is stable. If any there is a small left pleural effusion. " beefcf81-4a1b8072-ee6686eb-c28febc4-ef2cf7fa.jpg,test/p18/p18100010/s58268502/beefcf81-4a1b8072-ee6686eb-c28febc4-ef2cf7fa.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Immunosuppression, new cough, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes are now normal. There is mild elevation of the right hemidiaphragm and no evidence of pneumonia. No pulmonary edema. No pleural effusions. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " 5de5e881-36e82c29-b255f193-c1323454-51230efb.jpg,test/p12/p12572699/s56832915/5de5e881-36e82c29-b255f193-c1323454-51230efb.jpg,test," FINAL REPORT INDICATION: Vomiting. History of Schatzki ring dilation. COMPARISONS: Chest radiograph, ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. There is no pneumomediastinum. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 5a8cbd8c-8f3219a4-70ddcf64-b4829b68-28b55e9b.jpg,test/p10/p10165494/s59961841/5a8cbd8c-8f3219a4-70ddcf64-b4829b68-28b55e9b.jpg,test," FINAL REPORT CLINICAL INDICATION: Shortness of breath and bilateral lower extremity edema. Evaluate for pneumonia and congestive heart failure. COMPARISON: Chest radiographs ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Linear opacities within the left lung base most likely represent atelectasis. There is no focal consolidation, vascular congestion, pleural effusion, or pneumothorax. Elevation of the left hemidiaphragm is unchanged since ___. Normal heart size. The mediastinal contours are normal. There is no free air beneath the right hemidiaphragm. IMPRESSION: No pneumonia or evidence of congestive heart failure. " 9397475a-571c325b-e338d77f-bbc00d65-6ab0802c.jpg,test/p17/p17106498/s56682539/9397475a-571c325b-e338d77f-bbc00d65-6ab0802c.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. Degenerative changes are seen at the acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " f451ad38-4d352afa-df354c37-9b4b636d-0663174d.jpg,test/p11/p11119153/s51932369/f451ad38-4d352afa-df354c37-9b4b636d-0663174d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p tiss AVR,CABG // predischarge eval predischarge eval IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. There is again enlargement of the cardiac silhouette without appreciable vascular congestion. There is a small to moderate left pleural effusion with underlying basilar atelectasis. No evidence of acute focal pneumonia. Surgical clips again project over the right chest, presumably from previous breast surgery. " 34bf5607-89973e82-971933b8-81a52d92-9d78dfe7.jpg,test/p13/p13772123/s55246053/34bf5607-89973e82-971933b8-81a52d92-9d78dfe7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, the perihilar opacification has further decreased. Cardiac silhouette is within normal limits and there is no evidence of pulmonary edema. The lower lungs are essentially clear. " 86af0029-297a827f-aedae0b8-13f88dcd-f5a6ebd6.jpg,test/p16/p16624661/s50306568/86af0029-297a827f-aedae0b8-13f88dcd-f5a6ebd6.jpg,test," FINAL REPORT INDICATION: Left scapular pain, question of pulmonary pathology. COMPARISON: ___ chest radiograph and lumbar spine radiograph of ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. A lower thoracic vertebral compression fracture is unchanged compared to ___. IMPRESSION: No acute cardiopulmonary process. These findings were discussed with Dr. ___ by Dr. ___ at 3:23 p.m. on ___ by telephone. " bdd131c3-c1beeb1c-d316bfab-07109cb6-c05b7d96.jpg,test/p18/p18776647/s56390495/bdd131c3-c1beeb1c-d316bfab-07109cb6-c05b7d96.jpg,test," FINAL REPORT INDICATION: ___M with cough // Eval for acute process, PNA TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are essentially clear besides mild left basilar atelectasis. The cardiomediastinal silhouette is within normal limits. Degenerative changes noted at the left shoulder. IMPRESSION: No acute cardiopulmonary process. " 10853801-7ff7ab0e-55c789b8-30943fb7-3c3e3037.jpg,test/p11/p11522912/s50099921/10853801-7ff7ab0e-55c789b8-30943fb7-3c3e3037.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with resp failure // ETT ETT COMPARISON: Chest radiographs ___ through ___. Comparison chest radiographs ___ through ___. IMPRESSION: Previously extensive left lower lobe atelectasis or consolidation is improving. Less severe consolidation in the right lung base has been relatively stable since ___. Upper lungs are clear. Small to moderate left pleural effusion unchanged. Moderate cardiomegaly stable. ET tube and left pic line are in standard placements and a nasogastric drainage tube passes into the stomach and out of view. " 3c19d2f3-a83d3009-d7604418-54ba0c24-f078caf1.jpg,test/p13/p13940306/s54278148/3c19d2f3-a83d3009-d7604418-54ba0c24-f078caf1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with infected R BKA; to OR // pre op Surg: ___ (BKA washout) pre op IMPRESSION: Cardiomegaly is extensive, unchanged. Sternal wires are unchanged, unremarkable. Note is made of the broken most inferior wire on the left. Lungs are clear. There is no pleural effusion or pneumothorax. " 21d98d61-e34e2f5e-bb543ca1-2f9d3466-bce103af.jpg,test/p19/p19516231/s55301644/21d98d61-e34e2f5e-bb543ca1-2f9d3466-bce103af.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Status post left chest tube and talc pleurodesis. FINDINGS: There is a new NG tube. Gas is still seen in a slightly distended stomach, but it is no longer as severely distended as on the prior film. There continues to be dense retrocardiac opacity compatible with volume loss/infiltrate. Left chest tube is in place. Pleural thickening/effusion is again seen bilaterally. Scarring in the right upper lung is again visualized. " 95e7307a-9916eb19-bf59292e-ecdc6d48-7594d18c.jpg,test/p19/p19900961/s53025739/95e7307a-9916eb19-bf59292e-ecdc6d48-7594d18c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with CAD s/p stenting p/w jaw pain similar to prior MI and intermittent headache // ?acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Multiple priors most recent on ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 4e817d20-e3f7c53f-9e0e6882-b89247d3-059e9916.jpg,test/p19/p19132474/s58860802/4e817d20-e3f7c53f-9e0e6882-b89247d3-059e9916.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history for PE. geting follow up VQ scan. CXR for VQ scan purposes. // Patient having VQ scan of the lungs to follow up on prior PE. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Normal lung volumes. Minimal bilateral apical thickening, symmetrical in distribution. Old left-sided rib fracture. Relatively severe scoliosis with subsequent asymmetry of the ribcage. Normal size of the cardiac silhouette. The lateral radiograph only shows a small retrocardiac atelectasis, in the anterior portions of the left lower lobe. No pulmonary edema. No pneumonia. No larger lung nodules or masses. " fde4e756-c01103d9-d6781e13-55a452ff-8f84cd69.jpg,test/p11/p11172358/s54518001/fde4e756-c01103d9-d6781e13-55a452ff-8f84cd69.jpg,test," WET READ: ___ ___ ___ 8:17 AM No radiographic evidence of pneumonia. WET READ VERSION #1 ___ ___ ___ 8:52 PM No radiographic evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with apml and flu, ? pneumonia // ? secondary pneumolnia TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Multiple healing bilateral rib fractures are present have been more fully detailed on CT of ___. There remains no evidence of pneumothorax. Cardiomediastinal contours are stable. Bilateral nonspecific patchy infrahilar opacities have improved in the interval. Nonspecific peripheral opacities are present in both mid lung regions, and note is made of a small right pleural effusion. IMPRESSION: Healing bilateral rib fractures. The nonspecific mid and lower lung opacities could potentially be due to pneumonia. CT may be helpful for more complete characterization of lung findings if warranted clinically. " 29582202-6f0a1e7f-9d7032c2-3e009399-678dcb6f.jpg,test/p19/p19975044/s59641711/29582202-6f0a1e7f-9d7032c2-3e009399-678dcb6f.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT ___ CLINICAL INDICATION: ___-year-old with status post CABG, evaluate effusion or pneumothorax. Comparison is made to the patient's previous study dated ___ at 11:21. PA and lateral views of the chest, ___ at ___ are submitted. IMPRESSION: Status post median sternotomy for CABG with stable postoperative cardiac and mediastinal contours. Persistent small layering left effusion with associated retrocardiac opacity likely reflecting compressive atelectasis, although pneumonia cannot be entirely excluded. Right internal jugular central line continues to have its tip in the proximal SVC. There is improved aeration with no evidence of pulmonary edema or pneumothorax. " 6c0a1500-182deba5-08721bb4-18bfe569-081b532f.jpg,test/p17/p17030294/s56255967/6c0a1500-182deba5-08721bb4-18bfe569-081b532f.jpg,test," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: History of CHF and altered mental status. COMPARISON: ___ at 10:27, earlier the same date. FINDINGS: Single frontal view of the chest was obtained. A slight increase in interstitial markings bilaterally may be due to minimal interstitial edema versus less likely atypical infection. No lobar consolidation is seen. There is blunting of the left costophrenic angle suggesting a trace pleural effusion. The cardiac silhouette is top normal. No evidence of pneumothorax is seen. IMPRESSION: Diffuse slight increase in interstitial markings bilaterally may be due to mild interstitial edema, less likely atypical infection. Small left pleural effusion. Dedicated PA and lateral views would be helpful for further evaluation if and when patient able. " 895eab08-44bdfd04-efc04531-d03138e6-6c6ca359.jpg,test/p10/p10266720/s53886071/895eab08-44bdfd04-efc04531-d03138e6-6c6ca359.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with s/p L reverse total shoulder replacement ___ now w/ Tmax 39C unclear source, // eval ? traumatic, infectious changes TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Mild bibasilar atelectasis is seen. There is no definite focal consolidation. No large pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There has been interval removal of previously seen right-sided PICC. Partially imaged hardware in the left humerus is not well assessed on this study. IMPRESSION: No acute cardiopulmonary process. " 31bcb735-dbed8675-d1dd5de2-89695850-990f59a8.jpg,test/p10/p10520371/s57583644/31bcb735-dbed8675-d1dd5de2-89695850-990f59a8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with 9 days SOB, 6 bouts of recurrent respiratory infections in the last year. PNA? Bronchiectasis? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___ and ___. FINDINGS: Cardiomediastinal and hilar silhouettes are normal. There is no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No focal consolidation concerning for pneumonia. " 621552e4-cd53e9ea-e5452af9-ed5bf54a-a8b57582.jpg,test/p18/p18863512/s58017631/621552e4-cd53e9ea-e5452af9-ed5bf54a-a8b57582.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: *** FALL PRECAUTIONS *** History: ___M with agitation. r/o infection. elev WBC // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None PE FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute abnormality. " b36f9c08-68fa749f-2096308c-229d2cf5-3d8b47b3.jpg,test/p12/p12940106/s50722931/b36f9c08-68fa749f-2096308c-229d2cf5-3d8b47b3.jpg,test," WET READ: ___ ___ ___ 2:00 PM Nasogastric tube is seen with the tip ending in the stomach in the last side port below the GE junction. These findings were discussed with Dr. ___ By Dr. ___ ___ telephone at 9:45pm on ___, 10 minutes after discovery. WET READ VERSION #1 ___ ___ ___ 9:47 PM Nasogastric tube is seen with the tip ending in the stomach in the last side port below the GE junction. These findings were discussed with Dr. ___ By Dr. ___ ___ telephone at 9:45pm on ___, 10 minutes after discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ngt placement // please confirm position please confirm position IMPRESSION: The nasogastric tube coils in a hiatal hernia and extends to the antrum of the stomach. " 8d1b3834-d40ed298-388772c7-76b38819-e9963b90.jpg,test/p14/p14244279/s54633551/8d1b3834-d40ed298-388772c7-76b38819-e9963b90.jpg,test," FINAL REPORT INDICATION: ___-year-old man with dyspnea, abdominal pain, distention, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal silhouette is stable, consistent with at least moderate cardiomegaly. The thoracic aorta is tortuous, unchanged. The hila are within normal limits. The lungs are clear without focal consolidation. There is no pulmonary vascular congestion or pulmonary edema. There is no pneumothorax or sizable pleural effusion. Anterior cervical spine fusion hardware is partially imaged. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. Unchanged moderate cardiomegaly. " 7d67f4b7-48563dc6-404420c7-8ac470e2-2118c20e.jpg,test/p10/p10699336/s56189368/7d67f4b7-48563dc6-404420c7-8ac470e2-2118c20e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple trauma, trach // chronic respiratory failure chronic respiratory failure IMPRESSION: As compared to the previous radiograph, there is a subtotal atelectasis of the left lung, likely caused by a mucous plug, with near complete opacification of the left hemi thorax and shift of the mediastinal and cardiac structures to the left. The tracheostomy tube is in unchanged position. Unchanged normal appearance of the right lung. Unchanged position of the right PICC line. " c02677fd-fd829341-ba72b54e-31735aa9-7605d9de.jpg,test/p10/p10610928/s56035528/c02677fd-fd829341-ba72b54e-31735aa9-7605d9de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RLL nodule, now s/p ebus and Tbbx. ? PTX // post bx PTX? post bx PTX? IMPRESSION: Heart size and mediastinum are stable. Right basal opacity is related to transbronchial biopsy of the right lower lobe nodule. No pneumothorax is seen. " e0cf22f1-c18f19de-b74b4aee-0f3b4fab-43933d05.jpg,test/p10/p10401051/s53613688/e0cf22f1-c18f19de-b74b4aee-0f3b4fab-43933d05.jpg,test," FINAL REPORT HISTORY: Fell from horse, multiple fractures, assess pneumothorax. CHEST, TWO VIEWS. There is a small pneumothorax at the left lung apex. Compared with ___ at 22:37 p.m., it is probably very slightly smaller. There is minimal atelectasis in the lingula and at both lung bases, with slight interval imrpovement at the left lung base. The right hemidiaphragm is slightly elevated and lateralized, with blunting of the costophrenic angle, unchanged. The left costophrenic sulcus is grossly clear. No CHF. The cardiomediastinal silhouette is stable. The patient's rib fracture, scapular fracture, and left mid clavicular fracture are again noted, grossly unchanged. IMPRESSION: 1) Small left apical pneumothorax, very slightly smaller than on the most recent prior chest film. Findings were discussed with Dr. ___ at approximately 12:30 p.m. on ___ (___, phone). " 271c7b32-af28766d-45495947-eb033175-7a95c815.jpg,test/p16/p16536493/s59022777/271c7b32-af28766d-45495947-eb033175-7a95c815.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with sob // pna? TECHNIQUE: AP semi upright and lateral views obtained portably. COMPARISON: Chest PA and lateral ___. FINDINGS: Evaluation is markedly limited given suboptimal technique and obscuration of the mid to lower lungs. The upper lungs appear well aerated. Further evaluation is not possible. IMPRESSION: Nondiagnostic study. " 09e461d8-9bd0780f-271413af-122b3052-92f1bbfe.jpg,test/p15/p15772791/s54975309/09e461d8-9bd0780f-271413af-122b3052-92f1bbfe.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chest discomfort. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. Mild degenerative changes are noted of the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " b196c684-fc6a07dc-1f4102ba-5db4df11-b13436d9.jpg,test/p18/p18238341/s57999844/b196c684-fc6a07dc-1f4102ba-5db4df11-b13436d9.jpg,test," FINAL REPORT INDICATION: Patient with epigastric pain. COMPARISONS: Chest radiographs ___ ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. The aorta is tortuous with mild aortic arch calcifications. Heart size is top normal. Right lung base opacity is noted. Mild interstitial pulmonary edema and perihilar vascular congestion is present. IMPRESSION: 1. Right lung base opacity, likely atelectasis. 2. Perihilar vascular congestion and mild cardiomegaly. " 40c7d461-ae7c014a-a178a65b-619dd3d6-68e38127.jpg,test/p19/p19937193/s55608654/40c7d461-ae7c014a-a178a65b-619dd3d6-68e38127.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Stable cardiomegaly and tortuosity of the thoracic aorta. Minimal linear atelectasis at the left lung base, but no focal areas of consolidation to suggest the presence of pneumonia. Relative flattening of hemidiaphragms suggests the possibility of COPD in the appropriate clinical setting. Bones are diffusely demineralized, and degenerative changes are present within the spine. IMPRESSION: Linear left basilar atelectasis. No evidence of pneumonia. " 1a2be1cf-e9df8add-b98474dd-45e16562-0087a906.jpg,test/p10/p10537422/s57895692/1a2be1cf-e9df8add-b98474dd-45e16562-0087a906.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: ___. CHEST, PA AND LATERAL: The lungs are clear. The mediastinal and hilar contours are normal. There are no pleural effusions or pneumothorax. Discoid atelectasis persists in the left costophrenic angle. IMPRESSION: No acute cardiopulmonary process. " f54beffd-03f6ef4d-ba893ec4-86d5f1cc-29f2bc95.jpg,test/p14/p14442597/s52395340/f54beffd-03f6ef4d-ba893ec4-86d5f1cc-29f2bc95.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with nodular liver // sarcoid? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation or interstitial abnormality. There is no hilar or mediastinal lymphadenopathy. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No radiographic evidence of pulmonary sarcoid. " d1ee619c-deccc6eb-b24cd328-8e3112a3-1f7deebf.jpg,test/p11/p11407180/s55312399/d1ee619c-deccc6eb-b24cd328-8e3112a3-1f7deebf.jpg,test," WET READ: ___ ___ ___ 8:27 PM ETT 1 cm above carina, should retract another 2 cm. NGT in stomach. Improved pulmonary edema. Scarring seen at left costophrenic angle is better demonstrated on prior CT. Findings paged to Dr. ___ at ___. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after TVAR and exploratory laparotomy, assessment of the ET tube placement. The AP radiograph of the chest was compared to ___. The ET tube tip is low, at the level of the carina and should be pulled back at least 2 cm. Bibasal areas of atelectasis have developed in the interim involving upper lobes and left lower lobe. There is no appreciable pleural effusion. Mild interstitial pulmonary edema cannot be excluded. " 408b879b-478e09dc-7ce6d32e-55edcd3d-dc831045.jpg,test/p15/p15554295/s59367461/408b879b-478e09dc-7ce6d32e-55edcd3d-dc831045.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p GSW to abdomen s/p ex-lap, SBR w/anastamosis, colonic primary repair, sigmoid and colon resection in discontinuity, left EIV stent, left CIA primary repair who coded intraoperatively with ROSC after CPR. Patient has received massive transfusion and currently maintaining hemodynamic stability. // eval for tube migration eval for tube migration IMPRESSION: In comparison with the earlier study of this date, the tip of the endotracheal tube now measures approximately 5.8 cm above the carina. Other monitoring support devices are unchanged. Although difficult to assess, the arterial stent appears to have progressed more distally. Extensive retrocardiac opacification is consistent with volume loss in the left lower lobe and probable effusion. Continued enlargement of the cardiac silhouette with some pulmonary vascular congestion. " d09de382-ce9ed2ce-c7ba3fed-e6381005-fba47bd5.jpg,test/p13/p13408833/s50606168/d09de382-ce9ed2ce-c7ba3fed-e6381005-fba47bd5.jpg,test," FINAL REPORT INDICATION: ___F with cough // ?pna (?LLL) TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lungs are clear of confluent consolidation. There is pulmonary vascular congestion and small bilateral effusions. Incidentally noted is an azygos fissure. Cardiomediastinal silhouette is within normal limits for technique. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities identified. IMPRESSION: Pulmonary vascular congestion M small bilateral effusions. " 244a6980-db079445-f13cfc25-cab27068-bf03de3d.jpg,test/p11/p11528387/s59427705/244a6980-db079445-f13cfc25-cab27068-bf03de3d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of CLL, persistent cough, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal appearance of the lung parenchyma. No pleural effusions. No pneumonia. No pulmonary edema. Normal size of the cardiac silhouette. " fc95969b-a43e8b9f-31344a9c-614c229e-71577e3b.jpg,test/p18/p18111516/s50108928/fc95969b-a43e8b9f-31344a9c-614c229e-71577e3b.jpg,test," FINAL REPORT HISTORY: History of chest pain. Please evaluate for pneumonia. COMPARISON: Chest radiographs dating back to ___. TECHNIQUE: PA and lateral radiographs of the chest FINDINGS: Mild cardiomegaly has been stable compared to exams dating back to at least ___. Aortic knob calcifications are redemonstrated, otherwise the hilar and mediastinal contours demonstrate mild pulmonary vascular engorgement. Diffuse hazy opacities overlying the lung fields bilaterally, as well as interstitial thickening is secondary to moderate pulmonary edema. There is an additional opacity in the left retrocardiac region. Small bilateral pleural effusions appear new compared to the CT from ___. IMPRESSION: 1. Moderate pulmonary edema. 2. Retrocardiac opacity may be secondary to a summation effect of the patient's pulmonary edema, however an acute infectious process cannot be excluded. 3. New small bilateral pleural effusions. " cf6ad17f-0f1f152d-cb081ecf-8716f324-3bc4064e.jpg,test/p16/p16926271/s52723116/cf6ad17f-0f1f152d-cb081ecf-8716f324-3bc4064e.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Respiratory distress. TECHNIQUE: Chest, portable AP upright. COMPARISON: Earlier on the same day. FINDINGS: The patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours appear stable. There is new diffuse opacification most consistent with pulmonary edema. Costophrenic sulci are excluded but small persistent pleural effusions are suspected. There is no pneumothorax. IMPRESSION: Findings suggest new moderate pulmonary edema. " 236b3a18-e9e55561-c9bdd90d-8f602d2c-71609e1a.jpg,test/p11/p11846452/s53022886/236b3a18-e9e55561-c9bdd90d-8f602d2c-71609e1a.jpg,test," FINAL REPORT INDICATION: Lightheadedness and dyspnea, evaluate for acute cardiopulmonary process. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: There is no consolidation. No pneumothorax or pleural effusion is seen. The heart size is normal. Pleura is unremarkable. IMPRESSION: Normal chest radiograph. " 15dc28ca-085f2dfd-662889d8-3a5459a4-63f520e6.jpg,test/p12/p12426049/s50320343/15dc28ca-085f2dfd-662889d8-3a5459a4-63f520e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with hemochromatosis, migraines and chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are mildly hyperinflated but clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 3c729295-07ff8739-2365d3fe-2d0ca376-81bd44aa.jpg,test/p12/p12226373/s57339766/3c729295-07ff8739-2365d3fe-2d0ca376-81bd44aa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of eosinophilic pneumonia. Has persistent cough and clear sputum // assess for any return of infiltrates consistent with eosinophilic pna assess for any return of infiltrates consistent with eosinop IMPRESSION: In comparison with the study of ___, there is little change. Again there is enlargement of the cardiac silhouette without definite vascular congestion, pleural effusion, or acute focal pneumonia. Mild hyperexpansion of the lungs suggests some underlying chronic pulmonary disease. " b7130308-d9c6dc41-a9a68b57-d67ef5c7-4d233071.jpg,test/p17/p17106481/s53290506/b7130308-d9c6dc41-a9a68b57-d67ef5c7-4d233071.jpg,test," FINAL REPORT INDICATION: History: ___M with lt sided chest pain worse with sneezing // evaluate for PTX TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph from ___ FINDINGS: The heart size is normal. The hilar mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. There effusion or pneumothorax. No fracture is identified. IMPRESSION: No acute intrathoracic abnormalities identified. " 0927c5ea-5e784f95-735abd98-bb2ece4b-9e5eb648.jpg,test/p10/p10401337/s51207498/0927c5ea-5e784f95-735abd98-bb2ece4b-9e5eb648.jpg,test," FINAL REPORT HISTORY: ___ point hematocrit drop in the last week. No obvious source. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. CT abdomen and pelvis ___ at 17: ___. FINDINGS: The cardiac silhouette size is borderline enlarged with a left ventricular prominence, unchanged. The aorta remains tortuous. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is not engorged. The right central venous catheter has been removed. No focal consolidation or pneumothorax is present. Blunting of the costophrenic angles on the lateral view posteriorly is compatible small bilateral pleural effusions. No pneumothorax is seen. Diffuse sclerosis of the osseous structures is compatible with known sclerotic metastases. IMPRESSION: Small bilateral pleural effusions. " 6a35473d-dac7416b-3c8b7796-00d7b90e-126d3bfb.jpg,test/p10/p10519618/s56087168/6a35473d-dac7416b-3c8b7796-00d7b90e-126d3bfb.jpg,test," WET READ: ___ ___ ___ 6:05 PM ETT in appropriate position. NGT distal aspect in gastric fundus, side port may be within distal esophagus, recommend advancement so that it is well within the stomach. d/w Dr. ___ at 6:05 pm WET READ VERSION #1 WET READ VERSION #2 ___ ___ ___ 6:04 PM ETT in appropriate position. NGT distal aspect in gastric fundus, side port may be within distal esophagus, recommend advancement so that it is well within the stomach. multiple attempts made to page Dr. ___ without call back. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Aspiration and intubation, assess tube position. FINDINGS: Portable AP upright chest radiograph was provided. The endotracheal tube is seen with its tip 3.3 cm above the carina. NG tube courses into the left upper abdomen with its tip just beyond the GE junction. There is effusion on the right, which layers posteriorly. There is a small left effusion. There is vague opacity in the right mid and lower lung, which could represent in part layering fluid, though the possibility of pneumonia is not excluded. Biapical pleural parenchymal scarring is noted. The heart is mildly enlarged. Bony structures are intact. IMPRESSION: Bilateral effusions, right greater than left with possible consolidation in the right mid and lower lung. " 89ae4b0f-34178e81-61aa8c3c-1e1aae0e-608dc7e0.jpg,test/p16/p16490354/s55101826/89ae4b0f-34178e81-61aa8c3c-1e1aae0e-608dc7e0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with myasthenia ___ flair // serial monitoring serial monitoring IMPRESSION: Compared to prior chest radiographs ___ through ___. Severe left lower lobe consolidation worsened, moderate left pleural effusion increased. Lesser consolidation at the right lung base unchanged. Atelectasis is most likely and repeated aspiration and retained secretions should be considered. Heart size normal. Right upper lung clear. No pneumothorax. Indwelling right PIC line ends in the right atrium. " 28c87931-7a3838d9-3b09feaf-450c41df-971c6126.jpg,test/p17/p17805594/s58545638/28c87931-7a3838d9-3b09feaf-450c41df-971c6126.jpg,test," FINAL REPORT HISTORY: Fall with left-sided chest pain. Evaluate for rib fracture. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest. No displaced rib fractures seen. Deformity of the a left 9th rib is unchanged. No pleural effusion or pneumothorax. No focal airspace consolidation worrisome for pneumonia. Bibasilar atelectasis is present. Cardiac size is top normal. The mediastinal and hilar structures are unchanged with a tortuous aorta. IMPRESSION: No acute rib fracture. " 0d875850-f4d611e5-be4c2f7c-3716d07e-71d932e8.jpg,test/p15/p15964158/s56495653/0d875850-f4d611e5-be4c2f7c-3716d07e-71d932e8.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with chest pain. Assess for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The lungs are hyperinflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: 1. No acute cardiopulmonary process. 2. Findings suggestive of emphysema and chronic obstructive pulmonary disease. " 6deb0b4e-eccb2a08-46ddc35e-f699bd47-a29839e7.jpg,test/p10/p10621573/s56629315/6deb0b4e-eccb2a08-46ddc35e-f699bd47-a29839e7.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary findings. " 37960d37-8cd0bcd4-d7575e75-88756e99-de235910.jpg,test/p15/p15672432/s53609902/37960d37-8cd0bcd4-d7575e75-88756e99-de235910.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG // eval for effusion eval for effusion IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains enlarged. Continued left pleural effusion with basilar atelectatic changes. The right base is essentially clear. There may be mild residual elevation of pulmonary venous pressure. " 3f6266aa-df64d5c0-23eda2cb-664efa7f-95d50e7c.jpg,test/p15/p15619415/s59157538/3f6266aa-df64d5c0-23eda2cb-664efa7f-95d50e7c.jpg,test," FINAL REPORT HISTORY: Chest pain and cough. COMPARISON: None available. FINDINGS: 2 views of the chest demonstrates clear lungs. The hilar, cardiac, mediastinal contours are normal. No pleural abnormality is seen. The osseous structures are normal. IMPRESSION: No acute cardiopulmonary process. " 038f2894-9bbd5ccd-f326af7d-89850f04-4e3ef010.jpg,test/p17/p17400046/s50740460/038f2894-9bbd5ccd-f326af7d-89850f04-4e3ef010.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F pedestrian struck by motorcycle, polytrauma s/p ex-lap w/mesenteric lac/avulsion, right radius fracture s/p ORIF, right gluteal laceration s/p exploration and packing // interval change interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: ET tube in standard placement. Left PIC line ends in the upper right atrium. A second peripheral vascular line ends in the left axilla. Lungs are X very low in volume, but focal abnormality is limited to the left lower lobe either atelectasis or pneumonia, increased since ___, stable since ___. Despite the esophagogastric drainage tube ending in the upper stomach, the stomach is severely distended with gas and fluid. This resolved at the time of a subsequent chest radiograph, 09:18, available the time of this review. " bf305cf3-dcd029dd-befdeb3c-e114bdb9-fb0543ab.jpg,test/p18/p18912334/s50859397/bf305cf3-dcd029dd-befdeb3c-e114bdb9-fb0543ab.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with ESRD on HD presenting with tachycardia // C/f PNA, pulmonary edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are small bilateral pleural effusion with overlying atelectasis. The cardiac silhouette is top-normal to mildly enlarged. The aorta is calcified. No definite focal consolidation is seen. There is no pneumothorax. There may be minimal pulmonary vascular congestion. IMPRESSION: Bilateral pleural effusions with overlying atelectasis. " 5b5327db-1336a733-02cca437-029c31da-9c026519.jpg,test/p19/p19247731/s56423417/5b5327db-1336a733-02cca437-029c31da-9c026519.jpg,test," FINAL REPORT INDICATION: ___f s/p reduction bimal fx TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are well expanded and clear. Mediastinal contours, hila, and cardiac silhouette are normal. The aorta is tortuous. There is no pleural effusion or pneumothorax. No osseous abnormality identified within limits of plain radiography. IMPRESSION: No pneumonia or evidence of traumatic injury within the limits of plain radiography. " 17506e53-e7f71082-1db8327a-c491bf9c-fe4f9c6f.jpg,test/p14/p14508231/s59959228/17506e53-e7f71082-1db8327a-c491bf9c-fe4f9c6f.jpg,test," FINAL REPORT INDICATION: Chest pain. Pain developed after having injection for a bone scan earlier today. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Cervical fusion hardware is incompletely assessed. IMPRESSION: No acute cardiac or pulmonary process. " a8b83d71-5a19e012-9bc60836-9ced9109-34d2210d.jpg,test/p15/p15935768/s52774493/a8b83d71-5a19e012-9bc60836-9ced9109-34d2210d.jpg,test," FINAL REPORT INDICATION: ___-year-old man with right upper quadrant pain, to rule out pneumonia. COMPARISON: None available. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary pathology. " 24089a18-161a6334-7c928c14-22d2b300-caa25bec.jpg,test/p12/p12283783/s51012796/24089a18-161a6334-7c928c14-22d2b300-caa25bec.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with c/o right rib pain s/p fall // ? Fx COMPARISON: ___ chest radiograph and chest CT from ___. FINDINGS: PA and lateral views of the chest provided. Bibasilar atelectasis is noted. No pneumothorax or effusion. A rounded cystic structure overlying the lateral aspect of the left upper lung compatible with blebs on prior CT chest. No definite rib fracture is seen. Cardiomediastinal silhouette appears grossly within normal limits. IMPRESSION: Bibasilar atelectasis. No pneumothorax. No definite rib fracture though there is strong concern dedicated rib series is recommended to further assess. " a95e30c6-586ab916-5476ce33-3699b302-4aa39390.jpg,test/p17/p17451713/s54801233/a95e30c6-586ab916-5476ce33-3699b302-4aa39390.jpg,test," FINAL REPORT INDICATION: Dyspnea. COMPARISONS: CTA chest of ___ and chest radiographs of ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate hyperinflated lungs without pleural effusion, focal consolidation or pneumothorax. Apical scarring is unchanged. Hilar and mediastinal silhouettes are unremarkable. Heart size is top normal. There is no pulmonary edema. Multiple small postsurgical clips project over right lower hemithorax. Diffuse osteopenia is noted. IMPRESSION: No evidence of acute cardiopulmonary process. " 231686e2-a4e00674-f79b0a9d-3aa8362f-c822c78a.jpg,test/p19/p19499595/s52825626/231686e2-a4e00674-f79b0a9d-3aa8362f-c822c78a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with AMS and SOB // Pneumonia? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and cardiac valve replacement.The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac silhouette is mild to moderately enlarged. No pulmonary edema is seen. Mediastinal contours are unremarkable. IMPRESSION: Cardiomegaly. No pulmonary edema. " c57a795f-fc572271-f19ca5b0-af24134b-eff8213b.jpg,test/p11/p11931603/s55043191/c57a795f-fc572271-f19ca5b0-af24134b-eff8213b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough and smoking history. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. Bilateral breast prostheses are demonstrated. IMPRESSION: Normal chest radiographs. Several punctate calcifications in the upper lungs most likely represent calcified granuloma. " 9e0d5ab4-2ecbda54-6a108735-149ce11b-421cf11d.jpg,test/p16/p16616852/s53865254/9e0d5ab4-2ecbda54-6a108735-149ce11b-421cf11d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with CKD, HTN, AND HEART MURMUR // Evaluation for tansplant surgery. Evaluation for tansplant surgery. IMPRESSION: No previous images. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " f77c9feb-7a0de314-f65a547f-b6de17ad-76d1ad75.jpg,test/p18/p18687937/s55977121/f77c9feb-7a0de314-f65a547f-b6de17ad-76d1ad75.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough // ? infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: In comparison to ___ chest radiograph, there are no new findings. There are no consolidation, opacities, masses, pneumothorax, or pleural effusion appreciated. The cardiomediastinal silhouette and hilar silhouettes are normal size. The heart size is top-normal. . There is no acute bony abnormality nor evidence of acute fracture. IMPRESSION: 1. No acute cardiopulmonary process. " 62c33ff8-f83c1060-a968a670-9ce145d9-b163d244.jpg,test/p19/p19650702/s51161623/62c33ff8-f83c1060-a968a670-9ce145d9-b163d244.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p tracheoplasty admitted for PNA // PNA IMPRESSION: As compared to prior radiograph of 1 day earlier, cardiomegaly is accompanied by pulmonary vascular congestion and apparent development of asymmetrical right-sided pulmonary edema. Coexisting secondary process in the right lung such as aspiration or developing pneumonia is also possible. Right pleural effusion is a persistent finding as well as linear left lower lobe atelectasis. " d687af05-a7c37bb3-d111746e-e54406bd-26429b2c.jpg,test/p15/p15295413/s56010842/d687af05-a7c37bb3-d111746e-e54406bd-26429b2c.jpg,test," FINAL REPORT INDICATION: History: ___M with trauma // trauma COMPARISON: None. IMPRESSION: There is underlying trauma board artifact which limits the study. Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. " 1d826d28-3350ebf5-9d29a21a-4b2a9022-faa23210.jpg,test/p19/p19165656/s53658580/1d826d28-3350ebf5-9d29a21a-4b2a9022-faa23210.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with a pacemaker who is going to have an MRI // assess pacemaker lead placement assess pacemaker lead placement IMPRESSION: The view is lordotic. Left pectoral pacemaker, 1 lead projects over the right atrium and 1 over the right ventricle. Mild degenerative changes. At the first costo sternal junction, reflecting as rounded increase in radiodensity. No acute changes, no pulmonary edema. No pneumonia, no pleural effusions. " b6e6b0fc-8c37fb7c-64e5da11-626376c3-5af897ee.jpg,test/p12/p12872646/s50413242/b6e6b0fc-8c37fb7c-64e5da11-626376c3-5af897ee.jpg,test," FINAL REPORT INDICATION: Nontraumatic subarachnoid hemorrhage now hypertensive. Evaluate for pulmonary edema. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. Chest CT ___. FINDINGS: Interstitial opacities with basilar distribution are most compatible with mild pulmonary edema. There are likely trace, bilateral pleural effusions. No pneumothorax or focal airspace consolidation. Nonspecific biapical scarring is unchanged The heart is mildly enlarged, increased from ___. Mediastinal and hilar contours are unremarkable. The aorta is diffusely calcified and tortuous. IMPRESSION: Mild pulmonary edema. " c67be771-a20e6cde-40912b81-7ee149ab-6999c43e.jpg,test/p15/p15326361/s53635588/c67be771-a20e6cde-40912b81-7ee149ab-6999c43e.jpg,test," WET READ: ___ ___ ___ 10:20 PM Multiple focal parencymal opacities, mostly in the right lung, which are generally stable since the prior exam. The intersitial opacities are improving, suggestive of an improving instersitial pneumonia. The residual opacities may either be residual pneumonia or metastatic disease. There is no new opacity. There are small bilateral pleural effuions, including a loculate portion tracking along the right costophrenic angle. Stable cardiomediastinal silhouette. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: History of metastatic pancreatic cancer, evaluation for pneumonia. Concern for aspiration. COMPARISON: ___. FINDINGS: Focal parenchymal opacities of multiple origin, most are located in the right lung, with judge annually, stable as compared to the previous examination. The pre-existing interstitial opacities are improving, suggesting improving interstitial pneumonia or mild interstitial fluid overload. The residual opacities might eight be healing pneumonia or metastatic disease. No opacities have newly occurred. Small bilateral pleural effusions, stable mild cardiomegaly. " e5be80a7-6f554716-3fa82a87-665298d6-b7d6e32e.jpg,test/p11/p11086980/s56358400/e5be80a7-6f554716-3fa82a87-665298d6-b7d6e32e.jpg,test," FINAL REPORT HISTORY: Homogeneous and cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable and unchanged. Lungs are clear and mildly hyperinflated. No focal consolidation is identified. Minimal blunting of the left costophrenic angle on the posterior view may suggest a trace left pleural effusion. No right-sided pleural effusion is demonstrated, and there is no pneumothorax. No acute osseous abnormalities are present. IMPRESSION: Blunting of the costophrenic angle posteriorly on the left suggesting a trace pleural effusion. No pneumonia. " 75f7a813-80493a11-0c150547-240ffc73-b266e02f.jpg,test/p10/p10364180/s54024335/75f7a813-80493a11-0c150547-240ffc73-b266e02f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with copd and chf // eval for improvement in pulm edema eval for improvement in pulm edema IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with increasing indistinctness of pulmonary vessels consistent with worsening pulmonary venous congestion. There is hyperexpansion of the lungs consistent with chronic pulmonary disease. Some of the coarseness of interstitial markings could be a manifestation of this diagnosis as well. " c2d9cf71-86981f47-a81fcfc8-4364484d-9ea19754.jpg,test/p18/p18487934/s50745858/c2d9cf71-86981f47-a81fcfc8-4364484d-9ea19754.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with AMS // Eval for acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Mild bibasilar atelectasis is seen. There is no focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " 68add742-16e12c0e-194e7d0d-a68fe980-3a28220a.jpg,test/p11/p11551769/s50763101/68add742-16e12c0e-194e7d0d-a68fe980-3a28220a.jpg,test," FINAL REPORT INDICATION: Refractory AML with recent Aspergillus pneumonia. COMPARISON: ___ through ___, CT chest ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette and hilar contours are stable. There has been interval worsening of multifocal opacities particularly in the right middle lobe and also in the left mid and left lower lung in the same distribution as prior pneumonia, worrisome for recurrent worsening multifocal pneumonia. There is no pleural effusion or pneumothorax. A right PICC remains in place with the tip projecting over the low SVC. Increased interstitial markings are compatible with edema. IMPRESSION: Worsening multifocal opacities in the right middle lobe and left mid and lower lung in the same distribution as prior multifocal pneumonia concerning for recurrent multifocal pneumonia. Concurrent mild interstitial edema. Results were discussed over the telephone with Dr. ___ by ___ ___ at 4 p.m. on ___ at time of initial review. " 80b4db83-eed47f72-5e434dd1-05c22af6-dcd5e59f.jpg,test/p15/p15558349/s51106391/80b4db83-eed47f72-5e434dd1-05c22af6-dcd5e59f.jpg,test," FINAL REPORT CLINICAL INDICATION: ___-year-old male with chest pain. Evaluate for pneumonia. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette has decreased in size since ___ but appears relatively similar to ___. The mediastinal widening has also improvfed since ___. The lungs are clear without focal opacity, pleural effusion or pneumothorax. There is bibasilar atelectasis which is likely due to low lung volumes. IMPRESSION: No opacity concerning for pneumonia. Interval improvement of cardiomegaly since ___. " dcf40411-c7642a48-a6eea3cc-94f7b234-4115c320.jpg,test/p19/p19633644/s55673066/dcf40411-c7642a48-a6eea3cc-94f7b234-4115c320.jpg,test," FINAL REPORT HISTORY: Congestion and shortness of breath. FINDINGS: No previous images. There is hyperexpansion of the lungs raising the possibility of underlying chronic pulmonary disease. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. " 5f73daf4-ee1f94d8-bbfa32d5-fa4e49ed-07dcd2a1.jpg,test/p14/p14422845/s59390137/5f73daf4-ee1f94d8-bbfa32d5-fa4e49ed-07dcd2a1.jpg,test," FINAL REPORT INDICATION: Pulmonary mucormycosis, post right middle lobectomy and upper lobe wedge resection. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: A new air-fluid level within a moderate-sized anterior upper right hemithorax reflects upright positioning of this examination; this collection appears is a right perihilar opacity on recent radiographs, and is roughly similar in size. A persistent loculated fluid collection near the right apex is minimally changed since the most recent ___ radiograph. The left lung remains clear. The heart size is unchanged. An intrathecal line and right IJ central venous catheter are unchanged in position. A subcutaneous surgical drain overlies the right hemithorax. IMPRESSION: Moderate sized loculated collection of gas and fluid within the right anterior hemithorax is more easily demonstrated on this dedicated upright view, and is similar in size in comparison to recent radiographs. A second loculated right apical collection is stable. " 6d7e2e47-94b79a82-f1296858-366474a8-bd3547b5.jpg,test/p13/p13479418/s53279175/6d7e2e47-94b79a82-f1296858-366474a8-bd3547b5.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old man with history of lung cancer and radiation pneumonitis. COMPARISON: CTA from ___. FINDINGS: PA and lateral views of the chest are provided. There is an extensive reticular confluent opacity within the entire left lung similar to that seen on CT on ___. While there is obvious difference in technique, there does not appear to be any substantial change. In the right lower lobe, there also appears to be an ill-defined opacity which can be correlated to the CT as well. IMPRESSION: No significant resolution of the lung parenchymal process since the ___ CT. " 7ed569d5-f1eaf2ae-89ff43a6-b18d36aa-56b67564.jpg,test/p18/p18111516/s51941966/7ed569d5-f1eaf2ae-89ff43a6-b18d36aa-56b67564.jpg,test," FINAL REPORT HISTORY: Abdominal pain, end-stage renal disease on hemodialysis. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size remains mildly enlarged. The mediastinal and hilar contours are stable with mild aortic non calcifications demonstrated. The pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes in the thoracic spine. A clip is seen within the right upper quadrant the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 9dc28a55-d069d8b5-9b97b706-4b7a4d0f-ccc86c38.jpg,test/p13/p13233424/s50186857/9dc28a55-d069d8b5-9b97b706-4b7a4d0f-ccc86c38.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with history of CHF presents with left arm, pain, swelling TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from a ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Linear opacity in the left lung base is new from prior, and may relate to scarring as there are multiple chronic rib deformities noted in the left chest wall. Right lung is clear. No focal consolidation, pleural effusion or pneumothorax is seen. Fusion hardware within the cervical spine is incompletely assessed. IMPRESSION: No acute cardiopulmonary abnormality. " 55922cf7-85912afd-2dd01a2d-5de2aefd-b37e0f96.jpg,test/p10/p10518030/s51847507/55922cf7-85912afd-2dd01a2d-5de2aefd-b37e0f96.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain ,R sided // r/o pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. Mediastinal contours are stable. No pulmonary edema is seen. IMPRESSION: Mildly enlarged cardiac silhouette. No pulmonary edema or focal consolidation. " 6e3f5592-5e44f255-8e863ef9-851978fa-846a23e4.jpg,test/p14/p14618211/s58859263/6e3f5592-5e44f255-8e863ef9-851978fa-846a23e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PVD w LLE ulcer here for angiogram // pre-op Surg: ___ (angiogram) pre-op IMPRESSION: Comparison to ___. No relevant change is noted. The right central venous access line is stable. The vascular stent is in constant position. Minimal left pleural effusion. Borderline size of the silhouette. Moderate elongation of the descending aorta. " 1d297faa-cb40a6d4-c60b2e41-80346204-b3af1c16.jpg,test/p10/p10568523/s58303938/1d297faa-cb40a6d4-c60b2e41-80346204-b3af1c16.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent multifocal pna, now sx resolved. Is there complete resolution of infiltrates? TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: ___. FINDINGS: There has been complete resolution of previous consolidations involving the right upper and lower lobes. The lungs are now clear. There is no pneumothorax. The heart and mediastinum are within normal limits. Regional bones and soft tissues are unremarkable. IMPRESSION: Resolved multifocal pneumonia. " 6aefaa22-9dfcf242-6c5a37ca-67e1df01-b8cfd568.jpg,test/p13/p13035993/s52138478/6aefaa22-9dfcf242-6c5a37ca-67e1df01-b8cfd568.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain, question pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. Again seen is a prominent epicardial fat pad. There are no focal consolidations. There is no pleural effusion or pneumothorax. Again seen is kyphosis of the thoracic spine. The cardiomediastinal silhouette is stable. Calcified granuloma in right lower lobe is unchanged. IMPRESSION: No acute cardiopulmonary process. " da94f183-fa298ff7-d0dd3a35-4357abdc-6dc4887a.jpg,test/p15/p15977504/s52344508/da94f183-fa298ff7-d0dd3a35-4357abdc-6dc4887a.jpg,test," FINAL REPORT HISTORY: ___-year-old male presenting with delirium, similar to prior episodes when the patient presented with UTI secondary to chronic indwelling Foley catheter. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are low. There is an opacity in the left lower lobe, obscuring the left hemidiaphragmic contour, likely a left pleural effusion. The upper lobes are clear. The cardiomediastinal contours are unchanged. There is atherosclerosis of the thoracic aorta. Spinal fusion hardware is unchanged in appearance. There is no pneumothorax. IMPRESSION: Left pleural effusion. Pneumonia cannot be excluded. " a5cd8c60-86e4120d-4eb48635-b17386a0-9f2f7de0.jpg,test/p19/p19420204/s57292322/a5cd8c60-86e4120d-4eb48635-b17386a0-9f2f7de0.jpg,test," FINAL REPORT INDICATION: ___ year old man with stage IIIA lung adenocarcinoma with cough and hemoptysis // Pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiomediastinal shadow is normal. Right-sided PICC line in situ with the tip at the mid to distal SVC. Pulmonary overinflation. Mild coarsening of the bronchovascular markings. Nodular airspace consolidation with associated bronchograms seen in the medial basal segment of the right lower lobe. No pleural effusion. No pulmonary edema. IMPRESSION: Nodular airspace consolidation with associated air bronchograms/bronchiectasis seen in the medial basal segment of the right lower lobe. This was also noted on previous imaging. Pulmonary hyperinflation and mild coarsening of the bronchovascular markings: COPD should be excluded. " 2d432182-9bf3ffc9-5168db43-277efaa2-9a16f74a.jpg,test/p19/p19358609/s59658365/2d432182-9bf3ffc9-5168db43-277efaa2-9a16f74a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // ET tube interval change ET tube interval change IMPRESSION: Compared to chest radiographs ___ through ___. Combination of moderate right pleural effusion and right lower lobe atelectasis has decreased slightly. Severe volume loss in the left lower lobe and somewhat smaller left pleural effusion are stable. Multifocal left upper lobe consolidation is unchanged. Heart size is indeterminate. Right PIC line, ET tube, nasogastric drainage tube are all in standard placements. " 4b3d5177-42175e14-4d02c647-83949e2e-d165c1e2.jpg,test/p14/p14546527/s55147564/4b3d5177-42175e14-4d02c647-83949e2e-d165c1e2.jpg,test," WET READ: ___ ___ ___ 5:55 PM Moderate left pleural effusion has slightly increased in size. The small left apical pneumothorax appears decreased in size and nearly resolved. Right basilar atelectasis is improved. Unchanged cardiomediastinal silhouette, with an expected post-operative appearance. Linear lucencies overlying the chest wall and left shoulder suggest increasing subcutaneous air. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man after CABG. Evaluate effusions. IMPRESSION: PA and lateral chest compared to ___: New subcutaneous emphysema in the chest wall is most marked in the left axilla and supraclavicular region, where it was minimal on ___. Lateral view shows air in the anterior mediastinum and retrosternal space as well. Previous left pneumothorax is much smaller, while moderate left pleural effusion has increased. Lateral view suggests retrosternal drainage devices are still present. There is no right pneumothorax. Small right pleural effusion is stable. The appearance of the postoperative cardiomediastinal silhouette is unremarkable, and reflects mild-to-moderate cardiomegaly seen preoperatively. There is no pulmonary edema. Right jugular line ending in the low SVC is unchanged since ___. ___ was paged at 8:20 a.m., when the findings were recognized. " f4dc5489-4257488e-46738976-2a3d6ec0-055a64ab.jpg,test/p13/p13628037/s58676628/f4dc5489-4257488e-46738976-2a3d6ec0-055a64ab.jpg,test," FINAL REPORT INDICATION: Febrile neutropenia being treated for fungal pneumonia, query opacities. COMPARISON: Chest radiograph, ___, ___, chest CT, ___. FINDINGS: Again seen is a right subclavian catheter with tip terminating at the cavoatrial junction. The cardiomediastinal and hilar contours are stable with heart top normal in size. A small pleural effusion is seen on the lateral view, but it is difficult to tell which side is affected (and it may be bilateral). Previously seen left basilar opacity is improved, but mild linear opacities remain. There is no focal consolidation concerning for pneumonia. IMPRESSION: Pleural effusions, possibly bilateral, with left basilar atelectasis. Resolution of previous left basilar heterogeneity. " a0aaac8f-62b9560a-e857c2a5-726cadf3-ad587906.jpg,test/p12/p12893999/s59028207/a0aaac8f-62b9560a-e857c2a5-726cadf3-ad587906.jpg,test," FINAL REPORT INDICATION: ___-year-old female with positive PPD. Assess for active lung disease. COMPARISON: Comparison is made to radiograph of the chest from ___. FINDINGS: PA and lateral views of the chest are obtained. The lung volumes are low. The heart is top normal in size. There is no evidence of focal consolidation, pleural effusion or pulmonary edema. CONCLUSION: No acute cardiopulmonary disease. " f462a65b-ee51c232-e48dc954-e19080ca-5b3a8a53.jpg,test/p17/p17209077/s54057660/f462a65b-ee51c232-e48dc954-e19080ca-5b3a8a53.jpg,test," FINAL REPORT HISTORY: Male status post renal transplant with recent mold exposure. Assess for cardiopulmonary abnormalities. COMPARISON: Chest radiograph, ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Clear lungs bilaterally without pleural effusion. The heart size, mediastinal contour, and hilum are normal. No bony abnormality. IMPRESSION: Normal chest radiograph. " 121f19de-e2240800-7d392699-ea05a2e4-9782e663.jpg,test/p19/p19729398/s59552708/121f19de-e2240800-7d392699-ea05a2e4-9782e663.jpg,test," FINAL REPORT INDICATION: Pneumothorax, followup. COMPARISON: Chest radiograph from ___. FINDINGS: There is redemonstration of a small right pneumothorax, not significantly changed in size compared to the prior study from ___. Two right-sided pleural catheters are unchanged in position. There is evidence of prior aortic valve replacement. Midline sternotomy wires are intact. Mild right basilar atelectasis is unchanged. There may be a small right pleural effusion. Minimal left basilar atelectasis is unchanged. There is no left pneumothorax. Improving post-operative changes in right paramediastinal region. IMPRESSION: Unchanged small right pneumothorax, with two pleural catheters in place. " a12ccb54-a9ba7e0b-664b039b-52703330-5311913b.jpg,test/p12/p12465617/s53201572/a12ccb54-a9ba7e0b-664b039b-52703330-5311913b.jpg,test," FINAL REPORT HISTORY: Stab wound. Evaluate for interval change in pneumothoraces. COMPARISON: CT torso, ___. Multiple chest radiographs from ___. FINDINGS: Portable AP chest radiograph demonstrates a widened vascular pedicle, different in contour than initial radiograph. Subcutaneous emphysema involving both hemithoraces is again seen. The bilateral chest tubes are in place, but tiny left pneumothorax is appreciated and the left tube still impinges on the mediastinum. No pneumothorax is seen on the right. Mild cardiomegaly is stable. There is no focal consolidation or pleural effusion. IMPRESSION: Mediastinum remains widened with abnormal contour. Given lack of remote comparison, 6 hour follow-up radiograph is recommended. Findings were discussed by Dr. ___ with Dr. ___ by phone at 10:47 a.m. on ___. " da4bd572-93b407ed-f86254e5-29931af4-aded4f7c.jpg,test/p17/p17762094/s59836676/da4bd572-93b407ed-f86254e5-29931af4-aded4f7c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with robotic-assisted thymectomy/LUL wedge c/b PE and re-intubation // consolidation or effusions consolidation or effusions IMPRESSION: In comparison with the study of to ___, there again are bilateral pleural effusions, more prominent on the right, with basilar atelectasis. " 0d6c671d-eef670b3-659db332-5687b93b-9a5401a6.jpg,test/p12/p12423405/s53347397/0d6c671d-eef670b3-659db332-5687b93b-9a5401a6.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with an abnormal chest radiograph on ___. IMPRESSION: PA and lateral chest compared to ___ and ___: Borderline hyperinflation is longstanding and could be due to small airways obstruction or mild emphysema. Region of relatively linear peribronchial opacification in the left lower lung laterally has improved. This could be due to acute inflammation, but is more likely region of chronic scarring. Lungs are otherwise clear of any focal abnormality and there is no pleural effusion or indication of central adenopathy. Cardiomediastinal and hilar contours are normal. " 0029a210-6568a58a-4f76a751-79b4775a-7ab758ac.jpg,test/p18/p18387698/s50369720/0029a210-6568a58a-4f76a751-79b4775a-7ab758ac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chest tube // eval chest tube placement. PLEASE PERFORM FIRST THING IN MORNING, 7AM IS PREFERRED. eval chest tube placement. PLEASE PERFORM FIRST THING IN MOR COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Small left pleural effusion is larger. The persistent right pleural abnormality, at least of thickening of the costal pleural surface is unchanged since ___. There was a much larger right pleural effusion early in the day, that drained between 11:00 and 17:00 and has not subsequently recurred. The volume of subpulmonic pleural fluid is indistinguishable from elevation of the right hemidiaphragm. The right pigtail pleural drainage catheter is unchanged in position. There is no pneumothorax. Right basal atelectasis is at least moderately severe, and unchanged. Upper lungs are clear. Mild enlargement of the cardiac silhouette is stable " 08efa1e6-cb6f4c1b-751cdd26-07827c34-fb065f85.jpg,test/p15/p15696083/s59426181/08efa1e6-cb6f4c1b-751cdd26-07827c34-fb065f85.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: eval for effusion TECHNIQUE: AP chest x-ray COMPARISON: ___ FINDINGS: There is streaky density at the lung bases consistent with subsegmental atelectasis. There is no definite focal consolidation. The patient is status post median sternotomy as before. Mediastinal structures are unchanged. An endotracheal tube and right internal jugular sheath remain in place. A nasogastric tube has been advanced and now terminates below the diaphragm in the region of the gastric fundus or body. IMPRESSION: Tube and line placement as described. Bibasilar subsegmental atelectasis. No definite effusion. " 3b669320-a29280aa-ef773fc2-045f35b8-b8caf03e.jpg,test/p19/p19047570/s55358907/3b669320-a29280aa-ef773fc2-045f35b8-b8caf03e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with globus sensation in the throat and mid-chest. ?retained FB or cardiopulm change. TECHNIQUE: Chest PA and lateral COMPARISON: No prior relevant imaging is available on PACS at the time of this dictation. FINDINGS: Lung volumes is slightly low. The lungs are clear. No focal consolidation, edema, effusion, or pneumothorax. The heart size is normal. The mediastinum is not widened. The trachea and bilateral mainstem bronchi appear normal in caliber. Levoconvex scoliosis of the thoracic spine is mild. No acute osseous abnormality. No evidence of a radiopaque foreign body. IMPRESSION: No evidence of radio-opaque foreign body in the airways. The lungs are clear. " 39e6f3ff-2daeffe4-1131f739-71d9ef27-89adc615.jpg,test/p13/p13609253/s51023140/39e6f3ff-2daeffe4-1131f739-71d9ef27-89adc615.jpg,test," FINAL REPORT TWO VIEW CHEST OF ___ COMPARISON: ___ radiograph. FINDINGS: Left PICC has been repositioned, now terminating in the proximal superior vena cava. Heart size, mediastinal and hilar contours are normal, and lungs and pleural surfaces are clear. IMPRESSION: No radiographic evidence of active or latent pulmonary tuberculosis infection. " 53cf0e58-0bdc6bdf-eba95c4a-bdf1d200-7fc2547a.jpg,test/p19/p19992365/s54379562/53cf0e58-0bdc6bdf-eba95c4a-bdf1d200-7fc2547a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath. Evaluate for heart failure or pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. IMPRESSION: No acute cardiopulmonary process. No evidence of pneumonia or heart failure. " e7a73e70-1d8bf911-34a4ecc5-1adb82ee-0225f929.jpg,test/p13/p13621755/s51660183/e7a73e70-1d8bf911-34a4ecc5-1adb82ee-0225f929.jpg,test," WET READ: ___ ___ ___ 8:24 PM Comminuted right clavicular fracture as seen on prior radiograph. No PTX. ETT terminates 3.4 cm above carina. NG sidehole is in stomach. Ground glass opacities in right lung are better seen on prior CT. Cardiomediastinal silhouette is normal. WET READ VERSION #___ ___ ___ 8:22 PM Comminuted right clavicular fracture as seen on prior radiograph. No PTX. ETT terminates 3.4 cm above carina. NG sidehole is in stomach. Clear lungs. Cardiomediastinal silhouette is normal. ______________________________________________________________________________ FINAL REPORT HISTORY: Bike crash, question pneumothorax, pneumonia. CHEST, SINGLE AP VIEW. An ET tube is present, tip approximately 3.3 cm above the carina. An NG tube is present, tip beneath the diaphragm, off film. Mild sigmoid scoliosis of the upper thoracic spine is present, convex left at T3/4 and convex right at T6/7. No CHF, focal consolidation or effusion is identified. No pneumothorax is detected. A comminuted fracture of the mid shaft of the right clavicle is noted. In addition, the patient has multiple rib fractures, better depicted on the ___ CT scan. Suspect diffuse osteopenia. IMPRESSION: Lines and tubes in satisfactory position. No acute pulmonary process identified. Right clavicle and rib fractures noted. " 25bd3c76-b70b6883-ad5bc4fc-46df8937-934fb0eb.jpg,test/p13/p13992060/s59446803/25bd3c76-b70b6883-ad5bc4fc-46df8937-934fb0eb.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___ No prior radiographs for comparison. FINDINGS: Heart size is normal. Aorta is tortuous. There is no evidence of mediastinal or hilar lymph node enlargement. Lungs and pleural surfaces are clear. There are no acute skeletal abnormalities. IMPRESSION: No radiographic evidence of pulmonary metastases. " 51b6eb96-1e6acb41-f46989e2-484299f9-c308d82d.jpg,test/p15/p15801496/s52025231/51b6eb96-1e6acb41-f46989e2-484299f9-c308d82d.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate extensive consolidation in the lingula and left lower lobe. The cardiac silhouette is difficult to evaluate secondary to this overlying opacity, but is likely normal in size. There is also a moderate left pleural effusion. No pneumothorax is visualized. The visualized upper abdomen is unremarkable. IMPRESSION: Left lower lung consolidation compatible with lingular and left lower lobe pneumonia. Moderate left pleural effusion, likely parapneumonic. RECOMMENDATION(S): Followup chest radiograph in 4 weeks is recommended to evaluate for resolution following appropriate antibiotic therapy. " 43e36e34-4633177b-ec292a53-a5ef3ef8-5622f088.jpg,test/p17/p17179127/s57507982/43e36e34-4633177b-ec292a53-a5ef3ef8-5622f088.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with AMS // eval infiltrate TECHNIQUE: Portable chest COMPARISON: None FINDINGS: There is a severe rotoscoliosis convex right the heart is upper limits normal in size. There is mild pulmonary vascular redistribution. There are diffuse increase in lung markings but There is no focal infiltrate. IMPRESSION: The etiology of the diffuse increased lung markings is is unclear. This could be an atypical presentation of fluid overload, chronic lung disease, or an atypical presentation of an infectious process. Comparison with old films and clinical correlation would be helpful " 532b41c5-aa84f4e3-0680a169-3354c664-82013589.jpg,test/p15/p15446959/s51765753/532b41c5-aa84f4e3-0680a169-3354c664-82013589.jpg,test," WET READ: ___ ___ ___ 9:47 PM stable post-operative appearance in left lung. minimally increased opacification in right lower lung, may reprsent early infectious process in correct clinical setting. uncgaged cardiomediastinal borders. ___ ______________________________________________________________________________ FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with cough and metastatic lung cancer. Mild opacity in the right lower lobe likely corresponds to an infectious process given the clinical concern. Follow up is recommended. Mild cardiomegaly and tortuous aorta are stable. Opacities in the left hemithorax are consistent with post-operative changes, better evaluated by prior CT from ___. There is no pneumothorax or increasing pleural effusions. Left hemidiaphragm is elevated as before. Left perihilar opacities, though difficult to evaluate, are grossly unchanged from prior study. " fe28cc94-522998b4-bcbecc13-39c64b72-5eda21c7.jpg,test/p14/p14163729/s59024016/fe28cc94-522998b4-bcbecc13-39c64b72-5eda21c7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with headache // acute process TECHNIQUE: Single, AP, portable view of the chest. COMPARISON: ___. FINDINGS: The patient is rotated towards the right and the lung volumes are noted to be low. Streaky bibasilar opacities likely reflect atelectasis. There is no lobar consolidation, pneumothorax, pleural effusion, or overt pulmonary edema identified. A slightly asymmetrically prominent right hilum is likely secondary to patient rotation. Borderline cardiomegaly is stable but there is no real pulmonary vascular engorgement and certainly no edema. Calcifications are noted at the aortic knob. IMPRESSION: Chronic borderline cardiomegaly. Low lung volumes and bibasilar atelectasis. No lobar consolidation or pleural effusion. " cf32edb8-231046fa-d9ae75e9-fb2d44a2-af30e96a.jpg,test/p14/p14538785/s55677545/cf32edb8-231046fa-d9ae75e9-fb2d44a2-af30e96a.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Left-sided pleuritic chest pain and calf tenderness. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: Cardiac borders are partly obscured by a moderate sized left-sided pleural effusion with suspicion for substantial associated atelectasis involving the inferior part of the lingula and basilar segments of the left lower lobe. There is no net shift of midline structures. Aorta appears mildly tortuous. Right lung appears clear, without pleural effusion. IMPRESSION: Substantial left-sided pleural effusion. " 4167e5b7-d4136ebf-2e86b089-fd6aae08-66cc4893.jpg,test/p10/p10928558/s52995907/4167e5b7-d4136ebf-2e86b089-fd6aae08-66cc4893.jpg,test," FINAL REPORT HISTORY: Coronary artery disease, vascular dementia with mechanical fall. TECHNIQUE: Upright AP view of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. Heart size remains mildly enlarged, unchanged. Moderate size hiatal hernia is re- demonstrated. Aortic knob calcifications are present. The mediastinal and hilar contours are unchanged, and there is no pulmonary vascular congestion. Linear opacities in both lung bases likely reflect subsegmental atelectasis. Minimal blunting of the left costophrenic sulcus suggests a trace left pleural effusion. No pneumothorax is identified. IMPRESSION: Mild bibasilar atelectasis and probable trace left pleural effusion. Unchanged moderate size hiatal hernia. " 21d14616-b506e0fa-6bd23fc3-7ecb8402-0f2cc69a.jpg,test/p15/p15373430/s56851191/21d14616-b506e0fa-6bd23fc3-7ecb8402-0f2cc69a.jpg,test," FINAL REPORT INDICATION: A ___-year-old female with history of renal transplantation and 2 weeks of cough. COMPARISON: ___. PA AND LATERAL CHEST: The lungs remain clear without focal consolidation, effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. No pulmonary vascular congestion or edema. IMPRESSION: No evidence of pneumonia. " 1e5afc72-1a77c4a8-eea271a7-a17675b1-6623cb0a.jpg,test/p10/p10772100/s56388796/1e5afc72-1a77c4a8-eea271a7-a17675b1-6623cb0a.jpg,test," FINAL REPORT INDICATION: ___ M with hx diabetes found down after seen well 3 days ago. OSH found R subacute SDH, DKA, upper GI bleed. // eval ETT position TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: The tip of the endotracheal tube projects over the mid thoracic trachea (5.4 cm from the carina). A feeding tube extends into the proximal stomach although the side ports may be located within the distal esophagus. No focal consolidation, pleural effusion or pneumothorax identified. The size the cardiomediastinal silhouette is within normal limits. IMPRESSION: The tip of the endotracheal tube extends to the mid thoracic trachea. Interval placement of a feeding tube which extends to the proximal stomach however the side port may be located in the distal esophagus. Further advancement of the feeding tube is recommended. " 6645abe6-7a3c1b35-fbd03a49-bf2eca16-be590ff1.jpg,test/p18/p18264198/s51130855/6645abe6-7a3c1b35-fbd03a49-bf2eca16-be590ff1.jpg,test," FINAL REPORT INDICATION: Increased work of breathing, evaluate ET tube placement. COMPARISON: ___ at 20:10 hours. FINDINGS: Single frontal view of the chest shows ET tube whose tip is 6.4 cm above the carina. An OG tube tip courses through the esophagus and terminates out of view. A right subclavian catheter is present, whose tip is in the high SVC. Compared to the prior film, there is improving mild pulmonary edema as well as improvement in the right basilar consolidation. There is an unchanged retrocardiac opacity. The cardiac silhouette is enlarged but stable. There is no pneumothorax. IMPRESSION: Improvement in the mild pulmonary edema and right basilar opacity with a persistent retrocardiac opacity. " f456c91c-839b3269-27bd3257-fc8ff541-0ce6ad36.jpg,test/p13/p13186646/s51899543/f456c91c-839b3269-27bd3257-fc8ff541-0ce6ad36.jpg,test," FINAL REPORT INDICATION: ___-year-old male with basal ganglia, hemorrhage, end-stage renal disease and elevated white count, assess for pneumonia and assess for acute process. COMPARISONS: None. TECHNIQUE: Portable AP upright radiograph of the chest was obtained. FINDINGS: Valvular prosthesis and median sternotomy wires are noted with otherwise well expanded and clear lungs. There is no pleural effusion or pneumothorax. The heart is mildly enlarged. IMPRESSION: No acute intrathoracic process. " 898b3b0a-a6a11a26-832948da-78690f1f-26bb1997.jpg,test/p17/p17967970/s55111862/898b3b0a-a6a11a26-832948da-78690f1f-26bb1997.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/history of lung CA, s/p left VATS and LUL wedge resection in ___, right VATS w/RUL wedge resection in ___, found to have residual cancer at staple line, now POD2 from right-sided thoracotomy with RUL resection with significant intra-operative anemia. // interval eval interval eval IMPRESSION: ET tube tip is 5 cm above the carinal. Right internal jugular line tip is at the level of superior SVC. Right chest tube is in place. Basal loculated pneumothorax and soft tissue opacity are unchanged. Minimal apical pneumothorax is most likely present. Left lung is stable in appearance, overall clear. Small amount of left pleural effusion is present. Postsurgical changes in the right apex are stable. As compared to ___ there is interval decrease in right pleural effusion but increase in the air containing loculations. There is also interval improvement in the left basal consolidation with unchanged amount of small left pleural effusion. " 95005ed2-e207aa95-b94d68dd-e45bbef8-ad1978da.jpg,test/p11/p11218577/s58534795/95005ed2-e207aa95-b94d68dd-e45bbef8-ad1978da.jpg,test," FINAL REPORT HISTORY: ___-year-old man with recent admission for bronchitis in the with wheezing and cough. Question pneumonia. COMPARISON: ___. FINDINGS: PA and lateral radiographs of the chest demonstrate pacemaker with leads in appropriate position. Aorta is tortuous. The patient has had a median sternotomy. While there are no focal areas of opacities that are concerning for consolidation or infectious process. Bilateral ___ opacities, potentially scarring are unchanged. There are several areas of linear atelectasis, particularly in the left mid lobe. No pleural effusion or pneumothorax is present. IMPRESSION: No overt evidence of pneumonia. Bilateral atelectasis. " c3cb3ad7-dd64caba-bda77f45-405bd321-619051f0.jpg,test/p16/p16700191/s52016052/c3cb3ad7-dd64caba-bda77f45-405bd321-619051f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with L sided CP/SOB // eval for consolidation COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Clips noted in the right upper quadrant. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Prominent anterior spurs in the T-spine noted. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 3a5d7cf4-2f5d98ae-5f1426fa-08c2050b-977d63c5.jpg,test/p11/p11046365/s56901848/3a5d7cf4-2f5d98ae-5f1426fa-08c2050b-977d63c5.jpg,test," FINAL REPORT INDICATION: History: ___F with 1 month worsening cough // eval pna TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Focal opacity silhouetting the left hemidiaphragm represents dense consolidation in the left lower lobe. No pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. There is a dextroscoliosis in the thoracic spine. IMPRESSION: Dense consolidation in the left lower lobe is consistent with infection in the correct clinical setting. " 3dd9c388-275dec79-e1736d85-196deea4-f9e305ca.jpg,test/p13/p13345152/s51480571/3dd9c388-275dec79-e1736d85-196deea4-f9e305ca.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with stroke like symptoms, evidence of pneumonia COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 60e08368-c11dd864-0692c6e0-95ed1b2f-a2d9bc59.jpg,test/p10/p10596874/s57103837/60e08368-c11dd864-0692c6e0-95ed1b2f-a2d9bc59.jpg,test," FINAL REPORT INDICATION: Fall. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. Diffuse demineralization of the osseous structures is noted, which limits the detection for subtle fractures. No grossly displaced rib fractures are present, and no other acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary abnormality. Diffuse osteopenia limits evaluation for subtle fractures, but no acutely displaced fracture is visualized. " 8858e384-f1b06a5b-03d19cef-7eaecb1d-e3d93839.jpg,test/p16/p16990633/s56957943/8858e384-f1b06a5b-03d19cef-7eaecb1d-e3d93839.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pain in the lower aspect of the left hemithorax. Any abnormalities of the left hemithorax to account for pain in the lower and anterior aspect? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. Anterior wedge compression deformity in the mid thoracic spine is unchanged since ___. IMPRESSION: No acute cardiopulmonary process. " f07461a7-133e4df4-1cdb07c4-da62b86a-59a1d813.jpg,test/p10/p10882916/s52789758/f07461a7-133e4df4-1cdb07c4-da62b86a-59a1d813.jpg,test," FINAL REPORT CHEST PA AND LATERAL INDICATION: Patient with Crohn's, right upper quadrant bowel pain, rule out infiltrate, collapsed lung. COMPARISON: Multiple chest x-rays from ___ to ___. Chest CTA of ___. FINDINGS: Subtle bilateral lung opacities, mostly predominant in right upper lobe, have improved since the previous exam. There is no new lung consolidation or volume loss. The patient had prior sternotomy. The sternal wires are in unchanged position. Mediastinal and cardiac contours are normal. There is no pneumothorax or pleural effusion. CONCLUSION: 1. Mild bilateral opacities mostly predominant in right upper lobe have improved. 2. There is no new cardiopulmonary finding. " 40849251-3763476f-45501279-66669302-d660d29d.jpg,test/p10/p10021487/s51955860/40849251-3763476f-45501279-66669302-d660d29d.jpg,test," WET READ: ___ ___ ___ 7:08 PM No change since ___. Right pleural effusion with overlying atelectasis. Mottled appearance below right hemidiaphragm corresponds to known hepatic abscess. NGT below diaphragm. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CLINICAL HISTORY: Continued fever status post ileocolostomy. CHEST Right pleural effusion and atelectasis is still present and is little changed from the prior chest x-ray. Irregular gas patten is seen under the right hemidiaphragm. This correlates well with the CT from ___. Nasogastric tube is present with the tip in the satisfactory position. The lung fields are otherwise clear. " 63292935-2a72f015-3ec8d8a6-ad5ad1bf-a51eb39f.jpg,test/p16/p16033728/s53062020/63292935-2a72f015-3ec8d8a6-ad5ad1bf-a51eb39f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Shortness of breath. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are stable. There is interval resolution/substantial improvement of azygos distention and perihilar vascular congestion. Left elevation of the hemidiaphragm is unchanged. " 13b05da9-47e7464f-2616c4ae-2fcbed1b-4cb0be3d.jpg,test/p17/p17002760/s51212589/13b05da9-47e7464f-2616c4ae-2fcbed1b-4cb0be3d.jpg,test," FINAL REPORT EXAMINATION: Chest PA and lateral INDICATION: ___M with shortness of breath TECHNIQUE: PA and lateral COMPARISON: Chest PA and lateral ___ FINDINGS: PA and lateral views the chest were provided demonstrating clear well expanded lungs without focal consolidation, large effusion or pneumothorax. The heart is top-normal in size. The mediastinal contour is stable with mild atherosclerotic calcification at the aortic knob. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. " 87495090-65ae9c30-52cde258-ff11f39b-04c641cd.jpg,test/p12/p12183689/s58020108/87495090-65ae9c30-52cde258-ff11f39b-04c641cd.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post PEG device. The tracheostomy tube and the right internal jugular vein catheter are unchanged. Atelectasis at both the right and the left lung bases. No evidence of free air under the hemidiaphragms. No other changes in the lung. No pleural effusions. " ea7e8fb0-24d1c400-b3cb8a6a-4b435d57-455f8e5b.jpg,test/p18/p18615099/s51530024/ea7e8fb0-24d1c400-b3cb8a6a-4b435d57-455f8e5b.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Leukocytosis, fever, and CHF. Comparison is made with prior study ___. There are low lung volumes. Small right and moderate left pleural effusions with adjacent atelectasis have increased. Cardiomegaly is stable. Pacemaker leads are in standard position in the right atrium and right ventricle. Mild pulmonary edema has minimally improved. Right lower lobe atelectasis is unchanged. Left perihilar and left lower opacities have minimally increased consistent with increasing atelectasis and worsening pneumonia and pleural effusion. Sternal wires are aligned. Patient is status post CABG. " f3286e1e-5b476a84-2ae29560-fab93d34-c2d8d387.jpg,test/p17/p17062932/s50971342/f3286e1e-5b476a84-2ae29560-fab93d34-c2d8d387.jpg,test," FINAL REPORT HISTORY: Pancreatitis with repositioned line. FINDINGS: In comparison with the earlier study of this date, the left IJ catheter has been pulled back to the lower portion of the SVC. Otherwise, little change. " 1400cd14-be51d94f-52a88662-ff1cf856-c8a70d08.jpg,test/p13/p13259221/s54318707/1400cd14-be51d94f-52a88662-ff1cf856-c8a70d08.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pancreatitis, self- d'c'd L PICC today climbing out of bed, need to assure entire catheter removed. // please evaluate for complete removal of L PICC line COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the left PICC line has been completely removed. The course and position of the nasogastric tube is unchanged. No complication, minimal atelectasis at the left lung bases. No pneumothorax. No pulmonary edema. No pneumonia, no pleural effusion. Borderline size of the cardiac silhouette. " 40d2b7ba-a8a183bb-b7897096-7f28be0c-5041cf66.jpg,test/p17/p17071231/s53203212/40d2b7ba-a8a183bb-b7897096-7f28be0c-5041cf66.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, leukocytosis, evaluation for pathology. COMPARISON: Portable radiograph from ___. FINDINGS: As compared to the previous radiograph, the current image is acquired with the patient in rotated position. However, no relevant change is seen. No pneumonia, no pleural effusions. No pulmonary edema. Normal size of the cardiac silhouette. " 28313eb8-2a48060a-9408314a-198d4d59-a7528ea1.jpg,test/p15/p15125393/s56032682/28313eb8-2a48060a-9408314a-198d4d59-a7528ea1.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dizziness // evidence of pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable aside for a slightly tortuous aorta. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 356192bd-d3bd27e5-bc8deb6b-334fbc99-4a3f0c1f.jpg,test/p17/p17148408/s56402944/356192bd-d3bd27e5-bc8deb6b-334fbc99-4a3f0c1f.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with new pacemaker, check lead placement and assess for pneumothorax. Comparison is made to the patient's prior study of ___. PA and lateral views of the chest ___ at ___ are submitted. IMPRESSION: 1. Interval placement of a dual-lead left-sided pacer with the leads terminating over the expected location of the right atrium and right ventricle, respectively. No pneumothorax is appreciated. Lungs are well inflated without evidence of focal airspace consolidation, pulmonary edema, pleural effusions or pneumothorax. Overall cardiac and mediastinal contours are unchanged. " 6542a56d-71120cd6-46043a78-a4deef56-6c598c6c.jpg,test/p16/p16466609/s55107916/6542a56d-71120cd6-46043a78-a4deef56-6c598c6c.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with sob // sob COMPARISON: Prior study from ___. FINDINGS: AP supine and lateral views of the chest provided. Cardiomegaly is mild and unchanged. There is hilar congestion and mild interstitial edema. No supine evidence for effusion or pneumothorax. Mediastinal contour is unchanged. Bony structures are intact. IMPRESSION: Mild interstitial edema and mild cardiomegaly. " 5dca9d05-715ffe57-f8eb7537-654b8faa-f290ccd6.jpg,test/p19/p19403960/s51150074/5dca9d05-715ffe57-f8eb7537-654b8faa-f290ccd6.jpg,test," FINAL REPORT INDICATION: Acute kidney injury, on hemodialysis, presented with pericardial effusion, assess interval change. COMPARISON: Chest radiograph ___, ___, CT chest ___. FINDINGS: There has been interval reaccumulation of the right pleural effusion, now moderate. The left pleural effusion is stable. There is no pneumothorax. There is no new focal consolidation concerning for pneumonia. The patient is rotated to the right, which may account for the apparent increased widening of the upper mediastinum, consistent with central vascular engorgement. The right internal jugular line is present with tip in stable position. IMPRESSION: Reaccumulation of right pleural effusion with stable left pleural effusion and central vascular engorgement. " 6592a20c-a6523dea-9c064b6e-f39fce75-c54e93b3.jpg,test/p18/p18092965/s51300971/6592a20c-a6523dea-9c064b6e-f39fce75-c54e93b3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old woman with lung cancer, brain metastasis, status post CT-guided biopsy with tension pneumothorax status post chest tube placement. Evaluate pneumothorax. TECHNIQUE: AP upright portable chest radiograph COMPARISON: Multiple priors from the preceding days FINDINGS: Right apical pneumothorax is tiny. 3 radiopaque endobronchial valves are noted in the right suprahilar region. Right chest tube is unchanged in position. Lungs are hyperinflated but clear with no new parenchymal abnormality. Miniaml pleural effusions if any. IMPRESSION: Tiny right apical pneumothorax, not significantly changed from the preceding radiographs. " ba7c4e32-81cec643-1809c621-bcf0e8b4-4f051dfd.jpg,test/p19/p19291122/s53089733/ba7c4e32-81cec643-1809c621-bcf0e8b4-4f051dfd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new hypoxia, volume overloaded // eval for pulm edema/PNA TECHNIQUE: Portable semi upright chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: There is interstitial pulmonary edema, which has worsened in comparison to prior chest radiograph. There is a left retrocardiac opacity with silhouetting of the diaphragm and air bronchograms. Heart size is stable. The mediastinal and hilar contours are stable. No pneumothorax is seen. Again visualized is a calcified mitral annulus. IMPRESSION: 1. Left retrocardiac opacity with air bronchograms, which likely represents atelectasis, although underlying pneumonia cannot be ruled out. 2. Worsening interstitial pulmonary edema. " 9b1d06db-0320293b-31775e55-427e0a4a-304d3967.jpg,test/p17/p17284612/s51705328/9b1d06db-0320293b-31775e55-427e0a4a-304d3967.jpg,test," WET READ: ___ ___ 10:55 PM Poor exposure. Bibasilar atelectasis. No clear consolidation. Cardiomegally. Linear density adjacent to the right heart border may represent a prominent vessel or object outside the patient. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chest pain. There is stable mild-to-moderate cardiomegaly. Bibasilar atelectasis are larger on the left side. There is no evidence of pneumonia or CHF, pneumothorax or pleural effusion. " 882cf004-1490133b-f0acc324-00f18032-761ca507.jpg,test/p17/p17118056/s50491222/882cf004-1490133b-f0acc324-00f18032-761ca507.jpg,test," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with fever. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Patient's thoracic kyphosis is accentuated. Within this limitation, the lungs are grossly clear. The cardiomediastinal silhouette is unchanged given differences in positioning. No acute osseous abnormalities detected. No large pleural effusion. IMPRESSION: No definite acute cardiopulmonary process. " 9c897587-d709fb51-1f9443c1-d019338a-fe2d9767.jpg,test/p12/p12371641/s53577652/9c897587-d709fb51-1f9443c1-d019338a-fe2d9767.jpg,test," FINAL REPORT HISTORY: ___ year old woman with UBIG, intubated, diuresing COMPARISON: Exam is compared to a chest x-ray of ___. FINDINGS: ET tube has been pulled back of 1 cm. NG tube is still in place and the end of tip is not visualized in the chest x-ray The Right PICC line is in standard position with tip ending at the cavo-atrial junction The cardiomegaly is slightly improved, with reduction of pulmonary edema. Left base has an increased pleural fluid The basilar atelectasis seems more extensive. IMPRESSION: There is a mild improvement of pulmonary edema and the heart size is reduced. The left base pleural effusion is increased, and also the bibasilar atelectasis. " c1876398-2b191fb7-dd10f129-4f41b5a7-ee87c51d.jpg,test/p17/p17681138/s57893938/c1876398-2b191fb7-dd10f129-4f41b5a7-ee87c51d.jpg,test," FINAL REPORT INDICATION: History of metastatic breast cancer, dull breath sounds at the bases, shortness of breath. Evaluate etiology. COMPARISON: CT torso, ___. TECHNIQUE: PA and lateral upright radiographs of the chest. FINDINGS: The lungs are well expanded and clear. There is no consolidation to suggest infection. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present. A left subclavian Port-A-Cath terminates near the cavoatrial junction. Multifocal irregular sclerotic lesions throughout the thoracic spine are consistent with known metastatic breast cancer. IMPRESSION: 1. No consolidations to suggest infection. No radiographic findings to explain dull breath sounds at the bases. 2. Multifocal metastases in the thoracic spine The above results were communicated via telephone by Dr. ___ to Dr. ___, at 9:40 a.m. on ___ as requested. " 30d77741-a76144f0-cba7767b-c2063109-b78093fb.jpg,test/p12/p12535940/s53109482/30d77741-a76144f0-cba7767b-c2063109-b78093fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with epigastric pain // ? pna COMPARISON: ___ and PET-CT from ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 5bdbe0e3-b0c8fdd8-a6e71c99-33feb4be-66ad7574.jpg,test/p18/p18914461/s54178291/5bdbe0e3-b0c8fdd8-a6e71c99-33feb4be-66ad7574.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with screening, unable to have PPD. Rule out TB. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: No focal consolidation, pleural effusion or pulmonary edema is seen. The cardiac and mediastinal contours are within normal limits. IMPRESSION: No signs of tuberculosis are seen. " 237e3190-bc907c70-abd1a2b8-3b6c3b40-0ae0d55f.jpg,test/p13/p13641222/s54743398/237e3190-bc907c70-abd1a2b8-3b6c3b40-0ae0d55f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with HTN, DM, HLD, with L finger parathesias // ? cardiomegaly, pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " c1ba11bb-17054573-885866a2-55bb8fec-fe8723a7.jpg,test/p16/p16071433/s53021837/c1ba11bb-17054573-885866a2-55bb8fec-fe8723a7.jpg,test," FINAL REPORT INDICATION: ___F with cough sob // eval for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities IMPRESSION: No acute cardiopulmonary process. " c0655d07-e7ed7233-5e225f3d-df05a673-fbeec066.jpg,test/p16/p16262598/s57185584/c0655d07-e7ed7233-5e225f3d-df05a673-fbeec066.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with sob/cough // sob, recent PNA COMPARISON: ___ chest radiograph and CT chest from ___. FINDINGS: PA and lateral views of the chest provided. Left chest wall pacer device is again noted with pacer leads extending into the region the right atrium and right ventricle. Midline sternotomy wires again noted. Patient is known to have extensive calcified pleural plaque likely accounting for the areas of hyperdensity projecting over the left lung. Since the prior exam, there is perhaps slight decrease in right pleural effusion. Otherwise, no significant change in the appearance of the chest. Cardiomediastinal silhouette is stable. Bony structures appear grossly intact. IMPRESSION: Extensive calcified pleural plaque accounts for opacities projecting over the left hemi thorax. Persistent though slightly decreased right effusion. " 8743611d-75ff1e2e-6339f09a-16a8788a-87600436.jpg,test/p11/p11069015/s50082732/8743611d-75ff1e2e-6339f09a-16a8788a-87600436.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with recurrent effusions, status post chest tube placement. FINDINGS: Chest tubes within the left side are unchanged. There is persistent right-sided pleural effusion. There is no pneumothoraces on either side. Several healed right-sided rib fractures are seen. There are no signs for overt pulmonary edema. There are areas of consolidation and opacity in the left mid and lower lung fields which are stable. Overall, there has been no interval change. " b1fabc3b-2afe19eb-d4fef3ca-43519571-e15d554f.jpg,test/p18/p18302119/s59027839/b1fabc3b-2afe19eb-d4fef3ca-43519571-e15d554f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with history of HTN, a-fib s/p failed DCCV ___, on metoprolol and rivaroxaban, who presented with chest pain now s/p cardioversion // eval for new shortness of breath eval for new shortness of breath COMPARISON: PRIOR CHEST RADIOGRAPHS SINCE ___, MOST RECENTLY ___. IMPRESSION: MILD CARDIOMEGALY AND BORDERLINE PULMONARY VASCULAR CONGESTION UNCHANGED. NO PULMONARY EDEMA. NO PLEURAL EFFUSION. NO PNEUMOTHORAX. " 49a656a8-87e48864-21afa44f-fe16b357-2264bde1.jpg,test/p12/p12773009/s54524235/49a656a8-87e48864-21afa44f-fe16b357-2264bde1.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: ___-year-old man with CLL status post chemotherapy eight days ago with fever to 101.8, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is mild blunting of the right CP angle, which could represent a small effusion or pleural thickening. There is no focal consolidation to suggest the presence of pneumonia. No pneumothorax or signs of CHF. Heart size is top normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No findings to suggest pneumonia. Stable blunting of the right CP angle. Top normal heart size. " 20cf68a9-3091ecc2-9fa4c300-a1024975-2d8161b5.jpg,test/p14/p14947701/s58489980/20cf68a9-3091ecc2-9fa4c300-a1024975-2d8161b5.jpg,test," WET READ: ___ ___ 2:47 PM Interstitial lung disease related chronic fibrotic changes at the lung bases, with no strong evidence for pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with cough and fever // eval pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Chronic fibrotic changes at the lung bases are compatible with known interstitial lung disease. There is no focal consolidation to suggest pneumonia; however, the lung bases are obscured by the chronic changes. Heart size and mediastinal contours are normal. No pleural effusion or pneumothorax. IMPRESSION: Interstitial lung disease related chronic fibrotic changes at the lung bases, with no strong evidence for acute pneumonia. " d1e68ec6-9fc5ce9f-3b030f43-ef6c608c-23ebb4f8.jpg,test/p18/p18226754/s56423436/d1e68ec6-9fc5ce9f-3b030f43-ef6c608c-23ebb4f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with shortness of breath. // Assess for pulmonary edema, pna COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Moderate cardiomegaly. Mild basal apical blood flow redistribution, potentially suggesting mild pulmonary edema. No pleural effusions. No pneumonia. The hilar and mediastinal contours are normal on both the frontal and the lateral radiograph. " bffd9e14-2e41d745-f984ad66-738191f8-5e62a940.jpg,test/p15/p15993209/s58092238/bffd9e14-2e41d745-f984ad66-738191f8-5e62a940.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with pneumonia c/b lung abscess. // Assess interval change following antibiotic treatment. TECHNIQUE: Chest PA and lateral COMPARISON: Sequential chest radiographs obtained ___ to ___ ___ chest CTA FINDINGS: Interval resolution of a dense left lower lobe consolidation. Linear atelectasis is noted at the left lung base. A moderate left pleural effusion has decreased in size, now small. The right lung is fully expanded and clear. Heart size is top-normal. Median sternotomy wires are midline and intact. Mediastinal clips are noted. Cardiomediastinal and hilar silhouettes are otherwise unremarkable. IMPRESSION: Interval resolution of the dense left lower lobe consolidation. Small, but improved left pleural effusion. " e9845ad0-05a9a964-8c1da2ef-02680cf8-9e75b286.jpg,test/p10/p10521546/s52349785/e9845ad0-05a9a964-8c1da2ef-02680cf8-9e75b286.jpg,test," FINAL REPORT INDICATION: ___ year old man with POC for chemotherapy with slow blood return. // evaluate port placement TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Left-sided Port-A-Cath has a similar course with the tip in the low SVC. Bilateral coarse reticular markings with basilar predominance have not substantially changed. Moderate cardiomegaly. No pleural effusion or pneumothorax. IMPRESSION: Left-sided Port-A-Cath has a similar course with the tip in the low SVC. Generalized interstitial pulmonary abnormality unchanged since ___. Stable moderate cardiomegaly. " 481ff472-74a62628-877f8a17-a443a861-336d3bdb.jpg,test/p17/p17340385/s59602974/481ff472-74a62628-877f8a17-a443a861-336d3bdb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with CP // r/o occult infiltrate, CHF TECHNIQUE: PA and lateral chest radiographs. COMPARISON: None available FINDINGS: Lung volumes are within normal limits. The trachea is central. The cardiomediastinal contour is normal. There is moderate atherosclerotic calcification in the aortic arch. The hila appear mildly prominent but no pulmonary vascular congestion is appreciated. No consolidation, pneumothorax or pleural effusion seen. IMPRESSION: No acute cardiopulmonary process seen. " 6428ef34-467101fd-898033e8-6ada0584-4481639e.jpg,test/p13/p13224377/s50018247/6428ef34-467101fd-898033e8-6ada0584-4481639e.jpg,test," WET READ: ___ ___ ___ 7:04 PM Tracheostomy tube terminating approximately 3.1 cm above the carina. Interval removal of the OG tube. Right parenchymal opacities are similar, and remain concerning for an infectious process or aspiration. Left lung also appears similar. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with coughing // assess for change in ET tube- if sitting on carina assess for change in ET tube- if sitting on carina COMPARISON: Comparison to prior study dated ___ IMPRESSION: There are unchanged airspace opacities throughout the right lung and involving the left mid and lower lung with relative sparing of the left upper lobe. These findings could reflect an atypical appearance of pulmonary edema but are more concerning for pneumonia. Clinical correlation is advised. The right internal jugular dual-lumen catheter and tracheostomy tube are unchanged in position. There has been interval removal of a nasogastric tube. There are likely small layering effusions. No pneumothorax is appreciated. Overall cardiac and mediastinal contours are likely unchanged given differences in patient rotation between studies. " c1c7aab1-8e61c2bc-d36fe47c-ec83bb5c-39316879.jpg,test/p12/p12592398/s55578121/c1c7aab1-8e61c2bc-d36fe47c-ec83bb5c-39316879.jpg,test," FINAL REPORT HISTORY: Hypertension. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: The cardiac silhouette is mildly enlarged with mild tortuosity of the thoracic aorta. The hilar contours are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. The osseous structures are grossly unremarkable. IMPRESSION: No acute intrathoracic abnormality. " d61ad527-b3bf9ac8-bf00a857-2c5232c1-6248ab38.jpg,test/p11/p11540763/s58907226/d61ad527-b3bf9ac8-bf00a857-2c5232c1-6248ab38.jpg,test," FINAL REPORT HISTORY: Chest heaviness. TECHNIQUE: 2 views of the chest. COMPARISON: CT torso ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours and unchanged aortic tortuosity. IMPRESSION: No acute intrathoracic process. " afbc4d03-b35329e6-e5ba3655-a6d74c2f-8d5f14f6.jpg,test/p10/p10735843/s53963340/afbc4d03-b35329e6-e5ba3655-a6d74c2f-8d5f14f6.jpg,test," FINAL REPORT INDICATION: Evaluation for amiodarone toxicity in patient with long-term use. COMPARISON: Multiple chest radiographs, the most recent of ___. FINDINGS: PA and lateral views of the chest were reviewed. Compared to the prior study, the normal heart, lungs, mediastinum, and pleural surfaces are unchanged. IMPRESSION: No chest radiographic evidence of amiodarone lung toxicity. " 4364a6aa-ac02a152-a26ec8f9-8515b1d0-d4c0ecbd.jpg,test/p13/p13329429/s55040469/4364a6aa-ac02a152-a26ec8f9-8515b1d0-d4c0ecbd.jpg,test," WET READ: ___ ___ ___ 10:46 PM -Endotracheal tube low (2 cm from carina) - Recommend proximal repositioning -Stable wide mediastinum from known adenopathy -Known pulmonary masses in the RUL and RLL not well characterized -NG tube ok ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with history of lung adenocarcinoma presenting with CVA, now intubated. Evaluation for line placement. COMPARISON: CT from ___, and chest radiograph from ___. PORTABLE SEMI-ERECT AP CHEST RADIOGRAPH: The endotracheal tube terminates 2 cm above the level of the carina. Recommend proximal repositioning by at least 2 cm. A nasogastric tube courses below the diaphragm and is at least within the stomach, though the tip is incompletely imaged. Widening of the mediastinal contours corresponds with patient's known adenopathy. Known pulmonary masses within the right upper lobe and right lower lobe are not well characterized on this examination. There is no new consolidation or pneumothorax. There is no vascular congestion or pleural effusions. A moderate-sized hiatal hernia is stable. Compression deformity and vertebroplasty of the T11 vertebral body is stable. IMPRESSION: 1. Endotracheal tube 2 cm from the carina. Proximal repositioning by at least 2 cm is recommended. 2. Nasogastric tube at least within the stomach 3. Known mediastinal adenopathy and pulmonary masses appear stable. 4. Stable moderate hiatal hernia and compression deformity of T11. " 0fda0f09-cc758c02-6252d233-191684a7-102ed0a6.jpg,test/p19/p19017919/s52870097/0fda0f09-cc758c02-6252d233-191684a7-102ed0a6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man left sided ptx increased in size after CT removed // assess left ptx assess left ptx COMPARISON: ___ obtained at 07:16 IMPRESSION: Tracheostomy is in place. Is interval slight decrease in the left pneumothorax which is currently moderate. This up on the other hand interval increase in the left lung atelectasis surrounding the left hilus. Right basal consolidation has increased as well. " d4ce4336-489af4d1-792776c3-e3b56a6d-0cd45c67.jpg,test/p15/p15059404/s53152693/d4ce4336-489af4d1-792776c3-e3b56a6d-0cd45c67.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // eval for cardiopulmonary process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Right-sided pacemaker is seen with lead extending to the expected location of the right ventricle. The cardiac silhouette remains enlarged. The aorta is tortuous. The lungs are relatively hyperinflated. No focal consolidation is seen. There is no pleural effusion or pneumothorax. No pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " 482e79ef-a82c1a49-c033fcfb-5111777e-a1d59d81.jpg,test/p18/p18855147/s53815637/482e79ef-a82c1a49-c033fcfb-5111777e-a1d59d81.jpg,test," WET READ: ___ ___ 9:08 PM Congestive heart failure with mild cardiomegaly, venous congestion, interstitial and airspace opacities, probable small effusions. No frank consolidation, but consider repeat CXR after diuresis to evaluate for any underlying parenchymal/interstitial abnormalities. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Portable supine chest view was read in comparison with prior chest radiographs from ___. FINDINGS: Patient has received a new right dual-lumen dialysis catheter through the right internal jugular approach ending at mid SVC. Bilateral lung demonstrates increased interstitial marking and pulmonary vascular prominence likely from cardiac decompensation. Heart size is mildly enlarged, but unchanged to prior studies. Small pleural effusions seen on previous radiograph dated ___ have resolved. No pneumothorax. No discrete opacities concerning for pneumonia. Mediastinal silhouette is normal. IMPRESSION: Prominent interstitial marking, mildly enlarged heart size and prominent vascular markings likely from cardiac decompensation. " 88c11d58-7b60670f-2639bd70-30e28c19-0ab27cef.jpg,test/p15/p15625104/s52116057/88c11d58-7b60670f-2639bd70-30e28c19-0ab27cef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // check ETT placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 21:32 FINDINGS: ET tube tip is 3 cm above the carinal. NG tube tip is in the stomach. Rest of the findings are unchanged within the short interim. IMPRESSION: ET tube tip is 3 cm above the carinal. NG tube tip is in the stomach. Rest of the findings are unchanged within the short interim. " f3811084-91df356d-350f05a1-1b23d5d3-778d7fa3.jpg,test/p12/p12233133/s53538543/f3811084-91df356d-350f05a1-1b23d5d3-778d7fa3.jpg,test," FINAL REPORT HISTORY: DKA, question interval change. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___ at 20:04 p.m. and allowing for differences in technique, I doubt significant interval change. Again seen is an ET tube, tip approximately 5.3 cm above the carina, and an NG tube, tip overlying the gastric fundus. Also again seen is a fusion construct in the upper thoracic spine. No pneumothorax detected. The heart is not enlarged. There may be mild plethora of the upper zone vessels, suggesting mild fluid overload. No gross interstitial or alveolar edema is identified. No focal consolidation identified. No effusion. IMPRESSION: Probable mild vascular plethora, but overall similar to ___ at 20:04 p.m. " ac919961-c8fbf311-4bb5d0eb-37f49474-f6395e8a.jpg,test/p15/p15970954/s54302778/ac919961-c8fbf311-4bb5d0eb-37f49474-f6395e8a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pneumothorax, evaluation. COMPARISON: ___. Unchanged evidence of massive subcutaneous air. However, no right pneumothorax is visible. The right chest tube is in almost unchanged position. Unchanged appearance of the left lung and of the cardiac silhouette. " 486b8f05-451c7ce7-ef0e32f6-26a63f29-b98627c4.jpg,test/p13/p13439409/s53787065/486b8f05-451c7ce7-ef0e32f6-26a63f29-b98627c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with volume overload from heart failure exacerbation // ETT tube placement TECHNIQUE: Chest single view COMPARISON: ___ at 16:52 FINDINGS: Endotracheal tube tip is in the mid to distal stomach. Endotracheal tube tip 2 cm above carina. Cardiac pacemaker. Marked cardiac enlargement, similar. Increased pulmonary vascularity. Bilateral perihilar opacities are stable, likely edema. Increased left basilar consolidation, may represent atelectasis, consider pneumonitis in the appropriate clinical setting. Small left pleural effusion. Benign appearing pelvic calcification, likely uterine fibroid. No bowel dilatation. . IMPRESSION: Endotracheal tube tip 2 cm above carina. Increased left basilar consolidation, likely atelectasis; consider pneumonitis in the appropriate clinical setting. Increased heart size, pulmonary vascularity. " 04b8c30a-395fe64d-42958fb3-996057e6-0f11e4c9.jpg,test/p14/p14002189/s59156253/04b8c30a-395fe64d-42958fb3-996057e6-0f11e4c9.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of lung cancer, now presenting with cough and rhonchi. EXAMINATION: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: Sutures overlie the left lung apex in keeping with prior surgical resection. There is hyperinflation of the lungs with irregularity of the peripheral vasculature compatible with COPD. There are no focal opacities concerning for pneumonia. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is not increased. There has been interval callus formation involving a right mid thoracic rib fracture since ___. There are findings compatible with diffuse idiopathic skeletal hyperostosis. IMPRESSION: No acute cardiopulmonary process. " 96020af4-3e843d11-1e883c37-588af215-e45aeff2.jpg,test/p12/p12713218/s57584821/96020af4-3e843d11-1e883c37-588af215-e45aeff2.jpg,test," FINAL REPORT INDICATION: History of pneumonia, followup. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Slight elevation of the right hemidiaphragm persists. Lung volumes are low. No pleural effusion, pneumothorax or focal airspace consolidation. Heart remains mildly enlarged, unchanged from ___. Mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " ae8425af-2142c032-6dbcd944-a164cd69-082d917f.jpg,test/p13/p13174810/s58860806/ae8425af-2142c032-6dbcd944-a164cd69-082d917f.jpg,test," FINAL REPORT AP CHEST, 5:16 A.M., ___ HISTORY: ___-year-old man after motor vehicle collision with rib fracture, pneumothorax, and pneumonia. IMPRESSION: AP chest compared to ___, 5:19 p.m. As denoted by greater vascular congestion, mild pulmonary edema may account for the increase in the extent of heterogeneous consolidation in both the lower lungs, or this could be due to worsening pneumonia. Tip of the endotracheal tube is still above the upper margin of the clavicles, no less than 6 cm from the carina. It can be safely advanced 2 cm for more secured seating. Small left pneumothorax is of larger apical component today, probably increased somewhat overall since ___. I do not see appreciable right pneumothorax. Small right pleural effusion is presumed. The large hematoma in the lateral aspect of the right hemithorax is unchanged since at least ___. Cardiomediastinal silhouette is normal. Feeding tube is coiled in the stomach. Right central venous catheter ends in the mid SVC. Pleural tubes unchanged in positions crossing the right mid chest and in the left apex, respectively. " 392a1c5b-9e44f027-edb14fb9-8faa8e4e-5980af7e.jpg,test/p14/p14405475/s53093459/392a1c5b-9e44f027-edb14fb9-8faa8e4e-5980af7e.jpg,test," WET READ: ___ ___ ___ 6:03 AM No acute cardiopulmonary abnormalities. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with CAD, recent negative cath, w/ epig discfomfort and L chest pain // eval ? effusion TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest ___, a chest radiograph ___ FINDINGS: A left AICD is contiguous with the lead terminating in the region of the right ventricle. The cardiomediastinal and hilar contours are within normal limits. Lung volumes are low. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary abnormalities. " cb3a5f8a-50546bb1-52fcbfe0-95d49a8a-8f99229c.jpg,test/p13/p13265883/s52668542/cb3a5f8a-50546bb1-52fcbfe0-95d49a8a-8f99229c.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dizziness and recent stroke. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 128dfbee-22579f5e-28f5c0ff-08c57643-856c5610.jpg,test/p18/p18450763/s52319370/128dfbee-22579f5e-28f5c0ff-08c57643-856c5610.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with lung cancer and hypoxia. COMPARISON: Neck CT from ___ and chest x-ray from ___. FINDINGS: Frontal and lateral views of the chest. There are persistent opacities in the left perihilar region seen on prior, some of which may be accounted for by prior radiation changes. There is however a region which appears more dense than on prior which raises possibility of superimposed mass growth or infection. There is a new moderate left-sided pleural effusion. Right upper lung parenchymal opacity has increased. Increased interstitial markings also seen throughout the right lung which have slightly progressed since prior, potentially interstial edema although infection or tumor are possible. Given the significant change since prior, CT scan could be considered to further characterize these findings. " aab25da7-7907d0a3-33d0c9d7-2297b898-3cef27f6.jpg,test/p15/p15823892/s51913494/aab25da7-7907d0a3-33d0c9d7-2297b898-3cef27f6.jpg,test," FINAL REPORT HISTORY: Cough and fever. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lungs are clear. Cardiac silhouette is normal in size. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " a51ab127-5cd7975b-200e06d6-f9173408-b8645531.jpg,test/p18/p18194653/s50588948/a51ab127-5cd7975b-200e06d6-f9173408-b8645531.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Indwelling support and monitoring devices are unchanged in position. Marked interval improved aeration in the right lower lobe compared to the prior study, but continued diffuse airspace opacification throughout the majority of the left lung with relative sparing of the left lung base. These findings may be due to asymmetrical pulmonary edema with or without co-existing infection. Cardiomediastinal contours are stable in appearance with persistent right-sided cardiac enlargement. " 121da9e6-50fb2afe-c8c1886c-e151708f-e167a824.jpg,test/p10/p10024982/s54589172/121da9e6-50fb2afe-c8c1886c-e151708f-e167a824.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with exertional chest pain and shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___ and chest radiograph ___ FINDINGS: Patient is status post median sternotomy and CABG. A left-sided dual-lumen pacemaker device is noted with leads terminating in the right atrium and right ventricle. Heart size remains moderately enlarged but unchanged. Mediastinal and hilar contours are similar. There is mild pulmonary vascular congestion without overt pulmonary edema. Small right pleural effusion appears new in the interval. Streaky bibasilar airspace opacities may reflect atelectasis though infection cannot be completely excluded. No pneumothorax is detected. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: Small right pleural effusion with patchy bibasilar airspace opacities, possibly atelectasis though infection is not excluded. Mild pulmonary vascular congestion. " 27d9d709-2a888df5-0f1920d1-ab00bced-123c527c.jpg,test/p11/p11040347/s50361224/27d9d709-2a888df5-0f1920d1-ab00bced-123c527c.jpg,test," FINAL REPORT INDICATION: ___ year old woman with right arm paresthesias and axillary pain // rule out mass TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are well expanded and clear. Hila and cardiomediastinal contours and pleural surfaces are normal. IMPRESSION: Normal. No evidence of mass. " 480b4b7a-bc08bcb2-b2fc6f8b-ed860d80-2e279eab.jpg,test/p11/p11541295/s59015343/480b4b7a-bc08bcb2-b2fc6f8b-ed860d80-2e279eab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman presenting with a weeks of cough, general malaise, bilateral rib pain. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded and clear. No focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette, hila, and pleura are normal. No sub-diaphragmatic intra-abdominal free air. No evidence of hiatal hernia. Overall, no significant change from the prior exam. IMPRESSION: No acute cardiopulmonary process, including no pneumonia. " 8a1ef7da-4a735bab-30274b24-886d9e85-04473c1d.jpg,test/p15/p15433155/s50660722/8a1ef7da-4a735bab-30274b24-886d9e85-04473c1d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cardiogenic shock, now improving, nasogastric tube removed. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pleural effusion on the right might have minimally increased. Otherwise, there is no relevant change. The nasogastric tube has been replaced. The current tube projects over the prepyloric region with its tip. No other changes. Sternal wires and pacemaker leads are constant. " 19127cf6-7165c966-19f1a34b-a8197509-1c21c405.jpg,test/p16/p16312465/s55011763/19127cf6-7165c966-19f1a34b-a8197509-1c21c405.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with elevated PA pressures and SOB, suspicion for chronic PEs // Pre-VQ scan CXR; please perform before V/Q scan (planned for 12pm ___) Pre-VQ scan CXR; please perform before V/Q scan (planned for TECHNIQUE: Frontal chest radiograph COMPARISON: ___ FINDINGS: Cardiomediastinal is unremarkable considering change in patient position. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: Normal radiographic examination. This examination neither suggests nor excludes pulmonary embolism. " 61269d4b-82619690-8e7e4da8-daf1ca0f-c23727fe.jpg,test/p12/p12043836/s51009682/61269d4b-82619690-8e7e4da8-daf1ca0f-c23727fe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest tubes for prior hemothorax; now s/p central line placement attempt. // s/p central line placement attempt; r/o PTX TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 11:51 IMPRESSION: Questionable small left apical pneumothorax versus skin fold is demonstrated. Note is made that the central venous line insertion attempt was on the right. Small amount of left pleural effusion is unchanged as well as the appearance of the right hemi thorax. NOTIFICATION: Findings where discussed with Dr.___ " 5c712d74-f7696391-a2125f65-b9e69e58-c7edbdbb.jpg,test/p13/p13889150/s56493913/5c712d74-f7696391-a2125f65-b9e69e58-c7edbdbb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with increased oxygen requirement after MRI // Cardiopulmonary process? Concern for pulmonary edema Cardiopulmonary process? Concern for pulmonary edema COMPARISON: Prior chest radiographs ___ and ___. IMPRESSION: Moderate pulmonary edema has improved slightly in the left lung. Heart size is normal and has never enlarged. Pleural effusions are minimal if any. Right PIC line still crosses to the left into the left internal jugular vein, no less than 7 cm beyond the origin of the SVC. . " ee258f51-0fdead6f-f8beeed2-d706a6b7-cd866b8c.jpg,test/p10/p10466300/s58482439/ee258f51-0fdead6f-f8beeed2-d706a6b7-cd866b8c.jpg,test," WET READ: ___ ___ 5:05 PM Low lung volumes. No pneumothorax. Bibasilar atelectasis. Mild vascular congestion without edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p C3-C6 post lami/fusion on ___. // desaturation on RA. ?PNA. desaturation on RA. ?PNA. COMPARISON: Prior chest radiographs ___ IMPRESSION: Previous pulmonary edema has cleared, but lung volumes remain quite low with substantial left basal atelectasis. No pneumothorax. Small left pleural effusion unchanged. Normal cardiomediastinal silhouette. " c79f4b56-d7385b99-717bab02-a25f25d1-46cb7a2a.jpg,test/p19/p19746124/s54719741/c79f4b56-d7385b99-717bab02-a25f25d1-46cb7a2a.jpg,test," FINAL REPORT INDICATION: ___-year-old woman status post motor vehicle collision with bilateral pneumothorax, now status post left chest tube removal. COMPARISON: ___ at 5 a.m. PORTABLE AP CHEST RADIOGRAPH: In the interim since most recent prior examination, there has been removal of the left-sided chest tube. No pneumothoraces are visualized on today's study. Displaced left-sided rib fractures are noted. There is a resolving right apical contusion. " 7005622f-5229a9b2-75c06871-2d3b7c97-22911208.jpg,test/p16/p16132012/s56287543/7005622f-5229a9b2-75c06871-2d3b7c97-22911208.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with history of MDS, COPD, DVT with IVC filter on rivaroxaban, chronic pain, s/p R BKA, s/p colectomy, admitted with abdominal pain, tachypnea, bilious output via NGT, found to have multifocal pneumonia, UTI, SBO, now intubated, in septic shock. // evaluate interval change evaluate interval change IMPRESSION: Compared to chest radiographs ___. Previous pulmonary vascular congestion and edema in the right lung has cleared although heart size is slightly larger. Aeration in the left lung has decreased, following tracheal extubation, due in part to increasing moderate left pleural effusion. Diffuse atelectasis may be present as well. Right jugular line ends in the mid SVC. No pneumothorax. " 21ac3bc4-89ef3121-471fa3ee-b5c1d68a-26082a85.jpg,test/p14/p14955846/s58506267/21ac3bc4-89ef3121-471fa3ee-b5c1d68a-26082a85.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with bradycardia to ___; substernal chest pain at 130 TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: ___ FINDINGS: Lung volumes remain low. Heart size is accentuated as a result, and appears borderline enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Patchy atelectasis is noted at the lung bases without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " 2b5f422b-1e15af01-bbe3d2ba-fb2947f3-7931d4c4.jpg,test/p17/p17268630/s59871718/2b5f422b-1e15af01-bbe3d2ba-fb2947f3-7931d4c4.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest burning and strep throat // Eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable.. IMPRESSION: No acute cardiopulmonary process. " ad18cca1-f0919700-af1ffed2-4bcd9095-6a6eb7a9.jpg,test/p14/p14117743/s58872249/ad18cca1-f0919700-af1ffed2-4bcd9095-6a6eb7a9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC. // PICC placement IMPRESSION: Left PICC continues to terminate in the proximal right atrium. Cardiomediastinal contours are stable. Improving bibasilar opacities likely due to improving atelectasis with accompanying small bilateral pleural effusions " 02be7a13-29a7cdf6-e6665d89-aef5fc86-f3dca114.jpg,test/p16/p16070747/s59015663/02be7a13-29a7cdf6-e6665d89-aef5fc86-f3dca114.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough // cough TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded and clear. No focal consolidations. No pulmonary edema. Borderline cardiomegaly. No pleural effusion. No pneumothorax. IMPRESSION: No evidence of pneumonia. " 9cb57601-12e76d0a-8ec5b31c-80d1fb98-ba986bc7.jpg,test/p11/p11467004/s52221041/9cb57601-12e76d0a-8ec5b31c-80d1fb98-ba986bc7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Fatigue, weakness and dyspnea on exertion, history of chest pain. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears normal. The imaged osseous structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " cf75ec11-564ed32f-cad8a432-2bfbab35-fd813e4f.jpg,test/p16/p16151261/s53618150/cf75ec11-564ed32f-cad8a432-2bfbab35-fd813e4f.jpg,test," FINAL REPORT INDICATION: ___ year old man with C5 fracture s/p C3-C7 lami and fusion // assess for interval change; *please preform on ___ at ___ radiology rounds* please remove cooling blanket prior to XRAY**** COMPARISON: ___ FINDINGS: Tracheostomy and left PICC are in standard position. There is persistent left lower lobe collapse. There is likely associated small left effusion. No interstitial edema. No new consolidation. No pneumothorax. IMPRESSION: Persistent left lower lobe collapse, has not significantly changed. " f9c3b4ec-19dceac6-58a339f7-22e26b69-6cb25092.jpg,test/p16/p16839777/s59433948/f9c3b4ec-19dceac6-58a339f7-22e26b69-6cb25092.jpg,test," FINAL REPORT HISTORY: Altered mental status, assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. New opacities in the right midlung opacity projecting in the superior segment of the right lower lobe or posterior segment of the right upper lobe are concerning for pneumonia. There is no pleural effusion or pneumothorax. The heart is stably enlarged with post CABG changes. IMPRESSION: Pneumonia involving the posterior segment of the right upper lobe or superior segment of the right lower lobe. " f5bb64fe-8cdff12e-90cad3f2-2df9e383-32a277b2.jpg,test/p14/p14857506/s57561370/f5bb64fe-8cdff12e-90cad3f2-2df9e383-32a277b2.jpg,test," FINAL REPORT HISTORY: Low platelet count with shortness of breath and brown sputum, to assess for pneumonia. FINDINGS: In comparison with the outside study of ___, there are substantially lower lung volumes, which may account for some of the increased prominence of the transverse diameter of the heart. There is some fullness of pulmonary vessels, though again this could reflect low lung volumes or some mild element of elevated pulmonary venous pressure. Minimal atelectatic changes at the bases without evidence of acute focal pneumonia. " 2fa8f7ad-cdef9953-576ad8ae-be2e1c0f-488f96b7.jpg,test/p10/p10577339/s56389418/2fa8f7ad-cdef9953-576ad8ae-be2e1c0f-488f96b7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multiple myeloma, low grade fevers, cough // eval for pna TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: There is pulmonary vascular congestion with mild pulmonary edema. Left retrocardiac opacity is consistent with atelectasis. No focal consolidation, pleural effusion or pneumothorax. Mediastinal and hilar contours are stable. Severe cardiomegaly is unchanged. IMPRESSION: 1. No evidence of pneumonia. 2. Mild pulmonary edema. Stable substantial cardiomegaly. 3. Left retrocardiac opacity is consistent with atelectasis. " 9df6e224-6b33f925-5f28f103-1c16acf4-8d0491f0.jpg,test/p12/p12794940/s58755627/9df6e224-6b33f925-5f28f103-1c16acf4-8d0491f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with rigors // ?PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 1b3a2159-d15ca812-3da9cb8f-9b49eeef-07e6e4b2.jpg,test/p13/p13505226/s56658684/1b3a2159-d15ca812-3da9cb8f-9b49eeef-07e6e4b2.jpg,test," FINAL REPORT INDICATION: ___ year old man with complex hx related to acute pancreatitis now with fever and cough. TECHNIQUE: Portable supine semi-upright chest COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are slightly low. Linear opacity at the left base is unchanged since ___ and may reflect scarring. There is no evidence of pneumonia. The cardiomediastinal silhouette and hilar contours are normal. There is no pleural effusion or pneumothorax. There are surgical drains in the right upper quadrant. IMPRESSION: Low lung volumes. No evidence of pneumonia. " 98dc606e-ad0b3f61-51a7fe30-614109fb-cfc87ab9.jpg,test/p18/p18290366/s55706124/98dc606e-ad0b3f61-51a7fe30-614109fb-cfc87ab9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough x one month. Prior history of sarcoidosis. // Any intra-thoracic pathology to explain cough? Any intra-thoracic pathology to explain cough? IMPRESSION: Comparison to ___. No relevant change. Lung volumes are normal. Normal size of the cardiac silhouette. Mild scoliosis. No pneumonia, no pulmonary edema, no pleural effusions. " 23710c30-5b3e0988-8ac78689-71bee0ea-80af6a00.jpg,test/p19/p19996786/s53567676/23710c30-5b3e0988-8ac78689-71bee0ea-80af6a00.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Chest tightness, cough, status post smoke ingestion. FINDINGS: PA and lateral views of the chest provided demonstrate clear lungs without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 72be5f98-739d323d-e23b4cee-a490f049-a63307fe.jpg,test/p13/p13620449/s53948351/72be5f98-739d323d-e23b4cee-a490f049-a63307fe.jpg,test," WET READ: ___ ___ ___ 8:18 AM No opacity concerning for pneumonia. ___ ___ 22:36. WET READ VERSION #1 ___ ___ ___ 10:39 PM No opacity concerning for pneumonia. ___ ___ 22:36. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man pw from OSH with VT, ?PNA at OSH // ?PNA, acute processes ?PNA, acute processes IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with tortuosity of the aorta in a patient with a single -lead pacer device extending to the apex of the right ventricle. No evidence of appreciable vascular congestion or acute focal pneumonia or pleural effusion. " 10c1b420-0415d0e9-88c562e1-b78b9f23-180227ac.jpg,test/p17/p17157087/s52012043/10c1b420-0415d0e9-88c562e1-b78b9f23-180227ac.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___F w/chest heaviness // ___F w/chest heaviness TECHNIQUE: Chest PA and lateral COMPARISON: None available. Please note that comparison to old studies can be helpful to detect subtle interval change. FINDINGS: The lungs are well expanded and clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 3f043d05-6a5ea815-c037cb85-d5a8b78d-a69e161b.jpg,test/p17/p17175688/s56369015/3f043d05-6a5ea815-c037cb85-d5a8b78d-a69e161b.jpg,test," FINAL REPORT INDICATION: Asthma and heart failure with wheezing and fever. Evaluate for pneumonia or heart failure. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: The heart is mildly enlarged but unchanged. There is no evidence for pulmonary edema. There is no pleural effusion, pneumothorax or focal airspace consolidation. Enlargement of the pulmonary arteries is unchanged. Bilateral nipple shadows are noted and should not be mistaken for intraparenchymal masses. A circular metallic object is seen projecting anterior to the spine beneath the diaphragm but is unchanged. " 72c5ec38-9b2b2964-63723752-f320ed2d-d2e18a1f.jpg,test/p10/p10921049/s50998690/72c5ec38-9b2b2964-63723752-f320ed2d-d2e18a1f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cardiac arrest, respiratory failure. // ?interval change ?interval change IMPRESSION: Compared to chest radiographs ___ through ___. Moderate pulmonary edema and moderate right pleural effusion have worsened. Mediastinal widening is due to vascular engorgement, indicating biventricular decompensation. No pneumothorax. Left jugular line ends in the upper SVC, ET tube in standard placement, nasogastric drainage tube passes into the stomach and out view. Note is made of extensive central lymph node calcification suggesting sarcoidosis, and prior documentation of moderate pericardial effusion on a chest CT ___. " b6484394-34c355ef-986a8ba2-c8295800-cd80ed98.jpg,test/p11/p11607177/s56776323/b6484394-34c355ef-986a8ba2-c8295800-cd80ed98.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p Heartmate II LVAD // eval for hemothorax TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Severe cardiomegaly is unchanged. Left ventricular assisting device is partially imaged. Overall no substantial change in tubes and lines demonstrated. No interval increase in pulmonary edema is noted. " 2f0bc080-2dcbf717-3bd61948-ffe122c4-ab55cb73.jpg,test/p19/p19998350/s56616440/2f0bc080-2dcbf717-3bd61948-ffe122c4-ab55cb73.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dizziness and shortness of breath, no fevers TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes remain low. This accentuates the size of the cardiac silhouette which is mildly enlarged, unchanged. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Minimal atelectasis is noted in the lung bases. No focal consolidation, pleural effusion or pneumothorax is present. Mild to moderate multilevel degenerative changes are seen in the thoracic spine. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " 40618968-ddd70f81-72907ebf-482ff9f3-c45eed96.jpg,test/p14/p14260070/s59207730/40618968-ddd70f81-72907ebf-482ff9f3-c45eed96.jpg,test," FINAL REPORT HISTORY: ___-year-old male with peroneal nerve palsy and recent weight loss. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: Normal chest x-ray. " d14060f8-c6573d2b-e4d9b96f-e6e94296-15f83d87.jpg,test/p12/p12043836/s59063662/d14060f8-c6573d2b-e4d9b96f-e6e94296-15f83d87.jpg,test," FINAL REPORT INDICATION: Evaluate right-sided chest tube TECHNIQUE: Frontal chest radiograph. COMPARISON: ___ FINDINGS: There is a small right-sided pneumothorax. A chest tube is noted at the right lung base. There is a small right-sided pleural effusion with associated parenchymal opacity which could reflect atelectasis. The heart is enlarged. The visualized left hemithorax is clear. " ecb1f2b0-c090bf3f-4b90aa7b-2f4abb4e-34ff389c.jpg,test/p13/p13103745/s51876065/ecb1f2b0-c090bf3f-4b90aa7b-2f4abb4e-34ff389c.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old man status post right thoracentesis. Evaluate for pneumothorax. COMPARISON: Chest radiograph ___ through ___. FINDINGS: A frontal upright portable view of the chest was obtained. Increased opacity at the right lung base is pleural effusion and adjacent atelectasis, worse or in a different distribution compared to ___ but improved from ___. The right upper lung zone and left lung are clear. There is no pneumothorax. Cardiac and mediastinal silhouettes are stable allowing for patient rotation. IMPRESSION: 1. No pneumothorax. 2. Right effusion and atelectasis are increased from ___, but improved from ___ after thoracentesis. Findings were discussed with Dr. ___ by phone at 4:20 p.m. on ___. " b06743b3-a48a159f-65f79471-cb067d6b-e7dd12ca.jpg,test/p13/p13493660/s50350430/b06743b3-a48a159f-65f79471-cb067d6b-e7dd12ca.jpg,test," FINAL REPORT INDICATION: The patient with vomiting blood and coughing for two weeks. Assess for pneumonia. COMPARISONS: None available. FINDINGS: PA and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " 8ca45b1d-11e7b3c4-81d757ce-5fa29549-4efce674.jpg,test/p16/p16508811/s53943140/8ca45b1d-11e7b3c4-81d757ce-5fa29549-4efce674.jpg,test," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of dyspnea. COMPARISONS: ___. FINDINGS: There is moderate to severe pulmonary edema. There is a small left pleural effusion with overlying atelectasis. Small right pleural effusion may also be present. Subtle patchy right upper lobe opacity, underlying the EKG lead, may be due to developing consolidation or confluence of vessels. Repeat with removal/repositioning of the EKG lead may be helpful for further evaluation. The cardiac silhouette is enlarged. No pneumothorax. " edb1f352-a7ec0fcc-70d7dd0a-732d75ed-4e8895ec.jpg,test/p18/p18193242/s55799499/edb1f352-a7ec0fcc-70d7dd0a-732d75ed-4e8895ec.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain, evaluate for pneumothorax. COMPARISON: None. FINDINGS: PA and lateral views of the chest demonstrate well-expanded clear lungs. The heart is normal in size and cardiomediastinal contour is unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic process. " 37361c9d-57b0c067-f1a9f521-207e0d06-47c92668.jpg,test/p19/p19438264/s55000691/37361c9d-57b0c067-f1a9f521-207e0d06-47c92668.jpg,test," FINAL REPORT INDICATION: ___M with recent treatment for prostatitis and AMS, testicular TTP // eval for ICH, pneumonia, subcutaneous gas, periprostatic abscess TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Relatively low lung volumes are again noted with secondary crowding of the bronchovascular markings. Right PICC is seen with tip projecting over the lower SVC, better seen on the lateral projection. There is no definite consolidation or effusion there is apparent enlargement of the cardiac silhouette which is likely accentuated by low lung volumes and AP technique, unchanged. IMPRESSION: No definite acute cardiopulmonary process. " de666a4c-bf604609-84334915-c2b45700-234999dc.jpg,test/p15/p15858244/s59872190/de666a4c-bf604609-84334915-c2b45700-234999dc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with asthma exacerbation TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest CT ___ FINDINGS: Heart size is borderline enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Linear opacities within the right middle lobe and lingula likely reflect areas of scarring. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " ce6b5c92-68d3ef14-ccdbd4f4-ac2a7525-99c986a7.jpg,test/p16/p16461545/s58413508/ce6b5c92-68d3ef14-ccdbd4f4-ac2a7525-99c986a7.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // eval for pneumothorax TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There relatively low lung volumes, which accentuate the bronchovascular markings. Given this, somewhat linear right base opacity is felt to more likely represent atelectasis rather than consolidation. No pleural effusion or pneumothorax is seen. Mediastinal contours are unremarkable. Cardiac silhouette size is top-normal, likely accentuated by low lung volumes. IMPRESSION: Relatively low lung volumes which accentuate the bronchovascular markings. Given this, somewhat linear right base opacity is felt to more likely represent atelectasis rather than consolidation. " 25d50e72-2d791640-170bf024-33a7b19a-277113e9.jpg,test/p14/p14480043/s52175253/25d50e72-2d791640-170bf024-33a7b19a-277113e9.jpg,test," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH DATED ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are within normal limits allowing for apical lordotic projection and relatively low lung volumes. Bilateral lower lobe opacities are present, with some interval improvement on the right, but slight worsening in the left retrocardiac region. On the lateral view, these project posteriorly over the spine and are associated with air bronchograms. There are no pleural effusions. Skeletal structures are unremarkable. IMPRESSION: Bibasilar confluent opacities, slightly improved on the right and slightly worse on the left. Considering recent history of altered mental status, aspiration pneumonia should be considered in the appropriate clinical setting. " da777874-0ec4fe1c-3b89a874-4c9b46b3-7d0cb85e.jpg,test/p16/p16403658/s59282042/da777874-0ec4fe1c-3b89a874-4c9b46b3-7d0cb85e.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p mie // check interval change TECHNIQUE: PA and lateral views of the chest. COMPARISON: Multiple chest radiographs, the most recent prior from ___. FINDINGS: A left Port-A-Cath terminates in the mid SVC. Right chest tube is in unchanged position. An NG tube is also in unchanged position, terminating near the diaphragm. The cardiomediastinal and hilar contours are stable. The neoesophagus is not particularly distended. A new right apical pneumothorax is small. There is no large pleural effusion. There is no significant change in the lungs, with no new focal consolidations concerning for pneumonia. Surgical clips overlie the right axilla. IMPRESSION: 1. New small right apical pneumothorax with right chest tube in stable position. 2. No other significant interval change with stable positioning of support devices and no pneumonia or pulmonary edema. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:55 pm. " e55bdada-f06e7910-83afcb26-fe61714e-81be5b07.jpg,test/p15/p15753793/s59727542/e55bdada-f06e7910-83afcb26-fe61714e-81be5b07.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sepsis, UTI, volume overload // evaluate interval change COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous image. Moderate cardiomegaly. Bilateral pleural effusions, right more than left, with right basal and retrocardiac atelectasis. The monitoring and support devices are constant. " ddbe7f76-3d526f6b-30148894-e299e07a-7c29987b.jpg,test/p19/p19181281/s53305532/ddbe7f76-3d526f6b-30148894-e299e07a-7c29987b.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient status post left flank stab wounds and left pneumothorax. Perform images in standing to assess for interval change. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding portable chest examination obtained 10 hours earlier during the same day. Heart size is unchanged and remains normal. Thoracic aorta unremarkable. No mediastinal abnormalities are present. Several linear densities on the left base and mild blunting of the pleural lateral sinus is present as before and coincides with the previously described local chest wall emphysema related to stab wounds and surgical repair. The amount of chest wall emphysema present reaches up to the axillary area and appears to be stable in comparison with the next previous portable chest examination. As before, some local strands of chest wall emphysema are overlying the apical area, but there is no conclusive evidence for any apical pneumothorax. Thus, both lungs remain well aerated. IMPRESSION: Local stab wounds with small atelectasis on left base but no evidence of massive infiltrates, large pleural effusion or apical pneumothorax. " a5436df8-eaade3af-8d7606d3-6fe7fb2a-a22039c0.jpg,test/p11/p11316471/s53099444/a5436df8-eaade3af-8d7606d3-6fe7fb2a-a22039c0.jpg,test," FINAL REPORT INDICATION: ___F with globus sensation and epigastric, substernal pain x 1 day // Evaluate for foreign body, mediastinal air, evidence of aspiration TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no effusion, pneumothorax, or consolidation. The cardiomediastinal silhouette is within normal limits, no pneumomediastinum. Nipple rings identified bilaterally. No other radiopaque foreign bodies. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 35c1e1b9-4d1db41f-e761e520-bff59ec9-2f99ec15.jpg,test/p18/p18068560/s50868130/35c1e1b9-4d1db41f-e761e520-bff59ec9-2f99ec15.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LAD and LLL collapse now s/p LLL endobronchial stent placement // ptx, stent placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is on going mild elevation of the right hemidiaphragm. In the interval, a right basal atelectasis has developed. The left lung is minimally better ventilated in the retrocardiac lung regions and no effusions are seen on the left than on the right. There is a left lower lobe endobronchial stent placement. The stent is not visualized. There is no evidence for the presence of a pneumothorax. " 9d2b3227-34b8520c-f360bd19-f800ebbb-2eded974.jpg,test/p14/p14744387/s54641151/9d2b3227-34b8520c-f360bd19-f800ebbb-2eded974.jpg,test," FINAL REPORT INDICATION: Known hepatitis C cirrhosis, now with hypoxia. Interval evaluation. TECHNIQUE: Single frontal radiograph of the chest. COMPARISON: Multiple prior examinations, most recent dated ___. FINDINGS: There is progressive opacification in the left hemithorax with decreased aeration, concerning for worsening consolidation. As compared to the prior examination, a left-sided pleural effusion has increased. Lung volumes remain low with pulmonary vascular engorgement consistent with volume overload. No pneumothorax is seen. An esophageal catheter is unchanged coiled within the stomach. " 7b04d08b-eefc88ff-37f3178e-a4f57fca-b0c6a6cc.jpg,test/p12/p12096886/s57997092/7b04d08b-eefc88ff-37f3178e-a4f57fca-b0c6a6cc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with AAA w/ T2 endoleak s/p repair. Inc WBC concern for PNA // ?PNA ?PNA IMPRESSION: In comparison with study of ___, there is been placement of a right subclavian catheter that extends to the lower SVC close to the cavoatrial junction. Pacer device remains unchanged. Continued low lung volumes without definite vascular congestion or acute focal pneumonia. Blunting of the costophrenic angles is again seen. " 568ca4d7-4f00c3b5-5b1a8060-eae9400b-5106649a.jpg,test/p10/p10823359/s50164632/568ca4d7-4f00c3b5-5b1a8060-eae9400b-5106649a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with stroke, please assess for NGT displacement // please assess for NGT displacement please assess for NGT displacement IMPRESSION: In comparison with study of ___, the cardiac silhouette is more prominent and there is indistinctness of mildly engorged pulmonary vessels consistent with elevated pulmonary venous pressure. The left hemidiaphragm is not seen, consistent with substantial volume loss in the left lower lobe and small pleurally fusion. Nasogastric tube extends to the mid to lower body of the stomach. " c462d814-c520caef-649ccd0c-e754aafa-4e59889d.jpg,test/p18/p18767957/s50227249/c462d814-c520caef-649ccd0c-e754aafa-4e59889d.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: New onset weakness, fatigue. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Mediastinal contours are stable. The hila are less prominent likely due to decrease in previous mild fluid overload. The heart is top normal to mildly enlarged. IMPRESSION: No acute cardiopulmonary process. " 23351b1c-60bd9244-6c20fc3c-bf794861-97e2b0ad.jpg,test/p18/p18427812/s53566676/23351b1c-60bd9244-6c20fc3c-bf794861-97e2b0ad.jpg,test," FINAL REPORT HISTORY: Cough, bilateral leg weakness. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is mildly enlarged. The aorta is mildly tortuous and demonstrates diffuse mild atherosclerotic calcifications. Pulmonary vascularity is normal and the lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " a06820cf-de5b7182-bdca6623-5e628848-ebd42be7.jpg,test/p17/p17506723/s54408452/a06820cf-de5b7182-bdca6623-5e628848-ebd42be7.jpg,test," WET READ: ___ ___ ___ 9:29 PM The endotracheal tube is borderline high, approximately 7 cm from the carina. A left PICC is unchanged with the tip in the mid SVC. There is improved aeration of the right base, suggesting a decrease in the size of the right pleural effusion and/or an improvement in atelectasis or pneumonia. The left lung is clear. There is no left pleural effusion. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with frank blood in ETT, ?decreased breath sounds on L // Effusion? Effusion? COMPARISON: Prior chest radiographs since ___, most recently ___. IMPRESSION: Uniform opacification in the right lower chest has improved since ___. Whether this is pleural effusion alone or pleural effusion in combination with right lower lobe atelectasis or even consolidation would require at least a lateral view if not chest CT scanning to determine. There is no pneumothorax combine no left pleural effusion. Left lung is clear. Heart size is normal. ET tube is in standard placement. Left subclavian line ends in the mid SVC. " ca581755-cf89f6c9-b18a51a7-e92bfd16-b9eb1950.jpg,test/p17/p17454111/s52807447/ca581755-cf89f6c9-b18a51a7-e92bfd16-b9eb1950.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with weakness TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is top normal. The aorta remains tortuous. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy opacities in the lung bases may reflect atelectasis though infection or aspiration is not excluded in the correct clinical setting. No pleural effusion or pneumothorax is seen. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: Patchy opacities in the lung bases may reflect atelectasis but infection or aspiration is not excluded in the correct clinical setting. " e480d220-0a7b8ba1-54dffd2f-f48b106f-c9597cb9.jpg,test/p15/p15731226/s55668670/e480d220-0a7b8ba1-54dffd2f-f48b106f-c9597cb9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chronic pancreatitis, unable to tolerate po, please confirm that dobhoff is in the stomach; will need to go to IR for advancement // Dobhoff placement IMPRESSION: In comparison to ___ radiograph, a Dobhoff tube is been placed, terminating in the stomach. No other relevant change. " eaf8819c-a41ecb05-02e52e25-2b0e3294-cb4b7603.jpg,test/p17/p17529544/s57157084/eaf8819c-a41ecb05-02e52e25-2b0e3294-cb4b7603.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Sternal chest pain after motor vehicle collision TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acutely displaced fractures are visualized. IMPRESSION: No acute cardiopulmonary abnormality. No acutely displaced fractures identified. " 318d040c-3850068b-f229c222-834ed500-8ba7a6ab.jpg,test/p10/p10380616/s50965395/318d040c-3850068b-f229c222-834ed500-8ba7a6ab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ?pna, cough // interval change interval change IMPRESSION: In comparison with the study of ___, there again are low lung volumes. Atelectatic changes are again seen in the right mid and lower lung zones, as well as in the retrocardiac region at the left base. Continued elevation of the right hemidiaphragmatic contour and the cardiomediastinal silhouette is unchanged. In the appropriate clinical setting, superimposed pneumonia would be difficult to exclude, especially in the absence of a lateral view. " ca9b94ab-64133735-e056684f-442783aa-3ae856a0.jpg,test/p19/p19673689/s58025636/ca9b94ab-64133735-e056684f-442783aa-3ae856a0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with prolonged cough // r/o pulmonary abnormality r/o pulmonary abnormality IMPRESSION: In comparison with the study of ___, there again are relatively low lung volumes. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " 8631a9ad-969e69a2-c923f834-12324803-68a1f4d5.jpg,test/p18/p18497352/s50690516/8631a9ad-969e69a2-c923f834-12324803-68a1f4d5.jpg,test," FINAL REPORT INDICATION: History: ___M with chest pain s/p ICD firing // eval ICD placement, acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: Again seen is a posterior pleural based mass on the right which is previous the characterized as rounded atelectasis. No new focal consolidation is identified. The cardiac silhouette is unchanged. Left chest single lead AICD is in unchanged position. There are likely small pleural effusions. No pneumothorax is seen. IMPRESSION: Unchanged posterior pleural-based mass on the right which was previously characterized cyst rounded atelectasis. No acute findings. " af57cef2-27845ea3-7799e560-964eb900-c73dc39d.jpg,test/p17/p17033046/s51599785/af57cef2-27845ea3-7799e560-964eb900-c73dc39d.jpg,test," FINAL REPORT HISTORY: Tracheostomy. FINDINGS: In comparison with study of ___, the endotracheal tube has been removed and there is now a tracheostomy tube in place. No evidence of pneumothorax or pneumomediastinum. Nasogastric tube has been removed. Little change in the appearance of the heart and lungs. " 694357ef-bcdad037-3fd6583b-5e7c69db-a8308278.jpg,test/p17/p17967970/s56806618/694357ef-bcdad037-3fd6583b-5e7c69db-a8308278.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung cancer s/p resection with ?pneumoperitoneum vs. atelectasis on Xray // eval for interval change eval for interval change IMPRESSION: Comparison to ___. No change in appearance of the lung bases on the right, showing postoperative changes combines to a pneumoperitoneum, likely related to the placement of a feeding device in the stomach. Stable position of the tracheostomy tube and the right PICC line. Stable appearance of the left lung and the cardiac silhouette. " add2c0e8-c9fd7b1e-31fd907a-e70729e7-a7c612b9.jpg,test/p15/p15596774/s59894602/add2c0e8-c9fd7b1e-31fd907a-e70729e7-a7c612b9.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough, fevers, dyspnea, coarse breath sounds and chest pain, question pneumonia. COMPARISONS: PA and lateral chest radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. There are no acute skeletal abnormalities. IMPRESSION: No acute cardiopulmonary process. " c3e14375-bbc56559-2504fb8d-da429d05-73bcd333.jpg,test/p12/p12227694/s54224123/c3e14375-bbc56559-2504fb8d-da429d05-73bcd333.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with epigastric pain TECHNIQUE: Chest PA and lateral COMPARISON: CT torso ___ at 14:40, chest radiograph ___ FINDINGS: Heart size remains mild to moderately enlarged. The mediastinal contour is unchanged. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 50c5c8a5-0baa569c-b0ebc655-7a6c59f9-390f4680.jpg,test/p16/p16101197/s57598358/50c5c8a5-0baa569c-b0ebc655-7a6c59f9-390f4680.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " fa0c45eb-447b4943-44859b9f-11967550-334cd76b.jpg,test/p18/p18513797/s53532808/fa0c45eb-447b4943-44859b9f-11967550-334cd76b.jpg,test," FINAL REPORT INDICATION: Cough and chest pain. COMPARISONS: None. FINDINGS: The lung volumes are low. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The mediastinal contours are normal. The cardiac size is at the upper limits of normal. IMPRESSION: No acute cardiopulmonary process. " 59f2eabd-5ca9c6fb-9b4079f4-8d7da383-7ca5b5bd.jpg,test/p13/p13567471/s51123925/59f2eabd-5ca9c6fb-9b4079f4-8d7da383-7ca5b5bd.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath. Question pneumonia. COMPARISON: ___. FINDINGS: Single portable view of the chest. Right PICC again seen with tip in the mid SVC. The patient is slightly rotated towards the right. The lungs are clear noting that the right costophrenic angle is excluded from the field of view. Previously seen left basilar opacity is not seen on the current exam. The cardiomediastinal silhouette is unchanged. Median sternotomy wires are again noted. IMPRESSION: No acute cardiopulmonary process. " 6000441a-841d0702-270feaa6-57a626ae-6b54546e.jpg,test/p11/p11971799/s52013453/6000441a-841d0702-270feaa6-57a626ae-6b54546e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cirrhosis, rectal Ca with abd distention, oliguria COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires are again noted. The lungs appear clear. No signs of pneumonia or edema. There is a tiny residual left pleural effusion. No pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Small residual left pleural effusion. " 699c9c6f-0d559ace-7e28f453-195a1179-fee617c9.jpg,test/p16/p16789054/s57690623/699c9c6f-0d559ace-7e28f453-195a1179-fee617c9.jpg,test," FINAL REPORT HISTORY: History of interstitial lung disease with shortness of breath and hypoxia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size remains mildly enlarged. Mediastinal and hilar contours are unchanged. There is no pulmonary vascular congestion. Lung volumes remain reduced with increased interstitial opacities predominantly within a peripheral and basilar distribution compatible with chronic interstitial lung disease. Findings are relatively unchanged compared to the prior exam, with no new focal consolidation demonstrated. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary process. Chronic interstitial lung disease, relatively unchanged compared to the previous exam. " b2f590b4-96f88406-bc171187-c897bf1d-a8dd1674.jpg,test/p15/p15554295/s56769496/b2f590b4-96f88406-bc171187-c897bf1d-a8dd1674.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with GSW, migration of iliac venous stent into pulm artery, s/p bronch // ?improving cxr after bronchoscopy ?improving cxr after bronchoscopy IMPRESSION: Compared to chest radiographs ___ through ___:49. Left lower lobe still collapsed. Pulmonary vascular congestion unchanged. Parenchymal abnormality persists in the right lower lung. Vascular stent has not migrated from its initial position in a right lower lobe branch artery. Pleural effusions are small. No pneumothorax. ET tube, right subclavian line, and nasogastric drainage tube in standard placements. " 28bccac6-536323c9-a3d9b0dc-5bdc1823-ca3410ba.jpg,test/p18/p18969321/s50262066/28bccac6-536323c9-a3d9b0dc-5bdc1823-ca3410ba.jpg,test," FINAL REPORT INDICATION: Herniation, questionable metastasis. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Borderline size of the cardiac silhouette. There is a possibility of bilateral small pleural effusions. Mild fluid overload and retrocardiac atelectasis but no evidence of pneumonia. No pulmonary masses or nodules. " 3015bfc3-08c68a40-269de004-7d369b5e-126c1736.jpg,test/p15/p15993209/s59180934/3015bfc3-08c68a40-269de004-7d369b5e-126c1736.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lung abscess on antibiotics, now with worsening hemoptysis // changes from prior changes from prior IMPRESSION: In comparison with the study of ___, there is increasing opacification at the left base, consistent with worsening pleural effusion and volume loss in the left lower lobe. The generalized opacification obscures the region of the lung abscess. Opacification just above the effusion could represent site of infection. " 16be91c2-14bccfa1-0936f30a-ae17be80-7e0d6ab6.jpg,test/p15/p15886512/s59958733/16be91c2-14bccfa1-0936f30a-ae17be80-7e0d6ab6.jpg,test," FINAL REPORT STUDY: Chest PA and lateral radiograph. INDICATION: Chest pain, left scapular pain. For evaluation. TECHNIQUE: Two views of the chest were obtained. COMPARISON: ___. REPORT: Scarring and atelectasis in the right mid zone on the left base are unchanged from prior study. The heart size is normal. The lungs are grossly clear. Visualized osseous structures demonstrate no definitive acute findings. There is minor degenerative change in the thoracic spine, unchanged from before. No specific pathology related to the left clavicle or shoulder is noted. CONCLUSION: No definitive acute findings. Little interval change from prior study. It should be noted that in this patient with reported left scapular pain that much of the scapula has not been included on this field of view. " 7bc0eccc-4347f5b9-7543cf98-b524db95-f42e1ad6.jpg,test/p10/p10781100/s56415875/7bc0eccc-4347f5b9-7543cf98-b524db95-f42e1ad6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Pneumonia. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are within normal limits. There is moderate unfolding of the thoracic aorta, similar in appearance when compared to the prior study. Mild elevation of the left hemidiaphragm, also unchanged. No consolidation, pneumothorax or pleural effusion seen. Moderate degenerative changes throughout the thoracic spine. IMPRESSION: No acute cardiopulmonary process seen. " 550734af-59c2f781-38769060-0dab6431-8e333c49.jpg,test/p10/p10362716/s58015735/550734af-59c2f781-38769060-0dab6431-8e333c49.jpg,test," FINAL REPORT EXAMINATION: AP AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with weakness, cough, crackles in the right lower lobe. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are hyperinflated, suggestive of emphysema. Compared with prior exam there is mild interval increase of cardiac size, with worsening of vascular congestion, more prominent in both lower lobes. There is also coarse interstitial thickening, more prominent in the left lower lobe suggestive of interstitial pulmonary edema. There is chronic minimal blunting of the left costophrenic angle but no clear effusion. No right-sided effusion is seen. There is no pneumothorax. Old healed left-sided rib fractures are re-demonstrated. Severe degenerative changes of both shoulders are seen, right worse than left, with loss of the acromiohumeral interval in the right suggestive of rotator cuff pathology. IMPRESSION: 1. Vascular congestion and interstitial pulmonary edema in the setting of slightly worsened cardiomegaly compared with ___. 2. Severe degenerative changes of both shoulders, right worse than left. " 0c21d3fa-b4c4df29-271e37cb-c6c095e8-7cfacd76.jpg,test/p16/p16989180/s57122955/0c21d3fa-b4c4df29-271e37cb-c6c095e8-7cfacd76.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M otherwise healthy with right sided spont ptx s/p ___Fr chest tube placement // Interval change. Please perform at ___. TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Small right apical pneumothorax is stable. No other interval change from prior study. " d197b13b-c3a3aeaa-1508e890-c4b90a06-9c7b3848.jpg,test/p16/p16743731/s57920283/d197b13b-c3a3aeaa-1508e890-c4b90a06-9c7b3848.jpg,test," FINAL REPORT HISTORY: History of NASH cirrhosis and diffuse lymphadenopathy with recent upper GI bleed, now with oxygen requirement. Evaluate interval change. COMPARISON: ___. FINDINGS: ET tube has been removed. Pulmonary edema has improved since ___. Moderate left pleural effusion with left lower lobe collapse is unchanged. Left paramediastinal pleural fluid causes apparent widening of the mediastinum. No pneumothorax. IMPRESSION: Interval removal of ET tube with improvement in pulmonary edema and unchanged moderate left effusion with left lower lobe collapse. " 15cb93a0-8c222421-483e58d3-fd554d60-7cc59617.jpg,test/p12/p12876250/s54593311/15cb93a0-8c222421-483e58d3-fd554d60-7cc59617.jpg,test," WET READ: ___ ___ ___ 7:14 PM Short interval development of streaky and reticular opacities primiarily in the lingula/LLL and RLL in a patient with bacteremia, recent history of hemoptysis, and now suspicion for myocardial infarction (per discussion with team). Ddx include and may be a combination of pulmonary hemorrhage, flash pulmonary edema due to MI, fluid overload edema, and/or infection. Right IJ catheter in satisfactory location. Cholecystectomy clips. Contrast in colon. - dw Dr. ___ at 7p on ___ by ___ x _________________________________________________________________________________ FINAL REPORT HISTORY: Hemoptysis, to assess for hemorrhage. FINDINGS: In comparison with study of ___, there has been substantial increase in pulmonary opacification bilaterally, especially in the left mid and lower zones. In view of the clinical history, this could reflect flash pulmonary edema related to fluid overload, possibly with secondary infection or pulmonary hemorrhage. Monitoring and support devices remain in place. " c7d40c12-188fe0a3-9fad58ea-4ad6b89e-8f1a18a5.jpg,test/p12/p12551576/s55818254/c7d40c12-188fe0a3-9fad58ea-4ad6b89e-8f1a18a5.jpg,test," WET READ: ___ ___ ___ 2:44 PM Trace pulmonary edema ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with cough and dyspnea // please evaluate for pulmonary edema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. CT of the chest from ___. FINDINGS: Mild cardiomegaly, unchanged. Trace reticular infiltrate, peribronchial cuffing, and bilateral pleural effusions are slightly improved from previous examination. No pneumothorax or focal consolidation is seen. Surgical clips overlying the left axilla are unchanged. IMPRESSION: Mild cardiomegaly and trace pulmonary edema. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 1:43 PM, 5 minutes after discovery of the findings. " 11f9e619-8a0675e0-8a2a823d-7ba5f253-3d567ef5.jpg,test/p10/p10037432/s53928123/11f9e619-8a0675e0-8a2a823d-7ba5f253-3d567ef5.jpg,test," FINAL REPORT HISTORY: Fall on left side of chest, complaining of pain. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is normal. Mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. No definite fracture is identified. There is no evidence of a pneumoperitoneum. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. No definite fracture. If there is focal area of concern, dedicated rib series may be helpful. " e2935452-e732db7c-da1111a5-57977c6d-20835102.jpg,test/p14/p14138018/s55650199/e2935452-e732db7c-da1111a5-57977c6d-20835102.jpg,test," FINAL REPORT HISTORY: ___ years old man status post CABG, evaluation for pleural effusion. COMPARISON: Compared to chest x-ray of ___. FINDINGS: PA and lateral radiograph of the chest show no major interval changes since prior chest x-ray with low lung volumes and bibasilar atelectasis and minimal left pleural effusion. Left upper lung atelectasis has disappeared. There is no pneumothorax. Heart is still enlarged, with normal postoperative appearance of the mediastinum related to CABG procedure. IMPRESSION: Persistent left small pleural effusion and improved left upper lung ventilation. " 8e0e8a4b-c1426957-e0940e0b-83dc623a-603dd354.jpg,test/p12/p12382393/s52454860/8e0e8a4b-c1426957-e0940e0b-83dc623a-603dd354.jpg,test," WET READ: ___ ___ ___ 9:31 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with afib on xarelto w presyncope, evaluate for effusion or edema. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is stable. Minimal bibasilar atelectasis is noted. IMPRESSION: No acute cardiopulmonary process. " 66e8ed6c-b365fbd6-21bce1c2-9aaac2f7-930a5a26.jpg,test/p18/p18795271/s56199418/66e8ed6c-b365fbd6-21bce1c2-9aaac2f7-930a5a26.jpg,test," FINAL REPORT AP CHEST, 5:36 P.M., ___ HISTORY: ___-year-old man with partial bowel obstruction. Check NG tube placement. IMPRESSION: AP chest compared to ___: Two frontal views of the chest, one centered above the diaphragm, the other below both show nasogastric tube looped in lower esophagus, with the tip above the level of the aortic knob. Severe distention of the intestines may be responsible in part for diaphragm elevation, with the right hemidiaphragm is appreciably higher than the left accounting for marked atelectasis at the base of the right lung. Heart size normal. " 09583543-6dea5e38-b2034bf2-152dea99-b6b5bbb1.jpg,test/p19/p19396070/s50534773/09583543-6dea5e38-b2034bf2-152dea99-b6b5bbb1.jpg,test," FINAL REPORT INDICATION: History: ___M with h/o heart failure presenting with b/l ___ edema c/o intermittent SOB.Decreased breath sounds at bases worse on right // acute cardiopulmonary process TECHNIQUE: AP and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: AP and lateral chest radiograph demonstrates an enlarged heart, stable in size relative to prior examination. Central vascular prominence as well as perihilar opacities likely reflects pulmonary edema. There is no large pleural effusion. Cervical spine hardware is partially imaged. There is no pneumothorax. IMPRESSION: Enlarged heart with interval development of mild pulmonary and interstitial edema. " 675479c2-7a40f5e7-a32c4155-d4278178-505e869e.jpg,test/p12/p12936816/s54668123/675479c2-7a40f5e7-a32c4155-d4278178-505e869e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cerebral hemorrhages with change in Dobhoff position. // Please confirm correct Dobhoff placement. Please confirm correct Dobhoff placement. IMPRESSION: Compared to chest radiographs ___ through ___. Feeding tube ends in the mid stomach. Heart size top-normal. No edema or pulmonary vascular engorgement. No substantial pleural effusion. No pneumothorax. " 2e65498a-1644447a-003ff355-6c48f2e5-a47593ff.jpg,test/p13/p13554701/s51243818/2e65498a-1644447a-003ff355-6c48f2e5-a47593ff.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Positive blood culture. Question pneumonia. History of bilateral breast cancer. COMPARISONS: ___. TECHNIQUE: Chest, AP upright, and lateral. FINDINGS: Projecting over each axillary region are surgical clips. The heart is mildly enlarged. The mediastinal and hilar contours appear unchanged. Moderate relative elevation of the right hemidiaphragm is noted. The lungs are clear. There are no pleural effusions or pneumothorax. Minor degenerative changes are noted along the thoracic spine. IMPRESSION: No evidence of acute disease. " 222e22e6-a1c8124b-78b1e8cd-a77e379c-c670f6aa.jpg,test/p18/p18471486/s54944572/222e22e6-a1c8124b-78b1e8cd-a77e379c-c670f6aa.jpg,test," FINAL REPORT INDICATION: Hypoxia in the setting of alcohol abuse. COMPARISON: Chest radiograph, ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. The pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " bd2ea2e0-82ed91b8-d9526fbf-77932d2e-d0708b00.jpg,test/p17/p17689317/s59117000/bd2ea2e0-82ed91b8-d9526fbf-77932d2e-d0708b00.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with angioedema intubated // ? tube placement COMPARISON: None FINDINGS: AP portable supine view of the chest. An endotracheal tube is seen with its tip located 1.9 cm above the carinal. An orogastric tube extends into the left upper abdomen. There is retrocardiac opacity which could represent atelectasis versus pneumonia/ aspiration. There is a small left pleural effusion suspected. No supine evidence for pneumothorax. Mild right basal atelectasis noted. Bony structures appear demineralized though grossly intact. IMPRESSION: ET tube tip 1.9 cm above the carinal. OG tube positioned appropriately. Retrocardiac opacity, likely reflecting a combination of consolidation and effusion. " d6f0f5e5-4068e1be-209a34bc-950624f9-131f553b.jpg,test/p12/p12459180/s54880041/d6f0f5e5-4068e1be-209a34bc-950624f9-131f553b.jpg,test," FINAL REPORT HISTORY: Dyspnea, mechanical fall, question pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The patient's prior extensive multifocal pneumonia appears to have somewhat improved since the most recent prior studies. No new opacities are seen. The heart size is within normal limits. The aorta is tortuous. There is no pleural effusion or pneumothorax identified. IMPRESSION: Continued interval improvement in the previously widespread extensive pulmonary opacities. " f994bf02-8573743b-25802a3b-5039534c-730277c0.jpg,test/p17/p17535980/s59676163/f994bf02-8573743b-25802a3b-5039534c-730277c0.jpg,test," FINAL REPORT INDICATION: ___-year-old female with productive cough and chest pain. Evaluate for evidence of pneumonia. COMPARISON: Multiple chest radiographs, most recent on ___. TECHNIQUE: Frontal AP and lateral chest radiograph. FINDINGS: The lungs are well expanded. A vague opacity lateral to the right heart border triangulates to the superior segment of the right lower lobe on the lateral view. No other focal opacities are identified. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Rightward deviation of the trachea with focal narrowing is compatible with known goiter. IMPRESSION: Right lower lobe pneumonia. " b5d332b8-68883394-e760e2f1-3bf408fb-f6e3441d.jpg,test/p10/p10391104/s55929458/b5d332b8-68883394-e760e2f1-3bf408fb-f6e3441d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hemoptysis. Assess for infiltrate // assess for infiltrate IMPRESSION: As compared to the prior radiograph of 4 days earlier, consolidation in the left lung has nearly resolved. No other relevant changes. " b74d4aa1-1d69391e-809694cd-fa4d4f32-6e7ff583.jpg,test/p18/p18526154/s53232733/b74d4aa1-1d69391e-809694cd-fa4d4f32-6e7ff583.jpg,test," FINAL REPORT INDICATION: ___M with lung ca with mets to brain with DOE, evaluate for abnormalities. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: There is moderate pulmonary interstitial edema. The cardiac silhouette is not enlarged. There are small bilateral pleural effusions. No pneumothorax is seen. IMPRESSION: Moderate pulmonary interstitial edema with small bilateral pleural effusions. " f943a660-639de0c6-0c0ffed9-932d90c2-ac3d4fc4.jpg,test/p14/p14744387/s56783392/f943a660-639de0c6-0c0ffed9-932d90c2-ac3d4fc4.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 957 CLINICAL INDICATION: ___-year-old with cirrhosis, AMS status post intubation, check endotracheal tube placement. Comparison is made to the patient's previous study of ___ at 7:25 a.m. Single portable semi-erect chest film ___ at 957 is submitted. IMPRESSION: 1. Interval placement of an endotracheal tube which has its tip just approximately 1.2 cm above the carina. Pullback of the tube by approximately 3 cm would be advised. The patient's nurse, ___ was notified by phone on ___ at 1:55 p.m. of this recommendation. Nasogastric tube is seen coursing below the diaphragm and coiled within the stomach. Lungs remain grossly clear. No evidence of pulmonary edema. No large pleural effusions. No evidence of pneumothorax. " 7c574722-7c6a5a37-58549249-a103c12b-8d7f5a62.jpg,test/p14/p14324761/s53673160/7c574722-7c6a5a37-58549249-a103c12b-8d7f5a62.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with right middle lobe consolidation seen on prior CT of ___, is here for further evaluation. FINDINGS: The cardiomediastinal and hilar contours are normal. Heterogeneous opacities in the right middle lobe, are consistent with pneumonia. Dense curvilinear opacity overlying the left mid lung (since the prior study) likely a calcified granuloma or a small AVM is unchanged. Moderate-sized bilateral pleural effusions, left greater than right with left basal atelectasis is similar to prior CT. IMPRESSION: 1. Right middle lobe pneumonia. 2. Bilateral moderate pleural effusions with compressive left basal atelectasis. " 23439899-d31e1fa8-260d9124-07ff2e0d-29511168.jpg,test/p19/p19028690/s59630883/23439899-d31e1fa8-260d9124-07ff2e0d-29511168.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Shortness of breath. Cardiomediastinal contours are normal. There are bilateral perihilar plate-like atelectasis. There is no pneumothorax or pleural effusion. Moderate degenerative changes are noted in the C-spine. " 30009f01-cca1b937-f981c7d6-36c192bf-c8c4be98.jpg,test/p15/p15068566/s55568757/30009f01-cca1b937-f981c7d6-36c192bf-c8c4be98.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PMHx of asthma presenting with asthma exacerbation necessitating intubation with small left pleural effusion noted on CXR. Any interval improvement? // interval improvement? TECHNIQUE: Chest single view COMPARISON: ___ IMPRESSION: The endotracheal tube and NG tube are unchanged. There is a tiny left pleural effusion that is slightly decreased compared to prior. There is some increased interstitial markings in the left lower lung but no focal infiltrate " 190be2f5-46c4c493-ae40bfdf-a7aaf24c-b5f6c7f6.jpg,test/p17/p17472053/s55360762/190be2f5-46c4c493-ae40bfdf-a7aaf24c-b5f6c7f6.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with mild sternal discomfort after MVC, with some seat belt-related ecchymosis // eval for sternal injury TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture or definite sternal injury is identified. IMPRESSION: No acute cardiopulmonary process. No definite findings of an acute sternal injury, however, please note that dedicated sternal radiographs or, better CT, is more sensitive for such. " fa56bea6-f80741b1-70241f2b-992a81b0-1162e6cd.jpg,test/p10/p10398981/s55080528/fa56bea6-f80741b1-70241f2b-992a81b0-1162e6cd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis here with upper GI bleed, intubated, s/p NGT placement. // Eval for NGT placement. Eval for NGT placement. IMPRESSION: Compared to chest radiographs ___, most recently 07:47. Views of the chest and upper abdomen show the transesophageal drainage tube ends in the left paramedian abdomen. There is no evidence patient has had gastroenterostomy, therefore the catheter is probably in the midportion of a very dilated stomach. ET tube and right internal jugular line are in standard placement. Mild pulmonary edema, best appreciated in the right lung, has increased. Heart size top-normal but slightly larger. No appreciable pleural effusion. No pneumothorax. " e89c0a7e-833b2e8f-0b398309-79fb624f-8564e815.jpg,test/p10/p10206502/s51653011/e89c0a7e-833b2e8f-0b398309-79fb624f-8564e815.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with difficulty swallowing, chest pain. COMPARISON: ___ and chest CT from ___. FINDINGS: AP upright and lateral views of the chest provided. Abandoned pacer leads again seen projecting over the right chest wall extending into the heart. There is a left chest wall pacemaker with leads extending into the coronary sinus, right atrium and right ventricle. Fibrotic changes are again noted most prominent in the lower lungs, left greater than right. No convincing signs of a superimposed pneumonia. Calcified pleural plaque projects over the right hemi thorax as seen on prior CT chest. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Pulmonary fibrosis, similar in overall pattern to prior exam. Calcified pleural plaque. Pacemaker in place. " 8402980c-1844614a-2592e927-efc86724-6d23b6ba.jpg,test/p14/p14998572/s59565885/8402980c-1844614a-2592e927-efc86724-6d23b6ba.jpg,test," FINAL REPORT HISTORY: Multiple myeloma, fevers, question pneumonia. CHEST, TWO VIEWS. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is cardiomegaly. There is atelectasis and/or scarring at both bases, similar to ___ -- no interval change is identified. No focal infiltrate is seen. The aorta is tortuous. Clips are noted over the trachea at the level of the thoracic inlet. There is upper zone redistribution, but no overt CHF. No effusion. Lucency and expansion involving the lateral portion of the right clavicle and nonvisualization of the medial portion of the right clavicle is consistent with involvement by myeloma. IMPRESSION: 1. Bibasilar atelectasis or scarring, unchanged x 2 days. No focal infiltrate identified. 2. UZRD without overt CHF. 3. Lytic areas in right clavicle, consistent with known myeloma. " 58df753b-6ac510c0-48339244-37cd43a5-4eedaee6.jpg,test/p11/p11951880/s58186859/58df753b-6ac510c0-48339244-37cd43a5-4eedaee6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxia s/p R VATS wedge biopsy and CT removal // please eval for interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. No evidence of pneumothorax of the VATS resection. The diffuse nodularity in both lungs is constant. Constant size of the cardiac silhouette. " 06e7de1c-d606a802-fcac7760-34339c18-9ce70eba.jpg,test/p18/p18128235/s59338560/06e7de1c-d606a802-fcac7760-34339c18-9ce70eba.jpg,test," FINAL REPORT HISTORY: ___-year-old male status post fall and confusion. COMPARISON: Radiographs dated ___ as well as CT chest dated ___. FINDINGS: AP frontal and lateral radiographs were obtained. These demonstrate clear lungs bilaterally with no focal consolidation. The patient is status post large paraesophageal hernia repair. A retrocardiac density within the left lower hemithorax may relate to prior paraesophageal repair. Heart size is normal. Significant atherosclerotic calcifications are identified within the aortic arch. Visualized osseous structures are without acute abnormality. No evidence of pneumothorax. There is no right-sided pleural effusion. Obscuration of the left hemidiaphragm is suggestive of a small pleural effusion. IMPRESSION: Left lower hemithorax retrocardiac density may related to recent paraesophageal hernia repair/paraesophageal hernia. Small left sided pleural effusion. No focal consolidation convincing for pneumonia. " 1ecd7ed0-69f75280-7b6880f6-2cca2dc5-522e0f01.jpg,test/p10/p10076263/s51723085/1ecd7ed0-69f75280-7b6880f6-2cca2dc5-522e0f01.jpg,test," FINAL REPORT INDICATION: Pancreatitis. Rule out pleural effusion. COMPARISON: Chest radiographs, ___ and ___. FINDINGS: Upright PA and lateral radiographs of the chest. The lungs are normally expanded and clear. The cardiomediastinal silhouette and hilar contours are normal. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable radiographs of the chest. " 49477441-344a86c0-780f1459-503ede43-1a761688.jpg,test/p11/p11522912/s56980772/49477441-344a86c0-780f1459-503ede43-1a761688.jpg,test," FINAL REPORT AP CHEST, 6:05 P.M. ON ___ HISTORY: ___-year-old man with hypoxic respiratory failure. Suspect pneumonia. IMPRESSION: Two frontal views of the chest are compared to ___: The later of the two examinations, 6:06 p.m., shows ET tube in standard position, and upper enteric drainage tube passing into the stomach and out of view. Left lower lobe consolidation is unchanged over several days, accompanied by small bilateral pleural effusions, increased since ___. Heart size top normal is unchanged. Upper lungs are clear. No pneumothorax. " 79781612-5798ca5c-155bbca5-94baac6a-1116dadc.jpg,test/p11/p11005665/s53461154/79781612-5798ca5c-155bbca5-94baac6a-1116dadc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M h/o asc aorta/aortic arch (inominate/L CCA) replacement Type A cb distal graft aneurysm s/p desc ao tube graft, reimplant subclav a with hybrid graft L Chest recon w mesh // eval for interval change eval for interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Right lung is clear and there is no right pleural or chest wall abnormality. Widening of the upper mediastinum is slightly more more pronounced now than it was at 2:48 p.m. on ___. Atelectasis and fluid in the mediastinum combine to form a continuous mediastinal contour. Small to moderate left pleural effusion is stable. Relatively little of the left lung is aerated, and the extent of severe atelectasis is unchanged over the past week. A vascular stent above the apex of the aortic arch, is unchanged in position and orientation over the past several days. No pneumothorax. Sternal wires and 2 bridging devices are unchanged in orientation and alignment. " 2b0fc82b-e6b66443-c9caf8bd-100d9769-b09e432d.jpg,test/p14/p14508231/s57680689/2b0fc82b-e6b66443-c9caf8bd-100d9769-b09e432d.jpg,test," FINAL REPORT INDICATION: Patient with left chest pain and tachycardia. Assess for pneumonia. COMPARISONS: Chest radiograph from ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Cervical fixation hardware is noted. IMPRESSION: No evidence of acute cardiopulmonary process. " 4f96561e-f4f70a8a-4b21eef9-5cc93691-a9f11e3d.jpg,test/p18/p18222264/s58516645/4f96561e-f4f70a8a-4b21eef9-5cc93691-a9f11e3d.jpg,test," FINAL REPORT INDICATION: History of midsternal pleuritic chest pain x 1 day. Please evaluate. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar contours are normal, however at the level of the thoracic inlet, there is mild widening of the mediastinum. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: 1. No acute intrathoracic abnormalities identified. 2. Mild widening of the mediastinum at the thoracic inlet is concerning for an enlarged thyroid goiter. An ultrasound of the thyroid is recommended for further evaluation. Updated findings were submitted to the ___ nurse on the day of the exam by Dr. ___. " 8cc2a000-f4d9b6eb-dc78ddbc-09f3bc5b-a6f3cb93.jpg,test/p11/p11084430/s57179153/8cc2a000-f4d9b6eb-dc78ddbc-09f3bc5b-a6f3cb93.jpg,test," FINAL REPORT HISTORY: Substernal chest pain. COMPARISON: Chest radiograph on ___. FINDINGS: Frontal and lateral views of the chest. Mild cardiomegaly is unchanged. Aortic knob calcifications are unchanged. Again seen is enlargement of the main pulmonary artery. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Unchanged enlargement of the main pulmonary arteries. Mild cardiomegaly is unchanged. " 4a4be9a0-bf7e2790-f4c7e2cf-07d8a561-81ee4355.jpg,test/p13/p13179422/s51356025/4a4be9a0-bf7e2790-f4c7e2cf-07d8a561-81ee4355.jpg,test," FINAL REPORT HISTORY: History of pleural effusions with abnormal breath sounds. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is normal. Paramediastinal linear opacities compatible with prior radiation therapy are again demonstrated. The hilar contours are within normal limits. Pulmonary vasculature is normal. Small bilateral pleural effusions are new compared to the previous exam. No focal consolidation or pneumothorax is seen. Bilateral breast prosthesis are present. There are no acute osseous abnormalities. Remote right rib fracture is present. IMPRESSION: Small bilateral pleural effusions. " 5d347aac-67f0c51b-98ede694-6d54f308-41804381.jpg,test/p14/p14211964/s57807576/5d347aac-67f0c51b-98ede694-6d54f308-41804381.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M w/recent chest cold, please eval for occult PNA // ___M w/recent chest cold, please eval for occult PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 1f28dfd6-9b52365e-a5b1c2d6-56117e9c-7646db98.jpg,test/p13/p13732944/s55261526/1f28dfd6-9b52365e-a5b1c2d6-56117e9c-7646db98.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Left side wheezing. PA and lateral upright chest radiographs were reviewed in comparison to ___ and ___. Heart size is normal. The aorta is extremely tortuous, unchanged since the prior study with no evidence of focal dilatation. Nodular opacity seen on the prior radiograph on ___ appears to be less dense and most likely reflects residua of prior inflammation. There are no new nodules, masses or consolidations. No pleural effusion or pneumothorax is seen. Reevaluation of the patient in three months for documentation of complete resolution of the left upper lung nodular opacity is recommended with chest radiograph. " 5f6c9895-81164acd-1cd91975-ee1218b3-d3e15b40.jpg,test/p10/p10503045/s51524201/5f6c9895-81164acd-1cd91975-ee1218b3-d3e15b40.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: A ___-year-old male with history of shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is no overt pulmonary edema. The cardiac silhouette is top normal. The mediastinum and hilar contours are unremarkable. Degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " a16e2147-872a367c-05a9fc4e-e919bee0-2dedf0a7.jpg,test/p16/p16039388/s54366939/a16e2147-872a367c-05a9fc4e-e919bee0-2dedf0a7.jpg,test," WET READ: ___ ___ 6:24 PM Right PICC tip in low SVC. Low lung volumes bilateral lower lobe atelectasis. Ktalati ___, ___ mins after observation of findings. D/w Dr. ___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: DX CHEST 2 VIEW PICC LINE PLACEMENT INDICATION: ___ year old woman with s/p PICC placement. Radiology requires formal chest Xray // Post PICC placement TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Right PICC tip in low SVC. No pneumothorax. Tiny left effusion Low lung volumes compatible with bilateral lower lobe sepsis atelectasis. IMPRESSION: PICC line in good position " 816f4283-5be9dffc-957a3165-d7284a39-365dc999.jpg,test/p18/p18405111/s59402757/816f4283-5be9dffc-957a3165-d7284a39-365dc999.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with ankle pain and fever. She is status post Tendo-Achilles surgery ___ complicated by an ulcer. COMPARISON: Reference chest radiograph performed at an outside hospital today at ___ hours. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary pathology. " 1c2a27fb-d25a16ae-e0864b6b-22b2b92f-d3516f25.jpg,test/p18/p18065565/s52178027/1c2a27fb-d25a16ae-e0864b6b-22b2b92f-d3516f25.jpg,test," FINAL REPORT INDICATION: ___-year-old male with pancreatic cancer, now with fever. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are within normal limits with calcified mildly tortuous aorta. There has been interval placement of a right-sided Port-A-Cath, which terminates in the low superior vena cava. IMPRESSION: Interval placement of a right-sided Port-A-Cath without radiographic evidence for acute cardiopulmonary process. " 5e9d235a-51a04e8e-5219a438-c431d936-1218aa1e.jpg,test/p16/p16843636/s58644493/5e9d235a-51a04e8e-5219a438-c431d936-1218aa1e.jpg,test," FINAL REPORT INDICATION: ___ year old woman with dCHF, diabetes, lymphedema, p/w 2 days productive, blood-tinged cough, fever and dyspnea // assess for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There is increased opacity projecting over the spine on the lateral view consistent with pneumonia. It is difficult to tell which lower lobe it is in on the frontal view. Moderate to severe enlargement of the cardiac silhouette is stable. No pleural effusion or pneumothorax. IMPRESSION: Lower lobe pneumonia best seen on the lateral view NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:22 PM, 5 minutes after discovery of the findings. " 0a5142bb-253f2f95-3566b4fa-65a0fef9-b89963b4.jpg,test/p17/p17740146/s58849330/0a5142bb-253f2f95-3566b4fa-65a0fef9-b89963b4.jpg,test," FINAL REPORT HISTORY: Left anterior chest wall pain. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, four views. FINDINGS: Heart size is normal with mild tortuosity of the thoracic aorta. Hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 6584c4ba-1e5ec28c-c3407c87-679aff4f-6c965228.jpg,test/p15/p15154432/s51796724/6584c4ba-1e5ec28c-c3407c87-679aff4f-6c965228.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure // s/p bronch s/p bronch IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Continued low lung volumes accentuate the size of the cardiac silhouette. No definite vascular congestion. The the left hemidiaphragm is better seen an there appears to be some decrease in the retrocardiac opacification, consistent with some re-expansion of the left lower lobe following bronchoscopy. Specifically, there is no evidence of post procedural pneumothorax. " 9a099569-059d37d9-03f67a60-2f4b3750-a61aaf56.jpg,test/p13/p13567851/s53978431/9a099569-059d37d9-03f67a60-2f4b3750-a61aaf56.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with productive cough for several days and URI like sx // r/o PNA r/o PNA TECHNIQUE: PA and lateral views of the chest. COMPARISON: Prior chest radiograph from ___. FINDINGS: A left-sided pacemaker remains in unchanged position, with leads terminating in the right atrium and right ventricle. As compared to prior chest radiograph, lung volumes are decreased. There is blunting of the left costophrenic angle which could reflect a small pleural effusion. Otherwise, no focal consolidation or pneumothorax is identified. The cardiac silhouette remains stable in size. IMPRESSION: Decreased lung volumes. Blunting of the left costophrenic angle is likely secondary to a small left-sided pleural effusion. No focal consolidation concerning for pneumonia. " 3147988c-0d9a749e-74c5ac6e-2c1f7c11-06cda3c5.jpg,test/p11/p11433898/s57043884/3147988c-0d9a749e-74c5ac6e-2c1f7c11-06cda3c5.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Hypoxia. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The patient is status post mitral valve replacement. A dual-lead pacemaker/ICD device appears unchanged, with leads terminating in the right atrium and ventricle, respectively. The heart is again enlarged. The main pulmonary artery contour is likewise enlarged, as seen previously. There is dense new opacification of the left mid to lower lung, probably including the left lower lobe and lingula, with a pleural effusion of substantial size, moderate and possibly large. In addition, there is a moderate predominantly central interstitial abnormality with hazy perihilar opacification, consistent with moderate pulmonary edema. There is no pneumothorax or clear evidence for pleural effusion on the right. IMPRESSION: 1. Dense left basilar opacification with pleural effusion. Differential considerations include atelectasis associated with a substantial pleural effusion versus pneumonia. 2. Findings suggesting moderate pulmonary vascular congestion. " 94775276-1858f3a9-ff2923a7-a67c072f-382d2489.jpg,test/p12/p12106204/s58027451/94775276-1858f3a9-ff2923a7-a67c072f-382d2489.jpg,test," FINAL REPORT AP CHEST, 7:21 A.M., ___ HISTORY: ___-year-old man after AVR with a fever. IMPRESSION: AP chest compared to ___: Greater consolidation at the lung bases could be due to atelectasis alone or concurrent pneumonia as well. Small left pleural effusion is unchanged. Normal cardiomediastinal silhouette is stable. No pneumothorax. ET tube in standard placement. Feeding tube ends in the mid stomach, and a right subclavian line or PIC line ends in the low SVC. " a916a041-eb6a71d2-e1422d54-1c792483-223612ac.jpg,test/p10/p10673897/s53852879/a916a041-eb6a71d2-e1422d54-1c792483-223612ac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old with asthma COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. Dense breast tissue partially obscures the lower lungs on the first image of the series. On the second image of series, there is improved inspiratory effort resulting a more diagnostic quality imaged. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Clips in the right upper quadrant noted. IMPRESSION: No acute intrathoracic process. " 5d1a97ca-02b8f63f-1b704bb5-117259e5-c24f6424.jpg,test/p14/p14203055/s51316500/5d1a97ca-02b8f63f-1b704bb5-117259e5-c24f6424.jpg,test," FINAL REPORT INDICATION: ___-year-old man with a history of volvulus and presenting with abdominal pain, assess for free air. TECHNIQUE: Frontal and lateral radiographs of the chest. COMPARISONS: None. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. No free intraperitoneal air is seen with note made of a distended stomach. IMPRESSION: No acute intrathoracic process. " 45402710-3f734ed9-b2f71905-88664c5d-6294cdb8.jpg,test/p12/p12291041/s51436270/45402710-3f734ed9-b2f71905-88664c5d-6294cdb8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with ams // pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The cardiac silhouette is severely enlarged. The aorta is somewhat tortuous. There may be minimal pulmonary vascular congestion without overt pulmonary edema. Minimal left mid to lower lung linear atelectasis/scarring is seen. No lobar consolidation is seen. No large pleural effusion is seen although a small pleural effusion would be difficult to exclude on the right. There is a dual lead left-sided pacemaker with leads extending the expected positions of the right atrium and right ventricle. IMPRESSION: Marked enlargement of the cardiac silhouette could be due to cardiomyopathy or pericardial effusion. Possible minimal pulmonary vascular congestion without overt pulmonary edema. " 1c7e2328-2bd69164-8a94cc5f-849eac2d-182bc4f0.jpg,test/p14/p14116944/s55172596/1c7e2328-2bd69164-8a94cc5f-849eac2d-182bc4f0.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain. Evaluation for cardiopulmonary process. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. No pleural effusion, pneumothorax or pulmonary edema is present. A right cardiophrenic angle opacity is unchanged, likely a fat pad. IMPRESSION: No acute cardiopulmonary process. " 1504e7cc-06a4a1fb-6cfa2a08-54e2abd8-dfa7afdd.jpg,test/p17/p17770682/s51522306/1504e7cc-06a4a1fb-6cfa2a08-54e2abd8-dfa7afdd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with stroke // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are low. There is mild pulmonary vascular congestion. Otherwise no focal consolidation, pleural effusion or pneumothorax. Heart size is top-normal. No acute osseous abnormalities identified. IMPRESSION: Mild perihilar pulmonary edema, without focal pneumonia. " ce985e00-85117459-f470b401-55a6bdb0-2a78f6d7.jpg,test/p10/p10699336/s57891361/ce985e00-85117459-f470b401-55a6bdb0-2a78f6d7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with polytrauma s/p trach w/ copious mucus plugging and ? pulmonary nocardia // interval change IMPRESSION: Allowing for differences in technique and positioning, there has not been a substantial change in the appearance of the chest since the recent radiograph of 1 day earlier. " 3a999707-b537c503-30f40029-cd7e594e-d1e42f35.jpg,test/p17/p17875843/s50996149/3a999707-b537c503-30f40029-cd7e594e-d1e42f35.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p MVA w/ rib fracture and pulmonary edema, pleural effusion; please eval for interval change. // eval pleural effusion, chest tube eval pleural effusion, chest tube IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Severe cardiomegaly is exaggerated by low lung volumes but there may be mild pulmonary edema. Combination of atelectasis, moderate right pleural effusion and calcification of the pleura is unchanged alongside multiple displaced right rib fractures. If there is pneumothorax it is not large, but chest CT scanning would be needed to exclude it. " 7d1c5dbf-938f838c-49f57f7a-79870961-4a4685f3.jpg,test/p10/p10046679/s58689398/7d1c5dbf-938f838c-49f57f7a-79870961-4a4685f3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with asthma and atrial fibrillation, presenting with one week of acute worsening of his dyspnea // Rule out acute process COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Focal opacity in the right lower lobe is new. No pneumothorax. Bilateral small pleural effusions are new. Hilar contours are normal. Moderate cardiomegaly is unchanged. IMPRESSION: 1. Focal opacity in the right lower lobe is new from ___ and concerning for pneumonia. 2. Bilateral, small pleural effusions are new. " 46c21277-6c47cd20-ec1ab8ac-18a88ef3-09498bae.jpg,test/p10/p10345452/s50117879/46c21277-6c47cd20-ec1ab8ac-18a88ef3-09498bae.jpg,test," WET READ: ___ ___ ___ 6:21 PM Lung volumes are improved from the prior day's radioagraph with interstitial abnormalities consistent with known ILD. Overall, the radiographic appearance of the lungs in the frontal projection is unchanged from ___ where linear right basal and left midlung opacities were present along with more rounded left basal opacities. Unfortunately today's lateral view is non-interpretable due to motion. However, there is no specific finding to suggest pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Chest radiographs dating between ___ and ___ as well as chest CT of ___. FINDINGS: Lung volumes are low, and accompanied by basilar predominant pulmonary fibrosis in keeping with known chronic interstitial lung disease. No definite superimposed pneumonia is evident, but lateral view is limited by low lung volumes and extensive respiratory motion. Cardiac silhouette is mildly enlarged, but stable in size. Mediastinal and hilar contours are stable in appearance. IMPRESSION: Chronic basilar predominant interstitial fibrosis without convincing evidence of a superimposed acute infectious pneumonia. However, given limitations of the current lateral view, a repeat lateral view with improved technique may be helpful to exclude a subtle basilar pneumonia if clinical suspicion for infection persists. " ca0f7cf4-812eeae5-8366b4ce-c5d7c756-e18ca1e6.jpg,test/p16/p16630971/s51039921/ca0f7cf4-812eeae5-8366b4ce-c5d7c756-e18ca1e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD and cough // ? pneumonia ? pneumonia IMPRESSION: In comparison with the study of ___, there is been complete resolution of the bilateral consolidations. At this time, there is no evidence of pneumonia, vascular congestion, or pleural effusion. " 7cedfeee-a6410204-51885c66-e1b47a30-00579b52.jpg,test/p14/p14485079/s56389857/7cedfeee-a6410204-51885c66-e1b47a30-00579b52.jpg,test," FINAL REPORT INDICATION: Left-sided chest tube and pneumothorax, evaluate for change. COMPARISON: ___. FINDINGS: AP portable view of the chest. The tiny left apical pneumothorax is not significantly changed. Lungs are clear otherwise. Left-sided chest tube is unchanged in position, ending in the lower hemithorax. Heart size is top normal. The cardiomediastinal and hilar contours are normal. IMPRESSION: Stable tiny left apical pneumothorax. " a49d38f7-73fe4489-3aefd75d-0ca9cc4f-5314684f.jpg,test/p17/p17913240/s58016158/a49d38f7-73fe4489-3aefd75d-0ca9cc4f-5314684f.jpg,test," FINAL REPORT INDICATION: Left flank pain and persistent cough. Evaluate for infiltrate. TECHNIQUE: Frontal and lateral views chest. COMPARISON: Patchy opacities at the right lung base may reflect atelectasis, however, pneumonia should be considered in the correct clinical setting. No pneumothorax. There are trace bilateral pleural effusions, best appreciated on the lateral view. Heart is normal size and there is no evidence for pulmonary edema. Mediastinal and hilar contours are unremarkable. FINDINGS: Patchy opacities at the right lung base may reflect atelectasis, however, pneumonia should be considered in the correct clinical setting. Trace bilateral effusions. " 6ff76a0c-49246bc5-a7c149d1-59dc38d9-c11b7ec7.jpg,test/p11/p11763662/s58679067/6ff76a0c-49246bc5-a7c149d1-59dc38d9-c11b7ec7.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Tachycardia, cough and dyspnea on exertion. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: There is a substantial moderate cardiomegaly with a globular configuration, which appears increased since the prior examination. Indistinct prominent perihilar opacities suggest mild-to-moderate pulmonary edema. There is no definite pleural effusion or pneumothorax. In addition to other opacities, there is an infrahilar opacity on the lateral view that appears more prominent and may correspond to obscuring of the right cardiophrenic sulcus on this examination. Incidental note is again made of an azygos fissure, which is consistent with a normal variant. The osseous structures are unremarkable. IMPRESSION: 1. Moderate cardiomegaly including substantial increase. Clinical correlation is suggested. True cardiac enlargement is a consideration, but the possibility of a pericardial effusion could also be considered clinically. 2. Mild-to-moderate pulmonary edema. 3. Focal infrahilar opacity, of uncertain significance. It may reflect focal edema, but a separate process such as developing focal opacity such as pneumonia or atelectasis is an additional consideration. Short-term follow-up radiographs are suggested to evaluate further. " dabf009f-b76f96c8-e517e12d-99267706-236ed7d5.jpg,test/p18/p18933476/s58980127/dabf009f-b76f96c8-e517e12d-99267706-236ed7d5.jpg,test," WET READ: ___ ___ 6:29 PM Right chest tube with tip is at the right lung apex medially. Interval decrease in the size of right pleural effusion side, now small is present. Oral contrast noted in the stomach and lower esophagus. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Portable AP view of the chest INDICATION: ___ year old woman with chest pain and pleural effusions. // Please evaluate for placement of chest tube. COMPARISON: Comparison to prior plain film study dated ___ as well as selected images from a barium swallow performed on ___ IMPRESSION: Interval placement a right chest tube with decrease in size of the pleural effusion and improved aeration of the right lung but interval appearance of a small right apical lateral pneumothorax. The right subclavian line is unchanged in position. Residual contrast is seen within the esophagus and stomach. In addition, radiopaque material is seen overlying the left apex which when correlated with the recent barium swallow is extrinsic and related to spillage. There continues to be abnormal right paratracheal soft tissue which is known represent lymphadenopathy. There is persistent retrocardiac consolidation with associated effusion likely representing partial lower lobe atelectasis, although pneumonia cannot be excluded. There is a residual patchy opacity at the right base also likely reflecting atelectasis. In addition, the pulmonary vasculature on the left is somewhat more ill defined raising concern for a component component of superimposed interstitial edema. Clinical correlation is advised. " 01a792ad-101c3890-d58ace5a-1e2b3359-e7e53b9c.jpg,test/p12/p12594793/s51121781/01a792ad-101c3890-d58ace5a-1e2b3359-e7e53b9c.jpg,test," WET READ: ___ ___ 12:07 AM No notable interval change is identified. Left lung base opacity and small left pleural effusion are similar to before. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p CABG // f/u effusions, atx f/u effusions, atx IMPRESSION: Comparison to ___. Low lung volumes persist. Moderate cardiomegaly with mild pulmonary edema is stable. No larger pleural effusions. Retrocardiac atelectasis. " 9ff55d7d-01ff947a-abfc59bf-d5335809-20b9d552.jpg,test/p14/p14420485/s56956136/9ff55d7d-01ff947a-abfc59bf-d5335809-20b9d552.jpg,test," FINAL ADDENDUM ADDENDUM The tip of the port should have been recorded as the cavoatrial junction. ______________________________________________________________________________ FINAL ADDENDUM ADDENDUM The tip of the Port-A-Cath is at the cavoatrial junction. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with c/o dyspnea. // ? pneumonia ? pneumonia IMPRESSION: In comparison with the study of ___ from an outside facility, the patient has taken a better inspiration. The cardiac silhouette is within normal limits and there is mild tortuosity of the aorta. No vascular congestion, pleural effusion, or acute focal pneumonia. Right IJ Port-A-Cath tip is in the region of the cardioesophageal junction. " b65665f5-ccea44d1-3e4369e3-9b0512d8-c9fd5c30.jpg,test/p12/p12553538/s56260929/b65665f5-ccea44d1-3e4369e3-9b0512d8-c9fd5c30.jpg,test," FINAL REPORT PORTABLE CHEST FILM ___ AT 12:17. CLINICAL INDICATION: ___-year-old with mitral regurg and tachypnea, evaluate for change. Comparison is made to the patient's prior study of ___ at 23:44. Portable AP upright chest film ___ at 12:17 is submitted. IMPRESSION: There is retrocardiac opacity which on the prior surgery was felt to be related to a hiatal hernia. On the current study, there is no air seen in this vicinity, so either this represents a hiatal hernia or could represent partial lower lobe atelectasis in the setting of a layering effusion. Improved aeration in the right upper lobe consistent with resolved atelectasis. Lung volumes remain low. There is no evidence of pulmonary edema, although the pulmonary vasculature is crowded. Bilateral old healed rib fractures as well as a healed left humeral fracture are again seen. " 6c4e7e83-ec32fdd9-c79b66dd-8b7354de-cfbbd80f.jpg,test/p14/p14044629/s59283656/6c4e7e83-ec32fdd9-c79b66dd-8b7354de-cfbbd80f.jpg,test," WET READ: ___ ___ ___ 6:43 PM No changed from film one day prior. No pneumothorax. ___ p_________________________________________________________________________________ FINAL REPORT AP CHEST, 5:57 P.M. ON ___ HISTORY: ___-year-old woman after pericardiectomy, with new hypoxia and right-sided pain. Evaluate for pneumothorax. IMPRESSION: AP chest compared to ___ through ___ at 1:00 p.m. There has been little radiographic change since ___. Heterogeneous opacification in both lower lungs is stable, more likely atelectasis than pneumonia. There is no pulmonary edema or particular pulmonary or even mediastinal vascular engorgement. Severe enlargement of the cardiac silhouette has not changed appreciably. Right PIC line ends in the low SVC. Sternal wires are intact and aligned, although the upper sternum is unfused. There is no pneumothorax or even appreciable pleural effusion. " ba8c35c5-b16cace3-f3185c26-440b612d-635fe4d0.jpg,test/p11/p11121803/s58903172/ba8c35c5-b16cace3-f3185c26-440b612d-635fe4d0.jpg,test," FINAL REPORT HISTORY: Cough for six weeks, to assess for pneumonia. FINDINGS: No previous images. Hyperexpansion of the lungs with flattening of the hemidiaphragms is consistent with chronic pulmonary disease. However, no acute focal pneumonia, vascular congestion, or pleural effusion. " 48e8111c-be05acd2-3a5bacf0-47ec63dd-c0ffe05e.jpg,test/p12/p12921496/s58253578/48e8111c-be05acd2-3a5bacf0-47ec63dd-c0ffe05e.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post central line placement. COMPARISONS: ___. TECHNIQUE: Chest, portable AP supine. FINDINGS: A left internal central jugular venous catheter terminates in the superior vena cava. The lungs appear clear. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. IMPRESSION: Tip of catheter projecting over the lower superior vena cava. No evidence of acute cardiopulmonary disease. " 9ab0c07a-55465423-fbe5f8ab-441acda4-ee06602d.jpg,test/p10/p10274932/s57047906/9ab0c07a-55465423-fbe5f8ab-441acda4-ee06602d.jpg,test," FINAL REPORT AP CHEST, 9:38 A.M., ___ HISTORY: Lung cancer after thoracentesis, evaluate lung after reexpansion. IMPRESSION: AP chest compared to ___: Small-to-moderate volume of right pleural fluid remains after right thoracentesis. There is no pneumothorax. Atelectasis in the right middle and lower lobes is considerable. Large right hilar mass is revealed. Small left pleural effusion has increased. Overall, heart size is difficult to assess, probably not severely enlarged. Precise extent of mediastinal adenopathy and possible pericardial effusion is not resolved by conventional chest radiographs. " 98346be9-5bdaf088-74461ca3-2e1cd2a7-28eb145e.jpg,test/p14/p14092601/s57074263/98346be9-5bdaf088-74461ca3-2e1cd2a7-28eb145e.jpg,test," FINAL REPORT HISTORY: Cough and chest pain. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 2b50b42f-50c05b8c-99e75eff-0b02afd4-9ceb9ef7.jpg,test/p19/p19358609/s53839366/2b50b42f-50c05b8c-99e75eff-0b02afd4-9ceb9ef7.jpg,test," WET READ: ___ ___ ___ 8:16 AM The nasogastric tube and side-hole course below left hemidiaphragm and terminate in the left upper quadrant in the region of the stomach. WET READ VERSION #1 ___ ___ 6:05 PM The nasogastric tube and side-hole course below left hemidiaphragm and terminate in the left upper quadrant in the region of the stomach. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NG tube that was coiled in mouth, now replaced // Assess NG tube placement Assess NG tube placement IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube extends to the mid to upper stomach. Other monitoring and support devices are unchanged. The degree of pulmonary vascular congestion appears to have improved. Extensive opacification is again seen involving much of the left hemithorax. " df888700-33c5a044-5e70e2e7-aefa8560-3dec7e6b.jpg,test/p15/p15971063/s59693154/df888700-33c5a044-5e70e2e7-aefa8560-3dec7e6b.jpg,test," FINAL REPORT AP CHEST, 4:35 A.M., ___ HISTORY: A ___-year-old man with ventilator associated pneumonia. Is it worsening? IMPRESSION: AP chest compared to ___: Severe consolidation has not cleared from the left lower lobe, presumably the site of pneumonia. Milder peribronchial opacification in the right lower lobe should be followed. Pulmonary vascular congestion more pronounced accompanied by enlargement of the azygos vein suggests volume overload or incipient cardiac decompensation, even though heart size is normal. ET tube in standard placement, upper enteric drainage tube ends in the upper portion of a non-distended stomach, and a left PIC line tip projects over the upper SVC. No appreciable pleural effusion or pneumothorax. " 02274a21-924828c9-19bb256a-38804736-106b97ca.jpg,test/p18/p18015004/s59622916/02274a21-924828c9-19bb256a-38804736-106b97ca.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with ampullary adenocarcinoma and recent biliary stent now presenting with fevers to 102, also cough // Assess for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Mild bibasilar atelectasis is seen. No definite focal consolidation. No pleural effusion or pneumothorax is seen. Mediastinal contours are unremarkable. Cardiac silhouette is top-normal to mildly enlarged. IMPRESSION: No focal consolidation to suggest pneumonia. Mild basilar atelectasis. " dea2eaae-c487f148-57b2314c-1b4eb037-3658172a.jpg,test/p17/p17328613/s54670551/dea2eaae-c487f148-57b2314c-1b4eb037-3658172a.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough // ? pna EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. IMPRESSION: No pneumonia. " da0957ec-fa6a23dc-c33d7725-210b2879-56e8937d.jpg,test/p13/p13234534/s54600519/da0957ec-fa6a23dc-c33d7725-210b2879-56e8937d.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. Evaluate for acute process. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are clear without focal or diffuse abnormality. There is no evidence of pneumothorax or pleural effusion. The osseous structures are unremarkable. No radiopaque foreign bodies. IMPRESSION: No acute cardiopulmonary process. " 639f7828-e99dd094-6d3ebcd9-848c0287-1e37d65c.jpg,test/p16/p16316457/s55248178/639f7828-e99dd094-6d3ebcd9-848c0287-1e37d65c.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Respiratory distress. COMPARISONS: None. TECHNIQUE: Chest, portable AP. FINDINGS: A PICC line terminates at the right lower superior vena cava. The heart is probably enlarged to a mild degree. There is marked unfolding of the aorta and the arch may be dilated. Flattening of the right costophrenic sulcus suggests potentially an effusion versus pleural thickening or scarring, but the lungs appear clear. Left-sided rib deformities appear very likely chronic, with a remodeled appearance, and probably related to remote prior trauma. IMPRESSION: No evidence of acute process. Dilatation of the aorta. Blunting of the right costophrenic sulcus, possibly due to an effusion. PICC line terminating in the lower superior vena cava. " ddc5ae44-a87451c3-47c89f1a-c2aad263-f5f1e59f.jpg,test/p16/p16760293/s57151307/ddc5ae44-a87451c3-47c89f1a-c2aad263-f5f1e59f.jpg,test," WET READ: ___ ___ ___ 3:24 PM New from prior is small right pleural effusion, right basal atelectasis and apparent mass at the right medial lung base measuring up to 3.6 cm. CT advised. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea // r/o chf COMPARISON: prior chest radiograph dated ___. FINDINGS: PA and lateral views of the chest provided. There is a small right pleural effusion. A rounded density better seen on the lateral projection is located at the right medial lung base and measures approximately 3.5 x 3.6 cm, concerning for mass. Right basal atelectasis likely also present. No overt edema. No left effusion. Heart size is grossly stable. Aorta is unfolded. Bony structures appear grossly unchanged with chronic degenerative disease at both shoulders again noted. IMPRESSION: New from prior is small right pleural effusion, right basal atelectasis and apparent mass at the right medial lung base measuring up to 3.6 cm. CT advised. " f45462e0-afc7a83c-261958c5-a9f01910-d68468df.jpg,test/p16/p16319384/s52386935/f45462e0-afc7a83c-261958c5-a9f01910-d68468df.jpg,test," FINAL REPORT HISTORY: Increased shortness of breath. FINDINGS: In comparison with study of ___, there is now a dual-channel pacer device in place with leads extending to the right atrium and region of the apex of the right ventricle. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 9c94f3e5-6fb07649-26a8023a-228457c5-7914eb81.jpg,test/p15/p15131783/s55167419/9c94f3e5-6fb07649-26a8023a-228457c5-7914eb81.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea and thoracic rib pain // rib fxs/pneumonia TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture seen. IMPRESSION: No acute cardiopulmonary process. No displaced fracture seen. If clinical concern for rib fracture is high, dedicated rib series or CT is more sensitive. " 6c51ff5b-e7f54525-aa7a620e-1febdc08-74b269be.jpg,test/p10/p10795993/s54954298/6c51ff5b-e7f54525-aa7a620e-1febdc08-74b269be.jpg,test," FINAL REPORT INDICATION: Fever and tachycardia. Evaluate for pneumonia. COMPARISON: Chest radiograph ___ and ___. FINDINGS: A left subclavian MediPort terminates within the right atrium. No pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. The mediastinal and hilar structures are unchanged. Loss in height of a mid-thoracic vertebral body without prior studies is thought to likely be chronic. If pain is localized to this area, dedicated thoracic radiographs should be obtained. " 69f71b4e-282c7155-c338b7ab-af16a953-ef7ce951.jpg,test/p15/p15442180/s51834993/69f71b4e-282c7155-c338b7ab-af16a953-ef7ce951.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent influenza and ARDS, now s/p extubation, with some chest pain and congestion // pleural effusions, new opacities pleural effusions, new opacities IMPRESSION: In comparison with the study of ___, there again are multifocal areas of opacification bilaterally. This is consistent with some combination of pleural effusion, multifocal pneumonia, and atelectatic changes in a patient with a top normal sized heart and some elevation in pulmonary venous pressure. " 4fad6b10-042c69be-4a33df11-5358d769-5e5caa25.jpg,test/p16/p16720812/s56851433/4fad6b10-042c69be-4a33df11-5358d769-5e5caa25.jpg,test," FINAL REPORT INDICATION: Dyspnea and fever. COMPARISON: ___ Chest radiograph, ___ Chest CT. PA AND LATERAL VIEWS OF THE CHEST: The heart size is mildly enlarged with a left ventricular predominance. The cardiac silhouette size appears minimally increased when compared to prior study. The mediastinal and hilar contours are relatively unchanged, with calcification of the aorta redemonstrated. The pulmonary vascularity is not engorged. There is a small left pleural effusion, increased from the prior study, and mild patchy opacity in the left lung base, which could reflect atelectasis, though infection or aspiration is not excluded. Subsegmental atelectasis is also likely present within the right lung base. There is no pneumothorax. Mild degenerative changes of the thoracic spine are noted. IMPRESSION: Small left pleural effusion increased when compared to the prior exams from ___ with minimal patchy opacity in the left lung base which may reflect atelectasis but infection or aspiration cannot be excluded. Subsegmental atelectasis in the right lung base as well. " 05d5f3e5-3207bec5-b6f0a832-df01660d-0f0e2d30.jpg,test/p12/p12204055/s53651261/05d5f3e5-3207bec5-b6f0a832-df01660d-0f0e2d30.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG // eval for effusion eval for effusion IMPRESSION: In comparison with the study of ___, there is increased opacification at the bases silhouetting the hemidiaphragms, consistent with bilateral small pleural effusions an underlying compressive atelectasis. Extensive pleural calcification is again seen. " d2b4754f-674999c4-240f0c38-b9d34b05-83085ff7.jpg,test/p11/p11607177/s53502256/d2b4754f-674999c4-240f0c38-b9d34b05-83085ff7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p heartmate now Chest tube removal // eval for pneumo COMPARISON: ___ IMPRESSION: Status post removal of a small bore left-sided chest tube. There is no evidence of left pneumothorax. Unchanged monitoring and support devices, unchanged appearance of the lung parenchyma and of the cardiac silhouette as well as of the cardiac assist device. A lucent line paralleling the upper margin of the right clavicle is part of the thoracic soft tissues and does not represent a pneumothorax. " 4dc1a375-d6d7d132-8aa24990-e01c190f-31321227.jpg,test/p19/p19778204/s55386751/4dc1a375-d6d7d132-8aa24990-e01c190f-31321227.jpg,test," FINAL REPORT HISTORY: Epigastric pain radiating to the back and shoulders. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. Streaky opacities in both lower lobes likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: Mild bilateral lower lobe atelectasis. Otherwise no acute cardiopulmonary abnormality. " 2c6c53f6-af8f14fc-e9229e51-c4534e1b-ef36f2cb.jpg,test/p17/p17563982/s55697333/2c6c53f6-af8f14fc-e9229e51-c4534e1b-ef36f2cb.jpg,test," FINAL REPORT INDICATION: ___-year-old female with epigastric pain. Please evaluate for free air underneath the diaphragm. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. No free air is seen underneath the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 01afc858-6a0c86e2-8ee24eab-44453bcd-44076e25.jpg,test/p14/p14973190/s52563005/01afc858-6a0c86e2-8ee24eab-44453bcd-44076e25.jpg,test," FINAL REPORT INDICATION: Patient with recent bowel surgery, now with abdominal pain and distention. COMPARISONS: Concurrent CT abdomen and pelvis ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes, lungs are clear without pleural effusion, focal consolidations or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Free intraperitoneal air is seen under the left hemidiaphragm. NG tube terminates in the stomach. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Free intraperitoneal air. Please refer to concurrent CT abdomen for further details. " 381702e9-85c29e75-4407d5cd-5bff794d-f0deb730.jpg,test/p18/p18690555/s59624754/381702e9-85c29e75-4407d5cd-5bff794d-f0deb730.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with severe abdominal pain, COPD. COMPARISON: Prior study from ___. FINDINGS: AP portable upright view of the chest. Mild bibasilar opacity is suggestive of atelectasis though difficult to exclude pneumonia. No free air below the right hemidiaphragm. The heart remains mildly enlarged. There is mild hilar congestion without frank edema. Mediastinal contour is normal. No pneumothorax or large effusion. Bony structures appear intact. No free air is seen below the right hemidiaphragm. IMPRESSION: Mild cardiomegaly with hilar congestion. Bibasilar opacities likely atelectasis, difficult to exclude pneumonia. " dfe41f25-9bb97399-33dbf8c6-2a78cffb-08560f89.jpg,test/p16/p16948401/s57509003/dfe41f25-9bb97399-33dbf8c6-2a78cffb-08560f89.jpg,test," FINAL REPORT INDICATION: ___F with chest pressure, dyspnea // Please eval for any pna TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear besides linear right basilar atelectasis. Cardiomediastinal silhouette is stable noting tortuosity of the descending thoracic aorta. No acute osseous abnormalities. Prior PICC is no longer visualized. IMPRESSION: No acute cardiopulmonary process. " 0941b4b1-9466d36f-480cae34-6dba85a2-56b9827f.jpg,test/p10/p10049334/s54625686/0941b4b1-9466d36f-480cae34-6dba85a2-56b9827f.jpg,test," FINAL REPORT INDICATION: ___-year-old male with altered mental status and, purposes. Please evaluate for pneumothorax, consolidation, effusion or mass. TECHNIQUE: AP frontal lateral chest radiographs were obtained. COMPARISON: Chest radiographs from ___, ___, ___ and ___. FINDINGS: There are bibasilar opacities, right greater the left. There is also bilateral effusions. The heart is mildly enlarged with mild pulmonary edema. No pneumothorax is seen. Prior rib fractures are noted. IMPRESSION: 1. Mild cardiomegaly with mild edema. 2. Bibasilar opacities likely reflect pleural effusions with adjacent atelectasis, right greater than left. " 1dad3e69-6998af3d-bc877b55-02af6359-987e488d.jpg,test/p16/p16386563/s54189466/1dad3e69-6998af3d-bc877b55-02af6359-987e488d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with altered mental status TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Lung volumes are low. This accentuates the size of the cardiac silhouette which is mildly enlarged. Mediastinal and hilar contours are unchanged with atherosclerotic calcifications noted at the aortic knob. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. The pulmonary vasculature is normal. No acute osseous abnormalities visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 9509df02-9d292151-a6900131-bd9cca6c-22bc1ee1.jpg,test/p12/p12846283/s54689350/9509df02-9d292151-a6900131-bd9cca6c-22bc1ee1.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with ESRD, weaned off pressors from multifocal PNA // ? interval change/ worsening opacities TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiographs on ___ FINDINGS: Compared with chest radiographs on ___, there is interval improvement in multifocal opacities, including improvement in the previously seen dominant right infrahilar opacity. There has also been interval improvement in pulmonary vascular congestion and edema. There is a small left pleural effusion. No pneumothorax. Heart size is within normal limits. A right IJ catheter terminates at the cavoatrial junction. IMPRESSION: 1. Interval improvement in volume overload and multifocal opacities, including a previously dominant right infrahilar opacity. 2. Small left pleural effusion. " 33f7ed5b-fa1538f2-015e487a-7a20dd6b-7399ce29.jpg,test/p19/p19343087/s57908472/33f7ed5b-fa1538f2-015e487a-7a20dd6b-7399ce29.jpg,test," WET READ: ___ ___ ___ 1:39 PM These findings were discussed with Dr. ___ to via telephone at 12:16 on ___ by Dr. ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with resting tachycardia, O2 sat ___% at rest, recent hospitalizations in ___ and again in ___ for pericarditis with tamponade s/p paracardiocentesis, and bilateral pleural effusion s/p drainage with chest tubes (removed). // please compare with latest CXR from ___ TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ through ___ CTA chest on ___ FINDINGS: The cardiomediastinal and hilar contours are unchanged. Small bilateral pleural effusions are similar in size to the prior chest radiograph on ___. Bibasilar opacities, greater on the left, appear minimally increased which may reflect atelectasis or infection. Of note there is engorgement of the azygos vein, increased from the prior examination. No pneumothorax. IMPRESSION: Small left bilateral pleural effusion is not significantly increased from ___. Right-sided effusion may be minimally increased. Bibasilar opacities, greater on the left may reflect compressive atelectasis or infection in the appropriate setting. New engorgement of the azygos vein could reflect elevated pulmonary venous pressure or tamponade phenomenon. " 4ccffdac-5b77bf93-445b56a0-f84951ec-c665253e.jpg,test/p10/p10326117/s52388896/4ccffdac-5b77bf93-445b56a0-f84951ec-c665253e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure, exacerbation, question of pulmonary edema. COMPARISON: ___. FINDINGS: Compared to the previous radiograph, there is a slight increase in extent of the pre-existing bilateral pleural effusions. The pre-existing signs of moderate pulmonary edema are present in unchanged manner. Moderate cardiomegaly. No other change is detected on this technically limited radiograph. " bce77409-2e736d2f-657c417b-adc031fb-a2e0e7ac.jpg,test/p17/p17169964/s56619432/bce77409-2e736d2f-657c417b-adc031fb-a2e0e7ac.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with recurrent aspiration pneumonia. IMPRESSION: PA and lateral chest compared to ___ through ___. Emphysema is severe. The volume of lung affected by pneumonia in the right middle and lower lobes has improved, but the severity of consolidation has worsened and there is a new small right pleural effusion. Careful followup advised to monitor what could be developing purulent fluid collection. Smaller region of pneumonia in the left lower lobe is improved slightly. Heart size is normal. There is no pulmonary edema. " d0b19ea5-0c3f9c5a-e76d1541-6800bd9b-756a9224.jpg,test/p19/p19611269/s55897849/d0b19ea5-0c3f9c5a-e76d1541-6800bd9b-756a9224.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with left sided chest pain // r/o pneumothorax r/o pneumothorax TECHNIQUE: Frontal view of the chest. COMPARISON: None available. FINDINGS: There is prominence of the aortic knob with mild calcification. The cardiomediastinal and hilar contours are otherwise within normal limits. Lungs are well expanded. Note is made of increased retrocardiac opacity and atelectasis at the right lung base. There is no significant pneumothorax or large pleural effusion in this single frontal chest radiograph. IMPRESSION: 1. No evidence of pneumothorax in this single frontal chest radiograph. 2. Patchy left Retrocardiac opacity could reflect atelectasis versus aspiration. If clinical concern, dedicated chest radiograph with a lateral view can be considered for more complete evaluation and to help exclude the possibility of a developing infectious pneumonia at this site. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:28 PM. " 47f34f2c-6c591de9-6f290910-45050f3f-799ecf99.jpg,test/p11/p11208426/s54684056/47f34f2c-6c591de9-6f290910-45050f3f-799ecf99.jpg,test," FINAL REPORT INDICATION: Lung cancer, altered mental status, evaluate for acute process. COMPARISON: ___ chest radiograph. Chest CTA on ___. FINDINGS: PA and lateral views of the chest. The opacity within the left mid lung field compatible with known chest wall mass as seen on prior CT is again seen. Emphysematous changes and right upper lobe scarring are again seen and unchanged. Small right pleural effusion is new. No pneumothorax. The cardiomediastinal and hilar contours are stable. IMPRESSION: New small right pleural effusion. Redemonstration of left chest wall mass and severe emphysema. " ea550f18-96d2c359-98827d21-7174e50c-8619b891.jpg,test/p10/p10558918/s55296963/ea550f18-96d2c359-98827d21-7174e50c-8619b891.jpg,test," FINAL REPORT HISTORY: ___-year-old female with fever, sweats and cough. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___ and ___. FINDINGS: Frontal and lateral chest radiograph demonstrate well-expanded lungs. There is mild interstitial edema. Mild cardiomegaly is noted. The aorta is tortuous and atherosclerotic calcifications are seen at the aortic knob. A two-lead cardiac pacer is seen with a presumed abandoned third lead. There are moderate degenerative changes seen of the thoracic spine. " a91b49c3-e9abe76e-fb23f8d6-b1585577-fa7f88e6.jpg,test/p18/p18241194/s52143341/a91b49c3-e9abe76e-fb23f8d6-b1585577-fa7f88e6.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with brady and htn, dizziness? // ? mass, cxr- ? mass ? mass, cxr- ? mass TECHNIQUE: PA and lateral views of the chest. COMPARISON: None available. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. Nipple shadows should not be mistaken for lung nodules. IMPRESSION: No acute cardiopulmonary process. " d0839aca-8b543c2d-64c42c69-153014a4-27dc445a.jpg,test/p14/p14917177/s54230302/d0839aca-8b543c2d-64c42c69-153014a4-27dc445a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough // ? pna ? pna IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural " 53b4ffa8-ed1416e6-dfdaede7-52203b64-cd445914.jpg,test/p13/p13007657/s52020135/53b4ffa8-ed1416e6-dfdaede7-52203b64-cd445914.jpg,test," FINAL REPORT INDICATION: History: ___M with weakness, hypotension // eval for PNA TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___, ___ and ___. FINDINGS: There has been interval removal of a coiled right PICC line. The lungs are clear of focal consolidation, pleural effusions or pneumothoraces. The cardiac mediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 8c58ad85-2223658c-f19d2bf5-a5833426-941da533.jpg,test/p15/p15474097/s51673534/8c58ad85-2223658c-f19d2bf5-a5833426-941da533.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough, weakness, assess for acute intrathoracic process. FINDINGS: PA and lateral views of the chest were obtained. Midline sternotomy wires and mediastinal clips are again noted. There is obscuration of the left CP angle on the lateral view which could indicate a small effusion. Areas of linear density in the left lower lung could be secondary to areas of scarring or plate-like atelectasis. Tine right effusion persists. No definite signs of pneumonia or CHF. Cardiomediastinal silhouette appears stable. Bony structure is intact. IMPRESSION: Stable exam with tiny b/l pleural effusions and lower lung plate-like atelectasis versus scarring. " 52eeaaab-22f98e62-d3ac0184-554bf0d6-475e8466.jpg,test/p12/p12294267/s57774792/52eeaaab-22f98e62-d3ac0184-554bf0d6-475e8466.jpg,test," FINAL REPORT HISTORY: Elevated lactate upper GI bleed. Question pneumonia. COMPARISON: CT of the abdomen from the same day. FINDINGS: PA and lateral views of chest Extremely low lung volumes limit the evaluation of the lungs. With this in mind, there is bibasilar atelectasis but no evidence of pneumonia. Heart size is exaggerated by a epicardial fat pad as well as the low lung volumes. An NG tube is seen coursing into the stomach and curling upon itself. No pleural effusion or pneumothorax is identified. The right hemidiapghram is elevated; the CT from the same day demonstrates liver causing the elevation. IMPRESSION: Limited study without evidence of pneumonia. " eb6a2b59-1f03bcf3-dfd6b9b9-bf83548a-8e1b9c06.jpg,test/p16/p16633692/s57796056/eb6a2b59-1f03bcf3-dfd6b9b9-bf83548a-8e1b9c06.jpg,test," FINAL REPORT INDICATION: History of intermittent chest pain. Please evaluate for acute process. COMPARISONS: Chest radiographs dated back to ___, most recently from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Mild cardiomegaly has slightly increased compared to the prior exam from ___. Mild bibasilar atelectasis is likely secondary to low lung volumes. The hilar and mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: 1. Mild bibasilar atelectasis. 2. Mild cardiomegaly, slightly increased compared to the prior exam from ___. 3. No focal consolidations concerning for pneumonia identified. " 489fc37c-6aa5719c-89abcf32-6ebd08aa-54435544.jpg,test/p12/p12582857/s52431712/489fc37c-6aa5719c-89abcf32-6ebd08aa-54435544.jpg,test," FINAL REPORT INDICATION: COPD with shortness of breath. COMPARISON: Radiographs available from ___ and CT abdomen from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: Again seen is marked hyperlucency of the upper lung zones, compatible with severe emphysema. The hilar and mediastinal contours are within normal limits. Since ___ right basal atelectasis has cleared and mild vascular congestion resolved. There is no pneumothorax, or pleural effusion. IMPRESSION: Severe COPD. No evidence of pneumonia, heart failure or other acute abnormality. " d08f6ae5-e34c467d-4bafa889-9878c0f2-44b2fe82.jpg,test/p12/p12539779/s57219024/d08f6ae5-e34c467d-4bafa889-9878c0f2-44b2fe82.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough and right-sided crackles. COMPARISON: Semi-upright portable AP chest radiograph ___. TECHNIQUE: Upright AP portable chest radiograph with technically inadequate lateral view ( patient is in dissability chair). FINDINGS: There is slightly improved low lung volume with no areas of focal consolidation, pleural effusion, or pneumothorax identified. There is stable cardiomegaly with calcification of the aorta with no evidence of pulmonary edema or vascular congestion. The pleural surfaces are unremarkable. IMPRESSION: No evidence of heart failure or infection. " db516bca-4511ba7d-6eb30fb7-d35a02f4-828fd422.jpg,test/p17/p17881643/s55899500/db516bca-4511ba7d-6eb30fb7-d35a02f4-828fd422.jpg,test," FINAL REPORT INDICATION: Fever with cough. COMPARISON: None. FINDINGS: PA and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Lungs are well expanded and clear with no focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 747eba78-09f7d71e-546a7a81-2d181e83-3630a167.jpg,test/p17/p17211281/s52458736/747eba78-09f7d71e-546a7a81-2d181e83-3630a167.jpg,test," FINAL REPORT INDICATION: History: ___F with recent hospital admission WBC elevated since AM and reports chills // evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiomediastinal silhouette is within normal limits. On the lateral radiograph, there is slightly increased opacification over the lower spine which may represent developing pneumonia in the appropriate clinical context. There is no pleural effusion or pneumothorax. The bones and the upper abdomen are grossly unremarkable. IMPRESSION: Increased opacification projecting over the lower spine on the lateral radiograph may represent a developing pneumonia or atelectasis in the appropriate clinical context. " 6205d243-d8857199-6be2f04f-c91bdc4c-908a9c6e.jpg,test/p14/p14852007/s59788508/6205d243-d8857199-6be2f04f-c91bdc4c-908a9c6e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with asthma exacerbation requiring intubation, recently extubated c/o pleuritic chest pain // Please eval for pneumothorax or other acute cardiopulmonary pathology TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. No infiltrate. No pneumothorax. " d4f15030-551708c7-3717512c-e44378d7-cf87bcd0.jpg,test/p18/p18680835/s51147394/d4f15030-551708c7-3717512c-e44378d7-cf87bcd0.jpg,test," FINAL REPORT PORTABLE CHEST ___ ___ COMPARISON: ___ ___ ___. FINDINGS: Right-sided chest tube remains in place, with a small right apicolateral pneumothorax, which is decreased in size since the prior radiograph. The apical visceral pleural line is now just below the second posterior right rib level. The cardiomediastinal contours are stable in appearance. Worsening left retrocardiac opacities, likely a combination of atelectasis and effusion, and note is made of improving atelectasis at the right base. Persistent subcutaneous emphysema in the right chest wall. " ac0839ce-8a1ef7b0-ede87f5e-3db27ce8-9b7fe314.jpg,test/p16/p16151261/s53225988/ac0839ce-8a1ef7b0-ede87f5e-3db27ce8-9b7fe314.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cervical quadriplegia and tachypnea // Please evaluate for etiology of respiratory distress. Please evaluate for etiology of respiratory distress. COMPARISON: Prior chest radiographs ___. IMPRESSION: Heterogeneous consolidation in the right lower lobe developed between ___ and ___ , due to pneumonia has changed in appearance but not in overall severity since ___. Consolidation in the left lower lobe has been present to some degree since ___, probably a combination of recurrent aspiration pneumonia and intermittent lobar collapse. Upper lungs are grossly clear. Heart size is normal. Pleural effusion is small if any. " 5632d3d3-11397ff5-ca428c43-4f66c5f5-3a5f57cd.jpg,test/p18/p18102930/s55631697/5632d3d3-11397ff5-ca428c43-4f66c5f5-3a5f57cd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dyspnea on exertion x 1 month // eval for pulm edema eval for pulm edema IMPRESSION: Compared to chest radiographs ___. Heart size top-normal. Lungs clear. No pleural abnormality. Patient has had median sternotomy and at least coronary bypass grafting. Pulmonary vasculature is unremarkable and there is no edema in the lungs. " e041c467-e758cc54-78d2813b-8a07897c-cc22e612.jpg,test/p19/p19071652/s51618209/e041c467-e758cc54-78d2813b-8a07897c-cc22e612.jpg,test," WET READ: ___ ___ ___ 8:44 PM Significant improvement in lung aeration and pulmonary edema with minimal opacities persisting at the right base.` ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Pulmonary edema, hypertensive urgency, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have increased and there is a decrease in extent and severity of the pre-existing parenchymal opacities, predominantly at the lung bases. These changes are likely to reflect improvement in pulmonary edema. Remnant changes, however, are still seen at the bases of the left and right lung. Moderate cardiomegaly persists. No evidence of larger pleural effusions. " 578add9c-d6e17244-0277f215-b027ecc8-83900891.jpg,test/p17/p17355193/s51964821/578add9c-d6e17244-0277f215-b027ecc8-83900891.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with history of recurrent right breast cancer and positive left axillary lymph nodes who presents with worsening of chronic cough // please evaluate for cause of cough, ? metastatic disease TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Metal clips noted in the right axilla. No suspicious osseous abnormalities noted. IMPRESSION: No obvious suspicious lesions or osseous abnormalities. No acute cardiopulmonary process. " 8e97612c-7aca2c2d-46177890-0a5459a0-b79ee31d.jpg,test/p16/p16777182/s56257399/8e97612c-7aca2c2d-46177890-0a5459a0-b79ee31d.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with shortness of breath. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. And ___. FINDINGS: The lungs are clear. No edema, effusion, or pneumothorax. The heart is top-normal in size, not significantly changed. The mediastinum is not widened. No acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " fadd319c-5d5bd09a-9e59cc91-dcd76cf3-2de62476.jpg,test/p15/p15289901/s50758546/fadd319c-5d5bd09a-9e59cc91-dcd76cf3-2de62476.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cabg readmit for effusion // f/u post tap f/u post tap IMPRESSION: Compared to chest radiographs ___ through ___. Moderately severe pulmonary edema is unchanged. Moderate cardiomegaly and severe mediastinal venous engorgement and small to moderate left pleural effusion are unchanged. No pneumothorax. " e8aeccb3-ec7390df-a1759b19-2eb15283-03f7c895.jpg,test/p19/p19020115/s55738699/e8aeccb3-ec7390df-a1759b19-2eb15283-03f7c895.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with NG tube placement TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Nasogastric tube tip terminates within the stomach. Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Minimal patchy atelectasis is noted in the lung bases without focal consolidation. No pleural effusion or pneumo is detected. No acute osseous abnormality is identified. IMPRESSION: Nasogastric tube tip terminates within the stomach. No acute cardiopulmonary abnormality apart from mild bibasilar atelectasis. " 2124d052-5f4ecc7f-3da14cc0-5bd4a70e-7540a069.jpg,test/p15/p15851715/s56608881/2124d052-5f4ecc7f-3da14cc0-5bd4a70e-7540a069.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with sudden onset of wheezing, evaluate for any acute process. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding chest examination of ___. The heart size is within normal limits. No typical configurational abnormality is identified. Thoracic aorta is mildly widened and elongated but without local contour abnormalities or walled calcifications. Pulmonary vasculature is not congested. No evidence of acute or chronic pulmonary parenchymal infiltrates are present, and the lateral and posterior pleural sinuses are free. No signs of pneumothorax in the apical area. Skeletal structures demonstrate mild degenerative changes in the thoracic spine, but no evidence of vertebral body compression fracture is noted. In comparison with the next previous examination, the at that time identified poor inspiration with crowded pulmonary vasculature and plate atelectasis on the bases has normalized. Presently, the lungs are clear without evidence of acute infiltrates or evidence of pulmonary congestion. The lateral view discloses rather prominent surrounding soft tissue structures indicative of adiposity. " 295ec9ec-c8a8df49-cdad6f25-6cfb5dce-7ca74554.jpg,test/p16/p16893353/s58970149/295ec9ec-c8a8df49-cdad6f25-6cfb5dce-7ca74554.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with asthma/copd recently hospitalized with CT chest, worsening dyspnea. // PNA PNA IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Continued enlargement of the cardiac silhouette with pacer lead extending to the apex of the right ventricle. No evidence of acute pneumonia or vascular congestion. " 04a5c03c-8a1c9320-2c263909-ea40a0a7-578fc4a5.jpg,test/p12/p12736960/s58808348/04a5c03c-8a1c9320-2c263909-ea40a0a7-578fc4a5.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with cirrhosis, now with new hemodialysis line placement. FINDINGS: Comparison is made to previous study from ___ at 4:34 a.m. There is a new left IJ central line with distal lead tip in the proximal SVC perpendicular to the SVC wall. There is an unchanged right IJ central line, endotracheal tube, and feeding tube. Heart size is within normal limits. There are again seen areas of consolidation throughout both lung fields, most prominent in the perihilar regions. There are no pneumothoraces. There is a left-sided pleural effusion and left retrocardiac opacity. " 5006cee9-fcc10480-be6cc5c3-b2bc10fe-9c00c97f.jpg,test/p13/p13365915/s55106213/5006cee9-fcc10480-be6cc5c3-b2bc10fe-9c00c97f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cabg with cuff leak, attempted dht placement // eval for ptx COMPARISON: Prior exam from ___. FINDINGS: AP portable upright view of the chest. Midline sternotomy wires and mediastinal clips are again noted. There is a left IJ Swan-Ganz catheter with its tip again noted to enter the left pulmonary artery. The endotracheal tube is poorly visualized. A nasogastric tube extends inferiorly along the thoracic midline though the tip is excluded from view. Overlying EKG leads somewhat limit the assessment. There are bilateral pleural effusions which are similar to the prior exam. No large pneumothorax. Cardiomediastinal silhouette stable. Bony structures intact. IMPRESSION: Interval placement of an NG tube with its tip extending along the thoracic midline though the tip is not within the imaged field. Other support lines and tubes appear stable though the endotracheal tube is not clearly visualized. Small layering bilateral pleural effusions unchanged. " aa0d644e-bf7dd9c2-7056de53-8b9d61e4-ac1bb456.jpg,test/p18/p18296202/s55956416/aa0d644e-bf7dd9c2-7056de53-8b9d61e4-ac1bb456.jpg,test," FINAL REPORT INDICATION: Fall, evaluate for acute process. PA AND LATERAL VIEWS OF THE CHEST COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes are low, with persistent elevation of the right hemidiaphragm. Bibasilar atelectasis is present. Otherwise, the lungs appear clear. No pneumothorax or pleural effusion is present. There is unchanged appearance to tubing projecting over the right hemithorax, which may be and old VP shunt catheter, correlate clinically. IMPRESSION: No acute cardiopulmonary findings. Low lung volumes with bibasilar atelectasis. " a8738277-1849e89d-2c43f1e7-02391df3-2476dc04.jpg,test/p13/p13273041/s52855659/a8738277-1849e89d-2c43f1e7-02391df3-2476dc04.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with known CHF now with cough/SOB clear CXR earlier today, worsening dyspnea/tachypnea. // ? fluid overload TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There has been interval increase in the amount of alveolar infiltrate compared to the study from the prior day. This is now most marked in the right upper and lower lung. There continues to be a moderate right and small left pleural effusion. There is pulmonary vascular redistribution. IMPRESSION: Worsened CHF. An underlying infectious infiltrate on the right cannot be excluded. " a44e9807-f94407dc-9598d1c0-8ec46600-fb1b71d9.jpg,test/p18/p18143542/s55512178/a44e9807-f94407dc-9598d1c0-8ec46600-fb1b71d9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with septic shock, respiratory failure // assess for position of ETT assess for position of ETT IMPRESSION: Comparison to ___. The tip of the endotracheal tube projects 5 cm above the carina. The relatively extensive parenchymal consolidation on the left and a small right basilar atelectasis is stable. Stable position of the other monitoring and support devices, the tip of the feeding tube projects over the proximal parts of the stomach. " 7e475bd0-1703e978-99c5497e-913b3898-41788bfd.jpg,test/p12/p12578647/s52308753/7e475bd0-1703e978-99c5497e-913b3898-41788bfd.jpg,test," FINAL REPORT INDICATION: ___-year-old female status post liver transplant with tachycardia and fever. Evaluate for evidence of pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well inflated and clear. There are no focal opacities. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. " 4d120363-da298a78-48f9b30a-2c17fb14-a1481b8a.jpg,test/p15/p15039356/s50145228/4d120363-da298a78-48f9b30a-2c17fb14-a1481b8a.jpg,test," FINAL REPORT INDICATION: ___F with cough and SOB // Signs of CHF and COPD TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " ec658c90-ef42c88f-fb7f63ce-361ffaa4-c135c712.jpg,test/p18/p18009599/s56809024/ec658c90-ef42c88f-fb7f63ce-361ffaa4-c135c712.jpg,test," WET READ: ___ ___ ___ 9:59 PM ET tube, ___, ___ catheters are unchagned in position. descending aortic stent in place. left sided chect tube projects over left lung apex. No PTX is seen. left lung apex is now opacitied, fluid vs. consolidation. pulmonary edema has slightly progressed since prior. persistent small BL pleural effusion and bibasilar opacities. ___ ___ ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:53 P.M. ON ___ HISTORY: Thoracic aortic aneurysm repair complicated by ischemic bowel. IMPRESSION: AP chest compared to ___: New opacification at the apex of the left lung could be hemorrhage or pseudoaneurysm, as well as local pleural collection related to chest tube. Mild pulmonary edema is new and moderate right pleural effusion is larger. Cardiac silhouette is unchanged. ET tube and Swan-___ catheter are in standard placements. Aortic endograft is grossly unchanged. Notification of new findings was delayed until review of subsequent chest radiograph, reported separately. " 6b6b738d-8e798896-deb5009b-6e0cbcd7-d98d00a8.jpg,test/p14/p14591676/s57542006/6b6b738d-8e798896-deb5009b-6e0cbcd7-d98d00a8.jpg,test," WET READ: ___ ___ ___ 5:08 PM Bilateral pleural effusions, moderate on the left and small on the right, increased from the prior chest radiograph. However, no overt pulmonary edema identified. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea. Evaluate for acute cardiopulmonary process. TECHNIQUE: AP and lateral chest. COMPARISON: Chest radiograph from ___. FINDINGS: There are bilateral pleural effusions, moderate on the left and small on the right, with overlying compressive atelectasis, increased from the prior study. No evidence of overt edema. Right-sided pacemaker demonstrates leads in unchanged position. Calcified aortic arch is again seen. IMPRESSION: Bilateral pleural effusions, moderate on the left and small on the right, increased from the prior chest radiograph. However, no overt pulmonary edema identified. " 541f824a-33816345-50d47d24-b65935f6-8ccaee4a.jpg,test/p14/p14979348/s51511862/541f824a-33816345-50d47d24-b65935f6-8ccaee4a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with endotracheal tube placement TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___ at 18:38 FINDINGS: Endotracheal tube tip terminates approximately 4 cm from the carina. An enteric tube tip is within the stomach. Cardiac and mediastinal contours remain unchanged. There is persistent mild pulmonary vascular congestion. Patchy opacities in lung bases are also similar without new areas of focal consolidation. A trace left pleural effusion may be present. IMPRESSION: Endotracheal and enteric tubes in standard positions. There may be a trace left pleural effusion. Remainder of the chest appears grossly unchanged. " d4a05786-9d578706-7ad066ec-f23ce91b-22167fa5.jpg,test/p11/p11861017/s54509468/d4a05786-9d578706-7ad066ec-f23ce91b-22167fa5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SDH, failure to wean of trach // evaluate lung fields evaluate lung fields IMPRESSION: Comparison to ___. The tracheostomy tube is stable. Stable position of the left PICC line. The pre-existing parenchymal opacities have slightly increased in extent and severity. Part of these opacities is caused by pleural effusions. Moderate cardiomegaly persists. Mild to moderate pulmonary edema is unchanged. " 110a3b6c-6544580b-a38b6ea6-9a4e7797-f77bbeb4.jpg,test/p15/p15199994/s50887328/110a3b6c-6544580b-a38b6ea6-9a4e7797-f77bbeb4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o epilepsy presenting with breakthrough seizures, concern for aspiration pneumonia // R/O pneumonia COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous examination. Mild pleural thickening around old rib fractures at the level of the left lateral chest wall. No evidence of pneumonia. No pleural effusions. Borderline size of the cardiac silhouette without pulmonary edema. " 1e33846d-71d3a227-b973d8b1-81292681-ce9b39fe.jpg,test/p13/p13391049/s59338720/1e33846d-71d3a227-b973d8b1-81292681-ce9b39fe.jpg,test," FINAL REPORT INDICATION: ___ year old man with new syncope hypoxia // r/o infection, pneumo TECHNIQUE: Portable COMPARISON: ___ FINDINGS: Right-sided port terminates in the right atrium. Low lung volumes. Mild pulmonary vascular congestion. No lobar pneumonia. No pleural effusion or pneumothorax. Heart size is normal. IMPRESSION: Mild pulmonary vascular congestion. " a9d1fc72-558bc196-ffe46a67-69ba37d7-2289b018.jpg,test/p16/p16200793/s55979039/a9d1fc72-558bc196-ffe46a67-69ba37d7-2289b018.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with post TBBx // ? pmeumothorax TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There is no pneumothorax or pneumomediastinum. Widespread opacities larger in the upper lobes are grossly unchanged. Cardiomediastinal contours are stable. There is no pleural effusion. Patient has known emphysema. " 43165744-14cbd7a0-a0c1ec94-c7b57dd1-4c7454a6.jpg,test/p12/p12393609/s55440237/43165744-14cbd7a0-a0c1ec94-c7b57dd1-4c7454a6.jpg,test," FINAL REPORT HISTORY: Respiratory failure. FINDINGS: In comparison with the study of ___, there are continued relatively low lung volumes with enlargement of the cardiac silhouette and vascular congestion. Bibasilar opacifications again are consistent with atelectasis and effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered. " c30a7dd2-bf2c2074-657e7f43-21de4a04-206b480b.jpg,test/p13/p13178097/s50942676/c30a7dd2-bf2c2074-657e7f43-21de4a04-206b480b.jpg,test," FINAL REPORT HISTORY: Fall, head strike, loss of consciousness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are unchanged, with the heart size within normal limits. The aorta is mildly tortuous. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Numerous chronic bilateral rib fractures are noted. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary process. Multiple old bilateral rib fractures. " 02609d44-4528b816-f4a36977-c20e7695-48a52d54.jpg,test/p17/p17580398/s56310378/02609d44-4528b816-f4a36977-c20e7695-48a52d54.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Left base bronchi. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. " 09ce2817-1dbfa969-aa44ad75-c87f41b8-8b1cb981.jpg,test/p14/p14284307/s57221290/09ce2817-1dbfa969-aa44ad75-c87f41b8-8b1cb981.jpg,test," WET READ: ___ ___ ___ 8:21 AM The right internal jugular central venous line ends in the low SVC. Small right and moderate left pleural effusions with bibasilar consolidations appear similar to prior. Amorphous density projecting over the left lower thorax is new over the interval and may be external to the patient. Recommend correlation with physical exam. The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 7:30 PM, 5 minutes after discovery of the findings. WET READ VERSION #1 ___ ___ 7:33 PM The right internal jugular central venous line ends in the low SVC. Small right and moderate left pleural effusions with bibasilar consolidations appear similar to prior. Amorphous density projecting over the left lower thorax is new over the interval and may be external to the patient. Recommend correlation with physical exam. The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 7:30 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old woman with phoresis line manipulation // eval for line position IMPRESSION: Right internal jugular central venous catheter has been advanced and now terminates in the lower superior vena cava, with no visible pneumothorax. Allowing for artifact overlying the left thoracoabdominal junction region, overall appearance of the chest is otherwise not appreciably changed since recent study of earlier the same date. " 853f7149-553cb4b1-fe4e0131-75f81ca8-f910c92b.jpg,test/p18/p18855147/s59227699/853f7149-553cb4b1-fe4e0131-75f81ca8-f910c92b.jpg,test," FINAL REPORT HISTORY: ET tube placement. FINDINGS: In comparison with the earlier study of this date, there is little overall change. The endotracheal tube is not precisely seen on the study, suggesting that it may have its tip in the mid cervical region or higher. Little change in the appearance of the heart and lungs. Nasogastric tube extends well into the stomach with the tip distal to the cardioesophageal junction. The large central catheter tip is in the region of the mid portion of the SVC. " 447ca40a-bca89695-c278f1fa-31586c21-3d0fac16.jpg,test/p17/p17925184/s52932178/447ca40a-bca89695-c278f1fa-31586c21-3d0fac16.jpg,test," FINAL REPORT INDICATION: Altered mental status and delirium, here to evaluate for pneumonia. COMPARISON: Chest radiographs dated ___. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: There is increased opacification at the right lung base and a new air-space opacity in the right lung apex concerning for worsening infection. A small right pleural effusion is also likely present and unchanged. There is no pulmonary edema or pulmonary vascular congestion. Hyperinflation of the lungs with emphysematous changes at the lung apices are again seen. A left PICC tip is unchanged with the tip terminating in the upper SVC. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. IMPRESSION: Worsening right basilar opacity and possible new right apical opacity concerning for worsening infection. Aspiration is not excluded. Small right pleural effusion is unchanged from ___. " e149f857-b528f9fd-46cd268b-6cbcd1e6-0c5434d1.jpg,test/p18/p18624255/s57372839/e149f857-b528f9fd-46cd268b-6cbcd1e6-0c5434d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESRD on HD with dyspnea // Interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The hemodialysis catheter is in unchanged position. Low lung volumes. Moderate cardiomegaly. Moderate right and small left pleural effusion, with subsequent areas of atelectasis as well as a pre-existing perihilar opacity on the right. No new parenchymal opacities. No pneumothorax. " 7d5c314b-89d318b2-6cf4afa4-a88ab79a-61bf492a.jpg,test/p17/p17763712/s59389990/7d5c314b-89d318b2-6cf4afa4-a88ab79a-61bf492a.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old female patient with fever and cough, evaluate for infiltrates. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study ___ ___. Similar as to the previous examination, there is evidence of a subclavian approach central venous line terminating in the lower SVC. It most likely represents a Port-A-Cath system. Heart size remains normal and there is no evidence of pulmonary vascular congestion. The thoracic aorta is mildly widened and elongated but does not demonstrate any new local contour abnormalities. The pulmonary vasculature is not congested but somewhat irregular in the periphery, a finding which in conjunction with the low positioned and flattened diaphragm is suggestive of COPD. Acute new infiltrates cannot be identified. There is no evidence of pneumothorax in the apical area where there exist bilateral apical local pleural thickening which are smoothly delineated. Skeletal structures of the thorax demonstrate some mild degree of degenerative changes in the thoracic spine as identified on the lateral view, but no evidence of any significant vertebral body compression fracture. IMPRESSION: Stable chest findings. No evidence of pulmonary congestion or acute infiltrates, but typical signs compatible with COPD. " 82c1824b-f8af1cfa-72b4d68c-07a69555-57ca519a.jpg,test/p17/p17057667/s52577653/82c1824b-f8af1cfa-72b4d68c-07a69555-57ca519a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ is a ___ year old female with history of ILD (fibrotic nonspecific interstitial pneumonia), prior MI, HLD, HTN, Diabetes Mellitus, LBP, and GERD, who presented for 3 day history of neck swelling and hoarseness in the setting of 4-weeks of prednisone use, imaging significant for pneumomediastinum. // interval change IMPRESSION: As compared to ___ radiograph, diffuse pneumomediastinum extending into the cervical region is a persistent finding. There is likely a very small left apical pneumothorax. Widespread fibrotic interstitial lung disease is again demonstrated as well as increasing confluence of opacification in the left perihilar and retrocardiac regions, potentially due to developing infection in the appropriate clinical setting. No other relevant changes since recent study. " 20b2f640-9e81f8ed-bf2655bf-225e011b-71a4abb8.jpg,test/p19/p19524140/s58176268/20b2f640-9e81f8ed-bf2655bf-225e011b-71a4abb8.jpg,test," FINAL REPORT INDICATION: ___-year-old female with recent failed CABG and repeat stenting, now with hypoxia, shortness of breath and leg edema. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of top normal size with stable cardiomediastinal contours. The pulmonary vasculature is indistinct, compatible with mild edema. Bilateral effusions have increased, now moderate in size, with adjacent compressive atelectasis. No pneumothorax. Sternotomy wires are intact. Mediastinal clips and coronary artery stent are similar in position. IMPRESSION: Mild pulmonary edema with increased bilateral pleural effusions, now moderate in size. Findings were communicated via phone call by ___ to ___ on ___ at 13:25 p.m. " c1609062-d8ff4e98-3783ea36-46b8de72-7fbea152.jpg,test/p10/p10165672/s54051447/c1609062-d8ff4e98-3783ea36-46b8de72-7fbea152.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CRF, CHF, and prob opportunistic infection by CT // interval change in pulmonary infiltrates COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing parenchymal opacities have substantially decreased in extent and severity. They remain best visible at the right lung bases and in the left perihilar region. No new opacities. Ongoing borderline size of the cardiac silhouette without pulmonary edema. The lateral radiograph of today shows minimal dorsal pleural effusions. " 246c7dcc-021dd720-0a5cbbde-b2e7e520-a1dc5f0c.jpg,test/p12/p12106204/s56426942/246c7dcc-021dd720-0a5cbbde-b2e7e520-a1dc5f0c.jpg,test," FINAL REPORT STUDY: AP chest. CLINICAL HISTORY: ___-year-old man with effusion. FINDINGS: Comparison is made to previous study from ___. There is a right-sided PICC line, right IJ Cordis, endotracheal tube, feeding tube, which are all unchanged in position. The tip of the endotracheal tube is slightly low and is 3 cm above the carina. This could be pulled back 1 cm for more optimal placement. There are bilateral pleural effusions, left side greater than right. There is mild pulmonary interstitial edema. Persistent bibasilar atelectasis is seen. " 5fd59cbf-5ec7a77e-ac4f8b63-53056eca-f969a711.jpg,test/p13/p13836313/s50339153/5fd59cbf-5ec7a77e-ac4f8b63-53056eca-f969a711.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: There is a new single-lead pacemaker device which has been placed since the earlier examination, with its lead terminating in the right ventricle. A punctate hyperdense focus in the anterior mediastinum to the right of midline appears unchanged. The heart is again mildly enlarged. The mediastinal and hilar contours appear unchanged. A mild diffuse interstitial abnormality is quite similar to the prior examination. There is no pleural effusion or pneumothorax. The lungs are hyperinflated. Bony demineralization and mild degenerative changes along the thoracolumbar spine, including prominent anterior osteophytes along a few lower thoracic interspaces, appear unchanged. The patient is status post incompletely imaged left shoulder replacement. IMPRESSION: Stable appearance of the chest including a widespread mild-to-moderate interstitial abnormality. Differential considerations include chronic pulmonary vascular congestion or an intrinsic interstitial abnormality. " 8f401d79-0ba5c925-8ffabdbf-41295366-2b566c89.jpg,test/p13/p13954367/s51091175/8f401d79-0ba5c925-8ffabdbf-41295366-2b566c89.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pacemaker // Evaluate for lead placement TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: There has been interval placement of a left chest wall dual lead pacing device. The lead tips project over the right atrium and right ventricular apex based on a single frontal view. Lower lung volumes are noted with secondary crowding of the bronchovascular markings. There is no obvious pneumothorax. Cardiomediastinal silhouette is grossly stable. " 8bae806c-f00e4d26-3d703463-9616a2e6-4aeaf105.jpg,test/p14/p14729260/s52871249/8bae806c-f00e4d26-3d703463-9616a2e6-4aeaf105.jpg,test," FINAL REPORT HISTORY: ___-year-old female with history of lymphoma status post bone marrow transplant, now with shortness of breath. Evaluate for pneumonia. COMPARISON: Multiple prior chest radiographs dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well-expanded clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. A hemodialysis catheter is seen with the tip terminating in the right atrium. IMPRESSION: No evidence of pneumonia. " 3a855afc-53a7b4bc-f4fcff7a-2eaecb88-11a88e60.jpg,test/p10/p10514375/s58537437/3a855afc-53a7b4bc-f4fcff7a-2eaecb88-11a88e60.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with shortness of breath. Lung cancer. Question pneumonia or effusions. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. There has been no significant interval change. Left upper lung rounded opacity is again compatible with loculated pleural effusion. Blunting of the posterior costophrenic angles is also compatible with layering effusions bilaterally. Superimposed streaky opacities at the bases, left greater than right, suggestive of atelectasis, noting that superimposed infection cannot be excluded. Left hilar mass is best appreciated on prior CTs with most recent from ___. Osseous and soft tissue structures are unchanged. IMPRESSION: No significant interval change. Loculated fluid at the left lung superiorly and trace bilateral effusions. Superimposed linear opacities at the bases suggestive of atelectasis, noting that infection cannot be excluded. No significant change since prior. " 62a93ca3-11c24940-fbb385a6-464286ef-81d41141.jpg,test/p15/p15197176/s53774131/62a93ca3-11c24940-fbb385a6-464286ef-81d41141.jpg,test," FINAL REPORT HISTORY: Cough and shortness of breath. COMPARISON: ___. FINDINGS: Low lung volumes exaggerate the heart size which is mildly enlarged. There is bibasilar atelectasis. Chronic elevation of the right hemidiaphragm is present. No large pleural effusion or pneumothorax. Linear opacities in the left upper lobe likely reflect post radiation treatment changes. No focal consolidation. IMPRESSION: Bibasilar atelectasis. " e241528a-c270c707-e9ff8441-c164c696-8ec240dd.jpg,test/p15/p15002678/s50508258/e241528a-c270c707-e9ff8441-c164c696-8ec240dd.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Followup of the patient with hepatitis C and cirrhosis, to assess pleural effusion. Ap chest radiograph. As compared to ___, there is interval improvement of pulmonary edema as well as substantial improvement of bibasal opacities, most likely a part of the resolving edema. Small bilateral pleural effusions are noted, left more than right. Right PICC line tip is at the level of mid SVC. " 086a1a00-5019f953-193f51d0-12612609-0f80e6c9.jpg,test/p16/p16726403/s56019243/086a1a00-5019f953-193f51d0-12612609-0f80e6c9.jpg,test," WET READ: ___ ___ ___ 5:06 AM No evidence of acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with dyspnea, evaluate for acute process TECHNIQUE: Single portable frontal view radiograph of the chest. COMPARISON: None available. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. IMPRESSION: No evidence of acute cardiopulmonary process. " 1e2b9abb-672284a9-8e075426-7db00bda-50fe4dcf.jpg,test/p14/p14946203/s53464197/1e2b9abb-672284a9-8e075426-7db00bda-50fe4dcf.jpg,test," FINAL REPORT HISTORY: ___-year-old male with fevers and chills. Assess for pneumonia. COMPARISON: Chest radiograph from ___ PA AND LATERAL CHEST RADIOGRAPHS: A left-sided pacemaker/AICD is in unchanged position with the leads projecting over the right atrium, right ventricle, and coronary sinus. Median sternotomy wires appear intact. Scattered mediastinal clips are noted. Moderate-to-severe cardiomegaly is unchanged. Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. No pneumothorax is identified. IMPRESSION: No acute cardiopulmonary process. No pneumonia. " 4b23165a-4795228a-2eb846a2-23b27cd1-d92e349b.jpg,test/p18/p18816466/s53778842/4b23165a-4795228a-2eb846a2-23b27cd1-d92e349b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with hx of L breast cancer with sharp L sided rib pain // eval pneumonia, effusion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Blunting of the left costophrenic angle is stable. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable and stable. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 6f338dea-bf6bf963-1e8008da-ae34b104-11b6f344.jpg,test/p16/p16893353/s56619080/6f338dea-bf6bf963-1e8008da-ae34b104-11b6f344.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HFPEF, CAD, asthma, Afib, pneumonia; now worsening chest and back pain. // Please assess for mediastinal changes or other acute chest process TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there is substantial improvement in right lung opacity consistent with improvement of pneumonia. There is minimal interstitial edema present. Cardiomegaly is unchanged. Pacemaker defibrillator appears unchanged " ed4f8305-b1c4b44c-48dd9782-f4d59260-6cf3b2eb.jpg,test/p14/p14353305/s56540766/ed4f8305-b1c4b44c-48dd9782-f4d59260-6cf3b2eb.jpg,test," WET READ: ___ ___ ___ 8:13 PM Moderate sized right ptx. no def signs of tension. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH. COMPARISON: None. CLINICAL HISTORY: ___-year-old male with shortness of breath, assess for pneumothorax. FINDINGS: PA and lateral views of the chest were obtained demonstrating a moderate-sized right pneumothorax with no significant shift of midline structures. No pleural effusion is seen. Left lung is clear and well inflated. Heart and mediastinal contours appear grossly unremarkable. Bony structures are intact. IMPRESSION: Moderate right pneumothorax without definite signs of tension. Findings were posted and flagged to the ED dashboard at the time of this dictation. " d9b25edc-a6556779-32040c13-1ea99771-ebed1f6b.jpg,test/p17/p17436646/s53213195/d9b25edc-a6556779-32040c13-1ea99771-ebed1f6b.jpg,test," FINAL REPORT INDICATION: Dizziness for the past several hours, acute in onset with vertigo. Reports pleuritic chest pain and minimal shortness of breath. Nonproductive cough. Evaluate for acute intrathoracic process. COMPARISON: Chest radiograph from ___. Chest radiographs from ___. ___ CT from ___. FINDINGS: AP and lateral radiographs of the chest were acquired. An ___-mm right lower lobe pulmonary nodule was better assessed on prior chest CT from ___; please see the prior CT report for associated follow-up recommendations. The lungs are otherwise clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary process. " 5f46ea4f-ffd625cf-2fb74f29-a3fcc06c-674d6631.jpg,test/p14/p14189406/s53168410/5f46ea4f-ffd625cf-2fb74f29-a3fcc06c-674d6631.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p OG tube placement // correct OG placement? correct OG placement? COMPARISON: Chest radiographs ___ through ___. IMPRESSION: New nasogastric tube ends in the upper portion of a nondistended stomach. ET tube, right internal jugular line, and right PIC line are in standard placements respectively. A small volume of residual left perihilar edema is unchanged over the course of the day. Atelectasis has developed at the right base reflected in new elevation of the right hemi diaphragm. Heart size normal. Pleural effusion small if any. No pneumothorax. " 86af2dce-0af1d506-eca4cd44-156b6ab3-cd022f55.jpg,test/p13/p13501962/s58611508/86af2dce-0af1d506-eca4cd44-156b6ab3-cd022f55.jpg,test," FINAL REPORT AP CHEST, 9:39 A.M., ON ___. HISTORY: ___-year-old man with COPD and recent abdominal surgery, short of breath. IMPRESSION: AP chest compared to ___: Mild new peribronchial opacification in the lateral aspect of the right lung base, above the chronically elevated hemidiaphragm could be the residual of recent larger infection, or an early pneumonia. The upper lungs are clear. The heart is normal size and there is no appreciable pleural effusion. Dr. ___ was paged at 11:45 as soon as the findings were recognized. " 26a68329-b434f9c7-1926a104-ca6774c1-62dd4822.jpg,test/p11/p11607177/s51712078/26a68329-b434f9c7-1926a104-ca6774c1-62dd4822.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with severe CHF. // assess interval change IMPRESSION: Swan-Ganz catheter continues to terminate distally in the infrahilar region within a branch of the right lower lobe pulmonary vasculature. Cardiac silhouette remains enlarged and is accompanied by pulmonary vascular congestion and development of interstitial edema. " c0025a4d-8e2b70bf-910295ea-25651521-7a25c571.jpg,test/p17/p17527219/s54339896/c0025a4d-8e2b70bf-910295ea-25651521-7a25c571.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF, starting tailored therapy // interval change IMPRESSION: In comparison to prior radiograph of 1 day earlier, persistent cardiomegaly is accompanied by pulmonary vascular congestion. Interstitial edema has nearly resolved. No other relevant change. " a3320573-20ad10f4-32c01dbf-b737c263-04f478da.jpg,test/p18/p18696302/s57403825/a3320573-20ad10f4-32c01dbf-b737c263-04f478da.jpg,test," FINAL REPORT HISTORY: Status post CABG, evaluate for effusions and pneumothorax. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs, two views. FINDINGS: Compared to prior examinations, there is better expansion of the lung fields with redemonstration of a small left-sided effusion, but with improving bibasilar atelectasis. There has been interval removal of a right internal jugular central venous catheter. There is no pneumothorax. IMPRESSION: Improvement of left pleural effusion and bibasilar atelectasis. " ab2425c0-f9104ab8-b17e0e22-6a0d87c7-34053b0f.jpg,test/p16/p16287596/s57292001/ab2425c0-f9104ab8-b17e0e22-6a0d87c7-34053b0f.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest pain after motor vehicle collision. Evaluation for sternal fracture or pneumothorax. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no evidence of pleural effusion, pneumothorax, pulmonary edema or focal parenchymal opacity in the lungs. The bony structures are intact. IMPRESSION: No acute cardiopulmonary process. Bony structures are intact. " 60e541b1-f8598486-67407787-51c58726-cdc8c7f5.jpg,test/p14/p14253816/s50296395/60e541b1-f8598486-67407787-51c58726-cdc8c7f5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with aspiration // ?PNA ?PNA IMPRESSION: COMPARISON STUDY ON ___, THERE IS INCREASED OPACIFICATION AT THE LEFT BASE. IN THE APPROPRIATE CLINICAL SETTING, ASPIRATION OR INFECTIOUS PNEUMONIA WOULD HAVE TO BE SERIOUSLY CONSIDERED, IN ADDITION TO ATELECTASIS AND EFFUSION. THE RIGHT LUNG IS ESSENTIALLY CLEAR. ANCHORS 2 NOTIFICATION: TO DR. ___ " 8e6be5eb-2d7e7f22-798250ee-8bcaee21-a361593a.jpg,test/p11/p11887060/s54866189/8e6be5eb-2d7e7f22-798250ee-8bcaee21-a361593a.jpg,test," FINAL REPORT INDICATION: ___-year-old male with history of asthma presenting with shortness of breath and a productive cough. Evaluate for pneumonia. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. Heart size and cardiomediastinal contours are normal. The lungs are under-expanded but clear. No focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body. IMPRESSION: Low lung volumes without evidence for acute cardiopulmonary process. " 0a380d15-072ec90b-56eba0f6-69139e23-a053dd12.jpg,test/p17/p17985260/s56801918/0a380d15-072ec90b-56eba0f6-69139e23-a053dd12.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Cardiac, mediastinal and hilar contours are unchanged and within normal limits. Subsegmental atelectasis is seen within the left lower lobe. Lungs are otherwise clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 9bff1b5d-5f9ac3f2-bb461642-7044d9dd-12f6917a.jpg,test/p11/p11122196/s58881163/9bff1b5d-5f9ac3f2-bb461642-7044d9dd-12f6917a.jpg,test," FINAL REPORT INDICATION: ___ year old woman with R TMA wound infection, now with cough // evaluation pneumnia COMPARISON: ___ FINDINGS: Ill-defined airspace opacity in the right lower lobe medially appears slightly more apparent since ___, this could represent worsening airspace opacity. The left lung is relatively clear. No significant effusions or pneumothorax. The heart size is stable and the left lung is clear IMPRESSION: Ill-defined opacity in the right lower lobe can reflect atelectasis or pneumonia in the appropriate clinical setting. " 7374bd4e-3e9a60d0-ec519270-2ef5dd36-6fc5e87e.jpg,test/p19/p19524873/s55891307/7374bd4e-3e9a60d0-ec519270-2ef5dd36-6fc5e87e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic cancer s/p chest tube // chest tube placement TECHNIQUE: Portable chest COMPARISON: ___ at ___ . FINDINGS: right-sided pigtail catheter is again visualized. There are small bilateral pleural effusions left greater than right. There is hazy alveolar infiltrate left greater than right which have increased compared to the prior study. There is pulmonary vascular redistribution. . There is no pneumothorax. IMPRESSION: Increased alveolar infiltrates bilaterally. This may be due to pulmonary edema but underlying infection cannot be excluded " dd05cd78-aeefe58f-67e03c3e-4d3184fd-40d9c522.jpg,test/p10/p10514375/s54173461/dd05cd78-aeefe58f-67e03c3e-4d3184fd-40d9c522.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of metastatic lung cancer, now with shortness of breath. Evaluate for evidence of pneumonia. COMPARISON: Chest CT on ___. PORTABLE UPRIGHT AP CHEST RADIOGRAPH FINDINGS: The right lung is clear. The left lung again demonstrates a rounded left apical opacity, which is not significantly changed compared with prior CT and represents a loculated pleural effusion. Small amount of left pleural fluid is also noted at the base in this patient who is status post pleurodesis. Left hilar opacity is compatible with known mass, and streaky opacity within the left lung base radiating from the hilum is unchanged, likely reflective of atelectasis. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. IMPRESSION: No significant interval change in loculated left apical pleural effusion as well as minor left basilar pleural effusion. No new consolidation concerning for pneumonia. Ill-defined opacity in the left hilar region is compatible with known mass and streaky left basilar opacity likely reflects atelectasis. " 7e7558b6-8af7c8a3-67980159-9eb30484-33a2160c.jpg,test/p19/p19017482/s57817723/7e7558b6-8af7c8a3-67980159-9eb30484-33a2160c.jpg,test," FINAL REPORT HISTORY: Tremors, weakness and chest tightness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CTA ___. FINDINGS: Cardiac silhouette size is normal. The aorta is mildly tortuous but unchanged. Pulmonary vascularity and hilar contours are normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There is diffuse demineralization of the osseous structures. The patient is status post right mastectomy. IMPRESSION: No acute cardiopulmonary abnormality. " d8d58056-cf6e7466-4b6022d7-ab359203-c8d0d479.jpg,test/p14/p14197574/s59721042/d8d58056-cf6e7466-4b6022d7-ab359203-c8d0d479.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated // interval change COMPARISON: Chest x-ray from ___ at 23:18 FINDINGS: An ET tube is present, tip approximately knee 0.6 cm above the carina. An NG tube is present, tip and side-port overlying the stomach. A right IJ central line is present, tip overlying the right atrium. No pneumothorax is detected. Left-sided rib and scapular fractures seen on the CT from ___ are not well depicted radiographically. Heart size is at the upper limits of normal or minimally enlarged. There is slight elevation of the left hemidiaphragm. There is mild upper zone redistribution, without other evidence of CHF. There is minimal patchy retrocardiac opacity, grossly unchanged, and minimal atelectasis in the right cardiophrenic region, that is slightly more pronounced. No definite consolidation. No gross effusion. No free air seen beneath the diaphragms. IMPRESSION: 1. Lines and tubes nominal in position. No pneumothorax detected. 2. Bibasilar atelectasis. Atelectasis at the right base is more pronounced. No definite consolidation, though continued surveillance is recommended. 3. Upper zone redistribution, without overt CHF. 4. Known left-sided rib and scapular fractures not well depicted radiographically. " 35e2a86c-565282a3-b3e69d69-c4c28621-f8b80b41.jpg,test/p18/p18279430/s50456984/35e2a86c-565282a3-b3e69d69-c4c28621-f8b80b41.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old man with hx of AWMI s/p CABG, CHF s/p BiV ICD, liver cirrhosis, and CKD, admitted from clinic for diuresis and likely dialysis // ___-year-old man with hx of AWMI s/p CABG, CHF s/p BiV ICD, liver cirrhosis, and CKD, admitted from clinic for diuresis and likely dialysis ___-year-old man with hx of AWMI s/p CABG, CHF s/p BiV ICD, l IMPRESSION: In comparison with the study of ___, the endotracheal and nasogastric tubes have been. Otherwise, little change, with substantial enlargement of the cardiac silhouette and relatively mild elevation of pulmonary venous pressure, a combination the raises the possibility of cardiomyopathy or pericardial effusion. Bibasilar atelectatic changes with small pleural effusions. " a760eab2-9ce9c389-624f7562-1e305140-2fa110cb.jpg,test/p13/p13090958/s50266042/a760eab2-9ce9c389-624f7562-1e305140-2fa110cb.jpg,test," WET READ: ___ ___ ___ 7:47 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: ___M with shortness of breath, fever, IVDU // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with chest radiographs from ___ and ___ FINDINGS: The lungs well expanded and clear. There is no pleural effusion or pneumothorax. Hila appear prominent though this is similar to prior exams. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No pneumonia. Relative prominence of the pulmonary hila for which clinical correlation is advised. " aec07fe3-09170e0e-199eb8d2-973f8caf-1918c5d7.jpg,test/p16/p16364575/s56927801/aec07fe3-09170e0e-199eb8d2-973f8caf-1918c5d7.jpg,test," FINAL REPORT INDICATION: ___-year-old man with worsening dyspnea on exertion for months. COMPARISON: Portable AP chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours appear normal. Both lungs appear clear with no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 24e845c5-8f7847d5-6121307d-c391fe37-6ca8bf40.jpg,test/p16/p16428261/s57330465/24e845c5-8f7847d5-6121307d-c391fe37-6ca8bf40.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with intubation tube placement // Confirmation of intubation tube TECHNIQUE: Single AP portable view of the chest. COMPARISON: ___ at 11:51. FINDINGS: Interval placement of an endotracheal tube terminating 4.8 cm above the level of carina. A nasogastric tube terminates within the stomach. The lungs are clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unchanged in appearance. IMPRESSION: ETT terminating 4.8 cm above the level of the carina. No evidence of acute cardiopulmonary process. " b1918d62-c10f75fe-d4dd0586-e4a0c265-ae8a3200.jpg,test/p12/p12244625/s55422903/b1918d62-c10f75fe-d4dd0586-e4a0c265-ae8a3200.jpg,test," WET READ: ___ ___ 1:51 PM No acute cardiopulmonary abnormality. Mild irregularity of the contour of the right ___ posterior rib. Clinical correlation for tenderness in this region is recommended to exclude a nondisplaced fracture. ______________________________________________________________________________ FINAL REPORT HISTORY: Fall from bed with right hip, thoracic and lumbar spine pain. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. The aorta is diffusely calcified. The mediastinal and hilar contours are unchanged with mild unfolding of the thoracic aorta. Pulmonary vascularity is normal. The lungs are clear. There is no pleural effusion or pneumothorax. Multilevel degenerative changes are seen in the thoracic spine. Mild contour irregularity of the right ___ posterior rib could reflect a nondisplaced fracture. IMPRESSION: No acute cardiopulmonary abnormality. Mild irregularity of the contour of the right ___ and ___ posterior ribs. Clinical correlation for tenderness in this region is recommended to exclude a nondisplaced fracture. " e02aae8a-95da6e24-e234345a-ae7b4b5a-51b29070.jpg,test/p18/p18001587/s58832145/e02aae8a-95da6e24-e234345a-ae7b4b5a-51b29070.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of RA, TB sp treatment, hilar adenopathy // Tb , cause for cough Tb , cause for cough IMPRESSION: Compared to chest radiographs most recently ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . Previous borderline cardiomegaly and vascular congestion have resolved. " b4a1f796-9f378d5a-b6e7e56e-87998d43-a4b33b64.jpg,test/p14/p14244279/s50870253/b4a1f796-9f378d5a-b6e7e56e-87998d43-a4b33b64.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. Evaluate for pneumonia. COMPARISON: Multiple prior chest radiographs, most recent on ___ and ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. A cervical spine fixation plate is seen in the frontal view without evidence of hardware-related complication. IMPRESSION: Unremarkable chest radiographic examination. " e3cf2727-05edcbff-9ab99369-f2d94763-33bfed76.jpg,test/p19/p19736993/s52714690/e3cf2727-05edcbff-9ab99369-f2d94763-33bfed76.jpg,test," FINAL REPORT AP CHEST, 5:15 A.M., ___ HISTORY: An ___-year-old man with increased secretions, coronary artery disease and atrial fibrillation. Hypoxic. IMPRESSION: AP chest compared to ___: Mild increase in left perihilar opacification could represent recent aspiration. Previous vascular congestion in the upper lungs has improved, but moderate cardiomegaly and small bilateral pleural effusions have worsened. Vascular pattern suggests severe COPD. Patient has had median sternotomy and coronary bypass grafting. " 8801f294-0e4017be-196b9da9-dd59eca6-cb555d18.jpg,test/p14/p14538785/s59869175/8801f294-0e4017be-196b9da9-dd59eca6-cb555d18.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with empyema s/p chest tube. Please complete before 6 am // please eval chest tube placement and size of effusion please eval chest tube placement and size of effusion IMPRESSION: In comparison with the study ___ ___, there has been placement of a second left chest tube. The degree of the opacification at the left base is unchanged and there is no evidence of pneumothorax. Right lung remains clear. " 0bd798d9-bdd087ae-5c6f069a-cf00df93-90601abe.jpg,test/p18/p18628529/s59939259/0bd798d9-bdd087ae-5c6f069a-cf00df93-90601abe.jpg,test," FINAL REPORT HISTORY: History of sickle cell anemia, presenting with chest and back pain. Evaluate for an acute process. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest were obtained. Again seen is a left chest port catheter with the tip in the distal SVC/cavoatrial junction. There is no focal consolidation, edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is top normal in size, but unchanged from prior exam. No free air is seen under the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 326c2b19-8ff44177-0b30aa32-ba88cd90-dac8440c.jpg,test/p11/p11941858/s51036620/326c2b19-8ff44177-0b30aa32-ba88cd90-dac8440c.jpg,test," FINAL REPORT INDICATION: ___-year-old female with right breast pain, on steroids. COMPARISON: Unilateral breast ultrasound demonstrating nodular structure in the right breast at the site of indicated pain. PA AND LATERAL CHEST RADIOGRAPH: Cardiac, mediastinal and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion or pneumothorax. " 54f297c7-74d215d7-d582bbf8-676a3a68-938a95e4.jpg,test/p12/p12878814/s54219765/54f297c7-74d215d7-d582bbf8-676a3a68-938a95e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bilateral chest tubes for effusoins // eval interval change eval interval change COMPARISON: Conventional chest radiographs ___ through ___. IMPRESSION: No recurrence of left pleural effusion following complete pleural drainage by the pigtail catheter at the base of the left hemi thorax. Left lung clear aside from improving mild left basal atelectasis. Right basal pigtail pleural drain also unchanged in position. No appreciable pleural effusion. No appreciable pneumothorax on either side. Right basal atelectasis is more severe than the left, stable since ___. Upper lungs are clear. Heart size normal. Dual channel catheter ends in the region of the superior cavoatrial junction. " c0f7a890-63093d2b-90a5f909-2d9a5569-5f4eec53.jpg,test/p10/p10235789/s51864460/c0f7a890-63093d2b-90a5f909-2d9a5569-5f4eec53.jpg,test," WET READ: ___ ___ 2:55 PM Nondisplaced right ___ and ___ lateral rib fractures. Retrocardiac atelectasis. No definite radiographic evidence for pneumonia. ______________________________________________________________________________ FINAL REPORT HISTORY: Fall with subdural hematoma. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: None. FINDINGS: Lung volumes are low. The right hemidiaphragm is elevated and there is interposition of the colon between the diaphragm and the liver. The heart size is normal. The aorta is mildly unfolded. The pulmonary vasculature is not engorged. Minimal streaky opacity in the left retrocardiac region and likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Nondisplaced fractures of the right ___ and ___ lateral ribs appear to be present. IMPRESSION: Nondisplaced right ___ and ___ lateral rib fractures. Retrocardiac atelectasis. No definite radiographic evidence for pneumonia. " e2bd710d-5a54d36b-43f8a79c-1697afec-8f20c373.jpg,test/p17/p17869467/s55883825/e2bd710d-5a54d36b-43f8a79c-1697afec-8f20c373.jpg,test," WET READ: ___ ___ ___ 1:52 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with palpitations // acute process TECHNIQUE: Chest PA and lateral COMPARISON: Outside reference chest radiographs from ___ FINDINGS: The lungs are clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No focal consolidations are seen. No pulmonary edema, pneumothorax, or pleural effusion. Anterior osteophytes are noted in the thoracic spine on the lateral view. IMPRESSION: No acute cardiopulmonary process. " 85b5a55b-2e0d14a7-d2a041a6-056bf221-6b70baab.jpg,test/p19/p19017172/s52722191/85b5a55b-2e0d14a7-d2a041a6-056bf221-6b70baab.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: Altered mental status, vision loss. History of lung cancer. COMPARISON: Chest x-rays from ___, ___, and chest CT from ___. FINDINGS: AP upright and lateral views of the chest reveal chronic changes related to both prior surgery and radiation. There is a stable right perihilar and posterior density which has not changed. There is no new consolidation. Cardiomediastinal silhouette is stable. Post-thoracotomy changes seen on the right. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute intrathoracic process. Stable scarring/post-op changes in the right hemithorax. " 253ea360-d6f72214-0fd46d77-8e551291-68433ad2.jpg,test/p11/p11607177/s58340429/253ea360-d6f72214-0fd46d77-8e551291-68433ad2.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with history of cardiomyopathy, CHF, LV ejection fraction ___% and atrial fibrillation. Patient is status post ICD implant on ___. Check ventricular lead position as today the ventricular lead threshold is significantly higher. FINDINGS: PA and lateral chest views have been obtained with patient in semi-upright position. Comparison is made with a similar PA and lateral chest examination obtained on ___. The previously described cardiomegaly persists, rather unchanged. Position of previously described permanent pacer in left anterior axillary position unaltered. The pacer is connected to a single intracavitary electrode. The distal terminal wire enforcement is well identified and appears in unchanged position as identified on PA and lateral chest views. The distal point of the electrode points to the left and anteriorly which is indicative of the apical area of the right ventricle. Comparison of the pulmonary vasculature as seen on the frontal view demonstrates that the previously existing perivascular haze has decreased indicating improvement of pulmonary venous congestion. No new parenchymal infiltrates are seen, the pleural sinuses are free and no pneumothorax exists in the apical area. IMPRESSION: Unchanged position of single electrode ICD device in apical portion of right ventricle. To evaluate possible positional causes that may explain increasing thresholds, fluoroscopic evaluation of the distal catheter is recommended as the static routine PA and lateral chest views cannot account for events during normal cardiac motion. " d02d686f-92cfef0d-22af70ae-7efbea5e-98f76a00.jpg,test/p18/p18783648/s58582738/d02d686f-92cfef0d-22af70ae-7efbea5e-98f76a00.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with right back pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and chest CT ___ FINDINGS: Cardiac silhouette size is mildly enlarged, increased in the interval. The aorta is tortuous. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Lungs are hyperinflated but clear without focal consolidation. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 8ca2547f-bbf0b94a-2959c547-89d78c22-d0fd6322.jpg,test/p17/p17116651/s56215242/8ca2547f-bbf0b94a-2959c547-89d78c22-d0fd6322.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever // Eval for acute process, attn to PNA TECHNIQUE: PA and lateral chest radiographs COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes are unchanged compared to the prior study. The heart size is borderline enlarged. There are streaky retrocardiac opacities localizing to the left lower lobe on the lateral view, these are new when compared to the prior study and suspicious for pneumonia. No pneumothorax or pleural effusion seen. The visualized bony structures are unremarkable except to note posterior thoracic spine stabilization hardware. IMPRESSION: Left lower lobe consolidation. Recommend followup with repeat chest radiograph in ___ weeks following completion of treatment to ensure resolution. " 51d8c472-f9fcf4ed-9184942a-6cbef84f-8c5ae7a8.jpg,test/p16/p16856004/s58981605/51d8c472-f9fcf4ed-9184942a-6cbef84f-8c5ae7a8.jpg,test," WET READ: ___ ___ ___ 11:49 PM patchy opacities in right lower lung concerning for pneumonia. however, given right hemidiaphragm elevation, compressive atelectatsis is another consideration. streaky atelectasis alos noted in retrocardiac spce. trace bilateral pleural effusions, right greater than left. no pneumothorax. normal cardiomediastinal and hilar contours. ___ ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Leukocytosis and low-grade temperature. IMPRESSION: PA and lateral chest reviewed in the absence of prior chest radiographs: Right lung base is markedly elevated in a fashion that could be either a diaphragmatic eventration or even a chronic contained diaphragmatic rupture. Small right pleural effusion is collected in the anterior and posterior pleural sulci. A large elliptical area of opacity at the right base is probably atelectasis. A barely visible rounded lesion, about 7 cm in diameter projecting over the descending thoracic aorta could be a hiatus hernia or mass in the left lung or saccular thoracic aortic aneurysm. Any prior cross-sectional imaging that includes a lower chest should be consulted. Oblique views might be helpful for elucidation short of CT scanning. There is no pneumothorax. Upper lungs are clear. Thoracic aorta is generally large. The heart is mildly dilated. Dr. ___ was paged. " c8330522-05658cce-bcd16b8e-31bdfb80-1de0cf26.jpg,test/p18/p18899192/s56895770/c8330522-05658cce-bcd16b8e-31bdfb80-1de0cf26.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with chest pain. Evaluate for thoracic pathology. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Normal cardiomediastinal and hilar contours. Focal eventration of the right hemidiaphragm. Clear, fully expanded lungs. No definite soft tissue or osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f87bd8f0-4fdf30e5-a3176651-d95c9fee-683e3fd4.jpg,test/p12/p12176298/s55539638/f87bd8f0-4fdf30e5-a3176651-d95c9fee-683e3fd4.jpg,test," FINAL REPORT INDICATION: History of right lobectomy with new pleural effusion, catheter placement. COMPARISON: ___, 4:52 a.m. FINDINGS: As compared to the previous radiograph, the patient has received a new pigtail catheter on the right. The fluid collection at the medial right lung base has decreased in extent. The right hemithorax shows no evidence of pleural air inclusion. The lung volumes have overall decreased. This might account for a diffuse increase in radiodensity of the left lung parenchyma, with slightly enlarged diameters of the vascular structures. However, short-term radiographic followup must be performed to exclude the presence of early pneumonia or pulmonary edema. Unchanged appearance of the cardiac silhouette. " 6121b89c-f4c44948-2b23441d-acb9eb6e-19d1ca7a.jpg,test/p19/p19828353/s57396678/6121b89c-f4c44948-2b23441d-acb9eb6e-19d1ca7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with agitation // evaluate for pneumonia COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. The lungs appear relatively clear without convincing signs of pneumonia or edema. No pleural effusion or pneumothorax is seen. The heart and mediastinal contours appear unchanged. There may be minimal hilar congestion. Bony structures appear grossly intact. IMPRESSION: As above. " 86b7b0eb-4600a52c-92e300ce-c24f6f26-b8e98bd9.jpg,test/p17/p17925184/s59815945/86b7b0eb-4600a52c-92e300ce-c24f6f26-b8e98bd9.jpg,test," WET READ: ___ ___ 10:25 PM Dobhoff ends in the lower esophagus. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Dobbhoff placement, goal is to go beyond the carina. FINDINGS: The Dobbhoff tube tip is in the lower portion of the esophagus. The appearance of the lungs is unchanged. The left IJ line tip in the SVC is unchanged. " 83d6e856-f632ecaa-c41d8e6c-8b5f4367-847b091a.jpg,test/p10/p10481168/s54036330/83d6e856-f632ecaa-c41d8e6c-8b5f4367-847b091a.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with new pleuritic chest pain // Please evaluate for infection, effusion TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiograph ___, ___. FINDINGS: Since ___, retrocardiac consolidation and small left pleural effusion is new. Differential considerations include pulmonary infarct, pneumonia, or mass. Diffuse osseous metastatic disease is unchanged. The heart size is normal. Left chest wall calcified mass is also unchanged. No pneumothorax or pulmonary edema. Right Port-a-Cath tip terminates in the right atrium. IMPRESSION: 1. New retrocardiac consolidation and small left pleural effusion since ___. Differential considerations include pulmonary infarct, pneumonia, or mass. 2. Unchanged diffuse osseous metastatic disease and left chest wall calcified mass. RECOMMENDATION(S): Recommend CT chest for further evaluation of new retrocardiac consolidation. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 2:34 PM, 10 minutes after discovery of the findings. " e97723a3-05e1a745-4b524004-56f78302-768d78dc.jpg,test/p17/p17850903/s57282563/e97723a3-05e1a745-4b524004-56f78302-768d78dc.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs INDICATION: ___F with sob x 2 weeks // ? pna, effusions TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: As compared to the prior examination dated ___, there has been no relevant interval change. There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. Persistent elevation of the left hemidiaphragm is unchanged. The cardiomediastinal silhouette is within normal limits. Surgical clips overlie the mid left upper abdomen. IMPRESSION: No acute cardiopulmonary process. " d5ef62a5-dc83d175-b0112c01-0371e730-d70b2de6.jpg,test/p19/p19533730/s53283080/d5ef62a5-dc83d175-b0112c01-0371e730-d70b2de6.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY OF ___ COMPARISON: Radiograph, ___. FINDINGS: Endotracheal tube and nasogastric tube are in standard position. Permanent pacemaker remains in place, with one lead terminating in the right atrium, and a second right atrial lead with a very tortuous course, which has been present on multiple prior radiographs and is probably unchanged allowing for the degree of patient rotation. However, attention to this on a non-rotated radiograph would be helpful for more accurate comparison to prior studies. Cardiomegaly is accompanied by pulmonary vascular congestion and slightly improved asymmetrically distributed multifocal alveolar opacities, likely a combination of pulmonary edema and pneumonia. The latter likely accounts for confluent opacities in the right upper and left mid lung regions. Small right and moderate left pleural effusions have slightly improved. " e5d13a4c-c557cb4b-f24dcddc-ced8d1a7-5ade6e45.jpg,test/p17/p17858377/s51874203/e5d13a4c-c557cb4b-f24dcddc-ced8d1a7-5ade6e45.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: Status post fall with posterior head strike. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear. There is no pleural effusion. Cardiomediastinal silhouette is within normal limits. Osseous structures are notable for degenerative changes at the right glenohumeral joint. There is no visualized fracture. IMPRESSION: No acute cardiopulmonary process. " bffec05e-3ce24a31-b5982b1a-c555171b-eeaf5e33.jpg,test/p13/p13306609/s50055134/bffec05e-3ce24a31-b5982b1a-c555171b-eeaf5e33.jpg,test," FINAL REPORT INDICATION: ___ year old woman with chills, tachycardia // Please eval for infiltrate, effusion TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: The right PICC line terminates in mid SVC, unchanged. Enteric tube terminates in the stomach. Very slight increase in opacity in right lung base can represent early pneumonia in appropriate clinical setting. The hila are normal. No pleural effusions or pneumothorax. The cardiomediastinal silhouette is unchanged. IMPRESSION: Very slight increase in opacity in right lung base can represent early pneumonia in appropriate clinical setting. " c602c27d-8877a830-602ccf38-c1f51121-377f1dd2.jpg,test/p15/p15844553/s58431042/c602c27d-8877a830-602ccf38-c1f51121-377f1dd2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with s/p MVC // please assess for traumatic injury TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: Single supine AP portable view of the chest was obtained. No focal consolidation is seen. There is no pleural effusion or evidence of pneumothorax. Mediastinal contours are normal. The cardiac silhouette is accentuated by AP, supine technique. No displaced fracture is identified. IMPRESSION: No evidence of acute intrathoracic injury. " 15c90c93-364fe29d-4dde4409-7be192b4-3da7822a.jpg,test/p18/p18458646/s54560955/15c90c93-364fe29d-4dde4409-7be192b4-3da7822a.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with history of chronic lymphocytic leukemia and recent respiratory infection as well as history of interstitial pneumonitis. Compare to prior study. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next previous PA and lateral chest examination of ___. Heart size and appearance of thoracic aorta including mediastinal structures are unchanged. The pulmonary vasculature is not congested. No evidence of acute or chronic parenchymal infiltrates is present, and the lateral and posterior pleural sinuses are free. No evidence of new acute pulmonary parenchymal or pleural abnormalities, and no evidence of pneumothorax in the apical area. On previous examination identified minute peripheral plate atelectasis on the left base has resolved. Very mild degree of degenerative changes is seen in the thoracic spine vertebral body anteriorly. They have not progressed significantly. Our records include multiple previous chest CT examinations, the most recent dated ___, ___, ___, ___ and again ___. Previously identified scattered ground-glass densities were shown, but these are two subtle to be identified conclusively on the plain chest examinations. IMPRESSION: No evidence of significant cardiac enlargement, CHF, or acute pulmonary infiltrates. " 25272403-250f92fc-a4fe3de3-559603be-d06ab942.jpg,test/p11/p11234592/s57145991/25272403-250f92fc-a4fe3de3-559603be-d06ab942.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Patient with aortic valve abscess, also evaluate location of PICC line. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and CABG. A right-sided PICC is seen, terminating in the proximal to mid SVC, slightly higher in position than on the prior study from ___. There is mild left base atelectasis. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. Minimal left base atelectasis is seen. IMPRESSION: 1. Right PICC terminates in the proximal to mid SVC without evidence of pneumothorax. Mild left base atelectasis. " 04d1e212-97257f5f-be99688a-f03c7343-12846e6b.jpg,test/p10/p10470244/s53406490/04d1e212-97257f5f-be99688a-f03c7343-12846e6b.jpg,test," FINAL REPORT INDICATION: Chest pain and shortness of breath. Evaluate for pulmonary edema. COMPARISON: Chest radiographs ___, ___, ___ and ___. FINDINGS: Upright PA and lateral radiographs of the chest. There is chronic pleural thickening at the left costophrenic sulcus unchanged since at least ___. No new focal airspace opacity is detected. The cardiomediastinal silhouette and hilar contours are stable. The aorta is calcified and tortuous. There is no frank pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 23d619ec-f107dcfc-536823d8-1d8f6ac5-ed838ade.jpg,test/p13/p13835373/s57093601/23d619ec-f107dcfc-536823d8-1d8f6ac5-ed838ade.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man with resp distress, tracheostomy // eval for PNA COMPARISON: Chest radiograph ___ IMPRESSION: Previous areas heterogeneous opacification in the right midlung just above the minor fissure has resolved since ___. This may have been a region of aspiration. The lungs are fully expanded and clear. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. Narrowing of the mid portion of the tracheal airway would require CT for assessment. " 86e9a296-14504407-97a0f610-35ec0a28-929346f7.jpg,test/p15/p15005501/s52721839/86e9a296-14504407-97a0f610-35ec0a28-929346f7.jpg,test," FINAL REPORT INDICATION: ___M with seizure and immunocompromised on chemotherapy. // ?pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no focal consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Bilateral cervical ribs are incidentally noted. IMPRESSION: No acute cardiopulmonary process. " 9c12db79-092f1bc1-803b0dc7-28bb0c81-32c3a613.jpg,test/p10/p10778290/s55154080/9c12db79-092f1bc1-803b0dc7-28bb0c81-32c3a613.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cough, SOB // eval PNA TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is no focal consolidation, pneumothorax, or pulmonary edema. Blunting of the left costophrenic angle may represent focal atelectasis versus trace fusion. The cardiomediastinal contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " 924468b8-7a135fb6-55c3320b-75d2f476-84bd63f0.jpg,test/p18/p18131667/s54937440/924468b8-7a135fb6-55c3320b-75d2f476-84bd63f0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with kidney-pancreas transplant a/w AMS now improved looking for infectious source // Evaluate for PNA as cause of AMS TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities " a2b45475-b1624cc2-43bd1be2-28755963-ef31618a.jpg,test/p15/p15023210/s50637241/a2b45475-b1624cc2-43bd1be2-28755963-ef31618a.jpg,test," FINAL REPORT INDICATION: End-stage dementia status post syncope. Rule out pneumonia. TECHNIQUE: Bedside frontal chest radiograph. COMPARISON: Chest radiographs ___ and ___. FINDINGS: Lung volumes are exceedingly low, resulting in crowding of bronchovascular structures. This also distorts the contours of the cardiomediastinum. There is no pleural effusion, pneumothorax or focal airspace consolidation. IMPRESSION: Low lung volumes without an acute cardiopulmonary process. " 0cf12425-8f1a63ab-369f890e-f8b1d208-adf50ae7.jpg,test/p17/p17974607/s50862536/0cf12425-8f1a63ab-369f890e-f8b1d208-adf50ae7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recurrent aspiration pneumonia, continued cough, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. The lung volumes are low but there is no evidence of focal parenchymal opacity suggesting pneumonia. No pulmonary edema. No pleural effusions. Normal size of the cardiac silhouette. " 85682e77-72d2660b-3d6fd568-999f71cf-8b598a29.jpg,test/p10/p10204908/s52119910/85682e77-72d2660b-3d6fd568-999f71cf-8b598a29.jpg,test," FINAL REPORT HISTORY: Status post extubation. COMPARISON: ___. FINDINGS: Moderate right-sided pneumothorax is again visualized with slightly increased in size is also small left pneumothorax has also increased in size bilateral upper lobe tail catheters are again seen is wedge-shaped opacity in the right lower lobe likely representing an area of collapsed lung this is also increased compared to the film from earlier the same day the ETT has been removed. The right-sided PICC line tip is in the mid SVC. NG tube tip is in the stomach. IMPRESSION: Increased bilateral pneumothoraces. " a7002d6e-217defad-2bba668d-0647c3e8-8e27cc24.jpg,test/p15/p15159712/s57016743/a7002d6e-217defad-2bba668d-0647c3e8-8e27cc24.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Woman with CKD with chronic cough, to assess for pneumonia. Comparison is made with prior study ___. There are lower lung volumes. Mild cardiomegaly is accentuated by the lower lung volumes. The aorta is very tortuous. There is mild vascular congestion. There is no pneumothorax or pleural effusion. " 0baeeb8f-8cf63fc8-2b6a5ec0-09ceb0b4-a751424d.jpg,test/p14/p14641639/s56456919/0baeeb8f-8cf63fc8-2b6a5ec0-09ceb0b4-a751424d.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old man with recent respiratory infection and rales at right base. ?pneumonia right base. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The heart size, mediastinal, and hilar contours are normal. There appears to be eventration of the right hemidiaphragm, however without focal lung consolidation or pleural effusion. There is left basilar atelectasis. There is no pneumothorax. IMPRESSION: Left basilar atelectasis without evidence of pneumonia. " a55355a5-7d28d66b-3a1b0954-6c306db7-65144941.jpg,test/p16/p16237334/s56890040/a55355a5-7d28d66b-3a1b0954-6c306db7-65144941.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___M s/p dirt bike accident p/w TBI with R. temporal and L. Frontal lobe intraprenchymal hemorrhage, as well as small R. frontal lobe SAH // pneumonia? COMPARISON: Chest radiograph ___:27. IMPRESSION: Lungs clear. Normal cardiomediastinal silhouette and pleural surfaces. ET tube and nasogastric tube in standard placements respectively. Although no fracture is seen, conventional chest radiographs are not sensitive for detection of chest cage trauma. Regions where there are focal findings of possible trauma should be clearly marked and imaged with bone detail views. " 5d043e8a-ec9cf584-39466e1c-592cc477-418ba890.jpg,test/p16/p16178321/s51035386/5d043e8a-ec9cf584-39466e1c-592cc477-418ba890.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with aphasia, dysarthria // r/o aspiration r/o aspiration IMPRESSION: As compared to ___, a new bilateral medial and basal peribronchial opacities are visualized in both lungs. The findings would be consistent with aspiration pneumonia in the appropriate clinical setting. Otherwise the radiograph is unchanged. Normal size of the cardiac silhouette. No pulmonary edema. No pleural effusions, no pneumothorax. " 6c51a20d-ad614c00-74639c29-a955b0c2-daf48f6e.jpg,test/p19/p19358609/s50588678/6c51a20d-ad614c00-74639c29-a955b0c2-daf48f6e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with history of LUL lobectomy. intubated with PNA // pulm edema, ETT position, PNA progression pulm edema, ETT position, PNA progression IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are unchanged. The opacification in the left mid and upper zone has decreased. Basilar opacification on this side is consistent with postsurgical changes. " 5b397e39-c4bf2355-4f11a135-3f4fda2d-eb090d7b.jpg,test/p15/p15479525/s52041478/5b397e39-c4bf2355-4f11a135-3f4fda2d-eb090d7b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with atrial fibrillation // Amiodarone toxicity TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. No conventional chest radiographic evidence of amiodarone lung toxicity. " ae682fbd-0a1da17f-e04c098c-f765b778-4f007f07.jpg,test/p12/p12584492/s50796735/ae682fbd-0a1da17f-e04c098c-f765b778-4f007f07.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with CP // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac silhouette is top-normal, with left ventricular configuration. Aorta at arch is calcified. No pulmonary edema is seen. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " a38f73e8-8adccb22-6e3d142c-11e57967-81ce8aad.jpg,test/p12/p12367803/s54607786/a38f73e8-8adccb22-6e3d142c-11e57967-81ce8aad.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough // Eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Subtle patchy right lower lobe opacity is seen which may relate to atelectasis and overlying vascular structures but an early consolidation due to pneumonia is not excluded in the appropriate clinical setting. The left lung is clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The patient is status post median sternotomy and CABG. Additional surgical clips are also noted in the upper mediastinum. IMPRESSION: Subtle patchy right lower lobe opacity may relate to atelectasis and overlying vascular structures, but overlying consolidation due to pneumonia is not excluded in the appropriate clinical setting. " e553f9e6-adfe7b22-cee0a948-c2750c06-a265e1b4.jpg,test/p17/p17425991/s53350615/e553f9e6-adfe7b22-cee0a948-c2750c06-a265e1b4.jpg,test," WET READ: ___ ___ ___ 10:56 PM No acute intrathoracic abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever, mild cough, PNA?, recent prostate surgery // fever, mild cough, PNA? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 93fac14d-9ce25ff9-990a5b0c-311285d7-dc0885ea.jpg,test/p17/p17850903/s57282563/93fac14d-9ce25ff9-990a5b0c-311285d7-dc0885ea.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs INDICATION: ___F with sob x 2 weeks // ? pna, effusions TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: As compared to the prior examination dated ___, there has been no relevant interval change. There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. Persistent elevation of the left hemidiaphragm is unchanged. The cardiomediastinal silhouette is within normal limits. Surgical clips overlie the mid left upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 6adefe6a-b411b9e5-5217381b-465e3bb4-9c529e43.jpg,test/p14/p14505714/s56359192/6adefe6a-b411b9e5-5217381b-465e3bb4-9c529e43.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with neuroendocrine tumor, limbic encephalitis here with altered mental status TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest CTA ___ FINDINGS: Heart size is normal. The 2 dominant left mediastinal masses appear similar compared to the previous examinations. Heart size is normal. Hilar contours are unchanged. 1 cm nodule in the left lower lobe is compatible with known metastasis and is also unchanged. Minimal atelectasis is noted in the right lung base. No focal consolidation, pleural effusion or pneumothorax is seen. The pulmonary vasculature is normal. No acute osseous abnormalities present. IMPRESSION: No radiographic evidence for pneumonia. Unchanged left mediastinal masses and left lower lobe nodule compatible with metastases. " eba6ba8c-6f915478-fcbbc236-fe705d9c-1e121500.jpg,test/p12/p12306956/s50078546/eba6ba8c-6f915478-fcbbc236-fe705d9c-1e121500.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fall seven days ago, diagnosed with lumbar strain, now with low right thoracic pain, evaluate for infiltrate, cardiopulmonary process. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. No displaced fractures are seen. IMPRESSION: No acute cardiopulmonary process. " 81d8ccdb-e1c24dad-c88e3cc5-3e7f21f0-70e32139.jpg,test/p11/p11401718/s54772748/81d8ccdb-e1c24dad-c88e3cc5-3e7f21f0-70e32139.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___M with fever, AMS // Eval for pna COMPARISON: 276 FINDINGS: AP upright and lateral views of the chest provided.Lung volumes are low with bibasilar atelectasis and bronchovascular crowding. Low no large effusion or pneumothorax. Note convincing signs of congestion or edema. Heart appears mildly enlarged, unchanged, though not fully assessed. Mediastinal contours unremarkable. Bony structures appear intact. IMPRESSION: Bibasal opacities most compatible with atelectasis and bronchovascular crowding. Mild cardiomegaly appear stable. " 3c9459b5-6ae112e4-5b9b46af-1ebce3a1-98f2ed02.jpg,test/p15/p15155342/s58653027/3c9459b5-6ae112e4-5b9b46af-1ebce3a1-98f2ed02.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post Maze procedure. Question pneumothorax after chest tube removal. COMPARISONS: Prior day. TECHNIQUE: Chest, portable AP upright. FINDINGS: There is no pneumothorax. The cardiac, mediastinal and hilar contours appear unchanged. Left basilar opacities persist, but perhaps minimally improved. A Trace pleural effusion may be new on the right. It is difficult to exclude a very small pleural effusion on the left. IMPRESSION: No evidence of pneumothorax. " 62496912-1d870d71-cb78e66b-69e5a005-7098029b.jpg,test/p13/p13160399/s50871429/62496912-1d870d71-cb78e66b-69e5a005-7098029b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent cough, abdominal pain, fever, concerning for pneumonia. COMPARISON: Outside hospital film from ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Relatively large hiatal hernia. No acute lung disease, in particular no pneumonia or pulmonary edema. Normal size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. " 40364f52-6a58c096-ae0d6487-4ab7bf2d-376bcf42.jpg,test/p17/p17574863/s59638989/40364f52-6a58c096-ae0d6487-4ab7bf2d-376bcf42.jpg,test," WET READ: ___ ___ 12:01 AM Left large bore CV catheter terminating in right atrium. Feeding tube at least within the stomach - tip not imaged. Increased density of both lungs, R>L - concerning for layering pleural fluid given positioning, particularly on the right. Probable bibasilar atelectasis though infection (right base especially) cannot be excluded. Central venous congestion likely - though no overt edema. ___ p_________________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post liver transplant, evaluation. COMPARISON: ___. FINDINGS: Double-lumen left central venous access line, the tip projects over the right atrium. Nasogastric tube is in the stomach, the tip is not included on the image. Increased density over both lung bases, right more than left, concerning for pleural effusion with subsequent areas of atelectasis. Mild fluid overload and mild cardiomegaly. No newly appeared focal parenchymal opacity suggesting pneumonia. " 39abb081-dddd91b6-246659be-5e928fda-3a370479.jpg,test/p18/p18759164/s59690354/39abb081-dddd91b6-246659be-5e928fda-3a370479.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever/ cough // r/o pna COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. Airspace consolidation is noted within the right middle lobe concerning for pneumonia. Elsewhere lungs are clear. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: Right middle lobe pneumonia. " 4d51cc03-838e94b4-68f6808a-975a2e59-a8765764.jpg,test/p18/p18302636/s52458379/4d51cc03-838e94b4-68f6808a-975a2e59-a8765764.jpg,test," FINAL REPORT INDICATION: History: ___F with autoimmune hepatitis c/b cirrhosis now with fever x 3 days. // evaluate for infection TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute process " 4b6803b4-b553b3fd-d61d4bc6-361528ac-cce456ad.jpg,test/p18/p18652728/s51671195/4b6803b4-b553b3fd-d61d4bc6-361528ac-cce456ad.jpg,test," FINAL REPORT INDICATION: ___F with h/o HN coming in with fever and cough // Fever with cough, r/o PNA or infiltrate TECHNIQUE: Frontal lateral views the chest. COMPARISON: Chest CT from ___. Chest x-ray from ___. FINDINGS: Indistinct pulmonary vascular markings are seen bilaterally. There is no confluent consolidation or effusion. Cardiomegaly is similar compared to prior. Nodular density projecting over the anterior left first rib is compatible with pulmonary nodule seen on prior CT. No acute osseous abnormalities. IMPRESSION: Interstitial edema without confluent consolidation to suggest pneumonia. Left apical pulmonary nodule as seen on prior chest CT for which continued followup was recommended by CT and should be performed in ___. " e8f6a622-2f79337d-7d4e821d-154d63cc-9e4f2a32.jpg,test/p19/p19180532/s58746901/e8f6a622-2f79337d-7d4e821d-154d63cc-9e4f2a32.jpg,test," FINAL REPORT INDICATION: Patient with three episodes of syncope. COMPARISONS: Chest radiograph of ___. FINDINGS: Portable frontal view of the chest demonstrates hyperexpanded lungs. Moderate cardiomegaly is noted with perihilar vascular congestion, progressed from prio. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Most superior sternotomy wire appears fractured. Biventricular pacemaker device is in place. IMPRESSION: Moderate cardiomegaly with perihilar vascular congestion, appears progressed from ___ exam. " beb96822-09aff2f3-c0f0f9e8-84671aa5-bcfcec76.jpg,test/p18/p18663902/s52981604/beb96822-09aff2f3-c0f0f9e8-84671aa5-bcfcec76.jpg,test," FINAL REPORT HISTORY: Status post bronch with left atelectasis. COMPARISON: ___. FINDINGS: There is improved aeration of the left upper lobe. There continues to be dense opacity in the retrocardiac region compatible with volume loss/infiltrate/effusion. There is hazy opacity projecting over the right lung compatible with right-sided effusion and alveolar edema. An underlying infectious infiltrate can't be excluded. ET tube, NG tube, and right-sided PICC line are unchanged. IMPRESSION: Improved aeration in the left upper lung. " 35814b27-0a2d676f-cdad6a74-4e68908a-e6d1fa61.jpg,test/p11/p11455001/s55777250/35814b27-0a2d676f-cdad6a74-4e68908a-e6d1fa61.jpg,test," FINAL REPORT REASON FOR EXAMINATION: ET tube placement. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 5 cm above the carina. Dobbhoff tube and NG tube pass below the diaphragm terminating: NG tube in the stomach and Dobbhoff tube at least beyond the second portion of the duodenum. Right internal jugular line tip is at the level of low SVC. Bibasal areas of atelectasis are present, slightly improved since the prior study. " 8ba2a006-cd6e3dfb-43459a0a-6d018d98-2d11f67a.jpg,test/p12/p12773009/s50325024/8ba2a006-cd6e3dfb-43459a0a-6d018d98-2d11f67a.jpg,test," FINAL REPORT HISTORY: Increasing shortness of breath and sputum production. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: Previously noted consolidation in the anterior segment of the left upper lobe has improved when compared to the prior study, with residual opacity noted, compatible with improving pneumonia. Heart size is difficult to assess given the presence of a moderate left and small right bilateral pleural effusions. The effusion on the left has increased in size while the effusion on the right appears relatively unchanged. There is associated bibasilar atelectasis. The mediastinal contours are stable. New ill-defined opacification within the left apex may reflect a new area of infection. The pulmonary vascularity is not engorged. No acute osseous abnormality is seen and there is no pneumothorax. IMPRESSION: 1. Residual opacity in the left anterior segment of the left upper lobe is compatible with improving pneumonia. 2. New ill -defined opacification within the left lung apex may reflect a new site of infection. 3. Slight increase in size of the moderate sized left pleural effusion, and slight interval decrease in size of small right pleural effusion compared to the prior radiograph. There is associated bibasilar atelectasis. " f7fab4ed-9f40864c-71714637-a50a409c-c0a71510.jpg,test/p10/p10135185/s59387383/f7fab4ed-9f40864c-71714637-a50a409c-c0a71510.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old man with dyspnea, status post surgery. Evaluate for pneumonia, CHF or free air. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. The study is somewhat limited by patient body habitus. Lung volumes are low, resulting in bronchovascular crowding. Bilateral lower lobe opacities which have a somewhat linear component may represent atelectasis, but pneumonia is not completely excluded in the appropriate clinical setting. No other consolidation is seen. Small bilateral pleural effusions are noted. Heart size is normal. The mediastinal silhouette and hilar contours are normal allowing for low lung volumes. There is no pneumothorax. There is no free intraperitoneal air. IMPRESSION: Bilateral lower lobe opacities are likely atelectasis, but may represent pneumonia in the appropriate clinical setting. Small bilateral pleural effusions. " f16726d8-a32d5524-70195dfa-c56a4e77-80b4a8c3.jpg,test/p17/p17350899/s50300777/f16726d8-a32d5524-70195dfa-c56a4e77-80b4a8c3.jpg,test," WET READ: ___ ___ ___ 5:12 PM Consolidation at the left lung apex and possibly right are concerning for infection, possibly atypical, including mycobacterium. Clinical correlation is recommended. Follow up after resolution of symptoms or comparison to prior is recommended to exclude mass. WET READ VERSION #1 ___ ___ ___ 3:59 PM Consolidation at the left lung apex and possibly right are concerning for infection, possibly atypical, including mycobacterium. Clinical correlation is recommended. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cough, fever // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are hyperinflated. There is no pleural effusion. There is multilevel mild loss of vertebral body height. The cardiomediastinal silhouette is unremarkable. Consolidations note the left lung apex, and possibly the right. IMPRESSION: Consolidation at the left lung apex and possibly right are concerning for infection, possibly atypical, including mycobacterium. Clinical correlation is recommended. RECOMMENDATION(S): Follow up after resolution of symptoms or comparison to prior is recommended to exclude underlying mass. " 7c7ab2b1-73debdf7-612b658b-c73472af-88769757.jpg,test/p16/p16136367/s56032683/7c7ab2b1-73debdf7-612b658b-c73472af-88769757.jpg,test," FINAL REPORT INDICATION: ___-year-old female with right-sided chest pain, right upper quadrant pain, rule out pneumonia. COMPARISONS: PA and lateral chest radiograph from ___. FINDINGS: PA and lateral chest radiographs are provided. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 87702935-fa6409df-68bf2658-396c3502-04726373.jpg,test/p10/p10757690/s52054757/87702935-fa6409df-68bf2658-396c3502-04726373.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Single upright chest view was read in comparison with prior chest radiographs through ___ with the most recent from ___. IMPRESSION; Following thoracocentesis, moderate-to-large left pleural effusion has substantially resolved with minimal residual effusion. Bilateral lung volumes are low. Given the temporal development, new airspace opacities in the left lung and focal opacity in the right upper lobe are attributed to re-expansion edema (Reference- Reexpansion pulmonary edema CT findings in 22 patients. ___ et al, J Thorac Imaging ___;26:___). No evidence of pneumothorax. There is no pleural effusion on the right side. Heart size, mediastinal and hilar contours are normal and stable. " b95d52e5-359764b8-5d973cbb-05ff659e-bbc63012.jpg,test/p17/p17492158/s58719409/b95d52e5-359764b8-5d973cbb-05ff659e-bbc63012.jpg,test," WET READ: ___ ___ ___ 8:27 AM 1. No focal consolidation present. No obvious lymphadenopathy, although this is not as well evaluated without a lateral view. 2. Vascular engorgement without frank pulmonary edema. WET READ VERSION #1 ___ ___ ___ 11:06 PM 1. No focal consolidation present. No obvious lymphadenopathy, although this is not as well evaluated without a lateral view. 2. Vascular engorgement without frank pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HIV, fevers unknown etiology since ___, recent travel to ___, presenting with fevers to 104, chills, diarrhea. // evidence of lymphadenopathy, infiltrate? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette. Moderate elongation of the descending aorta. No pleural effusions. No pneumonia, no pneumothorax. " a65d6dad-d9b501d5-c1596af3-0d98985d-3086080e.jpg,test/p10/p10374990/s59311557/a65d6dad-d9b501d5-c1596af3-0d98985d-3086080e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chylothorax s/p chest tube placement // eval for interval change eval for interval change IMPRESSION: Compared to chest radiographs ___ through ___. Moderate to large right pleural effusion and small left pleural effusion have increased. Right basal pigtail pleural drainage catheter still place. No pneumothorax. Heart size normal. Aortic stent unchanged in position and caliber. " e7b8f52e-50b382ac-991a2e0b-3242295f-f3346e89.jpg,test/p17/p17800663/s54662168/e7b8f52e-50b382ac-991a2e0b-3242295f-f3346e89.jpg,test," FINAL REPORT HISTORY: Confusion. COMPARISON: Comparison is made to radiograph of the chest from ___ and ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. Mild cardiomegaly is unchanged. The cardiomediastinal silhouette is otherwise unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax or focal consolidation concerning for pneumonia. A hiatal hernia is again seen, an unchanged. IMPRESSION: Stable mild cardiomegaly. No acute cardiopulmonary process. " c8b335e7-93e15dc3-ac866050-01dbf3cc-adad1ab0.jpg,test/p19/p19156000/s53515793/c8b335e7-93e15dc3-ac866050-01dbf3cc-adad1ab0.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: Chest radiograph ___. FINDINGS: PA and lateral views the chest were viewed. Mild enlargement of the cardiac silhouette is new. There is no pleural effusion or pneumothorax. The lungs are well expanded with mild linear atelectasis at the right lung base. There is no focal consolidation concerning for pneumonia. IMPRESSION: New mild cardiomegaly and/or pericardial effusion. Mild right basilar atelectasis with no other acute process. Change from initial interpretation emailed to ED QA nurses. " 76604ef9-0f336c67-980309b0-f8d8e77e-b0461381.jpg,test/p17/p17506723/s54390287/76604ef9-0f336c67-980309b0-f8d8e77e-b0461381.jpg,test," FINAL REPORT INDICATION: ___ year old man with polytrauma, intubated, pneumonia // ?interval change TECHNIQUE: APsingle view COMPARISON: ___ FINDINGS: Endotracheal tube terminates 5.8 cm above the carina. Enteric tube traverses the diaphragm, distal tip not visualized. There is a right-sided ascending catheter, partially visualized. Hilar vascular prominence and mild haziness in both lower lobes is new compared to the prior radiograph. Mild cardiomegaly. No definite pleural effusion. There is no pneumothorax. IMPRESSION: Mild cardiomegaly and bilateral hilar and lower lobe vascular prominence likely related to mild fluid overload. No consolidation. Lines and tubes as above. " 799a1e79-6391085d-5116aa00-483b59b4-8a776a15.jpg,test/p13/p13313381/s59987091/799a1e79-6391085d-5116aa00-483b59b4-8a776a15.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with acute onset abdominal pain, nausea, and vomiting. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal chest. " 97fa9aea-bcf2c8ec-c1361f34-785efd37-c39886bc.jpg,test/p17/p17173041/s58910006/97fa9aea-bcf2c8ec-c1361f34-785efd37-c39886bc.jpg,test," FINAL REPORT INDICATION: ___F with substernal chest pain // R/O CHF/Pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no consolidation or pulmonary edema. Left chest wall dual lead pacing device is again seen. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 71675d7a-6b332768-be4ef973-256f3b8e-3e3a46eb.jpg,test/p12/p12830441/s51159562/71675d7a-6b332768-be4ef973-256f3b8e-3e3a46eb.jpg,test," FINAL REPORT HISTORY: Severe right rib pain. Evaluate for rib fracture or pneumothorax. COMPARISON: None available. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs and normal hilar and cardiomediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. No displaced rib fracture is seen. IMPRESSION: 1. Normal appearance of the heart and lungs. No pneumothorax. 2. No rib fracture is identified. However, this is a particularly insensitive test for the detection of subtle rib fractures. If there is continued clinical concern, a dedicated rib series with a skin marker at the location of the patient's pain is recommended. " d20eb046-6159e7bc-4c5cec16-577fcab8-f1a41e4b.jpg,test/p11/p11676649/s54203049/d20eb046-6159e7bc-4c5cec16-577fcab8-f1a41e4b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p CABGx4 (LIMA->LAD, SVG->diag, SVG->OM, SVG->RCA) and AVR (23mm ___ ___ ___ tissue) ___ desaturating // ? increasing pulm edema ? increasing pulm edema IMPRESSION: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with low lung volumes. No evidence of increase in pulmonary venous pressure. Continued bibasilar opacifications, now with poor definition of the right hemidiaphragm, consistent with pleural effusions and volume loss in the lower lobes, especially on the left. Streaks of atelectatic change are seen in the left mid-zone. " bffae0bd-e7b80391-7c8bf64b-9352ed72-cb5d9e11.jpg,test/p11/p11124675/s53453335/bffae0bd-e7b80391-7c8bf64b-9352ed72-cb5d9e11.jpg,test," FINAL REPORT AP CHEST 4:20 A.M., ___ HISTORY: COPD, obesity, hypoventilation. Delirium. Intubated. IMPRESSION: Views of the torso centered at the diaphragm and in the left upper abdominal quadrant show a nasogastric feeding tube, absent. The wire stylet, ending in the mid stomach. Volumes are still low and mediastinal widening is most likely due to vascular engorgement. Aside from right basal atelectasis there is no focal pulmonary abnormality. Pulmonary edema which was present on ___, not recurred. Tracheostomy tube in standard placement. " 7be1aeeb-ab435455-193fd77b-a8c621cb-f9dc34d2.jpg,test/p18/p18923852/s51447103/7be1aeeb-ab435455-193fd77b-a8c621cb-f9dc34d2.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: None. FINDINGS: There are relatively low lung volumes. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is mild prominence of the hila which may be due to low lung volumes and mild pulmonary vascular engorgement without overt pulmonary edema. The cardiac silhouette is not enlarged. The mediastinal contours are unremarkable. " 883526df-5722e4cb-eb822152-4942947f-1a0400fc.jpg,test/p15/p15571899/s59857773/883526df-5722e4cb-eb822152-4942947f-1a0400fc.jpg,test," FINAL REPORT HISTORY: Fever and no localizing symptoms. Evaluate for pneumonia COMPARISON: FINDINGS: Frontal and lateral radiographs of the chest demonstrate top normal heart size. The cardiomediastinal silhouette and hilar contours are normal. The lungs are clear. No pleural effusion or pneumothorax. IMPRESSION: No pneumonia. " a8d9fa61-d37025eb-679dfac4-b54915bf-cc8eb794.jpg,test/p15/p15415646/s59232826/a8d9fa61-d37025eb-679dfac4-b54915bf-cc8eb794.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with post op dyspnea // r/o pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Left base opacity could be due to atelectasis versus consolidation due to infection or aspiration. Additional left base subsegmental atelectasis is seen. There is mild right mid lower lung atelectasis. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac silhouette is top-normal. The aorta is somewhat tortuous. There may be some mild right perihilar peribronchial wall thickening. IMPRESSION: Left base opacity could be due to atelectasis versus consolidation due to infection or aspiration. " 20396332-c6cb0e4b-187ab1f7-fc31d854-a32042e3.jpg,test/p14/p14539501/s58976258/20396332-c6cb0e4b-187ab1f7-fc31d854-a32042e3.jpg,test," FINAL REPORT INDICATION: ___F with coughing/wheezing // r/o PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion or edema. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " c6073ab2-dbc54e62-28ad9252-a7e702b5-fe7feade.jpg,test/p11/p11543398/s53718677/c6073ab2-dbc54e62-28ad9252-a7e702b5-fe7feade.jpg,test," FINAL REPORT HISTORY: Cough. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: Chest radiograph ___ at 04:58. CT thoracic spine ___. FINDINGS: Heart size is moderate to severely enlarged but unchanged. The mediastinal contour remains widened superiorly, which based on the prior CT of the thoracic spine appears attributable to mediastinal fat and vascular structures. There is mild pulmonary vascular engorgement. Streaky opacities within the lung bases, more so on the left ,could reflect areas of atelectasis though infection is difficult to exclude. No large pleural effusion or pneumothorax is seen. Multiple old rib fractures are re- demonstrated bilaterally. Degenerative changes of the right glenohumeral joint are also noted. IMPRESSION: Mild pulmonary vascular engorgement and bibasilar patchy opacities, possibly reflecting atelectasis though infection is difficult to exclude. " d1eb48e6-c0f479c6-502145b6-5197b2ce-57b923f7.jpg,test/p12/p12174157/s54722873/d1eb48e6-c0f479c6-502145b6-5197b2ce-57b923f7.jpg,test," FINAL REPORT HISTORY: ___-year-old male with right-sided chest pain after fall. Evaluation for rib fracture or pneumothorax. COMPARISON: No prior imaging is available for comparison. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear, with no evidence of pneumothorax, pleural effusion, pulmonary edema, or focal consolidation. Cardiomediastinal silhouette is unremarkable. No displaced rib fractures are identified. Chronic-appearing irregularity of the bilateral acromioclavicular joints is likely not related to acute trauma. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture identified. " 0e3e49f0-c6002941-45c213c4-03325e7b-5e13e327.jpg,test/p14/p14997223/s50184528/0e3e49f0-c6002941-45c213c4-03325e7b-5e13e327.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Possible pneumonia, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Opacity, associated to volume loss of the middle lobe is constant. No newly appeared parenchymal opacity. No pleural effusions. Moderate cardiomegaly without pulmonary edema. Moderate tortuosity of the thoracic aorta. " 5fe62647-6cdc7d7c-27ab683a-d782b786-f31ac4db.jpg,test/p13/p13855132/s51923917/5fe62647-6cdc7d7c-27ab683a-d782b786-f31ac4db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure, intubated // assess pulmonary edema assess pulmonary edema IMPRESSION: Compared to chest radiographs ___ through ___. Combination of moderate pleural effusions and bibasilar atelectasis is more pronounced bilaterally. Right upper lobe is clear. Mild cardiomegaly is stable. ET tube, right internal jugular line are in standard placements and a transesophageal gastric drainage tube passes into the stomach and out of view. No pneumothorax. " 61b4f4ae-cd6ef8b3-050daa18-253bda7e-b1c10246.jpg,test/p16/p16258153/s54190435/61b4f4ae-cd6ef8b3-050daa18-253bda7e-b1c10246.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest radiograph. INDICATION: ___ year old woman s/p MVR/CABG // eval for swan position s/p CCO placement COMPARISON: Chest radiograph dated ___. FINDINGS: Since the prior exam, the right internal jugular venous catheter approach Swan-Ganz catheter tip has been advanced and now lies within the right main pulmonary artery, well within the mediastinal contours. The left-sided and right-sided chest tubes as well as mediastinal drain has since been removed. Otherwise, no significant interval change. Persistent lower lung volumes. No focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. The heart is mildly enlarged, unchanged. ETT in standard position. Median sternotomy wires unchanged. IMPRESSION: Swan-Ganz catheter in appropriate position. " 7a77f7da-f732945f-d3caac50-fe788155-ab0b243d.jpg,test/p10/p10364595/s57377419/7a77f7da-f732945f-d3caac50-fe788155-ab0b243d.jpg,test," FINAL REPORT INDICATION: ___-year-old male with seizures. COMPARISON: ___. CHEST, PA AND LATERAL: Lungs are clear, with resolution of the prior right lower lobe opacity. Mediastinal and hilar contours are unremarkable. There are no pleural effusions or pneumothorax. Chronic blunting of the right costophrenic angle reflects scarring. IMPRESSION: No acute cardiopulmonary process. " e0001d2d-99edf3e8-7da8a86d-47a51b6c-9eb27165.jpg,test/p16/p16789054/s53721986/e0001d2d-99edf3e8-7da8a86d-47a51b6c-9eb27165.jpg,test," FINAL REPORT INDICATION: History: ___F with shortness of breath, COPD // Eval for cardiopulmonary process TECHNIQUE: I upright AP and lateral views of the chest COMPARISON: Chest radiograph ___, chest CT ___ FINDINGS: Lung volumes are low. Chronic diffuse coarse interstitial opacities are re- demonstrated within the lungs, in a predominantly peripheral and basilar distribution, similar compared to the prior exam. Heart size is normal. Mediastinal contour is unchanged. No pulmonary edema or new areas of focal consolidation are seen. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is visualized. . IMPRESSION: Similar appearance of chronic interstitial lung disease. No new focal opacities identified. " e53850e4-cd575edc-377a89f0-f5d633e2-84d37a0a.jpg,test/p14/p14068639/s57050003/e53850e4-cd575edc-377a89f0-f5d633e2-84d37a0a.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with shortness of breath. COMPARISON: ___. FINDINGS: AP semi-upright and lateral views of the chest were obtained. Redemonstrated is mild-to-moderate cardiomegaly with stable appearance of the cardiomediastinal silhouette. A single lead pacemaker is unchanged in position. Lung volumes are low. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Stable cardiomegaly and persistently low lung volumes. " bafbef15-550a6520-fbcd3b2c-81552b65-3050c322.jpg,test/p18/p18855302/s53537225/bafbef15-550a6520-fbcd3b2c-81552b65-3050c322.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with hypotension. Now w R IJ CVL // Confirm R IJ CVL TECHNIQUE: Upright portable AP chest radiograph COMPARISON: Same-day CT chest abdomen and pelvis ___ FINDINGS: Interval placement of a right internal jugular catheter with tip in the right atrium. Heart size is normal and unchanged. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. There is bibasilar atelectasis. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Interval placement of right internal jugular catheter with tip in the right atrium. " 9a902833-dff23058-6876cbb4-a7f2382a-462bfc9a.jpg,test/p12/p12632105/s58149219/9a902833-dff23058-6876cbb4-a7f2382a-462bfc9a.jpg,test," FINAL REPORT INDICATION: Missing tooth fragment. Evaluate for tooth fragment aspiration. COMPARISONS: None. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without a consolidation or edema. There is no pleural effusion or pneumothorax. There is no evidence of a radiopaque foreign body. The cardiomediastinal silhouette is normal. No fracture is identified. IMPRESSION: No acute cardiopulmonary process. No evidence of a radiopaque foreign body. " d3f03692-82b0398b-941eecf8-6af8c3b1-47c85346.jpg,test/p10/p10578743/s56678596/d3f03692-82b0398b-941eecf8-6af8c3b1-47c85346.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p bowel surgery w/ worsening hypoxemia, AFib RVR and leukocytosis. Increased hypoxemia. TECHNIQUE: Single portable AP radiograph of the chest. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: The heart is mildly enlarged with engorged pulmonary vasculature throughout the bilateral lungs and blunting of the bilateral costophrenic angles, consistent with pulmonary edema from acute heart failure. Other possibilities could include a widespread infection in the correct clinical setting. There is no focal consolidation or pneumothorax. IMPRESSION: 1. Findings as above consistent with pulmonary edema from acute heart failure. In the correct clinical setting, widespread infection can't be considered. There is no focal consolidation however. " 182963dc-ce632837-d4f0968c-dcd15eb4-3eccaded.jpg,test/p12/p12448098/s57587293/182963dc-ce632837-d4f0968c-dcd15eb4-3eccaded.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with SOB, fevers // Eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: CT chest dated ___, chest radiographs dated ___. FINDINGS: The patient is status post right lower lobe wedge resection for addendum carcinoma. Lung volumes are low leading to crowding of the bronchovascular structures. Streaky bibasilar airspace opacities are noted, right greater than left. Left hilar prominence appears increased from the prior chest radiograph, and may represent enlargement of the pulmonary artery versus hilar lymphadenopathy. The heart size is normal. There is no appreciable pneumothorax or pleural effusion. IMPRESSION: Increased asymmetric left perihilar opacities, which may represent lymphadenopathy, enlarged pulmonary vasculature, or pneumonia. Right lower lobe opacities are also noted and may represent multifocal pneumonia. Recommend follow up in 4 weeks to document resolution. " b3fd656c-aaca0b56-4338c2ea-ee383a61-3686c341.jpg,test/p10/p10504635/s56410615/b3fd656c-aaca0b56-4338c2ea-ee383a61-3686c341.jpg,test," FINAL REPORT AP CHEST, 12:24 P.M. ON ___ HISTORY: AML. Allogenic stem cell transplant. Neutropenia. Cough. Rule out pneumonia. IMPRESSION: AP chest compared to ___: Heart size is small, decreased since ___. Lungs are fully expanded and clear. There is no pleural abnormality or evidence of central adenopathy. Left internal jugular line ends in the upper right atrium and could be withdrawn 3.5 cm to place it low in the SVC alongside the right PIC line. " aa25f54d-6eae7114-9a9b06e1-80f84c60-d2463c8c.jpg,test/p16/p16260564/s50725147/aa25f54d-6eae7114-9a9b06e1-80f84c60-d2463c8c.jpg,test," FINAL REPORT INDICATION: ___-year-old female with desaturation to the high 80s who presents for evaluation. COMPARISON: Chest radiographs from ___; ___; ___ and ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: There has been interval removal of the endotracheal tube. There is mild increase in bilateral pulmonary edema. There is a focal increase in consolidation at the left lower lung. The hilar and mediastinal contours are stable. The left heart border is obscured by the focal consolidation. There is no significant pleural effusion. There is no pneumothorax. The enteric tube terminates in the body of the stomach. IMPRESSION: 1. Interval increase in mild bilateral pulmonary edema. 2. Focal consolidation in the left lower lung concerning for pneumonia. These findings were discussed with Dr. ___ by Dr. ___ by telephone on the day of the exam at 10:30 a.m. " 5d30a10b-ea3973d1-3589d5c0-ba7f163e-e8448b3c.jpg,test/p19/p19906533/s56337445/5d30a10b-ea3973d1-3589d5c0-ba7f163e-e8448b3c.jpg,test," FINAL REPORT INDICATION: History of asthma and 10 days of pleuritic chest pain and cough. Evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Unchanged surgical clips are noted in the right upper quadrant, likely from a prior cholecystectomy. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia. " 397e1637-b9630461-86278e8b-28a084bd-044e69bd.jpg,test/p12/p12522208/s51085995/397e1637-b9630461-86278e8b-28a084bd-044e69bd.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: CKD, hypertension, accompanied with fevers, cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Pulmonary nodules seen on prior chest CT from ___ better evaluated on that study and recommendations per that study remain. Degenerative changes are again seen along the spine, similar to prior. IMPRESSION: No acute cardiopulmonary process. " e5691eb1-2087de28-8bc4b82b-92f37f1e-592743fb.jpg,test/p19/p19245176/s51275971/e5691eb1-2087de28-8bc4b82b-92f37f1e-592743fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with motorcycle accident and right ___ rib fractures and right hemopneumothorax // Interval change in hemopneumothorax Interval change in hemopneumothorax COMPARISON: Chest radiographs ___. IMPRESSION: Previous large right pleural effusion is substantially smaller and there is no pneumothorax. Multiple right rib fractures are severely displaced. Only a relatively small amount of residual right pleural effusion or extrapleural hematoma persists. Subcutaneous emphysema right chest wall has been present since at least ___. Left hemi thorax is normal. Heart is normal size. Mediastinal widening which developed between ___ and ___ has improved. This could be a venous engorgement due to volume resuscitation, since the pulmonary vasculature is engorged. There is no pulmonary edema. " bd873ba5-1a632375-e06d728e-b2a18b57-134c29f9.jpg,test/p19/p19533730/s58172244/bd873ba5-1a632375-e06d728e-b2a18b57-134c29f9.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Triple-lumen catheter placed at outside hospital. Evaluation. COMPARISON: ___, 7:27 p.m. FINDINGS: As compared to the previous radiograph, there is no relevant change. The right pectoral pacemaker is in constant position. A right internal jugular vein central access line is also normal. The tip projects over the lower SVC. No evidence of pneumothorax. Known pulmonary edema, overall mild, complicated by opacities at the lateral aspect of the left and right lung as well as at the lung bases. These changes are likely to represent pneumonia. Unchanged moderate cardiomegaly. " a4613482-70b9354c-78485a63-4bacdbc5-9ec6e11c.jpg,test/p18/p18273833/s53930957/a4613482-70b9354c-78485a63-4bacdbc5-9ec6e11c.jpg,test," FINAL REPORT HISTORY: Severe acute respiratory distress. Explain large circular mass overlying the trachea. COMPARISON: ___ at 408. FINDINGS: The apparent circular mass overlying the trachea is a curve in the trachea seen end on. Compared with 1 hr prior, there is increased bilateral parenchymal opacity consistent increasing pulmonary edema. Opacification at the right base has increased likely a combination of pleural effusion and atelectasis; although, consolidation is possible. No pneumothorax. IMPRESSION: 1. Circular mass overlying the trachea is a curve in the trachea seen end on. 2. Increased pulmonary edema since 1 hour prior. " 856819dd-f9d5f281-6bfb6377-83793f81-9c37740d.jpg,test/p18/p18777009/s53889475/856819dd-f9d5f281-6bfb6377-83793f81-9c37740d.jpg,test," FINAL REPORT CT CHEST; ___ CLINICAL HISTORY: ___-year-old man with chest tube removal. FINDINGS: Comparison is made to previous study from ___. The right-sided chest tube has been removed. There is a very tiny apical pneumothorax. There is some increased density at the right base which may be due to some pulmonary hemorrhage related to the chest tube versus some consolidation. The left lung is clear. The heart size is within normal limits. " 9ae498a8-b1daf724-0a36025d-0427f57d-3851300d.jpg,test/p15/p15613908/s53846750/9ae498a8-b1daf724-0a36025d-0427f57d-3851300d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with low resting oxygen saturation, hx COPD. // ? interstitial disease ? interstitial disease IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal in size or slightly enlarged. There is slightly less prominent so of the extensive increase in interstitial markings. This could represent some improvement in pulmonary vascular congestion in a patient with underlying chronic interstitial lung disease. No definite acute focal pneumonia is appreciated. " 094d3625-2f4682ef-fb0c3fcd-ae22873c-de975ecc.jpg,test/p13/p13562596/s53920954/094d3625-2f4682ef-fb0c3fcd-ae22873c-de975ecc.jpg,test," FINAL REPORT INDICATION: Cough and hypoglycemia. COMPARISON: Multiple prior chest radiographs, the most recent from ___. FINDINGS: The lungs are well expanded without a focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is stable. The pulmonary arteries remain enlarged. Right hilar opacity is again noted and appears stable to minimally decreased. No acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " f8c55096-6bbcbe34-19b09687-db5b456b-7cfd8f61.jpg,test/p13/p13778554/s51582340/f8c55096-6bbcbe34-19b09687-db5b456b-7cfd8f61.jpg,test," FINAL REPORT HISTORY: Fever. Evaluate for pneumonia. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: PET-CT ___ and chest radiographs of ___, ___ and ___. FINDINGS: A right upper extremity PICC terminates in the lower SVC. A percutaneous jejunostomy tube is partially imaged. The patient is status post a cholecystectomy. Coronary stents are appreciated. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9464666a-5a0f590f-3ae25170-9a4bff3d-9442906e.jpg,test/p16/p16081819/s52844087/9464666a-5a0f590f-3ae25170-9a4bff3d-9442906e.jpg,test," FINAL REPORT INDICATION: ___-year-old man with tracheostomy, recurrent hemoptysis. Study requested to rule out aspiration. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are well expanded and clear. There are no focal consolidations or pleural effusions. There is no pneumothorax. A pigtail catheter is seen projecting over the left upper quadrant. Visualized osseous structures are grossly unremarkable. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process. " a4e262fe-55d6e25c-79748290-6f38d3ab-11e14bf1.jpg,test/p19/p19020115/s54620390/a4e262fe-55d6e25c-79748290-6f38d3ab-11e14bf1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chest pain following recent CT guided lung biopsy // Please rule out effusion and pneumothorax Please rule out effusion and pneumothorax IMPRESSION: Compared to chest radiographs ___ since ___, most recently ___. Previous pulmonary edema has resolved. Residual right pleural effusion is small. No pneumothorax. Normal mediastinal and hilar silhouettes. " c3464b55-4422d11b-bed0d687-92bdc44e-65488d15.jpg,test/p10/p10378641/s50286615/c3464b55-4422d11b-bed0d687-92bdc44e-65488d15.jpg,test," WET READ: ___ ___ ___ 11:23 PM left basilar opacity appears similar to ___ but right medial basilar opacity is new with Kerly B lines suggesting mild-moderate pulmonary edema although aspiration is also a possiblity. there may be a small left pleural effusion. cardiac silhouette is obscured. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Subdural hematoma. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The patient is status post coronary artery bypass graft surgery. There is persistent leftward shift of mediastinal structures, possibly with some volume loss in the left lung and similar patchy mid lung opacification. A calcified pleural plaque is also noted in the left hemithorax. Widespread opacification of the right mid-to-lower lung is new including interstitial changes including Kerley B lines identifiable at the right lung base. Small pleural effusions are difficult to exclude. Rightward convex spinal curvature is similar. IMPRESSION: Findings suggesting moderate pulmonary edema. If that interpretation is compatible with clinical findings then repeat radiographs are suggested after treatment in order to assess whether an additional pulmonary process such as aspiration or pneumonia may potentially coincide. " fe15ecf3-68d5ae1a-ff1b222f-cf151c05-b00c86db.jpg,test/p15/p15438558/s50928027/fe15ecf3-68d5ae1a-ff1b222f-cf151c05-b00c86db.jpg,test," FINAL REPORT HISTORY: Congestive heart failure, presents with fatigue. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unchanged and within normal limits. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is visualized. No acute osseous abnormalities present. IMPRESSION: No acute cardiopulmonary process. " 3eecc09d-4081fa3a-08a7d2bd-860786bf-6945e83c.jpg,test/p16/p16417985/s53339849/3eecc09d-4081fa3a-08a7d2bd-860786bf-6945e83c.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pancreatectomy, evaluation for pneumothorax and pleural effusion. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The extent of the bilateral pleural effusions is constant. Also constant is a relatively large left retrocardiac atelectasis. Unchanged low lung volumes. No overt pulmonary edema. No pneumonia. The left upper quadrant drain is in constant position. " a540feb4-d015400d-b9c30645-6ab7f21a-0a9f9928.jpg,test/p17/p17078350/s50796339/a540feb4-d015400d-b9c30645-6ab7f21a-0a9f9928.jpg,test," FINAL REPORT INDICATION: shortness of breath. Evaluate for volume overload or infection. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. There is a moderate subpulmonic right pleural effusion. Adjacent heterogeneous opacity is concerning for pneumonia. The left lung is clear. There is no left effusion. No pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: Right basal opacity is worrisome for pneumonia with moderate subpulmonic pleural effusion. No edema. Dr. ___ ___ the findings with ___ by phone at 3:37 p.m. on ___. " 32f8e684-bf1c6020-04693978-bce970da-a903c6cd.jpg,test/p12/p12648465/s51733420/32f8e684-bf1c6020-04693978-bce970da-a903c6cd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with upper GI bleed TECHNIQUE: Upright AP view of the chest COMPARISON: ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. No subdiaphragmatic free air is visualized. Clip is seen projecting over the gastroesophageal junction. IMPRESSION: No acute cardiopulmonary abnormality. No subdiaphragmatic free air. " 1a050325-df9ae71b-3578fc2c-780f29f8-53139896.jpg,test/p11/p11828460/s55521657/1a050325-df9ae71b-3578fc2c-780f29f8-53139896.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p R lung VATS wedge // reexpansion TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiographs from ___ CTA chest with and without contrast from ___ Diffuse lung disease ___ FINDINGS: Again seen are diffuse bilateral hazy opacification of the mid and lower lungs, right greater than left, better assessed on recent CT Chest. Right chest tube is in place. Mediastinal and hilar lymphadenopathy is also better assessed on recent CT. A tiny apical right pneumothorax is noted. Subcutaneous emphysema is expected in the postoperative setting. IMPRESSION: 1. Unchanged appearance of diffuse bilateral opacities in the mid and lower lungs, correlating to ground glass opacities seen on recent CT. 2. Tiny right apical pneumothorax " 994d0044-fb64efd4-1fc1e0ea-5b4df9c9-61682d86.jpg,test/p12/p12670178/s51917934/994d0044-fb64efd4-1fc1e0ea-5b4df9c9-61682d86.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with metastatic colon cancer in CT. There was pleural effusion and adjacent consolidation on the left, assess for progression. The cardiac size is normal. The mediastinal lymph nodes are better seen in prior CT. New opacities in the right middle lobe could be due to atelectasis. A superimposed infection cannot be excluded. Small bilateral pleural effusions, larger on the left side, are grossly unchanged from prior associated with increasing adjacent atelectasis. Right Port-A-Cath tip is in the cavoatrial junction. There is no pneumothorax. Previously described nodule in the left lower lobe cannot be assessed in the exam, is obscured by the pleural parenchymal abnormalities. " d0d2aaf8-3e979c94-069d758c-d78eaba4-458b82bd.jpg,test/p11/p11861605/s55210948/d0d2aaf8-3e979c94-069d758c-d78eaba4-458b82bd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Patchy opacities are noted in both lung bases, findings which could reflect atelectasis as the lung volumes are somewhat low, but infection cannot be completely excluded. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with patchy bibasilar opacities, likely atelectasis. Infection however cannot be completely excluded in the correct clinical setting. " ec0cacb1-95286171-ce9a7f0e-246281e9-518e2aca.jpg,test/p18/p18658996/s52922739/ec0cacb1-95286171-ce9a7f0e-246281e9-518e2aca.jpg,test," FINAL REPORT HISTORY: ___-year-old male with retroperitoneal bleed, now with new NG tube. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Single frontal view of the chest was obtained. New nasogastric tube terminates below the left hemidiaphragm, which is elevated. Diffuse opacities overlying both lungs has increased since ___. Opacity overlying the left base is compatible with a moderate to large pleural effusion with probable underlying consolidation. Blunting of the right costophrenic angle persists, compatible with a moderate pleural effusion. No pneumothorax. Moderate cardiomegaly may be exaggerated by patient rotation. IMPRESSION: 1. New NG tube terminates below the diaphragm. 2. Increased left pleural effusion, now moderate to large, with probable underlying left base consolidation. Moderate right pleural effusion persists. " e27ddf2e-7ac52d09-5d58e6bf-6b658dfe-9bcb54c6.jpg,test/p16/p16911115/s58841945/e27ddf2e-7ac52d09-5d58e6bf-6b658dfe-9bcb54c6.jpg,test," FINAL REPORT HISTORY: Intubation. FINDINGS: In comparison with study of ___, little overall change. Monitoring and support devices remain in place. Continued opacification at the left base obscuring the hemidiaphragm and costophrenic angle, consistent with substantial volume loss in the left lower lobe and pleural effusion. No evidence of pulmonary vascular congestion. " 52abff0e-41e5adc5-10cb886a-3f8c8933-6d884d93.jpg,test/p13/p13498162/s54810651/52abff0e-41e5adc5-10cb886a-3f8c8933-6d884d93.jpg,test," FINAL REPORT INDICATION: ___-year-old male with variceal bleed. Previous study was concerning for free air or possible perforation. COMPARISON: Portable semi-upright AP chest radiograph, ___. TECHNIQUE: Portable semi-upright AP chest radiograph. FINDINGS: ___ device remains installed and is notable for under-inflation of the fundic balloon. There have been no significant changes in lung volumes bilaterally, though there has been a slight increase in right lower lobe atelectasis. Cardiomediastinal silhouette is unchanged and demonstrates cardiomegaly with no evidence of pneumomediastinum or pneumopericardium. Esophageal contour is expanded secondary to inflated ___ balloon but with no evidence of perforation. ET tube is seen terminating no less than 2 cm from the carina. A right IJ catheter sheath is seen terminating within the upper right atrium. No pneumothorax is observed. IMPRESSION: No evidence of pneumopericardium or pneumomediastinum. ___ device has under-inflated fundic balloon. These findings were reported to Dr. ___ at 11:29 a.m. via phone by ___. " 485014fa-f44727de-24b13f26-d2e9a979-086e5167.jpg,test/p18/p18635245/s57591038/485014fa-f44727de-24b13f26-d2e9a979-086e5167.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with L shoulder injury, + distal clavicle ttp // eval for fx, pnx. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart size, mediastinal, and hilar contours are normal. The lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " e760fc27-8a4c309c-829765cb-0daf9283-680d7f70.jpg,test/p13/p13208190/s50201535/e760fc27-8a4c309c-829765cb-0daf9283-680d7f70.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CT chest from ___ and a chest radiograph from ___. CLINICAL HISTORY: Hypoglycemia, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. The heart is top normal in size. Subtle opacity in the right lung base medially on the frontal projection could represent vascular crowding, less likely pneumonia. The left lung is clear. Mediastinal contour appears grossly stable. No pneumothorax or effusion. Bony structures are intact. IMPRESSION: Top normal heart size with vague opacity at the right medial lung base which could represent bronchovascular crowding, less likely pneumonia. " 35af7314-fa5b62de-03fef175-024ee5a9-a598914c.jpg,test/p19/p19885929/s58612281/35af7314-fa5b62de-03fef175-024ee5a9-a598914c.jpg,test," FINAL REPORT INDICATION: ___F with chest pain. COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE Frontal lateral view of the chest. FINDINGS: PA and lateral views the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The heart size is top-normal. Mediastinal contours unremarkable. Bony structures are intact. IMPRESSION: No acute findings. Top-normal heart size. " 6c577aea-2522ecaa-7d15f4a9-0d8ef1fe-20840c38.jpg,test/p11/p11296936/s59509355/6c577aea-2522ecaa-7d15f4a9-0d8ef1fe-20840c38.jpg,test," FINAL REPORT HISTORY: Chest pain COMPARISON: ___ and ___ FINDINGS: AP portable view of the chest once again demonstrates mild cardiomegaly and vascular congestion. The prior intersitial edema has improved since the prior study. A small right pleural effusion and perhaps a small left pleural effusion are probably stable from the prior studies. Minimal bibasilar atelectasis is noted. No focal consolidations to suggest pneumonia. IMPRESSION: Mild vascular congestion, improved since ___. " cdf2cfec-f2c6d30b-5f20237e-88aeec25-e887c3d8.jpg,test/p16/p16454913/s59699556/cdf2cfec-f2c6d30b-5f20237e-88aeec25-e887c3d8.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent multifocal pneumonia, metabolic acidosis, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Mild bilateral pleural effusions. Moderate cardiomegaly. Moderate pulmonary edema with a strong interstitial component. No newly appeared parenchymal opacities, but ongoing relatively severe atelectasis at both the left and the right lung base. The monitoring and support devices are constant. " eded0d7c-2a9a4266-2b1f2702-6e75d678-35a30025.jpg,test/p10/p10760672/s53814611/eded0d7c-2a9a4266-2b1f2702-6e75d678-35a30025.jpg,test," WET READ: ___ ___ ___ 8:36 AM Replaced endotracheal tube is appropriately positioned within stomach. Otherwise no significant change from prior study performed earlier the same day, with moderate pulmonary edema and cardiomegaly. WET READ VERSION #1 ___ ___ ___ 7:06 PM Replaced endotracheal tube is appropriately positioned within stomach. Otherwise no significant change from prior study performed earlier the same day, with moderate pulmonary edema and cardiomegaly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with head bleed, now s/p NG tube placement (he pulled out prior NG tube) // ?NG tube placement. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the nasogastric tube has been repositioned. The tip now projects over the pre-pyloric areas of the stomach. No complications, notably no pneumothorax. Moderate cardiomegaly and pulmonary edema persists in unchanged manner. " 2e1c9caf-c4f3a7bb-a315d254-14f5ee9b-9caeef24.jpg,test/p13/p13182319/s50277984/2e1c9caf-c4f3a7bb-a315d254-14f5ee9b-9caeef24.jpg,test," WET READ: ___ ___ 7:56 PM Endotracheal tube terminates 2.5 cm above the carina. Clear lungs. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man recently intubated and sedated // evaluate for ET tube placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip as 3 cm above the carinal. Heart size and mediastinum are unchanged overall in appearance as compared to previous portable radiographs but there is increase in the azygos vein as compared to ___, substantial and might potentially reflect volume overload. Lungs are essentially clear. There is no pleural effusion. " d761b70a-0e818e36-35016a8b-5690dc91-308d0fbb.jpg,test/p14/p14763276/s56123577/d761b70a-0e818e36-35016a8b-5690dc91-308d0fbb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with no symptoms // hyponatremia, ? siadh hyponatremia, ? siadh TECHNIQUE: PA and lateral chest films COMPARISON: CT dated the ___ FINDINGS: Since ___, there is a new T12 compression deformity. There is a chronic mild compression deformity at T8 grossly unchanged from prior. A healed right eighth posterior rib fracture is seen which correlates to CT dated ___. Linear bibasilar opacities are seen, but no discrete mass is seen. . The heart is at the upper limit of normal. IMPRESSION: No evidence of a lung nodule or mass to suggest primary lung malignancy. T12 compression deformity is new since ___, but is of indeterminate age. " 9f3bd291-a528528c-488d48c8-f293ea94-0e8e5c65.jpg,test/p17/p17396346/s51283380/9f3bd291-a528528c-488d48c8-f293ea94-0e8e5c65.jpg,test," FINAL REPORT INDICATION: Acute shortness of breath. COMPARISONS: Chest radiograph from ___. TECHNIQUE: A single frontal upright view of the chest was obtained. FINDINGS: Since the prior exam, there is increased vascular congestion with mild pulmonary edema. Linear opacities at the right base are likely atelectasis. There is no definite pleural effusion or pneumothorax. The mediastinal contours are unchanged. The heart is severely enlarged, and stable. Surgical clips are noted in the left breast. IMPRESSION: Slight interval increase in mild pulmonary edema. Stable cardiomegaly. " 2d3f89db-6fcc9172-e3d522f6-2b4e8d61-fb362e86.jpg,test/p10/p10611307/s52461516/2d3f89db-6fcc9172-e3d522f6-2b4e8d61-fb362e86.jpg,test," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Left-sided pacemaker device is noted with single lead terminating in the right ventricle. Heart size is top normal. The aorta remains tortuous. Mediastinal and hilar contours are stable. Pulmonary vasculature is normal. Apart from minimal atelectasis in the left lung base, lungs are clear without focal consolidation. Calcified granuloma in the left upper lobe is unchanged. No pleural effusion or pneumothorax is seen. There are multilevel moderate degenerative changes within the thoracic spine. IMPRESSION: No radiographic evidence for pneumonia. " 98f8707d-f5013c17-45a0392d-a94f98c7-37938b29.jpg,test/p13/p13990571/s56323427/98f8707d-f5013c17-45a0392d-a94f98c7-37938b29.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest and abdominal pain as well as productive cough. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The heart size is stable. The mediastinal and hilar contours are within normal limits. There is no pulmonary consolidation. Mild interstitial edema is improved. There is no pleural effusion or pneumothorax. Surgical material is present in the gastroesophageal region. " f282e7c6-17c14580-6bd133fc-08a1501d-bcf5ac6d.jpg,test/p14/p14997223/s58085922/f282e7c6-17c14580-6bd133fc-08a1501d-bcf5ac6d.jpg,test," FINAL REPORT INDICATION: ___-year-old man with shortness of breath but stable O2 sats, ? effusion versus opacity. FINDINGS: PA and lateral chest radiographs are obtained. Heart is moderately enlarged. Cardiomediastinal contours are normal. The opacity seen in the right lower lobe is stable. Right hemidiaphragm is not readily visilble and the opacity extends to the edge of the right major fissure on the lateral view, reflecting collapse of the lower lobe with possible sparing of the superior segment. The minor fisure is not readily itenfied raising the possibility of right middle lobe collapse as well. Mild left pleural effusion. No pneumothorax. IMPRESSION: Stable RLL and possibly RML collapse. " 703f5870-d73d3a42-30c11e4f-711c1f92-7efa2c26.jpg,test/p19/p19695893/s52923087/703f5870-d73d3a42-30c11e4f-711c1f92-7efa2c26.jpg,test," FINAL REPORT HISTORY: Chest pain, rule out acute process COMPARISON: ___ FINDINGS: Frontal and lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours. The lungs are clear. No pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " d08efcdf-a96c0ddf-dc16d4b3-9e02b695-86494931.jpg,test/p10/p10152121/s54390368/d08efcdf-a96c0ddf-dc16d4b3-9e02b695-86494931.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p MIE // R/O PTX post CT removal TECHNIQUE: AP chest x-ray COMPARISON: ___ FINDINGS: Compared to the prior study, the right chest tube has been removed. There is no right pneumothorax. Right basilar atelectasis and small right pleural effusion persist. There is likely a small left pleural effusion with minimal left basilar atelectasis. As before, the upper mediastinum is widened with recent surgery as well had the patient has a gastric pull-through with a small amount of residual barium from the upper GI performed on ___ remaining within the intrathoracic portion of the stomach. No unexpected mediastinal findings. " df445ff4-90b85cf7-8df99982-f2d6a2af-3e80bd94.jpg,test/p12/p12530439/s57552168/df445ff4-90b85cf7-8df99982-f2d6a2af-3e80bd94.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // r/o pneumothorax TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: There are relatively low lung volumes. Given this, no focal consolidation, pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Low lung volumes without acute cardiopulmonary process. " 9c270069-9907cd80-8a02fa73-8a873508-c862676b.jpg,test/p10/p10943603/s54991938/9c270069-9907cd80-8a02fa73-8a873508-c862676b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Acute dyspnea. FINDINGS: Portable supine AP chest radiograph is obtained. Endotracheal tube is seen with its tip located approximately 5 cm above the carina. NG tube courses into the left upper abdomen. Diffuse bilateral ground-glass opacities, which are most compatible with pulmonary edema. A right pleural effusion is noted, moderate in volume. There may be a tiny left pleural effusion. No pneumothorax is seen. Heart size difficult to evaluate though is at least top normal. Widening of the mediastinum is likely due to supine portable technique. The imaged osseous structures are intact. IMPRESSION: Endotracheal and nasogastric tubes appropriately positioned. Pulmonary edema with moderate right and tiny left pleural effusion. Top normal heart size. " 3d8e8cf3-71dd966e-049e2022-2370cff2-d6c0f72a.jpg,test/p10/p10251182/s51553594/3d8e8cf3-71dd966e-049e2022-2370cff2-d6c0f72a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with increase in WBC, please evaluate for infectious process. // ___ year old man with increase in WBC, please evaluate for infectious process. ___ year old man with increase in WBC, please evaluate for in IMPRESSION: In comparison with the study ___, there are continued low lung volumes. The margin is support devices have been removed. Opacification at the left base most likely reflects atelectasis. However, in the appropriate clinical setting, superimposed pneumonia could be considered. " 7ed083c3-3b8d402d-cfcabee2-46f28e0f-c6f47d8a.jpg,test/p11/p11872537/s51756475/7ed083c3-3b8d402d-cfcabee2-46f28e0f-c6f47d8a.jpg,test," FINAL REPORT INDICATION: History: ___F with cough, malaise // ? acute cardiopulm process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is a small new opacity in the left lower lobe, suspicious for consolidation, possibly pneumonia. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal size. IMPRESSION: There is a small new opacity in the left lower lobe, suspicious for consolidation, possibly pneumonia. RECOMMENDATION(S): Followup chest radiograph is recommended in 4 weeks after completion of treatment to monitor resolution and rule out any potential underlying lesion. " 0be81b7e-8559bca1-2a7a4e35-247d29be-c2095dd9.jpg,test/p11/p11811888/s56506675/0be81b7e-8559bca1-2a7a4e35-247d29be-c2095dd9.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with multiple sclerosis and epilepsy. AP radiograph of the chest was reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Bibasal opacities are noted most likely reflecting atelectasis, but pneumonia is a possibility. The upper lungs are essentially clear. No pleural effusion is seen. " 6722c21a-9a65dc03-dbc8707e-83f326f7-09e1768c.jpg,test/p17/p17398573/s52640725/6722c21a-9a65dc03-dbc8707e-83f326f7-09e1768c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with right IJ CVL TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___ at 18:46 FINDINGS: Right internal jugular central venous catheter tip terminates in the mid SVC. No pneumothorax is present. Moderate cardiomegaly is again noted. The mediastinal and hilar contours are unchanged. There is mild pulmonary vascular congestion, new since the prior study. There continued bibasilar patchy airspace opacities, not substantially changed in the interval. No large pleural effusion is present. IMPRESSION: Right internal jugular central venous catheter tip in the mid SVC. No pneumothorax. Mild pulmonary vascular congestion. " 7bb64264-3a27db3b-774da98c-671a380d-9805e329.jpg,test/p18/p18573829/s58940888/7bb64264-3a27db3b-774da98c-671a380d-9805e329.jpg,test," FINAL REPORT HISTORY: Septic shock from SBP and pleural effusions. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___ chest x-ray. FINDINGS: Slightly rotated positioning. The left IJ central line tip overlies the upper right atrium. No pneumothorax is detected. Sternotomy wires are present and there is probable cardiomegaly. There is upper zone re-distribution and diffuse vascular blurring, consistent with CHF. Hazy opacity at the lung bases suggests layering effusions, likely with underlying collapse and/or consolidation. The CHF and pleural parenchymal findings are new compared with the ___ CXR. Note is made of slight change in caliber in the trachea at the level of the lower neck, which is similar to the ___ film. " 04a2dbbf-dec4cb2b-c44cc242-0db4a0cd-d61e09a9.jpg,test/p13/p13901698/s52813944/04a2dbbf-dec4cb2b-c44cc242-0db4a0cd-d61e09a9.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___F w/ nonunion ulna s/p radial head implant removal, ulna ORIF revision, now with cough and O2 requirement // r/o pna r/o pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are decreased, accentuating the bronchovascular structures. The heart is enlarged. There is bibasilar atelectasis, most prominent at the right lung base. No focal consolidation or large pleural effusion identified. Extensive peribronchial cuffing is likely reflective of volume overload. IMPRESSION: Low lung volumes with bibasilar atelectasis. No focal consolidation concerning for pneumonia. " 3f08cc07-527618b0-5db69f0a-cfc4a152-7cb3a50a.jpg,test/p10/p10267709/s55257329/3f08cc07-527618b0-5db69f0a-cfc4a152-7cb3a50a.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: New onset aphasia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Right base opacity seen on the frontal view, not well substantiated on the lateral view, may be due to overlap of structures or atelectasis. Finding is similar as compared to chest radiograph from ___. The patient is status post median sternotomy and CABG. The aorta remains calcified and tortuous. The cardiac silhouette is top normal to mildly enlarged. Overall the cardiomediastinal silhouette is stable, particularly in comparison with ___. No pleural effusion or evidence of pneumothorax is seen. " 88d181b2-23bc7649-4b11fa69-b22f33b6-c664e012.jpg,test/p18/p18809506/s59956740/88d181b2-23bc7649-4b11fa69-b22f33b6-c664e012.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY ___ year old woman with question of sarcoid. // Please assess for perihilar fullness, evidence of sarcoid Please assess for perihilar fullness, evidence of sarcoid COMPARISON: ___ and ___ FINDINGS: Streaky density bilaterally most consistent with fibrotic change is again demonstrated. Prominence of the interstitium has improved since the more recent examination. The lungs are otherwise clear. Hilar fullness and prominence of the paratracheal soft tissues persists. The aorta is tortuous and calcified. The heart is normal in size. There are degenerative changes in the spine. IMPRESSION: Persistent hilar is fullness and prominence of the paratracheal soft tissues. Increased interstitial markings have improved. " e95e1b38-2018bac2-66619a93-04148efc-8e11cb88.jpg,test/p14/p14262369/s59347288/e95e1b38-2018bac2-66619a93-04148efc-8e11cb88.jpg,test," FINAL REPORT HISTORY: ___-year-old female with recent upper respiratory infection, with pleuritic chest pain, on immune-modulating medications for rheumatoid arthritis. Evaluation for infection. COMPARISON: Comparison is made to CTA of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pneumothorax, pleural effusion, pulmonary edema, or focal airspace opacity. The bony structures are intact. Cholecystectomy clips are present in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " a6781a53-27f62339-7ac509d7-a4ce07ce-d6ad9583.jpg,test/p14/p14792425/s59452399/a6781a53-27f62339-7ac509d7-a4ce07ce-d6ad9583.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Acute heart failure. COMPARISON: ___, 8:11 a.m. FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been removed. The right venous introduction sheath is in unchanged position. There is unchanged massive cardiomegaly, with shape of the cardiac silhouette, potentially indicative of pericardial effusion. The bilateral overall subtle but diffuse parenchymal opacities, indicative of pulmonary edema, are without relevant change. No pleural effusions. No evidence of parenchymal bleeding. Minimal atelectasis at the right lung base persists. " 8811478a-5640f3ca-ed73b52f-b9a98865-6d1b3f9d.jpg,test/p14/p14992605/s57310200/8811478a-5640f3ca-ed73b52f-b9a98865-6d1b3f9d.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Wheezing. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The chest is hyperinflated. A streaky opacity at the left lung base indicates minor atelectasis. Otherwise, the lungs appear clear. IMPRESSION: No evidence of acute disease. " 10792dbb-5ef38195-02cdd26a-18a14e61-d2b024c5.jpg,test/p14/p14388050/s53101497/10792dbb-5ef38195-02cdd26a-18a14e61-d2b024c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Afib, altered mental status, ?aspiration. // Please eval for PNA, aspiration Please eval for PNA, aspiration COMPARISON: Chest radiographs ___ through ___. IMPRESSION: LEFT LUNG IS NEWLY COLLAPSED, EXPLAINING LEFTWARD MEDIASTINAL SHIFT. THIS COULD BE DUE TO RETAINED SECRETIONS OR RECENT ASPIRATION. THERE IS NO APPRECIABLE LEFT PLEURAL EFFUSION. MILD EDEMA HAS RECURRED IN THE RIGHT LOWER LUNG OR PERHAPS THESE ARE FINDINGS OF ASPIRATION AS WELL. SMALL RIGHT PLEURAL EFFUSION IS STABLE. NO PNEUMOTHORAX. NOTIFICATION: Dr. ___ reported the findings to Dr ___ by telephone on ___ at 4:43 PM, minutes after discovery of the findings. " 171ab6cd-bfa94520-63ba5203-156258b9-a904bdeb.jpg,test/p18/p18933552/s53696052/171ab6cd-bfa94520-63ba5203-156258b9-a904bdeb.jpg,test," FINAL REPORT INDICATION: ___ year old man with lung ca and new L pleural effusion s/p drainage ___. // recurrence of pleural effusion TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___ and CT chest on ___. FINDINGS: The lungs are well expanded and clear. The left pleural effusion appears slightly increased from prior exam, consistent with recurrent pleural effusion. There is no right pleural effusion. There is no pneumothorax. The cardiomediastinal silhouette is unremarkable. Height loss is seen in a few vertebral bodies. IMPRESSION: Recurrent left pleural effusion. No right pleural effusion. " d16d943d-e00946a6-5e4e6506-f00bf5aa-c8b89ad4.jpg,test/p13/p13294497/s50679608/d16d943d-e00946a6-5e4e6506-f00bf5aa-c8b89ad4.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with L sided chest pain // c/f PNA TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are well expanded and clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " e98ec349-c149c993-d09905de-1a1a8504-b180a172.jpg,test/p10/p10496352/s52984666/e98ec349-c149c993-d09905de-1a1a8504-b180a172.jpg,test," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with history of tracheal removal, now with chest pain. // eval for pneumo. TECHNIQUE: Portable AP chest COMPARISON: ___ portable chest radiograph FINDINGS: Lung volumes remain low. Retrocardiac opacities and indistinctness of the left hemidiaphragm have increased. No pleural effusion or pneumothorax. Heart size is normal. Cardiomediastinal and hilar silhouettes are unremarkable. IMPRESSION: 1. No pneumothorax. 2. Increased retrocardiac opacity and indistinctness of the left hemidiaphragm may again reflect increasing left basilar atelectasis or developing pneumonia. " ce1b3b3e-1e42ecb7-9fdb7227-c90d1de8-c4f54438.jpg,test/p17/p17804936/s53970631/ce1b3b3e-1e42ecb7-9fdb7227-c90d1de8-c4f54438.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with altered mental status TECHNIQUE: Upright AP view of the chest COMPARISON: ___ FINDINGS: The patient is status post median sternotomy with a left-sided Port-A-Cath tip in the lower SVC. Heart size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion, focal consolidation or pneumothorax is present. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 5b2a9b69-62a73e22-c6dc8006-9de44a8f-f4a74a10.jpg,test/p19/p19962126/s50020923/5b2a9b69-62a73e22-c6dc8006-9de44a8f-f4a74a10.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxic resp failure, now s/p extubation // Eval for interval change IMPRESSION: In comparison to ___ chest radiograph, worsening, poorly defined areas of consolidation in the right mid and both lower lungs are concerning for developing multifocal pneumonia. Small bilateral pleural effusions are also demonstrated. " 3fc73ccb-189e8f66-5b88c696-d58b5958-df74c5c4.jpg,test/p10/p10165672/s54051447/3fc73ccb-189e8f66-5b88c696-d58b5958-df74c5c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CRF, CHF, and prob opportunistic infection by CT // interval change in pulmonary infiltrates COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing parenchymal opacities have substantially decreased in extent and severity. They remain best visible at the right lung bases and in the left perihilar region. No new opacities. Ongoing borderline size of the cardiac silhouette without pulmonary edema. The lateral radiograph of today shows minimal dorsal pleural effusions. " 55345998-6ddd8292-0794383f-f84cc4b4-1c348627.jpg,test/p16/p16904987/s54429928/55345998-6ddd8292-0794383f-f84cc4b4-1c348627.jpg,test," WET READ: ___ ___ ___ 10:13 PM Dobhoff tube in the body of the stomach. Cardiopulmonary findings similar to prior. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Assessment of Dobbhoff position. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the Dobbhoff catheter has been re-positioned. The catheter now shows a normal course, the tip of the catheter is in the middle parts of the stomach. In the interval, the patient has been extubated. The positions of the left central venous access line and of the left chest tube are unchanged. Unchanged appearance of the lung parenchyma and the cardiac silhouette. " d70240bc-8cf58d93-a9e876b7-b3d0ccd5-c4c5ca2f.jpg,test/p17/p17875843/s56183707/d70240bc-8cf58d93-a9e876b7-b3d0ccd5-c4c5ca2f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pig tail for pleural effusion on waterseal // ?pneumothorax ?change in pleural effusion compare to prior ?pneumothorax ?change in pleural effusion compare to prior IMPRESSION: Comparison ___. The right chest tube is in unchanged position. A small right pleural effusion with subsequent atelectasis has minimally increased in extent and severity. Moderate cardiomegaly persists. Mild elongation of the descending aorta. Mild pulmonary edema is present. " 685abeb6-c9bfae1f-b7fb50e6-746d1b0c-b32cdcef.jpg,test/p17/p17051420/s53723188/685abeb6-c9bfae1f-b7fb50e6-746d1b0c-b32cdcef.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old male with shortness of breath and chest pain. COMPARISON: ___. FINDINGS: Two portable views of the chest. Exam was somewhat limited due to positioning and portable technique. There is no confluent consolidation or overt pulmonary edema. The cardiac silhouette is enlarged but unchanged. IMPRESSION: Cardiomegaly without definite superimposed acute cardiopulmonary process. " c553fc7a-713d0aee-692f6c84-15561b75-bfeee167.jpg,test/p12/p12290869/s50251230/c553fc7a-713d0aee-692f6c84-15561b75-bfeee167.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p MVC // intrapulmonary process intrapulmonary process IMPRESSION: Comparison to ___. No relevant change. Moderate scoliosis of the thoracic spine. Mild elongation of the descending aorta. Normal size of the cardiac silhouette. No pleural effusions, no pulmonary edema. " 6124ac65-52da376e-a8f377e4-28e0d5e0-ee67751e.jpg,test/p11/p11886174/s56473814/6124ac65-52da376e-a8f377e4-28e0d5e0-ee67751e.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with cough, shortness of breath, tachypnea. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. Again seen is a right chest wall pacer device with a single lead projecting over the right ventricle. There is a left lower lateral pneumothorax, new. Lucencies projecting over the right costophrenic angle and along the lateral right pleural surface may reflect blebs, better seen on today's exam compared to ___, versus right-sided pneumothoraces. Diffuse increased interstitial markings are compatible with known severe emphysema. Calcified plaques are likely related to prior asbestos exposure. No definite focal consolidation or pleural effusion is seen. The visualized upper abdomen is unremarkable. IMPRESSION: Pneumothorax along the left lateral lower lung. Lucencies projecting over the right costophrenic angle and along the lateral right pleural surface may reflect blood is better seen on today's exam compared to ___ versus additional right-sided pneumothoraces. RECOMMENDATION(S): CT for further evaluation is recommended. NOTIFICATION: These findings were communicated via telephone by ___ ___, MD, to ___, NP, at ___ on ___, approximately 5 minutes after discovery. " 118543f3-fdcb6970-8c30abdb-e6df7178-4d7f1dd3.jpg,test/p13/p13325402/s58980708/118543f3-fdcb6970-8c30abdb-e6df7178-4d7f1dd3.jpg,test," FINAL REPORT INDICATION: ___ year old woman with vomiting, chest pain // eval for pneumonia COMPARISON: Chest radiograph from ___ FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Mild cardiomegaly is unchanged. The aortic knob appears prominent as on prior. Mild vascular congestion appears similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 2fd22430-6eb37df2-53770166-8bbfe9ed-25d6e8f8.jpg,test/p13/p13103526/s56172510/2fd22430-6eb37df2-53770166-8bbfe9ed-25d6e8f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___M w/ facial fractures, rib fractures, clavicle fx, left proximal humerus, and high transverse femur fractures s/p high-speed MVC as well as questionable ICH. // interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Mild interstitial edema persists, nearly all in the right lung. Moderate cardiomegaly unchanged. Small right pleural effusion stable. Right jugular line ends in the mid SVC, nasogastric tube passes into the mid stomach. There may be narrowing of the trachea at the thoracic inlet, just above the tip of the endotracheal tube which ends more than 6 cm above the carina. Rib and severely distracted right clavicle fracture are previously noted. " 106e24b0-e4efdb55-180e50e4-4503feb4-dd341aa1.jpg,test/p13/p13961236/s55042408/106e24b0-e4efdb55-180e50e4-4503feb4-dd341aa1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Leukocytosis, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The pre-existing changes suggestive of minimal fluid overload are still present. No pleural effusions. No evidence of pneumonia. Borderline size of the cardiac silhouette. " cab48533-edf1d06b-56e3b1c6-177261e0-05de9eb0.jpg,test/p11/p11861605/s59680556/cab48533-edf1d06b-56e3b1c6-177261e0-05de9eb0.jpg,test," FINAL REPORT HISTORY: Cough with fever assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are somewhat low in volume but clear. There is no pleural effusion or pneumothorax. The heart is top normal in size with normal mediastinal contours. IMPRESSION: No acute intrathoracic process. " d77d4789-de3f66cc-fa9e455d-4de9920a-9b9016ce.jpg,test/p18/p18781799/s57490615/d77d4789-de3f66cc-fa9e455d-4de9920a-9b9016ce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with probable lung cancer now with probable metastases to brain. // assess interval change TECHNIQUE: Chest PA and lateral COMPARISON: PET-CT ___ FINDINGS: Heart size is normal with a left ventricular predominance. The mediastinal contour is unchanged with widening of the superior mediastinum due to a combination of the patient's known right lower paraitracheal/suprahilar mass and lipomatosis as seen on the prior PET-CT. Fullness of the right hilum is compatible with hilar adenopathy. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen. IMPRESSION: Abnormal mediastinal contour is attributable to the presence of the patient's known right lower paratracheal/ suprahilar mass as well as lipomatosis as seen on the prior PET-CT. Known mediastinal lymphadenopathy is better appreciated on the prior PET-CT. Right hilar enlargement compatible with adenopathy. " 1595b344-6d52098c-c0accc72-80b42874-6edc1d01.jpg,test/p17/p17490954/s51816377/1595b344-6d52098c-c0accc72-80b42874-6edc1d01.jpg,test," FINAL REPORT INDICATION: ___-year-old male with dementia, acute mental status change and possible syncope with fall. COMPARISON: Chest radiograph ___, ___. TECHNIQUE: Fontal and lateral views of the chest were obtained. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well expanded. The previously seen focal area of increased density at the right lung base has improved; however, there is vague, more diffuse, subtle increased density at the right lung base, which may reflect an ongoing infectious process. The left lung is essentially clear. Multiple healed rib fractures of the left upper posterior ribs are again noted as well as chronic abnormalities of the right posterior rib 6. The upper abdomen is unremarkable. IMPRESSION: Persistent subtle vague increased density at the right lung base, which may indicate a residual consolidation. " d3ba90f6-aeef0bca-4612fc01-47e6067a-7e605d48.jpg,test/p17/p17846379/s54621030/d3ba90f6-aeef0bca-4612fc01-47e6067a-7e605d48.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: New right lower lobe infiltrate followup. REFERENCE EXAM: ___. FINDINGS: There continues to be obscuration of the right hemidiaphragm with increased alveolar infiltrate in the right lower lobe. The right effusion is slightly smaller; however, there is also an area of increased alveolar infiltrate in the left lower lung likely representing a small new infiltrate in that region. The right-sided PICC line with tip in the distal SVC is again visualized. IMPRESSION: Improved appearance on the right, worsened appearance in the left lower lobe. " 6c06e30b-c9c1e221-e694e291-89e2e242-808f30c9.jpg,test/p14/p14189406/s57791585/6c06e30b-c9c1e221-e694e291-89e2e242-808f30c9.jpg,test," FINAL REPORT HISTORY: Extubation. FINDINGS: In comparison with study of ___, there are continued low lung volumes. The bibasilar opacifications persist, most likely reflecting atelectasis with effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered. " cdb03a25-afddc182-284f9265-40bdaa45-0aa7a8b7.jpg,test/p12/p12749689/s50696269/cdb03a25-afddc182-284f9265-40bdaa45-0aa7a8b7.jpg,test," FINAL REPORT INDICATION: ___ year old man with acute liver failure // please evaluate for infiltrate TECHNIQUE: AP portable chest radiograph COMPARISON: None available FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiomediastinal silhouette is within normal limits. IMPRESSION: No radiographic evidence of acute cardiopulmonary disease. " 17658d53-035311d0-385aa079-5e7aa5ed-755bcbb3.jpg,test/p10/p10090768/s57224414/17658d53-035311d0-385aa079-5e7aa5ed-755bcbb3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with arthrlagias // ? hilar ___ or infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: None IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are well inflated. No pleural effusion or pneumothorax is seen. There is no evidence of mediastinal or hilar lymphadenopathy within the limitations of the study technique as well as no focal consolidation to suggest infectious process. If clinically warranted, correlation with chest CT is to be considered. " 440980b3-fc526290-f2093e69-9ce009e0-6eec1329.jpg,test/p18/p18092465/s51184079/440980b3-fc526290-f2093e69-9ce009e0-6eec1329.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/ARDS / AEP // Evaluate for interval change COMPARISON: ___ IMPRESSION: As compared to the previous image, the lung volumes have slightly decreased. There is an increasing atelectasis at the right lung base, at the level of the middle lobe. No new parenchymal opacities have occurred. Moderate cardiomegaly with moderate pulmonary edema is still present. Unchanged monitoring and support devices. " 348d45e6-321d4544-a6e5f3f6-e1ead923-1f939e52.jpg,test/p10/p10203225/s57463457/348d45e6-321d4544-a6e5f3f6-e1ead923-1f939e52.jpg,test," FINAL REPORT HISTORY: Catheter lysis for PE, to assess for pneumothorax. FINDINGS: There is no evidence of vascular congestion or pleural effusion. Some prominence of central pulmonary vessels could reflect pulmonary arterial hypertension. Retrocardiac opacification is consistent with volume loss in the lower lobe. " d489b6ab-960601bb-e63c5a90-5c0f5685-fd8d8fee.jpg,test/p15/p15509505/s57470784/d489b6ab-960601bb-e63c5a90-5c0f5685-fd8d8fee.jpg,test," FINAL REPORT INDICATION: Numbness and tingling in the hand. COMPARISON: Multiple prior studies including chest radiograph from ___. FINDINGS: The heart and mediastinal contours appear stable and within normal limits. A large hiatal hernia is again noted. The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. No free air is noted in the hemidiaphragms. No acute fractures are identified. IMPRESSION: Large hiatal hernia with no acute cardiopulmonary process. " 1dfee053-b6a869c0-7c918a24-0cdefd74-d69b052f.jpg,test/p10/p10459005/s57373025/1dfee053-b6a869c0-7c918a24-0cdefd74-d69b052f.jpg,test," FINAL REPORT INDICATION: ___ year old man with LVAD and volume overload now with worsening SOB, also has anterior pericardial effusion from surgery (loculated). // ? pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Left ventricular assist device projects over the left lower hemithorax/upper abdomen. Dual lead ICD with the right ventricular lead in the appropriate position, but the right atrial lead projects inferiorly (unchanged compared to prior imaging). Discontinuity of the superior most sternal wire but the sternal wires are well aligned. Right-sided PICC line in situ with the tip in the mid SVC. No pneumothorax. Stable transverse cardiomegaly. Presumed left lower lobe atelectasis. There is mild increase in congestion of the pulmonary vessels and the fluid seen in the right transverse fissure is unchanged, but there is no new overt pulmonary edema. IMPRESSION: Mild increase congestion of the pulmonary vessels but no overt pulmonary edema. " 284d6c12-a69ba2ee-3c0212ec-24f52bf2-e83dbe04.jpg,test/p11/p11842879/s59138767/284d6c12-a69ba2ee-3c0212ec-24f52bf2-e83dbe04.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Previous aspiration pneumonia, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the known right lower lung aspiration pneumonia is slightly smaller and better defined than on the previous image. The abnormality, however, is still clearly visible. No new abnormalities. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. " 2b7f60d6-380d930c-93c22811-b367ac48-1bf987c6.jpg,test/p11/p11775739/s55017357/2b7f60d6-380d930c-93c22811-b367ac48-1bf987c6.jpg,test," FINAL REPORT INDICATION: ___ year old man with metastatic osteosarcoma with acute on chronic CHF who presented with SOB, evaluate for pulmonary edema TECHNIQUE: Portable frontal chest radiograph was obtained. COMPARISON: Multiple priors with direct comparison made to study from ___ and CT chest from ___ FINDINGS: Compared to the prior study patient has taken a deeper breath. There are persistent bilateral patchy and rounded opacities which may represent multifocal pneumonia and/or pulmonary edema, although these could also represent coalescing metastatic lesions as seen on previous chest CT. A small right pleural effusion is present. There is no pneumothorax. IMPRESSION: Persistent bilateral rounded and patchy opacities which could represent multifocal pneumonia and/or pulmonary edema versus coalescing metastatic lesions as seen on recent chest CT. " 99cf3584-edf656e8-711665a4-8a09ed29-a71d572e.jpg,test/p10/p10180823/s57889799/99cf3584-edf656e8-711665a4-8a09ed29-a71d572e.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present. IMPRESSION: No acute cardiopulmonary abnormality. " e216e8ed-827fe965-2053ac43-4a7f45e6-c9a028d9.jpg,test/p19/p19524140/s53327316/e216e8ed-827fe965-2053ac43-4a7f45e6-c9a028d9.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Shortness of breath, effusions and pneumonia. Comparison is made with prior study, ___. Cardiac size is partially obscured by the lung abnormalities. There are low lung volumes. Moderate right and small left pleural effusions are stable. Right lower lobe opacity has increased, could be due to increasing atelectasis. Mild vascular congestion is stable. Right mild lung opacity has increased, consistent with worsening infection. Diffuse irregular interstitial opacities are grossly unchanged. " b8c26f05-35e7b2b2-a09233db-be173b14-89d4fb03.jpg,test/p14/p14823694/s55486662/b8c26f05-35e7b2b2-a09233db-be173b14-89d4fb03.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with continued oxygen requirement // eval for effusions, atelectasis eval for effusions, atelectasis IMPRESSION: In comparison with the study of ___, there is increased opacification at both bases with poor definition of the hemidiaphragms. This is consistent with layering effusions and underlying volume loss in the lower lobes, especially on the left. Streaks of atelectasis are also seen in the lower zones. " 1ee58133-6240eabc-26d03899-e5a987fc-a15e9ee3.jpg,test/p12/p12537194/s58048683/1ee58133-6240eabc-26d03899-e5a987fc-a15e9ee3.jpg,test," FINAL REPORT INDICATION: ___ year old man with met adeno ca, malig Rt pl eff, replacement of TPC // PTX? Residual fluid? TECHNIQUE: Chest PA and lateral COMPARISON: ___ 03:26 portable chest radiograph. FINDINGS: When compared to ___ 03:26 chest radiograph, a right chest tube has been placed at the level of the sixth and seventh posterior interspace. There is mild decrease of the large right pleural effusion. The large right pneumothorax is again seen. There is slight mediastinal leftward shift unchanged from most recent study. Increased vascular markings in the left lung is consistent with a the physiologic redirection of blood flow. However the left lung is well-expanded and clear. There is a possible small left pleural effusion not seen in prior study. IMPRESSION: 1. Interval placement of a right chest tube at the level of the sixth and seventh posterior interspace 2. There has been interval mild decrease in the large right pleural effusion. 3. There is persistent large right pneumothorax. 4. Possible new small left pleural effusion; however the left lung remains well-expanded and clear. " 6d4e82d3-e8276822-94936ed7-56027e4f-c4c0c7c2.jpg,test/p10/p10441044/s56976934/6d4e82d3-e8276822-94936ed7-56027e4f-c4c0c7c2.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, evaluation for change in pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is still no convincing evidence of a left pneumothorax. Two left chest tubes remain in situ, as do the other monitoring and support devices, with the exception of the left subclavian vein catheter that has been removed in the interval. Minimal increase in opacity at the right lung base, likely atelectatic in nature. Unchanged displaced left rib fractures. " 70a1514b-209558aa-bf46b270-a4efd2f4-7e5ed5ad.jpg,test/p10/p10078115/s53480792/70a1514b-209558aa-bf46b270-a4efd2f4-7e5ed5ad.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with left basal ganglia hemorrhage, interval change. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is approximately 6.5 cm above the carina. The NG tube tip is in the stomach. The right subclavian line tip is at the cavoatrial junction. The heart size and mediastinum are unchanged in appearance, though there is slight interval progression of interstitial pulmonary edema, mild. No definitive increase in pleural effusion or pneumothorax demonstrated. " 59463580-bc0826a1-6522a134-e6b4d88f-1084f408.jpg,test/p19/p19643415/s55588919/59463580-bc0826a1-6522a134-e6b4d88f-1084f408.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath. h/o copd // acute process? TECHNIQUE: Chest PA and lateral COMPARISON: Prior radiographs on ___ and ___ FINDINGS: A left-sided Port-A-Cath is in stable position. Low lung volumes are demonstrated, which may accentuate bronchovascular markings. A diffuse interstitial abnormality is present and is increased from the prior examination, consistent with mild pulmonary edema. No pneumothorax or pleural effusion. IMPRESSION: Diffuse interstitial abnormality is increased from the prior examination and likely reflects mild pulmonary edema. " 18986e10-63ba9e04-bc1c6f05-7927ff8a-f2c8f016.jpg,test/p17/p17991156/s50345337/18986e10-63ba9e04-bc1c6f05-7927ff8a-f2c8f016.jpg,test," FINAL REPORT INDICATION: Worsening dyspnea on exertion. History lung cancer. TECHNIQUE: Chest, AP and lateral views. COMPARISON: Scout view from CT performed on ___. FINDINGS: There is a new moderate-to-large pleural effusion on the right side which occupies much of the right chest with right upper and basilar lower lobe atelectasis. The right hilum is enlarged raising concern for malignant involvement. There is a small pleural effusion on the left. An irregular nodule is not very well visualized in the left upper lobe but corresponds to a vague left suprahilar opacity which is similar to the prior study. The bones appear demineralized. IMPRESSION: Moderate to large right-sided pleural effusion with extensive atelectasis in basilar segments of the right lower lobe as well as right upper lobe. This appearance includes right hilar enlargement. Malignancy is a likely explanation for these findings. " b35ce83d-353d047b-0ab7ac16-f35cbb60-c376e2ad.jpg,test/p13/p13554701/s50799735/b35ce83d-353d047b-0ab7ac16-f35cbb60-c376e2ad.jpg,test," FINAL REPORT INDICATION: Altered mental status, evaluate for pneumonia. COMPARISONS: None. FINDINGS: Single AP upright radiograph of the chest demonstrates low lung volumes. The cardiomediastinal silhouette is within normal limits. There is a linear opacity in the right lung base that likely represents atelectasis. There is no definite consolidation or pleural effusion. Surgical clips are noted in the bilateral axilla. IMPRESSION: Low lung volumes. No definite consolidation. " b7001b4b-b9096312-d078ac8c-ffe2754d-4f2c7570.jpg,test/p12/p12365988/s51832405/b7001b4b-b9096312-d078ac8c-ffe2754d-4f2c7570.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cabg // chest tube on water seal please do around ___ noon chest tube on water seal please do around ___ noon IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube and Swan-Ganz catheters have all been removed. The left chest tube is on water seal and there is no evidence of pneumothorax. There are lower lung volumes with opacification at the bases consistent with atelectasis and possible small effusions. " 93f9987a-1242e142-23764ba8-c8c23e1d-a41df306.jpg,test/p13/p13204640/s58107989/93f9987a-1242e142-23764ba8-c8c23e1d-a41df306.jpg,test," FINAL REPORT INDICATION: ___ year old man with left temporal IPH // NG tube replacement. EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal view COMPARISON: Chest radiograph ___ FINDINGS: The transesophageal tube is coiled in the esophagus. Mild bibasilar atelectasis is slightly worse compared to ___. There is mild pulmonary vessel congestion. Cardiomediastinal silhouette is within normal size limits. There is small bilateral pleural effusions. IMPRESSION: The transesophageal tube is coiled in the esophagus. Mild bibasilar atelectasis is slightly worse compared to ___. Mild pulmonary vessel congestion. NOTIFICATION: The findings regarding transesophageal tube position were text paged by Dr. ___ to Dr. ___ ___ at 1:30 PM " 8ce6d503-18daa28a-850f629d-fe6871a1-963b492c.jpg,test/p16/p16675693/s55105461/8ce6d503-18daa28a-850f629d-fe6871a1-963b492c.jpg,test," FINAL REPORT HISTORY: Left chest pain. COMPARISON: ___ through ___. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal. Moderate thoracic kyphosis and multilevel wedge deformities are unchanged. IMPRESSION: No acute cardiopulmonary process. " b757bc09-2d0daf3e-76910fbf-efae4805-d01565fe.jpg,test/p19/p19650702/s51412828/b757bc09-2d0daf3e-76910fbf-efae4805-d01565fe.jpg,test," FINAL REPORT EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old woman status post tracheobronchoplasty with readmission for pneumonia. TECHNIQUE: Chest PA and lateral. COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Interval removal of right-sided PICC. Stable, mild cardiomegaly. Normal mediastinal and hilar contours. Interval resolution of mild pulmonary vascular congestion. Stable postsurgical defect in the right posterior third rib. Interval decrease in size of right apical radiodensity suggests a decreasing postsurgical fluid collection. No pneumothorax or pleural effusion. No convincing radiographic evidence of pneumonia. IMPRESSION: 1. Interval resolution of mild pulmonary vascular congestion. 2. No convincing radiographic evidence of pneumonia. " 566ac959-4536ed9d-616d7ffa-19b3d724-9d12a93f.jpg,test/p16/p16332400/s51523197/566ac959-4536ed9d-616d7ffa-19b3d724-9d12a93f.jpg,test," WET READ: ___ ___ ___ 7:58 AM The endotracheal tube is 4.8 cm above the carina. Enteric tube terminates below the field of view. No focal consolidation, effusion or pneumothorax. Nodular opacity over the left base is likely a nipple shadow, similar to the prior examination. WET READ VERSION #___ ___ ___ ___ 7:22 PM The endotracheal tube is 4.8 cm above the carina. Enteric tube terminates below the field of view. No focal consolidation, effusion or pneumothorax. Nodular opacity over the left base is likely a nipple shadow, similar to the prior examination. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with AMS, epidural abscess s/p laminectomy and endotracheal intubation // Assess for ET tube position TECHNIQUE: Single view at ___ 5:50 PM COMPARISON: Not available FINDINGS: Lungs: No acute infiltrate is seen. A nodular density persists in the left base probably nipple shadow. This was present in the past. Pleura: There is no pleural effusion. Mediastinum: No mediastinal mass is seen on this AP examination. Heart: The heart is not enlarged. Osseous structures: The osseous structures are normal for age. Additional findings: The endotracheal tube is 4 cm above the carina. Monitor leads overlie the chest. A feeding tube is projected over the abdomen and extends beyond the field of view of this chest radiograph. Left-sided surgical clips are seen presumably in the breast. IMPRESSION: Endotracheal tube in satisfactory position " 4abbb669-81c25a33-c500efeb-2c31f816-34d59548.jpg,test/p19/p19454512/s56957077/4abbb669-81c25a33-c500efeb-2c31f816-34d59548.jpg,test," FINAL REPORT INDICATION: History: ___F with SOB, chest pain // Eval for cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Persistent markedly elevation the right hemidiaphragm is demonstrated. No focal consolidation is identified. When compared to prior chest radiograph dated ___, the cardiomediastinal silhouette is stable. Low lung volumes are seen. There is prominence of the vascular markings suggestive of pulmonary edema. Blunting of the bilateral costophrenic angles is suggestive of small pleural effusions. There is no pneumothorax. Osseous structures are without acute abnormality. " 955fdf1d-6d7e83e5-6950bacc-1e32a01f-fbd4d95f.jpg,test/p10/p10934419/s54327896/955fdf1d-6d7e83e5-6950bacc-1e32a01f-fbd4d95f.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Chest pain, question acute intrathoracic process. FINDINGS: PA and lateral views of the chest are provided. Lung volumes are low which limits evaluation. The heart appears moderately enlarged. No large effusion or pneumothorax. No definite signs of pneumonia or CHF. The bony structures appear intact. No free air below the right hemidiaphragm. The mediastinal contour is normal. IMPRESSION: Cardiomegaly, no convincing signs of pneumonia or CHF. Limited evaluation due to low lung volumes. " 9a092749-167b3745-7f25504b-d5313924-69efa984.jpg,test/p14/p14819550/s57802911/9a092749-167b3745-7f25504b-d5313924-69efa984.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Dyspnea on exertion. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size is normal. Mediastinum is normal. Pleural calcifications are noted at the pleura bilaterally, right more than left. There is no pleural effusion or pneumothorax. Degenerative changes in the right shoulder are again noted. They might include loose bodies in the shoulder joint. The calcifications were not clearly seen on prior examination but most likely due to slightly different projection of the radiograph. " c4d0f380-20827d61-f3f0925a-b2ff2cc0-2b810309.jpg,test/p14/p14286294/s56153465/c4d0f380-20827d61-f3f0925a-b2ff2cc0-2b810309.jpg,test," WET READ: ___ ___ ___ 5:46 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with shortness of breath and chest pain TECHNIQUE: Chest upright PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The aorta is calcified, indicating atherosclerosis. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 5c1a6d76-d45e51df-c0c95362-1ef9ed53-c5a33375.jpg,test/p18/p18068560/s56960196/5c1a6d76-d45e51df-c0c95362-1ef9ed53-c5a33375.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with COPD, had hypercarbic resrpiratory failure in setting of ERCP, now extubated but remaining with 2L nasal canula hypoxia // focal processes to explain focal processes to explain IMPRESSION: In comparison with the study of ___, there is little overall change. Mild elevation of the right hemidiaphragmatic contour. Minimal atelectatic changes at the bases with no vascular congestion or acute focal pneumonia. Apical pleural changes are again seen. " 673d64b9-ff6042ee-61a592ad-06ee70dc-72a5a67b.jpg,test/p16/p16131849/s54216975/673d64b9-ff6042ee-61a592ad-06ee70dc-72a5a67b.jpg,test," FINAL REPORT HISTORY: Left spontaneous pneumothorax status post chest tube at outside hospital, status post chest tube removal, question interval change. CHEST, TWO VIEWS. A small left apical pneumothorax remains visible. The ptx at the upper and upper medial left chest is very slightly larger than on the prior exam. The ptx along the mediastinal surface of the left chest is grossly unchanged. Hemothoraces are grossly unchanged, seen on the lateral view. Lucency at the right apex, of indeterminate significance, is unchanged. Parenchymal findings are unchanged, IMPRESSION: 1. Left apical pneumothorax is slightly larger, detailed above. 2. Otherwise, I doubt significant interval change. " 39fe3a23-259e1bf0-3aa2b843-b7ee4de3-d63274d0.jpg,test/p12/p12791607/s54579522/39fe3a23-259e1bf0-3aa2b843-b7ee4de3-d63274d0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/ polysubstance abuse and h/o pancreatitis presents with acute onset ___ abdominal pain found to have splenic infarct aneurysm with extrav on CT s/p IR embolization // any changes TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Again seen are bilateral lower lobe infiltrates and volume loss with associated effusion. The amount of volume loss and effusion of increased compared to the prior exam the upper lungs are clear IMPRESSION: Slight worsening in appearance of the lower lobes/effusions. " 987807a9-3e159951-1cae2abd-ef4642d3-99e05bdb.jpg,test/p15/p15810543/s51752321/987807a9-3e159951-1cae2abd-ef4642d3-99e05bdb.jpg,test," FINAL REPORT HISTORY: ___-year-old female with chest tightness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Again, low lung volumes are seen with secondary crowding of the bronchovascular markings. The lungs are clear of consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Mild S-shaped thoracolumbar scoliosis is seen. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " afd2d1e2-82683e6a-60d8c8e9-987da710-081e3f7e.jpg,test/p12/p12613687/s56350654/afd2d1e2-82683e6a-60d8c8e9-987da710-081e3f7e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest pain, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is noted. Moderate scoliosis. Borderline size of the cardiac silhouette. Normal lung volumes. No pneumonia, no pleural effusions. No pulmonary edema. No pneumothorax. " e34b4165-17941674-f73267ad-28c3ade1-087f4575.jpg,test/p15/p15326361/s55134587/e34b4165-17941674-f73267ad-28c3ade1-087f4575.jpg,test," FINAL REPORT INDICATION: Fever, shortness of breath, evaluate for a cardiopulmonary process. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiograph. Evaluation limted through the lower lungs due to kyphotic angulation. There may be a vague opacity in thre right lower lung which in the correct clinical setting could reflect pneumonia. No pleural effusion or pneumothorax evident. There is exaggerated kyphosis of the thoracic spine. No vertebral compression deformities are noted in the visualized upper thoracic spine though lower thoracic spine obscured. Degenerative changes are present at the right acromioclavicular joint. " e9fed58f-81080573-29e7c963-c3bae1ff-a15dab90.jpg,test/p19/p19991135/s51478737/e9fed58f-81080573-29e7c963-c3bae1ff-a15dab90.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post right thoracotomy, right upper lobectomy. Comparison is made with prior study performed 10 hours earlier. There is minimal decrease in still large amount of air in the pleural cavity in the right upper hemithorax. Two right chest tubes are in unchanged positions. Right subcutaneous emphysema is new. Cardiac size is normal. Cardiomediastinal silhouette is midline. Widened mediastinum, a post-op change, is stable. ET tube is in standard position. Right lower lobe has better aeration. There is persistent opacity in the right middle lobe. Mild interstitial edema has improved. The patient has known emphysema. " 83b419fc-a224bb32-5a82ab87-66944e72-be2710ac.jpg,test/p12/p12593838/s57574346/83b419fc-a224bb32-5a82ab87-66944e72-be2710ac.jpg,test," FINAL REPORT INDICATION: ___F with fall, injuries to L periorbital area and L shoulder // ? traumatic injuries TECHNIQUE: Frontal and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are well expanded and clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 7905c61f-58058490-980ae90d-0975060b-2df5c610.jpg,test/p11/p11519089/s57953786/7905c61f-58058490-980ae90d-0975060b-2df5c610.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Esophageal tear, questionable pneumomediastinum. COMPARISON: No comparison available at the time of dictation. FINDINGS: Normal lung volumes. No pneumomediastinum. No pneumothorax. No pleural effusions. Normal size of the cardiac silhouette. " a0130336-50d1c611-bae476c1-266910fd-e9bba918.jpg,test/p11/p11465548/s55158430/a0130336-50d1c611-bae476c1-266910fd-e9bba918.jpg,test," WET READ: ___ ___ ___ 8:59 PM Increased right lung base opacity potentially atelectasis given elevation the right hemidiaphragm versus infection. Enlarged cardiac silhouette with a configuration raising the possibility of a pericardial effusion. Mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with CHF, with CP, dyspnea on exertion // ? pulmonary edema TECHNIQUE: Frontal lateral views of the chest. COMPARISON: ___. FINDINGS: As on prior, there is apparent elevation of the right hemidiaphragm with the possibility of a subpulmonic effusion. Increased opacity at the adjacent right lung base has progressed since prior. Indistinct pulmonary vascular markings seen throughout. There is no large left effusion. The cardiac silhouette is significantly enlarged. IMPRESSION: Increased right lung base opacity potentially atelectasis given elevation the right hemidiaphragm versus infection. Enlarged cardiac silhouette with a configuration raising the possibility of a pericardial effusion. Mild pulmonary edema. " dcc5cf31-63a67920-531a9acf-fbfb5b43-42d4e2d3.jpg,test/p13/p13774492/s59939231/dcc5cf31-63a67920-531a9acf-fbfb5b43-42d4e2d3.jpg,test," FINAL REPORT INDICATION: ___F with hypoxia // Eval for infiltrate TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Patchy regions of consolidation seen in the right lung laterally. There are also persistent streaky bibasilar opacities, somewhat more conspicuous compared to prior. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Left PICC is no longer visualized. IMPRESSION: Patchy regions of consolidation in the right lung laterally compatible with infection in the proper clinical setting. Bibasilar opacities potentially some combination of atelectasis and/or infection. " 108f81d0-d7a5c93a-5de126bc-84d28613-3ef565af.jpg,test/p15/p15226510/s54746898/108f81d0-d7a5c93a-5de126bc-84d28613-3ef565af.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are in unchanged position. Unchanged small bilateral pleural effusions and retrocardiac atelectasis. Mild fluid overload is present, but no new focal parenchymal opacities have appeared in the interval. " e5dfbb00-2b84b2e7-23e51cad-a73ad67c-5e3c1723.jpg,test/p11/p11276090/s58460163/e5dfbb00-2b84b2e7-23e51cad-a73ad67c-5e3c1723.jpg,test," FINAL REPORT INDICATION: Difficulty breathing. Please evaluate for mass, pneumonia, or cardiomegaly. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Chest PA and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. Comparatively decreased bilateral lung volumes with appearance of vascular crowding in the lung bases. Otherwise, lungs are clear. No overt pulmonary edema. No pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic process. " 94a965af-1374428b-83997dfe-aaafaf64-23eaaffa.jpg,test/p17/p17051420/s59572404/94a965af-1374428b-83997dfe-aaafaf64-23eaaffa.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Productive cough and fluid overload. COMPARISON: ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is again moderately enlarged. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs show no focal opacification. There is no pleural effusion or pneumothorax. The interstitium shows again mild diffuse prominent appearance, although less striking, and there is again mild upper zone redistribution of pulmonary vascularity. IMPRESSION: Interstitial process suggesting mild pulmonary edema although less striking than before. " 2ee82256-8c7b19ff-07730cb4-d624834b-80ee701f.jpg,test/p12/p12993962/s58137321/2ee82256-8c7b19ff-07730cb4-d624834b-80ee701f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // ?pneumonia ?pneumonia COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection, including tuberculosis. " b11fd72f-025d2d85-2876ec3f-18d79e0a-9264f519.jpg,test/p11/p11958913/s52603944/b11fd72f-025d2d85-2876ec3f-18d79e0a-9264f519.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Left upper lobe pneumonia. PA and lateral upright chest radiographs were reviewed in comparison to ___. As compared to the prior study, there is substantial improvement in the left upper lobe pneumonia with almost complete resolution of these findings except for minimal lateral still present faint opacity. Tortuosity of the aorta is redemonstrated. Heart size and mediastinum are unremarkable, and no new lung consolidations demonstrated. Reevaluation of the patient in four weeks for documentation of complete resolution is recommended of this most likely post-pneumonia scarring. " 126ec8c7-328dba73-95575c43-227c7906-5ec8dc57.jpg,test/p10/p10251182/s54141224/126ec8c7-328dba73-95575c43-227c7906-5ec8dc57.jpg,test," FINAL REPORT HISTORY: ___-year-old man with fever. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lung volumes are low. Retro-cardiac opacity likely represents atelectasis, although infectious process can be considered. Cardiomediastinal silhouette is mildly enlarged. Patient is status post median sternotomy. No pleural effusion or pneumothorax is identified. " 4100235d-675f4f1f-2073fecb-b125c75b-efa3e4ee.jpg,test/p16/p16662264/s57833493/4100235d-675f4f1f-2073fecb-b125c75b-efa3e4ee.jpg,test," FINAL REPORT INDICATION: ___-year-old with end-stage renal disease status post transplant, presents with recent history of pneumonia. COMPARISON: Multiple chest radiographs dated back to ___, most recently ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: Study is essentially unchanged from immediately prior study dated ___. Middle lobe and lingular infiltrate are once again observed and essentially unchanged. There has been a slight interval decrease of bilateral pleural effusions. No new areas of consolidation are appreciated. No pneumothorax. The cardiomediastinal silhouette is stable and within normal limits. IMPRESSION: Unchanged bilateral pneumonia with decreased pleural effusions. " 34a3953a-8bf439de-7ef3e81d-2cb24168-fbfae662.jpg,test/p16/p16030116/s59906251/34a3953a-8bf439de-7ef3e81d-2cb24168-fbfae662.jpg,test," FINAL REPORT INDICATION: ___ year old woman with severe ARDS, evaluate for interval change. TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Since prior, there has been little change to diffuse bilateral pulmonary opacification. Right IJ, endotracheal tube, and NGT are unchanged in position. There cardiomediastinal and hilar contours are unchanged. There is no pneumothorax or large pleural effusion. IMPRESSION: No change to diffuse bilateral pulmonary opacifications consistent with ARDS. " 02616c36-75390239-909c5b0b-b82d57ec-56d26e9c.jpg,test/p12/p12043836/s55187188/02616c36-75390239-909c5b0b-b82d57ec-56d26e9c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusion and chest tubeplease perform at 5am // pleural effusion change pleural effusion change IMPRESSION: In comparison with the study ___ ___, there is little overall change. Again there is huge enlargement of the cardiac silhouette, which should raise the possibility of pericardial effusion. Extensive right pleural effusion with volume loss in the lower lungs is again seen. The left lung is essentially clear and there is no evidence of pulmonary vascular congestion. Is projected over the upper right abdomen. " 59dd2747-2bd8b207-53faef95-b96496c6-65e2be5d.jpg,test/p19/p19262736/s57305998/59dd2747-2bd8b207-53faef95-b96496c6-65e2be5d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o M with a h/o tobacco and EtOH use, chronic pancreatitis c/b pseudocyst ___, C. diff colitis, and UC, who originally presented for n/v/d and abdominal pain, C-Diff positive, course complicated by hypoxic respiratory failure ___ PNA, NSTEMI, anuria ___ ATN from contrast and diuresis, hemolytic anemia and thrombocytopenia of unclear etiology, and odynophagia. Called out to the floor ___, after ICU stay which began with admission on ___. His overall clinical picture remains quite difficult to piece together. // assess for hypoxia TECHNIQUE: Single AP radiograph of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Left PICC terminates in the low SVC. Right IJ catheter terminates in the mid SVC. Bilateral mid and lower lung parenchymal opacities have progressed, representing multifocal pneumonia. Superimposed pulmonary edema cannot be excluded. Upper lung zones are relatively spared. Stable appearance of the cardiomediastinal silhouette. No large pleural effusions. No pneumothorax. IMPRESSION: 1. Left PICC and right IJ catheter in appropriate position. 2. Progressing bilateral parenchymal opacities, representing multifocal pneumonia, however superimposed pulmonary edema cannot be excluded. " 49745300-f89311ff-1666c5df-144a05b9-3624d39e.jpg,test/p10/p10577647/s50466677/49745300-f89311ff-1666c5df-144a05b9-3624d39e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Port-A-Cath is unchanged with tip residing in the low SVC region. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 1c9ba5ea-996352ed-c900d608-957da0d5-9c9508f3.jpg,test/p15/p15957987/s59599529/1c9ba5ea-996352ed-c900d608-957da0d5-9c9508f3.jpg,test," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISONS: Portable AP chest x-ray ___. CT chest without contrast ___. INDICATION: ___-year-old with left PleurX catheter with no drainage. FINDINGS: The right pleural effusion is improved compared to prior imaging. The left pleural effusion is unchanged. A PleurX catheter is noted in the new position. An esophageal stent is noted in good position. The mediastinal silhouette is stable. IMPRESSION: 1. Unchanged left-sided pleural effusion. 2. Improved right-sided pleural effusion. " 13d1244c-e742e1c3-e15b2479-94126654-8a7b973e.jpg,test/p12/p12906270/s57230068/13d1244c-e742e1c3-e15b2479-94126654-8a7b973e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison with multiple prior studies, most recent dating ___. CLINICAL HISTORY: Cough, body pain, HIV history, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate clear well-expanded lungs without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No signs of pneumonia. " 5bf7f2ef-21ad34a0-246822ab-0f74e5a1-417ffe43.jpg,test/p11/p11894482/s58493485/5bf7f2ef-21ad34a0-246822ab-0f74e5a1-417ffe43.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with weight loss and tobacco history, or evaluate for mass TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___. Chest radiograph ___ and ___. FINDINGS: Heart size is normal. Prominence of the right hila is unchanged dating back to ___. The lungs are hyperinflated but clear. Deviation of the leftward deviation of the trachea reflects underlying enlarged thyroid, as demonstrated on prior chest CT. Pleural surfaces are normal. There is no pneumothorax. Calcified granuloma at the right lung apex is stable. IMPRESSION: No radiographic evidence of intrathoracic malignancy. " e7f6849b-d294338b-f3f2700f-0b88cef1-0bb66f05.jpg,test/p13/p13405890/s57439534/e7f6849b-d294338b-f3f2700f-0b88cef1-0bb66f05.jpg,test," FINAL REPORT EXAMINATION: PORTABLE CHEST RADIOGRAPH INDICATION: ___-year-old woman with hypotension; evaluate for pneumonia or pulmonary edema. TECHNIQUE: Portable semierect AP chest radiograph views were obtained. COMPARISON: Chest radiograph dated ___. Right shoulder radiograph dated ___. Left shoulder radiograph dated ___. FINDINGS: Small left pleural effusion appears to have resolved. Perhaps minimal pulmonary vascular congestion. Otherwise, no significant change from the prior exam. There may be trace persistent right pleural effusion. Bilateral atelectasis persists. No focal consolidation, pneumothorax, or overt pulmonary edema. Stable prominent cardiomegaly. Stable calcification of the aortic arch. Stable mediastinal and hilar contours. Bilateral narrowing of the AC joint and high-riding humerus as well as heterotopic ossification superolateral to the right humeral head, suggesting chronic rotator cuff tear and severe osteoarthritis/post-trauma changes, are overall similar to prior shoulder radiographs. IMPRESSION: 1. Interval resolution of small left pleural effusion; persistent probable trace right pleural effusion. 2. Minimal pulmonary vascular congestion and bilateral atelectasis. 3. No focal consolidation or frank pulmonary edema. " fc1a0d09-6cab8758-b309bbc3-e5c6cbc6-048833e1.jpg,test/p14/p14371035/s58646502/fc1a0d09-6cab8758-b309bbc3-e5c6cbc6-048833e1.jpg,test," FINAL REPORT HISTORY: For ET tube placement. FINDINGS: In comparison with the study of ___, there is little overall change. Monitoring and support devices remain in satisfactory position. Bibasilar opacification is consistent with bilateral effusions and volume loss in the lower lobes. More patchy areas of opacification could well represent superimposed pneumonia in the appropriate clinical setting. " 9906a136-a4a43de4-a4e3a559-39aec7ae-e3d18f92.jpg,test/p15/p15170582/s58004183/9906a136-a4a43de4-a4e3a559-39aec7ae-e3d18f92.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man prior to starting amiodarone // lung disease noted on CXR, pre-amiodarone lung disease noted on CXR, pre-amiodarone IMPRESSION: In comparison with study of ___, a there has been clearing of the pulmonary edema. No evidence of acute pneumonia or pleural effusion. Regional osseous sclerosis is again seen in the right mid zone. " b451e119-e28043e1-d1a465fc-f922c83a-1fafeeb8.jpg,test/p13/p13679831/s50063490/b451e119-e28043e1-d1a465fc-f922c83a-1fafeeb8.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. Evaluate chest pain, rule out pneumonia TECHNIQUE: Chest PA and lateral radiographs were obtained. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. Posterior cervical fusion hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " 66aea30b-249c6334-bff8425b-da974cf8-c3bbae43.jpg,test/p13/p13350579/s58901092/66aea30b-249c6334-bff8425b-da974cf8-c3bbae43.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___ COMPARISON: ___ radiograph, ___ chest CT and older chest radiographs and chest CTs dating back to ___. FINDINGS: The patient is status post previous right upper lobe resection with a post-operative volume loss and pleural thickening as well as peripheral parenchymal scarring in the lower right hemithorax. Heterogeneous opacities in the right lower lung have worsened compared to the ___ chest radiograph and are concerning for pneumonia with associated mucous plugging of bronchiectatic airways. Left lung demonstrates apical scarring at a previous wedge resection site and nonspecific lingular scarring, but no focal areas of consolidation. There are no pleural effusions. IMPRESSION: Heterogeneous opacities in right lower lung, likely corresponding to pneumonia complicating pre-existing bronchiectasis, with associated mucus plugging. Consider a 4 week followup chest x-ray to confirm resolution following appropriate therapy. If this fails to improve at followup chest x-ray, or if symptoms progress despite treatment, consider a chest CT with contrast to exclude an obstructing juxtahilar mass. Findings entered into radiology communications dashboard on the date of the study. " fdfb021a-f7347dad-e300b7ac-296fd4f0-516453f1.jpg,test/p11/p11621459/s54829358/fdfb021a-f7347dad-e300b7ac-296fd4f0-516453f1.jpg,test," FINAL REPORT INDICATION: Cough. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " ddc1b88c-e8502360-29023e1d-244adeb2-6291cb84.jpg,test/p19/p19601036/s58355820/ddc1b88c-e8502360-29023e1d-244adeb2-6291cb84.jpg,test," WET READ: ___ ___ ___ 9:00 AM Slight interval increase in right pleural effusion. Left pleural effusion stable in configuration. Otherwise stable exam. --___ WET READ VERSION #___ ___ ___ 11:53 PM Slight interval increase in right pleural effusion. Left pleural effusion stable in configuration. Otherwise stable exam. -___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chylothorax // assess effusions TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed the same day earlier in the morning. IMPRESSION: Apparent increase in right pleural effusion could be positional. No other interval change from prior study, including a small left effusion with adjacent atelectasis. " 4db9255c-28fc8ed4-1ecef7b5-0f8aad79-72f12afe.jpg,test/p19/p19149202/s53153550/4db9255c-28fc8ed4-1ecef7b5-0f8aad79-72f12afe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with inc O2 requirement // inc O2 requirement TECHNIQUE: Portable chest COMPARISON: CT from ___ FINDINGS: Bilateral lower lobe right greater than left hazy opacities are visualize that are similar in extent compared to the CT from the prior day that showed ground-glass opacities in these regions. The upper lungs are relatively clear. There is no pleural effusion or pneumothorax IMPRESSION: As mentioned on the CT, the bilateral lower lobe ground-glass opacities could be due to the either an infectious infiltrate or hypersensitivity pneumonitis. Clinical correlation and followup are recommended " 854f4c47-bff0fc6b-b4c1f71b-0735be16-9e2f14e5.jpg,test/p16/p16952127/s50482020/854f4c47-bff0fc6b-b4c1f71b-0735be16-9e2f14e5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure, intubated // Interval changes TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " f2f5bf5e-84318a00-50ed4688-ffeb1481-8a8348ad.jpg,test/p16/p16548129/s54156868/f2f5bf5e-84318a00-50ed4688-ffeb1481-8a8348ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB // Pneumonia? Pneumonia? IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " acb5a7e0-f78a01f5-22b44e15-a715a887-84909622.jpg,test/p13/p13396234/s54547779/acb5a7e0-f78a01f5-22b44e15-a715a887-84909622.jpg,test," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Status post AVR, evaluation for pulmonary edema. COMPARISON: Portable chest from ___. FINDINGS: There is a history of potential myeloma. The appearance of the bones constituting the bony chest wall as well as the shoulders and the clavicle suggests the presence of a diffuse bony disease, for example diffuse metastatic breast cancer. This finding should be further pursued with rechecking the history and potential further diagnostic tests. Low lung volumes. Moderate bilateral pleural effusions. Moderate cardiomegaly. Status post sternotomy and aortic valve replacement. Currently, there is only mild fluid overload but no overt pulmonary edema. " 69d8d822-dd78cab2-3cbf772e-ff81dc11-ad23bce1.jpg,test/p14/p14050547/s52819075/69d8d822-dd78cab2-3cbf772e-ff81dc11-ad23bce1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, ascites, ? volume overload TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. There is slight increase elevation of the right hemidiaphragm compared to the previous study, likely reflective of ascites. Small bilateral pleural effusions are noted along with bibasilar opacities likely reflective of atelectasis. No pneumothorax is present. An there are no acute osseous abnormalities. Clips are seen within the anterior abdominal wall. IMPRESSION: Bibasilar atelectasis with small bilateral pleural effusions. No evidence of pulmonary edema. " 37f9a58c-5d6420fe-aa641c7b-4f5e9c1e-89e8581a.jpg,test/p10/p10114059/s58515392/37f9a58c-5d6420fe-aa641c7b-4f5e9c1e-89e8581a.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Some degenerative changes are seen along the spine, including anterior osteophytosis. IMPRESSION: No acute cardiopulmonary process. " 727e74ba-da0e2579-00788bb8-21940905-ea0bc6c6.jpg,test/p13/p13103745/s51823701/727e74ba-da0e2579-00788bb8-21940905-ea0bc6c6.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after extubation and a replaced OG tube. AP radiograph of the chest was reviewed in comparison to ___. The NG tube tip is in the stomach. The right internal jugular line tip is at the level of mid SVC. Cardiomediastinal silhouette is unchanged. Left basal opacity appears to be minimally progressed since the prior study, most likely representing atelectasis, but assessment to exclude the possibility of developing infectious process is recommended with chest radiograph. " f2f62709-4b1d7dc5-5d0afab0-4834a02e-d74f3a26.jpg,test/p10/p10206502/s56342709/f2f62709-4b1d7dc5-5d0afab0-4834a02e-d74f3a26.jpg,test," FINAL REPORT INDICATION: ___M with multiple medical problems, known honeycombing on lungs, recently admission c/b respiratory failure requiring intubation who presents with generalized weakness, c/f PNA // evidence of pneumonia? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. ___. FINDINGS: Increased interstitial markings throughout the lungs are compatible with patient's known underlying interstitial abnormality. There bilateral moderate size pleural effusions left greater than right. Please note that underlying consolidation would be difficult to exclude. Left chest wall triple lead pacing device is again noted. The cardiomediastinal silhouette is stable. IMPRESSION: Chronic underlying interstitial abnormality with superimposed bilateral moderate pleural effusions, left greater than right. Superimposed infection particularly at the left lung base would be difficult to exclude. " a897c536-3f21fb3b-fb09df80-53162074-da69a933.jpg,test/p14/p14940318/s54475180/a897c536-3f21fb3b-fb09df80-53162074-da69a933.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation. COMPARISON: ___. FINDINGS: Compared to the previous radiograph, there is no relevant change. Constant appearance of the lung parenchyma and of the cardiac silhouette. No pleural effusions. No intra-abdominal air. No pneumothorax. No parenchymal opacity suggesting pneumonia. " 98b73662-0bc6f0a9-55f7c42c-e8074e6f-bca2dcb7.jpg,test/p18/p18988864/s58330593/98b73662-0bc6f0a9-55f7c42c-e8074e6f-bca2dcb7.jpg,test," FINAL REPORT HISTORY: Metastatic lung cancer with port placement. FINDINGS: The right subclavian port line extends to the lower portion of the SVC. No definite pneumothorax. When compared to the scout radiograph from the CT of ___, there is little overall change in the opacification in the right mid lung extending to the pleural surface, consistent with the dominant right upper zone mass. " 62e7e8a5-84c6b484-66fbae8b-68488747-89f73abe.jpg,test/p17/p17965737/s53929036/62e7e8a5-84c6b484-66fbae8b-68488747-89f73abe.jpg,test," FINAL REPORT HISTORY: Fever and neck pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The extreme lung apices are excluded from the field of view. Otherwise, the lungs are clear without focal consolidation. The heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 8e70427f-f58e9fa8-447c7ddd-52c5da27-547ee7ea.jpg,test/p17/p17477304/s56492407/8e70427f-f58e9fa8-447c7ddd-52c5da27-547ee7ea.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of aspiration and cough, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient is rotated. A goiter seems to cause widening of the right aspects of the mediastinum and moderate deviation of the trachea to the left. At the right lung base, a subtle parenchymal opacity has newly appeared. The location of this opacity would be consistent with pneumonia following aspiration. At the time of dictation and observation, 10:56 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification. " b0ccddee-2b5d0dfa-fc05ca18-d2fce369-30563e54.jpg,test/p13/p13285177/s52834697/b0ccddee-2b5d0dfa-fc05ca18-d2fce369-30563e54.jpg,test," FINAL REPORT HISTORY: CHF with possible effusions. FINDINGS: In comparison with study of ___, there are slightly lower lung volumes. Continued enlargement of the cardiac silhouette with pulmonary edema. Bibasilar opacifications are consistent with effusion and atelectasis, especially with volume loss in the left lower lobe. No evidence of acute focal pneumonia, though this would be difficult to exclude in the appropriate clinical setting. " ff87cb30-beb07910-101d74b9-be5cd293-dbd01d59.jpg,test/p19/p19607707/s55972835/ff87cb30-beb07910-101d74b9-be5cd293-dbd01d59.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cp, evaluate for pneumonia or sequelae of aspiration. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: None. FINDINGS: There are mildly low lung volumes. Allowing for changes due to this, the cardiomediastinal silhouettes are within normal limits. The bilateral hila are unremarkable. An azygos fissure is noted. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. No evidence of pneumonia or sequelae of aspiration. " 862498c9-7b858c29-56fa7744-4efe163a-ad5341bd.jpg,test/p11/p11595894/s51679277/862498c9-7b858c29-56fa7744-4efe163a-ad5341bd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with confusion, infx w/u // PNA TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The cardiomediastinal silhouette is unremarkable. There is no pleural effusion or pneumothorax. No definite consolidation is identified. IMPRESSION: No acute intrathoracic findings. " f6e95992-346c85f4-66051516-e4175339-97feb8b0.jpg,test/p12/p12241660/s57682820/f6e95992-346c85f4-66051516-e4175339-97feb8b0.jpg,test," WET READ: ___ ___ 8:06 AM 1. Cardiomediastinal silhouette is unchanged. 2. Moderate left pleural effusion and retrocardiac consolidation are persistent. 3. Right upper extremity PICC ends in the mid SVC. WET READ VERSION #1 ___ ___ ___ 11:54 PM 1. Cardiomediastinal silhouette is unchanged. 2. Moderate left pleural effusion and retrocardiac consolidation are persistent. 3. Right upper extremity PICC ends in the mid SVC. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man pre-op Mvr // eval for widened mediastinum COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the venous introduction sheet on the right has been removed. The right PICC line is in unchanged position. Unchanged appearance of the left pleural effusion. And the left retrocardiac atelectasis. Minimally decreased lung volumes, causing atelectasis at the right lung bases. The alignment of the sternal wires and the borderline size of the cardiac silhouette is unchanged. " 65b08576-b7bd88d2-79de869b-7489c3e0-a49203ac.jpg,test/p10/p10770896/s59679312/65b08576-b7bd88d2-79de869b-7489c3e0-a49203ac.jpg,test," FINAL ADDENDUM Addendum: Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state right rib pain. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Evaluate for rib fracture and a patient struck during boxing 10 days ago.. COMPARISON: None. FINDINGS: The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. No displaced rib fracture is seen. IMPRESSION: No displaced rib fracture is seen. The PA and lateral chest radiograph is insensitive in detecting subtle rib fractures. If there is ongoing clinical concern, please obtain dedicated rib series with marker placed at the site of pain. " 2221fde5-42d85119-6d3d264a-88770c8f-dd30ab6a.jpg,test/p12/p12108578/s59379017/2221fde5-42d85119-6d3d264a-88770c8f-dd30ab6a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cirrhosis, diminished breath sounds in the right lung base. Evaluate for pleural effusion. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size cannot be definitively assessed due to adjacent pleural effusion, but is likely unchanged. Compared to ___, no significant change in moderate right pleural effusion. There is adjacent right compressive atelectasis. No left pleural effusion. No pneumothorax. No acute osseous abnormalities. IMPRESSION: Moderate in size pleural effusion which appears similar to the prior with probable compressive right lower and middle lobe atelectasis. Difficult to exclude an underlying malignant process and follow-up to resolution is advised. RECOMMENDATIONS: Recommend follow-up to resolution. " b5c24f80-1e0b9114-cdf6f8d1-b781e982-d2595349.jpg,test/p17/p17577209/s54336780/b5c24f80-1e0b9114-cdf6f8d1-b781e982-d2595349.jpg,test," WET READ: ___ ___ 5:04 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: ___M with known lung malignancy, increased dyspnea // Eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with chest radiographs from ___ and ___ and CT chest from ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Mediastinal clips and median sternotomy wires are noted. Known pulmonary nodules are better seen on recent prior CT chest. IMPRESSION: No acute cardiopulmonary process. " b6a1056f-74185658-1b5e3afe-1c9c4197-1756008a.jpg,test/p18/p18049473/s59561591/b6a1056f-74185658-1b5e3afe-1c9c4197-1756008a.jpg,test," FINAL REPORT INDICATION: ___ year old woman with left VATS lung biopsy// check interval change TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiograph from ___ and ___. FINDINGS: There is improved aeration of the left lobe. No pneumothorax is seen, and there is no new focal consolidation. Heart size is normal. IMPRESSION: Interval improvement and aeration following left VATS. No new cardiopulmonary process. " 0acbc9b0-3513dcb0-b161e203-531c5428-d9612f66.jpg,test/p10/p10979480/s51725692/0acbc9b0-3513dcb0-b161e203-531c5428-d9612f66.jpg,test," FINAL REPORT INDICATION: Metastatic breast cancer with pneumonia. Evaluate for change. COMPARISONS: Chest radiograph, ___. Chest radiograph, ___. FINDINGS: A right subclavian infusion port ends at or just below the superior atriocaval junction. The lung volumes are low. Bilateral basilar opacifications are stable and likely pneumonia. There are no new consolidations. There is no edema, pleural effusion, or pneumothorax. The cardiac silhouette is normal. Thoracic spinal hardware is unchanged. IMPRESSION: Stable bibasilar pneumonia. " c7318b14-8802035b-2b793a84-2206a58b-ff64d1a6.jpg,test/p15/p15793456/s51587887/c7318b14-8802035b-2b793a84-2206a58b-ff64d1a6.jpg,test," FINAL REPORT INDICATION: Severe COPD with respiratory failure and intubated. Concern for left pneumothorax. TECHNIQUE: Frontal chest radiograph. COMPARISON: Radiographs from ___. IMPRESSION: Focal left basilar lucency remains similar in appearance to the ___ examination. This likely represents bullae given known history of emphysema, though differentiation from focal pneumothorax remains difficult. The cardiac and mediastinal contours remain unchanged, and there is no mediastinal shift. There is no focal consolidation or pleural effusion. A left PICC terminates at the cavoatrial junction. The endotracheal tube terminates 5.0 cm above the carina. " b26f99dd-eedff985-6dad309b-c1aec3cf-609eb93b.jpg,test/p12/p12327475/s51236851/b26f99dd-eedff985-6dad309b-c1aec3cf-609eb93b.jpg,test," FINAL REPORT INDICATION: History: ___F with EtOH hepatitis with worseing ascites // *assess PV with dopplers TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. There is a small left pleural effusion. There is no evidence of a pneumothorax. The visualized osseous structures are unremarkable. Mild left basilar atelectasis. IMPRESSION: Small left pleural effusion, likely secondary to hepatic hydrothorax. No focal consolidations concerning for pneumonia identified. " c8bb69d8-47c4444a-58cf07e8-d744aac2-85a6fd1d.jpg,test/p18/p18865198/s56898104/c8bb69d8-47c4444a-58cf07e8-d744aac2-85a6fd1d.jpg,test," FINAL REPORT INDICATION: ___-year-old female status post laparoscopic right colectomy on ___ presenting with larger pleural effusion status post pleurocentesis and pigtail placement. Evaluate pleural effusion. COMPARISON: ___. CHEST, PA AND LATERAL VIEWS: A pigtail catheter terminating in the right medial lung base is less kinked than on the prior exam, but otherwise unchanged. There is a partially loculated moderate right pleural effusion with a larger intrafissural component. A small residual pneumothorax is best seen on the lateral view. Evaluation of the cardiomediastinal silhouette is limited but overall unchanged. " 43216606-aa362b69-f28bd61d-b61c854c-865649f6.jpg,test/p14/p14997223/s56422326/43216606-aa362b69-f28bd61d-b61c854c-865649f6.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, ascites, oxygen requirement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The known right pleural effusion distributes in a slightly different manner but is overall unchanged. Overall unchanged is also the mild to moderate left pleural effusion. Unchanged areas of retrocardiac and basal atelectasis. No vascular evidence of fluid overload. Unchanged course of the nasogastric tube. " 494ed00b-3167e36e-aeed55c9-f8b6053e-14dcbc1d.jpg,test/p14/p14630468/s51416548/494ed00b-3167e36e-aeed55c9-f8b6053e-14dcbc1d.jpg,test," FINAL REPORT INDICATION: ___F with CP // PNA? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Tracheostomy tube is in similar position. Right PICC is no longer seen. Relatively low lung volumes are noted with secondary right basilar atelectasis. Otherwise, lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d57952c1-89986306-f483eb47-8dc115ff-36d4fb7b.jpg,test/p12/p12056668/s59819600/d57952c1-89986306-f483eb47-8dc115ff-36d4fb7b.jpg,test," FINAL REPORT AP CHEST, 5:22 A.M., ___ HISTORY: ___-year-old intubated man on a ventilator. IMPRESSION: AP chest compared to ___: Large bilateral pleural effusions and moderate enlargement of the cardiac silhouette are continuing to increase. It could be a pericardial effusion. Moderate pulmonary edema is exaggerated by low lung volumes, but also worsened. No pneumothorax. Right PIC line follows a course consistent with either the right internal mammary vein or upper right atrium. " 012e94fe-cef551d4-ef421ced-a3bd8e58-c5d7bdd4.jpg,test/p13/p13691037/s53846656/012e94fe-cef551d4-ef421ced-a3bd8e58-c5d7bdd4.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Chest pain and cough. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The lung volumes are low. The mediastinal and hilar contours appear within normal limits. There are no pleural effusions or pneumothorax. The lungs are clear. The osseous structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " ca1a74e6-0b44e4e6-036341e9-0f150c4d-c40b6cc8.jpg,test/p18/p18335071/s53089859/ca1a74e6-0b44e4e6-036341e9-0f150c4d-c40b6cc8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right sided pleural effusion s/p pleurex placement // evaluate for interval change IMPRESSION: As compared to ___ chest radiograph, the patient has been extubated. Cardiomegaly is accompanied by worsening pulmonary edema, along with increasing bilateral small to moderate pleural effusions. Right PleurX catheter remains in place, with no visible pneumothorax. Known intrathoracic lymphadenopathy and nodules are shown to better detail on recent CT of ___ in this patient with history of metastatic breast cancer. " bada0bba-57307ced-8829cd50-bbbb51f6-2f4a7a72.jpg,test/p18/p18364681/s50198089/bada0bba-57307ced-8829cd50-bbbb51f6-2f4a7a72.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with fever, chills, generalized chest pain and right basal crackles. Suspect right lower lobe pneumonia. IMPRESSION: PA and lateral chest compared to ___: Cardiac silhouette has grown quite large, accompanied by small bilateral pleural effusions, normal pulmonary vasculature and only minimal increase in caliber of mediastinal veins. I suspect this is due largely to pericardial effusion, presumably not acute, since there is no evidence of tamponade. Greater opacity at the base of the right lung could be the vestiges of pneumonia, or simply atelectasis. There is no pulmonary edema. Findings were discussed by telephone with Dr. ___ at 4:30, two minutes following recognition of the findings. " fe4b63fe-a2eda3d0-73aec765-dcb747c7-6df1920c.jpg,test/p11/p11291823/s59544991/fe4b63fe-a2eda3d0-73aec765-dcb747c7-6df1920c.jpg,test," FINAL REPORT HISTORY: Recent intubation, question interval change. CHEST, SINGLE AP PORTABLE VIEW: An ET tube is present, tip approximately 5.4 cm above the carina. An NG tube is present -- the tip is poorly visualized over the lower mediastinum but probably extends beneath the diaphragm. A left IJ central line is present -- its position is similar to the film from ___ at 2:15 a.m., perhaps slightly retracted compared with then. Its position is not fully characterized on this film -- it does not extend into the SVC, but may overlie the innominate vein. A dual-lumen right-sided central line is present, tips over mid/lower SVC and distalmost SVC near RA junction. Again seen is moderately-severe cardiomegaly, with increased interstitial and alveolar markings, suggesting CHF and pulmonary edema. There is a small right effusion with underlying collapse and/or consolidation. Increased retrocardiac density, consistent with bibasilar collapse and/or consolidation. The possibility of background acute or chronic process is difficult to exclude. IMPRESSION: 1. Pulmonary edema, similar or possibly slightly improved compared with one day earlier. 2. Probable bibasilar collapse and/or consolidation. 3. Lines and tubes, as described. Left IJ line has been similar over several films, but does not reach SVC. " e048375c-b032197e-12a4a16c-23963ae8-f16c794f.jpg,test/p12/p12388314/s53532701/e048375c-b032197e-12a4a16c-23963ae8-f16c794f.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluate for congestive heart failure. COMPARISON: None. FINDINGS: Frontal and lateral radiographs of the chest were acquired. Lung volumes are slightly low. Streaky opacities at the right lung base are likely secondary to atelectasis, although early infection in this region cannot be excluded. The lungs are otherwise clear. There is pulmonary vascular congestion without frank interstitial edema. Moderate cardiomegaly is noted. Mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Multilevel degenerative changes of the thoracolumbar spine are noted. IMPRESSION: 1. Streaky right lower lung opacities, likely atelectasis, although early infection in this region cannot be excluded. Clinical correlation recommended. 2. Pulmonary vascular congestion without frank interstitial edema. 3. Moderate cardiomegaly. " 6a3c2d0a-fc40a337-015725b1-c01881cd-1473dcae.jpg,test/p17/p17014029/s55928057/6a3c2d0a-fc40a337-015725b1-c01881cd-1473dcae.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cardiac surgery, CTs d/c'd // evaluate for pneumothorax TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: After chest tube removal, there is a tiny right apical pneumothorax. There are persistent low lung volumes. Widening mediastinum has improved. Retrocardiac atelectasis have improved. Left pleural effusion is a small. Sternal wires are aligned. Vascular congestion has improved. " 0fdaf641-c2772a6d-6de1931b-4950acb8-84864821.jpg,test/p12/p12448720/s53012843/0fdaf641-c2772a6d-6de1931b-4950acb8-84864821.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest tightness and shortness of breath COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. The heart appears moderately enlarged, increased from prior. There is a small right pleural effusion. No overt signs of edema. No convincing evidence for pneumonia. No pneumothorax. Bony structures are intact. The mediastinal contour is within normal limits. No free air below the right hemidiaphragm. Gaseous distention of the stomach noted. IMPRESSION: Cardiomegaly, progressed in the interval, small right pleural effusion. No edema or pneumonia. " f75f9793-06da0c5e-5cdbebdd-22dae3a8-ceb8c866.jpg,test/p13/p13194001/s59200003/f75f9793-06da0c5e-5cdbebdd-22dae3a8-ceb8c866.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Chest pressure, vomiting, question widened mediastinum. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. No signs of pneumomediastinum. " 800e5f93-728f3eee-0ec0f731-ec0efad4-96c3325d.jpg,test/p15/p15234245/s52371876/800e5f93-728f3eee-0ec0f731-ec0efad4-96c3325d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with concern for perforation COMPARISON: ___. FINDINGS: AP portable upright view of the chest. Left chest wall pacer device is seen with pacer leads extending into the region of the right atrium and right ventricle. Lung volumes are low. The heart is mildly enlarged. There is hilar congestion and mild interstitial edema. No large effusion is seen though the right CP angle is excluded. No pneumothorax. No convincing evidence for pneumonia though the left base is suboptimally assessed. No bony abnormalities. No free air below the right hemidiaphragm. IMPRESSION: No free air. Mild interstitial pulmonary edema. " 0c89185f-cd204092-3c574d5b-dc0753af-4ed0c37a.jpg,test/p10/p10459005/s57708196/0c89185f-cd204092-3c574d5b-dc0753af-4ed0c37a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LVAD // follow up fluid overload follow up fluid overload IMPRESSION: Comparison to ___. Mildly increasing right basilar atelectasis. Otherwise unchanged radiograph. Minimal fluid overload is still present. Moderate cardiomegaly persists. The ventricular assist device is in stable position. " 1523831f-111945fa-223a04e4-b5161635-0e5906e0.jpg,test/p13/p13156444/s51942020/1523831f-111945fa-223a04e4-b5161635-0e5906e0.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M current smoker with shortness of breath and diffuse wheezing TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Lungs are well-expanded and clear without focal consolidation concerning for pneumonia. The upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " fa586647-64a6d2e3-2c1220ef-d80a845f-7bacbeae.jpg,test/p12/p12907170/s59134457/fa586647-64a6d2e3-2c1220ef-d80a845f-7bacbeae.jpg,test," WET READ: ___ ___ ___ 9:40 PM ET tube terminates appropriately above the carina. Left IJ is malpositioned. New right subclavian line terminates in the right atrium. Interval worsening of pulmonary edema, and mild bibasilar opacities. No pneumothorax. Small left pleural effusion. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Septic shock, evaluation. COMPARISON: ___, 5:24 p.m. FINDINGS: The endotracheal tube terminates appropriately above the carina. The left internal jugular vein catheter is malpositioned. The catheter needs to be re-positioned. The new right subclavian line terminates in the right atrium. The line should be pulled back by approximately 2 to 3 cm. Interval worsening of the pulmonary edema and the pre-existing areas of basal atelectasis. No pneumothorax. The presence of small pleural effusions cannot be excluded. " 41254a24-76b1bba7-d7d5ff0c-604f60ff-de4840a2.jpg,test/p15/p15110728/s57011929/41254a24-76b1bba7-d7d5ff0c-604f60ff-de4840a2.jpg,test," FINAL REPORT HISTORY: Shortness of breath, question pulmonary edema. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. Dual lead left-sided pacemaker is unchanged in position. Retained pacer fragment overlying the left apex is again seen. Slight prominence of the hila may be due to pulmonary vascular engorgement. No focal consolidation, pleural effusion, for evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Possible slight pulmonary vascular engorgement without overt pulmonary edema. " be87511c-c0d8fc55-cc9d2a5c-aa4de7a5-5c569378.jpg,test/p14/p14320851/s55503672/be87511c-c0d8fc55-cc9d2a5c-aa4de7a5-5c569378.jpg,test," FINAL REPORT INDICATION: Shortness of breath and wheezes. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: Radiographs from ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. Moderate degenerate changes are again seen throughout the thoracic spine. IMPRESSION: No acute intrathoracic process. " 8a7a4b61-33e7fc82-ee595f7a-0ef5fc05-10dcced4.jpg,test/p12/p12364939/s58275687/8a7a4b61-33e7fc82-ee595f7a-0ef5fc05-10dcced4.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with cough and dyspnea. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Right chest wall port is seen with catheter tip similar to prior. The lungs are clear of focal consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 25800dcb-826262b9-732ae6e9-0da225f8-6ea6d27c.jpg,test/p16/p16830025/s52533808/25800dcb-826262b9-732ae6e9-0da225f8-6ea6d27c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with epigastric pain, constipation, hx of hiatal hernia // ? acute pathology COMPARISON: ___ and ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " ac370f6b-4bc673e4-58c6e809-7b5b6cb9-d8727034.jpg,test/p10/p10486935/s51221247/ac370f6b-4bc673e4-58c6e809-7b5b6cb9-d8727034.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with inhaled part of a sandwich last night with pain with deep breath. FINDINGS: Frontal and lateral views of the chest. No prior. The lungs are clear without focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. There are no radiopaque foreign bodies identified. No free air is seen below the diaphragm. IMPRESSION: Normal chest x-ray. " c2f93ff9-78913954-b1693436-c0c1af7e-627129ea.jpg,test/p11/p11522912/s57226279/c2f93ff9-78913954-b1693436-c0c1af7e-627129ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with c5 quadraplegia with worsening mental status // please eval for new cardiopulm process COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lungs are better ventilated. Unchanged relatively extensive parenchymal atelectasis both in the retrocardiac lung areas and at the level of the right lower lobe. Coexisting pneumonia cannot be excluded. Moderate cardiomegaly persists. No pulmonary edema. Unchanged normal position of the left-sided PICC line. " 12dde341-0c10ef55-b9aff9cc-f12f87b2-d74b1e44.jpg,test/p19/p19792891/s58823242/12dde341-0c10ef55-b9aff9cc-f12f87b2-d74b1e44.jpg,test," FINAL REPORT INDICATION: History: ___M with sob + new murmur. // Pulmonary edema? TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The cardiac silhouette is mildly enlarged. There is mild pulmonary edema with possible small left pleural effusion. No focal consolidation or pneumothorax. IMPRESSION: Mild pulmonary edema " 7edbbe5a-01511613-5e2585b3-a98c1d99-b7ab52cd.jpg,test/p13/p13709012/s59279618/7edbbe5a-01511613-5e2585b3-a98c1d99-b7ab52cd.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with pain in throat and emesis after swallowing chicken bone, also with RUQ pain and tenderness on exam. // Assess for evidence of foreign body, free air, acute process. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 7458de16-570a7a6c-60e40fe3-80304b8f-4c4c7272.jpg,test/p16/p16196296/s59724883/7458de16-570a7a6c-60e40fe3-80304b8f-4c4c7272.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with sob // acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Blunting of the right costophrenic angle is new since the prior study, suggesting small right pleural effusion with overlying right base atelectasis. Additional basilar opacity could be due to atelectasis although consolidation due to infection or aspiration is not excluded in the appropriate clinical setting. There is persistent enlargement of the cardiac silhouette. Mediastinal contours are grossly stable. No overt pulmonary edema is seen. IMPRESSION: Small right pleural effusion, new since prior study. Basilar opacity may be due to atelectasis, however, underlying infection/pneumonia is not excluded in the appropriate clinical setting. " f14418af-5181319c-3bbac7e2-2a4fd3a2-20f02624.jpg,test/p10/p10221634/s59554505/f14418af-5181319c-3bbac7e2-2a4fd3a2-20f02624.jpg,test," FINAL REPORT INDICATION: History of brain cancer and altered mental status who presents for evaluation of acute cardiopulmonary process. COMPARISONS: None. TECHNIQUE: Portable supine exam of the chest. FINDINGS: The endotracheal tube terminates 6 cm above the carina. There is an enteric tube coursing below the diaphragm with the sidehole within the stomach. The heart is mildly enlarged. There are low lung volumes, with evidence of bibasilar atelectasis. No definite evidence of focal consolidations concerning for infection is identified. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: 1. No focal consolidations concerning for infection identified. Bibasilar atelectasis. 2. Endotracheal tube terminates 6-cm above the carina. " 5e82b58c-9739d67c-c640823b-fdfc6299-ea169371.jpg,test/p19/p19921217/s55319708/5e82b58c-9739d67c-c640823b-fdfc6299-ea169371.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough // ?pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There are relatively low lung volumes and mild right basilar atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Aortic calcifications are noted. There are some degenerative changes along the spine. IMPRESSION: No acute cardiopulmonary process. Relatively low lung volumes. " 703006b8-12dcd6ee-f12cab89-3c46cc50-630e2d9b.jpg,test/p14/p14480043/s59935935/703006b8-12dcd6ee-f12cab89-3c46cc50-630e2d9b.jpg,test," FINAL REPORT HISTORY: Shortness of breath, abdominal distention, altered mental status. TECHNIQUE: AP upright view of the chest. COMPARISON: None. FINDINGS: Low lung volumes are present. This accentuates the size of the cardiac silhouette which is likely top-normal. Apparent mediastinal widening may also likely be due to poor inspiratory volumes. Pulmonary vascularity is not engorged. Patchy opacities in the lung bases likely reflect atelectasis though infection, particularly in the right lung base, cannot be completely excluded. Small right pleural effusion appears to be present. There is no pneumothorax. No acute osseous abnormality is visualized. IMPRESSION: Bibasilar patchy opacities, more confluent in the right lung base. Findings could reflect atelectasis though infection, particularly in the right lung base, is not excluded. Probable small right pleural effusion. " 793e51c5-5b7d8e78-40cf075e-69445ade-9cd4df66.jpg,test/p14/p14328996/s51095775/793e51c5-5b7d8e78-40cf075e-69445ade-9cd4df66.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with PMHx OSA presenting with 1 month of gradual onset leg swelling and orthopnea. // Ensure adequate film for V/Q scan. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are remarkable for a tortuous thoracic aorta. The pulmonary vasculature is normal. Lungs are clear except for calcified granulomas at the right apex. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No radiographic evidence of pulmonary edema " 182c1dff-4ff5dcd8-63b854f4-04642d30-cf6574d2.jpg,test/p14/p14219343/s51638271/182c1dff-4ff5dcd8-63b854f4-04642d30-cf6574d2.jpg,test," FINAL REPORT INDICATION: ___F with dyspnea // evidence of effusion TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: There is moderate bilateral pulmonary edema which appears slightly improved since recent exam. Bibasilar opacities suggest superimposed layering effusions. Heart is enlarged. Left chest wall dual lead pacing device is again noted. IMPRESSION: Persistent moderate pulmonary edema although improved since prior exam with probable moderate bilateral effusions. " 6d85317a-74f82364-60be4ce6-2c0cb65d-3420bf1e.jpg,test/p17/p17585916/s51774836/6d85317a-74f82364-60be4ce6-2c0cb65d-3420bf1e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new O2 requirement // eval for aspiration/pna TECHNIQUE: AP views of the chest COMPARISON: Multiple prior radiographs the most recent on ___ FINDINGS: Similar to multiple prior examinations, the exam is limited due to patient positioning. Given that, lung volumes are persistently low. Bilateral opacities are again demonstrated and may be increased from the prior examination raising the possibility of infection or aspiration. Cardiomediastinal contours cannot be evaluated due to patient positioning. . IMPRESSION: Low lung volumes. Bilateral pulmonary opacities appear increased from the prior examination could represent atelectasis, aspiration or infection. " 27df9e54-aa884a8b-7aa4481f-cddaecd1-1e24c2dd.jpg,test/p17/p17421663/s59495636/27df9e54-aa884a8b-7aa4481f-cddaecd1-1e24c2dd.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___ radiograph. FINDINGS: Cardiac silhouette is normal in size. Pulmonary vascularity appears engorged, and is accompanied by worsening diffuse bilateral airspace opacities, now involving the right lung to a greater degree than the left, and accompanied by peripheral septal lines. Although the observed findings may reflect worsening pulmonary edema, the relatively lobar distribution of opacification in the right upper lobe raises the concern for concurrent pneumonia in this region. Followup radiographs after diuresis may be helpful to better distinguish foci of edema from infection. Moderate right pleural effusion is also demonstrated. " ffacad63-99311661-78812c54-79ab7811-41cc1e02.jpg,test/p11/p11057136/s56699720/ffacad63-99311661-78812c54-79ab7811-41cc1e02.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right apical PTX and severe COPD exacerbation. // please assess for interval change in size of PTX TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right chest tube is in place. Subcutaneous air appears to be slightly decreased in the interim. A right apical pneumothorax is most likely slightly smaller as compared to previous study. Minimal basal component of the pneumothorax is more appreciable on the current radiograph than before. The left lung is essentially clear and cardiomediastinal silhouette is stable " aa75cc14-40db26a4-24b60e87-26e749a8-038f75d7.jpg,test/p15/p15816738/s58852352/aa75cc14-40db26a4-24b60e87-26e749a8-038f75d7.jpg,test," FINAL REPORT HISTORY: Postoperative with hemoptysis. FINDINGS: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends into the body of the stomach. The side hole is probably just beyond the level of the esophagogastric junction. Again, there is huge enlargement of the cardiac silhouette with minimal engorgement of pulmonary vessels. Left basilar opacification now obscures the hemidiaphragm and is consistent with some combination with volume loss in the lower lobe and atelectatic change. " 64f40787-b777a191-494608e2-51a406e3-69133993.jpg,test/p14/p14377190/s55382810/64f40787-b777a191-494608e2-51a406e3-69133993.jpg,test," FINAL REPORT HISTORY: ___-year-old female with dizziness and EKG abnormalities. Evaluation for cardiomegaly or effusion. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrates the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pulmonary edema, pleural effusion, pneumothorax or focal consolidation concerning for pneumonia. The bony structures are intact. IMPRESSION: No acute cardiopulmonary process. " 17563248-b5619d12-71d589df-57facf81-8d6a38bc.jpg,test/p19/p19358609/s56360897/17563248-b5619d12-71d589df-57facf81-8d6a38bc.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior exam from ___ as well as a chest x-ray from ___. CLINICAL HISTORY: Shortness of breath, fever, cough, question pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. The lungs are hyperinflated with chronic deformity of the left upper hemithorax and rib cage. There are opacities in the lower lungs which raise concern for pneumonia. Underlying scarring is better assessed on the prior CT. The heart size is difficult to assess, though appears grossly stable. The mediastinal contour also is grossly unchanged. Small right pleural effusion is present. IMPRESSION: Findings concerning for pneumonia within the lower lungs. " d4d02a29-11653e77-00876ec3-a2356a6c-b852abdc.jpg,test/p11/p11384537/s51956392/d4d02a29-11653e77-00876ec3-a2356a6c-b852abdc.jpg,test," FINAL REPORT HISTORY: Left-sided chest and shoulder pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen. IMPRESSION: No acute cardiopulmonary process. " a5251534-acfc5f88-f46be851-99d34d65-59de7919.jpg,test/p19/p19670384/s59518403/a5251534-acfc5f88-f46be851-99d34d65-59de7919.jpg,test," FINAL REPORT HISTORY: ___-year-old female patient with recent hospitalization for sepsis and UTI, with incidental right upper lobe ground-glass process. Study requested for followup of right upper lung process. COMPARISON: Prior chest radiographs from ___, ___ and prior chest CT from ___. FINDINGS: The heart is normal in size. The hilar and mediastinal contours are normal. Previously described heterogeneous opacities in the right upper lung have resolved. The lungs are well expanded and clear. No new focal consolidations are identified. There are no pleural effusions or pneumothorax. Bilateral shoulder prostheses are incompletely imaged. IMPRESSION: Resolution of right upper lobe opacities with no new focal consolidations. " 8d93a361-a275954d-e8f803fa-b05b5b2c-3427104a.jpg,test/p19/p19427735/s54157783/8d93a361-a275954d-e8f803fa-b05b5b2c-3427104a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with mitral valve replacement, followup. PA and lateral upright chest radiographs were reviewed in comparison to ___. Right internal jugular line tip is at the level of the low SVC. Heart size and mediastinum are stable in appearance. Bilateral pleural effusions and bibasilar consolidations are demonstrated, minimally increased since the prior study, although it does potentially maybe due to upright position of the patient during the chest radiograph. No pneumothorax is seen. " b2f5d933-e585b4fd-7f67c227-e11735bc-5f8fe081.jpg,test/p16/p16201645/s59086814/b2f5d933-e585b4fd-7f67c227-e11735bc-5f8fe081.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Right thoracotomy and pneumonectomy for lung cancer. IMPRESSION: AP chest compared to ___. Right pneumonectomy space continues to fill slowly with fluid. Mediastinum is in the appropriate position. Subcutaneous emphysema which was severe is clearing from the right chest wall. Left lung is clear. Heart size normal. " 8558fbf3-01f5eae4-03fa203f-b54e13d9-6a3ba34c.jpg,test/p18/p18895628/s54103436/8558fbf3-01f5eae4-03fa203f-b54e13d9-6a3ba34c.jpg,test," FINAL REPORT INDICATION: ___ year old man with fever // Please evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded and clear without focal consolidation concerning for pneumonia. The upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " bf1d08f1-f17b229e-b6b7a5a6-c4e54fd9-783519e1.jpg,test/p15/p15460343/s59325009/bf1d08f1-f17b229e-b6b7a5a6-c4e54fd9-783519e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough // pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Moderate to severe cardiomegaly is stable. The pulmonary arteries appear enlarged. The the aorta is tortuous. The lungs are hyperinflated. Bilateral pleural effusions are small unchanged. Faint opacities previously seen in the right mid lung are less conspicuous than before. Minimal opacities in the lower lobes are likely atelectasis. There is no pneumothorax. Wedge-shaped deformities of several mid thoracic vertebral bodies are unchanged IMPRESSION: COPD. Improved right pneumonia. Small bilateral effusions " 101a6278-8ca54590-41145a6f-ce4c0484-deb6daba.jpg,test/p10/p10109015/s59808200/101a6278-8ca54590-41145a6f-ce4c0484-deb6daba.jpg,test," WET READ: ___ ___ 4:29 AM Opacity at the right lung base could reflect atelectasis, infection or aspiration. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with s/p tpa stroke // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: The cardiac silhouette is mildly enlarged. There is increased opacity at the right lung base. No pleural effusion or pneumothorax. IMPRESSION: Opacity at the right lung base could reflect atelectasis, infection or aspiration. " 8750baef-441e2284-da0a0044-e2e5e092-4ce33ce0.jpg,test/p11/p11288058/s51992158/8750baef-441e2284-da0a0044-e2e5e092-4ce33ce0.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Weakness, orthopnea, fever, questionable progression. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a clear improvement, with decrease of the pre-existing signs of pulmonary edema, however, are still present. Complete resolution of the pre-existing pleural effusions. No evidence of pneumonia. Unchanged mild cardiomegaly. Unchanged position of the right pre-existing stent. " ca36213b-e67fb6d2-5dfdf916-2bf6d0be-80cd6a78.jpg,test/p17/p17653729/s56758333/ca36213b-e67fb6d2-5dfdf916-2bf6d0be-80cd6a78.jpg,test," WET READ: ___ ___ ___ 9:07 AM There has been mild interval improvement in aeration of the right lung compared to the prior exam performed at 06:00 the same date. Small bilateral pleural effusions are persistent. There has been slight interval increase in the left basilar atelectasis. Mild pulmonary edema. WET READ VERSION #1 ___ ___ ___ 10:10 PM There has been mild interval improvement in aeration of the right lung compared to the prior exam performed at 06:00 the same date. Small bilateral pleural effusions are persistent. There has been slight interval increase in the left basilar atelectasis. Mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with complete right lung collapse, now s/p post bronch // right lung post bronch TECHNIQUE: Single view at ___ 6:03 PM COMPARISON: ___ at 06:01 FINDINGS: There has been reduction in the right pleural effusion. There is some increased translucency in the right base but bibasilar parenchymal disease remains. There is probably a small left pleural effusion. The heart is not enlarged. The osseous structures are normal for age. Right-sided PICC line and nasogastric tube seen. Monitor leads overlie the chest. IMPRESSION: Improvement in the right pleural effusion and right basilar atelectasis. Bibasilar pleural and parenchymal disease persists " 908bc334-0d92f563-19ae6616-abe51a63-616344cc.jpg,test/p14/p14558830/s52115669/908bc334-0d92f563-19ae6616-abe51a63-616344cc.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man status post sigmoid colectomy. Evaluate for pulmonary edema. FINDINGS: Comparison is made to previous study from ___. There is again seen an opacity in the right middle-to-lower lobes with volume loss, suggestive of radiation changes. The heart size is enlarged, but stable. There has been removal of feeding tube since the previous study. Left lung is grossly clear. There are no pneumothoraces. " 557d63a2-7de67f86-e7dd3660-690065c1-8b092410.jpg,test/p18/p18236397/s59456159/557d63a2-7de67f86-e7dd3660-690065c1-8b092410.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with crackles on exam // Eval for pneumonia/infectious process TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiomediastinal contours are normal. Aside from the right upper lobe granuloma, The lungs are grossly clear. There are minimal retrocardiac atelectasis. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities " c9c73199-1ac2da91-5feefb2f-628305d8-b5821e11.jpg,test/p13/p13591339/s53859788/c9c73199-1ac2da91-5feefb2f-628305d8-b5821e11.jpg,test," FINAL REPORT INDICATION: ___ year old woman with leukocytosis // ?PNA COMPARISON: Radiographs from ___ IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusions, or pulmonary edema. There is coarsening of the bronchovascular markings and some hyperinflation, stable. There are no pneumothoraces. " f9c3973e-2c678583-c4888629-2a8db46c-c950571a.jpg,test/p15/p15457916/s52645806/f9c3973e-2c678583-c4888629-2a8db46c-c950571a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Biliary leak, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Very lower lung volumes with areas of bilateral basal atelectasis. On the current image, presence of minimal left and right pleural effusion cannot be excluded. Mild cardiomegaly without evidence of pulmonary edema. No evidence of pneumonia. " f79d6aa0-951e56fd-09cecd10-fb9ba5d3-e2f0baf9.jpg,test/p14/p14347415/s59016512/f79d6aa0-951e56fd-09cecd10-fb9ba5d3-e2f0baf9.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Left scapular pain after a fall. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " 9d10c876-a7f59819-3a3927f4-779fae64-dfed6070.jpg,test/p17/p17451713/s53475768/9d10c876-a7f59819-3a3927f4-779fae64-dfed6070.jpg,test," WET READ: ___ ___ ___ 2:55 PM No evidence of fracture or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with right-sided rib pain and difficulty breathing after fall last night. Evaluate for fracture or pneumothorax. TECHNIQUE: Chest AP upright and lateral radiographs COMPARISON: Chest radiograph ___. FINDINGS: Increased interstitial markings are stable. Cardiomediastinal contours are unchanged. No rib fracture or pneumothorax is seen. Biapical scarring is again noted. The lungs are mildly hyperinflated. A rounded density in the left retrocardiac region is likely a costochondral junction and unchanged. IMPRESSION: No evidence of fracture or pneumothorax. " b31bd4da-5e9acf48-dce886e7-b3472b91-0c93134d.jpg,test/p14/p14504631/s57691231/b31bd4da-5e9acf48-dce886e7-b3472b91-0c93134d.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p RLL // R/O PTX post CT removal TECHNIQUE: Chest PA and lateral COMPARISON: ___ from earlier in the day FINDINGS: Status post removal of the right chest tube. Unchanged small right pneumothorax. There is persistent elevation of the right hemithorax. No focal consolidation. Trace right pleural effusion. The size of the cardiac silhouette is enlarged but unchanged. IMPRESSION: Interval removal of the right chest tube with no other interval change. Persisting small right pneumothorax. " 963bfe48-ebab3874-ff2df5b1-c1eb5341-85c973de.jpg,test/p14/p14513439/s52887751/963bfe48-ebab3874-ff2df5b1-c1eb5341-85c973de.jpg,test," FINAL REPORT INDICATION: ___F with LUQ pain after colonoscopy 10 days ago // cxr: ?free apinct abd: ?perforation TECHNIQUE: 2 upright portable views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear despite low lung volumes. The cardiomediastinal silhouette is within normal limits. There is no free intraperitoneal air. Lucency in the midline of the upper abdomen is felt to be due to patient's protuberant abdomen with adjacent breast shadow. There is no free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process.No free intraperitoneal air. " 88dee8cc-401e99f5-dd9e7d40-445f1188-8f18aa29.jpg,test/p10/p10537484/s53169805/88dee8cc-401e99f5-dd9e7d40-445f1188-8f18aa29.jpg,test," FINAL REPORT HISTORY: Liver injury with right effusion and pigtail catheter. FINDINGS: With the pigtail catheter on waterseal, there is no definite pneumothorax. The degree of a pleural effusion has decreased. There is some relatively new opacification at the left base, consistent with some atelectatic change and probable effusion. " 9ad82be5-fed3680f-d9dc6429-e1c6906d-937df5f0.jpg,test/p11/p11658675/s53919274/9ad82be5-fed3680f-d9dc6429-e1c6906d-937df5f0.jpg,test," FINAL REPORT CLINICAL INDICATION: Fever, productive cough and green sputum. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Opacity in the left lower lung is increased since ___. There is no pulmonary edema, pleural effusion or pneumothorax. Aortic knob is calcified. Evaluation of heart size is difficult due to the low lung volumes; however, it is most likely normal. There is no free air beneath the right hemidiaphragm. There is no acute osseous abnormality. IMPRESSION: Opacity in the left lower lung is increased since ___ and most likely represents pneumonia. " 02011810-de93c33f-ad178543-c6291fc0-d80d3a92.jpg,test/p12/p12936816/s52210006/02011810-de93c33f-ad178543-c6291fc0-d80d3a92.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new dobhoff placement. // Eval for dobhoff position. Eval for dobhoff position. IMPRESSION: In comparison with the study of ___, there has been placement of a Dobhoff tube that extends to the mid body of the stomach. It could be pushed forward 5-10 cm for more optimal positioning. Left hemidiaphragm is not well seen laterally. This raises the possibility of pleural fluid with volume loss in the left lower lobe. The right lung is clear and there is no vascular congestion. " 10f33d5c-f4b06d15-3f16c96f-6728996e-fd2b7b62.jpg,test/p12/p12957124/s54523165/10f33d5c-f4b06d15-3f16c96f-6728996e-fd2b7b62.jpg,test," WET READ: ___ ___ ___ 8:36 AM Status post interval removal of a right chest tube. There is no pneumothorax. Retrocardiac opacity is likely a combination of atelectasis and a gastric pull-through after esophagectomy. WET READ VERSION #1 ___ ___ ___ 5:41 PM Status post interval removal of a right chest tube. There is no pneumothorax. Retrocardiac opacity is likely a combination of atelectasis and a gastric pull-through after esophagectomy. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p esophagectomy // R/O PTX post CT removal COMPARISON: ___ IMPRESSION: Of the esophagectomy free intra-abdominal air has now visible on both the frontal and the lateral image. Otherwise the postoperative changes in both the left and the right lung are constant. Retrocardiac atelectasis with air bronchograms. Mild cardiomegaly. Mild left pleural effusion. No pulmonary edema. No pneumothorax. " 61a52c60-72b7ab90-92fb9c25-3e9ea9ad-da793ff0.jpg,test/p10/p10449408/s55509904/61a52c60-72b7ab90-92fb9c25-3e9ea9ad-da793ff0.jpg,test," FINAL REPORT HISTORY: GI bleed, for Dobbhoff placement. FINDINGS: The Dobbhoff tube lies in the esophagus in the upper chest level, approximately 3 cm above the carina. Otherwise, little change. " e778c977-571b7f76-8074e4fd-f2d4a413-c06b9893.jpg,test/p19/p19778971/s54277245/e778c977-571b7f76-8074e4fd-f2d4a413-c06b9893.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST: REASON FOR EXAM: Intubated patient. Comparison is made with prior study performed a day earlier. The lower hemithoraces were not included on the film. Within this limitation, left retrocardiac opacity has worsened consistent with worsening atelectasis. Right lower lobe pneumonia is unchanged. Bilateral pleural effusions are probably stable. ET tube is in standard position. The tip is 5.7 cm above the carina. NG tube tip is out of view below the diaphragm. " ee1de00b-4d51842a-551957a1-85d6eb10-94543362.jpg,test/p12/p12537194/s50988617/ee1de00b-4d51842a-551957a1-85d6eb10-94543362.jpg,test," FINAL REPORT INDICATION: ___ year old man with SOB/backpain found to have R pleural effusion and widespread mets.PLEASE DO CXR ON ___ // Trend pleural effusion.PLEASE DO CXR ON ___ TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Right-sided pigtail in situ. The right-sided pleural effusion shows interval increase in size and so does the left mediastinal shift in comparison with prior serial radiographs. Persistent collapsed right lung unchanged. No consolidations seen in the left lung. IMPRESSION: Interval progression of the right-sided pleural effusion with associated mass effect. Right persistently collapsed lung unchanged. " 414aae0e-98a3f435-e2d57274-8e92665a-be0a5647.jpg,test/p14/p14285126/s52431237/414aae0e-98a3f435-e2d57274-8e92665a-be0a5647.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with delirium s/p back surgery now electively intubated for MRI head/back // ETT placement ETT placement COMPARISON: Chest radiographs ___. IMPRESSION: New transoral drainage tube passes through the nondistended neo esophagus, ending below the diaphragm. ET tube in standard placement. Left lung clear. Right apical pleural parenchymal soft tissue abnormality has been questioned on chest CT in ___ " da0fee0e-4d684802-70400e41-6f0f82db-c774d6b1.jpg,test/p14/p14733367/s52844789/da0fee0e-4d684802-70400e41-6f0f82db-c774d6b1.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Evaluate lung opacities. Comparison is made with prior study performed the same day earlier in the morning. There has been interval improvement of now mild pulmonary edema. Moderate cardiomegaly is stable. Bilateral perihilar opacities larger on the left side likely consistent with pneumonia have only minimally improved. Right pleural effusion is small. There is no pneumothorax. Right PICC tip is in the low SVC. " d87fb238-7dfc64c7-2e042cdb-b67a1848-a8c90bbe.jpg,test/p11/p11459120/s50734991/d87fb238-7dfc64c7-2e042cdb-b67a1848-a8c90bbe.jpg,test," FINAL REPORT INDICATION: ___F with several days weakness, lethargy, N/Vx2 // r/o PNA TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: Given rotation to the left, the lungs are clear. Cardiomediastinal silhouette is unchanged. There is no large effusion or vascular congestion. Left chest wall dual lead pacing device is again noted. No acute osseous abnormalities. Left shoulder arthroplasty is partially visualized on the lateral view. IMPRESSION: No acute cardiopulmonary process. " c9e5f35b-c6a65cbe-adb2ca51-428ee51d-f086523a.jpg,test/p11/p11607177/s53746469/c9e5f35b-c6a65cbe-adb2ca51-428ee51d-f086523a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with known L effusion // effusion effusion COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Severe enlargement of the cardiomediastinal silhouette has been stable for several days. There is no pneumothorax or appreciable right pleural effusion. The volumes of pleural fluid and atelectasis at the base the left lung are indeterminate, obscured by the cardiac silhouette. Pulmonary vasculature is minimally more engorged today but there is no pulmonary edema. Left internal jugular line and a right PIC line are unchanged in standard placements. Transvenous biventricular pacer leads also in stable position. " d95cd351-42740406-052fe2aa-645e8c41-0251da67.jpg,test/p16/p16144348/s51321196/d95cd351-42740406-052fe2aa-645e8c41-0251da67.jpg,test," FINAL REPORT INDICATION: ___ year old man with overdose and ?aspiration // aspiration vs. pulmonary edema after cocaine/heroin overdose EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portal Chest radiograph, single semi erect frontal view COMPARISON: Chest radiograph ___ FINDINGS: Previously seen right perihilar consolidation is worsened and now involves right upper and lower lobes and left upper and lower lobes. The consolidation is heterogeneous and dense, concerning for multifocal pneumonia, possibly from aspiration. Right lower lobe is partially collapsed. 5 mm calcified granuloma in the right mid lung is unchanged. Cardial mediastinal silhouette is normal size. The ET tube terminates 3 cm above the carina. NG tube extends inferiorly beyond the inferior edge of the film. IMPRESSION: Multifocal pneumonia, possibly from aspiration, is worsened compared to ___. " fe2f49dd-584e6ede-34ee8814-182e15d6-14f86b0f.jpg,test/p16/p16931692/s55492118/fe2f49dd-584e6ede-34ee8814-182e15d6-14f86b0f.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ WITH COMPARISON RADIOGRAPH OF TWO DAYS EARLIER FINDINGS: Interval placement of endotracheal tube terminating 3.3 cm above the carina, and a nasogastric tube coursing below the diaphragm. Cardiomediastinal contours are within normal limits for technique. Mild pulmonary vascular congestion is present. Improving atelectasis in the left retrocardiac area with persistent small left pleural effusion. New patchy and linear foci of atelectasis are present in the right mid and lower lung regions. No visible pneumothorax. " 9a428542-dc024d9e-81680b75-514ddd49-b3523b41.jpg,test/p18/p18714676/s53521040/9a428542-dc024d9e-81680b75-514ddd49-b3523b41.jpg,test," FINAL REPORT HISTORY: Fevers, question pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Given low lung volumes, there is no acute cardiopulmonary process identified with no focal consolidations worrisome for pneumonia. Cardiac size is top normal. There is no pleural effusion, pneumothorax, or pulmonary edema. The aorta is slightly tortuous. IMPRESSION: No acute cardiopulmonary process. " adc9e127-b114b033-e0f31050-84587d96-058c1ed4.jpg,test/p18/p18654576/s57723439/adc9e127-b114b033-e0f31050-84587d96-058c1ed4.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History of sickle cell disease with cough. Evaluate for pneumonia. TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low accentuating the cardiac silhouette and pulmonary vasculature. Heart size is upper limits of normal. Bibasilar atelectasis is mild. Lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 1c932fe5-bd3ab469-6a676937-7c35f477-2d5dc6c9.jpg,test/p13/p13060009/s53089879/1c932fe5-bd3ab469-6a676937-7c35f477-2d5dc6c9.jpg,test," FINAL REPORT PORTABLE CHEST ___ HISTORY: NG tube placement. FINDINGS: Single portable view of the chest is compared to CT scan from 11:59 p.m. from the same day and chest x-ray from ___. FINDINGS: NG tube is seen with tip projecting off the inferior field of view, side port is not clearly delineated but is certainly beyond the GE junction. Large amount of gas-filled bowel is seen in the upper abdomen. There is lucency below the right and left hemidiaphragm, potentially within a gas-filled stomach on the left and potentially loops of colon on the right, however, the configuration is slightly different when compared to CT scan and repeat exam is recommended to exclude possibility of free intraperitoneal air given change in appearance. Appearance of the lungs is unchanged and limited due to the severe scoliosis. No large confluent consolidation is identified. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures notable for probable proximal left humeral fracture which appears old. IMPRESSION: Lucency below the hemidiaphragms, potentially due to dilated air-filled stomach and bowel; however, given differences in configuration compared to CT scan from earlier the same date, two-view chest x-ray/ abdominal films is suggested for further evaluation given possibility of free intraperitoneal air. Findings were discussed with ___ at 7:20 on ___ on the phone at time of discovery. " f5bae0e9-3e864d95-636987c1-07cc3271-51d78bac.jpg,test/p13/p13224377/s59047585/f5bae0e9-3e864d95-636987c1-07cc3271-51d78bac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx of AML s/p chemo with respiratory failure // Interval change Interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. The bilateral pulmonary opacifications persist, worse on the right. They appear to be somewhat less prominent than on the previous study. " aad02642-a4ecafb3-51fe9480-1f40e7a3-a9379dd6.jpg,test/p16/p16403658/s58449114/aad02642-a4ecafb3-51fe9480-1f40e7a3-a9379dd6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p MIE // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest dated ___. Chest radiograph dated ___. Fluoroscopic images dated ___. FINDINGS: There is a Port-A-Cath overlying the left chest with the tip in the mid SVC. No change in the appearance of the right medial hemithorax in comparison to the radiograph dated ___. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There is chronic elevation of the right hemi diaphragm. There are no acute osseous abnormalities. There are surgical clips seen in the right chest wall. IMPRESSION: Stable appearance of right medial hemithorax since ___ without a pneumothorax or pleural effusion. " 4b154443-7f0b76c2-61a227df-13cfe89e-2c12da54.jpg,test/p13/p13397741/s50758199/4b154443-7f0b76c2-61a227df-13cfe89e-2c12da54.jpg,test," FINAL REPORT HISTORY: Anemia, congestive heart failure, history of mediastinal mass. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Left-sided pacemaker device is noted with leads terminating within the right atrium and right ventricle. The cardiac silhouette size is mildly enlarged. Mediastinal and hilar contours are unchanged. No focal consolidation is demonstrated. Small bilateral pleural effusions persist, slightly decreased compared to the previous exam. There is mild prominence of the pulmonary vascular interstitium but no overt pulmonary edema demonstrated. Linear opacities within the right lung base likely reflects atelectasis. There is no pneumothorax. No acute osseous abnormalities are demonstrated. IMPRESSION: Persistent small bilateral pleural effusions, but decreased compared to previous exam. Atelectasis within the right lung base. No overt pulmonary edema. " b7b72f30-1cfe502d-295b8e7f-98addcf6-55444324.jpg,test/p16/p16669225/s53267724/b7b72f30-1cfe502d-295b8e7f-98addcf6-55444324.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F CAD, MR, htn/hl, ?COPD, who p/w fever and cough, admitted for CAP and was initially treated with CTX/azithro. On HD #2, BP in 80s and HR in 130s-150s (Afib w/RVR), HD unstable after iv metop/dilt, so transferred to MICU for BP stabilization, where she was started on dilt drip and heparin, before being sent back to floor on ___. Broadened to vanc/zosyn on ___. Repeat CXR showed worsening consolidation, concerning for loculated effusion; s/p R chest tube placement on ___. Blood cx from ___ grew Staph Aureus in ___ blood cx bottles. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is unchanged position of the right pigtail catheter. The opacities at the right lung base are constant. The opacity at the right upper lobe base, likely reflecting pneumonia, is slightly more extensive than on the previous image. The moderate cardiomegaly and the retrocardiac atelectasis persist. Elevation of the left hemidiaphragm is constant, small left pleural effusion. " 9351e2bc-9a1dba2a-dbc2402a-6cc555d1-44065c07.jpg,test/p17/p17118648/s55349103/9351e2bc-9a1dba2a-dbc2402a-6cc555d1-44065c07.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pain in her anterior chest wall following coughing from bronchitis // r/o fracture TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. Right lower lobe opacity is unchanged, otherwise The lungs are clear. There is no pneumothorax. Blunting of the posterior CP angle on the left could be scarring or pleural effusion. . The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities. Questionable small left pleural effusion " 02f5db0a-c589ee8a-d9bf9929-41246b43-9efc3494.jpg,test/p19/p19934623/s54573936/02f5db0a-c589ee8a-d9bf9929-41246b43-9efc3494.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Cough COMPARISON: ___ avail FINDINGS: Asymmetric fullness of the right hilum is accompanied by a nonspecific right lower lobe opacity projecting over the lower thoracic spine on the lateral radiograph. Lungs are otherwise clear, and there are no pleural effusions. Cardiomediastinal contours are normal. IMPRESSION: Asymmetrical enlargement of right hilum accompanied by a cyst is is the wall it is is is as as any acute is a the all cysts is a is nonspecific right lower lobe opacity. In the absence of infectious symptoms, neoplasm should be considered. RECOMMENDATIONS: If the patient has infectious symptoms, recommend initial chest radiograph in 4 weeks after completion of antibiotic therapy. In the absence of infectious symptoms, contrast-enhanced chest CT would be recommended rather than followup chest radiograph. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 09:46 into the Department of Radiology critical communications system for direct communication to the referring provider. " edd5210d-944c6162-842d9c15-7797c152-d3d37293.jpg,test/p15/p15816738/s53100626/edd5210d-944c6162-842d9c15-7797c152-d3d37293.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Post-operative assessment. AP chest radiograph The patient is extubated after laparotomy with the ET tube tip being approximately 3 cm above the carina. Severe cardiomegaly including prominence of the main pulmonary artery consistent with pulmonary hypertension is re-demonstrated. Minimal bibasal atelectasis is noted, but no pneumothorax or overt pleural effusion is seen. There is also no evidence of pneumothorax. " ab235398-69682612-b378c32b-345f5e21-318781c2.jpg,test/p15/p15103745/s51785939/ab235398-69682612-b378c32b-345f5e21-318781c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypervolemia, attempting diuresis. // eval pleural effusion COMPARISON: Chest radiograph from ___. FINDINGS: AP portable upright view of the chest. A right-sided IJ catheter terminates at the lower SVC. An endotracheal tube and orogastric tube are unchanged in position. There is interval decrease in size of a small right pleural effusion, and unchanged size of a small left pleural effusion. There is no pneumothorax. The heart is mildly enlarged. IMPRESSION: Improved small right pleural effusion. Unchanged small left pleural effusion. " 93b91f11-e407dafa-519aedf6-7c23d467-b3c2e6a5.jpg,test/p15/p15130765/s50999934/93b91f11-e407dafa-519aedf6-7c23d467-b3c2e6a5.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: ___-year-old female with history of altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes, which accentuate the bronchovascular markings. There is minimal pulmonary vascular congestion. Dual-lead left-sided pacemaker is again seen. The cardiac silhouette remains mildly enlarged. The aorta is calcified and tortuous. No pleural effusion or pneumothorax is seen. Multilevel degenerative changes of the spine are seen. " f098faaa-3c616616-397eedb0-3cb830eb-27147fd3.jpg,test/p12/p12151772/s57213588/f098faaa-3c616616-397eedb0-3cb830eb-27147fd3.jpg,test," FINAL REPORT HISTORY: ___ years old woman with recent pigtail catheter placement for drainage of left pleural effusion. Please assess for interval changes. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: As compared to the chest x-ray of yesterday, new opacification on the left lung base, compatible with layering pleural effusion. Persistent bibasilar atelectasis is unchanged since prior chest x-ray. Cardiac contour is partially obscured by left pleural effusion. There are no consolidations suspicious for pneumonia. There is small left apical pneumothorax. IMPRESSION: New left base opacity is consistent with layering pleural effusion. Persistent bibasilar atelectasis. Small left apical pneumothorax. " a49c7b29-7f0360db-e9c19f4c-7853fa78-539baf09.jpg,test/p11/p11958553/s59522558/a49c7b29-7f0360db-e9c19f4c-7853fa78-539baf09.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Status post minimally invasive esophagectomy ___. Comparison is made with prior study, ___. Mild-to-moderate cardiomegaly and widened mediastinum are unchanged. There are persistent low lung volumes. If any, there is a small unchanged right effusion. There is no pneumothorax. Linear and reticular opacities in the hila bilaterally, larger on the left, consistent with bronchiectasis, are stable. There are no new lung abnormalities. There are moderate-to-severe degenerative changes in the thoracic spine. " 333ec3aa-db35df4e-2f5c933d-259cfb42-284197d8.jpg,test/p10/p10207476/s52297324/333ec3aa-db35df4e-2f5c933d-259cfb42-284197d8.jpg,test," FINAL REPORT HISTORY: History of AML. Cough. Rule out pneumonia. TECHNIQUE: PA and lateral views of the chest were obtained. COMPARISON: Chest radiograph from ___. And chest CT from ___. FINDINGS: Linear opacity in the lingula consistent with scar is unchanged. The heart is normal size. Epicardial vascular clips are unexplained. Bulge in the aortic arch of the known pseudoaneurysm is not grossly changed, but is best followed with cross-sectional imaging. Right rib deformities are chronic. IMPRESSION: 1. No pneumonia. 2. Pseudoaneurysm at the aortic arch not grossly changed; however, best followed with cross-sectional imaging. Findings discussed with Dr ___ by Dr ___ at 15:07 on ___ via phone. " c8e07bf9-0041e73d-becfc5cb-76488e91-7d8c7f9a.jpg,test/p12/p12614490/s53963208/c8e07bf9-0041e73d-becfc5cb-76488e91-7d8c7f9a.jpg,test," FINAL REPORT HISTORY: Esophageal perforation during recent ERCP. Assess for pneumothorax. COMPARISON: Subsequent abdominal radiographs from ___. FINDINGS: An enteric catheter courses below the level of the diaphragm, ending within the stomach. Note is made of a biliary catheter as well as surgical clips in the epigastric region. There is a moderate quantity of left pleural fluid with consolidation at the left lung base that could be compressive atelectasis. The lungs are otherwise clear. Heart size is difficult to accurately assess but is likely top normal. The mediastinal contours are normal. There is no evidence of pneumomediastinum. No pneumothorax is seen. There is a moderate quantity of what appears to be both intraperitoneal and retroperitoneal free air. The retroperitoneal air is better evaluated on the subsequent abdominal radiograph from ___, where free air is seen outlining the right kidney and psoas muscle. High-density material within the colon relates to prior ingestion of oral contrast material. IMPRESSION: 1. Moderate quantity of free air that appears to be located in both intraperitoneal and retroperitoneal locations. If clinically warranted, further evaluation could be performed with CT. 2. Moderate quantity of left pleural fluid, possibly transudative in nature, although hemorrhagic material related to esophageal perforation is certainly possible. Associated consolidative opacification of the left lung base could be compressive atelectasis. Findings were discussed with Dr. ___ by Dr. ___ at 4:47 p.m. via telephone on the day of the study, immediately after discovery of the findings. " 971553d8-0727c458-c98a7462-38d39f7b-1aedb2aa.jpg,test/p11/p11020740/s55722743/971553d8-0727c458-c98a7462-38d39f7b-1aedb2aa.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pulmonary edema, ETT repositioning. COMPARISON: ___, 2:52. FINDINGS: As compared to the previous radiograph, there has been a minimal pulling back of the endotracheal tube. The tube however, still projects 2.3 cm above the carina, the tube could be pulled back another 0.5-1 cm. The other monitoring and support devices are in correct position. The orogastric tube has a normal course, the tube is coiled in the stomach. No evidence of complications, notably no pneumothorax. Unchanged appearance of the lung parenchyma and the cardiac silhouette. " 656d7fb1-f0a468e2-31b21993-300be394-aa5deee3.jpg,test/p18/p18622374/s56800640/656d7fb1-f0a468e2-31b21993-300be394-aa5deee3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Progressively worsening productive cough with right-sided posterior chest discomfort associated with fevers and myalgias // please evaluate for pneumonia please evaluate for pneumonia COMPARISON: . Chest radiographs ___. IMPRESSION: The lateral view suggests a very small region of abnormal Lung at one of the bases, probably the right. I hesitate to call this pneumonia since the inspiration is less than complete. If more radiographic certainty is needed to decide whether tube treat pneumonia, repeat lateral view at full inspiration should be obtained, supplemented by oblique views if necessary. Upper lungs are clear. Heart is normal size and there is no pleural effusion or evidence of central lymph node enlargement " a5109459-b46f7f0f-aa76312d-e4ac5aee-cc117bc2.jpg,test/p15/p15573773/s55635413/a5109459-b46f7f0f-aa76312d-e4ac5aee-cc117bc2.jpg,test," FINAL REPORT HISTORY: Respiratory failure. FINDINGS: In comparison with the study of ___, there is little overall change. Again there are diffuse areas of opacification bilaterally consistent with multifocal pneumonia. Enlargement of the cardiac silhouette with pulmonary vascular congestion is also seen. Probable bilateral effusions with atelectatic changes at the bases as well. " 9affb1b8-b325399a-b007bbd8-954b8a8f-c687513a.jpg,test/p14/p14107609/s57393701/9affb1b8-b325399a-b007bbd8-954b8a8f-c687513a.jpg,test," WET READ: ___ ___ 7:59 PM New left-sided ICD. No evidence of a pneumothorax. Minimal bibasilar atelectasis. Unchanged cardiomegaly. Results were discussed with the EP fellow at 20:00. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF s/p ICD implant // pst ICD implant-eval for pericardial effusion,pneumothorax pst ICD implant-eval for pericardial effusion,pneumothorax COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: New left trans subclavian right ventricular defibrillator lead follows the expected course from the left pectoral generator. No pneumothorax, left pleural effusion or mediastinal widening. Moderate cardiomegaly is probably unchanged since ___. Lungs grossly clear. " bffc774f-24b001a9-4b0e0872-bb8ab49e-7b4941dd.jpg,test/p17/p17872708/s51400996/bffc774f-24b001a9-4b0e0872-bb8ab49e-7b4941dd.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___, CT PET from outside hospital. CLINICAL HISTORY: Lymphoma with hypotension, evaluate for pneumonia. FINDINGS: AP frontal upright view of the chest was provided. A Port-A-Cath resides over the right chest wall with catheter tip extending to the region of the low SVC. The heart size appears normal. There is hilar prominence, compatible with known lymphadenopathy. There is interstitial edema with a tiny left pleural effusion. No pneumothorax is seen. Calcification along the aortic knob is noted. Bony structures appear intact. IMPRESSION: Pulmonary interstitial edema, with small left pleural effusion, new from prior CT. Hilar prominence is compatible with known lymphadenopathy. " 22af58d7-30892703-e9699647-89e52ade-df1be193.jpg,test/p15/p15658321/s50006562/22af58d7-30892703-e9699647-89e52ade-df1be193.jpg,test," WET READ: ___ ___ ___ 10:38 AM Large hiatal hernia. No acute intrathoracic abnormality. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with cough and sore throat. Evaluate for infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrate clear lungs bilaterally. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are within normal limits. No overt pulmonary edema. A large hiatal hernia is again identified. Osseous structures are without an acute abnormality. IMPRESSION: Large hiatal hernia. No acute intrathoracic abnormality. " 7f6715ce-d82a2435-a3ccb22b-f33e12ab-68f5497b.jpg,test/p12/p12401831/s56655039/7f6715ce-d82a2435-a3ccb22b-f33e12ab-68f5497b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with history CVA presenting with acute abdominal pain after ingesting pills - unable to give an accurate history // Please assess for dilated loops of bowels, obstruction or free air under the diaphragm TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Lateral views a suboptimal due to patient's overlying arms.No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No evidence of free air is seen beneath the diaphragms in this semi upright patient. IMPRESSION: No acute cardiopulmonary process. " 184adcda-4e1710e2-2c9b70b2-bfd5af16-b2331b1b.jpg,test/p17/p17278174/s51435902/184adcda-4e1710e2-2c9b70b2-bfd5af16-b2331b1b.jpg,test," FINAL REPORT INDICATION: Tenderness over the ___ ribs, status post fall, evaluate for fracture or pneumothorax. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural abnormalities. A slight cortical step-off in the lateral aspect of the right 9th rib is likely a minimally displaced fracture. No additional fractures are identified. IMPRESSION: 1. No acute cardiac or pulmonary process. 2. Likely minimally displaced right 9th rib fracture. Further evaluation could be performed with a dedicated rib series with appropriate skin markers, if clinically indicated. " e2e4963c-7943cd12-506bb596-7b85971f-87137da0.jpg,test/p12/p12712057/s50772255/e2e4963c-7943cd12-506bb596-7b85971f-87137da0.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest AP and lateral COMPARISON: ___ chest radiograph, ___ chest CT FINDINGS: Cardiac silhouette size is normal. The aorta is unfolded. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion, focal consolidation or pneumothorax is demonstrated. There are mild degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " ef6f3b7b-51d1c12c-ddf23a5a-8a33fccc-3eaf5a29.jpg,test/p13/p13265615/s50032636/ef6f3b7b-51d1c12c-ddf23a5a-8a33fccc-3eaf5a29.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with left rib pain. Assess for fracture or pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are well inflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Visualized osseous structures are notable for minimal levoscoliosis centered at T10. No displaced rib fracture. IMPRESSION: 1. No acute cardiopulmonary process. Specifically, no displaced rib fracture or pneumonia. 2. Minimal levoscoliosis centered at T10. " 25ee6ef1-1e086650-4b388d67-99cae82c-8b65717e.jpg,test/p16/p16826047/s51795923/25ee6ef1-1e086650-4b388d67-99cae82c-8b65717e.jpg,test," WET READ: ___ ___ ___ 8:59 PM Increased opacification of the right hemi thorax, likely worsening pleural effusion. Prominence of the pulmonary vasculature may represent pulmonary vascular congestion. Right chest tube is in place. No pneumothorax. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea and chronic heart failure, evaluation for pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The extensive right pleural effusion is constant in distribution and extent. Also constant are the relatively massive subsequent parenchymal opacities in the right hemithorax. On the left, there is no visible change, the appearance of the left heart border, the left costophrenic sinus and the structure of the lung parenchyma is constant. No pneumothorax. No pleural effusions. " 48013b51-3478b2cd-5309e5c6-452a4a76-d7e19883.jpg,test/p18/p18060267/s56666885/48013b51-3478b2cd-5309e5c6-452a4a76-d7e19883.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CT torso from ___ and chest radiograph from ___. CLINICAL HISTORY: Weakness, numbness, question pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion, pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 1f7fde4b-316f24b3-72205b32-a52b8ba8-51e3281c.jpg,test/p14/p14889848/s59792494/1f7fde4b-316f24b3-72205b32-a52b8ba8-51e3281c.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:07 AM Normal chest radiograph. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest x-ray on ___. FINDINGS: PA and lateral radiographs of the chest demonstrate a normal cardiomediastinal silhouette. The lungs are clear without pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: Normal chest radiograph. " bff4924b-6290c92f-d28c0426-4596dc26-b8090fbb.jpg,test/p16/p16679893/s55625576/bff4924b-6290c92f-d28c0426-4596dc26-b8090fbb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with collapsed R. lower lobe // change IMPRESSION: As compared to prior radiograph of 1 day earlier, pulmonary vascular congestion is now accompanied by moderate pulmonary edema. Moderate to large right and small left pleural effusions have apparently increased in size. There remains postobstructive collapse of the right lower lobe and partial atelectasis of the right middle lobe. " 64a7d3e8-62f71479-6efcc300-9bc6ce72-e730746f.jpg,test/p19/p19601036/s50089049/64a7d3e8-62f71479-6efcc300-9bc6ce72-e730746f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with a thoracic duct injury, now status-post repair. Evaluate for pleural effusions. COMPARISON: Chest radiograph dated ___. CT dated ___. FINDINGS: No significant change since ___ when accounting for differences in imaging technique. Persistent bilateral effusions, moderate on the right and small on the left, with adjacent stable compressive atelectasis bilaterally. Stable elevation of left hemidiaphragm. The left upper lung peripheral opacity, better characterized on recent CT as a fluid and air collection, is unchanged. The lungs are otherwise clear, without focal consolidation to suggest pneumonia or pulmonary edema. No pneumothorax. Stable cardiomediastinal silhouette and hila appear Sternotomy wires, prosthetic cardiac valve, left PICC line, and enteric feeding tube read, appear intact and unchanged in position. Expected post-lymphangiogram appearance of the nodes. IMPRESSION: Persistent moderate right and small left pleural effusions. " 3ebfeaec-d4f7379b-f2adb4ce-55ed8990-a4b769d8.jpg,test/p14/p14916430/s55921970/3ebfeaec-d4f7379b-f2adb4ce-55ed8990-a4b769d8.jpg,test," FINAL REPORT HISTORY: Alcoholic hepatitis with NG tube placement. COMPARISON: Chest radiograph ___. TECHNIQUE: Single frontal portable chest radiograph. FINDINGS: Distal end of NG tube is in proximal stomach. Stable moderately enlarged cardiac silhouette with dilated azygos vein and vascular engorgement. No pleural effusions or pneumothorax. Partial clearing of right lower lobe opacity. Hila are normal. No bony abnormality. IMPRESSION: 1. Stable mild pulmonary edema. 2. End of NG tube in proximal stomach. " 9c8e908a-ed7f446c-d535af39-604391c1-2c7a6d32.jpg,test/p12/p12390274/s58523560/9c8e908a-ed7f446c-d535af39-604391c1-2c7a6d32.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___. FINDINGS: Lungs are well expanded and clear. No opacities concerning for pneumonia. Heart size is top normal. Mediastinal and hilar contours are normal. There is no pleural abnormality. IMPRESSION: No pneumonia. " 18e655fc-47c0597a-d43ad45d-a1b438f4-e30bd695.jpg,test/p15/p15190257/s52412865/18e655fc-47c0597a-d43ad45d-a1b438f4-e30bd695.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man POD ___ s/p liver xplant // Please assess for ETT position Please assess for ETT position IMPRESSION: In comparison with the study of ___, the tip of the endotracheal tube is approximately 3.8 cm above the carina. The Swan-Ganz catheter is been pulled back so that the tip is within the right atrium. Continued and probably increasing hazy opacification of the right hemithorax, consistent with layering effusion. Bibasilar atelectatic changes, more prominent on the right. " dc29d33e-bcf77ecf-c4fca6b6-8ea2ed29-d71aee14.jpg,test/p10/p10003956/s53245562/dc29d33e-bcf77ecf-c4fca6b6-8ea2ed29-d71aee14.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever // pna? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. No lobar consolidation, effusion or pneumothorax. No convincing signs of pneumonia. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No definite signs of pneumonia. " fa7c6d22-7711ea61-627c40c4-a98b562e-39a5369b.jpg,test/p19/p19729398/s58478031/fa7c6d22-7711ea61-627c40c4-a98b562e-39a5369b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Followup of pleural effusion. AP radiograph of the chest was reviewed in comparison to ___. The right pneumothorax appears to be small and overall unchanged. The right chest tubes are in place. Overall, the appearance of the chest radiograph is very similar to previous day. " 962d1b7f-bd8be2aa-56cb9acb-32f68301-a940659c.jpg,test/p16/p16742247/s50103430/962d1b7f-bd8be2aa-56cb9acb-32f68301-a940659c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with hx of AML s/p BMT in ___ currently on lenolamide, presents with fever // any e/o PNA? acute process? COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Airspace consolidation is noted within the inferior lingula and right lower lobe concerning for multifocal pneumonia. No definite additional areas of involvement. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Multifocal pneumonia. ___, MD CC: DR. ___ " a85f0a6d-5860b834-28f7777c-a57d6d3a-4a2bf702.jpg,test/p16/p16233087/s56695676/a85f0a6d-5860b834-28f7777c-a57d6d3a-4a2bf702.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___M with chest pressure since waking this morning, hx STEMI ___, s/p mitral valve replacement.Patient with hx cauda equina, s/p laminectomy ___ // Eval for acute process.Eval for cauda equina or acute lumbar spine process. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: A moderate left pleural effusion with adjacent atelectasis appears modestly improved from the prior examination. The right lung and left upper lung are clear without lobar consolidation or pneumothorax. Azygos fissure is incidentally noted. There is no frank pulmonary edema. The cardiomediastinal silhouette is unchanged. Median sternotomy wires are intact and well aligned. IMPRESSION: Perhaps minimally improved moderate left pleural effusion. Otherwise, no significant change from ___. " 5244c3b0-b37b0eb4-a2f03521-aecb3c79-dd0e4175.jpg,test/p15/p15753793/s55719958/5244c3b0-b37b0eb4-a2f03521-aecb3c79-dd0e4175.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Palpitations. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Single-lead left-sided AICD is again seen with lead extending to the expected position of the right ventricle. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are stable with the cardiac silhouette top normal to mildly enlarged. IMPRESSION: No acute cardiopulmonary process. " c84cd547-30d07136-264491bd-d9ad4adf-fe722cfc.jpg,test/p17/p17457354/s56595572/c84cd547-30d07136-264491bd-d9ad4adf-fe722cfc.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough, fever. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation is seen. There is no pleural effusion or pneumothorax. No pulmonary edema is seen. The cardiac silhouette is top normal. IMPRESSION: Top normal cardiac silhouette size. No focal consolidation to suggest pneumonia. " 7de261f1-cfa0a39b-b5a60cfd-34aee84f-eae2b3ab.jpg,test/p10/p10832658/s50429598/7de261f1-cfa0a39b-b5a60cfd-34aee84f-eae2b3ab.jpg,test," FINAL REPORT HISTORY: Shortness of breath and fever. Evaluate for pneumonia COMPARISON: Multiple prior radiographs the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate air is increased opacification of the left mid lung field, which is concerning for left lower lobe pneumonia. Additionally there is a subtle increased opacity within the right mid lungfield, which may represent a second site of infection. There is a small left-sided pleural effusion. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. IMPRESSION: 1. Increased opacification of the left mid lung field, which is concerning for left lower lobe pneumonia. Additionally there is a subtle increased opacity within the right mid lungfield, which may represent a second site of infection. 2. Small left-sided pleural effusion. " ac1cbe3a-72d789e5-d30d928d-1249a931-6b66474b.jpg,test/p16/p16200793/s51155125/ac1cbe3a-72d789e5-d30d928d-1249a931-6b66474b.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: Background emphysema is unchanged. There is persistent moderate pulmonary interstitial edema. Known consolidation in the superior segment of the left lower lobe is again identified. The cardiac silhouette is unchanged. There is no pleural effusion or pneumothorax. Multiple left-sided rib fractures are again noted. IMPRESSION: No focal consolidation to suggest acute pneumonia. Moderate interstitial edema. " e8313d0b-55d185c2-40da369a-6a04d725-e64bc38f.jpg,test/p16/p16877397/s55077718/e8313d0b-55d185c2-40da369a-6a04d725-e64bc38f.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Status post CABG and AVR, with cough and rales. Comparison is made with prior study, ___. Cardiomediastinal contours are normal. Left pleural effusion with adjacent atelectasis has improved. There is no pulmonary edema or pneumothorax. Sternal wires are aligned. Patient is status post CABG and AVR. There are mild degenerative changes in the thoracic spine. Elevation of the left hemidiaphragm is unchanged. " db8d9d53-454cd91e-faa2c8c4-bb3fd672-491de669.jpg,test/p16/p16087436/s56484112/db8d9d53-454cd91e-faa2c8c4-bb3fd672-491de669.jpg,test," FINAL REPORT INDICATION: ___-year-old man with intraparenchymal hemorrhage with persistent respiratory failure. COMPARISON: ___ to ___. FINDINGS: A tracheostomy remains in the upper airway. A left PICC line tip remains in the mid SVC. Bibasilar atelectasis and mild pulmonary edema are unchanged. No new focal consolidation, effusion, or pneumothorax is present. IMPRESSION: Stable bibasilar atelectasis and mild pulmonary edema. " ecdc3b9f-3b285574-1cba178c-91aec3ca-2f00b9dc.jpg,test/p19/p19845120/s56152548/ecdc3b9f-3b285574-1cba178c-91aec3ca-2f00b9dc.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after GI bleeding, evaluation for worsening pulmonary edema. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube is unchanged, the left PICC line tip is unchanged. Heart size and mediastinum are unchanged. Bibasal areas of atelectasis are present, but there is interval progression of interstitial pulmonary edema, currently mild to moderate. " 79554cf9-6a2e6bcd-fbca8479-f812ff30-ed4ff769.jpg,test/p18/p18230852/s55275759/79554cf9-6a2e6bcd-fbca8479-f812ff30-ed4ff769.jpg,test," FINAL REPORT EXAMINATION: Chest single view INDICATION: ___ year old man with epistaxis and recently extubated. Now with new epistaxis // evaluate for interval change TECHNIQUE: Portable AP. COMPARISON: ___. FINDINGS: The PICC line in SVC. The distal portion of the NG tube is not seen. Plate atelectasis in the right lower lung field seen, probably unchanged since the previous exam. However the left lower lobe is better aerated. No pleural effusion. IMPRESSION: Improved aeration of left lower lobe. " fb71ea67-cb10fb8d-9d780919-a23fef2a-8ac98b04.jpg,test/p12/p12750648/s59068826/fb71ea67-cb10fb8d-9d780919-a23fef2a-8ac98b04.jpg,test," FINAL REPORT INDICATION: History: ___F with pain tenderness post fall l lowe pos rib cage and l4 // ? fx COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: There is hyperinflation. There is no pneumothorax, effusion, consolidation or CHF. Degenerative changes are present in the spine. There is stable mild compression of a lower thoracic vertebrae. " 15e8e7ba-4a97e0fa-3e037c65-c806d47b-9e538a85.jpg,test/p16/p16156464/s55075673/15e8e7ba-4a97e0fa-3e037c65-c806d47b-9e538a85.jpg,test," FINAL REPORT HISTORY: Lung cancer, evaluate. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___, ___ and ___. CT trachea ___. FINDINGS: There is extensive changes from chronic obstructive pulmonary disease. There is no pleural effusion or pneumothorax. There is no focal airspace consolidation concerning for pneumonia. Bibasilar patchy opacities likely reflect scarring which also account for blunting of the costophrenic angles on the lateral view. No pleural effusion was evident on the prior CT. Moderate enlargement of the heart and pulmonary vessels is unchanged. The known bulky mediastinal lymphadenopathy is better appreciated on the prior CT. A mitral valve prosthesis is again noted. A compression fracture of the lower thoracic spine is stable. No new compression fractures. IMPRESSION: No acute cardiopulmonary process. " 5877c95e-6ea77322-4de7fe07-13847550-04a5e9dd.jpg,test/p18/p18933552/s58640860/5877c95e-6ea77322-4de7fe07-13847550-04a5e9dd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with NSSCL and metatastic disease to lung, liver and adrenals s/p right PleurX. // Evolution COMPARISON: CHEST RADIOGRAPHS ___. IMPRESSION: A PleurX catheter is barely visible at the base of the right lung, extending upward across the midline, impinging on the mediastinum, unchanged since ___, but nevertheless the previous small to moderate right pneumothorax has decreased substantially. There is new interstitial abnormality at the base of the right lung, which may be edema induced by negative pressure. Followup is advised to monitor what could be pneumonia or pulmonary hemorrhage instead. Previous consolidation in the right upper lobe is clearing. Moderate left pleural effusion and marked atelectasis around left hilar mass, obscuring the left heart border, is unchanged. " 0271ec63-ddedd0b0-8d5fd308-f4bbf0aa-b509d997.jpg,test/p16/p16590636/s57130765/0271ec63-ddedd0b0-8d5fd308-f4bbf0aa-b509d997.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with squamous cell cancer of the tongue after chemoradiation with severe mucositis, NG tube placement. AP radiograph of the chest was reviewed in comparison to ___. The NG tube tip is in the stomach. Heart size and mediastinum are stable in appearance. Minimal opacity in the left lower lung might reflect area of atelectasis versus aspiration. " 9b92a6ba-91e4f825-a6eb1adf-59bf38d2-d55cbb49.jpg,test/p17/p17547176/s57827526/9b92a6ba-91e4f825-a6eb1adf-59bf38d2-d55cbb49.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Stab wound to chest. AP and lateral radiographs of the chest were reviewed. The heart size is normal. The mediastinum is normal. There is subcutaneous air, better appreciated on the lateral view anteriorly, not clearly seen on PA radiograph. No pneumothorax can be detected on the current examination. Minimal amount of pleural effusion cannot be excluded. " 3fc8aeb0-9f79405e-59dd675a-e57d67f1-de210194.jpg,test/p17/p17396841/s50019185/3fc8aeb0-9f79405e-59dd675a-e57d67f1-de210194.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure s/p tracheostomy. // Please evaluate for pulmonary edema, consolidation, and interval change. Please evaluate for pulmonary edema, consolidation, and interval change. IMPRESSION: Compared to chest radiographs ___ through ___. Moderately severe pulmonary edema which worsened between ___ and ___ at 05:02 is unchanged. Severe left lower lobe consolidation, presumably atelectasis is stable over at least the past 5 days. Mild to moderate cardiomegaly also unchanged. Pleural effusions are presumed, but not large. No pneumothorax. Tracheostomy tube is midline. No mediastinal widening or pneumothorax. " 248f8600-afa8b16a-71989b5e-f69154b8-9ef53381.jpg,test/p17/p17447691/s58899636/248f8600-afa8b16a-71989b5e-f69154b8-9ef53381.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There no pleural effusions or pneumothorax. IMPRESSION: No evidence of acute disease. " 288de994-8ed71600-17b82c8c-d7b93e0b-0ab9635e.jpg,test/p17/p17973921/s55916640/288de994-8ed71600-17b82c8c-d7b93e0b-0ab9635e.jpg,test," WET READ: ___ ___ ___ 2:04 PM No free intraperitoneal air. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: AP AND LATERAL CHEST X-RAY INDICATION: ___-year-old man with nausea, vomiting, epigastric pain, evaluate for free intraperitoneal air. TECHNIQUE: AP and lateral upright chest radiographs. COMPARISON: Chest x-ray ___. FINDINGS: There is no free air under the diaphragm. The cardiomediastinal silhouettes are stable and within normal limits. The bilateral hila are unremarkable. The lungs are clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No free air under the diaphragm. . No acute cardiopulmonary process. " de653d46-c9ece595-297ff8e8-d197e5ee-edef1fd4.jpg,test/p17/p17298236/s57785600/de653d46-c9ece595-297ff8e8-d197e5ee-edef1fd4.jpg,test," FINAL REPORT INDICATION: ___-year-old male with cough and left basilar crackles. Evaluate for pneumonia. EXAMINATION: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: The lungs remain clear with no new focal areas of opacification concerning for pneumonia. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are stable demonstrating mild tortuosity of thoracic aorta. Heart size is normal. Pulmonary vascularity is not increased. There is stable mild wedging of a lower thoracic vertebral body. IMPRESSION: No acute cardiopulmonary process. " e4861046-70215612-401f158b-aaedd8f6-81ac5b82.jpg,test/p13/p13343787/s59135583/e4861046-70215612-401f158b-aaedd8f6-81ac5b82.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Worsening pedal edema. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. Lung volumes are mildly low. There is no pleural effusion or pneumothorax. Small anterior osteophytes are noted along the anterior aspect of the lower thoracic to mid thoracic spine. Prior healed right posterior sixth, seventh and eighth rib fractures are noted. IMPRESSION: No evidence of acute disease. " 4c4a4c42-e0548221-6338b6d9-71cc4e5c-fd77ef08.jpg,test/p19/p19215326/s50294988/4c4a4c42-e0548221-6338b6d9-71cc4e5c-fd77ef08.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with smoking, intermittent cough // assess for COPD changes/nodule assess for COPD changes/nodule IMPRESSION: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 3be477db-c6475031-d1946b3b-b8466f87-0addd4c8.jpg,test/p19/p19814293/s50126354/3be477db-c6475031-d1946b3b-b8466f87-0addd4c8.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of lower extremity swelling. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. Basilar atelectasis/scarring is seen on the lateral view without frank focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Basilar atelectasis/scarring without definite focal consolidation. " 72ced1ce-d3dfdf89-4012297f-840fc433-27847ba7.jpg,test/p19/p19873891/s51704160/72ced1ce-d3dfdf89-4012297f-840fc433-27847ba7.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with abdominal pain // eval infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Small left pleural effusion with overlying atelectasis persists. No right pleural effusion is seen. The right lung appears clear. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Persistent small to moderate left pleural effusion with overlying atelectasis. " 1e09cf44-6d21959b-7b2d9204-4aa38a44-843f7734.jpg,test/p18/p18299548/s58434716/1e09cf44-6d21959b-7b2d9204-4aa38a44-843f7734.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for pneumomediastinum. No prior examinations for comparison. CHEST, PA AND LATERAL: The lungs are clear. Cardiomediastinal and hilar contours are normal. There are no pleural effusions, pneumothorax, pneumomediastinum, or pneumopericardium. IMPRESSION: No acute cardiopulmonary process. " 6e5fdb92-5e480c6e-0323e964-a1c97054-5b7be03e.jpg,test/p17/p17135687/s51548014/6e5fdb92-5e480c6e-0323e964-a1c97054-5b7be03e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p GSW with bilateral hemopneumothorax s/p chest tubes now hypoxic // assess for interval changes TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 00:42 IMPRESSION: As compared to prior radiograph obtained approximately 1 hr ago there is substantial interval improvement of the aeration of the left lung. Minimal left apical pneumothorax is present. " e9a0c24e-e7f37086-63bb3143-c412c2eb-0055b8ce.jpg,test/p19/p19186632/s51907413/e9a0c24e-e7f37086-63bb3143-c412c2eb-0055b8ce.jpg,test," FINAL REPORT EXAM: Chest, single AP supine portable view. CLINICAL INFORMATION: ___-year-old female with history of femur fracture, preop chest radiograph. COMPARISON: ___. FINDINGS: Single supine AP portable view of the chest was obtained. Dual-lead left-sided pacemaker is again seen with leads seen without significant change in position. There is mild left base atelectasis. The right lung is clear. No large pleural effusion or pneumothorax is seen. The aorta is calcified and tortuous. The cardiac silhouette is stable. There is diffuse osteopenia. IMPRESSION: Mild left base atelectasis. Otherwise, no acute cardiopulmonary process seen. " d43d3f00-0189f723-1a58c353-7ca8e2b4-2311c570.jpg,test/p16/p16734287/s58707175/d43d3f00-0189f723-1a58c353-7ca8e2b4-2311c570.jpg,test," WET READ: ___ ___ ___ 4:45 PM Patchy right infrahilar opacity, atelectasis or potentially pneumonia; a component of this appears nodular and may reflect a true nodule - short-term follow-up radiographs are suggested to reassess versus evaluation with chest CT. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Dyspnea. Question effusion. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged. The aortic arch is calcified. The mediastinal and hilar contours appear unchanged. There is a patchy right infrahilar opacity including a nodular focus of about 15 mm in diameter, although perhaps part of a developing consolidation. Posterior and lateral costophrenic sulci are blunted, so there may be potentially tiny bilateral pleural effusions. There is no pneumothorax. Mild rightward convex curvature and moderate degenerative changes are noted along the mid-to-lower thoracic spine. Vascular calcifications are widespread. IMPRESSION: Patchy right infrahilar opacity worrisome for pneumonia, but including a nodular component. The possibility of a true lung nodule should be considered. Either evaluation with dedicated chest CT, preferably with intravenous contrast, if possible, or short-term followup radiographs are recommended to assess further. " 6425b8b8-b67f7ac2-f034cf1a-348907b7-dd3c31f2.jpg,test/p16/p16771607/s52416781/6425b8b8-b67f7ac2-f034cf1a-348907b7-dd3c31f2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intubation, resp failure, septic abortion // volumes, focal, interval IMPRESSION: As compared to ___ radiograph, there has not been no relevant is for interval change in the appearance of the chest. " e4151ab8-5e0d6a43-4c078411-a033b710-9c4d0522.jpg,test/p12/p12608816/s58076034/e4151ab8-5e0d6a43-4c078411-a033b710-9c4d0522.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: None. FINDINGS: 2 views of the chest were obtained. The lungs are well expanded and clear without pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " fa57f314-f94178ee-1c38b3fd-2e02ff8e-ed91c0b2.jpg,test/p19/p19424808/s53848574/fa57f314-f94178ee-1c38b3fd-2e02ff8e-ed91c0b2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F w/productive cough and fever, please rule out PNA // ___F w/productive cough and fever, please rule out PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 9ce32083-05a2f378-9e15c9c0-912c4b46-56dc4243.jpg,test/p15/p15505424/s57169720/9ce32083-05a2f378-9e15c9c0-912c4b46-56dc4243.jpg,test," FINAL REPORT HISTORY: Preoperative planning. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None. FINDINGS: Minimal left basilar atelectasis is noted. Subtle diffuse lucency within the bilateral upper lobes is suggestive of mild emphysema. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is normal. Mediastinal contours are normal. Cervical fusion hardware is noted. No acute bony abnormality is detected. IMPRESSION: 1. No acute cardiopulmonary process. 2. Emphysema. " 091d7e6f-99636e13-b9ee957c-9750fcc4-49ca3ddc.jpg,test/p16/p16897596/s53339106/091d7e6f-99636e13-b9ee957c-9750fcc4-49ca3ddc.jpg,test," FINAL REPORT INDICATION: Cough, left lower lobe pneumonia. Evaluate for progression. COMPARISONS: Chest radiograph of ___. FINDINGS: There has been interval worsening of left lower lobe consolidation compared to ___. Right lung remains clear. The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: Interval worsening of left lower lobe pneumonia. " 5e3952ba-dfc683c0-b87f1433-dd856dd4-2a911a3c.jpg,test/p15/p15638790/s50997648/5e3952ba-dfc683c0-b87f1433-dd856dd4-2a911a3c.jpg,test," FINAL REPORT INDICATION: ___-year-old man with shortness of breath and unsteady gait, assess for acute process. TECHNIQUE: AP upright and lateral chest radiographs. COMPARISONS: ___. FINDINGS: Left-sided pacemaker device is seen with unchanged lead position. The lungs appear well expanded and clear. No focal consolidation, pleural effusion, or pneumothorax is seen aside from retrocardiac atelectasis. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " 564ad1e0-0d4f2faf-8ec900b6-19467a8b-8a0034ec.jpg,test/p11/p11873032/s56025418/564ad1e0-0d4f2faf-8ec900b6-19467a8b-8a0034ec.jpg,test," FINAL REPORT EXAM: Chest, single supine AP portable view. CLINICAL INFORMATION: Left IJ line placed. COMPARISON: None. FINDINGS: Single supine AP portable view of the chest was obtained. Left internal jugular central venous catheter is seen terminating at the brachiocephalic/SVC confluence without evidence of pneumothorax. The cardiomediastinal silhouette is enlarged. Perihilar opacities suggest pulmonary edema. There are small bilateral pleural effusions. IMPRESSION: 1. Left IJ terminates at the brachiocephalic/SVC junction without evidence of pneumothorax. 2. Cardiomegaly, pleural effusions, and pulmonary edema, suggest CHF, underlying infection not excluded. " b29f6bbd-a3830770-3d8a6bd4-a1f2514d-b8806310.jpg,test/p15/p15481018/s51850117/b29f6bbd-a3830770-3d8a6bd4-a1f2514d-b8806310.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with liver failure, p/w hepatic encephalopathy COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Low lung volumes limits assessment. There is mild bronchovascular crowding in the lower lungs. No convincing signs of pneumonia or edema. No large effusion or pneumothorax. The heart and mediastinal contours appear unchanged. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: As above. " f7eeccf2-e96d337b-2bade0df-bf4d9e10-ff9937d8.jpg,test/p18/p18534781/s51279763/f7eeccf2-e96d337b-2bade0df-bf4d9e10-ff9937d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure // ?acute intra pulm process, worsening atelectasis? ?acute intra pulm process, worsening atelectasis? IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The nasogastric tube is in constant position. Unchanged appearance of the lung parenchyma. Normal to borderline size of the cardiac silhouette. No focal parenchymal opacities. " d492e1a5-9d363aa4-6d84054b-b6f8d6ce-4099f239.jpg,test/p12/p12854165/s52822525/d492e1a5-9d363aa4-6d84054b-b6f8d6ce-4099f239.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Followup pulmonary edema status post diuresis. Comparison is made with prior study performed a day earlier. Mild-to-moderate pulmonary edema has improved. Persistent consolidation in the left perihilar region is consistent with pneumonia. Small bilateral pleural effusions are unchanged , allowing diference positioning of the patient. There are low lung volumes. Cardiomegaly is stable., " a45898be-7a277064-b3338345-c2044677-1b9cffa4.jpg,test/p14/p14954732/s53597344/a45898be-7a277064-b3338345-c2044677-1b9cffa4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath, history of fluid // eval for fluid TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is top normal. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Moderate size right pleural effusion is new from the previous radiograph with associated right basilar atelectasis. Left lung is clear. No pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Moderate size right pleural effusion with right basilar compressive atelectasis. " 57e6bbf9-3c99ecf1-835803d6-e3ed02c8-b88bd58a.jpg,test/p10/p10247690/s59506936/57e6bbf9-3c99ecf1-835803d6-e3ed02c8-b88bd58a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p CABG // eval for pleural effusions eval for pleural effusions IMPRESSION: Comparison to ___. Stable appearance of the mild to moderate left pleural effusion with subsequent retrocardiac atelectasis. Moderate cardiomegaly persists. Mild fluid overload but no overt pulmonary edema. No pneumothorax. " d45c3bb5-a38e49b0-280613f0-01d132f3-c3037142.jpg,test/p19/p19174686/s54241106/d45c3bb5-a38e49b0-280613f0-01d132f3-c3037142.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with renal failure, chf, LLL pneumonia // ck clearing of pneumonia and chf COMPARISON: ___ IMPRESSION: The pre-existing pulmonary edema has completely cleared. Also cleared is the pre-existing left lower lobe pneumonia. Currently, the lung parenchyma shows normal structure and transparency. Moderate cardiomegaly with elongation of the descending aorta. No pulmonary edema. Status post distal right clavicular resection. " 545f2e1e-9731d266-16abb2e8-351ef167-a7a60721.jpg,test/p15/p15503520/s50501130/545f2e1e-9731d266-16abb2e8-351ef167-a7a60721.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 9ec84e93-bc44ab7f-228709a0-29a44f6f-d34c237c.jpg,test/p19/p19988669/s59390014/9ec84e93-bc44ab7f-228709a0-29a44f6f-d34c237c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CT to WS // Please eval interval change COMPARISON: ___, 05:39 IMPRESSION: As compared to the previous radiograph, the extent of the pre-existing millimetric right apical pneumothorax is not substantially changed. There is no evidence of tension. The right chest tube is in unchanged position. Moderate cardiomegaly persists. No pulmonary edema. " f4f63777-6a8a6b60-d6cb0718-9256537a-2ca41831.jpg,test/p18/p18690742/s56844948/f4f63777-6a8a6b60-d6cb0718-9256537a-2ca41831.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___ year old man with fevers // eval for pna COMPARISON: Chest radiograph dated ___. FINDINGS: Exam is limited by the patient body habitus. Lung volumes are low. Increased interstitial markings reflects mild-to-moderate moderate moderate pulmonary edema. No definite focal consolidations suggest a large pneumonia in background of edema and limited exam. No effusion or pneumothorax. Minimal larger heart is also overall unchanged. IMPRESSION: Low lung volumes and moderate pulmonary edema. A superimposed pneumonia cannot be excluded with these limitations. RECOMMENDATION(S): Close follow-up with radiographs to exclude superimposed pneumonia if clinical concern is high. " 65ce1010-65fc7a62-53223cd9-f5e53201-9c98516e.jpg,test/p15/p15683293/s57985292/65ce1010-65fc7a62-53223cd9-f5e53201-9c98516e.jpg,test," FINAL REPORT INDICATION: ___M with syncope, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " c7257254-846b2079-30ee9465-a051b314-af3ead94.jpg,test/p10/p10634195/s54780408/c7257254-846b2079-30ee9465-a051b314-af3ead94.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with increased edema, evaluate for acute pulmonary process. COMPARISON: Chest radiograph ___. FINDINGS: AP upright and lateral views of the chest were obtained. There is no focal consolidation or pneumothorax. There is some redistribution of fluid into the upper lung zone vasculature. There is a small, probably left-sided pleural effusion with a subpulmonic component given that more is seen on the lateral than the frontal radiograph. Allowing for AP technique and low lung volumes, the heart is upper limits of normal for size. The mediastinal silhouette is normal. Degenerative changes are seen in the shoulder girdles bilaterally. IMPRESSION: Findings consistent with mild congestive heart failure. " da96c400-d2b6315c-aed61184-1b138287-0539562d.jpg,test/p10/p10677834/s57762183/da96c400-d2b6315c-aed61184-1b138287-0539562d.jpg,test," WET READ: ___ ___ ___ 7:00 PM No acute cardiopulmonary process. NG tube terminates in the stomach. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: ___F with SBO and NGT from outside hospital TECHNIQUE: Portable upright AP image of the chest COMPARISON: Comparison is made with CT torso from ___. FINDINGS: NG tube terminates in the stomach. Right port-a-cath terminates in the low SVC. Lung apices are not fully visualized on this exam. The visualized portions of the lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. NG tube terminates in the stomach. " 6e808da8-e822f4c2-077f8d35-65d3afda-1dde00ce.jpg,test/p14/p14359057/s59212869/6e808da8-e822f4c2-077f8d35-65d3afda-1dde00ce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MS, septic shock from likely urinary source // Evaluate for interval change Evaluate for interval change COMPARISON: Chest radiographs ___ and ___. IMPRESSION: ET tube, right subclavian line, are in standard placements. Nasogastric drainage tube passes below the diaphragm and out of view. Moderate to large left pleural effusion has increased. Moderate right pleural is also larger. The extent of bibasilar atelectasis is probably underestimated by this study. No pneumothorax. Normal cardiomediastinal silhouette. " 9c28a051-4737dad5-a7d39e99-e5c6369d-1c16a415.jpg,test/p12/p12105725/s51091693/9c28a051-4737dad5-a7d39e99-e5c6369d-1c16a415.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RLL pneumonia ___ // f/u RLL pneumonia COUGH;F/U RLL PNA IMPRESSION: In comparison with study of ___, there has been essentially complete clearing of the right lower lobe pneumonia. Continued hyperexpansion of the lungs, but no evidence of acute pneumonia or vascular congestion. " e348f6e5-b0a6dc38-de5e1cd4-5c743b02-096ad773.jpg,test/p13/p13004545/s51742409/e348f6e5-b0a6dc38-de5e1cd4-5c743b02-096ad773.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left upper extremity weakness, numbness, facial numbness, tingling TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Minimal atelectasis appears to be present in the left lung base. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Minimal left basilar atelectasis. Otherwise, no acute cardiopulmonary abnormality. " 2f925ec5-d81b73e2-42ad7a36-e039723e-78925ca9.jpg,test/p17/p17981107/s50063800/2f925ec5-d81b73e2-42ad7a36-e039723e-78925ca9.jpg,test," WET READ: ___ ___ ___ 1:04 AM Persistent LLL airspace opacity compatible with pneumonia, as seen ___. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Non-small-cell lung cancer, abdominal pain, shortness of breath. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes, borderline size of the cardiac silhouette. The known left lower lobe pneumonia is barely apparent on the frontal radiograph, but is better seen on the lateral radiograph. The extent of the pneumonia has minimally decreased, but is still clearly visible. Unchanged is a band-like parenchymal opacity emanating from the left hilus, at the level of the left upper lobe. In addition, on today's radiograph, a 1 cm rounded opacity has newly appeared in the right upper lobe, projecting over the ventral part of the second rib. Overall, notably given the clinical history of the patient, further short-term radiographic followup may be considered, as multifocal pneumonia, potentially combined with malignancy, as possible. At the time of observation and dictation, 8:05 a.m., the referring physician, ___. ___, was paged for notification on ___. " 1a2b96f6-03ad4812-ccda4ecd-9c5f3399-386613cb.jpg,test/p19/p19928728/s59259617/1a2b96f6-03ad4812-ccda4ecd-9c5f3399-386613cb.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with pneumonia. Evaluate for progression. FINDINGS: Comparison is made to previous study from ___. The spinal hardware is again identified. There is an endotracheal tube whose tip is low, 1.8 cm above the carina. This could be pulled back an additional 2-3 cm for more optimal placement. There is a left-sided central venous catheter with the distal lead tip in the mid SVC perpendicular to SVC wall, unchanged. There is a nasogastric tube whose side port is below the gastroesophageal junction. There is an area of consolidation at the right base which is more apparent than on the prior study. There is sclerosis of the left humeral shaft with some central lucency. If there is pain in the shoulder, then would recommend dedicated left shoulder radiographs. " da76662c-9a9dfaf6-b1e0458d-aa206c6c-4b4e7d96.jpg,test/p18/p18656167/s56792412/da76662c-9a9dfaf6-b1e0458d-aa206c6c-4b4e7d96.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with HIV, COPD, here with fever, SOB. // evaluate for infiltrate/consolidation COMPARISON: Chest radiographs ___. IMPRESSION: On the frontal view there is still some peribronchial opacification in the right lower lung, and on the lateral the suggestion of a focus of consolidation or even a lung nodule anterior to the lower thoracic spine. Oblique views are recommended to better interrogate the lung bases. Upper lungs are clear. The hilar contours and radiodensity are borderline abnormal but long times stable, and not of active concern for adenopathy. Heart size is normal and there is no pleural effusion. " bada27e9-f2c0a5cc-08546102-d28d2deb-814bc3ed.jpg,test/p13/p13793576/s57266510/bada27e9-f2c0a5cc-08546102-d28d2deb-814bc3ed.jpg,test," FINAL REPORT INDICATION: ___F with episodic chest pain, shortness of breath and reproducible pain on palpation of her lower ribs bilaterally in the mid axillary line. // Evidence of fracture or other intrathoracic process? TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. If high clinical concern for rib fracture, dedicated rib series could be performed. " 1a427af4-78c58b2b-3e002f71-2ab41f4b-916af394.jpg,test/p11/p11504637/s52307619/1a427af4-78c58b2b-3e002f71-2ab41f4b-916af394.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with wheezing and L sided rib pain with lying flat // r/o infiltrate r/o infiltrate IMPRESSION: In comparison study of new ___, there arm improved lung volumes but otherwise little change. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. No evidence of rib fracture or pneumothorax on the frontal view. " 586cfa69-ba36e108-0a07b47b-0015904d-3b247440.jpg,test/p15/p15514793/s50522856/586cfa69-ba36e108-0a07b47b-0015904d-3b247440.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HIV hx R sided empyema s/p decortication w/ cough // ?resolution of prior dx, new PNA? ?resolution of prior dx, new PNA? IMPRESSION: Heart size and mediastinum are stable. Right pleural effusion has improved. There is questionable left infrahilar opacity that if new O might represent a developing infectious process. No pneumothorax is seen. No other abnormality as compared to previous study demonstrated. If clinically warranted, correlation with chest CT to exclude the possibility of radiographically occult pneumonia is to be considered. " 619e7a1b-911eac64-eb4b724e-a0b08550-9ed1342b.jpg,test/p19/p19358609/s59002259/619e7a1b-911eac64-eb4b724e-a0b08550-9ed1342b.jpg,test," FINAL REPORT INDICATION: Patient with shortness of breath and cough. COMPARISONS: Chest radiograph of ___, CT chest of ___. FINDINGS: Frontal and lateral views of the chest demonstrate a stable postoperative appearance of the left hemithorax status post thoracoplasty. Right apical scarring persists. Right lung base opacity partially obscuring right hemidiaphragm is new since prior exam. Ill-defined left lung base opacity is also noted. No pleural effusion is seen. There is no pulmonary edema. Emphysema predominantly involving upper lung zones is unchanged. Hilar and mediastinal silhouettes are stable. Heart size is normal. Partially imaged upper abdomen is unremarkable. IMPRESSION: Bibasilar opacities are new since ___ exam, possibly atelectasis, aspiration, or infection in appropriate clinical setting. " 68ca65c1-dbbd25d4-e1cfdfd1-7b7910a8-3474abc2.jpg,test/p15/p15173403/s57770930/68ca65c1-dbbd25d4-e1cfdfd1-7b7910a8-3474abc2.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Possible right pneumothorax. IMPRESSION: AP chest compared to ___, 2:39 p.m.: There is a small right pneumothorax with components at the apex, and at the right base lateral to the pleural drainage tube, probably comparable in volume to 2:39 p.m. when the pleural air was more readily visible at the base of the right lung. Right rib fractures are substantially displaced. There is no appreciable right pleural effusion. Left lung is clear. Heart is mildly enlarged but unchanged and there is no pulmonary vascular abnormality. " 4a827705-309100fb-c74bbb48-69fce10b-23b13a15.jpg,test/p13/p13451992/s50531303/4a827705-309100fb-c74bbb48-69fce10b-23b13a15.jpg,test," FINAL REPORT INDICATION: ___ year old man with pulmonary hypertension, evaluate new line placement. TECHNIQUE: Multiple (8) sequential supine AP chest radiographs. COMPARISON: Chest x-ray ___ at 21:54. FINDINGS: Right PICC is re-identified with tip projecting over the mid SVC, unchanged. EKG leads over the chest. Sequential radiographs demonstrate repositioning of a newly inserted right IJ Swan-Ganz/PA catheter. Final image demonstrates the tip projecting over the expected location of the right lower lobar pulmonary artery. The cardiomediastinal silhouette is stable and within normal limits. The hila are unremarkable. There is central prominence of the pulmonary vasculature suggesting elevated pulmonary vascular pressures, with unchanged pulmonary interstitial edema. There is no focal lung consolidation. There is no pneumothorax or pleural effusion. IMPRESSION: 1. New Swan-Ganz catheter with final tip position projecting over the expected location of the right lower lobar pulmonary artery. 2. Unchanged pulmonary interstitial edema. " 41a87c9e-b29a9788-7236b104-e025af81-1865beb8.jpg,test/p19/p19745571/s57008523/41a87c9e-b29a9788-7236b104-e025af81-1865beb8.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Melanoma. There is moderate cardiomegaly. Small bilateral pleural effusions are new. They are of unclear etiology. There is no evidence of pulmonary edema or pneumonia. There is no evidence of large lung nodules or pneumothorax. Sternal wires are aligned. Patient is status post CABG. IMPRESSION: New small bilateral pleural effusions of unknown etiology. " 06d05fda-a9b43449-ec7151d9-3c740973-ad8e0f19.jpg,test/p16/p16849946/s50421475/06d05fda-a9b43449-ec7151d9-3c740973-ad8e0f19.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest and abdominal pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Patient is status post median sternotomy and CABG. Heart size is normal. The aorta is tortuous and diffusely calcified. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary abnormality. " 4c80bc0b-9332d2f0-f2d17869-25888d84-76444c31.jpg,test/p19/p19910173/s58011013/4c80bc0b-9332d2f0-f2d17869-25888d84-76444c31.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: There is moderate enlargement of cardiac silhouette. The aorta is tortuous. The pulmonary vascularity is not engorged. There is eventration of left hemidiaphragm. There is blunting of the left costophrenic angle on the frontal view suggestive of a small effusion or pleural thickening. No focal consolidation or pneumothorax is present. There are multiple old bilateral rib fractures. Multilevel degenerative changes are present within the thoracic spine. IMPRESSION: Blunting of left costophrenic angle could suggest a small pleural effusion or pleural thickening. No radiographic evidence for pneumonia or congestive heart failure. " 0d1fc8ca-23081d36-8c3befbe-14cc4a17-72e5ad36.jpg,test/p13/p13262041/s51204974/0d1fc8ca-23081d36-8c3befbe-14cc4a17-72e5ad36.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with s/p fall // acute process? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Chronic appearing bilateral rib deformities are noted. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal to mildly enlarged. There may be a hiatal hernia. IMPRESSION: No focal consolidation. Chronic appearing bilateral rib deformities. Top-normal to mildly enlarged cardiac silhouette. " 9a88da28-2e6a59c7-df510540-130e97ca-64ef5aac.jpg,test/p13/p13207128/s51922166/9a88da28-2e6a59c7-df510540-130e97ca-64ef5aac.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HFrEF and shortness of breath. evaluate for volume overload // r/o vascular congestion r/o vascular congestion COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Lungs are essentially clear. Loculation of right hemidiaphragm is demonstrated. There is no pleural effusion or pneumothorax. " 0c8acedf-8f6a54a8-da16941c-d934b0d2-0755ac7b.jpg,test/p18/p18026405/s50532055/0c8acedf-8f6a54a8-da16941c-d934b0d2-0755ac7b.jpg,test," WET READ: ___ ___ ___ 3:05 PM 1. Patchy bibasilar opacities may represent aspiration, atelectasis or pneumonia. 2. No evidence of fracture, limited by lack of localizing history. 3. Severe degenerative change at the right glenohumeral joint, unchanged. WET READ VERSION #1 ___ ___ ___ 9:42 AM 1. No focal consolidation. 2. No evidence of fracture limited by lack of localizing history. 3. Severe degenerative change at the right glenohumeral joint, unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with mechanical fall and productive cough // ?pneumonia, rib fracture TECHNIQUE: AP and lateral views. COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes are low. Patchy bibasilar opacities are noted. No pleural effusion. Severe degenerative change at the right glenohumeral joint. No displaced rib fracture is seen, but exam is limited by low lung volumes and AP technique. . IMPRESSION: 1. Patchy bibasilar opacities may represent aspiration, atelectasis or pneumonia. 2. No evidence of acute, displaced rib fracture or pneumothorax. 3. Severe degenerative change at the right glenohumeral joint, unchanged. RECOMMENDATION(S): Repeat chest radiograph with improved technique is recommended when the patient is clinically able. NOTIFICATION: The updated findings were discussed by Dr. ___ with Dr. ___ on ___ at 3:05 PM, 10 minutes after discovery of the findings. " 156155cd-10e8c855-5e37bb3c-722de359-14414367.jpg,test/p18/p18279430/s50757671/156155cd-10e8c855-5e37bb3c-722de359-14414367.jpg,test," FINAL REPORT INDICATION: ___ year old man with CHF, cirrhosis, ckd, s/p PEA arrest and hypothermia protocol, with SBP // assess for pulmonary edema COMPARISON: Compared to radiographs from ___ IMPRESSION: The previously seen support lines and tubes are unchanged in position. There has been placement of a new nasogastric tube whose distal tip and side port are below the GE junction. There is unchanged cardiomegaly. There is a persistent left retrocardiac opacity and left-sided pleural effusion which is stable. Atelectasis at the right lung base is also unchanged. There are no pneumothoraces. " d87fe212-bb4710e4-05c2c42e-48aa1c3f-4c44b8bd.jpg,test/p16/p16213706/s57594999/d87fe212-bb4710e4-05c2c42e-48aa1c3f-4c44b8bd.jpg,test," FINAL REPORT HISTORY: Dyspnea, rule out infiltrate or right heart failure. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: The patient is status post CABG, with sternotomy wires seen in proper alignment. As compared to prior examination dated ___, there has been no significant interval change. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. The heart is normal in size. Mediastinal contours are normal. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " d0a117c0-94a29ba2-7d691249-b3b8d2fb-2336529b.jpg,test/p18/p18938959/s52127356/d0a117c0-94a29ba2-7d691249-b3b8d2fb-2336529b.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Left mainstem narrowing, status post stent placement. Comparison is made with prior study of ___ and CT of ___. The cardiomediastinal contours are unchanged with widened mediastinum consistent with mediastinal lymphadenopathy. Hilar lymphadenopathy is better appreciated in pror CT ___. Left main bronchus stent is visualized. There is no pneumonia, pneumothorax, or pleural effusion. Solid and ground-glass nodules in the lungs are better seen in prior CT. " 8a6e7a7d-e05ebe7f-73dbb8fa-b81442ea-98c7e39d.jpg,test/p11/p11691967/s50296297/8a6e7a7d-e05ebe7f-73dbb8fa-b81442ea-98c7e39d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever, Crohn's flare COMPARISON: Prior exam is dated ___. FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low though allowing for this, no convincing signs of pneumonia, edema, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 19953095-6584108b-9b7f6171-036e6ca7-11607eec.jpg,test/p12/p12849577/s56666509/19953095-6584108b-9b7f6171-036e6ca7-11607eec.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with seizure, cough, fever. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___, ___, and ___. FINDINGS: Compared with the prior radiograph, lung volumes are lower causing bronchovascular crowding and accentuation of the cardiac silhouette. However, there is no new focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Low lung volumes, causing bronchovascular crowding. However, no definite focal consolidation concerning for pneumonia. " b8a5ea00-a711a6ba-854791e2-ab2df277-bbc24af0.jpg,test/p14/p14421594/s51089633/b8a5ea00-a711a6ba-854791e2-ab2df277-bbc24af0.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough for 5 months. See prior report. // Evaluate LUL opacity TECHNIQUE: Chest radiograph from ___ COMPARISON: Since ___, left upper lobe opacity has resolved. Given the low lung volumes, heterogeneous opacity in the left lower lung is atelectasis, lessl likely pneumonia. Lunds are otherwise clear. Small left pleural effusion is new. Normal size cardiac silhouette. Normal hilar and mediastinal structures. RECOMMENDATION(S): Full inspiration chest radiograph in 2 weeks . " d12517de-ad73df65-93c814b5-113f31c3-6b5f950d.jpg,test/p16/p16143265/s52661177/d12517de-ad73df65-93c814b5-113f31c3-6b5f950d.jpg,test," FINAL REPORT HISTORY: ___-year-old male transferred from an outside hospital carrying a diagnosis of fungal pneumonia; while at rehab, had worsening dyspnea on exertion and palpitations while walking; also bilateral lower extremity swelling. STUDY: AP upright and lateral chest radiograph. COMPARISON: None. FINDINGS: The heart size is slightly enlarged, possibly exaggerated by AP positioning. The mediastinal contours demonstrate calcified atherosclerotic disease of aortic knob and a mildly tortuous aorta. The lungs demonstrate mildly heterogeneous parenchyma with vascular congestion. Prominence of the interstitial markings is more prevalent on the left with more subtle airspace consolidation at the right base. Small bilateral pleural effusions are present. There is no pneumothorax. Additionally, the left PICC courses across midline into the right brachiocephalic vein. IMPRESSION: 1. Mild cardiomegaly with mild interstitial edema and small bilateral pleural effusions; subtle left lower lobe airspace opacity. The findings most likely represent mild pulmonary edema with a superimposed left lower lobe pneumonia. Comparison with prior imaging may be helpful. 2. Left PICC tip in right brachiocephalic vein; this finding was discussed with IV nurse ___ by ___ at 9:45 am on ___. " 8da987e7-ce813075-0b683311-22373800-8f7a64a3.jpg,test/p16/p16238427/s53806701/8da987e7-ce813075-0b683311-22373800-8f7a64a3.jpg,test," FINAL REPORT INDICATION: ___-year-old female with AICD, now presenting with productive cough and pain/swelling around the AICD incision site. COMPARISON: Chest radiograph from ___ PA AND LATERAL CHEST RADIOGRAPHS: An atrioventricular pacer/defibrillator device is in standard expected position. There is no pneumothorax. Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Cardiomediastinal and hilar contours are within normal limits and unchanged. IMPRESSION: No acute cardiopulmonary process. No pneumonia. " 2dd64e59-a975543d-7ca9560c-d7b57511-a8b80757.jpg,test/p11/p11572107/s59876421/2dd64e59-a975543d-7ca9560c-d7b57511-a8b80757.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest discomfort // PNA? COMPARISON: None available FINDINGS: There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " cc2f606c-74ca7eb0-54f53d1d-f4699453-9d96b0c7.jpg,test/p14/p14898854/s56370626/cc2f606c-74ca7eb0-54f53d1d-f4699453-9d96b0c7.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 262dc981-51bfe658-0f387245-29fa1904-33bbac5f.jpg,test/p17/p17473651/s53825297/262dc981-51bfe658-0f387245-29fa1904-33bbac5f.jpg,test," WET READ: ___ ___ 6:18 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with ams s/p fall unwitnessed // r/o intracranial hemorrhage vs c-spine fx vs pneumonia TECHNIQUE: AP and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is slightly enlarged. Opacity in the left posterior costophrenic angle compatible with previously identified Bochdalek's hernia. IMPRESSION: No acute cardiopulmonary process. " 6c97e9e3-489fb24c-65de0e87-7c3247a6-0db81c8f.jpg,test/p12/p12974096/s57959427/6c97e9e3-489fb24c-65de0e87-7c3247a6-0db81c8f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intubation for EGD // ETT placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient was intubated. The tip of the endotracheal tube projects approximately 2 cm above the carinal. No evidence of complications, notably no pneumothorax. The lung volumes are low. Moderate retrocardiac atelectasis. No pleural effusions. No pneumothorax. Mild over distension of the stomach. " b4471caa-f52cb32a-000e2590-55d80b51-c172ad81.jpg,test/p15/p15529967/s56451203/b4471caa-f52cb32a-000e2590-55d80b51-c172ad81.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever // ? consolidation ? consolidation IMPRESSION: Compared to chest radiograph, ___. New mild interstitial abnormality is probably edema, could be related to volume or blood product administration. Heart size is normal. No appreciable pleural effusion. No pneumothorax. " 4c20c9c5-19c50cae-9e1383a7-fd4b187c-cf8f7285.jpg,test/p11/p11142607/s58770935/4c20c9c5-19c50cae-9e1383a7-fd4b187c-cf8f7285.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal, and hilar contours are normal. Lungs are clear. Pulmonary vasculature normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 0e7807f6-04937b8e-ac237c79-1200da23-76b0b8e3.jpg,test/p14/p14177219/s57001920/0e7807f6-04937b8e-ac237c79-1200da23-76b0b8e3.jpg,test," FINAL REPORT INDICATION: Dyspnea in a patient on dialysis. Evaluate for pulmonary edema. COMPARISON: Chest radiograph, ___. PA AND LATERAL VIEWS OF THE CHEST: The lungs are clear. There is mild, stable cardiomegaly. There is no pneumothorax or pleural effusion. Mild pulmonary vascular engorgement is stable. IMPRESSION: 1. Stable mild cardiomegaly and stable pulmonary vascular engorgement. 2. No pneumonia or pulmonary edema. " 3efb3f1c-2a553a53-f0a475f0-2c9d9302-38da3428.jpg,test/p19/p19810919/s57668976/3efb3f1c-2a553a53-f0a475f0-2c9d9302-38da3428.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h.o asthma and smoking and nodule seen on last cxray. Reassessing // Assess for progression of nodule seen on prior cxray TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 5c59fc42-b9b917ac-33b879ff-a6aeb888-a38819b0.jpg,test/p18/p18599567/s50955445/5c59fc42-b9b917ac-33b879ff-a6aeb888-a38819b0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with polytauma, intubated, with PTX and hemothorax. // interval change? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is no change in appearance of the right hemithorax. The right chest tube is in situ. There is no evidence of a pneumothorax. The known right displaced rib fractures are constant in appearance. Increase left retrocardiac atelectasis with small left pleural effusion. The endotracheal tube and the nasogastric tube as well as the right central venous access line are in constant position. " d7be258f-ccf95fcd-27a7c1f3-5864e262-449eb004.jpg,test/p19/p19367040/s53655215/d7be258f-ccf95fcd-27a7c1f3-5864e262-449eb004.jpg,test," FINAL REPORT INDICATION: ___-year-old with dizziness. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear, the cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: No acute intrathoracic process. " 1846cd40-656c49e1-f30dcffb-bdb079b1-aa00a2cc.jpg,test/p12/p12833710/s52300088/1846cd40-656c49e1-f30dcffb-bdb079b1-aa00a2cc.jpg,test," FINAL REPORT HISTORY: Fall and syncope. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___ at 17: ___, performed at an outside institution, as well as ___ performed here. FINDINGS: There is persistent enlargement of the cardiomediastinal silhouette. Bilateral perihilar opacities are most consistent with pulmonary edema and a left pleural effusion persists. There is also mild blunting of the right costophrenic angle which may in part be due to overlying soft tissue, but trace right pleural effusion is not excluded. No evidence of pneumothorax is seen. The osseous structures are not well evaluated. IMPRESSION: Pulmonary edema and left pleural effusion. Persistent enlargement of the cardiomediastinal silhouette. " b1c14526-40c2efc7-1df4f5cc-b24ccec0-cc920883.jpg,test/p17/p17421663/s53139578/b1c14526-40c2efc7-1df4f5cc-b24ccec0-cc920883.jpg,test," FINAL REPORT INDICATION: ___-year-old male with traumatic subarachnoid hemorrhage with history of multifocal pneumonia. Assess for interval change. COMPARISON: Chest radiographs dating back to ___, most recent from ___. PORTABLE SEMI-ERECT FRONTAL CHEST RADIOGRAPH: An endotracheal tube, Dobbhoff feeding tube, left approach PICC are in unchanged standard position. There is no pneumothorax. Overall aeration of the lungs has significantly improved compared to prior examination from 6 hours prior. Given rapid clearing of diffuse opacities, findings are consistent with pulmonary edema. Small bilateral pleural effusions persist. IMPRESSION: Rapid clearing of diffuse opacities, findings consistent with improving pulmonary edema. " acaffd0f-7f128bba-97fb272b-85f6b55b-9b219092.jpg,test/p15/p15588831/s50655526/acaffd0f-7f128bba-97fb272b-85f6b55b-9b219092.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG // eval for pneumothorax s/p chest tube removal TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 08:17 IMPRESSION: Since the prior study there has been extubation of the patient, removal of the NG tube, left and right chest tubes. Heart size and mediastinum are stable in appearance. Left apical opacity is similar to previous examination. Although ___ appears to be unchanged since the most recent prior study, it has been present after the surgery and potentially be for a surgery and close attention to this area is recommended and potentially chest CT for pre size characterization of the finding. Subcutaneous air is noted but no overt pneumothorax is seen. Right internal jugular line tip is at the level of superior SVC " 697fd1a6-c251c52a-35d7d2b6-b9ee6947-1d36378a.jpg,test/p11/p11208426/s51134046/697fd1a6-c251c52a-35d7d2b6-b9ee6947-1d36378a.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with severe pancytopenia, desaturation, peristent cough. Patient with history of a non-small cell lung cancer with brain mets status post chemo. Comparison is made with prior study ___. Moderate bilateral pleural effusions have increased with increasing adjacent opacities, right greater than left, consistent with atelectasis. There is no pneumothorax. Cardiomediastinal contours are unchanged. Patient has known severe emphysema with marked distortion of the architecture. Left chest wall mass is better seen in prior CT with associated pleural thickening and erosion of left ribs . " 336a79a9-adda89f2-0f53299f-ec64d166-587d34bd.jpg,test/p16/p16750909/s55481182/336a79a9-adda89f2-0f53299f-ec64d166-587d34bd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma, former smoker, with increasing SOB, 02 ___ upon ambulation // r/o abnormality INCREASED COUGH AND SOB W/SOME CONGESTION,O2 SAT ___% W/AMBULATION HX ASTHMA,FORMER SMOKER R/O ABNORMALITY,INFILTRATE IMPRESSION: Compared to prior chest radiographs, since ___, most recently ___. Lungs are well expanded. Linear scarring or atelectasis in the lingula is new. Lungs otherwise clear. Normal cardiomediastinal and hilar contours and pleural surfaces. Mild to moderate thoracolumbar scoliosis has worsened slightly. " 71e25a4e-0a175a6c-fa7dca29-5f41e1e6-97481c93.jpg,test/p16/p16875549/s58201685/71e25a4e-0a175a6c-fa7dca29-5f41e1e6-97481c93.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CT torso from ___ and chest radiograph from ___. CLINICAL HISTORY: ___-year-old woman with colon cancer with chest pain. FINDINGS: PA and lateral views of the chest were provided. A chest wall Port-A-Cath is present with left subclavian venous access and tip in the SVC region. Lungs are clear. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. Heart and mediastinal contours are normal. No free air below the right hemidiaphragm. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " b7b998c2-d314d00a-ff17aeb8-17033fcd-18bf70e3.jpg,test/p12/p12390274/s56561557/b7b998c2-d314d00a-ff17aeb8-17033fcd-18bf70e3.jpg,test," WET READ: ___ ___ ___ 1:15 AM Pulmonary edema. Underlying consolidation is not excluded. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F w/ cough congestion eval for pneumonia // ___F w/ cough congestion eval for pneumonia TECHNIQUE: Chest AP and lateral COMPARISON: ___ FINDINGS: The lung volumes are low. The cardiac silhouette is enlarged, similar to the prior examinations. Prominence of the central pulmonary vasculature, indistinctness of the peripheral pulmonary vasculature is noted, most consistent with edema. Patchy bilateral opacities are likely related to edema as well, though underlying consolidation is not excluded. IMPRESSION: Pulmonary edema. Underlying consolidation is not excluded. " 0fb1cae4-5804060c-865f7068-5bee4709-89ae0af5.jpg,test/p16/p16642653/s58826742/0fb1cae4-5804060c-865f7068-5bee4709-89ae0af5.jpg,test," FINAL REPORT INDICATION: ___-year-old man with hypoxemia and hypotension. COMPARISONS: None. FINDINGS: A single portable erect chest radiograph was obtained. The lung volumes are low. There is an ill-defined retrocardiac opacity, which does not silhouette the left hemidiaphragm. Median sternotomy wires are intact. The aortic arch is calcified. IMPRESSION: Low lung volumes. Retrocardiac opacity likely represents atelectasis rather than focal consolidation. " 1a42cba1-f051ff4a-822fa560-eee8c334-078141be.jpg,test/p15/p15789182/s57551952/1a42cba1-f051ff4a-822fa560-eee8c334-078141be.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cough and chills*** WARNING *** Multiple patients with same last name! // ?pna TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 92259199-b3291ff1-bf3c7b28-0825bf38-69a04b58.jpg,test/p10/p10624836/s55179656/92259199-b3291ff1-bf3c7b28-0825bf38-69a04b58.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for pneumonia or cardiomegaly. COMPARISON: ___ FINDINGS: PA and lateral views of the chest were obtained. Cardiomediastinal silhouette is stable, allowing for differences in positioning and degree of inspiration. There is increased bibasilar opacification, compared to the prior film, which on subsequent ___ CTA chest corresponds to atelectasis. There is no frank consolidation, pleural effusion or pneumothorax. No pulmonary edema. IMPRESSION: No focal consolidation to suggest pneumonia. " df1bc2ef-23833df0-ec18dc5c-825964a8-8cddc82c.jpg,test/p13/p13092910/s58503381/df1bc2ef-23833df0-ec18dc5c-825964a8-8cddc82c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p MCC and R tib fib, femur fx s/p repair now w/ R IJ pulled back // Confirm R IJ CVL placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has been extubated and nasogastric tube was removed. The right internal jugular vein catheter was pulled back. The tip of the catheter now projects over the mid SVC. No evidence of complications, notably no pneumothorax. Left basal atelectasis. Otherwise unremarkable lung parenchyma. Borderline size of the cardiac silhouette. " bfbcc567-a673729a-ae3029f8-76431354-a8770561.jpg,test/p13/p13391297/s59934859/bfbcc567-a673729a-ae3029f8-76431354-a8770561.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with HTN, COPD // ?pneumonia. Decreased O2 (___%), increased cough, but sig coughing at baseline with severe COPD. No fever. Prior pneumonia ___ so which to make sure that infiltrate has resolved. COMPARISON: ___ FINDINGS: Lung volumes remain low, resulting and accentuation of the cardiomediastinal contours and crowding of bronchovascular structures at the lung bases. Within this context, predominantly linear bibasilar opacities probably reflect atelectasis. The previously demonstrated left lower lobe opacity has decreased in extent on the lateral view. No pleural effusion. IMPRESSION: Limited assessment due to low lung volumes. Probable bibasilar atelectasis. " 96cde8eb-ee1338fb-3e930211-a38a23b6-e14aa869.jpg,test/p17/p17284612/s56543922/96cde8eb-ee1338fb-3e930211-a38a23b6-e14aa869.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ET intubation and O2 desaturation // evaluate interval change evaluate interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Continued retrocardiac opacification is consistent with substantial volume loss in the left lower lobe and lingula and The cardiac silhouette again is enlarged with mild elevation of pulmonary venous pressure. Pleural effusion. " dc4bfc02-28573512-9b77531b-c9a46a34-603fe301.jpg,test/p11/p11252741/s54803456/dc4bfc02-28573512-9b77531b-c9a46a34-603fe301.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with aspiration pneumonia, followup. COMPARISON: ___. The ET tube tip is 3.5 cm above the carina. The left PICC line tip is at the level of mid SVC. Heart size and mediastinum are unchanged. Large pleural effusion is noted on the right and bibasal consolidations are unchanged as well. " 67095bb5-4ed1d424-7cca50af-6c96795f-f7a3897e.jpg,test/p16/p16142166/s57839372/67095bb5-4ed1d424-7cca50af-6c96795f-f7a3897e.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ COMPARISON: ___ chest radiograph. FINDINGS: Patient is status post recent median sternotomy and cardiovascular surgery. Stable post-operative enlargement of the cardiac silhouette. Improved bibasilar atelectasis and pulmonary vascular congestion compared to the prior radiograph, as well as a slight decrease in bilateral pleural effusions, left greater than right. Additionally, small loculated right lateral hydropneumothorax is apparently new compared to the prior radiograph of ___, but was clearly visible on earlier radiograph of ___. Lack of visibility on the ___ radiograph may be due to positional differences. " 2973c265-e2886c6f-5c673b1f-21a6b9e5-b2909ee0.jpg,test/p17/p17175688/s56154014/2973c265-e2886c6f-5c673b1f-21a6b9e5-b2909ee0.jpg,test," WET READ: ___ ___ 6:52 AM Mild pulmonary interstitial edema with persistent cardiomegaly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with SOB, hx of CHF. // Pulm edema? PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___ FINDINGS: There is mild central pulmonary vascular congestion and interstitial edema. No focal consolidation is identified. There is evidence of pneumothorax. A small right pleural effusion is possible. Cardiomegaly is stable. IMPRESSION: Mild pulmonary interstitial edema with persistent cardiomegaly. " 3479184f-fca34eb2-9861843a-09832778-028f1ce4.jpg,test/p19/p19588408/s52519338/3479184f-fca34eb2-9861843a-09832778-028f1ce4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: PICC line placement. COMPARISON: ___. FINDINGS: The patient has received a right PICC line. The course of the line is unremarkable, the line appears to terminate in the mid SVC. There is no evidence of complications, notably no pneumothorax. " fc6a7024-f4439873-3733acef-6bda21bb-875654e3.jpg,test/p17/p17964176/s59740772/fc6a7024-f4439873-3733acef-6bda21bb-875654e3.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with history of shortness of breath. Rule out pulmonary pathology. COMPARISON: ___. FINDINGS: PA & lateral views of the chest are provided. A left-sided Port-A-Cath is in unchanged position. There are no parenchymal opacificaties worrisome for an infectious process. Small opacity in the right upper lobe is a calcified granuloma per correlation with the CT. No evidence of pulmonary edema. No pleural effusion or pneumothorax. IMPRESSION: No evidence of pulmonary pathology. A urgent reading was requested by Dr ___, ___ the listed phone number continually was busy. No pager was in the ___ system for her. " 9350c65e-4e61a153-63ca6da7-54d6042c-29ad1505.jpg,test/p17/p17429491/s53185936/9350c65e-4e61a153-63ca6da7-54d6042c-29ad1505.jpg,test," WET READ: ___ ___ 7:56 PM No significant change from recent priors. Interval removal of the ET and NG tubes. Right base and right upper lung opacities appear similar to the initial exam on ___ and remain concerning for an infectious process. Left perihilar opacity appears similar. Small left pleural effusion is unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever despite tx for HCAP // r/o worsening/new PNA TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: There is new consolidation in the left lower lobe, concerning for in interval progression of left basal opacity. Right lung base appears to be overall unchanged. Small bilateral pleural effusions are present. Note is made that the comparison is slightly difficult on the patient is rotated to the opposite side as compared to the prior study. The right hilus is partially obscured by the rotation. The left perihilar mass is better appreciated on the recent chest CT from ___ " ca64aa5c-4c52d67d-ffda20eb-0abbf580-bad311c2.jpg,test/p16/p16949700/s55217081/ca64aa5c-4c52d67d-ffda20eb-0abbf580-bad311c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with mult MI, CABG, recent pea arrest and hypoxemic resp failure now with emesis, worsening SOB. // interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right basal opacity has progressed since the prior study, concerning for atelectasis or potentially superimposed infection. Left retrocardiac opacity is unchanged. No pleural effusion is seen. Alternatively giving the provided history of emesis, aspiration in the right lower lobe is another possibility and repeated radiograph in 12 hr might be considered " 1eebd314-0d59c125-92ee3056-69f41e67-cb04e8f5.jpg,test/p17/p17071916/s51479531/1eebd314-0d59c125-92ee3056-69f41e67-cb04e8f5.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man after motor vehicle collision. IMPRESSION: PA and lateral chest. Compared to ___, consolidation at the posterior base of the left lung laterally has improved, both in decrease in size by more than one-half and decrease in intensity of opacification. This is consistent with resolving aspiration or bleeding. The smaller areas of vague opacification in the upper lungs, at the level of the first through second ribs yesterday have almost entirely resolved. There is no pleural effusion, or pneumothorax. Cardiomediastinal silhouette is perfectly normal. Mild upper lumbar scoliosis is unchanged, not related to trauma. IMPRESSION: Clearing pulmonary hemorrhage or aspiration. " d4cdf80e-33cdf959-4595d655-df904bf9-2e092482.jpg,test/p18/p18264198/s59262417/d4cdf80e-33cdf959-4595d655-df904bf9-2e092482.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, intubation, new central line. COMPARISON: ___, 1:26 p.m. FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube is not included in the image. The patient has also received a new right internal jugular vein catheter. The course of the catheter is unremarkable, the tip of the catheter projects over the lower SVC. No evidence of complications, notably no pneumothorax. Better seen than on the previous image are areas of bilateral atelectasis as well as small bilateral pleural effusions. Borderline size of the cardiac silhouette. No pneumothorax. " 3e68a569-ea770fde-b55f3dbf-39453748-bd4fdf4d.jpg,test/p16/p16120959/s50622616/3e68a569-ea770fde-b55f3dbf-39453748-bd4fdf4d.jpg,test," FINAL REPORT INDICATION: Fever, chills, fatigue, and cough. COMPARISON: None. FINDINGS: PA and lateral views of the chest were obtained. The lungs are clear bilaterally with no evidence of focal consolidation or pulmonary edema. No pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. There is no evidence of free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 53de72cd-676330b6-b70542a4-f368ea4d-9673f90d.jpg,test/p19/p19295613/s59563814/53de72cd-676330b6-b70542a4-f368ea4d-9673f90d.jpg,test," FINAL REPORT INDICATION: ___F with asthma vs copd with dyspnea, not responsive to usual nebs // evaluate for acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: When compared to prior, there has been no significant interval change. Rib cage deformity and accentuated thoracic kyphosis are again seen limiting detailed evaluation of the lung parenchyma which is grossly clear. Cardiomediastinal silhouette is stable in configuration. IMPRESSION: No definite acute cardiopulmonary process. " b0947d2f-c756c6c6-ca3fed37-b5a9503f-c0e2dad7.jpg,test/p12/p12878814/s53721995/b0947d2f-c756c6c6-ca3fed37-b5a9503f-c0e2dad7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo man with lymphoma s/p cord blood transplant, with multiple complications including recent pneumonia during last admission. now with new sob and increased cough // ___ yo man with lymphoma s/p cord blood transplant, with multiple complications including recent pneumonia during last admission. now with new sob and increased cough COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pre-existing bilateral pleural effusions have not substantially changed. Increasing atelectasis in the retrocardiac lung regions and at the left lung basis. The well ventilated lung parenchyma shows no current evidence of pneumonia. Unchanged borderline size of the cardiac silhouette. Unchanged position of the right central venous access line. " 3352c341-da0b72ee-7588555f-811cab2b-dbdefd6d.jpg,test/p19/p19828353/s57396678/3352c341-da0b72ee-7588555f-811cab2b-dbdefd6d.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with agitation // evaluate for pneumonia COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. The lungs appear relatively clear without convincing signs of pneumonia or edema. No pleural effusion or pneumothorax is seen. The heart and mediastinal contours appear unchanged. There may be minimal hilar congestion. Bony structures appear grossly intact. IMPRESSION: As above. " 0cc680a8-197a81d9-726bf831-e037c2c1-f170609f.jpg,test/p15/p15491652/s50264094/0cc680a8-197a81d9-726bf831-e037c2c1-f170609f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia // r/o pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Right pectoral Port-A-Cath size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. Low lung volumes. No pleural effusions. No pneumonia. No pneumothorax. " a50e3ddf-ae6f70b4-9608c423-e3b409c6-e60960f6.jpg,test/p18/p18418794/s57496773/a50e3ddf-ae6f70b4-9608c423-e3b409c6-e60960f6.jpg,test," FINAL REPORT INDICATION: NG tube placement. PORTABLE CHEST RADIOGRAPH: The right costophrenic angle is excluded from the study, which is severely underpenetrated. A transesophageal catheter is present, extending to at least the level of the GE junction, however, the distal portion is difficult to assess due to underpenetration and overlying soft tissues. The lungs are underinflated. There is central pulmonary vascular congestion with mild-to-moderate pulmonary edema, with superimposed left basilar and right upper zone atelectasis. No pneumothorax is seen. IMPRESSION: Nasogastric tube extending to at least the level of the diaphragm; however, the exact termination point is difficult to assess. Repeat images could be obtained in non-portable setting with better penetration. The initial findings were discussed by Dr. ___ with Dr. ___ ___ telephone at 11:38 AM on ___. " b09114f2-0f0a1851-90dd08c2-ae9f553b-1fb1bdf5.jpg,test/p13/p13689440/s55676703/b09114f2-0f0a1851-90dd08c2-ae9f553b-1fb1bdf5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p avr // s/p ct removal s/p ct removal IMPRESSION: In comparison with the study of ___, the chest tubes have been removed, as has been the endotracheal nasogastric tube. Specifically, there is no evidence of pneumothorax. There are lower lung volumes but otherwise little change. " 7ba659bc-fe67d0c7-bb31e4f0-57a67cb9-7ca8742e.jpg,test/p16/p16132910/s53334168/7ba659bc-fe67d0c7-bb31e4f0-57a67cb9-7ca8742e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post bronchoscopy and EBUS, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have substantially increased, likely reflecting improved ventilation. There is the known 1.7-cm lung nodule at the left lung base. No pneumothorax is observed. Moderate tortuosity of the thoracic aorta. Borderline size of the cardiac silhouette without evidence of pulmonary edema. " 5e8f5834-f4fb82c4-f4eba5f6-49e33757-5b7e95f6.jpg,test/p18/p18799590/s50427203/5e8f5834-f4fb82c4-f4eba5f6-49e33757-5b7e95f6.jpg,test," FINAL REPORT INDICATION: Small-bowel obstruction. Evaluation of NG tube position. COMPARISON: ___. FINDINGS: Portable AP chest radiograph. NG tube tip and sidehole are well within the stomach. Lung volumes are low with crowding of the bronchovascular markings and bibasilar atelectasis. There is no large pleural effusion or pneumothorax. No distended air filled loops of small bowel are seen in the included portions of the abdomen. " abc33faf-b89967c2-5456748b-4486b210-685988a9.jpg,test/p17/p17334661/s54472921/abc33faf-b89967c2-5456748b-4486b210-685988a9.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Study of earlier the same date. FINDINGS: There is no evidence of pneumothorax or pneumomediastinum following recent bronchoscopy procedure. Cardiomediastinal contours are stable in appearance. Pulmonary vascular congestion has resolved. Left lower lobe atelectasis has slightly improved, but there is worsening atelectasis at the right lung base adjacent to a small-to-moderate pleural effusion. Small left pleural effusion is similar to the prior study. Note is made of marked gastric distention within the imaged portion of the upper abdomen. " da46f3e2-715bf072-e8aaa5e0-86e8d684-d20ec06f.jpg,test/p15/p15602738/s58753955/da46f3e2-715bf072-e8aaa5e0-86e8d684-d20ec06f.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old female; non-smoker; URI illness x 2 weeks; peristent cough and hoarseness. R/o consolidation, apical disease, nodules, hilar lymphadenopathy. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: Normal heart size, mediastinum, hila, and pleural surfaces. Lungs are clear without focal consolidation or effusion. IMPRESSION: No acute cardiopulmonary process. " 43a2a5b3-a1bb3ea2-331c0baa-5c65f0d0-9f6ef102.jpg,test/p11/p11047238/s56177088/43a2a5b3-a1bb3ea2-331c0baa-5c65f0d0-9f6ef102.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with shortness of breath and wheezing. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: Chest, portable. There is left lower lobe atelectasis. A more heterogeneous opacity in the right lower lobe with possible air-bronchograms is more suspicious for infection. The hilar and mediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Heterogeneous opacity in the right lower lobe with air-bronchograms may represent early pneumonia or atelectasis. " de214da7-64a9a62b-d3bcf679-d75f659a-c85bb7ff.jpg,test/p12/p12271567/s55197463/de214da7-64a9a62b-d3bcf679-d75f659a-c85bb7ff.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with sob // sob TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Reference made to chest CT from ___ FINDINGS: Blunting of the right costophrenic angle suggests a small right pleural effusion. Overlying right base opacity may be due to atelectasis however, infectious process is not excluded. There is likely left base atelectasis. Interstitial appearing opacity at the right lung apex with upward retraction of the right hilum likely consistent with postradiation change, as seen on chest CT from ___. IMPRESSION: New blunting of the right costophrenic angle raises concern for small right pleural effusion with overlying atelectasis. Right base consolidation is difficult to exclude. Likely left base atelectasis. Right upper hemi thorax post radiation change. " d42cd0c4-809f9435-c9d6ef27-e3a65ccd-1f01e45d.jpg,test/p12/p12194254/s50496817/d42cd0c4-809f9435-c9d6ef27-e3a65ccd-1f01e45d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with syncope, dyspnea on exertion x several days, tachycardia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " b120e88d-de6938ed-410056e6-3bd00e28-b1b35a2d.jpg,test/p18/p18677225/s53331152/b120e88d-de6938ed-410056e6-3bd00e28-b1b35a2d.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: Melanoma. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. " 482262cf-29211465-1f6e0fe0-6547e582-b5937faf.jpg,test/p18/p18014061/s50445037/482262cf-29211465-1f6e0fe0-6547e582-b5937faf.jpg,test," FINAL REPORT INDICATION: Nasogastric tube position. COMPARISON: Radiograph from ___. TECHNIQUE: Frontal chest radiograph. FINDINGS: There has been interval repositioning of the nasogastric tube, now terminating within the stomach. The right-sided IJ catheter terminates at the cavoatrial junction. There is no pneumothorax, focal consolidation, pleural effusion, or pneumoperitoneum. IMPRESSION: Nasogastric tube terminating within the stomach. " c597c7d6-54334e24-ee44ea66-27c72f3b-ee4f560f.jpg,test/p15/p15245907/s59216102/c597c7d6-54334e24-ee44ea66-27c72f3b-ee4f560f.jpg,test," WET READ: ___ ___ ___ 8:07 PM Since the prior study, the patient has been intubated, with the endotracheal tube terminating 4.9 cm above the carina. There are persistent signs of mild decompensated congestive heart failure but atelectasis at the left lung base has improved with mechanical ventilation. The size of the effusion is likely unchanged and appears more diffuse due to supine positioning. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB // intubation, SOB TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study, the patient has been intubated, with the endotracheal tube terminating 4.9 cm above the carina. There are persistent signs of mild decompensated congestive heart failure but atelectasis at the left lung base has improved with mechanical ventilation. The size of the effusion is likely unchanged and appears more diffuse due to supine positioning. " be34527b-fe7f755d-6a2ca3aa-89a3d2e2-cb0bb8f5.jpg,test/p19/p19736038/s58479206/be34527b-fe7f755d-6a2ca3aa-89a3d2e2-cb0bb8f5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with left pleural effusion, s/p chest tube placement. Please perform ___ AM. // Evaluate chest tube, interval change in pleural effusion Evaluate chest tube, interval change in pleural effusion IMPRESSION: Comparison to ___. Stable position of the left-sided chest tube. Stable extent of the pre-existing left pleural effusion. No change in appearance of the normal right lung. " 17fee288-fc5e3859-2518f371-8f3fb1e2-4830c512.jpg,test/p10/p10751964/s58972710/17fee288-fc5e3859-2518f371-8f3fb1e2-4830c512.jpg,test," FINAL REPORT INDICATION: An ___-year-old woman with diastolic congestive heart failure, presenting with dizziness, lightheadedness and new oxygen requirement. Evaluate for pneumonia or CHF exacerbation. COMPARISON: ___. FINDINGS: A frontal upright view of the chest was obtained portably. Increased bilateral opacities, in the setting of cardiomegaly, are most likely due to congestive heart failure. There are probably small bilateral pleural effusions. There is no pneumothorax. Heart size is similar to the prior study. The patient is status post median sternotomy with an unchanged fractured upper sternal wire. No acute osseous abnormality is identified. Degenerative changes in the shoulder girdles are noted bilaterally. Increased densities projecting over the right upper quadrant are likely external to the patient. Left PICC line has been removed in the interim. IMPRESSION: Findings compatible with congestive heart failure. Underlying infection cannot be excluded. Recommend repeat radiograph after treatment. " fa189f84-f2993401-d62cb991-0df5c118-da498c21.jpg,test/p15/p15874317/s51840765/fa189f84-f2993401-d62cb991-0df5c118-da498c21.jpg,test," FINAL REPORT HISTORY: Weakness and palpitations. COMPARISON: ___. FINDINGS: PA and lateral radiographs of the chest demonstrate a left chest wall pacemaker generator with appropriately positioned right atrial and ventricular leads. Cardiac size is normal. Hilar and mediastinal contours are within normal limits, and a calcified aortic knob is seen. The lungs are clear and mildly hyperinflated. No pleural effusion or pneumothorax. Mild biapical scarring is noted. IMPRESSION: No acute cardiopulmonary process. " 3b1c1db2-9814082d-7f5da7f0-f1046b3b-d1ee01e4.jpg,test/p17/p17055354/s58402630/3b1c1db2-9814082d-7f5da7f0-f1046b3b-d1ee01e4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea on exertion, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Unchanged low lung volumes with areas of atelectasis at both lung bases. No interval appearance of pneumonia. No pleural effusions. Unchanged left pectoral pacemaker, unchanged borderline size of the cardiac silhouette, without pulmonary edema. " 401ce663-52382d55-ffebde14-7ec4d64e-e22efc77.jpg,test/p17/p17544092/s53217468/401ce663-52382d55-ffebde14-7ec4d64e-e22efc77.jpg,test," WET READ: ___ ___ 3:33 PM bibasilar opacities, could be atelectasis, consolidation, aspiration/infection/contusion not excluded. possible trace pleural effusion. loss of height of the superior endplate of at least one lower thoracic vertebral body of indeterminate age, no priors for comparison. if concern for acute injury, CT is more sensitive. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Status post fall. COMPARISON: None. FINDINGS: PA and lateral views of the chest were obtained. There are streaky bibasilar opacities which could be due to atelectasis; however, underlying consolidation from aspiration, contusion or infection are possible and not excluded. No large pleural effusion is seen, although difficult to exclude trace pleural effusion, particularly on the right. The cardiac silhouette is mildly enlarged. The aorta is tortuous. There is mild-to-moderate loss of height of the superior endplate of at least one lower thoracic vertebral body of indeterminate age (no priors available for comparison). There may be subtle minimal loss of height of the superior endplate of the vertebral body just inferior to this. IMPRESSION: 1. Loss of height of superior endplate of the lower thoracic vertebral body of indeterminate age, no priors for comparison. In the setting of trauma, if clinical concern for acute injury, CT is more sensitive. 2. Streaky bibasilar opacities could relate to atelectasis; however, consolidation due to aspiration, infection or even pulmonary contusion not excluded. " 65160f2d-2cbff495-a55f5491-a94ee043-00f11056.jpg,test/p16/p16059088/s58674280/65160f2d-2cbff495-a55f5491-a94ee043-00f11056.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Outside hospital, diarrhea, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The massive parenchymal opacities are constant in extent and distribution. Lung volumes remain low. The monitoring and support devices are constant. " 1732e4e3-9d7c5ba7-ea44f4f2-7b702f30-f85c2c48.jpg,test/p13/p13327132/s57590747/1732e4e3-9d7c5ba7-ea44f4f2-7b702f30-f85c2c48.jpg,test," WET READ: ___ ___ ___ 1:34 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT HISTORY: COPD now presenting with shortness of breath. Evaluate for pneumonia. COMPARISON: Chest radiograph ___ and ___. Chest CT ___. FINDINGS: Frontal and lateral views of the chest (4 exposures). Relative increase in lucencies within the lung apices is consistent with known emphysema. Bibasilar opacities appear similar to prior and are presumably vessels and atelectasis. There is no focal airspace consolidation that is worrisome for pneumonia. There is no pleural effusion or pneumothorax. Blunting of the left costophrenic sulcus may reflect scarring and is unchanged. The heart size is normal and there is no evidence for pulmonary edema. The mediastinal structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 50174d0f-2558bcf2-28dc500b-7ed0d72a-cb1122d0.jpg,test/p19/p19475214/s50795646/50174d0f-2558bcf2-28dc500b-7ed0d72a-cb1122d0.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Fever to 101.3, cough, body aches, question pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion, or pneumothorax. The heart is top normal in size. Mediastinal contour is normal. Bony structures intact. IMPRESSION: No signs of pneumonia. Borderline cardiomegaly. " f4296e9a-c36fc1a8-06ddaf5c-c2ad6ef4-2536d981.jpg,test/p19/p19020074/s54509139/f4296e9a-c36fc1a8-06ddaf5c-c2ad6ef4-2536d981.jpg,test," FINAL REPORT HISTORY: Nausea and vomiting. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: The heart is of normal size with normal cardiomediastinal contours. There is calcification of the aortic knob. Lung volumes are low, exaggerating bronchovascular markings. Blunting of the right costophrenic angle may represent a small pleural effusion. No focal consolidation or pneumothorax. No radiopaque foreign body. Osseous structures are unremarkable. IMPRESSION: Small right pleural effusion. No focal consolidation. " 2a60b651-e638f6ac-c0a7d363-fc3af637-3e63a81c.jpg,test/p14/p14216395/s50238846/2a60b651-e638f6ac-c0a7d363-fc3af637-3e63a81c.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough, fever, hx of asthma and on IVIG therapy // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well expanded and clear. The hila and pulmonary vasculature are normal. No pleural abnormalities. No pneumothorax. The cardiomediastinal silhouette is normal. No fractures. IMPRESSION: Normal chest radiograph. " fb66503a-c5e774de-13b6b8b3-13fbb852-ba304d1d.jpg,test/p10/p10918745/s53591341/fb66503a-c5e774de-13b6b8b3-13fbb852-ba304d1d.jpg,test," FINAL REPORT HISTORY: Female with NG tube that was reinserted after slipped out. Assess NG tube placement. COMPARISON: Chest radiograph, ___, ___. TECHNIQUE: Single portable frontal chest radiograph. FINDINGS: NG tube ends in stomach with side ports approximately 2 cm below the left hemidiaphragm. Mild increase in left lower lobe atelectasis with low lung volumes bilaterally. No additional focal opacity, pulmonary edema, pleural effusion or pneumothorax. Heart size, mediastinal contours and hila are otherwise normal. No bony abnormality. IMPRESSION: 1. NG tube with tip in stomach and side ports near but below the gastroesophageal junction. Consider advancing 3 cm to prevent risk of aspiration. 2. Mild increase in left lower lobe atelectasis. " 10b65c02-4a30d5eb-2f49bce8-6adac010-292d8eda.jpg,test/p16/p16779923/s50797260/10b65c02-4a30d5eb-2f49bce8-6adac010-292d8eda.jpg,test," FINAL REPORT HISTORY: Fatigue, lower extremity edema. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. There are mild atherosclerotic calcifications of the aortic knob. The pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Moderate multilevel degenerative changes are visualized in the thoracic spine. Clips from prior cholecystectomy are seen in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary process. " 482ed184-497cb29f-e8fd458c-28f036fc-bdadc7ce.jpg,test/p12/p12519472/s51209679/482ed184-497cb29f-e8fd458c-28f036fc-bdadc7ce.jpg,test," FINAL REPORT INDICATION: History of CHF. Post-op day 1 from ORIF with hypoxia. COMPARISONS: Chest radiograph ___. CT cervical spine ___. FINDINGS: Again, there is mild interstitial prominence, slightly improved from the prior exam. This likely represents mild pulmonary edema. Trace bilateral pleural effusions are unchanged. There is no consolidation or pneumothorax. The mediastinal contours are unchanged. Again, the trachea is deviated rightward, due to a known thyroid nodule identified on the CT of the cervical spine. The heart is moderately enlarged, and unchanged from the prior exam. A gas bubble in the retrocardiac area is likely due to a hiatal hernia. A large soft tissue prominence over the right shoulder is likely a hematoma. IMPRESSION: 1. Mild pulmonary edema, slightly improved from the prior exam. 2. Stable moderate cardiomegaly. 3. Retrocardiac gas bubble is likely due to a hiatal hernia. " 1be2dea6-c686b565-0d1eaaf5-840ede3c-74a115a2.jpg,test/p16/p16700191/s51451270/1be2dea6-c686b565-0d1eaaf5-840ede3c-74a115a2.jpg,test," FINAL REPORT INDICATION: ___ year old woman with daily cough on Humira. // ? cadiopulmonary disease TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral views the chest demonstrate well expanded clear lungs. The cardio mediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. Note is made of calcified atherosclerotic plaque in the aortic arch and right carotid artery. IMPRESSION: No acute cardiopulmonary process. " 8325b579-f4c6a1fd-bd5ebe1b-8165100e-0fe47ce9.jpg,test/p19/p19911133/s55359755/8325b579-f4c6a1fd-bd5ebe1b-8165100e-0fe47ce9.jpg,test," FINAL REPORT PORTABLE CHEST FILM ___ AT 4:02 A.M. CLINICAL INDICATION: ___-year-old with heart failure, hypoxia, fever, question pulmonary edema versus pneumonia. Comparison is made to the patient's previous study dated ___ at ___. A portable semi-erect chest film ___ at 4:02 a.m. is submitted. IMPRESSION: 1. Right internal jugular central line unchanged in position. A left-sided pacemaker unchanged. The heart remains enlarged. Mediastinal contours are stable. There is persistent retrocardiac consolidation and a layering effusion. The airspace consolidation most likely represents partial lower lobe atelectasis, although pneumonia or aspiration cannot be entirely excluded. Streaky opacities at the right base likely reflect patchy atelectasis, although aspiration should also be considered. No pulmonary edema. No pneumothorax. " 35b1aceb-c5f6e4d4-4937106c-a77275f2-26027abf.jpg,test/p16/p16014438/s58826476/35b1aceb-c5f6e4d4-4937106c-a77275f2-26027abf.jpg,test," WET READ: ___ ___ ___ 1:04 AM Interval improvement of the opacity in the right mid lung. WET READ VERSION #1 ___ ___ ___ 10:52 PM A subtle opacity in the right midlung is improved from ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with productive cough, recent PNA // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. A subtle opacity in the right midlung on prior is no longer visualized. There is no effusion or pneumothorax. No acute osseous abnormalities. IMPRESSION: Interval improvement of the opacity in the right mid lung which is now no longer seen. " cadf2aeb-e9871dde-648f130b-bcbe00d4-901f6b85.jpg,test/p18/p18124415/s57908167/cadf2aeb-e9871dde-648f130b-bcbe00d4-901f6b85.jpg,test," FINAL REPORT HISTORY: ___-year-old male with dyspnea, fever and chills. COMPARISON: None available FRONTAL AND LATERAL CHEST RADIOGRAPHS: Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax. IMPRESSION: No acute cardiopulmonary process " 89fd7005-d3eeac77-462df5fd-a9ec56ff-0aa83f17.jpg,test/p11/p11648387/s57225591/89fd7005-d3eeac77-462df5fd-a9ec56ff-0aa83f17.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with history of CF and bronchiectasis here with chest pain// ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CTA chest ___ FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unchanged. Lungs are hyperinflated without focal consolidation. Bronchiectasis within the lung bases and previously seen scattered inflammatory pulmonary nodules are better appreciated on the prior CT. Patchy atelectasis or scarring is noted in both lung bases without focal consolidation. No pleural effusion or pneumothorax is present. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " cb945367-94761f05-28ec6808-0e98ffb2-2f944305.jpg,test/p10/p10336855/s57170426/cb945367-94761f05-28ec6808-0e98ffb2-2f944305.jpg,test," WET READ: ___ ___ 5:27 PM 1. No evidence of pneumonia. 2. Mild-to-moderate cardiomegaly without central vascular congestion or overt pulmonary edema could represent cardiomyopathy or pericardial effusion. Recommend correlation with patient history and physical exam findings. WET READ VERSION #1 ___ ___ 5:08 PM 1. No evidence of pneumonia. 2. Severe cardiomegaly without central vascular congestion or overt pulmonary edema could represent cardiomyopathy or pericardial effusion. Recommend correlation with physical exam findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with recurrent seizures, somnolent, snoring // eval ? acute process, aspiration TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None provided. FINDINGS: Lung volumes are normal. No focal consolidation, large effusion or pneumothorax. There is no central vascular congestion or overt pulmonary edema. Mediastinal and hilar contours are normal. Mild cardiomegaly. Mild calcification of the aortic knob is noted. IMPRESSION: 1. No evidence of pneumonia. 2. Mild cardiomegaly. " 0ac8e91f-d63aed3c-422d56e1-546640a7-81b7426a.jpg,test/p13/p13299285/s54972444/0ac8e91f-d63aed3c-422d56e1-546640a7-81b7426a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with bilateral pleural effusion after bilateral thoracocentesis with increased shortness of breath. AP radiograph of the chest was reviewed in comparison to ___. The left PICC line tip terminates at the level of low SVC. Heart size and mediastinum are stable in appearance. There is interval improvement of pulmonary edema. Bilateral pleural effusions are present, small. No definitive evidence of pneumothorax is present. " 11ff4bb7-0c27aff7-4815bf1d-42c16ff6-e8d7ac8e.jpg,test/p10/p10646211/s53700548/11ff4bb7-0c27aff7-4815bf1d-42c16ff6-e8d7ac8e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " cc7b8e1f-7ddae921-3326c55e-50bae94b-4e8eaa76.jpg,test/p16/p16319384/s59964362/cc7b8e1f-7ddae921-3326c55e-50bae94b-4e8eaa76.jpg,test," FINAL REPORT HISTORY: Dyspnea, history of congestive heart failure. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size remains moderately enlarged but unchanged. The aortic knob is diffusely calcified. Pulmonary vascularity is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes within the thoracic spine. Surgical clip is seen within the upper abdomen on the lateral view. IMPRESSION: No acute cardiopulmonary abnormality. " 850258c8-384ddeb2-1fb625ae-fcf44829-c639410c.jpg,test/p16/p16428118/s50827111/850258c8-384ddeb2-1fb625ae-fcf44829-c639410c.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pneumonia, intubated. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is approximately 4 cm above the carina. The right internal jugular line tip is at the mid SVC. The NG tube passes below the diaphragm, not clearly seen on the current study. Bibasilar atelectasis, mild pleural effusion and pulmonary edema appear progressed as compared to prior examinations from ___ and ___. Left lower lobe atelectasis is better assessed on CT torso from ___. " cb7132b2-915de7fa-90ad0d70-160f57d7-37a8d0a7.jpg,test/p18/p18116283/s58795160/cb7132b2-915de7fa-90ad0d70-160f57d7-37a8d0a7.jpg,test," FINAL REPORT INDICATION: Fever and cough. Assess for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary findings. " d3d08cf4-4d8bb1a9-9eabfd04-048cc83c-5e5b7b74.jpg,test/p13/p13487147/s51276146/d3d08cf4-4d8bb1a9-9eabfd04-048cc83c-5e5b7b74.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with fall, rib fx pls eval hemo/ptx COMPARISON: None FINDINGS: AP portable upright and lateral view of the chest. Midline sternotomy wires and mediastinal clips are noted. Retrocardiac opacity is noted concerning for a large hiatal hernia. Right lung is clear. Left lower lung atelectasis is noted. No pneumothorax. No congestion or edema. Mediastinal contour is normal. Cardiac silhouette appears grossly within normal limits. There is subtle cortical irregularity involving the left tenth post for lateral rib arch. No free air below the right hemidiaphragm. IMPRESSION: Large hiatal hernia with left basal atelectasis. Possible left tenth posterior lateral rib fracture. Please correlate clinically. " ec4d9b72-eecef49d-ff8c224a-7a785c92-de47bbd1.jpg,test/p15/p15751809/s55238343/ec4d9b72-eecef49d-ff8c224a-7a785c92-de47bbd1.jpg,test," WET READ: ___ ___ 8:15 PM Low lung volumes and placement of a left-sided chest tube. No discrete pneumothorax is identified. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man chest tube placement for anterior spinal fusion. // chest tube placement/?pneumothorax chest tube placement/?pneumothorax COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Lungs are essentially clear with bibasal atelectasis. Left chest tube is in place. No pneumothorax is seen. " 7cdd3314-12c8a82e-3dab5e0f-06343beb-ad53ee43.jpg,test/p16/p16233333/s55233179/7cdd3314-12c8a82e-3dab5e0f-06343beb-ad53ee43.jpg,test," FINAL REPORT INDICATION: History of HIV, off meds one month ago, evaluate for acute process. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion or pneumothorax. The trachea is slightly deviated to the left suggesting an enlarged right lobe of the thyroid. The cardiomediastinal silhouette is normal. Note that the posterior spine is not included on the lateral image. The bones are intact. IMPRESSION: 1. No acute cardiopulmonary process. 2. Possible right thyroid enlargement which can be further evaluated by ultrasound. " 06a14fd9-8f89607b-b20836e4-7b3477f4-8434d888.jpg,test/p15/p15693523/s52654474/06a14fd9-8f89607b-b20836e4-7b3477f4-8434d888.jpg,test," FINAL REPORT INDICATION: ___M with lung ca // cough TECHNIQUE: Frontal lateral views of the chest. COMPARISON: Chest CT from ___. FINDINGS: Better delineated on recent CT scan is a left hilar mass compatible with patient's known malignancy with complete left lower lobe collapse is again seen. Scattered opacity in the aerated left upper lobe are compatible with opacity seen on recent CT. The right lung is grossly clear. Mediastinal shift to the left is as seen on prior. Left chest wall dual lead pacing device and right Port-A-Cath are again seen. Widespread metastatic disease is better seen on prior CT scan. IMPRESSION: No significant interval change noting left perihilar mass with subsequent left lower lobe collapse and opacities in the aerated left upper lobe. " 80054a6f-9151cdf2-c8623b8d-12e5dda7-44f8ba19.jpg,test/p16/p16124672/s51977120/80054a6f-9151cdf2-c8623b8d-12e5dda7-44f8ba19.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with shortness of breath. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 8d14ba8b-9bae1265-b653472a-ac3a1bf3-f8c1a3ec.jpg,test/p13/p13276258/s55005978/8d14ba8b-9bae1265-b653472a-ac3a1bf3-f8c1a3ec.jpg,test," FINAL REPORT INDICATION: ___-year-old male with right internal jugular line placement, evaluate for placement. COMPARISON: Chest radiograph from ___ and ___. ONE VIEW OF THE CHEST: The lungs are well expanded and show diffuse multifocal airspace opacities. A right IJ catheter is noted in appropriate position. No definite pneumothorax is present. The cardiomediastinal silhouette is normal. The hilar contours are not well evaluated. IMPRESSION: Multifocal airspace opacities are mildly progressed and likely represent a combination of known metastatic disease and mild to moderate pulmonary edema although super-infection, particularly in the right upper lobe, cannot be excluded. Appropriate position of right IJ line. " 8639d053-f238d674-a1346942-6f83ca8f-0dc49cb1.jpg,test/p18/p18612446/s53210338/8639d053-f238d674-a1346942-6f83ca8f-0dc49cb1.jpg,test," WET READ: ___ ___ ___ 11:22 PM No acute cardiopulmonary process. Known pulmonary nodules should be followed as recommended on prior report. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with DOE // ?cause of DOE TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. Known pulmonary nodules are not clearly delineated by x-ray. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. Known pulmonary nodules should be followed as recommended on prior report. " 791abda2-e7caf79e-2594729a-616189bb-420f090a.jpg,test/p15/p15160240/s56217047/791abda2-e7caf79e-2594729a-616189bb-420f090a.jpg,test," FINAL REPORT HISTORY: ___-year-old female with pulsatile tender neck mass on the right. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without consolidation, effusion, or pulmonary vascular congestion. Cardiomediastinal silhouette is unremarkable. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 0ccd7eaf-4457a1d7-2d215366-56bed798-1feedf91.jpg,test/p17/p17425991/s53350615/0ccd7eaf-4457a1d7-2d215366-56bed798-1feedf91.jpg,test," WET READ: ___ ___ ___ 10:56 PM No acute intrathoracic abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever, mild cough, PNA?, recent prostate surgery // fever, mild cough, PNA? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 84c73612-d96b91cd-ec3adb3e-18d42479-5f220d5e.jpg,test/p16/p16696931/s56619707/84c73612-d96b91cd-ec3adb3e-18d42479-5f220d5e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with wheezing, cough // Eval PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is noted with mild pulmonary edema. No large effusion or pneumothorax. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Cardiomegaly with mild pulmonary edema. " d058b81b-2d91cf07-4a9625d5-40409808-63707893.jpg,test/p18/p18618133/s54745529/d058b81b-2d91cf07-4a9625d5-40409808-63707893.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia, pulm edema and pleural effusion // eval for interval change in pulm edema, pleural effusion IMPRESSION: As compared to ___ chest radiograph, pulmonary edema has decreased in severity with residual asymmetrical edema worse on the right than the left. Moderate right pleural effusion has apparently increased in size, although positional differences limit comparison. Worsening bibasilar opacities are likely a combination of atelectasis and effusion although other secondary process such as infection is not excluded in the appropriate clinical setting. " ecb42ea7-75c23516-673469ec-c0c59296-2ca20a28.jpg,test/p12/p12176298/s56344495/ecb42ea7-75c23516-673469ec-c0c59296-2ca20a28.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient is status post right upper lobectomy for squamous cell Ca. Comparison is made with prior study, ___. There has been interval worsening in opacification in the right hemothorax that is a combination of increasing unknown amount of pleural effusion and lung collapse. The cardiomediastinal contours are midline. Mild-to-moderate diffuse interstitial abnormality in the left lower lobe is stable. Patient has known emphysema. Sternal wires are aligned. Multiple surgical clips are again noted in the right upper mid thorax and right hilum. Skin ___ project in the right mid hemithorax. " 5bb5376d-c8a7f423-723eeba2-2d718533-ff9aa4bd.jpg,test/p14/p14044629/s54997848/5bb5376d-c8a7f423-723eeba2-2d718533-ff9aa4bd.jpg,test," FINAL REPORT HISTORY: Pericardiectomy. FINDINGS: In comparison with the study of ___, there are low lung volumes following the procedure, but no evidence of pneumothorax. Endotracheal tube is now in place with the tip at the upper clavicular level, approximately 4.7 cm above the carina. The increased prominence of the transverse diameter of the heart most likely reflects the low lung volumes. No definite pneumonia, vascular congestion, or pleural effusion. Right IJ sheath extends to the upper clavicular level. " bd7f6a16-4c76822e-562b709c-098ed10e-73453483.jpg,test/p14/p14546769/s55834391/bd7f6a16-4c76822e-562b709c-098ed10e-73453483.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with lt sided upper back pain with previous PTX // evaluate for PTX COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Slight blunting at the left lateral lung base likely represents mild pleural thickening. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. Specifically, no pneumothorax. " 69b405b7-22dcfcd5-9ec37cf2-59736c7c-e890d475.jpg,test/p14/p14679533/s58242624/69b405b7-22dcfcd5-9ec37cf2-59736c7c-e890d475.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: ICD, lead placement, evaluation for pleural effusions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the external pacemaker lead that the patient has recently received is in unchanged position. Also unchanged is the left chest tube. The blunting of the left costophrenic sinus is less severe than on the previous image, this is likely reflecting a decrease in extent of pleural effusion. Mild cardiomegaly persists. No pneumonia, no pulmonary edema. " 0ebfea17-388d6e3e-19b4850d-4da084f8-0088c1c3.jpg,test/p16/p16826047/s50453673/0ebfea17-388d6e3e-19b4850d-4da084f8-0088c1c3.jpg,test," FINAL REPORT INDICATION: Fever. COMPARISON: Chest radiograph ___. PA AND LATERAL VIEWS OF THE CHEST: Swan-Ganz catheter has been removed, and a right-sided Port-A-Cath is noted with tip in the lower SVC. Consolidative opacity within the right lower lobe is concerning for pneumonia. There is elevation of the right hemidiaphragm with lateralization of the diaphragmatic peak suggesting a subpulmonic effusion. The cardiac silhouette size is top normal. There is mild prominence of the pulmonary vascular markings. No left-sided pleural effusion is seen, and there is no pneumothorax. There are no acute osseous abnormalities. IMPRESSION: Right lower lobe pneumonia with probable right subpulmonic effusion. " 4b2c6294-3cee4041-2c06e4c9-369094fc-0f83435c.jpg,test/p16/p16514153/s59157786/4b2c6294-3cee4041-2c06e4c9-369094fc-0f83435c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain and dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CTA chest ___ FINDINGS: Patient is status post median sternotomy, mitral valve replacement, and transcatheter aortic valve replacement. Cardiac silhouette size remains normal. The mediastinal and hilar contours are unchanged with left-sided mediastinal clips again noted. Pulmonary vasculature is normal. Mild upper lobe predominant emphysema is re- demonstrated. No focal consolidation, pleural effusion or pneumothorax is present. The osseous structures are diffusely demineralized without acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary abnormality. " 144731b8-e771fdfd-ccae3ded-9ec8eefd-a134ca4c.jpg,test/p14/p14821385/s51562889/144731b8-e771fdfd-ccae3ded-9ec8eefd-a134ca4c.jpg,test," FINAL REPORT INDICATION: ___-year-old man with chest pain. Evaluate for pneumonia. TECHNIQUE: Frontal view of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal opacity, pleural effusion or pneumothorax. Cardiac and mediastinal contours are normal. IMPRESSION: Clear lungs. " 96269c87-3f1e3e2d-0f8743c7-946ad1f3-b476d007.jpg,test/p13/p13204581/s54070906/96269c87-3f1e3e2d-0f8743c7-946ad1f3-b476d007.jpg,test," FINAL REPORT EXAMINATION: Chest single-view INDICATION: ___ year old woman s/p esophagectomy (abdominal and thoracic approach) // tube placement; appearance of gastric conduit TECHNIQUE: Portable AP COMPARISON: ___. FINDINGS: No significant change. The right chest tube and right NG tube in place. Widened mediastinum from previous the esophagectomy. Increased left effusion and left lower lobe atelectasis. Probable increased right effusion. IMPRESSION: Increased left effusion and left lower lobe atelectasis. " 834fdf0c-cf9b90a9-c0c52d4d-51582be3-8acdefa9.jpg,test/p16/p16728224/s57747095/834fdf0c-cf9b90a9-c0c52d4d-51582be3-8acdefa9.jpg,test," WET READ: ___ ___ ___ 12:13 PM Streaky retrocardiac opacity, possibly indicative of pneumonia in the correct clinical setting. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever,cough, chest pressure x 3 weeks // Eval for PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Subtle streaky retrocardiac opacity may represent pneumonia in the correct clinical setting. Otherwise the lungs are clear. No effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Streaky retrocardiac opacity, possibly indicative of pneumonia in the correct clinical setting. " 51988cc5-74eb114d-e8763ac4-004a9bab-a7aae0f9.jpg,test/p16/p16477871/s55032465/51988cc5-74eb114d-e8763ac4-004a9bab-a7aae0f9.jpg,test," FINAL REPORT INDICATION: Week of cough. Hemoptysis. COMPARISON: CTA of the abdomen on ___. FINDINGS: PA and lateral views of the chest. Sternotomy wires are intact. There is a 1.0 cm round opacity in the left upper lobe, also a 1.0 cm round opacity in the right lower lung field. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. There is scarring at the right lung base. Mild cardiomegaly. Otherwise, mediastinal and hilar contours are normal. IMPRESSION: 1. No acute cardiopulmonary process. Mild cardiomegaly. 2. Two possible pulmonary nodules as described above, recommend further evaluation with non-emergent CT of the chest. These findings were emailed to the ED QA nurses at 7:29pm on ___ by Dr. ___. " 88fb78ee-c96699f9-58e7d3d7-da75ab23-355c80cf.jpg,test/p11/p11115156/s51053666/88fb78ee-c96699f9-58e7d3d7-da75ab23-355c80cf.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Patient is status post median sternotomy and CABG. Superior most wire is again seen to be fractured, as well as the fifth uppermost wire is also fractured, as was also present on the prior study. Minimal bibasilar atelectasis is seen. No focal consolidation, pleural effusion, evidence of pneumothorax is seen. No overt pulmonary edema. IMPRESSION: Mild bibasilar atelectasis. Fractured sternal wires again seen. " 95843708-d3478b39-d80152e6-bb656f3f-2324b79b.jpg,test/p12/p12807272/s54633646/95843708-d3478b39-d80152e6-bb656f3f-2324b79b.jpg,test," WET READ: ___ ___ 1:03 AM Multifocal bilateral regions of opacity which could represent pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with upper respiratory tract infection symptoms for 6 days with cough and fever. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Postoperative changes are seen on the right with chain sutures projecting over the right mid lung and vertically-oriented linear opacities with tenting of the hemidiaphragm. There are however new patchy opacities in the left mid-upper lung and the right lung laterally. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: Multifocal bilateral regions of opacity which could represent pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. " a8ca90b8-2c95bf0a-1a5ccd46-0bf3404f-859a838c.jpg,test/p15/p15084854/s53449257/a8ca90b8-2c95bf0a-1a5ccd46-0bf3404f-859a838c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with crohns plan to start remicade but tb testing equivocal. Rule out pulm tub // rule out pulm tb rule out pulm tb IMPRESSION: Compared to prior chest radiographs ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 52051de6-12f425a6-7e6e8a6e-8b8c4176-b5d56a2b.jpg,test/p10/p10198310/s53321855/52051de6-12f425a6-7e6e8a6e-8b8c4176-b5d56a2b.jpg,test," WET READ: ___ ___ ___ 2:45 PM No evidence of rib fracture. Pacemaker and ICD leads are unchanged in position. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: Left back pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Severe cardiomegaly and cardiomediastinal hilar silhouettes are unchanged. Pacemaker and ICD leads are unchanged in position. No evidence of displaced rib fracture. IMPRESSION: No evidence of rib fracture. Pacemaker and ICD leads are unchanged in position. " 7d10455a-ad48d011-9e4467ba-9031624a-d626aded.jpg,test/p11/p11459120/s55205549/7d10455a-ad48d011-9e4467ba-9031624a-d626aded.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with productive cough // R/O PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Patchy right upper lung opacity, not clearly seen on the prior radiographs, or least significantly increased, is worrisome for pneumonia. Additional ground-glass opacities noted on chest CT from ___ for better appreciated on CT. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Dual lead left-sided pacer is stable in position. Partially imaged left humeral prosthesis is again noted. IMPRESSION: Patchy right upper lung opacity worrisome for pneumonia. Recommend followup to resolution. Additional ground-glass opacities seen on chest CT from ___ are better appreciated on CT. Findings should be followed up with CT. " bbe767d5-50ac04a5-e93e6b48-2ae3f197-09364c12.jpg,test/p13/p13186655/s54679884/bbe767d5-50ac04a5-e93e6b48-2ae3f197-09364c12.jpg,test," FINAL REPORT HISTORY: ___-year-old male with instability of gait, altered mental status. COMPARISON: ___ and ___. FINDINGS: AP and lateral views of the chest. Linear opacity at the left lung base laterally and posteriorly suggestive of atelectasis versus scarring. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No displaced fracture is identified. IMPRESSION: No definite acute cardiopulmonary process. " 5929300a-7bd7179a-7953aa1c-d0273e23-4aae9643.jpg,test/p18/p18175023/s59174552/5929300a-7bd7179a-7953aa1c-d0273e23-4aae9643.jpg,test," FINAL REPORT INDICATION: Fever, cough and GI symptoms, here to evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are appropriate. There is no focal consolidation concerning for pneumonia, pleural effusion or pneumothorax. Ill-defined nodular densities projecting over the right anterior third rib are of uncertain etiology. Calcified right paratracheal and right hilar lymph nodes suggest prior granulomatous infection. The cardiomediastinal contours are within normal limits. Partial calcification of the aortic knob is redemonstrated. No acute osseous abnormality is detected. IMPRESSION: 1. No focal consolidation concerning for pneumonia. 2. Calcified right paratracheal and hilar lymph nodes similar to the prior study suggest prior granulomatous infection. 3. Nodular opacities projecting over the right anterior third rib should be further evaluated with shallow oblique views of the chest. NOTIFICATION: Findings were discussed by Dr. ___ with Dr. ___ at 4:05 p.m. on ___. " b02afa47-178bb4a9-68ec80d5-6542cc97-31ae26e0.jpg,test/p19/p19206480/s51974830/b02afa47-178bb4a9-68ec80d5-6542cc97-31ae26e0.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with fever, cough, and hypoxia. COMPARISON: Chest x-ray from ___ and chest CT from ___. FINDINGS: Frontal and lateral views of the chest. There are increased opacities in the lungs at the bases and most conspicuous in the right mid lung. Blunting of the posterior costophrenic angle on the right is compatible with a small effusion. Cardiomediastinal silhouette is within normal limits. Osseous structures demonstrate no acute osseous abnormality. IMPRESSION: Small right effusion and hazy opacities in the lungs at the bases and the right mid lung could be due to atelectasis, infection, or aspiration " 7af22759-187748c5-054e98a6-2a8ed2fe-aa363dc9.jpg,test/p13/p13875890/s50798297/7af22759-187748c5-054e98a6-2a8ed2fe-aa363dc9.jpg,test," FINAL REPORT INDICATION: ___ year old woman with posterior fossa choroid plexus tumor s/p resection, had difficult extubation, reintubated // eval pulmonary edema nd ett COMPARISON: ___. IMPRESSION: Support lines and tubes are unchanged in position. Heart size is within normal limits. There has been some improvement of the airspace opacities bilaterally. There are no pneumothoraces. " 0e87e200-ec7f1af6-eb95673e-03bfd0a0-8aa40079.jpg,test/p13/p13077594/s56468157/0e87e200-ec7f1af6-eb95673e-03bfd0a0-8aa40079.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure s/p trach // Interval change? COMPARISON: Chest x-ray from ___ at 04:45 FINDINGS: Allowing for technical differences, there may be slight improved aeration at the right base. Otherwise, doubt significant interval change. PICC line tip lies at the level of the cavoatrial junction. " fa13075b-70cbcff3-420e1125-3030361c-6d13ec19.jpg,test/p16/p16839550/s52907497/fa13075b-70cbcff3-420e1125-3030361c-6d13ec19.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___ and ___ CT. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were obtained. An AICD again seen projecting over the left chest wall with lead tips in the expected location of the right atrium and right ventricle. Midline sternotomy wires and mediastinal clips are again noted. When compared with a prior CT chest ___ ___ and multiple prior chest radiographs, the pattern of pleural thickening at the lung bases is unchanged accounting for the blunted CP angle. Overall, there is no significant change in the appearance of the lower lungs compared with prior CT and chest radiographs from ___. No definite sign of pneumonia or CHF. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Stable exam from multiple prior studies with stable pleural thickening in the lower lungs, accounting for the vague hazy opacities. No acute intrathoracic process. " edd2d83f-d73d656e-14440830-d8c1662e-c4836dda.jpg,test/p14/p14749769/s57035849/edd2d83f-d73d656e-14440830-d8c1662e-c4836dda.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female ___ weeks pregnant with asthma presents with wheezing and shortness of breath. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation. There is suggestion of minimal right basilar atelectasis. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No definite acute cardiopulmonary process. " 96826eb7-3347adce-094eab64-61eba5e6-596045a9.jpg,test/p14/p14792353/s51661813/96826eb7-3347adce-094eab64-61eba5e6-596045a9.jpg,test," FINAL REPORT INDICATION: ___-year-old man with left-sided chest pain, assess for acute process. COMPARISONS: Chest radiograph from ___. FINDINGS: Two views of the chest were obtained. Changes from right posterior rib resection resulting in lateral and apical pleural thickening and volume loss in the right upper lobe are again seen, without new opacity, pleural effusion, or pneumothorax. The heart is normal in size with normal contours. IMPRESSION: No acute intrathoracic process. " d5978985-47599979-48fe882b-08fed3d7-3a5d4601.jpg,test/p17/p17419105/s56347718/d5978985-47599979-48fe882b-08fed3d7-3a5d4601.jpg,test," FINAL REPORT INDICATION: Replaced NG tube. TECHNIQUE: Frontal chest radiograph. COMPARISON: Radiographs from ___. FINDINGS: A nasogastric tube terminates within the stomach. Moderate right atelectasis has recurred since the ___ 4:20 PM radiograph with new right mediastinal shift. There is a small right pleural effusion. The heart size is normal. The hilar and mediastinal contours remain within normal limits. Again seen is mild rightward mediastinal shift. There is no pneumothorax. IMPRESSION: 1. Moderate right atelectasis has recurred since the ___ 16:23 examination. 2. Nasogastric tube terminating within the stomach. NOTIFICATION: The findings were discussed with Dr. ___ by Dr ___ on the telephone on ___ at 9:02 AM, 10 minutes after discovery of the findings. " bb31f02a-26cfe8cb-d6444793-d24a3c7a-3ba6afb6.jpg,test/p18/p18855147/s58301804/bb31f02a-26cfe8cb-d6444793-d24a3c7a-3ba6afb6.jpg,test," WET READ: ___ ___ ___ 7:28 PM ngt at GE junction or proximal stomach. recommend advancing. mild inc in pulm edema WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: NG placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of a nasogastric tube with its tip in the body of the esophagus. The side hole is in the region of the gastroesophageal junction and the tube should be advanced several centimeters. Pulmonary vessels are less well defined than on the previous study, consistent with some mild increase in pulmonary venous pressure. " b6f6456e-946d18f0-7854c187-b1987da2-a4d46390.jpg,test/p14/p14117743/s54334585/b6f6456e-946d18f0-7854c187-b1987da2-a4d46390.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubated for MSSA pneumonia // Assess for interval change TECHNIQUE: AP radiograph of the chest. COMPARISON: Plain radiograph dated ___. Correlation made to chest CT dated ___. FINDINGS: A right IJ central venous catheter ends in the upper SVC. A nasogastric tube courses below the hemidiaphragm, tip not visualized. The ET tube ends at the level of the clavicles. Lung volumes are low. Bibasilar subsegmental atelectasis is unchanged. Bilateral peripheral predominant airspace opacities are not changed in extent or distribution since the study of 1 day prior. There is no pneumothorax. IMPRESSION: No appreciable interval change in peripheral bilateral airspace opacities since the study of 1 day prior, which may be due to multifocal pneumonia or septic emboli. However, there has been interval improvement since ___. " 0113157e-91396395-3a9ac60b-7cf977f5-b1f5057d.jpg,test/p16/p16072940/s52131315/0113157e-91396395-3a9ac60b-7cf977f5-b1f5057d.jpg,test," FINAL REPORT INDICATION: Dyspnea, cough, wheezing. COMPARISONS: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs and normal hilar and cardiomediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiographs of the chest. " 0898eac4-d00b2a8a-5a7339d4-dc8857f8-33357e34.jpg,test/p16/p16144406/s52673412/0898eac4-d00b2a8a-5a7339d4-dc8857f8-33357e34.jpg,test," FINAL REPORT INDICATION: Chronic neck pain, status post MVC today, evaluate for new pathology. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs with the most recent comparison made to study from ___. FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Visualized upper abdomen is unremarkable. Osseous structures are unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. " 6b819926-7a223efc-32f914a8-29d8ada2-aacfc46d.jpg,test/p16/p16453781/s51283054/6b819926-7a223efc-32f914a8-29d8ada2-aacfc46d.jpg,test," FINAL REPORT INDICATION: ___F with cough // cough TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d5c0e8b8-3c0a5bf5-451a7f9d-3ed7859f-3b7fe10b.jpg,test/p17/p17190208/s57471671/d5c0e8b8-3c0a5bf5-451a7f9d-3ed7859f-3b7fe10b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff // placement placement IMPRESSION: In comparison with the earlier study of this date, the Dobhoff tube has been repositioned so that the tip is within the mid to upper portion of the stomach. There appears to be some decrease in opacification at the right base. Otherwise little change. " 36e6d28e-75add4da-464a3950-61c3c149-196d20e4.jpg,test/p11/p11585206/s52021330/36e6d28e-75add4da-464a3950-61c3c149-196d20e4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with L pigtail placement // eval placement pigtail catheter or for ptx COMPARISON: Prior chest radiograph from earlier today. FINDINGS: AP portable supine view of the chest. There has been interval placement of a left pigtail chest tube. The lateral left lower chest is excluded. There is now a small pneumothorax. ET and OG tubes are unchanged. Lower lobe consolidations consistent with aspiration. IMPRESSION: Left chest tube in place with small left pneumothorax. " da77d30b-2ea4a5f1-9b6ff45d-79867104-b6846029.jpg,test/p13/p13443290/s57777761/da77d30b-2ea4a5f1-9b6ff45d-79867104-b6846029.jpg,test," FINAL REPORT INDICATION: Patient with epigastric pain. Evaluate for free subdiaphragmatic air. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Apparent widening of the vascular pedicle is secondary to a tortuous and unfolded aorta, better assessed in the lateral view. Otherwise, the cardiomediastinal and hilar contours are unremarkable. Heart size is normal. There is no pleural effusion or pneumothorax. No rib fractures are identified. No subdiaphragmatic free air is present. IMPRESSION: No evidence of acute cardiopulmonary process. No subdiaphragmatic free air. " d335e4ff-1c465eab-1deb001b-f62feb1f-aef71a19.jpg,test/p11/p11577197/s57309932/d335e4ff-1c465eab-1deb001b-f62feb1f-aef71a19.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hx of CVA with new onset fevers and hypoxia // Please evaluate for any evidence of pneumonia TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is interval development of left basal opacity concerning for infectious process. Right basal opacity most likely represent atelectasis. No appreciable pleural effusion is seen. No pneumothorax is present. No pulmonary edema is demonstrated. " afcaf833-61e5988d-a19baa6d-00581088-c16cd4d8.jpg,test/p18/p18186439/s56813132/afcaf833-61e5988d-a19baa6d-00581088-c16cd4d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p pleuroscpy // check interval change check interval change IMPRESSION: In comparison with the study of ___, there has been a fluoroscopy performed with decrease in the effusion at the left base. The rounded opacification now seen in at the base may be consistent with the loculated rounded fluid collections seen within the fissure on CT. There is no evidence of acute pneumonia or vascular congestion. " 36f40a04-f6201d84-2a9968b9-3e6ce7fe-87e03879.jpg,test/p14/p14912272/s53988363/36f40a04-f6201d84-2a9968b9-3e6ce7fe-87e03879.jpg,test," FINAL REPORT INDICATION: ___-year-old man with cough and increased oxygen need after transbronchial biopsies in the right. Evaluate for pneumothorax. COMPARISONS: Portable AP chest radiograph from ___. FINDINGS: A right pigtail catheter is present within the right chest wall and there is no pneumothorax. There is no right pleural effusion. Bibasilar opacities are unchanged. Large right upper lung masses are unchanged. Cardiac silhouette is enlarged. IMPRESSION: No pneumothorax. " de074a5b-102c28a7-eb255c89-22bf54a2-a138bf49.jpg,test/p15/p15937283/s58750212/de074a5b-102c28a7-eb255c89-22bf54a2-a138bf49.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ___F h/o DM___ s/p renal/pancreas transplant ___, CAD, recurrent UTI presenting with ___, recent falls, auditory/visual hallucinations and worsening metabolic acidosis now improving with lower extremity fractures being treated for CAP // Evaluate for pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, a pre-existing right lower lobe parenchymal opacity is slightly bigger and more extensive than on the previous image. In the appropriate clinical setting, the finding is consistent with pneumonia. No other changes noted. At the time of dictation and observation, 12:37, on the ___, the referring physician ___. ___ was paged for notification. " 282a962e-fb5224bf-30337152-9da946e1-ff848a68.jpg,test/p19/p19638212/s58818616/282a962e-fb5224bf-30337152-9da946e1-ff848a68.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fevers // pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are ___ allowing for slight tortuosity and unfolding of the no CHF, focal infiltrate or effusion is detected. No pneumothorax identified. There are no acute osseous abnormalities. IMPRESSION: No evidence of pneumonia. " 3da01a04-7464de44-8ad9c6ed-676aaacf-5e098fd1.jpg,test/p14/p14868639/s55105526/3da01a04-7464de44-8ad9c6ed-676aaacf-5e098fd1.jpg,test," FINAL REPORT INDICATION: ___M with Hodgkins lymphoma with new cough and dyspnea // any PNA TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Right-sided Port-A-Cath is seen with catheter tip in the mid to lower SVC. The lungs remain clear of focal consolidation, effusion, or edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " bbe39a7f-eec3961b-116c526b-963ef28d-b728c225.jpg,test/p16/p16474416/s57141386/bbe39a7f-eec3961b-116c526b-963ef28d-b728c225.jpg,test," FINAL REPORT INDICATION: History: ___F with left sided chest pain // r/o PTX COMPARISON: Radiographs from ___. IMPRESSION: Lungs are clear. Heart size is normal. Bony structures are intact. There are no pneumothoraces. " 162b43f4-6d9a6ab2-1993f84e-b0b5d084-6751685c.jpg,test/p12/p12461500/s56584056/162b43f4-6d9a6ab2-1993f84e-b0b5d084-6751685c.jpg,test," FINAL REPORT EXAMINATION: TRAUMA #3 (PORT CHEST ONLY) INDICATION: History: ___M with s/p ___ft fall, struck by 60lbs carbon fiber wing // Assess for traumatic injuries TECHNIQUE: Portable chest radiograph COMPARISON: Same day CT torso ___ FINDINGS: There is no consolidation, sizeable effusion or pneumothorax. Cardiomediastinal contours are normal. No acute osseous abnormalities are identified. IMPRESSION: No acute cardiopulmonary process identified. " 5b64e3a5-986f5dd1-1793f9ee-594f1b3a-0f70fba4.jpg,test/p12/p12126715/s53146753/5b64e3a5-986f5dd1-1793f9ee-594f1b3a-0f70fba4.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Asymptomatic elevated white blood cell count. Portable AP radiograph of the chest was reviewed with comparison to ___. The heart size and mediastinum are unchanged with mediastinal widening most likely related to mediastinal lipomatosis. There is slight increase in the left basal opacity that might be related to superimposed soft tissues, but left lower lobe pneumonia cannot be excluded. Correlation with lateral view would be beneficial. There is no pleural effusion or pneumothorax. " 934578c3-206f820b-a1aed71e-d3385e95-90567b06.jpg,test/p13/p13714199/s50009839/934578c3-206f820b-a1aed71e-d3385e95-90567b06.jpg,test," FINAL REPORT HISTORY: Chest pain, here to evaluate for acute cardiopulmonary process. COMPARISON: Chest radiograph dated ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are symmetrically well-expanded and clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The pulmonary vasculature is not engorged. The trachea is midline. The visualized upper abdomen shows no free air beneath the right hemidiaphragm. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 88d1180d-207ef3c5-8e435817-7b41fdf8-e16a7390.jpg,test/p14/p14996161/s54123299/88d1180d-207ef3c5-8e435817-7b41fdf8-e16a7390.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Foreign body ingestion, assess location of pen. FINDINGS: PA and lateral views of the chest provided. There is a metallic density, linear, measuring 6.4 mm, likely representing the tip of the ingested pen, residing in the distal esophagus. Lungs are clear. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: 6-mm density in the expected location of the distal esophagus, likely representing tip of ingested foreign body (pen). " 941c25a1-739281cb-b954d911-2ba7f1b9-cc4d1bd0.jpg,test/p18/p18871802/s53295531/941c25a1-739281cb-b954d911-2ba7f1b9-cc4d1bd0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough, left sided chest pain, fever COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette appears normal. The pulmonary hilar markings appear minimally prominent though likely within range of normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 28e89126-7f5fc227-3dee41a3-bb5a234d-5516d248.jpg,test/p14/p14704955/s57908404/28e89126-7f5fc227-3dee41a3-bb5a234d-5516d248.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Epigastric pain. Evaluate for cardiomegaly, pneumonia, effusion. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None available. FINDINGS: The cardiac silhouette is slightly enlarged. The hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 2fe00cbb-35150e04-2f046518-23e1bb89-16de912f.jpg,test/p12/p12136372/s58875675/2fe00cbb-35150e04-2f046518-23e1bb89-16de912f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumonia and likely lung cancer. // ? empyema / worsening effusion ? empyema / worsening effusion IMPRESSION: In comparison with the study ___ ___, the extensive opacification in the left upper lobe persists and may be even more expansive than previously. The right lung remains essentially clear. " 3c79addb-4647b008-5d7cce43-3eb24870-6a099494.jpg,test/p13/p13637699/s53481284/3c79addb-4647b008-5d7cce43-3eb24870-6a099494.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff placement // dobhoff placement dobhoff placement IMPRESSION: In comparison with the study of ___, the final image shows the Dobbhoff tube in the mid to lower body of the stomach. Endotracheal tube has been removed and a left subclavian catheter remains in place. There are substantially lower lung volumes with continued opacification at the bases most likely reflecting pleural fluid and basilar atelectasis, worse on the right. " 52795d4b-a5066d6b-1efd40d9-190ad5d9-92855e08.jpg,test/p10/p10609750/s51015556/52795d4b-a5066d6b-1efd40d9-190ad5d9-92855e08.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with right elbow fx. // pre-op TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Lungs are clear of consolidation, pleural effusion or pneumothorax. No pulmonary edema. Cardiomediastinal contours are normal. No subdiaphragmatic free air. A radiodense structure projecting over the right mainstem bronchus is external to the patient, better demonstrated on the lateral view. IMPRESSION: Normal chest radiograph. " 51c608d9-0ba48153-673868af-f0751428-13d87bc7.jpg,test/p19/p19103751/s53615621/51c608d9-0ba48153-673868af-f0751428-13d87bc7.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest INDICATION: History: ___F with MM s/p cyclophosphamide presenting with neutropenic fever // please eval for pna TECHNIQUE: Upright PA and lateral chest COMPARISON: None available FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 2564d778-abc15042-64f58dd0-fc06c646-71b96109.jpg,test/p18/p18485280/s59241958/2564d778-abc15042-64f58dd0-fc06c646-71b96109.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with ams // infiltrate? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and CABG. The aorta is tortuous. The cardiac silhouette is top-normal. Left base atelectasis is seen. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary process. " 32842056-996c7e72-78dba40c-4dcfbd7d-f3737edf.jpg,test/p14/p14849286/s51291399/32842056-996c7e72-78dba40c-4dcfbd7d-f3737edf.jpg,test," FINAL REPORT INDICATION: ___ year old man with bronchitis // r/o pna TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with CT chest from ___ and chest radiograph from ___. FINDINGS: The patient is status post right pneumonectomy, with the expected rightward mediastinal shift. The left lung is well expanded and clear There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: Status post right pneumonectomy. No acute findings. " acc0d276-93214321-d261e09c-83778596-1fff8ac5.jpg,test/p18/p18787543/s56717107/acc0d276-93214321-d261e09c-83778596-1fff8ac5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with c/o SOB and CP // ? PNA or CHF COMPARISON: CTA chest ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. There is no pulmonary edema. Bilateral hilar prominence, more prominent right than left, is compatible with enlarged pulmonary arteries, as previously described on comparison study. Arthroplasty of the left shoulder is incompletely visualized. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 9e2a29bd-aee8c39f-6362d973-224239a2-0e94ef84.jpg,test/p19/p19808487/s52626941/9e2a29bd-aee8c39f-6362d973-224239a2-0e94ef84.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old man with renal failure and new ectopy this AM. // PICC placement PICC placement IMPRESSION: As compared to the previous examination from ___, the patient has received a right PICC line. The tip is at the cavoatrial junction. The course of the line is unremarkable. No complications, notably no pneumothorax. Mild cardiomegaly. No pleural effusions. " 91a1cb5c-55d93c36-017b6772-899a570d-7e318df5.jpg,test/p15/p15444445/s52110992/91a1cb5c-55d93c36-017b6772-899a570d-7e318df5.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Alcohol intoxication, history of COPD, now with cough and crackles on exam. COMPARISON: ___ as well as ___. FINDINGS: In the interval since the prior study, there has been development of a right upper lobe opacity which while could represent infection, given underlying COPD, malignancy is not excluded. Again seen there is relative lucency of the upper lobe and interstitial prominence consistent with pulmonary emphysema. Left base linear opacity may be due to atelectasis/scarring. No large pleural effusion is seen. No evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Interval development of right upper lobe/right apical opacity, could represent infection, given underlying COPD/pulmonary emphysema, malignancy is not excluded. Findings could be further assessed on CT. " 0009a9fb-eb905e90-824cad7c-16d40468-007f0038.jpg,test/p10/p10001401/s50225296/0009a9fb-eb905e90-824cad7c-16d40468-007f0038.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old woman with likely ileus after cystectomy // NGT placement confirmation NGT placement confirmation IMPRESSION: No previous images. Nasogastric tube extends to the mid body of the stomach, be for coiling on itself so that the tip lies close to the esophagogastric junction. For more optimal positioning, the to would have to be pulled back almost 10 cm and then hopefully redirected toward the lower stomach. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 0179cd18-5de823a7-167c0234-85a8bec5-92a2929f.jpg,test/p15/p15632977/s57714068/0179cd18-5de823a7-167c0234-85a8bec5-92a2929f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ? seizure s/p intubation now with productive cough; eval for PNA // Opacity Opacity IMPRESSION: In comparison to study of ___, the endotracheal tube has been removed, as has the nasogastric tube. Cardiac silhouette remains at the upper limits of normal or mildly enlarged. No evidence of acute focal pneumonia, vascular congestion, or pleural effusion. " 58b9675c-ccf7cb2d-d3943b3f-12d06c09-b895f476.jpg,test/p11/p11777244/s52700775/58b9675c-ccf7cb2d-d3943b3f-12d06c09-b895f476.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. There is evidence of a neoesophagus which contains radiopaque material. Cardiomediastinal and hilar contours are stable. There is no focal consolidation, pleural effusion or pneumothorax. The previously seen pleural thickening and post-operative change is unchanged. No pneumothorax. No pleural effusion. Partial right fifth rib resection. IMPRESSION: No acute cardiopulmonary process. " ae77fdec-7d445b72-7913fce6-fc622c68-c3370468.jpg,test/p12/p12278430/s57990556/ae77fdec-7d445b72-7913fce6-fc622c68-c3370468.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Crohn disease, abdominal pain, assessment for free intra-abdominal air. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Normal appearance of the hemidiaphragms. No evidence of free intra-abdominal air in the frontal and lateral projection. Normal transparency and fracture of the lung parenchyma. A 3 mm soft tissue structure projecting between the fifth and sixth left rib on the left lung apex is likely a vascular structure and is not visible on the lateral radiograph. Normal size of the cardiac silhouette. Normal appearance of the hilar and mediastinal organs. " 5aa857b1-aa29db0e-df42fe66-94a5f2f3-ac7355cc.jpg,test/p13/p13420559/s54838616/5aa857b1-aa29db0e-df42fe66-94a5f2f3-ac7355cc.jpg,test," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: Renal failure. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest. Per the radiology technologist, this is the best possible film, the patient cannot keep chin up. Left-sided pacer device is stable in position. There is a stable prominent ovoid calcification projecting over the left mediastinal border. Perihilar haziness is again seen, which may be due to a mild pulmonary edema or in part related to underpenetration from overlying patient's soft tissue. The cardiac and mediastinal silhouettes are stable. No definite large pleural effusion is seen. IMPRESSION: Overall, the appearance of the lungs has not significantly changed. If anything, pulmonary edema appears slightly decreased as compared to the prior study. " 109508f2-f53d9070-1ad7fc77-ea6493d7-077dce68.jpg,test/p13/p13346506/s54663498/109508f2-f53d9070-1ad7fc77-ea6493d7-077dce68.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with traumatic injury after falling down ladder. New onset afib // ?structural cause of afib COMPARISON: Chest radiograph from ___. FINDINGS: AP portable upright view of the chest. A small right pneumothorax is unchanged since the ___ examination. Multiple right rib fractures are again seen. The heart size remains normal. The hilar and mediastinal contours are within normal limits. Mild elevation of the right hemidiaphragm is stable. There are no new effusions or consolidations. IMPRESSION: 1. Unchanged small right pneumothorax. 2. Multiple right rib fractures. 3. Normal cardiac contour. " 386f3c2c-7b84edb2-2c65b1fb-50fcb77b-8b6fa64a.jpg,test/p15/p15139909/s59417277/386f3c2c-7b84edb2-2c65b1fb-50fcb77b-8b6fa64a.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old man status post bilateral VATS for pulmonary nodules. Question interval change. COMPARISON: ___. FINDINGS: In comparison to prior exam, bilateral pneumothoraces have resolved. 1.5 cm pulmonary nodule in the right hemithorax remains. Bibasilar atelectasis remains. No focal opacities concerning for infectious process. No pleural effusion. " 8346dd05-e3aec7c1-af98340b-60d92273-87f905d8.jpg,test/p14/p14828338/s59029108/8346dd05-e3aec7c1-af98340b-60d92273-87f905d8.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Neutropenic fever. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " 35dc7ff0-83325a3f-df1335a7-fb5c7c95-a30ee20e.jpg,test/p16/p16181165/s57425093/35dc7ff0-83325a3f-df1335a7-fb5c7c95-a30ee20e.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: None available. FINDINGS: 2 views of the chest demonstrates clear lungs with mild left basilar atelectasis. The cardiac, mediastinal and hilar contours are normal. No pleural abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " dfda8fad-9d1a8636-68f5195e-60ed3697-282ebfcc.jpg,test/p13/p13520965/s53531542/dfda8fad-9d1a8636-68f5195e-60ed3697-282ebfcc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman admitted with cholecystitis and septic shock s/p drain placement and ERCP with pulmonary flash edema yesterday. // fluid overload? volume status? TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed ___ at 18 hours IMPRESSION: Pulmonary edema has resolved. Low lung volumes persist. Bibasilar atelectasis have markedly improved. Suspected small bilateral effusions are larger on the right. No other interval changes " 7cd41f42-38d387b7-95f829d3-3a8d3db3-bac1c7a2.jpg,test/p15/p15078112/s52859232/7cd41f42-38d387b7-95f829d3-3a8d3db3-bac1c7a2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with AML and worsening dyspnea; bronchoscopy yesterday // Edema/Effusion? TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There is moderate cardiomegaly. There is pulmonary vascular redistribution with hazy ill-defined vascularity. There is volume loss at the bases. Right IJ line is unchanged. There small bilateral pleural effusions. IMPRESSION: Increased fluid overload. " 76c350ea-1a3f5c17-77dc0d18-f3ac57a7-27bd14f8.jpg,test/p16/p16826047/s50453673/76c350ea-1a3f5c17-77dc0d18-f3ac57a7-27bd14f8.jpg,test," FINAL REPORT INDICATION: Fever. COMPARISON: Chest radiograph ___. PA AND LATERAL VIEWS OF THE CHEST: Swan-Ganz catheter has been removed, and a right-sided Port-A-Cath is noted with tip in the lower SVC. Consolidative opacity within the right lower lobe is concerning for pneumonia. There is elevation of the right hemidiaphragm with lateralization of the diaphragmatic peak suggesting a subpulmonic effusion. The cardiac silhouette size is top normal. There is mild prominence of the pulmonary vascular markings. No left-sided pleural effusion is seen, and there is no pneumothorax. There are no acute osseous abnormalities. IMPRESSION: Right lower lobe pneumonia with probable right subpulmonic effusion. " ad6f6d45-8213b1c2-f4132523-47060ace-bd931306.jpg,test/p14/p14987576/s50615222/ad6f6d45-8213b1c2-f4132523-47060ace-bd931306.jpg,test," FINAL REPORT HISTORY: Hypertensive emergency. COMPARISON: ___ through ___. FINDINGS: AP upright and lateral chest radiographs were obtained. Lung volumes accentuate the central pulmonary vasculature. There is mild prominence of the upper lobe pulmonary vessels. Moderate cardiomegaly has significantly worsened since ___. There is no effusion or pneumothorax or consolidation. IMPRESSION: 1. Moderate cardiomegaly is new since ___. 2. Mild central pulmonary vascular congestion. " 59d33acd-cd1472c0-d8afc524-78b3e937-1d757c69.jpg,test/p19/p19524729/s51430670/59d33acd-cd1472c0-d8afc524-78b3e937-1d757c69.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: History of pleuritic chest pain, recent chest trauma, rule out pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy. Dual-lead left-sided pacer device is again seen, with one lead extending to the expected position of the right atrium. The second lead which extends more inferior is not well evaluated due to underpenetration. There are relatively low lung volumes. The cardiac enlargement persists, although appears minimally less prominent as compared to the prior study. No definite pleural effusion is seen. There is minimal central pulmonary vascular congestion. Evidence of DISH is seen along the spine. IMPRESSION: Continued enlargement of the cardiac silhouette with mild vascular congestion. " a0bce56d-46ccacb2-3761fc01-405134a2-fe0d46e1.jpg,test/p10/p10249080/s52574233/a0bce56d-46ccacb2-3761fc01-405134a2-fe0d46e1.jpg,test," FINAL REPORT INDICATION: ___-year-old man, rule out cough and pneumonia. FINDINGS: The lungs are well inflated and clear. There is no effusion, consolidation, or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 91958eba-114e15c3-878a71b5-6c68be38-9782bb72.jpg,test/p11/p11312914/s53200910/91958eba-114e15c3-878a71b5-6c68be38-9782bb72.jpg,test," FINAL REPORT INDICATION: ___M with 1 day int L sided CP // eval for cardiomegaly TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs dated back to ___. FINDINGS: Mild cardiomegaly has been stable compared to exams dating back to at least ___. The aorta is tortuous, particularly the descending aorta, otherwise the hilar and mediastinal contours are unremarkable. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: Mild cardiomegaly. No focal consolidations concerning for pneumonia identified. " 52da682d-40b34c0f-7413d90c-52d070d8-ab612478.jpg,test/p11/p11160460/s55560310/52da682d-40b34c0f-7413d90c-52d070d8-ab612478.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with influenza like illness and cough TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 8ac3b702-1f13ff04-7072e7a1-07610d0a-2800f81a.jpg,test/p18/p18963838/s51239280/8ac3b702-1f13ff04-7072e7a1-07610d0a-2800f81a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea, etoh cirrhosis // please eval for acute cp process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Scattered right mid to lower lung linear atelectasis/scarring is seen. There is a small left pleural effusion. No definite focal consolidation is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Small left pleural effusion. Scattered right mid to lower lung linear atelectasis/ scarring. " cf7be52f-4f852e24-d4eeed4e-83790a4d-a5858ce9.jpg,test/p11/p11647908/s57956321/cf7be52f-4f852e24-d4eeed4e-83790a4d-a5858ce9.jpg,test," WET READ: ___ ___ 6:20 PM Elevated right hemidiaphragm which is new since ___. Additional imaging is suggested and can be performed by CT as this could represent subdiaphragmatic process. Subpulmonic effusion is also possible although the configuration makes this less likely. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with dyspnea. COMPARISON: Chest x-rays from ___ and ___. FINDINGS: AP and lateral views of the chest. Elevation of the right hemidiaphragm with the most recent exam but is new since ___. Linear right basilar opacity seen medially is likely due to atelectasis and is similar to most recent prior. Linear left basilar opacity is likely atelectasis vs scar. There is no new consolidation. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: Elevated right hemidiaphragm which is new since ___. Additional imaging is suggested as this could represent subdiaphragmatic process. Subpulmonic effusion is also possible although the configuration makes this less likely. " 841a6750-509a2a4d-6bd24f0e-b0f8592c-c1f45b7e.jpg,test/p14/p14093425/s56961923/841a6750-509a2a4d-6bd24f0e-b0f8592c-c1f45b7e.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Cough and fever. Cardiomediastinal contours are normal. The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. " 436e11f5-169b1b5b-8533c6ed-cb413fce-a3c58b97.jpg,test/p15/p15644237/s59377164/436e11f5-169b1b5b-8533c6ed-cb413fce-a3c58b97.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever, diffuse coarse breath sounds on the right // Pneumonia? COMPARISON: No prior chest radiographs are available. FINDINGS: Asymmetric increased opacity in the right lower lung. Bilateral lung volumes. Mild plate-like atelectasis in the left lung. The cardiomediastinal silhouette and hila are normal. No pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: New right lower lung pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___, the referring provider,on the telephone on ___ at 12:13 PM, 10 minutes after discovery of the findings. " 0d0c259e-f34a7ed5-ec38e498-bfc26bc6-5e2cc359.jpg,test/p16/p16251549/s52817854/0d0c259e-f34a7ed5-ec38e498-bfc26bc6-5e2cc359.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lung volumes are slightly lower than on the prior study, resulting ni bronchovascular crowding. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal allowing for lung volumes. No displaced rib fractures identified. There is no free air under the diaphragm. IMPRESSION: No pneumonia, edema or effusion. " 9f534f79-32d21d36-9f15bf05-aeaa8427-461e9134.jpg,test/p10/p10900387/s59094325/9f534f79-32d21d36-9f15bf05-aeaa8427-461e9134.jpg,test," FINAL REPORT HISTORY: Fever. COMPARISON: ___, ___ and ___. FINDINGS: Frontal and lateral views of the chest. Moderate cardiomegaly is stable. Right lower lobe opacity has been present over multiple prior examinations and likely represents overlying soft tissue. No new opacity concerning for pneumonia is seen. No pleural effusion or pneumothorax is identified. The mediastinal contours are normal. IMPRESSION: No acute intrathoracic process. " 8bd6514b-356e8934-011ffaef-def8c43e-d2062b90.jpg,test/p16/p16615356/s59985908/8bd6514b-356e8934-011ffaef-def8c43e-d2062b90.jpg,test," FINAL REPORT HISTORY: ___-year-old male with assault, ETOH intoxicated. Cough with sputum. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is normal. Widening of the right acromioclavicular joint is again seen as well as chronic deformities of the left lateral ribs inferiorly. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 890607f1-5ac10203-f4e1d6a6-4300ed8a-26a0c555.jpg,test/p19/p19528638/s51811805/890607f1-5ac10203-f4e1d6a6-4300ed8a-26a0c555.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam dated ___. CLINICAL HISTORY: Cough and weakness, question infection. FINDINGS: PA and lateral views of the chest were provided. The lungs are hyperinflated with upper lobe lucency and splaying of bronchovasculature compatible with emphysema. No large consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Emphysema without definite signs of superimposed pneumonia. " afb835b1-e5719705-61bd2181-91f30889-d915a782.jpg,test/p11/p11274067/s58627046/afb835b1-e5719705-61bd2181-91f30889-d915a782.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man has history of ischemic cardiomyopathy. On amiodarone // ? abnormality ? abnormality IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lungs fully expanded and clear. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. Transvenous right atrial ventricular pacer defibrillator leads continuous from the left pectoral generator. No radiographic findings suggesting pulmonary toxicity from amiodarone. " a6ebfb30-8b7c9e01-a40ef96d-16b9030f-06a46ddd.jpg,test/p18/p18591791/s58711923/a6ebfb30-8b7c9e01-a40ef96d-16b9030f-06a46ddd.jpg,test," FINAL REPORT INDICATION: Chills and nausea. Evaluate for pneumonia. COMPARISON: Chest radiograph of ___ through ___. TECHNIQUE: Upright PA and lateral radiograph of the chest. FINDINGS: The lungs are normally expanded and clear. The heart is not enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is hardware in the right glenoid, likely from prior surgical repair. IMPRESSION: No acute cardiopulmonary abnormality. " 304953b3-865295fe-0e78882f-b24a8528-c7f0f025.jpg,test/p10/p10747985/s53152619/304953b3-865295fe-0e78882f-b24a8528-c7f0f025.jpg,test," FINAL REPORT HISTORY: Ankle edema, to assess for pulmonary edema. FINDINGS: In comparison with the study of ___, there is continued substantial enlargement of the cardiac silhouette in a patient with intact midline sternal wires from previous cardiac surgery. Pulmonary vascularity is essentially within normal limits, raising the possibility of cardiomyopathy or pericardial effusion. There is increased opacification at the left base obscuring the hemidiaphragm and costophrenic angle. This is most consistent with moderate pleural effusion and compressive atelectasis at the base. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. Some hyperexpansion of the lung and prominent AP diameter in the lateral view suggests some underlying chronic pulmonary disease. " bfbb8000-fc85acd9-768ce68d-057943a1-3a8c41b7.jpg,test/p12/p12016129/s54415065/bfbb8000-fc85acd9-768ce68d-057943a1-3a8c41b7.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 90eb281a-32e9304a-eb8a435b-49ec68b7-270a7413.jpg,test/p19/p19966115/s57445652/90eb281a-32e9304a-eb8a435b-49ec68b7-270a7413.jpg,test," WET READ: ___ ___ ___ 12:19 AM RE- DEMONSTRATION OF A KNOWN 4.4 CM RIGHT HILAR MASS, BETTER ASSESSED ON PRIOR CHEST CT. MILD PULMONARY VASCULAR CONGESTION. NO NEW FOCAL CONSOLIDATION. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HTN, Afib, ___'s Disease, prostate cancer s/p TURP p/w volume overload // Assess for PNA or pulmonary edema Assess for PNA or pulmonary edema IMPRESSION: Compared to chest radiographs ___ through ___, read in conjunction with the chest CT performed 00:28 on ___, available the time of this final review. Despite the apparent central lucency in the right juxta hilar mass, the subsequent CT just there is no cavitation. It also suggests that the asymmetric interstitial abnormality in the left lower lobe seen on this chest radiograph is probably early edema, improved compared to ___, rather than interstitial pneumonia or disseminated carcinoma. There is no appreciable pleural effusion. No pneumothorax. " a53e75bb-14b87d03-d03ad191-2f01324e-bec13b48.jpg,test/p10/p10755736/s50939160/a53e75bb-14b87d03-d03ad191-2f01324e-bec13b48.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with heart failure s/p swan adjustment // evaluate swan placement evaluate swan placement IMPRESSION: In comparison with the earlier study of this date, the Swan-Ganz catheter is been pulled back so that it is with in the mediastinum. Diffuse bilateral pulmonary opacifications are essentially unchanged. " c52365b1-d0b364b5-abb9ffc7-5970fabf-09739120.jpg,test/p10/p10933318/s57129951/c52365b1-d0b364b5-abb9ffc7-5970fabf-09739120.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 3c7bef26-450c3cf9-5efb8745-3c9b9853-a46a78d0.jpg,test/p10/p10514501/s58979542/3c7bef26-450c3cf9-5efb8745-3c9b9853-a46a78d0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion on right s/p R VATS pleurodesis and repair of diaphragm for catamenial pneumothorax. // 3 month interval CXR for resolution of right pleural effusion 3 month interval CXR for resolution of right pleural effusion COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Moderate right pleural effusion is smaller today than on ___. There is no pneumothorax. No left pleural abnormality. Left lung and right upper lung clear. Heart is mildly enlarged with some left atrial enlargement and dilatation of the pulmonary outflow tract. " 9dd53953-a70e5613-259a66a2-e294292e-796da146.jpg,test/p15/p15432819/s51281445/9dd53953-a70e5613-259a66a2-e294292e-796da146.jpg,test," FINAL REPORT HISTORY: History of dyspnea. Evaluate for acute process. COMPARISON: None. FINDINGS: Single portable supine chest radiograph was provided. Lung volumes are low. There is prominence of the pulmonary vasculature and the hila compatible with pulmonary congestion. There are bibasilar consolidations, likely a combination of atelectasis and pneumonia. There are small bilateral pleural effusions. The cardiomediastinal silhouette is notable for a tortuous aorta. There is no pneumothorax. The imaged upper abdomen is unremarkable. IMPRESSION: 1. Pulmonary congestion. 2. Bibasilar consolidations, likely atelectasis and pneumonia. 3. Likely small bilateral pleural effusions. " 4af49f42-57d32d5c-aff36540-cb0bae31-abbfbaa6.jpg,test/p18/p18809319/s52708332/4af49f42-57d32d5c-aff36540-cb0bae31-abbfbaa6.jpg,test," FINAL ADDENDUM Right midzone and perihilar opacities and recommendation of follow-up radiography to confirm resolution was discussed with Dr. ___ at approximately 9:07 am on ___ (___, phone). ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: Chest radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: There is vague increased opacity in the region of the right hilum latrealy and vague opacity in the right midzone laterally, new compared with ___. This likely correspnds to the irregular focal retrosternal opacity seen on the lateral view. Otherwise, no focal opacity, chf, effusion, or pneumothorax. Cardiomediastinal and hilar contours otherwise within limits. IMPRESSION: Focal opacity right perihilar area and right midzone laterally, new compared with ___, nonspecific in appearance. The differential includes, but is not limited to, an early pneumonic infiltrate or area of inflammation. It appears to represent a different location from the patchy opacity seen on the ___ CT scan. Recommend follow-up radiographs to document resolution. " 7498732d-980d76f0-07ee7d5e-413f1290-6731444b.jpg,test/p14/p14508231/s54912944/7498732d-980d76f0-07ee7d5e-413f1290-6731444b.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with left upper quadrant pain, status post surgery. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear of consolidation or effusion. There is no pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Anterior cervicothoracic hardware is identified as on prior. There is no free air below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 0110655a-be779522-66c04cbe-3042e9d8-acb0e161.jpg,test/p16/p16994918/s56478548/0110655a-be779522-66c04cbe-3042e9d8-acb0e161.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with significant smoking history and s/p CABG. Having non-productive cough. // Any intra-thoracic pathology to explain the cough? Any intra-thoracic pathology to explain the cough? IMPRESSION: In comparison with the study ___ ___, there is again hyperexpansion of the lungs consistent with chronic pulmonary disease and enlargement of the cardiac silhouette. No definite acute pneumonia or vascular congestion or pleural effusion. The area of increased opacification at the left base seen previously has cleared. " 5f1a04f1-41e9e6db-2a674198-3f511159-bea29ba3.jpg,test/p18/p18310858/s59527875/5f1a04f1-41e9e6db-2a674198-3f511159-bea29ba3.jpg,test," FINAL REPORT INDICATION: ___-year-old female with hypotension and shortness-of-breath. COMPARISON: Chest radiograph dated ___. FINDINGS: Single portable AP chest radiograph demonstrates hyperinflated lungs and flattening of bilateral diaphragms. Lucency within the upper lobes in addition to aforementioned findings are consistent with dense emphysematous changes as previously identified. Heart size is enlarged, present on prior examination and stable. No evidence of pulmonary edema. No focal opacity convincing for pneumonia is identified. There is no pleural effusion. Osseous structures are without acute abnormality. IMPRESSION: Emphysema and cardiomegaly without focal opacity convincing for pneumonia. " 77f5aa7e-8816c795-87e6cb80-6e2b234d-15b59a29.jpg,test/p15/p15191672/s50349049/77f5aa7e-8816c795-87e6cb80-6e2b234d-15b59a29.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RLL pna on ___ at___ - pt will bring CD of prior CXR // 4 wk f/u pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pre-existing a right lower lung opacity has completely resolved. The lung volume is now normal on both the frontal and the lateral chest radiograph. No pleural effusions. Normal size of the cardiac silhouette. " 4c3dd07a-59ff059d-971e3791-f2cf813a-9b95e29c.jpg,test/p14/p14811844/s58441991/4c3dd07a-59ff059d-971e3791-f2cf813a-9b95e29c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MI. // Comparison to previous Comparison to previous COMPARISON: Comparison to prior study of ___ at 03:37 FINDINGS: Portable supine image of the chest is submitted. The lung bases and costophrenic angles are not entirely included on the study. IMPRESSION: Given these limitations, bibasilar patchy opacities may reflect atelectasis although pneumonia or aspiration should also be considered. No evidence of pulmonary edema. No large pneumothorax, although the sensitivity to detect pneumothorax is diminished given supine technique. A more focal nodular opacity at the right lung base most likely represents a nipple shadow and could be better assessed on followup imaging. There has been interval resolution of the mild interstitial edema seen on the previous study. A densely calcified opacity at the left apex appears to be either related to the second anterior rib or be pleural in location when correlated with the ___ film study from ___ at 00:52. Correlation with more remote studies would be helpful. " dcb4036b-771635cf-6564c720-47ef99da-7fff54c4.jpg,test/p15/p15485853/s54972502/dcb4036b-771635cf-6564c720-47ef99da-7fff54c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated, volume overload // Eval for interval change COMPARISON: ___ IMPRESSION: No relevant change as compared to the prior image. The monitoring and support devices are constant. The basis of the left lung is better ventilated than on the previous examination. The postoperative appearance on the right is not substantially changed. Low lung volumes and moderate cardiomegaly persists. " c69bb026-34a714e9-04390686-1dbdbd39-6d0c573b.jpg,test/p13/p13265883/s57238981/c69bb026-34a714e9-04390686-1dbdbd39-6d0c573b.jpg,test," FINAL REPORT INDICATION: ___-year-old male with occipital stroke, to rule out pneumonia. COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lung volumes are low, but no focal consolidation, pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary pathology. " 6011a654-04d6e2d9-ed54d7e3-d8963f0a-82d8a6ef.jpg,test/p14/p14640173/s57759941/6011a654-04d6e2d9-ed54d7e3-d8963f0a-82d8a6ef.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Cough, shortness of breath, ex-smoker, baseline. COMPARISON: None. FINDINGS: Lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: Normal chest x-ray. " 70d4c7fc-b0f33ee9-54f84f95-004de7bb-c6fd529e.jpg,test/p19/p19901661/s51373959/70d4c7fc-b0f33ee9-54f84f95-004de7bb-c6fd529e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 33e11840-0141b2f2-23d6335d-65f1b263-e5999d31.jpg,test/p16/p16268439/s59466795/33e11840-0141b2f2-23d6335d-65f1b263-e5999d31.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: A ___-year-old man with new shortness of breath. IMPRESSION: PA and lateral chest compared to ___: Left central venous infusion catheter ends in the low SVC, as before. Normal heart, lungs, hila, mediastinum and pleural surfaces. " 9a4b8e4f-ef99cf07-34a93224-ddc5e7cc-0f34c862.jpg,test/p12/p12464071/s54088317/9a4b8e4f-ef99cf07-34a93224-ddc5e7cc-0f34c862.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/hypotension, please interval for interval change // ___M w/hypotension, please interval for interval change ___M w/hypotension, please interval for interval change IMPRESSION: Comparison to ___. Stable mild pulmonary edema. Low lung volumes and mild cardiomegaly. Stable retrocardiac atelectasis. The position of the right internal jugular vein catheter is unchanged and correct, with the tip projecting over the cavoatrial junction. " 7bda3602-0c770eed-48effe8a-03aa8271-b80d5388.jpg,test/p15/p15106749/s54840948/7bda3602-0c770eed-48effe8a-03aa8271-b80d5388.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lung cancer s/p talc pleurodesis/___ // eval for pneumothorax, procedural complcation, or effusion. TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are unchanged in appearance. A right-sided chest tube and epidural catheter are in place. Subcutaneous air on the right has minimally decreased since the prior study. A right apical pneumothorax has minimally increased since the prior study. Left basal atelectasis is unremarkable. No pleural effusion is seen on the left. " 47988967-583d06f4-ca515364-4b03989f-2e9036c4.jpg,test/p19/p19103751/s53663589/47988967-583d06f4-ca515364-4b03989f-2e9036c4.jpg,test," FINAL REPORT INDICATION: ___ year old woman with Multiple myeloma, pre bone marrow transplant workup. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___, ___, ___ and ___. FINDINGS: Lungs are well-expanded without focal consolidation, pleural effusion or pneumothorax. The cardiac size is normal. The mediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " f48420da-ce3b9479-6a065ae9-11add44c-e3b92064.jpg,test/p10/p10439374/s57246127/f48420da-ce3b9479-6a065ae9-11add44c-e3b92064.jpg,test," WET READ: ___ ___ ___ 6:31 PM Slightly lower lung volumes compared to chest radiograph from earlier on the same day. Similar to slightly increased mild pulmonary edema and unchanged mild retrocardiac atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man coughing during transfusion, while eating, after receiving volume resuscitation // TRALI? edema? TRALI? edema? IMPRESSION: Comparison to ___. Increase in severity of the pre-existing pulmonary edema that is now overall moderate. Bilateral opacities at the lung bases reflecting atelectasis. Overall low lung volumes. Mild cardiomegaly. " f007f587-ed734364-1bd221f8-ff097d1a-f183dd04.jpg,test/p10/p10420821/s54834947/f007f587-ed734364-1bd221f8-ff097d1a-f183dd04.jpg,test," FINAL REPORT HISTORY: ___-year-old female with dementia presents with generalized weakness and slurred speech after fall. COMPARISON: ___. FINDINGS: AP view of the chest. The lungs remain clear consolidation or effusion. Cardiomediastinal silhouette and stable. Dual lead pacing device again noted. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " a44b527a-ea09036e-6c210e9d-e5e53a74-401e56c0.jpg,test/p14/p14471647/s57123950/a44b527a-ea09036e-6c210e9d-e5e53a74-401e56c0.jpg,test," FINAL REPORT INDICATION: ___M with dyspnea, recent admission for CHF exacerbation // Eval for pulm edema TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: There is no consolidation, large effusion or pneumothorax. There is pulmonary vascular congestion without overt edema. Cardiomediastinal silhouette is within normal limits. Left chest wall dual lead pacing device is again noted. IMPRESSION: Pulmonary vascular congestion without overt edema. " 515f1e15-c07da508-6097ad46-7addcebf-c6206583.jpg,test/p15/p15975465/s51688608/515f1e15-c07da508-6097ad46-7addcebf-c6206583.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung cancer, new O2 requirement, pleural effusion seen on CXR ___ // eval for interval change TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the study from the prior day the right effusion is larger in there is increased pulmonary vascular redistribution with hazy ill-defined vasculature and compatible with increased fluid overload. The remainder of the appearance of the lungs are unchanged " 6e74d09f-0574cac7-5b164304-329dd815-5551457f.jpg,test/p19/p19849930/s51246464/6e74d09f-0574cac7-5b164304-329dd815-5551457f.jpg,test," FINAL REPORT HISTORY: New pacemaker, for lead position. FINDINGS: In comparison with study of ___, there is a dual-channel pacemaker in place with the leads in the region of the right atrium and apex of the right ventricle. No evidence of pneumothorax. Bibasilar opacifications most likely reflect atelectasis. In the appropriate clinical setting, supervening pneumonia would have to be considered. " 171e7917-43af53bd-7146bf9c-0f9777e1-95e6e872.jpg,test/p12/p12392072/s57459530/171e7917-43af53bd-7146bf9c-0f9777e1-95e6e872.jpg,test," FINAL REPORT HISTORY: Shortness of breath and fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Subsegmental atelectasis in the left lung base is present. Lungs are otherwise clear. No focal consolidation, pleural effusion or pneumothorax is present. Partially imaged is a left ureteral stent. IMPRESSION: Subsegmental atelectasis in the left lung base. " bc678414-3b3c0bf4-3041c4b2-6bd85432-0ee183fc.jpg,test/p18/p18039866/s56710845/bc678414-3b3c0bf4-3041c4b2-6bd85432-0ee183fc.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with left-sided chest pain TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Atherosclerotic calcifications are noted at the aortic knob. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Small left pleural effusion is noted, new from the prior study. Minimal atelectasis is demonstrated in the left lung base. No focal consolidation or pneumothorax is present. No acute osseous abnormality is detected. IMPRESSION: Small left pleural effusion and minimal left basilar atelectasis. " 2ff39ae3-953a57de-cb7778b6-1e54ea6a-bb0e6e28.jpg,test/p11/p11443083/s52657995/2ff39ae3-953a57de-cb7778b6-1e54ea6a-bb0e6e28.jpg,test," FINAL REPORT INDICATION: ___-year-old male with shortness of breath, evaluate for pneumonia. COMPARISON: Portable chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are unremarkable. Both lungs are clear with no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 15f3b77a-b6d568a0-54a786c9-9862a1ac-3fbe8204.jpg,test/p18/p18148412/s54700072/15f3b77a-b6d568a0-54a786c9-9862a1ac-3fbe8204.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo F with history of HTN, chronic lower back pain, alcohol abuse who presents with septic shock concerning for possible pulmonary vs GI source. GNRs in blood. // eval fluid status; on vent TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Pulmonary edema has improved. Cardiomegaly is stable. Bibasilar atelectasis and adjacent effusions are unchanged. Lines and tubes are in unchanged position. " 4617c37d-1673c7ff-bd1164d7-3285f12d-4ad4a124.jpg,test/p11/p11211680/s59606035/4617c37d-1673c7ff-bd1164d7-3285f12d-4ad4a124.jpg,test," FINAL REPORT HISTORY: Asthma and cough, to assess for pneumonia. FINDINGS: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " b73ed7a1-9b9f94bd-12882e47-5b2eeabc-4f87a119.jpg,test/p11/p11812613/s50569042/b73ed7a1-9b9f94bd-12882e47-5b2eeabc-4f87a119.jpg,test," FINAL REPORT INDICATION: ___-year-old male with dyspnea on exertion, coughing up blood. Rule out acute process. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Patchy right mid-lung opacity silhouettes the right heart border, compatible with right middle lobe airspace infiltration. No diffuse pulmonary abnormality is present. The heart is of normal size. No pleural effusion or pneumothorax. No radiopaque foreign body. Osseous structures are unremarkable. IMPRESSION: Right middle lobe infiltrate, compatible with pneumonia, although other etiologies including hemorrhage could be considered in the appropriate clinical setting. Particularly given history of malignancy, follow-up radiograph is recommended to ensure resolution. " 7775ae20-fc9d293c-19368071-003bd7bd-ec640057.jpg,test/p17/p17021161/s57264489/7775ae20-fc9d293c-19368071-003bd7bd-ec640057.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with clotted AV graft. Preoperative chest x-ray. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___ FINDINGS: Compared to the prior chest radiograph ___ there is no significant change in a small left retrocardiac opacity which most likely represents atelectasis. No new opacity, pleural effusion and pneumothorax. Mild cardiomegaly is stable. The mediastinal silhouette is stable. IMPRESSION: Left lower lobe atelectasis. Otherwise, clear lungs. " 3edc0dc7-78925af3-1024828d-395004de-8d5f37f3.jpg,test/p16/p16893353/s55506847/3edc0dc7-78925af3-1024828d-395004de-8d5f37f3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, shortness of breath, recent pneumonia // please eval for interval change COMPARISON: Chest radiograph dated ___. FINDINGS: Interval resolution of the pneumonia in the right lung. Increased residual right basilar atelectasis. No new focal consolidation. No pulmonary edema, pleural effusion, or pneumothorax. Stable bilateral low lung volumes. Stable cardiomegaly and mediastinal contours. The cardiac pacemaker device appears intact and unchanged in position. The patient has a hiatal hernia. IMPRESSION: 1. Complete interval resolution of right lung pneumonia. 2. Right basilar atelectasis. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___, the referring provider requesting ___ wet read, on the telephone on ___ at 3:15 PM, 15 minutes after discovery of the findings. " 26e84216-5b9a59be-9acf1758-ea4b4989-a6bee3aa.jpg,test/p10/p10030753/s52230171/26e84216-5b9a59be-9acf1758-ea4b4989-a6bee3aa.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Altered mental status. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable including mild cardiomegaly. There is no pleural effusion or pneumothorax. Streaky opacity suggesting minor scarring appears unchanged at the base of the right lung. The lungs appear otherwise clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 7329afa7-d6e5d12c-dff1a140-300e3a2f-5b834495.jpg,test/p10/p10203883/s53048846/7329afa7-d6e5d12c-dff1a140-300e3a2f-5b834495.jpg,test," FINAL REPORT HISTORY: Positive PPD. FINDINGS: In comparison with the study of ___, there is little change. Fibrosis or atelectasis is seen at the right base as on the previous study. Remainder of the examination is essentially within normal limits. Specifically, no evidence of old or acute tuberculous disease. " 40ab9383-4ebe527b-d097edc0-f3985226-66cfb005.jpg,test/p11/p11137007/s58946520/40ab9383-4ebe527b-d097edc0-f3985226-66cfb005.jpg,test," WET READ: ___ ___ 4:25 PM 1. Re-expansion pulmonary edema. No pneumothorax. 2. Multiple metastatic lesions are unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with hypotension following thoracentesis, evaluate for pneumothorax. TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to ___ and chest CT dated ___. FINDINGS: Increased opacity over bilateral lower lungs in the setting of recent thoracentesis is compatible with re-expansion pulmonary edema. A small residual layering left pleural effusion is likely present. Multiple metastatic lesions are unchanged from prior studies. There is no pneumothorax. There is mild cardiomegaly. IMPRESSION: 1. Re-expansion pulmonary edema. No pneumothorax. 2. Multiple metastatic lesions are unchanged. " 7b47c458-6d900699-e7a715fc-30d72354-8e1df25a.jpg,test/p11/p11020337/s53048830/7b47c458-6d900699-e7a715fc-30d72354-8e1df25a.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with seizure. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Linear opacities at the lung bases suggestive of atelectasis. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. Relatively curvilinear calcific density projects over the right chest wall and scapula, is stable dating back to ___ and is likely within the soft tissues. Old right lateral upper rib fractures are again noted. IMPRESSION: No acute cardiopulmonary process. " 0e1b7b25-9540c819-50fd9948-ecb93012-2c72a898.jpg,test/p12/p12488897/s51529818/0e1b7b25-9540c819-50fd9948-ecb93012-2c72a898.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with respiratory failure, intubated. FINDINGS: Comparison is made to previous study from ___ at 4:17 a.m. The endotracheal tube, feeding tube, and right IJ central venous line are in unchanged position. There is again seen low lung volume with crowding of the pulmonary vascular markings at the lung bases and subsegmental atelectasis at the bases. The nasogastric tube tip and side port are within the body of the stomach. " 936b3c70-9ff5b2da-08146328-a2cf4a87-b9c9843a.jpg,test/p11/p11414573/s57565665/936b3c70-9ff5b2da-08146328-a2cf4a87-b9c9843a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a chest radiograph from ___ as well as a CT torso from ___. CLINICAL HISTORY: Chest pressure, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No signs of pneumonia. " 70bc3536-f021f92a-29ebdd57-314282fa-f14d83e1.jpg,test/p11/p11154338/s54368437/70bc3536-f021f92a-29ebdd57-314282fa-f14d83e1.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with bilateral lower extremity edema and tachycardia. Question pulmonary edema. REcently traeted pneumonia. FINDINGS: AP and lateral views of the chest. No prior. There is increased opacity projecting over the right hilum within the right lower lobe. Elsewhere, lungs are clear. There is no effusion. Cardiac silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Right lower lobe parenchymal opacity which may be related to recently treated pneumonia. Please correlate clinically. Repeat exam recommended in 6 weeks to document resolution. " bb0728f0-fa909774-54ee583f-76d35b89-2735c56d.jpg,test/p17/p17763551/s50725955/bb0728f0-fa909774-54ee583f-76d35b89-2735c56d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cabg // f/u apical ptx TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Small right pneumothorax has mildly increased. There are persistent low lung volumes. Moderate cardiomegaly is accentuated by the low lung volumes and the projection. Vascular congestion has improved. If any there are small bilateral effusions. Multifocal atelectasis in the left lung and right lower lobe improved. " 4fe67ac7-1182f6da-34e5bdf7-98a8593b-db010ecc.jpg,test/p10/p10117474/s57267592/4fe67ac7-1182f6da-34e5bdf7-98a8593b-db010ecc.jpg,test," FINAL REPORT INDICATION: ___M presenting with Lt facial weakness. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no evidence of pulmonary edema. There is no pleural effusion or pneumothorax. Osseous structures demonstrates no acute abnormality. IMPRESSION: No acute intrathoracic abnormality. " e3af336d-56b5fa2f-8c9653d7-3b519e8b-e00704ff.jpg,test/p17/p17051517/s55424887/e3af336d-56b5fa2f-8c9653d7-3b519e8b-e00704ff.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Hyperglycemia, fatigue and malaise. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There is no pleural effusion or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 03e4f490-80c314d6-8e4e9cee-cfdf8702-faac4644.jpg,test/p16/p16562430/s51972257/03e4f490-80c314d6-8e4e9cee-cfdf8702-faac4644.jpg,test," FINAL REPORT EXAM: Chest AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of chest pain, fever, shortness of breath, hypotension. COMPARISON: ___. There is another comparison, a reference made to chest CT from ___ and ___. FINDINGS: Single, AP, upright, portable view of the chest was obtained. There are increased interstitial marking. Given history of pulmonary fibrosis on prior CT, although increased interstitial markings have significantly increased since the prior and there may be superimposed pulmonary edema. The cardiac and mediastinal silhouettes are stable. There is slight blunting of both costophrenic angles, felt most likely be due to overlying soft tissues, but a trace pleural effusions be difficult to exclude. No right pleural effusion is seen. There is no pneumothorax. IMPRESSION: Increased markings bilaterally may be due to the combination of underlying pulmonary fibrosis and moderate pulmonary edema, superimposed infectious process cannot be excluded. " 046a8a82-d95886f6-4a81d8f0-80d90462-8c105797.jpg,test/p11/p11255297/s56847382/046a8a82-d95886f6-4a81d8f0-80d90462-8c105797.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left VATS and left lower lobe wedge. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: PA and lateral images of the chest demonstrate improvement in the diffuse bilateral opacities from prior imaging. The loculated pleural effusion in the left lower zone has also improved since prior imaging. There remains some opacification in the retrocardiac area. Chain sutures are noted along the left hemidiaphragm. Diffuse lung markings are seen, indicative of elevated pulmonary venous pressure. The cardiomediastinal silhouette is unchanged. IMPRESSION: Interval improvement in diffuse bilateral lung opacities with some opacification remaining in the retrocardiac area. Improvement of the left-sided loculated pleural effusion. " 65a19b87-30057c53-8be6129d-16512140-cfa7fbce.jpg,test/p17/p17155697/s57124211/65a19b87-30057c53-8be6129d-16512140-cfa7fbce.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Metastatic myxoid sarcoma, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a newly appeared, huge, approximately 7 cm large right dorsal lesion. The lesion abuts the pleura and is likely to represent a metastatic disease. The marked elevation of the right hemidiaphragm is unchanged. Moderate cardiomegaly persists. No other lung lesions. At the time of dictation and observation, the finding was entered into the Radiology dashboard system. " 527bac2c-a50d6e12-a98ec24e-8f6dc89b-2f9ace0f.jpg,test/p13/p13505226/s52525378/527bac2c-a50d6e12-a98ec24e-8f6dc89b-2f9ace0f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year man with acute abdominal pain, evaluate perforation. TECHNIQUE: AP chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: There is no evidence of free intraperitoneal air on upright film. The cardiomediastinal contours are stable and within normal limits. The bilateral hila are unremarkable. The lungs are clear. There is no pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: Low lung volumes. No free intraperitoneal air. No acute cardiopulmonary process. " 00c9fe10-a3276088-2bf700a1-0caa69c6-6c86c39e.jpg,test/p17/p17370807/s57388879/00c9fe10-a3276088-2bf700a1-0caa69c6-6c86c39e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p R pneumonectomy with L pneumonia // eval for interval change eval for interval change IMPRESSION: Compare to prior postoperative chest radiographs ___ through ___. In addition to numerous persistent air and fluid loculations in the right pneumonectomy space, there is now a dominant air-fluid interface. If this does represent an increase in the volume of air in the right pneumonectomy space it is indirect evidence of stump leak. There is no evidence of spillover pneumonia in the left lung. The distribution of subcutaneous emphysema in the right chest wall has changed but the overall volume has not. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 1:12 PM, 1 minutes after discovery of the findings. " b08646fb-16172f83-0de670f6-ba402020-28f0cbdb.jpg,test/p19/p19943239/s54379490/b08646fb-16172f83-0de670f6-ba402020-28f0cbdb.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is top normal. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. 6-mm calcified granuloma in the right lung base is stable. Lungs are clear. No pleural effusion or pneumothorax is present. Cholecystectomy clips are noted in the right upper abdomen. The osseous structures demonstrate no acute abnormalities. IMPRESSION: No acute cardiopulmonary process. " 158e646e-bb1fc6a2-6e1556b6-0cd8437a-5eceedad.jpg,test/p10/p10888223/s58871963/158e646e-bb1fc6a2-6e1556b6-0cd8437a-5eceedad.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Vomiting. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. There is mild increase in the interstitial markings suggesting mild interstitial edema. There is mild bibasilar atelectasis. No large pleural effusion is seen. Thoracic scoliosis is again noted. The aorta remains calcified and tortuous. The cardiac silhouette is not enlarged. A linear radiopaque structure is seen projecting over the lower neck, unclear whether internal or external to the patient. There is diffuse osteopenia, and there are degenerative changes at both shoulder and acromioclavicular joints. IMPRESSION: Mild increase in the interstitial markings diffusely bilaterally, mild interstitial edema. " 5820932a-20f23372-00c816b4-6600a06a-9d291643.jpg,test/p16/p16019229/s56496712/5820932a-20f23372-00c816b4-6600a06a-9d291643.jpg,test," FINAL REPORT HISTORY: Sepsis with chest tubes, to assess for pneumothorax. FINDINGS: In comparison with study of ___, bilateral chest tubes remain in place. No evidence of pneumothorax. " c210f439-d4240ea6-f33fc17a-cefc3df3-08475e22.jpg,test/p13/p13166187/s52460600/c210f439-d4240ea6-f33fc17a-cefc3df3-08475e22.jpg,test," FINAL REPORT HISTORY: ___-year-old male with severe abdominal pain, history of colon cancer. Evaluation for nasogastric tube placement. COMPARISON: The study is read in conjunction with CT of the abdomen and pelvis, obtained two hours after this radiograph. FINDINGS: Single portable view of the chest demonstrates a nasogastric tube coursing through the esophagus, below the diaphragm, with tip terminating in the fundus of the stomach. The cardiomediastinal silhouette demonstrates a tortuous aorta, but is otherwise unremarkable. The lung volumes are relatively low, but demonstrate no focal opacity, pleural effusion, or pulmonary edema. No pneumothorax is present. Cholecystectomy clips are seen projecting over the right upper quadrant. IMPRESSION: NG tube in appropriate position, with tip terminating in the fundus of the stomach. No acute cardiopulmonary process. No evidence of subdiaphragmatic free air. " 35e10640-ae884eaa-9883b8bd-2b68d53a-3508b417.jpg,test/p19/p19372257/s56914252/35e10640-ae884eaa-9883b8bd-2b68d53a-3508b417.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with leukemia/lymphoma, here for chemo transplant, with PICC issues // Is central line in right place? Is central line in right place? COMPARISON: Prior chest radiographs ___. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Left subclavian line and a right central infusion catheter both end in the upper to mid SVC. No pleural effusion or pneumothorax. " cc0d9f38-a3f2ee70-150b3a70-5e0c0abf-6785f615.jpg,test/p19/p19997911/s52450782/cc0d9f38-a3f2ee70-150b3a70-5e0c0abf-6785f615.jpg,test," FINAL REPORT HISTORY: Abdominal pain, nausea, hypotension. TECHNIQUE: Portable AP view of the chest. COMPARISON: ___. FINDINGS: Heart size is mildly enlarged. The aorta remains tortuous and diffusely calcified. There is no pulmonary vascular congestion. Mild bibasilar atelectasis is seen. A moderate size hiatal hernia is re- demonstrated. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. Multilevel degenerative changes are noted in the thoracic spine with a levoscoliosis centered at the thoracolumbar junction. No free air is identified under the diaphragms. IMPRESSION: Moderate size hiatal hernia. Mild bibasilar atelectasis. No free air identified under the diaphragms. " bc8a8b48-2a99cfe9-d9fc2c30-25dca510-1afb40b8.jpg,test/p16/p16527660/s53902396/bc8a8b48-2a99cfe9-d9fc2c30-25dca510-1afb40b8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with advanced fibrosis // Please rule out TB. patient participating in clinical trial. Please ___ to ___ number ___ TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. There are moderate degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities There is no evidence of acute or chronic TB " 29b95e12-b7c36ed0-423b08ee-3bc78d65-b40a438a.jpg,test/p11/p11886174/s50130180/29b95e12-b7c36ed0-423b08ee-3bc78d65-b40a438a.jpg,test," WET READ: ___ ___ ___ 6:36 AM 1. No significant change in moderate left basilar pneumothorax. 2. Severe emphysema 3. Progression of bibasilar opacities are worrisome for aspiration or aspiration pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with PTX. Assess progression of PTX TECHNIQUE: Single portable AP chest radiograph. COMPARISON: Chest radiograph ___, ___, ___ CT chest ___ FINDINGS: No interval change since radiograph performed 4 hours prior. Again seen are well inflated lungs. Persistent heterogeneous granular opacities within bilateral lung bases noted. Lucencies projecting along the right costophrenic angle and lateral right pleural surface are consistent with blebs. Pleural plaques again noted. There is evidence of severe emphysema. Persistent moderate left basilar pneumothorax is unchanged in size or appearance. No pleural effusion. Heart size, mediastinal contour, and hila are unremarkable. Aortic arch calcifications are present. A right anterior chest wall pacer device with single lead tip within right ventricle again noted. IMPRESSION: 1. No significant change in moderate left basilar pneumothorax. 2. Severe emphysema 3. Progression of bibasilar opacities are worrisome for aspiration or aspiration pneumonia 4. Pleural plaques consistent with prior asbestosis exposure. " 5dd5002b-ef0b647a-ec65f7fb-d0bcf93e-68217235.jpg,test/p19/p19643415/s55940834/5dd5002b-ef0b647a-ec65f7fb-d0bcf93e-68217235.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fall, loss of conscious, right shoulder and rib pain. Evaluate for injury. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: A left Port-A-Cath is stable in position, terminating in the SVC. The cardiac silhouette is stable in size. There are coarse bronchovascular markings without focal consolidation, pleural effusion or pneumothorax. No overt pulmonary edema is seen. Chronic bilateral rib deformities are noted, and degenerative changes of the thoracic spine are seen. IMPRESSION: No acute cardiopulmonary process. " 168bcf56-0fa7afc0-628544f8-78072ca1-45e93fe5.jpg,test/p13/p13358134/s53731433/168bcf56-0fa7afc0-628544f8-78072ca1-45e93fe5.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with chest pain, confusion TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and CABG. Lung volumes are low which accentuates the size of the cardiac silhouette which remains mildly enlarged. Mediastinal and hilar contours are unchanged. There is crowding of the bronchovascular structures due to low lung volumes without overt pulmonary edema. Innumerable basilar predominant nodular opacities are less pronounced on the current study but compatible with known metastases. Patchy opacities are re- demonstrated in the lung bases likely reflective of atelectasis. No new focal consolidation, pleural effusion or pneumothorax is demonstrated. Multilevel degenerative changes are again noted in the thoracic spine. IMPRESSION: Innumerable pulmonary metastases are less pronounced on the current study. Bibasilar atelectasis. " b9a6fb06-c855f7ab-96387a18-85b81c84-a04858af.jpg,test/p18/p18111516/s59173869/b9a6fb06-c855f7ab-96387a18-85b81c84-a04858af.jpg,test," FINAL REPORT CHEST RADIOGRAPH: INDICATION: New left internal jugular vein catheter, evaluation of placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 18 mm above the carina, a newly placed nasogastric tube is in correct position. Normal size of the cardiac silhouette. Normal appearance of the lung parenchyma. The patient has also received a left internal jugular vein catheter. The course of the catheter is unremarkable, the tip of the catheter projects over the upper SVC, approximately at the level of the azygos arch. No evidence of complications, notably no pneumothorax. " 44417d00-273ba8b6-167851a1-03d57fe5-d3f18491.jpg,test/p13/p13398212/s58804553/44417d00-273ba8b6-167851a1-03d57fe5-d3f18491.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with decreased oxygen saturation, with nausea and vomiting. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pulmonary vascular congestion. Cardiomegaly is unchanged. Atherosclerotic calcifications again noted at the arch. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 81e6ebaf-3020996e-4e9e1cb9-dfaa8429-def15cbc.jpg,test/p17/p17627751/s54701672/81e6ebaf-3020996e-4e9e1cb9-dfaa8429-def15cbc.jpg,test," FINAL REPORT HISTORY: Possible pneumonia. FINDINGS: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " aaba720f-9e641f92-56160c83-0ddc0f16-6d2d15c2.jpg,test/p15/p15715874/s57279803/aaba720f-9e641f92-56160c83-0ddc0f16-6d2d15c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with inc'd sob and resp distress COMPARISON: ___ at 11:54 as well as a prior radiograph from ___. FINDINGS: AP portable upright view of the chest. As seen on the prior exam from earlier today, there is subtle opacity in the left upper lobe which is concerning for pneumonia. In addition, there is subtle increased opacity in the right upper lobe which could represent a second focus of pneumonia. Coarsened reticular markings are noted diffusely which could represent chronic lung disease which has been seen on prior radiographs dating back to from ___. Cardiomediastinal silhouette is stable. Bony structures appear grossly intact. No free air below the right hemidiaphragm. IMPRESSION: Coarsened lung markings suggest chronic lung disease with subtle increased opacity in the right upper and left upper lobes concerning for pneumonia. " 4114225b-63eaaa95-e2b56433-8a81ae0b-51d5b781.jpg,test/p15/p15680450/s51004284/4114225b-63eaaa95-e2b56433-8a81ae0b-51d5b781.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with h/o 2nd degree Mobitz 1 a/v block with Ling ILR placement, dislodged. // Check position of Ling implant TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. LINQ device seen in a somewhat horizontal orientation projecting over the medial left lower chest, approximately at the level of the anterior left fourth and fifth ribs. On the lateral view, the device is seen to be very superficial in the anterior skin of the chest, and possibly protruding from it. IMPRESSION: LINQ device seen in a somewhat horizontal orientation projecting over the medial left lower chest, approximately at the level of the anterior left fourth and fifth ribs. On the lateral view, the device is seen to be very superficial in the anterior skin of the chest, and possibly protruding from it. " 6769df7a-41a2679c-296fc112-a1167551-b418f8b1.jpg,test/p17/p17445268/s50188920/6769df7a-41a2679c-296fc112-a1167551-b418f8b1.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Hemoptysis, NG tube replaced. FINDINGS: NG tube tip is off the film, at least in the stomach. Bilateral pleural effusions are slightly worse. There continues to be mild cardiomegaly. There is lower lobe volume loss/infiltrate slightly worse than before as well. " c8f12872-98a470d8-26469fc1-a94dd0fe-9b68aae6.jpg,test/p18/p18519417/s56389373/c8f12872-98a470d8-26469fc1-a94dd0fe-9b68aae6.jpg,test," FINAL REPORT HISTORY: Altered mental status. Evaluate for infiltrate. COMPARISON: Prior chest radiograph from ___. FINDINGS: Decreased lung volumes accentuate the cardiac silhouette and bronchovascular structures. There is mild bibasilar atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. Note is made of air fluid levels and edema of multiple loops of small bowel in the visualized portions of the upper abdomen. IMPRESSION: Decreased lung volumes with no evidence of an acute cardiopulmonary process. Air fluid levels and edema of loops of small bowel in visualized portions of the abdomen, could relate to patient's known diagnosis of cirrhosis and ascites, as discussed with Dr. ___. However, if clinically warranted further evaluation with abdominal imaging could be considered. Findings discussed with Dr. ___ by ___ via telephone on ___ at 7:45 AM. " dd258158-5beea3f9-9a259a58-0d18a5b3-1eabbde7.jpg,test/p10/p10795993/s51983115/dd258158-5beea3f9-9a259a58-0d18a5b3-1eabbde7.jpg,test," FINAL REPORT HISTORY: Recent bile duct surgery and intractable hiccups, question free air. TECHNIQUE: AP upright portable view of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette is top-normal. There is minimal left base atelectasis. No focal consolidation is seen. There is no large pleural effusion or pneumothorax. There is no definite evidence of free air beneath the diaphragms. IMPRESSION: Mild left base atelectasis. Otherwise no acute cardiopulmonary process. No definite free air beneath the diaphragms. " cd8f3cbf-3483b325-166bbe05-e15bca07-adad015e.jpg,test/p18/p18006988/s51754926/cd8f3cbf-3483b325-166bbe05-e15bca07-adad015e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Asthma, RA on MTX presenting with SOB for 1 week // Evidence of infection COMPARISON: ___. FINDINGS: Cardiomediastinal contours are stable. A very large hiatal hernia is again demonstrated. Lungs and pleural surfaces are clear, with no new areas of consolidation. IMPRESSION: No evidence of pneumonia. " a7dbe37c-9c59cd15-f05ddd87-992250f8-4d4d891c.jpg,test/p16/p16040005/s58432261/a7dbe37c-9c59cd15-f05ddd87-992250f8-4d4d891c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB and cough // PNA? COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Subtle hazy opacity at the right medial lung base likely represents epicardial fat. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 1e778f99-42a9ba31-5271e49a-d8768ac5-3e1d93b9.jpg,test/p14/p14458470/s50252029/1e778f99-42a9ba31-5271e49a-d8768ac5-3e1d93b9.jpg,test," FINAL REPORT HISTORY: Hyperglycemia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Moderate enlargement of cardiac silhouette is noted. The lung volumes are low. The mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures but no pulmonary edema is seen. Streaky bibasilar airspace opacities likely reflect atelectasis in the setting of low lung volumes. Infection however is not excluded. There is no pleural effusion or pneumothorax. Remote left-sided rib fractures are present. IMPRESSION: Low lung volumes with probable bibasilar atelectasis, but infection is not completely excluded. " 40550b01-febf133d-4483a20c-3e471de9-35c8f9d9.jpg,test/p10/p10083754/s50779872/40550b01-febf133d-4483a20c-3e471de9-35c8f9d9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with MULTIPLE MYELOMA // PRE-BMT EVALUATION PRE-BMT EVALUATION IMPRESSION: No previous images. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 05b4e7dc-bf81d3e4-23df5ba2-9086683e-ab690165.jpg,test/p10/p10044391/s50090539/05b4e7dc-bf81d3e4-23df5ba2-9086683e-ab690165.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with epigastric pain s/p MVC // Assess for Fx vs atelectasis Assess for Fx vs atelectasis COMPARISON: Chest radiograph ___. IMPRESSION: Lungs fully expanded and clear. Normal cardiac and hilar silhouettes and pleural surfaces. The configuration of the upper mediastinum, with mild relative widening to the left and no tracheal displacement is most commonly seen with a persistent left SVC, not a clinically significant finding. " 3867b5a3-89c70b03-0910512e-256cbf1a-da4b5534.jpg,test/p14/p14895079/s59723928/3867b5a3-89c70b03-0910512e-256cbf1a-da4b5534.jpg,test," FINAL REPORT REASON FOR EXAM: Assess lung nodules seen on Port-A-Cath placement. Cardiomediastinal contours are normal. Nodular opacity in the left perihilar region is likely a vascular structure. A second nodular opacity projecting over the anterior left first rib is in unchanged location and likely is a bone island. There is no evidence of pneumothorax or pleural effusion. Left Port-A-Cath tip is in the lower SVC. Mild degenerative changes are in the thoracic spine. Shallow obliques are recommended to ensure that the nodular opacities are as described vascular and osseous structures. Findings were posted in the critical result reporting system to be conveyed to referring physician. " a15e6d15-0c00fce8-b80bc899-31b19dd6-cb9d10ce.jpg,test/p17/p17284612/s55316501/a15e6d15-0c00fce8-b80bc899-31b19dd6-cb9d10ce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p cardiopulmonary arrest intubated now extubated with respiratory distress. // ?interval change ?interval change IMPRESSION: Right internal jugular line tip is at the level of mid SVC. Heart size and mediastinum are stable. There are similar in appearance bibasal areas of atelectasis, left more than right. No interval development of pleural effusion or pneumothorax is seen. No pulmonary edema is present. " 2c23476e-9ff927c5-90117909-6b0c1f7f-0422c837.jpg,test/p15/p15752845/s55107086/2c23476e-9ff927c5-90117909-6b0c1f7f-0422c837.jpg,test," FINAL REPORT CLINICAL HISTORY: Status post liver resection, postop day 2, now with fever. Increased densities are present at both bases, more likely due to atelectasis than infection. Some mild blunting of the right costophrenic angle is present. There is no evidence of a pneumothorax. IMPRESSION: Bilateral atelectasis. " 5b5f975e-1fa1960e-ad5629a4-2d14e120-efab63e0.jpg,test/p14/p14541551/s54347592/5b5f975e-1fa1960e-ad5629a4-2d14e120-efab63e0.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, patient has received a Dobbhoff catheter. The catheter is coiled in the esophagus, not reached the stomach. The catheter needs to be repositioned. There is no evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged. At the time of observation and dictation, 4:38 p.m., on ___, the referring physician ___. ___ was paged for notification and the findings were subsequently discussed over the telephone. " 48c263fb-3caf4eee-78f9dd68-9052cc8e-4471427a.jpg,test/p14/p14948967/s56870862/48c263fb-3caf4eee-78f9dd68-9052cc8e-4471427a.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with mild cough, s/p renal txp on immunosuppress. // ?cpd TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are hyperinflated, similar the prior exams. No focal consolidation, effusion, edema, or pneumothorax. The heart is top-normal in size, unchanged. The mediastinum is not widened. No evidence of an acute osseous abnormality. Anterior osteophytes and calcification of anterior longitudinal ligament is noted in the mid thoracic spine. IMPRESSION: No acute intrathoracic process. " d4198dc3-03e265df-c8ff41a7-d415d5d0-b3bada91.jpg,test/p17/p17615451/s57521529/d4198dc3-03e265df-c8ff41a7-d415d5d0-b3bada91.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Low-grade prostate cancer with one week of fever, sweats, and dyspnea. Portable AP radiograph of the chest was reviewed in comparison to ___. The right PICC line tip is at the level of low SVC. Heart size is unchanged including cardiomegaly and most likely prominent bilateral atrial enlargement. Left lower lobe opacity is re-demonstrated, increased since ___ and ___ and potentially concerning for a combination of atelectasis and infectious process. Attention to this area on the subsequent study recommended. No pulmonary edema is seen. " 71d87a3f-5d11456c-c2daa27c-61a7f874-ad2981bb.jpg,test/p14/p14997223/s54931504/71d87a3f-5d11456c-c2daa27c-61a7f874-ad2981bb.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: PleurX catheter, recent pleurodesis, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right PleurX catheter is in unchanged position. There is unchanged evidence of a relatively extensive circumferential pleural fluid collection and signs of increasing parenchymal opacities in the right lung. The left lung, including partial atelectasis of the left lower lobe in retrocardiac position, is unchanged. Unchanged size of the cardiac silhouette. " a3bc1945-6c9433fc-e25b56ab-a688eec0-31b5df8c.jpg,test/p10/p10449408/s57109077/a3bc1945-6c9433fc-e25b56ab-a688eec0-31b5df8c.jpg,test," FINAL REPORT PATIENT HISTORY: ___ years old woman with respiratory failure and DIC, please evaluate for interval changes. COMPARISON: Exam is compared to chest x-ray of ___. IMPRESSION: AP single view of the chest shows interval improvement of bilateral multifocal opacity especially to the left for improvement of pulmonary edema, now minimal if any. Heart size is still midly enlarged. There is no pleural effusion or pneumothorax. " 3b4a49ca-8676e2ac-f556fe29-09fa3269-4d98a4d2.jpg,test/p10/p10027957/s50867638/3b4a49ca-8676e2ac-f556fe29-09fa3269-4d98a4d2.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP, SOB // eval for PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 27475733-ae047b2c-f9801906-1d93d6ab-1707f96e.jpg,test/p16/p16087436/s50424505/27475733-ae047b2c-f9801906-1d93d6ab-1707f96e.jpg,test," FINAL REPORT HISTORY: Cerebral hemorrhage with postoperative respiratory distress. FINDINGS: In comparison with the study of ___, the endotracheal tube has been removed. Nasogastric tube and left central catheter remains in place. There is no evidence of vascular congestion or acute focal pneumonia at this time. " 4c8ab914-fa393673-ba67c4a6-ed150ec4-37c7f510.jpg,test/p11/p11129702/s58981491/4c8ab914-fa393673-ba67c4a6-ed150ec4-37c7f510.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with sepsis after central venous line placement. Portable AP radiograph of the chest was reviewed in comparison to ___. Right internal jugular line tip is at the level of the cavoatrial junction. Heart size and mediastinum are stable. Bibasilar minimal opacities are noted and there are no pleural effusions or pneumothorax demonstrated. Vascular engorgement is present. " aaed973d-5df5a83c-72264828-bc1deccd-e4463438.jpg,test/p11/p11099330/s59354584/aaed973d-5df5a83c-72264828-bc1deccd-e4463438.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with hypoxia COMPARISON: ___ FINDINGS: AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Degenerative changes of the AC joint again noted. IMPRESSION: No acute intrathoracic process " f2d2fa81-ea03a47d-2a848afa-aeab9a36-e5cfefff.jpg,test/p17/p17613076/s52926323/f2d2fa81-ea03a47d-2a848afa-aeab9a36-e5cfefff.jpg,test," FINAL REPORT INDICATION: ___-year-old female with asthma, now with new symptoms, here to evaluate for superimposed pneumonia. COMPARISON: Chest radiograph last performed on ___ and non-contrast chest CT performed ___. FINDINGS: Frontal and lateral radiographs of the chest show multiple surgical clips along the right side of the trachea at the level of the right thyroid bed. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is top normal in size. Fullness in the right paratracheal region corresponds to known mediastinal cyst from CT of ___. The mediastinal and hilar contours are unchanged from the preceding radiograph. IMPRESSION: No acute cardiopulmonary process. Unchanged appearance of known mediastinal cyst. " cbc4a0bf-b2cbfb70-973db0a1-874fae09-7ed0e94d.jpg,test/p19/p19057052/s52547832/cbc4a0bf-b2cbfb70-973db0a1-874fae09-7ed0e94d.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Hypoxia. REFERENCE EXAM: ___. FINDINGS: There are new dense areas of volume loss most marked in the right mid to upper lung and left lower lung. There is also right lower lobe alveolar infiltrate. ET tube and right-sided PICC line and cervical spine fixation devices are unchanged. OG tube tip is off the film. IMPRESSION: Worsened pulmonary status with areas of volume loss/infiltrate. " 7707b78f-34f0d806-3a9a0e48-889397d4-eb63cf40.jpg,test/p11/p11790326/s51227890/7707b78f-34f0d806-3a9a0e48-889397d4-eb63cf40.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, rule out pulmonary pathology. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Sternal wires after sternotomy and CABG. On both the frontal and the lateral radiograph, the medial portions of the middle lobe appear slightly denser than the left lung base. In light of the clinical presentation, the presence of a small middle lobe pneumonia must be suspected. Moderate cardiomegaly. No pleural effusions. Relatively flat hemidiaphragms, potentially caused by mild overinflation. Moderate tortuosity of the thoracic aorta. At the time of dictation and observation, 2:07, on the ___, the office of the referring physician, ___. ___, was contacted by telephone and the findings were communicated to the nurse, ___. " 9bcd64c8-8486aadc-1fd5568c-40fd0714-6dbf5d47.jpg,test/p16/p16897258/s51005214/9bcd64c8-8486aadc-1fd5568c-40fd0714-6dbf5d47.jpg,test," FINAL REPORT HISTORY: ___-year-old male with pleural effusion. COMPARISON: Chest radiographs dated through ___. FINDINGS: Frontal and lateral chest radiograph demonstrates no significant change in the severity of the left pleural fluid. Several nodular opacities within the left upper lobe consistent with patient's known history of metastasis better demonstrated on CT dated ___. The right lung is grossly clear with no new focal consolidation. The cardiomediastinal and hilar contours are unchanged when compared to chest radiograph dated ___. No pneumothorax. IMPRESSION: No significant change in severity of left-sided pleural effusion. No pneumothorax. " e86e052b-7576d28e-c20aefc5-4528c56b-e2d5ce30.jpg,test/p18/p18699864/s53890711/e86e052b-7576d28e-c20aefc5-4528c56b-e2d5ce30.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with movement of chest tube // chest tube eval COMPARISON: Prior study from ___. FINDINGS: PA and lateral views of the chest provided. There is a right sided pigtail chest tube in place. There is no residual pneumothorax. No pleural effusion. No focal consolidation. Cardiomediastinal silhouette is normal. Bony structures are intact. Minimal subcutaneous emphysema in the right chest wall at the chest tube insertion site. IMPRESSION: No residual pneumothorax with right pigtail chest tube in place. " abb4f785-4598a6fc-13f6e34c-1c744795-86a55a8e.jpg,test/p12/p12268481/s52254692/abb4f785-4598a6fc-13f6e34c-1c744795-86a55a8e.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fever and cough // Please assess for evidence of pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There is subtle opacity linear opacity in the lingula, slightly more prominent from the previous examination, favoured to represent atelectasis. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: Increasing linear opacity in the lingula, favored to represent atelectasis rather than pneumonia. " f3890b50-755c7ec4-15100d28-c016dfb3-b6e8e93d.jpg,test/p13/p13077273/s56702279/f3890b50-755c7ec4-15100d28-c016dfb3-b6e8e93d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with epigastric pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and ___ CT chest FINDINGS: Cardiac silhouette size remains mildly enlarged, unchanged. Mediastinal and hilar contours are similar. Pulmonary vasculature is not engorged. Chronic fibrotic changes with bronchiectasis are again noted at the lung bases, with minimal chronic interstitial abnormality also seen along the periphery of both lungs, not significantly changed in the interval. No new focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities detected. IMPRESSION: Chronic fibrotic changes most pronounced at the lung bases without new focal consolidation. " 5efe68dd-cec58649-41c88d92-da02faf1-a0ff8330.jpg,test/p11/p11218867/s51876729/5efe68dd-cec58649-41c88d92-da02faf1-a0ff8330.jpg,test," FINAL REPORT CHEST TWO VIEWS INDICATION: ___-year-old woman with Hodgkin's lymphoma, on chemotherapy via A Port-A-Cath, with new ecchymosis surrounding port site, question port intact. CHEST TWO VIEWS: Comparison is made to prior examination of ___. The heart is normal in size. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. The lungs are clear. There are no pleural effusions. A Port-A-Cath is identified, the tip is at the cavoatrial junction. The port is intact. IMPRESSION: 1. Normal examination of the chest. 2. The Port-A-Cath is intact. " 96829fa6-36eb13fb-53cda211-8902d2a0-8e636e7d.jpg,test/p15/p15860820/s58522799/96829fa6-36eb13fb-53cda211-8902d2a0-8e636e7d.jpg,test," FINAL REPORT INDICATION: Postop fever. New shortness of breath. COMPARISONS: Chest radiograph from ___. TECHNIQUE: A single semi-upright AP view of the chest was obtained. FINDINGS: The right internal jugular central venous catheter is unchanged with tip in the upper SVC. Since prior exam, there are new small-to-moderate bilateral pleural effusions, which obscure the lower lungs. A lower lobe opacity is difficult to exclude. There is no pneumothorax. The cardiomediastinal silhouette is normal. The stomach is significantly distended. A drain overlying the left upper quadrant and surgical ___ are partially imaged in the mid abdomen. IMPRESSION: 1. New bilateral pleural effusions, which obscure the lower lungs. Recommend further evaluation with an upright chest radiograph to assess for basilar opacities. 2. Distended air-filled stomach. Results were initially discussed with Dr. ___ by Dr. ___ at 6:20 a.m. on ___ via telephone, 5 minutes after the findings were discovered. They were again discussed with Dr. ___ at 1:20 p.m. on ___ via telephone by Dr. ___. " 00d3a4ec-c39b7d04-ecee5dab-686c9073-e921be9d.jpg,test/p17/p17643710/s55659320/00d3a4ec-c39b7d04-ecee5dab-686c9073-e921be9d.jpg,test," WET READ: ___ ___ ___ 8:07 PM New retrocardiac opacity, persisting on the lateral view, is concerning for developing pneumonia, given the patient's clinical history. No change in the cardiomediastinal silhouette since ___. The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 20:00 on ___, ___ min after discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with FTT, r/o pna // r/o pna r/o pna IMPRESSION: Compared to a chest radiographs ___ through ___. New lower lobe consolidation, probably right rather than left, consistent with pneumonia. Lungs otherwise clear. Mild to moderate cardiomegaly is chronic. No evidence of cardiac decompensation. No pleural effusion or pneumothorax. Thoracic aorta is tortuous and generally enlarged, unchanged since ___. No esophageal feeding tube is seen. " 0a70687a-043c8362-43614f02-be388be9-553fc991.jpg,test/p14/p14014690/s52231485/0a70687a-043c8362-43614f02-be388be9-553fc991.jpg,test," FINAL REPORT HISTORY: Epigastric pain, shortness of breath, cough and vomiting. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. The lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No subdiaphragmatic free air is demonstrated. IMPRESSION: No acute cardiopulmonary process. " 8b3644c7-751d5f0b-589f4fa6-b28a2293-b086a855.jpg,test/p14/p14240547/s50211520/8b3644c7-751d5f0b-589f4fa6-b28a2293-b086a855.jpg,test," FINAL REPORT HISTORY: Rigors and fever, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. Again low lung volumes are associated with prominence of the cardiac silhouette. Continued mild pulmonary vascular engorgement with atelectatic changes in the retrocardiac region. If there are appropriate clinical findings, the possibility of supervening pneumonia in the retrocardiac region must be considered. " 282ff3cd-7251a28c-a6c5fc60-09815fdd-06b000f8.jpg,test/p14/p14260816/s56364568/282ff3cd-7251a28c-a6c5fc60-09815fdd-06b000f8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with asthma and recent pna // sob difficulty cathicng breath COMPARISON: ___ FINDINGS: There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 7701c07a-216882a5-44ea8185-902b9727-2b5a3d68.jpg,test/p10/p10500801/s59547910/7701c07a-216882a5-44ea8185-902b9727-2b5a3d68.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CT chest from ___ and chest radiograph from ___. CLINICAL HISTORY: Cough, shortness of breath, assess for CHF or pneumonia. FINDINGS: PA and lateral views of the chest were obtained. Lungs appear clear and hyperinflated. Flattened diaphragms and widened AP diameter of the chest suggests underlying emphysema. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures appear intact. IMPRESSION: COPD, no superimposed pneumonia or CHF. " 887618e0-b3bb6207-135b9147-904e9cff-37230ef7.jpg,test/p19/p19321265/s53113362/887618e0-b3bb6207-135b9147-904e9cff-37230ef7.jpg,test," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with pneumonia, who needs follow up film. // pnemonia TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dated ___ and ___. FINDINGS: The cardiomediastinal silhouette is normal. The pleura are unremarkable. Previously seen right middle lobe opacity is longer present. No consolidations, pleural effusions, pulmonary edema, or pneumothorax. IMPRESSION: Resolution of pneumonia. " c36ac9f7-decbec4c-b31df9ad-ab8ded55-a8b40d1e.jpg,test/p12/p12457907/s59447459/c36ac9f7-decbec4c-b31df9ad-ab8ded55-a8b40d1e.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Right upper lobectomy for adenocarcinoma. Chest tube to waterseal. IMPRESSION: PA and lateral chest compared to ___: Small volume of right pneumothorax is collected superiorly and anteriorly, unchanged and ___, apical pleural tube still in place. There is, however, greater subcutaneous emphysema in the right chest wall, now extending up to the neck. There is no appreciable pleural effusion. Left lung clear. Heart size normal. " 237a5440-6e403370-22b1fa0e-35845d63-1d04b178.jpg,test/p17/p17515788/s59087899/237a5440-6e403370-22b1fa0e-35845d63-1d04b178.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Shortness of breath. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. Coronary calcifications are discernible. The mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: Coronary artery calcifications. No evidence of acute cardiopulmonary disease. " 0f8305f1-cd594759-db902af8-9cb79673-2d76799a.jpg,test/p15/p15573773/s52907226/0f8305f1-cd594759-db902af8-9cb79673-2d76799a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PNA // interval change, pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Status post left shoulder repair. Healed bilateral rib fractures. Moderate cardiomegaly. Small right pleural effusion. Atelectasis at the right lung basis, coexisting pneumonia cannot be excluded. . No overt pulmonary edema. " ac9c2ad5-9dbe86de-86023ac0-dc498817-f318b5cf.jpg,test/p19/p19180767/s52320886/ac9c2ad5-9dbe86de-86023ac0-dc498817-f318b5cf.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with weakness, question infiltrate. COMPARISON: ___. FINDINGS: The lungs are clear. No effusion, consolidation or pneumothorax is present. The heart and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 96c607d6-d136eb18-5e9ae4fc-22033dce-2b7a8f0d.jpg,test/p15/p15005501/s53887580/96c607d6-d136eb18-5e9ae4fc-22033dce-2b7a8f0d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with presyncope. Evaluate for infection. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: The right PICC line tip projects in the region of the cavoatrial junction. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unremarkable. IMPRESSION: No focal consolidation concerning for pneumonia. Right PICC terminates at the cavoatrial junction. " bab0fb74-c1478d82-fb8a09fc-7ff8a4ed-fe5eb87e.jpg,test/p17/p17417175/s56764336/bab0fb74-c1478d82-fb8a09fc-7ff8a4ed-fe5eb87e.jpg,test," WET READ: ___ ___ 8:15 AM Left chest wall port catheter terminates in right atrium. Right infrahilar opacity is apparent in the frontal and lateral view and was present on prior radiographs, possibly representing an area of atelectasis. No strong evidence for pneumonia. WET READ VERSION #1 ___ ___ ___ 7:31 PM Left chest wall port catheter terminates in right atrium. Right infrahilar opacity is apparent in the frontal and lateral view and was present on prior radiographs, possibly representing an area of atelectasis. No strong evidence for pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with febrile neutropenia, pancreatic ca // Eval for pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, all monitoring and support devices, with the exception of the left Port-A-Cath, have been removed. Normal structure and transparency of the lung parenchyma. No pneumonia, no pulmonary edema, no pleural effusions. Normal size of the cardiac silhouette. Mild elongation of the descending aorta. Normal appearance of the mediastinum. " 341cca6f-f54d8912-4c33440c-c1de4521-3c6d779f.jpg,test/p14/p14483422/s51860249/341cca6f-f54d8912-4c33440c-c1de4521-3c6d779f.jpg,test," FINAL REPORT INDICATION: Shortness of breath after recent hospital admission and cardiac catheterization. COMPARISON: CTA chest ___ and chest radiograph ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The heart size is normal. Opacification within the medial left upper lobe appears more consolidated when compared to the prior chest radiograph, but appears relatively unchanged compared to the CT from ___ and is compatible with the patient's known lung mass with adjacent radiation fibrosis. Scarring within the right lung apex is stable. Emphysematous changes are again noted. No new areas of focal consolidation are seen. There is no pleural effusion or pneumothorax. The pulmonary vascularity is not engorged. Compression deformities of the T11 and T4 vertebral bodies are unchanged. IMPRESSION: No new areas of opacification identified to indicate pneumonia. Left upper lobe consolidative opacity compatible with the patient's known lung mass with adjacent radiation fibrosis. " f2dbdde9-24268c56-2ab3e82b-aa0f851e-234f36c2.jpg,test/p16/p16646670/s58145274/f2dbdde9-24268c56-2ab3e82b-aa0f851e-234f36c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with malignant effusion // please assess for interval change please assess for interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Large right pleural effusion is larger, responsible for atelectasis worsening in the right lower lobe. Multiple pulmonary metastases, some cavitated, have grown considerably since ___. Moderate enlarged of the cardiac silhouette is stable since ___ making it unlikely that there is clinically significant pericardial effusion, always a concern with disseminated malignancy. " ac85e6ab-40c3b889-d957b22e-2ba6d669-df0b1f36.jpg,test/p17/p17788370/s59704641/ac85e6ab-40c3b889-d957b22e-2ba6d669-df0b1f36.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with new hepatic failure. COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Overlying EKG leads are present. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " cc2d95cf-d3e03066-d9994187-031f956f-8e24fc05.jpg,test/p15/p15057394/s54471175/cc2d95cf-d3e03066-d9994187-031f956f-8e24fc05.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. The patient is apparently status post coronary artery bypass graft surgery. There is no pleural effusion or pneumothorax. There is a mild increase in patchy opacity in the left lower lobe which suggests minor atelectasis. Elsewhere the lungs appear clear. Deformity of the left anterior lateral left fifth rib appears unchanged. IMPRESSION: Mild increase in opacity at the left lung base suggesting mild increase in pre-existing atelectasis; no definite evidence of disease. " 1deae0d0-e4c438b9-459e2597-f8430d49-7ca19e3e.jpg,test/p17/p17212019/s51163766/1deae0d0-e4c438b9-459e2597-f8430d49-7ca19e3e.jpg,test," FINAL REPORT CHEST, TWO VIEWS ___ HISTORY: ___-year-old male with productive cough. Question pneumonia. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Lungs are clear of consolidation. Cardiomediastinal silhouette is within normal limits. Posterior right ninth and tenth rib fractures are again seen. Osseous structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " 6ad5d0aa-c6867c7d-807dea2b-459494c8-c614c291.jpg,test/p10/p10307557/s55813844/6ad5d0aa-c6867c7d-807dea2b-459494c8-c614c291.jpg,test," FINAL REPORT INDICATION: Dobbhoff tube placement. COMPARISONS: ___. FINDINGS: Semi-upright portable chest radiographs demonstrate Dobbhoff tube curled within the stomach. Right IJ catheter is in appropriate position in the upper SVC. Small right pleural effusion and pulmonary vascular congestion are seen with stable cardiomegaly and aortic calcifications without focal consolidation. IMPRESSION: Dobbhoff tube within the stomach. " 0c56a251-4c26905e-b5f81d19-c5fac061-4a7563a8.jpg,test/p18/p18933015/s56435735/0c56a251-4c26905e-b5f81d19-c5fac061-4a7563a8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with severe COPD, mild decrease in LVEF now presents with SOB // eval for PNA, CHF exacerbation, or other acute cardiopulmonary pathology COMPARISON: Chest radiographs ___. IMPRESSION: Hyperinflation and the vascular distribution in the upper lobes indicates emphysema. Since ___ pulmonary edema has nearly resolved and pulmonary vascular congestion improved and mild cardiomegaly decreased there is no pneumonia or appreciable pleural abnormality. " b3376ab5-efcedc75-274a925d-d28fb90f-72f81186.jpg,test/p17/p17834931/s58773245/b3376ab5-efcedc75-274a925d-d28fb90f-72f81186.jpg,test," FINAL REPORT HISTORY: Right upper quadrant pain. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Streaky linear opacities in the left lung base as well as the right hemithorax are linear atelectasis. No focal consolidations are present that are concerning for pneumonia. The heart size is top normal in size, unchanged. The aorta has a tortuous course, unchanged. There is no pneumothorax or pulmonary edema or pleural effusion. IMPRESSION: Bibasilar atelectasis without evidence of pneumonia or pneumothorax. " 540137f4-a45bfcae-d335b9ff-a687ae20-a89ae0bf.jpg,test/p14/p14253816/s59714293/540137f4-a45bfcae-d335b9ff-a687ae20-a89ae0bf.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Hydrocephalus, nausea and vomiting. Preoperative evaluation. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Heart size is normal with trace unfolding of the thoracic aortic arch. Cardiomediastinal silhouette and hilar contours are normal. Questionable 3 cm ovoid density in the left lung base with possible retrocardiac correlate. Lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. Bones are diffusely demineralized. IMPRESSION: Indeterminate 3 cm ovoid density in the left lung base with possible retrocardiac correlate on lateral view. While it is possible this represents a nipple shadow, either repeat radiograph with nipple markers or CT examination is recommended. " bdb95b27-a31d1fcf-301fcc1f-2f856708-b5ed7f2e.jpg,test/p13/p13493660/s55695475/bdb95b27-a31d1fcf-301fcc1f-2f856708-b5ed7f2e.jpg,test," FINAL REPORT INDICATION: Left-sided pleuritic chest pain. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 022db053-0e147b80-208a2666-3d3c5f26-a8231a6b.jpg,test/p17/p17474035/s56302656/022db053-0e147b80-208a2666-3d3c5f26-a8231a6b.jpg,test," FINAL REPORT CLINICAL INDICATION: ___-year-old with syncope, question CHF. No comparison studies. Please note that comparison to old films can be helpful to detect subtle interval change. PA and lateral views of the chest ___ at 18:05 are submitted. IMPRESSION: 1. Cardiac and mediastinal contours are within normal limits. Lungs are well inflated without evidence of focal airspace consolidation, pleural effusions or pneumothorax. No pulmonary edema. Probable small sliding hiatal hernia. No acute bony abnormalities. " d700fd1c-9a03831a-ebc3c16b-aff7259f-5a3c7529.jpg,test/p19/p19729398/s58355710/d700fd1c-9a03831a-ebc3c16b-aff7259f-5a3c7529.jpg,test," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___ through ___. A CT was performed subsequently. FINDINGS: A single portable frontal chest radiograph was obtained. A known right upper lobe mass widens the mediastinum. In addition, a right upper lobe ground-glass opacity is new. Elevation of the right minor fissure indicates volume loss. Linear opacities at both lung bases most likely reflects atelectasis. Rounded opacities at both lung bases are most compatible with nipple shadows. There is no pneumothorax. Bilateral pleural effusions, apparent on the subsequent CT, are no well seen on this exam. Moderate cardiomegaly is exaggerated by AP technique but may be bigger compared with the prior exam. Bilateral hilar lymphadenopathy is better seen on CT. Median sternotomy wires and valve prosthesis are intact. IMPRESSION: Known right upper lobe mass and post-obstructive pneumonia " 5acd71dc-c11445a3-d2643e4e-e3eb0c27-c650db0b.jpg,test/p14/p14311378/s55474802/5acd71dc-c11445a3-d2643e4e-e3eb0c27-c650db0b.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // ?pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 339e879d-9f7ddb22-62920391-171a7dfe-741d4440.jpg,test/p11/p11495809/s58260311/339e879d-9f7ddb22-62920391-171a7dfe-741d4440.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pericardial and L pleural effusions s/p pleural drain d/c // post-chest drain pull CXR TECHNIQUE: Plain film COMPARISON: ___ and ___. FINDINGS: Left-sided thoracic catheter seen on the study from earlier the same date has been removed and no pneumothorax is seen. The left hemidiaphragm, however remains persistently obscured by overlying fluid and consolidation and right pleural effusion is also present. Cardiomegaly is somewhat obscured by adjacent fluid a consolidation. Cardiac stents and calcified plaque in the thoracic aorta are visible. IMPRESSION: No pneumothorax status post removal of left-sided chest tube. " 4c5212fc-b7dd0454-2ac29684-784631bc-452e4134.jpg,test/p13/p13717902/s58570342/4c5212fc-b7dd0454-2ac29684-784631bc-452e4134.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, AP portable single view. INDICATION: ___-year-old female patient admitted for seizures, treated for possible pneumonia, with elevated white blood count and shortness of breath. Evaluate. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Drooping head and chin are obscuring apical portion of the lungs and makes it impossible to accurately inspect the superior trachea. It is assumed that the ETT present on the previous examination has been removed. No pneumothorax can be identified. The pulmonary vasculature is unaltered and there is no evidence of any new acute parenchymal infiltrate. Similar as on the preceding examination, the high positioned diaphragms result in crowded appearance of the basal pulmonary vasculature with some linear densities on the left base most likely representing plate atelectasis. The diaphragmatic contours can be identified and thus there is no evidence of significant pleural effusion on either side. Smaller amounts of pleural effusion would require a lateral view to be seen in the posterior dependent pleural sinuses. Cardiac enlargement of moderate degree is again seen and within the heart shadow, one can identify a band of calcium representing mitral annulus calcifications. IMPRESSION: No evidence of acute pneumonia on this portable chest examination. " 7cedda48-ec3fa321-c2f3123e-0c750b69-92bbf6c9.jpg,test/p15/p15426827/s54878844/7cedda48-ec3fa321-c2f3123e-0c750b69-92bbf6c9.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with cirrhosis and recurrent pleural effusion, evaluate for interval development in effusion. FINDINGS: The patient's condition required examination in sitting upright position using AP frontal and left lateral views. Comparison is made with the next preceding AP single view examination of ___. When comparing the frontal views, the right-sided basal haze has increased indicating that pleural effusion on the right side has increased, now obliterates the entire diaphragmatic contour. On the left side, the lateral pleural sinus remains free. The lateral view confirms the bilateral high position of the diaphragms and discloses a relatively small amount of pleural effusion that blunts right posterior pleural sinus. New pulmonary parenchymal infiltrates cannot be identified. The position of the previously identified right-sided PICC line is confirmed on the lateral view and seen to terminate in the lower third of the SVC. A previously present Dobbhoff line is not seen anymore. IMPRESSION: Increasing amount of right-sided pleural effusion. Quantification is impossible as the previous examination did not allow assessment of lateral view findings. " c2ea5262-18df1d94-b6dca5be-9c9fefd8-34d090b8.jpg,test/p16/p16741854/s52144508/c2ea5262-18df1d94-b6dca5be-9c9fefd8-34d090b8.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with history of left-sided pleural effusion, assess for interval change. FINDINGS: 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 ___. 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. IMPRESSION: Grossly stable changes with evidence of left-sided pleural effusion. " 9d92a6f3-90b7ce10-f4c89f22-ac91f3cb-3d3658cb.jpg,test/p10/p10585182/s57315903/9d92a6f3-90b7ce10-f4c89f22-ac91f3cb-3d3658cb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o prior smoking, asthma now with cough productive purulent blood tinged sputum -- PAGE ___ WITH WET READ // ? infiltrate ? infiltrate IMPRESSION: In comparison with the study of ___, there is little change. Specifically, no evidence of acute focal pneumonia. Again there is scoliosis of the thoracolumbar spine convex to the right and a thick linear mid lung opacity on the left consistent with atelectasis. " 9a9ef389-3b2e5f88-c375ff2a-d2a10e34-9c751040.jpg,test/p17/p17293739/s52124899/9a9ef389-3b2e5f88-c375ff2a-d2a10e34-9c751040.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of HIV/AIDS, 2 weeks of worsening cough and sputum // Please evaluate for a PNA. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs on ___ and ___ FINDINGS: Heart size is minimally enlarged. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 468ca9a2-bb9c0214-ee39db24-292a138e-17b3e0dd.jpg,test/p16/p16724859/s54107534/468ca9a2-bb9c0214-ee39db24-292a138e-17b3e0dd.jpg,test," FINAL REPORT ___-year-old man with HIV and low-grade fever. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Cardiomediastinal silhouette and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is a small opacity seen only on the lateral view could be a very early focus of pneumonia in the correct clinical setting. IMPRESSION: Small opacity seen best on the lateral film, possible pneumonia. Correlate clinically. " 0f356013-dc65442b-3dccce56-c97c041f-3a8faeab.jpg,test/p12/p12629841/s53092465/0f356013-dc65442b-3dccce56-c97c041f-3a8faeab.jpg,test," FINAL REPORT INDICATION: Evaluate for foreign body in a patient who recently swallowed a toothbrush. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are without focal consolidation, pleural effusion, or pneumothorax. Multiple radiopaque densities in an oval configuration compatible with the head of the tooth brush projected over the stomach. There is no evidence of intraperitoneal free air or pneumomediastinum. IMPRESSION: Toothbrush visualized in the stomach, without evidence of intraperitoneal free air or pneumomediastinum. " 1f519e41-6d4b4334-c00a4e55-f4090545-a51ca24f.jpg,test/p10/p10387377/s51735756/1f519e41-6d4b4334-c00a4e55-f4090545-a51ca24f.jpg,test," FINAL REPORT AP CHEST, 11:33 P.M., ___ HISTORY: ___-year-old woman transferred from an outside hospital for presumed COPD exacerbation and cough. IMPRESSION: AP chest compared to ___: Mild pulmonary vascular congestion is new, but there is no pulmonary edema. Right lung is grossly clear. Heterogeneous opacification at the base of the left lung could be early pneumonia, but is also readily explained by mild atelectasis and a small left pleural effusion. Conventional radiographs recommended when feasible for a more complete evaluation. Mild cardiomegaly stable. No pneumothorax. " b62e1c39-a1345c10-52252098-aa2b55c0-75694dae.jpg,test/p14/p14090192/s53036028/b62e1c39-a1345c10-52252098-aa2b55c0-75694dae.jpg,test," FINAL REPORT STUDY: PA AND LATERAL CHEST X-RAY. COMPARISON: None. INDICATION: ___-year-old with right elbow fracture and chest wall pain. FINDINGS: The heart size is top normal. The mediastinal and hilar contours are unremarkable. The lungs are well expanded and clear. There is evidence of prior left mastectomy. There is no pulmonary edema, pleural effusion or pneumothorax. The osseous structures are unremarkable. IMPRESSION: No rib fractures. " 21abbab3-ad46794f-07d40e09-da670fdf-dbdd2a0c.jpg,test/p11/p11658675/s53352159/21abbab3-ad46794f-07d40e09-da670fdf-dbdd2a0c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough/+ bc // r/p pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes, which accentuate the bronchovascular markings. Given this, there bibasilar atelectasis. Hilar and perihilar opacities may be due to a mild pulmonary edema, again exaggerated by the low lung volumes. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: There are low lung volumes, which accentuate the bronchovascular markings. Given this, there bibasilar atelectasis. Hilar and perihilar opacities may be due to a mild pulmonary edema, again exaggerated by the low lung volumes. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. " 4b1ecf84-145f7ed2-4930a5de-251f67d5-d44a0ae0.jpg,test/p14/p14943190/s54544945/4b1ecf84-145f7ed2-4930a5de-251f67d5-d44a0ae0.jpg,test," FINAL REPORT PORTABLE CHEST, ___. COMPARISON: ___ radiograph. FINDINGS: Endotracheal tube remains in standard position, and cardiomediastinal contours are stable in appearance allowing for patient rotation. Pulmonary vascular congestion has slightly improved, accompanied by decreased perihilar haziness. However, two focal areas of consolidation in the right lower lung are new. Considering the presence of transient right lung consolidation on earlier chest x-ray of ___, this may be due to recurrent aspiration and less likely asymmetrical edema. Short-term followup radiographs may be helpful to exclude developing infectious pneumonia. Apparent increased opacity adjacent to left heart border probably represents accentuation of pericardial fat on this rotated radiograph, but attention to this region on followup CXR with improved positioning would be helpful to exclude a lingular abnormality. " c44b49a8-ad22dd3b-ed71ddc7-f83705e3-1e146942.jpg,test/p12/p12304672/s51387729/c44b49a8-ad22dd3b-ed71ddc7-f83705e3-1e146942.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with concern for aspiration // pls eval for interval change pls eval for interval change COMPARISON: ___ IMPRESSION: ET tube tip is 5 cm above the carinal. Pacemaker leads terminate in the expected location of right atrium and right ventricle. Bibasal consolidations and bilateral pleural effusions are unchanged. Left lower lung is most likely entirely atelectatic. The opacities within the lungs most likely represent a combination of pulmonary edema and infectious multinodular process. RECOMMENDATION(S): Correlation with chest CT is to be considered. " 641fda26-10b8bc78-c16ee214-84b2ba3b-07f00e65.jpg,test/p16/p16061352/s56668695/641fda26-10b8bc78-c16ee214-84b2ba3b-07f00e65.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx of pleural effusions, crackles on exam and SOB // Interval change Interval change IMPRESSION: Comparison to ___. Increase in severity of the pre-existing and previously mild pulmonary edema, the edema is now moderate in severity. The left pleural effusion with subsequent left basilar atelectasis is constant. Clips projecting over the left axilla and the right breast are in stable position. " fe87f277-1863addc-ba13e371-9e857e3b-2c6b9c7e.jpg,test/p13/p13422558/s58044510/fe87f277-1863addc-ba13e371-9e857e3b-2c6b9c7e.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest radiograph. INDICATION: ___ year old man intubated/sedated // PNA? Tube position correct? COMPARISON: Chest radiograph dated ___. FINDINGS: Asymmetric increased opacity in the right lung is substantially improved since yesterday, suggesting component of edema. Consolidation the right infrahilar region persists but is overall similar to the prior exam and could represent atelectasis, aspiration appropriate clinical setting cannot be excluded. Retrocardiac opacity is now increased from the prior exam with silhouetting of the lateral border the descending thoracic aorta, and is likely atelectasis. No pleural effusion or pneumothorax. The heart is normal in size. The mediastinum and hilar contours are overall unchanged. ETT is in standard position. Nasogastric tube in side-port traverses the diaphragm, of the side port may be at the gastroesophageal junction. The right internal jugular venous catheter ends in the low SVC, unchanged. IMPRESSION: Interval improvement in asymmetric right edema. Increased focal retrocardiac opacity, likely atelectasis, but close interval follow up to exclude developing pneumonia could be performed. " c4578e07-19955135-9ae60a98-5c7ec462-69beadbb.jpg,test/p16/p16553329/s53060980/c4578e07-19955135-9ae60a98-5c7ec462-69beadbb.jpg,test," FINAL REPORT HISTORY: Slurred speech and altered mental status. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is within normal limits. Scattered calcifications within the upper lung fields bilaterally likely reflect the sequela of prior granulomatous disease. No focal consolidation, pleural effusion or pneumothorax is seen. There is likely minimal retrocardiac atelectasis. No acute osseous abnormalities are demonstrated. There are mild degenerative changes of the thoracic spine as well as within the imaged left AC joint. IMPRESSION: No acute cardiopulmonary abnormality. " f87c7bbc-e246c1b5-199d01a8-b0cc5ff7-af3249d7.jpg,test/p14/p14798598/s57270465/f87c7bbc-e246c1b5-199d01a8-b0cc5ff7-af3249d7.jpg,test," FINAL REPORT INDICATION: ___-year-old man with syncope, to rule out cardiomegaly. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are clear, without consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary pathology, especially no cardiomegaly. " c1957e9f-c51f13ff-c44d1bc2-6fe7d44a-54f84cf1.jpg,test/p15/p15672432/s54909518/c1957e9f-c51f13ff-c44d1bc2-6fe7d44a-54f84cf1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with CP // PNA? TECHNIQUE: AP upright portable chest radiograph. COMPARISON: Radiograph from ___. FINDINGS: There is bibasilar opacity, left worse than right. The hilar and mediastinal silhouette are stable without evidence of pulmonary edema. The heart size stably mildly enlarged. There is no pleural effusion or pneumothorax. Patient is status post median sternotomy with wires aligned and intact. IMPRESSION: Bibasilar atelectasis, left worse than right. However, pneumonia in the left lower lobe cannot be excluded. " 4894e20c-7748f81e-27bfa1a1-96ec4e17-2bf684bd.jpg,test/p16/p16751898/s54391654/4894e20c-7748f81e-27bfa1a1-96ec4e17-2bf684bd.jpg,test," FINAL REPORT INDICATION: Fevers, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are clear. No pleural effusion, pneumothorax or focal airspace consolidation. Heart is top normal in size. The mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " d7c7e382-84f24b2a-a5d92582-50ab77e3-ba52930c.jpg,test/p17/p17051420/s53840089/d7c7e382-84f24b2a-a5d92582-50ab77e3-ba52930c.jpg,test," WET READ: ___ ___ ___ 3:02 AM Mild to moderate pulmonary edema, moderate cardiomegaly, and no pleural effusions. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with SOB // pleural edema TECHNIQUE: Chest PA and lateral COMPARISON: ___. ___ FINDINGS: Bilateral interstitial opacities, predominantly at the bases, as indicative of pulmonary edema. The heart is enlarged and the pulmonary vasculature is congested. No pleural effusion is seen. IMPRESSION: Mild to moderate pulmonary edema, moderate cardiomegaly, and no pleural effusions. " ca3b9538-6e72f359-8cdd1e70-3ce64034-e6c23f56.jpg,test/p19/p19605370/s50164330/ca3b9538-6e72f359-8cdd1e70-3ce64034-e6c23f56.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Influenza-like illness, hemoptysis, evaluation for pneumonia. COMPARISON: ___. FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Moderate cardiomegaly, no pleural effusions. No lung nodules or masses. No pulmonary edema. " 78bc28ad-4d0323f6-ed5a6b0f-9de009e7-6d2e9257.jpg,test/p18/p18111896/s52334341/78bc28ad-4d0323f6-ed5a6b0f-9de009e7-6d2e9257.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post OLT with sepsis, unintubated. Comparison is made with prior study ___. Cardiac size is top normal. The aorta is tortuous. Right IJ catheter tip is in the mid SVC. Left IJ catheter tip is in unchanged position at the junction of the brachiocephalic vein. ET tube is in standard position. NG tube tip is out of view below the diaphragm. Right lower lobe opacity has minimally increased. This could be due to atelectasis but superimposed infection cannot be excluded. There is mild vascular congestion. There is no pneumothorax or pleural effusion. A drain projects in the right upper quadrant. " c2fd99ac-0efb1858-af740665-7023c321-b14eab08.jpg,test/p12/p12457907/s56928233/c2fd99ac-0efb1858-af740665-7023c321-b14eab08.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness. R/o pna. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and CT chest of ___. FINDINGS: Patient is post right upper lobectomy, with expected postsurgical changes and right lung volume loss. There is subtle increased density in the right lower lung which may in part reflect the presence of scarring and right breast implant, however in early pneumonia difficult to exclude in the correct clinical setting. Underlying emphysema is noted. Heart size is top normal. No pneumothorax. IMPRESSION: Status post right upper lobectomy. Subtle increased opacity in the right lower lung maybe due to scarring and right breast implant though difficult to exclude an underlying pneumonia. " a2519749-213e267d-537e43c2-6cacd008-8201f94b.jpg,test/p10/p10610928/s54601405/a2519749-213e267d-537e43c2-6cacd008-8201f94b.jpg,test," FINAL REPORT EXAM: Chest AP portable views. CLINICAL INFORMATION: ___-year-old male with history of intubation. COMPARISON: None. FINDINGS: Endotracheal tube is seen, terminating approximately 5.7 cm above the level of the carina. A nasogastric tube was placed, distal aspect not well seen but coursing below the level of the diaphragm. There are low lung volumes. Prominence of the interstitial markings suggests fluid overload. More confluent opacity at the right lung base may be due to vascular structures, although infection or aspiration is not excluded in the appropriate clinical setting. No pneumothorax or large pleural effusion. The cardiac silhouette is top normal. " d52429f4-2755bd83-5739ac2a-0787e886-f9838dfb.jpg,test/p13/p13565659/s55779966/d52429f4-2755bd83-5739ac2a-0787e886-f9838dfb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 3 months cough // any sign of active or latent tb? any sign of active or latent tb? IMPRESSION: Heart size is normal. Aorta is slightly tortuous. Lungs are clear. No pleural effusion or pneumothorax is seen. " 312daa2a-c2471c30-3289e3ef-da5f40e6-3645ac10.jpg,test/p17/p17184573/s50284133/312daa2a-c2471c30-3289e3ef-da5f40e6-3645ac10.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ileal Crohns considering biologics // Active TB TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None provided. FINDINGS: Lungs are fully expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Mediastinum, hila and pleural surfaces are unremarkable. Heart size normal. IMPRESSION: No evidence of active pulmonary tuberculosis. " c112a5a3-a1cbecf3-567408c8-85a5d86d-91d5a609.jpg,test/p14/p14474735/s55382498/c112a5a3-a1cbecf3-567408c8-85a5d86d-91d5a609.jpg,test," FINAL REPORT INDICATION: History of recent tracheal stent. Evaluate for location. COMPARISONS: Chest radiograph from ___. FINDINGS: Single portable chest radiograph was provided. The tracheal stent is not visualized on this exam. There is new collapse of the left upper lobe. Lung volumes are low. There is no pneumothorax. Cardiac silhouette is top normal. IMPRESSION: 1. Tracheal stent is not visualized. 2. New left upper lobe collapse and low lung volumes. " b18976ed-546585bb-435fc3aa-31eb1299-1aad5620.jpg,test/p11/p11255297/s53112890/b18976ed-546585bb-435fc3aa-31eb1299-1aad5620.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain, shortness of breath, and abdominal pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Since prior, there has been interval development of right middle and lower lobe parenchymal opacities. Nodular opacity at the left lateral costophrenic angle is again noted, better characterized by a CT scan. Postoperative changes with clips in the posterior mediastinum are again noted. Hiatal hernia is also visualized. Cardiomediastinal silhouette is otherwise within normal limits. Osseous structures are unremarkable. IMPRESSION: Right middle and lower lobar regions of consolidation compatible with pneumonia in the proper clinical setting. Repeat after treatment is recommended to document resolution. " 45ba26f6-1e41752a-95bf956f-26dcc990-17b39473.jpg,test/p19/p19403960/s50474353/45ba26f6-1e41752a-95bf956f-26dcc990-17b39473.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old female patient, status post renal transplant and pleural effusions, evaluate pockets of effusion. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. PA and lateral chest views with patient in upright position demonstrate mild enlargement of the cardiac silhouette without typical configurational abnormality. Unremarkable appearance of thoracic aorta. The pulmonary vasculature demonstrates an upper zone redistribution pattern, but there is no evidence of interstitial or alveolar edema. The previously identified bilateral pleural effusions have regressed markedly. There remains a mild degree of right-sided pleural effusion obliterating the lateral half of the diaphragmatic contour and filling the lateral pleural sinus. This extends into the posterior pleural sinus. On the other hand, evidence of left-sided pleural effusion has disappeared completely with clear delineation of the diaphragmatic contour and sharp delineation of both lateral and posterior pleural sinuses which indicates absence of any remaining fluid. No new acute pulmonary parenchymal infiltrates can be identified, and the apical areas do not show any pneumothorax. Skeletal structures of the thorax are quite unremarkable. IMPRESSION: Marked regression of pleural effusions with small right-sided pleural effusion remaining. Also, the enlargement of the cardiac silhouette has regressed markedly. " 50c08ad3-41ebccda-6712d6cb-1bbbb08c-ae026fe8.jpg,test/p17/p17421663/s57089981/50c08ad3-41ebccda-6712d6cb-1bbbb08c-ae026fe8.jpg,test," FINAL REPORT PORTABLE CHEST ___ ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Indwelling support and monitoring devices are unchanged in position. Cardiomediastinal contours are stable in appearance. Rapid worsening of predominantly perihilar and basilar airspace opacities as well as more widespread peripherally predominant interstitial opacities. The distribution and rapid time course favor pulmonary edema, but followup radiographs after diuresis would be helpful to ensure resolution and to exclude other co-existing process. Bilateral small partially layering pleural effusions are also noted. " a2d0bd2b-0358907c-bdc53ab9-4d142db6-96c4418b.jpg,test/p13/p13419866/s58206326/a2d0bd2b-0358907c-bdc53ab9-4d142db6-96c4418b.jpg,test," FINAL REPORT INDICATION: History: ___F with chest and abdominal pain. // pneumonia ? CHF? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. There is a chronic fracture deformity of the posterolateral left third rib. IMPRESSION: No acute cardiopulmonary process. " 62444ae5-b06c1795-f6d4f379-4626a8c6-211aee91.jpg,test/p14/p14127617/s57215180/62444ae5-b06c1795-f6d4f379-4626a8c6-211aee91.jpg,test," FINAL REPORT HISTORY: Prolonged cough. FINDINGS: No previous images. There is mild hyperexpansion of the lungs, which raises the possibility of some underlying chronic pulmonary disease. However, no acute pneumonia, vascular congestion, or pleural effusion. " d3f70f4c-19ebb635-d7c4e4d2-fc927378-5d7d99b6.jpg,test/p10/p10535897/s56056032/d3f70f4c-19ebb635-d7c4e4d2-fc927378-5d7d99b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p Stage 3 posterior T10-S1 fusion, also with pneumonia // pls assess for interval change pls assess for interval change IMPRESSION: There to chest radiographs ___ through ___. Mild to moderate pulmonary edema and small right pleural effusion are new. Persistent consolidation left lower lobe could be pneumonia or rounded atelectasis. No pneumothorax. Heart size normal. Previous severe gaseous distention of the stomach has resolved following insertion of esophageal drainage tube. ET tube and right internal jugular line in standard placements respectively. " 0083a95a-23a77afe-a52cdbe5-267b7e9f-bd334756.jpg,test/p13/p13648633/s50772746/0083a95a-23a77afe-a52cdbe5-267b7e9f-bd334756.jpg,test," FINAL REPORT HISTORY: Dislodged the catheter. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. Chest CT ___ FINDINGS: The cardiac silhouette size is normal. Multiple calcified left hilar lymph nodes are re- demonstrated compatible with prior granulomatous disease. The mediastinal and hilar contours are otherwise are unchanged. Left-sided central venous catheter has been removed. No catheter fragments are visualized, and no radio-opaque foreign bodies are seen. The lungs are clear. No pleural effusion, focal consolidation or pneumothorax is present. There is diffuse demineralization of the osseous structures. Loss of height with endplate scalloping of multiple thoracic vertebral bodies is relatively unchanged compared to the prior chest CT from ___. IMPRESSION: No catheter fragment identified or radio-opaque foreign body seen. No acute cardiopulmonary abnormality. " 007b62f8-a3e35f42-4d918d3b-475a56b0-1e3ade0c.jpg,test/p11/p11967908/s50608354/007b62f8-a3e35f42-4d918d3b-475a56b0-1e3ade0c.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with shortness of breath. COMPARISON: ___ chest x-ray and chest CT from ___. FINDINGS: Frontal and lateral views of the chest. There has been interval resolution of previously seen pulmonary edema. Calcific densities projecting over the right mid lung are compatible with calcifications in the region of the overlying soft tissues. Right apical scarring is again noted. There is no new focal consolidation. The cardiomediastinal silhouette is within normal limits. Right axillary surgical clips again seen. IMPRESSION: No acute cardiopulmonary process. " 20444ed1-f4b75503-cff6f25b-ea643810-95b866e8.jpg,test/p19/p19601036/s50568396/20444ed1-f4b75503-cff6f25b-ea643810-95b866e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with worsening SOB with activity. // Pleural effusion Pleural effusion IMPRESSION: In comparison with the study of ___, there again are bilateral pleural effusions, slightly more prominent on the left with underlying compressive atelectasis. No evidence of vascular congestion or acute focal pneumonia. Cardiac silhouette is within normal limits. " 34f0e585-67e8b87b-f2160383-38cd7d62-ffd9f140.jpg,test/p13/p13715870/s51370021/34f0e585-67e8b87b-f2160383-38cd7d62-ffd9f140.jpg,test," FINAL REPORT INDICATION: History of endocarditis and MVR, improved but now with cough and dyspnea on exertion. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. Moderate-to-severe cardiomegaly is unchanged. These findings were discussed with Dr. ___ by Dr. ___ at 1:51 p.m. on ___ by telephone. " ce74bb4c-c61b6800-46b0bbb9-273856d8-b9ae1b5e.jpg,test/p19/p19689065/s53828526/ce74bb4c-c61b6800-46b0bbb9-273856d8-b9ae1b5e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with decreased O2 saturation // atelectasis vs pna IMPRESSION: Cardiomediastinal contours are within normal limits considering low lung volumes. Lungs appear grossly clear, and there is no evidence of pleural effusion or pneumothorax. " da8e9060-23f2a046-bb0d2f82-2cabf92a-d2386e57.jpg,test/p11/p11309585/s58945855/da8e9060-23f2a046-bb0d2f82-2cabf92a-d2386e57.jpg,test," FINAL REPORT INDICATION: History: ___M with tachypnea, fever, dehydration // evaluate for acute process, abdominal free air COMPARISON: None available. FINDINGS: Portable frontal radiograph of the chest demonstrates a left chest wall pacemaker with leads in the expected location the right atrium and right ventricle. Retrocardiac opacification could represent atelectasis or pneumonia. Linear opacification in right lower lung likely reflects atelectasis. The right costophrenic angle is excluded from is image. There is a collection of air in the left upper quadrant which may within bowel, but free intraperitoneal air is possible. This could be further evaluated with a right lateral decubitus radiograph. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 7:26 AM, 5 minutes after discovery of the findings. " 29929685-ae7731db-33f9f7e2-2eed3f1e-51aa9261.jpg,test/p10/p10884708/s55751585/29929685-ae7731db-33f9f7e2-2eed3f1e-51aa9261.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic breast cancer and likely malignant R pleural effusion s/p R pleurex catheter placement on ___, now with small R apical pneumothorax. // assess interval change in R apical pneumothorax assess interval change in R apical pneumothorax IMPRESSION: Comparison to ___. Decrease in extent of the right pneumothorax that nonetheless remains clearly visible. Mild decrease in lung volumes. Stable extent of the known extensive right pleural effusion. Known masses in the left lung. " e0c2b674-f2e313d1-608e2e88-7077c609-f4f640e4.jpg,test/p19/p19322666/s52875189/e0c2b674-f2e313d1-608e2e88-7077c609-f4f640e4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, evaluation for pneumonia. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Normal hilar and mediastinal structures. Normal transparency of the lung parenchyma. No evidence of pneumonia or other acute pathologic parenchymal change. Normal size of the cardiac silhouette. No pleural effusions. " b3de31ae-ec91d29e-54e562f1-e67cabcb-2ef4240a.jpg,test/p14/p14637100/s57516146/b3de31ae-ec91d29e-54e562f1-e67cabcb-2ef4240a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESRD, growing GPCs in her blood, giving IVF, pt on 2L NC // eval for pna, pulmonary edema eval for pna, pulmonary edema IMPRESSION: Comparison to ___. No relevant change is noted. Low lung volumes. Moderate cardiomegaly. Mild fluid overload but no overt pulmonary edema. No new parenchymal opacities. Stable position of the right central venous access line. " 210762a5-72a7cb76-d209b015-b018b59c-4c31fd1d.jpg,test/p16/p16881590/s50510122/210762a5-72a7cb76-d209b015-b018b59c-4c31fd1d.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath. Evaluate for CHF exacerbation. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Previously seen interstitial opacities have improved in the interval with possible minimal pulmonary vascular congestion remaining. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Possible minimal pulmonary vascular congestion without overt pulmonary edema. No pleural effusion. Persistent mild enlargement of the cardiac silhouette. " 18a40475-1be7994c-dba3edb3-4e11579e-ce9e153d.jpg,test/p11/p11556982/s57873502/18a40475-1be7994c-dba3edb3-4e11579e-ce9e153d.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old woman with new fever spike to 101. Evaluate for infection. FINDINGS: Comparison is made to previous study from ___. The PICC line has been removed since prior study. The cardiac silhouette and mediastinum is normal. Lungs are clear. There is no focal consolidation, pleural effusion, or pulmonary edema. Bony structures are grossly intact. " 5e639a0e-056966f0-16ed0462-955ee28c-45b36ca0.jpg,test/p17/p17051420/s54695783/5e639a0e-056966f0-16ed0462-955ee28c-45b36ca0.jpg,test," FINAL REPORT HISTORY: Multifocal pneumonia,here with chest pain and worsening shortness of breath. CHEST, TWO VIEWS. COMPARISON: ___ radiograph dated ___ at ___ p.m. Compared to a prior film and allowing for technical differences, there is some new patchy opacity at the right base. Otherwise, I doubt significant interval change. Again seen is moderate cardiomegaly with upper zone redistribution with mild vascular plethora. IMPRESSION: 1. Cardiomegaly with upper zone redistribution and mild vascular plethora. 2. Developing patchy opacity at the right base. This could represent prominent atelectasis, but the possibility of a pneumonic infiltrate or focus of aspiration is also in the differential. No gross effusion. " 267150d9-dbf4a1e8-57c3e61b-0298831d-a80db361.jpg,test/p17/p17007226/s51189569/267150d9-dbf4a1e8-57c3e61b-0298831d-a80db361.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with new opacity and hypoxia // PNA, volume overload TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Increased opacity at the right lung base concerning for a right lower lobe pneumonia.Small right pleural effusion. The heart is mildly enlarged, unchanged compared to prior study. IMPRESSION: Right lower lobe pneumonia and small right pleural effusion. RECOMMENDATION(S): Follow-up chest x-ray is recommended in ___ weeks to confirm resolution of pneumonia. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 5:18 PM, 5 minutes after discovery of the findings. " 17f77838-8758e940-cd476ec5-ba6a1447-6511a2c4.jpg,test/p14/p14653468/s52978188/17f77838-8758e940-cd476ec5-ba6a1447-6511a2c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with shortness of breath // r/o pneumonia COMPARISON: CT chest from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are hyperinflated with upper lobe lucency compatible with known severe emphysema. There is no focal consolidation concerning for pneumonia. No large effusion or pneumothorax. No signs of edema or congestion. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Severe emphysema without superimposed pneumonia. " c3bfd049-22e75140-4750d2b6-6f86fe07-a1500ea4.jpg,test/p12/p12033460/s55948152/c3bfd049-22e75140-4750d2b6-6f86fe07-a1500ea4.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Lightheadedness and shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. Density projecting along the anterior medial right first rib is probably bony in origin. There is no evidence for congestive heart failure or pneumonia. IMPRESSION: No evidence of acute cardiopulmonary disease. Apparent increased density along the medial aspect of the right first rib, probably bony spurring; evaluation with a lordotic view is recommended to confirm and exclude a lung nodule. " 215779d1-5e837acb-7cc63e78-63fef136-f60ec8e6.jpg,test/p17/p17135687/s57895799/215779d1-5e837acb-7cc63e78-63fef136-f60ec8e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SOB, tachypnea // cause of SOB COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a further increase in extent of the left pleural effusion and the subsequent left atelectasis. Bronchoscopy might be helpful to exclude the presence of mucous plug 's. The right lung is unchanged. The monitoring and support devices, including the right pigtail catheter are in constant position. " dfcd1e0b-07e9cb55-8e57cd84-5c073ea5-65d40b2a.jpg,test/p10/p10261509/s53686995/dfcd1e0b-07e9cb55-8e57cd84-5c073ea5-65d40b2a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain, assess for pneumonia. FINDINGS: PA and lateral views of the chest are obtained. Lungs appear clear bilaterally without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette appears stable and normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " c62fa8f3-59e2c184-4df75939-d7e2d8a0-3cf88bb8.jpg,test/p12/p12554807/s52448550/c62fa8f3-59e2c184-4df75939-d7e2d8a0-3cf88bb8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with right arm pain // please assess cervical spine abnormality please assess cervical spine abnormality IMPRESSION: Comparison to ___. No relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. No abnormalities are noted in the chest wall. " 75e42d8c-753496af-29347802-4d2a476a-99d7e406.jpg,test/p11/p11235666/s53086094/75e42d8c-753496af-29347802-4d2a476a-99d7e406.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. Mild hyperinflation. There is no focal consolidation, pleural effusion or pneumothorax. Left-sided pacemaker with leads in the right atrium and right ventricle are unchanged. The cardiomediastinal and hilar contours are stable. Sternotomy wires are stable. IMPRESSION: No acute cardiopulmonary process. " f85f6046-587a12a3-5ced16ce-d4f50c8e-7e319a96.jpg,test/p16/p16454913/s59913964/f85f6046-587a12a3-5ced16ce-d4f50c8e-7e319a96.jpg,test," FINAL REPORT CHEST RADIOGRAPH: INDICATION: Tracheostomy, evaluation for nasogastric tube placement. COMPARISON: ___, 12:25 p.m. FINDINGS: As compared to the previous radiograph, the patient has received a new tracheostomy tube which is in correct position. The lung volumes have slightly increased, with subsequent reduction in extent and severity of the pre-existing bilateral basal opacities. The patient has also received a nasogastric tube, the course of the tube is unremarkable, the tip of the tube is not included in the image. Unchanged right chest tube, unchanged size of the cardiac silhouette. " 984f98bd-32cb6cff-75fc54c6-3f8401c5-5878eeae.jpg,test/p19/p19231238/s56334671/984f98bd-32cb6cff-75fc54c6-3f8401c5-5878eeae.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with borderline CXR for PNA presents with agitation, now on abx with elevating leukocytosis. Would like to know certainty of pulmonary source of infection after pt has been hydrated // please re-evaluate for PNA TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: Cardiac enlargement. Pulmonary vascularity has mildly improved. Interstitial edema has improved. Mild left pleural effusion is more prominent. Very shallow inspiration on the lateral radiograph. Bibasilar opacities have improved. Metallic density projected over upper abdomen. IMPRESSION: Improved pulmonary edema and pulmonary vascularity. Left pleural effusion is more prominent. Bibasilar opacities are improved. " 5dcd1922-9a8c647f-ff145511-80fa9840-59a97002.jpg,test/p19/p19818283/s57121252/5dcd1922-9a8c647f-ff145511-80fa9840-59a97002.jpg,test," FINAL REPORT AP CHEST, 10:02 A.M., ___ HISTORY: Bronchial breath sounds, right lower lobe. Question pneumothorax. IMPRESSION: AP chest compared to ___. Large right pleural effusion has increased. Mild pulmonary edema persists. Heart size top normal. Right-sided central venous catheter ends in the upper SVC. ET tube in standard placement. Nasogastric tube passes below the diaphragm and out of view. No pneumothorax. " 3081f7c6-6b8607e8-58d82f61-d186cbc7-afcb6c95.jpg,test/p12/p12000432/s58075573/3081f7c6-6b8607e8-58d82f61-d186cbc7-afcb6c95.jpg,test," FINAL REPORT HISTORY: Dementia, back pain. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: ___. FINDINGS: The heart size remains mildly enlarged. Aorta is tortuous and calcified. Mediastinal and hilar contours are unchanged, and the pulmonary vasculature is not engorged. Lung volumes are low which causes crowding of the bronchovascular structures. Patchy atelectasis in the left lung base is noted. No focal consolidation, pleural effusion or pneumothorax is present. There is diffuse demineralization of the osseous structures. IMPRESSION: Minor left basilar atelectasis. " 1cffecec-959034c2-252dc0bd-96e8a813-a2069d3c.jpg,test/p10/p10740962/s56467579/1cffecec-959034c2-252dc0bd-96e8a813-a2069d3c.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough for four days. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size and mediastinum are stable. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. Mild hyperinflation is suspected on the lateral view. " 101ddd63-f3dfd156-e2d89c9d-8613a7bc-f7ceeac8.jpg,test/p15/p15225349/s50123658/101ddd63-f3dfd156-e2d89c9d-8613a7bc-f7ceeac8.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with a history of cecal cancer complicated by liver metastases now status post segment 6 wedge resection, pericardial effusion status post pericardial window, and pleural effusion and pneumothorax status post chest tube removal. Assess for interval change. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Overall volume of the right hydropneumothorax is stable, with a slight increase in dependent fluid. Stable right apical pneumothorax. Unchanged left pleural effusion. Moderate bibasilar atelectasis, slightly increased on the right and stable on the left. Normal cardiomediastinal and hilar contours. IMPRESSION: Stable right hydropneumothorax with moderate bibasilar atelectasis. " 1d96f66f-c8570f23-47356506-15315e0d-71524dce.jpg,test/p16/p16296993/s53232459/1d96f66f-c8570f23-47356506-15315e0d-71524dce.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old female with history of asthma and cough. FINDINGS: Frontal and lateral views of the chest were compared to previous exam from ___. Exam is limited due to poor inspiratory effort and AP technique. Within this limitation, there is no large confluent consolidation identified. Costophrenic angles are sharp and the cardiac silhouette is enlarged but stable. Osseous and soft tissue structures are unchanged. IMPRESSION: Limited exam due to poor inspiratory effort, no definite large confluent consolidation, however. If desired, repeat with better inspiratory effort can be performed. " b1bbcb3a-0fb39fd9-f2fa9731-440e2252-36f34f8b.jpg,test/p16/p16444272/s54476134/b1bbcb3a-0fb39fd9-f2fa9731-440e2252-36f34f8b.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISONS: ___, ___ and CT chest of ___. FINDINGS: Frontal and lateral views of the chest demonstrate moderate-to-large right pleural effusion, which has increased since prior. Small-to-moderate left pleural effusion is also noted, increased since prior study. There is mild pulmonary edema. Heart is mildly enlarged. Extensive aortic calcifications are noted. Bibasilar opacities likely represent atelectasis. There is no pneumothorax. IMPRESSION: In comparison to ___ exam, there is interval progression of moderate-to-large right and small-to-moderate left pleural effusions. Mild pulmonary edema. Bibasilar opacities, likely atelectasis. " 65c41de4-bc7a0122-78294d6d-cfd6d623-f876e092.jpg,test/p15/p15282197/s52524775/65c41de4-bc7a0122-78294d6d-cfd6d623-f876e092.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p sigmoid colectomy complicated by prolonged postop ileus vs SBO // admission from outside hospital. assess position of lines and tubes. ?RUL mass COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable. The tip projects over the cavoatrial junction and the device should be advanced by approximately 10 cm. The right central venous access line is unchanged. The large right apical mass is constant in size and morphology. No evidence of pneumonia. No pulmonary edema. " d9ff895d-2365ab68-08d26216-2db00666-5c592142.jpg,test/p18/p18776647/s56390495/d9ff895d-2365ab68-08d26216-2db00666-5c592142.jpg,test," FINAL REPORT INDICATION: ___M with cough // Eval for acute process, PNA TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are essentially clear besides mild left basilar atelectasis. The cardiomediastinal silhouette is within normal limits. Degenerative changes noted at the left shoulder. IMPRESSION: No acute cardiopulmonary process. " 0be7931c-e8c46f2c-8837991e-bf41cebd-82c9bd08.jpg,test/p16/p16962961/s56401352/0be7931c-e8c46f2c-8837991e-bf41cebd-82c9bd08.jpg,test," FINAL REPORT INDICATION: Status post bicycle accident. Evaluate for traumatic injury. COMPARISONS: None. TECHNIQUE: A single AP supine view of the chest was obtained. FINDINGS: Within the limitations of exam, the lungs are clear without consolidation or edema. There is no large pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. No fracture is identified. IMPRESSION: No acute cardiopulmonary process. If there is continued suspicion for an injury to the chest, recommend further evaluation with conventional upright PA and lateral chest radiographs. " bfed536c-55f2a2c5-d62201c6-c915e0c5-98807779.jpg,test/p14/p14280192/s58156037/bfed536c-55f2a2c5-d62201c6-c915e0c5-98807779.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG/MVr?Tvr // eval for pneumo eval for pneumo IMPRESSION: Compared to prior chest radiographs, most recently 10:23. Previous malpositionned transesophageal feeding tube has been withdrawn. Small right pneumothorax may be slightly larger. Previous bilateral pleural effusions have improved. Moderate bibasilar consolidation, substantially atelectasis atelectasis has worsened. However the possibility of right lower lobe pulmonary hemorrhage or pneumonia should be entertained. The Cardiomediastinal silhouette is a normal postoperative appearance. Left jugular line ends close to the superior cavoatrial junction. ET tube has been removed. " 184da7ad-91a8a099-c77e8e92-3c665d37-b9255d5c.jpg,test/p14/p14415891/s58281248/184da7ad-91a8a099-c77e8e92-3c665d37-b9255d5c.jpg,test," FINAL REPORT STUDY: PA and lateral chest radiograph. COMPARISON EXAM: CT chest, ___. PA AND lateral chest x-ray of ___, ___, ___. INDICATION: ___-year-old with history of COPD and pneumonia with right-sided wheeze and decreased breath sounds. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion, pulmonary edema or pneumothorax. The cardiomediastinal and hilar contours are stable. IMPRESSION: Normal chest radiograph. No pneumonia. " 5aa2525a-0c88b79b-a14718d7-fd9ce206-122f1c8e.jpg,test/p12/p12764579/s53638409/5aa2525a-0c88b79b-a14718d7-fd9ce206-122f1c8e.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___ radiograph. FINDINGS: Right chest tube remains in place with persistent moderate to large loculated right pleural effusion, but no visible pneumothorax. Cardiomediastinal contours are stable in appearance. Mild pulmonary vascular congestion is present. Improving aeration at both lung bases likely due to improving atelectasis. " c1dec338-2bab351f-a066098f-c024055a-8d468ed8.jpg,test/p13/p13623501/s50725158/c1dec338-2bab351f-a066098f-c024055a-8d468ed8.jpg,test," FINAL REPORT INDICATION: Right shoulder pain. Evaluate for fracture. COMPARISON: Comparison is made to multiple prior chest radiographs, last dated ___ and CT chest performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. Lungs are clear. No pleural effusion or pneumothorax evident. The expansile lytic lesion within the right lateral seventh rib is not significantly changed compared to ___ and likely represents a plasmacytoma in this patient with known multiple myeloma. No associated displaced pathological fracture evident. IMPRESSION: No acute cardiopulmonary process. Stable-appearing right seventh expansile lytic lesion possibly representing plasmacytoma. No displaced pathologic fracture evident. " 0021b7e8-ccca204e-c885fff3-ef89e7b8-9a349d94.jpg,test/p18/p18932737/s59835744/0021b7e8-ccca204e-c885fff3-ef89e7b8-9a349d94.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with malaise, recent liver dz dx COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Lung volumes are low limiting assessment. There is left basal consolidation concerning for pneumonia with adjacent effusion. The right lung is clear. The heart size cannot be assessed. Mediastinal contours unremarkable. Bony structures intact. IMPRESSION: Left basal opacity concerning for effusion and possible pneumonia. " 9a6691ec-cc21878d-8fcdf170-627ff411-043559a6.jpg,test/p13/p13163471/s52882156/9a6691ec-cc21878d-8fcdf170-627ff411-043559a6.jpg,test," WET READ: ___ ___ 6:14 AM Low lung volumes with bilateral linear opacities, likely atelectasis. Orogastric tube courses below the diaphragm the tip is probably in the gastric fundus. The left central venous catheter is in unchanged position. The trachea appears slightly more lucent and deviated to the right on today's examination, likely positional in nature. Findings discussed with ___ by ___ via telephone on ___ at 6:14 a.m., 3 minutes after discovery. ______________________________________________________________________________ FINAL REPORT CHEST PORTABLE, ___ AT 23:46 CLINICAL INDICATION: Check Dobbhoff tube placement, rule out acute cardiopulmonary process. Comparison to prior study ___ at 16:14. Portable AP semi-upright chest film ___ at 23:46 is submitted. IMPRESSION: 1. Feeding tube is seen coursing below the diaphragm with the tip projecting over the stomach. Left internal jugular central line continues to terminate in the proximal SVC. Lung volumes remain low with streaky bilateral opacities likely reflecting subsegmental atelectasis. No evidence of pulmonary edema. No pneumothorax. No large effusions. Overall cardiac and mediastinal contours are unchanged. " 4731bde8-4142e875-28f288fc-0d9dbb11-3f5990a7.jpg,test/p15/p15267202/s55028557/4731bde8-4142e875-28f288fc-0d9dbb11-3f5990a7.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT 13:57 CLINICAL INDICATION: ___-year-old, redo sternotomy, AVR. Comparison is made to patient's prior study of ___ at 12:18. PA and lateral views of the chest ___ at 13:57 are submitted. IMPRESSION: 1. Status post median sternotomy with a mitral annular ring. There is persistent elevation of the left hemidiaphragm with a distended gas-filled stomach beneath. Streaky opacities at the right base are again seen likely representing atelectasis or scarring invovling the right middle and lower lobes. There are likely small bilateral effusions. No evidence of pulmonary edema. Lung volumes do remain diminished. Interval removal of the right internal jugular introducer catheter. " 5c20e30e-392acaaf-e3ca0077-edb73630-655aaf3f.jpg,test/p14/p14213029/s51109165/5c20e30e-392acaaf-e3ca0077-edb73630-655aaf3f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea, history of CHF, COPD TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and CT chest ___ FINDINGS: Patient is status post median sternotomy and CABG. Heart size is normal. Volume loss of the right lung with fibrosis, bronchiectasis, architectural distortion and scarring in the right upper lobe is unchanged causing rightward shift of mediastinal structures. Lungs are hyperinflated with extensive emphysema again noted. New patchy opacities are seen within both lung bases, more so within the right lower lobe, concerning for aspiration or pneumonia. Pulmonary vasculature is not engorged and hilar contours are similar. No pneumothorax or large pleural effusion is present. There are no acute osseous abnormalities. IMPRESSION: New patchy opacities in lung bases concerning for aspiration or pneumonia. Extensive emphysema with scarring, architectural distortion, bronchiectasis, and fibrosis in the right upper lobe with chronic right-sided volume loss. " 0b65fe77-2daedc8b-9ad88c9c-525bef71-1426c404.jpg,test/p12/p12974096/s52105530/0b65fe77-2daedc8b-9ad88c9c-525bef71-1426c404.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cirrhosis with new fever. also with cough // ?consolidation COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The lung volumes have decreased. There is elevation of the left hemidiaphragm, with subsequent area of atelectasis at the left lung bases. However, in the appropriate clinical setting, the presence of pneumonia cannot be excluded. No pleural effusion. Mild cardiomegaly without pulmonary edema. " 40524801-a734a706-751df3b2-10727758-1dd7704c.jpg,test/p14/p14604868/s56462084/40524801-a734a706-751df3b2-10727758-1dd7704c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for a month // cough for a month TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities " cd5bed8d-e7a38917-78f3bc98-fa01017e-2a7a5bbc.jpg,test/p19/p19270543/s52288744/cd5bed8d-e7a38917-78f3bc98-fa01017e-2a7a5bbc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever unknown origin // Evaluate for evidence of pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy. Heart size is mildly enlarged, slightly decreased compared to the prior exam. Mediastinal contours are unchanged. There is mild pulmonary vascular congestion without overt pulmonary edema. Streaky atelectasis is noted in the lung bases. No pleural effusion, focal consolidation or pneumothorax is present. No acute osseous abnormalities seen. IMPRESSION: Mild pulmonary vascular congestion and mild atelectasis at the lung bases. No focal consolidation to suggest pneumonia. " 593a3b13-92442b4d-bb944c67-674e8a8d-a5713b4e.jpg,test/p15/p15841225/s53166918/593a3b13-92442b4d-bb944c67-674e8a8d-a5713b4e.jpg,test," FINAL REPORT INDICATION: ___-year-old woman presenting with syncope, chills, and myalgias as well as a dry cough, evaluate for pneumonia. COMPARISON: None Available. TECHNIQUE PA and lateral view of the chest. FINDINGS: The cardiomediastinal contours normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No evidence of pneumonia. " 96c00e0b-15a0c9aa-b6c8547a-52d65b8f-891260ff.jpg,test/p11/p11124675/s52972230/96c00e0b-15a0c9aa-b6c8547a-52d65b8f-891260ff.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 13:30 CLINICAL INDICATION: Question tip position. Portable semi-erect chest film ___ at ___ submitted and compared to the prior study of ___ at 3:09. IMPRESSION: The right subclavian PICC line is seen with its tip in the mid SVC. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. The pulmonary edema appears to be improving. Overall, cardiac size is stable. The left upper lung is not included on the current examination. Results of the PICC position were communicated by phone to ___, the IV nurse on ___ at 2:12 p.m. " e36fc8f7-a4bb6338-00b15b65-3e2ec245-65e42135.jpg,test/p12/p12130564/s54663286/e36fc8f7-a4bb6338-00b15b65-3e2ec245-65e42135.jpg,test," FINAL REPORT INDICATION: ___ year old man with elevated WBC // evaluate for PNA EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___ FINDINGS: There is minimal left pleural effusion posteriorly. There is no consolidation or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. IMPRESSION: No evidence of pneumonia. Minimal left pleural effusion. " 46908224-c1cf9113-f86c02a2-c05e7c10-8504167e.jpg,test/p10/p10207476/s59384022/46908224-c1cf9113-f86c02a2-c05e7c10-8504167e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with GVHD and recent worsening respiratory status // ? infiltrate ? infiltrate IMPRESSION: In comparison with the study of ___, there is little interval change. Cardiac silhouette is within normal limits and there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. Stable contour of the aortic arch and known pseudoaneurysm. " 22639d8a-2c8965c3-ac7a4e96-83e32727-ca408a51.jpg,test/p11/p11831027/s58424626/22639d8a-2c8965c3-ac7a4e96-83e32727-ca408a51.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with epigastric, left upper quadrant abdominal pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild to moderate multilevel degenerative changes are seen throughout the imaged thoracic spine. No subdiaphragmatic free air is present. IMPRESSION: No acute cardiopulmonary abnormality. No subdiaphragmatic free air. " 35b9c6fa-00c88823-d2b016e7-860235a2-35e10b1b.jpg,test/p17/p17945610/s54832536/35b9c6fa-00c88823-d2b016e7-860235a2-35e10b1b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hemoptysis, known PE, chest tightness // ?interval change COMPARISON: None. FINDINGS: Compared with ___ at 16:27, the ET tube, NG tube and left IJ central line have been removed. The right pigtail has also been removed. Minimal blunting of the right costophrenic angle is very slightly greater. No pneumothorax or other evidence of right-sided effusion is identified. Allowing for technical differences, there is otherwise minimal interval change. Again seen is focal sclerosis in the right proximal humerus. Is there history of old healed fracture. No lucent fracture line is identified. IMPRESSION: As above.. " a99f8379-c58f8112-4f57043a-332a21e6-8c307f2f.jpg,test/p19/p19292817/s51483398/a99f8379-c58f8112-4f57043a-332a21e6-8c307f2f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with nausea, fatigue, cough x several days // eval ? infiltrate COMPARISON: ___ FINDINGS: There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Mild calcification of the aortic knob is similar to prior. IMPRESSION: No acute intrathoracic process. " 20ab92af-7f6c1a2c-30578f8d-b98c8ff8-b15e9cf6.jpg,test/p15/p15248985/s50427363/20ab92af-7f6c1a2c-30578f8d-b98c8ff8-b15e9cf6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest pain // widened mediastinum, effusion, pulmonary edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, pre-existing parenchymal opacities in the periphery of both upper lobes have increased in severity in extent. The mediastinum is not widened. Unchanged position of the left PICC line. " ff0522f6-8b04c34f-eb801f7c-0bf38c89-aa1c0d76.jpg,test/p10/p10617964/s54449925/ff0522f6-8b04c34f-eb801f7c-0bf38c89-aa1c0d76.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic uterine sarcoma // preop eval preop eval IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE ARE LOWER LUNG VOLUMES BUT OTHERWISE LITTLE CHANGE IN THE APPEARANCE OF HEART AND LUNGS. PORT-A-CATH REMAINS IN POSITION. " 09e7bc49-2904e978-bf6d1e58-6518ed69-6b9ecfd7.jpg,test/p13/p13021959/s53875289/09e7bc49-2904e978-bf6d1e58-6518ed69-6b9ecfd7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with AMS // eval for consolidation COMPARISON: Same day CTA head and neck, chest CT from ___. FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is noted with hilar congestion and mild to moderate pulmonary interstitial edema. There is a small layering right pleural effusion. No convincing signs of pneumonia. No pneumothorax. Bony structures appear intact. High riding right humeral head reflect chronic rotator cuff disease. IMPRESSION: Mild to moderate pulmonary edema, cardiomegaly, small right effusion. " 827d0465-3968f1c4-adf3d3d3-8d9cca26-2ae921bf.jpg,test/p17/p17627988/s54044776/827d0465-3968f1c4-adf3d3d3-8d9cca26-2ae921bf.jpg,test," FINAL REPORT INDICATION: Tachycardia and chest congestion, here to evaluate for acute cardiopulmonary process. COMPARISON: Chest radiographs dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs are symmetrically well expanded and well aerated, although lung volumes are slightly decreased from the most recent prior study. There is no focal consolidation concerning for pneumonia, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size, and the mediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 872f98c0-3d6627cb-4e979ce0-e6be9a0f-e7ee53ed.jpg,test/p13/p13398212/s50443939/872f98c0-3d6627cb-4e979ce0-e6be9a0f-e7ee53ed.jpg,test," FINAL REPORT INDICATION: ___-year-old female with shortness of breath, history of CHF. Evaluate for pulmonary edema. COMPARISON: Prior chest radiographs, most recently on ___ and ___, as well as a CT chest from ___. A radiograph from ___ appears to represent the patient's baseline. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: There are diffuse bilateral interstitial reticular opacities, more pronounced in both lung bases, slightly improved from ___ but worse from baseline at ___. There is a small left-sided pleural effusion, better seen in the lateral view. Mild-to-moderate cardiomegaly is unchanged from prior. There is a tortuous aorta. No pneumothorax is identified. IMPRESSION: Compared with ___, there is decreased degree of interstitial pulmonary edema with associated small left-sided pleural effusion. " aff90e41-7a1a5f63-0aa68c5f-de696507-c9cf252b.jpg,test/p13/p13286565/s57893211/aff90e41-7a1a5f63-0aa68c5f-de696507-c9cf252b.jpg,test," FINAL REPORT INDICATION: Heart block. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: A left-sided pacemaker is new since the ___ exam, projecting leads appropriately into the right atrium and ventricle. The heart size is normal. The hilar and mediastinal contours are unchanged. There is no pneumothorax, focal consolidation, or pleural effusion. Linear left basilar opacities are most compatible with atelectasis. IMPRESSION: Left pacemaker projecting leads into the right atrium and ventricle. " e3e8cd51-183a4e3a-f25850bb-3a5c954c-74dd40c6.jpg,test/p12/p12043836/s52541148/e3e8cd51-183a4e3a-f25850bb-3a5c954c-74dd40c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CT // CT TECHNIQUE: Portable semi upright chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: There are 2 right-sided chest tubes, which appear unchanged in comparison to the prior chest radiograph, without evidence of pneumothorax. The sternotomy wires appear intact and appropriately aligned. Unchanged appearance of right loculated pleural effusion with compressive atelectasis. The left retrocardiac opacity persists. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. There are no acute osseous abnormalities. IMPRESSION: 1. 2 right-sided chest tubes unchanged in positioning, without evidence of pneumothorax. 2. Unchanged right loculated pleural effusion with atelectasis. 3. Persistent left retrocardiac opacity, concerning for pneumonia. " 0afb0dc0-d78e0744-332ca882-9c1fb678-94172902.jpg,test/p18/p18545924/s59897519/0afb0dc0-d78e0744-332ca882-9c1fb678-94172902.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chronic pain here with wt loss and B symptoms // please evaluate for pneumonia vs hilar mass please evaluate for pneumonia vs hilar mass IMPRESSION: There are no prior chest radiographs available for review. Lungs are well expanded and clear. There is no evidence of central lymph node enlargement. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Bilateral breast prosthetic implants noted. " 1b4e78a2-e03bcf3f-59c8ae5c-7cb12084-d875cf73.jpg,test/p13/p13938778/s55660569/1b4e78a2-e03bcf3f-59c8ae5c-7cb12084-d875cf73.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough congestion // r/o PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There is right greater than left central vascular congestion without overt pulmonary edema. In is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette remains top-normal to mildly enlarged. The aorta is tortuous. IMPRESSION: Central vascular congestion without overt pulmonary edema. " a78790a4-a32517cf-1aa755c2-b44c871f-57af15b6.jpg,test/p16/p16730399/s53466709/a78790a4-a32517cf-1aa755c2-b44c871f-57af15b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with EETT, OGT in place // please eval placement please eval placement IMPRESSION: In comparison with the study of ___, the orogastric tube now extends to the distal stomach. Endotracheal tube tip lies approximately 3.5 cm above the carina. The lower neck is excluded from this image, so that it is impossible to assess the degree of subcutaneous emphysema. Again there is mild atelectatic change at the right base. " 0ee11e39-fca20d39-3abb3640-5470b2c1-e38e2ff1.jpg,test/p17/p17653729/s51975869/0ee11e39-fca20d39-3abb3640-5470b2c1-e38e2ff1.jpg,test," FINAL REPORT HISTORY: Intubated, question interval change. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___ at 5:22 a.m. An ET tube is present, the tip lies approximately 5.6 cm above the carina. An NG tube is present, tip extending beneath diaphragm overlying the fundus. Sideport lies in the region of the GE junction, possibly immediately distal to it. The right IJ central line is present, tip over distal SVC. A right subclavian central line is present, the tip is obscured, but is probably unchanged, overlying the mid SVC. No pneumothorax is detected. Compared with the earlier film, CHF with interstitial edema remains present. Hazy opacity at the lung bases is consistent with layering effusions, larger on the right, and underlying collapse and/or consolidation. Enlarged cardiomediastinal silhouette is also again noted. IMPRESSION: CHF, bilateral effusions, underlying collapse and/or consolidation, similar to the prior film. " f9c0ec8d-86ec3bee-ddb341ae-4c167ea3-c1711c15.jpg,test/p19/p19933545/s54327309/f9c0ec8d-86ec3bee-ddb341ae-4c167ea3-c1711c15.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with eval post op change following lap hiatal hernia repair // Eval post op change IMPRESSION: As compared to ___ chest radiograph, cardiomegaly is now accompanied by pulmonary vascular congestion and mild to moderate edema. An air-filled structure in the right retrocardiac region has an appearance suggestive of a hiatal hernia and is smaller in size than on the preoperative chest radiograph. New left lower lobe opacity could reflect aspiration, atelectasis or developing infection in the appropriate clinical setting. Subcutaneous emphysema is present in the left chest wall. " 7efa8308-a6cee804-584952f9-880901f4-4fae6b6f.jpg,test/p15/p15937283/s51262284/7efa8308-a6cee804-584952f9-880901f4-4fae6b6f.jpg,test," WET READ: ___ ___ ___ 9:09 PM Faint right basilar, potentially middle lobe opacity could potentially be due to atelectasis however a developing infection is also possible. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with kidney transplant on immunosuppression with cough and subjective fevers. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There is faint right basilar opacity likely localizing to the middle lobe based on the lateral exam. Elsewhere the lungs are grossly clear. There is no effusion. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: Faint right basilar, potentially middle lobe opacity could potentially be due to atelectasis however a developing infection is also possible. " e1e3bad1-404ed786-72221b09-e65d88c8-747c429c.jpg,test/p13/p13690191/s56639927/e1e3bad1-404ed786-72221b09-e65d88c8-747c429c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, purulent sputum and fever // Rule out pneumonia Rule out pneumonia IMPRESSION: In comparison with the study of ___, there is hyperexpansion of the lungs with flattening hemidiaphragms consistent with chronic pulmonary disease. However, no evidence of acute focal pneumonia, vascular congestion, or pleural effusion. " c74b4b50-7d7a53c4-fdd0f41d-774d8418-9325f928.jpg,test/p18/p18919240/s54390492/c74b4b50-7d7a53c4-fdd0f41d-774d8418-9325f928.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough // eval for infiltrate COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Fat pads (as seen on prior CT abdomen pelvis) abut the heart border likely accounting for subtle opacity seen. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 366d179e-bca54d62-b49baee4-576c0484-5dbd205c.jpg,test/p12/p12210632/s53766492/366d179e-bca54d62-b49baee4-576c0484-5dbd205c.jpg,test," FINAL REPORT INDICATION: Chest pain, query pneumothorax. COMPARISON: Chest radiograph, ___. FINDINGS: PA and lateral views of the chest were reviewed. Mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs are well expanded and clear. Pulmonary vasculature is within normal limits. IMPRESSION: No acute pulmonary process. " 5f2c2664-d567fade-0468f4ba-c2feb464-d9edf09e.jpg,test/p12/p12993962/s58137321/5f2c2664-d567fade-0468f4ba-c2feb464-d9edf09e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // ?pneumonia ?pneumonia COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection, including tuberculosis. " e4fe9187-ebca2df1-2fc6ca86-7b20350e-5fd6e52f.jpg,test/p12/p12272471/s53716553/e4fe9187-ebca2df1-2fc6ca86-7b20350e-5fd6e52f.jpg,test," FINAL REPORT HISTORY: Left effusion after chest tube placement and pleurodesis. FINDINGS: In comparison with the study of ___, there has been some decrease in the right effusion following placement of a right chest tube. No evidence of pneumothorax. The left lung and upper half of the right lung are essentially clear. " 0dabb25d-ae3e7954-2d3feea7-0c48fcc5-727d6d8c.jpg,test/p11/p11607177/s55845993/0dabb25d-ae3e7954-2d3feea7-0c48fcc5-727d6d8c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF with LVAD with increased work of breathing, O2 saturation OK, increased grogginess. // Comparison to previous, pulm edema, consolidation? Comparison to previous, pulm edema, consolidation? IMPRESSION: In comparison with the study of ___, the monitor and support devices are essentially unchanged. Continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. The area of increased opacification in the mid to upper left hemithorax laterally again could reflect a loculated collection, which is somewhat obscured by the overlying left pectoral pacemaker. " 99feac41-5dcb23fd-706a3353-c280e7a0-7e84b30b.jpg,test/p11/p11652381/s59953463/99feac41-5dcb23fd-706a3353-c280e7a0-7e84b30b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with MAC being treated now with cough for 4 weeks // rule out infiltrate, TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph ___, CT chest ___. FINDINGS: Again seen is extensive apical pleural calcifications bilaterally consistent with old tuberculous disease. Opacification in the left mid lung corresponding with previously demonstrated pneumonia with abscess in the lingular lobe has now decreased and likely represents fibrous scarring and healing from the pneumonia. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Left midlung opacity likely represents scarring and healing of the lingular lobe necrotizing pneumonia " ffce4186-a42dd456-90ff028e-ffafe0df-c1e54f2e.jpg,test/p18/p18059653/s59241770/ffce4186-a42dd456-90ff028e-ffafe0df-c1e54f2e.jpg,test," WET READ: ___ ___ 11:07 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with L-sided chest pain // ? acute cardiopulm process TECHNIQUE: Chest radiographs ___ through ___ COMPARISON: None available FINDINGS: The lungs are normally expanded. There is mild lingular scarring. Heart size is normal. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no evidence of pneumonia or pulmonary edema. As on the prior study there is anterior weding at the thoracolumbar junction with exaggerated kyphosis. There is a healed left lower rib fracture. IMPRESSION: No acute cardiopulmonary abnormality. " 0bd66869-e7c0e432-ca474338-bf3c49fc-ce93fe18.jpg,test/p15/p15155342/s57423569/0bd66869-e7c0e432-ca474338-bf3c49fc-ce93fe18.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after ASD repair. PA and lateral radiographs of the chest were reviewed in comparison to ___. Right internal jugular line tip is at the level of low SVC. Cardiomegaly is substantial. Pacemaker leads are unchanged. There is no appreciable pneumothorax. There is minimal amount of pleural effusion and there is substantial amount of mediastinal air and potentially minimal anterior pneumothorax, attention on the subsequent studies is recommended. " f60c7ef5-1a062d6d-b2c5f89d-851ddd64-1737fe39.jpg,test/p10/p10018684/s50386655/f60c7ef5-1a062d6d-b2c5f89d-851ddd64-1737fe39.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with SOB, concern for pna vs PE and DVT in RLE u/s wt 460 lbs // History: ___M with SOB, concern for pna vs PE and DVT in RLE u/s wt 460 lbs TECHNIQUE: Views of the chest COMPARISON: None FINDINGS: Exam is suboptimal due to underpenetration, or presumed secondary to patient body habitus. The cardiac silhouette is enlarged. The mediastinum is also widened however, given patient body habitus, this may be due to mediastinal lipomatosis. Central pulmonary vascular congestion. IMPRESSION: Suboptimal study due to underpenetration presumed secondary to patient body habitus. Enlarged cardiomediastinal silhouette. Possible underlying mediastinal lipomatosis. Possible central pulmonary vascular engorgement. " 405ada0e-a5cd75a9-e79351b1-878cf820-cd274d79.jpg,test/p15/p15143186/s50900904/405ada0e-a5cd75a9-e79351b1-878cf820-cd274d79.jpg,test," FINAL REPORT INDICATION: Dyspnea, evaluate for acute cardiopulmonary disease. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: The lungs are well expanded. There are diffuse bilateral interstitial opacities, more predominant in the lung bases, with ___ B lines and associated small bilateral pleural effusions. Cardiac size is slightly enlarged allowing for limitations of this AP view. Significant atherosclerotic calcifications of the aortic arch are present. There is no pneumothorax. Evidence of a large hiatal hernia is again seen. Left axillary soft tissue calcifications are again seen. IMPRESSION: Acute pulmonary edema with associated bilateral pleural effusions. " c378f1c6-887bdde8-bcd454a4-55a653fd-9cecb445.jpg,test/p13/p13339319/s51873083/c378f1c6-887bdde8-bcd454a4-55a653fd-9cecb445.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with gallstone pancreatitis, remains hypoxic, requiring 4 L o2. // ? extent of effusion, pulm edema, atelectasis COMPARISON: ___ IMPRESSION: The lung volumes have further decreased. The presence of bilateral pleural effusions is likely. Relatively extensive retrocardiac and small right basal atelectasis. No overt pulmonary edema. No pneumonia. " 516ed6f5-4f56cf7c-0d2c0d5f-3162e3a6-ec6e8965.jpg,test/p15/p15106749/s50772485/516ed6f5-4f56cf7c-0d2c0d5f-3162e3a6-ec6e8965.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with NSCLC on oral chemotherapy with erlotinib, now with nasal congestion and some cough, no fever. // pneumonia or effusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___ and chest radiograph ___ FINDINGS: Right lower lobe mass has been more fully characterized by a recent CT. Persistent right lower lobe volume loss, right pleural effusion and pleural thickening, similar to frontal scout image of recent CT. However, when today's lateral radiograph is compared to the lateral scout image from the CT scan, a subtle area of increased opacity has developed in the right lower lobe posteriorly, partially obscuring the right hemidiaphragm. The left lung is clear except for a focal area of linear atelectasis of the left lung base. Cardiomediastinal contours are stable in appearance. No acute skeletal findings. IMPRESSION: Possible right lower lobe pneumonia, best visualized on the lateral radiograph. Right lower lobe mass and pleural disease are grossly unchanged from CT of ___. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 11:14 into the Department of Radiology critical communications system for direct communication to the referring provider. " c5cb3811-b478e39d-ada460b2-c2d5809b-a686518e.jpg,test/p12/p12032671/s52092418/c5cb3811-b478e39d-ada460b2-c2d5809b-a686518e.jpg,test," FINAL REPORT INDICATION: ___M with hypoxia and cp // pna? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Right chest wall port is new since prior. Catheter tip at the RA/SVC junction. The lungs are clear without consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 5b3ace41-0a4d66f0-a8bf8280-80e24c79-4de78d48.jpg,test/p11/p11344751/s59108751/5b3ace41-0a4d66f0-a8bf8280-80e24c79-4de78d48.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multisystem organ failure // ETT position COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There is a minimal increase in lung density at the bases of the right hemi thorax. Improved ventilation in the retrocardiac lung region. All monitoring and support devices are in correct position, the tip of the endotracheal tube continues to project 2.5 cm above the carina. " 8aad1160-9cbc4ec4-577f8737-8784924b-ef451f49.jpg,test/p13/p13473495/s54050506/8aad1160-9cbc4ec4-577f8737-8784924b-ef451f49.jpg,test," FINAL REPORT INDICATION: Cough and positive blood cultures. Assess for pneumonia. COMPARISONS: Chest radiograph of ___ and CT chest of ___. FINDINGS: Frontal and lateral views of the chest were slightly limited due to patient's body habitus. Lung volumes are low, which accentuate bronchovascular markings. Mild pulmonary edema is unchanged. There is mild thickening of the minor fissure. Bibasilar opacities are noted. There is no pleural effusion. Moderate cardiomegaly is stable. Hilar and mediastinal silhouettes are unchanged. A dual-chamber dialysis catheter tip projects over proximal right atrium. IMPRESSION: Stable mild pulmonary edema and moderate cardiomegaly. Bibasilar opacities may represent atelectasis or infection in the appropriate clinical setting. " 81837fc8-060d8d18-74eb0304-20732885-cf2956f4.jpg,test/p14/p14371035/s58643522/81837fc8-060d8d18-74eb0304-20732885-cf2956f4.jpg,test," FINAL REPORT HISTORY: Fever, altered mental status. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is somewhat rotated and thoracolumbar scoliosis is again seen. Left-sided PICC / midline is again seen, terminating in the region of the proximal left axillary vein. There is persistent elevation the right hemidiaphragm with overlying right basilar atelectasis. No focal consolidation is seen. There is no pleural effusion pneumothorax. Cardiac mediastinal silhouettes are stable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " a9301bc9-fbd72287-42b4996d-8cfd42b4-141b5790.jpg,test/p15/p15395644/s55419332/a9301bc9-fbd72287-42b4996d-8cfd42b4-141b5790.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with left effusion // interval change COMPARISON: Chest radiographs from___ FINDINGS: Cardiomegaly and the mediastinal and hilar contours are similar to prior exam. The pulmonary vasculature is normal. Large left pleural effusion has progressed mildly since prior exam. Fluid in the fissures has progressed since prior exam. No focal consolidation or pneumothorax. Median sternotomy wires are intact. IMPRESSION: Worsened left effusion. No good evidence for edema. " 02da8119-2590f541-aa072b80-073ba81c-7af62995.jpg,test/p14/p14785541/s51487964/02da8119-2590f541-aa072b80-073ba81c-7af62995.jpg,test," FINAL REPORT EXAMINATION: Portable CHEST INDICATION: ___-year-old woman with respiratory distress and SOB; evaluate for pneumonia. TECHNIQUE: Portable AP upright radiograph view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Hyperinflation of the lungs, flattening of the diaphragms, and stable slight hyperlucency of the right upper lung are compatible with history of emphysema. No focal consolidation to suggest pneumonia. No pleural effusion, pulmonary edema, pneumothorax. Stable appearance of the cardiomediastinal silhouette and hila. IMPRESSION: No acute intrathoracic process. " b74ac69f-3bb716f9-565f3500-099e2443-a72e52d2.jpg,test/p10/p10115118/s55467078/b74ac69f-3bb716f9-565f3500-099e2443-a72e52d2.jpg,test," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with known endocarditis, presents with fevers and chills. COMPARISON: ___. FINDINGS: Prior left PICC no longer visualized. The lungs are clear without consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 9edfd7ad-411f1040-ae0c7c73-a98f2181-17dc0f32.jpg,test/p11/p11845452/s54767309/9edfd7ad-411f1040-ae0c7c73-a98f2181-17dc0f32.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is top normal. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " 1191a48e-ea290234-6d0e7f0d-c8a3e49b-d4c01ca5.jpg,test/p10/p10706635/s59183428/1191a48e-ea290234-6d0e7f0d-c8a3e49b-d4c01ca5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with shortness of breath // Worsening respiratory status COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes have improved and increased, likely reflecting improved ventilation. Pre-existing areas of atelectasis at the lung bases have completely resolved. The known left lung lesion is unchanged. No pulmonary edema. No pneumothorax. " 4d7e92c9-ef64f09e-906fbb3a-70c440ce-30dfa330.jpg,test/p17/p17473619/s52956221/4d7e92c9-ef64f09e-906fbb3a-70c440ce-30dfa330.jpg,test," FINAL REPORT HISTORY: Dyspnea and weakness. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: ___. FINDINGS: Exam is limited by patient positioning with the patient's chin obscuring a portion of the right apex. Low lung volumes are demonstrated. The heart size is difficult to assess, but is likely within normal limits. The aorta is tortuous. Opacification of the right lung base likely reflects a combination of consolidation with small right pleural effusion. There is mild pulmonary vascular congestion. No pneumothorax is demonstrated. There is gaseous distention of the stomach. Severe S-shaped scoliosis of the thoracolumbar spine is demonstrated with multilevel degenerative changes. Partially imaged are severe degenerative changes of the right glenohumeral joint. Remote left-sided rib fractures are again noted. IMPRESSION: Limited exam. Right basilar opacity is concerning for pneumonia or aspiration with a small right pleural effusion. Mild pulmonary vascular engorgement. No pneumothorax is identified. Gaseous distention of the stomach incidentally noted. " 2dec33ef-f99cecd9-5afbf42f-f7345769-54e22a20.jpg,test/p14/p14081435/s56864674/2dec33ef-f99cecd9-5afbf42f-f7345769-54e22a20.jpg,test," FINAL REPORT INDICATION: Altered mental status. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is top normal. The hilar and mediastinal contours are within normal limits. A small tent-like opacity at the right cardiophrenic border is not visualized on the lateral view, and may represent focal atelectasis. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: Small tent-like opacity at the right cardiophrenic border is not visualized on the lateral view, and may represent focal atelectasis. Follow-up if pertinent symptoms persist. " c543ecd0-870a126d-77f2c58d-863e7292-09f0ad64.jpg,test/p17/p17894121/s54428144/c543ecd0-870a126d-77f2c58d-863e7292-09f0ad64.jpg,test," FINAL REPORT INDICATION: Asthma and cough, here to evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The patient is status post median sternotomy with at least two discontinuous wires in the superior sternum, which are unchanged from the prior study. Epicardial wires are seen, as before. There is no new consolidation concerning for pneumonia. The inspiratory lung volumes remain decreased. No significant pleural effusions or pneumothorax is detected. The pulmonary vasculature is not engorged. The cardiac silhouette is mildly enlarged but stable. The mediastinal contours are prominent but unchanged with unfolding of the thoracic aorta. The hilar contours are also stable. Calcification in the posterior upper mediastinum on the lateral view corresponds to the abdominal aorta. IMPRESSION: 1. No focal consolidation concerning for pneumonia. 2. Stable mild cardiomegaly. " c36a3637-f390d426-52f933bb-f5f9bfd3-3bdcc71a.jpg,test/p11/p11683377/s59896895/c36a3637-f390d426-52f933bb-f5f9bfd3-3bdcc71a.jpg,test," FINAL REPORT HISTORY: Sudden onset chest pain in a patient with coronary artery disease and atrial fibrillation. COMPARISON: None available. FINDINGS: Chest, portable upright. There is bilateral lower lobe atelectasis. The lungs are otherwise clear. Mild pulmonary vascular congestion is present with minimal interstitial edema. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Mild pulmonary vascular congestion and mild interstitial edema. 2. Bibasilar atelectasis. " 7ff5484d-ba026c6a-fc854a16-628fe18f-051bcbd7.jpg,test/p12/p12040402/s50468536/7ff5484d-ba026c6a-fc854a16-628fe18f-051bcbd7.jpg,test," WET READ: ___ ___ ___ 4:45 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: History: ___M with s/p fall ?AMS // eval for traua TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: Lungs well expanded and clear. Right hemidiaphragm is slightly elevated compared to the left, unchanged from prior exam. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " b9d0bc07-22c11907-3e8589ae-f31168cf-0193aad7.jpg,test/p11/p11463144/s53548741/b9d0bc07-22c11907-3e8589ae-f31168cf-0193aad7.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with hepatomegaly, tachycardia, infectious workup TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Outside hospital CT abdomen pelvis ___ FINDINGS: Elevation of the right hemidiaphragm is attributable to an enlarged polycystic liver, as seen on the previous CT. Heart size appears normal, slightly displaced to the left by the elevated right hemidiaphragm. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. No focal consolidation, pleural effusion pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. Elevation of the right hemidiaphragm is attributable to an enlarged polycystic liver as seen on previous CT. " 4aa12076-7bccd351-3fc93e3e-e5615d3c-b99ad26a.jpg,test/p11/p11146299/s53450119/4aa12076-7bccd351-3fc93e3e-e5615d3c-b99ad26a.jpg,test," FINAL REPORT HISTORY: ___-year-old female with recent biopsy of right lung mass and pulmonary hemorrhage. Evaluate for interval change. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with some bronchovascular crowding. There are small bilateral pleural effusions, right greater than left, with adjacent atelectasis. The right upper lobe opacity is somewhat less conspicuous on this exam. Cardiomediastinal and hilar contours are unchanged. No pneumothorax. IMPRESSION: Small bilateral pleural effusions, right greater than left, with adjacent atelectasis. " ba59eaa0-3386a0af-a929c375-27656252-cb67171c.jpg,test/p19/p19476698/s58733828/ba59eaa0-3386a0af-a929c375-27656252-cb67171c.jpg,test," FINAL REPORT STUDY: Chest radiograph. INDICATION: Flank pain. TECHNIQUE: PA and lateral chest radiographs were obtained. REPORT: Cardiomediastinal silhouette is unremarkable. The lungs are clear. The visualized osseous structures are normal. No acute cardiopulmonary finding is evident. Please also refer to the same day CT. Despite the findings on CT, no definitive chest findings are noted on plain radiographs. CONCLUSION.Normal CXR.See CT report also " 4abc8bbf-cf7b3fd5-49cf498f-0eca4eb4-634ec82b.jpg,test/p15/p15848257/s50941578/4abc8bbf-cf7b3fd5-49cf498f-0eca4eb4-634ec82b.jpg,test," FINAL REPORT HISTORY: Cough for 1 week. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The cardiac silhouette size is top normal. Mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " 646ff039-9de36f23-3d2bf306-cdbef0a3-fb2d2d16.jpg,test/p14/p14809072/s54083705/646ff039-9de36f23-3d2bf306-cdbef0a3-fb2d2d16.jpg,test," FINAL REPORT CHEST TWO VIEWS ON ___ HISTORY: Cirrhosis and weakness. REFERENCE EXAM: ___. Compared to the prior study, there is no significant interval change and no focal infiltrate. " 2bee46ef-1760e582-2e733817-59107b1e-3cef7c0b.jpg,test/p17/p17062695/s50107350/2bee46ef-1760e582-2e733817-59107b1e-3cef7c0b.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old male with chest pain. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. There are slightly increased interstitial markings without evidence of frank edema or consolidation. There is no effusion. Cardiac silhouette is enlarged but unchanged. Aortic valve replacement is noted as well as postoperative changes of median sternotomy. Osseous and soft tissue structures are notable for hypertrophic changes in the spine. IMPRESSION: Increased interstitial markings in the lungs, which could be due to mild interstitial edema versus chronic underlying interstitial lung disease. " e2e1e50f-938207fd-468fc36b-7b5b1c9e-fb6816bd.jpg,test/p15/p15729033/s54887754/e2e1e50f-938207fd-468fc36b-7b5b1c9e-fb6816bd.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with multiple left-sided rib fractures, left pneumothorax with chest tube. Now hypotensive in 70s, shortness of breath, assess chest tube placement for possible pneumothorax. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar portable chest examination obtained six hours earlier during the same day. Previously identified left-sided pigtail end drainage catheter remains in unchanged position. There remains a 2 cm wide apical pneumothorax in the left hemithorax and appears unchanged during the latest six hours examination interval. Obliteration of left-sided diaphragmatic contours post=op pleural effusion appears unchanged in magnitude. No evidence of new pulmonary parenchymal abnormalities. Previously identified multiple mildly dislocated rib fractures in the left hemithorax appear unchanged as can be identified on this single view examination. In comparison with the next preceding portable chest examination obtained earlier today, there may be a slight increase of the basal densities, possibly caused by pleural effusion that mostly layers in the posterior compartment of the pleural space. More precise evaluation could be accomplished by a lateral view. IMPRESSION: Grossly stable findings with small-sized left apical pneumothorax. Probably increasing pleural effusions. " c73344ff-da1f0bcb-8cf8fd2e-adc12292-5421e172.jpg,test/p10/p10757917/s53507441/c73344ff-da1f0bcb-8cf8fd2e-adc12292-5421e172.jpg,test," WET READ: ___ ___ ___ 4:01 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA AND LATERAL CHEST X-RAY INDICATION: History: ___F with nausea, dyspnea, ostomy // eval ? infection, effusion TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Chest x-ray ___. FINDINGS: In comparison to most recent chest x-ray from ___, a left chest Port-A-Cath is in unchanged position with distal tip projecting over the right atrium. The cardiomediastinal silhouettes are stable and within normal limits. The bilateral hila are unremarkable. The lungs are clear. There is no pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary abnormality. " ff5c67d8-11251a18-74467f64-2c215115-2bf3fe6d.jpg,test/p11/p11263526/s58941068/ff5c67d8-11251a18-74467f64-2c215115-2bf3fe6d.jpg,test," FINAL REPORT INDICATION: Somnolence, Assess for infectious process. COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___. FINDINGS: Mediastinal and hilar contours are unremarkable. Appearance of a rounded opacification in the right upper mediastinal corresponds with vessels exaggerated by patient rotation. Heart size remains top normal. Lungs are clear. No pleural effusion or pneumothorax. Stable eventration of the right hemidiaphragm again noted. Redemonstration of multiple compression deformities throughout the thoracic spine with slight progression of the most superior, thoracic compression deformity. IMPRESSION: No acute cardiopulmonary process. Multiple compression deformities with slight progression of the most superior thoracic compression fracture. " aaaf94b9-37d0427f-4d8c0285-e70028b4-e0b67870.jpg,test/p11/p11849511/s57160921/aaaf94b9-37d0427f-4d8c0285-e70028b4-e0b67870.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Ventilator-dependent respiratory failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Low lung volumes. Areas of atelectasis at the right lung bases. Moderate retrocardiac atelectasis. Mild-to-moderate left pleural effusion with minimal signs of fluid overload. Unchanged appearance of the mediastinum. " 759a0de3-b7c67000-07c936c8-674c8ece-d4579522.jpg,test/p12/p12320644/s57547044/759a0de3-b7c67000-07c936c8-674c8ece-d4579522.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest discomfort. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. There is a bulging contour along the lower mediastinum suggesting a hiatal hernia. Streaky associated opacities are apparent on the lateral view which suggests coinciding atelectasis. Otherwise, the lung fields appear clear. There is no pleural effusion or pneumothorax. IMPRESSION: No definite acute cardiopulmonary process. Suspected hiatal hernia. " 4f52e2ec-417ef1c0-66ac1529-33fce1e4-8bb9fc68.jpg,test/p15/p15116019/s52966855/4f52e2ec-417ef1c0-66ac1529-33fce1e4-8bb9fc68.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Tracheobronchoplasty, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes remain exceedingly low. The lateral radiograph shows an air collection projecting over the retrosternal space that might be both pleural or located in the soft tissues. Severe cardiomegaly persists, signs of mild fluid overload are present. Fluid is located in the thickened right minor fissure. Minimal pleural effusion seen on the lateral radiograph. At the time of dictation and observation, 11:29 a.m., on the ___, the referring physician, ___. ___, was paged for notification. " 1587ec34-4150373a-178a0c96-ba714aa5-30c8c452.jpg,test/p15/p15003878/s58807789/1587ec34-4150373a-178a0c96-ba714aa5-30c8c452.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Semi-erect portable chest view was read in comparison with prior chest radiographs through ___ with the most recent from ___. FINDINGS: Bilateral lung volumes are very low. An endotracheal tube terminates at the level of the clavicle approximately 6 cm above the carina. Consider advancing ET tube by additional 2-3 cm for better seating. Left subclavian line ends at the right upper or mid atrium. Bilateral lung opacity may reflect pulmonary edema; however, given the low lung volumes, this appearance may be exaggerated. A single right chest tube ends at right lung base. Multiple rib fractures on the right side are seen. Cardiomediastinal silhouette is stable. Subcutaneous emphysema persists along the right chest and in the axillary region, minimally improve3d. Bibasilar atelectasis are similar. " f353f4d0-f5a659b3-fa946980-30da2553-26f0e4f5.jpg,test/p13/p13500772/s57623581/f353f4d0-f5a659b3-fa946980-30da2553-26f0e4f5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with metastatic prostate ca s/p resection of lung nodule presenting with UTI, bibaslar crackles on exam // acute process COMPARISON: Chest radiographs ___ and ___. IMPRESSION: The multi focal irregularly shaped nodular pulmonary abnormality which progressed between ___ and ___ has worsened, particularly in the right lower lung. Since the process appears to have begun in ___ or earlier, it would have to be an extremely indolent infection or as suggested in the report of the ___ chest CT, an unusual manifestation of cavitary, metastatic prostate carcinoma. Moderate cardiomegaly which also progressed between ___ and ___ is stable, but there is a new small left pleural effusion. " 60df95ab-da9a2526-a707825b-7e64be16-1dad0f8c.jpg,test/p16/p16289299/s56576834/60df95ab-da9a2526-a707825b-7e64be16-1dad0f8c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is mildly enlarged. The mediastinal and hilar contours are unchanged. Patchy opacities are noted in the lung bases, and not substantially changed from the previous exam. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Patchy bibasilar airspace opacities likely atelectasis. " 9138aafc-1c07b9d4-82e6017b-c4e80ead-044bf2df.jpg,test/p16/p16068315/s59912142/9138aafc-1c07b9d4-82e6017b-c4e80ead-044bf2df.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Preop, ankle fracture. FINDINGS: AP upright and lateral views of the chest are provided. There is mild left basilar atelectasis. There is no focal consolidation to suggest the presence of pneumonia. No pleural effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: Mild left basilar atelectasis. Otherwise normal. " de776a26-e934bd8b-2983907d-fffdea8a-550361fd.jpg,test/p17/p17112351/s54466869/de776a26-e934bd8b-2983907d-fffdea8a-550361fd.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST. REASON FOR EXAM: CHF exacerbation. Comparison is made with prior study ___. Widened mediastinum, enlarged pulmonary arteries and moderate cardiomegaly are unchanged. Improved left lower lobe opacities are consistent with improving atelectasis and pleural effusion. Right lower lobe atelectasis has improved. Mild pulmonary edema is grossly unchanged. " 602eebfa-bf8aa213-d37388e6-0f614fb1-12e5e8e3.jpg,test/p10/p10745810/s59693791/602eebfa-bf8aa213-d37388e6-0f614fb1-12e5e8e3.jpg,test," FINAL REPORT INDICATION: ___F with bradycardia, dyspnea, diarrhea // eval ? effusion, infiltrate TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: There are small bilateral pleural effusions. Lungs are otherwise clear without focal consolidation or edema. There is mild cardiomegaly and atherosclerotic calcifications of the aortic arch. Compression deformity in the mid thoracic spine is similar compared to prior. IMPRESSION: Small bilateral pleural effusions. " 07f7d5ec-c6f9377c-1f667b1b-5b438c45-d2159555.jpg,test/p14/p14002189/s59156253/07f7d5ec-c6f9377c-1f667b1b-5b438c45-d2159555.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of lung cancer, now presenting with cough and rhonchi. EXAMINATION: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: Sutures overlie the left lung apex in keeping with prior surgical resection. There is hyperinflation of the lungs with irregularity of the peripheral vasculature compatible with COPD. There are no focal opacities concerning for pneumonia. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is not increased. There has been interval callus formation involving a right mid thoracic rib fracture since ___. There are findings compatible with diffuse idiopathic skeletal hyperostosis. IMPRESSION: No acute cardiopulmonary process. " ec1bceb9-817e7969-99b42cf8-ab6d2e46-427546c7.jpg,test/p19/p19891107/s52066487/ec1bceb9-817e7969-99b42cf8-ab6d2e46-427546c7.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Shortness of breath and Klebsiella in the sputum, assessment for ventilation-acquired pneumonia. AP radiograph of the chest was reviewed in comparison to ___. The patient was extubated in the meantime interval with removal of the NG tube. The right PICC line tip is at the level of mid SVC. Heart size and mediastinum are stable. There is interval improvement of bibasilar consolidations with no evidence of new consolidation to suggest interval development of ventilation-acquired pneumonia. " a8835e97-f0c2d881-f03d3635-2d7991af-25a6fad3.jpg,test/p11/p11556950/s50767196/a8835e97-f0c2d881-f03d3635-2d7991af-25a6fad3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is detected. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 84c3c6ae-bde29e4d-8f674c7b-91b59ee9-f38d45f0.jpg,test/p10/p10262096/s53244284/84c3c6ae-bde29e4d-8f674c7b-91b59ee9-f38d45f0.jpg,test," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old female with chest pain and shortness of breath, question pneumonia or fluid overload. FINDINGS: Single portable view of the chest is compared to previous exam from ___. As previously noted, lung volumes remain low. There are subtle patchy opacities in the lungs bilaterally. There is possible left-sided pleural effusion. Left diaphragm is not clearly delineated. Prominence of the hila again noted. Cardiac silhouette is stable. Degenerative changes are again seen at the glenohumeral joints. IMPRESSION: Limited portable exam. Bilateral patchy opacities, potentially due to atelectasis given low lung volumes and; however, pulmonary edema is also possible, underlying aspiration/infection difficult to exclude. Possible left effusion If possible, repeat two-view chest x-ray would help to further characterize. " 9e85c829-2cf83581-4c6a4a66-65fba2e4-0f169276.jpg,test/p14/p14647159/s54226431/9e85c829-2cf83581-4c6a4a66-65fba2e4-0f169276.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough for last five days with known sick contacts. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are unremarkable. Lungs are essentially clear except for minimal bibasal atelectasis with no definite infection seen, although it cannot be entirely excluded in particular in the very posterior basal aspect of the left lower lobe. If clinically warranted, followup of the patient in four weeks after completion of antibiotic therapy might be considered. " a28398c2-29668c17-82ff1a4f-15480a98-b99280ee.jpg,test/p18/p18031120/s50187604/a28398c2-29668c17-82ff1a4f-15480a98-b99280ee.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with chf, sob // CHF exacerbation? COMPARISON: ___. FINDINGS: AP portable upright view of the chest. Underpenetration limits assessment. Left chest wall AICD is again noted with pacer lead extending into the right heart though the tip is poorly visualized. There is a right upper extremity PICC line partially imaged, tip in the upper SVC. Cardiomegaly is unchanged. There is no overt evidence for pneumonia or edema. No large effusion or pneumothorax. Bony structures are intact. IMPRESSION: Cardiomegaly without convincing evidence for pneumonia or edema. " 8cb59ff1-e8b7829d-0f221593-b14015d4-7a55c1b4.jpg,test/p12/p12301829/s52434030/8cb59ff1-e8b7829d-0f221593-b14015d4-7a55c1b4.jpg,test," FINAL REPORT HISTORY: Rhonchi at right base, to assess for pneumonia. FINDINGS: No previous images. No evidence of pneumonia, vascular congestion, or pleural effusion. There is a slight impression on the right side of the lower cervical trachea, raising the possibility of thyroid enlargement. " b86431ae-eb4123fa-b59c490a-caaade3d-75b4eea0.jpg,test/p15/p15851715/s56870831/b86431ae-eb4123fa-b59c490a-caaade3d-75b4eea0.jpg,test," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: There is mild bibasilar atelectasis. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Mild bibasilar atelectasis. Otherwise, no acute cardiopulmonary process. " fadc5814-e32329fd-6894e352-2b0f5800-fbeecf62.jpg,test/p19/p19890943/s58901991/fadc5814-e32329fd-6894e352-2b0f5800-fbeecf62.jpg,test," FINAL REPORT HISTORY: CHF and prior pericardial effusion now reported persistent cough, increased shortness of breath and decreased breath sounds with desaturation to ___% with exercise. TECHNIQUE: AP and lateral chest radiograph, 2 views. COMPARISON: ___ through ___. FINDINGS: There has been interval development of a large left pleural effusion with associated compressive atelectasis which shifts the cardiac silhouette to the right and shifts the left hemidiaphragm downward. Cardiac silhouette cannot be accurately gauged due to obliteration of the left cardiac border by the large effusion. The right lung is clear. There is no pneumothorax. No distracted bony injury is identified. IMPRESSION: Interval development of a large left pleural effusion. If there is history of recent trauma, hemothorax should be considered. Other causes include infection or malignancy and malignancy, but the latter is less likely given the short interval time of development. Results were discussed over the telephone with Dr. ___ by ___ ___ at 9:40 on ___ at time of initial review. " d6bd28f8-3fdbcff7-48cca41a-116a8379-a8b76092.jpg,test/p12/p12304672/s51310195/d6bd28f8-3fdbcff7-48cca41a-116a8379-a8b76092.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HCV cirrhosis and variceal bleeding s/p intubation // ETT placement (to be done at 8AM) TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 8 hours earlier IMPRESSION: ET tube is in standard position. Diffuse bilateral opacities worse in the medial lower lobes have increased from prior consistent with worsening aspiration/pneumonia. There is increase in loss of volume of the left lower lobe. Left pleural effusion is small. There is no pneumothorax. Cardiomediastinal contours are unchanged. Pacer leads are in standard position " 6b91220b-aff61d7a-021ee501-049112db-aba769e5.jpg,test/p12/p12151772/s50162434/6b91220b-aff61d7a-021ee501-049112db-aba769e5.jpg,test," FINAL REPORT HISTORY: Hypothermia and tachycardia with concern for infectious source. Also, bilateral pleural effusions. Assess for infectious source and interval change in bilateral pleural effusions. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate bilateral pleural effusions, large on the left and moderate on the right. Accounting for differences in positioning from the prior radiograph, these are relatively unchanged. Otherwise, the lungs are essentially clear aside from bibasilar atelectasis. The cardiac contour is obscured by a large left pleural effusion, but the mediastinal contour is normal. No pneumothorax is seen. IMPRESSION: Unchanged appearance of large left and moderate right pleural effusions with no acute pneumonia identified. " b30f638b-b67cffd0-354335f8-f8a67d0f-3e39d60e.jpg,test/p14/p14290495/s51207386/b30f638b-b67cffd0-354335f8-f8a67d0f-3e39d60e.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old male with cough and fever, history of sarcoid and HIV. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear of focal consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Osseous structures demonstrate no acute abnormality. IMPRESSION: No acute cardiopulmonary process. " f53b6a7e-9aacc93a-ab336553-5dba495a-48d4692f.jpg,test/p10/p10514722/s53148676/f53b6a7e-9aacc93a-ab336553-5dba495a-48d4692f.jpg,test," FINAL REPORT HISTORY: ___-year-old with history of asthma, 2 day history of cough, malaise. Decreased breath sounds at the right upper lung fields. Evaluate for abnormality. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: No consolidation, pleural effusion or pulmonary edema is seen, and the cardiac and mediastinal contours are normal. There is right apical pleural thickening. IMPRESSION: No acute cardiopulmonary disease. " 39f70bce-4b5e8016-b522a187-aa408957-69a44f52.jpg,test/p12/p12773009/s54117408/39f70bce-4b5e8016-b522a187-aa408957-69a44f52.jpg,test," FINAL REPORT INDICATION: ___ year old man with CLL // known pleural effusion, tachycardia, r/o PE + evaluate effusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___ FINDINGS: The moderate left pleural effusion is unchanged. Bibasilar atelectasis. Indeterminate cardiac silhouette. Normal mediastinal and hilar contours. The right lung is clear. No pneumothorax. No evidence of pneumonia. IMPRESSION: 1. Unchanged moderate left pleural effusion. 2. Bibasilar atelectasis. " a25d4073-c2f688e1-05b17c70-17f443c1-6f220191.jpg,test/p11/p11166200/s58409920/a25d4073-c2f688e1-05b17c70-17f443c1-6f220191.jpg,test," FINAL REPORT INDICATION: Status post lung biopsy. COMPARISON: Chest radiograph, ___. FINDINGS: A new right chest tube is present. There is no pneumothorax or pleural effusion. Lung volumes are low causing crowding of the bronchovascular structures and apparent increase in heart size, although they are likely unchanged and normal. There is no consolidation or pulmonary edema. IMPRESSION: 1. Right chest tube in proper position. No pneumothorax or pleural effusion. 2. Low lung volumes. " 233e673e-35afcff3-9e1427a5-936642b0-6f7c34d4.jpg,test/p16/p16486158/s51938936/233e673e-35afcff3-9e1427a5-936642b0-6f7c34d4.jpg,test," FINAL REPORT INDICATION: ___M with hypotension, n/v // eval for consolidation TECHNIQUE: Single portable view of the chest. COMPARISON: PET-CT from ___. FINDINGS: The lungs are grossly clear. There is no confluent consolidation, large effusion or visualized pneumothorax. The cardiomediastinal silhouette is within normal limits. Degenerative changes are seen at the shoulders, more so on the right. No free air seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " e087c2e3-39a3ed89-a0fc6045-7415b388-8f28530a.jpg,test/p11/p11225570/s50527097/e087c2e3-39a3ed89-a0fc6045-7415b388-8f28530a.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Fever and cough. Cardiomediastinal contours are normal. There is a pneumonic consolidation in the left lower lobe. There is probably also a pneumonic consolidation in the right lower lobe. There is no pneumothorax. If any, there is a small left pleural effusion. IMPRESSION: Multilobar pneumonia. Findings were discussed with Dr. ___ by phone on ___ at 2:10 p.m. " 71211428-ffe176b0-6d2ecf0c-311caacd-61823b0e.jpg,test/p18/p18079519/s53111635/71211428-ffe176b0-6d2ecf0c-311caacd-61823b0e.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pneumothorax, chest tubes on waterseal. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the chest tubes are in unchanged position. There could be millimetric apical pneumothoraces, particularly on the right. However, the extent of these pneumothoraces is minimal. The Swan-Ganz catheter has been removed. The mediastinal drains remain in situ. Unchanged appearance of the heart and of the lung parenchyma. " c3cad8ca-7ecadd30-0b381959-99cb8203-1a964229.jpg,test/p14/p14738661/s53346425/c3cad8ca-7ecadd30-0b381959-99cb8203-1a964229.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post motor vehicle accident. Evaluate for evidence of pneumothorax or any other acute cardiopulmonary process. COMPARISON: None available. TECHNIQUE: AP and lateral chest radiograph. FINDINGS: The lungs are well inflated and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. No rib fractures are noted. IMPRESSION: No evidence of acute cardiopulmonary process. " 84a6976a-b9d8d54e-8f2b62a0-846484e7-07687613.jpg,test/p10/p10337761/s56041312/84a6976a-b9d8d54e-8f2b62a0-846484e7-07687613.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with HIV, right-sided congenital heart failure and recent erythrodermic skin reaction, presents with fluid overload for any acute pulmonary condition. AP and lateral upright chest radiographs were reviewed in comparison to ___. Cardiomegaly is unchanged, moderate to severe as well as prominence of the main pulmonary artery, findings that might be consistent with pulmonary hypertension. Lungs are essentially clear. No focal consolidations, pleural effusion, or pneumothorax is seen. No definitive pulmonary edema is noted as well. " 96ce1aaa-8e12810f-2ff6378f-4df70af0-156bcef6.jpg,test/p12/p12116379/s57997286/96ce1aaa-8e12810f-2ff6378f-4df70af0-156bcef6.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " d56d127f-8783d7ac-e3abf402-110eb527-6c109f9a.jpg,test/p12/p12111976/s55931395/d56d127f-8783d7ac-e3abf402-110eb527-6c109f9a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain, assess for pneumothorax. FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires and mediastinal clips are again noted. An AICD device is positioned over the left chest wall with lead extending into the region of the right ventricle, unchanged. There is no pneumothorax or pleural effusion. No focal consolidation seen to suggest the presence of pneumonia. No pulmonary edema. There is mild subsegmental left lower lobe atelectasis. Cardiomediastinal silhouette is stable. Imaged bones appear intact. IMPRESSION: No acute findings, including no pneumothorax. " 8e720625-5b59487f-586d0b49-a6a3f5a3-cea914bf.jpg,test/p12/p12292383/s55286301/8e720625-5b59487f-586d0b49-a6a3f5a3-cea914bf.jpg,test," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with the study of ___, there is little change. The patient has taken a much better inspiration and there is no evidence of pneumonia, vascular congestion, or pleural effusion. " d39c212f-54d76259-e6845f6b-757ce420-43daac0a.jpg,test/p19/p19270930/s50453399/d39c212f-54d76259-e6845f6b-757ce420-43daac0a.jpg,test," FINAL REPORT INDICATION: Prior left upper lobe pneumonia. COMPARISON: Chest radiograph ___, CT chest ___. Please note that imaging from recent pneumonia is not available. FINDINGS: Cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Fibrotic changes at the right apex are again noted. There is no focal consolidation concerning for pneumonia. The patient is status post right mastectomy. IMPRESSION: Clear left upper lobe with no current signs of pneumonia. " 658f2be4-31632bf7-ecae0ca8-7e71e638-66cdb1c3.jpg,test/p10/p10978131/s59970126/658f2be4-31632bf7-ecae0ca8-7e71e638-66cdb1c3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with shortness of breath. Assess for progressive pneumonia. TECHNIQUE: Upright AP view of the chest COMPARISON: ___ at 13:23 chest radiograph, CT chest ___ at 14:48. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unchanged. Patchy opacities in the lung bases are re- demonstrated along with a more consolidative opacity within the right upper lobe, findings worrisome for multifocal pneumonia. Previously demonstrated suspicious nodule within the left mid lung field is better assessed on the previous CT. No pleural effusion, pneumothorax, or pulmonary vascular congestion is demonstrated. There are no acute osseous abnormalities. IMPRESSION: Multifocal airspace opacities are unchanged concerning for multifocal pneumonia. " 635be8ff-87a29329-3411b403-42ebd705-91232f5d.jpg,test/p16/p16907183/s56080834/635be8ff-87a29329-3411b403-42ebd705-91232f5d.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status and auditory hallucinations. COMPARISONS: None. TECHNIQUE: Chest, three views. FINDINGS: There is a dual lead pacemaker/ICD device whose leads terminate in the right atrium and ventricle, respectively. The heart is mildly enlarged. There is mild unfolding of the thoracic aorta. There is no pleural effusion or pneumothorax. Slight fullness of each hilum suggests minimal vascular congestion. Otherwise, the lungs appear clear. IMPRESSION: Findings suggestive of slight vascular congestion or fluid overload; otherwise unremarkable. " 7542e5a4-7f59381a-4afdb321-0580ee2d-cee00721.jpg,test/p15/p15402907/s58087762/7542e5a4-7f59381a-4afdb321-0580ee2d-cee00721.jpg,test," FINAL REPORT HISTORY: ___-year-old man with dyspnea and questionable CHF, evaluate for pulmonary edema. COMPARISON: ___. FINDINGS: A single portable AP supine view of the chest was obtained. Moderate cardiomegaly is unchanged. Diffuse bilateral opacities are most compatible with mild to moderate pulmonary edema. Increased opacity in the lateral aspect of the right base may be related to asymmetric edema; however, it could also be concealing pneumonia. There is no pneumothorax. IMPRESSION: 1. Moderate cardiomegaly and mild-to-moderate pulmonary edema. 2. Right lower lobe opacity could represent asymmetric edema, but may also conceal pneumonia. Attention on follow up is recommended. " fdc76c21-3f10ddad-c030b154-7893a0ed-e47509de.jpg,test/p19/p19859745/s50477497/fdc76c21-3f10ddad-c030b154-7893a0ed-e47509de.jpg,test," FINAL REPORT INDICATION: Cough and congestion. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The heart is mildly prominent. Mediastinal and hilar contours are within normal limits. There is no evidence for pulmonary edema, pulmonary consolidation, or pleural effusion. Visualized bones are grossly unremarkable. IMPRESSION: No evidence for active cardiopulmonary disease. " 71d9d323-f5fbf4d8-41adead9-c825c37d-6dd65417.jpg,test/p16/p16484232/s52220061/71d9d323-f5fbf4d8-41adead9-c825c37d-6dd65417.jpg,test," FINAL REPORT INDICATION: Trauma, status post fall with right-sided pain. COMPARISON: Chest radiograph from ___ and CT torso from ___. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. The aorta appears tortuous. Bones are diffusely demineralized and limited evaluation for an acute fracture. However, no acute fractures are identified. Mild degenerative changes are visualized throughout the thoracolumbar spine. IMPRESSION: No acute cardiopulmonary process. Osteopenia with no evidence of a fracture. " 0ac36f6a-d8e80cbf-271e53d6-8f81c189-c8aa5e52.jpg,test/p11/p11630519/s56616175/0ac36f6a-d8e80cbf-271e53d6-8f81c189-c8aa5e52.jpg,test," WET READ: ___ ___ ___ 8:36 PM NG tube with tip and side port just below the diaphragm projecting within the proximal stomach. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. COMPARISON: Chest radiograph from ___. FINDINGS: 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. " 074378fc-2d539490-5c98d1cd-cf6fb398-e832edda.jpg,test/p18/p18705722/s51864451/074378fc-2d539490-5c98d1cd-cf6fb398-e832edda.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with mech valve // Tachypnea TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: Severe cardiomegaly and widening mediastinum are stable. Vascular congestion is unchanged. Bilateral platelike atelectasis have increased on the left. There is no evident pneumothorax or enlarging effusions. Right IJ catheter tip is in the lower SVC. Sternal wires are aligned. Patient is status post MVR. " 4f8234d9-4a4762ea-a0704c36-a62f142e-8cc1668f.jpg,test/p16/p16742247/s50378868/4f8234d9-4a4762ea-a0704c36-a62f142e-8cc1668f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with AML s/p allo BMT with chronic bronchiectasis and chronic pseudomonas pneumonia in the hospital with recurrent AML, left rib/chest pain (likely secondary to cough), and worsening pneumonia to start decitabine today. // pneumonia? bronchiectasis? ribs ___ r/o fracture pneumonia? bronchiectasis? ribs ___ r/o fracture IMPRESSION: In comparison with the study of ___, there is little overall change in the diffuse bilateral pulmonary opacifications consistent with widespread pneumonia the PICC line is unchanged. ___, MD " 28adf269-d190571a-535711bb-2d0e7e2e-49bce559.jpg,test/p16/p16190725/s52309861/28adf269-d190571a-535711bb-2d0e7e2e-49bce559.jpg,test," FINAL REPORT INDICATION: Status post pericardial window. TECHNIQUE: Bedside frontal chest radiograph. COMPARISON: Chest radiographs ___ and ___. FINDINGS: The endotracheal tube terminates at the level of the carina and should be withdrawn 3 cm for standard positioning. Bilateral chest tubes, mediastinal drains and an enteric tube are well positioned. A left paramedian drain is sharply angulated and should be revised if poorly functioning. Sternotomy wires are constant. Retrocardiac atelectasis is unchanged. There is no pneumothorax. Pleural effusions, if there were any before, have resolved. The cardiac silhouette is smaller in size and pulmonary edema has resolved after pericardial window formation. Postoperative appearance of the mediastinum is unchanged from yesterday. IMPRESSION: 1. Endotracheal tube should be withdrawn 3 cm for better positioning. 2. Resolution of mild pulmonary edema and decrease in size of the cardiac silhouette after pericardial window formation. NOTIFICATION: The findings were discussed by Dr. ___ with ___, NP via telephone on ___ at 11:09 AM, 5 minutes after discovery of the findings. " 6370f969-c7e5b4d0-db88d0d4-65d63059-600510ca.jpg,test/p10/p10783934/s51341845/6370f969-c7e5b4d0-db88d0d4-65d63059-600510ca.jpg,test," FINAL REPORT HISTORY: Recent cardiac catheterization with weakness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d62bea09-b830685a-cbb46872-a9d738c8-af50c902.jpg,test/p17/p17894597/s59649831/d62bea09-b830685a-cbb46872-a9d738c8-af50c902.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with abdominal pain and elevated lactate // Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CT abdomen and pelvis dated ___. FINDINGS: There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. The heart is top-normal in size. Intravenous contrast material seen within the renal collecting systems from preceding CT. IMPRESSION: No acute cardiopulmonary process. " ff034bab-cfb98393-9658d946-b9ffbcc3-4fdfd0b7.jpg,test/p12/p12730395/s50810237/ff034bab-cfb98393-9658d946-b9ffbcc3-4fdfd0b7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CAD lung cancer with chest tube in place // Evaluate effusion progresion TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: There is persistent visualization of a loculated right basal pneumothorax. A chest drain is in-situ, this appears to been withdrawn slightly when compared to the prior study. There has been interval improvement in the aeration of the right upper lung the right-sided pleural effusion has increased slightly when compared to the prior study. No left-sided pleural effusion seen. Left lung remains grossly clear. IMPRESSION: Slight interval improvement in the aeration of the right upper lung, slight interval increase in size in the right-sided pleural effusion. Unchanged loculated right basal pneumothorax. " abcf06a6-52c86b1e-43988254-67b2b4b9-e283eb65.jpg,test/p13/p13036647/s54930715/abcf06a6-52c86b1e-43988254-67b2b4b9-e283eb65.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with L upper back pain, fever and productive cough green sputum COMPARISON: ___ and ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low though allowing for this the lungs appear clear aside from mild left basal atelectasis. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: Mild left basal atelectasis, otherwise unremarkable. " 03afb514-1e0ae3eb-0b679ef0-d1ba9ab5-8c15b678.jpg,test/p11/p11988232/s59683083/03afb514-1e0ae3eb-0b679ef0-d1ba9ab5-8c15b678.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F presenting with lethargy and fever concerning for sepsis. // ? pneumonia TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: The patient is somewhat rotated. No focal consolidation is seen. No pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " e134ee9c-37fd03b3-4bf4689f-2db79845-3de548f2.jpg,test/p13/p13325402/s54399638/e134ee9c-37fd03b3-4bf4689f-2db79845-3de548f2.jpg,test," FINAL REPORT HISTORY: Abscess. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Assessment is limited due to patient rotation. The heart size is at least mildly enlarged, and the aorta remains tortuous. There is a linear opacity within the left lung base likely reflective of atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. Severe degenerative changes of the right glenohumeral joint are present along with a well corticated ossific density adjacent to the distal right clavicle, which could reflect the sequelae of prior injury. Multilevel degenerative changes are noted in the thoracic spine with retrolisthesis demonstrated at the thoracolumbar junction, not significantly changed in the interval. Partially imaged is lumbar spinal fusion hardware. Deformity of the right thoracic rib cage suggests prior trauma. IMPRESSION: Limited exam. Linear atelectasis in the left lung base. Otherwise no acute cardiopulmonary abnormality. " 1f2ca2b6-e5e041b7-30170541-998b92e1-b2f4c5d6.jpg,test/p11/p11813685/s50470820/1f2ca2b6-e5e041b7-30170541-998b92e1-b2f4c5d6.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Back pain radiating to the chest. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. The heart is borderline in size with a left ventricular configuration. The aorta shows mild unfolding. A small calcified granuloma projects over the right lower lung, unchanged. Otherwise, the lung fields appear clear. IMPRESSION: No evidence of acute disease. " 2f3e1129-03b1d205-67a87c13-4b33a25f-d10186e6.jpg,test/p19/p19428331/s53900977/2f3e1129-03b1d205-67a87c13-4b33a25f-d10186e6.jpg,test," FINAL REPORT HISTORY: ___-year-old man with weakness, question CVA versus postictal, question pneumonia, low seizure threshold. COMPARISON: Prior exam is dated ___. FINDINGS: AP upright and lateral views of the chest were provided. Lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears normal. On the lateral view, a compression deformity is seen at the thoracolumbar junction, new from the ___ exam though appears chronic. Bilateral AC joint arthropathy is noted. IMPRESSION: No consolidation to suggest pneumonia. Chronic appearance of a vertebral body compression at the thoracolumbar junction. " 098152a5-5711f26e-011e4868-856a37c6-4a3b0d7b.jpg,test/p19/p19934623/s54573936/098152a5-5711f26e-011e4868-856a37c6-4a3b0d7b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Cough COMPARISON: ___ avail FINDINGS: Asymmetric fullness of the right hilum is accompanied by a nonspecific right lower lobe opacity projecting over the lower thoracic spine on the lateral radiograph. Lungs are otherwise clear, and there are no pleural effusions. Cardiomediastinal contours are normal. IMPRESSION: Asymmetrical enlargement of right hilum accompanied by a cyst is is the wall it is is is as as any acute is a the all cysts is a is nonspecific right lower lobe opacity. In the absence of infectious symptoms, neoplasm should be considered. RECOMMENDATIONS: If the patient has infectious symptoms, recommend initial chest radiograph in 4 weeks after completion of antibiotic therapy. In the absence of infectious symptoms, contrast-enhanced chest CT would be recommended rather than followup chest radiograph. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 09:46 into the Department of Radiology critical communications system for direct communication to the referring provider. " b10aab2c-33220e4a-23c182e9-06ea4916-4a79547a.jpg,test/p11/p11636169/s55949143/b10aab2c-33220e4a-23c182e9-06ea4916-4a79547a.jpg,test," FINAL REPORT AP CHEST, 12:13 A.M. ON ___ HISTORY: Cardiac arrest. IMPRESSION: AP chest compared to ___: Mild cardiomegaly has improved since ___, but there is new opacification at the base of the left lung which could be asymmetric edema, since there are clear septal lines, but the marked asymmetry raises concern for pneumonia particularly aspiration. Lesser degree of atelectasis is new at the right lung base. There is no pneumothorax. Pleural effusions are small if any. Upper mediastinum is not widened. ET tube is in standard placement. Left subclavian line ends in the left brachiocephalic vein, and a nasogastric tube passes into the stomach and out of view. The fracture of the second from uppermost sternal wire dates from at least ___, 3:55 p.m., the earliest examination available. There has been no subsequent derangement of wires. " eb7ba301-7875f23a-08b6a52d-55f4ec3d-bf736239.jpg,test/p12/p12423400/s50333138/eb7ba301-7875f23a-08b6a52d-55f4ec3d-bf736239.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old female with pulmonary fibrosis, recent COPD exacerbation with tenderness to the right side and shortness of breath. FINDINGS: Frontal and lateral views of the chest correlated to images from PET-CT from ___. Slightly increased interstitial markings within the lungs compatible with patient's history of pulmonary fibrosis, not significantly changed from prior CT scan. There is no evidence of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Osseous structures are notable for shortening of the right clavicle with an incompletely visualized and likely widened acromioclavicular distance. IMPRESSION: Evidence of patient's known pulmonary fibrosis without definite superimposed acute cardiopulmonary process. " c14d2ce0-e50b3047-342e2989-9a95e086-cc297176.jpg,test/p14/p14312973/s51000686/c14d2ce0-e50b3047-342e2989-9a95e086-cc297176.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with resolved dilated nonischemic CM, sinus node dysfunction s/p pace, a fib, CKD presented after fall. Currently having increased crackles on lung exam and edema in b/l UE and ___ // pulm edema? pulm edema? IMPRESSION: In comparison with the study of ___, there is little overall change in the cardiomegaly, vascular congestion, and bilateral layering pleural effusions with compressive atelectasis at the bases. In the appropriate clinical setting, it it would be extremely difficult to exclude superimposed pneumonia. Dual-channel pacer remains in place with leads in the right atrium and apex of the right ventricle. " 46ef4095-5be7e91c-d0e24893-a67166b8-39750837.jpg,test/p11/p11786671/s56074274/46ef4095-5be7e91c-d0e24893-a67166b8-39750837.jpg,test," FINAL REPORT INDICATION: ___-year-old male with right arm PICC question placement. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Chest radiograph performed ___ FINDINGS: PA and lateral chest radiographs demonstrate a right PICC, its tip terminating within the lower superior vena cava. Lung volumes are low with resulting atelectasis. No opacity convincing for pneumonia is present. Cardiomediastinal and hilar contours are stable relative to prior examinations. There is no air under the right hemidiaphragm. There is no pneumothorax, pleural effusion, or pulmonary edema. IMPRESSION: Right PICC terminating lower superior vena cava. " f4949c4b-868de1dc-b853b3a5-c27e7319-cbcffe9a.jpg,test/p17/p17175688/s53620418/f4949c4b-868de1dc-b853b3a5-c27e7319-cbcffe9a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and CT chest ___. FINDINGS: Mild to moderate cardiomegaly is unchanged. Prominence of the right hilum is re- demonstrated, and there is evidence of mild pulmonary vascular congestion. Trace pleural fluid is seen tracking along the fissural planes. Streaky opacity in the right lung base is likely atelectasis. No pleural effusion, pneumothorax, or focal consolidation. IMPRESSION: Mild pulmonary vascular congestion. Stable cardiomegaly. Trace pleural fluid. " 692bc1af-bcfbf03e-24510d7b-2e363b8f-04733cbd.jpg,test/p19/p19891107/s56102242/692bc1af-bcfbf03e-24510d7b-2e363b8f-04733cbd.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with morbid obesity with femurs and back pain. Evaluate for pneumonia. FINDINGS: The heart size is upper limits of normal. There is mild prominence of interstitial markings without overt pulmonary edema. No definite consolidation is seen. There are no pneumothoraces. Bony structures are grossly intact. " ffba94d5-43e5e000-6b6a8c1c-60bb5fd2-241f6e0e.jpg,test/p12/p12156923/s54401760/ffba94d5-43e5e000-6b6a8c1c-60bb5fd2-241f6e0e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p AAA with rising WBC // eval for opacity COMPARISON: Chest x-ray from ___ FINDINGS: PICC line tip appears to been retracted in the interval up interim in overlies distal most SVC. Vascular plethora appears increased. Right IJ sheath has been removed. Otherwise, I doubt significant interval change. Retrocardiac opacity and platelike atelectasis at the left base with small left effusion again noted. Minimal atelectasis noted the right base. No pneumothorax detected trace IMPRESSION: Interval increase in CHF. Mild increase in atelectasis at the right base. Left lower lobe collapse and/or consolidation with small left effusion is similar to the prior film. The possibility of an infectious pneumonic consolidation in the left lower lobe cannot be excluded. " 388e409f-1fe1aa86-31bf5a3b-5ac0304f-5de53a6f.jpg,test/p17/p17651554/s54805906/388e409f-1fe1aa86-31bf5a3b-5ac0304f-5de53a6f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF, complaining of increased work of breathing this AM // please evaluate for volume overload IMPRESSION: As compared to ___, there has been slight increase in cardiomegaly, accompanied by worsening pulmonary vascular congestion. Right pleural effusion is difficult to compare to the previous exam due to positional differences, but may be slightly smaller. Small left pleural effusion is not appreciably changed. " dee254a8-36178da0-7937d8f4-8f6c4ac7-15eae932.jpg,test/p17/p17981006/s55835301/dee254a8-36178da0-7937d8f4-8f6c4ac7-15eae932.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough and shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The chest is hyperinflated. The lungs appear clear. Bony structures are within normal limits. IMPRESSION: No evidence of acute cardiopulmonary disease. Hyperinflation. " 4ecf6616-b1818d26-cfd6da93-7699a08e-c6ba341e.jpg,test/p17/p17374166/s51320221/4ecf6616-b1818d26-cfd6da93-7699a08e-c6ba341e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with bladder cancer // Bladder cancer s/p cystectomy, r/o mets Bladder cancer s/p cystectomy, r/o mets IMPRESSION: In comparison with the study of ___, there is little change and no definite evidence of acute cardiopulmonary disease. Although no definite pulmonary metastases are identified, radiographs are insensitive for this purpose and CT could be obtained if clinically warranted. " 77bfb517-b9cdd414-e7cd5a34-3081d844-6764f8ef.jpg,test/p15/p15653759/s54531985/77bfb517-b9cdd414-e7cd5a34-3081d844-6764f8ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion and pigtail cath. Resolution of effusion? TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: Compared with the prior radiograph, the right pigtail catheter in the lower right hemithorax is unchanged in position with improvement in the large right-sided pleural effusion and improved aeration of the right lung. Bilateral pleural effusions are still present however. Consolidation of the right lower lobe and opacification of the left lower lobe are concerning for pneumonia. Left Port-A-Cath is unchanged and terminates in the right atrium. IMPRESSION: 1. Improvement in large right pleural effusion after right pigtail placement, with bilateral residual effusions. 2. Consolidation of the right lower lobe and opacification of the left lower lobe are concerning for pneumonia. " d6e1ba17-67fba452-7c25999a-858fe234-8f464dd5.jpg,test/p17/p17965724/s57267640/d6e1ba17-67fba452-7c25999a-858fe234-8f464dd5.jpg,test," FINAL REPORT INDICATION: ___ year old woman with hypercarbic respiratory failure now intubated // Please evaluate ET tube position. ; ___ year old woman with COPD with hypercarbic respiratory failure. // please evaluate ET position. Poor prior film TECHNIQUE: Serial AP chest radiographs dated ___ at 06:50 and 10:48. COMPARISON: ___ at FINDINGS: ET tube terminates 1.3 cm above the Carina pointing towards the right main bronchus. Enteric tube traverses beyond the diaphragm, distal tip not visualized. The lungs are well inflated with bibasilar linear atelectasis. There is no pleural effusion or pneumothorax. Stable cardiomegaly noted. No interval change in bony thorax. IMPRESSION: ET tube terminates 1.3 cm above the carina pointing towards the right main bronchus and could be retracted by about 2 cm. Enteric tube terminates in the stomach. Bibasilar linear atelectasis without consolidation or pleural effusions. " 2c86e7ec-e3cf29b7-1ffca43d-f14f7430-965d65c3.jpg,test/p12/p12734486/s55686770/2c86e7ec-e3cf29b7-1ffca43d-f14f7430-965d65c3.jpg,test," FINAL REPORT HISTORY: ___-year-old male with altered mental status. Question infiltrate. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest. Prior left IJ line is no longer seen. The lungs are clear of focal consolidation or effusion. There is no pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Descending thoracic aorta is tortuous. Multiple old healed right rib fractures are again noted. Compression deformity in the mid thoracic spine is unchanged from ___. IMPRESSION: No acute cardiopulmonary process. " f84e98d6-50ba6701-19cad058-e265b4b4-dd30b2e0.jpg,test/p11/p11522912/s54173511/f84e98d6-50ba6701-19cad058-e265b4b4-dd30b2e0.jpg,test," FINAL REPORT HISTORY: Respiratory distress and basilar opacifications. FINDINGS: In comparison with the study of ___, there is little overall change in the bibasilar opacifications, more prominent on the left, consistent with atelectasis and left pleural effusion. Central catheter remains in place. " 8a32d49e-6065a088-727412a3-bbb5d890-2cf84f51.jpg,test/p17/p17913240/s53587482/8a32d49e-6065a088-727412a3-bbb5d890-2cf84f51.jpg,test," WET READ: ___ ___ ___ 8:03 AM 1. Status post thoracentesis, with decreased left pleural fluid. No pneumothorax identified. 2. Persistently low lung volumes, with bibasilar atelectasis. WET READ VERSION #1 ___ ___ ___ 7:51 PM 1. Status post thoracentesis, with decreased left pleural fluid. No pneumothorax identified. 2. Persistently low lung volumes, with bibasilar atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with aids pleural effusion // s/p ___ left IMPRESSION: As compared to the recent radiograph of 1 day earlier, there is slight decrease in left pleural effusion following thoracentesis with no visible pneumothorax. Nonspecific right basilar opacity has slightly increased in extent. No other relevant changes. " a9f483be-8a8b3fdf-14624ebf-d552d9b3-484ddf4e.jpg,test/p15/p15605860/s54023936/a9f483be-8a8b3fdf-14624ebf-d552d9b3-484ddf4e.jpg,test," FINAL REPORT INDICATION: ___ year old man S/P repair L diaphragmatic hernia. TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs from ___ through ___. FINDINGS: Patient is status post repair of left diaphragmatic hernia. Compared to ___, there is no significant change. Previous left apical pneumothorax appear replaced with fluid. Left lung base atelectasis and pleural effusion appear stable and unchanged. The right lung is unchanged and grossly normal. The heart size is likely top normal. The mediastinal and hilar contours are unremarkable. IMPRESSION: Stable postop appearance. Previous small left apical pneumothorax now replaced with fluid. " a313d310-559b7c75-b394197e-7614f158-a40f52ad.jpg,test/p15/p15998296/s57965021/a313d310-559b7c75-b394197e-7614f158-a40f52ad.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Continued fever and cough. History of recent pneumonia. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. Central pulmonary arteries appear enlarged. There are persistent widespread multifocal opacities suggesting pneumonia, most extensive in the upper lobes. These are seen in a background diffuse interstitial abnormality which may represent part of a widespread infectious process, although coinciding etiologies such as fluid overload or interstitial lung disease are also possible. A right lower lung opacity which had worsened since the earliest study has now improved slightly, but other opacities are little if at all changed. There is no definite pleural effusion or pneumothorax. The bones appear demineralized. There is a mild anterior wedge compression deformity along the lower thoracic spine, likely chronic. IMPRESSION: Persistent multifocal opacities suggesting pneumonia, fairly similar in overall distribution; the only clear change is somewhat improved aeration at the right lung base. A coinciding interstitial abnormality may indicate an additional process such as fluid overload or interstitial disease. Comparison to earlier studies predating acute illness may be helpful to evaluate further and possibly CT if needed clinically. " 176f7dde-12dc3b94-98075b5f-24fb2e40-68231fdf.jpg,test/p15/p15342918/s53167372/176f7dde-12dc3b94-98075b5f-24fb2e40-68231fdf.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with pain with deep breath and shortness of breath. FINDINGS: Frontal and lateral views of the chest. No prior. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 84037cdc-0623cf83-551f6e76-9d6faca7-df915be8.jpg,test/p14/p14642407/s58720809/84037cdc-0623cf83-551f6e76-9d6faca7-df915be8.jpg,test," FINAL REPORT HISTORY: Hyperglycemia and chills. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs, three views. FINDINGS: Heart size is top normal. The mediastinal silhouette and hilar contours are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. The osseous structures are grossly unremarkable. IMPRESSION: No acute intrathoracic process. " c6e21ab3-1a3b3957-53786495-07254d41-33b6650d.jpg,test/p14/p14858066/s55383429/c6e21ab3-1a3b3957-53786495-07254d41-33b6650d.jpg,test," FINAL REPORT INDICATION: ___-year-old male with recent esophagogastroduodenoscopy, new chest tenderness, cough, and congestion. COMPARISON: ___. CHEST, PA AND LATERAL: The lungs are clear. Cardiomediastinal and hilar contours are normal. There is no pleural effusion, pneumothorax, pneumomediastinum, or pneumopericardium. IMPRESSION: No acute cardiopulmonary process. " 19ef1401-f50d7a6d-663b6e77-b70d0dc6-016862bc.jpg,test/p17/p17457075/s55375309/19ef1401-f50d7a6d-663b6e77-b70d0dc6-016862bc.jpg,test," FINAL REPORT HISTORY: HIV with cough. FINDINGS: No previous images. Cardiac silhouette is at the upper limits of normal in size. No evidence of vascular congestion or pleural effusion. Specifically, no acute focal pneumonia. " f66861d1-e733a4b6-09deccf4-e4dd184a-69521cf3.jpg,test/p19/p19778971/s55830081/f66861d1-e733a4b6-09deccf4-e4dd184a-69521cf3.jpg,test," FINAL REPORT REASON FOR EXAM: Hypoxia. Comparison is made with prior study of ___. Cardiomediastinal contours are unchanged. Bilateral opacity, larger on the left are a combination of atelectasis and pleural effusion. Superimposed infection cannot be excluded. Pulmonary edema has improved, now mild. There is no pneumothorax. NG tube tip is out of view below the diaphragm. " 1013dcb4-38f3d11c-765f8ae0-1be27088-1bee4355.jpg,test/p16/p16100723/s54456834/1013dcb4-38f3d11c-765f8ae0-1be27088-1bee4355.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Two days after small bowel surgery with fever. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size and mediastinum are stable. There is new right middle lobe atelectasis. There is also minimal left retrocardiac opacity most likely representing atelectasis. Although infection is a possibility, attention to this area is recommended. The left PICC line tip is at the level of mid SVC. Small amount of free intraperitoneal air demonstrated. " a626e33f-84875dcd-ae1e0d62-6e9b63e2-d18f0f2b.jpg,test/p10/p10337761/s55828349/a626e33f-84875dcd-ae1e0d62-6e9b63e2-d18f0f2b.jpg,test," WET READ: ___ ___ ___ 9:21 PM Endotracheal tube tip projecting approximately 4 cm above the carina. Decreased density layering along the minor fissure, which may be projectional. ______________________________________________________________________________ FINAL REPORT HISTORY: ET tube replacement. FINDINGS: Tip of the endotracheal tube is now approximately 4 cm above the carina. Otherwise, little change. " 1669c141-e5402d31-3d0b27ec-11fa3ee8-871b6e03.jpg,test/p10/p10845913/s54918253/1669c141-e5402d31-3d0b27ec-11fa3ee8-871b6e03.jpg,test," FINAL REPORT INDICATION: ___M with chest pain and syncope // eval for pna TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear of focal consolidation. Density projecting over the left lower lung localizes to the anterior left fifth rib and may be from prior trauma/healed fracture. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 79b1e2bf-5115b1da-7f040b1c-27499288-4180a8c5.jpg,test/p12/p12822417/s54474432/79b1e2bf-5115b1da-7f040b1c-27499288-4180a8c5.jpg,test," FINAL REPORT INDICATION: ___ year old man with right PA catheter. Cannot get accurate PA tracing. // Please evaluate if there has been any change in PA catheter positioning. COMPARISON: Prior radiograph ___. IMPRESSION: The intra-aortic balloon pump has been removed. There is again seen a Swan-Ganz catheter whose distal tip is near the main pulmonary artery trunk. There is a nasogastric tube with sideport above the GE junction and should be advanced several centimeters for more optimal placement. The endotracheal tube is 6.7 cm above the carina, unchanged. Heart size is normal. Lungs are clear. There are no pneumothoraces. " 02668916-806aa957-0b15d2a9-6192549f-5bb9b4d6.jpg,test/p14/p14497007/s55028182/02668916-806aa957-0b15d2a9-6192549f-5bb9b4d6.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fever and agitation. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is no radiographic evidence for focal consolidation, pleural effusion, or pneumothorax. New fissural density may represent atelectasis. Evidence of calcified mediastinal lymph nodes again seen. Cardiac silhouette is top normal to mildly enlarged. Spinal hardware appears similar. IMPRESSION: Top normal to mildly enlarged cardiac silhouette. No focal consolidation. " 6eb3d0bd-903a4ff2-1718edc3-05355c6f-6929773d.jpg,test/p15/p15097240/s55564836/6eb3d0bd-903a4ff2-1718edc3-05355c6f-6929773d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusions, 2 L-sided chest tubes s/p thoracoscopy // **PLEASE PERFORM AT 6AM ON ___ to r/o worsening pneumothorax **PLEASE PERFORM AT 6AM ON ___ to r/o worsening pneumothorax IMPRESSION: Left pigtail catheter in left chest tube are unchanged. Heart size and mediastinum are stable. Bibasal areas of atelectasis are unchanged. There is no pleural effusion. There is no pneumothorax. " 0e76d53b-500e40e2-9da55fc6-683f1799-e3932ef5.jpg,test/p13/p13405890/s51375228/0e76d53b-500e40e2-9da55fc6-683f1799-e3932ef5.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with AMS, acute onset confusion, no fever COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Overlying EKG leads noted. Cardiomegaly and hilar congestion persist with mild interstitial pulmonary edema again noted. Small bilateral pleural effusions likely present. There is increased bibasilar patchy opacity which may reflect a superimposed pneumonia or sequelae of aspiration. No pneumothorax. High-riding humeral heads bilaterally reflect chronic rotator cuff disease. IMPRESSION: As above. " 24c9b021-f9519101-630a2e99-5fc17e46-443bf9b5.jpg,test/p19/p19827390/s58082343/24c9b021-f9519101-630a2e99-5fc17e46-443bf9b5.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with femur fracture, pre-op cxr*** WARNING *** Multiple patients with same last name! // pre op TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The aorta is tortuous somewhat unfolded. The cardiac silhouette is top-normal. IMPRESSION: No focal consolidation to suggest pneumonia. " 8846ae59-0ce92bd4-615f7dea-c94e4f06-a6bb73ce.jpg,test/p10/p10814905/s59157795/8846ae59-0ce92bd4-615f7dea-c94e4f06-a6bb73ce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pancreatic CA now hemothorax s/p IP drainage with chest tube // evaluation of chest tube and pleural effusion evaluation of chest tube and pleural effusion COMPARISON: Prior chest radiographs ___ through ___ at 09:05. IMPRESSION: Moderate left pleural effusion has changed in distribution, but probably not in overall volume, basal pigtail pleural drainage catheter still in place. Small right pleural effusion is stable. Left lower lobe atelectasis unchanged. Upper lungs clear. Heart size normal. Right PIC line ends in the low SVC. " dd20f6fb-72cfb997-a50b0fa0-8f1e3cf5-0ea54e9f.jpg,test/p13/p13286565/s56951536/dd20f6fb-72cfb997-a50b0fa0-8f1e3cf5-0ea54e9f.jpg,test," FINAL REPORT AP CHEST, 10:30 A.M. ON ___ HISTORY: New positioning of pacer lead. IMPRESSION: AP chest compared to ___: As far as one can tell from a solitary frontal view, the right transjugular pacer lead has been withdrawn, still projecting over the mid portion of the right ventricular cavity inferiorly. Lateral view is still needed for more reliable localization. Course of the pacer lead suggests less displacement from the trachea. If there was a hematoma, it is smaller. There is no pneumothorax or pleural effusion. Heart size is normal and the lungs are clear. " b7a736cd-b4cb821d-f722bcc7-9fcac96f-65540bcc.jpg,test/p15/p15513924/s52041139/b7a736cd-b4cb821d-f722bcc7-9fcac96f-65540bcc.jpg,test," FINAL REPORT HISTORY: Dizziness, not feeling well. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low. Moderate enlargement of the cardiac silhouette is re- demonstrated. The aorta remains tortuous. The pulmonary vasculature is normal. Minimal patchy opacities in the lung bases likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Levoscoliosis of the thoracic spine is noted. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " 1a95d795-5a1f3aef-f9fef13b-7b467f37-bc9ab520.jpg,test/p12/p12043836/s52467233/1a95d795-5a1f3aef-f9fef13b-7b467f37-bc9ab520.jpg,test," FINAL REPORT CLINICAL HISTORY: MRSA bacteremia. CHEST Since the previous chest x-ray, there has been some re-expansion of the left lower lobe. Atelectasis persists on the right side and small amount of fluid is probably present within the minor fissure. The position of the ET tubes remains satisfactory. IMPRESSION: Re-expansion of left lower lobe, persistent atelectasis right side. " c78b3a14-2d7b9129-2d3c5a35-f0dad4b2-653ce1a7.jpg,test/p17/p17927957/s58046573/c78b3a14-2d7b9129-2d3c5a35-f0dad4b2-653ce1a7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman s/p RUL // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Improved right pleural effusion and perihilar opacification. Small bilateral pleural effusions remain. Unchanged appearance of left PICC. Heart size, borders, and mediastinal contours are unchanged. IMPRESSION: 1. Improved right pleural effusion and perihilar opacification. 2. Small bilateral pleural effusions remain. " 26737002-631059a7-f531f9fe-94a38d2a-b889cbb0.jpg,test/p11/p11508828/s56551712/26737002-631059a7-f531f9fe-94a38d2a-b889cbb0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recent TAVR // c/o hematoma causing tracheal deviation c/o hematoma causing tracheal deviation COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: The extent of leftward displacement of the trachea at the thoracic inlet is comparable to earlier studies, for example ___ due to a tortuous innominate artery. There is no reason to suspect mediastinal hematoma. Previous mild pulmonary edema has improved. Small right pleural effusion is stable. Heart size top-normal. The right transjugular temporary right ventricular pacer lead unchanged in standard position. TAVR has not migrated. No pneumothorax. " 3a9cfb47-179f0d6d-36175414-a629a5da-5ad2f310.jpg,test/p14/p14065514/s51384458/3a9cfb47-179f0d6d-36175414-a629a5da-5ad2f310.jpg,test," FINAL REPORT HISTORY: Esophageal cancer, nausea, vomiting after chemotherapy with productive cough for 3 days. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph. ___ CT abdomen and pelvis. FINDINGS: Heart size is normal. Mediastinal contours are unchanged, with evidence of prior esophagectomy and gastric pull-through. Left-sided Port-A-Cath tip terminates within the mid to lower SVC. Hilar contours are normal, and the pulmonary vascularity is within normal limits. Elevation of the right hemidiaphragm persists. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen. IMPRESSION: No acute cardiopulmonary abnormality. " 258decb6-074f6852-e7b09454-a4f94ffc-b2db3844.jpg,test/p13/p13417577/s56860462/258decb6-074f6852-e7b09454-a4f94ffc-b2db3844.jpg,test," FINAL REPORT INDICATION: Left upper lung resection for adenocarcinoma on ___. Evaluation for interval change. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Multiple priors, most recently on ___. FINDINGS: Bilateral pleural effusions have resolved. There is continued partial atelectasis of the right middle lobe. Postoperative findings are seen in the left upper lobe. There is no focal consolidation or pneumothorax. The heart is normal in size. The aorta is tortuous, unchanged. IMPRESSION: 1. Resolved bilateral pleural effusions. 2. Persistent partial atelectasis of the right middle lobe deserves additional followup. " 0509d60d-51a72783-56f11ff8-7abd48f9-ef94e5df.jpg,test/p13/p13325402/s50980134/0509d60d-51a72783-56f11ff8-7abd48f9-ef94e5df.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with OGT placement // OGT placement COMPARISON: ___. IMPRESSION: As compared to the previous image, the patient has received a nasogastric tube. The tip of the tube projects over the gastroesophageal junction. The tube needs to be advanced by at least 5-10 cm. No complications, notably no pneumothorax. The other monitoring and support devices as well as the appearance of the heart and the lungs is constant and unchanged. " f14fb1ca-94b04168-2fdca509-11eb22aa-40433814.jpg,test/p19/p19244907/s53054527/f14fb1ca-94b04168-2fdca509-11eb22aa-40433814.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with complicated PMH w/ Klebsiella sepsis, multifocal pneumonia // Interval change of pneumonia? Change in clinical picture, would like to see if reflected in CXR COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the widespread parenchymal opacities, diffusely distributed in both lungs, have moderately decreased in extent and severity but clearly remain visible. Small pleural effusions, right more than left, have also decreased but likewise are still present. Mild retrocardiac atelectasis persists. " 40a1657e-d6f85cca-f121a58e-c1a4e689-052ae86f.jpg,test/p17/p17155697/s55795927/40a1657e-d6f85cca-f121a58e-c1a4e689-052ae86f.jpg,test," FINAL REPORT HISTORY: Male with metastatic myxoid liposarcoma status post right lower anterior rib resection. Assess for hemothorax. COMPARISON: Chest radiograph ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Mild improvement of low lung volumes with bilateral platelike atelectasis, right greater than left. Interval increase of small right pleural effusion. No pulmonary edema or pneumothorax. Heart size, mediastinal contour and hila appear normal. No bony abnormality. IMPRESSION: 1.Mild improvement in low lung volumes with bilateral platelike atelectasis, right greater than left. 2. Interval increase of small right pleural effusion. No large hemothorax. " 57dee61b-e0860760-1f6c2494-708878f1-fd8f8715.jpg,test/p11/p11306899/s51064776/57dee61b-e0860760-1f6c2494-708878f1-fd8f8715.jpg,test," FINAL REPORT HISTORY: Ovarian carcinoma with pleural effusion. FINDINGS: In comparison with the study of ___, there are slightly lower lung volumes. Opacification at the right base again is consistent with pleural effusion and compressive atelectasis. There are similar changes of volume loss in the left lower lobe and a small effusion on the left. Continued relatively low lung volumes may contribute to the apparent elevation of pulmonary venous pressure. " 772265a1-d8b57482-7fcb7caf-d8bbce8a-cc3799eb.jpg,test/p15/p15543851/s56424985/772265a1-d8b57482-7fcb7caf-d8bbce8a-cc3799eb.jpg,test," FINAL REPORT EXAM: Chest, erect AP portable view. CLINICAL INFORMATION: Rapid heart rate, chest pain. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is minimal pulmonary vascular congestion. Silhouette is top normal to mildly enlarged. The aorta is calcified. IMPRESSION: Top normal to mild enlargement of the cardiac silhouette with mild pulmonary vascular congestion. " 810c1285-520e69a4-af29ec7e-b2a2acb8-120615a9.jpg,test/p13/p13815268/s50195983/810c1285-520e69a4-af29ec7e-b2a2acb8-120615a9.jpg,test," FINAL REPORT INDICATION: ___F with worsening dyspnea // ? signs of CHF exacerbation TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: There is no focal consolidation, effusion, or pneumothorax. Increased interstitial markings are noted bilaterally. Cardiomediastinal silhouette is stable. Coronary artery stent is noted. Median sternotomy wires are intact. No acute osseous abnormalities. IMPRESSION: Mild pulmonary edema. No effusion or focal consolidation. " 63ea58da-035606cb-e93117bc-beeed836-930ba2db.jpg,test/p16/p16267047/s54044685/63ea58da-035606cb-e93117bc-beeed836-930ba2db.jpg,test," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: None. FINDINGS: PA and lateral chest radiographs. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. 4-mm nodular opacity overlying the anterior left 4th rib may be a bone island or a prominent vessel. IMPRESSION: No acute cardiopulmonary process. " deb428a0-0db32cf8-1d206752-6dbfa5e2-8ecdf1f4.jpg,test/p15/p15438558/s56566403/deb428a0-0db32cf8-1d206752-6dbfa5e2-8ecdf1f4.jpg,test," FINAL REPORT INDICATION: ___ year old man with cough // cough, right midfield ronchi TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: A left chest wall AICD pacemaker is in unchanged position with leads in the expected location of the right atrium, right ventricle and coronary sinus normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute process. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:04 AM, 5 minutes after discovery of the findings. " 87323af6-5ed8f634-78a3f942-34d91835-630853ef.jpg,test/p13/p13565659/s55779966/87323af6-5ed8f634-78a3f942-34d91835-630853ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 3 months cough // any sign of active or latent tb? any sign of active or latent tb? IMPRESSION: Heart size is normal. Aorta is slightly tortuous. Lungs are clear. No pleural effusion or pneumothorax is seen. " c7d81e8e-528c2d85-8fa377f5-0b71349e-1aca0da1.jpg,test/p12/p12940106/s59137323/c7d81e8e-528c2d85-8fa377f5-0b71349e-1aca0da1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p NGT please assess NGT after advancement // please confirm placement s/p advancement COMPARISON: ___ IMPRESSION: As compared to the previous image, the nasogastric tube has been advanced by approximately 5 cm. The tip of the tube is still located in the proximal parts of the stomach. No complications, notably no pneumothorax. Otherwise unchanged radiograph. " 9f9ad6a8-2179f3d4-44be44ba-d7fe4ab1-215e94b2.jpg,test/p13/p13492756/s58225168/9f9ad6a8-2179f3d4-44be44ba-d7fe4ab1-215e94b2.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Shortness of breath. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable with stable appearance of post-sternotomy wires. Lungs are clear. There is no pleural effusion or pneumothorax. There is stable appearance of post-CABG surgical clips. " 33904641-8026d062-fdf37371-bce93ad4-7547a6fb.jpg,test/p19/p19754677/s53903751/33904641-8026d062-fdf37371-bce93ad4-7547a6fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with CP // evidence of fluid overload COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Bilateral pleural effusions are small. There is bibasilar opacity which is concerning for atelectasis though difficult to exclude aspiration or pneumonia. There is hilar engorgement with mild pulmonary edema. Heart size cannot be assessed. Mediastinal contour appears stable. Bony structures are intact. IMPRESSION: Findings consistent with decompensated congestive heart failure, with small bilateral effusions. Difficult to exclude a superimposed pneumonia at the lung bases. " bfbaa069-958578b1-c319eaa2-6d74d51e-4ce0a8b8.jpg,test/p10/p10041196/s57513869/bfbaa069-958578b1-c319eaa2-6d74d51e-4ce0a8b8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fatigue dyspnea // Chest pain. Chest pain. IMPRESSION: In comparison with the study of ___, there is again hyperexpansion of the lungs with flattening hemidiaphragms consistent with chronic pulmonary disease. No evidence of acute pneumonia, vascular congestion, or pleural effusion. Continued elevation of the tip of the right clavicle with respect to the acromion. " b1646201-76e7c098-62e5505a-45401b78-a5197dab.jpg,test/p13/p13778554/s57352733/b1646201-76e7c098-62e5505a-45401b78-a5197dab.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph ___. FINDINGS: Tip of right PICC terminates in the lower superior vena cava, just above the expected location of the cavoatrial junction. Heart size is normal, and lungs and pleural surfaces are clear. " 15c608eb-11f4fc69-f9b9d20a-c2639b2d-920a09b6.jpg,test/p16/p16518377/s59700117/15c608eb-11f4fc69-f9b9d20a-c2639b2d-920a09b6.jpg,test," FINAL REPORT INDICATION: ___ year old woman with chronic cough // eval for hyperinflation TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Since ___ the right peritracheal upper mediastinal extension of the very large goiter has not changed detectably, nor is there appreciable tracheal embarrasment. The thoracic aorta is tortuous, the heart size is top normal. There is no pulmonary vascular congestion, no edema, nor effusions nor pneumothorax. The lungs are normal volume and clear. IMPRESSION: 1. The lungs are not hyperinflated. 2. Very large cervicothoracic goiter unchanged since ___ could be the cause of patient's chronic cough. " 5720cddd-39dd870a-d63d3c7a-de06fa66-50a018a5.jpg,test/p10/p10427568/s53838658/5720cddd-39dd870a-d63d3c7a-de06fa66-50a018a5.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old male with chest pain. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Multiple prior chest radiographs, most recent on ___. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 6089e55f-7393ef14-99309c91-eed8acc2-48f55df5.jpg,test/p10/p10338508/s50157291/6089e55f-7393ef14-99309c91-eed8acc2-48f55df5.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are stable in appearance compared to the previous radiograph. Prominence of the pulmonary hila is similar to previous radiograph and may represent enlarged pulmonary arteries based on appearance on prior CT chest of ___. Lung volumes are increased in keeping with known emphysema. Linear areas of atelectasis or scar are present in the left mid and both lower lungs, but there are no focal areas of consolidation to suggest the presence of pneumonia. " 16083168-8562b0ae-4e8afccc-cb233510-9a3b08af.jpg,test/p11/p11284848/s53177668/16083168-8562b0ae-4e8afccc-cb233510-9a3b08af.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ ___ COMPARISON: Chest x-___ ___. FINDINGS: Cardiomediastinal contours are within normal limits for post-operative status of the patient. Pulmonary vascularity is normal. Partial atelectasis of the left lower lobe has slightly worsened in the interval. Linear atelectasis in the left mid lung region is slightly improved, however. Small bilateral pleural effusions are persistent, left greater than right, and note is made of persistent free intraperitoneal air. IMPRESSION: 1. Worsening left lower lobe atelectasis. 2. Small pleural effusions, left greater than right. 3. Free intraperitoneal air. This finding has been communicated by telephone to ___ at 4:25 p.m. on ___ at the time of discovery. " 04b6b30b-8f20840b-489994d2-e8a06c41-73b526a2.jpg,test/p16/p16997767/s54694886/04b6b30b-8f20840b-489994d2-e8a06c41-73b526a2.jpg,test," FINAL REPORT HISTORY: ___-year-old female with cough for 4 weeks. Evaluate for infiltrate. COMPARISON: Chest radiographs dated ___. FINDINGS: Frontal and lateral chest radiographs demonstrate well expanded and clear lungs. The cardiomediastinal and hilar silhouettes are unremarkable. There is no pleural effusion or pneumothorax. Visualized osseous structures are unremarkable. IMPRESSION: No findings suggest infection. " ed928826-f9db3ade-b817e4cd-4b8673ae-57802332.jpg,test/p16/p16347969/s50730523/ed928826-f9db3ade-b817e4cd-4b8673ae-57802332.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with intoxication p/w dyspnea // ?acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Prior radiographs the most recent on ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Chronic left-sided rib fractures are unchanged in appearance. IMPRESSION: No acute cardiopulmonary process. " d9042b28-2f21ebad-1ff4dea9-56bd9a5a-a3512658.jpg,test/p15/p15352446/s52196410/d9042b28-2f21ebad-1ff4dea9-56bd9a5a-a3512658.jpg,test," FINAL REPORT HISTORY: Fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: Normal chest radiographs. " d3180803-a832d663-10aa2932-d83870df-77b40d12.jpg,test/p15/p15233042/s50050714/d3180803-a832d663-10aa2932-d83870df-77b40d12.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is minimal improvement of the pre-existing moderate pulmonary edema. No new parenchymal opacities. Signs of edema, however, still persists. Unchanged moderate cardiomegaly, no larger pleural effusions. No pneumothorax. Unchanged position of the right internal jugular vein catheter. " c4fc7ad8-5ea85917-46e86245-6a7fb64b-58f05221.jpg,test/p16/p16432173/s50328051/c4fc7ad8-5ea85917-46e86245-6a7fb64b-58f05221.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old female with possible clinical stroke. Evaluate for pulmonary infiltrate TECHNIQUE: Portable chest radiograph COMPARISON: Chest radiograph ___ FINDINGS: Patient is slightly rotated during this examination. Lung volumes are slightly lower compared to ___. New bibasilar opacities may represent atelectasis in the setting of lower lung volumes, but aspiration or infection should be considered in the appropriate clinical setting. An oblong opacity in the right midlung could reflect linear atelectasis or fissural fluid. Pulmonary edema is mild and more pronounced on the left. Bilateral pleural effusions, left greater than right. No pneumothorax. Heart size remains moderately enlarged. Median sternotomy wires are intact. Multiple surgical clips are noted along the mediastinum. No acute osseous abnormalities identified. IMPRESSION: 1. New bibasilar opacities may represent atelectasis or aspiration/infection. 2. Mild asymmetrical pulmonary edema. 3. Left greater than right pleural effusions. " 3b323947-9e116da1-750aeef7-c7c99ed8-5dcc9e79.jpg,test/p14/p14487604/s59620728/3b323947-9e116da1-750aeef7-c7c99ed8-5dcc9e79.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with cough. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are low, causing crowding of vascular markings. Aside from left basilar atelectasis, the lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " 9b54b9f3-00b0c9a7-e58bdf10-2ce0e806-b6537846.jpg,test/p11/p11473993/s53380618/9b54b9f3-00b0c9a7-e58bdf10-2ce0e806-b6537846.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // Eval for cardiopulmonary process TECHNIQUE: Chest PA and Lateral COMPARISON: ___ FINDINGS: The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is top-normal in size IMPRESSION: Top normal cardiac silhouette. No evidence of pneumonia. " 53a02052-7b1e8ce0-0c2d1937-782debcb-dfb3b2db.jpg,test/p14/p14219343/s58083246/53a02052-7b1e8ce0-0c2d1937-782debcb-dfb3b2db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with severe resp distress on bipap. Hx of CHF. // eval for PNA, pulm edema TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph from ___. FINDINGS: There is prominence of the pulmonary vasculature and interstitial opacities compatible with interstitial edema and developing into alveolar edema. There are large bilateral pleural effusions. There is no pneumothorax. The cardiomediastinal silhouette is unchanged. A left chest wall pacemaker leads are present in the right atrium and right ventricle. IMPRESSION: 1. Interstitial edema likely a developing into alveolar edema similar to ___. 2. Large bilateral pleural effusions. " 54c69617-a7b49bc9-af2096f4-cf8470aa-d8c85bbe.jpg,test/p16/p16890177/s59761175/54c69617-a7b49bc9-af2096f4-cf8470aa-d8c85bbe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right sided chest tube/ // r/o ptx TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Tubes and lines are in unchanged position including left and right chest tube. Interval decrease in pleural effusion is demonstrated. Minimal left apical pneumothorax is present. " 76f6a6e8-e992df76-89c39f86-f7db8cba-ee4edebd.jpg,test/p13/p13119188/s58079603/76f6a6e8-e992df76-89c39f86-f7db8cba-ee4edebd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with shoulder pain for 2 mo, chest wall pain on right of sternum and sternocostal junctions // r/o bony or chest abnl r/o bony or chest abnl IMPRESSION: There no prior chest radiographs available for review. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referrable focal findings should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning. " 9c572953-60bb8cbf-7dbe53cf-a6341133-6679955d.jpg,test/p11/p11296936/s54141728/9c572953-60bb8cbf-7dbe53cf-a6341133-6679955d.jpg,test," FINAL REPORT INDICATION: ___ year old man with ESRD afib now with hypoxia // pulmonary edema? infiltrate EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, single frontal view COMPARISON: At the time of this dictation, the subsequent chest radiograph taken at 3:27 am was available. Chest radiograph ___. FINDINGS: There is a new dense consolidation in the right lung, which could be pneumonia or pulmonary hemorrhage. Right upper lung is obscured by head position. Pulmonary edema is noted in the left lung. There is no pleural effusion or pneumothorax. Moderate cardiomegaly is similar to prior. Dual channel right supraclavicular central venous hemodialysis catheter terminates in the low right atrium. IMPRESSION: New severe right pneumonia or, given the appropriate circumstances, pulmonary hemorrhage. Stable moderate left pulmonary edema. " 2011c950-026de4e0-f3e933cf-c033fc00-91c08be4.jpg,test/p14/p14001478/s52676334/2011c950-026de4e0-f3e933cf-c033fc00-91c08be4.jpg,test," FINAL REPORT HISTORY: IJ placement. FINDINGS: Right IJ catheter tip extends to the upper portion of the right atrium. It could be pulled back approximately 2.5 cm to be definitely above the cavoatrial junction. Some atelectatic changes are seen at the left base, but otherwise there is no evidence of acute cardiopulmonary disease. This information was telephoned to Dr. ___. " 68223939-e799a1cb-03bbbad9-f5f60d03-53f6595b.jpg,test/p11/p11999903/s57771640/68223939-e799a1cb-03bbbad9-f5f60d03-53f6595b.jpg,test," FINAL REPORT INDICATION: ___F with asthma, HTN, HLD with presyncope, back pain, and hypotension. // r/o PNA, widened mediastinum TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded clear without focal consolidation concerning for pneumonia. The upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 68c27f52-2d8e35cd-68b72770-1d439df8-aad6875b.jpg,test/p15/p15058800/s54157213/68c27f52-2d8e35cd-68b72770-1d439df8-aad6875b.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with syncope // r/o infiltrate COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 775c85c5-621d1f8e-b3e04c5c-4392c35a-ee6e359b.jpg,test/p19/p19398915/s58361945/775c85c5-621d1f8e-b3e04c5c-4392c35a-ee6e359b.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Interval placement of right pleural catheter with decrease in size with now moderate right pleural effusion with no visible pneumothorax. Apparent slight further worsening of diffuse airspace opacities in the left lung. No other relevant short interval change since recent study. " 96524fb8-0cfe1363-5ad5564e-8ed3a777-72c0216e.jpg,test/p10/p10449408/s57852248/96524fb8-0cfe1363-5ad5564e-8ed3a777-72c0216e.jpg,test," FINAL REPORT INDICATION: History of cirrhosis and GI bleed, now with intermittent hypoxia. Please evaluate for interval change. COMPARISONS: Chest x-ray from ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The ET tube terminates approximately 5.2 cm above the carina. There is a right sided central line which terminates in the low SVC. There is an enteric tube, which extends below the diaphragm with tip likely within the body of the stomach. A left hemodialysis catheter ends at the mid-to-upper SVC. There is moderate cardiomegaly. This is stable compared to exams dating back to at least ___. There is no pneumothorax. There is a slight interval increase in opacification overlying the upper-to-mid left lung. There are stable small bilateral pleural effusions. There is no pneumothorax. IMPRESSION: Interval increase in opacification overlying the mid-to-upper left lung concerning for pneumonia. Lines and tubes are in stable position. " 0d649447-19d2906c-bf914c20-d710f3d2-87c1753c.jpg,test/p11/p11658675/s54098838/0d649447-19d2906c-bf914c20-d710f3d2-87c1753c.jpg,test," FINAL REPORT HISTORY: Intubated with orogastric tube placed, distal aspect of feeding tube not well seen on the prior chest radiograph. COMPARISON: ___ at 11:27. FINDINGS: Endotracheal tube terminates approximately 5.3 cm above the carina. An enteric tube is seen coursing below the level of the diaphragm into the left upper quadrant, the expected position of the stomach. Lingular and bibasilar opacities persist most likely due to atelectasis, small underlying component of aspiration not excluded. No pleural effusion or pneumothorax is seen. No overt pulmonary edema is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Endotracheal and nasogastric tubes in appropriate position. " f8532a91-2d34769b-7afcc3c2-132b6010-90eafdf3.jpg,test/p18/p18061783/s52109079/f8532a91-2d34769b-7afcc3c2-132b6010-90eafdf3.jpg,test," WET READ: ___ ___ ___ 8:27 PM New NG tube courses through the esophagus, into the stomach and out of view. Cardiomegaly, bibasilar atelectasis, mild pulmonary edema and left pleural effusion are similar in comparison to prior study from ___. Right PICC is unchanged in position. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Radiograph centered at the thoracoabdominal junction was obtained for assessment of a nasogastric tube, which terminates within the stomach. Within the chest, note is made of cardiomegaly, pulmonary vascular congestion, and worsening edema as well as development of a small-to-moderate right pleural effusion. Left pleural effusion and adjacent basilar atelectasis have also slightly worsened. " 1a61acc6-c91babb2-e3797ffb-87eb637c-1d8631dc.jpg,test/p14/p14395528/s54453410/1a61acc6-c91babb2-e3797ffb-87eb637c-1d8631dc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with BiV PPM upgrade. // rule out pneumothorax TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Cardiomegaly is substantial. There is interval placement of the left ventricular pacemaker lead. There is no evidence of pneumothorax. There is minimal amount of right pleural thickening, unchanged " 56467af5-ebd20fd9-cb1ae088-955db6e4-c57fd15f.jpg,test/p15/p15333408/s52704722/56467af5-ebd20fd9-cb1ae088-955db6e4-c57fd15f.jpg,test," FINAL REPORT INDICATION: ___ year old man with PMHx sarcoidosis, with R inframammary chest wall pain // please assess cardiopulmonary architecture TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. The cardiomediastinal silhouette is unremarkable. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute radiographic intrathoracic pulmonary disease. " 2dc9744b-5f149054-96c68731-0ad4960d-788b314c.jpg,test/p16/p16030116/s59180805/2dc9744b-5f149054-96c68731-0ad4960d-788b314c.jpg,test," WET READ: ___ ___ ___ 1:46 AM Allowing for differences in technique and positioning, essentially unchanged from prior. Proper positioning of lines and tubes. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ARDS, intubated // Esophageal balloon and OG tube replaced COMPARISON: ___, 15:30 IMPRESSION: The orogastric tube and the esophageal balloon have been replaced. Unchanged position of the endotracheal tube and the right internal jugular vein catheter. The lung volumes remain low. Unchanged areas of atelectasis bilaterally at the lung bases and unchanged distribution of the pre-existing parenchymal opacities. Unchanged size of the cardiac silhouette. " 23533514-168201da-b9a31d24-9dfc79ef-fa40f917.jpg,test/p17/p17925184/s57591902/23533514-168201da-b9a31d24-9dfc79ef-fa40f917.jpg,test," FINAL REPORT PORTABLE AP CHEST FILM ON ___ AT 7:41 CLINICAL INDICATION: ___-year-old with increasing oxygen requirement and new right lower lobe opacity, question progression. Comparison to prior study of ___ at 12:28. Portable semi-erect chest film ___ at 7:41 is submitted. IMPRESSION: Interval improvement in aeration at the right base with residual patchy opacity which may reflect resolving partial lower lobe atelectasis rather than aspiration or pneumonia. However, clinical correlation is advised. A linear opacity at the left base is unchanged and may reflect post-inflammatory scarring or subsegmental atelectasis. There continues to be emphysema with changes in both upper lungs. There is no evidence of pulmonary edema. No pleural effusions or pneumothoraces are appreciated. Cardiac and mediastinal contours are stable. " dea93930-af6bd140-c17e728c-beb831c7-1f9b5777.jpg,test/p12/p12089662/s59729339/dea93930-af6bd140-c17e728c-beb831c7-1f9b5777.jpg,test," FINAL REPORT INDICATION: ___ year old man with seizure disorder, hypopituitarism, and bipolar disorder presenting with shock and respiratory failure now intubated. // Compare to prior EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal view COMPARISON: Chest radiograph ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. There is no pulmonary edema. Cardiomediastinal silhouette is normal size. ET tube terminates 3 cm above the carina. NG tube terminates in the stomach. Left jugular line terminates in the left brachiocephalic vein. IMPRESSION: No lung consolidation or pulmonary edema. " a0ee36a9-5a2b8b30-7c1cd9b5-41e64938-5880a380.jpg,test/p17/p17509032/s59687769/a0ee36a9-5a2b8b30-7c1cd9b5-41e64938-5880a380.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with ICD // evaluate for lead position TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___ FINDINGS: A left pectoral pacemaker is seen with a transvenous lead in the right ventricle. The lungs are clear. Heart size is top normal. Median sternotomy wires are intact and aligned. Right rib deformities are compatible with old rib fractures. No pneumothorax. IMPRESSION: Left pectoral pacemaker seen with transvenous leads in the right ventricle. No pneumothorax. " ac4cbfbc-7e955b9b-d8c68736-a2886188-71f03f95.jpg,test/p17/p17145985/s58692042/ac4cbfbc-7e955b9b-d8c68736-a2886188-71f03f95.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Fever and productive cough. PA and lateral upright chest radiographs were reviewed. COMPARISON: No prior studies available for comparison. Heart size is normal. Mediastinum is normal. Fullness in the left hilus is demonstrated, mild but should be further assessed with anterior shallow oblique views. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. Splenomegaly is suspected on the radiograph and might be potentially correlated with ultrasound. " 3d7f2708-bb789c31-dabc47c4-6fe0cfb6-b0996631.jpg,test/p11/p11812774/s53779058/3d7f2708-bb789c31-dabc47c4-6fe0cfb6-b0996631.jpg,test," FINAL REPORT INDICATION: ___F with chest pain and cough after breathing fumes in apartment // eval edema TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Vague opacities projecting over lung bases on the frontal view and are likely due to overlying soft tissues. The lungs are clear of consolidation, effusion or vascular congestion. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 4bf3576f-92efe7d4-094ae3f7-7d454a06-9fc13b4c.jpg,test/p15/p15801557/s53023372/4bf3576f-92efe7d4-094ae3f7-7d454a06-9fc13b4c.jpg,test," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Status post left thoracoscopy, wedge resection of a right upper lobe nodule, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pneumothorax on the left has decreased, but is still clearly visible. The surgical staple lines in the left apex are constant in appearance. Unchanged evidence of a mild lateral pleural adhesion. Normal appearance of the remaining lung parenchyma. Unchanged appearance of the heart. Known tortuosity of the thoracic aorta. " a7fc5753-81b61d14-5aa2de2b-85e8e1d5-df8702a2.jpg,test/p18/p18645118/s54252226/a7fc5753-81b61d14-5aa2de2b-85e8e1d5-df8702a2.jpg,test," FINAL REPORT INDICATION: Central line placement. Evaluate for pneumothorax. COMPARISON: ___ at 1:29 a.m. FINDINGS: AP view of the chest. Endotracheal tube measures 6.6 cm from the carina. The enteric tube ends off into the stomach. Again seen is mild pulmonary vascular congestion. There is no pleural effusion or pneumothorax. No focal consolidation. IMPRESSION: Mild pulmonary vascular congestion and bibisilar opacities are unchanged. No central line is seen. No pneumothorax. The ETT ends 6.6 cm from the carina and can be advanced 2 cm for more secure seating. " 143dcff4-b5a85c35-ce7cddf2-29959656-365a4d43.jpg,test/p19/p19699763/s58847872/143dcff4-b5a85c35-ce7cddf2-29959656-365a4d43.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old with pleuritic left-sided chest pain after six-hour flight, recent colon cancer diagnosis, concern for pulmonary embolism. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes. Given this, no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Hilar contours are also within normal limits. IMPRESSION: Low lung volumes, but otherwise, no acute cardiopulmonary process. " ad19092f-10aad38a-26a8b8e2-c0810554-8f0f1753.jpg,test/p18/p18083755/s55260016/ad19092f-10aad38a-26a8b8e2-c0810554-8f0f1753.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F s/ppericardiocentesis // ptx? TECHNIQUE: AP view of the chest COMPARISON: Prior radiographs most recent on ___ FINDINGS: A left-sided pacer and dual leads is in stable position. A drain overlies the left heart/left hemi thorax. The heart is enlarged and globular in contour. There is trace pneumopericardium, consistent with recent pericardiocentesis. Surgical material projects over the right midlung, as before. No focal consolidation is identified. There is a small left basal pneumothorax. IMPRESSION: Small left basal pneumothorax. Globular, enlarged heart consistent with pericardial effusion. Minimal pericardial air consistent with recent pericardiocentesis. " 89abe654-6eadf288-ee7f9b81-db8b8eff-58f2aa60.jpg,test/p11/p11873714/s54995826/89abe654-6eadf288-ee7f9b81-db8b8eff-58f2aa60.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoventilation, evaluation for interval change. FINDINGS: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. There is no evidence of pulmonary edema, pleural effusions or pneumonia on the current radiograph. Moderate cardiomegaly persists. No pneumothorax. " 250c8fd5-708c94e2-13283fd5-cd4d2f50-a28c6004.jpg,test/p17/p17071231/s55005041/250c8fd5-708c94e2-13283fd5-cd4d2f50-a28c6004.jpg,test," FINAL REPORT INDICATION: Altered mental status and known cirrhosis. COMPARISON: ___. TECHNIQUE: AP and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette and hilar contours are normal. There has been interval resolution of previously appreciated asymmetric pulmonary edema as well as withdrawal of a right internal jugular central venous catheter. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia. " 826cd829-aa1f23ae-c72041e0-5301ce16-5a246bce.jpg,test/p13/p13657623/s55620258/826cd829-aa1f23ae-c72041e0-5301ce16-5a246bce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with sob // eval for pna TECHNIQUE: Single frontal view of the chest COMPARISON: ___ at 14:50 FINDINGS: The patient's chin overlies the medial right lung apex, partially obscuring the view. Additionally, the right costophrenic angle is not fully included on the image. There are bilateral pleural effusions with overlying atelectasis. Bilateral perihilar opacities are seen, raising concern for pulmonary edema. The cardiac and mediastinal silhouettes are stable. Likely skin folds overlie the bilateral lateral upper chest. IMPRESSION: Right costophrenic angle not fully included on the image. Given this, bilateral pleural effusions. Perihilar opacities suggests component of pulmonary edema with some areas of atelectasis. " da99bd38-db13ba33-524328c9-e23b70f6-6feaae1b.jpg,test/p11/p11595140/s52466283/da99bd38-db13ba33-524328c9-e23b70f6-6feaae1b.jpg,test," FINAL REPORT INDICATION: Metastatic neuroendocrine tumor, on chemotherapy, malaise and crackles at the right lung base, evaluate for effusion, metastasis, and pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. A right Port-A-Cath ends in the low SVC. The lungs are clear. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " cf49e17a-f5500fe6-b563677e-1bcb43ac-e39b1871.jpg,test/p11/p11599292/s59153720/cf49e17a-f5500fe6-b563677e-1bcb43ac-e39b1871.jpg,test," FINAL REPORT INDICATION: ___ year old man with lung cancer s/p LLL superior segmentectomy. // eval post op change COMPARISON: Radiographs from ___ IMPRESSION: There is a new left-sided chest tube with distal tip at the medial left base. There is a new nodular area consolidation at the right base as well some atelectasis. Atelectasis at the left base is unchanged. There are low lung volumes. There are no pneumothoraces. Heart size is upper limits of normal. " 411e345b-c411ef73-f3232a96-cbdfd828-57ae1a88.jpg,test/p14/p14820732/s50662018/411e345b-c411ef73-f3232a96-cbdfd828-57ae1a88.jpg,test," FINAL ADDENDUM ADDENDUM: The above mention of cardiomegaly is likely reflective of prominent epicardial fat pad as the heart is normal in size and shape on the subsequent CTA performed on the same date. This finding was e-mailed to the patient's PCP physician, ___. ___ on ___. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain, assess for acute process. FINDINGS: PA and lateral views of the chest were obtained. Low lung volumes somewhat limits evaluation, though allowing for this, there is no focal consolidation, effusion, or pneumothorax. Heart is mildly enlarged which appears stable from ___, though new from ___. Clinical correlation is advised. Mediastinal contour is normal. No signs of CHF. Bony structures are intact. IMPRESSION: Mild cardiomegaly which given patient's age warrants an aggressive workup. " baccbd1e-458e0632-b15a4bbe-5b5061c0-3aab74f8.jpg,test/p17/p17919183/s53577216/baccbd1e-458e0632-b15a4bbe-5b5061c0-3aab74f8.jpg,test," FINAL REPORT INDICATION: Fever. COMPARISON: No relevant comparisons available. FRONTAL AND LATERAL CHEST: The lungs are mildly hyperexpanded, which may be due to vigorous inspiration in this young person. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: No pneumonia, edema, or effusion. " b5280b82-0c25d4a0-cd95ab27-97b37784-f7e1870a.jpg,test/p19/p19686705/s55925713/b5280b82-0c25d4a0-cd95ab27-97b37784-f7e1870a.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with progressive 1 month Hx SOB and 1 day right foot/ankle pain/swelling after fall yesterday. COMPARISON: None. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low. Bronchovascular crowding likely accounts for subtle opacity in the lower lungs. There is no large effusion or pneumothorax. No convincing signs of pneumonia or CHF. The heart size appears within normal limits. The aorta is slightly unfolded. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Somewhat limited exam without overt signs of pneumonia or edema. " 7b5a3dca-7213af2c-f631d4cf-6c15a146-ee154766.jpg,test/p10/p10509294/s52581523/7b5a3dca-7213af2c-f631d4cf-6c15a146-ee154766.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Shortness of breath for one week, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The heart and mediastinal contours are normal. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " b6078124-48f6dd81-caac590a-5bbbf4c7-8425442a.jpg,test/p17/p17523577/s57749548/b6078124-48f6dd81-caac590a-5bbbf4c7-8425442a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fatigue and HA c/f Lyme // infection work-up TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Minimal basilar atelectasis is seen without definite focal consolidation. There is no pleural effusion or pneumothorax. 1 cm left lower lobe pulmonary nodule is grossly stable. Cardiac silhouette is top-normal in size, appears less prominent as compared to the prior study. Mediastinal contours are unremarkable. Evidence of DISH is seen along the spine. IMPRESSION: No definite new focal consolidation to suggest pneumonia. Grossly stable 1 cm left lower lobe pulmonary nodule. Top-normal in size cardiac silhouette, appears less prominent as compared to the prior study. " 6946c33a-abb30971-83b87056-a616dbd1-5a6feb6b.jpg,test/p11/p11098660/s58252225/6946c33a-abb30971-83b87056-a616dbd1-5a6feb6b.jpg,test," FINAL REPORT INDICATION: ___ year old man with status post Bental // eval picc placement TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiograph from ___, ___, ___ and ___. FINDINGS: There is a right-sided PICC line which terminates within the brachiocephalic vein. The heart size continues to be at the upper limits of normal. The patient is status post median sternotomy and mitral valve replacement. There is mild vascular congestion and small bilateral pleural effusions, right greater the left. IMPRESSION: Right PICC terminates at the brachiocephalic vein. NOTIFICATION: The findings were discussed by Dr. ___ with ___ of the IV team on the telephone on ___ at 1:32 PM, following review. " cf76c430-48727400-46c055dd-9a3fa87e-7577dc86.jpg,test/p18/p18988864/s58593939/cf76c430-48727400-46c055dd-9a3fa87e-7577dc86.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NSCLC // post bronch biopsies post bronch biopsies IMPRESSION: In comparison with the previous study, there is no evidence of pneumothorax following bronchoscopy. Some haziness about the previously described right lung lesions suggests some procedural bleeding. " d5cc3f76-a3814fef-5e0b3d74-2dfa0d80-34a3c351.jpg,test/p18/p18303550/s50640833/d5cc3f76-a3814fef-5e0b3d74-2dfa0d80-34a3c351.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx met RCC with ongoing cough and worsening dyspnea // evaluate for change in left lung effusion/metastatic disease evaluate for change in left lung effusion/metastatic disease IMPRESSION: In comparison with the study of ___, there is now complete opacification of the left hemithorax with the pigtail catheter removed. This is consistent with a massive left pleural effusion with collapse of most of the left lung. There is abrupt cut off of the air column E an the left bronchial tree, worrisome for severe narrowing of the airway. Mild blunting of the right costophrenic angle is seen. " 0c037e9e-3dedaaa0-2d304039-f5545a57-2e7b92cc.jpg,test/p17/p17078350/s50796339/0c037e9e-3dedaaa0-2d304039-f5545a57-2e7b92cc.jpg,test," FINAL REPORT INDICATION: shortness of breath. Evaluate for volume overload or infection. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. There is a moderate subpulmonic right pleural effusion. Adjacent heterogeneous opacity is concerning for pneumonia. The left lung is clear. There is no left effusion. No pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: Right basal opacity is worrisome for pneumonia with moderate subpulmonic pleural effusion. No edema. Dr. ___ ___ the findings with ___ by phone at 3:37 p.m. on ___. " 71471c3f-ee8c035e-fab6be14-02ea6f7b-604e61bb.jpg,test/p10/p10486528/s52138752/71471c3f-ee8c035e-fab6be14-02ea6f7b-604e61bb.jpg,test," FINAL REPORT INDICATION: History: ___M with upper R chest pain // acute process? TECHNIQUE: Upright PA and lateral chest COMPARISON: Chest radiograph ___ FINDINGS: The lungs are slightly hyperexpanded but unchanged since ___. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Configuration of the aortic arch is typical for an aberrant right subclavian artery. IMPRESSION: No acute cardiopulmonary abnormality. " 7980c146-c7c80c5a-47adeef6-c292bbb7-6111cb95.jpg,test/p14/p14457200/s54719041/7980c146-c7c80c5a-47adeef6-c292bbb7-6111cb95.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 079041ae-de0a9f1b-ba233c09-99dce000-86592b57.jpg,test/p13/p13106590/s59816844/079041ae-de0a9f1b-ba233c09-99dce000-86592b57.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with history of trauma, may not get out of bed due to thoracic spine fracture. Comparison is made with prior study, ___. There are unchanged low lung volumes. Right lower lobe atelectasis has increased. Left lower lobe, retrocardiac opacity is stable. This could be due to atelectasis or pneumonia in the appropriate clinical setting. If any, there is a small left pleural effusion. There is no evident pneumothorax. Previously visualized tiny right pneumothorax on prior CT is not visualized in this examination. " 6dca0dca-30afd4bc-bb385427-7ee3d1df-2041d918.jpg,test/p14/p14141188/s54454852/6dca0dca-30afd4bc-bb385427-7ee3d1df-2041d918.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with history of congestive cardiac failure, found to have coronary artery disease status post thoracocentesis at an outside hospital. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPH: Cardiac silhouette is enlarged. Bilateral pleural effusions with possible adjacent compressive atelectasis is noted. Underlying infectious process cannot be completely excluded in the correct clinical setting. There is an approximately 3.3 x 3.5 cm mass at the level of the right lower lobe as well as a 2-cm soft tissue density within the right upper lobe. Mild prominence of the azygos vein is noted. IMPRESSION: 1. A 3.5-cm mass of the right lower lobe as well as a second soft tissue density measuring at least 2 cm in the right upper lobe. Recommend obtaining old images to document stability. If these are not available, then additional imaging such as CT scan should be performed for further evaluation. 2. Cardiomegaly with bilateral pleural effusions and adjacent compressive atelectasis. Findings discussed with Dr. ___ at ___ on ___ via telephone. " ef1992ff-11c6071a-7e7047e0-dd8d39a0-fe00cd8d.jpg,test/p13/p13445415/s59146967/ef1992ff-11c6071a-7e7047e0-dd8d39a0-fe00cd8d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with newly placed ngt // assess placement assess placement COMPARISON: Chest radiographs ___ through ___. Comparison: Chest radiographs ___ through ___. IMPRESSION: Lateral aspect of the right hemithorax is excluded from the examination. Small bilateral pleural effusions have increased since ___. There is no pneumothorax. Pulmonary vasculature and borderline interstitial edema have also progressed, but heart size remains top-normal. Esophageal drainage tube ends in the upper portion of a nondistended stomach. Left internal jugular line ends at the origin of the SVC. Transvenous right atrial right ventricular pacer leads are continuous from the right pectoral generator. " ea500ce5-258abeb9-55a251f4-3d99eb05-6c13ce10.jpg,test/p15/p15566987/s59682485/ea500ce5-258abeb9-55a251f4-3d99eb05-6c13ce10.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NG // NG tube position TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Dobbhoff tube is in the stomach. Cardiomediastinal silhouette is re- demonstrated. Bibasal areas of atelectasis are present. The replaced transcatheter aortic valve is unchanged. No pneumothorax is seen. " 3a876967-476964d0-cc8e6d6d-11071a55-eb85485b.jpg,test/p11/p11383428/s50287845/3a876967-476964d0-cc8e6d6d-11071a55-eb85485b.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest x-ray. FINDINGS: The heart size is mildly enlarged. Mediastinal and hilar contours are unchanged. No pulmonary vascular engorgement is seen. Apart from minimal scarring in the left lung base, the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. Cholecystectomy clips are again demonstrated in the upper abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 3ed9572f-ba8af3e2-7ee9edde-905eaead-dbcfc745.jpg,test/p19/p19169852/s50459184/3ed9572f-ba8af3e2-7ee9edde-905eaead-dbcfc745.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with CHF, chest pain intermittent for 1 day TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Right-sided AICD device is noted with leads terminating in unchanged positions. Abandoned pacer leads are also noted within the left chest wall. Severe cardiomegaly with left ventricular predominance is again noted. The mediastinal contour is unchanged. There is mild pulmonary vascular congestion, new in the interval. Retrocardiac streaky opacity likely reflects atelectasis. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. IMPRESSION: Retrocardiac atelectasis and new mild pulmonary vascular congestion. " 4f720cab-2e08c64f-ec524e17-dd7f81f0-66c1150e.jpg,test/p15/p15426827/s59929536/4f720cab-2e08c64f-ec524e17-dd7f81f0-66c1150e.jpg,test," FINAL REPORT AP CHEST, 1:08 P.M., ___ HISTORY: ___-year-old man with spontaneous bacterial peritonitis on antibiotics, now otherwise rising white count. IMPRESSION: AP chest compared to ___: Large right pleural effusion is probably unchanged since yesterday, but there is barely any residual aeration in the right lung. Consolidation is worsening at the left base and could be pneumonia. Accompanying it is very small and stable left pleural effusion. Heart size top normal. No feeding tube in the imaged part of the patient. No pneumothorax. " b1ea03e6-2e0463f2-d017b1a0-4b7a3cb5-a8eb538d.jpg,test/p17/p17078350/s53937120/b1ea03e6-2e0463f2-d017b1a0-4b7a3cb5-a8eb538d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with shortness of breath // ?interval increase in hydrothorax COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There has been significant interval increase in right pleural effusion with only partial residual aeration of the right upper lobe and shift of midline structures to the left. The left lung is clear. Heart size cannot be assessed. Bony structures appear intact. IMPRESSION: Large right pleural effusion with collapse of right middle and lower lobes and mild leftward shift of midline structures. Thoracentesis advised. " c33b515b-1262a224-d55ab389-2842f35f-e3c97037.jpg,test/p13/p13954248/s50962713/c33b515b-1262a224-d55ab389-2842f35f-e3c97037.jpg,test," FINAL REPORT HISTORY: ___-year-old male with epigastric pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. No free air seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " b747dd37-3c53fc21-72d93607-1a750cde-0426513a.jpg,test/p19/p19256840/s52878454/b747dd37-3c53fc21-72d93607-1a750cde-0426513a.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " a0cc87ec-3252a8e9-f0e0302a-daa18e6d-af6569ca.jpg,test/p12/p12325110/s53878690/a0cc87ec-3252a8e9-f0e0302a-daa18e6d-af6569ca.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new dobhoff // Dobhoff placement Dobhoff placement IMPRESSION: Comparison to ___. The patient has received a nasogastric tube. Otherwise the radiograph is unchanged. No complications, notably no pneumothorax. Stable appearance of the cardiac silhouette. " a68d7a2a-5ef945d5-3de04fe9-210217c0-af399c34.jpg,test/p16/p16651473/s52257269/a68d7a2a-5ef945d5-3de04fe9-210217c0-af399c34.jpg,test," FINAL ADDENDUM ADDENDUM The pre described subtle right lower lung abnormality has completely resolved. There is no evidence for pneumonia on the current examination. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with abnl cxr ___. // f/u cxr COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette no pulmonary edema. No pleural effusions. No pneumonia. Elongation of the descending aorta. " 68b4473f-999ae483-e7981cc2-9b4b7bf8-6109eab2.jpg,test/p13/p13652475/s53375902/68b4473f-999ae483-e7981cc2-9b4b7bf8-6109eab2.jpg,test," FINAL REPORT HISTORY: AML status post allogenic stem cell transplant, on immunosuppression, now with productive cough. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate clear lungs with no focal opacity. The cardiac contour is top normal. No mediastinal or hilar fullness is noted. No pleural abnormality is detected. IMPRESSION: No evidence of pneumonia. " e8264fff-ae3a306d-4c54af9f-14f652d6-3c29446e.jpg,test/p18/p18884866/s57784263/e8264fff-ae3a306d-4c54af9f-14f652d6-3c29446e.jpg,test," FINAL REPORT HISTORY: ___-year-old man, status post recent laminectomy. Please evaluate for consolidation. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lungs are clear. Cardiac silhouette and hilar contours are unremarkable. No pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " b0f39e0c-15176150-352a992a-0f90c345-936b9cdc.jpg,test/p13/p13370026/s52451234/b0f39e0c-15176150-352a992a-0f90c345-936b9cdc.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. Cholecystectomy clips are noted within the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 09215413-94125a8a-3359abed-08355d81-3847d034.jpg,test/p15/p15736763/s57089411/09215413-94125a8a-3359abed-08355d81-3847d034.jpg,test," FINAL REPORT HISTORY: COPD and ethanol abuse with cough, to assess for aspiration pneumonia. FINDINGS: In comparison with the study of ___, there is little change in the appearance of the right upper lobe bullous changes with continued hyperexpansion of the lungs consistent with emphysema. No evidence of acute focal pneumonia or vascular congestion. " d88eec95-1d22214a-b2607ed8-4908bad0-ff3fae01.jpg,test/p10/p10628475/s56785675/d88eec95-1d22214a-b2607ed8-4908bad0-ff3fae01.jpg,test," WET READ: ___ ___ ___ 5:24 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with shortness of breath. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: The lungs are clear and well inflated. There is no pleural effusion or pneumothorax. Heart size and mediastinal contours are within limits. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 7f8cd693-273bc387-a38d0530-a18b25f9-5e17ec09.jpg,test/p19/p19371747/s53236532/7f8cd693-273bc387-a38d0530-a18b25f9-5e17ec09.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with epigastric/RUQ pain worsening in severity // COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " d9a2576c-862bc635-cfa2eeb9-f3a1b4e9-7c8fa763.jpg,test/p10/p10286475/s55355476/d9a2576c-862bc635-cfa2eeb9-f3a1b4e9-7c8fa763.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo male, with h/o CML on hydroxyurea, recent admitted for AMS thought to be ___ medication overdose, presenting with AMS, leukocytosis and hypoxia w/2L O2 requirement. // please assess for interval change - please perform 7AM on ___ please assess for interval change - please perform 7AM on 0 IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Continued enlargement of the cardiac silhouette, probably with mild elevation of pulmonary venous pressure. Hazy opacification in the right hemithorax is again seen, consistent with layering pleural effusion. An area of more confluent opacification is suggested right above the minor fissure, raising the possibility of developing consolidation in the appropriate clinical setting. Poor definition of the left hemidiaphragm again is consistent with pleural fluid and volume loss in the left lower lobe. " 5465c85c-bea89648-903bcd7f-a81c0f1c-e4eb6687.jpg,test/p11/p11548370/s57431944/5465c85c-bea89648-903bcd7f-a81c0f1c-e4eb6687.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with syncope, hyponatremia // Please evaluate for infectious pathology TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are hyperinflated, suggesting chronic obstructive pulmonary disease. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Aortic knob calcification is noted. IMPRESSION: No acute cardiopulmonary process. " 38075ce4-356a103f-3a231f71-0904855f-e10af300.jpg,test/p14/p14295739/s56885799/38075ce4-356a103f-3a231f71-0904855f-e10af300.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with advanced dementia, right shoulder septic arthritis and colitis, appearing more ill this morning with poor inspiratory efforts. Please evaluate for consolidation or effusions. FINDINGS: Patient's condition required examinations in sitting semi-upright position using AP frontal and left lateral views. Comparison is made with a similar preceding study of ___. The heart size has increased and bilateral basal densities are now obscuring diaphragmatic contour and blunting the lateral pleural sinuses. The lateral view confirms the bilateral pleural effusions that have increased and blunting the posterior pleural sinuses more than before. Within the heart shadow, there are rather typical calcifications within the aortic valve area strongly suggesting the presence of aortic valve stenosis. Additional linear calcifications in the ascending aorta are seen as before. No new abnormalities in the pulmonary parenchymal area and skeletal structures are unchanged. Several preceding chest examinations are reviewed and include studies of ___, ___, and ___. A previously suspected calcification on the right lung base was identified as being located in the right breast. Thus, there is no evidence of new acute or old chronic pulmonary parenchymal abnormalities. On the previous examinations, the rather typical aortic valve calcifications were also noted but reported apparently as this finding was of no greater importance in this elderly demented patient. IMPRESSION: Evidence of bilateral pleural effusion, increasing heart size indicative of chronic CHF. No evidence of pneumonia. " beb5ec28-1990135e-cfdc7572-7a49ccf2-abc62a3a.jpg,test/p15/p15219741/s52644781/beb5ec28-1990135e-cfdc7572-7a49ccf2-abc62a3a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with HCC, HCV. s/p Tace ___ // new liver transplant eval. please assess for any cardiopulmonary abnormalities. new liver transplant eval. please assess for any cardiopulmonary abnormalities. IMPRESSION: No previous images. Cardiac silhouette is within normal limits and there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. " e5e0057a-25fc262c-f83e1c5b-429d5dbe-caee8402.jpg,test/p16/p16733321/s52836509/e5e0057a-25fc262c-f83e1c5b-429d5dbe-caee8402.jpg,test," FINAL REPORT INDICATION: ___M with cough x 2 weeks // ? pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT from ___ and chest x-ray from ___. FINDINGS: When compared to priors, there has been no significant interval change. Streaky peripheral right mid lung opacities are compatible with scar. Scarring in the right middle lobe is also again noted. There is no new focal consolidation or effusion. Incidentally noted is an azygos fissure. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 193ec19d-259e116e-cfecd315-c5ddd10b-0df3c48e.jpg,test/p14/p14074396/s52621464/193ec19d-259e116e-cfecd315-c5ddd10b-0df3c48e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NSCLC, new O2 requirement // cause for new hypoxia? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Almost complete opacification of the right lung is unchanged. Cardiomediastinal contours are midline. There is no left pneumothorax or pleural effusion. Small lung nodules in the left lung are better seen in prior CT. " 1046e793-d66c2a5a-bdacd91a-3053870d-33ad6d71.jpg,test/p15/p15421124/s50943716/1046e793-d66c2a5a-bdacd91a-3053870d-33ad6d71.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with cough and ovarian carcinoma, on chemotherapy. IMPRESSION: PA and lateral chest compared to ___: Previous right pleural effusion has resolved. Normal heart, lungs, hila, mediastinum and pleural surfaces. No good evidence for intrathoracic malignancy or infection. " 05290e8d-4636d3fc-780afd09-4124eb55-c8205f2b.jpg,test/p12/p12196030/s56190429/05290e8d-4636d3fc-780afd09-4124eb55-c8205f2b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with fever and chills. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " af32b93f-d3bb7e11-8f08c8f2-28779351-741910d1.jpg,test/p11/p11551769/s54383084/af32b93f-d3bb7e11-8f08c8f2-28779351-741910d1.jpg,test," FINAL REPORT HISTORY: Patient with AML and worsening cough, rule out pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. An area of increased opacity is present in the right upper lobe and left perihilar region. Previous interstitial abnormality from ___ is improved. A moderate right pleural effusion is present with compressive atelectasis. The heart size is normal. Mediastinal and hilar contours are normal. There is no pneumothorax. IMPRESSION: 1. Increased area of opacity in the right upper lobe and left perihilar region, concerning for pneumonia. 2. Moderate right pleural effusion with compressive atelectasis. Findings were communicated with Dr.___ by Dr.___ ___ telephone at 1:45pm on ___. " 67798566-fb9af530-5b5a10e3-e769a6ae-1ef88436.jpg,test/p10/p10914124/s56727590/67798566-fb9af530-5b5a10e3-e769a6ae-1ef88436.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of squamous cell neck cancer, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient was extubated and has received a tracheostomy tube. Nasogastric tube was removed. The pleural effusion and associated parenchymal opacity, likely atelectatic, on the left, have slightly increased in extent. Known parenchymal opacity on the right, likely caused by aspiration pneumonia, unchanged. Unchanged size of the cardiac silhouette. No pneumothorax. " e2a1de6a-156cae93-7f6932d0-f6c340df-e9684eb4.jpg,test/p13/p13616286/s50835608/e2a1de6a-156cae93-7f6932d0-f6c340df-e9684eb4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is top normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 5d5a6cd9-6068dccc-d7d74ea2-6215035e-d5bdf0d3.jpg,test/p17/p17463370/s52403281/5d5a6cd9-6068dccc-d7d74ea2-6215035e-d5bdf0d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p chest tube placement for LEFT pneumothorax. evaluate placement, interval change TECHNIQUE: Trauma portable chest radiograph COMPARISON: CT torso obtained concurrently. FINDINGS: Left chest tube terminates over the left mid lung. There is elevation of the left hemidiaphragm. Ill-defined opacity in the left lower lung likely reflects atelectasis. Left chest wall emphysema reflect chest tube insertion. No residual pneumothorax is clearly seen. Comminuted mid left clavicular fracture and multiple rib fractures are better seen on concurrent CT. IMPRESSION: Status post left chest tube insertion with no visible pneumothorax. Left chest wall subcutaneous emphysema. Left lower lung atelectasis. " 59af6701-cdfb6051-37ce386c-034491e4-487e4676.jpg,test/p12/p12006413/s54204434/59af6701-cdfb6051-37ce386c-034491e4-487e4676.jpg,test," FINAL REPORT PORTABLE CHEST OF ___ No prior studies for comparison. FINDINGS: Cardiac silhouette is enlarged, accompanied by pulmonary vascular and azygos vein distention. Lower lobe predominant bilateral alveolar opacities are present, and could reflect dependent pulmonary edema or a co-existing aspiration or infectious pneumonia in the appropriate clinical settings. Moderate bilateral pleural effusions are present, but there is no visible pneumothorax. " 3bcac0c7-182fe207-8acfee21-962f0d7d-93c09599.jpg,test/p13/p13961236/s50346094/3bcac0c7-182fe207-8acfee21-962f0d7d-93c09599.jpg,test," FINAL REPORT HISTORY: ___-year-old male status post pacer placement, now with elevated INR and swelling. COMPARISON: ___. FINDINGS: There is an apparent increase in soft tissue density in the left axilla compared with the prior study. The left chest single-lead pacemaker remains in place, with its lead positioned at the level of the ventricles. There is left basilar opacity. The remainder of the lungs are clear. There is no definite pleural effusion. There is no pneumothorax. The cardiac silhouette remains moderately enlarged. Note is made of mitral annular calcifications. The mediastinal contours are notable for calcification of the aortic arch. Pulmonary vasculature is normal. Surgical clips are noted in the right upper quadrant. IMPRESSION: 1. Left basal opacity, likely atelectasis, cannot exclude pneumonia. 2. Apparent increase in soft tissue in the left axilla. " ae45f26b-74d47eb7-559e7dce-9a1c62f2-d24405b8.jpg,test/p14/p14589273/s52323659/ae45f26b-74d47eb7-559e7dce-9a1c62f2-d24405b8.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with chest pain, back pain // please evaluate for acute abnormality TECHNIQUE: PA and lateral chest radiograph COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Heart size is top-normal. The mediastinal silhouette is unremarkable. IMPRESSION: No acute intrathoracic abnormalities. Top-normal heart size. " 8ad111d7-bd7f226a-d10f242f-59b1df46-5defb013.jpg,test/p16/p16553329/s56936171/8ad111d7-bd7f226a-d10f242f-59b1df46-5defb013.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with CKD stage V, CHF, presenting with AMS // ?infiltrate, effusion, pulmonary edema COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: New consolidation at the base the left lung could be either atelectasis or pneumonia, accompanied by stable small left pleural effusion. Chest is otherwise unchanged, including normal size heart, minimally dilated upper lobe pulmonary vessels, but no pulmonary edema. " 3eec1cb7-b3d759bb-f9ffe351-d770aa6e-b76a2ddb.jpg,test/p11/p11352876/s51565471/3eec1cb7-b3d759bb-f9ffe351-d770aa6e-b76a2ddb.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with wheezes and decreased breath sounds at the left base and left greater than right crackles, assess for pneumonia. COMPARISONS: ___. Two views of the chest were obtained. The lungs are somewhat lower in volume than on the previous examination with mild left lower lobe opacity most compatible with atelectasis. No focal consolidation, pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: Mild left lower lobe atelectasis " 445cb033-8dbc0351-b1475541-5ba099d8-1ca6d670.jpg,test/p17/p17103812/s50250978/445cb033-8dbc0351-b1475541-5ba099d8-1ca6d670.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Hepatitis, assess acute intrathoracic process. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. " c05952b3-f204fab7-da80b662-74841951-b34f8b96.jpg,test/p11/p11283792/s56517985/c05952b3-f204fab7-da80b662-74841951-b34f8b96.jpg,test," WET READ: ___ ___ 10:53 AM 1. No acute cardiopulmonary abnormality. 2. A somewhat oval radiopaque density projecting just above the mid right clavicle may be external the patient. Correlation with physical exam required. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___F with shortness of breath, cough, wheezing. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. Note is made of at least moderate osteophytosis in the visualized thoracic spine. A nonspecific somewhat oval radiopacity projecting above the mid right clavicle may be external to the patient. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. A somewhat oval radiopaque density projecting just above the mid right clavicle may be external the patient. Correlation with physical exam required. " e9a4bfaf-7c7ea5b6-a051124b-186e0e6f-21a74d86.jpg,test/p16/p16707063/s50963279/e9a4bfaf-7c7ea5b6-a051124b-186e0e6f-21a74d86.jpg,test," FINAL REPORT CLINICAL INDICATION: A ___-year-old male with mental status changes. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. Aortic tortuosity is noted. The heart and mediastinal contours are otherwise within normal limits. IMPRESSION: No acute cardiopulmonary process. " 17516224-fd3f5fd5-7eb4fa2b-8e8006f1-429120ee.jpg,test/p16/p16444272/s55115931/17516224-fd3f5fd5-7eb4fa2b-8e8006f1-429120ee.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with pleural effusion. COMPARISON: ___. FINDINGS: Right small-to-moderate pleural effusion has reaccumulated. Left small pleural effusion is unchanged. Mild pulmonary edema has resolved. Cardiac contour mild enlargement is stable. There is no pneumothorax. Extensive arterial calcification is seen. CONCLUSION: Right small-to-moderate pleural effusion has reaccumulated. Unchanged small left pleural effusion. " 971aea24-01d230a7-f0b6f4bf-95b9e518-870ed9b2.jpg,test/p11/p11991767/s50313454/971aea24-01d230a7-f0b6f4bf-95b9e518-870ed9b2.jpg,test," FINAL REPORT TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No consolidation, no pulmonary edema, no pleural effusion. IMPRESSION: Normal chest radiograph " fa363509-97dc6ca6-4b9c5109-6a279e45-cec431e9.jpg,test/p15/p15904137/s56470403/fa363509-97dc6ca6-4b9c5109-6a279e45-cec431e9.jpg,test," FINAL REPORT HISTORY: Post-surgery. FINDINGS: In comparison with the study of ___, there are lower lung volumes. Monitoring and support devices remain in place. No evidence of acute focal pneumonia. " 4a87bf1d-683fd779-712c71ef-6d6c6bcf-912aadb9.jpg,test/p12/p12330759/s52765404/4a87bf1d-683fd779-712c71ef-6d6c6bcf-912aadb9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with HIV presenting with cough // Please evaluate for pneumonia Please evaluate for pneumonia IMPRESSION: IN COMPARISON WITH STUDY OF ___, THE EXAMINATION IS NOW WITHIN NORMAL LIMITS. NO PNEUMONIA, VASCULAR CONGESTION, OR PLEURAL EFFUSION. THERE IS SOME DILATATION " c2d4d2db-86ded7a1-38ca9123-e17c1aaf-049658c1.jpg,test/p14/p14325424/s51500277/c2d4d2db-86ded7a1-38ca9123-e17c1aaf-049658c1.jpg,test," FINAL REPORT INDICATION: Weakness. COMPARISON: Chest radiograph from ___. FINDINGS: Upright AP and lateral radiographs of the chest. Compared to the prior examination, there is some increased opacity in the right lower lobe. The lungs are otherwise grossly clear. Heart size is normal and the hila appear unremarkable. There are aortic calcifications with unfolding of the aorta. There is no pneumothorax or pleural effusion. No chf. Probable background hyperinflation. IMPRESSION: Subtle right lower lobe opacity which could be secondary to atelectasis, but pneumonia or aspiration cannot be ruled out. Attention should be paid on followup examinations. " 2d4d0c38-3756f49b-6218f4ae-122cb9c6-03e03fec.jpg,test/p14/p14445477/s55384243/2d4d0c38-3756f49b-6218f4ae-122cb9c6-03e03fec.jpg,test," WET READ: ___ ___ ___ 6:29 PM Right lower lobe pneumonia. Follow up radiographs after treatment are recommended to ensure resolution of this finding. ______________________________________________________________________________ FINAL REPORT HISTORY: Renal transplant, fever, cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is not engorged. New patchy ill-defined opacity is noted within the right lower lobe concerning for pneumonia. Left lung is clear. There is minimal scarring within the lung apices. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Right lower lobe pneumonia. Follow up radiographs after treatment are recommended to ensure resolution of this finding. " fc222a10-0a08534a-7878f7c8-832577af-048df84d.jpg,test/p16/p16701040/s55981674/fc222a10-0a08534a-7878f7c8-832577af-048df84d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with SOB, worsened with inpiration // pna? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. IMPRESSION: No significant interval change. " 06064da6-9cf2c4f1-a2726e1a-2874dbba-c3da10d9.jpg,test/p19/p19165189/s55910235/06064da6-9cf2c4f1-a2726e1a-2874dbba-c3da10d9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Dyspnea, new onset atrial fibrillation TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Moderate to severe enlargement of the cardiac silhouette is present. The aorta is slightly tortuous. There is mild pulmonary edema with small bilateral pleural effusions. More focal opacities seen within the lung bases could reflect areas of atelectasis. No pneumothorax is identified. There are mild degenerative changes seen in the thoracic spine. IMPRESSION: Mild congestive heart failure with mild pulmonary edema and small bilateral pleural effusions. Probable bibasilar atelectasis. " ccb4db98-fdab3028-324c484c-578b1b7e-4d8dae57.jpg,test/p15/p15677235/s57591380/ccb4db98-fdab3028-324c484c-578b1b7e-4d8dae57.jpg,test," FINAL REPORT HISTORY: Dizziness, shortness of breath. TECHNIQUE: Upright AP and lateral views of the. COMPARISON: ___. FINDINGS: The cardiac silhouette size is top normal. Mediastinal and hilar contours are unchanged and within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary abnormality. " 27274f9e-0125a0a7-e4590bdf-76c6de3c-52da4465.jpg,test/p18/p18084645/s55502759/27274f9e-0125a0a7-e4590bdf-76c6de3c-52da4465.jpg,test," FINAL REPORT HISTORY: Intubation with concern for aspiration. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Continued opacification at the left base consistent with volume loss in the left lower lobe and small pleural effusion. In the appropriate clinical setting, superimposed pneumonia would have to be considered. The right lung is essentially clear. " 4f9637b3-1a55b5a4-8b054397-89f1a7f6-de2823d1.jpg,test/p11/p11152220/s58874109/4f9637b3-1a55b5a4-8b054397-89f1a7f6-de2823d1.jpg,test," FINAL REPORT INDICATION: ___-year-old female with hypotension and IJ placement. COMPARISON: Chest radiograph dated ___. FINDINGS: Single AP semi-erect chest radiograph demonstrates low lung volumes. Heart size is midly enlarged. Mild pulmonary vascular congestion identified. A left-sided internal jugular line is seen with its tip terminating in the upper superior vena cava. A right brachiocephalic stent is noted. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Mild pulmonary vascular congestion and enlarged heart. No focal consolidation. 2. New left sided internal jugular central venous line terminating in the upper SVC. No pneumothorax. " b0317ec4-8833cb46-cc676260-d8862691-79d9d19e.jpg,test/p18/p18220345/s52388893/b0317ec4-8833cb46-cc676260-d8862691-79d9d19e.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with 32 lb weight loss in last 6 months // please evaluate for possible underlying causes TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Lungs are fully expanded and clear without consolidations or suspicious pulmonary nodules. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No radiographic evidence of pneumonia, suspicious pulmonary nodules, or other significant cardiopulmonary abnormalities. " d6ceb049-9e8bb57d-4574fc8b-236df533-fe8de948.jpg,test/p13/p13961519/s51007516/d6ceb049-9e8bb57d-4574fc8b-236df533-fe8de948.jpg,test," FINAL REPORT EXAM: Chest single AP semi-erect portable view. CLINICAL INFORMATION: ___-year-old female with intubation. COMPARISON: ___ at 15:00. FINDINGS: Single AP semi-erect portable view of the chest was obtained. Endotracheal tube is seen, terminating approximately 2.6 cm above level of the carina. Nasogastric tube is seen, coursing below the level of the diaphragm, to the expected location of the stomach, although the inferior aspect is not fully included on the image. Three rounded radiopaque structures are again seen projecting over the left cardiac silhouette. There is minimal left base streaky retrocardiac opacity, most likely relates to atelectasis, although underlying aspiration would not be excluded. No large focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette remains mildly enlarged. The aorta is calcified. " 79dfa4fe-1ea1be43-e3c83fa2-e1056ad4-98843da8.jpg,test/p19/p19231238/s55856324/79dfa4fe-1ea1be43-e3c83fa2-e1056ad4-98843da8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESRD on HD, DM2, presenting with worsened hyperglycemia // please eval for pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has developed mild to moderate pulmonary edema. Cardiomegaly is unchanged. Small pleural effusion on the left is likely. No pneumonia, unchanged position of the right hemi dialysis catheter. " c28ac052-f5da3182-f6e969e8-18597879-61e3df89.jpg,test/p13/p13859181/s54789084/c28ac052-f5da3182-f6e969e8-18597879-61e3df89.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PE, CHF, and intubation. // Comparison to previous COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the aortic balloon pump has been removed. The other monitoring and support devices are in constant position. Minimal increase in severity of the pre-existing pulmonary edema. The retrocardiac atelectasis is unchanged. No new focal parenchymal opacities. " 52250a74-bd60bb96-531b0214-56291a9d-25062eda.jpg,test/p10/p10161112/s57792240/52250a74-bd60bb96-531b0214-56291a9d-25062eda.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with lung nodule and lymphadenopathy, now status post transbronchial needle biopsy. Evaluate for pneumothorax. FINDINGS: AP single view of the chest has been obtained with patient in upright position. No previous chest examination is available in our records for comparison. Multiple EKG leads are overlying the chest and an external air tube is overlying the right upper hemithorax. The heart size is normal. Thoracic aorta unremarkable, but shows some wall calcifications at the level of the arch. Pulmonary vasculature is not congested and there are no signs of acute pulmonary parenchymal abnormalities. No evidence of pneumothorax in the apical area on either side. The right-sided lateral lower pleural sinus is mildly blunted, but it is unclear from this single chest view if this is pleural effusion or scar formation. IMPRESSION: Portable chest examination does not reveal any pneumothorax in the apical area. " 1e31075c-48f6b01d-dfd7f8c7-cb5b1324-cea75faa.jpg,test/p11/p11632236/s57197284/1e31075c-48f6b01d-dfd7f8c7-cb5b1324-cea75faa.jpg,test," FINAL ADDENDUM ADDENDUM: Findings were discussed with Dr. ___ ___ the phone by Dr. ___ at 3:42 p.m. on ___ with a recommendation to advance the Dobbhoff tube. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Dobbhoff placement. AP radiograph of the chest was reviewed in comparison to ___. The Dobbhoff tube tip is in the lower esophagus and should be further advanced. Heart size and mediastinal silhouettes are unchanged. Widespread parenchymal opacities, left more than right, are unchanged in appearance. The biliary stent is re-demonstrated. " efffac57-08323083-c94bd970-48979886-9cc4a796.jpg,test/p13/p13415594/s57166759/efffac57-08323083-c94bd970-48979886-9cc4a796.jpg,test," FINAL REPORT HISTORY: Nausea, vomiting, abdominal distention, status post NG tube placement. CHEST, INCLUDING THE UPPER ABDOMEN, SINGLE AP PORTABLE VIEW: An NG tube is present, the tip and side port overlie the gastric fundus. The stomach is not distended. However, some gas-filled loops of small bowel are seen in the visualized portion of the upper abdomen, distended but not frankly dilated. Increased density along the ascending colon likely represents residual oral contrast.No free air is seen beneath the diaphragms. The right hemidiaphragm is minimally elevated. The heart is not enlarged. There is upper zone redistribution, but no overt CHF. No focal infiltrate or effusion. Slightly low inspiratory volumes noted. IMPRESSION: NG tube tip and side port overlie the gastric fundus. " f4711d84-c6f0b46b-66ba84ee-7f7c06ad-810e3dfd.jpg,test/p16/p16296993/s52937092/f4711d84-c6f0b46b-66ba84ee-7f7c06ad-810e3dfd.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever and shortness of breath. COMPARISONS: Earlier on the same day. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The heart is mildly enlarged. There is mild unfolding of the thoracic aorta and calcification along the arch. Patchy linear opacification in the left lower lung suggests minor atelectasis or scarring. There is no pleural effusion or pneumothorax. There is a prominent epicardial fat pad near the cardiac apex. Mild leftward convex curvature is noted along the thoracic spine with mild degenerative changes. The bones appear probably demineralized. IMPRESSION: No evidence of acute disease. " 21235e97-b5985d51-0c0b5453-dd189530-ca86efa7.jpg,test/p18/p18111516/s50049743/21235e97-b5985d51-0c0b5453-dd189530-ca86efa7.jpg,test," FINAL REPORT HISTORY: Dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ FINDINGS: There is moderate cardiomegaly, unchanged. The aortic knob is calcified. Mediastinal and hilar contours are unremarkable. Streaky retrocardiac and right basilar opacity may reflect atelectasis though infection cannot be excluded. Mild pulmonary vascular congestion. Small bilateral pleural effusions cannot be completely excluded posteriorly. There is no pneumothorax. Clip is noted within the right upper quadrant of the abdomen. IMPRESSION: Streaky opacities in the lung bases may reflect atelectasis though infection cannot be excluded. Small bilateral pleural effusions posteriorly also likely present. Mild pulmonary vascular congestion. " c85b92cc-b02d2e34-451303f5-9eae3b26-f0be004a.jpg,test/p11/p11512369/s55063138/c85b92cc-b02d2e34-451303f5-9eae3b26-f0be004a.jpg,test," WET READ: ___ ___ ___ 3:41 PM An endotracheal tube terminates 2.8 cm above the carina. A radiopaque pin projecting over the left lung apex is presumably external to the patient. WET READ VERSION #___ ___ ___ ___ 3:04 PM An endotracheal tube terminates 2.8 cm above the carina. Aside from linear atelectasis at the left lung base, lungs are unremarkable. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___F with endotracheal tube placement TECHNIQUE: Portable supine AP chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: An endotracheal tube terminates 2.8 cm above the carina. An enteric tube passes below the diaphragm, outside the field of view. There is retrocardiac linear atelectasis at the left lung base. Lung volumes are low with associated crowding of the bronchovascular structures. No pleural effusion or pneumothorax. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. Surgical clips projecting over the with right upper quadrant are presumably related to cholecystectomy. A radiopaque pin projecting over the left lung apex is likely external to the patient. IMPRESSION: An endotracheal tube terminates 2.8 cm above the carina. A radiopaque pin projecting over the left lung apex is presumably external to the patient. " 26acbf1c-a30a8fd8-fcdbbb41-499bb037-3ab33699.jpg,test/p17/p17805551/s59135169/26acbf1c-a30a8fd8-fcdbbb41-499bb037-3ab33699.jpg,test," FINAL REPORT HISTORY: Fever on chemotherapy. COMPARISON: Chest radiograph ___. FINDINGS: AP and lateral chest radiographs were obtained. The heart size is normal. Calcification of the thoracic aorta is noted. The mediastinal and hilar contours are otherwise unremarkable. There is of the wall thickening of the bronchovascular markings at the right lung base, concerning for atypical infection. There is no pleural effusion or pneumothorax. IMPRESSION: Increased bronchovascular markings at the right base concerning for atypical infection given the history. " d406dbf2-531db943-cc62ae23-8e60bd95-db15f5a2.jpg,test/p15/p15803381/s59448467/d406dbf2-531db943-cc62ae23-8e60bd95-db15f5a2.jpg,test," FINAL REPORT HISTORY: Status post aneurysm repair. COMPARISON: ___. FINDINGS: The endotracheal tube is 5 cm above the carina. There is dense retrocardiac opacity compatible volume loss/infiltrate/effusion. Left upper lung is slightly better aerated than on the prior exam. There continues to be some volume loss/infiltrate in the right lower lung with some minimal obscuration of the right hemidiaphragm. The remainder of the appearance of the chest is unchanged compared to prior. IMPRESSION: Dense retrocardiac opacity compatible with volume loss/infiltrate/effusion and right lower lobe volume loss/infiltrate. " 6173a427-e9374d3f-30d6f0b2-33322054-6c3eb7c0.jpg,test/p16/p16167724/s59924232/6173a427-e9374d3f-30d6f0b2-33322054-6c3eb7c0.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: NG tube placement. FINDINGS: The NG tube tip is in the proximal stomach. ET tube is 6 cm above the carina. The appearance of the lungs is unchanged. " c9c6f0db-aa5198eb-1bc22ab2-11bdb4ad-5edd195f.jpg,test/p11/p11868766/s54042811/c9c6f0db-aa5198eb-1bc22ab2-11bdb4ad-5edd195f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p thoracoaneurysm repair // eval for lung collapse/ pulm edema TECHNIQUE: Single AP radiograph of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: PA catheter has been removed. All lines and tubes are in appropriate positioning, and are unchanged compared to the prior radiograph. There continues to be opacification of the left hemithorax, representing left lower lobe collapse, unchanged compared to prior. The right basilar opacification likely represents atelectasis. The cardiomediastinal silhouette is stable. The pulmonary vasculature is normal. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Interval removal of the PA catheter, with unchanged positioning of all other lines and tubes. 2. Persistent and unchanged left lower lobe collapse, and right lower lobe atelectasis. " 74155497-e80ec02f-154721b7-bc76f816-069c92eb.jpg,test/p10/p10924949/s53623762/74155497-e80ec02f-154721b7-bc76f816-069c92eb.jpg,test," FINAL REPORT HISTORY: Seizure, evaluation for pneumonia. COMPARISON: Multiple prior studies with the most recent chest radiograph from ___. FINDINGS: Lung volumes are low and exaggerate pulmonary vascular markings. There are bibasilar atelectatic changes but the lungs are otherwise without a focal consolidation. The cardiac and mediastinal contours appears stable. Left ventriculoperitoneal shunt is again visualized traversing through the chest into the upper abdomen. No acute fractures are identified. Severe degenerative changes are noted at the right glenohumeral joint with moderate degenerative changes throughout the thoracolumbar spine. IMPRESSION: No acute cardiopulmonary process. " 59c567a0-c3af68f2-eaa1013e-2de117c8-408149c2.jpg,test/p15/p15333408/s52704722/59c567a0-c3af68f2-eaa1013e-2de117c8-408149c2.jpg,test," FINAL REPORT INDICATION: ___ year old man with PMHx sarcoidosis, with R inframammary chest wall pain // please assess cardiopulmonary architecture TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. The cardiomediastinal silhouette is unremarkable. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute radiographic intrathoracic pulmonary disease. " cbdac2c2-76189f44-56e7c73e-3b720277-aaf32335.jpg,test/p13/p13715870/s58158198/cbdac2c2-76189f44-56e7c73e-3b720277-aaf32335.jpg,test," WET READ: ___ ___ ___ 8:18 AM Compared to prior study from 09:21, there may be a trace left apical pneumothorax. No pneumothorax seen on the right. Appearance of the heart and lungs otherwise unchanged. WET READ VERSION #1 ___ ___ ___ 7:33 PM Compared to prior study from 09:21, there may be a trace left apical pneumothorax. No pneumothorax seen on the right. Appearance of the heart and lungs otherwise unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with + AL ct clamped // eval for ptx COMPARISON: ___, 09:21 IMPRESSION: As compared to the previous image, the chest tubes are now attempt. There is a millimetric apical left-sided pneumothorax. No pneumothorax on the right. The venous introduction sheet is in unchanged position. No evidence of tension. Moderate cardiomegaly persists. " f160cf8f-c7b304b5-b90308b9-25f3404c-8dd66302.jpg,test/p13/p13699008/s56711392/f160cf8f-c7b304b5-b90308b9-25f3404c-8dd66302.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fall with headstrike, left periorbital ecchymosis TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Moderate to severe enlargement of the cardiac silhouette is present. The aorta is mildly tortuous with atherosclerotic calcifications noted at the aortic knob. The pulmonary vasculature is normal and the hilar contours are unremarkable. Minimal atelectasis in the lung bases is demonstrated with longitudinally oriented linear opacity in the right lung base, likely an area of scarring. Remainder of the lungs are clear without focal consolidation. No pneumothorax or pleural effusion is evident. There mild degenerative changes seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 1e0e2cb4-a55d4ac4-be80c12f-b708dad6-2f898328.jpg,test/p19/p19140358/s56943183/1e0e2cb4-a55d4ac4-be80c12f-b708dad6-2f898328.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with gastric outlet obstruction with CT findings suggestive of PNA, likely ___ aspiration // LLL pna on CT, would like to follow up with CXR COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is a new parenchymal opacity in the left lower lobe, documented on a abdomen CT examination from ___. Distribution and morphology of the opacities suggests pneumonia. No evidence of accompanying pleural effusion. No abnormalities in the right lung. Normal appearance of the heart. " 72538569-4ac4699b-43b8a046-0754ab8f-e53797eb.jpg,test/p14/p14412978/s57875736/72538569-4ac4699b-43b8a046-0754ab8f-e53797eb.jpg,test," FINAL REPORT HISTORY: ___-year-old male with palpitations. COMPARISON: None available. FINDINGS: PA and lateral views through the chest demonstrates hyperinflated clear lungs. Cardiomediastinal and hilar contours are within normal limits allowing for a patient who is minimally rotated to the left. There is no pleural effusion or pneumothorax. No acute osseous abnormality is identified. IMPRESSION: No acute intrathoracic findings. " 5853a99c-6cc636a5-21be2392-a5d144e1-dfef7ce4.jpg,test/p13/p13799172/s52777352/5853a99c-6cc636a5-21be2392-a5d144e1-dfef7ce4.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Tachycardia and leukocytosis. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is an eventration of the right hemidiaphragm, as before. There is no pleural effusion or pneumothorax. The lungs appear clear. There is mild anterior wedging of two lower thoracic vertebral bodies at which point kyphotic curvature is mildly exaggerated. These deformities appear chronic with some increased loss in vertebral body heights and new anterior osteophytes since the remote prior examination. IMPRESSION: No definite evidence of acute disease. " f3c0d6af-d8836e05-a79cea40-6c7d2dc1-ee7c9cfd.jpg,test/p19/p19646078/s54630931/f3c0d6af-d8836e05-a79cea40-6c7d2dc1-ee7c9cfd.jpg,test," WET READ: ___ ___ ___ 9:35 AM Bibasilar opacities could represent areas of multifocal infection. Bilateral hilar opacities as well as diffuse interstitial prominence is consistent with mild to moderate pulmonary edema. No pleural effusion or pneumothorax identified. WET READ VERSION #___ ___ ___ ___ 9:30 PM Bibasilar opacities could represent areas of multifocal infection. Bilateral hilar opacities as well as diffuse interstitial prominence is consistent with mild to moderate pulmonary edema. No pleural effusion or pneumothorax identified. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with DM, ?CAD, COPD, h/o CVA, bioprosthetic MVR in ___, recent pna, and being treated for pna at OSH who was transferred from ___ for evaluation and management of dyspnea. // eval for pna, interstial lung disease, volume overload COMPARISON: No comparison IMPRESSION: The lung volumes are low. The overall radiodensity of the lung parenchyma is increased, showing mid and upper lobe predominant areas of ground-glass like opacities with air bronchograms. These could reflect the clinically known areas of pneumonia. In addition, however, bilateral areas of platelike atelectasis are visualized. The hilar structures are bilaterally enlarged. There is moderate cardiomegaly. Signs of basal apical blood flow redistribution are noted. No pleural effusions. Overall, the findings are highly suggestive of a combination of pneumonia and moderate pulmonary edema. " 7aac9cdb-5b358788-3de19bbc-868308c0-21d11f5c.jpg,test/p12/p12028465/s58377719/7aac9cdb-5b358788-3de19bbc-868308c0-21d11f5c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with dyspnea // Eval for pulmonary edema TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: As compared to the prior examination dated ___, there has been no relevant interval change. Mild blunting of the right sulcus may be secondary to atelectasis versus trace pleural effusion. MODERATE CARDIOMEGALY WHICH INCREASED BETWEEN ___ AND ___ IS UNCHANGED OVER THE PAST 8 MONTHS. MILD GENERALIZED INTERSTITIAL PULMONARY ABNORMALITY IS COMPARABLE TO THE APPEARANCE ON ___. THIS IS EITHER RECURRENT MILD PULMONARY EDEMA OR CHRONIC INTERSTITIAL CHANGE. Calcifications are seen IN THE PROXIMAL CORONARY ARTERIES, POSSIBLY STENTED. . IMPRESSION: CHRONIC MODERATE CARDIOMEGALY. RECURRENT MILD INTERSTITIAL EDEMA OR CHRONIC IRREVERSIBLE INTERSTITIAL ABNORMALITY UNCHANGED SINCE ___. " 4bce5549-10ddb8cb-93be4ea8-ec366fe8-8a0e105f.jpg,test/p11/p11276636/s53627852/4bce5549-10ddb8cb-93be4ea8-ec366fe8-8a0e105f.jpg,test," WET READ: ___ ___ 5:56 PM 3 sequential radiographs are provided. On the third radiograph, the nasogastric tube has been placed within the stomach. Right IJ CVL terminates in the low SVC. The lungs are clear. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old female with GI bleeding status post recent placement of nasogastric tube. Evaluate tube position. TECHNIQUE: Three sequential AP radiograph of the chest are submitted for evaluation on ___. COMPARISON: ___. FINDINGS: The tip of a right IJ central venous catheter projects over the mid SVC. The last radiograph obtained demonstrates appropriate placement of the nasogastric tube within the stomach. There is no pneumothorax. The lungs are clear. The heart and mediastinum are within normal limits despite the projection. Regional bones and soft tissues are unremarkable. IMPRESSION: NG tube in satisfactory position. Clear lungs. " bcfb2d4e-62a54a30-b88071d5-f334190e-f20097f6.jpg,test/p17/p17748848/s58181346/bcfb2d4e-62a54a30-b88071d5-f334190e-f20097f6.jpg,test," FINAL REPORT HISTORY: Cough and shortness of breath. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " c7c66e7a-947b5021-420cb4c5-dffc47d9-8a731bc0.jpg,test/p10/p10824274/s56187033/c7c66e7a-947b5021-420cb4c5-dffc47d9-8a731bc0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The aorta is likely tortuous. Pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " bff9eb94-d2ccc78b-7157fe6c-f6a94190-2e569d9e.jpg,test/p14/p14508231/s53309747/bff9eb94-d2ccc78b-7157fe6c-f6a94190-2e569d9e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea, wheeze // infiltrate? COMPARISON: ___ FINDINGS: There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. C-spine hardware is partially imaged. IMPRESSION: No acute intrathoracic process. " 3a1d76cc-2fedb068-51220f92-6a7f4d11-4dfd8181.jpg,test/p10/p10303503/s50667014/3a1d76cc-2fedb068-51220f92-6a7f4d11-4dfd8181.jpg,test," FINAL REPORT HISTORY: Status post liver transplant. Rule out infection. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " fcf71aee-de24672c-e34c961e-434df9a1-42607997.jpg,test/p19/p19301174/s54058629/fcf71aee-de24672c-e34c961e-434df9a1-42607997.jpg,test," FINAL REPORT INDICATION: Cough, right perihilar mass and wedge shaped right upper lobe opacity status post thoracotomy and right upper lobe lobectomy. Evaluate pneumothorax. COMPARISON: ___. FINDINGS: Portable frontal radiograph of the chest demonstrates a right chest tube in unchanged position. Post thoracotomy changes are again noted along the right chest wall. Lung volumes are lower with bibasilar atelectasis. Stable cardiomediastinal silhouette. Previously seen right apical pneumothorax is no longer definitively identified. " 96f7c75c-636e1574-ba2898e3-5c8ac4f6-26cecbbe.jpg,test/p12/p12911421/s55361412/96f7c75c-636e1574-ba2898e3-5c8ac4f6-26cecbbe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p cabg // eval for effusion eval for effusion IMPRESSION: In comparison with the study ___ ___, the degree of pulmonary vascular congestion has decreased. Some of this may merely reflect the erect PA rather than supine portable position. The hazy opacification seen at the bases with poor definition of the hemidiaphragms has decreased. However, on the lateral view there is still evidence of pleural effusion. " a16eba3b-5250da23-5193fdb9-8147dd2c-6bdfc4ed.jpg,test/p13/p13030232/s51674766/a16eba3b-5250da23-5193fdb9-8147dd2c-6bdfc4ed.jpg,test," FINAL REPORT EXAMINATION: Radiograph. INDICATION: ___M with hypoglycemia. Assess for infection or pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The lungs are well inflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. The left chest pacer device lead tips are unchanged in appearance. Median sternotomy wires are noted. IMPRESSION: No acute cardiopulmonary process. Specifically, no pneumonia. " 6fe39dde-338e731e-025a0a04-ab19ab4c-7c11cf7e.jpg,test/p12/p12807226/s52814882/6fe39dde-338e731e-025a0a04-ab19ab4c-7c11cf7e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with subarachnoid hemorrhage, fall // please evaluate for traumatic injury TECHNIQUE: Supine AP view of the chest COMPARISON: None. FINDINGS: Heart size is mild to moderately enlarged. The aorta is tortuous. Widening of the superior mediastinum is likely due to supine positioning and low lung volumes. While there is mild crowding of the bronchovascular structures, no overt pulmonary edema is present. Patchy atelectasis is seen in the lung bases without focal consolidation. No large pleural effusion or pneumothorax is identified on this supine exam. No acute osseous abnormalities. IMPRESSION: Low lung volumes. Mild to moderate cardiomegaly. Patchy atelectasis in the lung bases. " 5c5ff4db-c8d3a319-96b39f70-c56dac6e-b1f3d226.jpg,test/p13/p13050559/s51066996/5c5ff4db-c8d3a319-96b39f70-c56dac6e-b1f3d226.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with mediastinal B cell lymphoma, status-post recent right thoracotomy and right upper lobectomy with handsewn bronchus closure and intercostal flap overlay. Status-post recent chest tube removal. Concern of increased right paratracheal convexity on CXR earlier this morning; evaluate for interval change. COMPARISON: Chest radiograph from the same day, dated ___, at 09:25h. FINDINGS: No significant interval change from the study earlier today other than interval removal of the right chest tube. Stable appearance of the right paratracheal convexity contributing to widening of the right mediastinum. Overall stable small right apical pneumothorax. Expected post-surgical changes in the right hemithorax. Stable smaller lung volumes. No new focal consolidation to suggest pneumonia. No pleural effusion. Normal heart size. The right port-A-cath is intact and unchanged in position. IMPRESSION: Stable appearance of the right mediastinal convexity and small right apical pneumothorax status-post right chest tube removal. " 3454e0a2-c829695b-fc2d120f-8100d484-a177a746.jpg,test/p10/p10844378/s51534952/3454e0a2-c829695b-fc2d120f-8100d484-a177a746.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with seizures // r/o occult process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " c8173e74-d930a7cc-95334c18-7179ef7e-feb2c1bd.jpg,test/p10/p10519618/s50154661/c8173e74-d930a7cc-95334c18-7179ef7e-feb2c1bd.jpg,test," FINAL REPORT HISTORY: Enlarged cardiac silhouette with upper airway noises. FINDINGS: In comparison with study of ___, there is again enlargement of the cardiac silhouette with retrocardiac opacification consistent with volume loss in the lower lobe and hazy opacification at the bases consistent with layering effusions. No evidence of acute focal pneumonia. Impression on the right side of the upper thoracic trachea could possibly represent a substernal thyroid. " 87cbab5d-bad9d9b2-bc282ee2-909f2f0b-f11eaefa.jpg,test/p18/p18583455/s50780339/87cbab5d-bad9d9b2-bc282ee2-909f2f0b-f11eaefa.jpg,test," FINAL REPORT INDICATION: Cough and midepigastric pain. Recent surgery. Evaluate for acute intrathoracic process. COMPARISON: None. FINDINGS: The lung volumes are slightly low. The lungs are clear. The heart is top normal in size. There are no pleural effusions. No pneumothorax is seen. The esophagus is air-filled and dilated at the level of the thoracic inlet. There is a spinal stimulator device projecting along the posterior aspect of the thoracic spine. Cholecystectomy clips are noted. IMPRESSION: No radiographic evidence of an acute cardiac or pulmonary process, although this examination neither suggests nor excludes the diagnosis of pulmonary embolism. " 6930ad76-75ecc101-868f8730-7ee63c6a-b0422f3e.jpg,test/p15/p15877362/s53921049/6930ad76-75ecc101-868f8730-7ee63c6a-b0422f3e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___-year-old woman with chest pain, evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiograph ___. FINDINGS: Cardiomediastinal silhouette is unchanged. There is mild tortuosity of the thoracic aorta. There is no focal lung consolidation. There is no pleural effusion or pneumothorax. Nodular left lower lobe opacity ___, is seen on the current study, most likely corresponding to lingular atelectasis seen on the CT abdomen from ___. IMPRESSION: No radiographic explanation for chest pain. " 5e25a312-b53f8210-d1828fc8-31250bdf-22aaa528.jpg,test/p16/p16935275/s54120133/5e25a312-b53f8210-d1828fc8-31250bdf-22aaa528.jpg,test," FINAL REPORT CLINICAL HISTORY: Cerebral infarct. Evaluate position of orogastric tube. CHEST: The tip of the orogastric tube lies in the subdiaphragmatic position and is likely to be satisfactory, though the tip is not seen. On the previous chest x-ray, the endotracheal tube was somewhat low and remains in the same position, and lies between 1.5 and 2 cm from the carinal angle and should be withdrawn approximately 1-1.5 cm to better position. IMPRESSION: Orogastric tube, position satisfactory. Endotracheal tube remains somewhat low. " c7261893-2302ff0b-d1fb2d5e-ee1d609c-46c5cfef.jpg,test/p13/p13107111/s59832315/c7261893-2302ff0b-d1fb2d5e-ee1d609c-46c5cfef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p exlap, SBO, poor sat post-op // cardiopulmonary process cardiopulmonary process IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lung volumes are lower suggesting that new bilateral infrahilar consolidation is atelectasis, but pneumonia is not excluded. Severe cardiomegaly and marked enlargement of the hila due to pulmonary arterial hypertension are chronic. Esophageal drainage tube passes into the stomach and out of view. " d76996fa-07277593-67f7b478-0a8dabe3-afadfbf5.jpg,test/p13/p13239815/s58560634/d76996fa-07277593-67f7b478-0a8dabe3-afadfbf5.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 9d424fe1-23692af7-b397fe5a-3969b76f-584b5918.jpg,test/p17/p17165725/s57594626/9d424fe1-23692af7-b397fe5a-3969b76f-584b5918.jpg,test," FINAL REPORT INDICATION: History of pericardial effusion and VATS status post pericardiocentesis. Please evaluate for interval change. COMPARISONS: Multiple chest radiographs dating back to ___, most recently performed on the same day at 8:15 a.m. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The ET tube terminates approximately 5.5 cm above the carina. There is an enteric tube which courses below the diaphragm with the tip out of view from this radiograph. The heart is again severely enlarged overall stable compared to the prior exam. The massively enlarged triangular cardiac silhouette appears overall unchanged compared to the prior radiograph in morphology. There appears to be slight interval improvement in the opacification over the right lung suggestive of mild interval improvement of the large right pleural effusion. The left lung base consolidation appears to be stable compared to the prior exam. The small left pleural effusion is unchanged. The degree of bilateral pulmonary edema is constant. There is no evidence of pneumothorax. IMPRESSION: Overall, slight interval improvement of the extensive right pleural effusion. Stable left lung base consolidation, likely secondary to atelectasis, however, an acute infectious process cannot be excluded. " 707e869c-25900a86-e4b4090c-f8804665-813c2021.jpg,test/p11/p11177152/s54644380/707e869c-25900a86-e4b4090c-f8804665-813c2021.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Prior exam dated ___ ___M with pleuritic R posterior thoracic back pain, dyspnea, decreased breath sounds RL base COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lung volumes are low with bibasilar atelectasis noted. No convincing evidence for pneumonia though lung bases are poorly assessed due to presence of atelectasis. No large effusion or pneumothorax. No convincing signs of edema or congestion. Heart size is difficult to assess. Mediastinal contour is normal. Bony structures are intact. Prominent spurs are noted anteriorly in the lower T-spine. IMPRESSION: Bibasilar atelectasis. No convincing signs of pneumonia. " d918e729-cd8ec5c6-ce3afc6d-22a907f3-7768572a.jpg,test/p16/p16497039/s55922684/d918e729-cd8ec5c6-ce3afc6d-22a907f3-7768572a.jpg,test," FINAL REPORT REASON FOR EXAMINATION: NG tube placement. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 4 cm above the carina. The NG tube tip is in the stomach. The left subclavian line tip is at the level of mid SVC. The left chest tube is in place. There is no evidence of pneumothorax. There is minimal amount of left pleural effusion. Atelectasis of right middle lobe is redemonstrated, unchanged. Dense opacities projecting over the left lung base, seen on the prior radiograph from ___ obtained at 4:36 p.m. and not seen previously, and it is unclear if it represents superimposed objects or evidence of aspiration, attention to this area on the subsequent studies is recommended. The ET tube tip is 4 cm above the carina. NG tube tip is in the stomach and left subclavian line tip is at the level of mid SVC. " df8ccfaa-a7e82a3f-525ddc73-f0dfc5e2-125c589c.jpg,test/p14/p14593900/s58370999/df8ccfaa-a7e82a3f-525ddc73-f0dfc5e2-125c589c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever, tachycardia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy and CABG. Heart size is normal. The aorta is tortuous. Pulmonary vasculature is normal. Hilar contours are unremarkable. Lungs appear clear without focal consolidation. Minimal blunting of the right costophrenic angle suggests a trace pleural effusion. No pneumothorax is detected. There are no acute osseous abnormalities. IMPRESSION: Minimal blunting of the right costophrenic angle suggestive of a trace pleural effusion. Otherwise, no acute cardiopulmonary abnormality. " b4a939d3-05849610-14a75408-ef6f57b3-c3a0f6fb.jpg,test/p18/p18322589/s58898395/b4a939d3-05849610-14a75408-ef6f57b3-c3a0f6fb.jpg,test," FINAL REPORT AP CHEST, 12:01 A.M. ON ___ HISTORY: Recent cellulitis. IMPRESSION: AP chest compared to ___: Bedside frontal radiograph centered at the diaphragm shows nasogastric tube ending in the proximal duodenum, and the distal portions of a transvenous right ventricular pacer defibrillator and left ventricular pacer leads, as well as a right PICC lead that ends in the upper right atrium and retained epicardial leads. Previous mild pulmonary edema has improved, but there is still substantial consolidation at the right lung base probably largely atelectasis. There is no appreciable pleural effusion in the imaged portion of the chest. The apices of the lungs are not included in this image. Mild-to-moderate cardiomegaly is unchanged. Intestinal gas pattern is unremarkable. " 718f5204-1f949858-f375f411-4a56dd19-d206d548.jpg,test/p16/p16448755/s57491652/718f5204-1f949858-f375f411-4a56dd19-d206d548.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Studies dating between ___ and ___. FINDINGS: Tip of right internal jugular central venous catheter terminates in the lower superior vena cava, with no visible pneumothorax. Cardiac silhouette is slightly enlarged and there remains widening of the vascular pedicle accompanied by pulmonary vascular engorgement and slight improvement in perihilar edema since the recent radiograph. Recently described left retrocardiac opacity has also slightly improved. Bilateral pleural effusions are not appreciably changed allowing for positional differences of the patient. " 02bba880-fec341e3-d8a765a6-e63166c9-94d6c6b2.jpg,test/p11/p11166922/s52984857/02bba880-fec341e3-d8a765a6-e63166c9-94d6c6b2.jpg,test," FINAL REPORT INDICATION: Cough and leukocytosis in a patient with a history of chronic pancreatitis. COMPARISON: Multiple chest radiographs, the most recent of ___. FINDINGS: Portable AP upright view of the chest was reviewed and compared to the prior study. New retrocardiac opacity and increased right lower lobe opacity represent atelectasis or pneumonia. Small bilateral pleural effusions are unchanged. There is no pneumothorax. Normal cardiac and mediastinal contours. IMPRESSION: 1. Retrocardiac and right lower lobe opacities represent atelectasis and/or pneumonia. 2. Small bilateral pleural effusions are unchanged. COMMENT: Findings discussed with Dr. ___ by Dr. ___ at 11:51 a.m. at the time of discovery. " 58e9106b-41b4bfb0-73cc2a34-6e941cbf-c432256c.jpg,test/p11/p11966397/s54519514/58e9106b-41b4bfb0-73cc2a34-6e941cbf-c432256c.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Preop evaluation femoral endarterectomy. Comparison is made with prior study ___. Cardiac size is top normal. The cardiomediastinal shift is towards the left. There is loss of volume and dense opacity in the left apex, unchanged from prior. Multiple surgical clips project in the left hilum. Bibasilar opacities, right greater than left, have increased consistent with increasing atelectasis. There is no pneumothorax. " 2552708c-fe2bcc64-4b90d933-ad046b57-3de4bacf.jpg,test/p15/p15465911/s51133895/2552708c-fe2bcc64-4b90d933-ad046b57-3de4bacf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with pain crisis // ? signs of acute chest TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs on ___ through ___ FINDINGS: A left-sided PICC terminates at the cavoatrial junction as before. The heart is mildly enlarged but stable in size from the prior radiograph given differences in inspiration. Lung volumes are low which accentuates bronchovascular markings. A subtle peripheral right lower lobe opacity partially obscures the peripheral right hemidiaphragm and appears more prominent than on the ___ chest radiograph. There is no effusion or pneumothorax. IMPRESSION: Nonspecific peripheral right lower lobe opacity, which could be due to an early focus of pneumonia, atelectasis, or potentially acute chest syndrome. " 3baf6638-cecaf996-91009ac9-50cf415a-1bbcd65e.jpg,test/p11/p11613361/s59239009/3baf6638-cecaf996-91009ac9-50cf415a-1bbcd65e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG // eval fro effusions eval fro effusions IMPRESSION: In comparison with the study ___ ___, the cardiac silhouette remains enlarged with mild vascular congestion. Opacification at the right base with silhouetting hemidiaphragm is consistent with layering effusion and atelectatic changes. Minimal atelectasis is seen at the left base. Right jugular catheter is unchanged. " 8253e492-29726e1f-a5694371-883a7b65-684adcd5.jpg,test/p19/p19674603/s52783839/8253e492-29726e1f-a5694371-883a7b65-684adcd5.jpg,test," WET READ: ___ ___ 7:48 AM No acute intrathoracic abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // Please eval for pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax IMPRESSION: No acute intrathoracic abnormality. " 24cc97ce-097d5990-906c5728-03825021-24ce5525.jpg,test/p10/p10380616/s58603291/24cc97ce-097d5990-906c5728-03825021-24ce5525.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___ year old woman s/p tracheobronchoplasty // interval change, please evaluate COMPARISON: Chest radiograph dated ___. FINDINGS: Minimal, if any improvement compared to the prior exam. Persistent small right pleural effusion that is perhaps minimally decreased and persistent stable right lower lung atelectasis. Stable right pleural thickening. The previously noted right lower lobe opacity slightly obscuring the right hemidiaphragm, best seen on the lateral view, is slightly improved and less conspicuous today. Right lung pulmonary vascular congestion is better today. Trace left pleural effusion is best seen on the lateral view. Mild cardiomegaly is unchanged. The mediastinum and hila are unchanged. No pneumothorax or frank pulmonary edema. Calcification of the aortic knob is again noted. Surgical clips project over the right upper quadrant are unchanged. Degenerative changes in diffuse bony mineralization in the thoracic spine are also unchanged with some vertebrae demonstrating chronic appearing anterior wedge compression deformities. IMPRESSION: Slight improvement in small right pleural effusion and right lower lobe consolidation from ___. " c356ffc1-f48d0e18-23777ffc-f7407c99-2f99a7f2.jpg,test/p16/p16500918/s59935123/c356ffc1-f48d0e18-23777ffc-f7407c99-2f99a7f2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with as above // s/p PA cath reposition-check placement s/p PA cath reposition-check placement COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Normal postoperative cardiomediastinal silhouette. Tiny right apical pneumothorax unchanged. No left pneumothorax or appreciable pleural effusion. No pulmonary edema. In standard placements and/or unchanged are the ET tube, midline and left pleural drainage catheters, transvenous right atrial and right ventricular pacer leads and a nasogastric drainage tube. The Swan-Ganz catheter loop projects main pulmonary artery, but the tip could be in the left pulmonary artery as well. " 032a2ec4-4ac8e1d1-c48c8e82-e94e5bad-97d2f8c8.jpg,test/p12/p12371641/s51362736/032a2ec4-4ac8e1d1-c48c8e82-e94e5bad-97d2f8c8.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure, evaluation for effusion and pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a minimal increase in extent of the pre-existing bilateral pleural effusions. The monitoring and support devices are constant. Constant areas of atelectasis at the lung bases and signs of moderate pulmonary edema are unchanged. No pneumothorax. No new parenchymal opacities. " 6839c4cc-faedff21-660c19ed-e925f415-bbd5a9bb.jpg,test/p10/p10541305/s56991019/6839c4cc-faedff21-660c19ed-e925f415-bbd5a9bb.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Persistent cough. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 104487cb-d08ca993-cba98865-c80d8d61-6d5b157f.jpg,test/p13/p13483571/s59166383/104487cb-d08ca993-cba98865-c80d8d61-6d5b157f.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Diastolic CHF, possible pneumonia. Comparison is made with prior study, ___. Mild cardiomegaly is stable. Transvenous pacemaker leads are in standard position. Patient is status post CABG. Left lower lobe opacities have improved, consistent with improving atelectasis. There are no new lung opacities or pneumothorax. If any, there is a small left pleural effusion. There is mild vascular congestion. No overt pulmonary edema. " ddade466-b8b23763-966f8a68-dad003e8-cb11539f.jpg,test/p13/p13698008/s51062417/ddade466-b8b23763-966f8a68-dad003e8-cb11539f.jpg,test," FINAL REPORT INDICATION: ___ year old man with STEMI s/p PCI ___ // Infection work-up TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is no clear consolidation. There is pulmonary venous congestion. Mild-to-moderate cardiomegaly is unchanged. The mediastinum is normal. No pleural abnormalities. No pneumothorax. No fractures. IMPRESSION: Pulmonary venous congestion with cardiomegaly. No pneumonia. RECOMMENDATION(S): Conventional chest radiographs, if feasible. Radiology should be consulted before the patient leaves the department to see if oblique views would be helpful. . " 8527b5ec-49d3c1d7-9f43d352-fa29ca2a-98359e6f.jpg,test/p16/p16573945/s56688213/8527b5ec-49d3c1d7-9f43d352-fa29ca2a-98359e6f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG. PA and lateral upright chest radiographs were reviewed in comparison to ___. Right internal jugular line tip is at the cavoatrial junction. Cardiomegaly is present. Mediastinal appearance is stable. Sternal wires are intact. There is no pleural effusion. Minimal amount of new pleural effusion is noted on the left. Areas of basal atelectasis on the left have substantially improved since the prior study. " b86a81b5-5309c08d-99b90c0b-e0234e22-791f46e6.jpg,test/p13/p13210259/s52831117/b86a81b5-5309c08d-99b90c0b-e0234e22-791f46e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chest pain // r/o pleural effusion COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing left pleural effusion has decreased in extent and severity. The effusion is now limited to the left costophrenic sinus. Mild to moderate retrocardiac atelectasis, however, is still visualized. Borderline size of the cardiac silhouette without pulmonary edema. Normal appearance of the right lung. Unchanged normal position of the right PICC line. Bilateral, partially calcified apical thickening, symmetrical in distribution. " f8f1ebee-f00daded-ed1781af-d622f70d-d88d55f7.jpg,test/p14/p14848780/s52183393/f8f1ebee-f00daded-ed1781af-d622f70d-d88d55f7.jpg,test," FINAL REPORT INDICATION: History: ___F with trach, flail chest, dyspnea // PNA? COMPARISON: Outside hospital radiographs from ___ IMPRESSION: There is a tracheostomy tube. Several broken median sternotomy wires are seen consistent with prior sternal dehiscence. Heart size is upper limits of normal. There is atelectasis at the lung bases, left greater than right. There is flattening of the hemidiaphragms and likely small bilateral pleural effusions. Several healed right posterior rib fractures are seen. Lungs demonstrates no focal consolidation or overt pulmonary edema. There are no pneumothoraces. Irregularity of the humeral heads bilaterally are suggestive prior old fractures. " 1d278cb6-6f1c9c23-f4f3c6c1-0ba397f1-b072950f.jpg,test/p13/p13859037/s57869231/1d278cb6-6f1c9c23-f4f3c6c1-0ba397f1-b072950f.jpg,test," FINAL REPORT INDICATION: Fall. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Left-sided dual-lumen pacemaker device is noted with leads terminating in the right atrium and right ventricle. The heart size is normal with a left ventricular predominance. The aorta remains mildly tortuous and diffusely calcified. The pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is present. There are multilevel degenerative changes within the imaged thoracic spine. No displaced rib fractures are visualized. IMPRESSION: No acute cardiopulmonary abnormality. Specifically, no displaced rib fractures are present, but if there is continued clinical concern, a rib series can be obtained. No pneumothorax. " d92ef273-f846725d-cca8116d-c0df150c-b8f0d4a2.jpg,test/p11/p11805066/s57261059/d92ef273-f846725d-cca8116d-c0df150c-b8f0d4a2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx R lung cancer // evaluation interval change, esp effusions IMPRESSION: In comparison to the prior radiograph of 1 day earlier, there has been further opacification of the right hemi thorax, which is now nearly completely opacified except for a small portion at the right base. This appears to predominantly be due to an enlarging right pleural effusion combined with a large mediastinal mass, which is been more fully evaluated by a recent CT. Tracheostomy tube in bilateral bronchial stents remain in place. Exam is otherwise remarkable for worsening left lower lobe opacity with adjacent small pleural effusion. Known left lung nodules have been more fully evaluated by CT. " 2f50f051-78e55c8a-6eb654cb-04960d54-80173a63.jpg,test/p16/p16454913/s54432819/2f50f051-78e55c8a-6eb654cb-04960d54-80173a63.jpg,test," FINAL REPORT INDICATION: History of stroke, status post tracheostomy, now with increased respiratory distress and confusion, here to evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. TECHNIQUE: Portable semi-erect frontal radiograph of the chest. FINDINGS: The tracheostomy tube is in standard position. An orogastric feeding tube is seen coursing below the diaphragm and out of view on this image. Small bilateral pleural effusions appear unchanged on the right and slightly decreased on the left compared to the prior study of ___. Bibasilar opacities appear stable and likely reflect a combination of atelectasis and pleural effusion, greater on the right than the left. In the appropriate clinical context, superimposed infection cannot be excluded. Pulmonary vascular congestion and asymmetric interstitial pulmonary edema greater on the right than the left is similar to the prior study. The cardiac silhouette is incompletely evaluated due to obscuration by pleural parenchymal abnormalities. The prominent mediastinum is unchanged in contour from ___. Inferior subluxation of the right humeral head is incidentally noted. IMPRESSION: Improved aeration of left lung base. Otherwise, similar appearance of chest ___ ___. " 2804f4c0-c2aa515b-d1086b79-43b1aa34-891d94d9.jpg,test/p19/p19628950/s57822134/2804f4c0-c2aa515b-d1086b79-43b1aa34-891d94d9.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient status post left hepatic lobe resection, now with temperature 101.9, assess for infection. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of ___. The previously described right-sided PICC line remains in unchanged position, seen to terminate overlying the lower third of the SVC. A previously existing internal jugular approach right-sided sheath has been removed. No pneumothorax has developed. No new pulmonary abnormalities are seen. Drainage in right upper abdomen pointing towards left-sided liver lobe remains in unchanged position. No new pulmonary parenchymal infiltrates and no evidence of pleural effusion as can be seen on this portable chest examination. " 240dbaac-d7c06a7a-cc585507-096338dd-d1f6db21.jpg,test/p17/p17470135/s51018139/240dbaac-d7c06a7a-cc585507-096338dd-d1f6db21.jpg,test," FINAL REPORT INDICATION: ___-year-old female patient status post CABG. Study requested for evaluation of pneumothorax status post chest tube removal. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: Portable AP chest radiograph. FINDINGS: As compared to prior chest radiograph from ___, there has been interval removal of a Swan-Ganz catheter. The right internal jugular venous catheter sheath remains in place. Left chest tube, mediastinal drain and ET tube have been removed. Cardiomediastinal silhouette is stable. There are bilateral pleural effusions and bibasilar atelectasis. There is no pneumothorax. IMPRESSION: No evidence of pneumothorax. " f89cb043-a49073e2-6430fd03-eef0a66f-d612004f.jpg,test/p17/p17774821/s58334838/f89cb043-a49073e2-6430fd03-eef0a66f-d612004f.jpg,test," FINAL REPORT INDICATION: ___M with s/p fall, multiple small scalp lacerations most notably over occipital prominence, L sided anterior CW tenderness concerning for ___ rib fractures // fracture or bleed? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___ chest x-ray. Chest CT from ___. FINDINGS: The lungs are clear. Calcific densities projecting over the lung apices are compatible with vascular calcifications. Subclavian artery stent is also noted. . Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " c53ff728-15ee5f37-ebff71f5-1ac24a74-3cce3a91.jpg,test/p19/p19619647/s50924374/c53ff728-15ee5f37-ebff71f5-1ac24a74-3cce3a91.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bolus sensation s/p EGD c/b small esophageal tear // r/o esophageal perforation r/o esophageal perforation IMPRESSION: Heart size and mediastinum are stable. Lungs are clear. There is no pleural effusion or pneumothorax Slight indistinct appearance of the distal esophagus might be present but no evidence of pneumo mediastinum is currently seen. " a38d3e3d-ed165aac-7e3e345c-30111e9d-78c35de0.jpg,test/p11/p11990968/s56519955/a38d3e3d-ed165aac-7e3e345c-30111e9d-78c35de0.jpg,test," FINAL REPORT HISTORY: Chest pain shortness of breath. Evaluate for pneumonia. On further review of the medical record, the patient is known to have rheumatoid arthritis. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There is moderate enlargement of the cardiac silhouette. Prominence of the interstitium with fluid seen in the major fissures is consistent with chronic mild fluid overload. There is no pneumothorax or focal airspace consolidation. The hilar and mediastinal contours are unremarkable. IMPRESSION: Moderate enlargement of the cardiac silhouette which may reflect a pericardial effusion. These findings were discussed with Dr. ___ by Dr. ___ at 5:00 on ___ by telephone at time of discovery. " 9aba25d7-a883d97d-b84ae92e-ee5435ba-1684b052.jpg,test/p11/p11304959/s55522696/9aba25d7-a883d97d-b84ae92e-ee5435ba-1684b052.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with increasing shortness of breath and leg swelling, question congestive failure. COMPARISON: None. FINDINGS: AP and lateral views of the chest. Indistinct pulmonary vascular markings are seen bilaterally. There are moderate bilateral pleural effusions. The cardiomediastinal silhouette is not well assessed due to the bibasilar opacities but is at least slightly enlarged. Surgical clips project over the mid upper abdomen. IMPRESSION: Moderate bilateral effusions and moderate pulmonary edema. Please note that superimposed infection at the bases would be difficult to exclude. " 6ba6bf22-2e6da66c-6b5e0a42-bacdd946-582ce789.jpg,test/p10/p10019385/s51044398/6ba6bf22-2e6da66c-6b5e0a42-bacdd946-582ce789.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p CABG // predischarge eval TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Post CABG changes. The cardiomediastinal shadow is unchanged. Bilateral pleural effusions which show slight interval progression. No pulmonary edema. No airspace consolidation. No pneumothorax. IMPRESSION: Mild interval increase in the size of the bilateral pleural effusions. Post pericardiotomy syndrome should be excluded. " f2c1454e-c76ccfcf-1286707f-5bd19241-d03ad1da.jpg,test/p17/p17821267/s57657250/f2c1454e-c76ccfcf-1286707f-5bd19241-d03ad1da.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough for 1 month. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: Frontal PA and lateral chest radiograph demonstrates well expanded and clear lungs with no focal consolidation. There is no pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No pneumonia. " 1fda197e-8dcc406a-93f9a181-dafe2a66-45825852.jpg,test/p16/p16019229/s54994013/1fda197e-8dcc406a-93f9a181-dafe2a66-45825852.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with right lower lobe collapse, status post bronchoscopy and right lower lobe collapse. FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding portable study obtained 12 hours earlier during the same day. The patient remains intubated. The ET tube in unchanged position terminating the trachea. The same holds for the left-sided internal jugular approach central venous line seen to terminate overlying the mid SVC at a right-sided PICC line terminating in similar location. No pneumothorax has developed in the apical area. Previously described and observed bilateral small caliber pigtail ending chest tubes remain in place. Pleural densities partially obscuring the diaphragmatic contours as before. No new pulmonary abnormalities can be seen. " 74fb5a52-004f33cf-ede298b7-16f6bba2-82a42acd.jpg,test/p18/p18232511/s56270894/74fb5a52-004f33cf-ede298b7-16f6bba2-82a42acd.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Intubated patient. Comparison is made with prior study performed a day earlier. Cardiomegaly, enlarged pulmonary arteries and tortuous aorta are unchanged. Right lower lobe aeration is improved. There has been bibasilar opacities consistent with a combination of pleural effusions and atelectasis. Vascular congestion has improved. There is no pneumothorax. There are no new lung abnormalities. Lines and tubes are in unchanged positions. Spinal hardware is again noted. " ce019c61-d5a7bbdf-ad1a70e6-45af9c26-ed714fcc.jpg,test/p17/p17557505/s52627203/ce019c61-d5a7bbdf-ad1a70e6-45af9c26-ed714fcc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with tahcycardia // eval for acute process COMPARISON: None FINDINGS: AP portable upright view of the chest. Overlying EKG leads are present. There is no focal consolidation, effusion, or pneumothorax. Heart appears top-normal in size. Mediastinal contour is normal. . Imaged osseous structures are intact. IMPRESSION: Top normal heart size, otherwise unremarkable. " 9c0c1e34-9b8bb177-1383aeb4-b2752d58-18867a2e.jpg,test/p16/p16849946/s58954180/9c0c1e34-9b8bb177-1383aeb4-b2752d58-18867a2e.jpg,test," FINAL REPORT INDICATION: ___F with fevers, fatigue // ? pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is stable. There is tortuosity of the thoracic aorta with atherosclerotic calcifications seen at the aortic arch. Surgical clips in the anterior mediastinum and median sternotomy wires are again noted. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 36098188-785f8370-7999136f-7c193d79-3655ca06.jpg,test/p14/p14887088/s53015932/36098188-785f8370-7999136f-7c193d79-3655ca06.jpg,test," WET READ: ___ ___ ___ 11:20 PM Clear bilateral moderate pleural effusions with adjacent atelectasis better assessed on concurrent CT. Cardiomediastinal contours are unremarkable. No pneumothorax. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Increasing oxygen requirement, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Minimal bilateral pleural effusions. No pneumothorax. No acute lung changes. Known atelectasis at the left lung bases. No pneumothorax. " b75a8b5a-96e4e68a-8e5df8a1-0bd33433-ce0d5690.jpg,test/p15/p15905180/s50352450/b75a8b5a-96e4e68a-8e5df8a1-0bd33433-ce0d5690.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ M s/p evacuation of intraabdominal hematoma and resuscitation; increasing O2 requirement, decreasing sat and tachycardia // Rule out acute cardiopulmonary process Rule out acute cardiopulmonary process IMPRESSION: There are no prior chest radiographs available for review. Lung volumes are low. Opacification at both lung bases could be atelectasis alone or recent aspiration or early pneumonia. An oblong well circumscribed lucency at the base of the left lung projected over the left heart border could be a bulla or a herniated loop of bowel. There is no CT scan of the abdomen chest to clarify this. Close followup advised. Left pleural effusion is small. Similar right pleural effusion is likely. No pneumothorax. Heart size normal. " c51aebf4-8f6f863f-6f8a28f1-9ee7452b-9f410260.jpg,test/p17/p17702558/s57886569/c51aebf4-8f6f863f-6f8a28f1-9ee7452b-9f410260.jpg,test," FINAL REPORT INDICATION: ___ year old woman with NSCLC s/p left chest tube placement. // Eval pleural effusion. Please perform exam at ___. COMPARISON: Compared to prior radiographs from ___ at 12:21 IMPRESSION: There remains a left basilar pigtail catheter. Left-sided pleural effusion is unchanged and moderate in size. The right lung appears grossly clear. There are no pneumothoraces. " b92fa3b3-018a897a-1fb9b815-2e9734bc-e88ccbc4.jpg,test/p19/p19599769/s50430800/b92fa3b3-018a897a-1fb9b815-2e9734bc-e88ccbc4.jpg,test," FINAL REPORT INDICATION: ___-year-old male with substernal chest pain. Question pneumonia or pneumothorax. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate stable mildly prominent cardiac silhouette, accentuated by low lung volumes. The mediastinal and hilar contours are otherwise unremarkable. The lungs are clear with the exception of trace if any bibasilar atelectasis. Mild blunting of the left costophrenic angle may be related to presence of a pericardial fat pad. There is no pneumothorax or vascular congestion. Minimal multilevel lower thoracic spondylosis is present. IMPRESSION: No definite evidence of acute cardiopulmonary process such as pneumonia. Mild left costophrenic blunting likely due to pericardial fat pad. No pneumothorax. " 336da0a8-cfdf95ff-1c68959c-90730c77-7ede43e1.jpg,test/p16/p16783070/s54000055/336da0a8-cfdf95ff-1c68959c-90730c77-7ede43e1.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Status post small cell lung cancer. Now with pneumonia and possible pleural effusion. IMPRESSION: PA and lateral chest compared to ___: Previous left upper lobe collapse has resolved revealing a 22 mm left hilar mass. Small bilateral pleural effusions are still present. Heart is normal size. Vascular deficiency of the right upper lobe suggests severe emphysema. " 4893a80c-cae07066-13a4d4ad-ca8b919c-7f50449a.jpg,test/p16/p16553329/s53060980/4893a80c-cae07066-13a4d4ad-ca8b919c-7f50449a.jpg,test," FINAL REPORT HISTORY: Slurred speech and altered mental status. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is within normal limits. Scattered calcifications within the upper lung fields bilaterally likely reflect the sequela of prior granulomatous disease. No focal consolidation, pleural effusion or pneumothorax is seen. There is likely minimal retrocardiac atelectasis. No acute osseous abnormalities are demonstrated. There are mild degenerative changes of the thoracic spine as well as within the imaged left AC joint. IMPRESSION: No acute cardiopulmonary abnormality. " fc70e097-ea7913b6-820e3327-bd6470e0-01a29aa8.jpg,test/p13/p13325402/s56696064/fc70e097-ea7913b6-820e3327-bd6470e0-01a29aa8.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fever // please evaluate for focal consolidation or e/o infectious etiology TECHNIQUE: Single upright AP radiograph of the chest COMPARISON: Chest CT dated ___ FINDINGS: The lung volumes are low. There is persistent left lower lobe consolidation with improved aeration compared to the prior chest CT. The right lung is clear. No pleural effusions. Mild cardiomegaly and volume loss with shift of mediastinum to the left. Diffuse mild demineralization with severe right glenohumeral arthropathy. Right sided central venous catheter tip terminates in the distal SVC. IMPRESSION: 1. Improving left lower lobe consolidation with no new areas of consolidation or atelectasis. 2. Unchanged mild volume loss which shift of the mediastinum to the left. " 514afc51-0279265b-fc9ee7b1-8501bf78-f5af425c.jpg,test/p19/p19291771/s59698098/514afc51-0279265b-fc9ee7b1-8501bf78-f5af425c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p extubation and NGT placement // please assess for proper NGT placement please assess for proper NGT placement IMPRESSION: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends to at least the mid body of the stomach where it the comes hidden by the soft tissue opacification of the abdomen. The endotracheal tube is not definitely seen on the current study. The areas of increased opacification at the bases have improved. " 044785ef-0949cf58-5bea06b8-26894448-64c4c84d.jpg,test/p19/p19398915/s59290122/044785ef-0949cf58-5bea06b8-26894448-64c4c84d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with cirrhosis, s/p ___ 1.7L off right side yesterday // eval status of right hepatic hydrothorax and interstitial edema COMPARISON: Chest radiographs ___. IMPRESSION: Although interstitial edema has cleared from the small right lung, moderate to large right pleural effusion has recurred, producing more leftward mediastinal shift. Severe peripheral consolidation in the left lung has been present without appreciable change in the nondependent portion, although some edema has cleared from the base. Differential diagnosis of persistent left lung consolidation is pulmonary hemorrhage or if the ring shadows projecting over the left heart border and left hilus are genuine cavities, multifocal infection. Heart is mildly enlarged. Left pleural effusion minimal if any. No pneumothorax. NOTIFICATION: Dr. ___ reported the findings to Dr. ___ by telephone and page on ___ at 2:15 PM, 5 minutes after discovery of the findings. " 373a9d84-8525d1b0-1128a453-68bf0889-447f3d9f.jpg,test/p15/p15695407/s58634401/373a9d84-8525d1b0-1128a453-68bf0889-447f3d9f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough rib pain. left sided pain // r/o acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " a351ef3e-62d73b8f-2fdeae57-4291ec0e-5bc6804f.jpg,test/p10/p10788917/s51088566/a351ef3e-62d73b8f-2fdeae57-4291ec0e-5bc6804f.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of chest pain, question cardiomegaly. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. The cardiac silhouette is not enlarged. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. Cardiac silhouette is not enlarged. " 5017cdc9-6c18868c-79b5aca6-e58d326d-e4e151cf.jpg,test/p11/p11887414/s54493225/5017cdc9-6c18868c-79b5aca6-e58d326d-e4e151cf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with Hct ___.___ s/p port placement COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Port-A-Cath positioned over the right axilla with catheter tip in the region of the mid SVC. The heart is mildly enlarged. The hila appear engorged. There is a tiny right pleural effusion. Retrocardiac linear density is likely indicative of subsegmental atelectasis. There is no convincing evidence for pneumonia or edema. No pneumothorax. Mediastinal contour is unchanged. Bony structures are intact. IMPRESSION: Cardiomegaly with hilar congestion and tiny right pleural effusion. " f4222572-8e92079c-fe146bd6-14aeaf96-573958c7.jpg,test/p15/p15357165/s55165070/f4222572-8e92079c-fe146bd6-14aeaf96-573958c7.jpg,test," WET READ: ___ ___ ___ 2:33 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever, tachycardic, elevated lactate. ?infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, and ___ FINDINGS: The heart size, mediastinal, and hilar contours are normal. The lung volumes are slightly lower, but the lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 152e12cc-c133da81-480f8170-7de3ac52-6ba00247.jpg,test/p12/p12484082/s54275802/152e12cc-c133da81-480f8170-7de3ac52-6ba00247.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and wheezing // check for infiltrate TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None provided. FINDINGS: There is no focal consolidation, effusion, or pneumothorax. Heart size is normal. Mediastinal and hilar contours are normal. IMPRESSION: No evidence of pneumonia. " c8aab6b7-7c3b6bd0-0a157dc1-7ae054d8-43586995.jpg,test/p17/p17860352/s51490321/c8aab6b7-7c3b6bd0-0a157dc1-7ae054d8-43586995.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with aspiration PNA // eval for interval change COMPARISON: Chest x-ray from ___ at 16 53 FINDINGS: Slightly rotated positioning. Allowing for this, there has been some interval clearing of the retrocardiac opacity and of the right base opacity. As result, the left hemidiaphragm is now visible. Vascular crowding in the right cardiophrenic region is improved. Otherwise, I doubt significant interval change. " 85678c02-e40da457-eed6ac32-5a56d849-1f623e7a.jpg,test/p13/p13779389/s59516004/85678c02-e40da457-eed6ac32-5a56d849-1f623e7a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with fall and head strike TECHNIQUE: Supine AP view of the chest COMPARISON: ___ FINDINGS: Lung volumes are low. Heart size is top normal and unchanged. Mediastinal and hilar contours are within normal limits. Eventration of the right hemidiaphragm appears similar compared to the prior study with minimal atelectasis demonstrated in the right lung base. Remainder of the lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. No acutely displaced fractures are visualized. IMPRESSION: No acute cardiopulmonary abnormality. " fcc12a8d-fe275170-4801a053-86b3fa6b-43740b17.jpg,test/p17/p17613076/s55084944/fcc12a8d-fe275170-4801a053-86b3fa6b-43740b17.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: Chest radiographs from ___ as well as earlier CT and MR studies dated ___, and ___, respectively. FINDINGS: The heart is again at the upper limits of normal size. The aorta shows mild unfolding. A right upper mediastinal density produces an oval shadow measuring up to ___ x 40 mm which can be compared to the prior radiographic appearance from ___ when the same measurement within ___ x 25 mm so there has been an increase. However, previous studies showed that there was a benign cyst at the site so the appearance is consistent with some long-term increase in the size of a benign cyst. The airway is again splayed minimally to the left but does not appear narrowed or under substantial mass effect. The lungs appear clear. There no pleural effusions or pneumothorax. IMPRESSION: Increased size of mediastinal cyst. No evidence of acute cardiopulmonary disease. " 5fb2839e-e2b53159-2175dc90-ada592ac-ebb1cc85.jpg,test/p15/p15886512/s56389403/5fb2839e-e2b53159-2175dc90-ada592ac-ebb1cc85.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. Evaluate for acute cardiopulmonary process. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: CT from ___ and chest radiograph from ___, ___ and ___. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. Linear atelectasis is noted at the left lung base and right midlung. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " bfac2d34-df1cac08-1a4466cf-6dc9410a-05a1b100.jpg,test/p18/p18160767/s57143431/bfac2d34-df1cac08-1a4466cf-6dc9410a-05a1b100.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Multiple sclerosis, presenting with cough. Question infiltrate. COMPARISONS: Radiographs from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 69c7f62e-6ebae07b-087122d7-c6e97959-c27d6416.jpg,test/p18/p18574619/s58259873/69c7f62e-6ebae07b-087122d7-c6e97959-c27d6416.jpg,test," WET READ: ___ ___ ___ 7:29 PM Right upper lobe and suspected lingular regions of consolidation worrisome for pneumonia given history. Recommend repeat after treatment to document resolution. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with fever and SOB // PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: Focal area of consolidation is noted in the right upper lobe. Subtle opacity is also seen in the left midlung laterally suspicious for additional region of consolidation. Elsewhere the lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Degenerative changes are noted the left shoulder as well as widening of the left acromioclavicular joint. IMPRESSION: Right upper lobe and suspected lingular regions of consolidation worrisome for pneumonia given history. RECOMMENDATIONS: Recommend repeat after treatment to document resolution. " 7695e321-90966401-3333ea3e-5ba9db3d-6c042d64.jpg,test/p16/p16056611/s59316339/7695e321-90966401-3333ea3e-5ba9db3d-6c042d64.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: VATS right lower lobe wedge resection, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have substantially increased, potentially reflecting improved ventilation. As a consequence, areas of atelectasis that pre-existed at the right and left lung bases have partially or completely resolved. Soft tissue defect in the left chest wall. Borderline size of the cardiac silhouette with tortuosity of the thoracic aorta. The hilar and mediastinal structures are normal. No evidence of acute lung disease such as pneumonia or pulmonary edema. The lateral radiograph shows extensive degenerative vertebral disease. " d6286f38-6e6d527b-3322b4a7-e5912055-d798603e.jpg,test/p14/p14061397/s57417209/d6286f38-6e6d527b-3322b4a7-e5912055-d798603e.jpg,test," FINAL REPORT PORTABLE CHEST X-___ ___ ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are within normal limits for technique. Improving patchy and linear opacities at both lung bases favor atelectasis. No new areas of consolidation to suggest the presence of a pneumonia. " 118742b5-06282a16-2be815e5-18304ee3-83d23553.jpg,test/p16/p16056611/s53259918/118742b5-06282a16-2be815e5-18304ee3-83d23553.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: Hypertension and hyperlipidemia. Breast carcinoma. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. Sclerosis of the right first costosternal junction should not be mistaken for a lung nodule. The appearance is chronic. " 0dbe2100-00057c9d-b2d06fe1-e0d323d0-06100523.jpg,test/p17/p17767787/s55506504/0dbe2100-00057c9d-b2d06fe1-e0d323d0-06100523.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with diarrhea, loose stools, history of congestive heart failure TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___ and chest radiograph ___ FINDINGS: Left-sided central venous catheter has been removed. Moderate cardiomegaly is similar to the previous study. Mediastinal and hilar contours are unchanged. Mild pulmonary vascular congestion is improved compared to the previous examination. No focal consolidation, pleural effusion or pneumothorax is identified. IMPRESSION: Mild pulmonary vascular congestion, improved from the previous study. No focal consolidation. " 57934d7d-7fe098dd-8dce4060-8dc3e745-0b61e09e.jpg,test/p14/p14426231/s52061212/57934d7d-7fe098dd-8dce4060-8dc3e745-0b61e09e.jpg,test," WET READ: ___ ___ ___ 11:24 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with SOB // pls eval for pulm edema COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Streaky right basilar opacity is likely due to atelectasis given adjacent fat containing Bochdalek hernia. The lungs are otherwise clear. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute intrathoracic process. " 2eb504a9-27bf00fc-3825167b-ef4bdf53-75077f52.jpg,test/p16/p16839550/s58970395/2eb504a9-27bf00fc-3825167b-ef4bdf53-75077f52.jpg,test," FINAL REPORT HISTORY: Altered mental status and left lower extremity weakness after a fall. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The patient is status post median sternotomy and CABG. Left-sided dual-chamber pacemaker device is re- demonstrated with leads terminating in the right atrium and right ventricle. Moderate cardiomegaly is similar when compared to the prior study. There is mild pulmonary vascular congestion, not substantially changed from prior. Small bilateral pleural effusions are re- demonstrated, though the previously seen fluid tracking in the right minor fissure is less evident on the current exam. Bibasilar airspace opacities are present, and may reflect atelectasis but infection cannot be excluded. There is no pneumothorax. No acute osseous abnormality is visualized. IMPRESSION: Mild congestive heart failure, not significantly changed in the interval with small bilateral pleural effusions. Bibasilar patchy airspace opacities likely reflect atelectasis though infection cannot be completely excluded. " 45d2e7fc-96fb9d16-82961f4a-577cc527-fa42f343.jpg,test/p19/p19650702/s58541805/45d2e7fc-96fb9d16-82961f4a-577cc527-fa42f343.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p tracheobronchioplasty, new with c/f PNA, s/p bronchoscopy // Evaluate for interval change in opacities Evaluate for interval change in opacities IMPRESSION: Compared to chest radiographs, ___ through ___. Mild pulmonary edema, moderate cardiomegaly, mediastinal venous and bilateral hilar engorgement are unchanged. Hematoma related to right upper chest wall surgery unchanged. No pneumothorax. Unremarkable postoperative mediastinal silhouette, also on change. " ef90053d-1febf2a9-bafaa34d-394b2a79-4ad58a04.jpg,test/p17/p17866604/s51956171/ef90053d-1febf2a9-bafaa34d-394b2a79-4ad58a04.jpg,test," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Minimal mid lung atelectasis/scarring seen, best on the lateral view. No displaced rib fracture is seen. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture seen. However, if clinical concern for rib fracture is high, suggest dedicated rib series, which is more sensitive. " a76bd209-6c0d92bc-dc61b942-22f423c4-dc5cdc56.jpg,test/p17/p17375650/s51474910/a76bd209-6c0d92bc-dc61b942-22f423c4-dc5cdc56.jpg,test," FINAL REPORT INDICATION: ___F with chest pain // eval cardiomegaly TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 334f2538-ad266d91-1d42743b-68b65c7e-3188b635.jpg,test/p12/p12303894/s51706745/334f2538-ad266d91-1d42743b-68b65c7e-3188b635.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There are slightly low lung volumes. Right medial basilar opacity seen on the frontal view, not substantiated on the lateral view, may relate to atelectasis or overlap of vascular structures. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. Right mid-to-lower lung calcified subcentimeter nodule is seen in both the frontal and lateral views likely represents a calcified granuloma. IMPRESSION: No acute cardiopulmonary process. " aebb3d99-be68561a-c3aff08d-650de309-71bbfe90.jpg,test/p15/p15019924/s52767804/aebb3d99-be68561a-c3aff08d-650de309-71bbfe90.jpg,test," FINAL REPORT EXAMINATION: PORTABLE CHEST RADIOGRAPH INDICATION: ___M with recent placemt of a venous line and intubated. Assess for position. TECHNIQUE: Frontal supine chest radiograph COMPARISON: None available FINDINGS: Assessment is limited due to positioning. Allowing for this limitation, there is no pulmonary opacity or consolidation. No pleural effusion is identified. The heart is not enlarged. Apparent widening of the superior mediastinum is noted. An endotracheal tube ends 6.7 cm above the carina. An esophageal tube ends below the gastroesophageal junction, with the side port within the stomach. A left-sided venous line ends at the level of the left sternoclavicular joint. IMPRESSION: 1. No pulmonary parenchymal opacity or pulmonary edema. 2. Widening of the upper mediastinum. Attention on follow up is recommended. Chest CT could also be performed for further assessment if clinically indicated. 3. Monitoring and supporting devices as described above. " 22a2b6db-25800863-dafa1986-cb326c63-3d0af0e3.jpg,test/p15/p15868868/s58212673/22a2b6db-25800863-dafa1986-cb326c63-3d0af0e3.jpg,test," FINAL REPORT INDICATION: ___-year-old male with fever. Evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: There is a new right upper lobe opacity concerning for pneumonia. The heart continues to be enlarged. There is no overt pulmonary edema, pneumothorax or pleural effusion. IMPRESSION: Right upper lobe opacity concerning for pneumonia. " 34cb775c-1cf44ee8-82a98580-6aff45d4-4892e704.jpg,test/p19/p19994379/s54783503/34cb775c-1cf44ee8-82a98580-6aff45d4-4892e704.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC placement at OSH. PICC placement. TECHNIQUE: Portable AP radiograph of the chest from ___. COMPARISON: None available P. FINDINGS: A right-sided PICC line ends in the mid SVC. Hazy bilateral airspace opacities are likely due to pulmonary edema. Retrocardiac airspace opacities are likely due to atelectasis. There is a moderate layering right pleural effusion. Moderate cardiomegaly is present. There is no pneumothorax. IMPRESSION: Newly placed right PICC line ends in the mid SVC. Moderate pulmonary edema. Retrocardiac atelectasis. Moderate layering right pleural effusion. " 56f33dd3-e7f78d2d-fc16f6e6-7c44d4d9-753430ac.jpg,test/p13/p13031024/s51922170/56f33dd3-e7f78d2d-fc16f6e6-7c44d4d9-753430ac.jpg,test," FINAL REPORT INDICATION: History of chest pain. Please evaluate for acute process. COMPARISONS: Chest radiograph from ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: The heart size is top normal. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No acute intrathoracic process. " d905301b-a7663354-2408015a-2c61c40a-b2967b02.jpg,test/p18/p18651563/s53262954/d905301b-a7663354-2408015a-2c61c40a-b2967b02.jpg,test," FINAL REPORT INDICATION: Worsening productive cough and fevers. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: There are low lung volumes. The cardiac, mediastinal and hilar contours are unchanged, with tortuosity of the thoracic aorta redemonstrated. Pulmonary vascularity is normal. Streaky opacities in the lung bases are similar when compared to the prior exam and likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are multilevel degenerative changes in the thoracic spine. IMPRESSION: Streaky opacities in the lung bases most likely reflective of atelectasis, and similar when compared to the prior study. Infection or aspiration at the lung bases, however, cannot be completely excluded. " dd137d55-6d6737fe-01cb2264-04ab9ee6-b74a977c.jpg,test/p15/p15957987/s50696816/dd137d55-6d6737fe-01cb2264-04ab9ee6-b74a977c.jpg,test," FINAL REPORT INDICATION: ___-year-old male with neutropenic fever. Question infiltrate. COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral views of the chest demonstrate stable position of a left pectoral Port-A-Cath with tip in the lower SVC. A fusiform area of lucency projecting over the right heart border is consistent with a pull-through neoesophagus in this patient status post esophagectomy. The heart is normal in size. The mediastinal and hilar contours are otherwise within normal limits. There is no pneumothorax, vascular congestion, or pleural effusion. Small region of consolidation overlying the heart on the lateral view is new and could be early pneumonia. Cholecystectomy clips are noted. IMPRESSION: Possible small pneumonia. Findings reported to Dr. ___ ___ phone at 9am on ___. " a42da831-92b0fc22-3d4f097a-0b88f936-a3c751f9.jpg,test/p11/p11306899/s58593518/a42da831-92b0fc22-3d4f097a-0b88f936-a3c751f9.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Evaluate pleural effusion. Comparison is made with prior study, ___. Small bilateral pleural effusions with adjacent atelectasis have improved. Vascular congestion has almost resolved. Cardiomediastinal contours are unchanged. Right PICC tip is in the lower SVC. Right basal chest tube remains in place. There is no pneumothorax. There is a mitral annulus. Sternal wires are aligned. " 0f072754-e4646ee4-bae577d8-be70372f-fd81abb7.jpg,test/p11/p11826927/s55084530/0f072754-e4646ee4-bae577d8-be70372f-fd81abb7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison to chest radiograph from ___ and CTA chest also from that same day. CLINICAL HISTORY: Hypotension and sepsis, assess for pneumonia. FINDINGS: Portable AP upright chest radiograph is obtained. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. Clips are noted in the right axilla. The heart size is normal. There is an unusual configuration of the mediastinum which is stable from prior exams and likely reflects the extensive collateral vessels due to known left subclavian and brachiocephalic venous stenosis. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 443fae8c-15e7510c-5410427e-1a08577a-6a81b017.jpg,test/p16/p16223018/s56513502/443fae8c-15e7510c-5410427e-1a08577a-6a81b017.jpg,test," FINAL REPORT INDICATION: ___F with fever // evaluate for pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Patient is rotated to the right somewhat limiting exam. The lungs are grossly clear. Cardiomediastinal silhouette is within normal limits given rotation. There is relative elevation of left hemidiaphragm with a prominent gastric bubble. Air-filled loops of nondilated bowel are also seen in the abdomen. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process, no focal consolidation. " ca63733c-9d288aa5-824409c2-3c440d8f-7f4c1bd5.jpg,test/p12/p12431768/s59350451/ca63733c-9d288aa5-824409c2-3c440d8f-7f4c1bd5.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old female with history of COPD, presenting with abdominal pain and fever, assess pneumonia. FINDINGS: PA and lateral views of the chest are provided. Lung volumes are low. Bronchovascular crowding likely accounts for the lower lung opacity. No definite sign of pneumonia or overt CHF. Heart and mediastinal contours are stable. No pneumothorax. Bony structures are intact. IMPRESSION: Limited, negative. " 4fd8c4d5-348a60ea-f5cd95a6-8682db17-759611a8.jpg,test/p16/p16033554/s57305602/4fd8c4d5-348a60ea-f5cd95a6-8682db17-759611a8.jpg,test," FINAL REPORT HISTORY: Increasing white blood count, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there are slightly better lung volumes. Mild streak of atelectasis at the left base, but no evidence of acute pneumonia or vascular congestion. " e38c5cf6-fe95b63b-1f72d4df-80287c02-dd6a9d10.jpg,test/p10/p10410774/s52988485/e38c5cf6-fe95b63b-1f72d4df-80287c02-dd6a9d10.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with bilateral pulmonary nodules status post left upper lobe wedge resection, evaluate for interval change. COMPARISON: PA and lateral chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are normal. The previous right basal atelectasis is improved since the most recent prior examination. No new focal consolidation or pleural effusion is identified. Previously noted pneumothorax is largely resolved. " a3099dac-83ebdd54-76edd085-8cd89bb9-0ce4cd21.jpg,test/p14/p14634884/s59002306/a3099dac-83ebdd54-76edd085-8cd89bb9-0ce4cd21.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with sepsis // ?pulm edema COMPARISON: Prior exam from earlier today. FINDINGS: AP portable upright view of the chest. Dual lead pacemaker is unchanged. The heart remains moderately enlarged. Mitral annular calcifications are again suggested. There is aortic atherosclerosis is again noted. The lungs appear grossly clear without supine evidence for effusion or pneumothorax. Chronic left ribcage deformities are again noted. No acute osseous abnormality. Vertebroplasty changes in the thoracolumbar junction again noted. IMPRESSION: Cardiomegaly without acute intrathoracic process. " 49736b0c-209b38b3-168c9ce2-e7058b08-2a89b5f9.jpg,test/p14/p14068639/s57050003/49736b0c-209b38b3-168c9ce2-e7058b08-2a89b5f9.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with shortness of breath. COMPARISON: ___. FINDINGS: AP semi-upright and lateral views of the chest were obtained. Redemonstrated is mild-to-moderate cardiomegaly with stable appearance of the cardiomediastinal silhouette. A single lead pacemaker is unchanged in position. Lung volumes are low. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Stable cardiomegaly and persistently low lung volumes. " 4ca2f31a-18845df9-705c67ac-b0018bf7-69285bef.jpg,test/p17/p17244595/s56987791/4ca2f31a-18845df9-705c67ac-b0018bf7-69285bef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lung cancer s/p L pneumonectomy and R pneumothorax. // ET tube placement ET tube placement IMPRESSION: Compared to chest radiographs ___ through ___. Previous right lower lobe pneumonia has largely cleared. Severe emphysema is chronic in this patient with remote left pneumonectomy, responsible for severe leftward mediastinal shift. ET tube, esophageal drainage tube common left PIC line are in standard placements respectively. No pneumothorax. Right pleural effusion minimal if any. " ad422634-abb4c997-aff7feb6-0f7ddfd3-dda45aef.jpg,test/p14/p14875942/s53818322/ad422634-abb4c997-aff7feb6-0f7ddfd3-dda45aef.jpg,test," FINAL REPORT HISTORY: Worsening dyspnea x2 days. CHEST, TWO VIEWS. COMPARISON: Chest x-rays from ___. Targeted review of a chest CT from ___. Again seen is a single-lead left-sided pacemaker with lead tip over the right ventricle. Coiled density at the left lung base laterally could represent abandoned leads or a epicardial pacing devices. There is moderate cardiomegaly, unchanged. On the current study, there is vascular plethora and bronchiolar wall thickening, with increased interstitial markings, consistent with CHF. There are small bilateral effusions with underlying collapse and/or consolidation. IMPRESSION: CHF with interstitial edema, new compared with ___. Small bilateral effusions and underlying collapse and/or consolidation at both bases. Suspect background hyperinflation consistent with COPD. " 56722b82-a0280532-54b5ea2b-e3cd8d00-4b62a29f.jpg,test/p16/p16458160/s56882269/56722b82-a0280532-54b5ea2b-e3cd8d00-4b62a29f.jpg,test," WET READ: ___ ___ ___ 9:56 PM S/p right pleural decortication. Two right-sided chest tubes in place - though moderate pneumothorax. Recommend close interval follow-up. Persistent consolidation of right lung base. New atelectasis in left lung. D/w Dr. ___ at 9:56 pm on ___ by telephone. ___ p___WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p Right Decortication // R/A in PACU COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has undergone decortication. 2 right-sided chest tubes are in expected position. Clips are seen over the right chest wall and air inclusions are visualized in the soft tissues. The right lung apex is relatively well inflated. At the right lower lobe level, collapsed lung parenchyma is seen. There is a mild to moderate postprocedural pneumothorax. Moderate cardiomegaly persists. Minimal platelike atelectasis at the left lung bases. " affc73a6-18298dbe-9b2da112-ac34c168-e7e6ea8a.jpg,test/p10/p10070592/s50488552/affc73a6-18298dbe-9b2da112-ac34c168-e7e6ea8a.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 6d8cc914-c81ef46a-cdefcb14-cb158a59-4e14d299.jpg,test/p17/p17653729/s54206882/6d8cc914-c81ef46a-cdefcb14-cb158a59-4e14d299.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph from ___. CLINICAL HISTORY: ___-year-old female with wheezing, question consolidation or pulmonary edema. FINDINGS: AP upright and lateral views of the chest are provided. Subtle retrocardiac opacity is seen best on the lateral projection which could represent a lower lobe pneumonia, likely right-sided. Aside from this, the lungs appear clear. The cardiomediastinal silhouette is stable. Bony structures are intact. A calcified density is again seen projecting over the left shoulder in a somewhat different position, suggesting mobility. IMPRESSION: Findings concerning for pneumonia in the right lower lobe. " e14873bd-1b6af557-b415e187-4a188c1a-9bc72af6.jpg,test/p18/p18719447/s53731296/e14873bd-1b6af557-b415e187-4a188c1a-9bc72af6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with recent chemo and fever. // pneumonia? TECHNIQUE: AP AND LATERAL CHEST RADIOGRAPHS. COMPARISON: Chest radiographs ___ FINDINGS: A right-sided Port-A-Cath terminates in the mid to distal SVC. A right basal opacity likely reflects a combination of pleural fluid/thickening and atelectasis, this is unchanged compared to the prior study. Left lung appears grossly clear. The cardiomediastinal contour is unchanged in appearance. Multilevel degenerative changes noted in the thoracic spine. No pneumothorax seen. IMPRESSION: No significant interval change when compared to the prior study. Persistent right basal pleural effusion and atelectasis. " 8971e6be-dd08f0ec-ccfdb99c-6049dc41-80048e07.jpg,test/p15/p15901128/s53061232/8971e6be-dd08f0ec-ccfdb99c-6049dc41-80048e07.jpg,test," FINAL REPORT INDICATION: Fever and cough. Evaluate for pneumonia. COMPARISONS: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 8009ee28-ff0095ad-8f45462c-66be89fe-f81b5b52.jpg,test/p18/p18718681/s53859007/8009ee28-ff0095ad-8f45462c-66be89fe-f81b5b52.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are within normal limits. The aorta is mildly unfolded. The lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild degenerative changes are noted at the thoracolumbar junction. IMPRESSION: No acute cardiopulmonary abnormality. " 1bf6d572-d8fa4017-9e03f967-9df7337c-554701f9.jpg,test/p18/p18507152/s55838138/1bf6d572-d8fa4017-9e03f967-9df7337c-554701f9.jpg,test," FINAL REPORT INDICATION: New fever, here to evaluate for pneumonia. COMPARISON: Chest radiograph, last performed on ___. TECHNIQUE: Portable upright frontal radiograph of the chest. FINDINGS: Evaluation of the lung fields is limited due to poor patient positioning and low inspiratory lung volumes. Within these limitations, there is mild opacification at the bilateral bases which may represent atelectasis in the setting of such low lung volumes; however, superimposed infection cannot be excluded in the appropriate clinical context. No large pleural effusion or pneumothorax is detected. There is no pulmonary edema. A right PICC is in place with the tip terminating in the low SVC. A left pectoral pacemaker is unchanged in appearance with two leads terminating in the right atrium and right ventricle. The cardiac silhouette is mildly enlarged but stable. The mediastinal and hilar contours are within normal limits and unchanged from ___. IMPRESSION: Limited study due to technique and low lung volumes. Mild bibasilar opacification may represent atelectasis; however, superimposed infection cannot be excluded in the appropriate clinical context. " 287c5880-bdb674c7-f6fc2613-5cd744cb-e231cfc2.jpg,test/p17/p17215355/s57684639/287c5880-bdb674c7-f6fc2613-5cd744cb-e231cfc2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ct removal // eval for ptx COMPARISON: Postoperative chest radiographs since ___ most recently ___ at 07:28 IMPRESSION: There has been no accumulation of pleural fluid or development of pneumothorax since 7:00 following removal of the left pleural drainage catheter. Mild to moderate pulmonary edema has changed in distribution, but not appreciably in severity. Moderate to severe enlarged of the cardiac silhouette is comparable to the preoperative appearance. Small right pleural effusion is stable. Right jugular line ends in the mid to low SVC. " 0e44e612-dc278112-36de945c-ddc24b3d-392ee655.jpg,test/p14/p14177219/s55111273/0e44e612-dc278112-36de945c-ddc24b3d-392ee655.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Cough and fever. IMPRESSION: PA and lateral chest compared to ___: Moderate cardiomegaly and pulmonary vascular engorgement are chronic. There is no pulmonary edema, consolidation, or pleural effusion. " 73d59b9d-b2aa52bd-514f5ede-a1031a74-990566bf.jpg,test/p19/p19097933/s58569516/73d59b9d-b2aa52bd-514f5ede-a1031a74-990566bf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with CP // eval for pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. The bones are intact. IMPRESSION: No acute cardiopulmonary process. " dd442700-378c2bc0-51f5c77a-a8a31e61-b284e159.jpg,test/p13/p13031024/s59596599/dd442700-378c2bc0-51f5c77a-a8a31e61-b284e159.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with multiple comorbidities and chest pain for 1 day and cough for several weeks. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Multiple prior chest radiographs, most recent on ___. FINDINGS: The lungs are well expanded and clear. There has been significant improvement in vascular congestion and mild interstitial pulmonary edema compared with the previous exam. The heart is mildly enlarged, unchanged from prior. Cardiomediastinal and hilar contours are otherwise unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Mild cardiomegaly. No evidence of acute cardiopulmonary process. " 2add216b-110077a4-e4eb61f3-06aeb2f8-c45c23f9.jpg,test/p18/p18143542/s52850904/2add216b-110077a4-e4eb61f3-06aeb2f8-c45c23f9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p gastrectomy, pelvic collection s/p drainage, PE // ?fluid status ?fluid status IMPRESSION: Compared to chest radiographs ___ through ___, read in conjunction with chest CT on ___. Moderate left lower lobe atelectasis and moderate left pleural effusion persists. Heterogeneous opacification right lung base improving slightly consistent with treated pneumonia. Mild to moderate cardiomegaly stable. No pneumothorax. ET tube and left subclavian line are in standard placements. Nasogastric drainage tube ends in the upper stomach, but would need to be advanced at least 8 cm to move all the side ports into the stomach. " 5b51d7be-92e965bf-1a1ae1ce-c96ef875-4a58aab2.jpg,test/p17/p17445268/s54927063/5b51d7be-92e965bf-1a1ae1ce-c96ef875-4a58aab2.jpg,test," FINAL REPORT HISTORY: For ET tube placement. FINDINGS: In comparison with the study of ___, the tip of the endotracheal tube is at the lower clavicular level, approximately 7 cm above the carina. Nasogastric tube extends well into the stomach. Bibasilar opacification persists with blunting of the costophrenic angles and mild elevation of pulmonary venous pressure. " 210ea2b7-bd895771-4e15025e-41992e24-e55e3ee6.jpg,test/p19/p19211948/s58618875/210ea2b7-bd895771-4e15025e-41992e24-e55e3ee6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with acute cholecystitis. // pre-op TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The aorta is mildly tortuous. Mild atherosclerotic calcifications are noted at the aortic knob. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. Moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 0c15fad2-2c508181-e144a856-1a8c2902-fe67c73e.jpg,test/p11/p11341770/s57649129/0c15fad2-2c508181-e144a856-1a8c2902-fe67c73e.jpg,test," FINAL REPORT HISTORY: Cough, congestion, rhonchi. Evaluate for pneumonia. COMPARISON: Chest radiographs from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unchanged slight prominence of the upper right mediastinum and mild tortuosity of the descending aorta. The heart size is normal and the lungs are well-aerated and clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. A preliminary read was provided, upon request, via telephone by Dr. ___ ___ to Dr. ___ at ___ on ___. " 1b48782a-d4c3893e-244b9d74-b861d7bc-65c6461e.jpg,test/p10/p10250159/s55136740/1b48782a-d4c3893e-244b9d74-b861d7bc-65c6461e.jpg,test," FINAL REPORT INDICATION: HIV and glycemia, evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 5b735c9e-c581b7e9-7170796a-c3c1645e-9791695d.jpg,test/p19/p19020115/s52296203/5b735c9e-c581b7e9-7170796a-c3c1645e-9791695d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man here with hepatic encephalopathy and report of dry cough. // Pneumonia? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, a previously placed chest tube on the right. Was removed. Normal size of the cardiac silhouette. Mild right apical thickening. In the well ventilated areas of the lung parenchyma there is no evidence for the presence of pneumonia. No pleural effusions. No pulmonary edema. Normal appearance of the cardiac silhouette. " caafb571-a344ec0d-e8fa7493-6cb82036-df85275e.jpg,test/p14/p14310053/s57754666/caafb571-a344ec0d-e8fa7493-6cb82036-df85275e.jpg,test," FINAL REPORT INDICATION: Right upper quadrant pain. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are without focal consolidation, effusion, or pneumothorax. Bibasilar tubular opacities are again noted and appear similar dating back to ___. Cardiomediastinal and hilar contours are normal. No acute fractures are identified. IMPRESSION: Chronic bronchitis/bronchiectasis with no acute cardiopulmonary process. " 205b56cb-2f6e9c0b-1a727c79-f8c5b381-305dcd2b.jpg,test/p12/p12272471/s59427511/205b56cb-2f6e9c0b-1a727c79-f8c5b381-305dcd2b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Followup of the patient with right pneumothorax after thoracocentesis. Portable AP radiograph of the chest was reviewed in comparison to ___ obtained at 09:56 a.m. There is no appreciable change after the recent thoracocentesis in the small-to-moderate amount of most likely loculated right pleural effusion. There is no evidence of pneumothorax. No other changes have been demonstrated since the prior study. " 8f8c1f74-bbc9d4fb-7c87bb60-daab1b8d-8df05775.jpg,test/p11/p11648387/s52986121/8f8c1f74-bbc9d4fb-7c87bb60-daab1b8d-8df05775.jpg,test," WET READ: ___ ___ ___ 2:35 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA AND LATERAL CHEST X-RAY INDICATION: ___-year-old man with chest pain since ___:00 this morning, evaluate for acute cardiopulmonary process. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal silhouettes are unchanged compared to multiple prior studies. There is a soft tissue density adjacent to the right heart border, seen on multiple prior studies and likely due to a prominent epicardial fat pad as seen on a prior CT. The bilateral hila are unremarkable. The lungs are clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary abnormality. No significant interval change when compared to the prior studies. " 8679d902-7c99ae5b-744752bd-11c869ed-a3f3f126.jpg,test/p14/p14130631/s50982266/8679d902-7c99ae5b-744752bd-11c869ed-a3f3f126.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ?multifocal PNA // PNA PNA IMPRESSION: In comparison with the study of ___, there again are diffuse bilateral pulmonary opacification is in both lungs consistent with multifocal pneumonia. Cardiac silhouette is enlarged and there could be some contribution to the opacification related to elevated pulmonary venous pressure. Left hemidiaphragm is obscured consistent with volume loss in the lower lobe and possible small effusion. Small effusion is again seen at the right base as well. " 1356aed3-05100f37-b8f94a23-724364cf-638142c2.jpg,test/p18/p18532425/s58575014/1356aed3-05100f37-b8f94a23-724364cf-638142c2.jpg,test," FINAL REPORT INDICATION: ___ year old man with cirrhosis/severe alcoholic hepatitis and sepsis of unclear source. Evaluate for interval change, more precisely opacities suggestive of PNA. TECHNIQUE: Upright AP and lateral chest radiographs COMPARISON: Chest radiographs from ___. FINDINGS: Lung volumes are low, exaggerating interstitial opacities and heart size. Heart size is enlarged, unchanged from prior. Interstitial opacities, which may be atelectasis as well as edema, is not significantly worsened. However, underlying pneumonia cannot be excluded. Small bilateral effusion is likely. There is no evidence for pulmonary consolidation or pneumothorax. IMPRESSION: No significant interval change. " 01cc766e-ab0c50c8-4d0b637e-64ff1217-da35fc5d.jpg,test/p18/p18300044/s53506306/01cc766e-ab0c50c8-4d0b637e-64ff1217-da35fc5d.jpg,test," WET READ: ___ ___ ___ 2:39 PM The distal aspect of a right-sided PICC is not as well seen as compared to the prior study. On this study, it appears to terminate at the proximal SVC/SVC-brachiocephalic junction, higher in position than on the prior, and appears to have migrated proximally in the interval. Since the prior study, there has been increase in bilateral perihilar and mid to lower lung opacities which could relate to fluid overload although infectious process is not excluded. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with new kidney failure, hypoxia // Eval for volume status TECHNIQUE: Single frontal view of the chest COMPARISON: ___ . FINDINGS: The distal aspect of a right-sided PICC is not as well seen as compared to the prior study. On this study, it appears to terminate at the proximal SVC/SVC-brachiocephalic junction and appears to have migrated proximally in the interval. No pneumothorax is seen. Since the prior study, there has been increase in bilateral perihilar and mid to lower lung opacities which could relate to fluid overload although infectious process is not excluded. No large pleural effusion is seen. IMPRESSION: Distal aspect of a right-sided PICC is not as well seen as compared to the prior study. On this study, it appears to terminate at the proximal SVC/SVC-brachiocephalic junction, higher in position than on the prior, and appears to have migrated proximally in the interval. Since the prior study, there has been increase in bilateral perihilar and mid to lower lung opacities which could relate to fluid overload although infectious process is not excluded. " 8815b943-2c554971-ee9b62af-18dee2f0-3a257977.jpg,test/p12/p12043836/s58840934/8815b943-2c554971-ee9b62af-18dee2f0-3a257977.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recent VATS procedure. // r/o acute cardiopulmonary process IMPRESSION: As compared to ___ chest radiograph, 3 chest tubes remain in place in the right hemi thorax with apparent interval increase in moderate size loculated right pleural effusion with associated multiple loculated hydro pneumothorax components. Additionally, confluent opacification in the right middle and lower lobes has slightly worsened. New left retrocardiac opacification is likely due to atelectasis or aspiration given rapid development. No other relevant changes. " 308f3b13-ee94686b-373455f0-57b95ccd-43042dca.jpg,test/p17/p17244595/s56145043/308f3b13-ee94686b-373455f0-57b95ccd-43042dca.jpg,test," FINAL REPORT AP CHEST, 8:27 P.M. HISTORY: ___-year-old man with possible cardiogenic shock. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Vascular clips denote left hilar surgery. Mediastinum is shifted entirely into the left hemithorax and the volume of aerated lung on the left is very small, smaller than I would expect if patient has had just a lower lobectomy. Although I do not know the baseline appearance of the patient's chest radiograph, I suspect there is new collapse of the postoperative left lung. Interstitial edema is seen in the hyperexpanded right lung. There is no pneumothorax. Right subclavian line ends in the brachiocephalic vein. There is no appreciable right pleural effusion, although there may be a small amount. " 76732519-a8d49f7a-0020d036-534adbff-35e5aade.jpg,test/p17/p17463554/s55131445/76732519-a8d49f7a-0020d036-534adbff-35e5aade.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with labored breathing, O2 reqt, accessory muscles. // ?PNA ?vol overload ?PNA ?vol overload IMPRESSION: Compared to chest radiographs since ___, most recently ___ through ___. Previous foci of consolidation that worsened dramatically between ___ and ___ had substantially cleared by ___. The residual abnormalities at that time were probably edema, and have stated stable in the left lung, but several areas in the right lung are more radiodense and there is a new nodular opacity projecting over the anterior right second interspace. This could be a fissural fluid collection are could be a nodular infection, which is sometimes seen with disseminated sepsis. Clinical follow-up is advised. Heart size top-normal. Pleural effusions are small if any. No pneumothorax. " d5da338e-76dd06e2-8f9a6c52-ca60539b-d8754ad1.jpg,test/p13/p13752571/s53551385/d5da338e-76dd06e2-8f9a6c52-ca60539b-d8754ad1.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Productive cough, assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained. The lungs appear clear bilaterally without definite signs of pneumonia or CHF. No large effusions or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 9e6ab10c-f95cb95b-8a8b3bef-c9f595c9-a2f8a453.jpg,test/p10/p10274932/s53948401/9e6ab10c-f95cb95b-8a8b3bef-c9f595c9-a2f8a453.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest pain after right pleural biopsy, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has undergone a pleural drainage. The tube is seen in projection on the right pleural lung base. The extent of the effusion has substantially decreased, there is virtually no right pleural effusion left. However, there is a large right basal parenchymal opacity, combined to an apicolateral 1-cm pneumothorax. No evidence of tension. No abnormalities noted in the left lung. At the time of dictation, the referring physician, ___. ___ was paged for notification, 3:45 p.m. on ___ " fd77dbd2-58ad5e1d-06ae93ab-1b5de219-b34f0f7d.jpg,test/p15/p15452067/s54463936/fd77dbd2-58ad5e1d-06ae93ab-1b5de219-b34f0f7d.jpg,test," FINAL REPORT INDICATION: Dyspnea and chest pressure. Evaluate for acute process. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. As before, there is a left-sided pacemaker with an associated right ventricular lead. The patient is status post midline sternotomy and CABG. There is minimal right basilar atelectasis. The lungs are otherwise clear. Mild cardiomegaly is unchanged. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: 1. No acute intrathoracic process. 2. Unchanged mild cardiomegaly. " 4131ef29-ce151e26-0565bc40-56c00d1f-496bbfa3.jpg,test/p15/p15118979/s54878961/4131ef29-ce151e26-0565bc40-56c00d1f-496bbfa3.jpg,test," FINAL REPORT INDICATION: ___M with tachycardia palpitations // Infiltrate, effusion, edema. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lung volumes are low, accentuating the mediastinum/cardiac silhouette and causing vascular crowding. Atelectasis the left lower lobe is mild. Hila are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No pneumonia, pleural effusions, or pulmonary edema. " 4f488362-015f88a3-ffd02f0f-e8d6f0d6-adba06cd.jpg,test/p18/p18469699/s57516242/4f488362-015f88a3-ffd02f0f-e8d6f0d6-adba06cd.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with ILD on steroid taper // f/u ILD TECHNIQUE: Chest PA and lateral COMPARISON: Prior outside reference chest x-rays from ___, ___, ___ Prior chest CT from ___ FINDINGS: Since ___, diffuse interstitial markings appear worse which may be due to progressing interstitial lung disease or mild pulmonary edema. Possible bilateral small pleural effusions are noted.The cardiac silhouette is obscured and difficult to evaluate but does not appear grossly enlarged. No evidence of pneumothorax. IMPRESSION: 1. Progression of diffuse interstitial markings may be due to worsening interstitial lung disease vs pulmonary edema. A Chest CT is recommended for further evaluation. RECOMMENDATION(S): Recommend CT chest for further evaluation. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 15:55 into the Department of Radiology critical communications system for direct communication to the referring provider. " 4b6af42b-3153ef2a-9dfbcc0e-f54a1080-13822a5e.jpg,test/p13/p13751863/s57025630/4b6af42b-3153ef2a-9dfbcc0e-f54a1080-13822a5e.jpg,test," FINAL REPORT AP CHEST, 3:15 AM, ___ HISTORY: ___-year-old man with fluid overload and chest pressure. Shortness of breath, question pulmonary edema. IMPRESSION: AP chest compared to ___ and ___: Moderate-to-large right pleural effusion is increasing. Moderate enlargement of the cardiac silhouette, which worsened from ___ and ___ to ___ is still present and small left pleural effusion has increased, while mild pulmonary edema has remained unchanged. Findings could all be due to volume overload and cardiac decompensation, but possibility of serositis should be entertained because of the disproportion of increasing effusion to pulmonary edema. Left subclavian infusion port ends low in the SVC. No pneumothorax. " 7cc1732a-b499d1e8-ecda1fa7-6169637c-94d99b01.jpg,test/p18/p18011403/s57967524/7cc1732a-b499d1e8-ecda1fa7-6169637c-94d99b01.jpg,test," FINAL REPORT HISTORY: Aspiration and cough. FINDINGS: In comparison with study of ___, there has been placement of a Dobbhoff tube that extends at least to the upper body of the stomach where it crosses the lower margin of the image. No evidence of acute cardiopulmonary disease. Central catheter remains in place. " 4833a9fd-6d5e06a6-1eeb96fd-1b84830f-5372e000.jpg,test/p10/p10712245/s55805964/4833a9fd-6d5e06a6-1eeb96fd-1b84830f-5372e000.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged. The mediastinal and hilar contours appear unchanged. There are prominent and indistinct central pulmonary vessels worrisome for fluid overload, and potentially there is a developing opacity in the medial right lower lung, probably within the right lower lobe. IMPRESSION: Findings suggesting a mild congestive heart failure or fluid overload and the possibility of a developing focal opacity at the right lung base should also be considered in short-term follow-up depending on clinical presentation. " 8fe2fb65-83ac21c7-41d0fd81-9ff3678e-1887f8d0.jpg,test/p10/p10188275/s53960263/8fe2fb65-83ac21c7-41d0fd81-9ff3678e-1887f8d0.jpg,test," FINAL REPORT HISTORY: ___ year old man with COPD, chronic R sided pleural effusion drained on ___, p/w respiratory distress COMPARISON: Exam is compared with portable chest x-ray of ___. FINDINGS: Lung fields are more inflated. The right base is improved with reduction of the atelectasis. The small pleural effusion persists on the right base. The left lung is clear. The heart is still mildly enlarged. The vascular congestion is reduced IMPRESSION: The atelectasis of the right base is improved, but with persistent small pleural effusion. The vascular congestion is improved. " f03cb352-f68cd0dc-edaebbb8-2a5311e2-ef92d6d1.jpg,test/p17/p17397047/s51062046/f03cb352-f68cd0dc-edaebbb8-2a5311e2-ef92d6d1.jpg,test," FINAL REPORT HISTORY: Generalized weakness. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: ___. FINDINGS: Moderate cardiomegaly is present. Aortic knob is calcified. Linear opacities in both lung bases likely reflect subsegmental atelectasis. There is mild pulmonary vascular congestion. No overt pulmonary edema is seen. There is no pleural effusion or pneumothorax. No acute osseous abnormalities identified. IMPRESSION: Mild pulmonary vascular congestion and bibasilar atelectasis. " 92982086-ccbf842d-97409df3-59ec8972-2d72f84e.jpg,test/p11/p11056428/s55522427/92982086-ccbf842d-97409df3-59ec8972-2d72f84e.jpg,test," FINAL REPORT EXAMINATION: AP chest radiograph. INDICATION: ___-year-old woman with an unwitnessed fall, now with pain in the right shoulder, humerus, and chest. Evaluate for evidence of fracture. TECHNIQUE: AP chest radiograph. COMPARISON: None. FINDINGS: Normal cardiomediastinal and hilar contours. Normal pleural surfaces. Clear, hyperinflated lungs. No evidence of fracture. Metallic clips are noted in the right axilla. IMPRESSION: 1. No acute cardiopulmonary process. 2. No evidence of fracture. " 0577d6b0-693a1135-053e12d0-03945536-8fef5f74.jpg,test/p19/p19435428/s58415235/0577d6b0-693a1135-053e12d0-03945536-8fef5f74.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with chest pain. COMPARISON: None available. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Atherosclerotic calcifications are noted at the aortic arch. No acute fractures identified. IMPRESSION: No acute cardiopulmonary process. " 9c11d715-41902fd3-9fddce18-791b499d-22619182.jpg,test/p17/p17006872/s51424243/9c11d715-41902fd3-9fddce18-791b499d-22619182.jpg,test," FINAL REPORT INDICATION: ___-year-old female status post right VATS for bleb resection and pleurodesis. COMPARISON: ___. TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position. FINDINGS: Right chest tube terminates near the right lung apex. There has been interval decrease in size of right apical pneumothorax which is now tiny. There is decreased opacity surrounding the right apical chain suture, consistent with resolving postoperative change. No pleural effusion is detected on this view. Heart and mediastinal contours are within normal limits. The left lung appears well aerated without evidence for pneumothorax. IMPRESSION: Decreased size of right apical pneumothorax. " 04c4b6ae-872ae8f6-bc0b1933-ff548fc4-5ff5f2e3.jpg,test/p19/p19237377/s55891177/04c4b6ae-872ae8f6-bc0b1933-ff548fc4-5ff5f2e3.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures appear within normal limits. IMPRESSION: No evidence of acute disease. " a1741bb8-21b9688f-5eef69d8-8c994e87-dd961a99.jpg,test/p15/p15648077/s54462306/a1741bb8-21b9688f-5eef69d8-8c994e87-dd961a99.jpg,test," FINAL REPORT HISTORY: ___ year old man with altered mental status. COMPARISON: Outside hospital chest radiograph ___. FINDINGS: Frontal lateral views of the chest. The lungs are clear and well expanded. There is no pleural effusion or pneumothorax. There is a granuloma in the right lung. The cardiac and mediastinal contours are normal. IMPRESSION: Clear lungs. " 4f8402c5-4be0886b-5428118a-b30233a0-19500e75.jpg,test/p18/p18551611/s55866352/4f8402c5-4be0886b-5428118a-b30233a0-19500e75.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: asthma exacerbation for 2 weeks // rule out pna CHRONIC COUGH 2 WEEKS HX ASTHMA,STAGE 3 BRCA ___ YRS AGO R/O PNEUMONIA VS ASTHMA EXACERBATION IMPRESSION: No comparison. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " f38d780e-7b6e4596-e2ead3a3-e88323cb-85221763.jpg,test/p10/p10405915/s59329517/f38d780e-7b6e4596-e2ead3a3-e88323cb-85221763.jpg,test," WET READ: ___ ___ ___ 7:43 PM There has been interval removal of the left chest tube. No pneumothorax is seen. Stable position of the right chest tube and appearance of the chest. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man has 2 chest tubes in. // please do the chest x-ray at ___ today s/p left chest tube removal TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph obtained earlier on the same date. FINDINGS: There has been interval removal of the left-sided chest tube. No pneumothorax seen. The right chest tube is unchanged in appearance, this rays close to the lateral chest wall. Lung volumes remain low on the right. No pleural effusion. No consolidation. The cardiomediastinal contour is unchanged compared to the prior study. IMPRESSION: No pneumothorax seen status post removal of a left chest tube. " 9ddf776f-4fe606d9-e4e1661c-a830e442-75ecfb31.jpg,test/p12/p12043836/s57999325/9ddf776f-4fe606d9-e4e1661c-a830e442-75ecfb31.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea and cough // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and cardiac valve replacements. The cardiac silhouette remains enlarged, similar to prior. There is moderate to large right pleural effusion which appears slightly increased as compared to the prior study, with overlying atelectasis. Right basilar consolidation is difficult to exclude. No pneumothorax is seen on the current study. IMPRESSION: Moderate to large right pleural effusion with overlying atelectasis, underlying consolidation is not excluded. Persistently enlarged cardiac silhouette. " 307a80ff-675f3fe8-ca4c7153-16108e57-dbed7510.jpg,test/p15/p15448035/s56573081/307a80ff-675f3fe8-ca4c7153-16108e57-dbed7510.jpg,test," FINAL REPORT AP CHEST, 3:46 A.M., ___ HISTORY: A ___-year-old intubated man after ET tube placement. IMPRESSION: AP chest compared to ___: ET tube in standard placement, nasogastric drainage tube ends in the upper non-distended stomach. Lungs remain low in volume but clear of focal abnormality. Heart size top normal. No pleural abnormality. " 900150ed-e81999d0-323bad2e-a3affe9b-66d66afa.jpg,test/p13/p13375848/s59588516/900150ed-e81999d0-323bad2e-a3affe9b-66d66afa.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with one week worsening sob, fatigue // ?CPD TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is blunting of the bilateral costophrenic angles may be due to trace pleural effusions and/or related to atelectasis. The lungs are hyperinflated, suggesting chronic obstructive pulmonary disease. No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The aorta is tortuous. The cardiac silhouette is top-normal. No overt pulmonary edema is seen. IMPRESSION: Blunting of the bilateral costophrenic angles may be due to trace pleural effusions, atelectasis, or pleural thickening. No focal consolidation. " 5f33d747-c637d303-a1a034d7-355ac935-3d36172e.jpg,test/p15/p15245907/s50505746/5f33d747-c637d303-a1a034d7-355ac935-3d36172e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute respiratory failure // interval change interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Again there are bilateral pleural effusions with compressive atelectasis, elevated pulmonary venous pressure, and a top-normal sized heart. " d5d8c59f-b5ac7a8d-9e2deb0e-cc123780-5f9096b6.jpg,test/p19/p19590832/s50289353/d5d8c59f-b5ac7a8d-9e2deb0e-cc123780-5f9096b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with malaise,chest pain // eval heart and lungs TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are clear. No pleural effusion or pneumothorax. Heart size and mediastinal contours are normal. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 54b0cca1-af790ccb-52fe1f61-db2987f5-a0eddcf0.jpg,test/p10/p10767527/s56818617/54b0cca1-af790ccb-52fe1f61-db2987f5-a0eddcf0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with follow up penumonia // follow up pneumonia follow up pneumonia IMPRESSION: In comparison with the study of ___, there is substantial further clearing of the left basilar pneumonia. The residual could merely represent fibrotic healing. Otherwise, no change. " 673c482c-82c51f81-24d33522-a22641f5-6f016f50.jpg,test/p15/p15530265/s50469154/673c482c-82c51f81-24d33522-a22641f5-6f016f50.jpg,test," WET READ: ___ ___ ___ 7:59 AM Small bilateral pleural effusions are essentially unchanged since this morning. Right pleural catheter overlies the right lung base. Heterogeneous airspace opacities in the right upper lung are not significantly changed. -___ WET READ VERSION #1 ___ ___ ___ 8:09 PM Small bilateral pleural effusions are essentially unchanged since this morning. Right pleural catheter overlies the right lung base. Heterogeneous airspace opacities in the right upper lung are not significantly changed. -___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB s/p chest tube placement // evaluate for pneumothorax COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the position of the right pleural pigtail catheter is constant. Constant appearance of the left pleural effusion with a small left basilar atelectasis. Also unchanged is the parenchymal opacity in the right upper lobe, showing a peripheral rim of mild consolidations with air bronchograms. No new parenchymal opacity. Unchanged mild right hilar enlargement. " 98a2aa7a-4fb79c2d-2283bd47-151fcb81-d3cbf76d.jpg,test/p17/p17620982/s54348155/98a2aa7a-4fb79c2d-2283bd47-151fcb81-d3cbf76d.jpg,test," FINAL REPORT HISTORY: Cirrhosis, SBP, continued elevated white count, question pneumonia. CHEST, SINGLE AP PORTABLE VIEW. LORDOTIC POSITIONING. Possible background COPD. The right hemidiaphragm is elevated. There is some hazy and minimal patchy opacity at the right lung base. There is also increased retrocardiac density, slightly worse than on ___. No left-sided effusion. No CHF. Cardiac silhouette likely unchanged. IMPRESSION: New patchy and hazy opacity at the right lung base and new increased retrocardiac density. tHE Possibility of an infectious infiltrate cannot be excluded. If clinically indicated, a lateral view may help for further assessment. " 198b3743-7204315f-7f0f3b1b-60fd7046-0a95836d.jpg,test/p12/p12301829/s52434030/198b3743-7204315f-7f0f3b1b-60fd7046-0a95836d.jpg,test," FINAL REPORT HISTORY: Rhonchi at right base, to assess for pneumonia. FINDINGS: No previous images. No evidence of pneumonia, vascular congestion, or pleural effusion. There is a slight impression on the right side of the lower cervical trachea, raising the possibility of thyroid enlargement. " 798536b5-69416f93-36bca0c2-76a615ab-50c196d5.jpg,test/p10/p10264068/s58009408/798536b5-69416f93-36bca0c2-76a615ab-50c196d5.jpg,test," FINAL REPORT INDICATION: ___-year-old female with productive cough. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiograph from ___. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " ee576ccc-1a45791e-c8d4a2dc-740db30c-a167625c.jpg,test/p11/p11904134/s57124045/ee576ccc-1a45791e-c8d4a2dc-740db30c-a167625c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with MS flare states he has pain similar to MS flare // r/o pneumonia COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Subtle opacity adjacent to the left heart border likely represents bronchovascular markings. No convincing signs of pneumonia. There is no pleural effusion or pneumothorax. No edema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 7b03b8df-a86583ac-8507765b-dbf0c383-2bda12d7.jpg,test/p14/p14180305/s53308759/7b03b8df-a86583ac-8507765b-dbf0c383-2bda12d7.jpg,test," WET READ: ___ ___ 5:13 AM No free air beneath the right hemidiaphragm. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with vomiting with blood // ? free air TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are well-expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No free air seen beneath the right hemidiaphragm. IMPRESSION: No free air beneath the right hemidiaphragm. " a89a8f88-53fd2933-6e90bedc-bf21bee1-65404c2b.jpg,test/p19/p19500641/s51224566/a89a8f88-53fd2933-6e90bedc-bf21bee1-65404c2b.jpg,test," FINAL REPORT HISTORY: ___-year-old male with altered mental status and shortness of breath. COMPARISON: Chest radiograph from ___. AP PORTABLE CHEST RADIOGRAPH: Bilateral pleural effusions and probable associated compressive atelectasis may be slightly increased compared to ___. Air bronchograms are seen in the right lower lung and superimposed infectious process can not be excluded. The upper lungs are clear. Mild pulmonary vascular congestion appears stable; however, there is no overt interstitial edema. Mediastinal and hilar contours appear within normal limits. Evaluation of the cardiac silhouette is limited due to bibasilar opacities. There is no pneumothorax. IMPRESSION: Bilateral pleural effusions and probable associated compressive atelectasis appear increased compared to ___. Air bronchograms seen in the right lower lung, and a superimposed infectious process can not be excluded. " b1442ca4-7eda6992-9341df76-0712aed8-6b4c7066.jpg,test/p16/p16454913/s59544229/b1442ca4-7eda6992-9341df76-0712aed8-6b4c7066.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends to the lower body of the stomach. Lower lung volumes but otherwise little appreciable change. " bff4efdb-a0c34824-5e6140e7-76f9ae0d-58d24b45.jpg,test/p14/p14502109/s57007522/bff4efdb-a0c34824-5e6140e7-76f9ae0d-58d24b45.jpg,test," FINAL REPORT HISTORY: Cough and shortness breath. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: A right upper lobe consolidation persists, initially seen on ___. There are no new focal opacities. There are no signs of pulmonary edema, pneumothorax or pleural effusions. The heart and mediastinal contours are normal. IMPRESSION: Continued right upper lobe consolidation from ___. Recommend f/u until resolution. " 6d8c9947-980c8146-4e70503a-c9e3aa93-f760b087.jpg,test/p18/p18654206/s57817784/6d8c9947-980c8146-4e70503a-c9e3aa93-f760b087.jpg,test," WET READ: ___ ___ ___ 4:54 PM Left lower lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. ______________________________________________________________________________ FINAL REPORT HISTORY: Cough, yellow sputum, fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The pulmonary vasculature is normal. A focus of consolidation within the left lower lobe is concerning for pneumonia. Right lung is clear. No pleural effusion or pneumothorax is clearly seen. There are no acute osseous abnormalities. IMPRESSION: Left lower lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. " ef2ba9a5-53b49a0b-e7a8e582-81f15ede-ade3ba66.jpg,test/p16/p16251549/s52817854/ef2ba9a5-53b49a0b-e7a8e582-81f15ede-ade3ba66.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lung volumes are slightly lower than on the prior study, resulting ni bronchovascular crowding. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal allowing for lung volumes. No displaced rib fractures identified. There is no free air under the diaphragm. IMPRESSION: No pneumonia, edema or effusion. " 44947431-5ce39068-6dacb6a5-39d2ef61-32b2c4a4.jpg,test/p15/p15394622/s58576717/44947431-5ce39068-6dacb6a5-39d2ef61-32b2c4a4.jpg,test," FINAL REPORT INDICATION: Syncope. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: A 6 mm nodular opacity at the right lower lung is again seen, less conspicuous on the lateral view since the ___ examination. The lungs are otherwise clear. There is no pneumothorax or pleural effusion. The heart size is normal. The hilar and mediastinal contours are within normal limits. An intraabdominal catheter is seen. IMPRESSION: 1. No acute intrathoracic process. 2. Subcentimeter right lower lobe pulmonary nodular opacity, also seen on the prior radiograph, which may represnt a pulmonary nodule. Further workup can be obtained with non-contrast CT examination on an outpatient basis, if prior outside hospital studies are not already available. " 60e4537f-e5759ad5-359920e0-902b697c-9e7c1559.jpg,test/p15/p15159712/s53496013/60e4537f-e5759ad5-359920e0-902b697c-9e7c1559.jpg,test," FINAL REPORT HISTORY: Altered mental status and fever. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: There are low lung volumes. The aorta is tortuous and appears dilated, unchanged. Heart size is mildly enlarged but stable. There is no pulmonary edema, with crowding of the bronchovascular structures noted. Streaky bibasilar opacities may reflect atelectasis. Infection is not excluded in the correct clinical setting. No pleural effusion or pneumothorax is identified. Multilevel degenerative changes are noted in the imaged thoracolumbar spine. IMPRESSION: Low lung volumes. Patchy bibasilar airspace opacities likely reflect atelectasis though infection cannot be excluded in the correct clinical setting. " c71b2f69-fc7a9232-0b14c74f-d9e035d5-078807ec.jpg,test/p11/p11146013/s54670297/c71b2f69-fc7a9232-0b14c74f-d9e035d5-078807ec.jpg,test," FINAL REPORT EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old woman with dyspnea. Evaluate for an acute process. TECHNIQUE: Chest PA and lateral. COMPARISON: Prior chest radiograph from ___. FINDINGS: PA and lateral views the chest provided. Overlying EKG lead somewhat limits assessment. The lungs are clear bilaterally. No signs of pneumonia or edema. No large effusion or pneumothorax. Mild elevation the right hemidiaphragm is again noted. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 739286ed-4ed07bca-103a2068-b11c4a2b-f33bf049.jpg,test/p16/p16882281/s53769262/739286ed-4ed07bca-103a2068-b11c4a2b-f33bf049.jpg,test," FINAL REPORT AP CHEST, 11:17 A.M. ON ___. HISTORY: ___-year-old woman with report of an outside study showing pneumonia. IMPRESSION: AP chest compared to ___, the only prior chest radiograph currently available: Discrete areas of abnormality are present in both lungs, any of which could be infection. The largest region of abnormality is in the lingula, partially obscuring the left heart border, but there is peribronchial opacification in the right lower lung. Chronic right rib fractures are probably responsible for some of the heterogeneous opacification in the right mid lung zone, in combination with local pleural thickening. Possibility of small bilateral pleural effusions should be considered. Healed left upper rib fracture is also noted. A lateral chest radiograph would be extremely useful in distinguishing consolidation from pleural and other findings. " 68f36c7f-9c670c06-6aac6e1b-711d6c5a-854afdcb.jpg,test/p13/p13738898/s56194104/68f36c7f-9c670c06-6aac6e1b-711d6c5a-854afdcb.jpg,test," FINAL REPORT INDICATION: Left-sided weakness. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. No pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 62e7918f-03743486-6d5a5299-b268db13-b52ba3af.jpg,test/p13/p13035993/s59797698/62e7918f-03743486-6d5a5299-b268db13-b52ba3af.jpg,test," WET READ: ___ ___ ___ 10:16 AM No acute cardiothoracic process. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with elevated blood pressure. Please assess for acute process. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___, ___. CTA of the chest from ___. There is unchanged bibasilar (left greater than right) pleural thickening but no evidence of focal consolidation. No large pleural effusion and no pneumothorax. IMPRESSION: No acute cardiothoracic process. " d761f711-fa289ce0-ac4d57e7-86437bf5-4b343e26.jpg,test/p10/p10956814/s57529791/d761f711-fa289ce0-ac4d57e7-86437bf5-4b343e26.jpg,test," FINAL REPORT HISTORY: Status post fall, now with rib pain. Evaluate for fracture or pneumonia. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are hyperinflated with flattened diaphragms, suggesting chronic underlying obstructive disease. Lungs are clear without focal abnormality. No pleural effusion or pneumothorax. Chronic-appearing right-sided rib fractures are again seen. No acute displaced rib fracture is visualized. Compression deformity of a mid-thoracic vertebral body is similar to prior. No radiopaque foreign body. IMPRESSION: 1. Chronic right rib fractures without acute displaced rib fracture. 2. Emphysema. " c2ccb346-917b88c7-9cec0e70-5fc5b561-dfa4c7e6.jpg,test/p19/p19221612/s56431473/c2ccb346-917b88c7-9cec0e70-5fc5b561-dfa4c7e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with retrosternal chest pressure // evaluate for acute process TECHNIQUE: Chest PA and Lateral COMPARISON: ___ FINDINGS: The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is normal in size. IMPRESSION: Normal chest x-ray. " 05c8b079-e5c602f1-5ce4c46b-c97537a7-70651e58.jpg,test/p18/p18005911/s51955307/05c8b079-e5c602f1-5ce4c46b-c97537a7-70651e58.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with right-sided chest pain. TECHNIQUE: PA and lateral chest radiographs COMPARISON: None available FINDINGS: The lungs are well expanded. No focal opacities are identified. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " d0b16685-58e04bbc-c3f606ed-05aca766-50322207.jpg,test/p17/p17382208/s51191974/d0b16685-58e04bbc-c3f606ed-05aca766-50322207.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough x sev days, few end inspir crackles left base o/w clear // r/o PNA EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___ FINDINGS: There is new faint opacity in the right lower lobe, which could be a developing pneumonia in correct clinical setting. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. Right apical pleural scarring is again noted. IMPRESSION: There is new faint opacity in the right lower lobe, which could be a developing pneumonia in correct clinical setting. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:26 AM. " ef259339-403e7f06-f9f2e328-61ee26c1-e3d33ac9.jpg,test/p17/p17967970/s54892931/ef259339-403e7f06-f9f2e328-61ee26c1-e3d33ac9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ? PNA in RLL, POD ___ s/p RUL VATS wedge // please evaluate for interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the right lung volume has decreased and the might be a minimal increase in extent of a pre-existing right pleural effusion. No new right focal parenchymal opacities. Unchanged appearance of the heart and of the left lung. " 5f1d1ae1-44d38d74-259057a6-3c64e16b-9fee8de6.jpg,test/p16/p16085209/s56908106/5f1d1ae1-44d38d74-259057a6-3c64e16b-9fee8de6.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man after robotic-assisted thymectomy. IMPRESSION: PA and lateral chest compared to ___: Previously widened mediastinum now has a normal post-operative appearance. Lungs are clear. No pleural abnormality. Heart size normal. " 5f066717-36f758ae-948e3cd8-1a92b1ac-40191691.jpg,test/p14/p14792425/s59816544/5f066717-36f758ae-948e3cd8-1a92b1ac-40191691.jpg,test," WET READ: ___ ___ ___ 7:53 PM New SG catheter in place with tip in the proximal left pulmonary artery. Mild pulmonary congestion remains. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with Swan line placement, check position. Comparison to prior study of ___ at ___. A portable semi-erect chest film ___ at ___ is submitted. IMPRESSION: 1. Interval placement of a right internal jugular Swan-Ganz catheter with the tip in the right pulmonary artery. Enlargement is stable. Mediastinal contours are within normal limits. Lung volumes have slightly diminished with crowding of the pulmonary vasculature. There is mild perihilar edema. No focal airspace consolidation to suggest pneumonia. No pneumothorax. No acute bony abnormality. " 580ba7f4-3ac61200-66e3c34b-d2eaa5d8-ea5ac15e.jpg,test/p14/p14280192/s53104138/580ba7f4-3ac61200-66e3c34b-d2eaa5d8-ea5ac15e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p bronchoscopy // ___ year old man with s/p bronchoscopy ___ year old man with s/p bronchoscopy IMPRESSION: Comparison to ___, 07:34. Monitoring and support devices are stable. The lung volumes have decreased. Pulmonary edema has increased in severity, and small bilateral pleural effusions as well as moderate cardiomegaly is stable. No pneumothorax. " ab95f68d-58c8872b-9d466d48-0b0da4c1-28e41b78.jpg,test/p15/p15130765/s57470658/ab95f68d-58c8872b-9d466d48-0b0da4c1-28e41b78.jpg,test," FINAL REPORT HISTORY: Meningiomas, evaluate the revo pacemaker prior to MRI. COMPARISON: ___. FINDINGS: A left pacemaker with leads in the lower right atrium and right ventricle is unchanged from prior radiographs. No focal consolidation, pleural effusion or pneumothorax. Stable mild cardiomegaly. IMPRESSION: No change in appearance of left-sided pacemaker and mild cardiomegaly. " 04d5558e-5e5474bf-6253d5aa-7f6a4deb-cfa34176.jpg,test/p16/p16413192/s51508576/04d5558e-5e5474bf-6253d5aa-7f6a4deb-cfa34176.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Sudden onset of double vision today at 11:00 a.m., chills and cough are also noted, question pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. Heart and mediastinal contours are normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 115b0623-e749d335-6562b7f4-d1f01240-ad99af6b.jpg,test/p18/p18268243/s59293592/115b0623-e749d335-6562b7f4-d1f01240-ad99af6b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, fevers // eval pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 018af2d0-7f770476-eb455a40-6d212275-5da517fa.jpg,test/p18/p18624255/s54548729/018af2d0-7f770476-eb455a40-6d212275-5da517fa.jpg,test," FINAL REPORT INDICATION: ___F with shortness of breath // eval for pneumonia or volume overload TECHNIQUE: AP and lateral views the chest. COMPARISON: ___, an additional films dating back to ___. FINDINGS: There is a small to moderate left and probable small right effusion. There is additional retrocardiac opacity laterally potentially atelectasis noting that infection cannot be excluded. Prominent interstitial markings seen throughout. Cardiac silhouette is enlarged, similar compared to prior. Atherosclerotic calcifications noted at the aortic arch. Dense mitral annular calcifications are also noted. IMPRESSION: Bilateral left greater than right effusions. Retrocardiac opacity seen laterally could be atelectasis noting infection cannot be excluded. Pulmonary vascular congestion. " 22aa5d9e-345e0220-45373f48-837eaed6-3a5ba929.jpg,test/p17/p17463554/s57949986/22aa5d9e-345e0220-45373f48-837eaed6-3a5ba929.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pna // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, the opacification at the left base has cleared and the hemi diaphragm is sharply seen. No evidence of vascular congestion. The endotracheal and nasogastric tubes are unchanged in position. The right subclavian PICC line has been pulled back to the mid to lower portion of the SVC. " 12a34e61-c51497a5-a6839582-294549e1-57d8ffab.jpg,test/p17/p17845979/s57611409/12a34e61-c51497a5-a6839582-294549e1-57d8ffab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, neutropenia, hypotension // f/u infiltrates, new crackles, eval for pna vs edema f/u infiltrates, new crackles, eval for pna vs edema IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Opacification at the left base posteriorly is again seen. This most likely represents atelectasis, though superimposed pneumonia would have to be considered in the appropriate clinical setting. Multiple BB fragment is seen overlying the left chest. " 638b72db-c3784dff-78bae056-d69548d6-e1fd957d.jpg,test/p11/p11630519/s57464780/638b72db-c3784dff-78bae056-d69548d6-e1fd957d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with afib, CHF, DM, HTN, h/o CVA initially admitted ___ with mechanical fall on anticoagulation with intracranial bleeding. Now awaiting___ rehab placement, receiving inpatient stroke rehab, seized on ___ c/b lactic acidosis. On ___ more tachypneic s/p 1L fluids. Please assess for pulmonary edema. // r/o pulmonary edema r/o pulmonary edema IMPRESSION: In comparison with the study of ___, there is stable enlargement of the cardiac silhouette with little or no elevation in pulmonary venous pressure. This discordance raises the possibility of underlying cardiomyopathy or pericardial effusion. No evidence of acute focal pneumonia. There is again an impression on the right of the lower cervical trachea, suggesting thyroid enlargement. " 802b4d2c-6c6ca752-10cff1f5-03b364d2-5ec96dd2.jpg,test/p18/p18871003/s57171594/802b4d2c-6c6ca752-10cff1f5-03b364d2-5ec96dd2.jpg,test," FINAL REPORT INDICATION: ___M with ___ // ? infectious process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Tortuosity of the descending thoracic aorta is noted. No acute osseous abnormalities. Chronic likely congenital deformity of the anterior left sixth rib is again noted. IMPRESSION: No acute cardiopulmonary process. " 23f44245-c3dac2e5-2fe37a44-0f33bdee-fb440ccf.jpg,test/p17/p17327592/s51857131/23f44245-c3dac2e5-2fe37a44-0f33bdee-fb440ccf.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Shortness of breath , wheezing on exam. The right hemidiaphragm is elevated. Aside from linear atelectasis in the right base, the lungs are clear. There is no pneumothorax or pleural effusion. Cardiomediastinal contours are normal. The sternal wires are aligned. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " edc9591e-c1e54861-093d45bc-e7634ad2-cbf2ed1a.jpg,test/p18/p18065565/s51221372/edc9591e-c1e54861-093d45bc-e7634ad2-cbf2ed1a.jpg,test," FINAL REPORT HISTORY: Fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Right-sided Port-A-Cath tip terminates within the cavoatrial junction, unchanged. The cardiac, mediastinal and hilar contours are within normal limits. The pulmonary vascularity is normal. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. Multiple clips are demonstrated within the right upper quadrant of the abdomen along with a biliary stent. IMPRESSION: No acute cardiopulmonary abnormality. " c8e0d631-f9089d5a-5d286c26-109c4beb-724d56ca.jpg,test/p15/p15457995/s59529951/c8e0d631-f9089d5a-5d286c26-109c4beb-724d56ca.jpg,test," FINAL REPORT HISTORY: Weakness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is normal. The aorta remains tortuous. The mediastinal and hilar contours otherwise are unremarkable. Lungs are clear and the pulmonary vascularity is normal. Biapical scarring is unchanged. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 00a7ae8d-12039396-ddcdd36e-383d07e1-a687c8fb.jpg,test/p14/p14219343/s59764219/00a7ae8d-12039396-ddcdd36e-383d07e1-a687c8fb.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Hypoxia and crackles. Known congestive heart failure. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no definite pleural effusion or pneumothorax. There is a moderate interstitial abnormality consistent with pulmonary edema. There is asymmetric dense right perihilar opacification. This may be due to pulmonary edema superimposed on prominent background bronchovascular opacities in the area, but developing pneumonia is not excluded at this site. Short-term followup radiographs are suggested. " 0450378a-0ae1ceb2-370e29bc-c92a8dbd-4cc90237.jpg,test/p18/p18714676/s56408249/0450378a-0ae1ceb2-370e29bc-c92a8dbd-4cc90237.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old male hx. transplant, smoker with productive cough x5d // evaluate for pneumonia FINDINGS: As compared ___ radiograph, lung volumes remain low. Cardiomediastinal contours are within normal limits. Bronchial wall thickening appears chronic. No focal areas of consolidation to suggest pneumonia. IMPRESSION: Chronic bronchial wall thickening favors chronic bronchitis or bronchiectasis. No definite pneumonia. " aeaf76c4-3cf56174-62c37aa3-e0871a00-0baf7820.jpg,test/p15/p15653759/s52307473/aeaf76c4-3cf56174-62c37aa3-e0871a00-0baf7820.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with hx of pT3N2 stage IIIA gastric adenocarcinoma s/p gastrectomy with Roux-en-Y reconstruction, who presents with increased nausea/vomiting, poor po intake, and increase weight loss and now new cough // New cough.? Pneumonia COMPARISON: Chest radiographs from___ FINDINGS: Low lung volumes bilaterally. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Bilateral small to moderate effusions, increased from prior. Worsening bibasilar opacities. No pneumothorax.Diffuse haziness in the upper abdomen. IMPRESSION: 1. Worsening bibasilar opacities may be due to atelectasis, aspiration, or developing pneumonia. 2. Bilateral small to moderate effusions are increased from prior. 3. Diffuse haziness in the upper abdomen may suggest ascites. " 4f2c4feb-1494cc61-b6118c79-60f6b39a-2d46a330.jpg,test/p16/p16727046/s53961821/4f2c4feb-1494cc61-b6118c79-60f6b39a-2d46a330.jpg,test," WET READ: ___ ___ 10:48 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cough and chest pain, here to evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The inspiratory lung volumes are appropriate. There is slight underpenetration of the lung bases. Within this limitation, there is no focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 21fe8479-07aa2726-06031993-b4a71f93-5338cab9.jpg,test/p17/p17630853/s57173060/21fe8479-07aa2726-06031993-b4a71f93-5338cab9.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: A ___-year-old male with history of cough, fevers/chills. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Mild medial right lung base opacity may represent overlapping vascular structures, although an underlying mild consolidation cannot be excluded, although it is not clearly seen on the lateral view. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Right infrahilar and medial right base increased opacity could be due to infectious process in the appropriate clinical setting. " 7986cd76-7be63b70-35279266-4cf21f5d-6a7bc690.jpg,test/p12/p12003500/s51130741/7986cd76-7be63b70-35279266-4cf21f5d-6a7bc690.jpg,test," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old male patient with pulmonary nodules, status post right-sided VATS for middle and lower lobe wedge resections, evaluate for interval change. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. The patient's inspirational effort has significantly improved since the preceding study of ___. Laterally, the lateral and posterior pleural sinuses are now free from any remaining fluid collection. Linear thin scar formations are the only residuals that remain in relation to recently performed right middle lobe and lower lobe wedge resections. No pneumothorax in the apical area and no new pulmonary parenchymal infiltrates are seen. Normal heart size and unchanged appearance of moderately elongated and widened thoracic aorta. IMPRESSION: Satisfactory findings on followup examination to VATS procedure. " a555295d-122c3b5b-60de0438-13f0eeb2-9e66eda3.jpg,test/p19/p19231238/s52717491/a555295d-122c3b5b-60de0438-13f0eeb2-9e66eda3.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___F with shoulder and abdominal pain // eval for e/o of free air under diaphragm or other acute process TECHNIQUE: Single semi-upright portable view of the chest is obtained. COMPARISON: Comparison is made to outside radiograph of the chest and abdomen CT from 5 hr prior. FINDINGS: Lung volumes are low, accentuating the hilar structures with bibasilar atelectasis and small right effusions. Biapical pleural thickening is noted. The heart is mildly enlarged. There is no pneumothorax or focal consolidation. IMPRESSION: Mild cardiomegaly with low lung volumes, bibasilar atelectasis, and small right pleural effusion. " 5e50c75d-b9db2e73-807ab997-c3c5a812-df9772a0.jpg,test/p15/p15022408/s51502507/5e50c75d-b9db2e73-807ab997-c3c5a812-df9772a0.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient with right-sided ptosis, assess for mass. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is within normal limits. No typical configurational abnormality is seen. Unremarkable appearance of thoracic aorta and mediastinal structures are normal. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present, and the lateral and posterior pleural sinuses are free. Skeletal structures of the thorax are grossly unremarkable. There exists no prior chest examination in our records available for comparison. IMPRESSION: Chest findings within normal limits. " 0d291b58-5c48ebf1-c712d290-fcbc9cbc-f1e47774.jpg,test/p12/p12544860/s56305899/0d291b58-5c48ebf1-c712d290-fcbc9cbc-f1e47774.jpg,test," FINAL REPORT INDICATION: History of ovarian hyperstimulation syndrome. Evaluate for pleural effusion, no acute process. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. There is a small left pleural effusion. No definite pleural effusion seen on the right. There is no focal consolidation. The cardiac, mediastinal and hilar contours are normal. There is no pneumothorax. IMPRESSION: Small left pleural effusion. " 53ed4151-9d1140f1-0552b9fe-0d67a905-b0611daa.jpg,test/p17/p17945297/s55046392/53ed4151-9d1140f1-0552b9fe-0d67a905-b0611daa.jpg,test," FINAL REPORT HISTORY: Atraumatic right rib pain. TECHNIQUE: PA and lateral chest radiograph 2 views. COMPARISON: None available. FINDINGS: Heart size is top normal. The mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. The visualized osseous structures are grossly unremarkable. IMPRESSION: No acute intrathoracic abnormality. " e6104dec-9462c5ad-438de352-afb6e451-53ccbf24.jpg,test/p11/p11283792/s56517985/e6104dec-9462c5ad-438de352-afb6e451-53ccbf24.jpg,test," WET READ: ___ ___ 10:53 AM 1. No acute cardiopulmonary abnormality. 2. A somewhat oval radiopaque density projecting just above the mid right clavicle may be external the patient. Correlation with physical exam required. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___F with shortness of breath, cough, wheezing. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. Note is made of at least moderate osteophytosis in the visualized thoracic spine. A nonspecific somewhat oval radiopacity projecting above the mid right clavicle may be external to the patient. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. A somewhat oval radiopaque density projecting just above the mid right clavicle may be external the patient. Correlation with physical exam required. " bfa8cfc0-64acd4dd-32aa5110-c83ec053-950e1de6.jpg,test/p18/p18917209/s53117696/bfa8cfc0-64acd4dd-32aa5110-c83ec053-950e1de6.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cough, fever, +- sputum, HA // ? CAP TECHNIQUE: Chest PA and lateral COMPARISON: No prior study for comparison FINDINGS: The right middle lobe is opacified on both the frontal and lateral views, due to lobar pneumonia; contributing neoplastic process cannot be ruled out at this time. There are no pleural effusions nor pneumothorax seen. The cardiomediastinal and hilar contours are normal size. The heart size is normal. There are no acute bony abnormalities nor fractures noted. IMPRESSION: 1. Right middle lobe pneumonia. Recommend follow-up chest x-ray in ___ weeks to document sufficient clearing to eliminate any concern for malignancy. RECOMMENDATION(S): Follow-up chest x-ray in ___ weeks. NOTIFICATION: Unable to reach ordering provider via telephone. Left message with nurse ___ impression and recommendation above was entered by Dr. ___ ___ on ___ at 13:54 into the Department of Radiology critical communications system for direct communication to the referring provider. . " aa724e30-191f53b8-6e56e4aa-24153632-ae91bc66.jpg,test/p18/p18583455/s55859500/aa724e30-191f53b8-6e56e4aa-24153632-ae91bc66.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever // r/o PNA COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Interval removal of the right PICC line noted. A spinal stimulator catheter projects over the mid thoracic spine. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with mild cardiomegaly again noted. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Stable mild cardiomegaly with no acute intrathoracic process. " 67e4bc7f-a7a88272-e5d51ae3-e27c0807-ca6dad95.jpg,test/p16/p16707063/s58209932/67e4bc7f-a7a88272-e5d51ae3-e27c0807-ca6dad95.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of weakness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is blunting of the left costophrenic angle, consistent with a small pleural effusion. No focal consolidation is seen. There is mild right base atelectasis. No right pleural effusion is seen. There is no evidence of pneumothorax. The aorta is tortuous. The cardiac silhouette is top normal. Mild degenerative changes are seen along the spine. IMPRESSION: Small left pleural effusion. " d94f6c4b-92f83224-aae87531-9370b069-38621832.jpg,test/p18/p18083755/s54865593/d94f6c4b-92f83224-aae87531-9370b069-38621832.jpg,test," FINAL REPORT REASON FOR EXAMINATION: New hypoxia. PA and lateral upright chest radiographs were reviewed in comparison to ___. Bilateral pleural effusions, right more than left, are identified, slightly increased since the prior study. There is unchanged appearance of the right hilar opacity reflecting a combination of venous structures and right middle lobe atelectasis. No pneumothorax is seen. For precise details, please review CT chest that was obtained the same day earlier. " 95b46e01-24cc6a19-8b88c83b-8508c695-7ceb48e5.jpg,test/p11/p11494804/s59922077/95b46e01-24cc6a19-8b88c83b-8508c695-7ceb48e5.jpg,test," WET READ: ___ ___ ___ 11:12 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Fever, fatigue. Question pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Prior chest radiograph from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is no focal consolidation, pleural effusion or pneumothorax. Biliary stents and surgical clips are seen in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 117179a8-854b6826-349d699e-cb9a8b2c-e2c0ce32.jpg,test/p15/p15584013/s55523488/117179a8-854b6826-349d699e-cb9a8b2c-e2c0ce32.jpg,test," FINAL REPORT AP CHEST, 8:04 P.M., ___ HISTORY: ___-year-old woman with a right pigtail pleural catheter, on waterseal. IMPRESSION: AP chest compared to ___, 4:48 a.m. Small right apical pneumothorax has reappeared, apical pigtail pleural drain unchanged in position. Right subclavian line ends low in the SVC. No appreciable right pleural effusion. Lungs clear. Heart size normal. " 9784b14d-9a07c993-388c9256-d385d03c-94816924.jpg,test/p15/p15435415/s50394483/9784b14d-9a07c993-388c9256-d385d03c-94816924.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p AVR/CABG // eval for effusion TECHNIQUE: Chest two views COMPARISON: ___ at 05:05 FINDINGS: Sternotomy. Cardiac enlargement. Normal pulmonary vascularity. Central line has been removed. No pleural fluid. Lungs are clear. IMPRESSION: No effusion " 5d2ea635-bcceac25-ad6f90b8-41fe00b2-087a3ecc.jpg,test/p13/p13215261/s51055862/5d2ea635-bcceac25-ad6f90b8-41fe00b2-087a3ecc.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess ET tube. Comparison is made with prior study dating back to ___. Moderate cardiomegaly has increased. Moderate-to-severe pulmonary edema is new. Left transvenous pacemaker leads are in standard position, in the right atrium, right ventricle, and through the coronary sinus. ET tube tip is in standard position, 5.7 cm above the carina. There is no pneumothorax. " 480cddd3-76103c2e-734c3341-7287fc33-e2cd4a08.jpg,test/p11/p11692070/s56439992/480cddd3-76103c2e-734c3341-7287fc33-e2cd4a08.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ___-year smoking history, shortness of breath worsening over the last few months. // eval for any lesions, lung volumes, evidence of COPD eval for any lesions, lung volumes, evidence of COPD IMPRESSION: In comparison with the study of ___, the cardiac silhouette is again within normal limits and there is mild tortuosity of the aorta. No acute pneumonia, vascular congestion, or pleural effusion. Minimal atelectatic changes at the bases. " d5fc8b14-85cceb79-9b53db50-7fc0aea1-e2f3e324.jpg,test/p13/p13396234/s56347725/d5fc8b14-85cceb79-9b53db50-7fc0aea1-e2f3e324.jpg,test," FINAL REPORT AP CHEST, 9:35 A.M., ___ HISTORY: Possible pneumothorax after tube pull. Status post AVR. IMPRESSION: AP chest compared to ___: A tiny residual of pneumothorax persists at the base of the left lung. There is no appreciable pleural air elsewhere or substantial pleural effusion. Bibasilar atelectasis persists on the left, worsened on the right. There is no pulmonary edema. Cardiomediastinal silhouette has a normal postoperative appearance. Endotracheal tube has been removed. Feeding tube with a wire stylet passes into the stomach and out of view. Right jugular sheath ends just above the origin of the SVC. " 25568c18-4cdc767a-95882ad4-20b9e60b-3d39aab3.jpg,test/p16/p16975530/s59233027/25568c18-4cdc767a-95882ad4-20b9e60b-3d39aab3.jpg,test," FINAL REPORT HISTORY: URI symptoms and chest tightness. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest. FINDINGS: There is a small amount of peribronchial cuffing noted most prominently around the left hilum. Otherwise, the lungs are clear of focal opacities and there is no pleural effusion, pneumothorax or pulmonary edema. Heart size is normal and hilar contours are unremarkable. IMPRESSION: Small amount of peribronchial cuffing possibly related to small airways disease/bronchiolitis. " a342c5d2-261b69b3-9240f6b2-110f7896-111fc0b5.jpg,test/p10/p10577647/s56660652/a342c5d2-261b69b3-9240f6b2-110f7896-111fc0b5.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with fever, evaluate for acute process TECHNIQUE: AP and lateral chest radiograph COMPARISON: Chest radiograph ___ FINDINGS: Cardiomediastinal silhouette is unchanged. There is no focal lung consolidation. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of pneumonia. " 86691cd0-20def1dd-507527b1-438d87d6-05bdff65.jpg,test/p12/p12088626/s55939687/86691cd0-20def1dd-507527b1-438d87d6-05bdff65.jpg,test," FINAL REPORT INDICATION: ___ year old man with newly placed NG tube for concern of SBO // Assess for placement of NG tube. COMPARISON: Radiographs from ___. IMPRESSION: Side port of the enteric tube is just beyond the GE junction. This could be advanced 3-5 cm for optimal placement. The left-sided PICC line has the distal tip at the cavoatrial junction. Cardiomediastinal silhouette is within normal limits. There are no pneumothoraces. There is streaky atelectasis at the lung bases. " 5052e81f-48a572ee-81202093-951fec8a-ab3f4864.jpg,test/p18/p18032181/s53820517/5052e81f-48a572ee-81202093-951fec8a-ab3f4864.jpg,test," FINAL REPORT HISTORY: Pneumothorax with chest tube to water-seal. COMPARISON: ___ at 17:39. FINDINGS: Frontal and lateral radiographs of the chest demonstrate a left chest tube in unchanged position since the prior study. The previously noted left apical pneumothorax is slightly improved since the prior examination. Again seen is a small right-sided pleural effusion and a stable moderate left-sided pleural effusion. The heart size, hilar and mediastinal contours are normal. Scoliotic deformity of the spine is unchanged. IMPRESSION: Slight interval improvement in left apical pneumothorax with stable bilateral pleural effusions. " d983a679-9a3fdcae-d8a09ec1-ff6cb2cc-5abfa59a.jpg,test/p16/p16454295/s59540815/d983a679-9a3fdcae-d8a09ec1-ff6cb2cc-5abfa59a.jpg,test," WET READ: ___ ___ 7:26 PM Interval re-intubation with ETT in standard position. RIJ line and enteric catheter in unchanged positions. Similar appearance of lungs with diffuse bilateral infiltrates. Right upper lobe may be slightly improved, but left retrocardiac opacity is worsened. No pneumothorax. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure/recent intubation // eval ETT placement/acute change COMPARISON: ___, 04:09 IMPRESSION: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 4 cm above the carinal. The right internal jugular vein catheter and the nasogastric tube continue to be in correct position. Unchanged evidence of severe bilateral pulmonary edema, with an interstitial and an alveolar component. Moderate cardiomegaly persists. No pleural effusions. " 3a823e83-fb99e1c6-53f75299-81827b52-c9c63594.jpg,test/p19/p19528443/s57101641/3a823e83-fb99e1c6-53f75299-81827b52-c9c63594.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain. Please evaluate for acute process. TECHNIQUE: AP frontal and lateral chest radiographs were obtained. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. Cervical spinal hardware is partially visualized IMPRESSION: No acute cardiopulmonary process. " 374213c2-22060b1b-efd7180f-0e80c157-a78e9c1f.jpg,test/p18/p18848729/s52938892/374213c2-22060b1b-efd7180f-0e80c157-a78e9c1f.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // Please eval for PNA, pneumo TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 868d13ba-34a76407-a815551d-3e0c7915-5b44d931.jpg,test/p14/p14371035/s56286256/868d13ba-34a76407-a815551d-3e0c7915-5b44d931.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with urosepsis and respiratory failure, intubated. // Interval change Interval change IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are constant. Minimal increase in severity of the right basal parenchymal opacities. The diffuse opacities are otherwise unchanged. Mild cardiomegaly persists. " 5866f1da-6383c070-a65fbcbc-424665a7-cc75bf6b.jpg,test/p16/p16660343/s58719205/5866f1da-6383c070-a65fbcbc-424665a7-cc75bf6b.jpg,test," WET READ: ___ ___ ___ 4:25 AM Dobhoff tube initially in the esophagus is advanced into the stomach on follow-up image. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess Dobbhoff tube. Dobbhoff tube is initially in the mid esophagus, is advanced into the stomach on followup image. The tip ends in the stomach. Tracheostomy tube is in standard position. Cardiomediastinal contours are normal. Aside from atelectasis in the left base, the lungs are clear. Of note, the lateral aspect of the right hemithorax was not included in the film. " b6a6935d-4971116a-88062d67-ad36e7ac-0fc76bdf.jpg,test/p14/p14727722/s55687833/b6a6935d-4971116a-88062d67-ad36e7ac-0fc76bdf.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ 11:38 AM no evidence of pneumonia PFI VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with flu-like symptoms, HIV, and productive cough. STUDY: PA and lateral chest radiograph. COMPARISON: ___. ___. FINDINGS: The heart size and mediastinal contours are prominent but similar to prior studies. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 83e18c26-f0066cbb-b1feeaa8-60743e88-20da0ddc.jpg,test/p14/p14325424/s50838112/83e18c26-f0066cbb-b1feeaa8-60743e88-20da0ddc.jpg,test," FINAL REPORT HISTORY: Pneumonia and left pneumothorax with chest tube placed on water seal. Evaluate for interval change. COMPARISON: Chest radiographs 3:59 today and ___. FRONTAL CHEST RADIOGRAPH: Apical chest tube is unchanged in position, however, there is now a small left apical pneumothorax. An endotracheal tube terminates 5.5 cm above the carina. A left subclavian catheter ends within the upper SVC and is directed laterally. Opacity throughout the right lung has improved. Left lung remains clear. No pleural effusion. Heart size is normal. These findings were discussed with Dr. ___ by Dr. ___ at 16:23 on ___ by telephone at the time of discovery. " d84c6a78-3658b0a9-b29f6fde-2c1155d1-28f93d79.jpg,test/p15/p15244289/s55148162/d84c6a78-3658b0a9-b29f6fde-2c1155d1-28f93d79.jpg,test," FINAL REPORT HISTORY: Pneumothorax after thoracentesis. FINDINGS: In comparison with the study of ___, there has been a dramatic increase in opacification at the right base consistent with large pleural effusion. Minimal if any residual pneumothorax. Continued enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. This information has been conveyed to Dr. ___, ___ for Dr. ___. " 8a96f35d-b9ff1717-b6a49d6e-76e37b1b-1cf11ae2.jpg,test/p19/p19643415/s55348942/8a96f35d-b9ff1717-b6a49d6e-76e37b1b-1cf11ae2.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // r/o acute CPD TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. CT chest from ___. FINDINGS: Left dual lumen chest wall Port-A-Cath is seen with catheter tip in the mid SVC. Opacity at the left lung base is compatible with prominent fat pad. The lungs are otherwise clear without consolidation, effusion, or edema. Known pulmonary nodules are better seen on prior dedicated chest CT. The cardiomediastinal silhouette is within normal limits. Multiple healed right lateral rib fractures are noted as well as hypertrophic changes in the spine. IMPRESSION: No acute cardiopulmonary process. " 49c8af9f-cb28dccc-c7ac1bef-001ce65e-c1a41f19.jpg,test/p16/p16278732/s54328073/49c8af9f-cb28dccc-c7ac1bef-001ce65e-c1a41f19.jpg,test," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The aorta is mildly unfolded. The hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary abnormality. " d1c7e5e7-2591a0c8-79774b92-abdee598-e637d4e0.jpg,test/p12/p12532644/s59028929/d1c7e5e7-2591a0c8-79774b92-abdee598-e637d4e0.jpg,test," FINAL REPORT HISTORY: Syncope, assess for cardiomegaly. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. Opacities in the right lower lobe are new and could reflect atelectasis or pneumonia. No pleural effusion or pneumothorax is seen. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: Right lower lobe opacities could reflect an infectious process in the appropriate clinical setting. " 3ab88be7-82dec48b-b7082d4f-851db788-d0087246.jpg,test/p18/p18059653/s59241770/3ab88be7-82dec48b-b7082d4f-851db788-d0087246.jpg,test," WET READ: ___ ___ 11:07 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with L-sided chest pain // ? acute cardiopulm process TECHNIQUE: Chest radiographs ___ through ___ COMPARISON: None available FINDINGS: The lungs are normally expanded. There is mild lingular scarring. Heart size is normal. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no evidence of pneumonia or pulmonary edema. As on the prior study there is anterior weding at the thoracolumbar junction with exaggerated kyphosis. There is a healed left lower rib fracture. IMPRESSION: No acute cardiopulmonary abnormality. " de9b4767-9ef417c5-be0a4e5a-350d6e96-44d72088.jpg,test/p19/p19336651/s55023422/de9b4767-9ef417c5-be0a4e5a-350d6e96-44d72088.jpg,test," FINAL REPORT INDICATION: Fever, evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___. FINDINGS: Lungs are well inflated and clear. The cardiac silhouette is mildly enlarged. There is no pleural effusion or pneumothorax. Visualized upper abdomen is unremarkable. Median sternotomy wires and surgical clips project over the mediastinum. Surgical clips are also seen in the upper abdomen. Calcifications of the aortic arch is noted. IMPRESSION: No evidence of acute cardiopulmonary process. Mild cardiomegaly. " da74520f-80018d9e-7b6dab07-356bf1c5-3abcffb0.jpg,test/p14/p14240904/s57180130/da74520f-80018d9e-7b6dab07-356bf1c5-3abcffb0.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Cough, assess for pneumonia. Cardiomediastinal contours are normal. The lungs are clear. There is no pleural effusion. IMPRESSION: No evidence of pneumonia. " 035f1547-3d2cf9fe-65cc0fd1-8d1dac43-ec957410.jpg,test/p14/p14989617/s55949588/035f1547-3d2cf9fe-65cc0fd1-8d1dac43-ec957410.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with polysubstance abuse p/w palpitations, CP COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 25d9a81a-de472fb7-b8a9d38a-502cd0f2-f2284c9d.jpg,test/p18/p18427517/s57754061/25d9a81a-de472fb7-b8a9d38a-502cd0f2-f2284c9d.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with chest pain, vomiting // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded and clear. No focal consolidation, edema, effusion, or pneumothorax. The heart size is normal. The mediastinum is not widened. Hilar contours and pleura are normal. No acute osseous abnormality. IMPRESSION: Normal chest radiograph. No pneumonia. " e8180b7c-f593fb9e-5a703f71-922dc6a0-ca9aa3b5.jpg,test/p17/p17592232/s53528907/e8180b7c-f593fb9e-5a703f71-922dc6a0-ca9aa3b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory insufficiency, trached // interval change interval change IMPRESSION: Comparison to ___. Stable monitoring and support devices. The lung volumes have decreased. Small new bilateral pleural effusions with subsequent areas of atelectasis. Mild cardiomegaly without pulmonary edema. No evidence of pneumonia. " a234a04d-c9135048-4be0b4a2-02f2c1ff-309e3cce.jpg,test/p10/p10439374/s53968730/a234a04d-c9135048-4be0b4a2-02f2c1ff-309e3cce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COPD, going for hip surgery tomorrow. // Pt needs better inspiratory effort for this pre-op Xray Surg: ___ (Hip ) Pt needs better inspiratory effort for this pre-op Xray COMPARISON: Chest radiograph ___:14. IMPRESSION: Lung volumes have improved substantially, pulmonary edema has resolved and cardiomegaly and mediastinal vascular engorgement improved " b4cdda3d-ded86983-986513fc-d416968f-e6643d79.jpg,test/p15/p15287471/s57137119/b4cdda3d-ded86983-986513fc-d416968f-e6643d79.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Endocarditis, intubated patient. Comparison is made with prior study performed two hours earlier. ET tube has been repositioned, now is in a standard position. Left lower lobe atelectasis is new. There are no other interval changes. " 1f42144a-436adb8b-4230bc2b-acdfafc9-ef3c6809.jpg,test/p12/p12118473/s52982274/1f42144a-436adb8b-4230bc2b-acdfafc9-ef3c6809.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with syncope and question of vascular stenosis // check placement of cardiac implantable electrical device TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: Compared with prior radiographs on ___, there is new very mild interstitial edema, with no change in pulmonary congestion. There is heavy mitral annular valve calcification. There are extensive asbestos related pleural calcifications, similar to prior. Heart size is normal. There is no focal consolidation, pleural effusion, or pneumothorax. A left chest wall biventricular pacer is stable in position, with leads terminating in the right atrium, right ventricle, and coronary sinus. IMPRESSION: Appropriately positioned biventricular pacer. Unchanged vascular congestion, with new very mild interstitial edema. " f8e957ab-f75b873b-69ecb09c-d33a919d-e031cdb9.jpg,test/p11/p11455001/s57526571/f8e957ab-f75b873b-69ecb09c-d33a919d-e031cdb9.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Assessment of ET tube placement. COMPARISON: ___. ET tube tip is approximately 3.3 cm above the carina. NG tube and Dobbhoff tube passing below the diaphragm terminating in the stomach. Right subclavian line tip is at the cavoatrial junction. Heart size and mediastinum are unchanged. Bibasal, right more than left atelectasis is present. Mild interstitial pulmonary edema cannot be excluded. Overall unchanged since the prior study. There is no evidence of pneumothorax. " fa1f1101-c96d7d64-e6ca3550-2c8ff08a-8e725c60.jpg,test/p18/p18064435/s52054421/fa1f1101-c96d7d64-e6ca3550-2c8ff08a-8e725c60.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with fever, cough, sob, crackles L base // pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph ___, chest radiograph ___. FINDINGS: Focal opacity in the left lower lobe consistent with left lower lobe pneumonia. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unchanged. IMPRESSION: Left lower lobe pneumonia. " bc9dab4c-796788cc-93986258-9ebc9896-3bb595ea.jpg,test/p16/p16967171/s57333331/bc9dab4c-796788cc-93986258-9ebc9896-3bb595ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with dyspnea TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Low lung volumes are present. The cardiac silhouette size appears moderately enlarged but unchanged. Mediastinal contour appears similar with unfolding of the thoracic aorta again seen. Mild pulmonary edema is new in the interval with a small right pleural effusion appearing similar. Small amount of fluid is also seen within the minor fissure. Patchy opacities in the lung bases likely reflect areas of atelectasis. No pneumothorax is present. There arm mild degenerative changes noted in the thoracic spine. IMPRESSION: Mild pulmonary edema, new in the interval, and similar-appearing small right pleural effusion. Patchy atelectasis in the lung bases. " 590ac9a0-06aaf0d6-6a6538af-9ceac3f0-b995e0ce.jpg,test/p19/p19456470/s52245632/590ac9a0-06aaf0d6-6a6538af-9ceac3f0-b995e0ce.jpg,test," FINAL REPORT INDICATION: Query pneumonia. COMPARISONS: Chest radiographs from ___ to ___. Chest radiograph ___. FINDINGS: Cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The right basilar opacity is much improved on the current study. Mild plate-like atelectasis in the left mid lung and lower lung are still present. Paucity of vasculature in the apices is indicative of emphysematous changes. An ill-defined opacity persists at the right apex which was not present in ___. IMPRESSION: 1. Improved right basilar opacity. 2. Persistent ill-defined opacity in the right apex, which is concerning for malignancy. Chest CT is recommended for further evaluation. Dr. ___ ___ these results with Dr. ___ at 4:01 pm on ___ via telephone. " c3076149-ede5e91f-7c7d0b03-ca9161a8-1628bc26.jpg,test/p13/p13073860/s54478363/c3076149-ede5e91f-7c7d0b03-ca9161a8-1628bc26.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // r/o pna r/o pna IMPRESSION: In comparison with study of MK ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " f65b1a8b-9e18ac5c-734a285a-881e4d6d-f3702a3a.jpg,test/p16/p16051431/s59785603/f65b1a8b-9e18ac5c-734a285a-881e4d6d-f3702a3a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dobhoff // evaluate placement of dobhoff evaluate placement of dobhoff IMPRESSION: Compared to chest radiographs ___ through ___. Residual multifocal pneumonia is clearing in the right lung, unchanged on the left a most severe in the. Heart size normal. No appreciable pleural effusion. Feeding tube ends in the upper stomach. Preexisting cavitary infection and thick walled bronchiectasis noted in the left lung apex has been attributed to tuberculosis. " b3734d80-707bfb68-7de0987a-baaea082-49fde1df.jpg,test/p16/p16183583/s55644096/b3734d80-707bfb68-7de0987a-baaea082-49fde1df.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent intubation // ?tube placement ?tube placement COMPARISON: Comparison to prior study from ___ at 20:30 FINDINGS: Portable supine chest film ___ at 21:33 is submitted. IMPRESSION: Interval placement of an endotracheal tube with its tip 4.3 cm above the carina. Interval placement of nasogastric tube which courses below the diaphragm with the tip not identified. There continues to be a diffuse reticular nodular airspace process but there are now more confluent opacities in both lung bases consistent with worsening pneumonia. No pneumothorax. Overall cardiac and mediastinal contours are stable. " c2fd88b6-b93b107d-c17eeacc-72027a79-7da93b67.jpg,test/p19/p19615614/s52196718/c2fd88b6-b93b107d-c17eeacc-72027a79-7da93b67.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Status post motor vehicle collision. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours are unremarkable. The lung volumes are low, and in that context, streaky basilar opacities, left greater than right, suggest minor atelectasis. There is no pleural effusion or pneumothorax. No fracture is identified. IMPRESSION: No evidence of injury. " 33cbc9a9-27642947-8ab86dfd-49c1631b-6a97c15f.jpg,test/p12/p12008386/s59702441/33cbc9a9-27642947-8ab86dfd-49c1631b-6a97c15f.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with shortness of breath and chest tightness, evaluate for pneumonia or fluid overload. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest were obtained. The heart is normal size and cardiomediastinal silhouette is unremarkable. Lungs are symmetrically expanded. There is no CHF, focal infiltrate, pleural effusion or pneumothorax. IMPRESSION: No acute pulmonary process. " 53262841-1cced1d2-f181b254-7fcf8e6d-985126cc.jpg,test/p13/p13767558/s54211940/53262841-1cced1d2-f181b254-7fcf8e6d-985126cc.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough, rib pain // r/o PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy with the inferior most sternotomy wire is again seen to be fractured. The patient is status post CABG. There is left basilar atelectasis/scarring. No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Left basilar atelectasis/ scarring without definite focal consolidation. " 6c31d518-9446904d-a97f6b64-17704df5-b700f1c9.jpg,test/p17/p17058328/s54884489/6c31d518-9446904d-a97f6b64-17704df5-b700f1c9.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with a positive PPD, living in a group home. IMPRESSION: PA and lateral chest compared to ___: Severe cardiomegaly has progressed slightly, but pulmonary vascular engorgement is minimal if any and there is no edema or pleural effusion. Possibility of chronic pericardial effusion should be entertained, although this is relatively uncommon. There is no evidence of tuberculosis. " 3c236bfa-e2557304-5c8d685b-b5839060-569add06.jpg,test/p17/p17434499/s59367327/3c236bfa-e2557304-5c8d685b-b5839060-569add06.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with UC, PSC, on steriods, p/w ILI, difficulty swallowing // eval for PNA eval for PNA TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " d7fffeae-ebce7260-3d44c788-5f952a98-630d1371.jpg,test/p17/p17512499/s59160791/d7fffeae-ebce7260-3d44c788-5f952a98-630d1371.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Breast implants increase apparent density in the lower lungs. Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality, specifically no pneumothorax. " 508e66e4-0295d2fe-f70df941-d9a2e414-5635f345.jpg,test/p12/p12960546/s57166751/508e66e4-0295d2fe-f70df941-d9a2e414-5635f345.jpg,test," WET READ: ___ ___ ___ 6:06 PM 1. new right chest tube terminating over upper right lung. no pneumothorax present. 2. dcr right lower lung opacification, likley due to dcr effusion and atelectasis. dcr small left pleural effusion 3. increased, bilateral, predominantly perihilar opacifications with indistinct pulmoanry vessels, suggest worsening edema. given opacifications, cannot exclude underlying infectious process. 4. Stable cardiomegaly. 5. ETT well positioned. ___ ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:38 P.M. ___. HISTORY: ___-year-old man after AVR. Possible pneumothorax. Right chest tube placed. IMPRESSION: AP chest compared to ___: Mild pulmonary edema has worsened, small-to-moderate right pleural effusion substantially smaller following insertion of a right upper pleural tube. No appreciable right pneumothorax. Moderate cardiomegaly chronic. ET tube in standard placement. Swan-Ganz catheter ends in the main pulmonary bifurcation. Transvenous right atrial and right ventricular pacer leads are unchanged in their respective positions. No left pneumothorax. " aaeeeff1-8ee79496-d48ca36a-3f61bc38-e2d48300.jpg,test/p14/p14014690/s52231485/aaeeeff1-8ee79496-d48ca36a-3f61bc38-e2d48300.jpg,test," FINAL REPORT HISTORY: Epigastric pain, shortness of breath, cough and vomiting. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. The lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No subdiaphragmatic free air is demonstrated. IMPRESSION: No acute cardiopulmonary process. " 9aa1342d-e09425d1-612fc9a2-75a175ac-d2a6abce.jpg,test/p19/p19314531/s55257394/9aa1342d-e09425d1-612fc9a2-75a175ac-d2a6abce.jpg,test," FINAL REPORT HISTORY: Shortness of breath and coarse breath sounds. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___ and chest CT ___. FINDINGS: The cardiac, mediastinal and hilar contours are unchanged with the heart size within normal limits. Calcified left hilar lymph nodes as well as calcifications within the medial aspect of the left upper lung field are unchanged compatible prior granulomatous disease. Pulmonary vascularity is not engorged. The lungs are hyperinflated with relative lucency in the lung apices compatible with underlying emphysema. Previously noted right lower lobe opacity has resolved. No focal consolidation, pleural effusion or pneumothorax is identified. Scattered calcified granulomas are also noted within the lungs. Partial resection of the ___ right posterior rib is again noted. There are no acute osseous findings. IMPRESSION: No acute cardiopulmonary abnormality. Evidence of prior granulomatous disease. Emphysema. " 511d21dc-e098ff71-b47f410a-4ed94573-3d494cfb.jpg,test/p12/p12343684/s59497250/511d21dc-e098ff71-b47f410a-4ed94573-3d494cfb.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with withdrawal sxs, tachycardia, treumlousness, persistent metabolic abnormalities // eval? acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: The lungs are clear without lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unchanged in appearance. IMPRESSION: No acute cardiopulmonary process. " 0cdf71cc-0de86bc5-78c68c41-e5570fc1-6c65e241.jpg,test/p18/p18785003/s57584233/0cdf71cc-0de86bc5-78c68c41-e5570fc1-6c65e241.jpg,test," FINAL REPORT AP CHEST, 5:02 A.M., ___ RIGHT: Right colon perforation after knee replacement, now following exploratory laparotomy and hemicolectomy. IMPRESSION: AP chest compared to ___: Moderate right pleural effusion continues to enlarge. Pulmonary vasculature is engorged but there is no edema. Heart size is probably not enlarged. No pleural effusion. If there is an ET tube in place, it is more than 8 cm from the level of the carina, above the upper margin of the clavicles and should be advanced 5 cm. Right PIC line ends in the mid SVC and upper enteric drainage tube passes into the stomach and out of view. No pneumothorax. Dr. ___ was paged at 10:55 a.m., since the findings were recognized. " 8ee58089-dc58d035-b720eb95-ff0966c1-83945f16.jpg,test/p18/p18408877/s58247425/8ee58089-dc58d035-b720eb95-ff0966c1-83945f16.jpg,test," FINAL REPORT HISTORY: ___-year-old female with dyspnea and fever, rule out pneumonia. COMPARISON: ___. TWO VIEWS OF THE CHEST: There is marked hyperinflation of the lungs, without focal consolidation or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are unremarkable. Note is made of calcification of the aortic knob, unchanged. IMPRESSION: 1. No pneumonia 2. COPD. " 18f4eef0-8211cdaa-1946210f-51538784-6f169a66.jpg,test/p10/p10753287/s57507625/18f4eef0-8211cdaa-1946210f-51538784-6f169a66.jpg,test," WET READ: ___ ___ ___ 5:51 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with chest pain // Acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 35fca713-4aee23ae-41dfd1ad-fd31bc05-9df7a827.jpg,test/p17/p17915506/s50113036/35fca713-4aee23ae-41dfd1ad-fd31bc05-9df7a827.jpg,test," FINAL REPORT INDICATION: ___-year-old female with right lower lobectomy for adenocarcinoma. After chest tube removal. Evaluate for pneumothorax. EXAMINATION: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: There is a moderate right-sided hydropneumothorax after chest tube removal. The remainder of the right lung remains well aerated. Since the prior examination there is opacification demonstrated within the left lower lobe. There is a trace left pleural effusion. There is no evidence of left pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal. IMPRESSION: 1. Moderate right hydropneumothorax after chest tube removal; status post right lower lobectomy. 2. New patchy opacification within the left lower lobe may be due to acute aspiration or atelectasis. Recommend short-term interval followup to exclude development of pneumonia if infectious symptoms are present. " 31f14efc-226234d5-c0c90f85-23e6dcf4-167384b6.jpg,test/p18/p18062414/s58611170/31f14efc-226234d5-c0c90f85-23e6dcf4-167384b6.jpg,test," FINAL ADDENDUM ADDENDUM: The findings regarding the possible pericardial effusion were communicated by Dr. ___ to Dr. ___ ___ telephone at 9:15 a.m. after attending review of the film. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain. Question acute process. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Aside from a suggestion, along the left heart border, of small pericardial effusion, the cardiomediastinal silhouette is unremarkable. Osseous structures are intact. IMPRESSION: Possible pericardial effusion. No evidence of tamponade physiology. Clinical correlation advised. " 628124c1-a7ac50b1-141d8f79-bc93a6cd-9e6c72af.jpg,test/p15/p15079493/s56142014/628124c1-a7ac50b1-141d8f79-bc93a6cd-9e6c72af.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxia // assess for pneumothorax assess for pneumothorax IMPRESSION: Comparison to ___. The monitoring and support devices are in stable position. The patient shows signs of severe central pulmonary edema, predominating in the perihilar and upper lobe lung areas. In addition, the retrocardiac atelectasis is visualized. No pleural effusions. No pneumothorax. " 9cfef38d-9c43de4f-58cec5b7-742a5924-400e64cc.jpg,test/p14/p14041324/s56877479/9cfef38d-9c43de4f-58cec5b7-742a5924-400e64cc.jpg,test," WET READ: ___ ___ ___ 7:54 PM Low lung volumes. NG in the Stomach. Abdominal drain incompletely imaged. Epigastric and right mid abdomen surgical sutures/___ noted. ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post right colectomy, assess NG tube. NG tube tip is in the stomach. Cardiomediastinal contours are normal. The lungs are clear aside from minimal atelectasis in the left base. There is no pneumothorax or pleural effusion. Surgical clips present in the right lower quadrant and left upper quadrant of the abdomen. Abdominal drain is present. " 93f801d1-732b2b8c-46354b48-cd75e2e6-c6aac2e9.jpg,test/p16/p16132012/s58273712/93f801d1-732b2b8c-46354b48-cd75e2e6-c6aac2e9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man, intubated, PNA, // interval change TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " d1554ed8-d2b62ed2-e20a6e9f-9c063e71-bf38f876.jpg,test/p17/p17779045/s55502171/d1554ed8-d2b62ed2-e20a6e9f-9c063e71-bf38f876.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with a cough for two weeks. IMPRESSION: PA and lateral chest compared to ___: Mild cardiomegaly is chronic. Despite very heavily calcified mitral annulus, and coronary artery calcifications, there is no evidence of cardiac decompensation, pulmonary vasculature is normal. Mediastinal veins are not dilated and there is no edema or pleural effusion. Lungs are clear. Previous tracheal displacement by a large thyroid is no longer present. " 015190fe-06a72bff-91be47a0-7d5d31fb-6e50f502.jpg,test/p10/p10404367/s53918628/015190fe-06a72bff-91be47a0-7d5d31fb-6e50f502.jpg,test," FINAL REPORT INDICATION: Bilateral crackles. COMPARISON: Radiograph available from ___ through ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart is mildly enlarged. A left-sided Port-A-Cath terminates within the cavoatrial junction. Again seen is central vascular prominence which has increased somewhat. There is increased density at the left base, concerning for an early consolidation. Right basilar opacity is also new although less extensive than on the left side. This finding appears worse in comparison to the ___ study. IMPRESSION: Basilar opacities, increased since ___, concerning for infection in the appropriate setting. Findings suggesting there may be mild vascular congestion or fluid overload. " 0da7a987-2a1639d6-01639eb6-e21eb9a2-ec70261b.jpg,test/p18/p18396451/s53365258/0da7a987-2a1639d6-01639eb6-e21eb9a2-ec70261b.jpg,test," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Upright AP view of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Heart size is difficult to discern given the presence of left basilar opacity which likely reflects a combination of small left pleural effusion with atelectasis or infection. The heart size is slightly increased, now appearing moderately enlarged. The aorta remains mildly tortuous. The pulmonary vascularity is not engorged. No right-sided pleural effusion is seen, and there is no pneumothorax. An osseous excrescence off of the left humeral head may be posttraumatic in etiology. There are no acute osseous abnormalities otherwise demonstrated. IMPRESSION: Left basilar opacity likely reflects a combination of small left pleural effusion and left basilar atelectasis or infection. Heart size is difficult to discern but appears increased in size compared to the prior, now moderately enlarged. " ddf1a4ba-73c0c642-6c109579-197735cd-47d8ce33.jpg,test/p14/p14151932/s55726063/ddf1a4ba-73c0c642-6c109579-197735cd-47d8ce33.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LLL nodule in the setting of duodenal CA. // Please evaluate for post lung biopsy PTX thanks. To be done in RCU at ___ hours thanks Please evaluate for post lung biopsy PTX thanks. To be done in RCU at ___ hours thanks IMPRESSION: In comparison with the study of ___, following lung biopsy there is a small to moderate left pneumothorax. Area of increased opacification at the left base presumably reflects the lesion being biopsied. There is also an opacification overlying the anterior second rib on the left, which should be checked on subsequent studies to see whether it represents a true abnormality. " 0c7f8551-1e5e5afb-8331609a-40ef26b5-cceb49ab.jpg,test/p10/p10538311/s58312045/0c7f8551-1e5e5afb-8331609a-40ef26b5-cceb49ab.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with cough since mid ___, worse over the last two weeks ; evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: No prior dedicated chest imaging is available on PACS at the time of this dictation. FINDINGS: The lungs are clear. No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila and pleura are normal. Thoracic cage and soft tissues appear normal. IMPRESSION: No acute cardiopulmonary process. " c681e756-278b3b38-0472808c-ce2344ce-743125ee.jpg,test/p11/p11669319/s50335438/c681e756-278b3b38-0472808c-ce2344ce-743125ee.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with fevers/chills and productive cough // ? infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Old healed left lateral rib fractures are noted. IMPRESSION: No acute cardiopulmonary process. " fb71a12b-a47f0214-aec620ea-db767b56-9e7b2e99.jpg,test/p12/p12436423/s59973528/fb71a12b-a47f0214-aec620ea-db767b56-9e7b2e99.jpg,test," FINAL REPORT INDICATION: ___-year-old female with dyspnea and hypoxia x1 week. COMPARISON: Chest radiograph from ___ and chest CTA from ___. CHEST, PA AND LATERAL: Lung apices are hyperlucent, compatible with chronic obstructive airways disease. Discoid atelectasis has developed at both lung bases. There is partial silhouetting of the hemidiaphragms, and superimposed infection cannot be excluded. Small bilateral pleural effusions are present. There is no pneumothorax. Heart size is normal. IMPRESSION: 1. Bibasilar atelectasis and small effusions. 2. Emphysema. " e15a7b75-f4129e8d-2f922242-734a8467-745a5b21.jpg,test/p13/p13800851/s50513028/e15a7b75-f4129e8d-2f922242-734a8467-745a5b21.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Productive cough, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Moderate cardiomegaly, low lung volumes. Mild fluid overload, but no overt pulmonary edema. No pleural effusions. No pneumonia. " 3cccd818-ce6c905f-431d6387-8fb61de8-cd7c0b68.jpg,test/p15/p15069337/s50219828/3cccd818-ce6c905f-431d6387-8fb61de8-cd7c0b68.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with axtaxia // eval for pnaNCHCT eval for ICH TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Minimal basilar atelectasis/scarring is seen without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. Slight prominence of the hila likely relates to pulmonary vascular engorgement. Some degenerative changes are seen along the spine. IMPRESSION: Mild cardiomegaly and mild central pulmonary vascular engorgement. No focal consolidation to suggest pneumonia. " 2956a6c6-febd143e-68ef7f41-fefdf980-5c40efd0.jpg,test/p12/p12382393/s58732614/2956a6c6-febd143e-68ef7f41-fefdf980-5c40efd0.jpg,test," FINAL REPORT HISTORY: Weakness, AFib, question infiltrate. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___ ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Lucency seen just inferior to the inferior left heart border on the frontal view appears to be likely within the stomach on the lateral view. The aorta is somewhat tortuous. The cardiac silhouette is not enlarged. IMPRESSION: No focal consolidation. " 7638a502-3aed96db-cedbdd38-1c7f852c-f9e6ce86.jpg,test/p18/p18655830/s57868328/7638a502-3aed96db-cedbdd38-1c7f852c-f9e6ce86.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: The patient with diabetes and severe gastroparesis. Cardiomediastinal contours are normal. The lungs are grossly clear aside from minimal atelectasis in the left lower lobe. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of pneumonia. " 183d7896-ee0a67a3-cd4a7a73-18e1025c-4047ef79.jpg,test/p13/p13219116/s53144266/183d7896-ee0a67a3-cd4a7a73-18e1025c-4047ef79.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough. COMPARISON: Multiple prior chest radiographs, most recently ___. FINDINGS: Frontal and lateral views of the chest were obtained. Patient is slightly rotated with respect to film. The heart size and cardiomediastinal contours are normal. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body. Loose bodies in right shoulder redemonstrated. IMPRESSION: No acute cardiopulmonary process. " 6c75c7a9-3efbd77b-66928538-38a7a250-418f7f6f.jpg,test/p18/p18202111/s53427589/6c75c7a9-3efbd77b-66928538-38a7a250-418f7f6f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Left pleural effusion s/p thoracentesis // r/o pneumothorax COMPARISON: Chest ___ ; CT chest ___ FINDINGS: PA and lateral views of the chest provided. The lungs are well-inflated. 2.9 cm nodule in the lingula was better evaluated on CT chest ___. A small left pleural effusion is decreased in size. The hilar and cardiomediastinal contours are normal. IMPRESSION: 1. No pneumothorax. 2. 2.9 cm nodule in the lingula and additional pulmonary nodules were better evaluated on CT chest ___. No new nodules are seen. 3. A small left pleural effusion is decreased in size from the prior examination on the same date. " 30abee68-f4bc15bd-2c3171d4-b03c8721-3b3a89bd.jpg,test/p19/p19416143/s50467030/30abee68-f4bc15bd-2c3171d4-b03c8721-3b3a89bd.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hepatic disease COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Healed old left rib fractures. No evidence of acute changes such as pneumonia, pleural effusions or pulmonary edema. No pneumothorax. Borderline size of the cardiac silhouette with minimal tortuosity of the thoracic aorta. " c4f3d46e-ce631842-85cecf0b-6c00e79f-f24ba97b.jpg,test/p17/p17283683/s53009684/c4f3d46e-ce631842-85cecf0b-6c00e79f-f24ba97b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // Eval pneumothorax/pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are grossly stable with the aorta slightly more tortuous as compared to the prior study. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " aea67f03-9f0cbbb0-576a6397-4ea6e399-25e14662.jpg,test/p19/p19519251/s55819028/aea67f03-9f0cbbb0-576a6397-4ea6e399-25e14662.jpg,test," WET READ: ___ ___ ___ 8:12 AM Compared to the prior study, there are persistent asymmetric opacifications involving the right base and left perihilar regions, for which aspiration was previously mentioned. WET READ VERSION #1 ___ ___ ___ 7:29 PM Compared to the prior study, there are persistent asymmetric opacifications involving the right base and left perihilar regions, for which aspiration was previously mentioned. ______________________________________________________________________________ FINAL REPORT In comparison with the study of ___, EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with OMFS procedure with worsening hypoxia // Eval for infiltrate, other process Eval for infiltrate, other process IMPRESSION: There is increasing opacification bilaterally, again most prominent at the right base medially and in the left perihilar region. This again is consistent with worsening aspiration or infectious pneumonia. " 6b1d5082-28cd1dbf-2fc7ba1f-8672db6b-6714a515.jpg,test/p14/p14247006/s57615931/6b1d5082-28cd1dbf-2fc7ba1f-8672db6b-6714a515.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. Comparison is made with prior study from ___. CLINICAL HISTORY: Shortness of breath, dyspnea on exertion, assess for edema. FINDINGS: PA and lateral views of the chest were obtained. An AICD is unchanged in position with lead tip extending into the right ventricle region. Midline sternotomy wires are again seen. There is interstitial pulmonary edema with bilateral small pleural effusions. Heart size is stable and within normal limits. Central hilar engorgement is noted. No pneumothorax. Bony structures are intact. IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions. " a90e5246-8cad4558-24544ff8-922fe0e1-6675f8f3.jpg,test/p19/p19728795/s54806382/a90e5246-8cad4558-24544ff8-922fe0e1-6675f8f3.jpg,test," FINAL REPORT INDICATION: ___ year old man with ICD // rule out pneumothorax and lead placement TECHNIQUE: Chest PA and lateral COMPARISON: No prior FINDINGS: Left-sided ICD with the tip in the right ventricle. Low lung volumes with crowding of the bronchovascular markings. Right lower lung zone opacity may reflect a combination of atelectasis, crowded vessels and posterior rib, rather than pneumonia. No overt pulmonary edema. Mild cardiac enlargement. No pleural effusions or pneumothorax. IMPRESSION: No pneumothorax. Right lower lung zone opacity is probably a combination of atelectasis, crowded vessels and posterior rib, rather than pneumonia. If there are symptoms of infection, repeat chest radiographs including oblique views should be obtained. RECOMMENDATION(S): If there are symptoms of infection, repeat chest radiographs including oblique views should be obtained. " 26d55c50-43feeb3c-078c14ca-4483b1f3-0ca74c5e.jpg,test/p14/p14107609/s55867624/26d55c50-43feeb3c-078c14ca-4483b1f3-0ca74c5e.jpg,test," FINAL REPORT INDICATION: Patient with palpitations, assess for fluid overload. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes, which accentuate bronchovascular markings. Minimal perihilar vascular congestion is noted. There is no pulmonary edema. Hilar and mediastinal silhouettes are unchanged. Moderate cardiomegaly persists. No pleural effusion or pneumothorax. Ill-defined opacities project over lower thoracic spine, best seen on the lateral view, more conspicuous since prior. There is no focal consolidation. The imaged upper abdomen is unremarkable. IMPRESSION: 1. Moderate cardiomegaly, unchanged since ___. 2. Minimal perihilar vascular congestion. Ill-defined opacity projecting over the lower thoracic spine on the lateral view may relate to low lung volumes, atelectasis, or less likely infection in the appropriate clinical setting. " 8da97448-1ae409eb-668d315b-7b4173ec-48db9f11.jpg,test/p16/p16945756/s57850261/8da97448-1ae409eb-668d315b-7b4173ec-48db9f11.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with fever. Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___, chest radiograph ___ FINDINGS: Heart size is normal and unchanged. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. There is new consolidation in the right lower lobe, concerning for pneumonia. No pleural effusion. No pneumothorax. There are cholecystectomy clips in the right upper quadrant. No acute osseous abnormalities. IMPRESSION: New right lower lobe consolidation compatible with pneumonia. Follow-up radiographs are recommended after treatment to ensure resolution. " 848aa883-9e2dfd13-37adb003-112e1494-d3343af8.jpg,test/p15/p15798565/s59141539/848aa883-9e2dfd13-37adb003-112e1494-d3343af8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with diabetic ketoacidosis, persistent hypotension TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 7d820b2f-5c463838-18f4a5f0-1908864c-09425e6e.jpg,test/p15/p15519063/s56349214/7d820b2f-5c463838-18f4a5f0-1908864c-09425e6e.jpg,test," FINAL REPORT HISTORY: Altered mental status. Evaluate for pneumonia. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lung volumes are slightly decreased. Left midline linear opacity likely reflects atelectasis. There is however no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 6c24203f-eb2ae77d-f8dc8d4b-8ca91798-a6dddd76.jpg,test/p18/p18855147/s57304510/6c24203f-eb2ae77d-f8dc8d4b-8ca91798-a6dddd76.jpg,test," FINAL REPORT PORTABLE AP CHEST FROM ___ AT 5:36 CLINICAL INDICATION: ___-year-old with chest pain, assess for interval change. Comparison is made to the patient's prior study of ___, at 14:48. A single portable erect chest film ___ at 6:00 a.m. is submitted. IMPRESSION: 1. Right-sided internal jugular dual-lumen catheter is unchanged in position. There is worsening bilateral airspace and interstitial process, which most likely reflects worsening pulmonary and interstitial edema, possibly superimposed on underlying chronic interstitial changes. Overall cardiac and mediastinal contours are difficult to assess given patient rotation on the current examination. No evidence of pneumothorax. Probable small left layering pleural effusion. " 90e05c81-53e48b75-3eee4bca-6fd7888e-9b6b6d80.jpg,test/p11/p11837162/s53356773/90e05c81-53e48b75-3eee4bca-6fd7888e-9b6b6d80.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with n/v // ?PNA COMPARISON: Outside hospital film from ___ IMPRESSION: The extensive right lung changes, present on the previous radiograph, are not substantially increased. However, the nodular and masslike aspect of the upper rounded component of the changes, adjacent to the right upper mediastinum, is slightly increased. The lateral radiograph shows that, at least a part of the opacities are caused by fissural thickening. In any way, however, CT should be used to further clarify the nature and origin of the changes which were not present on a previous CT examination performed in ___. This information was added to the radiology dashboard at the time of dictation and observation. Normal size of the cardiac silhouette. No pleural effusions. " dc151f3c-62125f0a-fc62d135-eb797d01-f54846cd.jpg,test/p11/p11266603/s52749245/dc151f3c-62125f0a-fc62d135-eb797d01-f54846cd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p thoracentesis now with crackles on exam and hypoxia. // aspiration? pneumonia? aspiration? pneumonia? IMPRESSION: In comparison with the study of ___, there is been a thoracentesis on the right with removal of a substantial amount of pleural fluid. No evidence of pneumothorax. A moderate right effusion persists with areas of underlying atelectasis and re-expansion pulmonary edema. The left lung is essentially clear. " 1bf9f58e-dc547197-9c1c001b-778f20e5-11b45ab8.jpg,test/p19/p19616513/s51317568/1bf9f58e-dc547197-9c1c001b-778f20e5-11b45ab8.jpg,test," FINAL REPORT HISTORY: HIV, end-stage renal disease with chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. Left brachiocephalic vascular stent is re- demonstrated. Previously seen right sided dual lumen central venous catheter has been removed. Partially imaged is cervical fusion hardware. Mild loss of height of 2 vertebral bodies at the thoracolumbar junction is unchanged. IMPRESSION: No acute cardiopulmonary process. " 362a756f-cbfbe7ff-2a84d590-f40fae93-b11a69d6.jpg,test/p15/p15715501/s55188995/362a756f-cbfbe7ff-2a84d590-f40fae93-b11a69d6.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Pleuritic chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Slight rightward convex curvature is again centered along the lower thoracic spine. IMPRESSION: No evidence of acute disease. " a8569dcf-1ef8226c-f7079c7c-7533effd-e61b9319.jpg,test/p17/p17822878/s52137323/a8569dcf-1ef8226c-f7079c7c-7533effd-e61b9319.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: Comparison made with chest radiographs from ___ and ___. FINDINGS: PA and lateral views of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 5e013354-b4150b8b-ef30d217-7dcede7e-861e668b.jpg,test/p15/p15373430/s52928464/5e013354-b4150b8b-ef30d217-7dcede7e-861e668b.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with history of end-stage renal disease on peritoneal dialysis with fever of unknown origin and worsening shortness of breath. PA and lateral upright chest radiographs were reviewed in comparison to prior study from ___ obtained at 08:35 a.m. There is interval progression of bilateral interstitial opacities, highly concerning for progression of pulmonary edema. In addition, there is more pronounced right lower lobe consolidation that, although might be part of pulmonary edema, can also represent an unrelated infectious process. The assessment of the patient after diuresis is recommended. Small amount of pleural effusion is most likely present. " 4ec442b7-5fb340eb-efa7967d-ac80ab29-a4302440.jpg,test/p14/p14280192/s56020029/4ec442b7-5fb340eb-efa7967d-ac80ab29-a4302440.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent complicated MI // F/u MI, CABG, MVR, tricuspid repair, sho F/u MI, CABG, MVR, tricuspid repair, sho IMPRESSION: Comparison to ___. Bilateral pleural effusions are better visualized on the lateral than on the frontal radiograph. Minimal areas of atelectasis at the lung bases. No overt pulmonary edema. No pneumonia, borderline size of the cardiac silhouette. " 3ac68e75-77571934-ae24d154-f80e05b9-7ff3fd09.jpg,test/p15/p15467950/s58285988/3ac68e75-77571934-ae24d154-f80e05b9-7ff3fd09.jpg,test," FINAL REPORT INDICATION: ___F with fever // assess for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality, chronic changes the posterior left third rib are noted. IMPRESSION: No acute cardiopulmonary process. " 6ec4c670-95c6f9bb-97df7fd4-e68c51f6-407a75bf.jpg,test/p18/p18793292/s55826389/6ec4c670-95c6f9bb-97df7fd4-e68c51f6-407a75bf.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a prior chest radiograph from ___ and a chest CT from ___. CLINICAL HISTORY: Cough, question pneumonia. FINDINGS: PA and lateral views of the chest are obtained. Lung volumes are low. There is persistent elevation of the right hemidiaphragm with persistent small right effusion and right lower lobe atelectasis. There is likely mild left lung base atelectasis. Heart size is top normal. Mediastinal contour is stable. No pneumothorax. IMPRESSION: Persistent right effusion and basilar atelectasis. " 5f9bbd34-9e523648-5ed0a53c-deba5966-76980de7.jpg,test/p10/p10027957/s52771355/5f9bbd34-9e523648-5ed0a53c-deba5966-76980de7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with leukocytosis // pneumonia? pneumonia? COMPARISON: Previous chest radiographs ___. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection, including tuberculosis. Mild scoliosis is probably chronic. " 14ee581c-40b29c01-5f77815c-5bb35b60-c847fcf5.jpg,test/p16/p16214743/s59711895/14ee581c-40b29c01-5f77815c-5bb35b60-c847fcf5.jpg,test," FINAL REPORT HISTORY: Fever and rigors with hypoxemia. COMPARISON: None. FINDINGS: Two views were obtained of the chest. The lungs are low in volume but appear clear aside from subtly increased interstitial markings which could reflect an atypical infectious process. Blunting of the costophrenic angles on the frontal view is likely due to overlying soft tissue given their sharpness on the lateral. The heart is mildly enlarged with tortuous thoracic aorta. IMPRESSION: Reticular interstitial prominence could reflect an atypical infectious process. " e961189a-f9966f07-09a21246-a638be17-2b5b0af3.jpg,test/p18/p18483037/s57986565/e961189a-f9966f07-09a21246-a638be17-2b5b0af3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with metastatic prostate ca on lupron now with decreased breath sound on the L lung mid to base // pls assess for PNA, effusion, atelectasis, abnormalities TECHNIQUE: CHEST (PA AND LAT) COMPARISON: NONE. IMPRESSION: HEART SIZE IS TOP-NORMAL. TORTUOUS AORTA IS PRESENT. MAIN PULMONARY ARTERY IS SLIGHTLY ENLARGED. LUNGS ARE WELL EXPANDED. A RIGHT BE FILLING OPACITY MIGHT BE CONSISTENT WITH AREA OF ATELECTASIS. THERE IS NO PLEURAL EFFUSION OR PNEUMOTHORAX. QUESTIONABLE NODULAR OPACITY IN THE LEFT MID LUNG IS NOTED, 6.7 MM, AND CORRELATION WITH CHEST CT MIGHT BE BENEFICIAL FOR IS PRECISE ASSESSMENT. " 64d5b255-cb558066-c2e2425a-8190c8a5-3d69d276.jpg,test/p11/p11315005/s56802963/64d5b255-cb558066-c2e2425a-8190c8a5-3d69d276.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: Patient with cognitive delay, hypertension and with recent fall. New oxygen requirement. FINDINGS: Comparison is made to prior study from ___. There is cardiomegaly. There are numerous calcified mediastinal and hilar lymph nodes as well as calcified granulomas. There is a left retrocardiac opacity and left-sided pleural effusion. No pneumothoraces are seen. " a052639c-cfd3a641-cc531d6d-11fd84e3-2b74bc40.jpg,test/p14/p14319656/s54080090/a052639c-cfd3a641-cc531d6d-11fd84e3-2b74bc40.jpg,test," FINAL REPORT INDICATION: ___M with head trauma, EtOH, hypotension // eval for ICH, cspine fracture, intrathoracic trauma TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Lung volumes are relatively low. Lungs are grossly clear. Cardiomediastinal silhouette is within normal limits. No displaced fractures identified. IMPRESSION: No acute cardiopulmonary process. " 61f6afea-9bd6f88c-b84d52fb-b1c2e89f-f4e5063b.jpg,test/p17/p17473327/s50516006/61f6afea-9bd6f88c-b84d52fb-b1c2e89f-f4e5063b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, fatigue TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Minimal patchy opacity in the left lung base likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. There is mild compression deformity of a mid thoracic vertebral body as well as a vertebral body at the thoracolumbar junction, findings which appear unchanged from ___. Remote fractures of the left second, third, and fourth ribs are noted. IMPRESSION: Patchy left basilar opacity, likely atelectasis. " 481914df-06db782b-b94f08b4-6e3e7ebf-edb32201.jpg,test/p11/p11885827/s57982990/481914df-06db782b-b94f08b4-6e3e7ebf-edb32201.jpg,test," FINAL REPORT INDICATION: ___M PMHx HTN with episode of amnesia yesterday. // Eval for intracranial process TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d40b4035-0469e47b-fc9cc87d-f0ed6ab9-db2ee937.jpg,test/p19/p19039163/s59940298/d40b4035-0469e47b-fc9cc87d-f0ed6ab9-db2ee937.jpg,test," FINAL REPORT INDICATION: Wheezing. COMPARISONS: Chest radiograph, ___. CT chest, ___. FINDINGS: Subtle peribronchical thickening at the right base is suggestive of continued resolution of the prior infection. It has improved since the prior exam. The lungs are otherwise clear without a new consolidation or edema. There is no pleural effusion or pneumothorax. The fine nodular pattern seen on the prior CT is not well evaluated on chest radiograph. The cardiomediastinal silhouette is normal. IMPRESSION: Continued improvement of right lower lobe infectious process. No acute cardiopulmonary process. " ffe0a3b9-be1f963a-1cb74902-85982357-db5b4279.jpg,test/p11/p11842879/s54381576/ffe0a3b9-be1f963a-1cb74902-85982357-db5b4279.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Tachycardia, rash. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There has been no significant interval change. IMPRESSION: No acute cardiopulmonary process. " 50714710-f4b9efd1-ade11706-6b04e5af-fede30bd.jpg,test/p11/p11861017/s58046399/50714710-f4b9efd1-ade11706-6b04e5af-fede30bd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p craniotomy evacuation of SDH, reintubated for respiratory failure // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are stable. The cardiomediastinal silhouette is stable, but there is increased engorgement of indistinct pulmonary vessels consistent with worsening pulmonary edema. Opacification of the right lower lung with obscuration of the hemidiaphragm is consistent with a moderate right pleural effusion and compressive atelectasis at the base. Less prominent effusion and volume loss in the lower lobe on the left. " 30c2359f-f967d241-c116e63a-2626391e-a14439eb.jpg,test/p19/p19259490/s56483305/30c2359f-f967d241-c116e63a-2626391e-a14439eb.jpg,test," FINAL REPORT INDICATION: ___M with Fever S/P upper endoscopy/colonoscopy yesterday. // Rule out pneumonia, atelectasis TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There are few calcific nodular densities identified at the right lung base laterally likely calcified granulomas. Elsewhere, the lungs are clear without consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. There is no free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process. " 5180b573-0f76f3c5-4da3dd47-98e046b3-8c381923.jpg,test/p11/p11630519/s50264278/5180b573-0f76f3c5-4da3dd47-98e046b3-8c381923.jpg,test," FINAL REPORT AP CHEST, 10:39 A.M., ___ HISTORY: A ___-year-old man after NG tube placement. IMPRESSION: AP chest compared to ___ at 5:44 p.m.: Small region of opacity persists in the previously atelectatic left lower lobe. Lungs are otherwise clear. Moderate cardiomegaly is chronic. ET tube and left subclavian line are in standard placements. New upper enteric drainage tube ends in the mid portion of non-distended stomach. Pleural effusions are small if any. " 1bf9c76f-54a2aeff-bc4ff4bc-a750a7be-4925b773.jpg,test/p14/p14775533/s53062067/1bf9c76f-54a2aeff-bc4ff4bc-a750a7be-4925b773.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man status post cardiac surgery, evaluate for pneumothorax. Status post chest tube removal. FINDINGS: Comparison is made to previous study from ___. The right IJ central line and the feeding tube are unchanged in position. The median sternotomy wires are seen. There is extensive subcutaneous emphysema throughout the chest, which limits evaluation of lung parenchyma. Allowing for this, there is unchanged cardiomegaly. There are bilateral pleural effusions which are large but stable. There is a left retrocardiac opacity. No pneumothoraces are seen. " 22efda79-0f702699-d2be2806-24ace73a-24ad570a.jpg,test/p13/p13762583/s51379238/22efda79-0f702699-d2be2806-24ace73a-24ad570a.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with hypoxia, oxygen sats mid 90s TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unchanged with architectural distortion, superior bilateral hilar retraction, traction bronchiectasis, nodularity and fibrosis involving both upper lobes. No new focal consolidation, pleural effusion or pneumothorax is present. No pulmonary edema is detected, though there may be mild pulmonary vascular congestion. No acute osseous abnormality is visualized. IMPRESSION: Perhaps mild pulmonary vascular congestion. Otherwise, chronic changes in the upper lobes which may be due to sarcoidosis or chronic granulomatous disease. " 7ff54fff-b6354088-1b114e06-60f9fc93-832b6899.jpg,test/p17/p17175688/s51441845/7ff54fff-b6354088-1b114e06-60f9fc93-832b6899.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath, and history of congestive heart failure, med noncompliance TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is mildly enlarged but unchanged. The aorta is unfolded. Mediastinal and hilar contours are similar with unchanged asymmetric enlargement of the right hilum. There is no pulmonary vascular congestion. Lungs are hyperinflated but clear without focal consolidation. Minimal fluid is seen within the fissures. No large pleural effusion or pneumothorax is otherwise demonstrated. IMPRESSION: No evidence of congestive heart failure or pneumonia. " a62106fc-758fa008-768b8b1d-ee4138e2-bb55eb84.jpg,test/p19/p19314531/s51235569/a62106fc-758fa008-768b8b1d-ee4138e2-bb55eb84.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with shortness of breath. COMPARISON: ___ and chest CT from ___. FINDINGS: PA and lateral views of the chest. The lungs are hyperinflated but clear of consolidation. Calcified mediastinal nodes and calcifications projecting posterior to the left clavicular head and in the left midlung are unchanged. No acute osseous abnormality is detected. IMPRESSION: Hyperinflation without acute cardiopulmonary process. " dfee4634-27b5e27e-cf90b05b-2b87753e-a02890e2.jpg,test/p18/p18418740/s53371008/dfee4634-27b5e27e-cf90b05b-2b87753e-a02890e2.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of nausea and vomiting. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is a small right pleural effusion. Blunting of the posterior left costophrenic angle may be due to a left-sided pleural effusion as well. The mediastinum is more prominent compared to the prior study, but relatively similar in appearance as compared to the scout radiograph from ___ CT, likely related to unfolded aorta; however, if there is clinical concern for acute aortic/mediastinal process, findings could be further and better evaluated with chest CTA. " e373795f-6e42d3b9-73fea0f4-05ce9a8e-6ee7538b.jpg,test/p14/p14997223/s53421628/e373795f-6e42d3b9-73fea0f4-05ce9a8e-6ee7538b.jpg,test," FINAL REPORT INDICATION: ___-year-old man with increasing oxygen requirement and known hepatic hydrothorax, status post thoracentesis on ___ FRONTAL AND LATERAL UPRIGHT CHEST RADIOGRAPH: There is near-complete collapse of the entire right lung with possible minimal aeration of the right upper lobe secondary to a large right pleural effusion. This has worsened since earlier study of ___ . Small-to-moderate left pleural effusion, with left basilar atelectasis, is unchanged. The hilar and mediastinal contours are difficult to assess given the extensive pleural effusion on the right. There is no pneumothorax. IMPRESSION: Large right pleural effusion, with complete collapse of the right lung. The above findings were discussed with Dr. ___ at 4:25 p.m. on ___ via telephone. " 521157fb-ba082aed-41f746b6-de5347fa-e87678b4.jpg,test/p16/p16454913/s54981451/521157fb-ba082aed-41f746b6-de5347fa-e87678b4.jpg,test," FINAL REPORT AP CHEST, 8:18 A.M., ___ HISTORY: A ___-year-old man with diabetes after kidney and pancreas transplant has also had colon cancer and right thoracotomy and tracheobronchoplasty in ___ for tracheomalacia. Recently had emergency cricotracheostomy for airway occlusion. IMPRESSION: AP chest compared to ___ through ___: Progressive consolidation right lower lung is probably worsening pneumonia, possibly cavitary, accompanied by increasing small-to-moderate right pleural effusion. Right upper lobe consolidation is less radiodense, but may also contain cavitation. Cardiomediastinal silhouette has narrowed, suggesting decreasing cardiomegaly and mediastinal vascular engorgement. Tracheostomy tube in standard placement. Left lower lobe infrahilar consolidation is presumably atelectasis, unchanged. Small-to-moderate left pleural effusion is stable. No pneumothorax. " c0eb7dac-dc9a4fb8-c90d6d98-4372019c-6bd7779b.jpg,test/p15/p15690303/s50274638/c0eb7dac-dc9a4fb8-c90d6d98-4372019c-6bd7779b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CT chest and chest radiograph, both dated ___. CLINICAL HISTORY: Pleural effusion, assess. FINDINGS: PA and lateral views of the chest were provided. There is a left pleural effusion again seen with a fluid level suggesting a hydropneumothorax. Please note, a similar finding was seen on prior CT, though the loculated gas component appears slightly increased from prior exam. There is persistent left lower lobe consolidation, which could represent atelectasis or possibly pneumonia. The right lung remains clear. Cardiomediastinal silhouette appears grossly stable. Bony structures are intact with a left humeral head replacement again noted. IMPRESSION: Left hydropneumothorax, with gas component loculated and slightly increased from prior exam. Left lower lobe consolidation could represent a combination of atelectasis and pneumonia, though clinical correlation is advised. " 689f0cd0-ee982281-95438dd2-a6b493b7-d50387b7.jpg,test/p18/p18985761/s50707283/689f0cd0-ee982281-95438dd2-a6b493b7-d50387b7.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: CT from ___ to which comparison with the scout can be performed. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Mild rightward convex curvature is again centered along the upper thoracic spine. Cholecystectomy clips project over the right upper quadrant of the abdomen. Bony structures are unremarkable otherwise. IMPRESSION: No evidence of acute disease. " 3fcbbcf5-fab3aeef-eb2822ca-ab4bc738-1fb66f85.jpg,test/p13/p13159535/s54330603/3fcbbcf5-fab3aeef-eb2822ca-ab4bc738-1fb66f85.jpg,test," FINAL REPORT INDICATION: ___-year-old male with 4 days history of productive cough, subjective chills/fever. Travel from ___ in ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " be8b213a-9615a5b7-c62d7a30-aa470915-ac96f7ac.jpg,test/p14/p14083729/s58210381/be8b213a-9615a5b7-c62d7a30-aa470915-ac96f7ac.jpg,test," FINAL REPORT HISTORY: ___-year-old male with jerking movements. Question infection. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 63617239-d6ae5a70-271fc1b5-69569d16-788ff527.jpg,test/p10/p10087922/s53253214/63617239-d6ae5a70-271fc1b5-69569d16-788ff527.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with seizure // ?infection ?infection IMPRESSION: COMPARED TO PRIOR CHEST RADIOGRAPHS SINCE ___, MOST RECENTLY ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 7e7078dd-e1f11b0c-c449c5d1-58734703-676edf37.jpg,test/p15/p15573773/s59725160/7e7078dd-e1f11b0c-c449c5d1-58734703-676edf37.jpg,test," WET READ: ___ ___ ___ 3:55 PM Worsened bibasilar heterogeneous opacities consistent with aspiration pneumonia with background of chronic severe atelectasis. Stable severe cardiomegaly. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: Evaluate for pneumonia in patient with recurrent pneumonias, presenting with shortness of breath and low oxygen saturation, with a history of T1-T2 paraplegia. COMPARISON: Multiple chest radiographs from ___ dating back to ___. PORTABLE AP RADIOGRAPH OF THE CHEST: There is new heterogeneous opacification of the right lung base superimposed upon chronic atelectasis and fibrosis of the same area. The left hemidiaphragmatic contour is also obscured, although this region of the radiograph is underpenetrated. The upper lung fields are clear. There is stable severe cardiomegaly. A right PICC terminates at the cavoatrial junction. There is no pneumothorax. The left costophrenic angle is not well visualized and a small effusion cannot be excluded. Again noted is dextroscoliosis of the thoracic spine as well as stable ribcage deformity. IMPRESSION: 1. Right middle and possibly lower lobe consolidation consistent with pneumonia. 2. Pneumonia involving the left lower lobe cannot be entirely excluded. 2. Stable severe cardiomegaly with a right-sided predominance. " 5e8b722e-1a13e792-e6fb9380-0f4e3d3a-b9327649.jpg,test/p12/p12176298/s59030883/5e8b722e-1a13e792-e6fb9380-0f4e3d3a-b9327649.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right upper lobectomy, reconstruction, intubation, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the extent of the pre-existing pleural effusion on the right has decreased. However, there is a new zone of atelectasis visible at the right lung bases. The apical consolidation is constant in extent and severity. Unchanged postoperative bony changes on the right. The lung parenchyma on the left has similar appearance to the previous image, overall, the parenchymal changes are better documented on the CT torso from ___. Unchanged size of the cardiac silhouette. Unchanged monitoring and support devices. " 3e788da6-1766e340-348e534a-7e228c70-ed66ad23.jpg,test/p16/p16905057/s55747223/3e788da6-1766e340-348e534a-7e228c70-ed66ad23.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cp // R/O INFE CTIOUS PROCESS COMPARISON: None FINDINGS: There is no focal consolidation, effusion, or pneumothorax. There is scarring or atelectasis in the right perihilar region. Heart size is normal. Imaged osseous structures are intact. Sternotomy wires and surgical clips are seen in the anterior mediastinum. Degenerative changes are seen in the spine. IMPRESSION: No acute intrathoracic process. " a6b71195-80d85106-efb88540-9e0b5e82-903af9c0.jpg,test/p19/p19376171/s54854294/a6b71195-80d85106-efb88540-9e0b5e82-903af9c0.jpg,test," FINAL REPORT HISTORY: ___-year-old male with lung cancer, now with hypotension. STUDY: PA and lateral chest radiograph. COMPARISON: ___ chest radiograph and ___ PET-CT. FINDINGS: The cardiomediastinal and hilar contours appear normal. The lungs are clear; the previously noted left apical opacity on prior PET-CT is not appreciated currently, CT is more sensitive. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 944d29a1-93b55f59-af7a8a2a-ff06e34f-dd6e4ef6.jpg,test/p10/p10019003/s53307223/944d29a1-93b55f59-af7a8a2a-ff06e34f-dd6e4ef6.jpg,test," WET READ: ___ ___ ___ 3:24 AM 1. Right IJ CVL tip in low SVC. 2. Mild vascular congestion. 3. New small retrocardiac opacity with small left pleural effusion is worrisome for pneumonia in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with RIJ CVL. Assess line placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. CT chest without contrast ___. FINDINGS: The lungs are hypoinflated with crowding of vasculature, mild vascular congestion, and bibasilar atelectasis. Heterogeneous retrocardiac opacity is present. There is a new small left pleural effusion. No right pleural effusion. Heart size is likely accentuated due to low lung volumes and patient positioning. Mediastinal contour and hila are otherwise unremarkable. Right IJ CVL tip in low SVC. IMPRESSION: 1. Right IJ CVL tip in low SVC. 2. Mild vascular congestion. 3. New small retrocardiac opacity with small left pleural effusion is worrisome for pneumonia in the appropriate clinical setting. " c8144ffe-fda5bc97-f7d13cfb-0ddfa44f-56b36cc8.jpg,test/p16/p16651473/s57420307/c8144ffe-fda5bc97-f7d13cfb-0ddfa44f-56b36cc8.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with chest pain // r/o acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: A subtle right lower lobe opacity at the costophrenic angle is new as compared to the prior examination. There is no pleural effusion or pneumothorax. The descending thoracic aorta is noted to be tortuous. The cardiomediastinal silhouette is otherwise within normal limits. IMPRESSION: New, right lower lobe airspace opacity compatible with pneumonia in the appropriate clinical setting. NOTIFICATION: Up dated findings were conveyed by Dr. ___ to the ___ QA nurses via email at 07:44 on ___. " f9f54b2b-c3b937fc-e5148269-1e51092b-5fb52a0f.jpg,test/p19/p19186632/s57960333/f9f54b2b-c3b937fc-e5148269-1e51092b-5fb52a0f.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Status post ORIF femur fracture and delirium. Comparison is made with prior study, ___. Moderate cardiomegaly is stable. Pacemaker leads are in a standard position. Aeration of the lower lobes has improved. There is no pneumothorax, pleural effusion, or new lung opacities. The aorta is tortuous. Several wedge-shaped compression fractures in the thoracic and lumbar vertebral bodies are again noted. " cac3de33-b19c1573-82ca82e6-abc8c188-e27491ea.jpg,test/p11/p11183093/s58135686/cac3de33-b19c1573-82ca82e6-abc8c188-e27491ea.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with low sodium, coarse lung sounds // Eval for infiltrate, mass TECHNIQUE: CHEST (PA AND LAT) COMPARISON: None IMPRESSION: Heart size is mildly enlarged predominately left ventricle. There is also prominence of left atrium and potentially pulmonary artery that might be consistent with pulmonary hypertension. Lungs are essentially clear although hyperinflated. There is no pleural effusion or pneumothorax " b27d4f7d-f6831f48-ed1c495b-c294374c-b7d89f2b.jpg,test/p10/p10757533/s50863442/b27d4f7d-f6831f48-ed1c495b-c294374c-b7d89f2b.jpg,test," FINAL REPORT INDICATION: ___ year old woman with chest pain and subtle linear abnl on x-ray right apex // rule out pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. IMPRESSION: The lungs are well expanded and clear. Right apical lucency appears unchanged. Any residual pneumothorax would be small. The heart is top-normal in size. There is no pleural effusion, pneumonia, or vascular congestion. Mediastinal contour and hila are normal. " 2e18be5c-084b5244-e6258202-9b5301b3-01875bd0.jpg,test/p18/p18199379/s58219607/2e18be5c-084b5244-e6258202-9b5301b3-01875bd0.jpg,test," FINAL REPORT INDICATION: History: ___F with sarcoidosis, s/p VATS x3, here w/ pain at Site of VATS // PTX, infection? bony abnormalities? COMPARISON: Multiple prior exams, most recently of ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Lung volumes are low. Bilateral, left-greater-than-right, prominent interstitial markings are likely related to known sarcoid and are similar to prior. Postoperative changes in left hemithorax status post wedge resection is similar to prior. There is a persistent left pleural effusion but no pneumothorax. No new focal consolidation. Mild cardiomegaly is stable. IMPRESSION: No pneumothorax or new focal consolidation. Stable mild cardiomegaly, left pleural effusion, and prominent interstitial markings consistent with sarcoid. " b63fa2c8-c9ebc785-bf96bcca-c94ad6e5-517a15f3.jpg,test/p17/p17697993/s57494060/b63fa2c8-c9ebc785-bf96bcca-c94ad6e5-517a15f3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // rule out pneumonia rule out pneumonia IMPRESSION: In comparison with the study of ___, there is little change. Cardiac silhouette is at the upper limits of normal and there is no definite vascular congestion or acute focal pneumonia. Hyperexpansion of the lungs is consistent with chronic pulmonary disease. Blunting of the left costophrenic angle could reflect pleural thickening or possibly small effusion. " e61e7d5e-9c637175-315da755-074b6556-8399ca3b.jpg,test/p17/p17649217/s55964508/e61e7d5e-9c637175-315da755-074b6556-8399ca3b.jpg,test," FINAL REPORT HISTORY: Acute brain injury with possible hospital-acquired pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. Monitoring and support devices remain in place. There is again evidence of bilateral pleural effusions with compressive atelectasis at the bases as well as pulmonary vascular congestion. " 559bb727-37f4cd8f-58fb90be-1646b5ba-a9d83424.jpg,test/p17/p17641109/s54944468/559bb727-37f4cd8f-58fb90be-1646b5ba-a9d83424.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with DOE // r/o mass or infiltrate DYSPNEA;R/O MASS OR INFILTRATE IMPRESSION: In comparison with the study of ___, there is little interval change. Cardiac silhouette remains within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 27815ab5-4ab5ac07-faf5e35f-4d4b508f-696f97e8.jpg,test/p15/p15957987/s56694471/27815ab5-4ab5ac07-faf5e35f-4d4b508f-696f97e8.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pleural effusions, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, pleural drain on the left is in unchanged position. The extent of the minimal effusion on the left is constant. Also constant is the extent of the retrocardiac atelectasis. On the right, the effusion has minimally decreased in extent, allowing for a better right basal ventilation. Esophageal stent and left CVA line are in constant position. No pneumothorax. " 6d769077-39ac3564-415c3a47-23188dc1-40372a5c.jpg,test/p15/p15808515/s52723465/6d769077-39ac3564-415c3a47-23188dc1-40372a5c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ___ with Cr ___.0, PNA, new onset atrial fibrillation // please assess for interval change PNA; CHF; pulmonary edema TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: In comparison with chest radiograph from ___, pulmonary edema is mildly improved and is now mild-to-moderate. There is no new focal consolidation or pneumothorax. Small bilateral effusions, left greater than right. Bullous change in the right apex is seen. Mediastinal and hilar contours are stable. Heart size is top-normal. IMPRESSION: 1. Mildly improved pulmonary edema is now mild-to-moderate. 2. Small bilateral effusions, left greater than right. " e29ae467-665ce0b8-c72a6990-31f6f1bd-720aebf2.jpg,test/p15/p15367414/s58382238/e29ae467-665ce0b8-c72a6990-31f6f1bd-720aebf2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with generalized malaise. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Single lead AICD is unchanged with lead extending to the region the right ventricle. Lungs are clear. No effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures intact. IMPRESSION: No acute findings. " 2986face-58fd4d97-36122b08-6921fd6c-b511ea8e.jpg,test/p10/p10460703/s56377326/2986face-58fd4d97-36122b08-6921fd6c-b511ea8e.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Incidental note is made of eventration of the right hemidiaphragm. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 000a74b2-df695d25-489cf31c-626670f9-17347cd8.jpg,test/p10/p10559264/s58773204/000a74b2-df695d25-489cf31c-626670f9-17347cd8.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " bea0be5b-7caddc5f-272df9e8-edd9d4f2-82433aec.jpg,test/p11/p11639209/s58684003/bea0be5b-7caddc5f-272df9e8-edd9d4f2-82433aec.jpg,test," FINAL REPORT HISTORY: Acute respiratory distress. Question acute change. CHEST, SINGLE AP PORTABLE VIEW. No previous chest x-rays on PACS record for comparison. The lungs are hyperinflated, consistent with COPD. There is background parenchymal scarring, also consistent with COPD. There is mild cardiomegaly. The aorta is calcified. There is borderline upper zone redistribution, but no overt CHF. There is minimal linear atelectasis and/or scarring at the left lung base with minimal blunting of the left costophrenic angle. There is also slight blunting of the right costophrenic angle. There is considerable biapical pleural scarring, with suggestion of some parenchymal scarring and possible slight retraction in the upper zones medially on both sides. Of note, there is a focal 5.4-mm nodule in the right upper zone laterally, overlying the right fourth rib. IMPRESSION: 1. Suspect pronounced background COPD, with overall parenchymal scarring and also biapical pleural and parenchymal scarring, detailed above. 2. Mild cardiomegaly. No CHF or focal infectious infiltrate identified. 3. 5.4-mm nodule in right upper zone. Further evaluation with chest CT scan would be indicated when the patient is stable. " 4279ccbb-f4ee210b-f5c5df93-46af6f47-86419cf2.jpg,test/p12/p12805811/s59862995/4279ccbb-f4ee210b-f5c5df93-46af6f47-86419cf2.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: ESRD, status post transplant with NSTEMI. Comparison is made with prior study performed a day earlier. Cardiac size is top normal, unchanged. Left central catheter is in standard position. Intraaortic balloon pump is in standard position. Swan-Ganz catheter has been removed. Large right and probably moderate left effusions are unchanged, associated with adjacent atelectasis. Moderate pulmonary edema is unchanged. " 820634e3-10a11e72-dc698663-d955abb3-72a113fa.jpg,test/p13/p13031768/s58238847/820634e3-10a11e72-dc698663-d955abb3-72a113fa.jpg,test," FINAL REPORT HISTORY: Resolving AMS, now new O2 requirement. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___. Compared with the prior study, there is more confluent patchy opacity at the right lung base and in the retrocardiac region and adjoining left base. Doubt CHF. Curvilinear density in the right upper zone most likely represents a skin fold, as lung markings project beyond it and the density itself projects outside the chest wall. No CHF. No gross effusion. Left axillary surgical clips noted. IMPRESSION: Patchy opacities at both lung bases, worse compared with ___. Most likely differential are bibasilar pneumonic infiltrates and/or aspiration. " 3468493a-ea105718-facac2c3-1b28fe6f-f95cd517.jpg,test/p13/p13600005/s55588235/3468493a-ea105718-facac2c3-1b28fe6f-f95cd517.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusion now s/p pigtail. Assess interval change. TECHNIQUE: Portable upright chest radiograph COMPARISON: ___ FINDINGS: Compared to the prior study from 1 day prior. The right pleural catheter is unchanged, as is the right pleural effusion and volume loss in the right lower lobe. Cardiac and mediastinal contours are unchanged. IMPRESSION: No interval change from 1 day prior. " b7816381-7042bddd-5633e142-7e926079-92d120c4.jpg,test/p13/p13966009/s50212471/b7816381-7042bddd-5633e142-7e926079-92d120c4.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea/cough // ?PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Mild anterior wedging of a lower thoracic vertebral body is grossly stable since the prior study. IMPRESSION: No significant interval change. " 455c91f7-34886208-695ca8d5-42465e7a-a155b603.jpg,test/p16/p16521161/s59991974/455c91f7-34886208-695ca8d5-42465e7a-a155b603.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with weakness // pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. Aortic knob is calcified. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Somewhat triangular opacity measuring 7 mm projecting over the right upper lobe in the region of the fifth posterior rib could reflect a confluence of shadows. The Lungs are otherwise clear without focal consolidation. No pleural effusion or pneumothorax is identified. IMPRESSION: No radiographic evidence for pneumonia. 7 mm triangular opacity projecting over the right upper lobe, at the level of the right fifth rib posteriorly could reflect a confluence of shadows, but can be further assessed with shallow oblique imaging. " bc65d829-65186472-e4f8f3a2-620df893-165ab735.jpg,test/p10/p10250159/s50752614/bc65d829-65186472-e4f8f3a2-620df893-165ab735.jpg,test," FINAL REPORT AP CHEST 7:30 A.M. ON ___ HISTORY: A ___-year-old man with acute MI. IMPRESSION: AP chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. " 1885360c-3a00db5f-efbc9d05-40a1ec73-f86c8324.jpg,test/p11/p11320471/s56594348/1885360c-3a00db5f-efbc9d05-40a1ec73-f86c8324.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: wheezing bibasilar // any worrisome lesion? any worrisome lesion? IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 2ff3f1f3-ab9abf57-1bad11ef-ac99f708-a84dcbdd.jpg,test/p12/p12296420/s59254542/2ff3f1f3-ab9abf57-1bad11ef-ac99f708-a84dcbdd.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Heart is upper limits of normal in size. Mediastinal and hilar contours are normal. Lung volumes are relatively low. Focal opacity at left lung base with adjacent elevation of left hemidiaphragm favors atelectasis. Small pleural effusions are present bilaterally. IMPRESSION: 1. Focal left lower lobe opacity is likely due to localized atelectasis adjacent to an elevated hemidiaphragm. 2. No evidence of congestive heart failure. " 3a66e98b-f7891c8f-ec4ea628-28af1777-13687706.jpg,test/p17/p17062932/s57049576/3a66e98b-f7891c8f-ec4ea628-28af1777-13687706.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with ARDS and pancreatitis, assessment of fluid status. AP radiograph of the chest was reviewed in comparison to prior study obtained on ___ at 5:29 p.m. The patient is rotated differently as compared to prior study. The ET tube tip is 3 cm above the carina. The right pigtail catheter, the right internal jugular line and NG tube that passes below the diaphragm are all in appropriate positions. Interval increase in pleural effusion on the left is suspected, although it might be related to different rotation of the patient. No definitive pulmonary edema is seen. No pneumothorax is demonstrated. " bb1d3b0c-6514619d-c3b798dd-924642b9-dd4c3b56.jpg,test/p18/p18287972/s55959406/bb1d3b0c-6514619d-c3b798dd-924642b9-dd4c3b56.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with left shoulder and arm pain, history of CAD, s/p MI in ___ with stent placement. // Please rule out lung pathology vs. fracture as a cause of pain COMPARISON: ___. IMPRESSION: Unchanged calcified granuloma in the right upper lobe. No relevant other changes. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia. No pulmonary edema. " e2af8892-c79b7701-95c8be19-54ae96d9-ac5c06f0.jpg,test/p18/p18890285/s59259585/e2af8892-c79b7701-95c8be19-54ae96d9-ac5c06f0.jpg,test," FINAL REPORT HISTORY: Post-MVR. FINDINGS: In comparison with study of ___, there is again opacification at the bases consistent with pleural fluid and compressive atelectasis with enlargement of the cardiac silhouette, but no definite pulmonary vascular congestion. Right jugular line again extends to the low SVC. " 98f8fbce-eae6cec2-8b5463a3-0491569d-d6e2dec7.jpg,test/p19/p19444592/s57228920/98f8fbce-eae6cec2-8b5463a3-0491569d-d6e2dec7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Pleuritic chest pain, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours appear normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No signs of pneumonia or other acute intrathoracic process. " 7f6d6cf3-c2441b7e-926b385e-0a721ff5-64156289.jpg,test/p18/p18062414/s58611170/7f6d6cf3-c2441b7e-926b385e-0a721ff5-64156289.jpg,test," FINAL ADDENDUM ADDENDUM: The findings regarding the possible pericardial effusion were communicated by Dr. ___ to Dr. ___ ___ telephone at 9:15 a.m. after attending review of the film. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain. Question acute process. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Aside from a suggestion, along the left heart border, of small pericardial effusion, the cardiomediastinal silhouette is unremarkable. Osseous structures are intact. IMPRESSION: Possible pericardial effusion. No evidence of tamponade physiology. Clinical correlation advised. " b791c7e0-7aad97a3-c608cffb-352d3f4b-ab5e87ed.jpg,test/p19/p19352450/s54740250/b791c7e0-7aad97a3-c608cffb-352d3f4b-ab5e87ed.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with h/o asthma, p/w SOB // eval for acute cardiopulmonary pathology, pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___, CT chest dated ___. FINDINGS: As compared to the prior examination dated ___, there has been no significant interval change. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 28e6498f-79e13c2f-ba3466aa-835f3427-ce4c50a9.jpg,test/p15/p15268535/s51343251/28e6498f-79e13c2f-ba3466aa-835f3427-ce4c50a9.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with history of CHF and coronary artery disease, presents with wheezing. COMPARISON: ___. Comparison also made to CTA chest from ___. FINDINGS: Frontal and lateral views of the chest. Increased interstitial markings are seen throughout the lungs, which may represent interstitial edema. There is no large effusion. Retrocardiac opacity is compatible with previoulsy seen hiatal hernia. Median sternotomy wires and mediastinal clips are again noted. IMPRESSION: Mild edema without definite new focal consolidation. " 2d62d2ae-65bd7368-42daa716-b86fbd89-35719fa6.jpg,test/p16/p16036071/s53392976/2d62d2ae-65bd7368-42daa716-b86fbd89-35719fa6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p NG tube placement. Radiology requesting plain film prior to taking patient down for advancement under fluoroscopy. // please perform CXR TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Dobhoff tube tip isout of view, below the diaphragm. No other interval change from prior study. " bdfb9d6d-4fa0e298-a7c8bfcc-427d5572-e254267b.jpg,test/p12/p12464244/s53393298/bdfb9d6d-4fa0e298-a7c8bfcc-427d5572-e254267b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with aml, recent chest pain // Acute change Acute change COMPARISON: Prior chest radiographs ___. IMPRESSION: Previous pulmonary edema has resolved. Mild cardiomegaly is stable. Is no appreciable pleural effusion or any findings of pneumonia. Left PIC line ends in the upper SVC. " e888c548-3a92f333-d50d0369-cdebb671-a85e0907.jpg,test/p19/p19120479/s55377286/e888c548-3a92f333-d50d0369-cdebb671-a85e0907.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Chest x-ray ___ and CTA of the chest of ___. FINDINGS: A recently placed pacemaker remains in place with no pneumothorax. One of the leads terminates anteriorly within the right ventricle, and a second lead courses posteriorly in the expected location of the coronary sinus. Although its position is not typical for this location on the frontal view, correlation with prior CT shows altered position of cardiac chambers due to rotation and shift of the heart which may influence this appearance. The posterior course of the atrial lead with possible location in the coronary sinus was communicated to Dr. ___ by telephone on ___, at 12:30 p.m. at the time of discovery. Lungs are grossly clear except for minimal pleural and parenchymal scarring in the left lung base. A questionable nodule at the level of the left third anterior rib on the prior CXR is no longer visualized. " ba027842-d63bf962-406ae3ab-a0890b2b-b114dd8b.jpg,test/p14/p14539176/s57112639/ba027842-d63bf962-406ae3ab-a0890b2b-b114dd8b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with renal cell carcinoma and fall with right femoral neck fracture. // Please evaluate for acute process. Pre-op exam. Surg: ___ (Right Femoral Neck Fracutre Repair) COMPARISON: Outside chest CT ___ FINDINGS: Mild cardiomegaly and tortuosity of the thoracic aorta are similar to the recent CT. Patchy and linear bibasilar opacities are suggestive of atelectasis. Lungs are otherwise clear, and there is no evidence of pleural effusion or pneumothorax. Note is made of previous left axillary lymph node dissection. Multifocal skeletal metastases have been more fully assessed by the outside CT, along with intrathoracic lymphadenopathy. IMPRESSION: No acute cardiopulmonary radiographic abnormality. Metastatic disease, more fully assessed by outside CT. " fb148d2f-48d7392b-f8e74f4f-e42a80b6-190c3ce3.jpg,test/p18/p18446519/s53152610/fb148d2f-48d7392b-f8e74f4f-e42a80b6-190c3ce3.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with left rib pain // r/o ptx COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Prominent right nipple shadow projects over the right lung base as on prior. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No displaced rib fracture. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 31393678-c124c100-70bb218d-367446c9-016fa8e0.jpg,test/p18/p18628529/s59502530/31393678-c124c100-70bb218d-367446c9-016fa8e0.jpg,test," FINAL REPORT HISTORY: History of sickle cell disease and severe chest pain. Evaluate for acute chest syndrome. TECHNIQUE: Frontal views of the chest. COMPARISON: Multiple chest radiographs the most recent on ___ FINDINGS: A left-sided central venous catheter is seen with its tip at the cavoatrial junction. The lungs are clear without evidence of focal opacity or interstitial abnormality. The heart size is top-normal and the hilar contours are normal. The pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No evidence of acute chest syndrome or pneumonia. " ba9790ad-beaf75e1-8d554e8b-97e66006-fe0268d9.jpg,test/p19/p19141970/s55874830/ba9790ad-beaf75e1-8d554e8b-97e66006-fe0268d9.jpg,test," FINAL REPORT HISTORY: Productive cough, thoracic pain, fevers, chills. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary abnormality. " db7e5f33-712d1e42-9f1355cd-901c0521-9a8be566.jpg,test/p11/p11057357/s52346206/db7e5f33-712d1e42-9f1355cd-901c0521-9a8be566.jpg,test," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: A dual lead left-sided pacemaker is seen with leads terminating in the right atrium and right ventricle, expected locations. The cardiac silhouette is again mild to moderately enlarged. The hilar and mediastinal contours are within normal limits. There is mild tortuosity of the descending aorta. The lungs are hyperinflated and there is some flattening of the diaphragms which may relate to COPD. There is no new focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " bf0dccb7-5eb383a9-19f9f2a5-b5bedcc3-7630cc82.jpg,test/p10/p10699336/s54670438/bf0dccb7-5eb383a9-19f9f2a5-b5bedcc3-7630cc82.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with C5-___ fxs with quadraplegia, lasix gtt for pleural effusions // interval CXR interval CXR IMPRESSION: Comparison with the study of ___, there is little overall change. Substantial right and small left pleural effusions with compressive basilar atelectasis is again seen. Areas of opacification bilaterally again are consistent with pulmonary edema, though in the appropriate clinical setting superimposed pneumonia would have to be considered. Central catheter is unchanged. " 8471562b-ffbb15a0-12cc46b8-f9399a7c-d0733f1b.jpg,test/p15/p15390338/s53781353/8471562b-ffbb15a0-12cc46b8-f9399a7c-d0733f1b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of RCC, evaluation for metastatic disease. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged moderate cardiomegaly with tortuosity of the thoracic aorta. Minimal atelectasis at both lung bases, but no evidence of suspicious lung nodules or masses. A calcified millimetric right upper lobe granuloma is unchanged as compared to the previous examination. No pleural effusions. No evidence of chest wall lesions. " 8c35bdfd-53e858ce-d8e470fc-b17457fb-deca89ea.jpg,test/p15/p15078336/s58846944/8c35bdfd-53e858ce-d8e470fc-b17457fb-deca89ea.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Right-sided rib pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. There has been no significant change. IMPRESSION: No evidence of acute disease. " 18e73ef2-14096bac-4a00dd45-412efd9a-5fcf3b85.jpg,test/p17/p17421663/s51547499/18e73ef2-14096bac-4a00dd45-412efd9a-5fcf3b85.jpg,test," WET READ: ___ ___ ___ 8:43 PM New interstitial airspace opacities within the right upper lobe, right middle lobe and to a lesser extent in the left upper lobe, would be consistent with acute multi focal pneumonia given the provided clinical history. Aspiration and asymmetric edema are also possibilities. No pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Fever, evaluation for pneumonia. COMPARISON: Outside hospital film from ___. FINDINGS: As compared to the previous radiograph, there are increasing parenchymal opacities in the right upper lobe, the right middle lobe and also the left lower lobe. Multifocal pneumonia is likely. The size of the cardiac silhouette is unchanged. There are no pleural effusions and no pneumothorax. Normal appearance of the mediastinum. At the time of dictation and observation, ___, at 8:27 a.m., the referring physician, ___. ___, was paged for notification. " 500a7c6b-f7410ba7-c4e2fc98-9eee91e4-f0aa319d.jpg,test/p19/p19543748/s56681171/500a7c6b-f7410ba7-c4e2fc98-9eee91e4-f0aa319d.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: arrhythmia. Comparison is made with prior study, ___. There has been interval improvement in bilateral lung opacities, left greater than right. There is no pneumothorax. There are probably small bilateral effusions. Cardiomediastinal contours are unchanged. " dbeda8a5-0247764a-93dd0075-3c367048-ff3b8491.jpg,test/p15/p15225349/s59925496/dbeda8a5-0247764a-93dd0075-3c367048-ff3b8491.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F cecal adenoca w/liver met s/p lap segment 6 wedge on ___ c/b subhepatic collection s/p drainage now w/reaccum fluid, large pericardial/pleural effusion s/p pericardial window, BL CT // Possible infection or worsening infusion Possible infection or worsening infusion IMPRESSION: In comparison with the study of ___, the anterior and posterior air- levels are unchanged, consistent with regions of hydro pneumothorax. The small apical pneumothorax on the left is unchanged. Bibasilar opacifications are consistent with atelectatic changes and pleural effusion bilaterally. The possibility of superimposed pneumonia can certainly not be excluded. " 4e731fb8-dbf49ba2-9f321cd1-3c8a1037-5dde248f.jpg,test/p12/p12773009/s59041828/4e731fb8-dbf49ba2-9f321cd1-3c8a1037-5dde248f.jpg,test," FINAL REPORT INDICATION: History of CLL, one month of productive cough. COMPARISONS: ___ and ___. FINDINGS: PA and lateral chest radiographs again demonstrate mild cardiomegaly and small bilateral pleural effusions without pulmonary vascular congestion or other evidence of volume overload. The lungs are clear. There is mild hilar prominence likely reflective of the patient's known history of CLL. IMPRESSION: No acute cardiopulmonary process. " 4dfd454b-dc7f5aaa-ca83e29f-7261f1f0-838628a6.jpg,test/p17/p17613612/s57135415/4dfd454b-dc7f5aaa-ca83e29f-7261f1f0-838628a6.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Left arm pain and numbness. COMPARISON: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " cf317460-c0e7374f-8ac3b157-397e9103-530e40e8.jpg,test/p16/p16108772/s53641567/cf317460-c0e7374f-8ac3b157-397e9103-530e40e8.jpg,test," FINAL REPORT CLINICAL HISTORY: cough and dyspnea, history of COPD and CHF. CHEST, PA AND LATERAL COMPARISON: Outside film ___. There is a marked scoliosis of the thoracic spine. Probable hiatal hernia is present. The heart is not enlarged. No evidence of failure is present. No pneumonia is seen. IMPRESSION: No failure, no pneumonia. " 55a02f6f-0183cede-4489ea95-6387a209-e0e0780c.jpg,test/p16/p16525331/s51788851/55a02f6f-0183cede-4489ea95-6387a209-e0e0780c.jpg,test," FINAL REPORT COMPARISON: ___. FINDINGS: Cardiomediastinal contours are stable. Lungs are clear except for linearly oriented opacities in the left lower lobe and lingula, with appearance favoring atelectasis over infectious pneumonia. " 23f95fe0-8385e5d8-f3f4f421-f940ca07-d32bb089.jpg,test/p13/p13655179/s54760995/23f95fe0-8385e5d8-f3f4f421-f940ca07-d32bb089.jpg,test," FINAL ADDENDUM Addendum: Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state unspecified viral infection. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman who probably has the flu or asthma. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are clear. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette, hila, and pleura are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 83d1b49d-a9396df0-3266e1d7-5f949c5c-36a46d72.jpg,test/p14/p14775533/s51249826/83d1b49d-a9396df0-3266e1d7-5f949c5c-36a46d72.jpg,test," FINAL REPORT EXAM: AP portable view. CLINICAL INFORMATION: Shortness of breath. COMPARISON: ___. FINDINGS: Patient is status post median sternotomy. There has been interval removal of left internal jugular central venous catheter. There are small-to-moderate bilateral pleural effusions with overlying atelectasis. The cardiac silhouette remains enlarged. Mediastinal contours are stable. IMPRESSION: Bibasilar opacities are likely due to a combination of pleural effusion and atelectasis. Underlying consolidation is not entirely excluded in the appropriate clinical setting. " 5e711322-caf0a497-f097254a-dd249db6-47f1fb50.jpg,test/p10/p10717732/s50963920/5e711322-caf0a497-f097254a-dd249db6-47f1fb50.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p L VATS, evacuation of hemothorax, decortication // check interval change check interval change COMPARISON: Prior chest radiographs ___. IMPRESSION: Small to moderate residual left pleural abnormality, fissural and posterior, continues to resolve slowly since ___,, . No appreciable pneumothorax or layering effusion. Right lung clear. Normal postoperative cardiomediastinal silhouette. " 714c177f-a1bbbbd5-f1d45219-c6095faf-0313a227.jpg,test/p16/p16312465/s58072484/714c177f-a1bbbbd5-f1d45219-c6095faf-0313a227.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Multiple myeloma, new fever. Evaluation for pneumonia. COMPARISON: ___. FINDINGS: The radiograph is compared to ___. The pre-existing subtle opacities at the bases of the right lung have completely resolved. However, better seen than on the previous image, is a very subtle opacity at the bases of the right upper lobe as well as in the left perihilar regions. Previously non-visible on the frontal radiograph are bilateral small pleural effusions, visible on the lateral radiograph only. The findings raise suspicion for early pneumonia. CT should be performed to either confirm or exclude this diagnosis. At the time of dictation and observation, 10:20 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification. Findings were discussed one minute later over the telephone. " 433a0065-3fbccc36-c97be136-0c579bb9-9c46661e.jpg,test/p12/p12431768/s53644332/433a0065-3fbccc36-c97be136-0c579bb9-9c46661e.jpg,test," WET READ: ___ ___ ___ 10:58 PM ET tube ends 2.5 cm above the carina. Low lung volumes and positioning accentuates stable moderate enlargement of the cardiac silhouette and pulmonary vascularity. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with HCV cirrhosis. AP radiograph of the chest was reviewed in comparison to ___. The patient has been intubated with ET tube tip being 2.5 cm above the carina. Extensive cardiomegaly is unchanged as well as distention of the azygos vein. There is interval progression of widespread perihilar opacities consistent with progression of pulmonary edema. " 3aa8113c-4d7c7495-62bd08b7-f5932075-054e1a50.jpg,test/p10/p10476869/s50383756/3aa8113c-4d7c7495-62bd08b7-f5932075-054e1a50.jpg,test," FINAL REPORT INDICATION: ___ year old man with ptx s/p chest tube // eval ptx on water seal COMPARISON: Radiographs of ___. IMPRESSION: There is again seen a pigtail catheter at the left lung base. Loculated small pneumothorax at the left base is again seen. There is slight volume loss of the left lung. Heart size is within normal limits. There is no focal consolidation for signs of pulmonary edema. There is some pleural thickening along the left apex medially, stable. " fd3d22d7-7bc58b18-d2f49ee6-5c96d4e0-0f4aaed8.jpg,test/p15/p15128994/s54185977/fd3d22d7-7bc58b18-d2f49ee6-5c96d4e0-0f4aaed8.jpg,test," FINAL REPORT CLINICAL HISTORY: on hemodialysis. Evaluate for pneumonia. CHEST, PA AND LATERAL: COMPARISON FILM: ___. The position of the hemodialysis catheter is unchanged since the prior chest x-ray with the tip in the right atrium. The lung fields are clear. There is no evidence of pneumonia. IMPRESSION: No pneumonia. " 08a887eb-7fd28813-89699fca-313dd8a2-2ed14295.jpg,test/p14/p14997223/s57133870/08a887eb-7fd28813-89699fca-313dd8a2-2ed14295.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of end-stage liver disease, positive blood cultures, fatigue. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is blunting of bilateral costophrenic angles, most consistent with bilateral pleural effusions. Additional right base opacity is seen which could relate to effusion and atelectasis, although underlying consolidation is of concern. No focal consolidation is seen in the left lung. The cardiac and mediastinal silhouettes are unremarkable. No evidence of pneumothorax or pulmonary edema. " 75ab03db-cf364504-5d63c58b-092b6bdc-8d006391.jpg,test/p13/p13922124/s58267841/75ab03db-cf364504-5d63c58b-092b6bdc-8d006391.jpg,test," FINAL REPORT INDICATION: ___ year old man with PICC // PICC placement confirmation COMPARISON: Radiographs from ___ IMPRESSION: There is a right-sided PICC line with the distal lead tip at the distal SVC. Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. " 62590aa6-f6a79951-791d286f-eed33342-fac9f8fd.jpg,test/p16/p16233087/s50403310/62590aa6-f6a79951-791d286f-eed33342-fac9f8fd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dyspnea s/p MVreplacement // eval pleural effusions IMPRESSION: As compared to ___ chest radiograph, postoperative appearance of cardiomediastinal contours stable. Interval decrease in size of left pleural effusion with residual small to moderate effusion remaining. Persistent small right pleural effusion. Improving left lower lobe and lingular atelectasis and development of minor atelectasis at the right lung base. " 55da276f-df0212b7-8c16fc51-45969a01-7314e727.jpg,test/p13/p13954248/s58550822/55da276f-df0212b7-8c16fc51-45969a01-7314e727.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever and prod cough // r/o PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Minimal left basilar atelectasis is seen. There is no focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are stable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " b5a07347-f6e95bdd-2753f4be-f99d6cc3-1d8c15b6.jpg,test/p17/p17506723/s52449443/b5a07347-f6e95bdd-2753f4be-f99d6cc3-1d8c15b6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia, ETT // Interval change? Interval change? COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Right lower lobe consolidation and small right pleural effusion continued clear. Lungs are otherwise clear. Normal cardiomediastinal and hilar silhouettes. ET tube, with the chin flexed, is no less than 7 cm from the carina. The tube could safely be advanced 2 cm. Left subclavian line ends in the mid SVC. No pneumothorax. " 7c9b2c9e-5d40cac2-7c67e771-453010d9-f5b00a9c.jpg,test/p18/p18118099/s57658312/7c9b2c9e-5d40cac2-7c67e771-453010d9-f5b00a9c.jpg,test," WET READ: ___ ___ ___ 2:18 PM Left perihilar interstitial opacities may be due to aspiration or infection. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with b/l crackles on exam, evaluate for pneumonia. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: None. FINDINGS: Low lung volumes cause bronchovascular crowding. Left-sided perihilar interstitial opacities may be related to aspiration or infection. There is no pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: Left perihilar interstitial opacities may be due to aspiration or infection. " 14bf2bfb-f7d64a48-621d7206-e71fb95e-bc13646c.jpg,test/p19/p19729398/s56085049/14bf2bfb-f7d64a48-621d7206-e71fb95e-bc13646c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with influenza // eval for fluid eval for fluid COMPARISON: Chest radiographs and CT scan since ___, most recently chest radiograph ___. IMPRESSION: Substantial consolidation in both lower lungs, accompanied by a new small left and increasing moderate right pleural effusion suggest extensive intrathoracic infection. Left upper lung is clear and shows no pulmonary edema to suggest that cardiac decompensation is responsible. Patient has had treatment for large carcinoma in the right upper lobe, and mitral valve replacement. NOTIFICATION: Dr. ___ reported the findings to Dr. ___ By telephone on ___ at ___:26 PM, 1 minutes after discovery of the findings. " 45414c07-ad21f8ec-6d44e0ea-433003bd-826ce875.jpg,test/p17/p17469778/s50018337/45414c07-ad21f8ec-6d44e0ea-433003bd-826ce875.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with VAP, intubated, interval change. COMPARISON: Multiple chest x-rays from ___. FINDINGS: ET tube ends 6.1 cm above the carina. Feeding tube is curled in the stomach and ends in the first portion of the duodenum. Left double-lumen jugular line ends in lower SVC. Right lower atelectasis and LLL collapse are unchanged as shown on recent CT. Left pleural effusion is minimal. There is no pneumothorax. CONCLUSION: 1. Tube and lines are in adequate position. 2. Right lower lobe atelectasis and LLL collapse are unchanged. " f6e85c28-2dbb01a2-c0054dd5-115cf3ba-42352937.jpg,test/p18/p18819076/s54633130/f6e85c28-2dbb01a2-c0054dd5-115cf3ba-42352937.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, bibasilar ___ // r/o pna r/o pna IMPRESSION: In comparison with the study of ___, there is a patchy area of increased opacification in the right perihilar region and upper lobe. . Especially in view of the clinical history, this is worrisome for developing pneumonia. NOTIFICATION: Dr ___ " 1068bb07-19791a3d-a2ae90aa-54e1998a-5e60a2b4.jpg,test/p16/p16445377/s52383015/1068bb07-19791a3d-a2ae90aa-54e1998a-5e60a2b4.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___ No prior studies for comparison. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs and pleural surfaces are clear. Minimal scoliosis is noted. IMPRESSION: No acute cardiopulmonary radiographic abnormality. " 6c067673-d25672f6-95497b6d-fa8e2258-65e881bc.jpg,test/p18/p18280034/s56101775/6c067673-d25672f6-95497b6d-fa8e2258-65e881bc.jpg,test," FINAL REPORT INDICATION: ___-year-old man with thrombocytopenia. Please evaluate for acute process. COMPARISON: No relevant comparisons available. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " e765d838-a72ae9f8-6deec66d-881b5ea6-5f47065f.jpg,test/p18/p18031120/s51666284/e765d838-a72ae9f8-6deec66d-881b5ea6-5f47065f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with end stage chf // evaluate picc position evaluate picc position IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the PICC line, with the tip in the mid esophagus. Continued enlargement of the cardiac silhouette with possible mild elevation of pulmonary venous pressure in a patient with a pacer lead extending to the apex of the right ventricle. The area of opacification on the previous study at the right base has cleared. " 8800b026-7ff15610-248a09ca-b435014c-d4daae36.jpg,test/p14/p14368959/s55220851/8800b026-7ff15610-248a09ca-b435014c-d4daae36.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with tachycardia, left lower quadrant tenderness to palpation TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is normal. Moderate size hiatal hernia is re- demonstrated. Mediastinal and hilar contours are otherwise unchanged. Pulmonary vasculature is normal. Minimal atelectasis is noted in the left lung base. No focal consolidation, pleural effusion or pneumothorax is present. There are moderate multilevel degenerative changes within the thoracic spine. IMPRESSION: Unchanged moderate hiatal hernia with minimal left basilar atelectasis. " 48656041-2bdcfc2c-4679bb92-7a6c8c14-4ff019aa.jpg,test/p18/p18589881/s55703398/48656041-2bdcfc2c-4679bb92-7a6c8c14-4ff019aa.jpg,test," FINAL REPORT INDICATION: ___ year old woman with ESRD for pre kidney transplant eval // r/o cardiopulmonary abnormalities TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: There is mild scoliosis of the thoracic spine. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structure. No pneumonia, no pulmonary edema. No pleural effusions. IMPRESSION: Mild scoliosis, otherwise normal chest xray. " 9bb7b5a4-cbcdded2-f424fdae-e726ac3c-4afe7a2e.jpg,test/p17/p17175688/s56022495/9bb7b5a4-cbcdded2-f424fdae-e726ac3c-4afe7a2e.jpg,test," WET READ: ___ ___ ___ 8:15 AM Right hila demonstrates increased radiodensity and appears slightly larger, could reflect a nodal mass. Further evaluation with CT recommended. ______________________________________________________________________________ FINAL REPORT HISTORY: Dyspnea, rule out an acute process. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The left atrium is mildly enlarged. Calcifications are seen in the arotic valve. The mediastinal contours are within normal limits. The right hilum demonstrates increased radiodensity and appears slightly larger from prior examination. There is no focal consolidation, pleural effusion or pneumothorax. Unidentified foreign body in the heart, posterior to midline, is likely in the esophagus. IMPRESSION: Right hilum slightly larger, could be nodal mass. Further evaluation with CT is recommended. " 361a3a69-031fdc3b-8773cb48-9f75a509-fcdf2397.jpg,test/p11/p11967908/s50362398/361a3a69-031fdc3b-8773cb48-9f75a509-fcdf2397.jpg,test," FINAL REPORT INDICATION: ___F with dyspnea, cough // Any pneumonia? TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: Increased interstitial markings are seen throughout the lungs as on prior. Small bilateral pleural effusions persist. Scarring at the right lung apex is again noted. No focal consolidation. Calcifications again seen in the right chest wall in addition to multiple right axillary clips. Cardiomediastinal silhouette is stable. No acute osseous abnormality identified. IMPRESSION: Mild pulmonary edema with persistent small bilateral effusions. " 69ff5963-841d8a4c-3e4a4a52-8730422b-86dcaf72.jpg,test/p12/p12043836/s52233929/69ff5963-841d8a4c-3e4a4a52-8730422b-86dcaf72.jpg,test," FINAL REPORT STUDY: PA AND LATERAL CHEST RADIOGRAPH. INDICATION: ___-year-old male with history of severe pulmonary hypertension, new onset AFib, for evaluation. TECHNIQUE: Two views of the chest were obtained. COMPARISON: ___. REPORT: There is significant cardiomegaly noted. Prominent pulmonary hila are noted and there is some subcarinal splaying. Generalized pulmonary plethora is noted, although this is not as prominent as on the prior study. A few nonspecific interstitial lines are seen at the right lung base, again not as significant as on the prior study. CONCLUSION: Findings of cardiomegaly, pulmonary arterial hypertension and pulmonary plethora suggest a significant cardiac shunt. There is no evidence of consolidation on this study. There is probably mild fluid overload. This, however, is not as pronounced as on prior studies from ___. " f9967da6-f5646a39-5f1ccf32-2873c05b-854b2423.jpg,test/p13/p13975046/s55322870/f9967da6-f5646a39-5f1ccf32-2873c05b-854b2423.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with F/U pneumonia // ___ year old woman with F/U pneumonia TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: ___. FINDINGS: A left pectoral pacemaker is in place. The lungs are clear. There is no pneumothorax. The heart and mediastinum are within normal limits. IMPRESSION: Clear lungs. " 2a2277a9-b0ded155-c0de8eb9-c124d10e-82c5caab.jpg,test/p10/p10000032/s53189527/2a2277a9-b0ded155-c0de8eb9-c124d10e-82c5caab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Multiple clips are again seen projecting over the left breast. Remote left-sided rib fractures are also re- demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " 4aaa4527-c7991f1d-e2e5dac0-ed6939a1-e6e64fe0.jpg,test/p14/p14642114/s57076046/4aaa4527-c7991f1d-e2e5dac0-ed6939a1-e6e64fe0.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with congestive heart failure, CAD and CKD, now presents with lethargy and fever, to rule out pneumonia. COMPARISON: Chest radiograph, ___. PORTABLE AP CHEST RADIOGRAPHS: Moderate cardiomegaly is unchanged since the prior study. The hilar and mediastinal contours are stable, with multiple mediastinal surgical clips indicating CABG. A right internal jugular approach dialysis catheter ends in the right atrium. A right chest wall pacer ICD device is seen with the leads in expected position of the right atrium and right ventricle. The right lower lung fields are obscured by the pacer. Mild pulmonary edema is present. No consolidation, pleural effusion or pneumothorax is seen. IMPRESSION: Moderate cardiomegaly and mild pulmonary edema. No evidence of pneumonia. " bef4e780-d62c3839-c82734c9-83b65076-be3f73de.jpg,test/p10/p10476869/s57207510/bef4e780-d62c3839-c82734c9-83b65076-be3f73de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval IMPRESSION: In comparison with the study of ___, there has been a significant increase in the degree of left pleural effusion. No evidence of vascular congestion or acute focal pneumonia. No evidence of mediastinal shift, indicating that there has been substantial volume loss in the left lower lung. " 577a2209-e428a2f4-e374bad2-ecaf2cbc-b9bfcaf0.jpg,test/p17/p17122548/s56753857/577a2209-e428a2f4-e374bad2-ecaf2cbc-b9bfcaf0.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: Comparison is made with chest radiographs from earlier ___ and ___. FINDINGS: The lungs are well expanded. There is a patchy opacity in the right lung base concerning for infectious process. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. Visualized osseous structures are unremarkable. IMPRESSION: Patchy opacity in the right lung base concerning for pneumonia. " 02466ee6-ab2b3537-669d90bd-3a61ebcb-902b0c2b.jpg,test/p11/p11408283/s50274325/02466ee6-ab2b3537-669d90bd-3a61ebcb-902b0c2b.jpg,test," FINAL REPORT HISTORY: Dyspnea, left lower lung crackles. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is mildly enlarged with a left ventricular predominance. The aorta is tortuous. The mediastinal and hilar contours otherwise are unchanged, with a small hiatal hernia noted. The pulmonary vascularity is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There is mild retrolisthesis at the thoracolumbar junction, unchanged, likely T12 on L1 and L1 on L2. Mild loss of height of a mid thoracic vertebral body is also stable. The lungs are hyperinflated compatible with underlying COPD. IMPRESSION: No acute cardiopulmonary abnormality. " c99b0aac-c75ac3d1-c97a203b-9aff28f8-eafd1073.jpg,test/p11/p11151938/s59372408/c99b0aac-c75ac3d1-c97a203b-9aff28f8-eafd1073.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Dyspnea and cough. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy. Dual-lead left-sided AICD is again seen with leads extending to the expected positions of the right atrium and right ventricle, similar in position. The cardiac silhouette remains enlarged. The mediastinal contours are stable. No pleural effusion or evidence of pneumothorax is seen. There is moderate pulmonary vascular congestion. No definite focal consolidation. There is some thickening/possible fluid along the minor fissure seen on the lateral view. IMPRESSION: Enlarged cardiac silhouette and moderate pulmonary vascular congestion. " 099b84b4-babd1fb4-cd5dae48-6285d5dd-89363e6f.jpg,test/p11/p11589725/s50491374/099b84b4-babd1fb4-cd5dae48-6285d5dd-89363e6f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ with seizures alcoholism s/p fall year old man now with leukocytosis // interval cxr interval cxr IMPRESSION: In comparison with the study of ___, there is little overall change. Dobhoff tube again extends to the fundus of the stomach. Continued low lung volumes, though the atelectatic changes at the bases may be less prominent. Cardiac silhouette is within upper limits of normal in size with no evidence of pulmonary edema. " 86c0d6db-eac3bd67-f115ee14-9a2eac59-e7313344.jpg,test/p13/p13505226/s55664813/86c0d6db-eac3bd67-f115ee14-9a2eac59-e7313344.jpg,test," FINAL REPORT HISTORY: Fever, tachycardia, post-operative. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Compared to chest radiograph from ___, there is no significant interval change. Low lung volumes are seen bilaterally with bibasilar linear atelectasis. The lungs are otherwise clear. The pleural surfaces are normal without evidence of pleural effusion or pneumothorax. Heart is partially obscured by the left diaphragmatic surface; however, is mildly enlarged and unchanged from prior study. Mediastinal contour and hila are unremarkable. Visualized osseous structures are unremarkable. Limited assessment of the upper abdomen demonstrates clips in the left upper quadrant. No intraperitoneal free air. IMPRESSION: No acute cardiopulmonary process. Low lung volumes and bibasilar atelectasis. " 6a2ec5c4-1b86e478-b5dfbc1b-c91a8205-40ea9d0b.jpg,test/p19/p19063367/s58501669/6a2ec5c4-1b86e478-b5dfbc1b-c91a8205-40ea9d0b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with need for central line HD // r/o TB, preop eval COMPARISON: None. FINDINGS: There are low inspiratory volumes and underpenetration due to overlying soft tissues. Allowing for this, there is moderate to moderately severe cardiomegaly, straightening of left heart border trauma and effacement of the AP window. Mild prominence the right hilum is noted, but is likely accentuated by low inspiratory volumes. There is upper zone redistribution. There may be mild vascular plethora, but this is likely accentuated by low inspiratory volumes and underpenetration. No gross s right-sided effusion. The left costophrenic sulcus is clear. Minimal bibasilar atelectasis No calcified lymph nodes, apical scarring, hilar retraction and/or obvious calcified granuloma identified. IMPRESSION: Limited evaluation due to low inspiratory volumes, underpenetration and absence of lateral view. Moderate to moderately severe cardiomegaly. Mild vascular plethora, without other evidence of CHF. No definite infiltrate. No gross effusion. If there is clinical concern for detailed evaluation of the mediastinum and hila, then cross-sectional imaging would help for further assessment. " 137c89af-8338c058-fea769c0-3b6b90ea-94848e4f.jpg,test/p11/p11655748/s56524089/137c89af-8338c058-fea769c0-3b6b90ea-94848e4f.jpg,test," FINAL REPORT HISTORY: Fever. FINDINGS: In comparison with study of ___, the patient has taken a lower inspiration. No definite evidence of acute pneumonia. There is minimal asymmetry of opacification at the right base. Although this most likely reflects vascular structures with minimal atelectasis, the possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. " b0e24d6c-4f51a035-e3f40f07-e51b9e18-e1b5674b.jpg,test/p19/p19921217/s59599805/b0e24d6c-4f51a035-e3f40f07-e51b9e18-e1b5674b.jpg,test," FINAL REPORT INDICATION: Toe pain and chest pain. COMPARISONS: Chest radiograph ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 85f7e360-8e55754f-118098c8-013c5fbe-597ade98.jpg,test/p12/p12701743/s53759917/85f7e360-8e55754f-118098c8-013c5fbe-597ade98.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post motor vehicle accident with rib fractures, worsening shortness of breath, evaluation. COMPARISON: No comparison available at the time of dictation. FINDINGS: The rib fractures are not well depicted on the current radiograph but are documented on a CT from ___. Today's image shows moderate cardiomegaly and signs of interstitial fluid overload, associated to small bilateral pleural effusions. None of these were present on occasion of the last computed tomography examination. The changes are better seen on the lateral than on the frontal image. Mild atelectasis at the left lung bases. No evidence of pneumonia or pneumothorax. At the time of dictation and observation, 11:37 a.m., on the ___, the referring physician ___. ___ was paged for notification. " bf324e94-6b96c1c2-861387bc-a9c08878-7719553d.jpg,test/p18/p18738396/s56312048/bf324e94-6b96c1c2-861387bc-a9c08878-7719553d.jpg,test," FINAL REPORT CLINICAL INDICATION: Seizure. Evaluate for acute processes. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: A left chest wall vagal nerve stimulator is identified. Mild peribronchial cuffing and vascular congestion consistent with mild pulmonary edema. Left lower lobe opacities most likely infection. There is widening of the right paratracheal region. Calcified left hilar and mediastinal lymph nodes are again seen. A right clavicle deformity is again identified. IMPRESSION: Left lower lobe opacity concerning for atelectasis or pneumonia in the correct clinical setting. Mild pulmonary edema. " 147ce605-21239109-3a3ba634-45292ba2-af1c2a16.jpg,test/p14/p14338137/s56435533/147ce605-21239109-3a3ba634-45292ba2-af1c2a16.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mild cardiomegaly and ?CHF on outside CXR ___ at ___ after fluid resuscitation // r/o cardiomegaly and CHF r/o cardiomegaly and CHF IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal with tortuosity of the aorta. Little change in the appearance of the lungs. " a9f62820-5cdd4dbe-76fe16d7-a5465a30-f67a2858.jpg,test/p14/p14226260/s56187249/a9f62820-5cdd4dbe-76fe16d7-a5465a30-f67a2858.jpg,test," FINAL REPORT HISTORY: ___-year-old female with fever, cough, and myalgias. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 362fe216-93b7b7a0-b8c89758-b0c5de21-502c6fe4.jpg,test/p11/p11494099/s51051369/362fe216-93b7b7a0-b8c89758-b0c5de21-502c6fe4.jpg,test," FINAL REPORT INDICATION: Status post fall. Assess for acute intrathoracic process. COMPARISON: Multiple prior chest radiographs dating back through ___, including the most recent study from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. Lung volumes are low, causing exaggeration of the heart size and accentuation of the pulmonary vasculature. There is minimal bilateral lower lobe atelectasis. The lungs are otherwise clear. The heart remains moderately enlarged. The vascular pedicle is markedly widened, increased compared to the most recent radiograph from ___. There are no pleural effusions. No pneumothorax is seen. Loss of height of vertebral bodies along the thoracolumbar spine do not appear substantially changed compared to the prior study from ___. IMPRESSION: 1. Increased widening of the vascular pedicle compared to the most recent study from ___. A dedicated PA upright radiograph is recommended for further assessment, as a recently dilated ascending aorta cannot be excluded on the provided AP projection. 2. Minimal bilateral lower lobe atelectasis. 3. Unchanged cardiomegaly. Findings and recommendations were discussed with Dr. ___ by Dr. ___ at 9:40 a.m. via telephone on the day of the study. " cc6d9098-d38511e4-c407ecca-6c143c3d-6aedc608.jpg,test/p13/p13445140/s52494724/cc6d9098-d38511e4-c407ecca-6c143c3d-6aedc608.jpg,test," WET READ: ___ ___ ___ 1:28 PM Minimal perihilar bronchial cuffing. Otherwise, no acute cardiopulmonary process. No pneumothorax WET READ VERSION #1 ___ ___ ___ 11:47 AM No acute cardiopulmonary process. No pneumothorax. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. Minimal perihilar bronchial cuffing. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: Minimal perihilar bronchial cuffing. Otherwise, no acute cardiopulmonary process. No pneumothorax. " 288c85d0-d4e91d5a-005b4b11-521b8a9d-7afb35ad.jpg,test/p15/p15388421/s54408065/288c85d0-d4e91d5a-005b4b11-521b8a9d-7afb35ad.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man s/p esophagectomy // check interval change TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiograph ___ FINDINGS: Asymmetric pulmonary edema right greater than left, likely due to re-expansion is unchanged. Small pleural effusion is noted on the left. A chest tube at the right lung base is unchanged. Extensive atelectasis at the right lung base is unchanged. Pleural fluid in the lateral chest wall is unchanged. Moderate cardiomegaly is mildly increased. A right PICC ends in the mid SVC. Mediastinal surgical drain is in unchanged position. IMPRESSION: Mild asymmetric pulmonary edema likely due to re-expansion and bilateral pleural effusions are unchanged. Support devices are unchanged. " 273e7a62-7ba0db45-1b2a4eb4-09b396c7-bddb1673.jpg,test/p17/p17349580/s57256441/273e7a62-7ba0db45-1b2a4eb4-09b396c7-bddb1673.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Multiple surgical clips project over mid right inferior neck. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 97dbb346-43a06509-0084c3f6-b2928b65-d4f1412b.jpg,test/p13/p13089395/s56449206/97dbb346-43a06509-0084c3f6-b2928b65-d4f1412b.jpg,test," FINAL REPORT HISTORY: Increased oxygen requirement and chest pain.After 8 units PRBC in last three days, question pulmonary edema and ARDS. CHEST, SINGLE AP PORTABLE VIEW. IMPRESSION: Chest x-ray dated ___ at 18:10 p.m. The heart is not enlarged. The aorta is minimally unfolded. There are small bilateral effusions with underlying collapse and/or consolidation of both lung bases. Allowing for differences in positioning, the effusions are better defined. There has been considerable interval improvement in CHF findings, with essentially no residual CHF identified at this time. Minor thickening of the minor fissure is noted, but no significant upper zone redistribution or vascular plethora is detected. There is asymmetry of the breast shadows on this exam, but this may be an artifact of positioning. This was not present on the earlier film. Unusual linear lucency adjacent to left aortic knob appears non-physiologic and likely represents artifact. No suggestion of pneumothorax on the lateral view. IMPRESION: 1) No CHF. 2) Small-to-moderate effusions with underlying collapse or consolidation at both bases. The effusions are probably slightly larger. Bibasilar changes are different in configuration but overall similar. Possibility of underlying pneumonic infiltrate, however, cannot be excluded. " dd987fe7-7bc54dea-41e9362b-4e4c775e-efadcfd5.jpg,test/p13/p13570063/s57512691/dd987fe7-7bc54dea-41e9362b-4e4c775e-efadcfd5.jpg,test," FINAL REPORT HISTORY: ___-year-old female with intermittent chest pain. COMPARISON: Subsequent CTA of the chest from ___ at 6:21 am PA AND LATERAL CHEST RADIOGRAPH: The lungs are clear. There is no focal consolidation or pneumothorax. There is no vascular congestion or pleural effusions. The heart size is normal. The apparent enlargement of the aortic contour corresponds with tortuosity and unfolding of the aortic arch, seen on follow-up chest CT. The remaining mediastinal and hilar contours are within normal limits. IMPRESSION: 1. Clear lungs without consolidation or effusion. 2. Widened contour of the thoracic aorta corresponds to tortuosity and unfolding of the aortic arch, better characterized on follow-up chest CT. Dr. ___ communicated concerns about an abnormal aortic contour to Dr. ___ at 5:47 am on ___ by telephone. " eb2f6ccd-8a3fbc99-3fdc1000-98ca6f99-84230a3a.jpg,test/p15/p15285300/s55014874/eb2f6ccd-8a3fbc99-3fdc1000-98ca6f99-84230a3a.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fever, evaluate for infiltrate. COMPARISON: None. PA AND LATERAL CHEST RADIOGRAPH: The cardiac silhouette is unremarkable. Biapical scarring and possible right apical small nodules. Prominence of bilateral hila which are somewhat lobulated suggest underlying lymphadenopathy. Trace left pleural effusion cannot be excluded. There is no focal consolidation or pneumothorax. IMPRESSION: Findings suggesting hilar adenopathy. Recommend CT for further evaluation of this and right upper lung nodules. " 7a57b306-58a24989-0af26143-c2d14044-ecca6b46.jpg,test/p14/p14027149/s55476213/7a57b306-58a24989-0af26143-c2d14044-ecca6b46.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with weakness, wheeze TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Severe cardiomegaly is re- demonstrated. Mediastinal and hilar contours are similar. Mild pulmonary vascular congestion appears chronic. Minimal blunting of the costophrenic angles on the lateral view suggests trace bilateral pleural effusions. No focal consolidation or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Mild pulmonary vascular congestion, likely chronic, with severe cardiomegaly and trace bilateral pleural effusions. " 020b180f-141b52e1-87fab490-35bd2c94-b33ee409.jpg,test/p11/p11658675/s57853295/020b180f-141b52e1-87fab490-35bd2c94-b33ee409.jpg,test," FINAL REPORT HISTORY: ___-year-old male with altered mental status. COMPARISON: ___. FINDINGS: Single AP portable view of the chest. When compared to prior, there has been no significant interval change. Again seen are bibasilar opacities, left worse than right. These do not appear to have progressed since prior. Superiorly, the lungs remain clear. Cardiomediastinal silhouette is unchanged in not well evaluated due to positioning and the heart being below the hemidiaphragm on the left. Vertebroplasty changes seen in the lower thoracic spine. IMPRESSION: Persistent bibasilar opacities, left worse than right which may represent bilateral pneumonia, aspiration, or may be chronic and due to scarring. " 27b5eb03-c07f9480-0bf5d86e-3f61b5c7-f6c59f63.jpg,test/p15/p15874317/s59239762/27b5eb03-c07f9480-0bf5d86e-3f61b5c7-f6c59f63.jpg,test," FINAL REPORT INDICATION: Fall with complaint of right thoracic pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Left-sided dual-chamber pacemaker device is noted with leads projecting in the right atrium and ventricle, unchanged. The cardiac silhouette size is normal. The aortic knob is markedly calcified. The mediastinal and hilar contours are unremarkable. No focal consolidation, pleural effusion or pneumothorax is identified. Pulmonary vascularity is normal. Minimal biapical pleural scarring is seen. There are no acute osseous abnormalities. Remote right-sided rib fractures are noted. IMPRESSION: No acute cardiopulmonary abnormality. " 315a2693-c8483c07-c62f186c-20e4446f-ae481e5e.jpg,test/p11/p11086611/s58179558/315a2693-c8483c07-c62f186c-20e4446f-ae481e5e.jpg,test," FINAL REPORT HISTORY: Toxic inhalation on ___ presenting with shortness of breath and chest tightness. Assess for pneumonia or pneumonitis. COMPARISON: None. FINDINGS: 2 views were obtained of the chest. The lungs are hyperexpanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " c1c89942-829b4c5c-0160edcb-1d10f838-55f478c0.jpg,test/p17/p17398597/s51404116/c1c89942-829b4c5c-0160edcb-1d10f838-55f478c0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HFrEF, swan in R IJ // Confirm swan in place COMPARISON: Chest x-ray from ___ at 22:11 FINDINGS: Left-sided 2 lead pacemaker is present, with lead tips over the right atrium and right ventricle. A right IJ Swan-Ganz catheter is present, with tip distal, over lying an inferior branch of right pulmonary artery. Clinical correlation regarding retraction is requested. There is a right-sided PICC line. The tip is not well delineated, but is likely unchanged, lying at the level of the cavoatrial junction. No pneumothorax is detected. The cardiomediastinal silhouette is enlarged, similar to the prior study. Again seen is borderline upper zone redistribution, but doubt overt CHF. Minimal hazy opacity in the right cardiophrenic region is similar to prior. There may be minimal left lower lobe atelectasis, but no dense retrocardiac density. No other focal opacities are identified. No gross effusion. Again noted are multiple somewhat coiled wire like sutures overlying the right lateral lower chest and upper abdomen. IMPRESSION: Cardiomegaly, unchanged.No overt CHF. Minimal bibasilar atelectasis again noted. Swan-Ganz catheter tip is relatively distal, superimposed over lower right pulmonary artery. Clinical correlation regarding possible retraction is requested. " f9b8c6eb-40fc0c67-9e461f99-e6606211-d0e768bc.jpg,test/p16/p16528757/s50266454/f9b8c6eb-40fc0c67-9e461f99-e6606211-d0e768bc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hyponatremia and coarse breath sounds // ?PNA ?infection TECHNIQUE: Single frontal view of the chest COMPARISON: None. FINDINGS: Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary abnormality " 457120ee-9fbd4658-e349bed7-fb7586b3-54289dd4.jpg,test/p19/p19904800/s53693090/457120ee-9fbd4658-e349bed7-fb7586b3-54289dd4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with diffuse large B cell lymphoma presenting with fevers, cough COMPARISON: Prior study ___ FINDINGS: PA and lateral views of the chest provided. Right chest wall Port-A-Cath again seen with catheter tip extending into the upper SVC. Lungs are clear. No signs of pneumonia or edema. No pleural effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: No acute findings. Port-A-Cath appropriately positioned. " 5603478f-adf7bfc5-d888ea39-17ddcf42-96909d3a.jpg,test/p16/p16454913/s57378179/5603478f-adf7bfc5-d888ea39-17ddcf42-96909d3a.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Gastric perforation, status post primary gastric repair. Comparison is made with prior study, CT torso, ___. Cardiac size is minimally enlarged, is accentuated by the projection. Collapse in the left lower lobe is persistent. Opacities in the right lower lobe have increased, consistent with worsening atelectasis. If any, there are new small bilateral pleural effusions. HD catheter is in standard position. Tracheostomy tube is in standard position. There is new mild vascular congestion. NG tube tip is out of view below the diaphragm. " 797f6077-727659c4-3baed973-d5e96ccb-fe3ce7c8.jpg,test/p13/p13523567/s53187821/797f6077-727659c4-3baed973-d5e96ccb-fe3ce7c8.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with persistent cough, resistant to antibiotic therapy, bringing up brownish sputum, has fever on and off. Evaluate for possible pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is within normal limits. No typical configurational abnormality. Unremarkable appearance of thoracic aorta and mediastinal structures. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No evidence of pneumothorax in the apical area on the frontal view. Skeletal structures of the thorax grossly within normal limits. There exists no prior chest examination or records available for comparison. IMPRESSION: Chest findings within normal limits. No evidence of acute pulmonary infiltrates in patient with persistent cough. " c791cb6a-25087e5f-f21dbd3f-e5e29833-373a72b5.jpg,test/p17/p17426206/s55196084/c791cb6a-25087e5f-f21dbd3f-e5e29833-373a72b5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with amiodarone for af // exclude amiodarone lung toxicity exclude amiodarone lung toxicity IMPRESSION: Heart size and mediastinum are stable. Lungs are overall clear. There is hyperinflation. There is no pleural effusion or pneumothorax. Pacemaker leads terminate in right atrium and right ventricle. Apical thickening on the left is unchanged. No evidence of amiodarone lung toxicity is present. " f2067659-268bc35d-4d96149d-70b53a86-c1d8e3ce.jpg,test/p16/p16946732/s57205982/f2067659-268bc35d-4d96149d-70b53a86-c1d8e3ce.jpg,test," FINAL REPORT INDICATION: ___ year old woman respiratory insufficiency // interval change TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Right-sided Port-A-Cath in situ with tip in the mid SVC. ETT in situ with the tip 27 mm proximal to the carina. Nasogastric tube in situ projecting over the stomach. ECG leads on the chest. Surgical clips in relation to the right axilla. No airspace consolidation. No pleural effusions. No pneumothorax. The heart size is at the upper limits of normal. Unfolding of the thoracic aorta with associated atherosclerotic calcifications. Diffuse bony sclerosis consistent with an osseous metastasis. IMPRESSION: Tubes and lines as described above. No acute pneumonic process. " 09827c4e-93ab4c81-56c653e8-b5b7cd87-52641c40.jpg,test/p11/p11022501/s54885535/09827c4e-93ab4c81-56c653e8-b5b7cd87-52641c40.jpg,test," FINAL REPORT HISTORY: Shortness of breath, chest pain x. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. A few scattered subcentimeter rounded opacities projecting over the right lung, may be due to calcified granulomas and/or vessels on-end. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 81f2eac1-e5c7ddff-a96eb85f-85612dc2-0d95264c.jpg,test/p16/p16994918/s53702715/81f2eac1-e5c7ddff-a96eb85f-85612dc2-0d95264c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with progressive dyspnea. // PNA? Pulmonary Edema? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There small to moderate bilateral pleural effusions with overlying atelectasis. There is moderate pulmonary edema. Underlying infection is difficult to exclude. The cardiac silhouette is difficult to actually assessed due the basilar extends opacities although is likely mildly enlarged. Mediastinal contours are grossly unremarkable. The patient is status post median sternotomy and CABG. IMPRESSION: Bilateral pleural effusions with overlying atelectasis; underlying consolidation is difficult to exclude. Pulmonary edema. " 175e2fcf-1cf4b4c6-6ce526fb-e4498d53-994e6f87.jpg,test/p14/p14105959/s59169952/175e2fcf-1cf4b4c6-6ce526fb-e4498d53-994e6f87.jpg,test," FINAL REPORT HISTORY: ___-year-old male with confusion. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Lower lung volumes seen on the current exam. Taking this into account, there is no significant interval change. There is no confluent consolidation nor fusion. Cardiomediastinal silhouette is stable noting mild cardiomegaly. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 1cd0a927-a9801e6f-c20c57a2-819d8afe-d947fecc.jpg,test/p13/p13047671/s54711798/1cd0a927-a9801e6f-c20c57a2-819d8afe-d947fecc.jpg,test," WET READ: ___ ___ 11:55 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with cough // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumonia. " 956e1f5b-5344755f-4b3b4b70-0eda6b23-d18403be.jpg,test/p13/p13850557/s58346778/956e1f5b-5344755f-4b3b4b70-0eda6b23-d18403be.jpg,test," WET READ: ___ ___ ___ 9:41 AM 1. No pneumonia. 2. Emphysema or chronic obstructive pulmonary disease. WET READ VERSION #1 ___ ___ ___ 5:27 AM No acute cardiopulmonary process. Specifically, no pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with vertigo on experimental drug for lymphoma. Assess for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CT chest with contrast ___. FINDINGS: 3.6 x 2.2 cm partially calcified ovoid lesion along the anterior medial right middle lobe is unchanged since ___ and previously characterized as a calcified internal mammary lymph node. The lungs are mildly hyperinflated with flattening of diaphragms and are otherwise clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: 1. No pneumonia. 2. Emphysema or chronic obstructive pulmonary disease. 3. Calcified prevascular or internal mammary lymph node. " 4a243b05-04325567-7cf91577-296af09d-92d1af37.jpg,test/p19/p19143018/s56296259/4a243b05-04325567-7cf91577-296af09d-92d1af37.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cirrhosis, concern for pneumonia // please assess for evidence of pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. Bibasilar atelectasis are minimal increased. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: Minimally increase bibasilar atelectasis " 53f756af-ab8aa25d-37f9e2ae-50cbbc3b-404676cc.jpg,test/p12/p12711775/s55510573/53f756af-ab8aa25d-37f9e2ae-50cbbc3b-404676cc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with a fall. Tooth fractured, unclear if possibly aspirated. COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. No radiopaque foreign body is seen within the imaged field. Lungs are clear without focal consolidation, large effusion or pneumothorax. Patient is slightly rotated to the left. Cardiomediastinal silhouette appears normal. No large effusion or pneumothorax. No displaced rib fracture is seen. IMPRESSION: No acute findings. No radiopaque foreign body. " 2267a975-9e665071-72326687-828e26ba-ebb43d46.jpg,test/p13/p13834513/s59371260/2267a975-9e665071-72326687-828e26ba-ebb43d46.jpg,test," FINAL REPORT HISTORY: Motor vehicle accident and small laceration. Question foreign body in laceration. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiac silhouette is normal. There is no pleural effusion or pneumothorax. No radiopaque foreign bodies are identified. IMPRESSION: No evidence of acute cardiopulmonary process. " 7946af07-ad6b046f-88fe1b34-b18163ec-54307b1b.jpg,test/p19/p19220361/s53078178/7946af07-ad6b046f-88fe1b34-b18163ec-54307b1b.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient with protracted cough, evaluate for infiltrates. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is normal. No configurational abnormalities identified. Unremarkable appearance of thoracic aorta. No wall calcifications. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No pneumothorax in the apical area. Skeletal structures of the thorax are grossly unremarkable. Our records do not include a previous chest examination available for comparison. IMPRESSION: Chest findings are within normal limits. Thus, no evidence of acute pulmonary infiltrate or vascular congestion in this ___-year-old male patient with protracted cough. " adf87f04-23daf03a-e7813095-5a9bab9f-6be3656f.jpg,test/p19/p19910173/s59453389/adf87f04-23daf03a-e7813095-5a9bab9f-6be3656f.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Recent rectal cancer resection with transient hypoxia to ___%. TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___. Chest radiograph ___ through ___. FINDINGS: Moderate cardiomegaly is unchanged. Re- demonstration of postoperative mediastinal silhouette with intact sternotomy wires. Hilar contours are unremarkable. Improved consolidation at the left lung base correlates to scarring on prior CT. Lungs are otherwise clear. No effusion or pneumothorax. Right lower lobe nodule identified on prior CT is not visualized on this study. IMPRESSION: No acute cardiopulmonary abnormality. Nodule previously identified on CT is not evident on radiography. " 0095da6b-87eb357b-fb665bf0-7f3d5be9-af92c8c2.jpg,test/p11/p11062354/s57763605/0095da6b-87eb357b-fb665bf0-7f3d5be9-af92c8c2.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. History: Chest pain, low grade fevers. Findings: PA and lateral view of the chest, no prior. There is subtle left basilar opacity, potentially atelectasis, however, infiltrate is not excluded. In addition, there is a 7-mm nodular opacity projecting in the suprahilar region on the left. Elsewhere, the lungs are grossly clear, costophrenic angles are sharp. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Left basilar atelectasis versus infiltrate. Possible left suprahilar nodule. These findings can be followed up on the upcoming chest CT, which has been ordered. " e2a2ac36-345987b1-84c14ebd-b312b089-c026df31.jpg,test/p13/p13295971/s58129046/e2a2ac36-345987b1-84c14ebd-b312b089-c026df31.jpg,test," WET READ: ___ ___ ___ 8:58 PM Enteric catheter courses below the level of the diaphragm and out of the field-of-view inferiorly, ending at least in the proximal jejunum. No acute cardiac or pulmonary process. ______________________________________________________________________________ FINAL REPORT AP CHEST, 7:20 P.M., ___. HISTORY: Verify post-pyloric feeding tube. IMPRESSION: AP chest centered at the diaphragm, compared to ___. Feeding tube passes into the proximal jejunum and out of view. Left hemidiaphragm is elevated by a very large spleen. Lungs are clear and there is no pleural abnormality. Heart size normal. " 1e94fc0e-e60292ca-3611b220-3b6e3835-013acf77.jpg,test/p13/p13917858/s51490690/1e94fc0e-e60292ca-3611b220-3b6e3835-013acf77.jpg,test," FINAL REPORT EXAMINATION: Compared to chest radiographs on ___. INDICATION: ___ year old woman with heart failure, leukocytosis, and hypotension // ?worsening pneumonia or pulmonary edema IMPRESSION: Combination of bibasilar atelectasis and small to moderate pleural effusions unchanged. Retrocardiac opacity, is due at least in part to hiatus hernia. Severe cardiomegaly stable. No pulmonary edema. Region of opacity in the right upper lobe is larger today, could be pneumonia. No pneumothorax. Indwelling left internal jugular line ends in the mid SVC. . " 81731476-d68399cf-ccde6ba0-78ea3938-bd40cc6c.jpg,test/p13/p13224377/s50018247/81731476-d68399cf-ccde6ba0-78ea3938-bd40cc6c.jpg,test," WET READ: ___ ___ ___ 7:04 PM Tracheostomy tube terminating approximately 3.1 cm above the carina. Interval removal of the OG tube. Right parenchymal opacities are similar, and remain concerning for an infectious process or aspiration. Left lung also appears similar. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with coughing // assess for change in ET tube- if sitting on carina assess for change in ET tube- if sitting on carina COMPARISON: Comparison to prior study dated ___ IMPRESSION: There are unchanged airspace opacities throughout the right lung and involving the left mid and lower lung with relative sparing of the left upper lobe. These findings could reflect an atypical appearance of pulmonary edema but are more concerning for pneumonia. Clinical correlation is advised. The right internal jugular dual-lumen catheter and tracheostomy tube are unchanged in position. There has been interval removal of a nasogastric tube. There are likely small layering effusions. No pneumothorax is appreciated. Overall cardiac and mediastinal contours are likely unchanged given differences in patient rotation between studies. " 31a4c5b1-d7bc3696-8b5b8e1d-30a638bb-29de6eb7.jpg,test/p16/p16729058/s50073374/31a4c5b1-d7bc3696-8b5b8e1d-30a638bb-29de6eb7.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Presyncope and chest pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is borderline in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: Borderline heart size. No evidence of acute cardiopulmonary disease. " e4150bd9-6b460477-c19c93ec-599bad99-142f7ec8.jpg,test/p15/p15002645/s57675771/e4150bd9-6b460477-c19c93ec-599bad99-142f7ec8.jpg,test," FINAL REPORT INDICATION: ___M with CP // r/o PNA TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or vascular congestion. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 7eee3261-e0715849-5e03beb5-839fbb6b-40c6832a.jpg,test/p15/p15818607/s53675135/7eee3261-e0715849-5e03beb5-839fbb6b-40c6832a.jpg,test," FINAL REPORT INDICATION: ___ year old man with history of CAD, HFrEF presenting with CP // ?e/o dissecction TECHNIQUE: Chest PA and lateral COMPARISON: No prior FINDINGS: The lungs are clear. The cardiac silhouette is mildly enlarged. The aortic knob is visualized. No upper mediastinal widening. No pulmonary edema are pneumonia. Prior median sternotomy with intact sternal wires and dual lead defibrillator with the tips in the right atrium and right ventricle. IMPRESSION: No acute cardiopulmonary process. No radiographic evidence of dissection. " 30f83893-0689d311-4b9b2924-921bd6d2-fd2c0a8d.jpg,test/p12/p12466049/s57251214/30f83893-0689d311-4b9b2924-921bd6d2-fd2c0a8d.jpg,test," FINAL REPORT HISTORY: Cirrhosis, hypertension, dyspnea and worsening abdominal distention. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is top normal. Mediastinal and hilar contours are unchanged. There is new mild pulmonary edema. No pleural effusion or pneumothorax is identified. Lung volumes are decreased compared to the prior exam. There are no acute osseous findings. Mild degenerative changes are seen in the thoracic spine. Cholecystectomy clips are present in the right upper quadrant of the abdomen. IMPRESSION: Mild interstitial pulmonary edema. " 76581f82-0b74952b-847d7398-ffdfdb64-4f899a57.jpg,test/p12/p12473270/s52933867/76581f82-0b74952b-847d7398-ffdfdb64-4f899a57.jpg,test," FINAL REPORT INDICATION: Nausea and vomiting for two weeks. COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. The cardiac, hilar, and mediastinal contours are normal. Surgical clips are noted in the left upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 80b442e7-e1387bda-971283c4-5cd9c74e-e951d1c3.jpg,test/p19/p19589138/s55480563/80b442e7-e1387bda-971283c4-5cd9c74e-e951d1c3.jpg,test," FINAL REPORT INDICATION: ___-year-old female with shortness of breath, rule out congestive cardiac failure or rib fracture or pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Mild bibasilar atelectasis is noted. No pleural effusion or pneumothorax noted. The cardiomediastinal and hilar contours are unchanged from the prior examination. Mild low lung volumes are noted with crowding of bronchovascular markings. No rib fractures are visualized. IMPRESSION: 1. Low lung volumes with crowding of bronchovascular markings and bibasilar opacification increased on the right, most likely representing atelectasis; however, infectious process such as pneumonia cannot be completely excluded in the correct clinical setting. 2. No rib fractures. If rib fractures are clinically suspected then a dedicated rib series can be obtained. " 104fd695-35532d58-2ab3015d-905335e4-818d3a37.jpg,test/p18/p18109602/s59566960/104fd695-35532d58-2ab3015d-905335e4-818d3a37.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with cough and sputum. Evaluate for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " b00488c4-e8014c83-1c128768-b9d06728-ad8d63a2.jpg,test/p12/p12147671/s56817792/b00488c4-e8014c83-1c128768-b9d06728-ad8d63a2.jpg,test," FINAL REPORT INDICATION: ___-year-old female with a sharp sudden onset of chest pain with exertion. Evaluate for pneumothorax. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest radiographic examination. No evidence of pneumothorax. " a599c236-029d15c6-7268555e-0d01b017-c2bee56d.jpg,test/p17/p17692815/s52784870/a599c236-029d15c6-7268555e-0d01b017-c2bee56d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with shock physiology of unknown type/source, newly diagnosed depressed EF // please evaluate for interval change, position of lines and tubes please evaluate for interval change, position of lines and t IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. There has been the development of increased opacification at the right base, consistent with substantial volume loss in the right lower lobe and associated pleural effusion. Again there is moderate enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure. " 4eb009ce-654c6a44-03aae07d-3e895802-92d860b6.jpg,test/p16/p16909232/s54440596/4eb009ce-654c6a44-03aae07d-3e895802-92d860b6.jpg,test," FINAL REPORT INDICATION: Suspected aspiration event. COMPARISON: Most recent radiograph from ___ and a series of older studies dating back to ___. FINDINGS: A bedside AP radiograph of the chest once again demonstrates a moderate left pleural effusion with interval increase in the opacification of the left lower lobe. The left upper lobe and the right lung are clear. There is no pneumothorax or right-sided pleural effusion. The heart is top normal in size, stable. Pulmonary vascularity is normal. IMPRESSION: Stable moderate left pleural effusion with interval increase in left lower lobe opacity. This may represent worsening compressive atelectasis; however, consolidation due to an infectious process cannot be ruled out. " 925533c5-73934f8f-3c738894-b9cb3960-6d7f6960.jpg,test/p12/p12633029/s57714132/925533c5-73934f8f-3c738894-b9cb3960-6d7f6960.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Status post CABG. There are low lung volumes. Moderate-to-severe cardiomegaly is stable. Widened mediastinum is stable. Small left pleural effusion and adjacent left lower lobe atelectasis are grossly unchanged from ___. Vascular congestion has improved. Right lower lobe atelectases have improved. Right pleural effusion is small. Sternal wires are aligned. There is no pneumothorax. " fdbd919d-1ab3173e-d9c7484a-5daf60fd-f9c72943.jpg,test/p17/p17527875/s53751259/fdbd919d-1ab3173e-d9c7484a-5daf60fd-f9c72943.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p Right lung wedge resection, evaluate for post-op changes TECHNIQUE: Single upright AP chest radiograph COMPARISON: Chest CT dated ___. FINDINGS: A right chest tube projecting over the right midlung is associated with subcutaneous emphysema. Low lung volumes cause bronchovascular crowding and bibasilar atelectasis. Allowing for this, there is moderate pulmonary vascular congestion and mild to moderate pulmonary edema. There is no pneumothorax. The cardiomediastinal silhouette, including mild to moderate cardiomegaly, is unchanged. IMPRESSION: 1. Status post right lung wedge resection with right chest tube in place and no pneumothorax. 2. Moderate pulmonary vascular congestion and mild to moderate pulmonary edema. 3. Low lung volumes. " c1d5b61c-5f260cbb-3fe25449-8a93af89-ef1f1c0b.jpg,test/p12/p12911421/s53081964/c1d5b61c-5f260cbb-3fe25449-8a93af89-ef1f1c0b.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old woman status post CABG with shortness of breath. FINDINGS: Comparison is made to previous study from ___. There is improved aeration of the left lung. There is a small right-sided pleural effusion and a left retrocardiac opacity. The heart size is within normal limits. There are no pneumothoraces. " 04f16da2-ad8ca67b-6eb807c3-193063b7-40542f5c.jpg,test/p15/p15726347/s54595477/04f16da2-ad8ca67b-6eb807c3-193063b7-40542f5c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough productive // r/o pneumonia r/o pneumonia IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE IS LITTLE CHANGE AND NO EVIDENCE OF ACUTE CARDIOPULMONARY DISEASE. NO PNEUMONIA, VASCULAR CONGESTION, OR PLEURAL EFFUSION. PACER LEADS REMAIN IN GOOD POSITION. " fc47ccf8-5b565ce5-2ef24801-cf574f41-c70defe7.jpg,test/p14/p14065514/s54960883/fc47ccf8-5b565ce5-2ef24801-cf574f41-c70defe7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Esophageal cancer, removal of masses, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right pectoral Port-A-Cath has been removed. There is unchanged evidence of right perihilar surgical intervention with clips and hilar enlargement. This is consistent with history of esophageal cancer. The current radiograph shows no acute changes, in particular, no evidence of pleural effusions or nodular or mass-like opacities. Elevation of the right hemidiaphragm. Tortuosity of the thoracic aorta. Normal size of the cardiac silhouette. No pneumothorax. " ff43e196-59fbb585-28a0f1d8-fe4f432d-76ea5e02.jpg,test/p13/p13447728/s56254785/ff43e196-59fbb585-28a0f1d8-fe4f432d-76ea5e02.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ETOH withdrawal now febrile and coughing. // Please evalute for PNA. COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient is extubated. The left PICC line is in unchanged position. Mild atelectasis in the retrocardiac lung area has completely resolved. No pneumonia, no pulmonary edema, known pleural effusions. Better seen than on the previous radiograph is a healing fracture at the lateral aspect of the seventh and eighth left rib. " 75d6c5b6-bb6361cd-2027d9bb-b35802c6-b34d3cd0.jpg,test/p15/p15078112/s55285875/75d6c5b6-bb6361cd-2027d9bb-b35802c6-b34d3cd0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: AML // pre bmt eval pre bmt eval IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains within upper limits of normal or mildly enlarged. No evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 12f922d5-79d95a97-c3fe0aa8-cea49b0b-ea464ad4.jpg,test/p13/p13972871/s53814454/12f922d5-79d95a97-c3fe0aa8-cea49b0b-ea464ad4.jpg,test," FINAL REPORT INDICATION: History: ___F with cough. TECHNIQUE: Chest PA and lateral COMPARISON: RADIOGRAPH FROM ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. There is a subtle consolidation at the right lower lobe. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: Subtle consolidation in the right lower lobe, concerning for pneumonia. NOTIFICATION: Discuss with Dr. ___ at 15:40 on the day of the exam via phone. " 7c2327ce-bd8027ca-edec93be-26d11b81-67c7049c.jpg,test/p19/p19855045/s51957349/7c2327ce-bd8027ca-edec93be-26d11b81-67c7049c.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea, questionable worsening consolidation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes remain low, with a small area of atelectasis at the right lung bases, but no evidence of increasing or parenchymal opacities. Mild cardiomegaly, no overt pulmonary edema. No pleural effusions. No pneumothorax. Vertebral stabilization devices in the cervical region are constant. " 52ffeb4b-15437685-3a378477-014c3546-966e12d3.jpg,test/p15/p15510824/s53008110/52ffeb4b-15437685-3a378477-014c3546-966e12d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tamponade // eval tube position COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of bilateral chest tubes, endotracheal tube and right internal jugular vein catheter. The endotracheal tube is very high and currently projects 8 cm above the carinal, the tube should be advanced by at least 3 cm. No pneumothorax. No larger pleural effusions. " 9be00d4b-7f043a96-5b367575-89dae89a-d24932cf.jpg,test/p11/p11753870/s57412752/9be00d4b-7f043a96-5b367575-89dae89a-d24932cf.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with laparoscopic J-tube, bronchoscopy and EGD, evaluate for pneumothorax. Lung expansion. FINDINGS: AP single view of the chest has been obtained with patient in upright position. Comparison is made with the frontal view of the next preceding PA and lateral chest examination of ___. Multiple wires are overlying the frontal chest view. No pneumothorax can be identified in comparison with the frontal view of the previous examination. The patient is status post esophagectomy and gastric pull-up. No new pulmonary parenchymal abnormalities are seen, and the heart size remains within normal limits. " 5c4c7bd6-de8fc221-807ef5a6-eed8cb23-9951bf41.jpg,test/p12/p12724735/s55936831/5c4c7bd6-de8fc221-807ef5a6-eed8cb23-9951bf41.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF // eval for interval changes eval for interval changes IMPRESSION: Right internal jugular line terminates most likely at the junction of the left jugular vein and brachycephalic vein. Cardiomegaly is unchanged, moderate. There is substantial improvement in the left perihilar opacities that might reflect resolution of asymmetric edema or aspiration. Right basal opacity has improved as well. Right central venous line tip terminates in the right atrium. There is no pneumothorax. There is no interval increase in pleural effusion. " 76b3b9d7-c712ab01-a6267032-d36f6db7-69f5ca56.jpg,test/p16/p16458160/s52250574/76b3b9d7-c712ab01-a6267032-d36f6db7-69f5ca56.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p R VATS, pleural Bx, pneumostat in place // check interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The right pleural drain is in unchanged position. The expansion of the right lung is improved. However, there is a remnant right effusion that has not substantially changed. Unchanged appearance of the cardiac silhouette, normal appearance of the left lung. " 7ade2a50-aea4d33a-e92f515c-ceb5dd34-45f0cc3c.jpg,test/p13/p13826513/s51833590/7ade2a50-aea4d33a-e92f515c-ceb5dd34-45f0cc3c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with cirrhosis and shortness of breath // evaluate for pneumonia COMPARISON: Chest radiographs ___. IMPRESSION: Mild edema name developed in the lower lungs. The upper lungs are clear and there is no appreciable pleural effusion. Heart size is normal, but slightly increased since the prior study. There are no findings to suggest pneumonia. " d19cde9e-e59ed197-d8d96054-de3216ce-f5ac6904.jpg,test/p11/p11268251/s58457970/d19cde9e-e59ed197-d8d96054-de3216ce-f5ac6904.jpg,test," FINAL REPORT INDICATION: ___-year-old female with sudden onset of dyspnea. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ as well as chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates stable heart size and mediastinal contours. No focal consolidation is identified. There is no pleural effusion or pneumothorax. Osseous structures demonstrate no acute abnormality. IMPRESSION: No acute intra thoracic abnormality. " fe127a21-a94fe696-b5243960-65a1a812-d4b5284c.jpg,test/p10/p10598199/s50747730/fe127a21-a94fe696-b5243960-65a1a812-d4b5284c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Chest Pain s/p trauma 5 days ago // any worrisome lesion? COMPARISON: Chest radiographs from___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. NOTIFICATION: The findings were discussed with ___ on the telephone on ___ at 1:40 PM, minutes after discovery of the findings. " 4b4b9dd1-34c50906-443b0b57-b4ff0006-d3556a59.jpg,test/p12/p12176298/s56111195/4b4b9dd1-34c50906-443b0b57-b4ff0006-d3556a59.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: interval change COMPARISON: ___, 9:09 p.m. FINDINGS: As compared to the previous radiograph, the tip of the endotracheal tube projects 2.9 cm above the carina. The extent of the post-surgical right pneumothorax and the location of the two right chest tubes is constant. However, there is a minimal increase in radiodensity of the left lung. The increase in diameter of the vascular structures suggests potential mild pulmonary edema. Unchanged size of the cardiac silhouette. Unchanged moderate retrocardiac atelectasis. " 55670031-ec71bb40-af0b9304-869b82ae-7a480ac6.jpg,test/p14/p14916728/s50552898/55670031-ec71bb40-af0b9304-869b82ae-7a480ac6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with vent dependence // interval scan interval scan IMPRESSION: ET tube tip is 6 cm above the carinal. Right internal jugular line tip is at the level of superior SVC. NG tube tip is in the stomach. Heart size and mediastinum are unchanged in appearance. Multifocal opacities are similar to previous examination, concerning for interstitial pulmonary edema. Left lower lobe consolidation due to infection is most likely coexisting. " 61517001-efcb0c81-d113ed15-f5b5fad3-fe0167e1.jpg,test/p14/p14471216/s53693382/61517001-efcb0c81-d113ed15-f5b5fad3-fe0167e1.jpg,test," FINAL REPORT INDICATION: Abdominal pain and vomiting, status post enema, evaluate for free air. COMPARISON: Chest radiograph from ___. FINDINGS: One AP upright and one lateral view of the chest. There is no evidence of free air. Mild cardiomegaly is unchanged. There is no focal consolidation. No pleural effusion or pneumothorax. IMPRESSION: No evidence of free air. Mild cardiomegaly. " 2ed60d6d-1aad4f93-1052aaef-70219b5b-396ee19d.jpg,test/p15/p15211528/s58527630/2ed60d6d-1aad4f93-1052aaef-70219b5b-396ee19d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: RECURRENT CHF - 5 DAYS AGO TREATMENT IN HOSPITAL IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with pacer leads and new prosthetic aortic valve. Minimal prominence of interstitial markings is stable. No evidence of acute pleural effusion. " 77c6f18c-b843fb65-8531454a-68f064e2-44d08495.jpg,test/p19/p19403960/s54858211/77c6f18c-b843fb65-8531454a-68f064e2-44d08495.jpg,test," FINAL REPORT HISTORY: Dyspnea on exertion. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ at 10:37. FINDINGS: Severe enlargement of the cardiac silhouette is present which is partially attributable to the presence of a moderate pericardial effusion. The aorta is tortuous. There is no pulmonary vascular congestion. There are bilateral pleural effusions, small to moderate on the right and small on the left. Bibasilar atelectasis is also seen, more pronounced within the right lung base. There is no pneumothorax. No acute osseous abnormalities are seen. IMPRESSION: Bilateral pleural effusions, small to moderate on the right and small on the left with bibasilar atelectasis. Moderate size pericardial effusion, better assessed on the chest CT obtained earlier in the day. " 83959289-c07960d6-c4d5f1e7-80a24daf-30382f98.jpg,test/p12/p12420056/s54052028/83959289-c07960d6-c4d5f1e7-80a24daf-30382f98.jpg,test," FINAL REPORT INDICATION: History: ___M with persistent cough // infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: The lung volumes are overall low, there is persistent elevation of the right hemidiaphragm relative to the left side. Faint increased opacity in the left lower lobe/ lingula was also present on the prior chest radiograph dated ___ and has not changed in the interval, may represent atelectasis. There is no lobar consolidation. No pleural effusions. Cardiomediastinal silhouette is unchanged. Degenerative changes of the thoracic spine are as before. IMPRESSION: Low lung volumes, with persistent elevation of the right hemidiaphragm relative to the left side. No new consolidation or pulmonary edema. Faint linear opacity in the left lower lobe/ lingula remains unchanged and likely represents atelectasis. " dbfc5a25-28e0db51-7fe5613e-f66636ae-1a1b6d72.jpg,test/p13/p13026514/s54188274/dbfc5a25-28e0db51-7fe5613e-f66636ae-1a1b6d72.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pancreatic cancer, nephrolithiasis and hydro p/w fever // r/o pna TECHNIQUE: Portable semi-upright AP chest COMPARISON: CT chest ___ FINDINGS: Right Port-A-Cath terminates in the upper SVC. The lungs are normally expanded and clear. Heart size is normal. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " 2093873d-c79f43e2-a7fa1e47-52409065-8e6cc692.jpg,test/p11/p11967908/s53930672/2093873d-c79f43e2-a7fa1e47-52409065-8e6cc692.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Worsening shortness of breath. Recent diagnosis of lymphoma. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: Surgical clips are again present in the right axilla. The cardiac, mediastinal and hilar contours appear unchanged. Upward tenting of the medial right hemidiaphragm is very similar. There is a persistent small-to-moderate pleural effusion on the right witand a small one on the left. Fissures are mildly thickened. Subpleural thickening at the right lung apex appears stable. There is a new mild interstitial abnormality including Kerley B lines and peribronchial cuffing suggesting mild-to-moderate interstitial pulmonary edema. However, there is no definite new focal opacity. Bony structures are unremarkable. IMPRESSION: Findings most consistent with pulmonary edema. " 19b2a034-0980d206-d1958309-be95bb6a-2eca25b9.jpg,test/p15/p15166519/s52951214/19b2a034-0980d206-d1958309-be95bb6a-2eca25b9.jpg,test," FINAL REPORT INDICATION: Low-grade fevers, elevated white count of 16. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Cardiac, mediastinal, and hilar contours are normal. The lungs are clear, and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Normal chest radiograph. " d9e97517-2c6b6b71-eade850b-f5ec281f-eb1cab6a.jpg,test/p11/p11172358/s54900563/d9e97517-2c6b6b71-eade850b-f5ec281f-eb1cab6a.jpg,test," FINAL REPORT INDICATION: ___ year old woman with APL with coughing and inspiratory crackles on exam // eval for possible PNA? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: No evidence of acute cardiopulmonary disease. Right subclavian PICC line extends to the right atrium. It would have to be pulled back about 3-4 cm if the desired position of the tip is at or above the cavoatrial junction. IMPRESSION: No unfavorable change, no acute cardiopulmonary process within the limitations of chest radiograph. " d1461e2d-e1565199-c47aae3a-7a8d0da3-61eccffd.jpg,test/p13/p13717952/s56002758/d1461e2d-e1565199-c47aae3a-7a8d0da3-61eccffd.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old man with lower extremity swelling, assess for CHF. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear, though lung volumes are low. Heart size appears normal. Mediastinal contour is unremarkable. Bony structures are intact. No large pleural effusions are seen. IMPRESSION: No acute intrathoracic process. " 4655f2d1-beaac450-8da48484-3f120e52-e36d3bce.jpg,test/p11/p11315116/s53712180/4655f2d1-beaac450-8da48484-3f120e52-e36d3bce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with AMS // ?pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes are low. The heart is mildly enlarged. The hila are engorged. There is bronchovascular crowding in the lower lungs, difficult to exclude mild interstitial edema. No convincing evidence for pneumonia. No large effusion or pneumothorax. The aorta is unfolded as on prior. Imaged bony structures are intact. IMPRESSION: Mild cardiomegaly with hilar engorgement and probable mild interstitial pulmonary edema. " 743e6e92-defb64b6-ca7a0eca-1fbd7c00-a3e8e041.jpg,test/p13/p13620449/s59037372/743e6e92-defb64b6-ca7a0eca-1fbd7c00-a3e8e041.jpg,test," FINAL REPORT INDICATION: ___ year old man with esrd, chf // any pulmonary edema FINDINGS: As compared to the previous radiograph from ___, interval improvement in mild pulmonary edema. Moderate cardiomegaly persists. The single lead left pectoral pacemaker is in constant position. A hemodialysis catheter is placed in the right internal jugular vein. IMPRESSION: Interval improvement in mild pulmonary edema. " 0ecad8bc-3e0a1538-e959921b-cccf9649-fcd975fd.jpg,test/p15/p15795583/s58187598/0ecad8bc-3e0a1538-e959921b-cccf9649-fcd975fd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with multiple sclerosis presenting with a 2 week history of progressive leg weakness , and chills. Evaluate for infection. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The lungs are clear.Heart size is top normal. Mediastinal contours are normal.No pleural abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " 4aab4f1a-7253e087-c158c873-ed2d127b-afe652ef.jpg,test/p13/p13956561/s50998397/4aab4f1a-7253e087-c158c873-ed2d127b-afe652ef.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. Lung volumes are slightly low, causing accentuation of the pulmonary vasculature. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary process. " 4cb0dfec-79b16abf-9b31c9b3-dfdf57dc-c1225d96.jpg,test/p15/p15624749/s52772626/4cb0dfec-79b16abf-9b31c9b3-dfdf57dc-c1225d96.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with substernal chest pain. TECHNIQUE: Frontal and lateral areas of the chest were obtained. COMPARISON: CTA of the chest from ___. FINDINGS: The lungs are clear, the cardiomediastinal silhouette and hila are normal. Lung volumes are slightly on the lower side. There is no pulmonary edema, but mild vascular congestion. Surgical anchors are seen at the right glenohumeral joint, likely due to rotator cuff fixation. IMPRESSION: No acute cardiothoracic process. Mild vascular congestion. " 432a13e5-9fa7e3be-7f1315f6-5bd1f4a2-a4a20e0d.jpg,test/p18/p18777009/s56818803/432a13e5-9fa7e3be-7f1315f6-5bd1f4a2-a4a20e0d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Evaluate for interval change in a patient 2 weeks status post VATS right middle lobectomy. COMPARISON: Chest radiograph from ___. FINDINGS: Support Devices: None. Blunting of the right costophrenic angle may reflect pleural scarring. The tiny right apical pneumothorax is no longer seen. Right lung volume loss secondary to middle lobectomy is seen. The lungs are clear. There is no left pleural effusion. The heart size is normal. IMPRESSION: Right apical pneumothorax is no longer seen. " ca47a2c9-7a49d665-c0d92dc2-212bf885-30cb8dcc.jpg,test/p19/p19398915/s51767176/ca47a2c9-7a49d665-c0d92dc2-212bf885-30cb8dcc.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Assessment of the patient with cirrhosis after TIPS placement. Portable AP radiograph of the chest was reviewed in comparison to ___. The right pneumothorax has decreased in size. The pigtail catheter is in place. There is interval improvement in the left lower lung consolidation. No interval increase in pleural effusion which is most likely small and bilateral is demonstrated. " d5e57991-c3d36f38-54e50a98-a733b6fb-cbb5cc88.jpg,test/p16/p16627318/s54499535/d5e57991-c3d36f38-54e50a98-a733b6fb-cbb5cc88.jpg,test," FINAL REPORT HISTORY: Leukocytosis, status post liver transplant. Evaluate for effusion or superimposed pneumonia after thoracentesis. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. The right pleural effusion is decreased. There is bibasilar atelectasis, but no focal consolidation. There is no pneumothorax. IMPRESSION: Decreased right pleural effusion and bibasilar atelectasis. No focal consolidation to suggest a superimposed pneumonia. " 3f89e108-89fa407d-26628871-8e8731be-02819429.jpg,test/p12/p12056668/s55757032/3f89e108-89fa407d-26628871-8e8731be-02819429.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old male with recent paraesophageal hernia repair, NG tube placement who presents with nausea and vomiting, coffee grounds in his G-tube. Evaluate for free air and G-tube placement. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. When compared to prior, there has been no significant interval change in the size of the bilateral pleural effusions. There is no significant pulmonary vascular engorgement. Cardiac silhouette is grossly unchanged but limited due to bibasilar abnormalities. Hypertrophic changes are again seen in the spine. G-tube not clearly identified. No free air identified below the diaphragm. IMPRESSION: Moderate bilateral pleural effusions, not significantly changed from prior. No free air below the diaphragm. " c7089535-5ce59b88-ec78ab6b-3d7f72c4-ab2bf568.jpg,test/p19/p19685014/s51537241/c7089535-5ce59b88-ec78ab6b-3d7f72c4-ab2bf568.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with LUL and RLL infiltrate s/p bronch with BAL and biopsy. // eval for ptx eval for ptx IMPRESSION: In comparison with the previous study, there is no definite pneumothorax following bronchial brushing on the right. " a833f67f-0aec71bc-23cee40a-3b88ba18-f3193578.jpg,test/p11/p11558814/s55950047/a833f67f-0aec71bc-23cee40a-3b88ba18-f3193578.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of fever and recent upper respiratory infection. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are stable and unremarkable, as are the hilar contours. IMPRESSION: No acute cardiopulmonary process. " 06355fca-85324115-d7b1c409-5d3458ca-a58b7662.jpg,test/p11/p11629754/s50285723/06355fca-85324115-d7b1c409-5d3458ca-a58b7662.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with chest pain // Eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___, CT abdomen and pelvis dated ___. FINDINGS: The lungs are well expanded and clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unchanged in appearance. IMPRESSION: No acute cardiopulmonary process. " 3aab18c8-fbdb91ac-8b4ef81c-8468b53d-6d85cfa3.jpg,test/p10/p10080695/s57985622/3aab18c8-fbdb91ac-8b4ef81c-8468b53d-6d85cfa3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of VF s/p ICD // Crackles at bases COMPARISON: ___. FINDINGS: Low lung volumes accentuate the cardiac silhouette and bronchovascular structures, limiting assessment of the patient's cardiovascular status. Streaky peribronchiolar bibasilar opacities are associated with apparent bibasilar bronchial wall thickening. No definite pleural effusion. ICD remains in place, with leads in the right ventricle. Mild elevation of left hemidiaphragm is again demonstrated. IMPRESSION: Bibasilar opacities which could reflect atelectasis, aspiration or developing infectious pneumonia in the appropriate clinical setting. " b8a4fc13-ae15075a-4a5d536e-dc2dcecd-3936419a.jpg,test/p11/p11084812/s56927795/b8a4fc13-ae15075a-4a5d536e-dc2dcecd-3936419a.jpg,test," FINAL REPORT INDICATION: ___-year-old female with dyspnea and chest pain. Evaluate for evidence of pneumonia or edema. COMPARISONS: Multiple prior chest radiographs, most recent on ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: Assessment is limited due to poor positioning and underpenetration secondary to body habitus. Allowing for these limitations: There is no focal pulmonary opacity. The conspicuous interstitial pattern is felt to be related to superimposition of tissue due to patient's body habitus. The cardiomediastinal contour is unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process in this limited examination. " 1c00777c-d36e65f3-9fcaa7f1-914d449b-99a0c513.jpg,test/p11/p11304959/s57772862/1c00777c-d36e65f3-9fcaa7f1-914d449b-99a0c513.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF exac, urosepsis // interval change interval change IMPRESSION: In comparison with the study of ___, there are better lung volumes, though there is little change in the cardiomegaly, vascular congestion, and layering pleural effusions with compressive atelectasis at the bases, especially in the retrocardiac region where there is significant volume loss in the left lower lobe. . Areas of patchy opacification, especially in the upper lung zones, could reflect developing aspiration or pneumonia in the appropriate clinical setting. " 4e963f07-6a169915-48188abc-cfc2dd40-2d1f37d1.jpg,test/p15/p15239201/s51466735/4e963f07-6a169915-48188abc-cfc2dd40-2d1f37d1.jpg,test," FINAL REPORT HISTORY: Cirrhosis with altered mental status. FINDINGS: No previous images. The cardiac silhouette is mildly enlarged with left ventricular prominence. No vascular congestion or acute focal pneumonia or pleural effusion. There may be mild atelectatic changes in the retrocardiac region. " 1f2c8191-af4bb9f9-b0e437a0-1495b5b4-9c136ab6.jpg,test/p14/p14097607/s52170431/1f2c8191-af4bb9f9-b0e437a0-1495b5b4-9c136ab6.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: To rule out pneumonia. TECHNIQUE: PA and lateral chest views were viewed and read in comparison with prior radiograph from ___. FINDINGS: Both lungs are well expanded and there are no opacities concerning for pneumonia. Heart size is normal, mediastinal and hilar contours are unremarkable. Bilateral pleural spaces are normal. IMPRESSION: No pneumonia. " f4bcf3c5-f7aef9f1-832b9b66-69948082-c67c155f.jpg,test/p10/p10390732/s50759244/f4bcf3c5-f7aef9f1-832b9b66-69948082-c67c155f.jpg,test," FINAL REPORT HISTORY: Positioning disease status post kidney transplant with hypoxia and respiratory failure. COMPARISON: Multiple prior studies with the most recent chest radiograph from ___. FINDINGS: Endotracheal tube appears in place at 5.7 cm from the carina. Enteric tube traverses to the stomach. Median sternotomy wires, mitral valve prosthesis, and vascular stents projecting over the region of the brachiocephalic and right subclavian vein appear unchanged. Cardiac and mediastinal contours appear unchanged. There is however a new right basilar opacity with obscuration of the right hemidiaphragm which may be due to atelectasis or aspiration. Retrocardiac opacity is again noted and may be representative of atelectasis or infection, possibly due to aspiration. There is no pneumothorax. Small bilateral pleural effusions likely persists. IMPRESSION: New right basilar opacity with persistant retrocardiac opacity. These findings are suspicious for aspiration with possible overlying infection in the proper clinical setting versus atelectasis. Support structures appear in place. Continued followup is recommended. " bd8e5afe-212269f3-d5f15636-3e01cf41-fbfd752c.jpg,test/p11/p11216986/s59500107/bd8e5afe-212269f3-d5f15636-3e01cf41-fbfd752c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated // eval for interval change. eval for interval change. IMPRESSION: Comparison to ___. Minimal decrease in extent of a pre-existing right pleural effusion. Otherwise unchanged radiograph, the monitoring and support devices continue to be correctly positioned. No change in appearance of the cardiac silhouette. " 7c961330-fdc61d23-6f26a02c-28ae4271-86e277b9.jpg,test/p14/p14098914/s58312965/7c961330-fdc61d23-6f26a02c-28ae4271-86e277b9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with uretheral obstruction s/p PCN now with RLE DVT and new O2 requirement. // r/o pneumonia. r/o pneumonia. IMPRESSION: Comparison to ___. Mild increase in size of the cardiac silhouette. Mild elongation of the descending aorta. No evidence of pneumonia. Stable widening of the aortic contour (see previous report). Mild fluid overload but no overt pulmonary edema. " 9ae349a0-b2799de4-cf277a7b-e2f1608b-c34b866c.jpg,test/p12/p12835005/s52087937/9ae349a0-b2799de4-cf277a7b-e2f1608b-c34b866c.jpg,test," FINAL REPORT INDICATION: ___-year-old man with pneumothorax, to evaluate for interval change. COMPARISON: Chest radiograph done earlier today at 8:47 a.m. FINDINGS: A small right apical pneumothorax has minimally decreased, now measuring 8 mm in maximum width. A small right pleural effusion and right basal atelectasis are unchanged, with a catheter in the right basal pleural space. The left lung is clear, without effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: Mild decrease in the right apical pneumothorax, " 443d445c-5e4fda8d-3bb1bcc1-9830ef9f-6e8a6dbd.jpg,test/p13/p13194374/s56465226/443d445c-5e4fda8d-3bb1bcc1-9830ef9f-6e8a6dbd.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with rheumatoid arthritis, on immunosuppressants with cough for a week and rhonchi right greater than left. IMPRESSION: PA and lateral chest compared to ___: Lungs are fully expanded and clear. There is a slight increase in lobulation of the upper pole of the left hilus since ___, clearly new since ___. This ___ be benign reactive lymph node enlargement. If symptoms persist and the clinical situation warrants a chest CT (with intravenous contrast agent indicated for hilar evaluation) would be useful to assess possible central lymph node enlargement. Y-shaped calcification in the aortopulmonic window could be in the ligamentum arteriosum. The heart size is normal, pulmonary vasculature is unremarkable and there is no pleural abnormality. " 9f057c6c-b07b32ee-3fb7c386-eaf0295b-2f2ae726.jpg,test/p10/p10389638/s53949733/9f057c6c-b07b32ee-3fb7c386-eaf0295b-2f2ae726.jpg,test," FINAL REPORT INDICATION: Trauma, fall. COMPARISON: None available. FINDINGS: AP view of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal contours are normal. No fracture is identified. IMPRESSION: No acute intrathoracic process. No fracture however a solitary chest radiograph is not designed to evaluate for fracture. Dedicated views based on physical exam findings can be done. " fa72eff9-30f89909-7c65a6a0-bd5f4114-f6d43e70.jpg,test/p18/p18486197/s54987641/fa72eff9-30f89909-7c65a6a0-bd5f4114-f6d43e70.jpg,test," FINAL REPORT HISTORY: Cough and fever. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette is unremarkable. Prominence of the central pulmonary vasculature is similar to prior examination. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. Mild central pulmonary vascular engorgement is similar to prior examination. " 45bb32a2-23af55c7-c7d198d1-11a3b835-0a19fcb9.jpg,test/p18/p18663902/s50369843/45bb32a2-23af55c7-c7d198d1-11a3b835-0a19fcb9.jpg,test," FINAL REPORT HISTORY: Post-operative pseudocyst. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in good position. Continued enlargement of the cardiac silhouette. Bibasilar opacifications persist, consistent with pleural effusions and underlying atelectasis, especially volume loss in the left lower lobe. " 427b8eec-f2e94b60-d635652c-bd69aa29-874bc246.jpg,test/p12/p12632182/s53347954/427b8eec-f2e94b60-d635652c-bd69aa29-874bc246.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Lower lung volumes seen on the current exam. There are bibasilar opacities, potentially due to atelectasis given lower lung volumes; however, component of infection is not completely excluded. There is no effusion or evidence of pulmonary vascular congestion. Cardiac silhouette is stable given differences in technique. Stable calcified nodule projects over the right mid lung. There is diffuse osteopenia. Osseous and soft tissue structures are otherwise grossly unremarkable. IMPRESSION: Lower lung volumes on current exam making bibasilar opacities potentially due to atelectasis; however, infection is not excluded. Clinical correlation suggested. " afd36717-87d52ef6-7e737b17-d90b3f84-01bf2bfa.jpg,test/p16/p16449190/s56610774/afd36717-87d52ef6-7e737b17-d90b3f84-01bf2bfa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with empyema. s/p right VATS decort ___. Chest tube still in. // eval for interval change eval for interval change IMPRESSION: In comparison study of ___, there is little change in the appearance of the right chest tube and no evidence of pneumothorax. The opacification at the right base is slightly less prominent than on the previous study, most likely reflecting the more upright position of the patient. The left lung is clear and there is no evidence of vascular congestion. " 7cec38e9-936cf7b0-59b28905-1ea04f88-bbfff135.jpg,test/p18/p18128235/s56268501/7cec38e9-936cf7b0-59b28905-1ea04f88-bbfff135.jpg,test," FINAL REPORT INDICATION: Altered mental status and shortness of breath. COMPARISON: Multiple prior chest radiographs from ___. FINDINGS: Frontal and lateral chest radiographs. There are large bilateral pleural effusions with bibasilar atelectasis and collapse of the left lower lobe, similar to ___. The cardiac silhouette is obscured. There is no vascular engorgement. IMPRESSION: Large bilateral pleural effusions with compressive atelectasis, unchanged from ___. " ab007589-502eaa7b-57f72c42-8f378efc-d234c80d.jpg,test/p18/p18529262/s57373356/ab007589-502eaa7b-57f72c42-8f378efc-d234c80d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cervical neck fracture now with crackles at bases // r/o pna/ pulm edema. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: None available. FINDINGS: Lung volumes are low. There is elevation of the left hemidiaphragm with colonic interposition. Aside from the left lower lobe subsegmental atelectasis, the lungs are grossly clear. There is no pneumothorax. The heart and mediastinum are grossly unremarkable. A chronic left distal clavicular fracture and AC joint dislocation is incidentally noted. Irregularly shaped opacities at the left AC joint may be due to heterotopic ossification. IMPRESSION: Assessment limited by low lung volumes. Left lower lobe subsegmental atelectasis with no evidence of pneumonia. " fbb29b40-326c459b-3e704922-cb86debc-7598ed5c.jpg,test/p19/p19427735/s58735131/fbb29b40-326c459b-3e704922-cb86debc-7598ed5c.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of left lower lobe pneumonia and persistent sweats. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest. The heart is of normal size with stable hilar contours. Subtle patchy opacity in the anterior right upper lobe is new since ___. Previously seen left lung opacities have resolved. No pleural effusion or pneumothorax. A moderate-sized hiatal hernia is similar to prior. Pulmonary vascular markings are normal. No radiopaque foreign body. IMPRESSION: New right upper lobe patchy opacity, compatible with an early focus of pneumonia in the correct clinical setting. Recommend follow up CXR in 4 weeks to document resolution following appropriate therapy. Findings were discussed via phone call by ___ with Dr. ___ on ___ at ___ PM. " c1f674d5-7e36152f-fbd6eadc-a4030a72-2000a929.jpg,test/p18/p18573829/s59567651/c1f674d5-7e36152f-fbd6eadc-a4030a72-2000a929.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with new left sided PICC. Repeat examination to assess placement including lateral view. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph performed 3 hr earlier. FINDINGS: The left-sided PICC line is confirmed to end at the level of the mid SVC in the lateral view. Otherwise there is no significant change compared with radiograph performed 3 hr earlier, with bilateral pleural effusions, right worse than left with probable associated atelectasis. No focal parenchymal opacities are seen in the aerated portions of the lungs. There is no pneumothorax. A left-sided IJ line ends in the upper atrium. Sternotomy wires are intact. IMPRESSION: Left-sided PICC line is confirmed to end at the level of the mid SVC in the lateral view. Otherwise unchanged appearance of the thorax compared with radiograph performed 3 hr earlier. " daa70b5f-f4af403b-4c384e0e-3d28958f-22f3c891.jpg,test/p16/p16514111/s57277157/daa70b5f-f4af403b-4c384e0e-3d28958f-22f3c891.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF and now angioedema in the setting of starting lisinopril // ?interval changed of pulmonary edema ?interval changed of pulmonary edema IMPRESSION: In comparison with the study ___ ___, there again is substantial enlargement of the cardiac silhouette. However, the degree of pulmonary vascular congestion has substantially decreased. No evidence of acute focal pneumonia or definite effusion. Probable atelectatic changes at the left base. " 32b41dd2-d5a89915-5c29c1d3-76413ab9-57784cdc.jpg,test/p10/p10494753/s51714050/32b41dd2-d5a89915-5c29c1d3-76413ab9-57784cdc.jpg,test," WET READ: ___ ___ ___ 9:03 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with hemoptysis // mass? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are unremarkable. No focal consolidation is seen. No pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 71b4e4c4-c79a70d7-c16f1278-16eabacd-fadea292.jpg,test/p16/p16198326/s50858458/71b4e4c4-c79a70d7-c16f1278-16eabacd-fadea292.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with pneumonia at outside hospital TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 11:06 at ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Punctate calcification is seen projecting over the right breast, unchanged. No acute osseous abnormality is demonstrated. Remote fracture of the left seventh posterior rib is again noted. IMPRESSION: No acute cardiopulmonary abnormality. Punctate right breast calcification. Correlation with previous mammography is recommended. " 337d9286-e4b8c558-0a3ed6d9-8e2efa79-1c9d5ae7.jpg,test/p19/p19889304/s56049354/337d9286-e4b8c558-0a3ed6d9-8e2efa79-1c9d5ae7.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Code stroke, question acute intrathoracic process. FINDINGS: PA and lateral views of the chest provided demonstrate clear, well-expanded lungs without focal consolidation, effusion, or pneumothorax. Heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute findings in the chest. " 0ef9f306-53c74b58-e008f184-21506561-f7e571c6.jpg,test/p14/p14027149/s57097146/0ef9f306-53c74b58-e008f184-21506561-f7e571c6.jpg,test," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: None. FINDINGS: There is moderate to severe cardiomegaly. The aorta is tortuous and diffusely calcified. No overt pulmonary edema is demonstrated. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities demonstrated. IMPRESSION: Moderate to severe cardiomegaly. Otherwise, no acute cardiopulmonary process. " 509393fa-84290273-ed1da2aa-dc38a8d5-5446b4bf.jpg,test/p16/p16131849/s55343681/509393fa-84290273-ed1da2aa-dc38a8d5-5446b4bf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with spontaneous pnx // interval change COMPARISON: Chest x-ray dated ___ and ___ at 16:19 FINDINGS: A left-sided chest tube is in place. When compared to the films from ___ and ___, there appears to have been progressive retraction of the tip of the left chest tube, moving closer to the left chest wall. There is background COPD with hyperinflation, parenchymal scarring, and prominent areas of hyperlucency in both lung apices/upper zones, in the right lung laterally, and at the right lung base. There is probable bullous change at both apices. In the setting, it would be difficult to exclude a pneumothorax. Nonetheless, there is curvilinear lucency around the periphery of the left upper zone medially and laterally, likely continuing into the left along apex, consistent with a small to moderate size pneumothorax. This is similar, but probably slightly larger, compared to ___. Again seen is subcutaneous emphysema along the left upper and mid chest. No left-sided basilar pneumothorax is detected. Of note, however, though there is opacity at the left lung base consistent with a small to moderate effusion and underlying collapse and/or consolidation, new compared with ___, though similar to ___. In addition, the left hemidiaphragm is elevated, but unchanged. Incidental note is made of clips in the right upper quadrant and soft tissue anchors over the right shoulder. IMPRESSION: 1. Left chest tube has progressively retracted toward the left chest wall, compared with ___ and ___. The side port remains at over the lung itself. 2. Small to moderate left pneumothorax seen in the upper left lung, best appreciated medially and laterally, similar, but possibly slightly larger than on ___. 3. Small left effusion, with underlying collapse under consolidation that has progressed compared with ___. Elevated left hemidiaphragm again noted. 4. Hyperlucency in the right upper, right mid lateral, and right lower zones. This may very well represent relate to background COPD. Background parenchymal distortion scarring related to COPD is also suggested. " 22ddc756-2dfc9bc4-b68857f9-d1d527bd-e0d3e099.jpg,test/p14/p14395025/s52600170/22ddc756-2dfc9bc4-b68857f9-d1d527bd-e0d3e099.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Hypercarbic respiratory failure, concerning for aspiration. AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are unchanged, with multifocal opacities being even more progressed since the prior study, concerning for progression of multifocal infection. No interval development of pulmonary edema or increase in small amount of bilateral pleural effusion demonstrated. " c00f1099-b2ab48e3-8c6b5572-af79a5ab-fabd8958.jpg,test/p17/p17664313/s57863603/c00f1099-b2ab48e3-8c6b5572-af79a5ab-fabd8958.jpg,test," FINAL REPORT HISTORY: ___-year-old female with recent basal ganglia hemorrhage with increasing left-sided weakness for 1 day. COMPARISON: ___. FINDINGS: Single portable view of the chest. The patient is rotated to the left. The lungs remain clear. ET tube, enteric tube and right PICC are no longer visualized. The cardiomediastinal silhouette is unchanged. No acute osseous abnormalities detected. IMPRESSION: Interval removal of the lines and tubes. No acute cardiopulmonary process. " de6d9096-642d2547-3f0a58be-f77b9717-731e7e1b.jpg,test/p10/p10855371/s58607744/de6d9096-642d2547-3f0a58be-f77b9717-731e7e1b.jpg,test," WET READ: ___ ___ 10:28 AM 1. No acute sequelae of trauma. No acute cardiopulmonary process. 2. Linear radiodensity within the IVC most consistent with a lower extremity PICC line extending 5 cm beyond the RA/IVC junction. However, by report patient has no central access. This finding is of uncertain etiology but doubtful immediate clinical significance. Correlate with history of instrumentation or prior imaging of the abdomen/pelvis, if either can be obtained. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with assault, + head trauma, evaluate for traumatic injury. TECHNIQUE: Chest AP and lateral COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The visualized osseous structures appear intact. Degenerative changes of the right acromioclavicular joint are mild. A left pectoral pacemaker and its leads project in expected location. A linear radiodensity projects within the IVC extending into the mid right atrium. IMPRESSION: 1. No acute sequelae of trauma. No acute cardiopulmonary process. 2. Linear radiodensity within the IVC most consistent with a lower extremity PICC line extending 5 cm beyond the RA/IVC junction. However, by report patient has no central access. This finding is of uncertain etiology but doubtful immediate clinical significance. Correlate with history of instrumentation or prior imaging of the abdomen/pelvis, if either can be obtained. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 10:10 AM, 2 minutes after discovery of the findings. " b38704be-8a748d00-f6f11b8e-1d775185-2b8abe29.jpg,test/p17/p17512499/s59913671/b38704be-8a748d00-f6f11b8e-1d775185-2b8abe29.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with chest pain // Eval for pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs: ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. Hilar and pleural surfaces are normal. IMPRESSION: Normal chest. " 68217c55-126e95b3-6d9336b4-8cce2451-b6cecece.jpg,test/p18/p18143490/s51637687/68217c55-126e95b3-6d9336b4-8cce2451-b6cecece.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p replacement asc aorta // eval effusions TECHNIQUE: Portable supine chest radiograph. COMPARISON: Chest radiograph dated ___ at 03:16. FINDINGS: The patient is rotated to the left. ET tube terminates 4 cm above the carina. NG-tube with the side hole in the region of the GE junction. PA catheter terminating in the region of the pulmonic valve. Left IJ terminating in the left brachiocephalic vein. Sternotomy wires appear intact and appropriately aligned. Improved right pleural effusion. Persistent moderate left pleural effusion. Left basilar atelectasis. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pneumothorax is seen. IMPRESSION: 1. NG tube with the side hole in the region of the GE junction, which should be advanced 5 cm. 2. PA catheter with the tip in the region of the pulmonic valve, which should be advanced into the right main pulmonary artery. 3. Left IJ terminating in the left brachiocephalic vein. 4. Resolution of pulmonary edema and improving right pleural effusion, with persistent moderate left pleural effusion and compressive atelectasis. " 174943a0-cfc035a5-fb51b216-754d4ec7-85aebde3.jpg,test/p13/p13336695/s56639315/174943a0-cfc035a5-fb51b216-754d4ec7-85aebde3.jpg,test," FINAL REPORT INDICATION: ___M with epigastric pain // pna? chf? TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: Right central venous catheter seen with tip at the RA/SVC junction. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities. No free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process. " 4d659ce5-b66fa979-f13439b4-a671f6be-0840d7b1.jpg,test/p18/p18457014/s52277349/4d659ce5-b66fa979-f13439b4-a671f6be-0840d7b1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with implanted cardiac electrical devise for MRI. // Please evaluate cardiac electrical devise and leads for MRI. Please evaluate cardiac electrical devise and leads for MRI. IMPRESSION: No comparison. The patient carries a left pectoral single lead pacemaker. The tip of the pacemaker lead projects over the right ventricle. Borderline size of the cardiac silhouette. No pulmonary edema, no pleural effusions. " 1121cd44-fea49600-68733c6b-7efc50c6-fe117c28.jpg,test/p10/p10791554/s58312006/1121cd44-fea49600-68733c6b-7efc50c6-fe117c28.jpg,test," FINAL REPORT INDICATION: Fall with facial lacerations. COMPARISONS: Chest radiograph, ___. FINDINGS: The lung volumes are low, accentuating the vascular markings. There is no evidence of consolidation or pulmonary edema. There is no pleural effusion or pneumothorax. There is mild enlargement of the cardiac silhouette, unchanged from prior exam. Calcifications of the aortic arch are stable. No fracture is identified. IMPRESSION: No acute cardiopulmonary process. " e05066ce-ee5e02a1-7ee66b5c-c45ed869-21411792.jpg,test/p11/p11255297/s53983257/e05066ce-ee5e02a1-7ee66b5c-c45ed869-21411792.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. Recent VAT. History of COPD. COMPARISONS: Radiographs from ___, ___ and ___, as well as earlier PET-CT dated ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged. The aorta is partly calcified. The mediastinal and hilar contours appear similar. There is a widespread mild interstitial abnormality suggestive of pulmonary vascular congestion. Patchy opacities in the left lower lung are probably post-operative including visualization of a clip and chain sutures. The only change is increasing fluid within a loculated hydropneumothorax, with corresponding decrease in air, located along the left lateral chest wall, of uncertain significance in the short-term postoperative course. Mild degenerative changes are similar along the thoracic spine. Subcutaneous emphysema along the left lateral chest wall has mostly resolved. IMPRESSION: 1. Increased interstitial abnormality suggesting mild-to-moderate pulmonary congestion. 2. Similar post-operative changes in the left lower hemithorax, aside from increased fluid in a left lateral loculated hydropneumothorax with a corresponding likely decrease in total air content. " f1bcbbc5-f1727fe3-392333d7-1d8c3f68-cdd3a124.jpg,test/p17/p17911007/s50100546/f1bcbbc5-f1727fe3-392333d7-1d8c3f68-cdd3a124.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Metastatic pancreatic cancer, evaluation for pneumothorax or pleural effusions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The pigtail catheter in the left pleural space remains. On today's examination, a millimetric left apical pneumothorax is noted. Bilaterally at the lung bases, the known parenchymal opacities, dominated by a nodular pattern, are unchanged. No new parenchymal opacities. Unchanged appearance of the cardiac silhouette. Unchanged course of the right pectoral Port-A-Cath. The areas of intestinal distention persist. " 8cd0ee2d-2d52cc3b-69117585-e4c7d065-a54b9631.jpg,test/p17/p17490954/s54089917/8cd0ee2d-2d52cc3b-69117585-e4c7d065-a54b9631.jpg,test," FINAL REPORT INDICATION: ___-year-old male with hypoxia. COMPARISON: Chest radiograph dated ___ FINDINGS: AP upright and lateral chest radiograph demonstrates clear lungs bilaterally. Several bilateral healed rib fractures are noted. There is no pleural effusion or pneumothorax. No evidence of overt pulmonary edema. Cardiomediastinal and hilar contours are stable appearance. Degenerative changes at bilateral glenohumeral joints and acromioclavicular joints noted. IMPRESSION: No acute intrathoracic abnormality. Multiple bilateral healed rib fractures again noted. " 6fc687ed-0706e22f-96ef78f9-84dd4060-ccf55c2d.jpg,test/p13/p13604162/s57795338/6fc687ed-0706e22f-96ef78f9-84dd4060-ccf55c2d.jpg,test," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Indwelling support and monitoring devices are unchanged in position, and cardiomegaly appears unchanged allowing for lower lung volumes on the current study. Bibasilar atelectasis is present, has slightly worsened compared to prior study, currently most marked in the right retrocardiac area. New linear area of atelectasis has also developed in the left perihilar region. Persistent moderate elevation of right hemidiaphragm. " 789d2dbd-e834c91b-eabf7452-c9a156b1-5f7b4440.jpg,test/p17/p17967970/s55250072/789d2dbd-e834c91b-eabf7452-c9a156b1-5f7b4440.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atypical chest discomfort consitent with reflux. History of lung CA, pleaase assess // assess for mass COMPARISON: No comparison. IMPRESSION: No comparison is available at the time of dictation. The lung volumes are normal. The left lung apex shows surgical suture lines, presumably of the resection for a clinically known lung cancer. The lung volumes are normal. Normal hilar and mediastinal structures. Minimal right apical thickening. No intrapulmonary nodules or masses are visualized. Borderline size of the cardiac silhouette with minimal tortuosity of the thoracic aorta. No pleural effusions. " 4a9865ec-4d3c0226-5c95bd07-da44bd59-bc6b3c62.jpg,test/p17/p17963990/s51110683/4a9865ec-4d3c0226-5c95bd07-da44bd59-bc6b3c62.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with past medical history of psychosis presents with fever to 100.9 and right ""rib pain"" TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Elevation of the right hemidiaphragm is chronic, with similar blunting of the right costophrenic angle likely reflective of chronic pleural thickening. Thickening along the right minor fissure however suggests the possibility of a trace right pleural effusion as well. Apart from minimal right basilar atelectasis, the lungs are clear without focal consolidation. Cardiac and mediastinal contours are on remarkable. Hilar contours are normal. Pulmonary vasculature is not engorged. There is no pneumothorax. Mild degenerative changes are noted in the imaged thoracolumbar spine. No acute osseous abnormality is clearly noted. Remote fracture deformities of several right-sided ribs are unchanged. No acute osseous abnormality is detected. IMPRESSION: Thickening of the right minor fissure with blunting of the right costophrenic angle may suggest the presence of a trace right pleural effusion. Chronic elevation of the right hemidiaphragm. No acute osseous abnormality identified. Chronic right-sided rib fractures. " cc94f6c9-0ef0a659-454855cf-2730feec-009bf69d.jpg,test/p13/p13050109/s50636052/cc94f6c9-0ef0a659-454855cf-2730feec-009bf69d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with UTI, cord compression, w/ new cough, ? PNA // please eval ? PNA COMPARISON: Chest x-ray from ___ at 13 19 FINDINGS: Dual lead pacemaker is again noted, with lead tips over the right atrium and right ventricle. There is hyperinflation, consistent with background COPD. There is mild cardiomegaly, unchanged. There is upper zone redistribution, but no overt CHF. Minimal atelectasis at the left lung base. No frank consolidation. Possibility of tiny left and right effusions cannot be excluded. A rounded ___.2 mm calcification is noted overlying the superior mediastinum slightly to the right of midline -- ___ CT shows this to represent a calcified nodule in the inferior right thyroid lobe. Incidental note is made of coarse calcifications in the right breast IMPRESSION: 1. COPD and mild cardiomegaly. 2. Upper zone redistribution and probable trace bilateral effusions, without other evidence of CHF. 3. Minimal atelectasis at the left base. No focal infiltrate or consolidation to suggest pneumonia. If clinical suspicion for pneumonic infiltrate remains high, then further assessment with repeat radiograph including lateral view could help to assess for developing pneumonic infiltrate. 4. Small calcified thyroid nodule again noted. " d4703182-8a4559a1-501c5e36-bf78fe1a-248f8748.jpg,test/p17/p17697134/s56746550/d4703182-8a4559a1-501c5e36-bf78fe1a-248f8748.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with persistent fever, HD 6 SAH // Evalute for PNA Evalute for PNA IMPRESSION: Comparison to ___. Resolution of a pre-existing minimal opacity at the right lung bases. Currently no evidence of pneumonia. No pulmonary edema, no pleural effusions. No pneumothorax. " 3de66497-4217c577-4253e991-71a8a4a5-85849c02.jpg,test/p18/p18052701/s56640643/3de66497-4217c577-4253e991-71a8a4a5-85849c02.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with palpitations/dizziness/weakness earlier in the day. Known valvular disease. // cardiopulm abnormality? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 044b4cf2-b272fd68-250861da-16ceddfe-6d35b63a.jpg,test/p16/p16631345/s59833096/044b4cf2-b272fd68-250861da-16ceddfe-6d35b63a.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with one week of cough // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: CHEST RADIOGRAPH DATED ___. FINDINGS: Lung volumes are low. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Diffuse idiopathic skeletal hyperostosis is noted along the anterior thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary process. " 630b5daa-4356dc07-4538b7e4-b6bd870b-5b664b24.jpg,test/p16/p16289699/s52090195/630b5daa-4356dc07-4538b7e4-b6bd870b-5b664b24.jpg,test," FINAL REPORT INDICATION: CHF, decreased breath sounds on the right base, evaluate for pneumonia or effusion. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. The biventricular pacemaker terminates with leads in the appropriate positions. The patient is post-median sternotomy and CABG. There is a slight increase in right pleural effusion. Otherwise, the lungs are clear. There is no evidence of pneumonia and there is no left pleural effusion. There is no pneumothorax. IMPRESSION: Slight increase in right pleural effusion. Otherwise, unchanged from study on ___. " 35ac5db3-5db0e52a-2e72b13d-530aca9e-36060c49.jpg,test/p12/p12104721/s53552074/35ac5db3-5db0e52a-2e72b13d-530aca9e-36060c49.jpg,test," WET READ: ___ ___ ___ 7:12 AM Right middle lobe pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___M with productive cough. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well expanded. There are opacities silhouetting the right heart border. No other focal opacities. No pleural effusion or pneumothorax. Heart size is normal. LEFT HILUS IS ENLARGED, AN SHOULD BE RE-EVALUATED AFTER TREATMENT OF PNEUMONIA. IMPRESSION: Right middle lobe pneumonia. RECOMMENDATION(S): RE-EVALUATE WITH CONVENTIONAL RADIOGRAPHS IN NO MORE THAN 4 WEEKS " 0534227a-b2a7ba94-f161f2e8-69e5a452-08dc26bd.jpg,test/p17/p17071231/s50741902/0534227a-b2a7ba94-f161f2e8-69e5a452-08dc26bd.jpg,test," FINAL REPORT INDICATION: ___ year old woman s/p Dobhoff. Evaluate for placement of NG Tube. TECHNIQUE: Upright portable AP chest radiographs. COMPARISON: Chest radiographs from ___, ___. FINDINGS: Compared to ___, there is mild increase in interstitial opacities and mild enlargement of the hila, likely from pulmonary edema. 2 AP chest radiographs the demonstrate enteric tube with second radiograph demonstrating the enteric tube seen below the diaphragm and tip out of field-of-view, likely terminating in lower stomach. The heart size is mildly enlarged, unchanged. The lobulated mediastinal contour on right bases likely from no in esophageal varices. There is no evidence for pulmonary consolidation, pleural effusion or pneumothorax. IMPRESSION: 1. Mild pulmonary edema. 2. Enteric tube likely terminating in lower stomach. " 99e97bb3-da6780ab-990bbc5b-02b8cb5a-2e2f1311.jpg,test/p19/p19803391/s58726343/99e97bb3-da6780ab-990bbc5b-02b8cb5a-2e2f1311.jpg,test," FINAL REPORT INDICATION: ___M with metastatic anal CA, p/w subacute dyspnea; please eval for PNA // please eval for PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: PET-CT from ___. Subsequent CTA chest from ___. FINDINGS: Right chest wall port is again seen with catheter tip at the lower SVC. Diffuse bilateral pulmonary nodules are partially visualized, particularly overlying the lung bases. There are increased perihilar opacities bilaterally. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: Increased perihilar opacities since prior, better characterized by subsequent CTA as progression of disease. " 8535f9a0-12434f8c-bc89b844-9c7f7500-cff6ab68.jpg,test/p12/p12536530/s54473764/8535f9a0-12434f8c-bc89b844-9c7f7500-cff6ab68.jpg,test," FINAL REPORT HISTORY: ___-year-old male with back and chest pain. COMPARISON: ___ CT and chest x-ray. FINDINGS: Frontal and lateral views of the chest. The lungs remain clear. Cardiomediastinal silhouette is within normal limits. Moderate hiatal hernia is again noted. No acute osseous abnormality detected. Surgical clips in the upper abdomen again seen. IMPRESSION: No acute cardiopulmonary process. " 00d7e421-28c32409-9f56fedc-e4994048-64997c19.jpg,test/p10/p10668732/s59987311/00d7e421-28c32409-9f56fedc-e4994048-64997c19.jpg,test," FINAL REPORT HISTORY: Chest pain. Question widened mediastinum. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are hyperinflated. Heart size is borderline. The aorta is mildy unfolded, with minimal calcification of the aortic knob. Possible mild prominence of the hila with a tapered appearance, which could reflect pulmonary hypertension. Cardiomediastinal silhouette otherwise within normal limits, without evidence of widening on radiographs. No chf, focal infiltrate, effusion, or ptx detected. IMPRESSION: No evidence of acute pulmonary process. " fdff3665-7576c305-4a08cf87-9caaea9c-99f2a84e.jpg,test/p18/p18394695/s54418524/fdff3665-7576c305-4a08cf87-9caaea9c-99f2a84e.jpg,test," FINAL REPORT INDICATION: ___M with confusion delta ms // pna TECHNIQUE: 2 AP views of the chest. COMPARISON: Multiple prior exams including chest x-rays that seen ___ and ___ and chest CT from ___. FINDINGS: Chronic changes are again noted in the lungs. There is opacity with associated volume loss of the right lung apex. Calcific density in the left midlung is also likely chronic. Vague nodular opacities seen throughout the lungs, left greater than right. Overall, the appearance has not demonstrated significant interval change since most recent exams. Cardiomediastinal silhouette is unchanged. Calcified subcarinal lymph node is seen. Radiopaque densities in the left supraclavicular region are again noted. IMPRESSION: Chronic changes in the lungs most notably at the right lung apex and left midlung. Other scattered nodular opacities have not dramatically changed since most recent exams and could also be chronic however superimposed acute process would be difficult to exclude. " c0de1b3a-86df6d9a-f1168fd6-3620fef8-c0894b67.jpg,test/p19/p19353175/s52099548/c0de1b3a-86df6d9a-f1168fd6-3620fef8-c0894b67.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with left brachial plexopathy // Left brachial plexopathy Left brachial plexopathy COMPARISON: ___ IMPRESSION: Heart size is normal. Questionable opacity a adjacent to the superior vena cava is noted, not clearly seen on the previous study. No left abnormalities are noted. Manual bibasal area of atelectasis is present. Father assessment with chest CT would be justified per process characterization of the upper right mediastinum. " 762115f3-cb37d60d-ef33ba23-4458881f-2bfd381c.jpg,test/p10/p10845913/s54918253/762115f3-cb37d60d-ef33ba23-4458881f-2bfd381c.jpg,test," FINAL REPORT INDICATION: ___M with chest pain and syncope // eval for pna TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear of focal consolidation. Density projecting over the left lower lung localizes to the anterior left fifth rib and may be from prior trauma/healed fracture. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 87f467a6-c99daf3c-26536ac3-28909941-f0fa07c0.jpg,test/p15/p15481731/s52648053/87f467a6-c99daf3c-26536ac3-28909941-f0fa07c0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // eval for interval change COMPARISON: None. FINDINGS: An ET tube is present, tip at the level of the mid clavicular heads, approximately 7.1 cm above the carina. NG tube is present, tip extending beneath diaphragm, off film. Right IJ central line is present, tip overlying SVC/RA junction, similar to the prior film. No pneumothorax is detected. The mediastinal silhouette is unchanged. Hyperinflation and extensive opacity in both lungs, most pronounced in the upper zones and along the right chest wall and adjoining right base, as well as increased retrocardiac density, are similar to the prior film. Lateral aspect of both diaphragms and both costophrenic angles are excluded from the film. IMPRESSION: Doubt significant change compared with 1 day earlier. " 7fd5a9f9-eb754381-b51f8e5c-136df0a1-c34d6fc8.jpg,test/p13/p13473495/s50904351/7fd5a9f9-eb754381-b51f8e5c-136df0a1-c34d6fc8.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with gram-negative rod bacteria. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 3.9 cm above the carina. The NG tube tip passes below the diaphragm terminating in the stomach. Bilateral opacities appear to be unchanged, in particular involving lower lungs. Cardiomegaly is severe and unchanged. " 6652b3e6-85f5e764-03110698-d13f9c37-1bc0559d.jpg,test/p13/p13972513/s59861477/6652b3e6-85f5e764-03110698-d13f9c37-1bc0559d.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___-year-old woman with past medical history significant for metastatic breast cancer, pulmonary embolism, peripheral neuropathy with history of bilateral lumbar radiculopathy and spinal stenosis, presenting for 1 week of bilateral lower extremity swelling and shortness of breath evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiograph ___ and PET-CT ___. FINDINGS: Moderate cardiomegaly has increased from ___. There increased interstitial markings bilaterally. There is no focal consolidation. There are small bilateral pleural effusions. IMPRESSION: 1. Moderate cardiomegaly. 2. Mild interstitial edema with probable small bilateral pleural effusions. " b13e4ca4-36b0530c-31d9eca8-efb43f9f-8d501f3d.jpg,test/p17/p17729489/s55691624/b13e4ca4-36b0530c-31d9eca8-efb43f9f-8d501f3d.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dyspnea. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is moderate pulmonary edema. Superimposed infectious process is not entirely excluded. Trace blunting of the costophrenic angle suggests trace bilateral pleural effusions. The cardiac and mediastinal silhouettes are grossly stable. There is no pneumothorax. IMPRESSION: Pulmonary edema and small bilateral pleural effusions. " 416616e7-7431097b-23b72c23-7cfe1394-cff0a0dd.jpg,test/p10/p10361930/s57155923/416616e7-7431097b-23b72c23-7cfe1394-cff0a0dd.jpg,test," FINAL REPORT INDICATION: Type 1 diabetes, status post CABG, with cough and pleuritic chest pain. Evaluate for pneumonia. COMPARISON: Multiple prior radiographs of the chest, most recent ___. TECHNIQUE: PA and lateral upright radiograph of the chest. FINDINGS: The lung volumes appear normal. Median sternotomy wires are well aligned. The cardiomediastinal silhouette and hilar contours appear normal. Linear opacities at the bases are not appreciably changed since ___ and likely represents scarring. There are no focal opacities to suggest pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: Mild bibasilar scarring; however, no focal opacities to suggest pneumonia. The above results were communicated via telephone by Dr. ___ to ___ ___ at 11:57 p.m. on ___ as requested. " 9352cb27-774f6e39-f828d8ec-7613cde6-920d3821.jpg,test/p14/p14068632/s59400050/9352cb27-774f6e39-f828d8ec-7613cde6-920d3821.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after ascending aortic replacement and chest tube removal. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. There is interval resolution of pulmonary edema with only minimal bibasilar atelectasis present. There is small amount of pleural effusion bilaterally. There is right internal jugular line tip terminating at the level of the superior SVC. No pneumothorax is seen. " 970287e6-64d62237-1d6b2ed8-4dc9321d-038803f4.jpg,test/p14/p14716808/s57354809/970287e6-64d62237-1d6b2ed8-4dc9321d-038803f4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with myeloma and productive cough // ?infiltrate ?infiltrate IMPRESSION: Heart size is minimally enlarged. Aorta is tortuous. There is potentially aneurysmal dilatation at the level of mid thoracic aorta up to 4 cm, seen on previous study from ___ but enlarged (3.4 cm on the previous study). Lungs are clear with no evidence of infectious process. Calcification in the right first rib and multiple compression fractures are consistent with known diagnosis of multiple may Loma. No new consolidations to suggest infectious process demonstrated The patient is after abdominal aortic stenting. " e4ee156b-af4f725b-381db2ff-bf1eb795-bc68d31c.jpg,test/p13/p13750116/s57391055/e4ee156b-af4f725b-381db2ff-bf1eb795-bc68d31c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with left sided chest pain // evaluate for pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 6d5d2fd8-efcf0018-d3a6d291-62c47d9b-573bf87a.jpg,test/p17/p17175679/s58105430/6d5d2fd8-efcf0018-d3a6d291-62c47d9b-573bf87a.jpg,test," FINAL REPORT INDICATION: History: ___M with cough for 2 weeks. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiomegaly and a calcified aorta are again seen. Coarse interstitial markings at the right base and linear atelectasis or scarring at the left base appear chronic. No evidence for pulmonary consolidation, pulmonary edema, pleural effusion, or pneumothorax. Degenerative changes and ossification of the anterior longitudinal ligament are again seen in the thoracic spine. IMPRESSION: No evidence for acute cardiopulmonary abnormalities. " c7ce57d4-83836d1b-942c3524-72f3e2c5-8f528f80.jpg,test/p18/p18501051/s59440830/c7ce57d4-83836d1b-942c3524-72f3e2c5-8f528f80.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with fall, left hand bruising, dementia and amnestic to event TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___. FINDINGS: Low lung volumes are present. Heart size is borderline enlarged. Aortic knob calcifications are demonstrated. The mediastinal and hilar contours are within normal limits. Crowding of bronchovascular structures is demonstrated without overt pulmonary edema. Streaky bibasilar atelectasis is noted without focal consolidation. No pleural effusion or pneumothorax is present. Mild degenerative changes are noted in the thoracic spine. Fixation hardware within the left proximal humerus is incompletely imaged. Osseous structures are diffusely demineralized. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " 06747b96-f3a14e5f-03cc7eb6-1e7124c7-7724c17b.jpg,test/p18/p18170845/s55210473/06747b96-f3a14e5f-03cc7eb6-1e7124c7-7724c17b.jpg,test," FINAL REPORT INDICATION: ___ year old man with cirrhosis, hepatic encephalopathy. Evaluate for signs of infection. TECHNIQUE: Single AP view of the chest. COMPARISON: Chest x-ray from ___. FINDINGS: Lungs are well inflated and clear aside from minimal bibasilar atelectasis. The cardiac silhouette is mildly enlarged. There is no pleural effusion or pneumothorax. Cholecystectomy clips project over the right upper quadrant. IMPRESSION: Minimal bibasilar atelectasis. No focal consolidation. " e00885ca-2e479025-730ef1f2-9d738746-da42cbfa.jpg,test/p11/p11804719/s59685872/e00885ca-2e479025-730ef1f2-9d738746-da42cbfa.jpg,test," FINAL REPORT HISTORY: Alcoholism, question pneumonia. CHEST, TWO VIEWS. The heart is not enlarged. The aorta is minimally unfolded. No CHF, focal infiltrate, or effusion is identified.Incidental note is made of non-visualization of the left clavicular companion shadow. IMPRESSION: 1) No acute pulmonary process identified. 2) Non-visualization of the left clavicular companion shadow. Clinical correlation to assess for any left-sided supraclavicular lymphadenopathy is requested. " 3979ec58-986739c7-19860ac8-17bfc1d4-5b7dc51e.jpg,test/p18/p18111516/s55061995/3979ec58-986739c7-19860ac8-17bfc1d4-5b7dc51e.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chills and low-grade fever. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged. The main pulmonary artery contour is again prominent. The aortic arch is calcified. The mediastinal and hilar contours appear unchanged. There is mild interstitial abnormality suggesting pulmonary vascular congestion. There is patchy new retrocardiac opacity associated with a left-sided pleural effusion, probably small in size. There is also an opacity in the posterior basal right lower lobe concerning for pneumonia and visible on both views. Slight blunting of the right costophrenic angle may be due to a coinciding pleural effusion. Fissures are slightly thickened. A surgical clip projects over the upper abdomen. Slight degenerative changes are similar along the thoracic spine. IMPRESSION: 1. New right lower lobe opacity worrisome for pneumonia in the appropriate setting, although other etiologies such as atelectasis associated with a small pleural effusion could explain the finding. 2. Widespread mild interstitial abnormality with new pleural effusion and thickened fissures, suggesting vascular congestion. " 771a8b93-cbe0901b-8fe9a2e1-12bcc8ed-d4044a5e.jpg,test/p17/p17854307/s54619473/771a8b93-cbe0901b-8fe9a2e1-12bcc8ed-d4044a5e.jpg,test," FINAL REPORT INDICATION: ___ year old man s/p GSW intubated // ETT position TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph from ___. CT of the chest from ___ FINDINGS: Endotracheal tube terminates 4.4 cm above the carina, in appropriate position. Lung volumes are low with mild platelike atelectasis in the right lung base. No pleural effusion or pneumothorax. IMPRESSION: Endotracheal tube in appropriate position. " 3a77cb35-887d864e-8309c73c-dbbe66c0-4cfc835f.jpg,test/p17/p17964477/s58762267/3a77cb35-887d864e-8309c73c-dbbe66c0-4cfc835f.jpg,test," FINAL REPORT INDICATION: Shortness of breath and chest pain. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " acafda9b-cccea31c-b0f2cfa9-56c2c3d4-bedfd568.jpg,test/p15/p15481018/s51861110/acafda9b-cccea31c-b0f2cfa9-56c2c3d4-bedfd568.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with weakness and cirrhotic // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Borderline cardiomegaly. Pulmonary vascular congestion, but no frank edema. Lungs are clear. No pleural effusion or pneumothorax. IMPRESSION: Borderline cardiomegaly and pulmonary vascular congestion suggesting hyper volumia. No focal consolidations to suggest pneumonia. No pulmonary edema or pleural effusion " f49020d8-6622e1b8-f0861694-ae280b35-9806e79e.jpg,test/p19/p19206480/s51974830/f49020d8-6622e1b8-f0861694-ae280b35-9806e79e.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with fever, cough, and hypoxia. COMPARISON: Chest x-ray from ___ and chest CT from ___. FINDINGS: Frontal and lateral views of the chest. There are increased opacities in the lungs at the bases and most conspicuous in the right mid lung. Blunting of the posterior costophrenic angle on the right is compatible with a small effusion. Cardiomediastinal silhouette is within normal limits. Osseous structures demonstrate no acute osseous abnormality. IMPRESSION: Small right effusion and hazy opacities in the lungs at the bases and the right mid lung could be due to atelectasis, infection, or aspiration " fb2152d9-ad7b879b-51fa746c-139e222d-6d8fbbc9.jpg,test/p17/p17598587/s53059817/fb2152d9-ad7b879b-51fa746c-139e222d-6d8fbbc9.jpg,test," FINAL REPORT INDICATION: GI bleed and shock in an intubated patient. COMPARISON: Multiple chest radiographs, the most recent of ___. FINDINGS: Portable AP supine view of the chest was reviewed and compared to the prior studies. An endotracheal tube ends 2-3 cm above the carina. A right-sided line ends in the low superior vena cava. A nasogastric tube passes into the stomach. Since ___ the left pleural effusion has slightly increased and the small right pleural effusion has slightly decreased. Bibasilar atelectasis is unchanged. Cardiomegaly, specifically, left atrial enlargement is unchanged. There is no pneumothorax. IMPRESSION: The left pleural effusion has slightly increased and the small right pleural effusion has slightly decreased sine ___. Bibasilar atelectasis and cardiomegaly are unchanged. " d7a22620-9998e722-61fa1712-1932f82d-690dcc3e.jpg,test/p15/p15227491/s51743265/d7a22620-9998e722-61fa1712-1932f82d-690dcc3e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with b/l pleural effusions // s/p posterior pleural catheter drain pull b/l COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the previously placed left pleural drain was removed. The extent of the left pleural effusion is constant. Small right pleural effusion is also constant of the tube removal. The volumes of the lungs have decreased, causing increased crowding of vascular and bronchial structures. Retrocardiac atelectasis. Right basilar atelectasis. The extent and severity of the pre-existing parenchymal opacities is constant. " 222a11cc-2f007d25-597b9b41-20860823-993e3158.jpg,test/p15/p15930042/s55571318/222a11cc-2f007d25-597b9b41-20860823-993e3158.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // eval for PNA, CHF COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process " 150e4739-2c816448-cb588131-1c1c8596-88134d20.jpg,test/p17/p17239737/s51169794/150e4739-2c816448-cb588131-1c1c8596-88134d20.jpg,test," FINAL REPORT HISTORY: Chest pain and dyspnea. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: PA and lateral images of the chest. The lungs are moderately well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette chronically enlarged. IMPRESSION: 1. No acute cardiopulmonary process. 2. Mild chronic cardiomegaly. " 1fc7ab9a-e146650c-f97c3a38-82e2ebe5-b1166d63.jpg,test/p13/p13714199/s55448210/1fc7ab9a-e146650c-f97c3a38-82e2ebe5-b1166d63.jpg,test," FINAL REPORT INDICATION: Sickle-cell disease and fever. COMPARISON: Chest radiographs ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. The mediastinal silhouette and hilar contours are normal. IMPRESSION: No pneumonia, edema, or effusion. Findings discussed with Dr. ___ at 1:50 p.m. on ___ by phone. " da93c4db-bf7aa273-64f1c402-f28f4776-b74001ee.jpg,test/p10/p10146602/s56299651/da93c4db-bf7aa273-64f1c402-f28f4776-b74001ee.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with L arm numbness, fever, SOB // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There has been interval resolution of the right-sided pleural effusion. The left-sided pleural effusion persistent. The cardiomediastinal silhouette is similar to the prior examination in this patient status post recent CABG and more remote partial resection of the right lung. Midline sternal wires are well aligned and intact. Mediastinal clips are noted. No definite focal consolidation is identified. Multifocal subsegmental atelectasis has slightly decreased in the interval. IMPRESSION: No definite focal consolidation identified. " d02327cc-6bfd64f0-11a23470-c1a06b48-ea7b947e.jpg,test/p13/p13604162/s52939678/d02327cc-6bfd64f0-11a23470-c1a06b48-ea7b947e.jpg,test," FINAL REPORT INDICATION: ___-year-old woman, intubated. Check fluid status. COMPARISON: Prior chest radiographs from ___ through ___. TECHNIQUE: Portable supine AP chest radiograph. FINDINGS: Endotracheal tube terminates 4.2 cm above the carina. An esophageal drain terminates in the mid portion of a non-distended stomach. An enteric feeding tube is likely post pyloric, tip is not included in this examination. Right IJ central venous catheter terminates in the low SVC. Lung volumes remain low and there is persistent retrocardiac and left lung base opacity likely related to atelectasis and pleural fluid. No large pneumothorax. No definite pulmonary edema. IMPRESSION: Persistent retrocardiac and left base opacity likely reflective of a combination of atelectasis and pleural effusion. " 32375778-b039d794-5b559b72-fc28389e-a6e826d7.jpg,test/p16/p16474066/s50685123/32375778-b039d794-5b559b72-fc28389e-a6e826d7.jpg,test," FINAL REPORT INDICATION: Coronary artery disease status post CABG and stents now with left-sided chest pain. Evaluate for heart failure or pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs ___ and ___. FINDINGS: The lung volumes are normal. The lungs are clear. There no pleural effusion, pneumothorax or focal airspace consolidation. The heart is top-normal in size, however, there is no evidence of pulmonary edema. The mediastinal and hilar contours are unremarkable. Retrosternal fullness is unchanged from ___. Sternotomy wires, mediastinal clips and coronary stents are appreciated. IMPRESSION: No acute cardiopulmonary process. " 07d5d6e9-b66a91a7-6cd8b751-c6dd7dde-0a320936.jpg,test/p19/p19837032/s53277051/07d5d6e9-b66a91a7-6cd8b751-c6dd7dde-0a320936.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old man with Right PICC // Repeat PICC flushed in attempt to reposition. TECHNIQUE: Single view of the chest COMPARISON: Prior radiographs performed on same day on ___ at 10:26. FINDINGS: Compared with prior radiographs performed the same day on ___ at 10:26, a right-sided PICC line, which previously terminated in the jugular venous system, has been repositioned and now terminates in the mid SVC. There is otherwise no change. IMPRESSION: Right-sided PICC line terminates in the mid SVC. " 877a68a9-d46576f8-3aca4872-55f702f5-b223ef97.jpg,test/p10/p10917306/s58605600/877a68a9-d46576f8-3aca4872-55f702f5-b223ef97.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fever and cough // ? pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patchy right base opacity is worrisome for pneumonia. Minimal vascular congestion persists. No pleural effusion or pneumothorax is seen. Cardiac mediastinal silhouettes are stable. The patient is status post median sternotomy. IMPRESSION: Patchy right basilar opacity with possible involvement of the right middle lobe as well, worrisome for pneumonia. " 6fe178d8-fd2b8b86-bfc07453-2de5bdc9-4d4c877e.jpg,test/p15/p15481992/s52401900/6fe178d8-fd2b8b86-bfc07453-2de5bdc9-4d4c877e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with 2 weeks of sinus congestion with cough productive of green sputum, intermittent shortness of breath. Evaluate for consolidation. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. Mild elevation of the left hemidiaphragm is noted. IMPRESSION: No acute cardiopulmonary process. " d101e93a-8975694b-8978db2f-91b68405-f9b12777.jpg,test/p10/p10229323/s55571831/d101e93a-8975694b-8978db2f-91b68405-f9b12777.jpg,test," FINAL REPORT HISTORY: Dobbhoff tube placement. COMPARISON: Chest radiograph from the same day. FINDINGS: Dobbhoff tube is noted with the tip in the stomach. Otherwise, there is little interval change in comparison to prior studies the same day. Stable appearance of tracheostomy and left subclavian approach PICC with the catheter tip in the mid SVC. Cardiac and mediastinal silhouettes appears stable. Post surgical changes of the spine are stable. IMPRESSION: Dobhoff tube tip in the stomach. Otherwise, little change in comparison to the prior study. " ba7a9793-cbb976a0-df32ac0f-de00d871-3299ecf3.jpg,test/p15/p15106749/s56093940/ba7a9793-cbb976a0-df32ac0f-de00d871-3299ecf3.jpg,test," WET READ: ___ ___ 5:27 PM The left pleural effusion or strong evidence of adenopathy in the ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with left sided rib pain. // Please evaluate for rib fracture, or other acute cardiopulmonary process. COMPARISON: There is no prior chest imaging available. IMPRESSION: There is appreciable loss of volume in the right middle and lower lobes, both partially consolidated, with a strong suggestion of masses in the right lower lung, as large as 5 cm, involving the right lower lobe bronchus which is oriented vertically, alongside the medially retracted right hilus, indirect indications of volume loss. Sub cm nodules are numerous in the right upper lobe, less so in the left lung. Right pleural effusion is small. There is no left pleural effusion. Heart size is normal. CT scanning is recommended for assessment of what is quite possibly extensive intrathoracic malignancy. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 5;___ PM, 2 minutes after discovery of the findings. " 8abd9eae-22c5659a-103bb915-7d18fa30-217be497.jpg,test/p11/p11126801/s53283411/8abd9eae-22c5659a-103bb915-7d18fa30-217be497.jpg,test," WET READ: ___ ___ ___ 10:34 AM 1. Apparent widening of the mediastinum for which further evaluation with a chest CT with contrast is recommended. 2. Right upper lobe pneumonia. 3. The enteric tube could be advanced 8 cm for positioning of the side port within the stomach. ______________________________________________________________________________ FINAL REPORT HISTORY: Respiratory distress with possible pneumonia in an intubated. Evaluate for tube placement. COMPARISON: Outside hospital chest radiograph at 4:22 today. FINDINGS: PORTABLE SUPINE CHEST RADIOGRAPH (2 EXPOSURES): An endotracheal tube is in satisfactory position, 4 cm above the carina. An enteric tube courses along the esophagus and terminates just distal to the gastroesophageal junction. The gastric side port is located within the esophagus. There is a large consolidation of the right upper lobe, consistent with pneumonia. Additionally, there is volume loss of the right lower lobe with elevation of the right hemidiaphragm. There are probable small bilateral pleural effusions. There is evidence of mild pulmonary edema. No pneumothorax. Heart size is mildly enlarged. There is apparent widening of the mediastinum. Calcifications are seen within the aortic arch. IMPRESSION: 1. Widening of the mediastinum for which further evaluation with a chest CT with contrast or comparison to prior studies is recommended. 2. Right upper lobe pneumonia. 3. Mild pulmonary edema. 4. The enteric tube could be advanced 8 cm for positioning of the side port within the stomach. These findings were discussed with Dr. ___ by Dr. ___ at 10:28 on ___ via telephone at the time of discovery. " c0abaafd-d61dade6-3bce01ff-56fceb85-28c287ed.jpg,test/p12/p12224734/s59613125/c0abaafd-d61dade6-3bce01ff-56fceb85-28c287ed.jpg,test," WET READ: ___ ___ ___ 8:36 PM Persistent large pericardial effusion with globular appearance of the cardiac silhouette. Associated bibasilar atelectasis. Upper lungs are clear. No large effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mediastinal mass and pericardial effusion, s/p pericardial window, chest tube pulled today. ***PLEASE DO AT 7:30PM*** // eval after chest tube pulled- please check at 730pm eval after chest tube pulled COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous pulmonary vascular congestion has resolved. Large areas of lung are obscured by the very large cardiac silhouette, and although the frontal view suggests right infrahilar consolidation, there is no corresponding finding on the lateral. Right pleural effusion is tiny. The cardiac silhouette is comparable in its great size and shape to prior images, indicating large pericardial effusion persists. Deflection of the trachea the thoracic inlet is due to a large goiter. " 32974e52-82a17f25-eebc4329-2d7ceb98-1db295f4.jpg,test/p14/p14065514/s58334374/32974e52-82a17f25-eebc4329-2d7ceb98-1db295f4.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post MIE for esophageal cancer, now requiring assessment for interval change. COMPARISON: Comparison made with chest radiographs from ___ and ___. FINDINGS: There is a new air-fluid level noted in the neoesophagus, best seen on lateral image. Chest radiograph is otherwise essentially unchanged from prior imaging. The lungs are clear. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is unchanged. Right Port-A-Cath is in unchanged position. IMPRESSION: Air-fluid level in the neoesophagus to the right of the trachea. Otherwise, unchanged chest radiograph. " a531b5ae-f8f9a499-7d07405f-e1f79841-3a2ab829.jpg,test/p16/p16426502/s52563166/a531b5ae-f8f9a499-7d07405f-e1f79841-3a2ab829.jpg,test," FINAL REPORT INDICATION: Altered mental status, status post endotracheal tube placement. COMPARISONS: None. TECHNIQUE: A single AP supine view of the chest was obtained. FINDINGS: An endotracheal tube is in the low trachea approximately 2 cm from the carina. A nasogastric tube is present with the tip in the stomach. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 5ad8f074-e131adc1-2f389bf3-d8590146-ea205399.jpg,test/p11/p11699353/s59526251/5ad8f074-e131adc1-2f389bf3-d8590146-ea205399.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, pain // current sinusitis, cough, possible pnuemonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable. Surgical clips are again noted in the in right chest IMPRESSION: No acute cardiopulmonary abnormalities " 87849aca-121dda5c-73aefd09-02c71964-4bb71db0.jpg,test/p10/p10665449/s51341240/87849aca-121dda5c-73aefd09-02c71964-4bb71db0.jpg,test," WET READ: ___ ___ 8:09 PM Right subclavian central venous catheter remains terminating at the low SVC. Mild improvement of right base atelectasis. Otherwise unchanged. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:18 P.M., ___ HISTORY: ___-year-old woman with incarcerated umbilical hernia. Pulled out central venous line. Assess position. IMPRESSION: AP chest compared to ___: Right subclavian line still ends in the mid-to-low SVC. Moderate-to-severe cardiomegaly is more pronounced and mediastinal veins more dilated, perhaps a reflection of supine positioning. Pulmonary vasculature is engorged, but there is no pulmonary edema or large pleural effusion. No pneumothorax. " 7559d02e-9cd44eb9-a758b532-199deb5d-b257f96f.jpg,test/p16/p16939016/s52594588/7559d02e-9cd44eb9-a758b532-199deb5d-b257f96f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with malfunctioning HD catheter R subclav // HD catheter placement COMPARISON: Multiple chest radiographs dating from ___ until ___ FINDINGS: AP upright and lateral views of the chest provided. A right-IL access tunneled dialysis catheter terminates in the right atrium unchanged from prior study. A Dobhoff tube is noted to pass into the distal stomach and tip extends outside the field of view. Mild bibasilar pleural effusions are present, improved from prior study. Mild congestion and interstitial pulmonary edema again noted. Mild cardiomegaly. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: 1. Low position of dialysis catheter, tip situated in the right atrium. Please correlate for positional adequacy. 2. Persistent mild edema. " a9992d73-cc2b0393-267dae62-287b5bc5-123660e5.jpg,test/p19/p19557745/s55594604/a9992d73-cc2b0393-267dae62-287b5bc5-123660e5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with persistant cough // R/O PNA TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: HEART SIZE IS NORMAL. MEDIASTINUM IS NORMAL. LUNGS ARE CLEAR. THERE IS NO PLEURAL EFFUSION OR PNEUMOTHORAX. FLATTENING OF BOTH HEMIDIAPHRAGMS IS UNCHANGED AND MAY BE CONSISTENT WITH HYPERINFLATION " 5e707ef0-fdedfaae-a9fa3e17-bf871f8d-3755b198.jpg,test/p11/p11581298/s56035196/5e707ef0-fdedfaae-a9fa3e17-bf871f8d-3755b198.jpg,test," FINAL REPORT AP CHEST, 7:41 P.M., ___ HISTORY: Increased chest tube output after CABG. IMPRESSION: AP chest compared to ___: ET tube, Swan-Ganz line, midline and left pleural drains end in upper enteric drainage tube are all in standard positions, unchanged. Lung volumes remain low. Mild-to-moderate pulmonary edema, unchanged. Stable postoperative widening cardiomediastinal silhouette. No pneumothorax. " adc30d9e-f2e7356e-8f2af4d3-8eac1ef0-5f612b31.jpg,test/p17/p17081857/s53068185/adc30d9e-f2e7356e-8f2af4d3-8eac1ef0-5f612b31.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath. COMPARISON: None. FINDINGS: 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 and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " ac8703e3-d024cb19-2feb7358-b6b329bf-9a1d960b.jpg,test/p14/p14575349/s52896581/ac8703e3-d024cb19-2feb7358-b6b329bf-9a1d960b.jpg,test," FINAL ADDENDUM ADDENDUM Right apical opacity overlying the ___ anterior ribs may represent scarring. The previously noted rounded opacity seen on the lateral radiograph near the hemidiaphragms likely represents degenerate changes within the spine. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD and bronchiectasis with LLL opacity // eval LLL opacity seen on previous films TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is slightly enlarged. The imaged upper abdomen is unremarkable. The bones are intact. IMPRESSION: No acute cardiopulmonary process. " b663199a-769e7b4f-3221722c-ad254ef0-598cd2c4.jpg,test/p15/p15490195/s56853972/b663199a-769e7b4f-3221722c-ad254ef0-598cd2c4.jpg,test," WET READ: ___ ___ ___ 8:23 PM No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cirrhosis and chf, evaluate for PNA COMPARISON: Chest radiograph from ___ and CT abdomen and pelvis from ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation concerning for pneumonia. Pulmonary vasculature is normal. Cardiomediastinal and hilar contours are normal. Retrocardiac opacity on lateral projection is compatible with a large anterior osteophyte. There is no pleural effusion. IMPRESSION: No pneumonia. " 82a5bdb5-4daf257a-64e2ef66-67c72ecb-58e8886f.jpg,test/p18/p18828209/s57130545/82a5bdb5-4daf257a-64e2ef66-67c72ecb-58e8886f.jpg,test," FINAL REPORT INDICATION: ___-year-old male with sternal pain status post known fracture. Question pneumothorax. COMPARISON: Multiple radiographs and CT exams dating back to ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear. There is no appreciable pneumothorax or pleural effusion. A nondisplaced sternal fracture can be seen without displacement or evidence for change since the initial study although this is not to say necessarily that it might not be healing. Detailed assessment for slight change could be better assessed with CT if needed clinically. IMPRESSION: 1. Sternal fracture without displacement or pneumothorax. 2. No acute cardiopulmonary process. " 72b327ee-d60216fa-dd8923c1-d874596c-cc8375e9.jpg,test/p18/p18092465/s52913278/72b327ee-d60216fa-dd8923c1-d874596c-cc8375e9.jpg,test," FINAL REPORT INDICATION: ARDS. COMPARISON: Radiograph from ___. TECHNIQUE: Frontal chest radiograph. IMPRESSION: The endotracheal tube terminates 3.2 cm above the carina. The cardiac and mediastinal silhouette is unchanged since ___. Widespread opacities, reflecting mild edema, are stable. A left PICC has been retracted to the axilla. There is no pneumothorax. A small left pleural effusion is unchanged. " 069c4a48-0ed4bb60-5284b3b4-e1c81c07-05169a18.jpg,test/p17/p17835277/s51721631/069c4a48-0ed4bb60-5284b3b4-e1c81c07-05169a18.jpg,test," FINAL REPORT HISTORY: History of left periscapular myxofibrosarcoma. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___, and CT chest dated ___. FINDINGS: Minimal left lower lobe atelectasis is noted. There is no focal consolidation, pneumothorax, pleural effusion, or pulmonary edema identified. The heart size is normal. Mediastinal contours are normal. IMPRESSION: No radiographic evidence for acute cardiopulmonary process or pulmonary metastatic disease. " fc3fc55e-9c3789ac-917213f6-4d281aa3-c5473947.jpg,test/p16/p16739492/s59332588/fc3fc55e-9c3789ac-917213f6-4d281aa3-c5473947.jpg,test," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 3:59 PM PFI: 1. No evidence of marked pulmonary edema. 2. Near complete resolution of left pleural effusion and compressive atelectasis. 3. Stable cardiomegaly. ______________________________________________________________________________ FINAL REPORT INDICATION: Patient with diastolic heart failure, presenting with worsening lower extremity edema. COMPARISON: Chest radiograph from ___. PA AND LATERAL VIEWS OF THE CHEST: Compared to the prior radiograph, there is marked improvement in the left pleural effusion and compressive atelectasis with only a tiny component remaining. The lungs are otherwise clear. The cardiac silhouette is stably enlarged. The hilar and mediastinal contours are normal. There is no pneumothorax. Surgical clips are again noted in the left lingula. The pulmonary vascular markings are normal. IMPRESSION: 1. No evidence of pulmonary edema. 2. Near complete resolution of left pleural effusion and compressive atelectasis. 3. Stable cardiomegaly. " 73a7ecd0-77e9fa84-d5e15078-8e5bb30a-514dc1f5.jpg,test/p13/p13568806/s58860667/73a7ecd0-77e9fa84-d5e15078-8e5bb30a-514dc1f5.jpg,test," WET READ: ___ ___ ___ 8:25 PM No focal consolidation, pleural effusion or pneumothorax detected on this single view. Heart and mediastinal contours within normal limits. ______________________________________________________________________________ FINAL REPORT PORTABLE AP SUPINE CHEST FILM ___ AT 19:00 CLINICAL INDICATION: ___-year-old with dysphagia, aspiration risk, now febrile with labored breathing, question infiltrate. Comparison ___ at 18:18. Single portable supine chest film ___ at 18:38 is submitted. IMPRESSION: 1. Overall cardiac and mediastinal contours appear stable. Lung volumes are lower with crowding of the vasculature and no evidence of focal airspace consolidation to suggest pneumonia, pleural effusions, pneumothorax or pulmonary edema. If the patient's symptoms persist, followup imaging should be considered. " 97bf8899-4d9115c9-15afffce-21ac9404-15758c86.jpg,test/p11/p11845949/s57748776/97bf8899-4d9115c9-15afffce-21ac9404-15758c86.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with chronic cough and history of recurrent bronchitis and childhood pneumonia. Assess for bronchiectasis or infiltrate. COMPARISON: ___ and ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: The lungs are clear bilaterally. There is no evidence of bronchiectasis. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Deformity of the left mid clavicle is unchanged from ___ and may relate to prior trauma. IMPRESSION: 1. No evidence of bronchiectasis. 2. Deformity of the left mid clavicle stable since ___. " 0cbe7bf4-c28275f8-13ba267d-4e2b3c00-db4272ee.jpg,test/p18/p18148913/s52391084/0cbe7bf4-c28275f8-13ba267d-4e2b3c00-db4272ee.jpg,test," FINAL REPORT AP CHEST, 8:47 P.M. ON ___ HISTORY: Clogged G-tube. V-tach. Check ET tube. IMPRESSION: AP chest compared to ___: Previous large pneumoperitoneum no longer visible. New opacification in the right upper lung with volume loss could be largely atelectasis but raises concern for pneumonia. ET tube is in standard position, with the chin flexed. Upper enteric drainage tube passes into a non-distended stomach. The gut in the upper abdomen remains moderately to severely distended. Heart is moderately enlarged, unchanged, but there is no vascular congestion, edema or appreciable effusion. " 033f9605-e38386bc-51a8593c-d7e6b792-02724c3c.jpg,test/p19/p19356325/s56395812/033f9605-e38386bc-51a8593c-d7e6b792-02724c3c.jpg,test," FINAL REPORT INDICATION: Bibasilar rales, known CHF. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: Radiographs from ___. IMPRESSION: The heart is mildly enlarged, unchanged from the ___ examination. There is no pulmonary or interstitial edema. Coarse reticular opacities at the lung bases are unchanged, and may reflect underlying interstitial disease. No superimposed new focal consolidation is seen. There is no pneumothorax or pleural effusion. " 592119df-ee5ef033-17ec7d33-760c3e27-05d99c88.jpg,test/p18/p18350596/s53973457/592119df-ee5ef033-17ec7d33-760c3e27-05d99c88.jpg,test," FINAL REPORT INDICATION: Evaluate for postoperative changes after mitral valve, tricuspid valve, and left ventricular repair. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal lateral chest radiographs demonstrate intact sternal wires and a right internal jugular catheter which terminates at the cavoatrial junction, unchanged. The cardiac silhouette remains enlarged, unchanged. Bilateral small to moderate pleural effusions and retrocardiac opacity are unchanged. No new focal consolidation or pneumothorax is identified. The visualized upper abdomen is unremarkable. IMPRESSION: Unchanged bilateral small to moderate pleural effusions and retrocardiac opacity. " 8afdb28a-0a988b9c-f29128b7-19684e08-10b2581a.jpg,test/p17/p17109563/s56250317/8afdb28a-0a988b9c-f29128b7-19684e08-10b2581a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough shortness of breath chest pain COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Breast implants noted bilaterally. IMPRESSION: No acute intrathoracic process. " d92c9a46-0e991016-ec8274ad-6da8fc07-563e9689.jpg,test/p13/p13556315/s52312815/d92c9a46-0e991016-ec8274ad-6da8fc07-563e9689.jpg,test," FINAL REPORT INDICATION: ___-year-old female with left-sided chest pain, cough. Evaluate for cardiopulmonary abnormality. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 6280d939-f3137bcb-a0ee17e0-b225620d-5a5d8765.jpg,test/p12/p12459180/s57488888/6280d939-f3137bcb-a0ee17e0-b225620d-5a5d8765.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. As on prior, the lung volumes are low. The lungs are clear of consolidation or pulmonary vascular congestion. The cardiac silhouette is enlarged but stable in configuration. The thoracic aorta is tortuous. Blunting of the posterior costophrenic angle could represent small effusions. IMPRESSION: No definite acute cardiopulmonary process. " 8cecfe80-64b099a6-dd98ee53-8fbc7b98-4e94a719.jpg,test/p17/p17984444/s59785398/8cecfe80-64b099a6-dd98ee53-8fbc7b98-4e94a719.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with abdominal pain status post EGD. Evaluate for pneumoperitoneum. COMPARISON: Chest radiograph from ___. FINDINGS: Upright AP and lateral radiographs of the chest demonstrate underinflated but clear lungs. The hilar and cardiomediastinal contours are normal. There is minimal bibasilar atelectasis. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. There is no evidence of infradiaphragmatic free air. IMPRESSION: 1. No acute cardiopulmonary process. 2. No evidence of pneumoperitoneum. " b782469c-a510dfaa-5906b654-d6ba0f8e-fa90ae24.jpg,test/p12/p12307852/s50341885/b782469c-a510dfaa-5906b654-d6ba0f8e-fa90ae24.jpg,test," FINAL REPORT HISTORY: Cough fall, ataxia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are relatively hyperinflated with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. There is mild bibasilar atelectasis. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. Aortic calcification is again seen. Stable mild compression deformities in the mid thoracic spine are noted. No displaced fracture is seen. However if clinical clinical concern for rib fracture is high, dedicated rib series or chest CT are more sensitive. IMPRESSION: No acute cardiopulmonary process. " f01b2526-eb2011e2-f616278d-fef3d1cb-f49e684a.jpg,test/p10/p10030487/s56404897/f01b2526-eb2011e2-f616278d-fef3d1cb-f49e684a.jpg,test," FINAL REPORT INDICATION: History: ___F with nausea and vomiting // Eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: AP upright and lateral radiographs of the chest demonstrate clear lungs. No focal consolidation concerning for pneumonia. The heart is mildly enlarged, similar to prior. There is no pleural effusion or pneumothorax. A calcified and tortuous aorta is again seen. Left-sided Port-A-Cath terminates in the right atrium. Hilar contours are stable and unremarkable. Retrocardiac density noted containing an air-fluid level is compatible with a large hiatal hernia. IMPRESSION: 1. No pneumonia. 2. Large hiatal hernia. " 6699f66e-0909085e-a288ce84-4109a986-91ed395a.jpg,test/p10/p10514375/s50440981/6699f66e-0909085e-a288ce84-4109a986-91ed395a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Lung cancer, Pleurx catheter, chest tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the left-sided chest tube is in unchanged position. The extent of the pre-existing pleural effusion has slightly increased. As a consequence, there is increased atelectasis at the left lung base. Unchanged appearance of the right hilus. No newly appeared parenchymal opacities suggesting pneumonia. " e96ca1f0-71f4d8af-e49e62ab-6bdc7c69-2ae9b958.jpg,test/p17/p17033046/s57862791/e96ca1f0-71f4d8af-e49e62ab-6bdc7c69-2ae9b958.jpg,test," FINAL REPORT INDICATION: ___ year old man // eval effusions TECHNIQUE: Portable frontal view of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: The endotracheal tube has been removed. A right central venous catheter ends at the cavoatrial junction. A Dobbhoff tube ends in the stomach. Median sternotomy wires and mediastinal clips are again identified. Diffuse bilateral alveolar opacities, the combination of baseline interstitial lung disease and non cardiac edema, is generally increased, particularly in the left lower ___, ___ be due slightly lower lung volumes, but worsening edema is suspected. There is a small right pleural effusion. No pneumothorax is identified. The cardiac and mediastinal contours are stable. IMPRESSION: Interval removal of the endotracheal tube. Decreased lung volumes and increased opacity throughout the lungs. Apparent radiographic worsening ___ be due in part to withdrawal of positive pressure support, however, worsening lung disease is suspected. " 9d5a2315-35791d4a-4f778ef7-86720ec8-90c79cab.jpg,test/p10/p10397008/s55634772/9d5a2315-35791d4a-4f778ef7-86720ec8-90c79cab.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // immunosuppressed (Humira) also on methotrexate- persisting cough ? pneumonia vs evidence MTX lung injury immunosuppressed (Humira) also on methotrexate- persisting cough ? pneumonia vs evidence MTX lung injury IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " ff2d301c-bcd6ee33-d65b6628-ecf9ba3a-85b464ba.jpg,test/p19/p19557250/s51103296/ff2d301c-bcd6ee33-d65b6628-ecf9ba3a-85b464ba.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ET tube // interval change interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lung volumes remain low, and the left lower lobe is persistently opacified. Since the left hilus is depressed, this is due to either substantially or exclusively left lower lobe atelectasis. Pleural effusions are small if any. Moderate enlargement of cardiac silhouette is long-standing but there is no pulmonary edema. ET tube and right internal jugular line are in standard placements and an esophageal drainage tube passes into the stomach and out of view. " 54c194b6-dd830ec8-a834f143-09a9523f-7589722f.jpg,test/p12/p12846293/s58321352/54c194b6-dd830ec8-a834f143-09a9523f-7589722f.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fever/chills, coughing, sore throat, vomiting // eval for infection TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: Lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d05882ae-167a67ca-7dda18df-fc8f0561-ac60af9d.jpg,test/p19/p19646078/s51290959/d05882ae-167a67ca-7dda18df-fc8f0561-ac60af9d.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with dyspnea, s/p mitral valve replacement ___. TECHNIQUE: Chest AP upright and lateral COMPARISON: Chest radiograph ___. FINDINGS: Midline sternotomy wires and prosthetic cardiac valve again noted. There is interval increase in right pleural effusion, now moderate to large in size. Associated with this is right basal compressive atelectasis, difficult to exclude aspiration or pneumonia. A left mid lung opacity likely represents atelectasis. Heart size cannot be assessed. There is probable mild edema. Mediastinal contour remains prominent. No definite pneumothorax. No large left effusion. Bony structures are intact. IMPRESSION: As above. " 17974969-7eaa0f8c-209448e5-86dc58bc-7bf03bb3.jpg,test/p19/p19167068/s57444062/17974969-7eaa0f8c-209448e5-86dc58bc-7bf03bb3.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath and fever. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures appear within normal limits. IMPRESSION: No evidence of acute cardiopulmonary disease. " 2473f121-b649c7d4-2c158903-380266b2-c1df16ff.jpg,test/p11/p11897283/s58470516/2473f121-b649c7d4-2c158903-380266b2-c1df16ff.jpg,test," FINAL REPORT INDICATION: Left-sided chest and neck pain. Evaluate for pneumothorax. COMPARISON: No relevant comparisons available. FRONTAL AND LATERAL CHEST: The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: No pneumonia or pneumothorax. " 5505b8c6-814d1cfa-2d3c61c1-b87adb74-69a3bd2a.jpg,test/p14/p14809072/s58177020/5505b8c6-814d1cfa-2d3c61c1-b87adb74-69a3bd2a.jpg,test," FINAL REPORT HISTORY: Decreased breath sounds on the right. COMPARISON: Chest radiograph ___. FINDINGS: PA and lateral radiographs are provided for review. Again seen is elevation of the right hemidiaphragm with a new right pleural effusion and associated atelectasis. The heart size is top normal. The mediastinal and hilar contours are unremarkable. There is no focal consolidation concerning for pneumonia. There is no pneumothorax. IMPRESSION: New right pleural effusion with associated atelectasis. " 6f0444d1-68665596-724cefc5-c8f24413-1b7adc56.jpg,test/p18/p18154666/s59069847/6f0444d1-68665596-724cefc5-c8f24413-1b7adc56.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe CHF // effusions? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Left pleural effusion appears to be slightly decreased as compared to the prior study although it might be reflected. The due to lordotic projection on the current radiograph, still present at least moderate amount. Right pleural effusion is most likely present, minimal. Vascular congestion is noted, minimal. No pneumothorax is seen. " be9c841d-a01fe3ca-1031865f-996d83d2-38839979.jpg,test/p19/p19869327/s58926696/be9c841d-a01fe3ca-1031865f-996d83d2-38839979.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post MVC on ___ with upper right extremity weakness. Assess for C-spine malalignment. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. Pulmonary vasculature is unremarkable. Mild degenerative changes of the right acromioclavicular and glenohumeral joints are present. Osseous structures are otherwise unremarkable. No radiopaque foreign bodies. IMPRESSION: No acute cardiopulmonary process. " c1561cb9-a40f28c1-f2fa02bd-6dd42a18-c414ad20.jpg,test/p13/p13750396/s54574672/c1561cb9-a40f28c1-f2fa02bd-6dd42a18-c414ad20.jpg,test," FINAL REPORT INDICATION: ___F with history of asthma p/w 3 days of abdominal pain, fever // ? pneumonia TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. There is no free intraperitoneal air. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 139f2b98-566d3516-34b6975c-8f4c9270-bd7281aa.jpg,test/p11/p11632236/s55524832/139f2b98-566d3516-34b6975c-8f4c9270-bd7281aa.jpg,test," WET READ: ___ ___ ___ 2:52 AM interval development of left lung opacity with subpleural sparing since ___. RLL opacity is also increased. Right upper lung is clear. PCP is ___ consideration as the patient is status post liver transplant and off PCP prophylaxis since ___ per d/w Dr. ___. No pneumothorax. Blunting of the right costophrenic sulcus is stable. -___ d/w ___ by phone at 2:45am on ___. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST Compared to ___. HISTORY: ___-year-old man with cirrhosis after two liver transplants, now hypoxic and wheezing. Severe consolidation has developed through most of the left lung and at the right lung base, consistent with widespread pneumonia or pulmonary hemorrhage. The heart size is top normal. Pleural effusions are small if any. Findings were discussed on ___, 2:45 a.m. by Dr. ___ with Dr. ___ ___. " ee6246f9-601be2f9-f06b23a2-154d7be9-752d0faa.jpg,test/p10/p10494089/s52910290/ee6246f9-601be2f9-f06b23a2-154d7be9-752d0faa.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion on MRI // ?size ?size IMPRESSION: In comparison with the study of ___, allowing for the AP portable technique, there probably is little overall change in the degree of cardiomegaly. No definite vascular congestion. This raises the possibility of cardiomyopathy or pericardial effusion. Central catheter remains in place. In the absence of a lateral view, it is extremely difficult to assess for pleural effusion. " d0998ae8-2dc402a1-70982393-b1202bb7-af24e9a7.jpg,test/p13/p13305035/s50383091/d0998ae8-2dc402a1-70982393-b1202bb7-af24e9a7.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Chest radiograph: ___. FINDINGS: Nasogastric tube courses below the diaphragm but tip is not included on this radiograph. Cardiomediastinal contours are similar in appearance allowing for rightward patient rotation. Moderate left pleural effusion has apparently increased in size. Previously reported pulmonary edema has improved with only mild residual edema remaining. " 7bd6778b-3dfff390-b6731b06-46ce6abc-c3fd60bb.jpg,test/p16/p16131849/s51886861/7bd6778b-3dfff390-b6731b06-46ce6abc-c3fd60bb.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: Patient with decortication procedure. Assess interval change. FINDINGS: Comparison is made to prior study from ___. Heart size is upper limits of normal. There are chest tubes seen along the left chest at the base and the apex. No pneumothoraces are seen. There are areas of consolidation within the left mid and lower lung field. There is elevation of the left hemidiaphragm partially due to air within the colon. There is mild increased density at the right base without definite consolidation. Chest tube has been removed. Overall, the parenchymal lung findings are stable. " bb59bfa9-7f5782dc-b9dfdc99-7771c614-8f9692a3.jpg,test/p13/p13736930/s52042243/bb59bfa9-7f5782dc-b9dfdc99-7771c614-8f9692a3.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___M with syncope and hypoglycemia // infiltrate COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Left chest wall pacer device is noted with leads extending into the region the right atrium and right ventricle. Lungs appear clear. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. " 73a780eb-20777b8e-2c78ca6e-0f5a8c1b-69643986.jpg,test/p17/p17051420/s56998073/73a780eb-20777b8e-2c78ca6e-0f5a8c1b-69643986.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with recent pneumonia and chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Moderate cardiomegaly is chronic, but has been larger in the past. Mildly increased opacity in the lower lungs bilaterally could reflect an element of pulmonary edema. There is no pleural effusion or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: Mild pulmonary edema. Chronic moderate cardiomegaly. " 26160666-59e12bb9-4da18f0f-63565aa0-08f115c3.jpg,test/p13/p13063001/s59674577/26160666-59e12bb9-4da18f0f-63565aa0-08f115c3.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. There are new bibasilar opacities, right greater than left compatible with pleural effusions. Superiorly, the lungs are clear of focal consolidation. Cardiac silhouette is enlarged but likely not significantly changed since prior even lower lung volumes. No acute osseous abnormality detected. IMPRESSION: Moderate right and small left pleural effusion with likely underlying atelectasis noting that a component of infection cannot be excluded. Cardiomegaly. " e14c14fc-84c54fd7-c94e7b8c-e34b3ab8-ae8e9eb9.jpg,test/p12/p12885815/s50386191/e14c14fc-84c54fd7-c94e7b8c-e34b3ab8-ae8e9eb9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___/F s/p R TKA POD1, Temp > 101, please eval for pneumonia. // Infiltrate? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable in appearance. Right upper lobe opacity appears to be new in might represent infectious process. No pleural effusion or pneumothorax is seen. " 0af91961-27dade1b-f6bf4929-65ddb84a-532d06fd.jpg,test/p10/p10213765/s53853009/0af91961-27dade1b-f6bf4929-65ddb84a-532d06fd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with +LOC, polytrauma, grade 2 liver lac, infr pubic rami/iliac frx, R PTX, R 7th rib frx // Evaluation of pneumothorax COMPARISON: ___. IMPRESSION: As compared to the previous image, there is no substantial change in dimension of the right apical pneumothorax. The patient shows no evidence of tension. The pre described subtle right lower lung parenchymal opacity has completely resolved, a small atelectasis in the infra hilar right lung regions persists. Unremarkable left lung. Normal size of the cardiac silhouette. No pneumonia or pleural effusions. " 730ad0ba-0e2e10ef-c4d288cd-095cc69f-bf4631bd.jpg,test/p10/p10635271/s54383900/730ad0ba-0e2e10ef-c4d288cd-095cc69f-bf4631bd.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pacemaker placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. Expected position of the generator. Normal appearance of the wires, the tips are projecting over the region of the right atrium and right ventricle. There is no evidence of complication, notably no pneumothorax. Unchanged band-like atelectasis, associated to a minimal left pleural effusion. " 449ce409-80ec4f72-60ad149d-b02c544a-799bfeae.jpg,test/p16/p16383382/s54820496/449ce409-80ec4f72-60ad149d-b02c544a-799bfeae.jpg,test," FINAL REPORT INDICATION: Pulmonary edema and possible underlying pneumonia diagnosed ___. Followup examination. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: ___ and ___. FINDINGS: Perihilar opacities and pulmonary vascular congestion have resolved. There is residual bibasilar atelectasis, unchanged from ___. There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. Cardiomediastinal silhouette is within normal limits. IMPRESSION: Resolved pulmonary edema. No evidence of pneumonia. " fd7b5f59-b6ae03cc-e2cc750b-93c28f14-5f7da44e.jpg,test/p19/p19132043/s56291690/fd7b5f59-b6ae03cc-e2cc750b-93c28f14-5f7da44e.jpg,test," FINAL REPORT CLINICAL HISTORY: Worsening dyspnea, tachypnea. CHEST, SEMI-ERECT COMPARISON: ___. The position of the various lines and tubes is unchanged. The heart remains markedly enlarged. Rounded opacities are seen in both the right and left base, which were not present on the prior chest x-ray of ___. These could represent areas of pneumonic consolidation. Though some failure is present, this would be an unusual presentation. IMPRESSION: Somewhat rounded opacities in both bases suggesting pneumonic consolidations. " c0848009-493c4d65-53b28a3d-8734912c-77b5344d.jpg,test/p19/p19764001/s56474687/c0848009-493c4d65-53b28a3d-8734912c-77b5344d.jpg,test," FINAL REPORT INDICATION: ___M with altered mental status // eval for acute process TECHNIQUE: AP and lateral views the chest. COMPARISON: None. FINDINGS: Relatively low lung volumes are noted. Streaky bibasilar opacities are likely secondary to atelectasis. The lungs are otherwise clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 37b13a89-3787dce0-6680a974-bdcbe8cb-9bedbff6.jpg,test/p15/p15783233/s51723710/37b13a89-3787dce0-6680a974-bdcbe8cb-9bedbff6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M status post Whipple's procedure presenting with fever, abdominal pain, nausea, vomiting, temperature to 102 today TECHNIQUE: Chest PA and lateral COMPARISON: CT chest dated ___, chest radiograph ___ FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. Percutaneous catheter is seen projecting over the midline upper abdomen. IMPRESSION: No acute intrathoracic abnormality. " 8e9fff6c-faf776de-0428a734-9db5a3fe-776ec43e.jpg,test/p14/p14260816/s56190742/8e9fff6c-faf776de-0428a734-9db5a3fe-776ec43e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Feeling unwell for two weeks. FINDINGS: PA and lateral views of the chest are provided. Lungs are clear. No signs of pneumonia or CHF. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No signs of pneumonia. " 4f38840f-f7e5cd28-e4048816-0f438450-3c664057.jpg,test/p19/p19860832/s56599816/4f38840f-f7e5cd28-e4048816-0f438450-3c664057.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post bronchoscopy. Comparison is made to the prior study performed 9 hours earlier. Right upper lobe collapse has resolved. ET tube is in standard position. Cardiomediastinal contours are normal. Left lower lobe opacity has increased, consistent with increasing atelectasis. There is probably small left pleural effusion. Right lower lobe opacity is consistent with combination of atelectasis and small right pleural effusion, unchanged. There is no evident pneumothorax. " 5ae85ad7-17c8d720-a07b3f51-d1010832-8462e41d.jpg,test/p14/p14852646/s54663387/5ae85ad7-17c8d720-a07b3f51-d1010832-8462e41d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Patchy and linear opacity within the right lung base is unchanged, likely scarring. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 1fa1c571-df94b8f3-ab8e782f-6e27d994-384e1144.jpg,test/p18/p18001424/s51888634/1fa1c571-df94b8f3-ab8e782f-6e27d994-384e1144.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ER-positive breast cancer, on AI // left upper chest rib pain. Pathological fracture? COMPARISON: ___. IMPRESSION: Known fracture of the lateral aspect 's of the left eleventh rib. Several ribs, on both the left and the right side, have heterogeneous appearance suggestive of metastatic bone disease. The most ventral part of the tenth left rib shows a cortical discontinuity, potentially reflecting a pathologic fracture. No other fractures can be clearly identified. If the clinical suspicion for a pathologic fracture persists, a rib series should be performed given the better detection rate of this modality. " cea2a09c-aa846dc3-7c66e469-2d578cc2-d0675bb7.jpg,test/p18/p18777009/s56818803/cea2a09c-aa846dc3-7c66e469-2d578cc2-d0675bb7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Evaluate for interval change in a patient 2 weeks status post VATS right middle lobectomy. COMPARISON: Chest radiograph from ___. FINDINGS: Support Devices: None. Blunting of the right costophrenic angle may reflect pleural scarring. The tiny right apical pneumothorax is no longer seen. Right lung volume loss secondary to middle lobectomy is seen. The lungs are clear. There is no left pleural effusion. The heart size is normal. IMPRESSION: Right apical pneumothorax is no longer seen. " 87d3ae7c-0d90edf4-b8716280-47898783-0d415778.jpg,test/p11/p11632236/s58784817/87d3ae7c-0d90edf4-b8716280-47898783-0d415778.jpg,test," FINAL REPORT INDICATION: Pneumonia. Evaluate for change. COMPARISONS: Chest radiograph from ___. Chest radiograph from ___. CT of the chest from ___. TECHNIQUE: A single semi-upright AP view of the chest was obtained. FINDINGS: An endotracheal tube is in satisfactory position approximately 6.3 cm from the carina. An enteric tube courses below the diaphragm with the tip out of field of view. A right internal jugular catheter is unchanged with the tip in the mid-to-upper SVC. Extensive parenchymal opacities throughout the entire left lung and in the right middle and lower lung zones are similar to the prior exam. There is no new opacity. There are likely tiny bilateral pleural effusions. There is no pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Overall, no significant change from the prior exam, including the extensive bilateral parenchymal opacities. " b1bae132-d49a4969-eea08e6d-63e9dc28-4311e1be.jpg,test/p17/p17561108/s55462970/b1bae132-d49a4969-eea08e6d-63e9dc28-4311e1be.jpg,test," FINAL REPORT HISTORY: ___-year-old man with pneumonitis, status post VATS. COMPARISON: ___. TECHNIQUE: Single portable view of the chest. FINDINGS: Cardiac size is enlarged. Widening of the mediastinum and perihilar opacities are consistent with vascular engorgement and pulmonary edema. A right-sided Port-A-Cath terminates in the mid to high SVC. There is also right-sided atelectasis. The patient is status post AVR. IMPRESSION: Right upper lobe surgical changes. Mild - moderate pulmonary edema. " 13409f6c-f123586d-f12550b8-132afc55-40507917.jpg,test/p19/p19398915/s58719943/13409f6c-f123586d-f12550b8-132afc55-40507917.jpg,test," FINAL REPORT HISTORY: Thoracentesis and consolidation. FINDINGS: In comparison with study of ___, there again is substantial right pleural effusion with areas of basilar atelectasis. The left upper lobe parenchymal opacity with air bronchograms is steadily improving with some residual. Similarly, there is increasing aeration at the left base, with some residual opacifications. Mild elevation of pulmonary venous pressure persists. " a8b365d1-d5b85683-ad6a5a93-481211df-ebc67930.jpg,test/p12/p12241660/s56525418/a8b365d1-d5b85683-ad6a5a93-481211df-ebc67930.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Iabp // Please eval position of iabp Please eval position of iabp IMPRESSION: No previous images. The heart is normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Specifically, no IABP is identified on this image. " 7d8e75db-5a64240f-63dbb72d-72d03f5c-1bd59e3b.jpg,test/p19/p19358609/s54944374/7d8e75db-5a64240f-63dbb72d-72d03f5c-1bd59e3b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Mr. ___ is a ___ y/o ___-speaking man with COPD, lung cancer s/p left upper lobectomy, pAfib on dabigatran, HTN, ulcerative colitis on vedolizumab and chronic c.diff colitis, who presented to OSH with multifocal pneumonia and septic shock with progression to respiratory failure requiring, now admitted to FICU per family request for further management. // effectiveness of diuresis effectiveness of diuresis IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tubes have been removed. Little overall change in the appearance of the heart and lungs. " 347c9147-70d58112-3454574d-c32852f9-38819938.jpg,test/p13/p13299285/s54158133/347c9147-70d58112-3454574d-c32852f9-38819938.jpg,test," WET READ: ___ ___ ___ 10:18 PM no edema or CHF ___ d/w ___ @ ___:17 ___ by phone - ___ ______________________________________________________________________________ FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Crackles on clinical exam. Cardiac size is top normal. The aorta is tortuous. There is no evidence of pneumonia or pulmonary edema, pneumothorax or pleural effusion. Biapical pleural thickening is stable. Sternal wires are aligned. The patient is status post CABG. Findings were conveyed to ___ at ___, ___, by phone by Dr. ___. " 39747d61-63a961ae-40e19367-86eddce3-9fcd1a59.jpg,test/p17/p17828122/s58322656/39747d61-63a961ae-40e19367-86eddce3-9fcd1a59.jpg,test," FINAL REPORT HISTORY: Sickle cell disease with chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is normal. The mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. Mild H shape configuration of the imaged vertebral bodies is compatible with the history of sickle cell disease. IMPRESSION: No acute cardiopulmonary abnormality. " 45a534c5-877922b7-c95e8983-17ff7dcf-7c8ba22a.jpg,test/p12/p12671607/s59947472/45a534c5-877922b7-c95e8983-17ff7dcf-7c8ba22a.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___ and ___. CLINICAL HISTORY: Chest pain with white count, rule out pneumonia. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear without focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No signs of pneumonia. " b1047556-a4ed0d80-c10dd637-de33c33e-736d202a.jpg,test/p11/p11668433/s59121536/b1047556-a4ed0d80-c10dd637-de33c33e-736d202a.jpg,test," WET READ: ___ ___ ___ 8:50 PM upport devices in standard position. Right appical opacity similar to prior and may be related to vascular engorgement as no opacity seen there on recent CT cervical spine. No large effusions, interstial edema, or confluent consolidation. ___ p_________________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Question pneumonia. Comparison is made with prior study ___. Cardiomediastinal contours are unchanged with tortuosity of the aorta and elongated neck vessels. Cardiac size is top normal. The lungs are clear. There is no pneumothorax or pleural effusion. NG tube tip is in the stomach. ET tube is in standard position 4 cm above the carina. " 81bb077c-32a83542-49225f3a-844ede77-6f6fb982.jpg,test/p13/p13483571/s50880194/81bb077c-32a83542-49225f3a-844ede77-6f6fb982.jpg,test," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___ radiograph. FINDINGS: Permanent pacemaker remains in place, and cardiomegaly is stable. Pulmonary vascular congestion is accompanied by minimal interstitial edema. Worsening patchy opacity at left lung base could be due to atelectasis or developing pneumonia, and is accompanied by a small left pleural effusion. " cf89223b-7f3538ab-ffd81ef1-3b09fa50-058f258f.jpg,test/p10/p10364180/s52871343/cf89223b-7f3538ab-ffd81ef1-3b09fa50-058f258f.jpg,test," FINAL REPORT INDICATION: History: ___F with COPD p/w worsening sob // interval change TECHNIQUE: Single portable view of the chest COMPARISON: Multiple prior studies including ___ and a chest x-ray dated ___ CT FINDINGS: Lungs are hyperinflated with emphysematous changes again noted. The patient's known spiculated 1.5 cm right lower lobe lesion is partially obscured on this study. Right basilar opacities appear worsened since the prior study. There is probably also a concurrent small right pleural effusion with adjacent atelectasis. Irregular nodular opacities in the upper lobes are probably slightly improved. There is no evidence of pneumothorax. Cardiomegaly is stable. Dense aortic knob calcifications are seen. Enlargement of the hila bilaterally is compatible with pulmonary arterial hypertension. IMPRESSION: 1. Ill-defined opacities in the right lung base, worsened since the prior study, likely due to a combination of infection and small pleural effusion. 2. Slightly improved aeration of the upper lobes. 3. 1.5 cm right lower lobe lesion which was concerning for malignancy as seen on the recent chest CT is not as well visualized on the current exam. " b2e5e365-f6deb239-15aceb8a-8211fd9d-68508770.jpg,test/p16/p16201645/s56467323/b2e5e365-f6deb239-15aceb8a-8211fd9d-68508770.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post fiducial placement, evaluation of left lower lobe. COMPARISON: Fluoroscopy from ___ and chest x-ray from ___. FINDINGS: As compared to the previous radiograph, the new fiducial marker is placed at the level of the left hilus, approximately 2 cm laterally of the previous marker. There is no evidence of pneumothorax or other post-procedural complication. The left heart contour is unchanged. Unchanged complete opacification of the right hemithorax with deviation of the trachea to the right. " 0f147993-22e6928e-ed180992-6ea37e1c-42c62552.jpg,test/p16/p16891573/s55231340/0f147993-22e6928e-ed180992-6ea37e1c-42c62552.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o HIV (last CD4 200s) who p/w cough and sputum production // ? infiltrate ? infiltrate IMPRESSION: In comparison with the study of ___, there is little change. No evidence of pneumonia, vascular congestion, or pleural effusion. Of incidental note, of the PICC line is no longer present. " 14bf9cee-090b19d4-95a42781-a51904c7-7bf6d1a6.jpg,test/p13/p13812958/s52799554/14bf9cee-090b19d4-95a42781-a51904c7-7bf6d1a6.jpg,test," WET READ: ___ ___ ___ 7:45 PM Prominence of interstitial markings consistent with elevated pulmonary venous pressure. No overt pulmonary edema or pleural effusions. ______________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with worsening hypoxia COMPARISON: ___ to ___. FINDINGS: Mild pulmonary edema is unchanged. However, mild cardiomegaly has worsened since previous exam. Mild right lower lung atelectasis and pleural effusion has worsen. Right-sided Port-A-Cath ends in lower SVC. There is no pneumothorax. CONCLUSION: 1. Unchanged mild pulmonary edema. 2. Worsening of small right pleural effusion with adjacent atelectasis. " 34b68682-4cdf0419-09cceefa-f70f841a-a2c46f21.jpg,test/p17/p17302022/s58239399/34b68682-4cdf0419-09cceefa-f70f841a-a2c46f21.jpg,test," FINAL REPORT INDICATION: Chest discomfort and desaturations. COMPARISON: Chest radiograph on ___. FINDINGS: AP view of the chest. Right-sided pacemaker leads end in the right atrium and right ventricle. There is a right lower lung opacity, either right middle lobe or right lower lobe. There is also a smaller left lower lobe opacity. The cardiomediastinal and hilar contours are stable. No pneumothorax or pleural effusion. The lungs are hyperinflated. IMPRESSION: Right lower lung and left lower lobe opacities may represent atypical pneumonia. Alternatively, this can represent mild pulmonary edema or amiodarone toxicity. " 609d33a5-d29cf409-c07d74d9-9722941c-bdb5ea93.jpg,test/p17/p17784749/s54276266/609d33a5-d29cf409-c07d74d9-9722941c-bdb5ea93.jpg,test," WET READ: ___ ___ 8:33 PM No acute cardiopulmonary process. Mid left clavicular fracture, potentially chronic, however the acuity of which is uncertain based on this single view and clinical correlation suggested regarding need for additional imaging. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with alcohol intoxication, s/p fall. // bleed/fracture, pneumonia? TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Tortuosity descending thoracic aorta is noted. Old healed anterior rib fractures and degenerative changes at the shoulders are also seen. There is a mid left clavicular fracture, the acuity of which is difficult to assess on this single view. IMPRESSION: No acute cardiopulmonary process. Mid left clavicular fracture, potentially chronic, however the acuity of which is uncertain based on this single view and clinical correlation suggested regarding need for additional imaging. " 4114c5c7-ea52ba92-2dbf604a-65c834d5-485b651e.jpg,test/p16/p16887478/s54386770/4114c5c7-ea52ba92-2dbf604a-65c834d5-485b651e.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with seizure. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 7083ac2f-dcb059b1-6694ca7c-9a37c24c-a4dbe981.jpg,test/p10/p10684181/s59270105/7083ac2f-dcb059b1-6694ca7c-9a37c24c-a4dbe981.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with left-sided pain and dyspnea after altercation. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Mid thoracic dextroscoliosis is again noted. There is no visualized acute fracture or other soft tissue or osseous abnormality. Surgical clips noted in the right upper quadrant, possibily from prior cholecystectomy. IMPRESSION: No acute cardiopulmonary process. " ea09eb39-33bd4a19-730791e4-99b127d5-4e4f8677.jpg,test/p13/p13748721/s52522599/ea09eb39-33bd4a19-730791e4-99b127d5-4e4f8677.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F w/ vascular risk factors who presents with TIA vs stroke. Also had URI last week. // eval for lung infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is top-normal, stable. Mediastinum is unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. Normal " 9164648e-df4d0d0f-8be9cd4f-d0d2baf3-e7ad6a77.jpg,test/p14/p14123600/s59523881/9164648e-df4d0d0f-8be9cd4f-d0d2baf3-e7ad6a77.jpg,test," FINAL REPORT INDICATION: Altered mental status, evaluate for infiltrate. TECHNIQUE: Bedside, frontal chest radiograph. COMPARISON: None. FINDINGS: The lungs are grossly clear. There is undulation and elevation of the right hemidiaphragm without a baseline for comparison. No pleural effusion or pneumothorax. Heart is normal size. Mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 3784c6fc-af9a19aa-3c80e2cf-f04dd640-de33814f.jpg,test/p15/p15094321/s57100193/3784c6fc-af9a19aa-3c80e2cf-f04dd640-de33814f.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Right-sided chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. There is some thoracic dextroscoliosis. IMPRESSION: No acute cardiopulmonary process. " 39302eed-fb149f19-f50d08bb-8fe4726f-852126e1.jpg,test/p15/p15079493/s59912488/39302eed-fb149f19-f50d08bb-8fe4726f-852126e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with suspected aspiration PNA/ARDS in setting of seizure/fall // interval change TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There has been some interval increase in the centralized pulmonary edema with dense alveolar infiltrate central greater than peripheral. the heart continues to be of normal size. The NG tube, ET tube, right subclavian line are unchanged. There continued to be dense retrocardiac opacification compatible with volume loss/ infiltrate/effusion IMPRESSION: Worsened appearance to the lungs " dba3adfc-a6c2f286-3c735a66-fa59f1f2-9ea2c02e.jpg,test/p13/p13715870/s51370021/dba3adfc-a6c2f286-3c735a66-fa59f1f2-9ea2c02e.jpg,test," FINAL REPORT INDICATION: History of endocarditis and MVR, improved but now with cough and dyspnea on exertion. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. Moderate-to-severe cardiomegaly is unchanged. These findings were discussed with Dr. ___ by Dr. ___ at 1:51 p.m. on ___ by telephone. " c44cecb8-45996ab2-bd694f86-16260f9c-b360cf01.jpg,test/p15/p15738125/s57457398/c44cecb8-45996ab2-bd694f86-16260f9c-b360cf01.jpg,test," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old male with diaphoresis. Question cardiomegaly. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Vague opacities at the right lung base are compatible with callus formation due to prior posterior right rib fractures. The lungs are clear of focal consolidation or effusion noting that they are slightly hyperinflated. Old left lateral rib fractures are also seen. Cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 702e6c30-d5586a89-26195d62-cd28ce11-547022d2.jpg,test/p18/p18708817/s55201330/702e6c30-d5586a89-26195d62-cd28ce11-547022d2.jpg,test," FINAL REPORT HISTORY: Hypoxia. COMPARISON: ___ through ___ FINDINGS: Moderate pulmonary edema is new since ___. Severe cardiomegaly is similar. The lungs are well expanded. There is no effusion or pneumothorax. IMPRESSION: New moderate CHF since ___. " 2cc042d3-6807a0c0-29bc79c6-295027bc-568256cd.jpg,test/p15/p15831598/s57626012/2cc042d3-6807a0c0-29bc79c6-295027bc-568256cd.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with elevated WBC count and no clear source // eval for infection TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Upper to mid thoracic scoliosis is noted. IMPRESSION: No acute cardiopulmonary process. " 0b44f618-221b82d0-db2b6dc1-c480146b-234ae5ad.jpg,test/p18/p18880988/s52464429/0b44f618-221b82d0-db2b6dc1-c480146b-234ae5ad.jpg,test," FINAL REPORT INDICATION: Headache and neurologic symptoms. Evaluate for pneumonia. COMPARISON: None. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. The cardiac, hilar, mediastinal contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " 4ce848b2-9928ba5d-ebc0fd05-07296d5c-45ac2444.jpg,test/p15/p15304101/s56589925/4ce848b2-9928ba5d-ebc0fd05-07296d5c-45ac2444.jpg,test," FINAL REPORT INDICATION: ___-year-old male with altered mental status. COMPARISON: None available. FINDINGS: Single frontal view of the chest demonstrates top normal cardiac size, likely accentuated by AP technique and supine positioning. There is minimal unfolding of the thoracic aorta. The mediastinal and hilar contours are unremarkable. Despite slightly low lung volumes, the lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. No displaced osseous injury is evident. IMPRESSION: No acute cardiopulmonary process. " 6efe7478-af8bb612-519324ab-75682de1-66d14e6d.jpg,test/p12/p12206908/s56998627/6efe7478-af8bb612-519324ab-75682de1-66d14e6d.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Persistent hypoxia. COMPARISON: ___ as well as ___. FINDINGS: Frontal and lateral views of the chest were obtained. Slight increase in interstitial markings bilaterally consistent with interstitial edema has improved since the prior study with minimal remaining. Again patchy left base retrocardiac opacity is seen which may be due to atelectasis, though an underlying consolidation may be present. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Interval improvement in interstitial edema with mild remaining. Patchy left base retrocardiac opacity is again seen, which could be due to atelectasis or consolidation. Additionally, small patchy opacity projecting over posterior left sixth rib is new since the prior study and could represent a focus of infection. " ff9e223a-08d17760-3e2d0c63-4a8ff961-bc6d5881.jpg,test/p12/p12759187/s55702536/ff9e223a-08d17760-3e2d0c63-4a8ff961-bc6d5881.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with leukocytosis, recent ppm placement // interval changes COMPARISON: Chest x-ray from ___ at 09:31 FINDINGS: Again seen is the single lead left-sided pacemaker, lead tip over right ventricle. Inspiratory volumes are low. The cardiomediastinal silhouette is unchanged. There may be minimal upper zone redistribution and slight vascular plethora, but I doubt other evidence of CHF. Minimal bibasilar atelectasis is also again noted. A small right effusion is likely present. IMPRESSION: As above. " 5228a209-583880c5-5db0a7f0-16a7bb2a-5344a278.jpg,test/p16/p16548129/s56729564/5228a209-583880c5-5db0a7f0-16a7bb2a-5344a278.jpg,test," FINAL REPORT HISTORY: Cough and shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. In the lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " d0350f22-67f9e1ca-d41bed66-94adb3a9-76b2fb3d.jpg,test/p14/p14256999/s50897416/d0350f22-67f9e1ca-d41bed66-94adb3a9-76b2fb3d.jpg,test," WET READ: ___ ___ 12:10 AM Low lung volumes. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___M with cp // eval ffor intrathorac process TECHNIQUE: AP and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The inspiratory lung volumes are decreased. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits and unchanged. No acute osseous abnormality is detected. IMPRESSION: Low lung volumes. No acute cardiopulmonary process. " 2c52b84f-1edc2b3b-524332d7-3ade110f-603039ad.jpg,test/p15/p15481018/s53936828/2c52b84f-1edc2b3b-524332d7-3ade110f-603039ad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis, fatigue COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Slightly improved aeration at the right lung base compared with prior. Mild residual left basal atelectasis noted. No convincing evidence for pneumonia, edema, large effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild left basal atelectasis, otherwise unremarkable exam. " 86cf700e-d868a1b9-88de883c-dd264407-efd3d306.jpg,test/p17/p17292202/s59247052/86cf700e-d868a1b9-88de883c-dd264407-efd3d306.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pancreatitis // please evaluate for interval change please evaluate for interval change IMPRESSION: In comparison with the study of ___, there is suggestion of some increased opacification at the right base. Although this could merely represent asymmetric pulmonary edema in a patient with some enlargement of the cardiac silhouette, in the appropriate clinical setting superimposed pneumonia could be considered. " 1ac92246-18074ae3-2a96a271-6fe17564-cb0b51fb.jpg,test/p18/p18022983/s51605945/1ac92246-18074ae3-2a96a271-6fe17564-cb0b51fb.jpg,test," WET READ: ___ ___ ___ 8:00 AM Comminuted sternal fracture, multiple bilateral rib fractures, and trace bilateral basilar pneumothoraces are better assessed on CT of the chest performed concurrently. WET READ VERSION #1 ___ ___ ___ 1:55 AM No acute displaced rib fracture identified. If concern remains for rib fracture, recommend dedicated rib films with a BB marker placed over the location of pain. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with pain after mvc // R sided chest pain after mvc s/p rib removed TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___, and CT chest dated ___. FINDINGS: Lung volumes are low, resulting in bronchovascular crowding. Atelectatic changes at the bilateral bases are presumed to be secondary to hypoventilation in the setting of splinting. Cardiomediastinal and hilar contours are unchanged. No pleural effusion or consolidation. Partially imaged spinal fusion hardware appears intact. Comminuted sternal fracture, multiple bilateral rib fractures, and trace bilateral basilar pneumothoraces are better assessed on CT of the chest performed concurrently. IMPRESSION: Comminuted sternal fracture, multiple bilateral rib fractures, and trace bilateral basilar pneumothoraces are better assessed on CT of the chest performed concurrently. " 407d7a94-19ded099-4363acde-b1c08043-2c887d47.jpg,test/p15/p15487342/s55929334/407d7a94-19ded099-4363acde-b1c08043-2c887d47.jpg,test," FINAL REPORT HISTORY: Hypoxic respiratory failure. COMPARISON: ___ through ___. FINDINGS: A single portable frontal chest radiograph was obtained. Lung volumes have slightly increased since yesterday morning. Diffuse pulmonary opacities are again seen throughout both lungs. There is no effusion or pneumothorax. Mild cardiomegaly is unchanged. The tip of a right PICC line terminates in the low SVC. IMPRESSION: Persistent parenchymal opacities compatible with severe pulmonary edema. Lung volumes have slightly increased since yesterday at 09:00. " 8fb782f7-0f513c14-78940916-19c0868c-cc59dafc.jpg,test/p14/p14760891/s58701327/8fb782f7-0f513c14-78940916-19c0868c-cc59dafc.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Bilateral leg swelling. Question pulmonary edema. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The heart is at the upper limits of normal size. The lung volumes are low. There is no pleural effusion or pneumothorax. However, a moderate interstitial abnormality is most suggestive of pulmonary edema. This appearance is new since the prior study. Bony structures are unremarkable. IMPRESSION: Moderate interstitial abnormality suggesting pulmonary edema. " 21b1ac38-500b545e-f6f8a3a7-5c6fb6ac-813dbd4f.jpg,test/p16/p16805727/s54214493/21b1ac38-500b545e-f6f8a3a7-5c6fb6ac-813dbd4f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o MI ___, VT ___, Lad + Lcx stents ___, EF ___%. Riata lead explanted ___. // Pt is S/p ICD implant with new RV lead ___, today increased lead threshold please lead position for possible lodgement. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Both pacemaker leads are intact and both tips appear to be positioned in the right ventricle. No pneumothorax. Borderline size of the cardiac silhouette. No pulmonary edema. No pleural effusion. " 004ef26a-c5aa9bb1-86265ecf-1161c21c-48b00860.jpg,test/p19/p19097933/s55254835/004ef26a-c5aa9bb1-86265ecf-1161c21c-48b00860.jpg,test," FINAL REPORT HISTORY: Six weeks of cough, to assess for pneumonia. FINDINGS: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 12f70b54-f387e872-9536d89e-1290eb8c-d3b5b25d.jpg,test/p11/p11472206/s50732097/12f70b54-f387e872-9536d89e-1290eb8c-d3b5b25d.jpg,test," FINAL REPORT HISTORY: ___-year-old male with shortness of breath and anemia. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest. There is blunting of one of the posterior costophrenic angles compatible with effusion. The lungs are otherwise unremarkable without consolidation or overt pulmonary edema. Moderate cardiomegaly is again noted. No acute osseous abnormalities detected. IMPRESSION: Small effusion. Otherwise no significant interval change. " d3694b6c-c3f593b5-64299259-622fbf29-be3a19ae.jpg,test/p11/p11119441/s59685505/d3694b6c-c3f593b5-64299259-622fbf29-be3a19ae.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with multiple myeloma and new fever as well as previous cough. AP radiograph of the chest was reviewed in comparison to ___. The right central venous line (Port-A-Cath) terminates at the cavoatrial junction. Heart size and mediastinum are stable. There is interval development of diffuse interstitial opacities most likely consistent with volume overload, but infectious process is another possibility , although less likely. If pulmonary edema is out of the question, then correlation with chest CT for precise determination of the interstitial abnormalities should be considered. " 9c6b0649-4d52323b-fe208761-62d9482f-47c0581d.jpg,test/p18/p18446519/s51824451/9c6b0649-4d52323b-fe208761-62d9482f-47c0581d.jpg,test," FINAL REPORT HISTORY: HIV positive male with productive cough and pleuritic back pain COMPARISON: ___ through the ___. CT abdomen pelvis ___ FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal. A previously seen right lower lobe nodule is not visualized on this study. IMPRESSION: No acute cardiopulmonary process. " 89767d26-00afd170-5fc27e9e-cf647c79-78ede2b2.jpg,test/p15/p15301388/s57038406/89767d26-00afd170-5fc27e9e-cf647c79-78ede2b2.jpg,test," FINAL REPORT AP CHEST, 8:46 A.M., ___ HISTORY: ___-year-old woman postoperative day 2 after aortic surgery following chest tube removal. IMPRESSION: AP chest compared to ___: Postoperative widening of the upper mediastinum has improved, and pneumomediastinum largely resolved. Lungs are generally clear aside from relatively mild atelectasis, left lower lobe. There is no pneumothorax or appreciable volume of pleural fluid, no pulmonary edema. " 0059326a-d6538b29-e6c7533f-c6788432-811f050c.jpg,test/p17/p17705162/s50141198/0059326a-d6538b29-e6c7533f-c6788432-811f050c.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with six weeks of cough and general malaise. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is normal. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " a22544d7-e8c95962-e5ebbda9-8c45c0b1-0db6f156.jpg,test/p17/p17683350/s52856061/a22544d7-e8c95962-e5ebbda9-8c45c0b1-0db6f156.jpg,test," FINAL REPORT HISTORY: Septic shock and ARDS. FINDINGS: In comparison with study of ___, the monitoring and support devices remain in place. The mild cardiomegaly persists, along with some elevation in pulmonary venous pressure. There are bibasilar atelectatic changes with possible small pleural effusions. " bea6dc1c-403927a6-d98ac5d8-af70c132-aa42abfe.jpg,test/p15/p15942910/s56969609/bea6dc1c-403927a6-d98ac5d8-af70c132-aa42abfe.jpg,test," FINAL REPORT HISTORY: ___F with L distal rib pain COMPARISON: ___. FINDINGS: PA and lateral views of the chest were provided demonstrating clear well-expanded lungs without focal consolidation effusion or pneumothorax. Tiny clips project over the breasts bilaterally. There is no effusion or pneumothorax. The heart and mediastinal contours are normal. No acute osseous abnormality. No displaced rib fracture is identified. IMPRESSION: No acute findings. " a8d70e5e-6fec9edc-631847f8-ec407c37-00a8585b.jpg,test/p13/p13702908/s51132392/a8d70e5e-6fec9edc-631847f8-ec407c37-00a8585b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest burning, palps // eval for consolidation TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 5e99275a-28cc07ad-6e8e602c-35835252-62d17f63.jpg,test/p13/p13557753/s50005118/5e99275a-28cc07ad-6e8e602c-35835252-62d17f63.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Transient left upper quadrant pain. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " e891c1d9-36759432-dcadf35d-8a88631f-8079017d.jpg,test/p13/p13119719/s56128652/e891c1d9-36759432-dcadf35d-8a88631f-8079017d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left leg pain and SOB // ?acute cardio/pulmonary process? TECHNIQUE: Chest PA and lateral COMPARISON: AP and lateral views of the chest dated ___ FINDINGS: The cardiac silhouette is unremarkable. There is vascular engorgement. The right hilum is more prominent than prior. There is a right lower lobe nodule, at not seen on prior examination.There is no pleural effusion or pneumothorax. IMPRESSION: Suspected new right lower lobe nodule for which CT is recommended for further evaluation. " 0c7c68c6-3934b418-4fa5bd67-e1049c4e-cbcc73de.jpg,test/p10/p10204908/s53300077/0c7c68c6-3934b418-4fa5bd67-e1049c4e-cbcc73de.jpg,test," FINAL REPORT HISTORY: Sepsis, liver abscess and tachypnea. Evaluation for pneumonia or pulmonary edema. TECHNIQUE: Frontal view of the chest. COMPARISON: ___. FINDINGS: The heart is enlarged and the structures of the mediastinum are shifted to the left. There is elevation of the right hemidiaphragm. The lung volumes are low and there is some opacification at the base of the right lung consistent with atelectasis. Additionally, there is a small pleural effusion on the right. There is no evidence of pneumothorax. IMPRESSION: 1. Elevated right hemidiaphragm, which is pushing the heart and structures of the mediastinum to the left. 2. Atelectasis at the base of the right lung and small right pleural effusion. No evidence of pneumonia or pulmonary edema. " 4bba7f9a-2f8b748d-9ff3931f-223c9ae8-98b5dcf5.jpg,test/p11/p11522912/s56056720/4bba7f9a-2f8b748d-9ff3931f-223c9ae8-98b5dcf5.jpg,test," FINAL REPORT AP CHEST, 8:44 A.M., ___ HISTORY: A ___-year-old man with a past history of quadriplegia, now possible pneumonia. IMPRESSION: AP chest compared to ___: Right basal consolidation and accompanying moderate right pleural effusion have worsened since ___. Mild cardiomegaly and mediastinal venous engorgement, as well as upper lobe vascular dilatation are unchanged. Small left pleural effusion has increased. Tracheostomy tube in standard placement. Left PIC line ends in the mid SVC and a feeding tube in the region of the pylorus. No pneumothorax. " 0b27e632-24473bd9-2627bec6-a52347c1-7a881f2f.jpg,test/p11/p11929538/s53282414/0b27e632-24473bd9-2627bec6-a52347c1-7a881f2f.jpg,test," FINAL REPORT INDICATION: History: ___F with ongoing cold/cough and fatigue for the past few weeks // ? pneumonia COMPARISON: Radiographs from ___. IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. " 574acf2a-c6c46c01-c829d9c9-ab76979d-e1710f11.jpg,test/p17/p17752411/s57855895/574acf2a-c6c46c01-c829d9c9-ab76979d-e1710f11.jpg,test," FINAL REPORT INDICATION: ___-year-old female with shortness of breath. COMPARISON: ___ at approximately 8:15 a.m. and CTA chest dated ___ at approximately 10:00 a.m. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: Lung volumes are slightly low. There is slightly increased pulmonary vascular prominence compared to prior. No focal consolidation, pleural effusion, or pneumothorax is detected on this study; of note, the left costophrenic angle is incompletely imaged on lateral view. Right suprahilar and right upper lobe masses are again seen. Aortic tortuosity is again noted. Heart size is top normal. IMPRESSION: New mild pulmonary vascular congestion. Right lung masses as previously noted. These findings were discussed with Dr. ___ by Dr. ___ by telephone at 12:25 p.m. on ___. " cc144f67-5aca64ec-ebd90a91-943367b7-7a34b85c.jpg,test/p13/p13948246/s52560741/cc144f67-5aca64ec-ebd90a91-943367b7-7a34b85c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with 5 days URI sxs now N/V x ___ today. Hx asthma, mild ronchi on R // eval ? infitlrate eval ? infitlrate IMPRESSION: Comparison to ___. Moderate overinflation, best seen on the lateral image. . Borderline size of the cardiac silhouette. No pulmonary edema. No pneumonia, no pleural effusions. " b22c1c11-4ece5dae-e5ea39fc-4c21ecd0-c05420ad.jpg,test/p19/p19064758/s50317565/b22c1c11-4ece5dae-e5ea39fc-4c21ecd0-c05420ad.jpg,test," FINAL REPORT INDICATION: Patient with abdominal discomfort. Rule out air under diaphragm. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Surgical clips are seen projecting over the left mediastinal region. Mild cardiomegaly and mild vascular congestion, but no pulmonary edema. No pleural effusion and no pneumothorax. No evidence of pneumoperitoneum. IMPRESSION: 1. Mild cardiomegaly and mild vascular congestion, but no pulmonary edema. No acute cardiothoracic process. 2. No pneumoperitoneum. " 5d2898b1-34244de5-fdae2554-e6bbdc68-a3330f19.jpg,test/p17/p17190208/s55698737/5d2898b1-34244de5-fdae2554-e6bbdc68-a3330f19.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new intubation. // Please eval ETT placement Please eval ETT placement IMPRESSION: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 4.5 cm above the carina. Otherwise, no change in the appearance of the heart and lungs and the other monitoring and support devices. " 06f0c4f0-60aa81dc-e499fc23-fe00134a-3ff3048d.jpg,test/p17/p17989027/s54017050/06f0c4f0-60aa81dc-e499fc23-fe00134a-3ff3048d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with R lower rib bruising s/p fall, unknown headstrike // bleed or fx? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low limiting assessment. There is a large retrocardiac opacity containing an air-fluid level consistent with large hiatal hernia. Coarsened interstitial markings which are more pronounced along the periphery of the lungs likely reflecting interstitial lung disease. No large effusion or pneumothorax. Heart size appears grossly within normal limits the difficult to assess given large hiatal hernia. Mediastinal contour appears normal. The imaged bony structures are intact. Surgical anchors are seen imbedded in the left humeral head. IMPRESSION: Large hiatal hernia. Coarsened interstitial markings concerning for interstitial lung disease. " ac929e8d-5044821c-78e5a3e9-8fd06fbd-4f840e7f.jpg,test/p19/p19140358/s56268932/ac929e8d-5044821c-78e5a3e9-8fd06fbd-4f840e7f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/ appendiceal ca and gastric outlet obstruction, s/p duodenal stent, continues to have GI discomfort and no more respiratory symptoms suggesting aspiration pneumonitis vs pna. // evaluate for PNA, compare to CXR from ___ TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ chest radiograph and ___ CT abdomen IMPRESSION: Heart size is normal. Mediastinum is normal. Left lower lobe consolidation is mall conspicuous than on the prior study consistent with progression of pneumonia. Right lung is clear as well as left upper lobe. No pleural effusion is demonstrated on the right but small amount of left pleural effusion is most likely present. Stent is projecting over the upper abdomen Port-A-Cath catheter tip is at the level of mid SVC " f687f577-0a00f8c3-f2929ffb-9ea3089a-3a0cc6c6.jpg,test/p10/p10497657/s52360060/f687f577-0a00f8c3-f2929ffb-9ea3089a-3a0cc6c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with EF of 15%, with tachycardia and episodes of hypoxia. // Please evaluate for intraparenchymal process. Please evaluate for intraparenchymal process. IMPRESSION: Comparison to ___. The patient has been extubated and the nasogastric tube was removed. Also removed is the right internal jugular vein catheter. No relevant change in appearance of the lung parenchyma. Moderate cardiomegaly persists. No pulmonary edema. Minimal right basilar atelectasis. " 41b0b8c4-8fab5d09-f24836a7-b166e43a-87947a31.jpg,test/p15/p15023390/s57984874/41b0b8c4-8fab5d09-f24836a7-b166e43a-87947a31.jpg,test," FINAL REPORT INDICATION: ___ year old woman with sinus issues and cough. r/o pna // evaluate for cough TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Retrocardiac opacity has improved since the prior, probably related to improved inspiration. Linear opacities in the left lower lobe are chronic and likely scarring. The right lung is clear. Cardiac size is top-normal. Moderate to severe scoliosis convex to the right. IMPRESSION: No new focal consolidation, improving retrocardiac opacity can be resolving atelectasis. " fa2756dd-d5fc9ac1-24643efe-ec96a645-e70e41ef.jpg,test/p16/p16041916/s51216011/fa2756dd-d5fc9ac1-24643efe-ec96a645-e70e41ef.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old male with cough and fevers. Weakness. FINDINGS: Frontal and lateral views of the chest. No prior. The lungs are clear of focal consolidation or effusions. Mild bibasilar atelectasis is seen on the frontal view. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9fd0f301-9c740a2b-bc63c266-356b6797-eee17fbe.jpg,test/p15/p15915799/s59551483/9fd0f301-9c740a2b-bc63c266-356b6797-eee17fbe.jpg,test," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: A ___-year-old female with a history of recent GIST removal, now with abdominal pain, rigid abdomen, question free air. COMPARISON: ___. FINDINGS: The study was made available for my interpretation, today, ___ at 2:45 p.m. A right-sided PICC is seen terminating in the distal SVC/cavo-atrial junction. The left costophrenic angle likely relates to small left pleural effusion. The right lung is clear. No right pleural effusion is seen. There is no pneumothorax. A drain is seen extending into the left upper quadrant. No evidence of free air seen beneath the hemidiaphragm. IMPRESSION: 1. No evidence of free air beneath the diaphragm. 2. Small left pleural effusion with overlying atelectasis. " 3e2117cc-26f3b9ff-dfb690ee-f0a3a1c8-a8ecbadf.jpg,test/p17/p17635650/s50889558/3e2117cc-26f3b9ff-dfb690ee-f0a3a1c8-a8ecbadf.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old male with weakness. TECHNIQUE: AP upright and lateral radiographs COMPARISON: ___, ___, ___ and ___. FINDINGS: AP upright and lateral views the chest provided. Midline sternotomy wires and prosthetic aortic valve again noted. Mild basilar atelectasis without convincing evidence for pneumonia or edema. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: As above. " 34180328-39166a8b-d6b6b9ef-f39bb3f4-02fcc06e.jpg,test/p11/p11288058/s54540383/34180328-39166a8b-d6b6b9ef-f39bb3f4-02fcc06e.jpg,test," FINAL REPORT INDICATION: ___-year-old female with fever and cough, here to evaluate for pneumonia. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph, last performed on ___. FINDINGS: There is persistent mild pulmonary edema and increased vascular congestion from ___. No pleural effusion, focal consolidation or pneumothorax is present. The inspiratory lung volumes are appropriate. The cardiac silhouette is mildly enlarged but stable. The mediastinal and hilar contours are unchanged. A right-sided stent is unchanged in position, presumably extending from the right subclavian vein into the superior vena cava. Degenerative changes are again noted in the thoracic spine with right-sided bridging osteophytes. IMPRESSION: 1. No focal consolidation. 2. Persistent mild pulmonary edema with increased vascular congestion since ___. " df36cfc8-d9443493-6ba076ab-1a49111b-4eb4cfbe.jpg,test/p10/p10033552/s56920846/df36cfc8-d9443493-6ba076ab-1a49111b-4eb4cfbe.jpg,test," FINAL REPORT INDICATION: History: ___F with left shoulder pain, DOE, chest discomfort // Eval for widened mediastinum or pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dated ___ through ___.. FINDINGS: Frontal and lateral radiographs of the chest demonstrate low lung volumes which results in bronchovascular crowding. The cardiomediastinal and hilar contours are gross unchanged. The heart is top normal in size. There is slight upper zone redistribution, improved compared with the ___ radiograph, but no overt CHF There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: Upper zone redistribution, without overt CHF. Minimal bibasilar atelectasis, in the setting of low lung volumes. Cardiomediastinal silhouette is grossly unchanged. " f7cdf1f1-39b44040-a414eba4-63795463-99e2c53e.jpg,test/p14/p14249822/s59455177/f7cdf1f1-39b44040-a414eba4-63795463-99e2c53e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with ___ swelling and shortness of breath, history of lymphoma. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. PET-CT ___. FINDINGS: The cardiomediastinal and hilar contours are stable with calcification of the aortic knob. There is no pneumothorax or pleural effusion. The lungs are well-expanded. A small peripheral left base opacity may represent atelectasis or scarring and was present on the most recent prior chest radiograph. Moderate degenerative changes are present throughout the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " d98be0d5-a648e485-4473a3ef-7762b3ef-2d70507e.jpg,test/p10/p10028159/s56342713/d98be0d5-a648e485-4473a3ef-7762b3ef-2d70507e.jpg,test," WET READ: ___ ___ 9:21 AM A left chest Port-A-Cath terminates in the mid SVC. There is bibasilar streaky atelectasis. No focal consolidation is identified. There is no pneumothorax. WET READ VERSION #1 ___ ___ ___ 9:42 PM A left chest Port-A-Cath terminates in the mid SVC. There is bibasilar streaky atelectasis. No focal consolidation is identified. There is no pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dementia and stage III rectal cancer s/p LAR // Port cath placement COMPARISON: No previous ___ radiographs on PACs record for compare. FINDINGS: Left-sided Port-A-Cath is present, tip over mid SVC. No pneumothorax is detected. The heart is not enlarged. Aorta is tortuous. No CHF, focal infiltrate or effusion is detected. Minimal bibasilar atelectasis noted. Calcifications over the lung apices may represent vascular calcifications. Possibility of a tiny right apical calcified granuloma cannot be excluded. Incidental note made of severe osteoarthritis in the right glenohumeral joint. IMPRESSION: Port-A-Cath tip over mid SVC. No acute pulmonary process identified. " 2dc3fed7-d8443aec-01c07fd6-cd985dee-ab690859.jpg,test/p17/p17994012/s56531416/2dc3fed7-d8443aec-01c07fd6-cd985dee-ab690859.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with chest pain and shortness of breath. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___. FINDINGS: Compared with the prior study, heart size is top normal, without new focal consolidation, effusion, or pneumothorax. No overt pulmonary edema. Rightward curvature of the thoracic spine is again seen. IMPRESSION: No acute intrathoracic process. " be3cfb85-9194330d-1a9b93d2-bb6aeefd-a01dcf46.jpg,test/p15/p15006483/s54362708/be3cfb85-9194330d-1a9b93d2-bb6aeefd-a01dcf46.jpg,test," FINAL REPORT INDICATION: ___F with PMH dementia, CKD, and HTN, who presented with altered mental status and shock likely secondary to sepsis. // interval change FINDINGS: As compared to ___ interval development of widespread airspace opacity and central pulmonary vascular congestion with enlargement of the heart. There are likely bilateral layering pleural effusions. No pneumothorax. Support devices are in standard position. IMPRESSION: New widespread airspace opacity can be moderate interstitial edema, multifocal pneumonia or noncardiogenic edema. " d8efc9a9-40b2ca3d-fda5a5f7-85d7e43c-e4cd4df1.jpg,test/p19/p19845120/s51273696/d8efc9a9-40b2ca3d-fda5a5f7-85d7e43c-e4cd4df1.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after Dobbhoff placement. AP radiograph of the chest was compared to ___. The Dobbhoff tube is coiled most likely within the upper esophagus and should be re-positioned. Heart size is enlarged but essentially unchanged since the prior study. Vascular engorgement is unchanged. " 32b68edb-5bbe16f0-3daa12b7-f3cc1d15-16df9892.jpg,test/p16/p16427239/s52706908/32b68edb-5bbe16f0-3daa12b7-f3cc1d15-16df9892.jpg,test," FINAL REPORT STUDY: AP chest performed on ___. CLINICAL HISTORY: ___-year-old male with ileus after cystectomy. Nasogastric tube placement. FINDINGS: Comparison is made to the prior study from ___. There is a right-sided central venous line with the distal lead tip at the cavoatrial junction. There is a feeding tube whose distal tip is in the fundus of the stomach. The side port is at the GE junction and this could be advanced 10 cm for more optimal placement. There is left ventricular prominence which is stable. The lungs are grossly clear without focal consolidation, pleural effusions or signs for overt pulmonary edema. There is mild atelectasis at the lung bases. No pneumothoraces are seen. " e40e9a39-14c9defa-6cec06c6-2e98582b-aeca15d6.jpg,test/p17/p17169478/s55820009/e40e9a39-14c9defa-6cec06c6-2e98582b-aeca15d6.jpg,test," FINAL REPORT INDICATION: ___-year-old man status post right thoracentesis, to rule out pneumothorax. COMPARISON: Chest radiograph, ___. FINDINGS: There is complete resolution of a previously seen right pleural effusion with re-expansion of the right lower lobe. No pneumothorax is seen. Small left pleural effusion and left basal atelectasis is unchanged. Moderate cardiomegaly are unchanged. The hilar and mediastinal contours are stable. A right internal jugular approach dialysis catheter terminates in the lower SVC. IMPRESSION: Resolved right pleural effusion. No pneumothorax. " 6b126688-19a15c4d-56c2b854-a4921910-05671ca0.jpg,test/p10/p10401337/s54799876/6b126688-19a15c4d-56c2b854-a4921910-05671ca0.jpg,test," FINAL REPORT HISTORY: Rhonchi within the left lung. TECHNIQUE: Portable AP view of the chest. COMPARISON: ___. FINDINGS: Right-sided subclavian central venous catheter tip terminates at the cavoatrial junction. The heart remains mildly enlarged. The aorta is tortuous. The hilar contours are unremarkable. Mild elevation of the right hemidiaphragm contour is unchanged. There is minimal right basilar atelectasis. Lungs are otherwise grossly clear. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " f8f27ffc-a310fd52-e90b9c7b-0790ecb0-4e19cd95.jpg,test/p16/p16081970/s55226940/f8f27ffc-a310fd52-e90b9c7b-0790ecb0-4e19cd95.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain over sternum after car accident COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Volumes are low limiting assessment. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Evaluation for sternal fracture is limited. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 47720bf6-4975f285-1d27f0b6-61ff4c54-ed5fc067.jpg,test/p12/p12068551/s56291957/47720bf6-4975f285-1d27f0b6-61ff4c54-ed5fc067.jpg,test," WET READ: ___ ___ 9:01 PM No acute cardiopulmonary process. No evidence of mediastinal widening. Ordering physician paged twice as per wet read request without response. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atypical chest pain radiating to back, unable to obtain chest CTA today so would like to assess for any mediastinal widening. // ?aortic dissection TECHNIQUE: CHEST (PA AND LAT) IMPRESSION: Heart size and mediastinum are stable. Lungs are clear. There is no pleural effusion or pneumothorax. " 3109c88a-f15f3a5c-e7edaf49-ce467314-54a97999.jpg,test/p13/p13751863/s54138211/3109c88a-f15f3a5c-e7edaf49-ce467314-54a97999.jpg,test," FINAL REPORT HISTORY: Pleural effusion. FINDINGS: In comparison with study of ___, there is little overall change in the appearance of the right pleural fluid with opacification running up along the lateral chest wall. On the lateral view, the configuration raises the possibility of an extrapleural or loculated collection. Fibrotic streaks are again seen at the bases and the central catheter remains in place. " 7c056967-dd32a066-577b0667-516df48c-42d2a93a.jpg,test/p17/p17114171/s59052266/7c056967-dd32a066-577b0667-516df48c-42d2a93a.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with cough and low-grade fever and history of smoking. COMPARISON: None. FINDINGS: PA and lateral images of the chest demonstrate well-expanded lungs which are clear. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Visualized osseous structures are unremarkable. IMPRESSION: Normal chest radiographs. " 2c54b581-af577e03-ec55af29-1d69510c-413fb09e.jpg,test/p15/p15058800/s57726034/2c54b581-af577e03-ec55af29-1d69510c-413fb09e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with multiple myeloma, now relpased., c/o new shortness of breath // volume overload, effusions TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Stable cardiomegaly and tortuosity of the thoracic aorta. The pulmonary vasculature is normal. Lungs are clear except for new linear bibasilar atelectasis. . No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Bones are demineralized and mild compression deformity in the mid thoracic spine is unchanged. IMPRESSION: Linear bibasilar atelectasis. " 5e07d313-8f78bbad-043d6853-794c9ceb-6a1c6f99.jpg,test/p17/p17750747/s59238405/5e07d313-8f78bbad-043d6853-794c9ceb-6a1c6f99.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is persistent elevation of the right hemidiaphragm. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 1ff9abed-3c4310b4-17536133-9c3ddd53-43c847fb.jpg,test/p18/p18157835/s54875602/1ff9abed-3c4310b4-17536133-9c3ddd53-43c847fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with dyspnea. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Low lung volumes. The mediastinal and hilar contours are normal. Heart size is within normal limits. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " b2bc1113-3f8a5bd5-f85835eb-92079ff2-764ad354.jpg,test/p10/p10168138/s58958315/b2bc1113-3f8a5bd5-f85835eb-92079ff2-764ad354.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. There is mild to moderate rightward convex curvature centered along the mid thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary disease. " 88ad73a6-643c9747-ffb7b1fd-d819f921-82fc3193.jpg,test/p14/p14726463/s51430276/88ad73a6-643c9747-ffb7b1fd-d819f921-82fc3193.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Respiratory failure, evaluate position of ET tube. Comparison is made with prior study, ___. There are low lung volumes. Mild cardiomegaly is accentuated by the low lung volumes and projection. ET tube tip is in standard position, 5.3 cm above the carina. NG tube is coiled in the stomach; the tip is in the stomach. There is mild vascular congestion. Bibasilar opacities, larger on the left side, are unchanged consistent with atelectasis, superimposed infection cannot be excluded in the appropriate clinical setting. Right medial supraclavicular surgical clips are again noted. " e8fd2a79-8a001940-1e9a4bb1-c7e76265-86f1e107.jpg,test/p18/p18866492/s50820319/e8fd2a79-8a001940-1e9a4bb1-c7e76265-86f1e107.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with SOB, abd pain // PNA, colitis? COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. There is mild bibasal atelectasis. The heart appears mildly prominent likely in part due to AP technique. Mediastinal contour is unremarkable. No pneumothorax or large effusion. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild cardiomegaly. Mild bibasilar atelectasis. " 34c4985b-92f128f2-163cf4ad-419e44a3-2fcdbecf.jpg,test/p11/p11210828/s58145916/34c4985b-92f128f2-163cf4ad-419e44a3-2fcdbecf.jpg,test," FINAL REPORT HISTORY: Cough and wheeze. COMPARISON: None. FINDINGS: PA and lateral views of the chest. Lungs well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 19c145ef-c5858ffd-5098ea19-61ab6455-52671ccd.jpg,test/p15/p15465911/s53258119/19c145ef-c5858ffd-5098ea19-61ab6455-52671ccd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with sickle cell dz, cough pls eval pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Portacath again noted in the left chest wall - catheter tip in the low SVC. Cardiomegaly again noted. There is no focal consolidation, effusion, or pneumothorax. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. Stable cardiomegaly. " b9cefdef-3369a41e-f240ec78-9e0a1bd2-05114f04.jpg,test/p16/p16581134/s54767664/b9cefdef-3369a41e-f240ec78-9e0a1bd2-05114f04.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old female with a history of NIDDM, HTN, breast cancer s/p mastectomy, CKD (baseline Cr 1.8) who presented to PCP today with abdominal pain. // tube placement tube placement IMPRESSION: In comparison with the earlier study of this date, there is an placement of a endotracheal tube with its tip approximately 5 cm above the carina. There are lower lung volumes with continued elevation of the right hemidiaphragmatic contour. Mild enlargement of the cardiac silhouette with minimal elevation of pulmonary venous pressure. No evidence of acute focal pneumonia. " fa506906-4c16fa96-0a1fa096-3bb6172a-d1bf8f9c.jpg,test/p15/p15024484/s55357745/fa506906-4c16fa96-0a1fa096-3bb6172a-d1bf8f9c.jpg,test," FINAL REPORT HISTORY: Hypotension, tachycardia. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: Chest radiograph ___ and chest CTA ___. FINDINGS: The heart size is within normal limits. The aorta remains unfolded. Pulmonary vascularity is not engorged. A small to moderate size partially loculated right pleural effusion appears increased in size compared to the prior exam. Bibasilar airspace opacities could reflect atelectasis, but infection is not excluded. Small left pleural effusion may be present, though assessment of the left costophrenic angle is obscured due to overlying wires. No pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Interval increase in size of small to moderate size right pleural effusion, a component of which is loculated laterally. Possible small left pleural effusion, though the left costophrenic angle is not well assessed. Bibasilar airspace opacities could reflect atelectasis but infection cannot be excluded. " a83da73f-f47b6a74-7f9c180e-b9ef4ff6-86046625.jpg,test/p17/p17477876/s54662023/a83da73f-f47b6a74-7f9c180e-b9ef4ff6-86046625.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of Lynch sydnrome and endometrial cancer, presents with rhonchi L base x 1 week, cough x 2 weeks, productive of yellow sputum COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. Cardiomediastinal and hilar contours are normal. The no pleural effusions. IMPRESSION: Normal chest radiograph. " 68920b60-3c4b2be9-3e139f53-2868a488-b6fe3f02.jpg,test/p17/p17051420/s50391244/68920b60-3c4b2be9-3e139f53-2868a488-b6fe3f02.jpg,test," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Cough. COMPARISON: Radiographs from ___ and CT from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: New since the prior radiographs but also since the recent prior CT are opacities in the superior segment of the left lower lobe and also more vague but new right upper lobe opacity, all suggesting development of pneumonia. There is no pleural effusion or pneumothorax. Mild to moderate degenerative changes are similar along the thoracic spine. IMPRESSION: New opacities suggesting pneumonia. " 799ed2e9-66776fcc-c3dab840-398a2746-462da86f.jpg,test/p16/p16633852/s54661005/799ed2e9-66776fcc-c3dab840-398a2746-462da86f.jpg,test," FINAL REPORT INDICATION: Presyncope, here to evaluate for cardiomegaly. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are decreased. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. The pulmonary vasculature is essentially within normal limits. The cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " ddb7101a-7c72f67d-6c4298c3-037c3770-3cc190f5.jpg,test/p19/p19143908/s58490698/ddb7101a-7c72f67d-6c4298c3-037c3770-3cc190f5.jpg,test," FINAL REPORT INDICATION: Hypotension. History of squamous cell carcinoma of the tongue, on chemotherapy. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, most recent dated ___. FINDINGS AND IMPRESSION: There are bibasilar opacities with some confluent areas at the right base and extending laterally from the right hilum concerning for infection. There is bibasilar atelectasis. No pneumothorax or significant pleural effusion is present. The heart size is normal. A right-sided port is unchanged. " 2be183c4-b86070af-86be9f9c-2105eb07-ee784e4d.jpg,test/p18/p18490309/s53296610/2be183c4-b86070af-86be9f9c-2105eb07-ee784e4d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RCC with mets, s/p transbronchial biopsy,. Evaluate for pneumothorax. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph of ___ and chest CT of ___. FINDINGS: Extensive right lower lobe opacification, less so in the left lower lobe, corresponds with findings on the recent CT. Left lower lobe opacification appears increased since the prior chest CT. No evidence of pneumothorax or hemothorax. The heart borders are obscured by the opacifications. IMPRESSION: 1. No evidence of pneumothorax or hemothorax. 2. If there is no transbronchial biopsy on the left, increased opacification in the left lung could be a progression of the process identified on the recent chest CT. If the mass at the lingula was biopsied, then the left-sided opacification may represent resulting hemorrhage. " f355bde5-ade11fa5-b1ec27c5-26d8c8f3-33b1418b.jpg,test/p10/p10625923/s59176992/f355bde5-ade11fa5-b1ec27c5-26d8c8f3-33b1418b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough, fever // eval for PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Subtle retrocardiac opacity raises concern for an early right lower lobe pneumonia. There is mild platelike left basal atelectasis. The heart appears top normal in size. No large effusion or pneumothorax. Mediastinal and hilar contour appears normal. Bony structures are intact. IMPRESSION: Possible early pneumonia in the right lower lobe. " 8857447b-25a7f9ec-4cb77ed7-e5bc077b-a86ba515.jpg,test/p17/p17957742/s52551394/8857447b-25a7f9ec-4cb77ed7-e5bc077b-a86ba515.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia s/p CABG // eval for edema/effusion TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are unchanged compared to the prior study. There has been an increase in the patchy airspace opacity seen throughout the left lung with a second more focal area in the right lower lung. Although the appearances may reflect pulmonary edema, particularly given the waxing waning appearance over the last several days, superimposed infection cannot be excluded. Probable left pleural effusion. Support lines and tubes are unchanged in appearance when compared to the prior study. No pneumothorax seen. IMPRESSION: Progression of the airspace opacity in the left upper and right lower lung. As this has been waxing and waning, this may reflect pulmonary edema however infection cannot be excluded. " 70efbe51-85d86d89-badbd361-3d6bac8d-17c3bbd5.jpg,test/p12/p12668116/s56753772/70efbe51-85d86d89-badbd361-3d6bac8d-17c3bbd5.jpg,test," FINAL REPORT INDICATION: ___-year-old male with likely renal cell carcinoma and recent pleurodesis requiring assessment status post chest tube placement. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: Two frontal images of the chest demonstrate a pigtail catheter and a chest tube in place in the right chest with persistent right lung base opacity which is unchanged from prior imaging. There is no pneumothorax. The left lung is clear. There is some atelectasis noted bilaterally at the bases. Cardiomediastinal silhouette is unchanged. IMPRESSION: Pigtail catheter and chest tube located in the right chest. Essentially unchanged chest radiograph from prior imaging. " 30e85fae-8547294f-d886313d-97bb920d-e5f77691.jpg,test/p13/p13568806/s50840594/30e85fae-8547294f-d886313d-97bb920d-e5f77691.jpg,test," WET READ: ___ ___ 7:07 PM ill-defined opacity in the right infrahilar region does not appear significantly changed. a previously seen linear opacity at the left base is improved. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: history of aspiration, just coughed up tube feeds. REFERENCE EXAM: ___. Compared to the prior study increased lung markings are again seen in both lower lungs that could represent areas of atelectasis or aspiration similar in appearance compared to prior with no new infiltrate. " 9adb7e32-9cec7e89-41aa460b-a0f7b9b4-5a53f20b.jpg,test/p12/p12009813/s56595611/9adb7e32-9cec7e89-41aa460b-a0f7b9b4-5a53f20b.jpg,test," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old male with cough and leukocytosis. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation or effusion. The mediastinal silhouette is within normal limits. The osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " bb0dc052-4b4ba535-56ea0c5d-dc46853a-b9704203.jpg,test/p11/p11407341/s50935444/bb0dc052-4b4ba535-56ea0c5d-dc46853a-b9704203.jpg,test," FINAL REPORT INDICATION: Fever, weight loss, cough. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The heart is moderately enlarged. The aorta is tortuous and calcified. The hila appear somewhat enlarged bilaterally, but no pulmonary edema is present. Left basilar opacification may reflect atelectasis. Blunting of the costophrenic angles bilaterally suggests small pleural effusions. No pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: 1. No radiographic evidence to suggest tuberculosis. 2. Left basilar opacity may reflect atelectasis. 3. Small bilateral pleural effusions. 4. Enlarged hila bilaterally is suggestive of pulmonary arterial hypertension. " 8af24a2d-b7c5a81f-a202cd74-0abd8343-9088e474.jpg,test/p11/p11394025/s58127441/8af24a2d-b7c5a81f-a202cd74-0abd8343-9088e474.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with palpitations and fever // PNA? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No focal consolidation to suggest pneumonia. " eef0db67-25178c83-af9e5668-0677bfa4-e8aebfff.jpg,test/p10/p10546797/s50447338/eef0db67-25178c83-af9e5668-0677bfa4-e8aebfff.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: CHF. REFERENCE EXAM: ___. FINDINGS: The heart is mildly enlarged and there is some mild pulmonary vascular re-distribution and small bilateral pleural effusions. However, compared to the prior exam, the appearance of the lungs has improved and the effusions are slightly smaller. IMPRESSION: Persistent but slightly improved CHF. " e9bb63ef-e01f7ae2-237505db-2621b797-def48eed.jpg,test/p18/p18016258/s59005700/e9bb63ef-e01f7ae2-237505db-2621b797-def48eed.jpg,test," FINAL REPORT INDICATION: ___ year old woman with cardiogenic shock s/p impella with new fevers overnight // Evaluate for pulmonary edema; consolidations; interval change EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal view COMPARISON: Chest radiograph ___ FINDINGS: There is increased consolidation of left lung base in the retrocardiac region compared to ___. Mild pulmonary vascular congestion and probable small bilateral pleural effusion is similar to prior. Mildly enlarged cardiomediastinal silhouettes is stable. ET tube terminates 2.8 cm above the carina. Transesophageal tube courses below the diaphragm and out of view. Right PICC probably terminates at low SVC. A right internal jugular Swan-Ganz catheter terminates in proximal right pulmonary artery. Impella device terminates in the left ventricle. IMPRESSION: 1. There is increased consolidation of left lung base. This is commonly due to atelectasis, however pneumonia is not excluded in the appropriate clinical setting. 2. Mild pulmonary vascular congestion and bilateral pleural effusions are similar to prior. " b10f2d87-1486cc6f-c7a78a5d-df013cd2-01d4a38f.jpg,test/p18/p18143490/s51637687/b10f2d87-1486cc6f-c7a78a5d-df013cd2-01d4a38f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p replacement asc aorta // eval effusions TECHNIQUE: Portable supine chest radiograph. COMPARISON: Chest radiograph dated ___ at 03:16. FINDINGS: The patient is rotated to the left. ET tube terminates 4 cm above the carina. NG-tube with the side hole in the region of the GE junction. PA catheter terminating in the region of the pulmonic valve. Left IJ terminating in the left brachiocephalic vein. Sternotomy wires appear intact and appropriately aligned. Improved right pleural effusion. Persistent moderate left pleural effusion. Left basilar atelectasis. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pneumothorax is seen. IMPRESSION: 1. NG tube with the side hole in the region of the GE junction, which should be advanced 5 cm. 2. PA catheter with the tip in the region of the pulmonic valve, which should be advanced into the right main pulmonary artery. 3. Left IJ terminating in the left brachiocephalic vein. 4. Resolution of pulmonary edema and improving right pleural effusion, with persistent moderate left pleural effusion and compressive atelectasis. " ec06c893-64ab57a5-ad071568-3aad3726-b49eb9c4.jpg,test/p15/p15002645/s50490163/ec06c893-64ab57a5-ad071568-3aad3726-b49eb9c4.jpg,test," FINAL REPORT INDICATION: ___M with chest pain // Eval for cardiopulmonary process TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 4ce75026-3462c2ed-bdbb3491-7aae6d81-09b0392c.jpg,test/p17/p17551805/s53675349/4ce75026-3462c2ed-bdbb3491-7aae6d81-09b0392c.jpg,test," FINAL REPORT INDICATION: ___M with naseous, presyncope // acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or edema. Cardiac silhouette is mildly enlarged. Median sternotomy wires and mediastinal clips are noted. Hypertrophic changes noted in the spine without acute osseous abnormality. IMPRESSION: Cardiomegaly without acute cardiopulmonary process. " ed9d1bad-38d3063f-676f68a5-40bf20c5-3460b36f.jpg,test/p15/p15731226/s50139355/ed9d1bad-38d3063f-676f68a5-40bf20c5-3460b36f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusions s/p thoracentesis with chest tube removed yesterday. Now with right anterior chest pain. // Please eval for complications from chest tube vs msk pathology. TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to___. FINDINGS: There has been interval removal of the right pleural drainage tube. The moderate right pleural effusion with adjacent pleural thickening and atelectasis appears unchanged from the prior study. The right upper lung and left lung are unremarkable. The heart is mildly enlarged. There is no pneumothorax, pneumomediastinum, focal consolidation, or pulmonary edema. IMPRESSION: Stable moderate right pleural effusion with adjacent pleural thickening and atelectasis after removal of right pleural drainage tube. " 64edb433-6c6f8c7d-82a8ad4c-6dd98138-969d7502.jpg,test/p12/p12844527/s51903524/64edb433-6c6f8c7d-82a8ad4c-6dd98138-969d7502.jpg,test," FINAL REPORT HISTORY: Back pain and cough. Evaluate for pneumonia. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: Chest radiographs ___ and ___. FINDINGS: The posterior spinal fusion hardware of the upper thoracic spine is unchanged. There is no pleural effusion, pneumothorax or focal airspace consolidation. Lungs are hyper inflated. The cardiomediastinal contours are unchanged. A levoscoliosis of the thoracic spine is constant. IMPRESSION: No acute cardiopulmonary process. " bf7c01b6-c58cca64-b47277b1-d59c55b2-cd398cdc.jpg,test/p17/p17684842/s53803369/bf7c01b6-c58cca64-b47277b1-d59c55b2-cd398cdc.jpg,test," FINAL REPORT INDICATION: Nausea and vomiting with mid epigastric pain. Assess for pleural effusions. COMPARISON: None. FINDINGS: The lungs are hyperinflated. There is no focal consolidation. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: Hyperinflated lungs. No acute cardiac or pulmonary process. " ca1db4f3-c5f29d4b-a9d30bda-c0ea95e7-984645c5.jpg,test/p16/p16776336/s53273548/ca1db4f3-c5f29d4b-a9d30bda-c0ea95e7-984645c5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p CABG // f/u effusions, atx COMPARISON: ___ FINDINGS: Compared with 1 day earlier, the right IJ line has been removed. No pneumothorax is detected. The patient the cardiac silhouette is less pronounced than vascular plethora is slightly improved. The left pleural effusion and underlying collapse and/or consolidation are again seen. As before, there is atelectasis and a small effusion at the right base. Platelike atelectasis is again seen in the left upper and right mid zones. Sternotomy wires noted. IMPRESSION: Slight interval improvement in cardiac enlargement and CHF " 77fc77cc-eeb20022-0f24b465-380015fd-f8e7bec1.jpg,test/p11/p11730422/s54148552/77fc77cc-eeb20022-0f24b465-380015fd-f8e7bec1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p open L sup segmentectomy and lingulectomy c/b hemothorax req takeback and PNA // ? interval change, attn to R lung opacity c/f PNA and L hemothorax TECHNIQUE: Chest PA and lateral COMPARISON: Multiple portable views of the chest dated ___, a PA and lateral view of the chest dated ___ FINDINGS: In comparison with the prior examinations, there is no significant change. There are 2 chest tubes in place on the left with persistent, largely stable hydro pneumothorax along the lateral aspect of the left chest. There are persistent, diffuse, bilateral pulmonary opacity, consistent with edema. The cardiomediastinal silhouette is unchanged since prior examination, with rightward displacement of the trachea from the aorta, IMPRESSION: No significant change since recent comparisons. Persistent edema. " 3a3c013d-a8e553d2-6457c8cd-d1df9cfc-c80f32c4.jpg,test/p16/p16167724/s56189663/3a3c013d-a8e553d2-6457c8cd-d1df9cfc-c80f32c4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with trach? // progression of pneumomediatinum COMPARISON: ___. IMPRESSION: The signs indicative of pneumomediastinum have been documented on the CT trachea performed on ___. Given the difference in techniques, there appears to be no relevant change in extent and severity of the pneumomediastinum. The tracheostomy tube is in correct position. New atelectasis at the upper parts of the middle lobe whereas the medial parts of the middle lobe up better ventilated than on the previous examination. No other relevant changes. " 0d5f948e-d5d0883a-c8e25020-32599917-7a4ab28e.jpg,test/p19/p19701893/s51127596/0d5f948e-d5d0883a-c8e25020-32599917-7a4ab28e.jpg,test," FINAL REPORT INDICATION: ___ year old woman with smoker and weight loss , chronic cough // r/o abn TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are well expanded and clear. The hila and pulmonary vascular are normal. No pleural effusions or pneumothorax. The cardiomediastinal silhouette is normal. No obvious osseous abnormalities. IMPRESSION: Normal chest radiograph. " cb3c8382-0d6a0d8d-56f7a456-6632d08d-e1daaed7.jpg,test/p10/p10307557/s52082049/cb3c8382-0d6a0d8d-56f7a456-6632d08d-e1daaed7.jpg,test," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with extensive soft tissue injuries from dog bite and massive transfusion. FINDINGS: Comparison is made to previous study from ___. There is an endotracheal tube whose tip is at the level of the aortic knob, 7 cm above the carina. There is a feeding tube whose side port is below the gastroesophageal junction. The patient is slightly rotated on the study. There is elevation of the left hemidiaphragm. There are no signs for overt pulmonary edema or definite consolidation. Pleural effusions or pneumothoraces are identified. " 40741984-cb898948-7935d0ac-5c2bb889-2f687b2b.jpg,test/p14/p14709954/s58336965/40741984-cb898948-7935d0ac-5c2bb889-2f687b2b.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with chest pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. There is no pneumothorax, effusion or consolidation. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unchanged. IMPRESSION: No acute cardiopulmonary process. " 13979aad-0fbe709d-a58598fb-e0033945-fa62f790.jpg,test/p18/p18573829/s57755274/13979aad-0fbe709d-a58598fb-e0033945-fa62f790.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam is dated ___ and ___. CLINICAL HISTORY: ___-year-old female with NASH, portal vein thrombus history. FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires are again seen along with mediastinal clips. There is a tiny right pleural effusion. Otherwise, the lungs are clear. No signs of edema or pneumonia. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Small right pleural effusion. Otherwise, normal. " 534e508e-7cbfbcc9-68db86fe-d06156b3-251627d6.jpg,test/p19/p19230716/s53424750/534e508e-7cbfbcc9-68db86fe-d06156b3-251627d6.jpg,test," FINAL REPORT INDICATION: Syncope. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. Right middle lobe opacity is likely pneumonia. The remainder of the lungs are clear. There is no pleural effusion or pneumothorax. Biapical thickening is noted. The cardiac silhouette is mildly enlarged. Mediastinal silhouette and hilar contours are normal. IMPRESSION: Right middle lobe pneumonia. " f1160928-5b1d63e6-7da5fdbf-dc25c44c-6e2e3a41.jpg,test/p17/p17413422/s52372526/f1160928-5b1d63e6-7da5fdbf-dc25c44c-6e2e3a41.jpg,test," FINAL REPORT HISTORY: Dyspnea, rule out infiltrate. COMPARISON: Chest radiographs from ___ ___ ___. FINDINGS: Frontal and lateral views of the chest were performed. The lungs are clear and the lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The pleura is unremarkable. The imaged upper abdomen is normal. There are no osseous abnormalities appreciated. IMPRESSION: No acute cardiopulmonary process. " de9335af-7e235934-c00659b5-3094a343-61b22a0b.jpg,test/p16/p16136367/s53544782/de9335af-7e235934-c00659b5-3094a343-61b22a0b.jpg,test," FINAL REPORT INDICATION: ___-year-old female with cough and upper abdominal pain. PA AND LATERAL CHEST RADIOGRAPHS COMPARISONS: ___. FINDINGS: The lungs are clear. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal. IMPRESSION: Normal chest. " 96780460-d30e3626-d8ae60cb-1e2b7ab3-7e3279b3.jpg,test/p14/p14832062/s54830211/96780460-d30e3626-d8ae60cb-1e2b7ab3-7e3279b3.jpg,test," FINAL REPORT HISTORY: ___ years old man with tracheomalacia, new pulmonary infiltrates. COMPARISON: Exam is compared with ___. Right lung is reduced in volume compared to the left lung for complete consolidation/atelectasis of the right middle and lower lobes, which appears more dense compared to prior exam with increasing volume loss. Streaky opacities probably in the left mid lung, probably in the lingula, are similar and suggest minor atelectasis. A pleural effusion is suspected on the right but difficult to quantify; for the most part opacification is likely parenchmal. There is no pleural effusion on the left. IMPRESSION: Increasing dense opacification and volume loss involving the right middle and lower lobes, suggesting worsening extensive atelectasis - infectious etiology is not excluded; a coinciding pleural effusion is suspected on the right but difficult to quantify. " 5b339f3d-5cfe24b6-b58d0a12-922ccdf1-7251f899.jpg,test/p12/p12494432/s52599072/5b339f3d-5cfe24b6-b58d0a12-922ccdf1-7251f899.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Followup of the patient after right upper lobe pneumonia with loculated right pleural effusion after VATS and decortication. AP radiograph was obtained after removal of the right chest tube. There is no evidence of pneumothorax. There is loculation of the pleural effusion similar to the prior study. There is also no change in the lucency projecting over the right lower chest/upper abdomen. " d1702d9b-f943ad8f-25c8dd44-917e2532-daa477de.jpg,test/p18/p18591791/s59846823/d1702d9b-f943ad8f-25c8dd44-917e2532-daa477de.jpg,test," FINAL REPORT INDICATION: Pleuritic chest pain and difficulty breathing. COMPARISONS: Chest radiograph of ___. FINDINGS: AP and lateral views of the chest demonstrate normal lung volumes. There is no focal consolidation, pleural effusion or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Imaged osseous structures are intact. Multiple metallic densities project over right glenoid fossa. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " a6616b46-0faa64d8-6cf748d1-2bb0086d-86f19fab.jpg,test/p14/p14138018/s58285148/a6616b46-0faa64d8-6cf748d1-2bb0086d-86f19fab.jpg,test," FINAL REPORT PATIENT HISTORY: ___ years old man with aortic valve replacement and CABG, check atrial pacing lead. COMPARISON: Chest x-ray is compared to exam of ___. FINDINGS: Frontal radiograph of the chest in patient that has had medial sternotomy for CABG and AVR, sternal wires are intact. Swan-Ganz catheter and endotracheal tube have been removed. Mediastinal drains are unchanged. Left axillary pacemaker has leads following the expected course and ending in the right atrium and right ventricle respectively. Right jugular catheter ends in upper SVC. Lung volume is low but with improvement of vascular congestion, especially to the left. There been interval increase of left pleural effusion. There is no pneumothorax. IMPRESSION: Left axillary pacemaker is normally positioned without evidence of pneumothorax. Interval increase of left pleural effusion with mild improvement of vascular congestion to the left. Swan-Ganz and ET have been removed. " a75e7d29-f766ea33-9e56d884-58a04df3-5dcd16a7.jpg,test/p17/p17147147/s50999298/a75e7d29-f766ea33-9e56d884-58a04df3-5dcd16a7.jpg,test," FINAL REPORT INDICATION: ___ year old woman with SCLC invading right pulm artery and right main bronchus, s/p PA stenting // evaluate interval change TECHNIQUE: Chest AP COMPARISON: ___ FINDINGS: Right-sided Port-A-Cath tip close to the cavoatrial junction. The endotracheal tube is in good position. There is worsening right upper lobe opacity representing loculated pleural fluid and airspace opacity. The right lower lobe effusion has also increased. No change in appearance of the left lung. IMPRESSION: Interval worsening of the right-sided pleural effusion and right upper lobe opacity. " f8d08e77-22cf95ca-3080e446-31b93206-8643fb31.jpg,test/p13/p13560848/s55924685/f8d08e77-22cf95ca-3080e446-31b93206-8643fb31.jpg,test," FINAL REPORT INDICATION: ___ year old man with ICD placement // eval for lead placement TECHNIQUE: Chest PA and lateral FINDINGS: As compared to chest radiograph from 1 day prior, left-sided ICD terminates in the right ventricle. No pneumothorax or pleural effusion. Mild bibasilar atelectasis. Moderate cardiomegaly. Prior median sternotomy and AVR. IMPRESSION: Left ICD terminates in the right ventricle. " b96cd137-ac009cd9-33eeae03-2a497da9-d7368eb8.jpg,test/p19/p19380754/s55354374/b96cd137-ac009cd9-33eeae03-2a497da9-d7368eb8.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Shortness of breath and cough. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The heart is normal in size. The cardiac, mediastinal and hilar contours appear unchanged. There is probably a trace pleural effusion on the right, but likely decreased. There is no evidence for pneumonia or parenchymal edema. IMPRESSION: Perhaps minimal residual pleural effusion on the right, although probably decreased. " b3bec6a6-3b75741c-5f6c8799-2897e936-6925ab8f.jpg,test/p11/p11862800/s51382998/b3bec6a6-3b75741c-5f6c8799-2897e936-6925ab8f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CAD, afib, s/p fall with hemorrhage // evaluate for infiltrates evaluate for infiltrates IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. The cardiac silhouette remains within normal limits in this patient with intact midline sternal wires and evidence of previous CABG procedure. No definite vascular congestion or acute focal pneumonia. " 968bdfe3-3e3a4227-1a84b9f9-a427a44b-d9464fbe.jpg,test/p15/p15884351/s53462460/968bdfe3-3e3a4227-1a84b9f9-a427a44b-d9464fbe.jpg,test," FINAL REPORT INDICATION: Acute desaturation, rule out flash pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have slightly decreased, likely reflecting a lesser inspiratory effort. Minimal areas of atelectasis at both lung bases. Borderline size of the cardiac silhouette. No evidence of pulmonary edema, no pleural effusions. No pneumothorax. No evidence of local hyperemia. " 3aaa46ad-0a98371d-c30a1791-b6639668-0a53e31f.jpg,test/p18/p18658996/s53992149/3aaa46ad-0a98371d-c30a1791-b6639668-0a53e31f.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Pulmonary edema, intubated. FINDINGS: The ET tube is 4.4 cm above the carina. The NG tube tip is difficult to visualize but is at least in the stomach. There is a large left-sided pleural effusion with mediastinal shift to the right. There is a moderate right pleural effusion. There is pulmonary vascular re-distribution more marked on the left than on the right and hazy alveolar infiltrate, left greater than right. It is unclear how much of this is due to effusion layering posteriorly. Compared to the prior study, the left-sided effusion and mediastinal shift has increased. " 4f0f2fcc-58392c80-f5885bb8-663968b9-c31e1f37.jpg,test/p14/p14325424/s52344138/4f0f2fcc-58392c80-f5885bb8-663968b9-c31e1f37.jpg,test," FINAL REPORT AP CHEST, 12:32 P.M., ___ HISTORY: ___-year-old man with respiratory failure and endobronchial valve placement. IMPRESSION: AP chest compared to ___ at 3:53 a.m.: Bronchial valve projects over the left hilus. There is minimal, if any, left pneumothorax or pleural effusion, pigtail pleural drain in place. Consolidation in the right mid and lower lung zones and perihilar edema in the left lung have both improved over the preceding nine hours. ET tube in standard placement. Upper enteric drainage tube ends in the upper stomach and would need to be advanced 5 cm to move all the side ports beyond the gastroesophageal junction. There is no pneumothorax. " 85ba69a2-f806f595-dff45187-7bd692a7-6361fae1.jpg,test/p16/p16773288/s56929787/85ba69a2-f806f595-dff45187-7bd692a7-6361fae1.jpg,test," FINAL REPORT AP CHEST, 3:33 P.M., ___ HISTORY: A ___-year-old man with bilateral chest tubes. IMPRESSION: AP chest compared to ___: Minimal if any left pneumothorax, and small if any left pleural effusion, apical and basal pleural tubes in place, unchanged since ___. Stable cardiomediastinal silhouette including a severely enlarged thoracic aorta and moderate cardiomegaly. No right pneumothorax or pleural effusion, basal chest tube in place. Right lower lobe atelectasis increased from ___ through ___, subsequently stable. Right internal jugular sheath ends just above the origin of the SVC. " e853cd72-11bf894d-e2786f35-ef17b00f-af43dd38.jpg,test/p17/p17359302/s55045145/e853cd72-11bf894d-e2786f35-ef17b00f-af43dd38.jpg,test," FINAL ADDENDUM ADDENDUM No evidence of pneumothorax ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESRD and CHF with R pleural effusion s/p CT // r/o pneumo COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, a pleural drain was inserted into the right pleural space. The pre-existing pleural effusion has mildly decreased in extent but still occupies approximately ___% of the right hemi thorax. Subsequent areas of atelectasis at the right lung base. Unchanged moderate cardiomegaly. Unchanged appearance of the left lung. Known healed left rib fractures. " 09047e23-13cd6a15-10c0d193-cdc557ec-b29c1787.jpg,test/p16/p16982881/s58715711/09047e23-13cd6a15-10c0d193-cdc557ec-b29c1787.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with UC // evaluate for signs of TB or prior TB evaluate for signs of TB or prior TB IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " b8496fdf-db744146-1f56dbc1-be1bdb9e-b193a4fe.jpg,test/p19/p19151721/s54159628/b8496fdf-db744146-1f56dbc1-be1bdb9e-b193a4fe.jpg,test," WET READ: ___ ___ ___ 10:12 PM Resolution of right upper lobe atelectasis. No acute cardiac or pulmonary findings. Unchanged positioning of support lines and tubes ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a pre-existing atelectasis at the level of the right upper lobe has completely resolved. The lung parenchyma appears well ventilated, there is no evidence of pneumonia or pulmonary edema. No pleural effusions. Borderline size of the cardiac silhouette. Right and left internal jugular vein catheters as well as the nasogastric tube are in unchanged position. " dc78bb8d-6947a6f9-56a513a1-0caa4ed7-14934cc7.jpg,test/p14/p14929313/s54058812/dc78bb8d-6947a6f9-56a513a1-0caa4ed7-14934cc7.jpg,test," FINAL REPORT EXAMINATION: Chest two views INDICATION: PICC line placement TECHNIQUE: Chest radiographs COMPARISON: Chest radiograph ___ FINDINGS: A right-sided PICC is in-situ, this appears to have been withdrawn when compared to the prior study and now terminates in the mid SVC. No pneumothorax seen. The cardiomediastinal contour is within normal limits, the heart is not enlarged. No consolidation, pneumothorax or pleural effusion seen. IMPRESSION: A right-sided PICC terminates in the mid SVC a " 46d9bfae-ce6c9e22-986268e2-61ef801e-87a36fe7.jpg,test/p15/p15002645/s51575970/46d9bfae-ce6c9e22-986268e2-61ef801e-87a36fe7.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " d24ebcb9-efaf76a0-321e962b-fe8d99c6-959ce115.jpg,test/p16/p16487527/s56190892/d24ebcb9-efaf76a0-321e962b-fe8d99c6-959ce115.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with episodes c/f seizure // r/o infection , aspiration r/o infection , aspiration IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Streak of atelectasis is seen at the left base. " 2c268a6a-1102f223-ce46ff98-9a19d5cc-27273108.jpg,test/p12/p12190636/s59341216/2c268a6a-1102f223-ce46ff98-9a19d5cc-27273108.jpg,test," FINAL REPORT HISTORY: Intermittent dysphagia over several weeks, discomfort with swelling. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Left-sided dual chamber pacemaker leads terminate in the right atrium and right ventricle, in unchanged positions. The patient is status post median sternotomy and CABG. The cardiac, mediastinal and hilar contours are within normal limits. The pulmonary vascularity is normal. Apart from scarring within the left lung base and lung apices, the lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. There is diffuse demineralization of the osseous structures. Several wedge compression deformities within the upper and mid thoracic spine are unchanged. IMPRESSION: No acute cardiopulmonary abnormality. " baeb35f7-865e55c7-1da53be9-bf5bce07-ee436efd.jpg,test/p13/p13520909/s57676913/baeb35f7-865e55c7-1da53be9-bf5bce07-ee436efd.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ s/p sigmoidectomy and end colostomy (___) c/b brief PEA arrest, now presenting with fevers and leukocytosis // evaluate for interval change: effusions, bibasilar opacities TECHNIQUE: AP and lateral views of the chest COMPARISON: Multiple prior chest radiographs the most recent on ___ and CT abdomen and pelvis on ___ FINDINGS: The cardiomediastinal and hilar contours are stable. Moderate to large bilateral pleural effusions are increased from ___. There is mild to moderate pulmonary edema, which may be minimally increased from the prior study. No pneumothorax. IMPRESSION: Moderate to large bilateral pleural effusions are increased from the prior examination. Mild to moderate pulmonary edema is minimally increased from the prior study. " 87ca06e4-657d51bb-8f660ff0-655f3f25-3c421dbe.jpg,test/p11/p11287042/s50391562/87ca06e4-657d51bb-8f660ff0-655f3f25-3c421dbe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval COMPARISON: Chest radiographs ___ and ___, read in conjunction with CT of the PET-CT scan on ___. IMPRESSION: Small to moderate right subpulmonic pleural effusion has re accumulated, substantially smaller than its volume on ___. Aside from mild right basal atelectasis lungs are clear. There is no left pleural effusion. There is no evidence of central lymph node enlargement. Incidental note is made of a heavily calcified mitral anulus and possible left atrial enlargement, but there is no overall cardiomegaly or any pulmonary vascular congestion or pulmonary edema. " b3090cfc-5d8999d1-dc9ac0d5-f2aeb813-0311dbc2.jpg,test/p16/p16660031/s57958315/b3090cfc-5d8999d1-dc9ac0d5-f2aeb813-0311dbc2.jpg,test," FINAL REPORT HISTORY: Fall, cough. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are decreased compared to the prior study. This accentuates the size of the cardiac silhouette which is likely within normal limits. Mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures. Minimal bibasilar atelectasis is noted, but no focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities detected. IMPRESSION: Low lung volumes without focal consolidation to suggest pneumonia. No displaced fractures are seen, though if there is continued concern for rib fracture, then a dedicated rib series is recommended. " 3af8fb86-163348a6-cb56946d-c9af95e3-d94347ba.jpg,test/p11/p11765192/s51276297/3af8fb86-163348a6-cb56946d-c9af95e3-d94347ba.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with SVT // eval for CHF/pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Mild right base atelectasis is seen.There is no focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. No pulmonary edema is seen. IMPRESSION: Mild enlargement of the cardiac silhouette without pulmonary edema. " 57f2034d-f10955ea-3a117945-5437861c-9f81f42e.jpg,test/p10/p10441957/s52408429/57f2034d-f10955ea-3a117945-5437861c-9f81f42e.jpg,test," FINAL REPORT HISTORY: ___-year-old female with fever, chills, malaise. COMPARISON: None available. FINDINGS: PA and lateral chest radiographs through the chest demonstrate clear lungs bilaterally with no focal consolidation identified. The cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion. There is no pneumothorax. Incidental note is made of pectus carinatum. Osseous structures are otherwise unremarkable. IMPRESSION: No acute intrathoracic abnormality. " 7e352265-1cb33daa-fe1e7651-bc339a21-6c731b5a.jpg,test/p10/p10449408/s52190662/7e352265-1cb33daa-fe1e7651-bc339a21-6c731b5a.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, evaluation for interval change, rule out acute process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Moderate cardiomegaly. Mild pulmonary edema. Retrocardiac atelectasis and atelectasis at the right lung base. No new parenchymal opacities. No pneumothorax. No larger pleural effusions. The monitoring and support devices are in constant position. " 4d7a820e-14c1b965-2d9aa054-874ea2e3-27cfcd38.jpg,test/p14/p14536465/s50097409/4d7a820e-14c1b965-2d9aa054-874ea2e3-27cfcd38.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx of HFpEF in shock of unknown origin. // eval for evidence of edema or effusion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient was intubated. The tip of the endotracheal tube projects 6.5 cm above the carinal. The course of the nasogastric tube is unremarkable but the tip is not visualized on the image. Unchanged normal position of the right internal jugular vein catheter, projecting over the mid to lower SVC. Moderate cardiomegaly, areas of atelectasis at the right lung bases. No larger pleural effusions. Minimal fluid overload but no overt pulmonary edema. " fe44018e-e50a4341-b8d0bbe6-d140bb7e-edde3b2a.jpg,test/p11/p11588425/s59753616/fe44018e-e50a4341-b8d0bbe6-d140bb7e-edde3b2a.jpg,test," FINAL REPORT HISTORY: Fever and cough. TECHNIQUE: AP and lateral chest radiograph. 2 views. COMPARISON: Chest radiograph from ___, ___. FINDINGS: The heart size is normal. The cardiomediastinal silhouette and hilar contour is stable. The lungs are clear without focal consolidation, effusion or pneumothorax. No acute bony abnormality is identified. IMPRESSION: No acute intrathoracic process. " 1880f1fa-ed1ceb07-cbfbef42-374320ab-7c11803f.jpg,test/p14/p14185804/s52592170/1880f1fa-ed1ceb07-cbfbef42-374320ab-7c11803f.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with recent falls TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Lung volumes are low. Cardiac, mediastinal and hilar contours are unchanged. Heart size is normal. There is crowding of the bronchovascular structures, but no pulmonary edema is demonstrated. Linear and streaky opacities in the lung bases likely reflect atelectasis in the setting of low lung volumes. No definite pleural effusion or pneumothorax is identified. Degenerative changes are again noted throughout the thoracic spine. IMPRESSION: Low lung volumes with probable bibasilar atelectasis. " bc1cc45d-060883d1-499bc40f-21eb9460-6d04c2fc.jpg,test/p17/p17702558/s52968196/bc1cc45d-060883d1-499bc40f-21eb9460-6d04c2fc.jpg,test," FINAL REPORT INDICATION: ___ year old woman with NSCLC s/p left chest tube placement. // Eval pleural effusion COMPARISON: Radiographs from ___ IMPRESSION: There has been placement of a left basilar pigtail catheter. There has been slight decrease in the pleural effusion which is moderate in size. Heart size is grossly within normal limits. Right lung is clear. There are no pneumothoraces. " fab0059d-595340c3-5e027f91-ef5fca7c-400ab574.jpg,test/p11/p11226405/s50410953/fab0059d-595340c3-5e027f91-ef5fca7c-400ab574.jpg,test," FINAL REPORT INDICATION: ___F with chest tightness and cough, evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. Clear lungs. " 05855785-a89779d2-18598ef9-95b3a1ff-797a1d88.jpg,test/p19/p19314531/s57159544/05855785-a89779d2-18598ef9-95b3a1ff-797a1d88.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of COPD, productive cough, green sputum, low-grade temperatures. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has developed minimal bilateral pleural effusions as well as areas of opacities in both lower lobes. Given the clinical presentation of the patient, the presence of pneumonia is likely. In addition, the cardiac silhouette is slightly enlarged as compared to the previous exam, so that mild fluid overload could be present. Defect in the posterior part of the fifth right rib, unchanged. Mild bilateral symmetrical apical thickening. IMPRESSION: Suspicion of newly appeared bilateral lower lobe pneumonia, associated with minimal pleural effusions. At the time of dictation and observation, 1:14 p.m., on ___, the referring physician, ___. ___ was paged for notification. Findings were discussed minutes later over the telephone. " 84da84ce-6714b049-905531b6-08145a67-c072d7c6.jpg,test/p18/p18624005/s50049318/84da84ce-6714b049-905531b6-08145a67-c072d7c6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p left sided dual chamber pacemaker implantation // r/o PTX; check lead positions COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is slightly increasing and improving ventilation of the right hemi thorax. However, the overall extent of the combined pleural and parenchymal changes on the right are constant. Unchanged normal appearance of the left lung. Borderline size of the cardiac silhouette. Unchanged position of the sternal wires and of the pacemaker leads that are new. 1 lead projects over the right atrium and 1 over the anterior wall of the right ventricle. There is no evidence of pneumothorax. " 4fcffb74-a64e0f02-143a7013-e89462c2-5b8db7ed.jpg,test/p14/p14502109/s56372317/4fcffb74-a64e0f02-143a7013-e89462c2-5b8db7ed.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Asthma exacerbation, evaluation for cough. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has developed a right upper lobe pneumonia that occupies most parts of the lateral and basal right upper lobe. No other relevant changes. Normal size of the cardiac silhouette. No pleural effusions. At the time of dictation, Dr. ___ was paged for notification, ___:09 a.m., ___. Findings were discussed 1 minute later over the telephone. " acfc8fc8-febdf4b6-9c775290-835d7ed0-2d750e58.jpg,test/p14/p14513247/s58146548/acfc8fc8-febdf4b6-9c775290-835d7ed0-2d750e58.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with productive cough and myalgias. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Rectangular metal density overlying the right neck likely represents a hair clip. Normal cardiomediastinal and hilar contours. Normal pleural surfaces. Fully expanded, clear lungs. No acute pneumonia. IMPRESSION: No acute pneumonia. " c767fb09-7440e6f1-73f58d24-265f202e-99d29304.jpg,test/p13/p13999026/s55178349/c767fb09-7440e6f1-73f58d24-265f202e-99d29304.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with cirrhosis. PA and lateral upright chest radiographs were reviewed in comparison to ___. There is interval development of left pleural effusion. Heart size and mediastinum are stable. Lungs are essentially clear. No pneumothorax is seen. Minimal vascular engorgement is present. IMPRESSION: Interval development of pleural effusion on the left that can potentially obscure newly developed consolidation. " fc87c021-93db156b-0a239d51-e80f486b-4d5c9e7d.jpg,test/p12/p12211590/s55820250/fc87c021-93db156b-0a239d51-e80f486b-4d5c9e7d.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Orthopnea, history of Crohn's disease. COMPARISON: ___. FINDINGS: Mild scoliosis of the thoracic spine with subsequent mild asymmetry of the rib cage. Normal lung volumes. Normal size of the cardiac silhouette. No acute parenchymal changes such as pneumonia, pulmonary edema or atelectasis. The lung parenchyma shows normal structure and transparency on both the frontal and the lateral radiograph. No pleural effusions. No pneumothorax. " 088cbe97-fa8d5050-96783cc2-20aace6d-db56ca6b.jpg,test/p13/p13826513/s53651669/088cbe97-fa8d5050-96783cc2-20aace6d-db56ca6b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with EtOH cirrhosis p/w variceal bleeding, PNA c/b ARDS // eval ETT, pulm edema eval ETT, pulm edema IMPRESSION: In comparison with the study of ___ summary, the patient has taken a slightly better inspiration. Diffuse bilateral pulmonary opacifications persist, but may have slightly improved. Monitoring and support devices are unchanged. " bc003a2b-0621ed16-92d1b7f5-6317f30e-7b2bd500.jpg,test/p11/p11414573/s57565665/bc003a2b-0621ed16-92d1b7f5-6317f30e-7b2bd500.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a chest radiograph from ___ as well as a CT torso from ___. CLINICAL HISTORY: Chest pressure, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No signs of pneumonia. " a8e9bd11-15912f2a-04b6a761-c7e63f84-6040a062.jpg,test/p15/p15225349/s50123658/a8e9bd11-15912f2a-04b6a761-c7e63f84-6040a062.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with a history of cecal cancer complicated by liver metastases now status post segment 6 wedge resection, pericardial effusion status post pericardial window, and pleural effusion and pneumothorax status post chest tube removal. Assess for interval change. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Overall volume of the right hydropneumothorax is stable, with a slight increase in dependent fluid. Stable right apical pneumothorax. Unchanged left pleural effusion. Moderate bibasilar atelectasis, slightly increased on the right and stable on the left. Normal cardiomediastinal and hilar contours. IMPRESSION: Stable right hydropneumothorax with moderate bibasilar atelectasis. " 561aa77f-36bdb76f-e2a79068-a9c24ac5-0e745c62.jpg,test/p16/p16826047/s57622301/561aa77f-36bdb76f-e2a79068-a9c24ac5-0e745c62.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest CT from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: ___-year-old man with chronic right empyema, PleurX catheter with decreased drainage, increasing dyspnea, question interval worsening. FINDINGS: PA and lateral views of the chest are provided. PleurX catheter is again seen on the right with its tip at the level of the right sixth and seventh posterior rib interspace. There is persistent effusion and consolidation within the right lung, though there is slight improvement in the aeration in the right upper lung as compared with the prior chest radiograph. There is persistent loculated right pleural effusion for which a slight increased fluid component is seen along the right lateral upper lung. The left lung is unchanged and clear. Heart size cannot be assessed due to effacement of the right heart border. Bony structures appear intact. IMPRESSION: Persistent consolidation and loculated right pleural effusion with PleurX catheter in unchanged position. " 470c992f-a5927881-837a9b12-1164d0f3-527a7ca9.jpg,test/p16/p16514153/s50787320/470c992f-a5927881-837a9b12-1164d0f3-527a7ca9.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD exacerbation, increasing SOB, crackles on exam // pulmonary edema? pulmonary edema? IMPRESSION: In comparison with the study of ___, there is little change. The cardiac silhouette remains within normal limits. No evidence of acute pneumonia. There is a mild asymmetric indistinctness of pulmonary vessels at the right base. This could be a manifestation of mild elevation of pulmonary venous pressure. " eb5d1138-c6be3cb1-416430d5-b32b418c-c1ceb05f.jpg,test/p15/p15199758/s59450655/eb5d1138-c6be3cb1-416430d5-b32b418c-c1ceb05f.jpg,test," FINAL REPORT INDICATION: ___-year-old female with acute on chronic pancreatitis, now with mild hypoxemia, here to assess for pulmonary pathology. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph was performed on ___. FINDINGS: The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is borderline enlarged. The thoracic aorta is tortuous in its course. The mediastinal and hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " cfaef971-cb60c598-2af79dd3-f3bbce4c-0c45069c.jpg,test/p19/p19589747/s52174205/cfaef971-cb60c598-2af79dd3-f3bbce4c-0c45069c.jpg,test," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with right rib pain after fall. COMPARISON: CTA chest ___ and CT abdomen ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Scarring in the right upper lung is similar to CT ___. Linear medial right upper lobe opacity is likely sequelae of prior radiation. Heart size is normal. Mediastinal silhouette and hilar contours are stable. Haziness at the right heart border is mediastinal fat, seen on CT. Surgical clips are seen in the left upper quadrant. No displaced rib fracture is seen. Thoracic vertebral body heights are maintained. IMPRESSION: No evidence of acute intrathoracic injury. " 4a41fbbb-769bde36-aadfbc0f-b93bccdb-f305725b.jpg,test/p16/p16420717/s51547033/4a41fbbb-769bde36-aadfbc0f-b93bccdb-f305725b.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Given slightly low lung volumes and a large amount of soft tissue attenuation, the lungs appear clear aside from minimal right basilar atelectasis. The cardiac size is within normal limits. There is no pleural effusion. There is no pneumothorax. Mediastinal contours are within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 67a286e5-29d1cf74-580ce60e-35447efc-7d1ca5ef.jpg,test/p12/p12620123/s51223062/67a286e5-29d1cf74-580ce60e-35447efc-7d1ca5ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxemia, likely multifactorial incl PE, pulm edema // Evaluate for interval change in pleural effusions, opacities Evaluate for interval change in pleural effusions, opacities IMPRESSION: Prior chest radiographs ___ through ___. Substantial bibasilar consolidation worsened between ___ and ___, probably worse today as well with improvement in moderate bilateral pleural effusions. Mild cardiomegaly unchanged. Upper lungs clear. No pneumothorax. ET tube and right internal jugular line are in standard placements and an esophageal drainage tube can be traced only as far as the low esophagus. " bae7dc92-76ff6b9b-d518515a-9dabb2b3-8390440b.jpg,test/p14/p14540393/s50677359/bae7dc92-76ff6b9b-d518515a-9dabb2b3-8390440b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with COPD and acute onset dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy, aortic and mitral valve replacement. Moderate to severe cardiomegaly is unchanged. The mediastinal and hilar contours are similar with atherosclerotic calcifications noted at the aortic knob. Mild pulmonary edema is demonstrated with trace bilateral pleural effusions. No focal consolidation or pneumothorax is present. Atelectasis is seen in the lung bases. No acute osseous abnormality is detected. IMPRESSION: Mild congestive heart failure with mild pulmonary edema and trace bilateral pleural effusions. " b37afe93-a52afe58-e5ff587d-17eff5a2-f2777c11.jpg,test/p14/p14744538/s54332433/b37afe93-a52afe58-e5ff587d-17eff5a2-f2777c11.jpg,test," FINAL REPORT INDICATION: History: ___F with confusion // Eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: A left dual lead pacemaker is present with tips terminating in the right atrium and right ventricle as expected. Heart size is top normal. Mediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. Lungs are well-expanded without focal consolidation concerning for pneumonia. Mild bibasilar atelectasis is present. Pulmonary vasculature is within normal limits. The upper abdomen is unremarkable. IMPRESSION: Mild bibasilar atelectasis. No pneumonia. " e964e86e-aa8ef335-06c8b512-7a9d7e6c-4f2bd051.jpg,test/p13/p13223663/s52220972/e964e86e-aa8ef335-06c8b512-7a9d7e6c-4f2bd051.jpg,test," FINAL REPORT INDICATION: Dyspnea. Evaluate for infiltrate or edema. COMPARISON: Chest radiograph ___ through ___. TECHNIQUE: Upright PA and lateral chest radiographs. FINDINGS: Prior right lung consolidation is completely resolved. Nodular opacity at the right base may reflect the nipple or less likely pulmonary nodule. Mild cardiomegaly is unchanged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is mild pulmonary vascular congestion but no frank pulmonary edema. IMPRESSION: 1. Nodular opacity at the right base likely reflecting the nipple shadow. Confirmation with nipple markers and shallow oblique projections should be obtained. 2. Stable moderate cardiomegaly. ___ to ___ at 9:30 am, ___, by phone, 2 hours after discovery " 0c36c794-ea62829e-6ff9cd29-ba1cb428-83987814.jpg,test/p14/p14744387/s58101367/0c36c794-ea62829e-6ff9cd29-ba1cb428-83987814.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with new Dobbhoff tube placement. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: A Dobbhoff tube is visualized with the tip coiled in the stomach. Otherwise, the visualized endotracheal tube has since been removed. The lungs are hypoinflated but clear with no evidence of consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Visualized osseous structures are normal. IMPRESSION: Dobbhoff tube with tip coiled in the stomach. " 6de4f821-f15830f2-ad544c86-6fd5f4a6-8c9c1fb2.jpg,test/p19/p19768452/s57853481/6de4f821-f15830f2-ad544c86-6fd5f4a6-8c9c1fb2.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old female patient with shortness of breath, evaluate for pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is normal. No configurational abnormality is identified. Unremarkable appearance of thoracic aorta. No mediastinal abnormalities are present. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present, and the lateral and posterior pleural sinuses are free. No pneumothorax in the apical area on frontal view. Skeletal structures of the thorax grossly unremarkable. Our records do not include a previous chest examination available for comparison. IMPRESSION: Normal chest findings in ___-year-old female patient with history of shortness of breath. " f573a9f7-7f1d2396-616aae26-859989f7-024c9ffc.jpg,test/p11/p11763662/s53975135/f573a9f7-7f1d2396-616aae26-859989f7-024c9ffc.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Evaluation for pulmonary edema, pleural effusion, heart borders, consolidation and atelectasis in a ___-year-old man with a history of congestive heart failure with increased shortness of breath. COMPARISON: Chest PA and lateral, ___. FINDINGS: PA and lateral views of the chest were obtained. Lungs are clear bilaterally with no evidence of focal consolidation or congestive heart failure. No pleural effusions or pneumothorax. The cardiomediastinal silhouette is normal. There are no bony abnormalities. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 2bfdf03a-690e9b38-e9ca1537-26a5d162-097e97e9.jpg,test/p12/p12645334/s56146460/2bfdf03a-690e9b38-e9ca1537-26a5d162-097e97e9.jpg,test," FINAL REPORT INDICATION: ___M with SOB, decreased BS on left // ?pl eff, CHF TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: When compared to prior, there is a new moderate left-sided pleural effusion. There is persistent small right-sided pleural effusion with adjacent atelectasis. Superiorly the lungs are clear. Atherosclerotic calcifications noted at the aortic arch. Hypertrophic changes noted in the spine. IMPRESSION: New moderate left pleural effusion. Persistent small right pleural effusion with adjacent atelectasis. " 2c306616-b3005c87-d05f4dd6-a7f274c1-e15bf2a1.jpg,test/p13/p13473495/s58858468/2c306616-b3005c87-d05f4dd6-a7f274c1-e15bf2a1.jpg,test," FINAL REPORT INDICATION: ___M with ESRD DM2 morbody Afib RVR crackles on lower lung field // evalu pulomonary edema vs pna TECHNIQUE: AP upright view of the chest. COMPARISON: Chest radiograph ___, ___. Fistulogram ___. FINDINGS: A right subclavian approach dialysis catheter is again noted with tip terminating in the right atrium. A left subclavian vein stent is visualized projecting over the left lung apex. Moderate cardiomegaly is again visualized. The mediastinal and hilar contours are unremarkable. There is no pneumothorax or large pleural effusion. Lung volumes are slightly low without focal consolidation concerning for pneumonia. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " b32dc805-5621e720-57b50820-0c1828b8-8b81c87a.jpg,test/p17/p17973921/s53676705/b32dc805-5621e720-57b50820-0c1828b8-8b81c87a.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with SOB // infiltrate? COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " da4288e4-4a5e443d-70fe3b73-fc20b279-60decbe5.jpg,test/p12/p12924518/s59577814/da4288e4-4a5e443d-70fe3b73-fc20b279-60decbe5.jpg,test," WET READ: ___ ___ 8:21 PM Right IJ approach pacing lead projects over the expected location of the right ventricle. Aortic valve replacement is noted. Pulmonary vascular congestion with mild interstitial edema is new from prior study. Probable small left-sided effusion. ______________________________________________________________________________ FINAL REPORT HISTORY: Pacer leads. FINDINGS: In comparison with study of ___, the right IJ pacing lead projects over the region of the apex of the right ventricle. Lower lung volumes with developing pulmonary vascular congestion and probable small pleural effusion, as well as poor definition of the left hemidiaphragm, indicating volume loss in the left lower lobe. " 1b453458-99cd458f-0ff4b533-c26b519f-6ffed966.jpg,test/p14/p14485086/s52095910/1b453458-99cd458f-0ff4b533-c26b519f-6ffed966.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Hypertension, cholangitis, septic shock. Portable AP radiograph of the chest was compared to ___. The ET tube tip is 4.5 cm above the carina. The NG tube tip passes below the diaphragm terminating in the stomach. The left subclavian line tip is at the level of mid SVC. The patient continues to be in pulmonary edema with large bilateral pleural effusions. Heart size and mediastinum are unchanged. " 20ec3ccb-2377c16d-154e3c57-e0262433-6eeb2975.jpg,test/p12/p12791752/s59902252/20ec3ccb-2377c16d-154e3c57-e0262433-6eeb2975.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of altered mental status. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4d39d709-5f33fb94-271fb1f5-adfa9c26-92d84af6.jpg,test/p14/p14319656/s59891964/4d39d709-5f33fb94-271fb1f5-adfa9c26-92d84af6.jpg,test," FINAL ADDENDUM ADDENDUM Chest CT with contrast (if not contraindicated) to evaluate hilar enlargement is recommended as an inpatient/on a nonemergent basis. This recommendation was communicated by Dr. ___ to Dr. ___ via telephone at 9:16 AM on ___. 1 hr after discovery of the findings ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with hypoxia and ams // eval for aspiration pna COMPARISON: Chest radiographs ___ FINDINGS: There is no effusion or pneumothorax. Pulmonary vascular congestion is very mild. There is prominent streaky subsegmental atelectasis at the right base. In addition, there may be superimposed consolidation. There is persistent enlargement of the right hilum as well as slight enlargement of the left hilum. The cardiomediastinal silhouette is otherwise normal. Retrocardiac opacities, likely atelectasis is mild. IMPRESSION: 1. Opacity in the right middle lobe may be due to a combination of atelectasis and pneumonia. 2. Bilateral hilar enlargement, right greater than left. RECOMMENDATION(S): Chest CT to evaluate hilar enlargement. " 4f2ff405-0fede0eb-1a38e213-c1b25c10-bb22ee10.jpg,test/p13/p13877204/s57719820/4f2ff405-0fede0eb-1a38e213-c1b25c10-bb22ee10.jpg,test," FINAL REPORT HISTORY: ___-year-old male with history of AML, presents with pneumonia, acute kidney injury and increasing oxygen requirement. Assess for pulmonary edema. COMPARISON: CT chest ___. Chest radiograph ___; ___; ___. TECHNIQUE: Single portable frontal chest radiograph. FINDINGS: Persistent low lung volumes with mild interval improvement in multiple ill-defined bilateral heterogeneous opacities. No cavitation noted. There is a crowded appearance of pulmonary vasculature at the bases and mild cardiac enlargement from low lung volumes. Mediastinal and hilar contours are normal. Stable mild bibasilar atelectasis, left greater than right. No pneumothorax or large pleural effusion. IMPRESSION: 1. Mild interval improvement in multifocal opacities suggestive of infectious process. 2. No pulmonary edema. " cdadfe94-e47f97e3-ff29c20a-ab7fce4d-87158df0.jpg,test/p11/p11495809/s59607615/cdadfe94-e47f97e3-ff29c20a-ab7fce4d-87158df0.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pericardial or pleural effusion post pericardial drain pullout. AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier at 07:44 a.m. Cardiomediastinal silhouette is unchanged. Left chest tube is in place with unchanged appearance of the left pleural effusion. Right pleural effusion is unchanged as well, both moderate to large. There is no interval change in increased cardiac silhouette as compared to the prior examination. Upper lungs are essentially clear except for vascular engorgement and upper zone re-distribution. " d24194db-97fffaaf-87fb59c0-e105396f-c8000a15.jpg,test/p19/p19773650/s57976419/d24194db-97fffaaf-87fb59c0-e105396f-c8000a15.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Elevated white blood cell count, question pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable, as are the hilar contours. IMPRESSION: No acute cardiopulmonary process. " 583276b0-1394b86e-d8499d25-2293bcbc-570d7dc2.jpg,test/p18/p18683964/s55975900/583276b0-1394b86e-d8499d25-2293bcbc-570d7dc2.jpg,test," FINAL REPORT INDICATION: History of metastatic breast cancer, pain in the left lateral ribs, cause for rib pain. COMPARISON: CT torso on ___. FINDINGS: PA and lateral views of the chest. There is a small right pleural effusion. The lungs are clear. There is no pneumothorax. The cardiac, mediastinal, and hilar silhouettes are normal. No rib lesions are identified; however, better visualization of ribs is seen on concurrent rib films done today. The lung nodules are better seen on CT torso from ___. These findings were discussed with Dr. ___ at 2 o'clock p.m. on ___ by telephone. " 57da037a-f23a66c8-17c356c6-741de6ce-810c221b.jpg,test/p14/p14836874/s50308863/57da037a-f23a66c8-17c356c6-741de6ce-810c221b.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Weakness and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs remain hyperinflated with flattening of the diaphragms and increased AP diameter, suggesting chronic obstructive pulmonary disease. Nipple shadows are again noted bilaterally. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are stable and unremarkable. Biapical, left greater than right pleural scarring is again seen, similar to prior. IMPRESSION: No acute cardiopulmonary process. " e0c7f82f-6288e71b-1f563f80-9218160b-42705ec7.jpg,test/p17/p17122548/s54265940/e0c7f82f-6288e71b-1f563f80-9218160b-42705ec7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent cough // r/o PNA, effusions, CHF r/o PNA, effusions, CHF IMPRESSION: In comparison with study of ___, there has been almost complete clearing of the increased opacification in the right mid zone. Cardiac silhouette is at the upper limits of normal or mildly enlarged and there is some indistinctness of pulmonary vessels consistent with mild elevation of pulmonary venous pressure. Tortuosity of the descending thoracic aorta is again seen. " a3c82a7e-a511f223-5732e777-28862e8c-872bf136.jpg,test/p15/p15297415/s57410325/a3c82a7e-a511f223-5732e777-28862e8c-872bf136.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new O2 requirement // pul edema pul edema IMPRESSION: In comparison with the study of ___, the monitoring and support devices have been removed. Extensive opacification is again seen in the lower half of the right hemithorax consistent with substantial pleural effusion and volume loss in the right middle and lower lobes. The left lung is essentially clear and no definite vascular congestion is appreciated. " 4098aaee-f8b43816-0f2f5220-18a0f47a-3db61f47.jpg,test/p13/p13494014/s50743653/4098aaee-f8b43816-0f2f5220-18a0f47a-3db61f47.jpg,test," WET READ: ___ ___ ___ 10:38 PM no evident pneumothorax on this supine view. no foreign body. opacity at left apex likely represents overlapping structures though a post procedure hematoma would be difficult to exclude. known left suprahilar mass and nodules on the right. new ETT approximately 2 cm above carina. right port unchanged. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: S/p left central line placement, assessment for complications. COMPARISON: Prior study obtained the same day earlier. Portable AP radiograph was reviewed. No definitive evidence of pneumothorax is demonstrated on the left as well as on the right. The ET tube tip is 6 cm above the carina. Port-A-Cath catheter tip inserted through the right subclavian approach terminates at the level of cavoatrial junction/right atrium. No change in mediastinal contour is demonstrated. Left basal atelectasis is noted. Multiple pulmonary nodules are better seen on CT, although still can be seen on the current radiograph. " 897d0a2e-29035b58-a8d40080-d529c37e-f9a1f3c5.jpg,test/p12/p12278337/s51735328/897d0a2e-29035b58-a8d40080-d529c37e-f9a1f3c5.jpg,test," FINAL REPORT INDICATION: Shortness of breath and recent pneumonia. Rule out acute process. COMPARISON: Chest radiographs ___ and ___. CT thoracic and lumbar spine ___. FINDINGS and IMPRESSION: Frontal and lateral view of the chest. The lungs are hyperinflated with expansion in the AP dimension, consistent with chronic obstructive pulmonary disease. Atelectasis and pleural thickening is again seen at the left lung base, and the abnormal upward bulging contour of the left diaphragmatic pleural surface is longstanding. There are no definite pleural effusions. There is no pneumothorax or focal consolidation worrisome for pneumonia. An elliptical 10mm wide nodule projecting over the left fourth rib anteriorly could be rib calcification, but a CT scan would be needed to exclude a lung nodule. The heart size is normal and the mediastinal contours are unchanged. Calcifications are again seen in the aortic arch. ED QA nurses were notified by email of alteration from initial reading. " 162bd45c-416ba7da-8f5b91bb-3220aab6-f1c570ee.jpg,test/p12/p12390274/s53313242/162bd45c-416ba7da-8f5b91bb-3220aab6-f1c570ee.jpg,test," FINAL REPORT INDICATION: One week of nonproductive cough without fever. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size appears moderately enlarged, slightly increased when compared to the prior study. The aorta remains tortuous and mildly calcified. There is likely mild pulmonary vascular congestion. Minimal streaky opacities in the lung bases likely reflect atelectasis, without focal consolidation, pleural effusion or pneumothorax visualized. There are mild degenerative changes in the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion. Minimal bibasilar atelectasis. " 8a434cdb-6cf45f08-2a5eb0fe-c7b101ea-2daf97b0.jpg,test/p10/p10955242/s59011117/8a434cdb-6cf45f08-2a5eb0fe-c7b101ea-2daf97b0.jpg,test," FINAL REPORT INDICATION: Evaluate for pneumonia or abnormal cardiac silhouette in a patient with chest pain radiating to the back. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 0a0f1292-26229aac-04760e09-9a2137ff-db3685d3.jpg,test/p17/p17225573/s50439944/0a0f1292-26229aac-04760e09-9a2137ff-db3685d3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with decompensated cirrhosis // Please evaluate for pulmonary edema or pneumonia TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Lung volumes are low. Bilateral linear opacities representing new areas of atelectasis. No focal consolidations to suggest infection demonstrated. No pneumothorax is seen. No definitive pneumonia is present. " fe3aa632-6dc9561c-c9c5c9c7-9e124820-db022656.jpg,test/p17/p17025650/s53164476/fe3aa632-6dc9561c-c9c5c9c7-9e124820-db022656.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with history of HCC, NASH cirrhosis with shortness of breath, fatigue and failure to thrive TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___ and CT chest ___ FINDINGS: Mild to moderate cardiomegaly is re- demonstrated with diffuse atherosclerotic calcifications of the thoracic aorta noted. Mediastinal and hilar contours are otherwise unchanged. Pulmonary vasculature is not engorged. Lung volumes are low with mild patchy opacities in the lung bases, likely atelectasis. No pleural effusion or pneumothorax is present. Two clips are seen projecting over the left lung apex as well as epigastric region. IMPRESSION: Low lung volumes with patchy bibasilar opacities, likely atelectasis. " 973d82c0-2580b9b8-e4fb51f6-3a0332f1-f9d3179b.jpg,test/p15/p15025695/s59376223/973d82c0-2580b9b8-e4fb51f6-3a0332f1-f9d3179b.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with cough, dyspnea on exertion, dizziness and wheezing, rule out pneumonia. COMPARISON: None. FINDINGS: The lungs are clear. There is no pneumothorax or pneumomediastinum. There is no pleural effusion. Mediastinal and cardiac contours are normal. CONCLUSION: There are no acute cardiopulmonary findings. This has been verbally discussed with Dr. ___. " d450a695-a061337d-add2f9e2-2cd40fa8-771f46b5.jpg,test/p15/p15009233/s58131029/d450a695-a061337d-add2f9e2-2cd40fa8-771f46b5.jpg,test," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Interval increase in heart size accompanied by pulmonary vascular engorgement and moderate diffuse pulmonary edema. In the imaged upper abdomen, gastric distention is new. " 895c9c20-52dee268-4d0c87e8-2ec1f9dd-07c21025.jpg,test/p16/p16535066/s53539006/895c9c20-52dee268-4d0c87e8-2ec1f9dd-07c21025.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: HIV, status post bone marrow transplant, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The right jugular vein catheter is no longer visible. Normal size of the cardiac silhouette. The lung parenchyma shows normal structure and transparency, there is no evidence of pneumonia or other abnormality, lateral radiograph also looks unremarkable. Clips are projecting over the left upper quadrant. " 7c335f0a-7a1db1d4-12a5bd99-71e2ed9a-d1167d4c.jpg,test/p17/p17058141/s58722326/7c335f0a-7a1db1d4-12a5bd99-71e2ed9a-d1167d4c.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 4913018f-e9a28af8-623453c7-1be03381-e8810491.jpg,test/p19/p19457990/s52286159/4913018f-e9a28af8-623453c7-1be03381-e8810491.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever // please eval for pneumonia, other pulmonary process COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 5af63859-1815a16c-800887b1-3c3ee1ff-e77f3e22.jpg,test/p11/p11194247/s50805897/5af63859-1815a16c-800887b1-3c3ee1ff-e77f3e22.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with non-small cell lung cancer and cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Port-A-Cath catheter is inserted through the left subclavian approach with its tip terminating at the level of mid SVC. Heart size is slightly shifted to the right giving the interval development of right pleural effusion and at least partial atelectasis of the right lower lung. Right perihilar consolidation reflecting combination of the mass and loculated effusion is redemonstrated. Left lung is essentially clear. IMPRESSION: Interval development of right pleural effusion or at least redistribution as compared to the prior PET-CT from ___. The amount of effusion is at least moderate. Right perihilar consolidation consistent with known lung cancer. Left lung is unremarkable. " 027f80a9-dc0b921c-b63b9885-c5762100-d0c11777.jpg,test/p19/p19631869/s56360687/027f80a9-dc0b921c-b63b9885-c5762100-d0c11777.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p corevalve // eval for effusion COMPARISON: Chest radiograph ___ through ___. IMPRESSION: Lung volumes have improved since ___, responsible in part for the continued improvement in mild pulmonary edema since ___. Small right pleural effusion persists. Heart size top-normal. No appreciable atelectasis. No pneumothorax. Aortic core valve has normal postoperative appearance. " 6662f562-874d668a-17c5ece4-426fc021-d889ed61.jpg,test/p19/p19845120/s54088476/6662f562-874d668a-17c5ece4-426fc021-d889ed61.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Refractory bleeding after colectomy. Portable AP radiograph of the chest was reviewed in comparison to ___. Cardiomegaly is unchanged. Mediastinal silhouette is unchanged. Bilateral pleural effusions and bibasal consolidations are unchanged. No appreciable pneumothorax demonstrated. " 8780ddcd-defb9489-b65daa89-f22cb1a8-6b524fe7.jpg,test/p19/p19065401/s53177972/8780ddcd-defb9489-b65daa89-f22cb1a8-6b524fe7.jpg,test," FINAL REPORT HISTORY: ___-year-old male patient with catatonia and UTI, new fever. Patient is status post PEG tube placement on ___. Study requested for evaluation of infiltrate. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: AP and lateral views of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. Lungs are well expanded. There is no focal consolidation. There is no pleural effusion or pneumothorax. The right PICC line tip is seen at the confluence of the brachiocephalic veins. The left-sided pacemaker leads terminate in the right atrium and right ventricle, expected locations. There is moderate amount of free air within the abdomen. Visualized osseous structures are grossly unremarkable. IMPRESSION: 1. No radiographic evidence of acute cardiopulmonary process. 2. Moderate amount of free air within the abdomen, likely related to recent PEG tube placement. These findings were discussed with ___ by Dr. ___ on ___ at 12:00 PM, time of discovery. " b3e6ce3c-32015605-396a1edd-2fd48f09-11b04e46.jpg,test/p17/p17421663/s56303279/b3e6ce3c-32015605-396a1edd-2fd48f09-11b04e46.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient, intubated for anaphylactic shock, evaluate for placement of ETT. FINDINGS: AP single view of the chest has been obtained with patient in semi-erect position. Comparison is made with the next preceding similar study obtained 11 hours earlier during the same day. The previously observed bilateral extensive scattered and somewhat confluenting parenchymal infiltrates persist and may have even increased slightly, now involving the left lower lobe area as well. During the latest examination interval, the patient has been intubated, the ETT seen to terminate in the trachea 8 cm above the level of the carina. This is a rather unusual high position but may be otherwise acceptable. Referring physician was paged at 4:30 p.m. " 41dd1231-dae98e3b-ee843b13-5692e18b-1dd7029e.jpg,test/p10/p10146602/s52162525/41dd1231-dae98e3b-ee843b13-5692e18b-1dd7029e.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ year old man with w/HIV, HBV, recent lung adenoCA, and complicated diverticulitis w/h/o multiple procedures, now p/w recurrent ventral hernia s/p ex-lap/LOA/re-do component separation w/mesh // ?crackles at base of right lung TECHNIQUE: Upright portable radiograph of the chest. COMPARISON: Comparison is made to chest radiographs from ___. FINDINGS: Linear areas of atelectasis are present in the left mid lung and left lung base, as well as postsurgical changes related to prior right upper lobe resection. Otherwise, the lungs are relatively well inflated, with no focal consolidation, large pleural effusion, or pneumothorax. The cardiomediastinal silhouette is stable. IMPRESSION: Left mid and lower lung atelectasis. Otherwise, no acute cardiopulmonary process. " 90d9929a-7c5d47db-5c964540-15057da8-2da1321f.jpg,test/p12/p12795828/s59633502/90d9929a-7c5d47db-5c964540-15057da8-2da1321f.jpg,test," FINAL REPORT INDICATION: Patient with persistent cough. Assess for pneumonia. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes, without pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 03b5613c-933cf961-588e876a-e232efec-88084ff6.jpg,test/p19/p19056385/s52013479/03b5613c-933cf961-588e876a-e232efec-88084ff6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with fall approx ___ ft onto chest // fall ___ft off ladder onto chest TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: There are low lung volumes which likely in part accentuate the cardiomediastinal silhouette. There is mild prominence of the superior mediastinum, most likely related to low lung volumes, and AP, portable view. However, if there is clinical concern for acute mediastinal injury, chest CT is more sensitive. The lungs are grossly clear. No focal consolidation is seen. There is no pleural effusion or pneumothorax. No displaced fracture is identified. IMPRESSION: Low lung volumes. Mild prominence of the superior mediastinum most likely related to low lung volumes, and AP, portable view. However, there is high clinical concern for acute mediastinal injury, chest CT is more sensitive. No focal consolidation. No pneumothorax seen. " d22a598b-1d666829-f177f0e4-2a3e892f-5e57a925.jpg,test/p18/p18674922/s51649245/d22a598b-1d666829-f177f0e4-2a3e892f-5e57a925.jpg,test," FINAL REPORT HISTORY: Chest pain and cough with fever. Assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are somewhat low in volume with linear left basilar opacities, most likely atelectasis. There is no pleural effusion or pneumothorax. The heart is top normal in size and intervally increased over the prior two days which may reflect pericardial effusion. Mediastinal and hilar contours are normal. IMPRESSION: Linear left basal opacities most likely atelectasis. Interval increase in size of cardiac silhouette over the past few days could reflect pericardial effusion. Findings discussed with Dr. ___ by Dr. ___ by phone at ___ on ___. " da859a9b-a3328f58-ed218d3b-bd4bff96-73d089ba.jpg,test/p17/p17366913/s59014893/da859a9b-a3328f58-ed218d3b-bd4bff96-73d089ba.jpg,test," FINAL REPORT HISTORY: Fall. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: There is a right sided VP shunt coursing over the right hemithorax. There are relatively low lung volumes. Right middle lobe atelectasis/scarring is seen. No definite focal consolidation. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Right middle lobe atelectasis/scarring. " 28caf64f-0c609b34-7236c665-be754642-35667dde.jpg,test/p16/p16421524/s59592339/28caf64f-0c609b34-7236c665-be754642-35667dde.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with right PTX, s/p CT removal. // post CT pull film, assess for any new PTX. Please get CXR at ___ COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the right chest tube has been removed. The known right pneumothorax has now a diameter of approximately 2-3 cm, it has increased since chest tube removal. There is no convincing evidence of tension. Normal appearance of the cardiac silhouette and of the left lung. " 5c84cdb3-d10780a1-542a05de-ef8fde1b-c6860009.jpg,test/p15/p15746885/s57857946/5c84cdb3-d10780a1-542a05de-ef8fde1b-c6860009.jpg,test," FINAL REPORT INDICATION: ___ year old man with opacity seen on previous radiograph, evaluate for improvement. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ through ___. Chest CT ___. FINDINGS: Since prior, there has been interval improvement of small irregular opacities at the lung bases, although they do persist. The cardiomediastinal silhouette is stable. There is no pleural effusion or pneumothorax. A posterior nodularity seen on lateral view, correlates to a Bochdalek hernia seen on chest CT. IMPRESSION: Improvement of irregular opacities at the lung bases, although they do persist. A chest CT can be obtained for further evaluation. NOTIFICATION: The impression above was entered by Dr. ___ On ___ at16:31 into the Department of Radiology critical communications system for direct communication to the referring provider. " ec3253b8-6eb0f3b2-d11d8c97-35430341-1daf4efe.jpg,test/p17/p17492158/s52502114/ec3253b8-6eb0f3b2-d11d8c97-35430341-1daf4efe.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with intermittent persistent cough, evaluate for pathology. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar chest examination of ___. The heart size is normal. No configurational abnormality is identified. Thoracic aorta is mildly widened and elongated but without evidence of local contour abnormalities. Pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present, and lateral and posterior pleural sinuses are free. Noteworthy are some low positioned and slightly flattened diaphragms coinciding with slightly increased translucency of the lung bases suggesting the possibility of emphysema. There is no evidence of pneumothorax in the apical area on the frontal view. Skeletal structures of the thorax are grossly unremarkable. IMPRESSION: Stable chest findings, no evidence of cardiac enlargement, pulmonary congestion or acute infiltrates in this ___-year-old male patient with intermittent cough. " 1c8be650-d7bddbc8-df1e96e7-8d6f016f-f8b71e35.jpg,test/p11/p11784648/s58446970/1c8be650-d7bddbc8-df1e96e7-8d6f016f-f8b71e35.jpg,test," FINAL REPORT HISTORY: Fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present. IMPRESSION: Normal chest radiograph. " f8567cdc-0eaa6626-594730ba-de52b3c6-b0607220.jpg,test/p18/p18015004/s59622916/f8567cdc-0eaa6626-594730ba-de52b3c6-b0607220.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with ampullary adenocarcinoma and recent biliary stent now presenting with fevers to 102, also cough // Assess for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Mild bibasilar atelectasis is seen. No definite focal consolidation. No pleural effusion or pneumothorax is seen. Mediastinal contours are unremarkable. Cardiac silhouette is top-normal to mildly enlarged. IMPRESSION: No focal consolidation to suggest pneumonia. Mild basilar atelectasis. " 14c5ce9f-0ce12eab-a536b2a8-36a15e85-ebc4944a.jpg,test/p10/p10439374/s53706716/14c5ce9f-0ce12eab-a536b2a8-36a15e85-ebc4944a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new tachycardia, rhonchi, AMS // r/o PNA, acute process r/o PNA, acute process COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lungs remain low in volume. Moderate left lower lobe atelectasis is more pronounced. Upper lungs clear. Borderline cardiomegaly is exaggerated by low lung volumes. Mediastinal widening probably due to combination of fat deposition and vascular engorgement is unchanged. No definite pleural abnormality. " 3e7af712-008df97e-4476ff9a-66300e98-bd0ce2be.jpg,test/p18/p18167484/s53300045/3e7af712-008df97e-4476ff9a-66300e98-bd0ce2be.jpg,test," FINAL REPORT INDICATION: History: ___F s/p fall // ? ptx, effusion, consolidation TECHNIQUE: Chest PA and lateral COMPARISON: NONE. FINDINGS: Heart is normal size and mediastinal contours are within normal limits. Calcifications are noted in the aortic arch. Lungs are symmetrically expanded and clear. There is no pleural effusion. No pneumothorax. Bones are grossly unremarkable. IMPRESSION: 1. No acute intrathoracic abnormality. 2. Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referrable focal findings should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning. " eae699b9-eaaf16be-82d75aa4-56b5ac89-83b13c2b.jpg,test/p11/p11552741/s56559233/eae699b9-eaaf16be-82d75aa4-56b5ac89-83b13c2b.jpg,test," FINAL REPORT INDICATION: ___ year old man with bilateral pleural effusions // pleural effusions TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ 11:45 AM FINDINGS: Compared to ___, the left moderate pleural effusion and small right pleural effusion is decreased in size. Possible loculated effusion bordering right pleura is unchanged in size. Moderate cardiomegaly is unchanged in size. An area of focal consolidation in the right upper lobe is concerning for pneumonia. IMPRESSION: Possible right upper lobe pneumonia.Improved bilateral pleural effusions since ___. Unchanged right loculated effusion. RECOMMENDATION(S): The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:16 PM, 15 minutes after discovery of the findings. " a7b7fc78-9658a8a0-600a2904-924b54a8-100afb08.jpg,test/p14/p14775533/s56476833/a7b7fc78-9658a8a0-600a2904-924b54a8-100afb08.jpg,test," FINAL REPORT INDICATION: ___M with wheezing, s/p esophageal-aortic fistula repair // eval aorta, trachea TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Previously seen pleural effusions are no longer visualized. There is streaky right basilar opacities which may be due to atelectasis. There is no consolidation worrisome for pneumonia. The cardiac silhouette is enlarged and there is tortuosity of the descending thoracic aorta as on prior. Median sternotomy wires are again noted. No acute osseous abnormality is identified. IMPRESSION: Cardiomegaly without acute cardiopulmonary process. " 69dff496-c7e03816-2454faaf-02678638-bfb2013f.jpg,test/p16/p16196296/s59618417/69dff496-c7e03816-2454faaf-02678638-bfb2013f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with URI, now resolved without antibiotics. ? Status of infiltrate on previous film. // Is infiltrate persistent or changed? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing right lower lobe opacity has decreased in extent and severity in is barely visible on today's image. No new opacities. Moderate cardiomegaly persists. No pleural effusions. " 3d243cfc-acdb4c47-ad394c15-03f56875-73c90d13.jpg,test/p13/p13040755/s56066087/3d243cfc-acdb4c47-ad394c15-03f56875-73c90d13.jpg,test," FINAL REPORT INDICATION: ___ year old woman with left PTX, rule out pneumothorax with chest tube clamped for 4 hours. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs for direct comparison made to a study from ___ FINDINGS: Left pleural pigtail catheter is in unchanged position. The left hydropneumothorax at the lung base has improved while the small apical pneumothorax as well as a tiny medial pneumothorax remain. Extensive opacities in both lung fields, left greater than right, are unchanged. A small right pleural effusion is unchanged. Severe background emphysema is unchanged. Visualized upper abdomen is unremarkable. IMPRESSION: 1. Interval decrease in the left hydro pneumothorax at the left lung base with persistent small left apical pneumothorax and tiny medial pneumothorax. 2. Unchanged small right pleural effusion. " e5d1a58f-4096d600-dd400350-e7e600ea-64844b57.jpg,test/p18/p18128235/s52970140/e5d1a58f-4096d600-dd400350-e7e600ea-64844b57.jpg,test," FINAL REPORT PA AND LATERAL RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old male with lower extremity edema, evaluate for effusion. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: None. FINDINGS: There is a left-sided pleural effusion present with blunting of the costophrenic angle. Trace pleural fluid is seen on the right side as well. There is associated compressive atelectasis at the left side. A paraesophageal hernia is present. Heart size is normal. There are aortic arch vascular calcifications present. Mild degenerative change is present throughout the thoracic spine. IMPRESSION: 1. Moderate left pleural effusion. 2. Paraesophageal hernia. " 5ef7272b-87af54ac-1dafb238-5cd04d8e-46b7deb3.jpg,test/p14/p14358282/s50940306/5ef7272b-87af54ac-1dafb238-5cd04d8e-46b7deb3.jpg,test," FINAL REPORT INDICATION: Extensive cardiac history, now with lightheadedness, here to evaluate for pneumonia, pulmonary edema, or pneumothorax. COMPARISON: Chest radiograph, last performed on ___. TECHNIQUE: PA and lateral upright radiographs of the chest. FINDINGS: The inspiratory lung volumes are decreased from the prior study with mild streaky opacification of the bilateral lower lobes, most likely representing mild atelectasis. No focal consolidation concerning for pneumonia, pleural effusion, or pneumothorax is detected. The cardiac silhouette is moderately enlarged with a globular shape, which is unchanged from the prior study. The mediastinal and hilar contours are within normal limits. The pulmonary vasculature is not engorged and there is no pulmonary edema. A left pectoral pacemaker is in place with two leads terminating in the right atrium and right ventricle, respectively. The visualized upper abdomen is unremarkable. IMPRESSION: 1. No acute cardiopulmonary process. 2. Mild bibasilar atelectasis. 3. Cardiomegaly. " 0e8f3e22-9cadaf59-ca6f48bc-aca65555-e8190f2e.jpg,test/p16/p16605694/s54230155/0e8f3e22-9cadaf59-ca6f48bc-aca65555-e8190f2e.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The descending aorta is moderately tortuous. A prominent pericardial fat pad projects along the cardiac apex. There is no pleural effusion or pneumothorax. The lungs appear clear aside from streaky right mid lung opacities suggesting minor atelectasis or minor fissural thickening. There is mildly exaggerated kyphotic curvature centered along the lower thoracic spine and a mild anterior wedge compression deformity that appears chronic. The mid-to-upper thoracic spine is mildly lordotic. IMPRESSION: No evidence of acute disease. " 4837d58c-ca728b14-121ab2c3-d7d6a7af-e066277b.jpg,test/p18/p18655830/s53953012/4837d58c-ca728b14-121ab2c3-d7d6a7af-e066277b.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: Patient with history of gastroparesis and recent cardiac surgery presenting with nausea vomiting. Evaluate for acute cardiopulmonary process. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Multiple prior chest radiographs, most recent from ___ FINDINGS: Compared to baseline there is a new right middle lobe opacity partially obscuring the inferior right cardiac margin. There is also an opacity in the right costophrenic angle with an associated small pleural effusion better seen in the lateral view. Linear atelectasis is seen in the right mid lung. Stable moderate-to-severe cardiomegaly. There is no pneumothorax. Sternotomy wires are intact. IMPRESSION: Right middle and right lower lobe opacities with associated pleural effusion may represent a combination of atelectasis and infection/aspiration in this patient with recent vomiting episodes. " 79ad25ce-b9ad46bd-2e9b1527-b9d8f552-6ad92e39.jpg,test/p10/p10514375/s57627206/79ad25ce-b9ad46bd-2e9b1527-b9d8f552-6ad92e39.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with self presentation with ""collapsed lung"" // eval pulm process TECHNIQUE: Chest Frontal and Lateral COMPARISON: Chest CT from ___ and chest radiographs from ___ FINDINGS: Left apical pleural collection is again seen grossly similar in extent. Blunting of the left costophrenic angle was seen on prior chest CT, scout image, from ___. Left basilar opacity may be chronic. The appearance of the chest is grossly similar as compared to the scout image from chest CT from ___. The right lung is clear. IMPRESSION: Left apical pleural collection is again seen grossly similar in extent. Blunting of the left costophrenic angle was seen on prior chest CT, scout image, from ___. Left basilar opacity may be chronic. The appearance of the chest is grossly similar as compared to the scout image from chest CT from ___. The right lung is clear. " 5e1f0de1-5d0263e6-abe62764-770dc56a-3815a195.jpg,test/p19/p19438264/s54221212/5e1f0de1-5d0263e6-abe62764-770dc56a-3815a195.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with s/p fall out of bed. midline c-spine tenderness, l-spine tenderness. ALso with R shoulder pain. // Fracture or hemorrhage? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Streaky left retrocardiac opacity most likely represents atelectasis. There is otherwise no focal consolidation, pleural effusion or pneumothorax. Heart size is mildly enlarged. Atherosclerotic calcifications are noted in the aortic arch. There is no evidence of acute fracture. There is bilateral glenohumeral and acromioclavicular joint osteoarthritis. IMPRESSION: No acute cardiopulmonary process. " 2a84add4-6f66af9d-4c395105-6cae88c5-664dc464.jpg,test/p14/p14912045/s51712456/2a84add4-6f66af9d-4c395105-6cae88c5-664dc464.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p MVR // post-op changes COMPARISON: Chest radiographs from___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Right apical pneumothorax is slightly improved. Allowing for differences in patient positioning, the right-sided effusion is probably similar in volume. No focal consolidation. Mitral valve ring appears in similar location. Left shoulder calcific tendonitis appears similar to prior exam. IMPRESSION: 1. Right apical pneumothorax is slightly improved. 2. Allowing for differences in patient positioning, the right-sided effusion is probably similar in volume. 3. Mitral valve ring appears in similar location. " ca3abdf5-eda0684d-b56c79a2-e151a69a-02ee0139.jpg,test/p14/p14471647/s56280612/ca3abdf5-eda0684d-b56c79a2-e151a69a-02ee0139.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: RECENT CH / PNEUMONIA IMPRESSION: Comparison to ___. The lung volumes have increased, likely reflecting improved ventilation. The pre-existing parenchymal opacities have decreased in extent and severity but are still present, notably at the basis of the left lung. No pulmonary edema. Borderline size of the cardiac silhouette persists. Stable normal course of the pacemaker wires. " 3e683cfa-e1d86405-50e24c0f-a5f2b3eb-b3e37361.jpg,test/p11/p11214611/s50455422/3e683cfa-e1d86405-50e24c0f-a5f2b3eb-b3e37361.jpg,test," FINAL REPORT HISTORY: ___-year-old male status post esophagectomy. Evaluate interval change. COMPARISON: Chest radiograph dated ___. FINDINGS: As compared to chest radiograph dated ___, frontal and lateral chest radiographs demonstrate interval removal of enteric tube. The right Port-A-Cath is seen in unchanged position with its tip in the low superior vena cava. The bilateral lungs are well expanded without new focal consolidations. Prior right loculated pleural fluid largely resolved. Stable cardiomegaly. There is no pneumothorax. IMPRESSION: Decreased right pleural fluid with well-expanded clear lungs. " a1bfe59a-242e2eb0-86969bcf-07838e83-f147a8a6.jpg,test/p10/p10175944/s50814649/a1bfe59a-242e2eb0-86969bcf-07838e83-f147a8a6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intubation. // pls eval ET tube placement TECHNIQUE: Single frontal view of the chest COMPARISON: Prior radiographs of ___ FINDINGS: Compared with prior radiographs of ___, there has been interval placement of an ET tube which is located at the origin of the right mainstem bronchus and should be pulled back 4 cm for more standard positioning. A left perihilar consolidation is increased from prior. There is no pneumothorax. There is no large pleural effusion. Overall lung volumes are low, with atelectasis at the left lung base. Heart size is normal. IMPRESSION: 1. ET tube is located the origin of the right mainstem bronchus, and should be pulled back 4 cm for more standard positioning. 2. Worsening left upper lobe pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 12:09 PM, 10 minutes after discovery of the findings. " c3bd621e-13e49f64-cc2d2eba-077546e7-56975aac.jpg,test/p19/p19343878/s53223205/c3bd621e-13e49f64-cc2d2eba-077546e7-56975aac.jpg,test," FINAL REPORT HISTORY: Metastatic HCC, weakness. Evaluate for infiltrate, effusion. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: CT chest from ___. FINDINGS: There are trace bilateral pleural effusions, improved from ___. There is no focal opacity, pulmonary edema or pneumothorax seen. The cardiac and mediastinal contours are normal. Radiopaque density in the right upper quadrant is likely secondary to prior chemoembolization. IMPRESSION: No acute cardiopulmonary process. " b0fa0e04-4e85ddd0-d7966e8a-eb349eee-b9b8e72e.jpg,test/p11/p11106897/s50537483/b0fa0e04-4e85ddd0-d7966e8a-eb349eee-b9b8e72e.jpg,test," WET READ: ___ ___ ___ 6:19 PM Swan-ganz, ETT, and chest tubes removed. Right IJ sheath still in place. Small left pleural effusion and bibasilar atelectasis. No PTX. Cardiomediastinal silhouette not well seen due to low lung volumes. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: chest tubes, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, all monitoring and support devices, with exception of the right internal jugular vein introduction sheath, have been removed. There is no evidence of pneumothorax. The signs indicative of mild pulmonary edema have decreased in severity. Atelectasis persists in both perihilar areas and at both lung bases. Also persisting is a small left pleural effusion. No newly occurred parenchymal changes. " a36daefd-1164f0ae-de121119-07d71b92-62c1b26e.jpg,test/p18/p18628103/s58199405/a36daefd-1164f0ae-de121119-07d71b92-62c1b26e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with L thalamic hemorrhage, NG prev in airway, obtain repeat in 1hr (___) // Any pneumothorax TECHNIQUE: Portable chest radiograph COMPARISON: Chest radiograph ___ FINDINGS: Since the prior chest radiograph performed earlier on the same date, there has been interval repositioning of the enteric tube, which now terminates in the proximal stomach. Further advancement could be considered. There has otherwise been no interval change in the lungs. Bibasilar opacities likely represent atelectasis, although aspiration could be considered in the appropriate setting. No other consolidation, sizeable effusion or pneumothorax. Widened cardiomediastinal contours are unchanged. IMPRESSION: Interval repositioning of the enteric tube which terminates in the proximal stomach. " e3240b1d-6bd78128-e5055074-03ef18a7-33091063.jpg,test/p14/p14130631/s55849592/e3240b1d-6bd78128-e5055074-03ef18a7-33091063.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // et tube position et tube position COMPARISON: Chest radiographs ___ through ___ at 9:54 a.m. IMPRESSION: Tip of the newly placed endotracheal tube is in standard position, 5 cm above the carina. Lung volumes have improved, responsible for the apparent decrease in the severity of widespread severe pulmonary consolidation,. Heart size is normal. Moderate right pleural effusion, with an apical loculation, looks smaller because lung volumes have increased. No pneumothorax. " fe3cf576-366263c4-bc91f3fa-43daf799-1dc2527e.jpg,test/p10/p10292574/s59141134/fe3cf576-366263c4-bc91f3fa-43daf799-1dc2527e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: AFib, RVR, pleuritic chest pain, recent fall, question fracture or pneumonia. FINDINGS: PA and lateral views of the chest were provided. The heart is mildly enlarged, though this is stable. Patient is slightly rotated to the left on the frontal radiograph, which limits evaluation. There is no focal opacity to suggest pneumonia. No signs of CHF, no effusion and no pneumothorax. A calcified nodular opacity in the left upper lung is stable and likely represents a calcified granuloma. There is no pneumothorax. No displaced rib fractures are seen. IMPRESSION: Mild cardiomegaly, unchanged. Otherwise, unremarkable. " 2d19bbb0-eedc1016-de9c423a-710e6898-cde1e107.jpg,test/p12/p12180682/s50985490/2d19bbb0-eedc1016-de9c423a-710e6898-cde1e107.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old female with intubation and altered mental status. FINDINGS: Single portable view of the chest. No prior. Endotracheal tube is seen with tip approximately 4.5 cm from the carina. Endotracheal tube is seen coiled in the stomach with tip at the gastric fundus. The lungs are clear of large confluent consolidation or effusion. Cardiac silhouette is within normal limits. There is no evidence of pulmonary vascular engorgement. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. ET and enteric tubes as above. " ac277596-5c3b9719-41671839-4aedfd51-6e90e579.jpg,test/p16/p16662264/s50639964/ac277596-5c3b9719-41671839-4aedfd51-6e90e579.jpg,test," FINAL REPORT INDICATION: Cough and fever. History of renal transplant, on immunosuppression. COMPARISONS: Chest radiograph, ___. Multiple chest radiographs dating to ___. TECHNIQUE: AP and lateral views of the chest show a consolidation in the left lower lung zone obscuring the left heart border. This is new from the prior exam and most consistent with left lingular pneumonia. No other focal consolidations are identified. There is no pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is stable and normal in size. IMPRESSION: New lingular pneumonia. " cbf130da-37ec4822-58c4091c-eb409625-d2933762.jpg,test/p19/p19554621/s57193513/cbf130da-37ec4822-58c4091c-eb409625-d2933762.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ashma // not responding ? chets path WHEEZING AND COUGH SEVERAL WEEKS HX ASTHMA,NOT RESPONDING TO TREATMENT R/O PNEUMONIA,CHEST/LUNG PATHOLOGY,ABNORMALITY IMPRESSION: There are no prior chest radiographs available for review. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . " ca43829a-aa82815f-1363a57f-5738e8ce-994d08b8.jpg,test/p16/p16825136/s51933270/ca43829a-aa82815f-1363a57f-5738e8ce-994d08b8.jpg,test," WET READ: ___ ___ ___ 10:18 PM No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F trx from OSH, fell from garden wall onto driveway, polytrauma w/ lac forehead elbow wrist open left wrist fx, ICH/SAH freq falls,L ___ rib fx, L clavicular fx, T1 VB fx. Now with WBC ___ // eval for infection TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is top-normal, stable. Descending aorta is tortuous but otherwise mediastinal structures are within normal limits. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. The patient is after left axillary surgery. " 81d8b340-0eaa2b22-f91b3d26-60b99de4-9bc9c58b.jpg,test/p15/p15638163/s58660092/81d8b340-0eaa2b22-f91b3d26-60b99de4-9bc9c58b.jpg,test," FINAL REPORT HISTORY: Membranous nephropathy status post renal transplant, worsening leukopenia, question infection. CHEST, TWO VIEWS Chest x-ray examination is within normal limits. No focal infiltrate is identified. " 27bfbd2d-a9b3fee8-3fbe875c-5a79266c-7a68d91d.jpg,test/p17/p17190208/s50277180/27bfbd2d-a9b3fee8-3fbe875c-5a79266c-7a68d91d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute worsening respiratory status // interval change interval change IMPRESSION: Comparison to ___. Known pre-existing left predominant hilar lymph node calcifications. There is no visible pneumothorax. Pre-existing basal opacities have slightly improved. No larger pleural effusions are present on today's image. No pulmonary edema. Unchanged monitoring and support devices. " da4dd3bf-e3c3cef6-c2932712-4ea1868f-bb49a679.jpg,test/p13/p13247581/s51179137/da4dd3bf-e3c3cef6-c2932712-4ea1868f-bb49a679.jpg,test," FINAL REPORT HISTORY: Postoperative cardiac surgery. FINDINGS: In comparison with the study of ___, there are some continued areas of opacification at the bases consistent with small effusions and atelectasis. Cardiac size is unchanged and there is no vascular congestion. Right IJ catheter again extends to the mid SVC. " 730f1a8e-3f3f03c1-072ff3a2-b387ee34-88e253ea.jpg,test/p12/p12676785/s51812032/730f1a8e-3f3f03c1-072ff3a2-b387ee34-88e253ea.jpg,test," WET READ: ___ ___ ___ 2:30 PM Rounded density in the aorta pulmonary window and widening of the mediastinum concerning for lymphadenopathy. This can be further assessed with chest CT. No evidence of pneumonia or pulmonary edema. Mid thoracic compression deformity of uncertain chronicity ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with abnormal EKG, presyncope // R/O pneumonia/CHF TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Mildly enlarged cardiac silhouette. There is rounded soft tissue density in the aorta pulmonary window and widening of the mediastinum concerning for lymphadenopathy. No focal consolidation, pleural effusion, pulmonary vascular congestion or pneumothorax. Compression deformity of the mid thoracic spine is noted of uncertain chronicity. IMPRESSION: 1. Rounded density in the aorta pulmonary window and widening of the mediastinum concerning for lymphadenopathy. This can be further assessed with chest CT. 2. No evidence of pneumonia or pulmonary edema. 3. Mid thoracic compression deformity of uncertain chronicity. " 43b103be-5b920393-c8a01389-a72a72e3-04f1d417.jpg,test/p19/p19259960/s53487032/43b103be-5b920393-c8a01389-a72a72e3-04f1d417.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: AP upright and lateral views of the chest were provided. Calcified pleural plaque is noted, which may account for the scattered opacities within both lungs. The lung volumes are low, which limits the assessment. Given the rounded appearance of a lesion projecting over the right mid-to-upper lung, a CT is needed to ensure the aforementioned lesions represent pleural calcified plaque. There is mild bibasilar atelectasis and bronchovascular crowding without discrete evidence for pneumonia or overt CHF. No large effusions or pneumothorax seen. Midline sternotomy wires are noted. There is a prosthetic cardiac valve. The heart size and mediastinal contour appear within normal limits. No acute bony injuries. IMPRESSION: Scattered calcified pleural plaque, likely accounts for the rounded and vague opacities projecting over both lungs. Recommend CT to confirm, on a non-emergent basis. " 471d4354-ffb6ef40-992388c5-c3445d53-f5dcedfe.jpg,test/p14/p14237047/s59186584/471d4354-ffb6ef40-992388c5-c3445d53-f5dcedfe.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness, ? PNA // ? acute cardiopulm process COMPARISON: Prior chest radiograph from ___ as well as a prior CT of the abdomen pelvis from ___. FINDINGS: PA and lateral views of the chest provided. Free air persists below the right hemidiaphragm. There is a small residual right pleural effusion with mild right basal opacity likely representing atelectasis. There is no convincing evidence for pneumonia or edema. Cardiomediastinal silhouette appears normal. A calcific density projecting over the mediastinum likely represents a calcified lymph node. Calcified granulomas project over the left upper lung. Bony structures are intact. IMPRESSION: 1. Free air below the right hemidiaphragm is unchanged from prior CT abdomen pelvis. 2. Small right pleural effusion with right basal atelectasis. " 76e34788-3ea462f0-c9a90b59-b56e11f9-a9fd443e.jpg,test/p14/p14867487/s59671324/76e34788-3ea462f0-c9a90b59-b56e11f9-a9fd443e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with sob // r/o infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___, CT chest dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Pulmonary nodules as described on prior chest CT are not discretely visualized on today's examination. Mild scoliosis is again noted in the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary process. " 5bb3bff6-7620a819-e5368680-834c7670-c84de00f.jpg,test/p19/p19630748/s51304184/5bb3bff6-7620a819-e5368680-834c7670-c84de00f.jpg,test," FINAL REPORT HISTORY: History of ventricular tachycardia and vomiting. Evaluate for heart failure or pneumonia. COMPARISON: None available. FINDINGS: Portable semi-upright radiograph of the chest demonstrate well expanded clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion, pneumothorax or consolidation. IMPRESSION: No acute cardiopulmonary process. " a7e25d9f-273c4fd2-57e6dd95-6ca8add3-56745d6c.jpg,test/p10/p10271581/s59010200/a7e25d9f-273c4fd2-57e6dd95-6ca8add3-56745d6c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old smoker with recent LUL PNA and ? new RUL nodule. Reassess nodule, surveillance for resolution prior opacification. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___, ___, and ___. FINDINGS: Moderate emphysema is unchanged, and lungs are persistently hyperinflated. Previously described left upper lobe opacification and right upper lobe nodule are no longer detected. There is no new focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. IMPRESSION: No focal consolidation concerning for pneumonia. Previously described nodule is no longer detected radiographically. " 20b4d426-09ff8432-6232a919-c6325673-e2c7d4fd.jpg,test/p19/p19011488/s58103311/20b4d426-09ff8432-6232a919-c6325673-e2c7d4fd.jpg,test," FINAL REPORT INDICATION: Crackles and productive cough x1 week. Evaluate for congestive heart failure or pneumonia. COMPARISON: Multiple prior radiographs of the chest, most recent ___. TECHNIQUE: PA and lateral upright radiograph of the chest. FINDINGS: Moderate pulmonary edema, worsening moderate cardiomegaly, and widening of the vascular pedicle suggests congestive heart failure exacerbation. Opacity of the left lower lung is likely due to pleural effusion and some component of atelectasis. However, underlying infectious process such as pneumonia cannot be excluded. There is no evidence of apical pneumothorax. IMPRESSION: 1. Worsening cardiomegaly, bilateral pulmonary edema, and widening of the vascular pedicle suggest CHF exacerbation. 2. Left lower lung opacity is likely pleural effusion with a component of atelectasis, however, underlying pneumonia cannot be excluded. The above results were communicated via telephone by Dr. ___ to Dr. ___ ___ at 3:10 p.m. on ___, 30 minutes after discovery. " b8a13396-4ed73ef5-1919e379-4800a891-abab1b2f.jpg,test/p11/p11234232/s57373990/b8a13396-4ed73ef5-1919e379-4800a891-abab1b2f.jpg,test," WET READ: ___ ___ ___ 9:43 PM 1. Right upper mediastinal mass should be further assessed with CT. 2. Right lower lobe pneumonia with associated pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with failure to thrive and cough. Evaluate for pneumonia. TECHNIQUE: AP and lateral chest radiographs COMPARISON: None available. Correlation is made to thyroid ultrasound from ___. FINDINGS: The lungs are well expanded. Better seen in the lateral view there is a right lower lobe opacity at least in part due to pleural effusion. The left lung is clear. There is a large mass in the upper mediastinum,, larger on the right when compared to the left with associated narrowing of the trachea at the thoracic inlet which is also displaced anteriorly. Cardiac size is normal. There is no pneumothorax. IMPRESSION: 1. Right greater than left upper mediastinal mass with mass effect on and apparent narrowing of the trachea, likely an enlarged thyroid, could be further assessed with CT. 2. Small right effusion with possible associated consolidation. " 609d853f-ef2ff2e8-2d3d093a-9b4b9fbd-41c23110.jpg,test/p15/p15281491/s53615642/609d853f-ef2ff2e8-2d3d093a-9b4b9fbd-41c23110.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " 4a494370-5d95a7fc-f77a34dc-d5ba2209-ee64fcb2.jpg,test/p13/p13214943/s50159639/4a494370-5d95a7fc-f77a34dc-d5ba2209-ee64fcb2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with PICC line partially out at skin site // Assess PICC COMPARISON: Chest radiograph ___ FINDINGS: AP upright and lateral views of the chest provided. Right PICC tip is in the lower SVC, not significantly changed since prior. There is no focal consolidation, effusion, or pneumothorax. There is mild pulmonary vascular congestion. There is trace interstitial edema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Right PICC tip is in the lower SVC, not significantly changed since prior. " f4e1ce47-c552a520-bb54ebfe-f82e7614-58fe2520.jpg,test/p12/p12940106/s55191829/f4e1ce47-c552a520-bb54ebfe-f82e7614-58fe2520.jpg,test," FINAL REPORT INDICATION: ___M with s/p intubation // eval for tube placement TECHNIQUE: Frontal chest radiographs were obtained COMPARISON: Reference chest radiograph from ___ at 06:20. FINDINGS: A nasogastric tube terminates in the stomach with a large hiatal hernia noted. The lungs are grossly clear, and an endotracheal tube terminates in appropriate position. Central pulmonary artery enlargement may reflect pulmonary hypertension. IMPRESSION: Nasogastric tube and endotracheal tube in appropriate position with a large hiatal hernia noted. " f675621f-96be5017-1c9913de-b0c32777-8217f637.jpg,test/p15/p15586018/s59745922/f675621f-96be5017-1c9913de-b0c32777-8217f637.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain, assess cardiomegaly. FINDINGS: PA and lateral views of the chest are provided. Mild interstitial edema is present, without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. The imaged osseous structures are intact. IMPRESSION: Mild interstitial edema. " ebcbef7f-58798f2b-46bb8e5d-b84ca82e-9d71d134.jpg,test/p19/p19516231/s59142980/ebcbef7f-58798f2b-46bb8e5d-b84ca82e-9d71d134.jpg,test," FINAL REPORT HISTORY: Left pleural effusion, status post thoracentesis of 750 mL fluid. Evaluate for pneumothorax. COMPARISON: Chest radiograph from approximately 1.5 hours prior on the same day. FINDINGS: There has been interval development of a moderate left apical pneumothorax. The left pleural effusion is significantly decreased compared to prior radiograph. The remainder of the exam, including a widened peritracheal stripe and postsurgical changes of the right apex, are unchanged. IMPRESSION: 1. Interval development of a moderate left apical pneumothorax. 2. The left pleural effusion is significantly decreased. " be625433-18c39b26-a087a1fa-6b31b5cc-374e8d82.jpg,test/p19/p19103751/s52138717/be625433-18c39b26-a087a1fa-6b31b5cc-374e8d82.jpg,test," FINAL REPORT INDICATION: ___ year old woman with fever and hx of multiple myeloma // r/o pna/consolidation r/o pna/consolidation IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " be1af890-77ae2564-f607a612-8a8c9086-682fb193.jpg,test/p11/p11366266/s55192254/be1af890-77ae2564-f607a612-8a8c9086-682fb193.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulmonary edema, being diuresed. // interval change interval change IMPRESSION: Right internal jugular line tip is at the level of lower SVC. Heart size and mediastinum are unchanged. There is gradual interval improvement of widespread parenchymal opacities with still substantial amount of parenchyma involved, in particular in the upper lobes, left more than right. Small bilateral pleural effusion is most likely present. " 8fd1ca77-0fc828dd-42c3208d-21d86bf3-cfa368fe.jpg,test/p15/p15616077/s55920199/8fd1ca77-0fc828dd-42c3208d-21d86bf3-cfa368fe.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam dated ___ and CT torso from ___. CLINICAL HISTORY: Lower extremity edema for two days, question cardiomegaly or pleural effusion. FINDINGS: AP upright and lateral views of the chest were provided. There is mild pulmonary edema, new from prior exam. There is no large effusion or pneumothorax. No focal consolidation to suggest the presence of pneumonia. The heart is stable in size and within normal limits. The aorta is mildly calcified. There is normal mediastinal contour. The imaged bony structures appear intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild pulmonary edema. " aa33a93b-c24b3814-a14bf1ca-c31571ee-b9bb4772.jpg,test/p15/p15185911/s54694338/aa33a93b-c24b3814-a14bf1ca-c31571ee-b9bb4772.jpg,test," FINAL REPORT INDICATION: ___F with SBO now s/p NGT // eval NGT placement TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Lower lung volumes seen on the current exam with secondary crowding of the bronchovascular markings. Linear left basilar opacity is likely atelectasis. Cardiac silhouette is enlarged but unchanged given differences in technique. Enteric tube passes below the diaphragm, side-port past the GE junction. No acute osseous abnormalities identified. IMPRESSION: Enteric tube seen with the tip in the stomach, side-port past the GE junction. " cfdde59e-6d223610-95dfb54f-1781d7f1-11c9f2ff.jpg,test/p14/p14464902/s56244853/cfdde59e-6d223610-95dfb54f-1781d7f1-11c9f2ff.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with prior renal-liver transplantation, severe aortic stenosis with status epilepticus, now after pulseless electrical activity arrest. COMPARISON: ___ obtained at 3:45 p.m. AP radiograph Pacemaker leads terminate in right atrium and right ventricle. Cardiomegaly is unchanged. Mediastinal silhouette is stable. Right basal opacity is still present, may be slightly progressed, but overall unchanged since the prior study. Improvement in the left basal atelectasis and right mid lung atelectasis is noted. No interval increase in pleural effusion or development of pneumothorax is seen. " d3b0b7ae-01bd3057-e564937b-5c3e7fe0-1f0f6fda.jpg,test/p14/p14696549/s59790008/d3b0b7ae-01bd3057-e564937b-5c3e7fe0-1f0f6fda.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Right-sided expanding airspace, concerning for chronic pneumothorax. COMPARISON: ___, ___ and several prior chest CTs dating back to ___. Heart size is top normal, stable. Tortuous aorta is redemonstrated. The expanding right air-filled space is unchanged as compared to ___ and ___ radiograph. Most likely secondary atelectasis of the right lower lung is redemonstrated. The posterior mediastinal mass suspected on the prior study cannot be assessed in detail on the chest radiograph. " 7ebd823a-4eb6b394-537842d2-8da1b964-92cc64ff.jpg,test/p17/p17173041/s55609064/7ebd823a-4eb6b394-537842d2-8da1b964-92cc64ff.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Shortness of breath, question pneumonia or pulmonary edema. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. " 3f5de107-6dae86fe-16c9b9fb-8d2e031a-10c063ae.jpg,test/p18/p18083755/s59837095/3f5de107-6dae86fe-16c9b9fb-8d2e031a-10c063ae.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with back pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, ___ chest CT FINDINGS: Left-sided dual-chamber pacemaker device is re- demonstrated with leads terminating in the right atrium and right ventricle, unchanged. Mild enlargement of the cardiac silhouette is again noted. Mediastinal and hilar contours are stable. Emphysematous changes are again noted. Small bilateral pleural effusions are new since the previous chest radiograph, and there is mild pulmonary vascular engorgement. Nodular opacities within both lung bases and right upper lobe, previously demonstrated on CT, are not as well visualized on the current exam. Right mid lung scarring is again noted. No acute osseous abnormality is seen. There is no pneumothorax. IMPRESSION: Mild pulmonary vascular congestion and small bilateral pleural effusions, new from the previous study. " daeb15c6-0bb35846-37161523-26e179e2-457803e1.jpg,test/p12/p12240787/s55683501/daeb15c6-0bb35846-37161523-26e179e2-457803e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p trach replacement // Assess for interval change TECHNIQUE: AP radiographs of the chest. COMPARISON: Plain radiograph dated ___. Chest CT dated ___. FINDINGS: A tracheostomy tube has been inserted. The patient is rotated. The patient has had prior right lung wedge resection with stable volume loss. There is no pneumothorax. Mild cardiomegaly is unchanged. The left-sided PICC line has been removed. A small left layering pleural effusion has slightly increased. A right upper lobe airspace opacity is unchanged. Airspace opacification at the left base has increased. IMPRESSION: Unchanged right upper lobe airspace opacity which is most likely due to pneumonia. Status post left pigtail catheter removal with increased small left layering pleural effusion. A chest CT may be obtained to distinguish between consolidation with aspiration or pleural effusion at the left base if clinically warranted. " b137a28b-13a4a923-7a11e571-2fa56021-20abbb49.jpg,test/p14/p14108973/s59346823/b137a28b-13a4a923-7a11e571-2fa56021-20abbb49.jpg,test," FINAL REPORT INDICATION: ___ year old man s/___ CRT-D s/p left axillary vein access // confirm lead placement TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are hyperexpanded and clear without focal consolidation concerning for pneumonia. A 3 lead pacemaking device is present with leads terminating in the right atrium, right ventricle, and coronary sinus as expected. IMPRESSION: Appropriate position of pacemaker leads, as described above. " 206d4b1f-536cfa8f-0c1806bb-8a5c0cc9-15609758.jpg,test/p19/p19243336/s53365058/206d4b1f-536cfa8f-0c1806bb-8a5c0cc9-15609758.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dyspnea, status post CABG on ___. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and CABG. The cardiac silhouette remains enlarged. Mediastinal contours are grossly stable, although possibly slightly less prominent as compared to the prior study given differences in technique. There are scattered areas of mid lung linear atelectasis/scarring. Small-to-moderate bilateral pleural effusions are seen along with possibly fluid in the minor fissure. No definite focal consolidation is seen. IMPRESSION: Small bilateral pleural effusions. Persistent enlargement of the cardiac silhouette. Mediastinal contours are grossly stable to possibly slightly less prominent as compared to the prior study. " 6e30111b-bd0c846c-a3553b70-f6a3acb0-12d37429.jpg,test/p15/p15632977/s55742435/6e30111b-bd0c846c-a3553b70-f6a3acb0-12d37429.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with altered mental status // eval for pneumonia COMPARISON: None FINDINGS: Left perihilar opacities may be due to aspiration. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Endotracheal tube tip is approximately 1 cm above the carina. Side port of the NG tube is below the GE junction. IMPRESSION: 1. Left perihilar opacities may be due to aspiration. 2. Endotracheal tube tip is approximately 1 cm above the carina. Withdrawal by 1-2 cm may provide more optimal placement. " 7032c277-9d19c5d1-d8e4be16-5a105435-a83b3d0d.jpg,test/p11/p11868766/s50430342/7032c277-9d19c5d1-d8e4be16-5a105435-a83b3d0d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with thoracic aneurysm s/p open repair // eval post-op baseline TECHNIQUE: Single AP radiograph of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: There is an ET tube, which is advanced too far and terminates at the origin of the left mainstem bronchus, with opacification of the left lung, which may represent atelectasis. Alternatively, the left lung opacification may represent pulmonary edema or layering pleural effusion. The right PICC line terminates in the distal SVC. There is a PA catheter and left chest tube, which appear in appropriate positioning. Although the image is severely rotated, the cardiomediastinal silhouette appears stable. IMPRESSION: 1. ET tube which terminates at the origin of the left mainstem bronchus, and should be retracted. 2. New left lung opacification, which may represent atelectasis, edema, or layering pleural effusion. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 4:54 PM, 5 minutes after discovery of the findings. " c70d304b-6e0d052a-d082bd0b-30fa8809-539ac1b3.jpg,test/p10/p10455192/s56655234/c70d304b-6e0d052a-d082bd0b-30fa8809-539ac1b3.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with respiratory failure, evaluate progression. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study obtained on ___. The previously described Dobbhoff line remains in unchanged position, seen to terminate in the upper portion of the stomach. Significant elevation of the right diaphragm persists and is unchanged. Poor inspirational effort with high positioned diaphragms explains crowded position of pulmonary vasculature. There is a plate atelectasis now seen on the left lung base. No evidence of new pulmonary parenchymal infiltrates are present and no pneumothorax is seen in the apical area. A previously existing left subclavian central venous line has been removed. " ae7ccdf1-e7d09746-418c7bc9-eedd39fb-1d8b36e6.jpg,test/p11/p11304959/s54587683/ae7ccdf1-e7d09746-418c7bc9-eedd39fb-1d8b36e6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p MitraClip, chronic aspiration and central apnea now with hypotension - patient in process of transferring to CCU, if not on floor please come to CCU // eval for interval change TECHNIQUE: Semi-upright portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: There is a pacemaker overlying the left upper chest with the wires terminating in the right atrium and right ventricle, which appears unchanged in comparison to the prior radiograph. There is a Dobhoff tube, which terminates in the stomach. There are mitral valve clips and other surgical clips noted in the upper abdomen. In comparison to the prior chest radiograph, the pulmonary vascular congestion has improved. The bilateral pleural effusions have also improved with better visualization of the right hemidiaphragm. Stable enlargement of the cardiac silhouette. The mediastinal and hilar contours are stable. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Dobhoff in appropriate positioning. 2. Improving perihilar edema and bilateral effusions. " dd2136f8-1ffd77ba-e6581e67-3e5ffc90-9c1e77f8.jpg,test/p19/p19135637/s57326587/dd2136f8-1ffd77ba-e6581e67-3e5ffc90-9c1e77f8.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man s/p R VATS wedge // R/O PTX post CT removal TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: Compared with prior radiographs on ___, there has been interval removal of a right-sided chest tube, with a very tiny right-sided pneumothorax. There is no evidence of tension. Lung volumes are low with bibasilar atelectasis, similar to prior. There is vascular congestion . The cardiac and mediastinal silhouettes are slightly decreased in size from prior. IMPRESSION: Very tiny right-sided pneumothorax status post chest tube removal. NOTIFICATION: The findings were discussed by Dr. ___ with ___ on the telephoneon ___ at the time of the findings. " 9233bff2-6ef3603b-641e0bfe-a43d387d-65833fa3.jpg,test/p15/p15147932/s50944756/9233bff2-6ef3603b-641e0bfe-a43d387d-65833fa3.jpg,test," FINAL REPORT CLINICAL HISTORY: Fluid overload. Evaluate for pulmonary edema or effusions. CHEST AP: COMPARISON: ___. The position of the various lines and tubes is unchanged since the prior chest x-ray. The left lung shows some atelectasis, but is otherwise clear. A right effusion is present, decreased in size since the prior chest x-ray. IMPRESSION: Right effusion is somewhat smaller. " e182506b-b0527211-38c3cec9-b46daa0c-cb9d8b9b.jpg,test/p16/p16286243/s51291814/e182506b-b0527211-38c3cec9-b46daa0c-cb9d8b9b.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: None. FINDINGS: PA and lateral views of the chest reviewed. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded without focal consolidation. Pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 8eb265d1-87f71c0d-dfe90fc5-47b50000-37bcb3cb.jpg,test/p15/p15040921/s55992124/8eb265d1-87f71c0d-dfe90fc5-47b50000-37bcb3cb.jpg,test," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Two views of the chest demonstrate a normal cardiomediastinal silhouette. The lungs are well aerated and clear without focal consolidation, pleural effusion, or pneumothorax. Degenerative changes of the thoracic spine are again seen. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " f199c2f5-88df6a98-be2dfc0d-d789232d-f96225fc.jpg,test/p14/p14256884/s53115194/f199c2f5-88df6a98-be2dfc0d-d789232d-f96225fc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with concern for stroke with 2 aphasic episodes, per neuro workup requesting CXR TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is top normal. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Faint patchy opacity in the retrocardiac region most likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Moderate multilevel degenerative changes are noted in the imaged thoracic spine. IMPRESSION: Retrocardiac atelectasis. " bf8b276b-05cb3c4f-68b660c0-e906e51a-e050984a.jpg,test/p18/p18855302/s54573055/bf8b276b-05cb3c4f-68b660c0-e906e51a-e050984a.jpg,test," FINAL REPORT INDICATION: ___ year old woman with advanced cervical fever and new fever to 101.6 overnight // pneumonia? COMPARISON: Radiographs from ___ IMPRESSION: A left-sided nephrostomy tube is seen. Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. " ad993f75-c54c536a-be32f5b4-1fc6b135-0abd38da.jpg,test/p13/p13148913/s57397454/ad993f75-c54c536a-be32f5b4-1fc6b135-0abd38da.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are slightly low. Heart size remains mildly enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " aa81ecb9-a8029e06-d53d4cec-fae5af64-9b1481fa.jpg,test/p17/p17552655/s53994744/aa81ecb9-a8029e06-d53d4cec-fae5af64-9b1481fa.jpg,test," FINAL REPORT INDICATION: Slurred speech. Assess for pneumonia. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation, or pneumothorax. Minimal perihilar vascular congestion is noted. There is no pulmonary edema. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is mild blunting of the right cardiophrenic angle, suggestive of pericardial fat pad, lymph node, or tiny Morgagni hernia, stable for at least one year. Partially imaged upper abdomen is unremarkable. Right lower lobe density seen on ___ exam has resolved. IMPRESSION: No evidence of acute cardiopulmonary process. " e8debe20-c5ed17ae-1b16e896-5d733937-ca2a0507.jpg,test/p16/p16525191/s52213967/e8debe20-c5ed17ae-1b16e896-5d733937-ca2a0507.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain // r/o pneumothorax COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 0b5e5514-e414299d-51c29798-45f83a49-64ae4f63.jpg,test/p11/p11199429/s56191285/0b5e5514-e414299d-51c29798-45f83a49-64ae4f63.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with anterior, bilateral chest pain // lesions? lesions? IMPRESSION: In comparison with the study of ___, there is little change. Mild hyperexpansion of the lungs without vascular congestion, pleural effusion, or acute focal pneumonia. " 5015a1d0-b1fe31fb-6aaecd6c-af119edd-09a74667.jpg,test/p18/p18418794/s52013888/5015a1d0-b1fe31fb-6aaecd6c-af119edd-09a74667.jpg,test," FINAL REPORT INDICATION: Status post laminectomy, please evaluate for pulmonary edema. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Portable chest radiograph demonstrates bilateral low lung volumes with interval resolution of pulmonary edema. Bibasilar atelectasis is evident as well as bandlike atelectasis in the right upper lobe and retrocardiac region. Cardiomegaly is stable. The appearance of widened mediastinum is decreased compared to prior study and is likely exaggerated by low lung volumes. IMPRESSION: Resolved pulmonary edema. " 777de020-3fd371ad-800fa6d4-06742c42-352f00d2.jpg,test/p14/p14486947/s52415774/777de020-3fd371ad-800fa6d4-06742c42-352f00d2.jpg,test," FINAL REPORT HISTORY: Pacemaker, prostate cancer, fall and feeling unwell with nausea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Study is somewhat limited due to patient rotation. Right-sided pacemaker device with leads terminating in the right atrium and right ventricle is again noted. The patient is status post median sternotomy and CABG. Cardiac silhouette size is normal, with a left ventricular predominance. The aorta remains tortuous and diffusely calcified. There is no pulmonary vascular congestion. Streaky left basilar opacity could reflect atelectasis or infection. No pleural effusion or pneumothorax is definitively seen. There is diffuse demineralization of the osseous structures with evidence of prior kyphoplasty of T12 with adjacent clips. IMPRESSION: Streaky left basilar opacity could reflect atelectasis but infection is not excluded. " b5c91331-daf8bbde-830a7c19-54a8bde9-497268b2.jpg,test/p16/p16132910/s51304739/b5c91331-daf8bbde-830a7c19-54a8bde9-497268b2.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient status post lung biopsy, evaluate for pneumothorax. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Moderate cardiac enlargement with left ventricular prominence as before. Generally widened and somewhat elongated thoracic aorta with calcium deposits in the wall, also unchanged. The pulmonary vasculature is not congested. There is no evidence of pneumothorax on either side in this patient who has undergone CT-guided interventional procedure earlier during the same day. IMPRESSION: No evidence of post-interventional pneumothorax. " b2a66e0a-260a1741-90b211a2-6a5e9436-344e6b48.jpg,test/p18/p18968637/s56101679/b2a66e0a-260a1741-90b211a2-6a5e9436-344e6b48.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man POD3 CABG // effusion/atlectasis COMPARISON: Chest x-ray from ___ at 14:30 FINDINGS: Compared to the prior film, inspiratory volumes are considerably improved. The cardiomediastinal silhouette is unchanged. Right pleura effusion and right base opacities are improved, with minimal residual right base atelectasis and a small right effusion still present. Collapse and/or consolidation at the left base is also improved, though not completely resolved, with minimal residual blunting of left costophrenic angle. There is mild upper zone redistribution, but no evidence of CHF. Right IJ line again seen, unchanged in position. No pneumothorax detected. IMPRESSION: Ongoing improvement in postoperative appearance. Significant interval improvement in inspiratory volumes. " 62aa52ae-1e21321b-7a50f7c9-de204996-679eed41.jpg,test/p13/p13013799/s53228608/62aa52ae-1e21321b-7a50f7c9-de204996-679eed41.jpg,test," FINAL REPORT HISTORY: Status post dual chamber pacemaker placement. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Multiple chest radiographs the most recent on ___. FINDINGS: Again seen is free intraperitoneal air under the right hemidiaphragm, likely due to recent PEG placement. Pacemaker leads are appropriately in place. The cardiomediastinal and hilar contours are normal. There is an interval increase in left retrocardiac opacity, likely related to a moderate left pleural effusion and worsening atelectasis. There is no evidence of pneumothorax. IMPRESSION: 1. Pacemaker leads appropriately in place. 2. Worsening left retrocardiac opacity, likely related to pleural effusion and worsening atelectasis. " 21bc102f-506f886e-5c616ec3-193c1989-7a2c5a64.jpg,test/p14/p14727268/s55474823/21bc102f-506f886e-5c616ec3-193c1989-7a2c5a64.jpg,test," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with HIV and HAART. fever, rule out pneumonia, PCP, ___ ___. COMPARISON: ___. FINDINGS: The lungs are clear. Left lower lobe pneumonia that was on chest x-ray of ___ has completely resolved. Mediastinal and cardiac contours are within normal limits. There is no pneumothorax or pleural effusion. CONCLUSION: There is no pneumonia. " 2f59755b-67f24a6a-5d43ffa5-b9a60b68-8c0d2b80.jpg,test/p12/p12420277/s50914678/2f59755b-67f24a6a-5d43ffa5-b9a60b68-8c0d2b80.jpg,test," FINAL REPORT INDICATION: ___-year-old male with right-sided rib pain. Evaluate for evidence of rib fracture. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are hyperinflated, without focal opacities. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. No rib fractures are identified. IMPRESSION: Unremarkable chest radiographic examination. No rib fractures are identified. Please note that this study is not tailored for accurate assessment of the ribs. If there is further clinical suspicion, dedicated rib views should be obtained. " dd3e6a36-30c56b4c-c76408ae-3c2d8cdf-6428c9c0.jpg,test/p15/p15327199/s57115012/dd3e6a36-30c56b4c-c76408ae-3c2d8cdf-6428c9c0.jpg,test," FINAL REPORT INDICATION: Persistent cough and chest pain, evaluate for pneumonia. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Cardiomediastinal and hilar contours are unchanged. There is persistent elevation of the left hemidiaphragm with mild associated atelectasis. Overall, lungs are clear without opacification concerning for pneumonia. No pleural effusion or pneumothorax identified. IMPRESSION: No acute cardiopulmonary process. " 3fb94253-46b347c8-88ac7902-61f83887-4f766fa4.jpg,test/p11/p11463988/s54282346/3fb94253-46b347c8-88ac7902-61f83887-4f766fa4.jpg,test," FINAL REPORT INDICATION: History: ___F with hx of lung ca, + myalgia, concern for hyponatremia. // eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Compared with ___, no significant change is detected. Again seen is cardiomegaly, with a calcified aorta and prominent main pulmonary artery silhouette. Slight upper zone redistribution is unchanged. No overt CHF, focal infiltrate or consolidation, pleural effusion, or pneumothorax is identified. Lungs are borderline hyperexpanded. Posttraumatic changes at the left distal clavicle are unchanged. Cervical spinal fusion hardware is in unchanged position. IMPRESSION: No radiographic evidence of pneumonia. No significant change compared with ___. " 9c3e9b1a-8ec049b1-ecf44a79-da1fc702-56f5577d.jpg,test/p14/p14347948/s50370223/9c3e9b1a-8ec049b1-ecf44a79-da1fc702-56f5577d.jpg,test," FINAL REPORT HISTORY: Post-operative right effusion. FINDINGS: In comparison with the study of ___, there is little overall change in the right pleural effusion with underlying compressive atelectasis and pigtail catheter in place. No evidence of a pneumothorax. The remainder of the study is essentially within normal limits. " e35ba0a6-34fb5888-b0428b41-3acaae7f-2778bd43.jpg,test/p17/p17716210/s56863883/e35ba0a6-34fb5888-b0428b41-3acaae7f-2778bd43.jpg,test," FINAL REPORT HISTORY: ___-year-old female with right-sided rib pain. Evaluation for fractures. COMPARISON: Chest radiograph from ___. PA AND LATERAL CHEST RADIOGRAPHS: The lungs are clear. There is no focal consolidation or pneumothorax. There is no vascular congestion or pleural effusions. Cardiomediastinal and hilar contours are within normal limits. The spinal stimulator device appears unchanged compared to prior. A gastrostomy catheter is visualized below the diaphragm terminating in the right upper quadrant. IMPRESSION: No evidence of acute cardiopulmonary process. " cd90febc-83574841-fd0d41f0-b32d9d2c-c68f019f.jpg,test/p14/p14754077/s52856262/cd90febc-83574841-fd0d41f0-b32d9d2c-c68f019f.jpg,test," FINAL REPORT HISTORY: Intubation. FINDINGS: In comparison with study of ___, there has been placement of an endotracheal tube with its tip approximately 3.2 cm above the carina. Little overall change in the appearance of the heart and lungs. " 3d7f5012-298f4d2e-06b71d66-d8e5f814-a2692fa3.jpg,test/p12/p12660416/s55613336/3d7f5012-298f4d2e-06b71d66-d8e5f814-a2692fa3.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. COMPARISON EXAM: PA and lateral chest ___, ___ and portable chest ___, ___. INDICATION: ___-year-old male with pancreatitis and fever. FINDINGS: There is a right PICC line with tip terminating in the lower SVC. The cardiomediastinal and hilar silhouettes are normal. The lungs are well expanded and clear. There is no pleural effusion, pulmonary edema, or pneumothorax. IMPRESSION: Normal chest radiographs with satisfactory position of right PICC line. " cd7c7eab-fa1a3817-21f7728f-a2656744-ebeffc54.jpg,test/p17/p17246353/s57244300/cd7c7eab-fa1a3817-21f7728f-a2656744-ebeffc54.jpg,test," FINAL REPORT INDICATION: ___F with bradycardia // acute process? TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 2082b1b4-fc8c8e3f-065d1e0d-fb0aca60-240e0109.jpg,test/p17/p17171746/s56535781/2082b1b4-fc8c8e3f-065d1e0d-fb0aca60-240e0109.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // r/o infection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac silhouette is top-normal. Mediastinal contours are grossly unremarkable. IMPRESSION: No acute cardiopulmonary process. No focal consolidation to suggest pneumonia. " 88d9daa3-f0718d57-7e622ec8-572cbc6a-3f1e6aca.jpg,test/p18/p18186439/s52112606/88d9daa3-f0718d57-7e622ec8-572cbc6a-3f1e6aca.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion, now s/p pleurex and chest tube // bleeding? pneumothorax? COMPARISON: ___ IMPRESSION: INTERVAL REMOVAL OF ENDOTRACHEAL TUBE. LEFT CHEST TUBE REMAINS IN PLACE, WITH SMALL LEFT PLEURAL EFFUSION AND PROBABLE SMALL LOCULATED PNEUMOTHORAX ADJACENT TO THE CHEST TUBE. IMPROVING CONFLUENT OPACITY IN LEFT RETROCARDIAC REGION, BUT DEVELOPMENT OF A NEW FOCUS OF AIRSPACE OPACITY IN THE LEFT APEX. CONSIDERING THE RAPID DEVELOPMENT, THIS MOST LIKELY REPRESENTS ACUTE ASPIRATION. FOLLOWUP RADIOGRAPHS MAY BE HELPFUL TO EXCLUDE DEVELOPING PNEUMONIA IN THIS REGION. " d9eeae73-4ae3c7be-1d5d41dd-d094ce95-f3f1d8dc.jpg,test/p13/p13580435/s55412572/d9eeae73-4ae3c7be-1d5d41dd-d094ce95-f3f1d8dc.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // chest pain TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Dual lead right-sided pacemaker is stable in position. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Partially imaged hardware in the proximal right humerus. Anterior wedging of a mid thoracic vertebral body is similar in appearance compared to CT from ___. IMPRESSION: No acute cardiopulmonary process. " a22117c7-2c237ec9-53d2e70c-820dcbde-f9d1fa62.jpg,test/p11/p11017660/s54398685/a22117c7-2c237ec9-53d2e70c-820dcbde-f9d1fa62.jpg,test," FINAL REPORT HISTORY: Dyspnea, hypoxia and renal failure. COMPARISON: ___. TECHNIQUE: Portable frontal chest radiograph, two views. FINDINGS: Heart size is normal with mild tortuosity of the thoracic aorta. There is prominence of the central pulmonary vasculature with trace interstitial pulmonary edema. There are increased somewhat nodular opacities in the right greater than left lung bases. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: 1. Pulmonary vascular congestion with trace interstitial edema. Mild hyperinflation. 2. Right greater than left bibasilar opacities, somewhat reticular nodular in nature, could be secondary to aspiration or infection. " 21a6b11d-deff579e-dacdbd50-bd2ab97a-cd960134.jpg,test/p17/p17051420/s55868603/21a6b11d-deff579e-dacdbd50-bd2ab97a-cd960134.jpg,test," WET READ: ___ ___ ___ 9:16 PM Peribronchiolar opacity within the right middle lobe which may reflect aspiration though early or resolving pneumonia cannot be excluded. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with recent pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates borderline enlarged heart, stable since prior examination dated ___. Hilar contours are within normal limits. No evidence of overt pulmonary edema. Wispy equivocal opacity projecting over the medial right lung base may represent an early pneumonia in the correct clinical setting. Otherwise the lungs are clear. Osseous structures demonstrate degenerative changes without an acute abnormality. IMPRESSION: Equivocal subtle opacity projecting at the medial right lung base, possibly representing an early pneumonia in the correct clinical setting. Otherwise unremarkable. " 6bfa86b8-bc2dfe78-e0cbcaef-8d5e50bb-9e3cbab6.jpg,test/p12/p12668116/s58755015/6bfa86b8-bc2dfe78-e0cbcaef-8d5e50bb-9e3cbab6.jpg,test," FINAL REPORT CHEST TWO VIEWS ON ___ HISTORY: Followup left effusion. REFERENCE EXAM: ___. Compared to the study from the prior day, there is no significant interval change. " 4009db15-4dcde838-f838be82-3567b5e6-2c24f9d0.jpg,test/p16/p16934035/s56205019/4009db15-4dcde838-f838be82-3567b5e6-2c24f9d0.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Belching, assess free air. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. No free air below the right hemidiaphragm. No signs of pneumomediastinum. Bony structures are intact. IMPRESSION: No acute findings in the chest. " ce5327bc-0b6b84e3-455fde97-d3bfaca2-6208df44.jpg,test/p19/p19088580/s50830284/ce5327bc-0b6b84e3-455fde97-d3bfaca2-6208df44.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M in MICU for AMS, please eval for interval change, PNA // ___M in MICU for AMS, please eval for interval change, PNA ___M in MICU for AMS, please eval for interval change, PNA IMPRESSION: Comparison to ___. Lung volumes have decreased. Otherwise no relevant change. Borderline size of the heart. Mild fluid overload but no overt pulmonary edema. No pneumonia, no pleural effusions. The non recent rib changes " f55d3d8e-1a9cae32-f53737ed-162dfb08-c64d6288.jpg,test/p15/p15151397/s54052899/f55d3d8e-1a9cae32-f53737ed-162dfb08-c64d6288.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // eval cariomegaly COMPARISON: None. FINDINGS: The heart is not enlarged. The cardiomediastinal silhouette is within normal limits. Slight haziness over the right heart border is likely artifact due to mild pectus excavatum configuration. No CHF, focal infiltrate, effusion, or pneumothorax detected. There is suggestion of slight left convex curvature of the thoracic spine centered at the approximate T5 level. On the lateral view, visualized vertebral body heights and vertebral body alignment is preserved. IMPRESSION: 1. Heart size normal. No acute pulmonary process identified. 2. Note made of mild pectus excavatum and slight left convex curvature of the thoracic spine. " 7efb96ef-61b0d37b-252d01ec-52b55e60-c13af6fc.jpg,test/p17/p17057667/s51239017/7efb96ef-61b0d37b-252d01ec-52b55e60-c13af6fc.jpg,test," FINAL REPORT INDICATION: Fall, evaluate for pneumothorax. COMPARISONS: None. FRONTAL AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette is mildly enlarged, and there is bilateral interstitial prominence. There is no pleural effusion or pneumothorax identified. No focal consolidation is seen to suggest pneumonia. Calcifications are seen in the aortic arch. IMPRESSION: Mild cardiomegaly and interstitial opacities compatible with mild pulmonary edema. Less likely, this could represent chronic lung disease, and correlation with EKG and cardiac enzymes is recommended. " d8506f35-84db23e9-fdd96cef-aaf5e3a5-7c4efbdc.jpg,test/p11/p11884841/s57547085/d8506f35-84db23e9-fdd96cef-aaf5e3a5-7c4efbdc.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain s/p cath on ___ // Acute cardiopulmonary process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 3fd91925-e752e8c7-e58e55ae-4fb71c57-1e5c950c.jpg,test/p10/p10611307/s54443212/3fd91925-e752e8c7-e58e55ae-4fb71c57-1e5c950c.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with hypoxia and dizziness. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are hyperinflated. There is mild bibasilar atelectatic changes are visualized but the lungs are without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. A density projecting over the left lung base appears stable and likely representative of either a calcified granuloma or a sclerotic rib lesion. Degenerative changes are visualized throughout the thoracic spine. No acute fractures are noted. IMPRESSION: No acute cardiopulmonary process. " 28d350ad-59cb126d-6f527c93-dc728ac6-dba9995b.jpg,test/p14/p14892854/s57081930/28d350ad-59cb126d-6f527c93-dc728ac6-dba9995b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " ec054828-107cf8c5-93964ae3-b93b75db-931c409b.jpg,test/p10/p10337761/s54508928/ec054828-107cf8c5-93964ae3-b93b75db-931c409b.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old female with shortness of breath and chest pain. FINDINGS: Single portable view of the chest is compared to previous exam from ___. Right PICC is no longer seen. Vascular markings are indistinct which could be in part due to technique; however, there may be a component of mild interstitial edema. Cardiomediastinal silhouette is stable given differences in positioning and technique. Osseous and soft tissue structures are unremarkable. IMPRESSION: Possible mild pulmonary vascular congestion. No significant change from prior. " 4d0cb971-0e076202-fa69f19f-3263324c-651a5aed.jpg,test/p13/p13653653/s53575036/4d0cb971-0e076202-fa69f19f-3263324c-651a5aed.jpg,test," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old woman with fever. FINDINGS: Comparison is made to prior study from ___. Heart size is within normal limits. The lungs are hyperexpanded suggesting emphysema. There are some hazy density seen at the right base; however, this does not correlate with the definite infiltrate on the lateral view. Mild degenerative changes of the thoracic spine are seen. " 69e73350-9d996aa9-7d71d300-fd70316a-a5d5289e.jpg,test/p19/p19773753/s57450024/69e73350-9d996aa9-7d71d300-fd70316a-a5d5289e.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with OSA and morbid obesity p/w labored breathing // evaluation for pulmonary edema or consolidation. TECHNIQUE: Upright AP and lateral radiograph views of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes remain slightly low with bronchovascular crowding. Nonetheless, there appears to be mild to moderate central edema. Moderate cardiomegaly is unchanged. No pleural effusion. No pneumothorax. Retrocardiac opacity may reflect atelectasis in the setting of lower lung volumes and moderate edema. IMPRESSION: Low lung volumes with probable mild-to-moderate moderate edema. " 0fec0bd8-dd9fa0b6-a85886d9-6e870257-d595536b.jpg,test/p11/p11122426/s56159177/0fec0bd8-dd9fa0b6-a85886d9-6e870257-d595536b.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with left chest pain // ?cpd TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is minor atelectasis. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. Partially imaged cervical spine hardware is noted. Some degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " c6c040e1-2c613fe2-50faefbf-55b33447-f0d1a756.jpg,test/p19/p19461413/s56084706/c6c040e1-2c613fe2-50faefbf-55b33447-f0d1a756.jpg,test," FINAL REPORT INDICATION: ___ year old woman with new NG tube // please eval NG tube placement TECHNIQUE: AP portable chest radiographs COMPARISON: ___ from earlier in the day FINDINGS: Sequential images of the chest and left upper quadrant demonstrate advancement of a feeding tube into the stomach. The tip of the endotracheal tube projects over the mid thoracic trachea. A left PICC line extends to the cavoatrial junction. Low bilateral lung volumes with unchanged pulmonary vascular congestion and bilateral pleural effusions. No pneumothorax identified. The appearance of the cardiomediastinal silhouette is unchanged. IMPRESSION: Interval advancement of the feeding tube into the gastric body. Low bilateral lung volumes with unchanged pulmonary vascular congestion, pleural effusions and overlying atelectasis. " c7b4088d-cd26b3f8-2e3d4347-b7521cb6-e13e1ed7.jpg,test/p14/p14036332/s58649963/c7b4088d-cd26b3f8-2e3d4347-b7521cb6-e13e1ed7.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: A ___-year-old man with myeloma, now with cough and shortness of breath. IMPRESSION: PA and lateral chest compared to ___ and ___: Only focal pulmonary abnormality is best appreciated on the lateral view where there is a very small cluster of irregular opacities projecting over the diaphragmatic insertion of one of the major fissures. I doubt that this is an acute pneumonia. Lungs are otherwise clear. Heart size is normal. Mild fullness in the right lower paratracheal station is due to a mildly distended azygos vein, present since at least ___. There is no good evidence for central lymph node enlargement or splenomegaly. " 6879ec77-66795318-e61328b5-880850bf-9d7e5faf.jpg,test/p11/p11144198/s58561558/6879ec77-66795318-e61328b5-880850bf-9d7e5faf.jpg,test," FINAL REPORT HISTORY: ___F with s/p arrest COMPARISON: None. FINDINGS: Portable supine AP view of the chest provided. An endotracheal tube is seen with its tip approximately 12 mm above the carina. Retraction by 1-2 cm is advised for more optimal positioning. The NG tube courses into the left upper quadrant though it's tip is excluded from this field of view. Underlying trauma board is in place. Hilar prominence is noted which could represent central congestion. The lungs appear clear though volumes are low. The heart size appears normal. Mediastinal contour is unremarkable. No acute bony injury. IMPRESSION: 1. Endotracheal tube low in position. Please retract by 1-2 cm for more optimal positioning. NG tube positioned appropriately. 2. Hilar prominence likely secondary to congestion. " 4b89b532-919e0ed6-6b93a320-0a149aed-38fc285b.jpg,test/p17/p17030279/s58367725/4b89b532-919e0ed6-6b93a320-0a149aed-38fc285b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with syncope. Evaluate for pneumonia. TECHNIQUE: Chest AP and lateral COMPARISON: ___ FINDINGS: Low lung volumes. The patient is status post median sternotomy. Unchanged cardiomegaly. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Mild cardiomegaly. No acute cardiopulmonary abnormality. " 983d93fd-4f0496eb-1e9d922b-b0914144-277dd2ac.jpg,test/p17/p17355193/s55998748/983d93fd-4f0496eb-1e9d922b-b0914144-277dd2ac.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with productive cough, history of pneumonia, decreased breath sounds in left lower lobe area. Evaluate for pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. The heart size remains unchanged and is within normal limits. Normal appearance of thoracic aorta with a few calcium deposits in the wall at the level of the arch. Pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No evidence of pneumothorax in the apical area on the frontal view. Skeletal structures of the thorax grossly unremarkable. Unchanged evidence of surgical clips in the right axillary area in this patient with history of treated breast cancer. IMPRESSION: Stable chest findings, no evidence of left lower lobe pneumonia in this patient with history of productive cough. " 1de0615a-088b1be7-9c577b19-644b7ff4-824e60b1.jpg,test/p18/p18304053/s56310430/1de0615a-088b1be7-9c577b19-644b7ff4-824e60b1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with hypertension, dyspnea on exertion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is borderline enlarged. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " fad4f48a-d98f3f98-af9fd5ea-24ca9084-a99b9a93.jpg,test/p18/p18663902/s59411169/fad4f48a-d98f3f98-af9fd5ea-24ca9084-a99b9a93.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pancreatic pseudocyst, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Monitoring and support devices are constant. Constant parenchymal opacities in both the left and the right lung. Moderate cardiomegaly. No larger pleural effusions. " a33d5821-f53489da-84940f09-efc509e2-4db15495.jpg,test/p18/p18477769/s54334068/a33d5821-f53489da-84940f09-efc509e2-4db15495.jpg,test," FINAL REPORT HISTORY: Dyspnea and stridor. COMPARISON: Chest radiograph from an outside facility performed on ___ at 00:34. FINDINGS: Chest, PA and lateral. The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiographs of the chest. " 8f86804e-a4b690b3-f00bf062-be198b5c-1dbfbc99.jpg,test/p16/p16773288/s52593285/8f86804e-a4b690b3-f00bf062-be198b5c-1dbfbc99.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Thoracic aortic aneurysm repair. COMPARISON: ___ to ___. FINDINGS: ET tube ends 6 cm above the carina. Right-sided Swan-Ganz is in right pulmonary artery. Right chest tube projects in mid hemithorax and two chest tubes are seen in the left lung, one at the apex and the other at the base. There is no pneumothorax. Bibasilar pleural effusion and atelectasis are small. Moderate cardiac contour and enlargement is stable. Mediastinal contour enlargement including the ascending aorta has not changed significantly. CONCLUSION: 1. Tubes and lines are in adequate position. 2. Unchanged small pleural effusion and bibasilar atelectasis. " a4e83f7f-8b502994-4498266b-656b9185-efd29762.jpg,test/p16/p16444272/s56930749/a4e83f7f-8b502994-4498266b-656b9185-efd29762.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with chylothorax, status post lymphangiogram, still with oxygen requirement, evaluate for interval change of effusion or contrast in the lungs. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The moderately enlarged heart appears unchanged. Thoracic aorta as before with marked extensive wall calcifications. The previously observed right-sided pleural effusion that blunts the lateral and posterior pleural sinus has again increased and reaches now to the mid portion of the right-sided lateral chest wall. On the lateral wall, the increased densities are located most posteriorly and have also increased when comparison is made between the lateral views. No new acute pulmonary infiltrates can be identified and there is no pneumothorax in the apical area. The patient has undergone a lymphangiogram on the preceding day, which showed some filling of lymphatic channels from the left leg up to the retroperitoneal structures and periaortic location. At no point was communication with the thoracic duct established. Thus, it is not surprising that any pulmonary arterial embolization with contrast particles cannot be identified on the plain chest examination. It is possible, however, that lymphangiographic material has entered in the right lower pleural and pulmonary parenchymal territory as the CT examination of ___ suggested. IMPRESSION: Mild progression of pleural density on the right base, no conclusive evidence of contrast embolization. " 0cee833f-2be4d561-61e2279f-fe03c6c8-c94b087b.jpg,test/p10/p10855190/s51345680/0cee833f-2be4d561-61e2279f-fe03c6c8-c94b087b.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISON: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: There is a moderate diffuse interstitial abnormality suggesting pulmonary vascular congestion. Otherwise, the lungs appear clear. There is no pleural effusion or pneumothorax. Mild-to-moderate relative elevation of the left hemidiaphragm compared to the right appears unchanged. The heart is mildly enlarged. The aortic arch is calcified. The mediastinal and hilar contours appear unchanged. Degenerative changes are similar along the thoracic spine. Surgical clips project along the upper abdomen. IMPRESSION: Moderate interstitial abnormality most suggestive of pulmonary vascular congestion. " 60f01c41-678b6d9a-6acb0886-ae43b3c1-e2d5abbd.jpg,test/p13/p13093114/s52675841/60f01c41-678b6d9a-6acb0886-ae43b3c1-e2d5abbd.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with fever, chest pain // eval for pneumonia COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided.There is a congested appearance of the pulmonary hila concerning for fluid overload. ___ B-lines are noted suggestive of mild interstitial pulmonary edema. No large effusion or pneumothorax. No focal opacity concerning for pneumonia. The heart size is within normal limits. Mediastinal contour is normal. The imaged bony structures appear intact. IMPRESSION: Pulmonary vascular congestion with mild interstitial pulmonary edema. " 8f122b7d-c7893b15-1d7e50fe-234eb4e1-435b9274.jpg,test/p15/p15467950/s51074007/8f122b7d-c7893b15-1d7e50fe-234eb4e1-435b9274.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Myalgia, cough and fever in HIV positive patient. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are essentially clear. Asymmetric appearance of the left apex is redemonstrated. No new consolidations to suggest infectious process have been demonstrated. IMPRESSION: No evidence of acute cardiopulmonary process within the limitations of this study technique demonstrated. " 3f79242e-8c1c36a3-6c0b907b-52d35043-1a7c24ce.jpg,test/p15/p15712408/s58116934/3f79242e-8c1c36a3-6c0b907b-52d35043-1a7c24ce.jpg,test," FINAL REPORT INDICATION: ___-year-old man with cellulitis and sudden-onset nausea, left-sided chest pain. COMPARISON: ___. FINDINGS: A single portable semi-erect chest radiograph was obtained. Lungs are well expanded and clear. No focal consolidation, effusion, or pneumothorax is present. The inferior left costophrenic angle is excluded from the field of view. The cardiac and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 74b9a6a0-13fb7e99-70c896f7-9f7db83e-e358a0c9.jpg,test/p13/p13480587/s50176524/74b9a6a0-13fb7e99-70c896f7-9f7db83e-e358a0c9.jpg,test," WET READ: ___ ___ ___ 9:50 PM Clear lungs without focal consolidation. Prominence at the AP window, underlying lymphadenopathy not excluded. Findings further assessed with a nonurgent CT. ______________________________________________________________________________ FINAL REPORT HISTORY: Hyperglycemia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is not enlarged. There is prominence of the AP window and underlying lymphadenopathy is not excluded. IMPRESSION: Clear lungs without focal consolidation. Prominence at the AP window, underlying lymphadenopathy not excluded. Assess further with a nonurgent chest CT. " f6927fb6-2a19c61d-16e91222-59e9f3a2-0ae311db.jpg,test/p16/p16366110/s58733052/f6927fb6-2a19c61d-16e91222-59e9f3a2-0ae311db.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p AVR // predischarge eval predischarge eval COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Mild pulmonary edema, mediastinal vascular engorgement, and small bilateral pleural effusions have improved since ___. Heart is mildly enlarged. No pneumothorax. " 14f62720-91ec1653-ba2755f4-5756587b-3060e225.jpg,test/p13/p13590729/s59082545/14f62720-91ec1653-ba2755f4-5756587b-3060e225.jpg,test," FINAL ADDENDUM ADDENDUM: On the reverse image, there appears to be a small apical pneumothorax following the chest tube removal. ______________________________________________________________________________ FINAL REPORT HISTORY: Chest tube removal. FINDINGS: In comparison with the study of earlier in this date, the left chest tube has been removed. No evidence of pneumothorax. Remainder of the study is essentially unchanged. " 1e24ae22-3027891c-c7bba699-0786d004-453d20de.jpg,test/p15/p15751809/s54988589/1e24ae22-3027891c-c7bba699-0786d004-453d20de.jpg,test," FINAL REPORT EXAMINATION: AP and lateral chest radiographs INDICATION: ___ year old man s/p L chest tube after T11-T12 corpectomy and multi-level fusion. // Chest tube pulled at ___. Please perform x-ray to assess for pneumothorax around ___ today. TECHNIQUE: Chest AP and lateral COMPARISON: Portable chest radiograph dated ___ at 10:02 FINDINGS: In comparison to the chest radiograph obtained 6 hours prior, there has been interval removal of the left-sided chest tube with no change in the small left apical pneumothorax. A small amount of subcutaneous emphysema is unchanged. Heart size, mediastinal silhouette, and right basilar atelectasis are unchanged. IMPRESSION: Interval removal of a left-sided chest tube with no change in the small left apical pneumothorax. " 22bbe58b-343ff5ca-7cc66266-20238c4c-dcc7f0a7.jpg,test/p10/p10900387/s56072727/22bbe58b-343ff5ca-7cc66266-20238c4c-dcc7f0a7.jpg,test," FINAL REPORT INDICATION: ___ year old man with ESRD on HD, recent HCAP now on ABx, now more tachypneic // r/o pulm edema, r/o new effusion, assess for interval change TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrate well expanded lungs. Mild bibasilar atelectasis and mild pulmonary vascular engorgement are present. Cardiomediastinal and hilar contours are unchanged. No pneumothorax or overt pulmonary edema. Right-sided PICC line ends in the cavoatrial junction. IMPRESSION: Mild bibasilar atelectasis and mild pulmonary vascular engorgement are present. No overt pulmonary edema. " 4725bdee-104742d3-c01f5831-9ad4e482-964956e5.jpg,test/p10/p10070592/s59696628/4725bdee-104742d3-c01f5831-9ad4e482-964956e5.jpg,test," FINAL REPORT HISTORY: Cough. COMPARISON: Multiple prior radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart size and cardiomediastinal contours are normal. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Normal chest radiographs. " 7cb20676-fa2f9668-25f845dd-5bd2b34a-4240d426.jpg,test/p16/p16733321/s58354519/7cb20676-fa2f9668-25f845dd-5bd2b34a-4240d426.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with chest pain. Evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: No significant interval change other than a small focal opacity in the right upper lobe which could represent a focal consolidation, mucous plugging, or areas of superimposed normal structures. No pleural effusion, edema, or pneumothorax. Cardiomediastinal silhouette is unchanged. Descending thoracic aorta calcifications are unchanged. Mild dextroconvex scoliosis of the thoracic spine is also unchanged. Moderate anterior osteophytes in the lower thoracic vertebral bodies are unchanged. An incidental azygous fissure is again noted. There is pectus excavatum. IMPRESSION: Small focal rounded opacity in the peripheral right upper lobe could reflect focal pneumonia or mucous plugging, less likely a mass given the short time course of development. Recommend treatment for infection and short interval follow-up after treatment to ensure resolution. RECOMMENDATION(S): Follow-up radiograph after treatment for pneumonia to ensure resolution of new right upper lobe opacity. " 882d1443-12e5cced-4bd477fc-b1c06aeb-58e02e4c.jpg,test/p13/p13218600/s53855775/882d1443-12e5cced-4bd477fc-b1c06aeb-58e02e4c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old female presenting for evaluation of left shoulder and back pain that has been present intermittently since ___. Negative D-dimer. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities are identified. There is dextroconvex scoliosis of the upper thoracic spine. IMPRESSION: No acute intrathoracic process. " 16311503-cdf9f158-83b46f07-19b52471-297c2e77.jpg,test/p11/p11119286/s59593142/16311503-cdf9f158-83b46f07-19b52471-297c2e77.jpg,test," FINAL REPORT INDICATION: Focal reproducible right-sided chest pain and repeated emesis. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion, pneumomediastinum, or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. Specifically, no evidence of pneumomediastinum or pneumothorax. " b8abb591-8c16eb2d-40d16fd7-b2a28cdf-60b5a00b.jpg,test/p11/p11005665/s53461154/b8abb591-8c16eb2d-40d16fd7-b2a28cdf-60b5a00b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M h/o asc aorta/aortic arch (inominate/L CCA) replacement Type A cb distal graft aneurysm s/p desc ao tube graft, reimplant subclav a with hybrid graft L Chest recon w mesh // eval for interval change eval for interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Right lung is clear and there is no right pleural or chest wall abnormality. Widening of the upper mediastinum is slightly more more pronounced now than it was at 2:48 p.m. on ___. Atelectasis and fluid in the mediastinum combine to form a continuous mediastinal contour. Small to moderate left pleural effusion is stable. Relatively little of the left lung is aerated, and the extent of severe atelectasis is unchanged over the past week. A vascular stent above the apex of the aortic arch, is unchanged in position and orientation over the past several days. No pneumothorax. Sternal wires and 2 bridging devices are unchanged in orientation and alignment. " 9b0edfdf-39ba65b3-01d1917f-df69a950-46cec2bb.jpg,test/p11/p11004450/s56823121/9b0edfdf-39ba65b3-01d1917f-df69a950-46cec2bb.jpg,test," WET READ: ___ ___ ___ 1:53 AM unchanged exam. no PNA. ___ ______________________________________________________________________________ FINAL REPORT AP CHEST, 7:44 P.M., ___ HISTORY: ___-year-old woman with AML and febrile neutropenia. IMPRESSION: AP chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces aside from elevation of left hemidiaphragm, a chronic finding. Dual-channel right supraclavicular central venous infusion set ends in the mid-to-low SVC. " e35d5404-fb9fe3bb-5d72a8d5-111304c9-25eff5d1.jpg,test/p15/p15341255/s53671657/e35d5404-fb9fe3bb-5d72a8d5-111304c9-25eff5d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p CABG, CT to waterseal at 4am-- please perform CXR after 9am ___ // f/u pneumothorax TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change in the appearance of the left apical lateral pneumothorax. This is small to moderate in size. Left chest tube is present. There small bilateral pleural effusions. Right at T8 line tip is in the SVC. The ET tube is no longer visualized. There is a moderate amount of subcutaneous emphysema in the left neck. . IMPRESSION: Persistent small to moderate left apical lateral pneumothorax. " 4ab59db2-27f23140-63a9dde8-757c5118-6b46e4b7.jpg,test/p17/p17165725/s55296206/4ab59db2-27f23140-63a9dde8-757c5118-6b46e4b7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Bacteremia, intubation, pneumonia. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pigtail catheter in the right pleural space has been pulled back substantially. There is only a small portion of the catheter located within the pleural space. The extent of the remnant right pleural fluid collection is constant. Constant atelectasis at the right lung bases. Unchanged normal appearance of the left lung. The other monitoring and support devices are constant. Moderate cardiomegaly without overt pulmonary edema. " b8eb6cdd-0ec611d8-277205c3-d1f7b10e-57187365.jpg,test/p13/p13774492/s54605295/b8eb6cdd-0ec611d8-277205c3-d1f7b10e-57187365.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with SOB // eval for PNA COMPARISON: ___ and ___ peer FINDINGS: AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process " da726505-ef4aac98-1b48e523-577cdfa6-7d62d0e5.jpg,test/p11/p11337007/s54682881/da726505-ef4aac98-1b48e523-577cdfa6-7d62d0e5.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post pulmonary valve replacement. Evaluate for cardiomegaly. COMPARISON: None. PA AND LATERAL CHEST: A pulmonary valve replacement is noted. Sternotomy wires are in normal alignment, though there is discontinuity of the inferior most sternotomy wire. The lungs are clear without focal consolidation. There is no effusion or pneumothorax. Hilar contours are normal, though the heart size is mildly enlarged. There is no pulmonary vascular congestion or pulmonary edema to suggest failure. IMPRESSION: Mild cardiomegaly with no evidence of failure. " 59a319b7-ee3c384f-171e721f-3056f40a-c0e687ac.jpg,test/p14/p14485079/s56936344/59a319b7-ee3c384f-171e721f-3056f40a-c0e687ac.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Chest tube removal in a patient with left apical pneumothorax. AP chest radiograph. As compared to the prior study, after removal of the chest tube the left apical pneumothorax is still present, although decreased. No interval pleural effusion accumulation is noted with only small amount of pleural fluid seen on the lateral view. Heart size and mediastinum are stable in appearance. " ef2186c7-e409fb60-39b82839-f80f1bc0-820a17e3.jpg,test/p14/p14558830/s57554037/ef2186c7-e409fb60-39b82839-f80f1bc0-820a17e3.jpg,test," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Followup pleural effusion. Comparison is made with study performed a day earlier. Cardiomediastinal contours are unchanged deviated towards the right side. Small right pleural effusion is unchanged. Right lower lobe atelectasis has minimally increased. The left lung is clear. Right perihilar post-radiation changes are better seen in prior CT. The left lung is grossly clear. Persistent radiolucency medially in the lower right hemithorax likely corresponds to aereated lung medial to the atelectasis, but a small pneumothorax cannot be totally excluded. " d7beac82-fbb35d0b-32a77262-a9813074-6498bec1.jpg,test/p16/p16514111/s55971549/d7beac82-fbb35d0b-32a77262-a9813074-6498bec1.jpg,test," FINAL REPORT PORTABLE CHEST ___ ___ COMPARISON: Comparison ___ radiograph. FINDINGS: Interval placement of endotracheal tube, with tip terminating 6.6 cm above the carina. Swan-Ganz catheter terminates at junction of the distal right and proximal intralobar pulmonary artery, and a nasogastric tube terminates within the stomach. Cardiomediastinal contours are within normal limits. Improving pulmonary vascular congestion. Left juxtahilar linear atelectasis as well as bibasilar patchy atelectasis is present, with otherwise clear lungs. " 383e812f-38d6c143-26c4e31e-0dcac6d4-14320120.jpg,test/p11/p11828460/s52529906/383e812f-38d6c143-26c4e31e-0dcac6d4-14320120.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p R VATS wedge biopsy s/p chest tube d/c // ? pneumothorax IMPRESSION: Since the recent study from earlier today, a moderate right pneumothorax with apical and basilar components has slightly decreased in size. Multifocal parenchymal opacities in the mid and lower lungs have slightly improved on the right and slightly worsened on the left. Intrathoracic lymphadenopathy has been more fully characterized by a recent CT. " f611609a-40270d3d-c84ae06a-d8f2291a-e9833585.jpg,test/p18/p18945267/s58775688/f611609a-40270d3d-c84ae06a-d8f2291a-e9833585.jpg,test," FINAL REPORT HISTORY: ___-year-old male with mycosis. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear of consolidation or effusion. Calcified granuloma projects over the left lung base, similar to prior. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " d0d24188-dda41b64-e5f6888e-f545079d-30220d0a.jpg,test/p18/p18386740/s56503182/d0d24188-dda41b64-e5f6888e-f545079d-30220d0a.jpg,test," WET READ: ___ ___ ___ 7:58 AM Subtle right lower lobe opacity may represent atelectasis or pneumonia in the appropriate clinical setting. WET READ VERSION #1 ___ ___ ___ 1:54 AM No acute cardiopulmonary process. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with cough. Assess for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are well inflated with subtle right lower lobe opacity. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: Subtle right lower lobe opacity may represent atelectasis or pneumonia in the appropriate clinical setting. NOTIFICATION: The updated findings were emailed to the ED ___ nurses by ___ ___, M.D. on ___ at 8:00 AM, 15 minutes after discovery of the findings. " 793c3c3f-7b464ab5-4f189068-1d10ab32-a7ed7624.jpg,test/p19/p19475729/s55696583/793c3c3f-7b464ab5-4f189068-1d10ab32-a7ed7624.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB // eval for PTX, PNA COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " e3a2abe7-cbc72e8f-766edbbd-cdb2880e-003fc598.jpg,test/p13/p13922124/s55812099/e3a2abe7-cbc72e8f-766edbbd-cdb2880e-003fc598.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with DLBCL s/p allo-HSCT ___ c/b GVHD, recently admitted with zoster and discharged, back with fever // please eval for e/o pna please eval for e/o pna IMPRESSION: Comparison to ___. No relevant change is noted. The feeding tube and the right central venous access line are in correct position. The transparent see and structure of the lung parenchyma. Is unremarkable. No pneumonia, no pulmonary edema, no pleural effusions. No pneumothorax. " c48c50c1-c7a221d4-550c3ca7-ff812084-7cc6c8cc.jpg,test/p17/p17051420/s59128711/c48c50c1-c7a221d4-550c3ca7-ff812084-7cc6c8cc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with with history of COPD who currently has had a few episodes of hemoptysis. Currently on xarelto for anticoagulation for atrial fibrillation // Concern for hemoptysis TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is substantially enlarged, unchanged. Mediastinum is stable. Lungs are essentially clear with no pleural effusion or pneumothorax. Specifically no evidence of pulmonary hemorrhage is demonstrated within the limitations of the study technique " ace44e4f-1de1915c-0f443bc3-6675bc73-a03d46e5.jpg,test/p17/p17550028/s50872242/ace44e4f-1de1915c-0f443bc3-6675bc73-a03d46e5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old male with history of alcohol abuse presents from outside hospital intubated status post seizure, with hyponatremia and acute anemia, found to have likely new diagnosis of alcoholic hepatitis, complicated by SBO, now s/p intubation and NG tube placement. // ?interval change ?evidence of pulmonary edema ?PNA ?interval change ?evidence of pulmonary edema ?PNA IMPRESSION: Comparison to ___. The monitoring and support devices are unchanged. The patient is intubated, the tip of the endotracheal tube projects approximately 4 cm above the carinal. The patient carries a right-sided PICC line. The course is unremarkable, the tip projects over the right atrium, for positioning at the cavoatrial junction, the line would need to be pulled back by approximately 2 cm. The course of the nasogastric tube is unremarkable, the tip is not included on the image. Moderate cardiomegaly retrocardiac atelectasis and mild to moderate pulmonary edema. No pneumothorax. " 5996c90a-05c7f4f6-70843b2d-f80dffe1-e3bef557.jpg,test/p11/p11865423/s52253475/5996c90a-05c7f4f6-70843b2d-f80dffe1-e3bef557.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with headache general maliase // eval for pna COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are quite low. Increased pulmonary opacities could reflect crowding of bronchovascular STIR in the setting of low lung volumes. Difficult though to exclude a component of edema or pneumonia. No large effusion or pneumothorax is seen. The overall cardiomediastinal silhouette appears grossly unchanged. Bony structures are intact. IMPRESSION: Limited due to low lung volumes, difficult to exclude mild edema or pneumonia. Recommend repeat with more optimal inspiratory effort. " fb67f528-0bb5bce4-ec2888af-d845657e-e282eee4.jpg,test/p13/p13657911/s50763764/fb67f528-0bb5bce4-ec2888af-d845657e-e282eee4.jpg,test," FINAL REPORT HISTORY: Right upper lobectomy, to assess for change. FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. Cardiac silhouette is within normal limits and there is no vascular congestion or pleural effusion. There is elevation of the right hemidiaphragmatic contour consistent with prior right upper lobectomy. However, no evidence of acute pneumonia or other pulmonary abnormality. " 5d25385f-5c56a53d-130cf087-7eea3483-7b28a71d.jpg,test/p19/p19810919/s57668976/5d25385f-5c56a53d-130cf087-7eea3483-7b28a71d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h.o asthma and smoking and nodule seen on last cxray. Reassessing // Assess for progression of nodule seen on prior cxray TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary abnormality. " c244a475-9bb49f08-874be4d6-3ea4bc27-1e7baec1.jpg,test/p11/p11962176/s52109960/c244a475-9bb49f08-874be4d6-3ea4bc27-1e7baec1.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Fever and the wound dehiscence and infection for 2 days. Evaluate for infectious process. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Prior chest radiographs from ___ and ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is mild calcification around the aortic arch. There is mild streaky atelectasis at the lung bases. Otherwise, the lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " b2ca4252-6e5bd102-6a072d5e-81260c98-07b21355.jpg,test/p15/p15487342/s52090895/b2ca4252-6e5bd102-6a072d5e-81260c98-07b21355.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY. INDICATION: Patient with asthma, ground-glass opacities on CT. Progression of the disease? COMPARISON: X-rays from ___ to ___, chest CT of ___. FINDINGS: Bilateral lung opacities, right more than left, have slightly improved mainly in the right upper lobe. There are still some atelectatic bands in the left mid lung. There is no pneumothorax or pleural effusion. Mediastinal and cardiac contours are top normal and unchanged. Right-sided PICC line ends at cavoatrial junction. CONCLUSION: Slight improvement of widespread bilateral lung opacities which were mainly ground-glass opacities and atelectatic bands on recent CT. " cbc294fa-72a50ca7-548db3e1-6afd4525-7f8cd0f7.jpg,test/p12/p12381610/s57440140/cbc294fa-72a50ca7-548db3e1-6afd4525-7f8cd0f7.jpg,test," FINAL REPORT HISTORY: Seizures. TECHNIQUE: Portable frontal chest radiograph single-view. COMPARISON: None available. FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. There is minimal opacity in the right costovertebral sulcus which is likely atelectatic however may represent minimal aspiration. Lungs are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: Minimal opacity at the right costovertebral sulcus which is likely atelectatic however may represent mild aspiration. " dbbd7560-56f65b0b-fe6b33b8-ce42eb42-93013fcf.jpg,test/p15/p15239201/s53658064/dbbd7560-56f65b0b-fe6b33b8-ce42eb42-93013fcf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis and pleural effusions and ?PNA on prior CXR // Assess for worsening pleural effusion, pulm edema, or infiltrates Assess for worsening pleural effusion, pulm edema, or infiltrates IMPRESSION: Comparison to ___. No relevant change. Moderate signs of mild to moderate pulmonary edema. Low lung volumes. Mild cardiomegaly. No evidence of pneumonia. " 4dbe64ff-6d8f2c21-32eef061-059a8ee5-6f1ddbcc.jpg,test/p15/p15684838/s51639281/4dbe64ff-6d8f2c21-32eef061-059a8ee5-6f1ddbcc.jpg,test," FINAL REPORT EXAMINATION: Portable AP chest radiograph. INDICATION: ___-year-old woman with pneumonia. Evaluate for pulmonary edema. TECHNIQUE: Portable AP chest radiograph. COMPARISON: Multiple prior chest radiographs, most recent from ___.Chest CT from ___. FINDINGS: Left IJ catheter is in unchanged position, terminating in the mid SVC. Interval removal of a right IJ catheter, endotracheal tube, and nasogastric tube. Stable low lung volumes bilaterally. Stable, small, bilateral pleural effusions with adjacent relaxation atelectasis appears unchanged compared to the prior chest CT from ___. Stable, borderline engorgement of the mediastinal veins. No pulmonary edema. IMPRESSION: Stable, small bilateral pleural effusions with adjacent relaxation atelectasis. " b23d12cf-a1a42985-01929f61-53d55196-b32b2dcc.jpg,test/p11/p11177152/s54644380/b23d12cf-a1a42985-01929f61-53d55196-b32b2dcc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Prior exam dated ___ ___M with pleuritic R posterior thoracic back pain, dyspnea, decreased breath sounds RL base COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lung volumes are low with bibasilar atelectasis noted. No convincing evidence for pneumonia though lung bases are poorly assessed due to presence of atelectasis. No large effusion or pneumothorax. No convincing signs of edema or congestion. Heart size is difficult to assess. Mediastinal contour is normal. Bony structures are intact. Prominent spurs are noted anteriorly in the lower T-spine. IMPRESSION: Bibasilar atelectasis. No convincing signs of pneumonia. " 9589fc0b-5aa4ddd0-58b7a0e8-c7f1ae6e-84636374.jpg,test/p11/p11971081/s55491977/9589fc0b-5aa4ddd0-58b7a0e8-c7f1ae6e-84636374.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with history of metastatic RCC, right pleural effusion. Presenting with worsening dyspnea. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in the upright position. COMPARISON: CT scan from ___. FINDINGS: Large right pleural effusion has increased with associated right lung collapse. Small left pleural effusion is also seen. Numerous mediastinal adenopathy consistent with previous tumor burden seen on last CT scan. No focal consolidation or pulmonary edema is seen. IMPRESSION: Increased right pleural effusion with associated right lower lobe collapse. Small left pleural effusion. Mediastinal tumor metastases as seen in previous CT scan. " 3eddce09-0d773068-cad74c48-07b6bd7a-4a0b31f7.jpg,test/p19/p19770723/s58369470/3eddce09-0d773068-cad74c48-07b6bd7a-4a0b31f7.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent pneumonia, evaluation for changes. COMPARISON: ___. FINDINGS: History of left lower lobe pneumonia. The current radiograph is unremarkable. There is no evidence of pneumonia in the left lower lobe. All previous changes have completely resolved. No evidence of complications. No pleural effusions. No adenopathy. Normal size of the cardiac silhouette. " 1e8f7682-2efc9fd0-f8e53d04-538b66fd-5d2d88e1.jpg,test/p11/p11051429/s51276026/1e8f7682-2efc9fd0-f8e53d04-538b66fd-5d2d88e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with right facial droop, cough TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph, chest CTA ___ FINDINGS: Left-sided pacemaker device is again noted with leads terminating in the right atrium and right ventricle. Moderate enlargement of the cardiac silhouette is again noted. The aorta remains tortuous. Mediastinal and hilar contours are somewhat. Mild pulmonary vascular congestion is noted with patchy bibasilar opacities, left greater than right, likely reflective of atelectasis, but infection cannot be excluded in the left lung base. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is seen. Surgical clips are again noted at the thoracic inlet suggestive of prior thyroid surgery. IMPRESSION: Mild pulmonary vascular congestion. Probable bibasilar atelectasis however infection in the left lung base cannot be completely excluded " ddaff12b-6b0e827f-6c8f34e0-0375390f-0c55ab0b.jpg,test/p18/p18700581/s54249567/ddaff12b-6b0e827f-6c8f34e0-0375390f-0c55ab0b.jpg,test," FINAL REPORT INDICATION: Trauma. TECHNIQUE: Single supine view of the chest. COMPARISON: None. FINDINGS: There is elevation of the right hemidiaphragm. Streaky right basilar opacities are likely secondary to atelectasis. Elsewhere, the lungs are clear. There is no obvious pneumothorax on this supine film. The cardiomediastinal silhouette is within normal limits. No displaced fractures. IMPRESSION: No acute cardiopulmonary process. " 876d1816-bf770028-cdbe046e-cf03f795-2873846e.jpg,test/p13/p13471464/s57135068/876d1816-bf770028-cdbe046e-cf03f795-2873846e.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Weakness, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires and prosthetic cardiac valve are again noted. The lungs appear clear. There is no pleural effusion or pneumothorax. Kyphoscoliosis somewhat limits evaluation. There is tracheobronchial tree calcification. No pneumothorax or pleural effusion is seen. Old right rib deformities are noted. Otherwise, the imaged bony structures appear unremarkable. IMPRESSION: No acute findings in the chest. " af57cd04-89338c37-d70f96d7-c5cf9970-a1af03d2.jpg,test/p16/p16428118/s50930638/af57cd04-89338c37-d70f96d7-c5cf9970-a1af03d2.jpg,test," FINAL REPORT INDICATION: ___-year-old man with respiratory failure, assess for interval change. COMPARISONS: Chest radiograph from one day prior. AP portable supine radiograph was obtained. Endotracheal tube terminates 5 cm above the carina. Nasogastric tube terminates in the proximal stomach as in the previous examination. Right internal jugular central venous catheter ends in the distal SVC. Mild pulmonary edema is mildly improved with unchanged cardiomegaly and small left greater than right pleural effusions and atelectasis. IMPRESSION: Mild improvement in pulmonary edema with unchanged basal atelectasis and small effusions. " f9efedc9-cae960fb-e176c2c4-d8348646-cfcf1aa5.jpg,test/p10/p10866613/s55766852/f9efedc9-cae960fb-e176c2c4-d8348646-cfcf1aa5.jpg,test," FINAL REPORT HISTORY: Asthma and cough. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Cardiac silhouette is within normal limits, and there is no acute pneumonia or vascular congestion or pleural effusion. " 796006de-5793cc7c-2cedf5b0-919ed57a-df60d4f6.jpg,test/p12/p12483723/s54292691/796006de-5793cc7c-2cedf5b0-919ed57a-df60d4f6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with LLL pneumonia ___. Evaluate for clearing of pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, and ___. FINDINGS: The left lower lobe pneumonia has resolved. The heart, lungs, hila, mediastinum, and pleural surfaces are normal. IMPRESSION: Interval resolution of the left lower lobe pneumonia. " f92d8040-02ceb4d1-dc1c240b-32f98ede-c6b1cd8f.jpg,test/p10/p10291112/s57649587/f92d8040-02ceb4d1-dc1c240b-32f98ede-c6b1cd8f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F intubated eval for cardiopulm change // ___F intubated eval for cardiopulm change IMPRESSION: With the exception of slight decrease in size of bilateral pleural effusions, there has not been a relevant change in the appearance of the chest since the previous study of 1 day earlier. " e0147bdb-f5b890f8-0bee59ea-721a1a08-e3e1ab8c.jpg,test/p15/p15354831/s52870956/e0147bdb-f5b890f8-0bee59ea-721a1a08-e3e1ab8c.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with generalized weakness. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Slightly lower lung volumes seen on the current exam with secondary crowding of the bronchovascular markings. The lungs, however, remain clear of consolidation or effusion. The cardiac silhouette is slightly enlarged, likely accentuated by technique and lower lung volumes. S-shaped thoracic scoliosis is identified. IMPRESSION: No acute cardiopulmonary process. " 8176ce11-24b86c61-57f701ae-59441bc8-766563fe.jpg,test/p10/p10337761/s52796605/8176ce11-24b86c61-57f701ae-59441bc8-766563fe.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status. History of HIV. COMPARISONS: Prior radiographs from ___ and more recent ones from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear similar to earlier baseline radiographs. Right basilar opacification has resolved. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable aside from minimal degenerative changes. IMPRESSION: No evidence of acute disease. " ccbe3c16-ccd7f719-5f4b467e-4b115a7e-74513f1b.jpg,test/p18/p18026405/s50532055/ccbe3c16-ccd7f719-5f4b467e-4b115a7e-74513f1b.jpg,test," WET READ: ___ ___ ___ 3:05 PM 1. Patchy bibasilar opacities may represent aspiration, atelectasis or pneumonia. 2. No evidence of fracture, limited by lack of localizing history. 3. Severe degenerative change at the right glenohumeral joint, unchanged. WET READ VERSION #1 ___ ___ ___ 9:42 AM 1. No focal consolidation. 2. No evidence of fracture limited by lack of localizing history. 3. Severe degenerative change at the right glenohumeral joint, unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with mechanical fall and productive cough // ?pneumonia, rib fracture TECHNIQUE: AP and lateral views. COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes are low. Patchy bibasilar opacities are noted. No pleural effusion. Severe degenerative change at the right glenohumeral joint. No displaced rib fracture is seen, but exam is limited by low lung volumes and AP technique. . IMPRESSION: 1. Patchy bibasilar opacities may represent aspiration, atelectasis or pneumonia. 2. No evidence of acute, displaced rib fracture or pneumothorax. 3. Severe degenerative change at the right glenohumeral joint, unchanged. RECOMMENDATION(S): Repeat chest radiograph with improved technique is recommended when the patient is clinically able. NOTIFICATION: The updated findings were discussed by Dr. ___ with Dr. ___ on ___ at 3:05 PM, 10 minutes after discovery of the findings. " fbc8941f-49470b89-67fbcb5c-5ef2019d-cc8d5469.jpg,test/p16/p16517237/s56838651/fbc8941f-49470b89-67fbcb5c-5ef2019d-cc8d5469.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pneumonia, evaluation for interval change. COMPARISON: ___, 4:38 a.m. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Moderate cardiomegaly with minimal non-characteristic scarring at the right lung base but no evidence of recent pneumonia or pulmonary edema. Pleural effusions, if any, are minimal. The monitoring and support devices are constant. " fe5ade20-832e5f10-2fcedcb6-4c3c8557-e8bfb513.jpg,test/p18/p18828251/s51246566/fe5ade20-832e5f10-2fcedcb6-4c3c8557-e8bfb513.jpg,test," FINAL REPORT CHEST RADIOGRAPH: INDICATION: Non-healing lower extremity ulcers, preoperative radiograph. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing right upper lobe pneumonia is completely resolved. The pre-existing signs of mild fluid overload, however, are still present. The pre-existing cardiomegaly is unchanged. Several calcified lung nodules are also unchanged. Unchanged alignment of the sternal wires. No acute pneumonia, no pleural effusions. " 80278965-530771cc-7e724191-8f50bdb3-8141883e.jpg,test/p11/p11129702/s55569901/80278965-530771cc-7e724191-8f50bdb3-8141883e.jpg,test," WET READ: ___ ___ ___ 6:15 PM L PICC and R IJ end at cavoatrial junction. Low lung volumes. Bibasilar atelectasis. Pneumoperitoneum, expected post surgery. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:48 P.M., ___ HISTORY: ___-year-old man after gastric surgery. Confirm PICC placement. IMPRESSION: AP chest compared to ___: Left PICC line ends at level 6.5 cm below the carina and would need to be withdrawn 2.5 cm to place it low in the SVC. Right internal jugular line ends in the upper right atrium at level 5 cm below the level of the carina. Mild bibasilar atelectasis is new. Upper lungs clear. No appreciable pleural effusion or indication of pneumothorax. Heart size normal. " 2a103e8a-7cd11d2a-3d8ced4a-62341290-5e2d8c54.jpg,test/p16/p16971820/s59751002/2a103e8a-7cd11d2a-3d8ced4a-62341290-5e2d8c54.jpg,test," WET READ: ___ ___ ___ 9:22 PM Enteric tube 6.5 cm above the carina. A left MediPort terminates in the lower SVC. There is new mild to moderate pulmonary edema with new mild cardiomegaly. No pneumothorax. Hilar lymphadenopathy again appreciated. ______________________________________________________________________________ FINAL REPORT AP CHEST, 7:22 P.M. ON ___ HISTORY: A ___-year-old man for high-grade SBO and bowel ischemia. IMPRESSION: AP chest compared to ___ at 7:22 p.m.: Previous mild pulmonary edema has progressed to severe global pulmonary consolidation, exaggerated by probable new posteriorly layering pleural effusions, small to moderate on the left, indeterminate on the right. Heart size is normal. Endoscope ends at the subcarinal level in the midline. ET tube tip at the thoracic inlet in standard placement, left subclavian infusion port ends in the low SVC, right subclavian line in the upper SVC. Thin-bore catheter tubing curled over the cardiac silhouette, tip projecting over the right atrium is unclear, unless it is a pericardial catheter. Upper enteric drainage tube ends in the upper stomach but would need to be advanced 10 cm to move all the sideports below the GE junction. Second endoesophageal device, ending in the distal esophagus is either a thermometer or manometer. Heart size is normal. No pneumothorax. " 35d1eeb4-3094353e-a26782e1-01cb9d16-17933653.jpg,test/p14/p14014948/s53520057/35d1eeb4-3094353e-a26782e1-01cb9d16-17933653.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // infiltrate? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiomediastinal contours are unchanged. Lines and tubes are in unchanged standard position. Right lower lobe atelectasis has improved otherwise lungs are clear. There is no pneumothorax or pleural effusion " c1b6e220-2fe6fe36-4f691b48-e9d37acd-1f969972.jpg,test/p11/p11786671/s58078123/c1b6e220-2fe6fe36-4f691b48-e9d37acd-1f969972.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with prior picc line. // to ensure proper picc position to ensure proper picc position IMPRESSION: Compared to chest radiographs ___. Indwelling right PIC line ends in the low SVC. Lungs clear. Heart size normal. No pleural abnormality. Hilar and mediastinal contours unremarkable. " 1ef64d55-b80da23e-67810283-ad56b0ab-22c83b5b.jpg,test/p18/p18767957/s50744964/1ef64d55-b80da23e-67810283-ad56b0ab-22c83b5b.jpg,test," FINAL REPORT INDICATION: Hypoxia. COMPARISON: Chest radiographs from ___, ___, ___, and ___. FINDINGS: A portable frontal chest radiograph demonstrate an unchanged cardiomediastinal silhouette, which is top-normal in size. Bilateral opacities are consistent with moderate pulmonary edema. No definite focal consolidation or pneumothorax is identified. There are likely trace bilateral pleural effusions. IMPRESSION: Moderate pulmonary edema. " cf99f071-d82283d8-be300f44-65655397-ed55b3e8.jpg,test/p11/p11805066/s54907688/cf99f071-d82283d8-be300f44-65655397-ed55b3e8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new endobronchial stent // ? interval change after endobronchial stent ? interval change after endobronchial stent IMPRESSION: In comparison with the study of ___, there is an placement of an endotracheal tube with its tip approximately 6 cm above the carina. Extensive right upper lobe mass inferiorly displacing the minor fissure is essentially unchanged. The left perihilar round opacification is less well seen on the current study. " b55faad8-b6b80ec3-cd9d5254-2266c763-7d9981c7.jpg,test/p19/p19891680/s58475634/b55faad8-b6b80ec3-cd9d5254-2266c763-7d9981c7.jpg,test," FINAL REPORT INDICATION: ___-year-old man with vagus nerve stimulator which has been disconnected, but the ED lead remains in place. Evaluate lead to determine whether it is safe to have spine MRI. TECHNIQUE: Chest PA and lateral. Soft tissue neck AP and lateral. COMPARISON: None available. FINDINGS: A disconnected left vagus nerve stimulator lead is in place. Chest: Cardiac, mediastinal, and hilar contours are within normal limits. There is no evidence for pulmonary consolidation, pulmonary edema, pleural effusion, or pneumothorax. There are endplate degenerative changes in the thoracic spine and a mild dextroconvex curvature in the upper thoracic spine. Neck: The contours of the aerodigestive tract are unremarkable. There are multilevel degenerative changes in the cervical spine, including minimal retrolisthesis at C3-C4 and C4-C5, and bilateral uncovertebral spurring from C4-C5 through C6-C7. IMPRESSION: 1. A disconnected left vagus nerve stimulator lead is in place. 2. Degenerative changes in the cervical and thoracic spine. " f5a70623-658c86aa-de42fe8a-a7a10f5f-ef38064f.jpg,test/p13/p13977634/s50237024/f5a70623-658c86aa-de42fe8a-a7a10f5f-ef38064f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Cough. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. The aorta is slightly tortuous, but no focal dilatation is seen. Post-sternotomy wires are stable. Lungs are essentially clear although hyperinflated. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary process demonstrated. " f32682c3-f428e6e8-2598dd94-c46a028c-35a77c79.jpg,test/p13/p13332086/s59177179/f32682c3-f428e6e8-2598dd94-c46a028c-35a77c79.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o schizoprenia receiving ECT inpatient s/p fall off stationary bike. Pain R chest wall below axilla. // r/o rib fracture for ECT clearance r/o rib fracture for ECT clearance COMPARISON: Comparison to ___ at 22:57 FINDINGS: PA and lateral views of the chest ___ at 13 57 are submitted. IMPRESSION: The lungs are well inflated without evidence of focal airspace consolidation. A linear opacity at the left costophrenic angle either represent scarring or subsegmental atelectasis. Overall cardiac mediastinal contours are stable. No definite displaced rib fracture is seen. However, there is slight irregularity of the lateral aspect of the right anterior eighth rib. A dedicated rib series may be helpful to entirely exclude a injury in this vicinity as this is in the area of concern per housestaff. No pulmonary edema. No pneumothorax or pleural effusions. NOTIFICATION: Results were communicated to the patient's house staff, Dr. ___ By phone on ___ at 14:20. " 7e349f96-2d258657-1743b0ab-14fbe8cc-a96e6f54.jpg,test/p18/p18325765/s58927079/7e349f96-2d258657-1743b0ab-14fbe8cc-a96e6f54.jpg,test," FINAL REPORT HISTORY: CHF. FINDINGS: In comparison with the study of ___, there is stable substantial enlargement of the cardiac silhouette without definite vascular congestion. This discordance raises the possibility of cardiomyopathy or pericardial effusion. No acute focal pneumonia identified. " ef0a0fe6-b0fe5dc8-fc8bc4a2-0003e69d-a8f0cb7b.jpg,test/p18/p18591791/s59846823/ef0a0fe6-b0fe5dc8-fc8bc4a2-0003e69d-a8f0cb7b.jpg,test," FINAL REPORT INDICATION: Pleuritic chest pain and difficulty breathing. COMPARISONS: Chest radiograph of ___. FINDINGS: AP and lateral views of the chest demonstrate normal lung volumes. There is no focal consolidation, pleural effusion or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Imaged osseous structures are intact. Multiple metallic densities project over right glenoid fossa. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " b51c9879-bbca7156-e702d4f5-a2e35afa-abbc28fb.jpg,test/p18/p18148412/s53048059/b51c9879-bbca7156-e702d4f5-a2e35afa-abbc28fb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETOH abuse presenting with GNR sepsis, intubated and unable to wean from ventilator // please assess for pulmonary edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 3.5 cm above the carinal. NG tube tip is in the stomach. Right internal jugular line tip is at the lower SVC. Cardiomediastinal silhouette is unchanged. There is interval development of moderate to severe pulmonary edema associated with large bilateral pleural effusions. " b43782c1-882e33ff-d311a901-0af245a1-3f15ff8d.jpg,test/p13/p13568806/s50201711/b43782c1-882e33ff-d311a901-0af245a1-3f15ff8d.jpg,test," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Single portable semi-erect chest view was read in comparison with prior chest radiographs through ___ with the most recent from ___. FINDINGS: Since ___ mild interstitial edema and azygos distention suggesting volume overload with cardiac decompensation has substantially improved. Heart size is normal. There are no new lung opacities concerning for pneumonia. There is no pleural abnormality. Mediastinal and hilar contours are stable. " 7525d306-39275a81-18b7e52f-f62eacf8-6addb595.jpg,test/p12/p12878814/s54512818/7525d306-39275a81-18b7e52f-f62eacf8-6addb595.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusions s/p chest tubes b/l // pneumothorax TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 10:43 IMPRESSION: Bilateral pigtail catheters has been placed with slight interval decrease in pleural effusion. Pulmonary edema and bibasal consolidation is unchanged as well as the position of the right central venous line. Minimal right apical pneumothorax cannot be excluded. " 6f7efee9-7e621fb0-bb890d61-9cd38d60-ad1886c0.jpg,test/p12/p12643221/s59957368/6f7efee9-7e621fb0-bb890d61-9cd38d60-ad1886c0.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with weakness, evaluate for pneumonia. TECHNIQUE: Portable frontal chest radiograph was obtained. COMPARISON: Chest x-ray from ___ FINDINGS: Lung volumes are low, which leads to bronchovascular crowding. Poorly defined opacities in the left mid and lower lung are new, superimposed on pre-existing linear scarring. Left hemidiaphragm remains mildly elevated compared to the right. There is no pneumothorax, but left apex is obscured by overlying soft tissue structures of the chin and neck, precluding assessment for left apical pneumothorax or parenchymal process in this region. IMPRESSION: Low lung volumes. Poorly defined left mid and lower lung opacities could reflect atelectasis or developing infectious pneumonia. Standard PA and lateral chest radiographs would be helpful for more complete assessment of these findings when the patient's condition permits. . " af823246-9685863d-6ed30afb-2093f1b4-0c4e201b.jpg,test/p14/p14811844/s58441991/af823246-9685863d-6ed30afb-2093f1b4-0c4e201b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MI. // Comparison to previous Comparison to previous COMPARISON: Comparison to prior study of ___ at 03:37 FINDINGS: Portable supine image of the chest is submitted. The lung bases and costophrenic angles are not entirely included on the study. IMPRESSION: Given these limitations, bibasilar patchy opacities may reflect atelectasis although pneumonia or aspiration should also be considered. No evidence of pulmonary edema. No large pneumothorax, although the sensitivity to detect pneumothorax is diminished given supine technique. A more focal nodular opacity at the right lung base most likely represents a nipple shadow and could be better assessed on followup imaging. There has been interval resolution of the mild interstitial edema seen on the previous study. A densely calcified opacity at the left apex appears to be either related to the second anterior rib or be pleural in location when correlated with the ___ film study from ___ at 00:52. Correlation with more remote studies would be helpful. " a458707e-bdc29bb1-75db6a23-b1ae2595-e5d2914b.jpg,test/p14/p14591676/s52590378/a458707e-bdc29bb1-75db6a23-b1ae2595-e5d2914b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion // Pleural effusion Surg: ___ (Thoracoscopy) Pleural effusion IMPRESSION: In comparison with the study of ___, there is mild further expansion of the large left pleural effusion. Continued enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure. No evidence of acute focal pneumonia. " 5747ca2e-6eb8a61f-4dff312e-8124abeb-bc89e082.jpg,test/p19/p19457990/s52286159/5747ca2e-6eb8a61f-4dff312e-8124abeb-bc89e082.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever // please eval for pneumonia, other pulmonary process COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 2a9482d0-ea084ed7-4dae75c5-a5811483-67e09c03.jpg,test/p13/p13628037/s54872639/2a9482d0-ea084ed7-4dae75c5-a5811483-67e09c03.jpg,test," WET READ: ___ ___ ___ 5:29 PM Reticulonodular opacities in the left lung base not seen on ___ may represent focal infection. No pleural effusion, pneumothorax or pulmonary edema. ______________________________________________________________________________ FINAL REPORT HISTORY: AML status post allogenic stem cell transplant complicated by deep neck soft tissue infection and now desaturating. COMPARISON: ___. TECHNIQUE: Portable frontal chest radiograph, two views. FINDINGS: The heart size is normal. Cardiomediastinal silhouette and hilar contours are unchanged. A large bore tunneled right IJ central venous catheter terminates at the low SVC. There is increased heterogeneous consolidation at the left lung base, worrisome for infection. The right lung is essentially clear. There is no large pleural effusion or pneumothorax. IMPRESSION: Heterogeneous left lung base consolidation worrisome for infection. A wet read was entered into the system by Dr. ___ on ___ 5:29 PM. " ddc128a7-60c9d82d-ee24eacf-64ca0a74-0398ebcb.jpg,test/p19/p19885929/s53728849/ddc128a7-60c9d82d-ee24eacf-64ca0a74-0398ebcb.jpg,test," WET READ: ___ ___ ___ 5:14 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with severe dysphagia x 7 days, // pneumomediastinum? esophageal pathology? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No evidence of pneumomediastinum. No acute osseous abnormalities are identified. IMPRESSION: No acute cardiopulmonary process. " c29596b2-867fa228-5d9ce1da-0defe41e-071146c8.jpg,test/p12/p12251785/s58664514/c29596b2-867fa228-5d9ce1da-0defe41e-071146c8.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of hypertension. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is interval removal of a right-sided dialysis catheter. There is persistent elevation of the right hemidiaphragm, with overlying atelectasis. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Persistent elevation of the right hemidiaphragm without acute cardiopulmonary process seen. " 7e386662-d330df30-587f5956-7f02c8a4-10e8aa3d.jpg,test/p13/p13434571/s59470587/7e386662-d330df30-587f5956-7f02c8a4-10e8aa3d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough for 3 weeks // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal contours are remarkable for a tortuous thoracic aorta. The pulmonary vasculature is normal. Lungs are clear except for a subtle new opacity at the left lung base posteriorly overlying the spine on the lateral radiograph. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Asymmetrical degenerative changes at the first left costochondral junction appear unchanged. IMPRESSION: New posterior basilar segment left lower lobe opacity could reflect an early or resolving pneumonia. RECOMMENDATION(S): Followup chest radiograph in 4 weeks to document resolution. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 10:37 into the Department of Radiology critical communications system for direct communication to the referring provider. " b1d79cd4-24e39545-5e193fd1-767adb0d-24ded2cc.jpg,test/p18/p18536004/s52203146/b1d79cd4-24e39545-5e193fd1-767adb0d-24ded2cc.jpg,test," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with chronic obstructive asthma, never smoker, with ongoing shortness of breath, wheezing, cough // any infiltrate or edema TECHNIQUE: Chest PA and lateral COMPARISON: PA and lateral chest radiographs dated ___ FINDINGS: Chest radiographs obtained ___, no significant changes are appreciated. Lungs are fully expanded and clear without consolidations or effusions. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal. IMPRESSION: No radiographic evidence of pneumonia, pulmonary edema, or other significant cardiopulmonary abnormalities. " 5597c0f2-a27a1ce5-1ce12bb4-d90d0ab4-92e932ff.jpg,test/p11/p11232789/s50317834/5597c0f2-a27a1ce5-1ce12bb4-d90d0ab4-92e932ff.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ y.o F with dyspnea on exertion, healthy, recently on dapsone COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is mild bibasilar atelectasis. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " ac1d0a04-a8c518cf-beba021f-95ec1a2d-a66b162f.jpg,test/p18/p18680835/s57382168/ac1d0a04-a8c518cf-beba021f-95ec1a2d-a66b162f.jpg,test," FINAL REPORT HISTORY: Chest tube, on suction. FINDINGS: In comparison with the study of ___, the degree of pneumothorax has increased. This information was telephoned to Dr. ___. Otherwise, there is little overall change with some residual atelectasis at the bases and subcutaneous gas along the right lateral chest wall. " bae4a1b8-62626514-4a4708b8-d877680a-bfb49a1e.jpg,test/p11/p11922514/s50340307/bae4a1b8-62626514-4a4708b8-d877680a-bfb49a1e.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis, hypoxemia // pre VQ scan COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has made a stronger inspiratory effort. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. No pneumonia, no pulmonary edema. No focal lung lesions. " aa709c44-9cc62366-2e4aca98-686ff41b-bf9dd412.jpg,test/p17/p17339400/s57233109/aa709c44-9cc62366-2e4aca98-686ff41b-bf9dd412.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with r/o sarcoidosis // follow up on history of sarcoidosis TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is bulky asymmetry of the right hilum. There is also an asymmetry abutting the lower right peritracheal stripe. Mild enlargement of the cardiac silhouette. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Asymmetry of right hilum and right peritracheal stripe, likely representing lymphadenopathy. Recommend CT with contrast to further characterize these abnormalities. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 16:13 into the Department of Radiology critical communications system for direct communication to the referring provider. RECOMMENDATIONS: Recommend CT with contrast . " 6060ae56-99a2e711-2c686d45-24f7adcb-e3ea3454.jpg,test/p13/p13849733/s51332489/6060ae56-99a2e711-2c686d45-24f7adcb-e3ea3454.jpg,test," FINAL REPORT STUDY: CHEST RADIOGRAPH INDICATION: Pneumonia persistent right pleural effusion, now worsening tachypnea and heart failure. TECHNIQUE: Portable AP radiograph was obtained. COMPARISON: ___ REPORT: Pulmonary hyperinflation is noted. There is a right-sided pleural effusion which is moderate which may have a loculated component. Multiple rib fractures on the right side is seen. There are biapical fibrocalcific changes with definite evidence of some volume loss, and likely scarring. There is some tracheal dilatation also which may be tractional. In addition to this, there is some superimposed likely pulmonary edema just change. There is sparing of the left base. COINCLUSION Pulmonary edema superimposed on background chronic biapical fibrocalcific process. Effusion and atelectasis in the right base. The overall appearances are probably little improved from prior study. " 4ec0a9ed-1cddadd5-fbc599c1-eb37cfba-2f891694.jpg,test/p16/p16887254/s51602776/4ec0a9ed-1cddadd5-fbc599c1-eb37cfba-2f891694.jpg,test," FINAL REPORT HISTORY: For ET tube placement. FINDINGS: In comparison with the earlier study of this date, the endotracheal tube tip now is projected below the clavicular level, approximately 5.1 cm above the carina. Remainder of the study is essentially unchanged. " 49a1b898-ed302b4d-620d878a-1c75b0c2-136c65ee.jpg,test/p12/p12285052/s55513903/49a1b898-ed302b4d-620d878a-1c75b0c2-136c65ee.jpg,test," FINAL REPORT INDICATION: ___-year-old female status post intubation. Evaluate tube placement. COMPARISON: None available. TECHNIQUE: Two portable supine radiographs were obtained before and after manipulation of an endotracheal tube. FINDINGS: After manipulation of the tube, the tip of the tube is seen 3 cm above the carina in appropriate position in the radiograph labeled #2. Otherwise, the lungs are well expanded, with an area of interstitial and alveolar opacities in the right lung base. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Endotracheal tube in appropriate position after manipulation. 2. Right lung base opacity is compatible with right lower lobe pneumonia versus aspiration. " 016f57c7-35d23660-7a1e51f7-0b16715f-993c9320.jpg,test/p18/p18329975/s54771574/016f57c7-35d23660-7a1e51f7-0b16715f-993c9320.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with right sided chest pain, and cough at times // r/o abnormality TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are essentially clear. There is no pleural effusion or pneumothorax " f116d5a0-54a87227-52dcd8c0-23c9516a-0a8f97d6.jpg,test/p18/p18347925/s56881672/f116d5a0-54a87227-52dcd8c0-23c9516a-0a8f97d6.jpg,test," FINAL REPORT PA AND LATERAL CHEST OF ___. COMPARISON: ___ radiograph. FINDINGS: A focal convexity of the left mediastinal contour in the region of the aorticopulmonary window is stable in the postoperative period, but new compared to preoperative radiographs prior to the patient's coronary bypass surgery procedure. Moderate-sized left pleural effusion is a persistent postoperative finding, accompanied by adjacent left lower lobe atelectasis. Right lung is grossly clear, but small pleural effusion is again demonstrated posteriorly. IMPRESSION: 1. Persistent postoperative left mediastinal widening in aorticopulmonary window, which may be due to a postoperative hematoma or loculated fluid collection. 2. Persistent moderate left pleural effusion and adjacent left lower lobe atelectasis. Unchanged small right effusion. " fb2d7125-67efa2ce-045344c5-b4b35a6f-79024acb.jpg,test/p13/p13666088/s52689936/fb2d7125-67efa2ce-045344c5-b4b35a6f-79024acb.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pericardial effusion s/p pericardiocentesis with drain in place. // Please evaluate for effusion, edema, infiltrate, and tubes/drain placement. Please evaluate for effusion, edema, infiltrate, and tubes/drain placement. IMPRESSION: Comparison to ___. Moderate left pleural effusion persists. Moderate left retrocardiac atelectasis. Stable position of the pericardial drain. Mild fluid overload but no overt pulmonary edema. No new focal parenchymal opacities. " 57aa95a2-3f1e3a80-b1c75c4e-50e6640b-ef7725ef.jpg,test/p10/p10459005/s55747957/57aa95a2-3f1e3a80-b1c75c4e-50e6640b-ef7725ef.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p LVAD // eval for pleural effusions eval for pleural effusions IMPRESSION: Comparison to ___. All monitoring and support devices are stable. No change in appearance of the moderately enlarged cardiac silhouette, the ventricular assist device is in stable position. Small left pleural effusion persists. No other relevant changes. " b00c23c7-5634ce49-0b100eb9-e59d2818-f7235d79.jpg,test/p10/p10610928/s54133194/b00c23c7-5634ce49-0b100eb9-e59d2818-f7235d79.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with bipolar disorder after motor vehicle collision. End-stage renal disease with lithium toxicity on hemodialysis after renal transplant with delayed graft function requiring dialysis. Is there pulmonary edema? IMPRESSION: PA and lateral chest compared to ___: There was previously marked asymmetry in the extent of pulmonary abnormality, dense consolidation in the right upper lobe, on ___, moderate consolidation in left upper lobe, and milder edema elsewhere, improved on ___ and continues to resolve with only a relative ghost of residual consolidation in the right upper lobe and mild pulmonary edema, vascular congestion elsewhere. Heart is mildly to moderately enlarged, mediastinal veins reflected in the azygos, are still distended, and small bilateral pleural effusions persist, left greater than right. No pneumothorax. " 0f7cd685-2038ba59-ebb59ce1-dba36688-8bc0ef7d.jpg,test/p12/p12738736/s53952930/0f7cd685-2038ba59-ebb59ce1-dba36688-8bc0ef7d.jpg,test," FINAL REPORT INDICATION: ___-year-old female with complex history presenting with substernal chest pain. Evaluate and rule out acute process. COMPARISONS: Multiple prior chest radiographs, most recently ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The pulmonary vasculature is unremarkable. The lungs are clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. Anterior wedging of a mid thoracic vertebral body is again seen, similar to prior. No radiopaque foreign bodies. IMPRESSION: No acute cardiopulmonary process. " 1c0776fd-1aee697c-7e4510fb-47861944-80581cad.jpg,test/p19/p19013230/s51120930/1c0776fd-1aee697c-7e4510fb-47861944-80581cad.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain on exertion // Evaluate for acute coronary syndrome TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " cd988751-b83391b7-70762d00-4813b8e9-c6d83999.jpg,test/p11/p11336923/s56361583/cd988751-b83391b7-70762d00-4813b8e9-c6d83999.jpg,test," FINAL REPORT INDICATION: ___F with dyspnea // any e/o PNA? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Dense atherosclerotic calcifications seen throughout the thoracic aorta. No acute osseous abnormalities. Mild height loss of a lower thoracic vertebral body is unchanged. IMPRESSION: No acute cardiopulmonary process. " cf89fa5e-683f5d72-708b3463-bac94677-655dfc34.jpg,test/p17/p17012742/s53535665/cf89fa5e-683f5d72-708b3463-bac94677-655dfc34.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with atrial fibrillation and dyspnea. Question edema. IMPRESSION: PA and lateral chest compared to ___. Heart is normal size. Previous pulmonary vascular congestion is no longer present and there is no pulmonary edema or pleural effusion, although substantial left atrial enlargement is visible on the lateral projection. A 6-mm round opacity projecting over the left third anterior rib could be a small lung nodule or bone island in that rib. Shallow oblique views should be obtained in hopes of differentiating between those possibilities. Ultimately, CT scanning may be necessary. Lungs are otherwise clear. There is no pleural effusion or evidence of central adenopathy. Dr. ___ and I discussed these findings by telephone at the time of dictation. " 10b2f6cb-66ccea2f-81046b76-51423766-32633da4.jpg,test/p15/p15327750/s58996161/10b2f6cb-66ccea2f-81046b76-51423766-32633da4.jpg,test," FINAL REPORT INDICATION: ___-year-old female with chest pain and cough. Evaluate for evidence of pneumonia. COMPARISONS: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " a64beb1a-f5a0fa7a-aa865c6f-f5a2dc25-1dde77a3.jpg,test/p19/p19920828/s52512335/a64beb1a-f5a0fa7a-aa865c6f-f5a2dc25-1dde77a3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F h/o chronic HCV cirrhosis and longstanding biliary cystadenoma, s/p open central segmentecomy, CCY ___ with epidural placement and post-op hypotension // s/p right IJ withdraw 4cm; please access line for placement s/p right IJ withdraw 4cm; please access line for placement FINDINGS: A right internal jugular line terminates in the cavoatrial junction, adjusted. Heart size and mediastinum are stable in appearance. There is interval development of interstitial pulmonary edema. A right basal opacity most likely represents vascular congestion but atelectasis or aspiration is a possibility. Close followup on the subsequent study is recommended. No pneumothorax. " 84be01fa-d9bb563a-5030978d-9e42a65d-bdd062eb.jpg,test/p16/p16960956/s52813123/84be01fa-d9bb563a-5030978d-9e42a65d-bdd062eb.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___. CLINICAL HISTORY: Fever and hypotension, assess pneumonia. FINDINGS: AP upright portable view of the chest was provided. There is scarring in the right mid-to-lower lung with pleural thickening, similar to prior CT scan. Pleural thickening and scarring at the left lung base is also similar to prior, likely accounting for the blunted appearance of the bilateral CP angle. Cardiomediastinal silhouette appears normal. No definite signs of pneumonia or CHF. No pneumothorax. There is an old deformity of the left clavicular mid shaft. No acute bony abnormalities. IMPRESSION: Stable scarring in the lungs as better assessed on prior CT chest. No definite signs of superimposed pneumonia. " 1bb46049-e82817cd-3c9cbecd-3024cf5a-30f9c7ee.jpg,test/p14/p14800808/s56597390/1bb46049-e82817cd-3c9cbecd-3024cf5a-30f9c7ee.jpg,test," FINAL REPORT INDICATION: History: ___M with tachypnea TECHNIQUE: Portable frontal view of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: Left lingular and lower lobe airspace opacity is concerning for pneumonia. Linear opacities at the right lung base likely represent atelectasis. No pleural effusion or pneumothorax. The cardiac and mediastinal contours are stable.Pulmonary vasculature is normal. IMPRESSION: Left basilar opacity concerning for pneumonia. Follow up radiographs after treatment are recommended to assess for resolution of this finding. " 029fe45f-dd902cfa-031eb6fd-6fcfc892-ffbff2e9.jpg,test/p18/p18246895/s51763716/029fe45f-dd902cfa-031eb6fd-6fcfc892-ffbff2e9.jpg,test," FINAL REPORT INDICATION: Cough and sputum production for two weeks. COMPARISONS: None. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. Mild deviation of the trachea and prominence of the upper mediastinum is most consistent with an enlarged thyroid. The cardiac silhouette is normal. IMPRESSION: 1. No acute cardiopulmonary process. Specifically, no evidence of pneumonia. 2. Probable thyroid enlargement. Results were text paged to Dr. ___ at 11:16 a.m. on ___ via telephone by Dr. ___. " bed08240-99f8b10a-aff539ca-ab69ec14-1d733387.jpg,test/p19/p19461413/s57713453/bed08240-99f8b10a-aff539ca-ab69ec14-1d733387.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alcoholic hepatitis, worsening respiratory distress // eval for PNA/volume overload IMPRESSION: In comparison to previous radiograph of ___, pulmonary vascular congestion is accompanied by slight worsening of perihilar opacities, which may reflect pulmonary edema or infection. Worsening opacities at the lung bases appear to correspond to areas of atelectasis on interval chest CTA, dictated separately. " 6cd5b4d0-886633db-4d73c6b5-13dbe99a-0e1f0e5b.jpg,test/p12/p12402931/s54523869/6cd5b4d0-886633db-4d73c6b5-13dbe99a-0e1f0e5b.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Fever, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is widening of the AP diameter of the chest without focal consolidation, effusion, pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 459c458a-5e584494-c86a6c7f-08354d35-167eb972.jpg,test/p17/p17288913/s56237958/459c458a-5e584494-c86a6c7f-08354d35-167eb972.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new cough, ? aspiration event ___ // pna? effusion? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are stable with cardiac size top normal and tortuous aorta. Faint opacities in the left lower lobe are stable. There are no new lung abnormalities. The upper lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable. Left PICC in standard position IMPRESSION: Stable left lower lobe opacities. No new lung abnormalities " 4efabff4-b596e9d1-1f4d15e9-6fa6e50f-03b861e7.jpg,test/p12/p12108578/s52151954/4efabff4-b596e9d1-1f4d15e9-6fa6e50f-03b861e7.jpg,test," FINAL REPORT HISTORY: Cirrhosis, to assess for liver transplantation. FINDINGS: No previous images. The heart is normal in size and the lungs are clear without vascular congestion or pleural effusion. IMPRESSION: No radiographic abnormality. " 2d79be78-e29d4acc-63c67d10-cf9d7cb4-056221eb.jpg,test/p17/p17763712/s56478253/2d79be78-e29d4acc-63c67d10-cf9d7cb4-056221eb.jpg,test," WET READ: ___ ___ ___ 1:34 PM 1. Left greater than right pleural effusions, increased from ___. 2. Bibasilar airspace opacities, may represent atelectasis or infection in the appropriate clinical setting. 3. Interval improvement in left upper lobe opacity, which may represent resolving infection. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with met breast cancer // increasing SOB--___ evaluate pleura, lungs and pericardium compare to recent chest imaging available in our system TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Right-sided Port-A-Cath is unchanged in position, and terminates near the superior cavoatrial junction. Previously noted left upper lobe opacity has improved, and suggests resolving infection. There are bilateral pleural effusions, left greater than right, which have increased from ___. Adjacent bibasilar opacities most likely represent compressive atelectasis, although infection should be considered in the appropriate clinical setting. No pneumothorax. Cardiomediastinal contours are unchanged. No acute osseous abnormalities identified. IMPRESSION: 1. Left greater than right pleural effusions, increased from ___. 2. Bibasilar airspace opacities, may represent atelectasis or infection in the appropriate clinical setting. 3. Interval improvement in left upper lobe opacity, which may represent resolving infection. " 05646a65-0d6f0bc1-27c36940-af9df854-84d2932a.jpg,test/p11/p11040162/s54346941/05646a65-0d6f0bc1-27c36940-af9df854-84d2932a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with intubation cardiac arrest // eval ett COMPARISON: None FINDINGS: AP portable supine view of the chest. Endotracheal tube is seen with its tip residing approximately 1.5 cm above the carinal. Bilateral pulmonary opacities are noted concerning for pneumonia and possible edema. No supine evidence for effusion or pneumothorax the right CP angle is excluded. Cardiomediastinal silhouette is normal. No bony abnormalities. A clip in the right upper abdomen noted. IMPRESSION: Low lying ET tube- consider 1 cm retraction for more optimal positioning. Bilateral opacities in the lungs concerning for pneumonia and edema. " 6f4f4e00-c6d70f78-9bc1175f-bff220d6-8d6bd767.jpg,test/p12/p12156452/s55779890/6f4f4e00-c6d70f78-9bc1175f-bff220d6-8d6bd767.jpg,test," FINAL REPORT INDICATION: History: ___M with confusion TECHNIQUE: AP upright and lateral views of the chest COMPARISON: Chest radiograph dated ___, CT abdomen and pelvis ___ FINDINGS: AP and lateral chest radiograph demonstrates no focal opacity convincing for pneumonia. Compared to prior study dated ___, overall appearance of the chest is not significantly changed. Cardiomediastinal and hilar contours are stable, the heart appears mildly enlarged. Prominence of the mediastinum is stable. Blunting of the left costophrenic angle is likely secondary to pleural thickening. Streaky atelectasis is seen in the left lung base with unchanged mild elevation of the left hemidiaphragm. No focal consolidation is present. No large pleural effusion, pneumothorax or evidence of pulmonary edema. IMPRESSION: No focal opacity convincing for pneumonia. " fd25da55-f69dce81-8b8a3dee-b2430425-0e8edb0e.jpg,test/p15/p15614836/s50673413/fd25da55-f69dce81-8b8a3dee-b2430425-0e8edb0e.jpg,test," FINAL REPORT HISTORY: ___-year-old woman with chest pain and congestion. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiac silhouette is normal in size. No pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 9ffacabf-b4572d78-c9c547c8-9ab638aa-88a1914b.jpg,test/p15/p15769492/s57523198/9ffacabf-b4572d78-c9c547c8-9ab638aa-88a1914b.jpg,test," FINAL REPORT INDICATION: ___-year-old female, intubated for mental status change, evaluate if ET tube and feeding tube is in place. COMPARISON: PA and lateral chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: The ET tube is 3.9 cm above the carina. Feeding tube passes below the diaphragm with side port within the expected region of the stomach and tip not clearly visualized in the field of view provided. Bilateral low lung volumes are noted with crowding of bronchovascular markings. No focal consolidation, pleural effusion or pneumothorax is noted. Cardiomediastinal and hilar contours are unchanged. " 4084a2e9-e169b660-8f2f612e-14ccac3a-42198000.jpg,test/p18/p18810739/s59508709/4084a2e9-e169b660-8f2f612e-14ccac3a-42198000.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Unexpected weight loss, evaluation for thoracic process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the hilar structures and the cardiac silhouette. The lung parenchyma shows normal structure and transparency. Known old clavicular fracture. No evidence of lung nodules or masses. " 56732a1d-cec2778f-c168bd66-b5cba260-d6287f76.jpg,test/p14/p14738773/s53465013/56732a1d-cec2778f-c168bd66-b5cba260-d6287f76.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness. Question pneumonia. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The lung volumes are low. The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. The osseous structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " 1c2d677c-e2e7de78-a3b74965-e2d4a3b2-31bf1e75.jpg,test/p14/p14354835/s51043564/1c2d677c-e2e7de78-a3b74965-e2d4a3b2-31bf1e75.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fallopian cancer, ARDS // eval intubated pt with ARDS eval intubated pt with ARDS COMPARISON: Previous chest radiographs ___ through ___ at 12:31, and chest CTA at 13:12 on ___. IMPRESSION: Judging from the correlation of yesterday';s chest radiographs and concurrent chest CTA, there has been no change in large right and moderate left pleural effusion, bilateral lower lobe collapse, and bilateral upper lobe consolidation, predominantly in the anterior segments, with features of scarring. Heart is normal size. There is no pneumothorax. ET tube and right internal jugular line are in standard placements. Feeding and esophageal drainage tubes pass into the stomach and out of view. " cb28f3ab-29879763-513f0419-00675b39-d0fa21ba.jpg,test/p11/p11979534/s53622090/cb28f3ab-29879763-513f0419-00675b39-d0fa21ba.jpg,test," FINAL REPORT INDICATION: History of ataxia and nausea. Please evaluate for pneumonia. COMPARISONS: Chest radiographs dated back to ___. TECHNIQUE: AP and lateral radiographs of the chest. FINDINGS: Moderate cardiomegaly has been stable compared to exams dated back to at least ___. The hilar and mediastinal contours are normal. Redemonstrated is a large left goiter with rightward deviation of the trachea, unchanged compared to the prior exam. There is no large pleural effusion or pneumothorax. Mild bibasilar atelectasis is persistent. IMPRESSION: Stable cardiomegaly. No focal consolidations concerning for pneumonia or pulmonary edema. " dce5a006-1d0179f9-d4816977-c3311a5e-a1c86581.jpg,test/p13/p13679831/s50063490/dce5a006-1d0179f9-d4816977-c3311a5e-a1c86581.jpg,test," FINAL REPORT INDICATION: ___-year-old male with chest pain. Evaluate chest pain, rule out pneumonia TECHNIQUE: Chest PA and lateral radiographs were obtained. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal. Posterior cervical fusion hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " b9e8657b-7bc5a99d-2a554602-ad5f4bbb-7b55a97e.jpg,test/p11/p11401718/s59355613/b9e8657b-7bc5a99d-2a554602-ad5f4bbb-7b55a97e.jpg,test," FINAL REPORT HISTORY: Cough for 3 days and hypotension. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Again, the lungs are relatively hyperinflated, suggesting chronic obstructive pulmonary disease. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette top-normal. Some degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " 391c20ed-9b717b59-881c269d-5ff8df72-4adc16b9.jpg,test/p10/p10826816/s53221391/391c20ed-9b717b59-881c269d-5ff8df72-4adc16b9.jpg,test," FINAL REPORT INDICATION: ___-year-old male admitted with cerebellar hemorrhage and new AFib, now with cough, here to evaluate for pneumonia or other pulmonary pathology. COMPARISON: Chest radiographs last performed on ___. FINDINGS: Frontal and lateral radiographs of the chest show interval removal of an endotracheal tube since the preceding radiograph. Mild pulmonary edema is improved with decreased pulmonary vascular congestion since ___. Low inspiratory lung volumes are unchanged. Bibasilar opacification with air bronchograms may represent focal consolidation in the correct clinical context or atelectasis. The right lung base is elevated by a subjacent subpulmonic right pleural effusion. No pneumothorax is present. The cardiomediastinal silhouette is unchanged. Severe degenerative changes are noted in the thoracic spine. IMPRESSION: 1. Bibasilar pneumonia in the correct clinical context or, alternatively, atelectasis. 2. Improved mild pulmonary edema and decreased pulmonary vascular congestion from ___. 3. Small subpulmonic right pleural effusion. " 8f934fa2-295412c0-c37ca62b-5062d3f4-37eafd23.jpg,test/p10/p10100810/s57823070/8f934fa2-295412c0-c37ca62b-5062d3f4-37eafd23.jpg,test," FINAL REPORT INDICATION: ___-year-old after PICC pulled. TECHNIQUE: Frontal radiograph of the chest was obtained. COMPARISON: CT of the chest from ___, chest radiograph from ___. FINDINGS: Left PICC line now ends at the distal left innominate vein. No pneumothorax. Lungs are clear, the cardiomediastinal silhouette and hila are normal. There is no pleural effusion. " 4de66f4d-8953da70-4a4cfcaa-cba1b70c-5a72d0ce.jpg,test/p17/p17647154/s55387595/4de66f4d-8953da70-4a4cfcaa-cba1b70c-5a72d0ce.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right pneumothorax, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Unchanged ___ of the right apical pneumothorax. Unchanged position of the right chest tube. No evidence of tension. Unchanged presentation of the left lung. " d3798c4b-9096eb15-bbd2d88e-4e32409f-e911cfd2.jpg,test/p14/p14560099/s55642664/d3798c4b-9096eb15-bbd2d88e-4e32409f-e911cfd2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with increasing WBC // ?PNA ?PNA IMPRESSION: In comparison to study of ___, the cardiac silhouette remains at the upper limits of normal in size or mildly enlarged. There has been the development of engorgement of indistinct pulmonary vessels, consistent with pulmonary vascular congestion. On the lateral View there are probable bilateral pleural effusions. " 6ac5f2ed-5ba1c017-a5f65a71-eb1f561f-76c55eac.jpg,test/p14/p14044601/s59223312/6ac5f2ed-5ba1c017-a5f65a71-eb1f561f-76c55eac.jpg,test," FINAL REPORT INDICATION: ___M with increased seizures // Eval for PNA TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: Lateral view is obscured by patient's arms. Lungs are clear without focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 3123b38d-f74d6ffb-708124a4-c2dab347-f88bd26f.jpg,test/p19/p19962126/s54020338/3123b38d-f74d6ffb-708124a4-c2dab347-f88bd26f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ett // ett IMPRESSION: Allowing for differences in technique and projection, there has not been a substantial change in the appearance of the chest since recent study of 1 day earlier. " eb806309-fcd4a140-631da8e8-20093b81-e2d60ed3.jpg,test/p14/p14513247/s55257994/eb806309-fcd4a140-631da8e8-20093b81-e2d60ed3.jpg,test," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with chills. Evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs COMPARISON: ___. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The appearance of the thorax is unchanged from ___. IMPRESSION: No evidence of acute cardiopulmonary process. " da83151b-8ffc967e-8aa26f08-7de7782e-5c291724.jpg,test/p12/p12960546/s54977072/da83151b-8ffc967e-8aa26f08-7de7782e-5c291724.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post dual-chamber pacer placement requiring assessment for lead position. COMPARISON: Comparison is made with chest radiograph from ___ and chest CT from ___. FINDINGS: Pacer is in left anterior axillary position with intact leads along the expected course to the right atrium and right ventricle. There is no pneumothorax or other related complication. There is mild pulmonary edema and bibasilar atelectasis. There are persistent small-to-moderate bilateral pleural effusions. Cardiomediastinal silhouette is unchanged. IMPRESSION: Pacer leads in appropriate position. Mild pulmonary edema with bilateral pleural effusions. " c962c8c6-e44fec04-ed821f0d-6f58ad56-c7eb4490.jpg,test/p18/p18043242/s58984559/c962c8c6-e44fec04-ed821f0d-6f58ad56-c7eb4490.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: History of recent pneumonia. COMPARISON: Chest radiographs ___. IMPRESSION: Lungs are clear, and including the region of prior consolidation in the left lower lobe. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal " ff84aa7e-d4ffd15e-a2e4558a-11715337-a648999f.jpg,test/p13/p13043768/s57890724/ff84aa7e-d4ffd15e-a2e4558a-11715337-a648999f.jpg,test," FINAL REPORT HISTORY: Status post MVC with right lower rib pain. COMPARISON: None. FINDINGS: AP and lateral images of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. No acute fracture is seen. IMPRESSION: 1. No acute cardiopulmonary process. 2. No acute fracture seen, however chest radiographs are insensitive for nondisplaced rib fractures. If clinical concern persists for buckle fracture, recommend dedicated rib views for further evaluation. If focal tenderness exists, this ___ be marked prior to rib views. " b4a4472d-b80016be-9d88443b-5ba4f47b-debd1395.jpg,test/p13/p13648633/s51909728/b4a4472d-b80016be-9d88443b-5ba4f47b-debd1395.jpg,test," FINAL REPORT INDICATION: ___-year-old man with coarse breath sounds and fever. COMPARISONS: Multiple chest radiographs from ___, dating back to ___. FINDINGS: Again noted are bilateral lower lobe opacities, which have been present on multiple prior studies, including a CT from ___. These were characterized as multifocal pneumonia. The upper lobes are clear. There is no pneumothorax or pleural effusion. Heart size is normal, as is the pulmonary vasculature. There is a nasogastric tube terminating within the stomach and a tunneled central venous catheter terminating at the cavoatrial junction. IMPRESSION: Bilateral lower lobe opacities in a pattern similar to multiple prior images, consistent in appearance with multifocal pneumonia. Consider non-emergent, outpatient evaluation with CT to further assess in the setting of nonresolving opacity. " e061017e-47bdd991-820a7b91-4b032efd-63e0c5ca.jpg,test/p13/p13273041/s59334049/e061017e-47bdd991-820a7b91-4b032efd-63e0c5ca.jpg,test," FINAL REPORT INDICATION: Post-thoracentesis. COMPARISON: Radiographs available from ___. FRONTAL CHEST RADIOGRAPH: There has been slight decrease in size of a very large left pleural effusion since the ___ examination, with improved aeration of the left upper zone. The right lung remains clear. The mediastinal contour is unchanged. There is no pneumothorax. IMPRESSION: Interval decrease in size of a very large left pleural effusion with slightly improved left aeration. No pneumothorax. " e4c9085a-6bc9e9b4-68ca5425-29b32d2b-95982a7b.jpg,test/p19/p19089446/s58123001/e4c9085a-6bc9e9b4-68ca5425-29b32d2b-95982a7b.jpg,test," FINAL REPORT HISTORY: Cough and fever. COMPARISON: Right shoulder radiographs ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. Elevation of the left hemidiaphragm is probably from eventration. IMPRESSION: No pneumonia, edema, or effusion. " 9f3c1525-622b3786-d4ec71b4-0ce69eb7-b8ebd96a.jpg,test/p13/p13313381/s50050632/9f3c1525-622b3786-d4ec71b4-0ce69eb7-b8ebd96a.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain and dyspnea. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 6e42d695-596cf8de-4600970d-d629597c-1ece32b4.jpg,test/p17/p17390712/s59370874/6e42d695-596cf8de-4600970d-d629597c-1ece32b4.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Fever, cough, right chest hemodialysis catheter, please evaluate for pneumonia. FINDINGS: PA and lateral views of the chest are provided. A right subclavian dialysis catheter is seen with its tip extending to the level of the low SVC/cavoatrial junction. There is no consolidation concerning for pneumonia. Mild pulmonary edema is likely present. No large effusion or pneumothorax is seen. The heart and mediastinal contour is normal. IMPRESSION: Probable mild pulmonary edema. " 5c248e3f-dbde5aa8-57e37845-a148ca65-52275166.jpg,test/p19/p19840128/s51730766/5c248e3f-dbde5aa8-57e37845-a148ca65-52275166.jpg,test," FINAL REPORT INDICATION: ___-year-old female with dyspnea and palpitations. COMPARISON: Chest radiograph from ___ and CTA chest from ___. CHEST, AP UPRIGHT AND LATERAL: Lungs were previously hyperexpanded. There is new pulmonary edema with mild cardiomegaly, central venous congestion, and interstitial edema. Note is made of mitral annular calcifications and mediastinal clips. No pleural effusions or pneumothorax. IMPRESSION: 1. Congestive heart failure. " ea7d21fd-6faed228-78bde2a5-161bf8bf-03d722ed.jpg,test/p15/p15798014/s52314249/ea7d21fd-6faed228-78bde2a5-161bf8bf-03d722ed.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Pulled chest tube with Pleurx catheter in place. COMPARISON: ___. Current study demonstrates no substantial change in the appearance of the right hemithorax including loculated effusions. The Pleurx catheter is in place. Subcutaneous air has decreased in the interim. Cardiomediastinal silhouette is stable. Left lung is clear. Right upper lung mass is projecting over the right upper lobe, unchanged since the prior study as well as right hilar lymphadenopathy. " 74be9485-af6a4bf5-97ab96c0-531c9a47-c6efb842.jpg,test/p14/p14182884/s51040943/74be9485-af6a4bf5-97ab96c0-531c9a47-c6efb842.jpg,test," FINAL REPORT INDICATION: Cough. Evaluate for infiltrate. COMPARISONS: None. FINDINGS: The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. S-shaped scoliosis of the thoracolumbar spine is noted. IMPRESSION: No acute cardiac or pulmonary process. " 1dcd2762-1cd0cb73-99454b1b-88b35f81-f01346a3.jpg,test/p18/p18799551/s57940609/1dcd2762-1cd0cb73-99454b1b-88b35f81-f01346a3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with congestive heart failure, OSA, obesity hypoventilation, CKD, with right-sided chest pain. // r/o localized pneumothorax COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. There is no evidence for the presence of a pneumothorax. Low lung volumes. Borderline size of the cardiac silhouette. No pleural effusions. No pneumonia. " 7c8364c0-a2e444d8-b4b86515-dfa71055-a56ae1d1.jpg,test/p17/p17399604/s58538776/7c8364c0-a2e444d8-b4b86515-dfa71055-a56ae1d1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hypoxia // eval for hypoxia TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: There are relatively low lung volumes. The cardiac silhouette is enlarged. The aorta is calcified and unfolded. Prominence of the superior mediastinum may relate today AP portable technique low lung volumes and unfolded aorta however, if there is clinical concern for acute mediastinal process, chest CT is more sensitive. Bilateral perihilar opacities are concerning for vascular congestion. Patchy right basilar opacities are seen with differential diagnosis including infection, aspiration, an atelectasis. No large pleural effusion or pneumothorax is seen. IMPRESSION: Prominence of the superior mediastinum may relate today AP portable technique low lung volumes and unfolded aorta however, if there is clinical concern for acute mediastinal process, chest CT is more sensitive. Bilateral perihilar opacities are concerning for vascular congestion. Patchy right basilar opacities may relate to atelectasis but underlying infection or aspiration not excluded. " eed12d48-da95e1de-784de705-610e11ef-32a642b8.jpg,test/p19/p19524729/s51430670/eed12d48-da95e1de-784de705-610e11ef-32a642b8.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: History of pleuritic chest pain, recent chest trauma, rule out pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy. Dual-lead left-sided pacer device is again seen, with one lead extending to the expected position of the right atrium. The second lead which extends more inferior is not well evaluated due to underpenetration. There are relatively low lung volumes. The cardiac enlargement persists, although appears minimally less prominent as compared to the prior study. No definite pleural effusion is seen. There is minimal central pulmonary vascular congestion. Evidence of DISH is seen along the spine. IMPRESSION: Continued enlargement of the cardiac silhouette with mild vascular congestion. " ee985bf4-df04a7a9-a5e329ff-40ca3869-4b869c30.jpg,test/p18/p18656167/s53700576/ee985bf4-df04a7a9-a5e329ff-40ca3869-4b869c30.jpg,test," FINAL REPORT INDICATION: Leg cellulitis and rhonchi on exam. COMPARISON: ___ chest radiograph and ___ chest CT. PA AND LATERAL VIEWS OF THE CHEST: Cardiac, mediastinal and hilar contours are unchanged, with heart size within normal limits. Linear opacities in both lung bases likely reflect subsegmental atelectasis and/or scarring. No focal consolidation, pleural effusion, or pneumothorax is present. Old right-sided rib fractures are present. There are mild degenerative changes of the thoracic spine. IMPRESSION: Bibasilar atelectasis and/or scarring. Otherwise, no radiographic evidence for pneumonia. " 73a014fe-3b02fda6-2c0d2754-bdf661f0-40e25d29.jpg,test/p12/p12457086/s51913935/73a014fe-3b02fda6-2c0d2754-bdf661f0-40e25d29.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETT // Interval change TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: Compared to the prior study the endotracheal tube has been removed. Lung volumes are decreased when compared to the prior study consistent with removal of the ET tube. There is patchy left lower lobe consolidation likely reflecting atelectasis, infection cannot be excluded. The right lung is grossly clear. The cardiomediastinal contour is unchanged compared to the prior study. No pneumothorax seen. No definite pleural effusion seen. IMPRESSION: Patchy consolidation in the left lower lobe likely reflects residual a atelectasis given the decrease in lung volumes compared to the prior study. " 5e5208a8-dddfcb62-fdcaa1bf-b833f74e-5aa9d2a8.jpg,test/p10/p10074434/s57980377/5e5208a8-dddfcb62-fdcaa1bf-b833f74e-5aa9d2a8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent cough x weeks. Never smoker // Evaluate for abnormalities Evaluate for abnormalities IMPRESSION: Compared to chest radiographs since ___, most recently ___. Hyperinflation reflects substantial emphysema, a chronic finding. . No focal pulmonary abnormality. Moderate cardiomegaly is chronic but there is no pulmonary vascular congestion or other evidence of acute cardiac decompensation. No central adenopathy or pleural effusion. " d1460554-a97bbc81-daf4ba72-bbf6ab9b-09f0f92e.jpg,test/p13/p13648633/s58573317/d1460554-a97bbc81-daf4ba72-bbf6ab9b-09f0f92e.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man with portal pulmonary hypertension and increasing lower extremity edema with bibasilar lung crackles. IMPRESSION: PA and lateral chest compared to ___ through ___: Previous severe infiltrative abnormality in both lungs improved, but still has substantial residual in both lower lungs. Heart size is normal and there is no vascular congestion or pleural effusion to suggest cardiac decompensation. A tunneled catheter ends low in the SVC. Heart size is normal. Large calcified left hilar lymph nodes precede the widespread pneumonia in ___. " 2225b7e3-b00d512a-593b4836-fb3e6b4a-fa2b1ae5.jpg,test/p17/p17123098/s55665898/2225b7e3-b00d512a-593b4836-fb3e6b4a-fa2b1ae5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F h/o MVC c5-6 facet dislocation s/p anterior fusion, currently intubated // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, the endotracheal tube tip lies approximately 4.5 cm above the carina. Otherwise little change. Continued enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure. Probable bilateral layering pleural effusions with underlying compressive atelectasis, more prominent on the left. " 538acaf2-48deb749-ec8ed1da-3b7ba3c0-c2f6ae17.jpg,test/p19/p19601036/s59058556/538acaf2-48deb749-ec8ed1da-3b7ba3c0-c2f6ae17.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p cabg and mv repair with chylothorax // eval effusion TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Left pleural effusion appears to be increasing in the interim. Right pleural effusion has increased as well. Cardiomediastinal silhouette is unchanged. Sternal wires in replaced mitral valve are unchanged. No definitive pneumothorax demonstrated " 1649a723-b6089355-70e27790-9d387257-6e7f8bae.jpg,test/p12/p12361982/s56873538/1649a723-b6089355-70e27790-9d387257-6e7f8bae.jpg,test," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Influenza-like illness, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. " 65477252-ac859ebd-141d3eeb-19de921e-dfeeae2a.jpg,test/p14/p14505714/s58665486/65477252-ac859ebd-141d3eeb-19de921e-dfeeae2a.jpg,test," WET READ: ___ ___ ___ 8:59 PM No definite acute cardiopulmonary process. Focal opacity in the retrosternal clear space localizing to a medial left anterior rib. Additional nodular opacity in the left lung for which chest CT suggested to further characterize, not necessarily acutely. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___M w/hx of lower back pain and BPH presenting with acute onset confusion, memory deficits, and inattentiveness. TECHNIQUE: PA and lateral chest radiographs COMPARISON: None available FINDINGS: The lungs are well expanded. In the lateral view there is a 2.5 cm focal opacity in the anterior mediastinum abutting the anterior thoracic wall in the retrosternal clear space. This likely localizes in the infrahilar location on the frontal view localizing to the region the anterior left fourth rib. There is also a 1.3 cm nodule projecting over the left midlung laterally. Smaller nodules also seen in the left lung more inferiorly. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No definite acute cardiopulmonary process. Focal opacity in the retrosternal clear space localizing to the anterior fourth rib. Additional nodular opacity in the left lung for which chest CT suggested to further characterize, not necessarily acutely. " 02e4a7f5-c9848941-8931a3a1-2a93cd52-df890767.jpg,test/p14/p14310147/s50094259/02e4a7f5-c9848941-8931a3a1-2a93cd52-df890767.jpg,test," FINAL REPORT HISTORY: ___-year-old male with right upper extremity weakness. STUDY: AP upright and lateral chest radiograph. COMPARISON: ___ at 18:57. FINDINGS: The heart size is within normal limits. Mediastinal and hilar contours are unremarkable. The lungs are hyperinflated. There is no definite evidence of pneumonia or CHF. There is a focal opacity along the left heart border on the frontal view, likely a prominent fat pad. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic process. " 56b82bd4-75bc615d-35822d9d-077ad8b7-eb713690.jpg,test/p19/p19919570/s54946330/56b82bd4-75bc615d-35822d9d-077ad8b7-eb713690.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M with astrocytoma and known seizure disorder presenting with seizure. ?cardiopulmonary etiology // ___M with astrocytoma and known seizure disorder presenting with seizure. ?cardiopulmonary etiology TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Right-sided Port-A-Cath terminates in the proximal right atrium without evidence of pneumothorax. Patient is status post median sternotomy and cardiac valve replacement. Minimal left base atelectasis/scarring is seen.No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 1628bbec-627a7888-c4707cad-35003cba-64d1f153.jpg,test/p11/p11805066/s51455190/1628bbec-627a7888-c4707cad-35003cba-64d1f153.jpg,test," FINAL REPORT INDICATION: ___ year old woman with large right lung mass dx on this hospitalization has had worsening resp status // effusions, consolidation? TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: The large right superior mediastinal mass extending into the right hemithorax is unchanged. Tracheostomy tube in situ. Right main bronchus stent is unchanged. Feeding tube in situ. Right-sided pigtail catheter in situ with no visualized right-sided pleural effusion. Minor left-sided pleural effusion with adjacent atelectatic changes appear similar compared to previous imaging. IMPRESSION: No significant interval change. " 0a5fd2dc-17a6385e-71229a2b-690887f2-638ef7e0.jpg,test/p10/p10976602/s51438850/0a5fd2dc-17a6385e-71229a2b-690887f2-638ef7e0.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with reported ""lung crackles"" // eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: 2 lead left-sided pacemaker is seen with lead extending to the expected positions of the right atrium and right ventricle.Bilateral pleural effusions with overlying atelectasis there is seen. Enlargement of the cardiomediastinal silhouette is stable. Central pulmonary vascular engorgement is seen. IMPRESSION: Bilateral pleural effusions with overlying atelectasis. Persistent enlargement of the cardiomediastinal silhouette. Central pulmonary vascular engorgement. " debbc4e0-71d5c802-f6b7aa78-924cbbe7-949c20f7.jpg,test/p11/p11708364/s50378640/debbc4e0-71d5c802-f6b7aa78-924cbbe7-949c20f7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, admitted for bowel obstruction with new hypoxemia, leukocytosis, and fevers concern for aspiration pneumonia with component of pulmonary edema // please assess for development of infiltrate concerning for pneumonia and presence of pulmonar edema COMPARISON: Chest x-ray from ___ at 6:51 am FINDINGS: An NG tube is present. Although the infra diaphragmatic portion of the tube is not well seen, it does pass beneath the diaphragm. The cardiomediastinal silhouette and background COPD appear unchanged. There is vascular plethora consistent with mild CHF and interstitial edema. A small left effusion and minimal blunting of the right costophrenic angle are similar to the prior film. There is patchy opacity at the left base similar to the prior film. The possibility of an early infiltrate cannot be entirely excluded, but the appearance is grossly unchanged and no frank consolidation is seen. Minimal atelectasis at the right base. Prominent right paratracheal soft tissues are similar to the prior film. IMPRESSION: 1. Patchy opacity left base. The possibility of an early infiltrate cannot be entirely excluded, but the appearance is grossly unchanged compared with ___ and no frank consolidation is seen. 2. Mild CHF/interstitial edema, similar to the ___ chest x-ray. " 778db8bc-d28b610d-9440db1e-87f85f44-2d5cc8c9.jpg,test/p17/p17469724/s59439594/778db8bc-d28b610d-9440db1e-87f85f44-2d5cc8c9.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: One to two months of left chest pain. IMPRESSION: PA and lateral chest compared to ___ through ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. No radiographic change since ___. " 70fb30e6-19d2ce00-b9738f21-57d84e75-c080fb38.jpg,test/p12/p12730395/s56976454/70fb30e6-19d2ce00-b9738f21-57d84e75-c080fb38.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic NSCLC, s/p PICC placement, now with acute dyspnea. // Evaluate for acute interval change. COMPARISON: ___, 08:23 IMPRESSION: As compared to the previous radiograph, no relevant change is seen in extent of the known right basal pneumothorax and of the consolidation at the right lung base. Unchanged alignment of the sternal wires. Unchanged moderate cardiomegaly. The right PICC line continues to project over the right atrium. The line should be pulled back by 2-3 cm if it should lie at the cavoatrial junction. " 6277180a-57add45b-45a2fdf8-ee88d4fa-aac67e87.jpg,test/p19/p19564280/s51049587/6277180a-57add45b-45a2fdf8-ee88d4fa-aac67e87.jpg,test," FINAL REPORT HISTORY: Hypoxia, to assess for pneumonia. FINDINGS: In comparison with study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " 6a39903d-6bc13786-faa32c72-c55f1fce-7bc771f8.jpg,test/p10/p10514722/s52562765/6a39903d-6bc13786-faa32c72-c55f1fce-7bc771f8.jpg,test," FINAL REPORT INDICATION: Wheezing. Assess for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: A previously seen heterogeneous right upper lung opacity has resolved. The lungs are now clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: 1. No acute cardiac or pulmonary process. 2. Resolution of previously seen right upper lobe pneumonia. " fdf4f24b-1710f453-57c00ba5-021cde0e-618578b9.jpg,test/p16/p16077947/s54787777/fdf4f24b-1710f453-57c00ba5-021cde0e-618578b9.jpg,test," FINAL REPORT INDICATION: ___M with palpitations // Infiltrate? TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or vascular congestion. There is moderate cardiomegaly. No acute osseous abnormalities identified. IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process. " 93f529b3-63f8a80c-26e2ded8-f368512e-573a4fbf.jpg,test/p15/p15768236/s50251497/93f529b3-63f8a80c-26e2ded8-f368512e-573a4fbf.jpg,test," FINAL REPORT INDICATION: ___-year-old man presenting with pain status post fall. COMPARISON: Chest radiograph from ___. FINDINGS: Heart is normal in size and cardiomediastinal contour is unremarkable. Lungs are clear. There is no focal consolidation, pleural effusion, or pneumothorax. No displaced fracture is detected. IMPRESSION: No acute intrathoracic abnormality. " 92febdaf-9bfad264-19ca2763-5815ed5f-d9af80ff.jpg,test/p11/p11434374/s53274082/92febdaf-9bfad264-19ca2763-5815ed5f-d9af80ff.jpg,test," FINAL REPORT INDICATION: ___ year old man with pneumothorax s/p CT placement (right) // placement. reaccumulation? AT 5am please COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: Previously noted right pneumothorax has decreased in size since the prior study. The pigtail catheter is at the right lung base. There is stable patchy density in both lung bases. There is no CHF. Central line position unchanged. " 8eee6732-6c53cae9-09415a82-c15dca36-2536bb8a.jpg,test/p10/p10236222/s56747124/8eee6732-6c53cae9-09415a82-c15dca36-2536bb8a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with tachycardia, nausea // Please eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 05aa913a-687f56a3-5a12301c-c660ecea-708f2472.jpg,test/p16/p16298869/s58547052/05aa913a-687f56a3-5a12301c-c660ecea-708f2472.jpg,test," WET READ: ___ ___ 11:18 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___M with L sided chest pain pls eval pna or effusion TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: None. FINDINGS: The inspiratory lung volumes are appropriate. An incidental azygos fissure and lobe is noted. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 78fab7e6-6f10e4df-d5636ac9-e6b69ce7-502a4942.jpg,test/p12/p12498222/s59127031/78fab7e6-6f10e4df-d5636ac9-e6b69ce7-502a4942.jpg,test," FINAL REPORT HISTORY: T-cell lymphoma, cough with fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph, PET-CT ___. FINDINGS: The heart size is normal. The aorta remains tortuous. The pulmonary vascularity is normal. Nodular opacity within the lateral right apex is re- demonstrated, similar compared to the prior PET-CT. No new focal consolidation, pleural effusion or pneumothorax is present. Mild compression deformity of a low thoracic vertebral body is unchanged. Left ___ anterior rib bone island is also re- demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. Unchanged nodular opacity within the lateral aspect of the right apex. " 178dd398-dfe35075-b9367dcc-ebef9b84-3ff652db.jpg,test/p12/p12333537/s52073740/178dd398-dfe35075-b9367dcc-ebef9b84-3ff652db.jpg,test," FINAL REPORT INDICATION: ___-year-old male with diabetes and chest tightness. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, pneumothorax or pulmonary edema. Heart and mediastinal contours are within normal limits. Deformity of the right acromioclavicular joint appears unchanged compared to ___, likely due to remote trauma. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 7310da05-a45f0389-d87405bc-bc410548-becd8c41.jpg,test/p13/p13660761/s54923984/7310da05-a45f0389-d87405bc-bc410548-becd8c41.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/ recurrent diverticulitis now s/p lap -> open sigmoid colectomy // r/o PNA r/o PNA COMPARISON: Prior chest radiographs are not available. IMPRESSION: Lungs are fully expanded and essentially clear. An elliptical opacity projecting over the tip of the right scapula is probably thickening in the right minor fissure, not clinically significant. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 7a60829e-c19347d0-6166a279-9fc9fb08-c04b5b88.jpg,test/p13/p13638768/s52145412/7a60829e-c19347d0-6166a279-9fc9fb08-c04b5b88.jpg,test," FINAL REPORT INDICATION: Metastatic prostate cancer. Continues fever of unclear origin. COMPARISON: Compared to the chest CT from ___. FINDINGS: Heart size is upper limits of normal. The lungs are grossly clear without focal consolidation. There are low lung volumes due to poor inspiratory effort. The bones appear somewhat dense and is consistent with known diffuse metastatic bony disease. No pneumothoraces are present. IMPRESSION: No acute cardiopulmonary process. " 11f9c16d-c60a6b46-3ec2ba36-c76fcdca-0d9f54b0.jpg,test/p14/p14177219/s52589781/11f9c16d-c60a6b46-3ec2ba36-c76fcdca-0d9f54b0.jpg,test," FINAL REPORT INDICATION: ___-year-old male with HCV and ESRD and chronic dyspnea presents with worsening shortness of breath. COMPARISON: Chest radiographs on ___. FINDINGS: PA and lateral views of the chest. There is stable mild pulmonary vascular engorgement. No evidence of pulmonary edema. There are no focal consolidations. No pneumothorax or pleural effusion. Heart size is top normal. IMPRESSION: Stable mild pulmonary vascular engorgement. Heart size is top normal. No evidence of pneumonia. " 1d62f16d-0b0b688a-a0726151-f9801390-e89661fd.jpg,test/p16/p16428118/s53442936/1d62f16d-0b0b688a-a0726151-f9801390-e89661fd.jpg,test," FINAL REPORT CHEST RADIOGRAPH HISTORY: Altered mental status and respiratory compromise. COMPARISONS: None. TECHNIQUE: Chest, supine AP portable. FINDINGS: The cardiac contours are not well delineated, but the heart is probably mild to moderately enlarged. The lung volumes are low. Streaky right basilar opacity suggests minor atelectasis. There is more extensive but vague left lower lung opacity; a pleural effusion is suspected on the left but not well demonstrated. There is no pneumothorax. An endotracheal tube terminates below the thoracic inlet about 6 cm above the carina, and an orogastric tube courses into the stomach. IMPRESSION: 1. Status post endotracheal intubation. If clinically indicated, the tube could be advanced 2 cm for more optimal positioning. Orogastric tube coursing into the stomach. 2. Cardiomegaly. 3. Substantial left basilar opacification, which could be seen with atelectasis and possibly pleural effusion, but pneumonia is not excluded by this study. " e1690599-dfef70dc-c0143034-c6f2e502-3419dba7.jpg,test/p14/p14339198/s55250281/e1690599-dfef70dc-c0143034-c6f2e502-3419dba7.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with chest pain. Evaluate for acute coronary syndrome and pulmonary embolus. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. CT chest ___ FINDINGS: Left basilar atelectasis is minimal. No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. Fullness of the left hilum appears unchanged. The descending thoracic aorta is tortuous. IMPRESSION: No acute cardiopulmonary process. " 0f769e42-613e38f5-d9e0523d-4f620151-6614a7bc.jpg,test/p15/p15591377/s54919968/0f769e42-613e38f5-d9e0523d-4f620151-6614a7bc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with vertigo/lightheadedness TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 1f281165-79103b73-86048738-f48eab90-c2a6ed01.jpg,test/p15/p15193875/s52750209/1f281165-79103b73-86048738-f48eab90-c2a6ed01.jpg,test," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with glioblastoma Port-A-Cath. COMPARISON: Chest x-rays of ___ and ___. FINDINGS: Right-sided Port-A-Cath has been repositioned since previous exam and is now in adequate position ending in lower SVC. There is no kink. The lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: Right-sided Port-A-Cath has been repositioned and is now in adequate position without any kink. " b5e238ee-d4154388-080a508a-b0d0f3b6-8df2b72d.jpg,test/p15/p15021205/s59614130/b5e238ee-d4154388-080a508a-b0d0f3b6-8df2b72d.jpg,test," FINAL REPORT INDICATION: Shortness of breath and fever. Non-small cell lung cancer. COMPARISON: Chest radiograph ___ from ___ ___. CT torso ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: Since the prior chest radiograph, there has been interval worsening of the left upper lobe/perihilar mass, which appears increased in size when compared to the prior study. Heart size is difficult to assess given the presence of the perihilar mass. A moderate left-sided pleural effusion is new when compared to the prior chest radiograph, with evidence of mild pulmonary vascular congestion. Left basilar consolidative opacity likely reflects atelectasis. No pneumothorax is identified. Mild emphysematous changes are seen within the lung apices. There are no acute osseous abnormalities. IMPRESSION: Increased size of left upper lobe/perihilar mass compatible with known malignancy. Moderate-sized left pleural effusion with left basilar opacity likely reflecting atelectasis. Mild pulmonary vascular congestion. " 225e1e65-e8a8f936-80db4083-12321c72-afd74f79.jpg,test/p10/p10383890/s53567898/225e1e65-e8a8f936-80db4083-12321c72-afd74f79.jpg,test," WET READ: ___ ___ ___ 6:08 AM 1. Right IJ central venous catheter terminates in the right atrium, 2 cm distal to the cavoatrial junction. 2. Mild pulmonary vascular congestion without frank pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with shock, sepsis evaluate for pulmonary edema and evaluate right IJ central venous line placement. TECHNIQUE: Single upright AP chest radiograph COMPARISON: Outside hospital chest radiographs dated ___. FINDINGS: The right IJ central venous line terminates within the right atrium, 2 cm distal to the cavoatrial junction. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. There is mild pulmonary vascular congestion. The cardiomediastinal silhouette is normal. IMPRESSION: 1. Right IJ central venous catheter terminates in the right atrium, 2 cm distal to the cavoatrial junction. 2. Mild pulmonary vascular congestion without frank pulmonary edema. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 6:03 AM, 4 minutes after discovery of the findings. " 7b9c5458-06aaace6-a9619e4b-8a20d625-bdb49ee8.jpg,test/p17/p17057667/s59515023/7b9c5458-06aaace6-a9619e4b-8a20d625-bdb49ee8.jpg,test," WET READ: ___ ___ 8:13 PM Extensive chronic pulmonary fibrotic changes are again noted in a similar distribution. Underlying edema or infection is difficult to exclude. Moderate cardiomegaly is stable. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___F with cough // r/o infiltrate TECHNIQUE: AP and lateral. COMPARISON: Chest CT: ___. Chest radiograph: ___. FINDINGS: Extensive confluent interstitial fibrotic changes are again noted, in a similar distribution compared to prior exams, with peripheral basilar predominance. No new opacification is identified. The cardiomediastinal silhouette is unchanged compared to the prior radiograph, with stable moderate cardiomegaly and calcifications in the aortic arch. There is no pleural effusion or pneumothorax. Surgical clips are noted in the upper abdomen. IMPRESSION: 1. Extensive chronic pulmonary fibrotic changes are again noted in a similar distribution. 2. Underlying edema or infection is difficult to exclude. 3. Moderate cardiomegaly is stable. " b4ac032d-b17e9cbd-3a47792d-0574a441-72db1f79.jpg,test/p13/p13214943/s55781619/b4ac032d-b17e9cbd-3a47792d-0574a441-72db1f79.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with symptomatic shortness of breath, cough, foreign body sensation // Assess for pulmonary edema, effusion TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There has been some mild improvement in the amount of pulmonary edema. The heart is mildly enlarged. There small bilateral pleural effusions. There is pulmonary vascular redistribution but the hazy alveolar infiltrate has decreased. However there are dense areas of opacification both lower lobes. It is unclear how much of this is due to volume loss or if focal infectious infiltrates are present. IMPRESSION: Mild improvement in pulmonary edema but with bilateral lower lobe volume loss/infiltrate " ec8e0285-5d01b3eb-7385a2ee-263da739-3a47eb5a.jpg,test/p12/p12797041/s55126255/ec8e0285-5d01b3eb-7385a2ee-263da739-3a47eb5a.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with lung cancer on chemo w/ n/v, weakness // eval for PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A right Port-A-Cath is seen terminating in the low SVC. IMPRESSION: No acute cardiopulmonary process. " 8e16bf6b-4c5ab6cc-35e516e1-a9726be3-1f0fa0a3.jpg,test/p17/p17366913/s59014893/8e16bf6b-4c5ab6cc-35e516e1-a9726be3-1f0fa0a3.jpg,test," FINAL REPORT HISTORY: Fall. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: There is a right sided VP shunt coursing over the right hemithorax. There are relatively low lung volumes. Right middle lobe atelectasis/scarring is seen. No definite focal consolidation. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Right middle lobe atelectasis/scarring. " 2c48234e-7e168461-57e9f703-542e5828-608cc7b7.jpg,test/p13/p13032235/s55619320/2c48234e-7e168461-57e9f703-542e5828-608cc7b7.jpg,test," FINAL REPORT HISTORY: Cough and pleuritic chest pain. FINDINGS: No previous images. The heart is normal in size and there is no vascular congestion or pleural effusion. No acute pneumonia or pneumothorax. " c344503c-1a9a8726-e2e8ae15-7d51964f-a683adf2.jpg,test/p16/p16617005/s57604649/c344503c-1a9a8726-e2e8ae15-7d51964f-a683adf2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH and agitation, hypoxia. // hypoxia, agitation, new afib with RVR hypoxia, agitation, new afib with RVR IMPRESSION: Comparison to ___. The radiograph now shows mild to moderate pulmonary edema. The size of the cardiac silhouette. Is mildly enlarged. There are no pleural effusions and no evidence of pneumonia. The feeding tube was removed, the left central venous access line is in stable position. Calcified pleural plaques are again visualized at the lung bases. " 6ba03539-e40b14d7-256f85be-7b5ee982-da4c6ffd.jpg,test/p19/p19381010/s52927325/6ba03539-e40b14d7-256f85be-7b5ee982-da4c6ffd.jpg,test," WET READ: ___ ___ ___ 9:25 AM Mild pulmonary vascular congestion noted on the prior study has improved. There is no pulmonary edema. Left-sided pleural effusion is unchanged. WET READ VERSION #1 ___ ___ ___ 7:54 PM Mild pulmonary vascular congestion noted on the prior study has improved. There is no pulmonary edema. Left-sided pleural effusion is unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx recent TAVR complicated by LV tear, now s/p pacemaker for CHB w/ 4+TR and worsening dyspnea on exertion w/ CHF exacerbation. // Eval for left pleural effusion. Eval for left pleural effusion. IMPRESSION: In comparison with the study ___, there is little overall change in the left pleural effusion with volume loss in the left lower lobe. No evidence of pulmonary vascular congestion. The right lung remains clear. " de58f59e-49432eff-91ea8f40-5015cda2-bd054cb6.jpg,test/p13/p13340770/s53171681/de58f59e-49432eff-91ea8f40-5015cda2-bd054cb6.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD/asthma with CXR ___ showing some atelectasis vs. pneumonia, any change? // any infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are fully expanded and clear without any atelectasis. No pleural effusion or pneumothorax is seen the diaphragms appear flattened, which suggests hyperinflation. IMPRESSION: 1. Resolution of previous bibasilar atelectasis. 2. Diaphragmatic flattening suggesting hyperinflation. " 14a25e34-d9603328-97b91f47-b4d69f7d-4c7a7c31.jpg,test/p10/p10717732/s55231821/14a25e34-d9603328-97b91f47-b4d69f7d-4c7a7c31.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Renal artery stenosis, evaluation for endotracheal tube position. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change in position of the endotracheal tube. The tip of the tube projects approximately 5 cm above the carina, the tube could be advanced by 1-2 cm. No evidence of complications, unchanged position of the nasogastric tube and the right internal jugular vein catheter. Moderate cardiomegaly with bilateral pleural effusions of moderate extent, no evidence of newly appeared focal parenchymal opacities. " 1f5aaf6d-bc208c55-acecfc61-0d136cea-3db2789c.jpg,test/p17/p17567629/s56095961/1f5aaf6d-bc208c55-acecfc61-0d136cea-3db2789c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F w/history of COPD, presenting with fatigue and cough, please eval for PNA // ___F w/history of COPD, presenting with fatigue and cough, please eval for PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The patient is rotated somewhat to the left. The cardiac silhouette remains mild to moderately enlarged. There is slight increase in central pulmonary vascular prominence suggesting mild pulmonary vascular congestion. There may be slight prominence of the main pulmonary artery which can be seen with underlying pulmonary hypertension. No pneumothorax is seen. The lungs remain relatively hyperinflated, consistent with COPD. No discrete focal consolidation is seen to suggest lobar pneumonia. There is slight blunting of the costophrenic angles, also present on the prior study, without large pleural effusion seen. IMPRESSION: Mild pulmonary vascular congestion and mild to moderate cardiomegaly. Persistent blunting of the costophrenic angles without large pleural effusion seen. No discrete focal consolidation to suggest lobar pneumonia. " 64d7d166-d5a6354d-70817302-762e879f-5c1d6541.jpg,test/p13/p13714231/s57391231/64d7d166-d5a6354d-70817302-762e879f-5c1d6541.jpg,test," FINAL REPORT INDICATION: Fever and cough. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, most recent dated ___ and correlation with CT chest dated ___. FINDINGS: Focal consolidation is seen probably in the left lower lobe. Multiple bilateral patchy opacities could also more generally represent superinfection in this patient with known bronchiectasis at the bases, left greater than right. No pneumothorax is seen. A trace left pleural effusion may be present. The heart size is normal. IMPRESSION: Increasing bibasilar opacification particularly in the left lower lobe worrisome for pneumonia superimposed on background findings of bronchiectasis and scarring. " 235ff481-c7618ee3-1ff423ba-3117b419-4f8ba9d4.jpg,test/p15/p15368003/s59532875/235ff481-c7618ee3-1ff423ba-3117b419-4f8ba9d4.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a small newly occurred left pleural effusion. The right lung base also shows blunting of the costophrenic sinus, potentially caused by a small pleural effusion. There is increasing left lower lobe atelectasis. Minimal fluid overload is present. The monitoring and support devices are in unchanged position. " 2372b1d8-779d0e23-8775d393-83801c35-d9dc5186.jpg,test/p16/p16561059/s53154702/2372b1d8-779d0e23-8775d393-83801c35-d9dc5186.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with right facial droop for two weeks and history of prior stroke. Question CVA versus recrudescence versus pneumonia. FINDINGS: The lungs remain clear, noting left basilar atelectasis versus scar. There is no pleural effusion. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. IMPRESSION: No acute cardiopulmonary process. " 19e2a702-14a8c26c-87ac2664-b70c6d9f-4e7bb19b.jpg,test/p17/p17032571/s57985057/19e2a702-14a8c26c-87ac2664-b70c6d9f-4e7bb19b.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old male with cough and fever. COMPARISON: None. FINDINGS: PA and lateral views of the chest. There is subtle increased opacity in the left mid lung seen posteriorly on the lateral view. Elsewhere, there is no confluent consolidation nor effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Subtle opacity in the left lower lobe compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. " d24c775c-013cc0d1-be48279b-84d7f01f-0c0fd96d.jpg,test/p10/p10879723/s55139535/d24c775c-013cc0d1-be48279b-84d7f01f-0c0fd96d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: PERSISTANT COUGH, PREVIOUS SMOKER IMPRESSION: Heart size is normal. Large anterior right more the knee hernia contains substantial amount of mesenteric fat as demonstrated on the chest CT from ___, unchanged. Lungs are overall clear. There is no pleural effusion. There is no pneumothorax. " 1c3d1d21-d7908782-e4678f60-23732090-02f306c2.jpg,test/p14/p14766138/s50400525/1c3d1d21-d7908782-e4678f60-23732090-02f306c2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old lady with HIV on HAART, HCV, ESRD on HD (___), and multiple myeloma who presents with left-sided chest pain with chest tube placed on ___ by IP and 600cc of fluid drained. // Please assess for interval change. COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous image. Unchanged position of the left pleural drain. Unchanged extent of the left pleural effusion. Constant appearance of the right lung. " 00745076-683a289e-623b4f32-2d7974f9-45768bc6.jpg,test/p18/p18591791/s52533478/00745076-683a289e-623b4f32-2d7974f9-45768bc6.jpg,test," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old woman with history of positive PPD. Please assess for active TB. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The heart size, mediastinal, and hilar contours are normal.The lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No evidence of active or latent TB. " aede4bcf-40226ac5-d9e02bc1-7eea9f83-b27515cc.jpg,test/p17/p17199551/s52400919/aede4bcf-40226ac5-d9e02bc1-7eea9f83-b27515cc.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with cough and some blood in sputum. It could be from bronchitis, but the patient has been a smoker for ___ years, quit ___ years ago, evaluate for pneumonia versus TB or other processes. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. The heart size is within normal limits. No configurational abnormality is identified. Thoracic aorta is unremarkable. The pulmonary vasculature is not congested and there are no signs of acute or chronic pulmonary parenchymal abnormalities. The lateral and posterior pleural sinuses are free. No evidence of pneumothorax in the apical area on frontal view. Skeletal structures demonstrate mild degree of degenerative changes in the thoracic spine, but no other bony abnormalities are identified in the thoracic area.Prominent soft tissue structures surround the thorax and are indicative for adiposity. In comparison with the next preceding study of ___, no significant interval change can be identified. Thus, there is no evidence of CHF or acute infiltrates in this patient with a long smoking history. No suspicious mass lesion exists. " 8063bcab-8a26d72a-e007316a-44475995-104e2166.jpg,test/p16/p16996526/s52851894/8063bcab-8a26d72a-e007316a-44475995-104e2166.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Altered mental status, crackles, evaluation for PICC line placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has made a substantially lesser inspiratory effort. As a consequence, the lung volumes have decreased bilaterally. In addition, crowding at both lung bases is seen. The lack of abnormalities on the lateral radiograph suggests that the crowding is the result of poor inspiration. The PICC line shows a normal course, the tip of the line projects over the right atrium on today's examination, it could be pulled back by approximately 1-2 cm to ensure a safe position in the mid-to-lower SVC. Moderate cardiomegaly. No pneumothorax, no pleural effusions. " b14b5ce2-16691f3e-8ac89fd6-b398a228-37dce306.jpg,test/p16/p16346361/s51656701/b14b5ce2-16691f3e-8ac89fd6-b398a228-37dce306.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post right wedge resection, rule out pneumothorax. COMPARISON: ___. FINDINGS: Compared to the previous examination, the minimal left apical pneumothorax is no longer visible. Otherwise, the lung parenchyma in both the left and the right hemithorax is of unchanged appearance. Unchanged borderline size of the cardiac silhouette. In the left lateral chest wall, soft tissue air inclusion is unchanged in extent. " e43b2af6-809885f5-4bec6160-67d14747-88617225.jpg,test/p12/p12959560/s50108558/e43b2af6-809885f5-4bec6160-67d14747-88617225.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___f with chest pain. COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 23373d8c-e9d80ba0-61151011-8a407d79-9049cd13.jpg,test/p19/p19507970/s55007789/23373d8c-e9d80ba0-61151011-8a407d79-9049cd13.jpg,test," FINAL REPORT CLINICAL HISTORY: Cough, evaluate for pneumonia. CHEST Marked elevation of the left hemidiaphragm is present, more so than on any prior chest x-ray. Cause of this is not apparent. Evaluation of the left lower lobe cannot be made. Elsewhere, there is no evidence of pneumonia. IMPRESSION: Elevation of left hemidiaphragm, more marked than on previous occasions. " 31d0d021-ef4ea1bf-c036d439-74fa6fd2-4ca4e746.jpg,test/p18/p18317245/s50780341/31d0d021-ef4ea1bf-c036d439-74fa6fd2-4ca4e746.jpg,test," FINAL REPORT HISTORY: Chest pain TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. No displaced fracture is identified. IMPRESSION: No acute cardiopulmonary process. " 65cff93c-fd8f05d9-b0e69788-12fda67a-5f6360fb.jpg,test/p16/p16860641/s56692371/65cff93c-fd8f05d9-b0e69788-12fda67a-5f6360fb.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with chest pain. Evaluate for mediastinal widening or pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are clear. No focal consolidation, effusion, edema, or pneumothorax. The thoracic aorta is tortuous and/or ectatic. The heart is normal in size. IMPRESSION: 1. No pneumothorax. 2. Tortuous thoracic aorta. " 89e33baf-5305ccb0-7bc6857b-d9c2b937-8c1e12a2.jpg,test/p11/p11451979/s58359613/89e33baf-5305ccb0-7bc6857b-d9c2b937-8c1e12a2.jpg,test," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: Coronary artery disease. Chest pain and acute shortness of breath. IMPRESSION: PA and lateral chest compared to ___ through ___: Lordotic positioning exaggerates heart size which is moderate and probably increased since ___. Pulmonary vascular engorgement and borderline edema are unchanged. Pleural effusion is small on the right, if any. Stomach is severely distended with air and fluid. Dual-channel right supraclavicular central venous catheter ends in the mid and low SVC. Dr. ___ was paged at 10:19, 2 minutes after recognition of pertinent findings. " 4c213d73-0b8b84b7-e09dbf8c-e9eb1442-1129e09d.jpg,test/p14/p14738661/s53346425/4c213d73-0b8b84b7-e09dbf8c-e9eb1442-1129e09d.jpg,test," FINAL REPORT INDICATION: ___-year-old male status post motor vehicle accident. Evaluate for evidence of pneumothorax or any other acute cardiopulmonary process. COMPARISON: None available. TECHNIQUE: AP and lateral chest radiograph. FINDINGS: The lungs are well inflated and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. No rib fractures are noted. IMPRESSION: No evidence of acute cardiopulmonary process. " 2b3b6c95-2bf41c65-0f3df4c3-5a078675-640a554a.jpg,test/p14/p14065959/s55715929/2b3b6c95-2bf41c65-0f3df4c3-5a078675-640a554a.jpg,test," FINAL REPORT EXAMINATION: Correlated with stent was no CT is a 8 right the would not of neither currently subtle a C2 of this and in the AA if the fused the adjoining ___ its ___ and the low there really CT INDICATION: ___ year old man with sCHF and pulm HTN // CHest x-ray as required prior to V/Q scan TECHNIQUE: Chest PA and lateral COMPARISON: Portable chest radiograph dated ___ FINDINGS: In comparison to the chest radiograph obtained 3 days prior, there is increased, severe pulmonary edema and unchanged severe cardiomegaly. Lung volumes appear lower, but otherwise without focal consolidation. Pleural effusions are small if any. No pneumothorax IMPRESSION: Worsened cardiac decompensation. " 65cdd6ec-7035ac4a-2b404046-5ed4f97c-901cefd5.jpg,test/p16/p16677256/s58171271/65cdd6ec-7035ac4a-2b404046-5ed4f97c-901cefd5.jpg,test," FINAL REPORT INDICATION: ___-year-old male with polytrauma. Evaluate for fracture. COMPARISON: None. PORTABLE AP CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are stable. Low lung volumes are noted bilaterally with no focal consolidation, pleural effusion or pneumothorax. No acute fractures are identified. " c8abd5cf-65284bae-12435c05-320cd599-0dd255fb.jpg,test/p11/p11124675/s57516354/c8abd5cf-65284bae-12435c05-320cd599-0dd255fb.jpg,test," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old woman with morbid obesity. FINDINGS: Comparison is made to previous study from ___. Endotracheal tube, feeding tube, and right-sided PICC line are unchanged in position. There is prominence of pulmonary interstitial markings and cardiomegaly. No large pneumothoraces are seen. Overall, the findings are stable. " 1cce58ae-c30bfdaf-ccbb2543-ca9c6497-f3d790a2.jpg,test/p15/p15459844/s53943095/1cce58ae-c30bfdaf-ccbb2543-ca9c6497-f3d790a2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PNA, COPD exacerbation // interval change? TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph obtained earlier on the same date. FINDINGS: Again seen are findings suggests of COPD with increased lucency in the bilateral apices consistent with bullous change. There is a stellate opacity in the right upper lobe with associated volume loss. While this may reflect scarring, neoplastic lesion cannot be excluded. In addition there are ill-defined airspace opacities of the right lung base suspicious for pneumoniae. No definite pleural effusion seen although the costophrenic angles are not fully visualized. IMPRESSION: No significant interval change when compared to the prior study. A spiculated opacity with volume loss in the right apex may represent scarring but an neoplastic lesion cannot be excluded, recommend CT chest to further evaluate. Right basal consolidation. " 53e0f255-1f876a2a-0a4073ff-edd35fb4-7b1235e1.jpg,test/p10/p10476869/s58095696/53e0f255-1f876a2a-0a4073ff-edd35fb4-7b1235e1.jpg,test," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with history of lobectomy and Legionella. Evaluate for interval change. FINDINGS: PA and lateral chest views have been obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. There is status post left upper lobectomy remaining scar formations in the apical area and surgical clips in the left anterior lateral wall status post thoracotomy. Mild degree of left diaphragmatic elevation is noted but no other significant abnormalities can be identified. No new infiltrates are seen. IMPRESSION: Stable chest findings. No interval change since ___. " bbd465e3-79952d32-099fd3c7-1707b184-b566e25b.jpg,test/p10/p10449408/s59747380/bbd465e3-79952d32-099fd3c7-1707b184-b566e25b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis and renal failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing pulmonary edema has mildly increased in severity. The radiograph is otherwise unchanged. Minimal pleural effusions might be present. Atelectasis in the dorsal lung areas. The monitoring and support devices are constant in appearance. " 0e4788b1-9584d168-a1abbc1a-0a5fa35b-61f2de9d.jpg,test/p10/p10254837/s53987664/0e4788b1-9584d168-a1abbc1a-0a5fa35b-61f2de9d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea on exertion // r/o acute process COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is mild with mild pulmonary interstitial edema. No large effusion or pneumothorax is seen. Subtle confluent opacity in the right CP angle could represent a very early pneumonia. Followup to resolution is advised. No bony abnormalities are seen. IMPRESSION: Cardiomegaly with mild pulmonary edema. Subtle confluent opacity in the right CP angle could represent an early pneumonia in the right clinical setting. Please followup to resolution. " 64a6acf1-edf06c3f-9bf65cbc-70ce032c-152068d1.jpg,test/p16/p16239546/s53721482/64a6acf1-edf06c3f-9bf65cbc-70ce032c-152068d1.jpg,test," FINAL REPORT HISTORY: Continued aspiration, elevated white count and febrile. COMPARISON: ___. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: Lung volumes remain persistently low with unchanged hazy bibasilar/perihilar opacities which could be representative of aspiration. The cardiomediastinal silhouette and hilar contours are unchanged. A tracheostomy tube remains in standard position. There is no pleural effusion or pneumothorax. IMPRESSION: Similar appearance of bibasilar/perihilar hazy opacities which may represent aspiration. " 6ccf1398-c21018a3-de8ab2d2-85a01b78-2813978b.jpg,test/p11/p11549427/s59276726/6ccf1398-c21018a3-de8ab2d2-85a01b78-2813978b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with history of ingestion/aspiration // progression of bilateral infiltrates progression of bilateral infiltrates COMPARISON: ___ IMPRESSION: Widespread parenchymal consolidations are unchanged. Heart size and mediastinum are stable. No interval increase in pleural effusion or development of pneumothorax is present. " 129a8a26-656c4c2c-7adb2acd-09dcc588-fdd14886.jpg,test/p17/p17800072/s51353995/129a8a26-656c4c2c-7adb2acd-09dcc588-fdd14886.jpg,test," FINAL REPORT AP CHEST, 10:44 A.M. ON ___ HISTORY: A ___-year-old man with encephalopathy, question pneumonia. IMPRESSION: AP chest compared to ___: Lungs clear. Heart size normal. No pleural abnormality. " 7249826d-912c07b8-8df49284-91afac36-3c19e398.jpg,test/p16/p16352630/s54897711/7249826d-912c07b8-8df49284-91afac36-3c19e398.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o asthma, now with increased sputum production and increased cough // PResence of pneumonia PResence of pneumonia COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Small region of peribronchial opacification base of the right lung could be a small lower lobe pneumonia. Oblique views might be helpful in better localization. Hyperinflation indicates chronic obstructive lung disease. Heart size top-normal. No pulmonary edema. No pleural effusion. Indwelling RV pacer lead unchanged in standard placement. NOTIFICATION: Pertinent critical findings were posted by Dr. ___ on ___ at 17:17 to the Department of Radiology online critical communications system for direct communication to the referring provider. " fc1ab3a8-db1eb8d8-cb9291bb-c7f710ca-e3ed9264.jpg,test/p18/p18446519/s51635368/fc1ab3a8-db1eb8d8-cb9291bb-c7f710ca-e3ed9264.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with L flank pain*** WARNING *** Multiple patients with same last name! // assault, L flank pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 3dba5f16-e2d5c9f6-a30b0316-9bfea1d1-7272faf2.jpg,test/p11/p11124186/s54427592/3dba5f16-e2d5c9f6-a30b0316-9bfea1d1-7272faf2.jpg,test," WET READ: ___ ___ ___ 7:55 AM 1. No acute cardiopulmonary process. Specifically, no pneumonia. 2. Right lower lobe atelectasis atelectasis or scarring. WET READ VERSION #1 ___ ___ ___ 6:40 AM 1. No acute cardiopulmonary process. Specifically, no pneumonia. 2. Right lower lobe atelectasis along the cardiophrenic angle as well as persistent linear atelectasis or scarring in the right lower lobe. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with AMS. Infectious workup for AMS TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. CT chest ___. FINDINGS: Lungs are well-expanded with persistent right lower lobe linear opacity consistent with atelectasis or scarring. The lungs are otherwise clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: 1. No acute cardiopulmonary process. Specifically, no pneumonia. 2. Right lower lobe atelectasis atelectasis or scarring. " 05b093f9-fee5b208-6fe0cd13-7460d47d-dfbc580c.jpg,test/p12/p12471550/s53870814/05b093f9-fee5b208-6fe0cd13-7460d47d-dfbc580c.jpg,test," FINAL REPORT CHEST. TWO VIEWS: ___ HISTORY: ___-year-old male with ascites. Question pneumonia. FINDINGS: PA and lateral views of the chest. No prior. Low lung volumes are noted. There is no pleural effusion or confluent consolidation identified. Cardiomediastinal silhouette is within normal limits. The left hemidiaphragm is mildly elevated above a stomach distended with large air-fluid level. IMPRESSION: No focal consolidation based on this study with low lung volumes. Mildly elevated left hemidiaphragm above a stomach distended with large air-fluid level. " 2d535a9f-6104ae0d-2f934344-70773e2e-8be98afa.jpg,test/p14/p14546527/s54268653/2d535a9f-6104ae0d-2f934344-70773e2e-8be98afa.jpg,test," FINAL REPORT HISTORY: Followup left pleural effusion. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: A portable view of the chest demonstrates some accumulation of a left pleural effusion compared to yesterday's chest radiograph. There are low lung volumes, but the right lung is grossly clear. There is no pneumothorax. The cardiomediastinal contour is unchanged. A left chest tube remains in the left lower lateral hemithorax. A left IJ projects over the origin of the SVC. IMPRESSION: Slight re-accumulation of left pleural effusion compared to yesterday. " 813b498f-0f83191d-430af7cf-588c23cf-1f659d8f.jpg,test/p18/p18862543/s58259400/813b498f-0f83191d-430af7cf-588c23cf-1f659d8f.jpg,test," FINAL REPORT CHEST TWO VIEWS, ___. HISTORY: ___-year-old female with worsening dyspnea, cough and wheezing. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Surgical clips project over the left chest wall. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9e5d9675-077994e0-10e58ba4-6bddae64-9cbdc283.jpg,test/p14/p14754762/s57098953/9e5d9675-077994e0-10e58ba4-6bddae64-9cbdc283.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with new peribronchial opacification in the right lung base on chest portable radiograph. Evaluate this region. IMPRESSION: PA and lateral chest compared to ___: Finding at the right lung base can be explained by atelectasis and small bilateral pleural effusion. Pneumonia cannot be excluded, but there do not appear to have been any progressive changes in the appearance of the right lung base. The upper lungs are clear. Heart is mildly enlarged. No pneumothorax. " 19a7867d-9c28f100-075e8e1f-33051980-19210dfe.jpg,test/p15/p15048999/s54562494/19a7867d-9c28f100-075e8e1f-33051980-19210dfe.jpg,test," FINAL REPORT HISTORY: Hemodialysis with fever. FINDINGS: In comparison with the study of ___, there is continued vascular congestion. Dialysis catheter remains in the right atrium. The possibility of pleural effusion cannot be properly assessed in the absence of a lateral view. Cardiac size remains at the upper limits of normal. " 71389a86-a328ef46-5a13102d-b383ad9f-566f5e2f.jpg,test/p14/p14367674/s55471434/71389a86-a328ef46-5a13102d-b383ad9f-566f5e2f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumonia, CHF, rising leukocytosis // r/o pleural effusion, new pneumonia r/o pleural effusion, new pneumonia IMPRESSION: Compared to chest radiographs ___. Moderate pulmonary edema has worsened. Severe cardiomegaly is chronic. Small bilateral pleural effusions unchanged. " 0545f1f9-0f3d9e52-3f3572ab-0298eb0f-211c0130.jpg,test/p11/p11577197/s59507886/0545f1f9-0f3d9e52-3f3572ab-0298eb0f-211c0130.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pna, CHF // eval for pna vs pulmonary edema TECHNIQUE: Chest single view COMPARISON: ___ 18:05 FINDINGS: Shallow inspiration accentuates heart size, pulmonary vascularity. Pulmonary vascularity has improved. Improved bilateral perihilar opacities, improving pneumonitis versus improving edema. Improved right basilar atelectasis. Increased retrocardiac opacity, atelectasis versus infiltrate. Small right pleural effusion is new. Probable small left pleural effusion, stable. IMPRESSION: Improving perihilar opacities. More prominent retrocardiac opacity, atelectasis likely; consider pneumonitis in appropriate clinical setting. " e905aa65-cfc88ff6-0148eb0a-c660a55f-5f37626a.jpg,test/p11/p11730422/s59175617/e905aa65-cfc88ff6-0148eb0a-c660a55f-5f37626a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with takeback for l hemothorax s/p vats and hematoma evac // eval for interal change eval for interal change COMPARISON: Chest radiographs since ___, most recently ___, along with chest CT on that date. IMPRESSION: New left thoracostomy tubes have been placed, extending from base to apex. There still considerable atelectasis in the left lung and probably some persistent pleural effusion and air, although the distribution has changed. Widening of the upper mediastinum could be due to adjacent pleural fluid, but mediastinal veins are dilated. Small right pleural effusion is new. Heart is still enlarged. " fd7e9f57-b0592382-e6a0125d-35348260-73ffa7ac.jpg,test/p11/p11015757/s51988110/fd7e9f57-b0592382-e6a0125d-35348260-73ffa7ac.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dizziness. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " f8b06c69-748c00cb-320c197a-c6643c3d-1bf878a1.jpg,test/p18/p18656167/s56628354/f8b06c69-748c00cb-320c197a-c6643c3d-1bf878a1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with hx hiv, chf, here w/ cp // ? ptx, effusion, consolidation TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities " f8903e7e-250cc06e-3a987bf6-0e6026d4-cf7cb046.jpg,test/p15/p15554295/s50754466/f8903e7e-250cc06e-3a987bf6-0e6026d4-cf7cb046.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/subclavian CVL in SVC, please eval for successful replacement // ___M w/subclavian CVL in SVC, please eval for successful replacement TECHNIQUE: Chest single view COMPARISON: ___ 17:54 FINDINGS: Right subclavian central line has been readjusted, tip is in the low SVC. No pneumothorax. Otherwise stable exam. IMPRESSION: Right subclavian central line with tip in the low SVC. " 7111ed9f-1fd9f675-25334981-20232c5e-26075e17.jpg,test/p12/p12027307/s55610196/7111ed9f-1fd9f675-25334981-20232c5e-26075e17.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Myalgias. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " a37f8ba6-3e85382c-ccc16e28-4430fa27-62a93f6c.jpg,test/p12/p12874703/s59576570/a37f8ba6-3e85382c-ccc16e28-4430fa27-62a93f6c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with lupus, asthma, and hx of pneumonia who presents with a 7-day history of productive cough. // pna? pna? IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. The cardiac silhouette is at the upper limits of normal in size or mildly enlarged. No vascular congestion, pleural effusion, or acute focal pneumonia. " abc73fca-20844bd5-e59daa9f-d451e1fc-2c7d48c1.jpg,test/p12/p12844527/s52941385/abc73fca-20844bd5-e59daa9f-d451e1fc-2c7d48c1.jpg,test," FINAL REPORT INDICATION: Fevers. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, three views. Of note, this exam became available for interpretation on PACS only on ___ although the images were acquired on ___. FINDINGS: Heart size is top normal. Mediastinal silhouette and hilar contours are stable. A subtle retrocardiac density is noted, new from ___. There is no pleural effusion or pneumothorax. Extensive fixation hardware is visualized in the thoracic spine. IMPRESSION: New retrocardiac density which is likely atelectasis given patient's clinical improvement without therapy as discussed with Dr. ___ ___ by ___ over the telephone on ___ at 11:15 a.m. . " 469d5b59-51913772-7822293f-99cd5bb2-ef5226be.jpg,test/p16/p16476559/s52870391/469d5b59-51913772-7822293f-99cd5bb2-ef5226be.jpg,test," WET READ: ___ ___ ___ 8:51 PM Low lung volumes with moderate edema. ET Tube and Swan-Ganz appear in place. Stable enlarged heart. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Intubation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 5 cm above the carina, the tube could be advanced by 1 cm. The patient has also received a Swan-Ganz catheter that is in correct position. The sternal wires are showing normal alignment. Low lung volumes. Moderate cardiomegaly with signs of mild fluid overload but no overt pulmonary edema. Blunting of the left costophrenic sinus could suggest the presence of a minimal left pleural effusion. No other relevant changes. " ab385ac0-d52bdad7-1fe5157a-ec5637e4-b20b4014.jpg,test/p13/p13083956/s50057246/ab385ac0-d52bdad7-1fe5157a-ec5637e4-b20b4014.jpg,test," FINAL REPORT HISTORY: Palpitations. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 9d6ecdf9-9b9da392-91108dbf-4e7b9dbd-45ffe888.jpg,test/p10/p10728002/s52890480/9d6ecdf9-9b9da392-91108dbf-4e7b9dbd-45ffe888.jpg,test," FINAL REPORT INDICATION: ___F with history of breast cancer, HTN who presents with significant leukocytosis in the setting of night sweats, weight loss, easy bruising with high concern for new acute leukemia. // r/o mediastinal mass, other acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The heart size is normal. The hila are normal. Low lung volumes. Linear opacification the left lung base most likely represents atelectasis. No lobar consolidation. No pleural effusion. Surgical clips in situ in the right breast and right chest wall. IMPRESSION: Low lung volumes with suspected atelectasis in the left lung base. " f3d773cc-4a7b6f7b-b519eec2-0f3d1352-41075c25.jpg,test/p14/p14394983/s58013465/f3d773cc-4a7b6f7b-b519eec2-0f3d1352-41075c25.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chest pain and vomiting. Evaluation for pneumothorax or pneumomediastinum. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: Single frontal radiograph of the chest demonstrates the heart is top normal in size. The lungs are clear bilaterally with no evidence of pneumothorax, pleural effusion, pulmonary edema, or focal pneumonia. There is no evidence of pneumomediastinum. IMPRESSION: No acute cardiopulmonary process. " 3576ff7d-f8e735e6-0e17f015-ceddcfdc-708faa3b.jpg,test/p16/p16500918/s50776318/3576ff7d-f8e735e6-0e17f015-ceddcfdc-708faa3b.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, history of congestive heart failure TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy and mitral valve replacement. Right-sided dual-chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle. Mild enlargement of the cardiac silhouette is unchanged. The mediastinal and hilar contours are similar with mild tortuosity of the thoracic aorta again noted. Pulmonary vasculature is not engorged. Lungs are clear. No pleural effusion or pneumothorax is seen. Clips are noted in the right upper quadrant of the abdomen compatible with prior cholecystectomy. IMPRESSION: No acute cardiopulmonary abnormality. " d9a0da54-a1e9bfb1-0926e69c-c4a2d527-a9dd3984.jpg,test/p17/p17020905/s50931476/d9a0da54-a1e9bfb1-0926e69c-c4a2d527-a9dd3984.jpg,test," FINAL REPORT HISTORY: ___-year-old male with chemotherapy and fever and cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. Surgical clips seen in the region of the gastroesophageal junction. IMPRESSION: No acute cardiopulmonary process. " 99004dc3-66828310-1c076b8d-6313426a-590ba503.jpg,test/p10/p10532466/s50441514/99004dc3-66828310-1c076b8d-6313426a-590ba503.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, edema. FINDINGS: AP upright and lateral views of the chest were obtained. The patient is rotated slightly to the left. Prominence of the main pulmonary artery is again seen, possibly slightly increased, suggesting pulmonary arterial hypertension. There is prominence of the pulmonary vasculature suggesting component of pulmonary edema. There are small-to-moderate bilateral pleural effusions. The cardiac silhouette is moderate-to-markedly enlarged. Aorta is calcified. Bibasilar opacities likely relate to pleural effusions and prominent vascular structures. IMPRESSION: 1. Enlargement of the main pulmonary artery suggesting pulmonary hypertension. 2. Markedly enlarged cardiac silhouette, pleural effusions, and prominent vascular structures suggest fluid overload due to cardiac decompensation. " 3582c3b2-76450b64-410f1548-bf9ee0f9-6c8777dd.jpg,test/p13/p13626512/s58965443/3582c3b2-76450b64-410f1548-bf9ee0f9-6c8777dd.jpg,test," FINAL ADDENDUM ADDENDUM In the retrocardiac region, there is a suggestion of a nodule, which is only seen on the lateral view. Recommend nonemergent chest CT for further evaluation of this region. The impression and recommendation above was emailed by Dr. ___ on ___ at 16:44 to the ED QA nurses for direct communication to the referring provider. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left rib pain status post motor vehicle collision. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. Retrocardiac region, CT IMPRESSION: No acute cardiopulmonary process. No evidence of rib fractures. " 17cf7f7c-b27bc3f4-e902bbcb-b4c608b1-5984f415.jpg,test/p16/p16319384/s58022694/17cf7f7c-b27bc3f4-e902bbcb-b4c608b1-5984f415.jpg,test," FINAL REPORT HISTORY: Shortness of breath. Evaluate for fluid versus infection. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Single frontal portable view of the chest was obtained. The heart is moderately enlarged, similar to prior. There is calcification of the aortic knob. The pulmonary vasculature is indistinct, compatible with mild pulmonary edema. Small bilateral pleural effusions are present. No pneumothorax. Osseous structures are unremarkable. No radiopaque foreign body. IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions. " 8803fc82-f0137f40-a50e1e62-054d9db7-b6b1392f.jpg,test/p11/p11849511/s51149496/8803fc82-f0137f40-a50e1e62-054d9db7-b6b1392f.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with fall and currently dyspnea and tachycardia with chest tube delivering 1.3 liters of serosanguineous white fluid on the left, re-assessment. AP radiograph of the chest was reviewed in comparison to ___. The left internal jugular line tip terminates at the level of mid SVC. Heart size and mediastinum are stable. Left pleural effusion is re-demonstrated, at least moderate. No pneumothorax is seen. Right basal opacity appears to be minimally increased, most likely reflecting atelectasis. " 87f273ef-ca409122-c70d761c-2051e580-07450996.jpg,test/p16/p16012048/s54211788/87f273ef-ca409122-c70d761c-2051e580-07450996.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stroke. // ?Aspiration ?Aspiration IMPRESSION: Comparison to ___. The feeding tube was removed. Lung volumes remain low. No pleural effusions. No pulmonary edema. No pneumonia. " abe182ff-98f12951-e108a80c-75698fa5-423e2ea8.jpg,test/p10/p10678758/s52582752/abe182ff-98f12951-e108a80c-75698fa5-423e2ea8.jpg,test," FINAL REPORT INDICATION: Status post CABG. Evaluate for pneumothorax. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Interval removal of enteric catheter, endotracheal tube and bilateral drains without development of pneumothorax. Linear lucency at the level of the left upper mediastinum may represent a small pneumomediastinum. Cardiomediastinal and hilar contours are unremarkable. Minimal left lower lung opacification likely reflects atelectasis. No pleural effusion evident. IMPRESSION: No pneumothorax. Possible trace pneumomediastinum. ___ communicated these findings to ___ at 17:20 on ___ via telephone 1 hour after discovery of findings. " 1a88a1ec-ab3b6601-cdc6a681-1eab2295-37f7d2eb.jpg,test/p16/p16159749/s54067308/1a88a1ec-ab3b6601-cdc6a681-1eab2295-37f7d2eb.jpg,test," FINAL REPORT HISTORY: Pedal edema, to assess for abnormality in patient with previous asbestos exposure. FINDINGS: In comparison with study of ___, there is little overall change. Some hyperexpansion of the lungs is again seen consistent with chronic pulmonary disease. No vascular congestion or pleural effusion. No acute pneumonia. No evidence of diaphragmatic pleural calcifications that could be seen in asbestos-related disease. Of incidental note is an apparent old healed fracture of the distal right clavicle. " 119d91b4-117fe8a1-8493930a-898b8e63-997009b2.jpg,test/p15/p15225349/s52713412/119d91b4-117fe8a1-8493930a-898b8e63-997009b2.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with metastatic cecal adenocarcinoma with history of pleural and pericardial effusion s/p pericardial window. // any reaccumulation of effusion or other etiology of SOB. COMPARISON: ___. IMPRESSION: Minimal decrease in extent of the left and right pleural effusions. Normal size of the cardiac silhouette. Areas of atelectasis at both the left and right lung bases. No pulmonary edema. No pneumonia, " 25f73eb9-fb0f734c-f5bba666-17520357-31a17a9c.jpg,test/p16/p16467648/s54788968/25f73eb9-fb0f734c-f5bba666-17520357-31a17a9c.jpg,test," FINAL REPORT HISTORY: Back and chest pain. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. No overt traumatic findings. IMPRESSION: No acute cardiopulmonary abnormality. " a1d93951-64da613a-71a6f3b5-4daff2d3-d778d58d.jpg,test/p14/p14240547/s52885587/a1d93951-64da613a-71a6f3b5-4daff2d3-d778d58d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with unexplained weight loss, difficulty breathing, and smoking history // please evaluate for lung cancer please evaluate for lung cancer IMPRESSION: In comparison with the study of ___, again low lung volumes that accentuate the transverse diameter of the heart. Probable mild elevation of pulmonary venous pressure, but no acute pneumonia or pleural effusion. " e596fe90-89563b5d-5c840d27-daec9e05-d85bd3a4.jpg,test/p12/p12459873/s57741310/e596fe90-89563b5d-5c840d27-daec9e05-d85bd3a4.jpg,test," FINAL REPORT EXAM: Chest, single AP supine portable view. CLINICAL INFORMATION: ___-year-old male with history of MVC. COMPARISON: None. FINDINGS: Single supine AP portable view of the chest was obtained. Underlying trauma board partially obscures the view. The costophrenic angles are fully included on the image. Given this, the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute intrathoracic process. " 5d4c8c3c-85173676-c725ccc3-4e67538e-dd6a236d.jpg,test/p18/p18462562/s56890450/5d4c8c3c-85173676-c725ccc3-4e67538e-dd6a236d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with hx lymphoma on chemo, p/w generalized weakness // eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Right-sided Port-A-Cath is seen terminating in the region of the proximal SVC, similar to prior. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Hilar contours are stable. Mediastinum is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 3be5af6e-7507ddcf-9a2525be-41f8072b-c59daf3c.jpg,test/p16/p16296993/s50120604/3be5af6e-7507ddcf-9a2525be-41f8072b-c59daf3c.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old female with shortness of breath. COMPARISON: ___. FINDINGS: Single portable view of the chest. Relatively low lung volumes are seen compared to prior. Somewhat streaky right basilar opacity is most suggestive of atelectasis. Elsewhere, the lungs are grossly clear. The cardiac silhouette is enlarged but stable in configuration. Atherosclerotic calcifications noted at the aortic arch. IMPRESSION: No definite acute cardiopulmonary process. No evidence of pulmonary edema. " b4f400af-e5672816-2d6c42f3-661a2182-76f400aa.jpg,test/p15/p15168170/s51769638/b4f400af-e5672816-2d6c42f3-661a2182-76f400aa.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with epigastric pain, evaluate for cardiopulmonary change // ___F with epigastric pain, evaluate for cardiopulmonary change TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Calcified right mid lung nodule consistent with calcified granuloma is again seen, stable. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. Cervical surgical hardware is incidentally noted. IMPRESSION: No acute cardiopulmonary process. " f3645932-b6b3e8fd-ca3f683d-7b5133a5-b62e0a64.jpg,test/p17/p17511292/s58922794/f3645932-b6b3e8fd-ca3f683d-7b5133a5-b62e0a64.jpg,test," FINAL REPORT HISTORY: Right atrial lead revision. FINDINGS: In comparison with study of ___, the position of right atrial lead has been slightly changed, though with tip still lies within this structure. Patient taken a much better inspiration. No vascular congestion or acute focal pneumonia. " 72118a4c-61c4a73d-643fc40b-a0ce9bb4-4a947691.jpg,test/p13/p13907527/s52901425/72118a4c-61c4a73d-643fc40b-a0ce9bb4-4a947691.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Locally advanced squamous cell carcinoma, presenting with dizziness and right-sided rhonchi. COMPARISON: None. Reference made to chest CT from ___. FINDINGS: Again seen is a large left pleural effusion with overlying atelectasis. The left aspect of the cardiac silhouette is not well assessed due to the left-sided pleural effusion and atelectasis, opacity. Known cavitary mass in the left lung apex, better assessed on CT. The right lung is clear. There is no right pleural effusion. No pneumothorax is seen. IMPRESSION: 1. Clear right lung without focal consolidation or pleural effusion. 2. Large left pleural effusion with overlying atelectasis. Left apical cavitary lesion, better assessed on CT. " 73db8214-b6bac279-a0b854d7-dbe7bd33-889272ed.jpg,test/p13/p13050559/s53116365/73db8214-b6bac279-a0b854d7-dbe7bd33-889272ed.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man sp RU lobectomy, eval for effusion, concern for hemothorax // effusion IMPRESSION: As compared to the previous radiograph from several hours earlier, postoperative widening of the mediastinum is similar in appearance as well as postoperative volume loss related to recent right upper lobe resection. Low lung volumes result in crowding of pulmonary vasculature. Small right pleural effusion is present but there is no visible pneumothorax. Subcutaneous emphysema is present in the right chest wall near the insertion site of a right chest tube. " 8cb710d5-850a81aa-dc98768b-0a24348f-57f8d639.jpg,test/p17/p17217213/s51527055/8cb710d5-850a81aa-dc98768b-0a24348f-57f8d639.jpg,test," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old female with altered mental status. COMPARISON: ___ and ___. FINDINGS: Single portable view of the chest. Low lung volumes are again noted with crowding of the bronchovascular markings. Streaky left basilar opacities are more conspicuous and may be due to atelectasis. Elevation of the left hemidiaphragm with respect to the right is again seen. Cardiomediastinal silhouette is stable. Left PICC is no longer visualized. IMPRESSION: No definite acute cardiopulmonary process. " 3a9757d1-1ef4a3ac-b636bd1b-48803c6c-b347313a.jpg,test/p18/p18982551/s51242771/3a9757d1-1ef4a3ac-b636bd1b-48803c6c-b347313a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with a history of AV block status post pacemaker implantation and biventricular ICD upgrade, chronic kidney disease, congestive heart failure, dilated cardiomyopathy, hepatitis C, and a history of endocarditis status post mechanical mitral valve replacement in ___. She has noted a anterior chest wall nodule with intermitted oozing. She was referred to Dr. ___. // please eval pacing wires please eval pacing wires COMPARISON: Prior chest radiographs most recently ___. IMPRESSION: There has been no change since at least ___ in the disposition of following transvenous leads, right atrial and right ventricular and left ventricular pacer leads and a right ventricular pacer defibrillator lead. Epicardial lead fragments are also unchanged in their positions. Heart is normal size. Lungs are grossly clear. " ea5921e1-3d69922f-99be75c2-80df49e9-241ce37c.jpg,test/p17/p17013671/s53251091/ea5921e1-3d69922f-99be75c2-80df49e9-241ce37c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with dizziness and mild altered mental status with concern for possible infectious etiology // Please assess for possible pneumonia or pleural effusion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Degenerative changes are seen along the spine including DISH and anterior bridging osteophytes in the mid to lower thoracic spine. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. No focal consolidation or pleural effusion. " 2dcca50c-b4dbf4b7-5c8677c7-47c644e8-9cc228a9.jpg,test/p16/p16587046/s56503321/2dcca50c-b4dbf4b7-5c8677c7-47c644e8-9cc228a9.jpg,test," FINAL REPORT INDICATION: ___F with pneumonia // Eval for infiltrate TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Low lung volumes are again seen on the current exam. Increased opacity at the lung bases particularly on the lateral may be secondary to atelectasis given lower lung volumes, the frontal view is relatively clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Limited exam. Bibasilar opacities particularly on the lateral view could represent atelectasis in the setting of low lung volumes although infection is not excluded. " 73d47300-100d3db7-acf4ad5d-f0b29854-984e6470.jpg,test/p16/p16830759/s57338936/73d47300-100d3db7-acf4ad5d-f0b29854-984e6470.jpg,test," FINAL REPORT HISTORY: Possible pneumonia. FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Continued enlargement of the cardiac silhouette, with evidence of elevated pulmonary venous pressure. Retrocardiac opacification is again consistent with volume loss in the left lower lobe and pleural effusion. Less prominent changes are seen at the right base. In the appropriate clinical setting, supervening pneumonia would have to be considered. " 1970b2bf-33c795b4-6cffc039-da5e69a1-c8b516cf.jpg,test/p16/p16805727/s56575426/1970b2bf-33c795b4-6cffc039-da5e69a1-c8b516cf.jpg,test," FINAL REPORT CXR, TWO VIEWS HISTORY: Followup patchy nodular density right lung on prior chest x-ray of ___. FINDINGS: Heart is mildly enlarged. No congestive heart failure. No pneumonia. Minimal patchy density projected in the right upper lung on previous chest x-ray of ___ is no longer present. AICD device noted. CONCLUSION: The lung fields are clear. No pneumonia. Patchy densities in the right lung, in the upper as well as the middle lobe seen previously have cleared. " 1212c1eb-dd8be3d6-4527800f-938a5070-c3625f32.jpg,test/p15/p15996527/s59617093/1212c1eb-dd8be3d6-4527800f-938a5070-c3625f32.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with SOB and cough // infection? effusion? cause persistent SOB TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Subsegmental atelectasis is seen in the left lung base. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Left basilar subsegmental atelectasis. No evidence for pneumonia or pleural effusion. " 4a6a9248-fd3a226d-8c170e79-afdcb7b4-c450e1a4.jpg,test/p11/p11712537/s58859764/4a6a9248-fd3a226d-8c170e79-afdcb7b4-c450e1a4.jpg,test," FINAL REPORT REASON FOR EXAM: ___ years old man, evaluation for pneumonia. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: AP portable single-view chest x-ray shows moderate lung volume without opacity concerning for pneumonia. There is no pleural effusion or pneumothorax. Heart size is moderately enlarged in patient with median sternotomy for prior cardiac surgery. The right IJ catheter ends in upper SVC, unchanged since prior chest x-ray. IMPRESSION: There are no signs of acute cardiopulmonary process. Cardiomegaly. " 9daf45bd-4c575d88-b0740f5f-62df1f86-9c3fa90a.jpg,test/p16/p16426000/s54999302/9daf45bd-4c575d88-b0740f5f-62df1f86-9c3fa90a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ___ year old man with right 1 st rib resection and small apical pneumo. // assess for pneumothorax expansion. assess for pneumothorax expansion. IMPRESSION: In comparison to study ___, there has been a much better inspiration. There is no evidence of acute cardiopulmonary disease or pneumothorax. " 6572e972-9a306c41-3ead02df-42efd6ec-1e2be0c7.jpg,test/p12/p12078716/s58419606/6572e972-9a306c41-3ead02df-42efd6ec-1e2be0c7.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 3 EXAMS INDICATION: ___ year old man with new dobhoff // dobhoff placement TECHNIQUE: Portable chest radiograph COMPARISON: Chest radiograph. ___ FINDINGS: The first image shows a Dobhoff tube is coiled in the proximal esophagus and then terminates in the distal esophagus. Subsequent images show positioning more distally with the tip seen in the distal stomach or duodenum on the final image. Lung volumes are unchanged. The cardiomediastinal contour is also unchanged with prominence of the hila consistent with pulmonary arterial enlargement. Aortic valve replacement and median sternotomy again noted. No consolidation or pneumothorax seen. IMPRESSION: The final image shows a Dobhoff tube positioned in the distal stomach or duodenum. " db1a5931-08946ce4-afb37565-1b360438-f0e4c19a.jpg,test/p19/p19620193/s57496111/db1a5931-08946ce4-afb37565-1b360438-f0e4c19a.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with ongoing cough and wheeze // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. Chest radiograph dated ___. FINDINGS: No significant interval change. No edema, effusion, focal consolidation, or pneumothorax. Mild cardiomegaly is unchanged. The ascending and descending thoracic aorta is ectatic, unchanged since at least ___. IMPRESSION: 1. No pneumonia. 2. Tortuous thoracic aorta, similar to ___. " 9a939f02-3c245435-2267bc6c-a705e1e6-b41a8543.jpg,test/p17/p17828122/s53738535/9a939f02-3c245435-2267bc6c-a705e1e6-b41a8543.jpg,test," WET READ: ___ ___ ___ 2:33 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with sickle cell and body/chest pain // please eval for acute chest TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dated ___ through ___.. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 04d25bf5-0feeff18-96cd314c-10b51288-00c57ffa.jpg,test/p10/p10299070/s51650486/04d25bf5-0feeff18-96cd314c-10b51288-00c57ffa.jpg,test," WET READ: ___ ___ ___ 5:59 PM Slightly improved aeration of the left lower lobe although persistent left upper and lower lobe opacities with volume loss with shift of the heart and mediastinum to the left. Interval extubation with removal of NG tube and right IJ catheter. WET READ VERSION #1 ___ ___ ___ 5:45 PM Slightly improved aeration of the left lower lobe although persistent left upper and lower lobe opacities with volume loss with shift of the heart and mediastinum to the left. Interval extubation with removal of NG tube and right IJ catheter. WET READ VERSION #2 ___ ___ ___ 5:56 PM Slightly improved aeration of the left lower lobe although persistent left upper and lower lobe opacities with volume loss with shift of the heart and mediastinum to the left. Interval extubation with removal of NG tube and right IJ catheter. ______________________________________________________________________________ FINAL REPORT INDICATION: Altered mental status. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal and lateral chest radiographs. IMPRESSION: A left retrocardiac opacity persists, likely severe atelectasis, although more detail assessment is limited due to suboptimal positioning. Underlying consolidation cannot be excluded. There is no pneumothorax or pleural effusion. The patient has been extubated, and orogastric tube and right IJ catheter removed. " 06a566d1-cc391998-53202af2-1e630722-486c742c.jpg,test/p15/p15605860/s54023936/06a566d1-cc391998-53202af2-1e630722-486c742c.jpg,test," FINAL REPORT INDICATION: ___ year old man S/P repair L diaphragmatic hernia. TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs from ___ through ___. FINDINGS: Patient is status post repair of left diaphragmatic hernia. Compared to ___, there is no significant change. Previous left apical pneumothorax appear replaced with fluid. Left lung base atelectasis and pleural effusion appear stable and unchanged. The right lung is unchanged and grossly normal. The heart size is likely top normal. The mediastinal and hilar contours are unremarkable. IMPRESSION: Stable postop appearance. Previous small left apical pneumothorax now replaced with fluid. " 85ba2591-3a2020ff-1a2ee2a9-822c7fde-f1a751d0.jpg,test/p14/p14964445/s58361312/85ba2591-3a2020ff-1a2ee2a9-822c7fde-f1a751d0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with weight loss // r/o path TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There are low lung volumes. There is mild cardiomegaly. The aorta is tortuous. Nodular dense opacities in the right hilum could represent adenopathy. Aside from bibasilar atelectasis, the lungs are clear. There is no evidence of pneumonia or pulmonary edema. There is no pneumothorax or pleural effusion. There is kyphosis, mild degenerative changes in the thoracic spine and a compression fracture in a lower thoracic vertebral body IMPRESSION: Low lung volumes. Rounded opacities in the right hilum could represent adenopathy, CT should be considered. " 1f52ddf4-9c3a5ea5-190bc90d-2058f141-31591bc5.jpg,test/p18/p18326030/s51492330/1f52ddf4-9c3a5ea5-190bc90d-2058f141-31591bc5.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alcoholic cirrhosis c/b portal HTN, ascites, hepatic hydrothorax s/p chest tube pull from R side. // interval change in R pleural effusion TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: In comparison with chest radiograph from ___, right thoracostomy tube has been removed. Tiny right apical pneumothorax has improved. Right basilar effusion has slightly increased. There is no left effusion. Lungs are otherwise clear. Mediastinal hilar contours are stable. Mild to moderate cardiomegaly is unchanged. IMPRESSION: 1. Mildly improved tiny right apical pneumothorax. 2. Slightly increased right basilar effusion. " 58458914-dcf9a69f-18660ce3-331b8314-e67e6a0b.jpg,test/p13/p13620449/s51096176/58458914-dcf9a69f-18660ce3-331b8314-e67e6a0b.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness and dizziness and head strike. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A single-lead pacemaker terminates in the right ventricle, as before. The heart is moderately enlarged. The mediastinal and hilar contours appear stable. The lungs appear clear. There is no pleural effusion or pneumothorax. The right hemidiaphragm is mildly elevated compared to the left. The bones are probably demineralized. IMPRESSION: Stable cardiomegaly. No evidence of acute cardiopulmonary disease. " cfc34c6d-f5a89a85-f9d0f532-5eac8095-4ba660bc.jpg,test/p19/p19533644/s52011111/cfc34c6d-f5a89a85-f9d0f532-5eac8095-4ba660bc.jpg,test," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with fever and cough. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear without focal consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 83e25fde-d6cb0e9d-e71bea2d-c02c233a-1e59f7f4.jpg,test/p19/p19931923/s50154207/83e25fde-d6cb0e9d-e71bea2d-c02c233a-1e59f7f4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with hyperglycemia and concern for diabetic ketoacidosis// Please assess for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lung volumes are low but the lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " dd53ebdb-77aa2901-f15dc870-e3c72146-e54cacd8.jpg,test/p12/p12660416/s50075956/dd53ebdb-77aa2901-f15dc870-e3c72146-e54cacd8.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Pancreatitis and bacteremia; assess for septic emboli. Cardiac size is top normal. The lungs are clear. There is no evidence of pneumonia. There is no pneumothorax. Bilateral pleural effusions are small. " 838af82d-e7167abe-923e1d1e-d76c8af1-5f84d105.jpg,test/p12/p12878814/s57825585/838af82d-e7167abe-923e1d1e-d76c8af1-5f84d105.jpg,test," FINAL REPORT INDICATION: ___ year old man with bilateral chest tubes for effusions // Interval change FINDINGS: As compared to chest radiograph from 1 day earlier, stable or effaces including bilateral pigtail catheters and tunneled right-sided catheter in similar position. New widespread opacity throughout the right lung with increasing left retrocardiac and lingular opacities. No pneumothorax. Cardiomediastinal silhouette is stable. IMPRESSION: New widespread opacity throughout the right lung is likely asymmetric pulmonary edema. Differential diagnosis includes pulmonary hemorrhage and massive aspiration. " 5da23282-debd85fd-4583d9a6-acc34e06-a95ca2c8.jpg,test/p15/p15239201/s52664493/5da23282-debd85fd-4583d9a6-acc34e06-a95ca2c8.jpg,test," WET READ: ___ ___ ___ 6:36 PM Supine portable chest radiograph demonstrates an endotracheal tube, its tip which projects approximately 3.8 cm above the level of the carina. Enteric tube descends the thorax in uncomplicated course, its tip incompletely imaged. A Swan-Ganz catheter projects over the anticipated location of the main pulmonary artery, advanced relative to prior examination. There persist complete opacification of the right hemi thorax, increased relative to prior examination performed approximately 7 hours prior. There is no significant shift of normally midline structures. Scattered opacities are perihilar and location within the right chest. A ___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PA catheter, advanced // ?swan placement ?swan placement COMPARISON: CHEST RADIOGRAPHS ___ THROUGH ___ AT very useful study 11:47. IMPRESSION: Patient has had a large left pleural effusion since ___. It was slightly smaller earlier today. New opacification in the left hemi thorax is due to collapse. There is no pneumothorax. Mild to moderate diffuse infiltrative abnormality in the right lobe is unchanged cover could be edema. Right pleural effusion is small if any. Swan-Ganz catheter ends near the pulmonary outflow tract, probably below the valve. ET tube in standard placement. Esophageal drainage tube passes into the stomach and out of view. " f72670c8-25742684-74a7512c-0f4cd63e-e20a87bb.jpg,test/p18/p18944791/s57062387/f72670c8-25742684-74a7512c-0f4cd63e-e20a87bb.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: Right lower lobe pneumonia, intubated, question interval change. REFERENCE EXAM: ___ FINDINGS: There is increased elevation of the right hemidiaphragm with increased infiltrate in the right lower lobe. There continues to be pulmonary vascular re-distribution. There is patchy area of infiltrate in the left lower lung. ET tube and NG tube are unchanged. " 80ff2749-ef33c2f2-d427a6e0-fd7af72f-ab3908ab.jpg,test/p15/p15143186/s50900904/80ff2749-ef33c2f2-d427a6e0-fd7af72f-ab3908ab.jpg,test," FINAL REPORT INDICATION: Dyspnea, evaluate for acute cardiopulmonary disease. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: The lungs are well expanded. There are diffuse bilateral interstitial opacities, more predominant in the lung bases, with ___ B lines and associated small bilateral pleural effusions. Cardiac size is slightly enlarged allowing for limitations of this AP view. Significant atherosclerotic calcifications of the aortic arch are present. There is no pneumothorax. Evidence of a large hiatal hernia is again seen. Left axillary soft tissue calcifications are again seen. IMPRESSION: Acute pulmonary edema with associated bilateral pleural effusions. " 7e5bbfc6-9b90d5c9-84b3f29f-0d7d65a0-bb9b4262.jpg,test/p19/p19575197/s59931957/7e5bbfc6-9b90d5c9-84b3f29f-0d7d65a0-bb9b4262.jpg,test," FINAL REPORT INDICATION: Evaluation of patient with history of cough. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " 802ed688-1ef1424d-41de7cbd-280dbb18-61c023bd.jpg,test/p16/p16863449/s52415147/802ed688-1ef1424d-41de7cbd-280dbb18-61c023bd.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with month of cough // assess for mass/infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " d578c64c-c04b848d-8ab41753-fd538582-823e1d62.jpg,test/p18/p18006988/s51754926/d578c64c-c04b848d-8ab41753-fd538582-823e1d62.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Asthma, RA on MTX presenting with SOB for 1 week // Evidence of infection COMPARISON: ___. FINDINGS: Cardiomediastinal contours are stable. A very large hiatal hernia is again demonstrated. Lungs and pleural surfaces are clear, with no new areas of consolidation. IMPRESSION: No evidence of pneumonia. " fb4cdacc-a7a33ca3-708cc99e-e0859a45-e9472cb4.jpg,test/p15/p15439394/s54999771/fb4cdacc-a7a33ca3-708cc99e-e0859a45-e9472cb4.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of melanoma // please evaulate disease status COMPARISON: ___ FINDINGS: Cardiomegaly is stable compared to the prior study. Bilateral interstitial lung opacities are similar to the prior study and have been more fully characterized on recent CT of ___. Low lung volumes may be due to restrictive physiology. No new suspicious nodules or masses are identified. There is no evidence of pleural effusion or acute skeletal abnormality. IMPRESSION: 1. No chest radiographic evidence of pulmonary metastases. 2. Chronic interstitial lung disease ttern, more fully characterized on recent CT of ___. " ecb87ca2-4f0cd538-eb9b3501-0181f7b6-15ef780e.jpg,test/p16/p16783674/s57364496/ecb87ca2-4f0cd538-eb9b3501-0181f7b6-15ef780e.jpg,test," FINAL REPORT CHEST ON ___ HISTORY: CVA, tube feeds, check Dobbhoff tube. FINDINGS: The Dobbhoff tube is coiled in the stomach. There is mild pulmonary vascular re-distribution. There is volume loss at both bases. Heart size is mildly enlarged. The amount of fluid overload is slightly increased compared to the prior exam. " 2a1354d9-33d0f3b7-95c6a5e2-4203d5b3-2b17d78e.jpg,test/p17/p17561108/s57961610/2a1354d9-33d0f3b7-95c6a5e2-4203d5b3-2b17d78e.jpg,test," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old man with lymphoma and right pleural thickening. Recent viral pneumonia. Assess changes to right pleural effusion. IMPRESSION: A PA and lateral chest compared to ___: A previous mild pulmonary edema on ___ has almost cleared, extensive right pleural thickening or loculated fluid at the periphery of the right lung is unchanged. Previous left lower lobe pneumonia has also cleared. Right supraclavicular jugular infusion port ends high in the SVC. No pneumothorax. Moderate cardiomegaly is chronic. " b0c1a951-4a603a83-2b534d70-df731f09-858e52ac.jpg,test/p12/p12551576/s59874490/b0c1a951-4a603a83-2b534d70-df731f09-858e52ac.jpg,test," WET READ: ___ ___ 3:55 PM No acute cardiopulmonary process. No pneumoperitoneum. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with heartburn presenting after one episode hematemesis at 3am. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___ FINDINGS: The lungs are clear. Mild bibasilar atelectasis noted. Apparent prominence of the cardiac silhouette likely reflect AP technique and known epicardial fat pads. The hilar contours and pleural surfaces are unremarkable. No pneumothorax, pulmonary edema, or pneumonia. There is no free air seen under the diaphragm. Surgical clips again noted in the left axilla. IMPRESSION: No acute cardiopulmonary process. No signs of pneumoperitoneum. " 0c366ee5-20030df2-9463b6e1-148e4db0-4dc8c764.jpg,test/p19/p19960115/s51620808/0c366ee5-20030df2-9463b6e1-148e4db0-4dc8c764.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with trach, now s/p bronch for RLL atelectasis // Interval change? resolution of atelectasis? IMPRESSION: As compared to prior study of 2 days earlier, pulmonary vascular congestion and interstitial edema are new, accompanied by slight increase in size of a small to moderate right pleural effusion. Small left pleural effusion is a persistent finding. " 8550a08a-e884a455-5a0c6737-a64221fb-441ca2bf.jpg,test/p11/p11235666/s56152408/8550a08a-e884a455-5a0c6737-a64221fb-441ca2bf.jpg,test," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are mildly hyperexpanded but clear. Postsurgical changes are seen in the right upper hemithorax from prior lobectomy with resultant volume loss. Mild hyperinflation and leftward shift of the cardiomediastinum--___ some extent a function of mild thoracic scoliosis--___ chronic. There is no pleural effusion or pneumothorax. The heart is normal in size with dual lead pacemaker defibrillator noted in conventional position. IMPRESSION: No acute intrathoracic process. " f7c3bc44-74d7e47f-c6ae29d0-42980f5b-65bfe0fd.jpg,test/p14/p14454079/s56846622/f7c3bc44-74d7e47f-c6ae29d0-42980f5b-65bfe0fd.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with productive cough. // pneumonia?? TECHNIQUE: Chest PA and Lateral COMPARISON: ___ FINDINGS: The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is normal in size. IMPRESSION: No acute cardiopulmonary process " f93d0ee7-3c2e9efc-e5c33079-b4150e5b-b5aace20.jpg,test/p10/p10161233/s57347968/f93d0ee7-3c2e9efc-e5c33079-b4150e5b-b5aace20.jpg,test," FINAL REPORT INDICATION: ___-year-old female with history of sarcoidosis and asthma, persistent cough, question pneumonia. COMPARISONS: Multiple prior chest radiographs, most recently PA and lateral from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " ec9732b5-eeb9d061-4818dc77-1f2e9677-d26062ad.jpg,test/p18/p18976991/s51942999/ec9732b5-eeb9d061-4818dc77-1f2e9677-d26062ad.jpg,test," FINAL REPORT HISTORY: Abdominal distention and respiratory failure. FINDINGS: In comparison with the study of ___ from an outside facility, there is again substantial enlargement of the cardiac silhouette. Mild indistinctness of pulmonary vessels could reflect some elevated pulmonary venous pressure. Mild atelectatic changes are seen at the bases, without definite pneumonia. Endotracheal tube lies at the upper clavicular level, approximately 7.5 cm above the carina. Left IJ catheter extends to the lower portion of the SVC. Nasogastric tube extends to the upper stomach, where it crosses the lower margin of the image. Again, there is huge dilatation of what appears to be gas-filled loops of colon. " fb726e3c-bfadb709-8d820ec3-9d9ec8ca-a9a81c22.jpg,test/p15/p15435415/s51701215/fb726e3c-bfadb709-8d820ec3-9d9ec8ca-a9a81c22.jpg,test," FINAL REPORT INDICATION: ___ year old man with pre-op AVR // pre-op chest xray TECHNIQUE: Chest PA and lateral COMPARISON: No priors. FINDINGS: Enlargement of the cardiac silhouette may reflect cardiomegaly or pericardial effusion. Lung volumes are low. No pulmonary edema. No airspace consolidation. No pleural effusions. Spondylotic changes of the thoracic spine. IMPRESSION: Enlarged cardiac silhouette could reflect cardiomegaly or pericardial effusion. No pulmonary edema. No pneumonia. " 5eaca41a-8c02a488-5bd234d5-5015f5d1-6fd9e324.jpg,test/p16/p16387058/s59219841/5eaca41a-8c02a488-5bd234d5-5015f5d1-6fd9e324.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Gallstones with left lower quadrant abdominal pain, question free air. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Basilar atelectasis is again seen. Right base calcified granuloma is again noted. Posterior mid lung calcified granuloma is also again seen best on the lateral view. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top normal to mildly enlarged. The aorta remains tortuous. No overt pulmonary edema is seen. IMPRESSION: Mild bibasilar atelectasis. Otherwise, no acute cardiopulmonary process. " d14f77bc-26fe4351-00d23f62-5ac80c96-5667a7b4.jpg,test/p17/p17288913/s56710962/d14f77bc-26fe4351-00d23f62-5ac80c96-5667a7b4.jpg,test," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with syncope, head strike and cspine pain, hx of cspine surg pls eval for injury, also eval cxr for pna // History: ___M with syncope, head strike and cspine pain, hx of cspine surg pls eval for injury, also eval cxr for pna TECHNIQUE: Chest AP and lateral COMPARISON: ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. Calcifications are seen within the aortic arch. The cardiomediastinal silhouette is within normal limits. A surgical anchor is seen within the left humeral head. Degenerative changes are noted within the bilateral AC joints. IMPRESSION: No evidence of acute cardiopulmonary process. " 76a9859e-ae0ff047-98e72ae4-16d2cb20-fbdcd2ee.jpg,test/p19/p19657904/s51105576/76a9859e-ae0ff047-98e72ae4-16d2cb20-fbdcd2ee.jpg,test," FINAL REPORT INDICATION: Respiratory distress. COMPARISONS: Chest radiograph of ___. FINDINGS: AP portable view of the chest demonstrates low lung volumes. No large pleural effusion, pneumothorax or focal consolidation. The aorta is markedly tortuous without focal aneurysmal changes. Heart is mildly enlarged. Mild perihilar vascular congestion is noted. IMPRESSION: Mild cardiomegaly and perihilar vascular congestion. " a5b8ea3c-8e86fb4e-e11babfa-998c86d7-9a2d4fce.jpg,test/p12/p12304672/s52487162/a5b8ea3c-8e86fb4e-e11babfa-998c86d7-9a2d4fce.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, s/p urologic procedure now with hypoxia, leukocytosis and hypotension // ?pna, volume overload IMPRESSION: In comparison to ___ chest radiograph, a small left pleural effusion has increased in size and is accompanied by adjacent atelectasis and or consolidation in the left mid and lower lungs. Right lung and pleural surfaces remain clear. " 8816456e-4455cc43-7cb70ab3-ec4d61de-8f256a35.jpg,test/p15/p15586571/s53567587/8816456e-4455cc43-7cb70ab3-ec4d61de-8f256a35.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fall and SAH. Eval for CHF/pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart size, mediastinal, and hilar contours are normal. The lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 681b6427-707e9421-3b0d129b-5bedec2a-708104d7.jpg,test/p14/p14350265/s56983456/681b6427-707e9421-3b0d129b-5bedec2a-708104d7.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with stroke vs seizure // rule out pna COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Mild cardiomegaly is increased since ___, accompanied by increased caliber of mediastinal veins, but there is no edema or appreciable pleural effusion in the lungs are clear of any focal abnormality. No pneumothorax. " 7e2313a2-63f82ae4-52f3c6bc-07c44c65-9515eaf0.jpg,test/p10/p10498545/s56789676/7e2313a2-63f82ae4-52f3c6bc-07c44c65-9515eaf0.jpg,test," FINAL REPORT EXAM: CHEST FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Asthma, reports onset of cough with hemoptysis today. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " afa18b4a-5d8cb5c0-a4d9cf54-d3339089-2142462a.jpg,test/p19/p19271682/s54706003/afa18b4a-5d8cb5c0-a4d9cf54-d3339089-2142462a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESRD now s/p tunneled HD cath placement ___ c/o reproducible chest pain // PTX? Cardiopulmonary process? TECHNIQUE: Plain film COMPARISON: ___ FINDINGS: Portable upright AP chest radiograph shows left internal jugular tunneled hemodialysis catheter with the tip at the level of the right atrium. No new lung parenchymal consolidation or mediastinal change is seen. Small right pleural effusion may be present but the blunted lateral CP angle there is not different compared to ___. Old healed proximal right humeral fracture. IMPRESSION: Expected appearances status post left tunneled hemodialysis catheter without findings to account for pain " d0bd8e2e-6dea1fa0-abcb8ebb-0f3d648c-616c4694.jpg,test/p11/p11344751/s50132124/d0bd8e2e-6dea1fa0-abcb8ebb-0f3d648c-616c4694.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HIV and shock COMPARISON: Chest radiograph from ___. FINDINGS: AP view of the chest provided. Compared to prior study, there is interval increase in right lung opacity, more confluent in the bases with air bronchograms. There is no shift in mediastinum. Findings concern developing pneumonia. The opacity is stable. Endotracheal tube, left IJ line, right IJ dialysis catheter are in appropriate positions. Nasogastric tube is seen coursing into the stomach and out of view. IMPRESSION: Worsening right lower lobe pneumonia compared to prior study 1 day ago. " 012d35bd-45cf39f3-051ff971-5ae485d5-e9bf8d9c.jpg,test/p18/p18931099/s52275650/012d35bd-45cf39f3-051ff971-5ae485d5-e9bf8d9c.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with loculated pleural effusion s/p right VATS decortication // assess for interval change TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There has been interval significant improvement in pulmonary edema with minimal to none remaining. Loculated right pleural effusion is again seen, similar in appearance. The left lung is clear. There is no left pleural effusion. The cardiac silhouette remains enlarged. The aorta calcified and tortuous. IMPRESSION: Interval decrease in pulmonary edema with minimal to none remaining. Loculated right pleural effusion again seen, stable. " fc58d51d-46e1dc38-0151632a-1b684536-46b49b53.jpg,test/p15/p15155342/s58768401/fc58d51d-46e1dc38-0151632a-1b684536-46b49b53.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after ASD closure and Maze procedure. AP radiograph of the chest was reviewed in comparison to ___. The patient was extubated. The right internal jugular line tip is at the level of low SVC. Pacemaker leads terminate in the expected locations. There is interval improvement in aeration of the left mid and lower lungs. There is no pulmonary edema. There is no appreciable pneumothorax. " 1c3b1fbd-1da06801-7e095b62-f4fb4363-36eb30fa.jpg,test/p19/p19398915/s57651522/1c3b1fbd-1da06801-7e095b62-f4fb4363-36eb30fa.jpg,test," FINAL REPORT HISTORY: Hydrothorax. FINDINGS: In comparison with study of ___, the monitoring and support devices are unchanged. ___ tube has been removed. Bilateral substantial pleural effusions with retrocardiac opacification consistent with volume loss in the left lower lobe. Mild interstitial pulmonary edema is again seen. " 8e428b8b-c080c07d-2c3797e3-6947ba16-34aa31d8.jpg,test/p13/p13050109/s53055893/8e428b8b-c080c07d-2c3797e3-6947ba16-34aa31d8.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with leukocytosis, past pleural effusions, wish to assess interval change // progressive pleural effusions? progressive pleural effusions? IMPRESSION: Comparison to ___. Decrease in severity of the pre-existing right basilar atelectasis. Stable moderate cardiomegaly with left retrocardiac atelectasis. No overt pulmonary edema. No pneumothorax. " acb415e1-58749b4a-6fd6b548-31676bf8-add51ae0.jpg,test/p14/p14900452/s57674636/acb415e1-58749b4a-6fd6b548-31676bf8-add51ae0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with FB sensation in throat // ? free air or visible foreing body TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No radio-opaque foreign bodies identified. IMPRESSION: No acute cardiopulmonary abnormality. No radio-opaque foreign bodies identified. " 23a95947-9bdd896c-bc79e205-e541eee6-eeff733f.jpg,test/p13/p13715870/s54268288/23a95947-9bdd896c-bc79e205-e541eee6-eeff733f.jpg,test," FINAL REPORT HISTORY: ___-year-old male with altered mental status. COMPARISON: Prior exam is dated ___. FINDINGS: PA and lateral views of the chest provided demonstrate midline sternotomy wires and mediastinal clips again noted. The heart remains top-normal in size. Aorta is unfolded. The lungs are clear without focal consolidation effusion or pneumothorax. The bony structures are intact. No free air is seen below the right hemidiaphragm. A metallic coil is again noted in the upper mid abdomen. IMPRESSION: No acute intrathoracic process. " 12d26569-c03d9ebd-bfb02bf5-c341e253-9020be7d.jpg,test/p18/p18979163/s57764810/12d26569-c03d9ebd-bfb02bf5-c341e253-9020be7d.jpg,test," FINAL REPORT HISTORY: Cough. FINDINGS: In comparison with study of ___, there is no change or evidence of acute cardiopulmonary disease. Specifically, no evidence of acute pneumonia. " 67fce22a-74ab51fc-b8de860b-7d8c19a4-91c2c547.jpg,test/p16/p16891303/s59213782/67fce22a-74ab51fc-b8de860b-7d8c19a4-91c2c547.jpg,test," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath and pedal edema. Question acute process. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A dual-lead pacemaker/ICD device appears unchanged. The heart is mildly enlarged with left ventricular configuration. The mediastinal and hilar contours appear unchanged. There is similar elevation of the right hemidiaphragm compared to the left. Patchy right basilar atelectasis has resolved. A linear opacity in the left costophrenic angle suggests scarring that appears unchanged. Degenerative changes are similar along the thoracic spine. IMPRESSION: No evidence of acute disease. " e7b3b542-294a82be-004fd1ab-5c6c5187-aae2495b.jpg,test/p13/p13510413/s54955714/e7b3b542-294a82be-004fd1ab-5c6c5187-aae2495b.jpg,test," WET READ: ___ ___ ___ 11:13 PM left base opacity- potentially pneumonia WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old male with vomiting. Question pneumonia. FINDINGS: Single portable view of the chest is compared to previous exam from ___. Since prior, there has been development of a left basilar opacity seen laterally. Superiorly, the lungs are clear. Cardiomediastinal silhouette is within normal limits for technique. Osseous and soft tissue structures are unremarkable. IMPRESSION: Left basilar opacity which may represent pneumonia in the proper clinical setting. Repeat after treatment is recommended to document resolution. " 7fec20a0-f2a3fabf-2e27f1c1-a1bcec9a-909c54ee.jpg,test/p16/p16332400/s53815056/7fec20a0-f2a3fabf-2e27f1c1-a1bcec9a-909c54ee.jpg,test," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old woman s/p laminectomy and placement of NGT // eval placement eval placement COMPARISON: Comparison to ___ at 11:15 FINDINGS: Portable semi-erect chest radiograph ___ at 10:37 is submitted. IMPRESSION: Nasogastric tube courses below the diaphragm and has its tip projecting over the stomach. Endotracheal tube has tip 5.5 cm above the carina. Interval placement of incompletely visualized hardware overlying the mid cervical spine in this patient status post surgery for cervical epidural abscess. Left axillary surgical clips and evidence of prior left breast surgery. Lungs remain well inflated without evidence of focal airspace consolidation to suggest pneumonia. No pulmonary edema. Overall cardiac and mediastinal contours are stable. Nodular opacity overlying the left lower lung is felt to correspond to the patient's nipple shadow. " db5899f9-855b0ddf-4844bd1e-79d8c49e-9e9c8b52.jpg,test/p12/p12448720/s57311157/db5899f9-855b0ddf-4844bd1e-79d8c49e-9e9c8b52.jpg,test," FINAL REPORT HISTORY: Chest tightness, to assess for acute process. FINDINGS: In comparison with the study of ___, the cardiac silhouette remains within normal limits and there is no vascular congestion or pleural effusion. There is minimal asymmetry of opacification at the right base medially. In the appropriate clinical setting, this could represent an area of consolidation, though it may merely reflect fortuitous overlap of pulmonary markings. " ee036b05-ec41c5fc-23818842-f8f319eb-64dd6db3.jpg,test/p11/p11531307/s56283004/ee036b05-ec41c5fc-23818842-f8f319eb-64dd6db3.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory distress COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Midline sternotomy wires are again seen. There is a right upper extremity access PICC line with its tip in the region of the low SVC unchanged. There is no focal consolidation, large effusion or pneumothorax. The lungs appear hyperinflated with scarring in the right upper lung unchanged. Findings may reflect emphysema. No signs of congestion or edema. The heart appears top-normal. Mediastinal contours unremarkable. Bony structures are intact. IMPRESSION: As above. " 4f3d1862-0b22d2ba-3f944c09-a8348485-a1da9b0f.jpg,test/p14/p14761445/s56611359/4f3d1862-0b22d2ba-3f944c09-a8348485-a1da9b0f.jpg,test," FINAL REPORT INDICATION: Evaluate for foreign body in a patient with a food bolus in the esophagus. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are without focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body is seen. The visualized upper abdomen is unremarkable. IMPRESSION: No radiopaque foreign body present. " f15a522f-696a5b2c-16eec114-01bf39a5-7b255b01.jpg,test/p17/p17894121/s53199455/f15a522f-696a5b2c-16eec114-01bf39a5-7b255b01.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of renal transplant on immunosuppression, subjective fevers and chills for 1 week and left sided rib/flank pain // evidence of infection TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are stable with Cardiac size top-normal. The lungs are clear. There is no pneumothorax or pleural effusion. Sternal wires are aligned. Again noted the second and third sternotomy wires are fractured IMPRESSION: No acute cardiopulmonary abnormalities " a2b1fead-4041c37c-02bc1174-2ccf53ae-19edb80d.jpg,test/p17/p17804936/s57245351/a2b1fead-4041c37c-02bc1174-2ccf53ae-19edb80d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with recent falls will like to rule out infection // ? acute cardiopulmonary process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires are again noted. There is a left chest wall Port-A-Cath with its tip in the region of the mid SVC. Lungs are clear without focal consolidation, large effusion or pneumothorax. The cardiomediastinal silhouette is stable and normal. Imaged bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " dc630d53-d4613e70-45d214b9-8caffb20-caed89cc.jpg,test/p12/p12464244/s56196989/dc630d53-d4613e70-45d214b9-8caffb20-caed89cc.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with newly diagnosed likely AML now with febrile neutropenia and increasing hypoxia // eval PNA, effusion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. The diameter of the hilar and vascular structures has increased and there is minimal increase in interstitial markings. Overall, the findings are strongly suggestive of mild to moderate pulmonary edema. There is no focal parenchymal opacities suggesting pneumonia. No pleural effusions. Mild cardiomegaly. " a2f4b509-8848ebcc-b7947758-347837fa-7848c272.jpg,test/p10/p10900387/s50078633/a2f4b509-8848ebcc-b7947758-347837fa-7848c272.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with flash pulmonary edema after treatment with also right lower lobe and right middle lobe pneumonia. PA and lateral upright chest radiographs were reviewed in comparison to ___. There has been interval improvement of pulmonary edema, substantial with only minimal residual Kerley B lines demonstrated. Right lower lung opacity is still present, consistent with known right middle lobe and right lower lobe infectious process. Mild vascular engorgement is still demonstrated. Cardiomegaly is moderate to severe, unchanged. No pneumothorax is seen. " f6bfd70a-d2b591d3-35863a70-c6d73b68-4ad09664.jpg,test/p11/p11084430/s50130027/f6bfd70a-d2b591d3-35863a70-c6d73b68-4ad09664.jpg,test," WET READ: ___ ___ 3:59 PM 1. Bibasilar opacities which likely represent atelectasis, however an infectious etiology cannot be ruled out. WET READ VERSION #___ ___ ___ ___ 1:58 PM 1. No definite evidence of pneumonia. 2. Cardiomegaly grossly unchanged from ___ 3. Bilateral enlarged pulmonary arteries, grossly unchanged. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with chest pain and cough TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___ Chest radiograph ___ FINDINGS: The lung volumes are normal. Mild to moderate enlargement of the cardiac silhouette is unchanged from chest radiograph ___. Bilateral hilar enlargement is compatible with enlargement of the bilateral pulmonary arteries as seen on CT chest ___. There are bibasilar opacities which likely represent atelectasis, however an infectious etiology cannot be ruled out. Degenerative changes of the lower thoracic spine. Mild pulmonary vascular congestion without frank pulmonary edema or pleural effusions is demonstrated. No pneumothorax. IMPRESSION: 1. Bibasilar opacities which likely represent atelectasis, however an infectious etiology cannot be excluded in the correct clinical setting. 2. Cardiomegaly grossly unchanged from ___ with mild pulmonary vascular congestion. 3. Pulmonary arterial enlargement suggestive of underlying pulmonary arterial hypertension. " 231d1b62-0ca76e91-ad21b031-2809e212-e616dc7f.jpg,test/p14/p14065514/s54463809/231d1b62-0ca76e91-ad21b031-2809e212-e616dc7f.jpg,test," FINAL REPORT HISTORY: MIE, to assess for change. FINDINGS: In comparison with study of ___, there is little overall change other than removal of the nasogastric tube. Low lung volumes persist with some elevation of the right hemidiaphragm. Evidence of gastric pull-through following esophagectomy. No evidence of acute pneumonia or vascular congestion. " a5fa705d-b3d74beb-f6f07fec-68ac7d27-a1decd07.jpg,test/p16/p16668735/s59350943/a5fa705d-b3d74beb-f6f07fec-68ac7d27-a1decd07.jpg,test," FINAL REPORT INDICATION: Fever. COMPARISON: Right clavicular radiograph from ___. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Again noted is a healed proximal one-third right clavicular fracture. Otherwise, no acute osseous abnormalities are identified. IMPRESSION: No acute cardiopulmonary process. " abf58b9b-510bd00f-c6f4625c-db6a18c4-68a2aa00.jpg,test/p17/p17629726/s50951049/abf58b9b-510bd00f-c6f4625c-db6a18c4-68a2aa00.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Melanoma, rule out metastatic disease. COMPARISON: ___. FINDINGS: As compared to the previous image, no relevant change is seen. Normal size of the cardiac silhouette. Unchanged appearance of the mediastinum. Moderate tortuosity of the thoracic aorta. No pleural effusions, no pneumonia, no pulmonary edema. No lung nodules suspicious for metastatic disease. " 64bf2593-8a527ab8-f1c4ba51-24aed2a1-6f7a6647.jpg,test/p10/p10617964/s52134503/64bf2593-8a527ab8-f1c4ba51-24aed2a1-6f7a6647.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ___F chest tube // pleural effusion interval change pleural effusion interval change COMPARISON: Chest radiographs since ___, most recently ___ through ___. IMPRESSION: Moderate left pleural effusion may have decreased slightly since ___, with a small bore pleural drainage catheter in place. Large right pleural effusion however is increasing. Bibasilar atelectasis is moderate on the right, severe on the left. Cardiac silhouette is partially obscured, but not grossly enlarged. There is no pneumothorax. A right supraclavicular jugular line ends in the region of the superior cavoatrial junction. Left lung nodules are difficult to see because of overlying pleural effusion and atelectasis. " e9c13852-5f1fba5d-20b59bcc-f4fae83a-e149a680.jpg,test/p17/p17804936/s52551888/e9c13852-5f1fba5d-20b59bcc-f4fae83a-e149a680.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Respiratory distress. Portable AP radiograph of the chest was reviewed in comparison to ___. The NG tube tip is in the stomach. The heart size and mediastinum are is stable. The ET tube tip is in appropriate position. Lungs are overall essentially clear. No interval development of pleural effusion or pneumothorax is seen as well as nonspecific focal consolidation demonstrated. " 62b08c32-179678e8-0f799c53-90a99d0b-7340dbb0.jpg,test/p14/p14428548/s54011428/62b08c32-179678e8-0f799c53-90a99d0b-7340dbb0.jpg,test," FINAL REPORT INDICATION: History of chest pain, shortness of breath while hyperventilating at the gym. Please evaluate for pneumothorax. COMPARISONS: None. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: No acute intrathoracic abnormalities identified. " a031c2fa-fd3b348b-d7c45dab-96ec2f33-d607a7bf.jpg,test/p11/p11390883/s55418524/a031c2fa-fd3b348b-d7c45dab-96ec2f33-d607a7bf.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory distress // any acute pulmonary process TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Interval progression of widespread parenchymal opacities is noted, highly concerning for severe pulmonary edema. Right internal jugular line tip is at the level of lower SVC. A etiology such as ARDS " a3162218-1e42b11f-b785a6c9-0ac61f23-3049c396.jpg,test/p12/p12176298/s56860886/a3162218-1e42b11f-b785a6c9-0ac61f23-3049c396.jpg,test," FINAL REPORT REASON FOR EXAMINATION: New ET tube placement. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. The patient was intubated with the ET tube tip being 2.5 cm above the carina. There is interval progression of interstitial pulmonary edema better appreciated in the left lung. Although rest of the findings are unchanged. " e7400f7c-caae80a3-0290d0db-9c7d6653-29d16a00.jpg,test/p17/p17079941/s52485187/e7400f7c-caae80a3-0290d0db-9c7d6653-29d16a00.jpg,test," WET READ: ___ ___ ___ 10:39 AM LOW LUNG VOLUMES. likely pulmonary edema. increased opacity at left lung base may be ateletasis or infection ___ d/w ___ (primary team) by phone at 10:38am ___. ______________________________________________________________________________ FINAL REPORT CLINICAL HISTORY: Tachycardia, hypoxia. CHEST, PA COMPARISON: ___. The opacities in the right and left lobe present on the prior chest x-ray are less pronounced on today's study. However, opacification is now seen in the left lower lobe, which was not present on the previous film. Lung volumes remain low. In view of the changing nature of the opacities, appearances most likely represent evidence of failure but pneumonia is not excluded. " 73adf652-fcebb36c-5e9744f8-01d792b3-d3f9c31a.jpg,test/p14/p14889442/s54554026/73adf652-fcebb36c-5e9744f8-01d792b3-d3f9c31a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with newly placed CVL // confirm R IJ TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 6 hours earlier. IMPRESSION: Right IJ catheter tip is in themid SVC. Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. " f3fcbda8-43ced708-1386efce-06910f23-abd0e1c3.jpg,test/p18/p18871870/s59153339/f3fcbda8-43ced708-1386efce-06910f23-abd0e1c3.jpg,test," FINAL REPORT INDICATION: ___ year old woman with hypoxia, ?ILD, fever overnight // Any evidence of consolidation, pneumonia? TECHNIQUE: Portable AP chest radiograph COMPARISON: Chest radiographs since ___, most recently ___. CT of the chest from ___. FINDINGS: Multifocal airspace opacities with peripheral and basilar predominance have been progressively worsening since ___, suggesting subacute time course. Mediastinal contours and heart borders are normal. No substantial pleural effusion. No pneumothorax. IMPRESSION: Multifocal opacities with peripheral basilar predominance suggest cryptogenic organizing pneumonia, less likely subacute eosinophilic pneumonia or subacute hypersensitivity pneumonitis which could have a similar appearance but typically have an upper lobe predominance not seen in this patient. Appearance inconsistent with infectious pneumonia. " ca797eba-cd259033-c72499f0-6a973b85-867d077f.jpg,test/p13/p13119476/s53959039/ca797eba-cd259033-c72499f0-6a973b85-867d077f.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p PPM upgrade to BIV (LV lead add to RV lead). Subclavian access. Eval for lead position and post procedure complications. // ___ year old man s/p PPM upgrade to BIV (LV lead add to RV lead). Subclavian access. Eval for lead position and post procedure complications. COMPARISON: Chest x-ray from ___ at 20:30 FINDINGS: Compared to the prior study and allowing for differences in technique, I doubt significant interval change. On the lateral view, lead tips project anteriorly and posteriorly and could lie in relation to the right and left ventricles. Small amount of subcutaneous emphysema is noted about the battery pack, compatible with recent surgery. There is hyperinflation consistent with COPD. Changes along the right mediastinum are consistent with known neo esophagus. Rounded area of increased density in the lower middle mediastinum could also be related to the esophageal surgery. Prominence of the pulmonary hila could reflect pulmonary hypertension. There is deformity and pleural thickening along the right chest wall consistent with prior trauma and/or surgery. Multiple clips are seen posteriorly in the chest. There is blunting of both costophrenic angles posteriorly consistent with pleural fluid and/or thickening. No pneumothorax is detected. IMPRESSION: Leads extend over the right and left ventricles, respectively. Small bilateral effusions. No pneumothorax detected. Small amount of subcutaneous emphysema is noted about the battery pack compatible with recent surgery. Cardiomediastinal silhouette is enlarged but unchanged. No overt CHF. No focal consolidation. " 976247ee-5bcb53a8-1d6612e3-8163b12e-2256eb5c.jpg,test/p10/p10542587/s53565139/976247ee-5bcb53a8-1d6612e3-8163b12e-2256eb5c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with wheezing // eval infiltrate COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Subtle opacity is seen projecting over the right lung base which could represent a very early pneumonia in the right lower lobe. Otherwise, lungs are clear. No effusion or pneumothorax. Heart size is top-normal. Mediastinal contour is normal. Fusion hardware in the lower cervical spine is noted. Bony structures appear intact. No free air is seen below the right hemidiaphragm. IMPRESSION: Subtle right lower lung opacity could represent an early pneumonia in the right lower lobe. Top-normal heart size. " 9a64be21-faed0f1d-21ae5500-61274641-4ae9eb5f.jpg,test/p11/p11275268/s58179380/9a64be21-faed0f1d-21ae5500-61274641-4ae9eb5f.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough and fevers, extensive history of smoking. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable, as are the hilar contours. IMPRESSION: No acute cardiopulmonary process. " b92d3099-a0f18686-e5e94f11-d606219b-8e2d13e1.jpg,test/p12/p12759187/s53083861/b92d3099-a0f18686-e5e94f11-d606219b-8e2d13e1.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multiple comorbidities, worsening anemia, concern for ongoing blood loss. // Evidence of hemothorax Evidence of hemothorax IMPRESSION: Comparison to ___. Interval increase of the pre-existing right pleural effusion. The effusion now causes a decrease in radiolucency of the entire right hemi thorax. A small left pleural effusion is new. Moderate cardiomegaly. No overt pulmonary edema. Bilateral areas of atelectasis but no evidence of pneumonia. Unchanged position of a left-sided hemodialysis catheter. " 783eb1ef-458adee6-4dd47804-f9bbd68d-2eee276e.jpg,test/p16/p16259867/s56331557/783eb1ef-458adee6-4dd47804-f9bbd68d-2eee276e.jpg,test," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that coils within the upper stomach, so that the tip points upward just below the level of the esophagogastric junction. Extensive atelectatic changes are seen in the left mid and lower lung. " fd907749-09614d1b-a90020d5-5e232aaa-b8e1fedb.jpg,test/p19/p19067090/s52350747/fd907749-09614d1b-a90020d5-5e232aaa-b8e1fedb.jpg,test," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Preop. IMPRESSION: PA and lateral chest compared to ___: Heart size is top normal, unchanged since ___. Lungs fully expanded and clear. The hilar and mediastinal contours and pleural surfaces are normal. Atherosclerotic calcification is heavy in the left and possibly right carotid. Heavy mitral annulus calcification seen on the lateral view with no indication of mitral regurgitation. " c6eee531-12c0abae-cab3a26e-e10c38d1-21e19a86.jpg,test/p17/p17447691/s51004885/c6eee531-12c0abae-cab3a26e-e10c38d1-21e19a86.jpg,test," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with malaise. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Interposed colonic loops seen superior to the liver below the diaphragm. There is no visualized free intraperitoneal air. Compression deformity in the lower thoracic/upper lumbar spine is unchanged. No acute osseous abnormality identified. IMPRESSION: No acute cardiopulmonary process. " 994618d5-7295b089-a66dfb5e-1155e8fd-df3eed90.jpg,test/p11/p11493185/s55485142/994618d5-7295b089-a66dfb5e-1155e8fd-df3eed90.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with LLL mass sp sup segmentectomy // eval interval change eval interval change IMPRESSION: In comparison with the study of ___, there are substantially lower lung volumes with atelectatic changes at the bases. Little change in the appearance of the left chest tube, which makes an abrupt turn inferiorly at the level of the aortic arch and has its distal tip at the level of the hemidiaphragm. No evidence of pneumothorax. The heart and lungs are otherwise unchanged. " 634389aa-7e8b843d-dac50c3b-14723941-60a1bf44.jpg,test/p17/p17856154/s58586833/634389aa-7e8b843d-dac50c3b-14723941-60a1bf44.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Productive cough with yellow sputum. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is mild biapical pleural thickening. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. Thoracolumbar scoliosis is noted, but not well assessed. IMPRESSION: No acute cardiopulmonary process. " 5f25e023-b062b4aa-8f7a6a12-1b3be329-4befd61c.jpg,test/p12/p12559662/s56808761/5f25e023-b062b4aa-8f7a6a12-1b3be329-4befd61c.jpg,test," FINAL REPORT HISTORY: Change in mental status. COMPARISON: Chest radiograph ___, abdominal radiograph ___. FINDINGS: AP and lateral views of chest were reviewed. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. IMPRESSION: No acute cardiopulmonary abnormality. " af3f67ac-ce7ca469-a4c49af5-2f004315-f3802668.jpg,test/p16/p16002684/s53427748/af3f67ac-ce7ca469-a4c49af5-2f004315-f3802668.jpg,test," FINAL REPORT INDICATION: History: ___M with AMS, rigors // assess for pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Persistent opacity in the right upper paramediastinal area. The extrapulmonary lesion along the costal surface of the right mid lung appears smaller, but this may be secondary to projection. The left lung is clear. Elevated left hemidiaphragm unchanged. No pulmonary edema or pleural effusion. IMPRESSION: Persistent right upper paramediastinal density and right extra pulmonary lesion. A CT chest may be performed for better characterization. No new areas of airspace consolidation. " b8525d63-f169df70-87eb0df6-58ea0516-6776d665.jpg,test/p19/p19864559/s53915009/b8525d63-f169df70-87eb0df6-58ea0516-6776d665.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with cough, SOB // Cough, SOB, worse lying down, assess for pulmonary edema, infiltrate Cough, SOB, worse lying down, assess for pulmonary edema, in TECHNIQUE: PA and lateral views of the chest. COMPARISON: None available. FINDINGS: Low lung volumes exaggerates heart size which is probably top-normal. There is no focal consolidation, pleural effusion or pneumothorax. Air-filled loops of bowel noted in the left upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 9884dae0-61b342f3-dd12749f-df1b4ebf-1592117d.jpg,test/p13/p13685411/s55755433/9884dae0-61b342f3-dd12749f-df1b4ebf-1592117d.jpg,test," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough and fever // eval pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 57c9e7e5-74a872e4-85ccd032-8ab59a2d-33a6bd55.jpg,test/p13/p13228627/s51523313/57c9e7e5-74a872e4-85ccd032-8ab59a2d-33a6bd55.jpg,test," FINAL REPORT INDICATION: ___-year-old woman with trapezius lymph nodes on MRI. COMPARISON: MRI cervical spine ___. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well inflated and clear. No focal consolidation, effusion, or pneumothorax is present. The cardiac and mediastinal contours are normal. There is no evidence of hilar adenopathy. The posible trapezius node would be better evaluated with CT. IMPRESSION: No acute cardiopulmonary process. No evidence of hilar adenopathy. " ca57619c-cd158518-2fa01125-cd0815a6-acd9a784.jpg,test/p10/p10476869/s50210736/ca57619c-cd158518-2fa01125-cd0815a6-acd9a784.jpg,test," FINAL REPORT INDICATION: Increasing cough in a patient with a history of a prior pneumonia and lymphoma. COMPARISON: Multiple chest radiographs, the most recent of ___. FINDINGS: PA and lateral chest radiographs with the patient in the upright position were reviewed. Comparison was made to the immediate prior exam of ___. The cardiac, mediastinal and hilar silhouettes are stable. Scar formation in the left upper lobe, and surgical clips are expected post-lobectomy and are stable. A mild degree of left diaphragmatic elevation is unchanged and expected post lobectomy. There are no new infiltrates, no pneumothorax or pleural effusion. IMPRESSION: Unchanged chest radiograph with no radiographic evidence of pneumonia. COMMENT: These findings were communicated to Dr. ___ by Dr. ___ via telephone at ___ on ___, 20 minutes after the time of discovery. " 4bf8eb39-5fc7081f-1c76fff8-64f2dfb9-2a17738f.jpg,test/p10/p10708431/s52227353/4bf8eb39-5fc7081f-1c76fff8-64f2dfb9-2a17738f.jpg,test," FINAL REPORT AP CHEST, 10:20 A.M., ON ___ HISTORY: Right chest tube removed. IMPRESSION: AP chest compared to ___ through ___, 5:24 a.m.: There is no large right pneumothorax or appreciable pleural fluid collection following removal of the right pleural tube, although a small amount of pleural air would be difficult to detect in the setting of persistent severe subcutaneous emphysema and pneumomediastinum. Left basal atelectasis has cleared. Emphysema is severe. There is probably a small to moderate left pneumothorax, which has remained stable since the earliest chest radiographs here on ___. Heart is not enlarged. " 9431a59e-d26fb27e-c747c957-c12ba242-4aa7c436.jpg,test/p14/p14349552/s55371200/9431a59e-d26fb27e-c747c957-c12ba242-4aa7c436.jpg,test," FINAL REPORT HISTORY: Pre syncope, weakness. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is mild to moderately enlarged. Mitral annular calcifications are re- demonstrated. Diffuse aortic calcifications are present. Lung volumes are low with mild bibasilar atelectasis noted. No focal consolidation, pleural effusion or pneumothorax is identified. There may be mild pulmonary vascular congestion but no overt pulmonary edema is present. Multilevel degenerative changes in the thoracic spine are noted within slight loss of height of a mid thoracic vertebral body anteriorly. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. No overt pulmonary edema. Mild loss of height anteriorly of a mid thoracic vertebral body, age indeterminate, but new when compared to the prior radiograph. " da0c110f-57fefbe3-d27bbe24-4184a848-940eb060.jpg,test/p17/p17549883/s53408599/da0c110f-57fefbe3-d27bbe24-4184a848-940eb060.jpg,test," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Portable AP view of the chest. COMPARISON: Chest radiograph ___ at 16:31. FINDINGS: Lung volumes are low. There is perihilar haziness with moderate pulmonary edema, new compared to the prior study. Small right pleural effusion is present. The heart size is mildly enlarged. Mediastinal contours are unchanged. No pneumothorax is seen. IMPRESSION: Moderate congestive heart failure and small right pleural effusion. " ebb29ca4-ed56d62d-72562534-afd02747-aacfa07b.jpg,test/p19/p19093103/s53478895/ebb29ca4-ed56d62d-72562534-afd02747-aacfa07b.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of rheumatoid arthritis. Questionable infection. COMPARISON: ___, outside hospital films. FINDINGS: As compared to the previous examination from an outside hospital, there is no relevant change. Low lung volumes without evidence of pulmonary edema or pneumonia. No pleural effusions. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " c0c38fa1-66b0e9cf-8b2d5909-d5d25d6b-20979a36.jpg,test/p11/p11503474/s53381307/c0c38fa1-66b0e9cf-8b2d5909-d5d25d6b-20979a36.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man w/ bowel leak s/p RC/IL now with ngt placed. // enteric tube placement. enteric tube placement. IMPRESSION: In comparison with the earlier study of this date, in there again are low lung volumes with bibasilar atelectatic changes. No evidence of vascular congestion or acute focal pneumonia. Substantial dilatation of the colon process. Nasogastric tube coils in the upper stomach with the tip pointing upward just below the esophagogastric junction. Of incidental note are bilaterally ureteral catheters. " 18884f08-48f6e44d-27543cdc-059ec52d-118995b7.jpg,test/p18/p18370472/s53388631/18884f08-48f6e44d-27543cdc-059ec52d-118995b7.jpg,test," FINAL REPORT INDICATION: Altered mental status. Evaluate for infectious process. COMPARISONS: Multiple prior radiographs, most recently ___. TECHNIQUE: PA and lateral chest radiographs are provided. FINDINGS: Port-A-Cath terminates in the upper SVC as on the prior study. Previously noted focal opacity just lateral to the access port is different in appearance than prior exam and likely is part of the access catheter. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. Previously noted rounded opacity projecting inferior to the access port now lies lateral to it and likely is part of the catheter. " 572096d2-85785f1d-da67672b-903af252-c1bccce2.jpg,test/p13/p13751863/s53302636/572096d2-85785f1d-da67672b-903af252-c1bccce2.jpg,test," FINAL REPORT HISTORY: Fall and syncope. COMPARISON: Chest radiograph from ___. FINDINGS: There are chronic small bilateral pleural effusions and thickening with chronic atelectasis/scarring of the lower lobes. The hilar and cardiomediastinal contours are normal and the lungs are otherwise clear. There is no pneumothorax. A left chest wall port catheter terminates in the low SVC. IMPRESSION: No acute cardiopulmonary process. " 6b632649-b5c1d36e-56194930-d3dde589-965e3ee1.jpg,test/p14/p14693603/s51194066/6b632649-b5c1d36e-56194930-d3dde589-965e3ee1.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Neuroendocrine cancer, status post perforation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right internal jugular vein catheter has been removed. The dialysis catheter placed over the left side is in constant position. The pleural effusion on the right has slightly increased, on the left, a minimal pleural effusion has become visually apparent. As a consequence of the effusions, areas of basal atelectasis are seen, right more than left. However, there is no evidence of pneumonia. The size of the cardiac silhouette is unchanged. " 884c9285-de074791-a1f70ee4-2d358285-810b23be.jpg,test/p14/p14865329/s52685775/884c9285-de074791-a1f70ee4-2d358285-810b23be.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with ETT, aspiration pneumonia // Interval change? COMPARISON: Chest radiographs ___ through ___ at 06:04. IMPRESSION: Mild pulmonary edema has increased, moderate cardiomegaly and mediastinal vascular engorgement are greater. Small left pleural effusion is new or increased. ET tube is in standard placement, upper enteric drainage tube passes into the stomach and out of view. Tip of the right PIC line projects over the upper SVC. No pneumothorax. " 592949a5-38d8386e-08aadffc-adfeb6f2-d8bc2546.jpg,test/p16/p16584291/s59751252/592949a5-38d8386e-08aadffc-adfeb6f2-d8bc2546.jpg,test," FINAL REPORT INDICATION: ___ year old woman with pericarditis, new coufh // ? increase in effusion, atelexctasis or new infiltrate TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___. CTA chest ___. FINDINGS: Compared to the prior chest CT of ___ a small left pleural effusion and left lower lobe atelectasis has slightly decreased in size. There is no significant right pleural effusion. Bilateral linear opacities most likely represent atelectasis. There is no new consolidation or focal opacity concerning for infection. The cardiac contour is stable. No pneumothorax is identified. IMPRESSION: Slightly decreased left pleural effusion and left lower lobe atelectasis since ___. No new opacity concerning for infection. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:24 PM, 5 minutes after discovery of the findings. " 2e54f98b-c4bfd60b-d3f5db36-e7a9c721-e16cc3a5.jpg,test/p19/p19442789/s58531142/2e54f98b-c4bfd60b-d3f5db36-e7a9c721-e16cc3a5.jpg,test," FINAL REPORT REASON FOR EXAMINATION: Coronary artery disease, chest pain. PA and lateral upright chest radiographs were reviewed in comparison to ___. Lung volumes remain low with elevated right hemidiaphragm, unchanged in appearance. Lungs are clear. There is no pleural effusion or pneumothorax. There is no evidence of congestive heart failure on the current radiograph. " 7a1be1de-7b103af0-402b4d61-65f465ed-e6b9962c.jpg,test/p18/p18835890/s57684353/7a1be1de-7b103af0-402b4d61-65f465ed-e6b9962c.jpg,test," WET READ: ___ ___ ___ 10:59 PM Right jugular catheter terminates in the distal SVC / cavoatrial junction. No pneumothorax. Unchanged to slightly smaller left pleural effusion. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post cardiac surgery, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a new right jugular catheter shows a normal course, the tip projects over the mid-to-lower SVC. There is no pneumothorax or other complication. The alignment of the sternal wires is constant. Unchanged small-to-moderate left pleural effusion with atelectasis, unchanged mild enlargement of the lower right hilar areas. " 19d27b30-13da8455-7cfaed95-7f87653c-723765c1.jpg,test/p19/p19151936/s58217720/19d27b30-13da8455-7cfaed95-7f87653c-723765c1.jpg,test," FINAL REPORT HISTORY: Possible congestive failure on shoulder x-ray. FINDINGS: No previous images. Cardiac silhouette is within normal limits. There is no evidence of pulmonary vascular congestion, acute pneumonia, or pleural effusion. Of incidental note is a fracture of the mid shaft of the right clavicle. " 1125aed0-fc039a28-96b2eca5-fa8576ac-980ecf7d.jpg,test/p17/p17427285/s56005044/1125aed0-fc039a28-96b2eca5-fa8576ac-980ecf7d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with inflammatory metastatic breast cancer, s/p 2 thoracentesis demonstrating malignant effusion, please assess for re-accumulation // extent of pleural effusion extent of pleural effusion IMPRESSION: Comparison to ___. In the interval, there is a moderate to severe right-sided pleural effusion, with an intrafissural component, that occupies approximately ___% of the right hemi thorax. As a consequence, areas of atelectasis have developed at the right lung bases. Stable normal appearance of the left lung and of the left heart border. Stable position of the left Port-A-Cath. ___, MD, PhD " 8562ffc0-ca46d184-8a4dc3ba-4b7f6c58-6a161c16.jpg,test/p16/p16662264/s58952060/8562ffc0-ca46d184-8a4dc3ba-4b7f6c58-6a161c16.jpg,test," WET READ: ___ ___ ___ 6:39 PM No definitive evidence of pneumothorax. Unchanged bibasilar opacities. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Questionable left apical pneumothorax. Shortness of breath. COMPARISON: ___, 4:08 p.m. FINDINGS: As compared to the previous radiograph, there is now no evidence of pneumothorax. Previous change could have been simulated by a skinfold. The extensive bilateral predominantly basal parenchymal opacities are constant in appearance and severity. Unchanged appearance of the cardiac silhouette. " ebf5ac8b-97d2ac65-3bcb25bb-cd126b79-82e650c4.jpg,test/p11/p11690362/s55655241/ebf5ac8b-97d2ac65-3bcb25bb-cd126b79-82e650c4.jpg,test," FINAL REPORT HISTORY: Cough for one week with pleuritic chest pain. FINDINGS: In comparison with the study of ___, there is little change. There is tortuosity of the descending thoracic aorta without evidence of vascular congestion, pleural effusion, acute focal pneumonia or appreciable enlargement of the cardiac silhouette. " 93a44f42-885c41bb-69c9c929-e42444b6-90c61cd0.jpg,test/p12/p12420056/s57370920/93a44f42-885c41bb-69c9c929-e42444b6-90c61cd0.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, rhonchi R>L, ?pna // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are unchanged with mild cardiomegaly and tortuous aorta. Elevation of the right hemidiaphragm is chronic. The lungs are clear. There is no pneumothorax or pleural effusion. There are moderate degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities " 42e47ebc-da13aafd-dc5c4c8d-231c2d2e-445422de.jpg,test/p17/p17713856/s56361335/42e47ebc-da13aafd-dc5c4c8d-231c2d2e-445422de.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever and cough // eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. There is a subtle opacity seen best on the lateral view consistent with a focal right lower lobe pneumonia. . No pleural effusion or pneumothorax is seen. IMPRESSION: Right lower lobe pneumonia. NOTIFICATION: Updated findings emailed to the ED ___ nurses at 10:00 on ___ by Dr. ___. " 302bef6b-1e27f27e-156b7e97-884e0d19-b125707a.jpg,test/p14/p14597448/s53744386/302bef6b-1e27f27e-156b7e97-884e0d19-b125707a.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with MDS ___/p transplant now fever, headache, and cough, clear lungs // is there pneumonia? COMPARISON: Slight IMPRESSION: Generalized increase in interstitial abnormality compared to ___ is probably mild pulmonary edema. However, there is no increase in heart size, mediastinal venous caliber, or pleural effusion. Careful radiographic followup is recommended therefore to exclude interstitial pneumonia, including pneumocystis infection, simulating pulmonary edema. Multiple small irregular opacities conforming to nodules and the areas of peribronchial infiltration seen on the chest CT ___ have not resolved. Hyperinflation is due to emphysema. Heart size is normal. A right-sided central venous catheter ends in the region of the superior cavoatrial junction. " fcc08e57-2d45a192-9a882ef2-552aa77d-50385b0e.jpg,test/p19/p19461413/s55110572/fcc08e57-2d45a192-9a882ef2-552aa77d-50385b0e.jpg,test," FINAL REPORT INDICATION: ___ year old woman with concern for infection // eval for infection and PICC line. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Patchy of bibasilar opacities are present, greater on the left, which may reflect pneumonia in the proper clinical context. There is no pleural effusion or pneumothorax identified. The size the cardiomediastinal silhouette is within normal limits. The tip of the left PICC line projects over the left brachiocephalic/ SVC confluence. IMPRESSION: Patchy bibasilar opacities, greater on the left which may reflect pneumonia in the proper clinical context. The tip of the left PICC line projects over the left brachiocephalic/SVC confluence. " dad56abe-17972a70-d0003c64-3b9e7111-cca6a06f.jpg,test/p11/p11472206/s52667209/dad56abe-17972a70-d0003c64-3b9e7111-cca6a06f.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea, leukocytosis, evaluation for pneumonia. COMPARISON: ___. FINDINGS: Compared to the previous radiograph, there is no relevant change. Moderate cardiomegaly with retrocardiac atelectasis, normal alignment of sternal wires and without evidence of parenchymal opacities, with the exception of minimal atelectasis in the retrocardiac lung region. The lateral radiograph, however, shows a small dorsal effusion. No overt pulmonary edema. " 0dc52a57-43ac97ce-2f90d653-18c551da-203eb5c8.jpg,test/p18/p18151002/s54415063/0dc52a57-43ac97ce-2f90d653-18c551da-203eb5c8.jpg,test," FINAL REPORT INDICATION: ___ year old woman smoker with 2 weeks cold no with worsening cough and wheezing // r/o infectious process TECHNIQUE: Chest PA and lateral COMPARISON: NONE. FINDINGS: Cardiomediastinal contours are normal. A subtle patchy opacity is present in the right infrahilar region, obscuring a very small portion of the right heart border and associated with a corresponding opacity overlying the heart on the lateral view. Lungs are otherwise clear, and there are no pleural effusions or acute skeletal findings. IMPRESSION: Probable early/focal right middle lobe pneumonia. Considering clinical suspicion for pneumonia, recommend followup chest x-ray in ___ weeks after antibiotic therapy to assess for resolution. NOTIFICATION: The impression above was entered by Dr. ___ on ___ at 13:28 into the Department of Radiology critical communications system for direct communication to the referring provider. " 4627ac2b-502a26f5-3797d306-55559b1c-161bf5e7.jpg,test/p12/p12910092/s50575620/4627ac2b-502a26f5-3797d306-55559b1c-161bf5e7.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. A left-sided PICC is seen, distal aspect not well seen, but appears to at least enter the SVC. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. A cervical hardware is seen. IMPRESSION: No acute cardiopulmonary process. " 02c2bf34-bdc5c056-7126534d-4f0a837f-da7af3f3.jpg,test/p15/p15781781/s56300116/02c2bf34-bdc5c056-7126534d-4f0a837f-da7af3f3.jpg,test," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with fever, sob // eval for pna eval for pna TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph from ___. FINDINGS: The cardiac silhouette is mildly enlarged. The hilar contours are within normal limits. There is minimal atelectasis at the right lung base. Blunting of the bilateral costophrenic angles is likely secondary to a small amount of pleural effusion. Lungs are otherwise clear. There is no focal consolidation or pneumothorax. IMPRESSION: Blunting of the bilateral costophrenic angles is likely secondary to a small amount of pleural effusion. Otherwise, no acute cardiopulmonary process. " dd24ea59-9dcbe758-cbb18239-bc8096ac-3c0aa08a.jpg,test/p14/p14601638/s56839802/dd24ea59-9dcbe758-cbb18239-bc8096ac-3c0aa08a.jpg,test," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Severe COPD and shortness of breath. Comparison is made with prior study ___. Cardiac size is normal. The aorta is elevated. Enlarged pulmonary arteries are again noted. The lungs are hyperinflated, the hemidiaphragms are flattened consistent with emphysema. There is no pneumothorax or pleural effusion. There is no evidence of CHF or pneumonia. " 0ec362f6-b0b64cc9-d27ca819-5be72c95-b2c82775.jpg,test/p19/p19336751/s50059390/0ec362f6-b0b64cc9-d27ca819-5be72c95-b2c82775.jpg,test," FINAL REPORT INDICATION: ___ year old man with hx met prostate cancer. R/o metastatic disease to lungs. Hx lung infections // pt with hx met prostate cancer;to start new treatment. R/o metastatic disease to lungs. Hx lung infections TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest CT without contrast FINDINGS: Multiple right and left apical focal opacities correlate with lung parenchymal scarring seen on ___ chest CT. Severe emphysematous changes are noted in bilateral mid lung regions. There are no visible micro or macro nodules within the lung parenchyma. The hilar, cardiomediastinal, and pleural surfaces are normal. There are no acute bony abnormalities nor fracture. IMPRESSION: 1. Biapical lung parenchymal scarring correlate with findings seen on ___ chest CT. However, please refer to ___ chest CT for further characterization of these apical findings. 2. At the limited resolution of plain radiograph, there are no lung parenchymal nor skeletal lesions concerning for metastasis disease. Please refer to ___ chest CT for better evaluation of metastatic lesions. 3. Severe emphysema. " f3e9b4bc-0612e242-b085e534-6a9f1b0f-0b6436e1.jpg,test/p12/p12010209/s58354398/f3e9b4bc-0612e242-b085e534-6a9f1b0f-0b6436e1.jpg,test," FINAL REPORT INDICATION: Cough in a patient with a recent diagnosis of multiple myeloma. COMPARISON: None. FINDINGS: PA and lateral views of the chest were reviewed. Normal heart, lungs, pleural and mediastinal surfaces. Incidental note is made of pectus excavatum. IMPRESSION: No radiographic evidence of pneumonia. " 2f37c518-46959e49-5f37997e-286cb1d0-c53fc75c.jpg,test/p17/p17665442/s55284068/2f37c518-46959e49-5f37997e-286cb1d0-c53fc75c.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with severe HTN, SOB. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: No focal consolidation concerning for pneumonia. Mild cardiomegaly is again seen, with mild pulmonary edema and central pulmonary vascular congestion. No pneumothorax or pleural effusions. IMPRESSION: Mild cardiomegaly with central pulmonary vascular congestion and mild pulmonary edema. No focal consolidation concerning for pneumonia. NOTIFICATION: The above findings were entered by Dr. ___ ___ the ___ Imaging Findings Dashboard for communication to the ordering clinician at 13:26 on ___. " 3e44ca19-a126dd2f-4404bab7-3cdcbde9-091e162c.jpg,test/p13/p13139059/s58456977/3e44ca19-a126dd2f-4404bab7-3cdcbde9-091e162c.jpg,test," FINAL REPORT INDICATION: Cough. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 8b2a3169-c3a06cd2-a604c754-9e11802d-0371fd64.jpg,test/p13/p13050559/s51750973/8b2a3169-c3a06cd2-a604c754-9e11802d-0371fd64.jpg,test," WET READ: ___ ___ 8:10 AM There is worsening opacification of the right upper lobe. There is no pneumothorax. Worsening bilateral hazy opacities likely reflect mild pulmonary edema. WET READ VERSION #___ ___ ___ 5:35 PM There is worsening opacification of the right upper lobe. There is no pneumothorax. Worsening bilateral hazy opacities likely reflect mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with RUL obstruction now s/p RUL debridement and cannulation // ptx COMPARISON: Chest radiographs since ___. IMPRESSION: Consolidation in the right upper lobe improved between ___ and ___ with remission of central adenopathy. It worsened between ___ and ___, the last preprocedure chest radiograph. Now following bronchoscopy the consolidation is more severe. This could be due to worsened occlusion and more atelectasis and retained secretions, or bleeding. Chest radiograph obtained 6 hr later, available the time of this review shows improvement, nearly to the extent of aeration prior to the bronchoscopy. On this study there is no pneumothorax or pleural effusion in the left lung is clear. Heart size has been consistently normal. The right supraclavicular dual channel central venous catheter still ends in the low SVC, as before. " f8d27840-4754698b-819bb5fa-c185b9f8-f412dc47.jpg,test/p17/p17374306/s56387591/f8d27840-4754698b-819bb5fa-c185b9f8-f412dc47.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, basilar crackles // ?pneumonia COMPARISON: No comparison IMPRESSION: Moderate cardiomegaly. Elongation of the descending aorta. No pleural effusions. No pulmonary edema. No focal or diffuse lung disease. No pneumothorax. " e3641bf6-db5f7170-40bb321e-d0ac3280-471d0d14.jpg,test/p13/p13379136/s51547962/e3641bf6-db5f7170-40bb321e-d0ac3280-471d0d14.jpg,test," FINAL REPORT INDICATION: ___M with weakness, lightheadedness // Any pneumonia? TECHNIQUE: Frontal lateral views of the chest. COMPARISON: ___. FINDINGS: Lower lung volumes seen on the current exam with more conspicuous streaky bibasilar opacities, likely atelectasis. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. Right lateral electronic device with leads likely within posterior soft tissues of the back. IMPRESSION: Bibasilar opacities likely atelectasis, no definite acute cardiopulmonary process. " 495c5d51-741e295b-1e564355-47a51477-61c8dd6e.jpg,test/p10/p10708772/s55407127/495c5d51-741e295b-1e564355-47a51477-61c8dd6e.jpg,test," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT ___ CLINICAL INDICATION: ___-year-old with a partial right thyroidectomy, now with right vocal cord paralysis, and at risk for aspiration. No comparison studies. Please note that comparison to old films can be helpful to detect subtle interval change. PA and lateral views of the chest ___ at ___ is submitted. IMPRESSION: Cardiac and mediastinal contours are within normal limits. Lungs appear well inflated without evidence of focal airspace consolidation to suggest aspiration or pneumonia. No pleural effusions or pneumothorax. No acute bony abnormality. " 4a237505-63fb90b7-21a91da7-100b874c-967a4294.jpg,test/p12/p12365617/s56119144/4a237505-63fb90b7-21a91da7-100b874c-967a4294.jpg,test," WET READ: ___ ___ ___ 8:47 PM Single lead pacemaker in expected position. Subsegmental atelectasis in the bilateral lung bases. Relative increased density of the right base as compared the rest is non-specific. ___ reflect atelectasis, aspiration or early developing pneumonia. Close interval follow-up recommended. ___ p___WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ AT 18:58 CLINICAL INDICATION: ___-year-old with hemoptysis, question etiology. No comparison studies. Please note that comparison to old films can be helpful to detect subtle interval change. PA and lateral views of the chest, ___ at 18:58 is submitted. IMPRESSION: Right-sided pacemaker is in place with a single lead terminating over the expected location of the right ventricle. There are patchy and streaky opacities at both lung bases, which are nonspecific and could reflect areas of atelectasis, although the differential would also include post-inflammatory scarring or residual changes from pulmonary hemorrhage. An acute infectious process also cannot be entirely excluded. Therefore, comparison to remote studies should be considered. If prior chest films are not available, further imaging evaluation with CT may be helpful especially as the patient has hemoptysis. No evidence of pulmonary edema. No pneumothorax. No large effusions. " 3b04a65f-83d0c0a9-36ac7f6f-b6813cd1-a4818dc1.jpg,test/p13/p13011896/s58298787/3b04a65f-83d0c0a9-36ac7f6f-b6813cd1-a4818dc1.jpg,test," FINAL REPORT HISTORY: ET tube replacement. FINDINGS: In comparison with the earlier study of this date, the endotracheal tube has been pushed forward so that the tip now lies approximately 5 cm above the carina. Otherwise, little change. " b3967389-d9a127ea-477e9b7c-38125cf8-465c63ea.jpg,test/p10/p10274932/s50668796/b3967389-d9a127ea-477e9b7c-38125cf8-465c63ea.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Stage IV non-small-cell lung cancer. Followup. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the extent of the apical pneumothorax is unchanged in the range of 1 to 1.5 cm. The amount of the right pleural effusion has substantially increased, the effusion now fills approximately half of the right hemithorax. The right chest tube is in unchanged position. Moderate left hilar enlargement. The left lungs are unremarkable. " 27c34ad5-7941d778-beb8a5b8-5f7d5940-64dfb143.jpg,test/p16/p16921333/s59830520/27c34ad5-7941d778-beb8a5b8-5f7d5940-64dfb143.jpg,test," FINAL REPORT HISTORY: ___-year-old male with cough. COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral chest radiograph demonstrate well expanded and clear lungs with no focal consolidation. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are within normal limits. Spinal hardware is noted at the thoracolumbar spine. IMPRESSION: No acute cardiopulmonary abnormality. " 098ab46e-b8f1e8e7-cb17f3fe-52991687-43f32058.jpg,test/p13/p13902721/s51383556/098ab46e-b8f1e8e7-cb17f3fe-52991687-43f32058.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with abd pain // eval PNA COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Lungs are hyperinflated. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " d5c0c37a-b4381638-ad28d342-e436433c-cededdcb.jpg,test/p14/p14274108/s56618427/d5c0c37a-b4381638-ad28d342-e436433c-cededdcb.jpg,test," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath. COMPARISON: ___, ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs remain hyperinflated with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. The cardiac and mediastinal silhouettes are stable, as are the hilar contours. No pleural effusion or pneumothorax is seen. There is no definite focal consolidation. Slight relative increase in opacity over the right hemithorax as compared to the left is most likely technical. " 910f27eb-eb43f981-4d25119e-2e724f96-bb099c35.jpg,test/p18/p18387698/s53764605/910f27eb-eb43f981-4d25119e-2e724f96-bb099c35.jpg,test," WET READ: ___ ___ ___ 10:01 PM Decreased size of right pleural effusion from study performed at 11:18. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest tube // eval for change eval for change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous large right pleural effusion is substantially smaller, with right basal pigtail pleural drainage catheter unchanged in configuration since ___. Left pleural effusion is small. Upper lungs are clear. Right middle and lower lobe still substantially atelectatic. Heart mildly enlarged but unchanged. No pneumothorax. " b6c19acc-26e29adf-2e16b86b-a44fabdc-9552e845.jpg,test/p17/p17585359/s53594293/b6c19acc-26e29adf-2e16b86b-a44fabdc-9552e845.jpg,test," WET READ: ___ ___ 11:40 PM 1. No pneumothorax. 2. Retrocardiac atelectasis. 3. Right internal jugular central venous line ends at the cavoatrial junction. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p OPCAB // eval ptx eval ptx COMPARISON: Chest radiographs since ___ most recently ___ through ___. IMPRESSION: Lung volumes have improved, mild interstitial pulmonary edema has decreased. Heart size is top-normal. Opacification at the base of the right hemithorax is probably atelectasis, more recognizable in the retrosternal left retrocardiac left lower lobe. No pneumothorax. Right jugular line ends in the low SVC. " 9bcf7b88-c90cac0c-ea2c262b-14115840-5cedd6f2.jpg,test/p13/p13855132/s52733570/9bcf7b88-c90cac0c-ea2c262b-14115840-5cedd6f2.jpg,test," WET READ: ___ ___ ___ 7:19 PM No evidence of pneumothorax after bilateral thoracentesis. Pleural effusions have decreased, evidenced by slightly increased aeration of the bilateral lungs. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ PMH of HTN, dementia w/ babesiosis and grade III splenic laceration s/p splenic artery embolization (___), admitted to TSICU with w/ hypoxic respiratory failure requiring prolonged intubation. Now s/p trach/PEG (___), tolerating trach mask and TFs with respiratory distress on // s/p b/l thoracentesis; eval for PTX, injury s/p b/l thoracentesis; eval for PTX, injury IMPRESSION: Compared to chest radiographs since ___, most recently ___. Previous moderate pulmonary edema has substantially improved. Residual opacification at the lung bases could be explained by persistent edema and atelectasis, but worsening opacification in the left lower lobe raises concern for concurrent pneumonia or loose worsening atelectasis. Small pleural effusions are presumed. Mild cardiomegaly has worsened. No pneumothorax. Right PIC line ends close to the superior cavoatrial junction. Tracheostomy tube roughly midline. " 62dec63c-ae709a47-901fd590-b11cf0ca-d16a1de3.jpg,test/p12/p12951471/s55512156/62dec63c-ae709a47-901fd590-b11cf0ca-d16a1de3.jpg,test," FINAL REPORT INDICATION: ___F with complex ABD surgical hx, pain and bloating, peritoneal exam // **UPRIGHT** Eval for free subdiaphragmatic air TECHNIQUE: Single AP upright portable view of the chest. COMPARISON: ___. FINDINGS: Right chest wall port is again seen with catheter tip in the lower SVC as on prior. Patient is known to have situs inversus. The lungs are clear without consolidation, large effusion, or edema. Cardiomediastinal silhouette is stable. Surgical clips project over the lower mediastinum and upper abdomen as well as the right chest wall. There is no free air below the diaphragm. IMPRESSION: No free intraperitoneal air. " 584f0387-62d962c4-600bd1cb-ba380a66-1bceb642.jpg,test/p10/p10476869/s59814838/584f0387-62d962c4-600bd1cb-ba380a66-1bceb642.jpg,test," FINAL REPORT INDICATION: ___-year-old man with left upper lobe lobectomy, check interval change. COMPARISON: PA and lateral chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: The patient is status post left upper lobe lobectomy. Post-surgical changes are noted in the left upper lobe. No focal consolidation, pleural effusion or pneumothorax is identified. The cardiac, mediastinal and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. Post-surgical changes in the left upper lobe. " 92f04dea-ce94fa08-c4a41528-8a9161ad-da4a5753.jpg,test/p12/p12938515/s59008890/92f04dea-ce94fa08-c4a41528-8a9161ad-da4a5753.jpg,test," FINAL REPORT AP CHEST, 4:22 P.M., ___. CLINICAL HISTORY: ___-year-old man with cirrhosis after Dobbhoff tube placement. Confirm location. IMPRESSION: AP chest compared to 3:30 p.m.: Moderately-severe pulmonary edema and small-to-moderate right pleural effusion unchanged. Mild cardiomegaly stable. Feeding tube with a wire stylet in place ends in the proximal stomach, as before. A right jugular vascular line ends at the origin of the SVC. No pneumothorax. " d0748456-6f8cfabe-eea1b47c-169ee685-9c57a875.jpg,test/p16/p16296993/s57198479/d0748456-6f8cfabe-eea1b47c-169ee685-9c57a875.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Interval development of left moderate pleural effusion. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous examination, the lung volumes have increased, likely reflecting improved ventilation. Moderate cardiomegaly persists. On today's radiograph, there is no evidence of pleural effusions. Moderate tortuosity of the thoracic aorta. Normal hilar and mediastinal structures. " bee8a473-552e3a8d-95d27b30-f2a58ca2-12cc9899.jpg,test/p19/p19009907/s58444456/bee8a473-552e3a8d-95d27b30-f2a58ca2-12cc9899.jpg,test," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiac, mediastinal, and hilar contours appear unremarkable. There is no pneumothorax. There is no evidence for pulmonary edema, pulmonary consolidation, or pleural effusion. Degenerative changes in the thoracic spine with prominent lower thoracic anterior endplate osteophytes, and asymmetric hypertrophic ossification of the right first costochondral junction, appear unchanged. IMPRESSION: No evidence for acute cardiopulmonary abnormalities. " fd0d723a-5409c678-f6ca41b8-69ec0b63-089791fc.jpg,test/p11/p11434374/s58401840/fd0d723a-5409c678-f6ca41b8-69ec0b63-089791fc.jpg,test," FINAL REPORT EXAMINATION: chest radiograph INDICATION: ___ year old man with pneumothorax // change TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___ CT chest without contrast ___ FINDINGS: Since ___, moderate to large right-sided predominantly basilar and lateral pneumothorax is increased in size, and is associated with a basilar hydro pneumothorax component. A small left pleural effusion and adjacent left basilar opacification are slightly improved. The right pig-tailed pleural catheter is changed in position and appears to have moved superior and medially. Positioning of right internal jugular central line is unchanged. The heart size is normal. IMPRESSION: 1. Moderate right-sided pneumothorax is increased in size, with a small basilar hydro pneumothorax component. 2. Right pigtailed pleural catheter has changed in position, as detailed above. . NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 10:20 AM, 10minutes after discovery of the findings. " f762bf98-b2141d3c-a5c0a0b1-4fb662f7-fce29b8d.jpg,test/p17/p17614057/s53572658/f762bf98-b2141d3c-a5c0a0b1-4fb662f7-fce29b8d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, weakness // presence of infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " bdbb61cd-a56ac66e-5d5dee83-ca1f4ad6-190e56db.jpg,test/p19/p19845120/s51165532/bdbb61cd-a56ac66e-5d5dee83-ca1f4ad6-190e56db.jpg,test," FINAL REPORT CHEST RADIOGRAPH INDICATION: Tachypnea, shortness of breath, evaluation for pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, lung volumes have slightly increased, potentially reflecting improved ventilation. An atelectasis seen on the previous image, located at the right lung base, is no longer visible. The atelectasis in the retrocardiac lung region is constant in appearance. Moderate cardiomegaly persists in unchanged manner. " defbb652-bd6f795e-661a4450-328e7252-116a5671.jpg,test/p13/p13609730/s57039275/defbb652-bd6f795e-661a4450-328e7252-116a5671.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sarcoma, posttreatment, pleural fluid seen on CT, just had thoracentesis // ? pneumothorax, post procedure. TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. CT chest dated ___. FINDINGS: The lung volumes are moderate. The right chest port terminates at the cavoatrial junction. There is mild blunting of the left costophrenic angle, without definite evidence of pleural fluid. The heart is unremarkable. IMPRESSION: No evidence of pneumothorax. " 81ed2444-69791f5b-db879a54-d095f758-3fa7694d.jpg,test/p14/p14457200/s50109921/81ed2444-69791f5b-db879a54-d095f758-3fa7694d.jpg,test," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with history of atrial fibrillation presents with lightheadedness TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " c75d35fb-27dc0ff4-34b6ef1d-5e1c3a4f-2a56739c.jpg,test/p15/p15934572/s50381837/c75d35fb-27dc0ff4-34b6ef1d-5e1c3a4f-2a56739c.jpg,test," FINAL REPORT CXR PORTABLE FILM HISTORY: Shortness of breath. FINDINGS: Sternotomy. ET tube tip is satisfactory. There is diffuse haziness throughout both lung fields along with prominent vessels. Findings suggest congestive heart failure as well as pleural effusions. No focal consolidation is identified. CONCLUSION: Sternotomy and prior CABG. CHF. These are worse from the previous examination of ___. " fe0ccdd2-af2c88f4-bb7d24e3-4412e50e-7104c2e7.jpg,test/p16/p16531888/s51955955/fe0ccdd2-af2c88f4-bb7d24e3-4412e50e-7104c2e7.jpg,test," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of productive cough, HIV. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process; no significant interval change. " 0f3e46c2-fa349820-8fa837ac-16901d27-91309217.jpg,test/p18/p18275305/s51298215/0f3e46c2-fa349820-8fa837ac-16901d27-91309217.jpg,test," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with sob // ?pulm edema TECHNIQUE: Single frontal view of the chest COMPARISON: ___ AT 00:30 FINDINGS: Left-sided central venous catheter terminates in the low SVC without evidence of pneumothorax. There are low lung volumes. Patchy right basilar opacity likely represent atelectasis given that it was not present 7 hr earlier. There are small bilateral pleural effusions, better appreciated on pre seeding CT. The cardiac silhouette is top-normal to mildly enlarged, accentuated by AP technique and low lung volumes. Mediastinal contours are stable. "